Severe symptomatic aortic stenosis is a serious condition of elderly, mostly geriatric patients with a poor prognosis if the valve is not replaced. Since geriatricians are able to provide major expertise in the prognostic assessment as well in the clinical management of these patients, they need to be more closely involved in the decision making process. For this reason the European Union Geriatric Medicine Society (EUGMS) represented by the authors phrased three propositions: (1) geriatricians need to be aware of the impact of severe aortic stenosis on patients outcomes and should be encouraged to take an active role in aortic stenosis management; (2) they need to be aware of treatment options and are required to support multidisciplinary teams with their expertise in assessing geriatric patients; (3) they should routinely perform a comprehensive geriatric assessment in patients with severe aortic stenosis scheduled to undergo surgical or transcatheter aortic valve replacement and during ...
Multidisciplinary approach reduced readmissions in patients with CHF. The optimal management of elderly persons after hospital discharge as well as those living independently in the community has generated intense interest. The extensive literature on this subject is complemented by these 2 well-designed studies: 1 tested the hypothesis that intensive follow-up after hospital discharge in patients with CHF will reduce costs and hospitalizations; the other tested the hypothesis that in-home comprehensive geriatric assessments will help prevent disability among elderly persons. Several points made by the 2 studies invite comment. In both studies, the intervention increased quality of life and functional outcomes, which were primary outcomes of the study by Stuck and colleagues. In this study, however, the rates of admission to acute care hospitals and short-stay nursing homes were not reduced. In addition, organizing a full-scale geriatric outreach program with geriatrician-supervised, specially ...
Older patients are at high risk for poor outcomes after acute hospital admission. The mortality rate in these patients is approximately 20%, whereas 30% of the survivors decline in their level of activities of daily living (ADL) functioning three months after hospital discharge. Most diseases and geriatric conditions that contribute to poor outcomes could be subject to pro-active intervention; not only during hospitalization, but also after discharge. This paper presents the design of a randomised controlled clinical trial concerning the effect of a pro-active, multi-component, nurse-led transitional care program following patients for six months after hospital admission. Three hospitals in the Netherlands will participate in the multi-centre, double-blind, randomised clinical trial comparing a pro-active multi-component nurse-led transitional care program to usual care after discharge. All patients acutely admitted to the Department of Internal Medicine who are 65 years and older, hospitalised ...
Methods and Results-This is a prospective study of 487 patients aged ≥75 years admitted for decompensated heart failure. At discharge, a CGA score (range, 0-10) was calculated based on limitation in activities of daily living, mobility limitation, comorbidity, cognitive decline, and previous medication use. The analysis of the association between the CGA score and 2-year subsequent mortality was performed with Cox regression and adjusted for the main confounders. A 1-point increase in the CGA score was associated with a 19% higher mortality (hazard ratio, 1.19; 95% confidence interval, 1.11-1.27). Results were similar regardless of age, sex, left ventricular ejection fraction, and the coexistence of atrial fibrillation, ischemic heart disease, or hypertensive cardiopathy. All components of the CGA score showed a consistent association with higher death risk: the hazard ratio (95% confidence interval) of mortality was 1.78 (1.25-2.54) with ≥3 versus 0 limitations in activities of daily ...
Methods and Results-This is a prospective study of 487 patients aged ≥75 years admitted for decompensated heart failure. At discharge, a CGA score (range, 0-10) was calculated based on limitation in activities of daily living, mobility limitation, comorbidity, cognitive decline, and previous medication use. The analysis of the association between the CGA score and 2-year subsequent mortality was performed with Cox regression and adjusted for the main confounders. A 1-point increase in the CGA score was associated with a 19% higher mortality (hazard ratio, 1.19; 95% confidence interval, 1.11-1.27). Results were similar regardless of age, sex, left ventricular ejection fraction, and the coexistence of atrial fibrillation, ischemic heart disease, or hypertensive cardiopathy. All components of the CGA score showed a consistent association with higher death risk: the hazard ratio (95% confidence interval) of mortality was 1.78 (1.25-2.54) with ≥3 versus 0 limitations in activities of daily ...
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies. ...
Anxiety and depression are the two most prevalent illnesses among patients, and in the general population. Because these two mood disorders are frequently co-morbid they can have especially problematic outcomes. The nature of these mood disorders can make filling out long questionnaires difficult if patients are suffering from fatigue or loss of concentration. Furthermore, time is at a premium in any clinical practice. Therefore, the Patient Health Questionnaire-4 (PHQ-4) was developed and validated by Kroenke, Spitzer, Williams, & Lowe, (2009) in order to address these needs ...
For older patients hospitalized with heart failure, a comprehensive geriatric assessment (CGA) score is associated with mortality over two years.
Patients ≥ 75 years who have undergone surgery for colon cancer stage III, are eligible for inclusion in the study. Non-eligibility includes patients with obvious impaired cognitive or physical function or patients living in nursing homes. After signing informed consent, the patients first undergo geriatric assessment. Patients that are classified as having fit or intermediate function, and with no significant cardiovascular disease, are randomized with a 2:1 randomization process to either chemotherapy (Arm A: Capecitabine 1000 mg/m2 bid day 1-14 q3 weeks, 8 cycles) or no chemotherapy (Arm B: observation).. The purpose of this study is to examine the tolerability of chemotherapy in elderly (, 75 years) patients operated on for colon cancer stage III. There is little evidence of benefit and tolerability of this therapy in the elderly; it is recommended individual consideration in elderly. In the study, a comprehensive geriatric a comprehensive geriatric assessment is performed first, to ...
Joyce Hamelin, MSW, RSW, has been practicing in the Ottawa area for 30 years. She has worked in a variety of social work positions with individuals and families across the lifespan. Presently, and for the past 13 years, Joyce holds a full-time position as a Geriatric Assessor with the Regional Geriatric Program of Eastern Ontario. As such, she has developed skills in completing in-home, geriatric assessments; and providing supportive interventions to her older adult clients and their caregivers, as a member of a multidisciplinary Geriatric Outreach Assessment team. Joyce has been pursuing her interest in teaching/public speaking for the past 15 years. She has been a Professor at Algonquin College in Ottawa, teaching a variety of subjects in the Department of Social Sciences, both in the classroom and now with online virtual classrooms. Currently, Joyce is an online facilitator, teaching Psychology and Communication and Interpersonal Skills with Dementia Care Clients. The focus of intervention is ...
General approach to care of the elderly: Essential principles in the care of the elderly / William Reichel, Chrine Arenson, and Jan Busby-Whitehead; The biology of aging / Allyson K. Palmer and James L. Kirkland; Comprehensive geriatric assessment / Rachel Mason and John D. Gazewood; Prevention and screening / James T. Birch, Jr., and Shelley Bhattacharya; Appropriate use of medications in the elderly / Emily R. Hajjar, Amber E. King, and Lauren R. Hersh; Healthy aging : exercise and nutrition as medicine for older adults / Diane Villanyi, Maria A. Fiatarone Singh, and B. Lynn Beattie; Geriatric syndromes: Frailty / Mindy J. Fain and M. Jane Mohler ; Gait impairment and falls / Daina L. Sturnieks and Catherine Sherrington; Evaluation and management of dizziness / Samuel C. Durso and David Newman-Toker; Evaluation and management of dementia / Lauren Collins, Barry W. Rovner, and Kadesha Collins-Fletcher; Recognition, management and prevention of delirium / Lindsay A. Wilson and Margaret ...
Limited data are available on the treatment of older adults with cancer. Comorbidities may preclude the administration of effective therapies, particularly in the extreme elderly. Comprehensive geriatric assessment can identify specific weaknesses of the patient and predict unexpected toxicities, thus enabling an optimized treatment strategy in this population. We report a case of the successful management of a 99-year-old female lymphoma patient with a strong wish for active treatment to improve quality of life and prolong survival past her 100th birthday ...
Our mission at the Senior Health Clinic is to promote healthy aging by keeping older adults well, active and independent for as long as possible. Because our clinic is devoted exclusively to the service of older adults, our staff and services are uniquely sensitive to their needs and abilities. We are able to distinguish between the normal changes caused by aging and changes caused by disease. Illnesses that linger are an unfortunate accompaniment of old age, but sometimes older people with multiple chronic health problems assume they have to cope with continued symptoms and disability. A comprehensive geriatric assessment can determine what conditions are present and determine if increased or different care could help patients improve. With this approach, the best care can be identified ...
Background:. In patients with COPD, a preserved BMI may improve survival. However, the implications for function and health status have not been fully established. We hypothesised that obese patients would have reduced physical capacity and more impairments than non-obese patients with COPD and comparator subjects.. Method:. As part of a longitudinal study of co-morbidities in COPD (ARCADE), 400 patients (COPD confirmed with spirometry) and 100 comparator subjects (past or current smokers) free from respiratory disease were assessed. In all subjects, spirometry, BMI, six minute walk distance (6MWD), the Timed Up and Go (TUG) and physical, medical, functional and psychosocial impairments using the Comprehensive Geriatric Assessment (CGA) were determined. Patients also completed the St Georges Respiratory Questionnaire (SGRQ) and were categorised by BMI.. Results:. Patients and comparators were similar in gender and BMI COPD 28.0(5.5) comparators 28.5(4.6) kg/m2, and had similar proportions ...
Comprehensive Geriatric Assessment and Transitional Care in Acutely Hospitalized Patients: The Transitional Care Bridge Randomized Clinical Trial. In a double-blind, randomised 5-cell cross-over 4-day plaque regrowth study, 19 volunteers rinsed 2 x a day with 15 ml of each of the ...
Fingerprint Explore the research topics touched on by this project. These labels are generated based on the underlying awards/grants. Together they form a unique fingerprint. ...
Dr. Cohens research program includes clinical research relating to aspects of the pathways to functional decline with aging, geriatric assessment, and cancer in the elderly. Pathways to functional decline are being explored through the NIA funded Claude Pepper Older Americans Independence Center, and includes studies of the contributions of age related physiologic change, in particular changes in inflammatory parameters, comorbid diseases and conditions, environment, genetics, and the interactionas among them.
Dr. Cohens research program includes clinical research relating to aspects of the pathways to functional decline and reilience with aging, geriatric assessment, and cancer and anemia in the elderly.
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A geriatric care manager is someone who can be hired to assess an older persons social and medical needs, arrange services and monitor care.
The Invacare® 3-Position Deluxe Geriatric Recliner recliner offers a contoured seat and back with lumbar support for all day comfort. Suitable for home or clinical use - EnableYourLife.com
MODEL RELEASED. Geriatric care. Nurse putting a plaster on an older mans arm after giving him an injection. - Stock Image C007/3988
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Beefy and I are totally turning into old people. We got up at 6 am (on a Saturday!) to grocery shop and then headed out to look for birds. Next thing you know, well be lunching at Golden Corral and talking about how easy young folks have it these days ...
GAL COSTA. You get the feeling that the tropicalia subversives were really trying to make a hit with this one, and its all the better for it. Beck would have to become a scientologist to make this...er...wait a minute.... ...
With a growing population of people ,65 years of age, there is an increasing focus on identifying and evaluating interventions that maintain elderly people in their own homes for as long as possible. This study examined whether an in-hospital, comprehensive geriatric assessment alone or combined with an interdisciplinary home intervention after discharge would affect mortality, functional status, rehospitalisation, nursing home placement, and direct costs.. The results of this study support the work done in the Program for All-inclusive Care of the Elderly (PACE), begun in San Francisco.1 By using a comprehensive assessment that addresses both functional and medical concerns, care can be coordinated and provided to meet the needs of older people. However, of note in the study by Nikolaus et al is the finding that comprehensive geriatric assessment alone did not improve outcomes. The addition of a home intervention team accounted for improvement in outcomes. These findings can help gerontological ...
Cancer researchers warned Monday that the number of elderly cancer patients would likely double from 2000 to 2030, creating huge challenges to healthcare systems worldwide.
The purpose of this study was to compare the validity of the 15-item Geriatric Depression Scale (GDS-15) in nonelderly (,65 years), young-elderly (age, 65-75), and old-elderly (,75 years) patients with Parkinsons disease (PD). 57 nonelderly, 88 young-elderly, and 81 old-elderly PD patients were administered the GDS-15 and the Structured Clinical Interview for DSM-IV depression module. Receiver-operating characteristic (ROC) curves were plotted for GDS-15 scores against a DSM-IV diagnosis of major or minor depression. The discriminant validity of the GDS-15 was high for nonelderly, young-elderly, and old-elderly subjects (ROC area under curve = 0.92, 0.91, and 0.95, respectively), with optimal dichotomization at a cut-off of 4/5 (85% sensitivity and 84% specificity in nonelderly; 89% sensitivity and 82% specificity in young-elderly) and 5/6 (90% sensitivity and 90% specificity in old-elderly). In conclusion, the GDS-15 has comparable validity in younger and older PD patients, suggesting its ...
© 2015, Springer-Verlag Berlin Heidelberg. Background: Anemia and hypoalbuminemia (HA) are acknowledged independent risk factors for morbidity and mortality in geriatric patients and are associated with nutritional status and frailty. Data exist regarding the association between albumin and frailty, anemia and frailty as well as frailty and nutritional status; however, there is a lack of information on the association between HA, anemia and nutritional status in older people. Patients and methods: This study retrospectively analyzed 626 patients admitted to a German geriatrics department (average age 81.1 years, 68.2 % female and 31.8 % male) for anemia and HA. Data from the comprehensive geriatric assessment (CGA) and from the mini-nutritional assessment (MNA) were available in all patients. Results: Patients with anemia suffered significantly more often from HA (p | 0.001) than patients without anemia, with an odds ratio (OR) of 1.99 (95 % confidence interval CI: 1.2-3.2) and of 5.41 (CI 95 %: 2.3-12
Geriatric Care at the Riverside Geriatric Assessment Center focuses on the needs of patients who are age 50 and older while addressing the multiple problems that may occur with aging.
Once a person has been identified as frail, a holistic review by a GP will allow for optimisation of the persons health and for considered forward care planning. It may involve onward referral for a more Comprehensive Geriatric Assessment by an interdisciplinary team. An appropriate period of time should be put aside to allow for this holistic review (it is likely to take at least 45 - 60 minutes - depending on how well the individual is known to the GP or specialist nurse doing the assessment). It may be appropriate to invite relatives and carers to be present at the assessment as well as any care workers involved with the individual. The setting of the review can be agreed with the patient; however the physical examination needed as part of this assessment will limit choice.. Underlying diagnoses and reversible causes for these problems must be considered and addressed as part of the assessment.. In looking for cognitive impairment, it is helpful to use a standardised cognitive assessment ...
Executive Summary Comprehensive geriatric assessment (CGA) is a multidimensional and usually interdisciplinary diagnostic process designed to determine a frail older persons medical conditions, mental health, functional capacity and social
Kim SW, Han HS, Jung HW, et al.. JAMA Surg 2014;149:633-40. Publication date: July 1, 2014. Summary. The number of older patients who undergo surgery is increasing, and these patients often have comorbid conditions that may lead to postoperative mortality and morbidity. Therefore, it is important to identify at-risk patients. Yet, there are insufficient tools to predict postoperative outcomes in older patients.. The authors performed a single-center prospective cohort study aimed to develop a scoring model to predict unfavorable outcomes and prolonged hospital stays quantitatively after surgery. A comprehensive geriatric assessment (CGA) was performed in 275 consecutive patients aged 65 years or older undergoing intermediate- or high-risk elective operations at the Seoul National University Bundang Hospital, South Korea. The primary outcome measure was 1-year all-cause mortality. Secondary outcomes were postoperative complications, length of hospital stay, and discharge to a nursing ...
Comprehensive Geriatric Assessment - Each newly admitted resident is seen by Dr. Elizabeth Baum, MD, CMD, and/or Abbey Baum-Beigie, ANP-BC, FGNLA within 24 hours of admission to develop a team approach to medical treatment and nursing care. Residents are followed closely by nursing staff and medical providers throughout admission to Bethany. These assessments are focused on treating all parts of the resident and are updated quarterly by the Bethany interdisciplinary team. ​. Bethany accepts Medicare A, Aultcares Primetime Plan, some Aetna Managed Care Plans, the Health Plan/Hometown, United Health Care, and Caresource. If a patient is ineligible for a skilled rehab stay they can also pay privately for a room and receive therapy benefits under their Medicare Part B benefits. ​. ...
Weve shown that an aged immune system can combat cancer just as well as a young one if you remove the impediments to successful immunity, which are different that those in younger hosts," Dr. Curiel said. "Weve shown that if you test all your immune therapy just in young mice and young people, youll never learn how it works in older patients - the ones most at risk for cancer. You might conclude that drugs dont work in aged hosts, when they do. But they have to be combined with some help.". After discovering this in melanoma, the researchers then looked at whether the same action held true in colon cancer, a major cancer killer in the elderly.. "The details were different in colon cancer. The bad immune cells that increased in the aged mice and how they were knocked down by the drugs were different than in melanoma," Dr. Curiel said. "But the result was the same - we identified a drug combination that was highly effective in the aged mice.". That means that not only must this strategy be ...
Recently, the International Society of Geriatric Oncology released a position paper where the obligatory integration of a comparable form of geriatric assessment is strongly recommended in future studies (Wildiers, 2013). The Multidimensional Prognostic Index (MPI) has been developed from a complete CGA and, differently from it, MPI may be administered and scored in a consistent manner. In order to answer this prioritary issue of geriatric oncology, the second project of this doctoral research program has been devoted to validate the MPI in patients with advanced cancer (Pilotto, 2008) to predict the 6 and 12-months overall mortality risk. In addition to estimate the tumor-independent survival, a CGA is essential when planning a cancer treatment as it uncovers medical conditions that may worsen the chemotherapy toxicity reported in clinical trials involving younger patients (Balducci, 2007). Despite there is strong evidence that any treatment decision in elderly cancer patients should be ...
The U-M Geriatrics Center offers a full array of patient care services and programs as part of our mission to provide comprehensive health care to our aging community. Our goal is to help adults over the age of 60 lead healthier and more satisfying lives. With this aim, the Geriatrics Center offers primary care, specialty care, transitional and sub-acute care as well as geriatric assessment and consultation. In fact, the Geriatrics Center is a national leader in the development and implementation of novel and effective treatments and therapies in the provision of care for older individuals.. We are pleased that we have long been recognized as one of the countrys best geriatrics programs by U.S. News and World Report. Geriatrics Center physicians are among the most accomplished clinicians, researchers and educators in the field of geriatrics and aging. Geriatric Medicine physicians are highly-trained specialists who provide both primary care and consultative services. In addition, Geriatrics ...
Two focus group sessions last week launched the public portion of a review of community geriatric care on the Saanich Peninsula and Gulf Islands.. Island Health is currently in the process of assessing the regions need for local geriatric care in the face of new funding models.. Dr. Marilyn Bater, a physician specializing in geriatric care for 23 years, is the lead physician on Island Healths committee looking to redesign community geriatric care.. "Island Health is in the middle of re-organizing and we are facing budget changes," she said. "We have known for a while that we are going to have to look at how we deliver geriatric care in any case.". Thats due to the changing demographic, she explained, meaning people are living longer and many are facing complex health conditions, some with variety of issues that become more pronounced as they get older.. Island Health currently provides community geriatric care on the Saanich Peninsula and Gulf Islands. Operating out the Peninsula Health Unit ...
Instrumental activities of daily living (IADLs) are things you do every day to take care of yourself and your home. They are one way to measure how well you can live on your own. While activities of daily living (ADLs) are basic self-care tasks like bathing, IADLs require more complex planning and thinking.. Sometimes aging and health problems make it hard to do these tasks. You might not even notice that you cant do them as well as you used to. Often, the first sign that someone needs a little extra help is when that person cant do IADLs.. Your doctor uses IADLs to measure how much help you need. Knowing what you can and cant do for yourself is an important first step to getting help. And when you have the help you need, you can stay as independent as possible.. Your doctor will want to know if you are able to do tasks such as:. ...
Subjective health and quality of life among elderly people living with chronic multimorbidity and difficulty in activities of daily living in rural South Africa
Findings published in the March 31 issue of NEJM suggests that a combination of weight loss and exercise provides greater improvement in physical function than either intervention alone in older adults who are obese.. In this 1-year, randomized controlled trial, researchers evaluated the independent and combined effects of weight loss and exercise in 107 adults who were 65 years of age or older and obese. Participants were randomly assigned to a control group, a weight-management (diet) group, an exercise group, or a weight-management-plus-exercise (diet-exercise) group. The primary outcome was the change in score on the modified Physical Performance Test. Secondary outcomes included other measures of frailty, body composition, bone mineral density, specific physical functions, and quality of life.. A total of 93 participants (87%) completed the study. In the intention-to-treat analysis, the score on the Physical Performance Test, in which higher scores indicate better physical status, increased ...
Findings published in the March 31 issue of NEJM suggests that a combination of weight loss and exercise provides greater improvement in physical function than either intervention alone in older adults who are obese.. In this 1-year, randomized controlled trial, researchers evaluated the independent and combined effects of weight loss and exercise in 107 adults who were 65 years of age or older and obese. Participants were randomly assigned to a control group, a weight-management (diet) group, an exercise group, or a weight-management-plus-exercise (diet-exercise) group. The primary outcome was the change in score on the modified Physical Performance Test. Secondary outcomes included other measures of frailty, body composition, bone mineral density, specific physical functions, and quality of life.. A total of 93 participants (87%) completed the study. In the intention-to-treat analysis, the score on the Physical Performance Test, in which higher scores indicate better physical status, increased ...
What Community Geriatric Resources Are Available In Your County? In the fall of 2014, Center for Healthy Aging staff conducted focus groups with primary care physicians throughout Western North Carolina about their experience providing care to older adults - what they liked, what challenges arose, and what they wanted more training in. See results here.. Several physicians said they wanted to know what community-based services were available to help older adults continue living independently. In response, we have compiled the following county-specific lists of geriatric resources available - helping older adults live independently and addressing common geriatric syndromes such as dementia, depression, and fall risk. Many thanks to consultant Rebecca Chaplin for compiling these lists. Please share these lists with patients and send updated information to [email protected] Let us know how you use the lists and what you think of them!. ...
Learn from the most trusted educators in geriatric massage the teaching of safe, appropriate and life-enhancing techniques for use in elderly massage. We offer valuable hands-on learning with geriatric clients-the number one fastest-growing population in the U.S. Our number one priority is to administer appropriate care to this vital generation. Adding geriatric massage to your skill set is also a way for you to rapidly increase your client base and expand your income potential-all while fulfilling your need for continuing education! (18 CE hours) Fri (6:30-9:30), Sat (9-5), Sun (9-5). ...
Learn from the most trusted educators in Geriatric Massage the teaching of safe, appropriate, and life-enhancing techniques for use in elderly massage. We offer valuable hands-on learning with geriatric clients-the number one fastest-growing population in the U.S. Our number one priority is to administer appropriate care to this vital generation. Adding Geriatric Massage to your skill set is also a way for you to rapidly increase your client base and expand your income potential-all while fulfilling your need for continuing education! (18 CE hours) Fri (6:30-9:30), Sat (9-5), Sun (9-5). ...
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Vaccines really do help save lives, which is why weve answered some of the most frequently asked questions about elderly vaccines.