Recent Advances in Geriatrics: Drug-Related Problems in the Elderly

2000 ◽  
Vol 34 (3) ◽  
pp. 360-365 ◽  
Author(s):  
Joseph T Hanlon ◽  
Leslie A Shimp ◽  
Todd P Semla

OBJECTIVE: To review recent articles examining drug-related problems in the elderly and comment on their potential impact on geriatric pharmacy practice. DATA SOURCES: Six articles published in 1997 and 1998. DATA SYNTHESIS: One study estimated that the cost of drug-related morbidity and mortality with the services of consultant pharmacists was $4 billion, compared with $7.6 billion without the services of consultant pharmacists. A study of ambulatory elderly patients with polypharmacy documented that 35% reported experiencing at least one adverse drug event within the previous year. Another study of ambulatory elderly found that in those with discontinued medications, adverse drug withdrawal events were uncommon. Two studies, one from Canada and one from the US, describe the development, by consensus, of explicit criteria for defining and identifying inappropriate drug use in the elderly (i.e., drugs to avoid, drugs with dose limits, drug–drug and drug–disease interactions). Finally, a modified Delphi survey of an expert panel reached consensus on 18 potential risk factors for drug-related factors in long-term care facility residents. CONCLUSIONS: Drug-related problems are considerable for elderly patients. Data from published studies should provide some guidance for today's practitioners as well as direction regarding future research.

Author(s):  
Simone Maximo Pelis ◽  
Nirvana Ferraz Santos Sampaio

This article presents the result of research developed with the language of elderly residents at the Long Term Care Facility for the Elderly - ILPI, in Vitória da Conquista, Bahia, Brazil. In response to the initial questions as to whether institutionalization affects the language of the elderly, whether the re-signification of verbal by non-verbal speech occurs, and whether silence, as language is part of an alternative system of possible meaning for the elderly, it was perceived that language in institutionalized long-lived individuals it reveals that in response to diversified processes of silencing, they have instituted silence as a possibility of reframing, and structuring of meaning. We collected data through the filming and recording of the elderly in enunciative-discursive situations, considering the uniqueness of each subject's history and their respective crossings as well as the condition of production of the narratives based on the concept of data-finding by Maria HadlerCoudry (1), aligned with notions relevant to Linguistics in the theoretical-methodological perspective of Discursive Neurolinguistics.


1986 ◽  
Vol 49 (11) ◽  
pp. 362-364 ◽  
Author(s):  
Jean Parker

Long-term care patients need a meaningful existence. It is our responsibility to ensure that time and energy are channelled into purposeful solutions for the disease of ‘time with nothing to do’. The author has taken up this challenge. Working as an activities organizer with the elderly for 11 years, she was determined never to take the role of a baby-sitter. The recreation unit has grown from its first eight guests to a purpose-built unit with approximately 1,500 attendances per month. A busy happy atmosphere now prevails where once there was a sea of dead faces. The choice to retain a sense of dignity and purpose should be available to all elderly patients who require long-term care.


2008 ◽  
Vol 71 (2) ◽  
pp. 365-372 ◽  
Author(s):  
JENNIFER M. NELSON ◽  
ROBERT BEDNARCZYK ◽  
JOELLE NADLE ◽  
PAULA CLOGHER ◽  
JENNIFER GILLESPIE ◽  
...  

Foodborne illness is an important problem among the elderly. One risk factor for foodborne illness and diarrhea-associated mortality among the elderly is residence in a long-term care facility (LTCF); thus, these facilities must implement measures to ensure safe food. To assess safe food practices, knowledge, and policies, we used a mailed, self-administered questionnaire to survey food service directors at LTCFs that were certified to receive Medicare or Medicaid at eight Foodborne Diseases Active Surveillance Network (FoodNet) sites. Surveys were distributed to 1,630 LTCFs; 55% (865 of 1,568) of eligible facilities returned a completed questionnaire. Only three LTCFs completely followed national recommendations for prevention of Listeria monocytogenes contamination. Nine percent of LTCFs reported serving soft cheeses made from unpasteurized milk. Most LTCFs reported routinely serving ready-to-eat deli meats; however, few reported always heating deli meats until steaming hot before serving (only 19% of the LTCFs that served roast beef, 13% of those that served turkey, and 11% of those that served ham). Most LTCFs (92%) used pasteurized liquid egg products, but only 36% used pasteurized whole shell eggs. Regular whole shell eggs were used by 62% of facilities. Few LTCFs used irradiated ground beef (7%) or irradiated poultry products (6%). The results of this survey allowed us to identify several opportunities for prevention of foodborne illnesses in LTCFs. Some safety measures, such as the use of pasteurized and irradiated foods, were underutilized, and many facilities were not adhering to national recommendations on the avoidance of certain foods considered high risk for elderly persons. Enhanced educational efforts focusing on food safety practices and aimed at LTCFs are needed.


2019 ◽  
Vol 48 (Supplement_4) ◽  
pp. iv13-iv17
Author(s):  
Mi Hyun Kim ◽  
Chang Hee Go ◽  
Jung Min Lee ◽  
Ji-Young Kang ◽  
Jae-Young Lim

Abstract Introduction To reduce the rate of falls in the rehabilitation ward, fall prevention program was developed and educated for physical and occupational therapists, which increased the attitude towards falls and knowledge towards fall prevention activities. Method Participants of this study include 17 therapists currently employed at a university-affiliated hospital located in Gyeongg-do, South Korea. Systematic protocol for fall prevention with the emphasis in the roles of rehabilitation teams was developed. This standardized protocol consists of educating therapists with adequate assistive device use, safe ambulation techniques, and client-centered transfer techniques. The therapists then record the paitent's status related to fall prevention and or risks, which is then shared with other medical professionals including registered nurses and medical doctors. Paper-based questionnaires regarding 9 questions on attitude towards falls and 12 questions on knowledge towards fall prevention activities were done by the participants after the education of systematic protocol. The rate of falls was then compared with the change of attitudes in participants. Rate of falls was calculated by dividing the number of fall by the patient bed days and multiplying by 1000. Result After the education of fall prevention program, the mean score of attitude towards falls significantly increased (t=-3.99, p=0.001). The mean score of knowledge towards fall prevention activities significantly increased (t=-4.79, p<0.001). The rate of falls decreased from 4.2 to 1.4. The effectiveness of systematic protocol regarding therapists' change in attitude and the resulting change in rate of falls was mainly seen in patients' ward. The decline in rate of falls was observed when patients transferred from bed to wheelchair. Conclusion In order to effectively convey the fall prevention education program, the multidisciplinary approach showed promising results in this study. Implications for future research include translation of this program to the community, such as long term care facility.


1988 ◽  
Vol 1 (3) ◽  
pp. 195-201
Author(s):  
Ruthanne R. Ramsey

Geriatric teams have emerged as an accepted method of health care delivery to the elderly patient in ambulatory and acute inpatient settings. As one model of specialized health care teams, geriatric teams vary in structure, membership, and type. The purposes may be diverse, ranging from providing primary care to multidimensional functional and diagnostic assessment. Geriatric teams have convincingly demonstrated benefit to the care of the elderly. Overcoming significant barriers to their formation, geriatric teams are beginning to develop in long-term care facilities as a result of economic and educational pressures. However, the unique environment and needs of the long-term care facility have resulted in differences in leadership, membership, and structure of long-term care teams. Pharmacist involvement in the long-term care geriatric team could benefit the facility, patient care, and the profession. The key to future involvement by pharmacists in teams appears to depend on their interest, ability to acquire necessary skills, and demonstration of unique professional contributions.


2005 ◽  
Vol 26 (2) ◽  
pp. 184-190 ◽  
Author(s):  
Tjasa Zohar Cretnik ◽  
Petra Vovko ◽  
Matjaz Retelj ◽  
Borut Jutersek ◽  
Tatjana Harlander ◽  
...  

AbstractObjectives:To determine the prevalence and incidence of methicillin-resistantStaphylococcus aureus(MRSA) colonization among residents and healthcare workers (HCWs) of a long-term-care facility (LTCF), to assess possible routes of nosocomial spread, and to determine genetic relatedness of the isolates.Setting:A 351-bed community LTCF for the elderly.Design and Participants:Study investigators made two visits, approximately 3 months apart, to the facility. Samples for cultures were obtained from 107 residents during the first visit, 91 residents during the second visit, and 38 HCWs.Results:The prevalence of MRSA colonization among residents was 9.3% during the first visit and 8.8% during the second visit. During the first visit, two HCWs were colonized. During the second visit, no HCWs were colonized. The colonization of HCWs suggested a potential role in the transmission of MRSA. Molecular typing showed that two of three roommates in one room had the same strain, whereas two in another room differed from one another. All isolates, except one, belonged to two related clonal groups. It seems that the clonal group to which most isolates belonged had the greatest potential for spreading among both residents and HCWs.Conclusions:Similar prevalence rates of MRSA colonization have been found in other European countries, but such studies have usually involved residents with better functional status than that of the participants in this study. Nosocomial spread of MRSA occurred in the facility examined, but not frequently. More attention should be focused on the hand hygiene of HCWs.


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