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Literature Review for the Non-pharmacological Treatment of Geriatric DepressionWillis , Melissa Ann 13 May 2016 (has links)
No description available.
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A comparison of the opinions of public health nurses and their elderly patients regarding these patients' activities of daily livingBoyle, Lynda T. January 1966 (has links)
Thesis (M.S.)--Boston University / PLEASE NOTE: Boston University Libraries did not receive an Authorization To Manage form for this thesis or dissertation. It is therefore not openly accessible, though it may be available by request. If you are the author or principal advisor of this work and would like to request open access for it, please contact us at open-help@bu.edu. Thank you. / 2999-01-01
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Falls in older people in geriatric care settings : predisposing and precipitating factorsKallin, Kristina January 2004 (has links)
Falls and their consequences are a major health problem in the older population, increasing their immobility, morbidity and mortality. This thesis focuses on older people living in geriatric care settings, frail older people who are most prone to suffer falls. The aim was to study predisposing and precipitating factors associated with falls in older people with or without cognitive impairment. In a cross-sectional study with a one-year prospective follow-up for falls 63% of the 83 residents suffered 163 falls and 65% of the fallers fell more than once. The antidepressants selective serotonine reuptake inhibitors (SSRIs), impaired vision and being unable to use stairs independently were the factors most strongly associated with sustaining falls. Acute diseases were judged to have precipitated 32 % of the falls and drug side effects 9%. In another cross-sectional study with a one-year follow-up for falls, including 199 residents, previous falls and treatment with antidepressants (mainly SSRIs) were found to be the most important predisposing factor for falls. Acute disease was judged to be the precipitating factor alone or in combination, in 39% of the falls, medical drugs in 8%, external factors such as obstacles in 8% and other conditions both related to the individual and the environment, such as misinterpretation, misuse of roller walkers or mistakes made by the staff were judged to have precipitated 17% of the falls. In a population-based cross-sectional study including 3604 residents in geriatric care settings more than 8% sustained a fall at least once during the preceding week. A history of falls, the ability to get up from a chair, the need for a helper when walking, pain, cognitive impairment, use of neuroleptics and use of antidepressants were all associated with falls in multivariate analyses. In the subgroup of people with cognitive impairment (2008 residents) more than 9% had sustained a fall at least once during the preceding week. As for the whole population, being able to get up from a chair, previous falls, needing a helper when walking with the addition of hyperactive symptoms were the factors independently associated with falls. In a study with a one-year prospective follow up for falls, including 439 residents in residential care facilities, 63% sustained 1354 falls, corresponding to an incidence rate of 3.5 falls / person year. Thirty-three percent of the falls and 37% of the injurious falls occurred during the night (9pm-6am). There were significantly higher fall rates in the evening and in January, April, May, November and December. There were no associations between fall rates and any of the weather parameters studied. In conclusion falls and fall-related injuries in older people in geriatric care settings are common. Both predisposing and precipitating factors contribute to the risk of falling. Addressing precipitating factors for falls seems to be important in an individualised preventive strategy among older people in geriatric care settings.
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Emergency room referrals to a geriatric outreach team: the analysis of referral reasons.Kliewer, Sandra Sharon 23 August 2010 (has links)
The purpose of this study was to explore the referrals that were generated from one hospital emergency room to a community outreach team. This study used a specific geriatric program assessment team in Winnipeg, Manitoba, Canada as the community outreach team.
Malcolm Payne’s description of Task Centered Casework and Crisis Intervention and Irene Pollin’s Medical Crisis Counseling served as the theoretical structure and design to gain an understanding of the reasons geriatric patients were referred to the GPAT on discharge.
This study aimed to answer three research questions:
1) What is the emergency room medical team’s main reason for referral to a geriatric outreach team?
2) Are the referrals received from the emergency room medical team clearly identifying psychosocial issues as areas for examination by an outreach team?
3) Are psychosocial issues identified only after an outreach team clinician completed a comprehensive assessment?
This study revealed that out of the 209 referrals to geriatric program assessment team, the highest number of times referred was for functional decline. It revealed that the emergency room medical team saw functional decline as a valid reason to have the geriatric program assessment team assess the individual in their home settings to ensure that any functional issue be addressed and possible adaptations made in a timely manner to avoid the reverberation that one ailment can set off. The second most common reason for referring to the geriatric program assessment team was for social issues. Forty percent of the referrals identified that there were concerns in relation to social issues which clearly identifies that the emergency room medical team identified psychosocial issues as an area for further examination.
And finally, the findings show psychosocial issues were not identified only after an outreach team clinician completed a comprehensive assessment, but that both appear cognizant of the interplay between medical issues and social issues.
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Emergency room referrals to a geriatric outreach team: the analysis of referral reasons.Kliewer, Sandra Sharon 23 August 2010 (has links)
The purpose of this study was to explore the referrals that were generated from one hospital emergency room to a community outreach team. This study used a specific geriatric program assessment team in Winnipeg, Manitoba, Canada as the community outreach team.
Malcolm Payne’s description of Task Centered Casework and Crisis Intervention and Irene Pollin’s Medical Crisis Counseling served as the theoretical structure and design to gain an understanding of the reasons geriatric patients were referred to the GPAT on discharge.
This study aimed to answer three research questions:
1) What is the emergency room medical team’s main reason for referral to a geriatric outreach team?
2) Are the referrals received from the emergency room medical team clearly identifying psychosocial issues as areas for examination by an outreach team?
3) Are psychosocial issues identified only after an outreach team clinician completed a comprehensive assessment?
This study revealed that out of the 209 referrals to geriatric program assessment team, the highest number of times referred was for functional decline. It revealed that the emergency room medical team saw functional decline as a valid reason to have the geriatric program assessment team assess the individual in their home settings to ensure that any functional issue be addressed and possible adaptations made in a timely manner to avoid the reverberation that one ailment can set off. The second most common reason for referring to the geriatric program assessment team was for social issues. Forty percent of the referrals identified that there were concerns in relation to social issues which clearly identifies that the emergency room medical team identified psychosocial issues as an area for further examination.
And finally, the findings show psychosocial issues were not identified only after an outreach team clinician completed a comprehensive assessment, but that both appear cognizant of the interplay between medical issues and social issues.
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Features of Swedish municipal elderly and psychiatric group dwelling care after the 1990s health care reformations /Kristiansen, Lisbeth Porskrog, January 2006 (has links)
Diss. (sammanfattning) Stockholm : Karol. inst., 2006. / Härtill 6 uppsatser.
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Unethical behaviour in homes for the agedO'Donoghue, Carmelia Ellen 10 September 2012 (has links)
M.Cur. / The purpose of the research study is to describe guidelines to counteract unethical behaviour in homes for the aged by auxiliary nurses and care workers. The objectives are to explore and describe the factors related to the unethical behaviour in homes for the aged by auxiliary nurses and care workers by: Exploring and describing the perceptions of the auxiliary nurses and care workers relating to unethical behaviour of auxiliary nurses and care workers in homes for the aged; and Exploring and describing the perceptions of the registered nurses relating to unethical behaviour of auxiliary nurses and care workers in homes for the aged. The point of departure for the research was an uncovering of abuse in homes for the aged by M-Net's Carte Blanche team and the observations of the researcher over a long period of time
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Prädiktive Wertigkeit dreier onkogeriatrischer Screenings: G8, optimierter G8 sowie CARG (Hurria) Score bezüglich der Vorhersage schwerer Chemotherapie assoziierter Toxizität bei älteren KrebspatientenKotzerke, David Immanuel 05 March 2021 (has links)
Background: Older patients are vulnerable to chemotherapy-related toxicity (CRT). Therefore we evaluated
screening tools in their power to predict CRT.
Methods: Patients with cancer aged ≥65 years completed three screening questionnaires (G8, optimised G8 and
Cancer and Ageing Research Group (CARG). Additionally, Comprehensive geriatric assessment (CGA) for verification
of supportive care needs was undertaken on patients with impaired G8 scores. During chemotherapy
treatment patients were assessed, capturing grade 0–5 CRT as defined by NCI CTCAE 4.
Results: 104 patients with non-haematological cancers were included at three study sites. Median age was 73
years (range 65–85). Onco-geriatric screening detected 74% as impaired using G8 and optimised G8 questionnaires
and 86% using CARG screening. Grade 3–5 toxicity affected 64.4% of all patients. G8 (OR 0.3 95% CI
[0.1;1.0]) and optimised G8 (OR 0.4 95% CI [0.1; 1.5]) did not reliably predict CRT, whereas screening with
CARG demonstrated a strong prediction of severe CRT: OR 4.2, 95% CI [1.1, 15.9]. CGA was undertaken on 66 patients,
revealing deficiencies in nutritional (83%) and functional-status (54%) and occurrence of relevant comorbidity
(53%).
Conclusion: The CARG tool could be useful for predicting CRT. CGA showed clinically relevant supportive care
needs in patients with a positive G8 screening.:1. Einleitung ..................................................................................................................................... - 3 -
1.1 Epidemiologie der Krebserkrankungen bei älteren Patienten .................................................. - 4 -
1.2 Herausforderungen der geriatrischen Onkologie ..................................................................... - 5 -
1.3 Status Quo ................................................................................................................................. - 7 -
1.4 Geriatrisches Assessment (GA)................................................................................................ - 11 -
1.6 Geriatrisches Screening ........................................................................................................... - 13 -
1.5 Chemotherapie assoziierte Toxizität ....................................................................................... - 15 -
2 Ableitung der Studienrationale ...................................................................................................... - 17 -
3 Publikationsmanuskript .................................................................................................................. - 18 -
4 Zusammenfassung der Arbeit ........................................................................................................ - 26 -
5 Literaturverzeichnis der Einleitung ................................................................................................ - 29 -
6 Anlagen ........................................................................................................................................... - 35 -
7 Abkürzungsverzeichnis ................................................................................................................... - 52 -
8 Erklärung über die eigenständige Abfassung der Arbeit ................................................................ - 53 -
9 Lebenslauf – David Immanuel Kotzerke ......................................................................................... - 54 -
10 Spezifizierung des eigenen Beitrages ........................................................................................... - 56 -
11 Danksagungen .............................................................................................................................. - 58 -
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A Narrative Study of the Older Patient and Family Caregiver Experience of Alternate Level of CareCressman, Greg 10 1900 (has links)
<p>Alternate Level of Care, or ALC, is a designation assigned to a patient during an acute care hospital stay when that patient is occupying a bed but no longer requires that intensity of service. A high proportion of beds occupied by patients requiring ALC results in problems in the healthcare system related to patient flow, access, and efficiency. The purpose of this study was to better understand the experience of older patients and family caregivers while the patient is designated as requiring ALC. This study employed the Three-Dimensional Narrative Inquiry Space method of Clandinin and Connelly (2000) to examine the experiences of five patients and four family caregivers. The primary data source for this study was a series of semi-structured interviews with individual participants over time while they were in the midst of the experience of ALC. Data analysis involved a twofold process of restorying all interview transcriptions for a given participant into a single story summarizing his or her experience, and analyzing the content across stories to identify common themes. The major finding of this study was that uncertainty was a significant part of the experience of ALC. This uncertainty was manifest in relation to self-concept, waiting for placement, not knowing about information, not being included in planning, lack of mobility, and lack of meaningful activity. The study findings have implications for strategies to manage uncertainty in the areas of practice, policy, education, and research in order to improve the experience of older patients and their family caregivers.</p> / Master of Science (MSc)
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General Motor Function Assessment and Perceptions of Life Satisfaction during and after Geriatric RehabilitationÅberg, Anna Cristina January 2003 (has links)
<p>Two main goals of geriatric rehabilitation are to re-establish ability for physical function in order to facilitate independence in activities of daily living (ADL), and to promote an optimal degree of well-being, i.e. life satisfaction, in the individual. In this research a new scale, the General Motor Function assessment scale (GMF), was developed and evaluated. Subsequently, factors perceived as important for the life satisfaction of people undergoing geriatric rehabilitation were investigated. </p><p>The GMF includes both mobility and upper limb functions and comprises three subscales covering different aspects of functioning, namely performance-related Dependence, Pain and Insecurity. The clinical practicality of the GMF was evaluated by a field test. Its psychometric properties were analysed in both hospital and community-based settings of geriatric rehabilitation, using non-parametric statistical methods. The results indicated that the GMF is clinically adequate, possesses good reliability and is sensitive enough to demonstrate changes from pre- to post-intervention in different forms of geriatric rehabilitation. </p><p>For investigation of perceptions of life satisfaction, individual qualitative interviews were conducted with old (80+) care recipients and with their significant others, who had a helping relationship with them. The results revealed that habitual activity, independence and adaptation were generally considered to be important for the life satisfaction of the care recipients. Recalling of pleasant past memories in an effort to achieve current life satisfaction was a commonly used adaptive strategy among the care recipients. This strategy created a temporary sense of life satisfaction, with a potential for concealing dissatisfaction with conditions that might otherwise be correctable. From the perspective of the significant others, protection of the continuity of the care recipients’ self was seen as vital for the latter's life satisfaction, and was thus an underlying general purpose of the informal caregiving. </p>
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