Clinical Interventions to Improve Nutritional Care in Older Adults and Patients in Primary Healthcare – A Scoping Review of Current Practices of Health Care Practitioners

Introduction: This systematic scoping review aims to synthetize the available evidence on the epidemiology, risk factors, clinical characteristics, screening tools, prevention strategies, interventions and knowledge of health care providers regarding elder abuse in the emergency department (ED). Methods: A systematic literature search was performed using three databases (Medline, Embase and Cochrane Library). Grey literature was scrutinized. Studies were considered eligible when they were observational studies or randomized control trials reporting on elder abuse in the prehospital and/or ED setting. Data extraction was performed independently by two researchers and a qualitative approach was used to synthetize the findings. Results: A total of 443 citations were retrieved from which 58 studies published between 1988 and 2018 were finally included. Prevalence of elder abuse following an ED visit varied between 0.01% and 0.03%. Reporting of elder abuse to proper law authorities by ED physicians varied between 2% to 50% of suspected cases. The most common reported type of elder abuse detected was neglect followed by physical abuse. Female gender was the most consistent factor associated with elder abuse. Cognitive impairment, behavioral problems and psychiatric disorder of the patient or the caregiver were also associated with physical abuse and neglect as well as more frequent ED consultations. Several screening tools have been proposed, but ED-based validation is lacking. Literature on prehospital- or ED-initiated prevention and interventions was scarce without any controlled trial. Health care providers were poorly trained to detect and care for older adults who are suspected of being a victim of elder abuse. Conclusion: Elder abuse in the ED is an understudied topic. It remains underrecognized and underreported with ED prevalence rates lower than those in community-dwelling older adults. Health care providers reported lacking appropriate training and knowledge with regards to elder abuse. Dedicated ED studies are required.

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Nutritional Care for older adults in Primary Health Care, from the perspective of health professionals

Revista Brasileira de Geriatria e Gerontologia ◽

10.1590/1981-22562020023.200168 ◽

2020 ◽

Vol 23 (6) ◽

Author(s):

Carolina Lou de Melo ◽

Maria Angélica Tavares de Medeiros

Keyword(s):

Older Adults ◽

Health Care ◽

Primary Health Care ◽

Health Professionals ◽

Healthy Aging ◽

Structured Interview ◽

Cross Sectional ◽

Nutritional Care ◽

Primary Health ◽

Theoretical Saturation

Abstract Objective: to characterize and analyze Nutritional Care (NC) for older adults in Primary Health Care (PHC), identifying how food and nutrition actions (F&N) were performed and the conceptions that guided them. Methods: a cross-sectional, quantitative and qualitative study was performed in PHC in Santos, São Paulo, Brazil, in two phases: i) a census study was carried out of health units, N=28 (100%), with managers who answered a structured interview to assess NC; followed by descriptive analysis. ii) a deeper investigation of this diagnosis was performed, using semi-structured interviews with key informants (interviewees) of care for older adults; being a nutritionist was not a criteria, as there were only three such professionals throughout the entire PHC, and one of the health regions studied was not served by a nutrition professional. The concept of theoretical saturation was used for the sampling plan; content analysis was carried out and the inferences were supported by references of integrality and aging. Results: NC for older adults was highlighted by individual care, predominant in all the services studied (28) (100%); nutritionists participated in this activity in just nine units (32.1%). Theoretical saturation was achieved with nine interviews. According to the discourse analysis, F&N actions were generic, focused on the treatment of diseases, influenced by negative aspects attributed to aging, there was no planning based on the needs of the territory, and health professionals identified themselves as information transmitters, leaving the responsibility of acting on such information to the older adults themselves. Conclusion: F&N actions were guided by the biomedical paradigm, fragmented, restricted to disease management, imputing the responsibility for health to the individual themselves. Thus, NC distanced itself from the promotion of healthy aging, weakening its strategic role in the quest for integrated care.

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A nursing minimum dataset for documenting nutritional care for adults in primary healthcare: a scoping review protocol

The JBI Database of Systematic Reviews and Implementation Reports ◽

10.11124/jbisrir-2015-2290 ◽

2015 ◽

Vol 13 (8) ◽

pp. 92-100 ◽

Cited By ~ 1

Author(s):

Sasja Jul Håkonsen ◽

Preben Ulrich Pedersen ◽

Merete Bjerrum ◽

Ann Bygholm ◽

Micah D J Peters

Keyword(s):

Scoping Review ◽

Primary Healthcare ◽

Nutritional Care ◽

Review Protocol ◽

Minimum Dataset

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A Scoping Review of the Evidence About the Nurses Improving Care for Healthsystem Elders (NICHE) Program

The Gerontologist ◽

10.1093/geront/gnz150 ◽

2019 ◽

Cited By ~ 2

Author(s):

Allison Squires ◽

Komal Patel Murali ◽

Sherry A Greenberg ◽

Linda L Herrmann ◽

Catherine O D’amico

Keyword(s):

Older Adults ◽

Health Care ◽

Quality Of Care ◽

Work Environment ◽

Older Adult ◽

Patient Outcomes ◽

Scoping Review ◽

Adult Care ◽

Program Adoption

Abstract Background and Objectives The Nurses Improving Care for Healthsystem Elders (NICHE) is a nurse-led education and consultation program designed to help health care organizations improve the quality of care for older adults. To conduct a scoping review of the evidence associated with the NICHE program to (a) understand how it influences patient outcomes through specialized care of the older adult and (b) provide an overview of implementation of the NICHE program across organizations as well as its impact on nursing professionals and the work environment. Research Design and Methods Six databases were searched to identify NICHE-related articles between January 1992 and April 2019. After critical appraisal, 43 articles were included. Results Four thematic categories were identified including specialized older adult care, geriatric resource nurse (GRN) model, work environment, and NICHE program adoption and refinement. Specialized older adult care, a key feature of NICHE programs, resulted in improved quality of care, patient safety, lower complications, and decreased length of stay. The GRN model emphasizes specialized geriatric care education and consultation. Improvements in the geriatric nurse work environment as measured by perceptions of the practice environment, quality of care, and aging-sensitive care delivery have been reported. NICHE program adoption and refinement focuses on the methods used to improve care, implementation and adoption of the NICHE program, and measuring its impact. Discussion and Implications The evidence about the NICHE program in caring for older adults is promising but more studies examining patient outcomes and the impact on health care professionals are needed.

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Perceptions and Understandings of Frailty Language: A Scoping Review

Innovation in Aging ◽

10.1093/geroni/igaa057.572 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 177-177

Author(s):

Mariko Sakamoto ◽

Pamela Durepos ◽

Kyla Alsbury ◽

Patricia Hewston ◽

Alyson Takaoka ◽

...

Keyword(s):

Older Adults ◽

Health Care ◽

Scoping Review ◽

Health Care Professionals ◽

Health Care Systems ◽

Community Dwelling ◽

Critical Examination ◽

Primary Research ◽

Care Systems ◽

Research Studies

Abstract Diagnosing and responding to frailty in older adult populations is of growing interest for health care professionals, researchers and policymakers. Preventing frailty has the potential to improve health outcomes for older adults, which in turn has significant implications for health care systems. However, little is known about how older people understand and perceive the term “frailty”, and what it means for them to be designated as frail. To address this concern, a scoping review was undertaken to map the breadth of primary research studies that focus on community-dwelling older adults’ perceptions and understanding of frailty language, as well as explore the potential implications of being classified as frail. Searches were conducted in MEDLINE, Ageline, PsychInfo, CINAHL and EMBASE databases for articles published between January 1994 and February 2019. 4639 articles were screened and ten articles met the inclusion criteria, detailing eight primary research studies. Using content analysis, three core themes were identified across the included studies. These themes included: 1) understanding frailty as a multi-dimensional concept and inevitable consequence of aging, 2) perceiving frailty as a generalizing and harmful label; and 3) resisting and responding to frailty. Recommendations stemming from this review include the need for health care professionals to use person-centered language with older adults, discuss the term frailty with caution, and be aware of the potential consequences of labeling a person as frail. Importantly, this review demonstrates that for frailty interventions to be successful and meaningful for older adults, ongoing and critical examination of frailty language is necessary.

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Using Living Labs to Explore Needs and Solutions for Older Adults With Dementia: Scoping Review (Preprint)

10.2196/preprints.29031 ◽

2021 ◽

Author(s):

Henk Verloo ◽

Adrien Lorette ◽

Joëlle Rosselet Amoussou ◽

Estelle Gillès de Pélichy ◽

Alcina Matos Queirós ◽

...

Keyword(s):

Older Adults ◽

Health Care ◽

Scoping Review ◽

Independent Living ◽

Cognitive Disorders ◽

Health Care Facilities ◽

Community Or ◽

Scoping Reviews ◽

Living Labs

BACKGROUND Numerous living labs have established a new approach for studying the health, independent living, and well-being of older adults with dementia. Living labs interact with a broad set of stakeholders, including students, academic institutions, private companies, health care organizations, and patient representative bodies and even with other living labs. Hence, it is crucial to identify the types of cocreations that should be attempted and how they can be facilitated through living labs. OBJECTIVE This study aims to scope publications that examine all types of living lab activities, exploring the needs and expectations of older adults with dementia and seeking solutions, whether they live in the community or long-term health care facilities (LTHFs). METHODS This scoping review was reported according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) recommendations for the extension of scoping reviews. We searched six bibliographic databases for publications up to March 2020, and a forward-backward citation chasing was performed. Additional searches were conducted using Google Scholar. The quality of the selected papers was assessed. RESULTS Of the 5609 articles identified, we read 58 (1.03%) articles and retained 12 (0.21%) articles for inclusion and final analysis. All 12 articles presented an innovative product, developed in 4 main living labs, to assist older adults with cognitive disorders or dementia living in the community or LTHFs. The objectives of these studies were to optimize health, quality of life, independent living, home care, and safety of older adults with cognitive disorders or dementia, as well as to support professional and family caregivers or reduce their burdens. The overall methodological quality of the studies ranged from poor to moderate. CONCLUSIONS This scoping review identified several living labs playing a pivotal role in research aimed at older adults with dementia living in the community or LTHFs. However, it also revealed that living labs should conduct more better-quality interventional research to prove the effectiveness of their technological products or service solutions. INTERNATIONAL REGISTERED REPORT RR2-10.2147/SHTT.S233130

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