scholarly journals Adverse Events and Their Contributors Among Older Adults During Skilled Nursing Stays for Rehabilitation: A Scoping Review

2021 ◽  
Vol Volume 12 ◽  
pp. 323-337
Author(s):  
Udoka Okpalauwaekwe ◽  
Huey-Ming Tzeng
Keyword(s):  
Older Adults ◽  
Adverse Events ◽  
Scoping Review ◽  
Skilled Nursing

Reducing Hospital Readmissions of Older Adults Pursuing Postacute Care at Skilled Nursing Facilities: A Scoping Review

2022 ◽  
Vol 76 (1) ◽  
Author(s):  
Antoinette Shaw ◽  
Pamela Talero Cabrejo ◽  
Abby Adamczyk ◽  
MJ Mulcahey
Keyword(s):  
Older Adults ◽  
Occupational Therapy ◽  
Scoping Review ◽  
Early Identification ◽  
Hospital Readmissions ◽  
Skilled Nursing Facilities ◽  
Nursing Facilities ◽  
Clinical Practices ◽  
Skilled Nursing ◽  
Postacute Care

Importance: Unplanned hospital readmissions can profoundly affect older adults’ quality of life and the financial status of skilled nursing facilities (SNFs). Although many clinical practices focus on reforming these issues, occupational therapy’s involvement remains unclear. Objective: To explore clinical practices aimed at reducing hospital readmissions of older adults pursuing postacute care (PAC) at SNFs and describe how they align with occupational therapy’s scope of practice. Data Sources: We searched CINAHL, Scopus, PubMed, and OTseeker for articles published from January 2011 to February 2020. Study Selection and Data Collection: We conducted a scoping review of peer-reviewed articles with functional outcomes of clinical practices reducing unplanned hospital readmissions of patients older than age 65 yr pursuing PAC services in SNFs. Trained reviewers completed the title and abstract screens, full-text reviews, and data extraction. Findings: Thirteen articles were included and focused on five areas: risk and medical disease management and follow-up, hospital-to-SNF transition, enhanced communication and care, function, and nutrition. Early coordination of care and early identification of patients’ needs and risk of readmission were common features. All clinical practices aligned with occupational therapy domains and processes, but only 1 study specified occupational therapy as part of the research team. Conclusions and Relevance: Comprehensive, multipronged clinical practices encompassing care coordination and early identification and management of acute conditions are critical in reducing preventable readmissions among older adults pursuing PAC services in SNFs. Further research is needed to support occupational therapy’s value in preventing hospital readmissions of older adults in this setting. What This Article Adds: This scoping review maps the presence of occupational therapy’s domains and processes in the clinical practices that reduce hospital readmissions of older adults pursuing PAC services in SNFs. Findings provide occupational therapy practitioners with opportunities to assume roles beyond direct patient care, research, advocate, and publish more, thereby increasing their presence and adding value to occupational therapy interventions that reduce hospital readmissions.

Interventions for quality of life and related outcomes among unpaid caregivers of older adults with visual impairments: A scoping review

2021 ◽  
pp. 026461962110190
Author(s):  
Afeez Abiola Hazzan ◽  
Pamela Haibach-Beach ◽  
Lauren Lieberman ◽  
Jamia Williams
Keyword(s):  
Quality Of Life ◽  
Older Adults ◽  
Adverse Events ◽  
Scoping Review ◽  
Critical Role ◽  
Visual Impairments ◽  
Social Model ◽  
Scoping Reviews ◽  
The Impact

Unpaid family caregivers play a critical role in the care of older adults with visual impairments. Caring for older adults with visual impairments requires much time and energy, often resulting in psychological stress and reduced quality of life for the unpaid caregiver. However, there is a paucity of data on the impact of caregiving on quality of life and related outcomes among these caregivers. The purpose of this study was to conduct a scoping review examining issues of quality of life, health, stress, burden, and barriers among unpaid caregivers of older adults with visual impairments. The study also aimed to summarize interventions for addressing these issues. This study followed the Arksey and O’Malley five-stage approach for scoping reviews. We performed a search of published peer-reviewed articles available in PubMed, CINAHL Complete, and PsycINFO to identify relevant studies. Two reviewers conducted the screening of titles, abstracts, and full-texts. A total of 24 articles were eligible for full-text screening from the 452 records identified, and 5 articles met the final inclusion criteria. The following four themes were identified: (1) prevalence of quality of life–related barriers among unpaid caregivers of older adults with visual impairments; (2) adverse events among unpaid caregivers of older adults with visual impairments; (3) interventions for unpaid caregivers of older adults with visual impairments; and (4) potential impacts of intervention on unpaid caregivers of older adults with visual impairments. These findings point to a lack of interventions for unpaid caregivers of older adults with visual impairments, despite the prevalence of quality of life–related barriers and adverse events in this population. This study aligns with the social model of disability as it relates to the failure of the system to meet the needs of older adults with visual impairments. Research addressing these issues is urgently needed.

Servicing the Senior Swallow: A Family-Centered Private Practice Model of Service Delivery

2020 ◽  
pp. 1-4 ◽  
Author(s):  
Yvette M. McCoy
Keyword(s):  
Older Adults ◽  
Medical Model ◽  
Recovery Process ◽  
Swallowing Disorders ◽  
Current Evidence ◽  
Care Needs ◽  
Skilled Nursing ◽  
Person Centered Care ◽  
Centered Care ◽  
Traditional Medical Model

Purpose Person-centered care shifts the focus of treatment away from the traditional medical model and moves toward personal choice and autonomy for people receiving health services. Older adults remain a priority for person-centered care because they are more likely to have complex care needs than younger individuals. Even more specifically, the assessment and treatment of swallowing disorders are often thought of in terms of setting-specific (i.e., acute care, skilled nursing, home health, etc.), but the management of dysphagia in older adults should be considered as a continuum of care from the intensive care unit to the outpatient multidisciplinary clinic. In order to establish a framework for the management of swallowing in older adults, clinicians must work collaboratively with a multidisciplinary team using current evidence to guide clinical practice. Private practitioners must think critically not only about the interplay between the components of the evidence-based practice treatment triad but also about the broader impact of dysphagia on caregivers and families. The physical health and quality of life of both the caregiver and the person receiving care are interdependent. Conclusion Effective treatment includes consideration of not only the patient but also others, as caregivers play an important role in the recovery process of the patient with swallowing disorders.

scholarly journals Effectiveness of Tai Chi for Health Promotion of Older Adults: A Scoping Review of Meta-Analyses

2021 ◽  
pp. 155982762110012
Author(s):  
Fei-Chi Yang ◽  
Aishwarya B. Desai ◽  
Pelareh Esfahani ◽  
Tatiana V. Sokolovskaya ◽  
Doreen J. Bartlett
Keyword(s):  
Older Adults ◽  
Health Promotion ◽  
Health Outcomes ◽  
Scoping Review ◽  
General Health ◽  
Tai Chi ◽  
Well Being ◽  
Cochrane Library ◽  
Care Providers ◽  
Meta Analyses

Background. Tai Chi is a form of exercise that is accessible to people from different socioeconomic backgrounds, making it a potentially valuable activity for health promotion of older adults. Purpose. The objective of this scoping review was to summarize the current knowledge about the effectiveness of Tai Chi for older adults across a range of general health outcomes from published, peer reviewed, unique meta-analyses. Methods. Meta-analyses were retrieved from Medline, Embase, AMED, CINAHL, SPORTDiscus, PsychINFO, Web of Science, PubMed Health, and the Cochrane Library from database inception to late August 2019. Multistage deduplication and screening processes identified eligible full-length meta-analyses. Two people independently appraised 27 meta-analyses based on the GRADE system and organized results into 3 appendices subsequently collated into heterogeneous, statistically significant, and statistically insignificant tables. Results. “High” and “moderate” quality evidence extracted from these meta-analyses demonstrated that practicing Tai Chi can significantly improve balance, cardiorespiratory fitness, cognition, mobility, proprioception, sleep, and strength; reduce the incidence of falls and nonfatal stroke; and decrease stroke risk factors. Conclusions. Health care providers can now recommend Tai Chi with high level of certainty for health promotion of older adults across a range of general health outcomes for improvement of overall well-being.

Parental Bereavement in Older Age: A Scoping Review

2021 ◽  
pp. 105413732199581
Author(s):  
Patricia Moyle Wright
Keyword(s):  
Older Adults ◽  
Scoping Review ◽  
Adult Child ◽  
Older Age ◽  
Parental Bereavement ◽  
Older Parents ◽  
Physical Decline ◽  
Scoping Reviews ◽  
Cultural Mores ◽  
Meta Analyses

A scoping review of parental bereavement in older age was conducted to identify the unique needs of older adults after the loss of an adult child. Inclusion and exclusion criteria were developed in accordance with the stated objectives of this review, which was guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). In total, 26 research studies were included. The data were then analyzed using a systematic approach for organizing and synthesizing key data. The results indicated that some consequences and mediators of parental bereavement are similar regardless of age. But, older adults experience greater loneliness, isolation, and stigma than their younger counterparts. Older parents are also at greater risk for physical decline, mortality, and institutionalization following the death of an adult child. Religious and cultural mores also have influence on the bereavement process.

The Socialization of Unpaid Family Caregivers: A Scoping Review

2021 ◽  
pp. 016402752110050
Author(s):  
Kirstie McAllum ◽  
Mary Louisa Simpson ◽  
Christine Unson ◽  
Stephanie Fox ◽  
Kelley Kilpatrick
Keyword(s):  
Older Adults ◽  
Family Caregivers ◽  
Scoping Review ◽  
Family Caregiving ◽  
Family Processes ◽  
Future Research ◽  
Socialization Process ◽  
Role Negotiation ◽  
Role Learning ◽  
Socialization Agents

As unpaid family caregiving of older adults becomes increasingly prevalent, it is imperative to understand how family caregivers are socialized and how they understand the caregiving role. This PRISMA-ScR-based scoping review examines the published literature between 1995–2019 on the socialization of potential and current unpaid family caregivers of older adults. Of 4,599 publications identified, 47 were included. Three perspectives of socialization were identified: (1) role acculturation; (2) role negotiation and identification; and (3) specialized role learning. The findings show how socialization involves different contexts (e.g., cultures), imperatives for action (e.g., circumstances), socialization agents (e.g., family), processes (e.g., modeling), and internal (e.g., normalization) and external (e.g., identification) consequences for caregivers. Future research could fruitfully explore how caregivers manage key turning points within the socialization process, disengage from the caregiving role, and negotiate the socialization and individualization processes within diverse cultural and funding contexts.

scholarly journals 1206. Association of Aging, Frailty and Place of Residence with Skin, Oral and Gut Microbiome Characteristics and Pathogenicity Reservoirs

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S625-S625
Author(s):  
Peter J Larson ◽  
Julia Oh ◽  
Julie Robison ◽  
James Grady ◽  
George Kuchel
Keyword(s):  
Older Adults ◽  
Gut Microbiome ◽  
Skilled Nursing Facility ◽  
Antibiotic Resistance Genes ◽  
Community Dwelling ◽  
Colonization Resistance ◽  
Nursing Facility ◽  
Skilled Nursing ◽  
Cutibacterium Acnes ◽  
Control And Prevention

Abstract Background Despite their elevated risk for morbidity and mortality from infections, the microbiota of older adults remain understudied. While colonization resistance from resident microflora is a promising means to prevent infections, little is known about pathogenicity reservoirs and colonization resistance in this vulnerable population. Here we study the skin, oral, and gut microbiome dynamics of older adults in both community and Skilled Nursing Facility (SNF) settings, investigating relationships between age, frailty, environment, microbiota, and pathogenicity reservoirs. Methods We conducted a longitudinal metagenome survey of 47 adults age 65+ years of age; 22 residents of 3 different SNFs and 25 community dwelling individuals. We performed metagenomic whole genome shotgun sequencing on stool, oral, and skin samples from 8 sites, 1421 total. To correlate clinical and behavioral variables, we measured frailty, collected medical records, and interviewed participants on diet and lifestyle. We also draw comparisons with previous younger cohorts. Results • Compared to younger adults, the skin microbiota of older adults was characterized by ◦ High heterogeneity ◦ Decreased stability over time, suggesting increased susceptibility to colonization and pathogenicity ◦ Compositional differences including significantly lower levels of Cutibacterium acnes, with reciprocal increases in Staphylococci, Corynebacteria, and Malassezia • In older adults, Frailty (Rockwood) was found to have linear correlation with relative abundance of species relevant to infection risk including acnes, staphylococci, streptococci, E. coli, Akkermansia mucinophila, and Enterococcus faecalis. • The skin, oral, and gut microbiota of SNF residents had substantially elevated virulence factor and antibiotic resistance genes. Conclusion To the best of our knowledge, this is largest report to date of the skin metagenome in older adults. We demonstrate distinct and significant differences between cohorts with clinically relevant implications. We believe these results may inform infection control and prevention by increasing our understanding of colonization resistance and pathogenicity reservoirs, as well as advance our knowledge of the relationship between aging, the microbiome, and infections. Disclosures All Authors: No reported disclosures

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