scholarly journals Flexible Textile-Based Pressure Sensing System Applied in the Operating Room for Pressure Injury Monitoring of Cardiac Operation Patients

Sensors ◽  
2020 ◽  
Vol 20 (16) ◽  
pp. 4619
Author(s):  
De-Fen Shih ◽  
Jyh-Liang Wang ◽  
Sou-Chih Chao ◽  
Yin-Fa Chen ◽  
Kuo-Sheng Liu ◽  
...  
Keyword(s):  
Kalman Filter ◽  
Operation Time ◽  
The Elderly ◽  
Readout System ◽  
Term Care ◽  
Pressure Sensing ◽  
Cardiac Operation ◽  
Sensing System ◽  
Interfacial Pressure ◽  
Pressure Injury

Pressure injury is the most important issue facing paralysis patients and the elderly, especially in long-term care or nursing. A new interfacial pressure sensing system combined with a flexible textile-based pressure sensor array and a real-time readout system improved by the Kalman filter is proposed to monitor interfacial pressure progress in the cardiac operation. With the design of the Kalman filter and parameter optimization, noise immunity can be improved by approximately 72%. Additionally, cardiac operation patients were selected to test this developed system for the direct correlation between pressure injury and interfacial pressure for the first time. The pressure progress of the operation time was recorded and presented with the visible data by time- and 2-dimension-dependent characteristics. In the data for 47 cardiac operation patients, an extreme body mass index (BMI) and significantly increased pressure after 2 h are the top 2 factors associated with the occurrence of pressure injury. This methodology can be used to prevent high interfacial pressure in high-risk patients before and during operation. It can be suggested that this system, integrated with air mattresses, can improve the quality of care and reduce the burden of the workforce and medical cost, especially for pressure injury.

Pharmacology Issues Related to Dementia Syndrome of Depression in Elderly Residents of Long-Term Care Settings

2015 ◽  
Vol 25 (2) ◽  
pp. 61-69
Author(s):  
Angel L. Ball ◽  
Adina S. Gray
Keyword(s):  
Depressive Symptoms ◽  
The Elderly ◽  
Environmental Communication ◽  
Pharmacological Intervention ◽  
Team Approach ◽  
Discussion Paper ◽  
Term Care ◽  
Anticholinergic Medications ◽  
Inappropriate Treatment ◽  
Dementia Syndrome

Pharmacological intervention for depressive symptoms in institutionalized elderly is higher than the population average. Among the patients on such medications are those with a puzzling mix of symptoms, diagnosed as “dementia syndrome of depression,” formerly termed “pseudodementia”. Cognitive-communicative changes, potentially due to medications, complicate the diagnosis even further. This discussion paper reviews the history of the terminology of “pseudodementia,” and examines the pharmacology given as treatment for depressive symptoms in the elderly population that can affect cognition and communication. Clinicians can reduce the risk of misdiagnosis or inappropriate treatment by having an awareness of potential side effects, including decreased attention, memory, and reasoning capacities, particularly due to some anticholinergic medications. A team approach to care should include a cohesive effort directed at caution against over-medication, informed management of polypharmacology, enhancement of environmental/communication supports and quality of life, and recognizing the typical nature of some depressive signs in elderly institutionalized individuals.

The Unusual Cruelty of Nursing Homes Behind Bars

2020 ◽  
Vol 32 (5) ◽  
pp. 264-271
Author(s):  
Rachel E. López
Keyword(s):  
Nursing Homes ◽  
Human Dignity ◽  
Prison Population ◽  
Financial Burden ◽  
The Elderly ◽  
The United States ◽  
Term Care ◽  
Trained Staff ◽  
State Prisons ◽  
The Cost

The elderly prison population continues to rise along with higher rates of dementia behind bars. To maintain the detention of this elderly population, federal and state prisons are creating long-term care units, which in turn carry a heavy financial burden. Prisons are thus gearing up to become nursing homes, but without the proper trained staff and adequate financial support. The costs both to taxpayers and to human dignity are only now becoming clear. This article squarely addresses the second dimension of this carceral practice, that is the cost to human dignity. Namely, it sets out why indefinitely incarcerating someone with dementia or other neurocognitive disorders violates the Eighth Amendment of the United States Constitution’s prohibition on cruel and unusual punishment. This conclusion derives from the confluence of two lines of U.S. Supreme Court precedent. First, in Madison v. Alabama, the Court recently held that executing someone (in Madison’s case someone with dementia) who cannot rationally understand their sentence amounts to cruel and unusual punishment. Second, in line with Miller v. Alabama, which puts life without parole (LWOP) sentences in the same class as death sentences due to their irrevocability, this holding should be extended to LWOP sentences. Put another way, this article explains why being condemned to life is equivalent to death for someone whose neurodegenerative disease is so severe that they cannot rationally understand their punishment.

Status and Degree of Dysphagia in the Elderly-A Comparison Study of Long-Term Care Elderly People in an Outpatient Clinic

2003 ◽  
Vol 54 (4) ◽  
pp. 277-284 ◽  
Author(s):  
Masanori Komatsu ◽  
Kayoko Hirata ◽  
Idumi Mochimatsu ◽  
Kazuo Matsui ◽  
Hajime Hirose ◽  
...  
Keyword(s):  
Elderly People ◽  
Outpatient Clinic ◽  
Long Term Care ◽  
The Elderly ◽  
Comparison Study ◽  
Term Care

Predictors of Mortality in Board and Care Homes

1997 ◽  
Vol 36 (1) ◽  
pp. 77-87 ◽  
Author(s):  
Nicholas G. Castle
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Social Services ◽  
Long Term Care ◽  
Significant Proportion ◽  
The Elderly ◽  
Term Care ◽  
Care Facilities ◽  
Board And Care

Long-term care institutions have emerged as dominant sites of death for the elderly. However, studies of this trend have primarily examined nursing homes. The purpose of this research is to determine demographic, functional, disease, and facility predictors and/or correlates of death for the elderly residing in board and care facilities. Twelve factors are found to be significant: proportion of residents older than sixty-five years of age, proportion of residents who are chair- or bed-fast, proportion of residents with HIV, bed size, ownership, chain membership, affiliation with a nursing home, number of health services provided other than by the facility, the number of social services provided other than by the facility, the number of social services provided by the facility, and visits by Ombudsmen. These are discussed and comparisons with similar studies in nursing homes are made.

scholarly journals Impact of Frailty on Medical and Long-Term Care Expenditures for the Elderly Age 75 or Over in Japan

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 176-176
Author(s):  
Hiroto Yoshida ◽  
Yuriko Kihara
Keyword(s):  
Long Term Care ◽  
The Elderly ◽  
Elderly Age ◽  
Term Care ◽  
Intentional Weight Loss ◽  
Long Term Care Insurance ◽  
And Gender ◽  
The Impact

Abstract This study examined the impact of frailty on medical and long-term care expenditures in an older Japanese population. The subjects were those aged 75 years and over who responded to the survey (March 2018) in Bibai, Hokkaido, Japan (n=1,203) and have never received certification of long-term care insurance at the survey. We followed up 867 individuals (72.1%) until the end of December 2018 (10 month-period). We defined frailty as a state in performing 4 items and over of 15 items which were composed of un-intentional weight loss, history of falls, etc. Among 867 subjects, 233 subjects (26.9%) were judged to be frailty group, and 634 subjects (73.1%) non-frailty group. We compared period to the new certification of long-term care insurance (LTCI), accumulated medical and long-term care expenditures adjusted for age and gender between the two groups during the follow-up period. Cox proportional hazard models were used to examine the association between baseline frailty and the new certification of LTCI. The relative hazard ratio (HR) was higher in frailty group than non-frailty group (HR=3.51, 95% CI：1.30-9.45, P=.013). The adjusted mean accumulated medical and long-term care expenditures per capita during the follow-up were significantly (P=.002) larger for those in the frailty group (629,699 yen), while those in the non-frailty group were 450,995 yen. We confirmed strong economic impact of frailty in the elderly aged 75 or over in Japan.

scholarly journals Risk Management in nursing homes: an Italian experience in 2019

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
M F Furmenti ◽  
F Bert ◽  
M Rucci ◽  
U Fiandra ◽  
A Scarmozzino ◽  
...  
Keyword(s):  
Risk Management ◽  
Nursing Homes ◽  
Management Practices ◽  
Well Being ◽  
The Elderly ◽  
Management Plan ◽  
Management Policy ◽  
Insurance Company ◽  
Term Care ◽  
Starting Point

Abstract Background The ageing of the European population leads to an increasing demand for Long-Term Care services. The security and well-being of the elderly population hosted in nursing homes (NHs) needs an effective Risk Management policy, officially sanctioned in Italy by the so-called “Legge Gelli” n.24 (March 8th, 2017) and the Directive 2011/24/EU on the application of patients' rights in cross-border healthcare. In order to verify the effective application of common “best practices” in terms of Risk Management in NHs, a tool useful to analyse risk management attitudes in Northern Italy was conceived and applied in a sample of NHs. Methods The tool, developed in collaboration with the health insurance company SHAM Italia, is composed of 124 items (with a dichotomous answer -YES/NO) on topics related to various Risk Management practices. This tool was submitted in a face-to-face interview to several Directors (Health Directors or Nursing Coordinators) of NHs in the Piedmont Region. A list of randomly-chosen NHs was contacted: 4 of them were selected for the pilot study and compiled the questionnaire. Answers were gathered and analyzed through Microsoft Excel. Results Only the 25% of NHs has a Risk Management plan with objectives and indicators of effectiveness and uses Risk Analysis instruments for a pre- and post-” risk detection. Only one has employees working mainly on Risk Management alone. The 75% of the reported events were “Adverse Events”, and all the NHs (100%) have a protocol for a patient voluntary departure or for fall prevention or for bedsores prevention; while 50% have a protocol for prevention of aggressions towards operators or for patients' suicide prevention. Conclusions This work provides a starting point to face new challenges that are looming on the European Health-care Systems: the care for the elderlies needs to be perfected to reduce inefficiencies, cut useless costs and improve safety of patients in the NHs setting. Key messages Despite safety of older patients in nursing homes is not only important but mandatory in Italy, risk management tools for this setting are lacking in literature. A new tool applied in Italian nursing homes showed that risk management needs to be implemented in practice and these results can be extended to European context.

A Model for Working with the Elderly in Institutions

1981 ◽  
Vol 62 (7) ◽  
pp. 420-425 ◽  
Author(s):  
Alicia S. Cook
Keyword(s):  
Theoretical Model ◽  
Long Term Care ◽  
The Elderly ◽  
Term Care ◽  
Human Needs

Abraham Maslow's hierarchy of human needs provides a useful operating framework for professionals working with residents of long-term care institutions. The difficulties and obstacles that the elderly often encounter in these facilities are addressed and discussed for each level of the theoretical model.

A Study of Patterns of Dying in a Multilevel Geriatric Setting

1983 ◽  
Vol 2 (2) ◽  
pp. 79-85
Author(s):  
Isabel Brown
Keyword(s):  
Retrospective Study ◽  
Long Term Care ◽  
Death And Dying ◽  
Chronically Ill ◽  
The Elderly ◽  
Care Hospital ◽  
Term Care ◽  
Apartment Complex ◽  
General Community

ABSTRACTA retrospective study was conducted in a large multilevel geriatric centre to analyse the deaths reported in the year 1981. This centre provides accommodation for 750 elderly and/or chronically ill persons in three agencies—an apartment complex, a home for the aged, and a long-term care hospital The study revealed that the hospital is the place of death for a high proportion of the elderly residents of the centre. In particular, residents of the home for the aged are unlikely to remain in the “home” to die. It was found that patterns of death and dying for individuals admitted to the hospital from the general community differ in several ways from the patterns of those who are already living in the centre in terms of age and probable cause of death.

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