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Dignity on the ward: pain and older people
- Authors:
- SCHOFIELD Pat, et al
- Publisher:
- Help the Aged
- Publication year:
- 2008
- Place of publication:
- London
This guide aims to highlight the main issues nursing staff need to consider when managing pain in older adults. It covers assessment and different methods of pain management. It also helps assist nurses in their decision making regarding treatment or referral to a members of multidisciplinary teams.
Elderly people with alcohol-related problems: where do they go?
- Author:
- MULINGA John Dickson
- Journal article citation:
- International Journal of Geriatric Psychiatry, 14(7), July 1999, pp.564-566.
- Publisher:
- Wiley
The aim of this study was to investigate the clinical presentation and rehabilitation of elderly people with alcohol-related disorders by studying the case notes of all patients with final diagnoses of alcohol dependence and alcohol abuse admitted to a hospital.
Orientation by seasons
- Author:
- BENDER Michael
- Journal article citation:
- Nursing Times, 26.4.95, 1995, pp.64-65.
- Publisher:
- Nursing Times
Describes how the author devised a way for staff to relate to people with advanced dementia through 'unison' groups.
Emergency medical service, nursing, and physician providers' perspectives on delirium identification and management
- Authors:
- LaMANTIA Michael A., et al
- Journal article citation:
- Dementia: the International Journal of Social Research and Practice, 16(3), 2017, pp.329-343.
- Publisher:
- Sage
Purpose of the study: The study objective was to understand providers' perceptions regarding identifying and treating older adults with delirium, a common complication of acute illness in persons with dementia, in the pre-hospital and emergency department environments. Design and methods: The authors conducted structured focus group interviews with separate groups of emergency medical services staff, emergency nurses, and emergency physicians. Recordings of each session were transcribed, coded, and analysed for themes with representative supporting quotations identified. Results: Providers shared that the busy emergency department environment was the largest challenge to delirium recognition and treatment. When describing delirium, participants frequently detailed hyperactive features of delirium, rather than hypoactive features. Participants shared that they employed no clear diagnostic strategy for identifying the condition and that they used heterogeneous approaches to treat the condition. To improve care for older adults with delirium, emergency nurses identified the need for more training around the management of the condition. Emergency medical services providers identified the need for more support in managing agitated patients when in transport to the hospital and more guidance from emergency physicians on what information to collect from the patient's home environment. Emergency physicians felt that delirium care would be improved if they could have baseline mental status data on their patients and if they had access to a simple, accurate diagnostic tool for the condition. Implications: Emergency medical services providers, emergency nurses, and emergency physicians frequently encounter delirious patients, but do not employ clear diagnostic strategies for identifying the condition and have varying levels of comfort in managing the condition. Clear steps should be taken to improve delirium care in the emergency department including the development of mechanisms to communicate patients' baseline mental status, the adoption of a systematised approach to recognising delirium, and the institution of a standardised method to treat the condition when identified. (Edited publisher abstract)
The outcomes of an inpatient treatment program for geriatric patients with dementia and dysfunctional behaviors
- Authors:
- HOLM Alvin, et al
- Journal article citation:
- Gerontologist, 39(6), December 1999, pp.668-676.
- Publisher:
- Oxford University Press
Evaluates the outcomes of an inpatient programme in the USA, designed to reduce severe agitated behavior in geriatric patients with dementia who could not be successfully treated on an outpatient basis. An individualized treatment plan was created for each patient that involved pharmacological and nonpharmacological interventions with behavioural, environmental, and psychological components. Significant improvements on these assessments were observed. Concludes that the longitudinal, multidisciplinary approach used in this study was effective in significantly reducing intrusive and dangerous behaviours while preserving or enhancing patients' cognitive and functional abilities.
Locations of facilities with special programmes for older substance abuse clients in the US
- Authors:
- SCHULTZ Susan K., ARNDT Stephan, LIESVELD Jill
- Journal article citation:
- International Journal of Geriatric Psychiatry, 18(9), September 2003, pp.839-843.
- Publisher:
- Wiley
Given the growth of our aging population, developing strategies for managing late-life alcoholism is increasingly important. The authors compared substance abuse treatment facilities with and without services designed for older adults and explored the location of these services relative to the regional distribution of older adults across the United States. A public use dataset from a national survey of facilities offering substance abuse treatment was used to address this issue. This survey included all identified substance abuse/dependence treatment facilities in the US and surveyed the facilities' treatment services, services for special groups, number of clients admitted, type of ownership (e.g. public, private for profit), and whether or not the facility was associated with a hospital, as well as questions about licensure and income sources. Of the 13 749 responding facilities, relatively few programmes (17.7%) were specifically designed for older adults (i.e. over age 65). Facilities with such programmes tended to be associated with hospitals, particularly those with a psychiatric inpatient service. Importantly, the number of facilities with special programmes for older adults did not correlate with size of the older population in each state. Despite an increasing need for older adult substance abuse services, there are relatively few programmes available designed for this age group. The setting where patients with substance abuse are identified (e.g. in a hospital) may partially explain the pattern of locations of age-specific programmes.
The effectiveness of old age psychiatry services
- Author:
- DRAPER Brian
- Journal article citation:
- International Journal of Geriatric Psychiatry, 15(8), August 2000, pp.687-703.
- Publisher:
- Wiley
This Australian study examines outcomes of acute service delivery in old age psychiatry using a review of the literature. The review includes controlled trials, audits and surveys of the outcomes of service delivery in old age psychiatry located in acute hospitals and community settings. With the exception of outreach services to nursing homes, long term institutional care was excluded. The majority of studies indicated that old age psychiatry services have positive acute treatment outcomes, particularly with depression. There is insufficient evidence to determine which types of care are associated with better outcomes.
The economic and social cost of dementia in Ireland
- Authors:
- O'SHEA Eamon, O'REILLY Siobhan
- Journal article citation:
- International Journal of Geriatric Psychiatry, 15(3), March 2000, pp.208-218.
- Publisher:
- Wiley
The economic and social burden of dementia on society is the value of all the resources used to prevent, diagnose, treat, and generally cope with the illness. This article assess the overall resource implications of dementia in Ireland. Six main areas are covered in the cost analysis as follows: mortality and life years lost, in-patient acute care, in-patient psychiatric care, residential long-stay care, family care, and primary and social care in the community. The critical role of carers in maintaining people with dementia in their own home is reflected in the results showing that family care accounts for almost 50 percent of the overall resource burden, based on an opportunity cost valuation of carer time.
The impact of two changes in service delivery on a geriatric psychiatry liaison service
- Authors:
- BAHEERATHAN Mala, SHAH Ajit
- Journal article citation:
- International Journal of Geriatric Psychiatry, 14(9), September 1999, pp.767-775.
- Publisher:
- Wiley
The impact of two changes in service delivery (alteration in the admission policy of the medical unit and the introduction of a formal liaison component to a 'consultation only' liaison geriatric psychiatry service) on the associated liaison geriatric psychiatry was examined in this study. There was a significant decline in the number of referral for each month across the three study phases. Although this study was not designed as a cost-effectiveness study, the results suggest that the liaison component has the potential to be cost-effective.
Central steering and local networks: old-age care in Sweden
- Authors:
- JOHANSSON Roine, BORELL Klas
- Journal article citation:
- Public Administration, 77(3), 1999, pp.585-598.
- Publisher:
- Wiley
This article gives an account of major Swedish reform in the area of old-age care, whereby the boundaries between regional and local areas of responsibility for care of the elderly were displaced. By using a variety of control methods, central government was able to structure and steer the old-age implementation networks. The consequences of this central steering were different on different administrative levels: for the county councils, the reform has resulted in a specialisation for the core areas of primary health care and hospital treatment, whereas the municipalities have had to diversity their areas of activity.