scholarly journals Frail Older Persons’ Experiences of Information and Participation in Hospital Care

2019 ◽  
Vol 16 (16) ◽  
pp. 2829 ◽  
Author(s):  
Berit Forsman ◽  
Ann Svensson
Keyword(s):  
Health Literacy ◽  
Older Patients ◽  
Hospital Care ◽  
Older Persons ◽  
Qualitative Method ◽  
Healthcare Professionals ◽  
Frail Older People ◽  
Centered Care ◽  
Frail Older Persons ◽  
To Receive

The aim of this paper is to describe frail older persons’ experiences of hospital care of information and participation when being an inpatient at a hospital. A qualitative method was used. Data were collected at the hospital from 20 interviews with frail older patients, together with observations in the environment at the hospital ward. A content analysis was performed. Patients experienced not receiving information about their care and rehabilitation, or receiving such information in noisy surroundings. They experienced situations of misunderstanding related to their medication, which indicates the need for appropriate discharge calls for frail older patients. They expressed feelings of distress concerning the future, caused by hasty admissions or relatives’ problems to handle the situation. The results highlight the need to receive appropriate information and to participate in decision-making. The level of health literacy should be taken notice of when giving information, using peaceful and quiet environments when informing frail older persons. Person-centered care should be recognized to a greater extent in order for healthcare professionals to give information to frail older people in a health literacy-friendly way. This might make it easier for frail older persons to participate in a partnership in care.

scholarly journals Frailty and the Risk of Polypharmacy in the Older Person: Enabling and Preventative Approaches

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Martin C. Nwadiugwu
Keyword(s):  
Older Persons ◽  
Medication Reconciliation ◽  
Frailty Index ◽  
Health Record ◽  
Older Person ◽  
Frail Older People ◽  
Negative Effects ◽  
Inherent Risk ◽  
Stopp Criteria ◽  
Frail Older Persons

Frail older people have an inherent risk of polypharmacy due to the need to treat multiple comorbidities, thus leading to various negative effects on their health due to the adverse actions from the drugs. This issue was discussed from a person-centered perspective, highlighting the category of frail older adults who are at a higher risk. Appropriate medication reconciliation in this population with useful prescribing tools (Beers and START/STOPP criteria) to minimize polypharmacy and to provide alternative prescriptive intervention could go alongside primary care to reduce the extent of frailty and polypharmacy. Reducing delayed referrals and extended hospitalization with electronic health record systems and using the signs of frailty from the Electronic Frailty Index (EFI) to predict polypharmacy for frail older persons are preventative approaches that proactively respond to frailty associated with the risk of polypharmacy.

scholarly journals Models of care for frail older persons who present to the emergency department: a scoping review protocol

2020 ◽  
Vol 9 (1) ◽  
Author(s):  
Ya-Ling Huang ◽  
Megan McGonagle ◽  
Rebecca Shaw ◽  
Julie Eastham ◽  
Nemat Alsaba ◽  
...  
Keyword(s):  
Emergency Department ◽  
Older People ◽  
Scoping Review ◽  
Older Persons ◽  
Grey Literature ◽  
Models Of Care ◽  
The Body ◽  
Model Of Care ◽  
Frail Older People ◽  
Frail Older Persons

Abstract Background People aged ≥ 65 years comprise around 1 in 5 emergency department (ED) presentations. Many of these presentations occur due to complications associated with chronic diseases and frailty. This review aims to provide a comprehensive understanding of available research regarding models of care for frail older people presenting to the ED. Methods The Joanna Briggs Institute scoping review framework will be used to guide this review. Literature searches will be conducted in the following electronic databases (from January 2009 onwards): CINAHL via EBSCOhost, Ovid MEDLINE, Embase, SocINDEX. Grey literature will be identified through searching Google Scholar. This review will consider primary research studies (including observational and interventional studies) published in English on models of care for frail older people (aged ≥ 65) presenting to the ED. Two researchers will independently screen all citations, full-text articles, and abstract data. Potential disagreements will be resolved through discussion with a third researcher. Data extracted from included studies will include the following: author(s), year of publication, country, research design and aim, time frame of the study, study population and sample size, data collection methods, definition of frailty, model of care, and key findings that pertain to the ability to inform this review. The strength of the body of evidence will be assessed using the National Health and Medical Research Council level of evidence hierarchy body of evidence matrix. Data will be presented in a tabular format and accompanied by a narrative that describes the characteristics of the body of literature. Discussion Despite the increased number of ED presentations for frail older people, there has been no synthesis of the sources of evidence of model of care for frail older people in the setting of emergency care. The results of this scoping review will provide an overview of different models of care and help inform future research in the development of models of care for frail older persons, tailored to the healthcare system in the emergency context. Systematic review registration This scoping review has been registered in the Open Science Framework (osf.io/h2t94).

Older ill persons’ and their adult children’s experiences with primary healthcare: A reflective lifeworld research approach

2020 ◽  
pp. 205715852096675
Author(s):  
Helle E. Andersen ◽  
Bente Hoeck ◽  
Dorthe S. Nielsen ◽  
Jesper Ryg ◽  
Charlotte Delmar
Keyword(s):  
Primary Healthcare ◽  
Lived Experiences ◽  
Older Persons ◽  
Healthcare Professionals ◽  
Aging In Place ◽  
Healthcare Systems ◽  
Research Approach ◽  
Frail Older Persons ◽  
At Home

Aging in place puts ill and frail older persons in a vulnerable situation, and relatives, especially adult children, are expected to assume caring responsibilities. Healthcare professionals, like homecare nurses, play a key role in providing care to older persons needing support to live at home. However, the quality of primary home care has been questioned. The aim of this study was to describe older persons living at home and their adult children’s lived experiences with caring responsibility assumed by healthcare professionals. We used a reflective lifeworld research approach and analyzed 23 interviews and eight diaries. The COREQ checklist was followed. The findings revealed that caring responsibility is tantamount to being professionally competent and balancing immanent power to either promote or inhibit important areas of the older persons’ and their adult children’s lifeworld. Blurred lines of caring responsibility between the participants, the healthcare professionals, and the healthcare systems occurred and indicated that there were errors of commission and omission regarding the safety of older persons in their own homes.

scholarly journals Healthcare professionals´ experiences of assessing, treating and preventing constipation among older patients during hospitalization: An interview study

2020 ◽  
Author(s):  
Veronica Lundberg ◽  
Anne-Marie Boström RN ◽  
Kristina Gottberg ◽  
Hanne Konradsen
Keyword(s):  
Older Patients ◽  
Healthcare Professionals ◽  
Quality Care ◽  
Individual Interviews ◽  
Healthcare Needs ◽  
Exploratory Approach ◽  
Centered Care ◽  
Patients At Risk ◽  
Group Interviews ◽  
Person Centered Approach

Abstract Background Constipation is a common and troublesome condition among older patients and can result in a variety of negative health consequences. It is often undiagnosed or undertreated. Healthcare professionals have a responsibility to understand and address patients’ overall healthcare needs so exploring their experiences is, therefore, highly relevant. The purpose of the study was to explore healthcare professionals’ experiences of assessing, treating and preventing constipation among older patients. Methods A qualitative design with an exploratory approach was used. The participants were purposively sampled from three wards in a geriatric department in a medium-sized hospital in Sweden. Data were collected through focus group interviews and individual interviews and analyzed using content analysis. Results Three categories were generated: depending on resources and uncertainties, using different strategies, and approaching the patients’ needs. In the care of older patients at risk of or with constipation, decisions were made based on personal knowledge, personal experience and clinical reasoning. A person-centered approach was highlighted but was not always possible to incorporate. Conclusions Different strategies for preventing and treating constipation were believed to be important, as was person-centered care, but were found to be difficult to perform. Healthcare professionals need adequate resources. Evidence-based clinical guidelines might help the delivery of high-quality care. Constipation needs to be given more focus in hospitals in order to potentially improve the care and patient outcomes for older people.

scholarly journals Using the Brief Health Literacy Screen in Chronic Care in French Hospital Settings: Content Validity of Patient and Healthcare Professional Reports

2020 ◽  
Vol 18 (1) ◽  
pp. 96
Author(s):  
Adèle Perrin ◽  
Luiza Siqueira do Prado ◽  
Amélie Duché ◽  
Anne-Marie Schott ◽  
Alexandra L. Dima ◽  
...  
Keyword(s):  
Health Literacy ◽  
Content Validity ◽  
Chronic Care ◽  
Routine Care ◽  
Related Information ◽  
Concept Of Health ◽  
Patient Reported ◽  
Centered Care ◽  
Health Related ◽  
French Hospital

Person-centered care has led healthcare professionals (HCPs) to be more attentive to patients’ ability to understand and apply health-related information, especially those with chronic conditions. The concept of health literacy (HL) is essential in understanding patients’ needs in routine care, but its measurement is still controversial, and few tools are validated in French. We therefore considered the brief health literacy screen (BHLS) for assessing patient-reported HL in chronic care settings, and also developed an HCP-reported version of the BHLS with the aim of using it as a research instrument to assess HCPs’ evaluation of patients’ HL levels. We assessed the content validity of the French translation of both the patient-reported and HCP-reported BHLS in chronic care within hospital settings, through cognitive interviews with patients and HCPs. We performed qualitative analysis on interview data using the survey response Tourangeau model. Our results show that the BHLS is easy and quick to administer, but some terms need to be adapted to the French chronic care settings. Health-related information was observed to be mainly communicated orally, hence a useful direction for future literacy measures would be to also address verbal HL.

scholarly journals How Do Patients with Life-Limiting Illness and Caregivers Want End-Of-Life Prognostic Information Delivered? A Pilot Study

Healthcare ◽  
2021 ◽  
Vol 9 (7) ◽  
pp. 784
Author(s):  
Ebony T. Lewis ◽  
Kathrine A. Hammill ◽  
Maree Ticehurst ◽  
Robin M. Turner ◽  
Sally Greenaway ◽  
...  
Keyword(s):  
Older Adults ◽  
Pilot Study ◽  
Health Services ◽  
End Of Life ◽  
Older Patients ◽  
Prognostic Information ◽  
Clinical Scenarios ◽  
Delivery Format ◽  
Patient Groups ◽  
To Receive

We aimed to identify the level of prognostic disclosure, type of prognostic information and delivery format of prognostic communication that older adults diagnosed with a life-limiting illness or caregivers prefer to receive. We developed and pilot tested an open-ended survey to 15 older patients and caregivers who had experience in health services for life-limiting illness either for a relative, friend or themselves. Five hypothetical clinical scenarios of prognostic options were presented to ascertain preferences. The preferred format to receive prognostic information was verbal delivery by the clinician with a written summary. Photos and videos were less favoured, and a table with numbers/percentages was least preferred. Distress levels to the prognostic scenarios were low, with the exception of a photo. We conclude that older patients/caregivers want end-of-life prognostic information delivered the traditional way, verbally by clinicians. Options to deliver prognostic information may vary across patient groups but empower clinicians in introducing end-of-life discussions with patients/caregivers. Our study illustrates the feasibility of involving terminal patients and caregivers in research that contributes to eliciting prognostic preferences. Further research is needed to understand whether the prognostic preferences of hospitalized patients with life-limiting illness differ.

Older people's satisfaction with intermediate care: a systematic review

2007 ◽  
Vol 17 (3) ◽  
pp. 199-218 ◽  
Author(s):  
Andrew Wilson ◽  
Suzanne Richards ◽  
Janette Camosso-Stefinovic
Keyword(s):  
Systematic Review ◽  
Older People ◽  
Older Patients ◽  
Hospital Care ◽  
Patient Choice ◽  
Intermediate Care ◽  
Care Services ◽  
The Relationship

Although intermediate care takes a variety of different forms and has developed somewhat differently in different countries, we believe that intermediate-care schemes have enough in common to make it meaningful to examine the relationship between this method of care and the views of older patients receiving either it or its alternatives. This is particularly important as one of the underlying principles of intermediate care is to extend patient choice; furthermore, most intermediate-care services target older people. In this review we examine evidence about whether older people prefer intermediate or hospital care, and what they like and dislike about intermediate care.

scholarly journals Development and validation of a delirium risk assessment tool in older patients admitted to the Emergency Department Observation Unit

2021 ◽  
Author(s):  
A. Zucchelli ◽  
R. Apuzzo ◽  
C. Paolillo ◽  
V. Prestipino ◽  
S. De Bianchi ◽  
...  
Keyword(s):  
Risk Assessment ◽  
Emergency Department ◽  
Older Patients ◽  
Older Persons ◽  
Assessment Tool ◽  
Training Sample ◽  
Risk Assessment Tool ◽  
Observation Unit ◽  
Old Patients ◽  
Two Samples

Abstract Background Delirium is frequent though undetected in older patients admitted to the Emergency Department (ED). Aims To develop and validate a delirium risk assessment tool for older persons admitted to the ED Observation Unit (OU). Methods We used data from two samples of 65 + year-old patients, one admitted to the ED of Brescia Hospital (n = 257) and one to the ED of Desio Hospital (n = 107), Italy. Data from Brescia were used as training sample, those collected in Desio as testing one. Delirium was assessed using the 4AT and patients’ characteristic were retrieved from medical charts. Variables found to be associated with delirium in the training sample were tested for the creation of a delirium risk assessment tool. The resulting tool’s performances were assessed in the testing subsample. Results Of all possible scores tested, the combination with the highest discriminative ability in the training sample included: age ≥ 75 years, dementia diagnosis, chronic use of neuroleptics, and hearing impairment. The delirium score exhibited an AUC of 0.874 and 0.893 in the training and testing samples, respectively. For a 1-point increase in the score, the odds of delirium increased more than twice in both samples. Discussion We propose a delirium risk assessing tool that includes variables that can be easily collected at ED admission and that can be calculated rapidly. Conclusion A risk assessment tool could help improving delirium detection in older persons referring to ED.

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