scholarly journals Feasibility and Acceptability of Nurse-Led Primary Palliative Care for Older Adults with Chronic Conditions: A Pilot Study

2018 ◽  
Vol 21 (8) ◽  
pp. 1114-1121 ◽  
Author(s):  
Shigeko (Seiko) Izumi ◽  
Basilia Basin ◽  
Margo Presley ◽  
Jean McCalmont ◽  
Jon P. Furuno ◽  
...  
Keyword(s):  
Older Adults ◽  
Palliative Care ◽  
Pilot Study ◽  
Chronic Conditions

Impact of Participation in a Theatre Programme on Quality of Life among Older Adults with Chronic Conditions: A Pilot Study

2011 ◽  
Vol 18 (4) ◽  
pp. 201-208 ◽  
Author(s):  
Hon Keung Yuen ◽  
Kris Mueller ◽  
Ellise Mayor ◽  
Andres Azuero
Keyword(s):  
Quality Of Life ◽  
Older Adults ◽  
Pilot Study ◽  
Chronic Conditions

Multiple Chronic Conditions among Seriously Ill Adults Receiving Palliative Care

2021 ◽  
pp. 019394592110411
Author(s):  
Komal P. Murali ◽  
Gary Yu ◽  
John D. Merriman ◽  
Allison Vorderstrasse ◽  
Amy S. Kelley ◽  
...  
Keyword(s):  
Older Adults ◽  
Palliative Care ◽  
Chronic Conditions ◽  
Metastatic Cancer ◽  
Severe Illness ◽  
Multiple Chronic Conditions ◽  
Comorbidity Burden ◽  
Latent Subgroups ◽  
Ill Adults ◽  
Seriously Ill

The objective of this study was to characterize multiple chronic conditions (MCCs) among seriously ill adults receiving palliative care at the end of life. A latent class analysis was conducted to identify latent subgroups of seriously ill older adults based on a baseline Charlson comorbidity index (CCI) measurement, a measure of comorbidity burden, and mortality risk. The three latent subgroups were: (1) low to moderate CCI with MCC, (2) high CCI with MCC, and (3) high CCI and metastatic cancer. The “low to moderate CCI and MCC” subgroup included older adults with chronic obstructive pulmonary disease (COPD), cardiovascular disease, congestive heart failure, myocardial infarction, dementia, diabetes, and lymphoma. A “high CCI and MCC” subgroup included individuals with severe illness including liver or renal disease among other MCCs. A “high CCI and metastatic cancer” included all participants with metastatic cancer. This study sheds light on the MCC profile of seriously ill adults receiving palliative care.

scholarly journals Emergency Medicine Palliative Care Access (EMPallA): protocol for a multicentre randomised controlled trial comparing the effectiveness of specialty outpatient versus nurse-led telephonic palliative care of older adults with advanced illness

BMJ Open ◽  
2019 ◽  
Vol 9 (1) ◽  
pp. e025692 ◽  
Author(s):  
Corita R Grudzen ◽  
Deborah J Shim ◽  
Abigail M Schmucker ◽  
Jeanne Cho ◽  
Keith S Goldfeld
Keyword(s):  
Quality Of Life ◽  
Older Adults ◽  
Palliative Care ◽  
Randomised Controlled Trial ◽  
Case Management ◽  
Controlled Trial ◽  
Chronic Obstructive ◽  
Randomised Controlled ◽  
End Stage

IntroductionEmergency department (ED)-initiated palliative care has been shown to improve patient-centred outcomes in older adults with serious, life-limiting illnesses. However, the optimal modality for providing such interventions is unknown. This study aims to compare nurse-led telephonic case management to specialty outpatient palliative care for older adults with serious, life-limiting illness on: (1) quality of life in patients; (2) healthcare utilisation; (3) loneliness and symptom burden and (4) caregiver strain, caregiver quality of life and bereavement.Methods and analysisThis is a protocol for a pragmatic, multicentre, parallel, two-arm randomised controlled trial in ED patients comparing two established models of palliative care: nurse-led telephonic case management and specialty, outpatient palliative care. We will enrol 1350 patients aged 50+ years and 675 of their caregivers across nine EDs. Eligible patients: (1) have advanced cancer (metastatic solid tumour) or end-stage organ failure (New York Heart Association class III or IV heart failure, end-stage renal disease with glomerular filtration rate <15 mL/min/m2, or global initiative for chronic obstructive lung disease stage III, IV or oxygen-dependent chronic obstructive pulmonary disease); (2) speak English; (3) are scheduled for ED discharge or observation status; (4) reside locally; (5) have a working telephone and (6) are insured. Patients will be excluded if they: (1) have dementia; (2) have received hospice care or two or more palliative care visits in the last 6 months or (3) reside in a long-term care facility. We will use patient-level block randomisation, stratified by ED site and disease. Effectiveness will be compared by measuring the impact of each intervention on the specified outcomes. The primary outcome will measure change in patient quality of life.Ethics and disseminationInstitutional Review Board approval was obtained at all study sites. Trial results will be submitted for publication in a peer-reviewed journal.Trial registration numberNCT03325985; Pre-results.

scholarly journals Environmental Influences of Extreme Heat on the Health of Older Adults: A Retrospective Study

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 280-280
Author(s):  
Mei Liu ◽  
Carol Buller ◽  
Barbara Polivka ◽  
Terri Woodburn ◽  
Mark Jakubauskas ◽  
...  
Keyword(s):  
Older Adults ◽  
Chronic Conditions ◽  
Environmental Influence ◽  
Emergency Department Visits ◽  
Extreme Heat ◽  
Extreme Weather Events ◽  
Study Cohort ◽  
Outpatient Visits ◽  
Extreme Heat Event ◽  
Heat Event

Abstract Studies have suggested that extreme weather events have differential effects by age. By leveraging electronic medical records, we aim to analyze the environmental influence of extreme heat on the health of older adults. From our healthcare system’s de-identified data warehouse, we extracted a retrospective cohort of 108,192 patients who were ≥65 years of age as of 1/1/2018 with pre-existing chronic conditions including diabetes, COPD, cardiovascular disease, or kidney disease. Extreme heat event period was defined as 5/1/2018 to 9/1/2018 (79 days with temperature ≥90o; 15 days of moderately poor/poor air quality index (AQI) [≥75] values) and the comparison period was defined as 5/1/2019 to 9/1/2019 (51 days with temperature ≥90o; 0 days with moderately poor/poor AQI values) in the Kansas City area. We randomly partitioned the study cohort into two sets and demonstrated the two patient sets were statistically similar (p&gt;0.05) with respect to their demographic and underlying health conditions. Finally, we compared the respiratory, cardiovascular, and renal health outcomes between the 2018 and the 2019 cohorts. Most patients were Caucasians, female and had comorbid conditions. Results showed significantly higher number of all-cause emergency department visits (p=0.04) and outpatient visits (p=&lt;.001) during the extreme heat event period in 2018. Analyses also showed significantly higher number of outpatient visits due to upper respiratory diseases (p=0.008) and acute renal failure (p=0.01) in 2018. In conclusion, extreme heat increased use of healthcare services in older adults with chronic conditions.

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