Search results for ‘Subject term:"older people"’ Sort:
Results 1 - 10 of 18
Hungry to be heard: the scandal of malnourished older people in hospital
- Author:
- AGE CONCERN ENGLAND
- Publisher:
- Age Concern England
- Publication year:
- 2006
- Pagination:
- 26p.
- Place of publication:
- London
Six out of 10 older people are at risk of becoming malnourished, or their situation getting worse, in hospital. Up to 14% of older people aged over 65 years in the UK are malnourished. Four out of 10 older people admitted to hospital are malnourished on arrival.Patients over the age of 80 admitted to hospital have a five times higher prevalence of malnutrition than those under the age of 50. Up to 50% of older people in general hospitals have mental health needs. Patients who are malnourished stay in hospital for a longer time, require more medications, and are more likely to suffer from infections. The toll of malnutrition on health and health care costs is estimated to exceed £7.3 billion per year (much more than obesity). Over half of this cost is expended on people aged 65 years and above.
Depressive symptom profile in Parkinson's disease: a comparison with depression in elderly patients without Parkinson's disease
- Authors:
- EHRT Uwe, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 21(3), March 2006, pp.252-258.
- Publisher:
- Wiley
Depression is a common neuropsychiatric syndrome in Parkinson's disease (PD), and may be etiologically related to the neurochemical changes accompanying this disease. It is still unclear whether the disturbances of neurotransmitter activities lead to a specific profile of depressive symptoms, that is characteristic for PD and differs from that in depressed patients without PD. The authors compared the individual depressive symptoms of 145 non-demented depressed patients with PD and 100 depressed patients without PD by comparing item scores on the Montgomery-Åsberg Depression Rating Scale by way of MANCOVA. The severity of depression and the level of cognitive functioning in depressed PD patients were comparable with that of depressed control subjects. However, patients with PD showed significant less reported sadness, less anhedonia, less feelings of guilt and, slightly less loss of energy, but more concentration problems than depressed control subjects. The profile of depressive symptoms in PD differs from that in depressed subjects without PD. This finding is important for the conceptualisation and clinical diagnosis of depression in PD.
Reducing emergency hospital stays for older people: Innovation Forum first year report
- Authors:
- WISTOW Gerald, KING Derek
- Publisher:
- Innovation Forum
- Publication year:
- 2006
- Pagination:
- 54p.
- Place of publication:
- London
This report from the Innovation Forum is based on the idea that good housing, a range of facilities for transport, leisure and entertainment, families and friends can all help older people thrive and stay healthy thereby reducing the need for emergency hospital stays. And, if any of this is to come about, it means a firmer strategy than currently exists to ensure there is a sufficiently significant transfer of funding from acute to community settings.
The Act one year on - a mental health officer's perspective
- Author:
- LOCKERBIE Gordon
- Journal article citation:
- Rostrum Magazine, 86, October 2006, pp.12-13.
- Publisher:
- British Association of Social Workers (Scotland)
The author, a Mental Health Officer, discusses the impact of the new Mental Health (Care and Treatment) (Scotland) Act 2003 on managing work for older people. Although it has increased workloads, he argues it is more professional rewarding, improves patients rights and will improve services for people with mental health problems.
Delirium subtype identification and the validation of the Delirium Rating Scale - Revised-98 (Dutch version) in hospitalized elderly patients
- Authors:
- DE ROOIJ Sophia E., et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 21(9), September 2006, pp.876-882.
- Publisher:
- Wiley
Delirium is the most common acute neuropsychiatric disorder in hospitalized elderly. The Dutch version of the Delirium Rating Scale - Revised-98 (DRS-R-98) appears to be a reliable method to classify delirium. The aim of this study was to determine the validity and reliability of the DRS-R-98 and to study clinical subtypes of delirium using the DRS-R-98. Patients received the Dutch version of the DRS-R-98, the Mini-Mental State Examination, the Confusion Assessment Method, and a clinical diagnosis of delirium according to DSM-IV criteria, and their relatives the Informant Questionnaire Cognitive Decline in the Elderly. The DRS-R-98 validation cohort (n = 65) consisted of 23 patients with delirium, 22 patients with dementia, and 20 non-psychiatric comparison patients. For the delirium subtype study, a second cohort comprising 54 delirious patients was investigated. Median DRS-R-98 scores significantly distinguished delirium from dementia and no psychiatric disorder. Inter-rater reliability (intra-class correlation 0.97) and internal consistency (Crohnbach's alpha 0.94) were high. Positive scores of DRS-R-98 item 4 (affect liability) and item 7 (motor agitation) predicted the presence of non-hypoactive delirium, with a specificity of 89% and a sensitivity of 57%. The results show that the Dutch version of the DRS-R-98 is a valid and reliable measure of delirium severity and distinguishes patients with delirium from patients with dementia and comparison patients.
Screening for depression in older medical inpatients
- Authors:
- CULLUM Sarah, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 21(5), May 2006, pp.469-476.
- Publisher:
- Wiley
Older people with depression make greater use of healthcare services, but the detection of the disorder is poor. The National Service Framework for Older People recommended screening for depression in acute healthcare settings to improve health outcomes of older people. This study aims to estimate, in a large representative sample of older medical inpatients in a UK hospital setting, the prevalence of depressive symptoms and ICD-10 depressive disorder and to examine the sensitivity and specificity of the 15-item Geriatric Depression Scale (GDS-15) as a screening instrument. A two-phase prevalence study of depressive disorder was carried out in acute wards of a district general hospital. Six hundred and eighteen (61%) of 1,009 eligible older medical inpatients were screened using the GDS-15. A stratified sample of 233 people was further assessed using the Geriatric Mental State, from which ICD-10 diagnoses were determined. The weighted prevalence estimate of ICD-10 depressive disorder was 17.7%. Forty-four percent of participants scored above the normally recommended cut-point of 5 on the GDS-15. However, on the basis of ROC, the optimal cut-point of the GDS-15 for screening for depressive disorder in this hospitalised population is two points higher at 7. This study confirms that depression is common amongst older UK medical inpatients with 1 in 6 suffering from clinical depression. The cut-point for GDS-15 for this population is 7.
Skin care of people with dementia: S/NVQ unit HSC358: candidate guide
- Author:
- MCALLAN William
- Publisher:
- University of Stirling. Dementia Services Development Centre
- Publication year:
- 2006
- Pagination:
- 49p.
- Place of publication:
- Stirling
This guide is written for care workers who are undertaking their S/NVQ qualification or are engaged in continuous professional development. It provides a knowledge base for S/NVQ unit HSC358 ‘Identify the individual at risk of skin breakdown and undertake the appropriate risk assessment’ and links with The Dementia Services Development Centre’s study guide – caring for the skin of people with Dementia.
Posttraumatic stress disorder and general health problems following myocardial infarction (Post-MI PTSD) among older patients: the role of personality
- Authors:
- CHUNG Man Cheung, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 21(12), December 2006, pp.1163-1174.
- Publisher:
- Wiley
This study aimed to: (1) investigate the degree to which older myocardial infarction (MI) patients experienced post-MI PTSD and general health problems, and to (2) identify the association between five personality traits, post-MI PTSD and general health problems among these older people. The sample comprised 96 older MI patients and were recruited from two general practices. They were interviewed using the Posttraumatic Stress Diagnostic Scale (PDS), the General Health Questionnaire-28 (GHQ-28) and the NEO-Five Factor Inventory (NEO-FFI). The control group comprised 92 older people who experienced no MI. They were assessed using the GHQ-28. The older MI patients experienced hyperarousal the most, followed by avoidance and re-experiencing symptoms. PDS revealed that 30% had full PTSD. The older patients were conscientious and agreeable individuals. They were also somewhat extraverted and open to experience. They also showed traits of neuroticism. Controlling for bypass surgery, heart failure, previous mental health difficulties, angina and angioplasty, regression analyses showed that neuroticism predicted re-experiencing and avoidance symptoms and general health total. Neuroticism and less agreeableness predicted hyperarousal symptoms. MI older patients could manifest PTSD symptoms and general health problems following their MI. Personality traits, particularly neuroticism and antagonism, played a role in the manifestation of these symptoms.
Neurocognitive functioning in dually diagnosed middle aged and elderly patients with alcoholism and schizophrenia
- Authors:
- MOHAMED S., et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 21(8), August 2006, pp.711-718.
- Publisher:
- Wiley
Alcohol abuse and dependence have important clinical implications for managing patients with schizophrenia. Alcoholism in schizophrenia patients can interfere with the course and prognosis of the schizophrenic illness. The purpose of the present study was to compare the cognitive status, symptom profile and quality of life of middle aged and older patients (>44 years old) with schizophrenia and alcohol abuse/dependence vs those without alcohol abuse/dependence. We initially hypothesized that more males in this age group with schizophrenia would exhibit alcoholism. The authors also examined the characteristics of the 45-54 year age group with those of the 55 year old group and hypothesized that comorbidity with alcohol would be associated with worse cognition and quality of life in later life. Data were obtained from a database from the Center for Services and Interventions research at the University of California, San Diego. Patients had diagnoses of schizophrenia or schizoaffective disorder. Data collected included demographic characteristics, cognitive status (tested with the Mattis Dementia Rating Scale learning, the Figural and Story Memory Test of the Wechsler Memory Scale-Revised and the California Verbal Learning Test [CVLT]). In addition, patients had undergone psychopathologic assessment and were screened for quality of life using the Quality of Well Being scale. The authors demonstrated that the older aged patients with alcoholism had worse scores assessing cognition relative to the same aged group without alcoholism. In addition, they had worse cognitive scores relative to the younger group (45-54 year old) with alcoholism. There was no significant difference with regards to quality of life. In addition, more males than females exhibited alcoholism. The results are consistent with the premise that the higher cognitive function in the younger schizophrenia patients with alcoholism appear to mask the effects of alcohol use on cognition at that age. However, for the older group of schizophrenia patients, the effects of alcohol use on neuropsychological functioning appear to be deleterious
Factors related to medication adherence in memory disorder clinic patients
- Authors:
- OWNBY R. L., et al
- Journal article citation:
- Aging and Mental Health, 10(4), July 2006, pp.378-385.
- Publisher:
- Taylor and Francis
Medication adherence is a substantial problem in the elderly. It may be even more important among elderly persons with memory problems, since other factors that lead to non-adherence may be compounded with the memory problems themselves. The objective was to determine whether a model that integrates research on medication adherence from several research domains is useful in understanding adherence in elderly patients. The methodology involved a cross-sectional observational study using a convenience sample of 63 patients drawn from a university-affiliated outpatient memory disorders clinic. The primary measure of medication adherence was caregivers’ reports of patients’ medication adherence. Patients and their caregivers were asked questions assessing their beliefs about the seriousness of each condition for which a medication was prescribed and the likely outcome of that condition without treatment. Additional data collected included presence of side effects, total number of medications taken, and patients’ mood and cognitive status. Multilevel path analysis confirmed several model-based predictions. Caregivers’ reports of adherence were predicted by estimates of disease outcome, the presence of side effects, and patients’ relying on themselves to remember to take medications. Results partially confirm the integrative model in understanding medication adherence in these patients. Patients’ beliefs about the likely effect of medication treatment for their condition and the presence of side effects influence reported medication adherence. Results thus suggest that efforts to educate patients about the likely response of their medical condition to treatment and to assess and deal with medication side effects might improve patient adherence