Obesity in Older Adults: Synthesis of Findings and Recommendations for Clinical Practice

2007 ◽  
Vol 33 (12) ◽  
pp. 19-35 ◽  
Author(s):  
Meredith Flood ◽  
Ann M. Newman
Keyword(s):  
Older Adults ◽  
Clinical Practice

Prevalence and Phenomenology of Sensory Experiences of a Deceased Spouse: A Survey of Bereaved Older Adults

2021 ◽  
pp. 003022282110162
Author(s):  
Karina S. Kamp ◽  
Edith Maria Steffen ◽  
Andrew Moskowitz ◽  
Helle Spindler
Keyword(s):  
Older Adults ◽  
Clinical Practice ◽  
Late Life ◽  
Danish Population ◽  
Sensory Experiences ◽  
Grief Process ◽  
Sensory Modalities ◽  
Potential Resource

Sensory and quasi-sensory experiences of the deceased (SED), also called bereavement hallucinations, are common in bereavement, but research detailing these experiences is limited. Methods: An in-depth survey of SED was developed based on existing research, and 310 older adults from the general Danish population participated in the study 6–10 months after their spouse died. Results: SED were reported by 42% of the participants with wide-ranging phenomenological features across sensory-modalities. In particular, seeing and hearing the deceased spouse was experienced as very similar to the couple’s everyday contacts before death. SED were endorsed as positive by a majority of experiencers, and the experiences were often shared with family and friends. Discussion: SED are conceptualized as social and relational phenomena, which may comfort the surviving spouse in late-life bereavement, but also provide tangible help to some experiencers. In clinical practice, SED may be considered a potential resource for the therapeutic grief process.

Use of the geriatric assessment in clinical practice in Mexico: A survey of cancer providers.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e24013-e24013
Author(s):  
Haydee Cristina Verduzco-Aguirre ◽  
Laura Margarita Bolano Guerra ◽  
Hector Martínez-Said ◽  
Gregorio Quintero Beulo ◽  
Eva Culakova ◽  
...  
Keyword(s):  
Older Adults ◽  
Clinical Practice ◽  
Geriatric Assessment ◽  
Geriatric Oncology ◽  
Public Institution ◽  
Care Providers ◽  
Cross Sectional Survey ◽  
Qualified Personnel ◽  
Medical Oncologists ◽  
Oncology Providers

e24013 Background: Despite the growing burden of cancer in older adults in Mexico, it is unknown how many cancer care providers in Mexico use information obtained through a geriatric assessment (GA) and/or geriatric oncology principles in their everyday clinical practice. Methods: We administered a cross-sectional survey to oncology providers in Mexico via the Mexican Society of Oncology mailing list (n = 1240). The survey included questions on demographics, awareness about geriatric oncology principles, and the use of the GA and other geriatric clinical tools. The primary outcome was to estimate the proportion of providers using GA tools through the question: “For your patients ≥65 years, do you perform a multidimensional geriatric assessment using validated tools?”. We hypothesized that ≤10% of respondents would give a positive answer. We used descriptive statistics and X2 tests to compare groups of respondents. Results: We obtained 196 answers (response rate 15.8%). 121 (62%) respondents were male; median age 42. 98 (50%) were surgical oncologists, 59 (30%) medical oncologists, and 38 (19%) radiation oncologists. Median time in practice was 8 years, with 39% practicing in Mexico City. A third had their practice at a public institution, 26% at a private institution, and 38% in both. The proportion of patients aged 65-79 and ≥80 seen on an average clinic day by the respondents was 30% and 10%, respectively. 121 (62%) reported having a geriatrician available at their practice site. 37 respondents (19%) reported using validated GA tools to evaluate older adults with cancer in their practice. The proportion of respondents who evaluated each GA domain is shown in Table 1. Male respondents (p=0.03), medical oncologists (p<0.01), and those with a less busy practice (≤10 patients/day) (p=0.01) were more likely to use validated tools to perform a GA. Regarding barriers for implementing GA, 37% reported lack of time, 49% lack of qualified personnel, 44% lack of knowledge of geriatric tools, 6% patient unwillingness to undergo a GA, and 8% prohibitive cost. Only 17 (9%) thought that information obtained through a GA would not lead to practice changes. Conclusions: According to our survey, the proportion of Mexican oncology providers using validated tools to perform a GA is 19%, which is higher than expected. Some GA domains, such as comorbidity and functional status, were commonly assessed, while others, such as fall history, were seldom evaluated. Common barriers for GA implementation were lack of qualified personnel and of knowledge about geriatric tools. We plan to further explore these barriers and potential facilitators through focused interviews in order to guide future interventions.[Table: see text]

National consensus project for quality palliative care

2015 ◽  
pp. 11-19 ◽  
Author(s):  
Constance M. Dahlin
Keyword(s):  
Older Adults ◽  
Palliative Care ◽  
Clinical Practice ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Quality Care ◽  
Life Threatening ◽  
National Consensus

The National Consensus Project for Quality Palliative Care’s Clinical Practice Guidelines for Quality Care is a significant resource that offers the nurse a framework for quality care in all settings. The Clinical Practice Guidelines are appropriate to a range of populations from neonates to children to adults and older adults; a range of chronic progressive and serious life-threatening illnesses, injuries, and trauma; and a range of vulnerable and underresourced populations. The Clinical Practice Guidelines are appropriate for any setting because they facilitate partnerships for caring for patients with debilitating and life-limiting illnesses and offer support for the nurse in delivering the care, particularly for long-term patients.

scholarly journals Development of a Dementia-Focused End-of-Life Planning Tool: The LEAD Guide (Life-Planning in Early Alzheimer’s and Dementia)

2019 ◽  
Vol 3 (3) ◽  
Author(s):  
Kara Dassel ◽  
Rebecca Utz ◽  
Katherine Supiano ◽  
Sara Bybee ◽  
Eli Iacob
Keyword(s):  
Older Adults ◽  
Clinical Practice ◽  
Focus Groups ◽  
End Of Life ◽  
Family Caregivers ◽  
Early Stage ◽  
Healthy Adults ◽  
Planning Tool ◽  
Healthy Older Adults ◽  
Life Planning

Abstract Background and Objectives To address the unique characteristics of Alzheimer’s disease and related dementias (ADRD) that complicate end-of-life (EOL), we created, refined, and validated a dementia-focused EOL planning instrument for use by healthy adults, those with early-stage dementia, family caregivers, and clinicians to document EOL care preferences and values within the current or future context of cognitive impairment. Research Design and Methods A mixed-method design with four phases guided the development and refinement of the instrument: (1) focus groups with early-stage ADRD and family caregivers developed and confirmed the tool content and comprehensiveness; (2) evaluation by content experts verified its utility in clinical practice; (3) a sample of healthy older adults (n = 153) and adults with early-stage ADRD (n = 38) completed the tool, whose quantitative data were used to describe the psychometrics of the instrument; and (4) focus groups with healthy older adults, family caregivers, and adults with early-stage ADRD informed how the guide should be used by families and in clinical practice. Results Qualitative data supported the utility and feasibility of a dementia-focused EOL planning tool; the six scales have high internal consistency (α = 0.66–0.89) and high test–rest reliability (r = .60–.90). On average, both participant groups reported relatively high concern for being a burden to their families, a greater preference for quality over length of life, a desire for collaborative decision-making process, limited interest in pursuing life-prolonging measures, and were mixed in their preference to control the timing of their death. Across disease progression, preferences for location of care changed, whereas preferences for prolonging life remained stable. Discussion and Implications The LEAD Guide (Life-Planning in Early Alzheimer’s and Dementia) has the potential to facilitate discussion and documentation of EOL values and care preferences prior to loss of decisional capacity, and has utility for healthy adults, patients, families, providers, and researchers.

Scoping Review of Clinical Practice Guidelines for Fall Risk Screening and Assessment in Older Adults across the Care Continuum

2020 ◽  
pp. 1-18
Author(s):  
Hazel Williams-Roberts ◽  
Catherine Arnold ◽  
Daphne Kemp ◽  
Alexander Crizzle ◽  
Shanthi Johnson
Keyword(s):  
Older Adults ◽  
Clinical Practice ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Scoping Review ◽  
Fall Risk ◽  
Community Dwelling ◽  
Risk Screening ◽  
Care Continuum ◽  
Fall Risk Screening

ABSTRACT Given the rising numbers of older adults in Canada experiencing falls, evidence-based identification of fall risks and plans for prevention across the continuum of care is a significant priority for health care providers. A scoping review was conducted to synthesize published international clinical practice guidelines (CPGs) and recommendations for fall risk screening and assessment in older adults (defined as 65 years of age and older). Of the 22 CPGs, 6 pertained to multiple settings, 9 pertained to community-dwelling older adults only, 2 each pertained to acute care and long-term care settings only, and 3 did not specify setting. Two criteria, prior fall history and gait and balance abnormalities, were applied either independently or sequentially in 19 CPG fall risk screening algorithms. Fall risk assessment components were more varied across CPGs but commonly included: detailed fall history; detailed evaluation of gait, balance, and/or mobility; medication review; vision; and environmental hazards assessment. Despite these similarities, more work is needed to streamline assessment approaches for heterogeneous and complex older adult populations across the care continuum. Support is also needed for sustainable implementation of CPGs in order to improve health outcomes.

Neuropsychological assessment in older people: old principles and new directions

2000 ◽  
Vol 6 (5) ◽  
pp. 362-370 ◽  
Author(s):  
Robin G. Morris ◽  
Claire Worsley ◽  
David Matthews
Keyword(s):  
Older Adults ◽  
Clinical Practice ◽  
Older People ◽  
Neuropsychological Assessment ◽  
Rating Scales ◽  
Clinical Psychologist ◽  
Narrow Sense ◽  
New Directions ◽  
Different Types ◽  
Common Clinical Practice

Neuropsychological assessment, in the broader sense, is common clinical practice with older adults because of the widespread use of mental status examinations and dementia rating scales. In the more narrow sense, a neuropsychological assessment conducted by a clinical psychologist or clinical neuropsychologist is used less frequently and for more specific purposes. This paper outlines these uses and provides a brief overview of the different types of test that might be used, with a clinical example to illustrate the type of information gained. This review is designed not to be comprehensive, but to provide a pointer towards the latest trends in test development.

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