Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “GERIATRICS”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 595 records · Page 33Linked to original sources
PubMed2004

Geriatric assessment in elderly patients with prostate cancer.

As a result of demographic evolution, oncologists will treat more and more elderly patients with prostate cancer. Aging is frequently associated with the coexistence of several medical complications that can increase the complexity of cancer treatment decision-making. Unfortunately, clinical oncologists need to be more familiar with the multidimensional assessment of elderly patients. To acquire this skill, we implemented a multidimensional geriatric assessment program at our cancer center. This instrument prospectively assessed 60 elderly patients with prostate cancer. Herein, we describe geriatric aspects detected in our patient sample and report treatment options proposed to elderly patients with prostate cancer at different disease stages. The minimal comprehensive geriatric assessment (mini-CGA) procedure revealed that 66% of our patient population was dependent in one or more of the Katz Activities of Daily Living and 87% were dependent in 1 or more of the Lawton Instrumental Activities of Daily Living; all patients had significant comorbidity according to the Cumulative Illness Rating Scale-Geriatrics, 75% having at least one severe comorbidity. We identified 19 cases of drug interaction. We also observed that half of these patients had a risk of falling and some physical disability; 45% had cognitive disorders requiring more investigation; one third had depressive symptoms. Finally, 65% of the patients were either malnourished or at risk of malnutrition. Many of these problems were unknown before the mini-CGA processing and may interfere with cancer and cancer treatment. Thus, the correct management of elderly patients with cancer requires comprehensive geriatric assessment as well as relevant disease staging at diagnosis. This approach will help us to propose the most appropriate treatment with the main aim of preserving quality of life.

Activities of Daily Living↗
PubMed2006

[Task analysis of Korean geriatric care managers].

PURPOSE: This study was designed to create a job description for Korean geriatric care managers and examine performance frequency, importance, and difficulty of task elements. METHOD: The sample consisted of 38 geriatric care managers and professors who performed duties related to geriatric care management at community based-facilities in Korea. A survey method was used, and the questionnaire included frequency, importance, and difficulty of task elements in job descriptions using the DACUM method. Using SPSS WIN 10.0, descriptive statistics such as frequency distribution, means, and standard deviation were conducted to examine the subject's general characteristics, frequency, importance, and difficulties of task performance. RESULT: The job description of geriatric care managers revealed 10 duties, 34 tasks, and 105 task elements. On all ten duties, the average performance frequency, importance, and difficulty was 2.55, 2.21 and 2.43 respectively. CONCLUSION: The job description of geriatric care managers includes duty, task, and task elements and the definition of a completed job. Thus we recommend a data based trial to confirm and validate the information gathered.

Adult↗
PubMed1988

A descriptive framework for new hospital roles in geriatric care.

Changes in demographics and in the operating environments of acute care hospitals have resulted in the development of new geriatric service products. Presented in this article is a framework for describing the variety of new services in terms of sponsor goals and core activities. Five broad types of geriatric service developments are described: geriatric medical care, post-acute care, transition management, chronic care, and information services. Assessing the implications of new services for the organizational functioning of hospitals is discussed, followed by an examination of the potential contributions of new geriatric services to the quality and accessibility of geriatric care.

Acute Disease↗
PubMed2000

Development and implementation of a geriatric care/case management program in a military community-based family medicine residency.

This article discusses how the development of a longitudinal geriatric assessment form facilitated a case management program in identifying high-risk frail elders within a military family practice clinic. A careful review of geriatric assessment tools was performed. From this review, a model geriatric assessment form was developed. A "SWOT" (strengths, weaknesses, opportunities, and threats) analysis of the family medicine department was completed to determine if the environment was ready for case management. Analysis of the SWOT data revealed that the environment was favorable for a population-based approach to case management. Results of this initial study are encouraging. The new longitudinal geriatric assessment form has assisted family practice residents in organizing problems and data while seeing elderly patients. As a direct result, higher-risk frail elders have been identified for closer evaluation and follow-up. Future goals are to measure outcomes-based data and to refine the geriatric assessment process.

Aged↗
PubMed2001

[Heparin use in geriatrics and risk profiles of treated patients. A survey in France].

OBJECTIVES: Nursing home residents and geriatric ward patients have a high risk of venous thromboembolism. Prevention is a major challenge. We conducted a one-day audit to ascertain heparin use patterns in a large sample of geriatric facilities in France. METHODS: This one-day audit was made with a questionnaire mailed to 150 geriatric centers in France. Items were the number of subjects receiving heparin on the day of the survey, and for each of these subjects, the reason for the prescription, risk factors for venous thromboembolism and date of treatment onset. RESULTS: Ninety-six centers (63%) participated. These centers had 14,208 beds the day of the survey (short-term hospitalization, day-care hospitalization, nursing homes, retirement homes). These centers reported 1,312 subjects (9.2%) receiving heparin on the day of the survey. Their mean age was 83.4 days. Among the hospital centers, heparin had been prescribed in 33.4% of the short-term hospitalization patients, 27.3% of the day-care patients, and 5.6% of the nursing home patients. Heparin was prescribed for prophylaxis in 1,143 patients (87%)--basically low-molecular-weight heparin. These patients had on the average 3.33 risk factors. The duration of preventive treatment was more than 30 days in 481 subjects (50%) and 161 (17%) had received heparin for 6 months or more. CONCLUSION: Prevention of venous thromboembolism is a major concern in geriatric centers in France. Although the preventive efficacy has not been clearly demonstrated in geriatric medical patients, low-molecular weight heparin is widely used for this purpose with, in a large number of cases, very long treatment durations.

Aged↗
PubMed2004

[Delayed discharge of older patients from the Department of Geriatric Medicine of the Erasmus Medical Centre and factors affecting the length of stay; July 2001--June 2002].

OBJECTIVE: To determine how the discharge of older patients proceeds and what factors affect it. DESIGN: Descriptive. METHOD: Data were collected on the 123 patients admitted to the Department of Geriatric Medicine of the Erasmus Medical Centre in Rotterdam, the Netherlands: retrospectively, from the patient files, for the admissions in the period from 1 July 2001 to 31 March 2002, and prospectively for the admissions between 1 April and 30 June 2002. Key figures in the discharge process were also interviewed during the period from 1 September to 21 November 2002. RESULTS: The average age was 83.5 years (SD: 7); 34% were males. The average duration of treatment was 13 days while the average length of admission was 22 days. There was an average of 10 days between the request from the Geriatrics Department to discharge from the hospital, via a care office for an additional-care facility, an Aftercare Office and a Regional Indicating Office (RIO). Patient characteristics that were associated with a longer duration of admission and a longer discharge procedure were: discharge to a somatic nursing home, a diagnosis of 'delirium' or 'dementia', and living independently at home before admission. Patients who were known to the Geriatrics Department (either via the outpatient clinic or via a previous admission) had a shorter duration of admission. Of all the indication decisions of the RIO, only one deviated from the recommendation of the Geriatrics Department. CONCLUSION: The average duration of admission was 9 days longer than the average duration of treatment. The discharge procedure could be accelerated by simplifying the bureaucratic process surrounding indication and referral to an additional-care facility and by accepting the recommendations of the Geriatrics Department.

Aged↗
PubMed2006

[What's new in geriatric oncology?].

Remarkably, although 60% of new cancer cases and over 70% of cancer deaths occur in patients aged 65 years and older in Europe, standard treatment strategies have been mostly validated in younger adults. This demographic trend has led to the emergence of a new medical discipline, geriatric oncology and the development worldwide of geriatric oncology programs for the individualized management of elderly cancer patients. Elderly cancer patients represent an increasing share of the population and strategies for treating cancer must evolve to face this ineluctable reality. Treatment should take into account the highly heterogeneous physiological age of the elderly, their individual life expectancy, functional reserves, social support and preferences. French geriatric oncology programs have been mostly based on the interdependence of geriatricians, oncologists and auxiliary nursing people. This approach represent the best way to offer patients optimal management; oncologists and geriatricians collaborate to assess both global health status by means of Comprehensive Geriatric Assessment (CGA) and tumor stage by means of Comprehensive Tumor Assessment (CTA) and to initiate individualized care plans, involving comprehensive management and follow-up of all identified problems. This paper focuses on progress observed in the field of geriatric oncology both in France and worldwide.

Aged↗
PubMed2006

A national survey of family medicine residency education in geriatric medicine: comparing findings in 2004 to 2001.

BACKGROUND AND OBJECTIVES: We compared findings from this 2004 survey with our 2001 survey to determine progress in family medicine residency programs' efforts to better train residents to care for America's aging population. METHODS: A survey was mailed and made available on-line to all 470 family medicine residency directors in the United States. RESULTS: The response rate was 71%. Ninety-six percent of family medicine residencies have a required geriatrics curriculum, compared to 92% in 2001. There was a significant increase in the number of required lecture hours in geriatrics in 2004 as compared to 2001. Since 2001, the median number of MD geriatrics faculty per program has nearly doubled from .5 full-time equivalent (FTE) to .9 FTE. Conflicting time demands with other curricula was ranked as the most significant barrier to geriatrics education in both 2004 and 2001. However, in 2001, the attitude of residents was listed as a significant barrier by 32.1% of the program directors as compared to just 3.6% in 2004. CONCLUSIONS: Family medicine educators are continuing to improve the training of residents to provide state-of-the-art care for the aging population. Faculty must take advantage of this period of experimentation in residency education to identify best practices for geriatrics education.

Aged↗
PubMed2006

[The handling of acute life-threatening choking in geriatric and nursing home patients].

It is unknown how often choking occurs in geriatric wards and in nursing homes and what the treatment and outcomes are in regular practice. A questionnaire was sent to Dutch geriatricians (N = 130), nursing home physicians (N = 130), and trainees for these disciplines (N = 215), in order to gain information about the experience, practice and competence of physicians in choking in geriatric and nursing home patients. We also analysed to what extent geriatric and nursing home wards were prepared for accurate handling of choking. The response rate was 30%. More than half of the responders had experienced an episode of food choking at least once in the past five years. The mortality rate in the reported cases was high (30%). The majority of the patients who died of choking had not received the Heimlich-manoeuvre. Physicians who had attended resuscitation training long ago felt as competent to manage a choking episode as physicians that had recently attended resuscitation training. Of all geriatric wards and nursing homes, the majority lacked a guideline on how to handle in acute food choking. Geriatric wards and nursing homes do not seem to be well prepared for acute food choking in several aspects. Despite methodological shortcomings of this study, the results underline the necessity of clarification of the terms used, and development and implementation of guidelines for this important problem.

Acute Disease↗
PubMed2006

[Effectiveness of teaching gerontology and geriatrics in students of the 1st Faculty of Medicine, Charles University in Prague].

BACKGROUND: Increasing number of seniors in the society requires more university-degree educated professionals--health care professionals, social care workers and managers with basic exposure to and knowledge of gerontology and geriatrics. The aim of our paper was to evaluate the effectiveness of undergraduate training of gerontology and geriatrics among students of the 1st Faculty of Medicine, Charles University in Prague. METHODS AND RESULTS: To get information about knowledge of medical students and students of ergotherapy and physiotherapy and about their attitudes towards senior citizens we conducted a survey using two anonymous questionnaires prepared in our department and piloted earlier. The survey ran during the academic year 2004/2005. Students completed identical questionnaires twice, first time before the start of the clinical rotation and second time after the training end (n=134). Evaluation of knowledge and attitudes confirmed that one to two weeks clinical rotation at Department of Geriatrics was effective and increased knowledge of students in the topic trained. The percentage of correct answers in all three evaluated training programmes increased after the completion of the clinical rotation and reached 83% and more. From 134 participating students, 54.5 % appreciated life experience and wisdom of seniors they met, 98.4 % of students were satisfied with the training programme and 67.2 % of students reported that after training they changed their attitude towards senior population. CONCLUSIONS: Our survey confirmed that clinical training in geriatric medicine at 1st Faculty of Medicine, Charles University in Prague, prepared in agreement with current European recommendations is sufficiently effective and well accepted by the students. Therefore we recommend introduction of formal geriatric training for students in all medical faculties in the Czech Republic.

Czech Republic↗
PubMedDate not supplied

[Gerodontics and geriatric psychiatry].

Some of the important points in geriatric psychology and geriatric psychiatry (such as vocabulary and base line concepts, old myths in geriatrics, reference models, principle of action, therapeutic procedures, nasalgraphy, pluri, inter and transdisciplinarity) will be developed for the dentist practicing geriatric dentistry. Knowledge of these concepts should provide the basis for an effective association with the psychiatrist, in order to enhance better care for the elderly. Two types of approaches of the elderly, well known of the geriatric psychiatrist will be developed. The cognitive and motory approaches will be set as examples capable of helping the exchange between the two specialties.

Aged↗
PubMed1990

Consultative geriatric assessment for ambulatory patients. A randomized trial in a health maintenance organization.

Previous studies have shown that comprehensive geriatric assessment and follow-up can improve the health of hospitalized elderly patients. To evaluate the effectiveness of consultative geriatric assessment and limited follow-up for ambulatory patients, we randomized 600 elderly patients who were enrolled in a health maintenance organization into three groups: (1) consultation by a geriatric assessment team, (2) consultation by a "second opinion" internist, and (3) only traditional health maintenance organization services (control patients). The geriatric assessment team identified previously unrecognized problems in 35% of patients and advised changes in medication regimens for more than 40%. Nevertheless, patients who received assessment achieved only a small benefit in cognitive function after 3 months, which was not sustained for 1 year. There was no difference among groups in other measures of health status. Consultative geriatric assessment with limited follow-up did not benefit most older ambulatory patients in a health maintenance organization; if such care can be used effectively for ambulatory patients, it will require either additional targeting or continuing care or both.

Aged↗
PubMed1990

Effect of a geriatric educational experience on graduates activities and attitudes.

Clinical geriatric dentistry has not been an important part of most dental curricula. However, changes in demographic and patient expectations signify that geriatric oral health care can no longer be equated with supplying dentures for an aging population, but must be understood as treatment of the complex needs of a dentate population. The 1975 to 1985 graduates of the University of Iowa College of Dentistry were surveyed to evaluate the influence on dental practice of a comprehensive geriatric dental curriculum introduced in 1980. The post-1980 graduates were more likely to be practicing in larger population centers and less likely to be treating patients over 75 years of age. The dentists who graduated before 1980 were more likely to be consultants in nursing homes and carrying out examination, emergency care, and/or denture care, whereas the group of dentists who graduated after 1980 and had geriatric clinical experience with frail and functionally dependent older adults were more likely to be carrying out comprehensive care. When given a list of 18 geriatric dental and gerontological topics, few differences were found between cohort groups in terms of knowledge and confidence in carrying out procedures.

Cohort Studies↗
PubMed1989

Rehabilitation and the geriatric patient.

The true challenge in the care of the elderly is to keep people at home, in the community, with a high degree of functional ability. This is beneficial to the individual and, from a financial point of view, to the community and public. Maintenance and restoration of function are best accomplished within a framework that considers the psychosocial and developmental needs of the geriatric patient and in a setting specifically intended for the geriatric rehabilitation patient. Unlike the rehabilitation process in younger age groups, which is often dramatic, successful work with geriatric patients is likely to be subtle, but it will result in a return to the community and allow patients to experience a higher level of satisfaction (both emotional and functional) at the end of their lives. The needs of this population are many, and the health care provider must consider disease, physiologic changes associated with aging, and developmental needs when planning and implementing care. Initial research has pointed to the efficacy of geriatric rehabilitation programs; this would seem to indicate a need for a true specialization in geriatrics within the field of rehabilitation.

Aged↗
PubMed1989

Inclusion of geriatric nutrition in ADA-approved undergraduate programs.

All ADA Plan IV programs were surveyed to determine whether geriatric nutrition was included in their curriculums. Of the 268 Plan IV programs, 66% responded. Less than one-fifth of the programs offered or planned to offer a specific geriatric nutrition course. An overview of geriatric nutrition occurred most frequently in a human nutrition course. A practicum/clinical experience or a course other than nutrition most frequently provided in-depth study, if such was available. Nursing homes and congregate meal sites were the primary locations for experiences with the geriatric population. Major activities with that age group included (a) taking diet histories, (b) making nutrition assessments, and (c) providing diet instruction. In some programs, didactic and experiential training with the geriatric population may not be adequate to prepare dietetic undergraduate students to meet the health care needs of that growing segment of society.

Aged↗
PubMedDate not supplied

Geriatric fellowships in family medicine: status and directions.

The American Board of Medical Specialties recently approved the concept of certificates of added qualifications in geriatrics within both internal medicine and family practice. Certification requirements have been worked out for each training model, and questions have quite naturally arisen addressing whether the developing family practice model is substantially different from the longer established internal medicine model. A survey was made of 12 family practice based geriatric fellowship programs. Program directors were asked how they felt family practice geriatrics differed from internal medicine geriatrics in approaches to patient care and training and in areas of research interests. Information was also gathered about program size, length of training, and operational status. Eight fellowship programs were found to be active at the time of the survey, but only two for more than six months. Of the eight functioning programs, four were currently without fellows--a forewarning, perhaps, of potential recruitment problems for additional programs under development. Survey responses indicated a universal feeling among directors of family practice geriatric programs that their model does serve a unique function. Within the "distinguishing characteristics" most frequently noted, an emphasis on psychosocial and family issues can be identified. This emphasis can also be seen in the suggestions for distinctive research, with an indication of special interest in the delivery of health care.

Curriculum↗
PubMed1988

[The department of geriatrics].

This contribution discusses a major report on the Geriatric Patient in General Hospitals in the Netherlands. Now for the first time the central advisory bodies in health and hospital care acknowledge the 'geriatric patient' in his own. The report describes the consequences for organization and training. In the comments the following points are made: inadequacy of the Dutch health-system with respect to the geriatric patient; necessity of speeding up training of geriatricians; in accordance to developing geriatrics as a discipline a change in the position of the nursing-home doctor and the necessary evaluation of implementation of geriatric departments in general hospitals.

Aged↗
PubMed1987

Current status of Geriatric Dentistry Educational Activities in U.S. dental schools.

The current status of Geriatric Dentistry Educational Activities (GDEA) in U.S. dental schools is reported in this survey. Data were collected regarding faculty involvement in geriatric programs, didactic and clinical academic curricula, and other aspects of the ongoing activities in schools. Data were reported by 50 (88 percent) of the nation's 57 dental schools in continuing operation. Forty-two schools reported discrete GDEA at the time of the study. Seven of these schools had a formal division or department of geriatric dentistry. The survey indicated that educational qualification of GDEA coordinators had risen significantly in recent years. The mean number of didactic hours (29) of instruction in geriatric education available to students has also risen. Curriculum time and financial considerations were the primary obstacles to expansion of clinical geriatric activities. With the current economic constraints in dental education, present GDEA levels are unlikely to expand in the foreseeable future, unless governmental or private agencies recognize the importance of developing GDEA and increase their support.

Curriculum↗