Virtual Geriatric Education Preferences of Rural Social Workers

Older adults in rural communities need access to comprehensive healthcare services provided by practitioners equipped with geriatric knowledge and skills. The Geriatric Rural Extension of Expertise through Telegeriatric Service (GREETS) project goal is to use telemedicine and telehealth to expand geriatric service options to underserved Michigan regions. GREETS educational programs train health practitioners to provide geriatric care for vulnerable older adults. To determine gaps in geriatric competencies, the team conducted an online survey of health professionals including behavioral health practitioners. Respondents identified educational topics and preferred virtual delivery methods. Demographic information included respondent’s professional position, practice setting, and county. The respondents were asked to indicate level of educational need using a scale ranging from a low, medium, or high need. Fifty (47%) of 106 total responses were from social workers. We compared the percent of social workers to other practitioners’ responses in our analysis. Four topics emerged for both groups as medium or high educational needs: 1) transitional care when changing residential settings or post-hospitalization; 2) assisting family caregivers cope with caregiving responsibilities; 3) incorporating community-based services into care plans; and 4) and managing frail older adults. Social workers noted higher need than the other respondents for: 1) managing chronic pain; 2) managing care of patients with multiple chronic conditions; 3) having serious illness conversations; 4) diagnosing dementia; and 5) discussing advance care planning. Both social worker and other respondents indicated interactive case-based webinars; published tools, toolkits, tip sheets; and didactic webinars as their top three learning formats.

Uncovering Pet Issues: A Survey of Professionals Working With Older Adults and Care Partners

Pets can play an important role in older adults’ health behaviors and decisions. However, the degree to which these issues are encountered or addressed by professionals working with this population remains unknown. An interdisciplinary (e.g., healthcare, social services) sample of professionals (N=72, 93.05% female, Mage=48.82, SDage=12.57) completed an online survey focused on the pet ownership issues they have encountered while working with older adults, persons with dementia, and care partners. The professionals (n=66) estimated 42.86% of their clients had been pet owners, and 45.58% regularly asked their clients about pets. Issues raised to the professionals varied by type of client. Older adults most often brought up exercising the pet, routine veterinary care, and the financial aspect of ownership (all 37.50%). Persons with dementia most often discussed accessing pet care items (12.50%), exercising the pet (9.72%), and basic pet care (8.33%). Care partners brought up basic pet care (33.33%), planning for the pet due to their care recipients’ housing transition (26.38%), and exercising the pet (25.00%). Professionals reported talking to clients about planning for the pet due to housing transition, concerns about falling, and concerns about the pet’s behavior (all 31.94%). The professionals (n=69) were very favorable toward pet ownership in general (M=4.43, SD=0.78) (1=extremely unfavorable, 5=extremely favorable), less favorable about older adult pet ownership (M=4.15, SD=0.72, p=.002), and even less favorable about persons with dementia owning pets (M=3.51, SD=0.93, p<.001). The results provide evidence that pet ownership issues are likely encountered in geriatric service settings and may shape healthy aging.

Preventive steps implemented on geriatric services in the primary health care centers during COVID-19 pandemic

Background: The emergence of the COVID-19 pandemic has changed the delivery of medical care across the world. The objective of the study is to understand and document the preventive steps implemented on geriatric services in the primary health care centers during COVID-19 pandemic. Design and Methods: This is a retrospective study carried on geriatric services utilization (Geriatric clinic- osteoporosis clinic – Memory and dementia clinic) in primary health care centers in Dubai Health Authority in 2020.Results: The study showed that the overall in person visits for all geriatric service in 2020 declined by almost 70%. The total number of telephone consultations in geriatric clinics, osteoporosis clinics and memory clinics were 1479, 1149 and 104 respectively. The COVID-19 pandemic had led to a reduction in most of the geriatric services including outpatient clinics, screening and referral. Telephone consultation provided a foundation for delivery of the service.Conclusion: This study reflected the potential for telehealth services to bring benefits and convenience to the geriatric population, even after the end of the pandemic.

Extramural gerontology management devising an integrating record for a geriatric care service, an experience report

ABSTRACT. The Gerontological Care Plan is idealized through case management that includes in its aspect engaging the elderly, self-care and the acquisition and maintenance of health-promoting behaviors. Objective: To evaluate the importance of a gerontological care plan, in a geriatric service of a referral hospital in the city of São Paulo. Methods: Fifteen older adult patients were interviewed and the Gerontological Care Plan (PAGe) was applied. Results: Most respondents were classified as independent for instrumental activities of daily living, 42% of whom lived alone. Data from 277 yellow sheets were analyzed, that is, referral forms, in which it was found that the most affected areas were: social work and psychology. For the social worker, the most recurring requests were: verification of the social support network, namely lack of companion and caregiver, with 53%; family problems, with 20%; lack of adherence to treatment, 12%, and problems related to medication, 10%. In the area of psychology, 82% of referrals were due to the need for psychological support, psychotherapy, and help with family problems, depression and grief. Conclusions: A gerontological management proposal was developed within the Geriatric Services of Hospital das Clínicas. The management plan was intended to integrate the actions carried out by the interprofessional team, through the creation of an Integrating Form that allowed the gerontologist to propose, execute and implement a plan of care, follow-up, and monitoring of cases, including the extra context-hospital.

SYSTEM-BASED SUPPORT OF IMPROVEMENT OF QUALITY OF LIFE FOR ELDERLY PEOPLE IN RUSSIA: OUTLOOK AND CHALLENGES

В статье рассмотрены проблемы и перспективы реализации функций системной поддержки деятельностиорганизацийздравоохраненияисоциального обслуживания населения в процессе оказания ими медицинских, социальных и психологических услуг гражданам старших возрастных групп (далее - Граждане), в частности в связи с преодолением кризисных ситуаций, таких как пандемия COVID -19. Представлены понятие, структура и алгоритм оказания комплексной медико-социальной помощи (далее - Комплексная помощь)Гражданам. Показано, что организация системы оказания Комплексной помощи позволит обеспечить повышение качества жизни Граждан и продление периода их активного долголетия за счет предоставления им услуг социального профиля в составе индивидуальных пакетов, сформированных на основе персонифицированного подхода. Приводится понятие и детализируются функции системной поддержки оказания Комплексной помощи Гражданам. Описаны условия организации системной поддержки на уровне отдельного региона. Анализируются состав, задачи и формы организации Гериатрической службы как базовой составляющей системы оказания Комплексной помощи Гражданам, проблемы организации согласованной работы подразделений Гериатрической службы, их взаимодействия с учреждениями социального обслуживания населения и профильными медицинскими организациями. Обоснована необходимость создания в составе Гериатрической службы специализированной научно-методической структуры - Центра системной поддержки. The article examines the outlook and challenges relating to the provision of system-based support of healthcare providers and social services in the course of delivering their healthcare, mental health and social services to elderly people, in particular amidst a crisis, such as the COVID-19 pandemic. The article gives the definition of integrated health and social care, its structure and the algorithm of delivering integrated health and social care to elderly people. The article argues that a system of integrated health and social care will improve the quality of life of older populations and extend their active longevity through a person-centered social services plan offered according to an older person’s needs. The article gives the definition and a detailed description of the goals of system-based support of integrated health and social care for older populations. It describes the conditions for providing such system-based support in one specific region of the country. The article analyses the structure, aims and type of entity of the Geriatric Service which is viewed by the authors as a building block of the system of integrated health and social care for elderly people, and discusses the issues relating to coordination of activities among various divisions of the Geriatric Service and their cooperation with social services and healthcare providers. The article explains why it is important to establish a special research and methodological unit - the Center for System-Based Support - within the Geriatric Service.

Implementing a Geriatric Fracture Program in a Mixed Practice Environment Reduces Total Cost and Length of Stay

Introduction: Geriatric-orthopaedic co-management models can improve patient outcomes. However, prior reports have been at large academic centers with “closed” systems and an inpatient geriatric service. Here we describe a Geriatric Fracture Program (GFP) in a mixed practice “pluralistic” environment that includes employed academic faculty, private practice physicians, and multiple private hospitalist groups. We hypothesized GFP enrollment would reduce length of stay (LOS), time to surgery (TTS), and total hospital costs compared to non-GFP patients. Materials and Methods: A multidisciplinary team was created around a geriatric Nurse Practitioner (NP) and consulting geriatrician. Standardized geriatric focused training programs and electronic tools were developed based on best practice guidelines. Fracture patients >65 years old were prospectively enrolled from July 2018 – June 2019. A trained biostatistician performed all statistical analyses. A p < 0.05 was considered significant. Results: 564 operative and nonoperative fractures in patients over 65 were prospectively followed with 153 (27%) enrolled in the GFP and 411 (73%) admitted to other hospitalists or their primary care provider (non-GFP). Patients enrolled in the GFP had a significantly shorter median LOS of 4 days, compared to 5 days in non-GFP patients (P < 0.001). There was a strong trend towards a shorter median TTS in the GFP group (21.5 hours v 25 hours, p = 0.066). Mean total costs were significantly lower in the GFP group ($25,323 v $29085, p = 0.022) Discussion: Our data shows that a geriatric-orthopaedic co-management model can be successfully implemented without an inpatient geriatric service, utilizing the pre-existing resources in a complex environment. The program can be expanded to include additional groups to improve care for entire geriatric fracture population with significant anticipated cost savings. Conclusions: With close multidisciplinary team work, a successful geriatric-orthopaedic comanagement model for geriatric fractures can be implemented in even a mixed practice environment without an inpatient geriatrics service.

THE PROBLEMATIC ISSUES OF PERSONNEL TO ENSURE THE DELIVERY OF GERIATRIC CARE

В статье отражены проблемы кадрового обеспечения оказания гериатрической помощи. Указано на необходимость совершенствования системы подготовки врачей-гериатров, в том числе на популяризацию этой специальности у медицинского персонала и населения. The article reflects the problems of personnel provision of geriatric care. this reflects a serious concern about the staffing of the geriatric service. The need to improve the system of training geriatric doctors, including the need to popularize this specialty among medical personnel and the population, is pointed out.

Evaluation of a Combined HIV and Geriatrics Clinic for Older People Living with HIV: The Silver Clinic in Brighton, UK

As life expectancy in people living with HIV (PLWH) has increased, the focus of management has shifted to preventing and treating chronic illnesses, but few services exist for the assessment and management of these individuals. Here, we provide an initial description of a geriatric service for people living with HIV and present data from a service evaluation undertaken in the clinic. We conducted an evaluation of the first 52 patients seen in the clinic between 2016 and 2019. We present patient demographic data, assessment outcomes, diagnoses given, and interventions delivered to those seen in the clinic. The average age of attendees was 67. Primary reasons for referral to the clinic included management of complex comorbidities, polypharmacy, and suspected geriatric syndrome (falls, frailty, poor mobility, or cognitive decline). The median (range) number of comorbidities and comedications (non-antiretrovirals) was 7 (2–19) and 9 (1–15), respectively. All attendees had an undetectable viral load. Geriatric syndromes were observed in 26 (50%) patients reviewed in the clinic, with frailty and mental health disease being the most common syndromes. Interventions offered to patients included combination antiretroviral therapy modification, further health investigations, signposting to rehabilitation or social care services, and in-clinic advice. High levels of acceptability among patients and healthcare professionals were reported. The evaluation suggests that specialist geriatric HIV services might play a role in the management of older people with HIV with geriatric syndromes.