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At least 1,423 records · Page 79Linked to original sources
PubMed1989

[Geriatric assistance: an unresolved health problem].

Although the number of elderly needing health care is increasing in Spain, geriatric patients do not receive enough attention or support when compared to that given in other countries. When the elderly get sick they present peculiar and special problems which should be attended following their needs. Because in hospitals the elderly are cared for in a progressive fashion, geriatrics plays a perfect role in organizing the hospitals and out-patient centers. For the aforementioned, a broad coordination and efficiency within the health centers, units of community social services and the hospital are needed. Geriatric care should be present in the health care system of the government as well as in the private sector.

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PubMedDate not supplied

[Malnutrition in geriatric patients: the Bethanien nutritional study].

Demographic developments in the Federal Republic of Germany indicate a future marked increase in the aged population. With this, there will be an increase in elderly patients. Malnutrition can contribute to disease as well as result from it. While most urgent nutritional problems of the population in general reside in the areas of increased intakes of energy and certain nutrients, nutritional deficiencies are frequent in older citizens, and in particular, geriatric patients. These deficiencies may result from psycho-social factors such as isolation, depression, or chronic brain failure, as well as from clinical factors (diseases which increase nutritional requirements or utilization of nutrients, drug/nutrient-interactions, etc.). The following questions are addressed: 1) How frequent is malnutrition in geriatric patients and which forms of malnutrition can be found? 2) What are the causes of malnutrition? 3) What is the relationship between malnutrition and mortality? 4) Which strategies for prevention and treatment of malnutrition can be developed from the above findings? The study is performed in Bethanien-Hospital, Heidelberg, FRG, a geriatric hospital and day clinic. Three hundred patients aged 75 years or older (representative sample) were included. Nutrition and nutritional status are determined and related to health, drug therapy and other psycho-social conditions in the very old. The prospective part of the study is planned for 18 months and this will also be the duration of the intervention phase.

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PubMedDate not supplied

[A new after-care model in geriatrics].

78 geriatric patients predominantly suffering from cardiocerebrovascular diseases (stroke, heart insufficiency) and lesions respectively operations of the locomotion system (fractures, arthroses) were admitted in 1987 from acute hospitals for after-treatment (short-term care). 35 (= 45%) of them (average age 80 (61-92) could be discharged after 63.5 days on average, 11 died from intercurrent complications, 9 remained for long-term care as inrehabilitable. Besides other concomiting troubles mainly cardiac and circulation affections were present in the majority of patients. Their identification (a. o. by means of ultrasonic methods) and therapy also means a secondary prevention of cerebral as well as of fall and injuries inducing risk factors. The results confirm the principal rehabilitation chance of multimorbid geriatric patients by use of the diagnostic and therapeutic special potential of geriatrics.

Aftercare↗
PubMed1988

Admission of geriatric patients to hospital on Niue Island 1977-1982.

This report analyses the admission to hospital of people aged 65 years or more on Niue Island in the years 1977-1982. Geriatric admissions, of which 59% were female, comprised 8% of all admissions, equalling the proportion of old people in the community. There were no significant differences by age and or sex for admission rates, reasons for admission, length of stay or disposition. Acute illnesses, particularly respiratory problems, accounted for the majority of geriatric admissions although chronic degenerative disorders, usually cardio-vascular in nature, also played a role. The median hospital stay was 10.5 days, with 81% of all geriatric patients being discharged within one month. The majority (79%) of patients are discharged back into the community. Longest hospital stays resulted from potentially preventable accidents and injury, which constitute a leading cause of death for elderly men, from infectious/parasitic diseases, and from nonspecific nursing care admissions.

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PubMedDate not supplied

[Documentation and research in clinical rehabilitation of geriatric patients].

Although we have extensive knowledge about rehabilitative treatment procedures in geriatrics, we lack an emphasis on geriatric rehabilitation in our institutions of public health. And we lack objective methods to illustrate the performance profile. Documentation and internal clinical evaluation that show results of patient rehabilitation programs may alleviate this deficiency. These will illustrate what may be expected from rehabilitation efforts. The example of one medical and geriatric clinic shows how documentation and research are applicable in clinical practice and how they are beneficial in daily life. The evaluation and changing of treatment methods, the training of staff, the cooperation of patients' relatives, and after-care institutions are all necessary elements. Steps should be taken for internal clinical evaluations and continual follow-ups that demonstrate the rehabilitation process in clinical and after-care situations.

Activities of Daily Living↗
PubMed1988

Atypical presentation of geriatric infections.

Infection is a common problem in elderly patients, the most common infections being those in the urinary tract and the respiratory tract. In geriatric practice, infection is most frequently seen in combination with many other problems. The geriatric presentation is described in which patients may present with an increased dependency upon care providers due to the development of fresh problems like falls, immobility, confusion, incontinence of urine, and fecal impaction with incontinence. It is important to recognize this presentation and not to miss the diagnosis. It is well recognized that pneumonia is the most frequently missed diagnosis in the elderly. An increase in dependency should not be ignored and attributed to old age. The presence of pathophysiological changes and organ involvement, together with fever, raised white count, or elevated ESR, are strongly supportive of a diagnosis of infection. Once identified, the infection can usually be appropriately treated, resulting in significant improvement in multiple geriatric problems which these patients suffer from.

Accidental Falls↗
PubMed1986

Geriatric assessment programs in the United States. Their growing role and impact.

Geriatric assessment programs have become a growing component of the health care delivery system for the elderly in the United States. They generally provide interdisciplinary assessment, treatment planning, case management, and often rehabilitation for frail elderly persons and are especially important for persons suspected of needing long-term institutional care. Their development here stems from long experience with geriatric assessment in the United Kingdom and increasing evidence of their effectiveness in North American settings. Among their demonstrated benefits are better diagnostic accuracy and treatment planning, more appropriate placement decisions with less referral to nursing homes, and improved patient functional status, general well-being, and survival. This article provides, in addition to an overview of geriatric assessment programs and their effectiveness, practical guidelines for their establishment in the hospital setting.

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PubMed1986

A geriatric service in East London.

The background and establishment of a geriatric service in East London are described. Data relating to 37 admissions for geriatric assessment to the long-stay wards at Frere Hospital and 250 patients dealt with by the District Surgeon's community geriatric service staff are analysed to indicate the multifactorial nature of the assessments and care provided. Taken in conjunction with previous experience elsewhere, the indications are that effective services for care of the aged can be developed without special facilities, by re-allocation of some duties of existing staff and without vast capital expenditure. Certain recommendations are made for the development of an effective network of services for hospital-based care of the aged throughout the RSA.

Black or African American↗
PubMed1987

An acute inpatient geriatric assessment and treatment unit.

The inpatient geriatric assessment unit (GAU) is an important component of the Geriatric Assessment and Treatment Centre (GATC) at the Royal Jubilee Hospital in Victoria, British Columbia. The Centre attempts to accomplish the following: to provide, at the request of the attending physician, diagnostic, treatment, and management services where it best suits the patient (ie, at home, in the outpatient service, or following admission to the ward); and to provide, if necessary, follow-up service after discharge to help prevent readmission to the acute hospital or any part of the geriatric service.

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PubMed1987

A geriatric neuropsychiatric inpatient unit.

Geriatric neuropsychiatry units have been developed in hospitals in various parts of the United States to provide an intensive diagnostic and treatment program for geriatric patients who have behavioral problems or the early signs of dementia. The Geriatric Neuropsychiatry Unit at the Boston City Hospital is described as a model unit. The process of patient selection and admissions criteria are outlined. Diagnostic interventions and the full evaluative process are then presented, followed by a summary of the therapeutic interventions. These interventions include pharmacologic, psychotherapeutic, behavioral, and milieu therapies. The communications process essential for effective multidisciplinary team function is also reviewed. Discharge planning procedures are presented, along with a summary of patient outcomes.

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PubMedDate not supplied

Knowledge and attitudes of family practice residents toward geriatric patients.

The knowledge and attitudes of family practice residents toward geriatric patients was surveyed in eight residencies. Since geriatric care will, in the future, become a more important aspect of the family physician's practice, it is important to ascertain the knowledge and attitude level of physicians in training concerning their geriatric patients. Three aspects of this study indicate serious deficits in the educational background of these residents: the number and quality of courses offered to them is inadequate; they demonstrate a paucity of knowledge concerning the aged; the residents show a low preference for working with the aged. Clearly, medical education should address these needs and deficits.

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PubMed1985

Reduced serum zinc levels and oral zinc supplementation in geriatric patients.

Serum Zinc levels have been measured in 15 male and 64 female patients admitted to geriatric wards from home or other hospital wards. There was no significant difference between the zinc levels in the two sexes. The zinc concentrations were significantly lower in the geriatric patients than in adult patients whose serum zinc levels were measured by the same method. Levels for serum zinc did not differ significantly between the patients who had previously been receiving hospital diets in other hospital wards, and the patients admitted directly from home who had been receiving less nutritious domestic diets. Oral supplementation with zinc salts resulted in a variable response in serum zinc. It is concluded that the low serum zinc concentrations found in geriatric patients are attributable to abnormal cell metabolisms in individual patients rather than to deficient dietary intake of zinc.

Administration, Oral↗
PubMed1968

A screening project for the geriatric mentally ill. Appraisals to determine suitable care facilities.

The Geriatric Screening Project, the purpose of which is to determine whether referred patients can be dealt with by some means of care less drastic than commitment to a state hospital, has significantly reduced commitments from San Francisco. Geriatric commitments previously numbered almost 500 a year. In its first three calendar years, 1,290 persons were directly served by the project. The commitments dropped successively in the three years to 40, to 12 and then to three. The project has demonstrated that vast reductions of geriatric commitments can be achieved with enlightened screening and recommendations before resort to petition for mental illness is considered. Essential to the dramatic success are home visits, supportive community resources and a dedicated staff unafraid to meet the depressing needs of old people.

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PubMed1983

Evaluation of a medication-monitoring service for geriatric patients in a congregate housing facility.

The effects of a medication-monitoring service provided by a pharmacist in a congregate housing facility for geriatric patients were evaluated. A medication-monitoring service was provided by a clinical pharmacist to geriatric patients in two congregate housing facilities during an 18-month period. Patients were offered the service if they had histories of noncompliance and were referred for this reason to the study by physicians, staff, or family. The clinical pharmacist made weekly visits to each patient for assessment and provision of instructions and reinforcement regarding medication compliance. Medications were provided in special reminder packages prepared by a technician, and cost data for both materials and time were recorded. A total of 14 patients were referred to the study and received services for at least three months. Eight of these patients received services for one year. The costs of providing the service were $33/patient/month for personnel and $2/patient/month for materials. An 82-100% compliance rate was recorded; the mean compliance rate was 96%. Patients or their legal representatives paid the pharmacist directly for costs incurred. A medication-monitoring service is useful for geriatric patients whose primary limitation is inability to administer their own medications.

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PubMed1983

[Social geriatric examination].

The method of social-geriatric examination is described. This type of examination by an ambulatory team takes place at the patient's home. The examination is firstly directed to the interactions in the human-environmental system. By means of a scheme as an aid the interactions can be analyzed. This analysis, how people are dealing with each other and with need for care and with care, precedes the analysis of the chain of interacting unfavourable conditions of social, mental and physical nature, which are responsible for the disturbance of the balance of the system. This disturbance is signaled by way of the primary health care system to the geriatric examination circuit of which the social-geriatric team functions as first receiver of those signals.

Activities of Daily Living↗
PubMed1978

Estimation of serum digoxin levels in geriatric patients.

The correlation in geriatric patients between estimated serum digoxin levels based on pharmacokinetic calculations and serum digoxin levels measured by radioimmunoassay was studied. Serum digoxin levels were estimated for 17 geriatric patients recieving digoxin using the "total body stores" concept. A statistically significant correlation between calculated and measured digoxin levels was shown (p less than 0.05, r = 0.51); however, 95% confidence limits were so large (+/- 1.75 ng/ml) that the results were clinically unacceptable. Until data describing specific causes of variance are available and calculations modified to account for specific variations, pharmacokinetic models should not be relied upon for accurate estimates of digoxin levels in geriatric patients.

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PubMed1982

Who cares? A microplan for geriatric practice.

Geriatric medicine is defined and difficulties in the attainment of its ideals are described, both in Great Britain, where the specialty was born, and in South Africa. As regards the situation in South Africa, it is likely in the foreseeable future that the load will be carried by a wide range of clinicians in hospitals and the community, and that we shall not see the emergence of geriatricians as specialists in their own right except in a few academic departments. In laying down guidelines for practice an attempt has been made to describe the elements of geriatric medicine that it is hoped can be practised by any doctor performing this work. These elements have been presented as a microplan for geriatric practice.

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PubMedDate not supplied

[The return of geriatric patients to the home - results of a pilot study in Berlin hospitals].

Geriatric in-patients often stay longer in hospital than would be necessary on medical grounds alone due to the lack of intermediate facilities and the paramount influence of social conditions. Day-hospital services contribute largely to an early return of geriatric and long-term patients. The potential amount of patients eligible for this kind of service is investigated by a 5% sample of all non-psychiatric in-patients age 65+ in Berlin (West). Social conditions at home and the number of patients to receive day services showed a significant relation. Based on the findings it is estimated that 15 day-hospitals will be needed in Berlin (West) to promote re-integration of geriatric patients into their familiar surroundings.

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