scholarly journals COVID-19, Telehealth and Access to Care

2021 ◽  
Author(s):  
Charles M. Lepkowsky
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Information Technology ◽  
Access To Care ◽  
Older Adult ◽  
Patient Communication ◽  
It Use ◽  
Age Related

Telehealth has become increasingly prominent during the COVID-19 pandemic, highlighting limitations in access to care for older adults less fluent in information technology (IT). Although the 20 percent disparity in IT use between younger and older adult cohorts remains unchanged over several decades, insurers, institutional and independent providers of health care have made increasing use of IT for patient communication. Data demonstrate an age-related decline in the frequency of IT use for accessing health care. Restrictions on reimbursement for the use of the telephone for accessing health care during the COVID-19 pandemic are discussed as a barrier to access to care. Recommendations are made for assessment of media most available to older adults for accessing health care, as well as providing funding to support increased access to care.

scholarly journals Starting an Older Adult Lecture for First Semester Nursing Students With a Truth or Myth Game

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 14-14
Author(s):  
Lynn Brown ◽  
Pao-feng Tsai
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Nursing Students ◽  
Older Adult ◽  
Care Needs ◽  
Final Exam ◽  
Negative Stereotypes ◽  
First Semester ◽  
Positive Attitudes ◽  
New Information

Abstract False ideas about the physical and psychosocial characteristics of older adults exist in America. It is especially important that nurses are not susceptible to myths and stereotypes as these myths can affect the quality of patient care. For example, some people stereotype older adults as forgetful, disabled, ill, and unable to understand new information. Misconceptions and negative stereotypes are also present in first year nursing students. It is vital that students assess their own attitudes about older adults to form positive attitudes and gain knowledge about aging and health care needs. To achieve this goal, the older adult lecture in a first semester theory and fundamental course begins with a PowerPoint slide presentation asking students to distinguish truths and myths. The truth or myth topics include a) developmental tasks; b) common physiological changes; c) a comparison of delirium, dementia, and depression; and d) addressing health concerns of older adults. Active discussion follows the activity. Seventy to ninety percent of students correctly answered nine of ten questions related to older adult content on the final exam. Considering the increasing number of older adults in the health care setting, nurse educators must dismantle negative stereotypes with creative teaching strategies.

scholarly journals Registered nurses’ experiences of information technology use in home health care - from a sustainable development perspective

BMC Nursing ◽  
2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Vicki Koltsida ◽  
Lise-Lotte Jonasson
Keyword(s):  
Health Care ◽  
Information Technology ◽  
Sustainable Development ◽  
Registered Nurses ◽  
Home Health Care ◽  
Technology Use ◽  
Qualitative Content Analysis ◽  
Well Being ◽  
Home Health ◽  
It Use

Abstract Background The work of registered nurses in home health care is complicated and extensive, and information technology (IT) is used in everyday activities. Coordination between care and resource efficiency is important. There is a wealth of information that supports the notion of sustainable development, but what sustainable development means from the perspective of the registered nurse in home health care when using IT is limited. The term “sustainable development” is not clearly defined and is poorly researched in nursing. Sustainable development in this study includes the ecological, economic, social, technical and ethical dimensions. The aim of this study was to describe registered nurses’ experience of IT use in home health care through a sustainable development model. Methods This study was conducted using ten semi-structured lifeworld interviews with registered nurses. The method employed was a qualitative content analysis with a deductive approach. The deductive approach consisted of a model of sustainable development. Results Analysis of the interviews and the model of sustainable development provided categories: using IT from an ecological dimension, the registered nurses experienced reduced consumption and damage to the environment; using IT in the economical dimension, saving of time and resources was experienced; the use of IT affected social aspects such as the work environment and patient safety, and positive consequences, such as accessibility, were also mentioned; using IT from a technical dimension was characterized by the nurse’s attitude towards it – the registered nurses felt it improved the quality of care and gave users an overview of the organization; and from an ethical dimension, the registered nurses expressed the need for IT to be adaptable to the patient’s well-being and indicated that more awareness of risks in the care meeting may be needed. Conclusion The findings are discussed based on the synergies and conflicts that arise between the different dimensions of sustainable development. IT intertwines and overlaps with, and within, the environment, economy, society, technology and ethics. Registered nurses in home health care want to conduct good and safe care, while using IT could benefit patients.

Designing and Implementing a Comprehensive Telehealth Aural Rehabilitation Program for Adult Cochlear Implant Recipients

2021 ◽  
pp. 1-9
Author(s):  
Cornetta L. Mosley
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Cochlear Implants ◽  
Older Adult ◽  
Health Care Professionals ◽  
Rehabilitation Program ◽  
Perceptual Training ◽  
Aural Rehabilitation ◽  
Additional Information ◽  
The University

Purpose A comprehensive aural rehabilitation (AR) program incorporates sensory management, perceptual training, counseling, and instruction. However, the process of designing and implementing such a program is inconsistent across clinical sites, and additional information regarding the use of teleaudiology to implement AR services is needed. The purpose of this clinical focus article is to describe the process of creating and implementing a comprehensive teleaudiology AR program for older adults who use cochlear implants (CIs) at the University of South Alabama (USA) Speech & Hearing Center. Conclusions A comprehensive teleaudiology AR program may be successfully designed and implemented for older adult populations. Information provided in this clinical focus article may serve as a guide or example for other trained health care professionals looking to create an in-person or telehealth AR program for older adults who use CIs. Supplemental Material https://doi.org/10.23641/asha.16755289

Age-related susceptibility to muscle damage following mechanotherapy in rats recovering from disuse atrophy

2021 ◽  
Author(s):  
Zachary R Hettinger ◽  
Kyoko Hamagata ◽  
Amy L Confides ◽  
Marcus M Lawrence ◽  
Benjamin F Miller ◽  
...  
Keyword(s):  
Older Adults ◽  
Muscle Mass ◽  
Older Adult ◽  
Recovery Period ◽  
Male Rats ◽  
Hindlimb Suspension ◽  
Disuse Atrophy ◽  
Adult Rats ◽  
Transverse Stiffness ◽  
Age Related

Abstract The inability to fully recover lost muscle mass following periods of disuse atrophy predisposes older adults to lost independence and poor quality of life. We have previously shown that mechanotherapy at a moderate load (4.5 N) enhances muscle mass recovery following atrophy in adult, but not older adult rats. We propose that elevated transverse stiffness in aged muscle inhibits the growth response to mechanotherapy and hypothesize that a higher load (7.6 N) will overcome this resistance to mechanical stimuli. F344/BN adult and older adult male rats underwent 14-days of hindlimb suspension, followed by 7-days of recovery with (RE+M) or without (RE) mechanotherapy at 7.6 N on gastrocnemius muscle. The 7.6 N load was determined by measuring transverse passive stiffness and linearly scaling up from 4.5 N. No differences in protein turnover or mean fiber cross sectional area were observed between RE and RE+M for older adult rats or adult rats at 7.6 N. However, there was a higher number of small muscle fibers present in older adult, but not adult rats, which was explained by a 16-fold increase in the frequency of small fibers expressing embryonic myosin heavy chain. Elevated central nucleation, satellite cell abundance, and dystrophin -/laminin + fibers were present in older adult rats only following 7.6 N, while 4.5 N did not induce damage at either age. We conclude that age is an important variable when considering load used during mechanotherapy and age-related transverse stiffness may predispose older adults to damage during the recovery period following disuse atrophy.

Increasing the Propulsive Demands of Walking to Their Maximum Elucidates Functionally Limiting Impairments in Older Adult Gait

2020 ◽  
Vol 28 (1) ◽  
pp. 1-8 ◽  
Author(s):  
Katie A. Conway ◽  
Jason R. Franz
Keyword(s):  
Older Adults ◽  
Older Adult ◽  
Functional Limitations ◽  
Reaction Force ◽  
Ankle Moment ◽  
Effective Interventions ◽  
Age Related ◽  
Walking Performance ◽  
Biomechanical Changes ◽  
Hip Extension

The authors elucidated functional limitations in older adult gait by increasing horizontal impeding forces and walking speed to their maximums compared with dynamometry and with data from their young counterparts. Specifically, the authors investigated which determinants of push-off intensity represent genuine functionally limiting impairments in older adult gait versus biomechanical changes that do not directly limit walking performance. They found that older adults walked at their preferred speed with hallmark deficits in push-off intensity. These subjects were fully capable of overcoming deficits in propulsive ground reaction force, trailing limb positive work, trailing leg and hip extension, and ankle power generation when the propulsive demands of walking were increased to maximum. Of the outcomes tested, age-related deficits in ankle moment emerged as the lone genuine functionally limiting impairment in older adults. Distinguishing genuine functional limitations from age-related differences masquerading as limitations represents a critical step toward the development and prescription of effective interventions.

scholarly journals Dynapaenic obesity and its association with health outcomes in older adult populations: protocol for a systematic review

BMJ Open ◽  
2019 ◽  
Vol 9 (5) ◽  
pp. e027728 ◽  
Author(s):  
Siobhan Leahy ◽  
Marica Cassarino ◽  
Matthew DL O' Connell ◽  
Liam Glynn ◽  
Rose Galvin
Keyword(s):  
Systematic Review ◽  
Older Adults ◽  
Health Outcomes ◽  
Older Adult ◽  
Observational Studies ◽  
Functional Disability ◽  
Age Groups ◽  
Ageing Population ◽  
Cross Sectional ◽  
Age Related

IntroductionTwo major global health challenges are the rapidly ageing population and the high prevalence of obesity in all age groups. Older adults are also susceptible to age-related loss of muscle strength, termed dynapaenia. The co-occurrence of both obesity and dynapaenia, termed dynapaenic obesity (DO), has been associated with poorer health outcomes and increased healthcare usage compared with either state alone. The purpose of this systematic review is to quantify the prevalence and incidence of DO in older adult populations, and to explore the association between DO and health outcomes, specifically chronic disease and multimorbidity, functional disability and healthcare usage.Methods and analysisUsing the Meta-analyses Of Observational Studies in Epidemiology guidelines, we will conduct a systematic review of cross-sectional and longitudinal observational studies of older adults, which include measures of DO and specified outcomes. Detailed literature searches of will be conducted using six electronic databases: Excerpta Medica dataBASE (EMBASE), PubMed, MEDLINE, SCOPUS, ScienceDirect and Cumulative Index of Nursing and Allied Health Complete (CINAHL), including articles published from database inception until Febuary 2019. The reference lists of included articles will also be searched. Two independent reviewers will undertake a three-step screening and review process using the Population, Risk Factor, Outcome framework to define eligibility. The Newcastle Ottawa Scale for non-randomised studies will be used to assess risk of bias and to rate study quality. The findings will be synthesised in a narrative summary, and a meta-analysis will be conducted where appropriate.Ethics and disseminationEthical approval is not required for this systematic review. Findings from this research will be submitted for peer-reviewed publication in academic journals, and presented at relevant academic conferences.PROSPERO registration numberCRD42018112471.

scholarly journals Epidemiology of Frequent/Urgent Urination in Older Adults in China: A Multicenter, Cross-Sectional Study

2021 ◽  
Vol 9 ◽  
Author(s):  
Yiwen Zhang ◽  
Xiao-Dan Wang ◽  
Yehua Song ◽  
Ruiqiang Peng ◽  
Ting Tang ◽  
...  
Keyword(s):  
Older Adults ◽  
Older Adult ◽  
Well Being ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Female Ratio ◽  
Chinese Older Adults ◽  
Adult Men ◽  
Age Related

Background: Frequent/urgent urination is an event of multifactorial origin where involuntary leakage of urine occurs. Epidemiological study of this condition is of high importance due to its negative impact on the psychological, physical, and social well-being of the victims.Objective: This cross-sectional study aimed to investigate the prevalence of frequent/urgent urination in older adults in China.Method: In this study, a face-to-face questionnaire survey was conducted between April 2019 and August 2019 among 4,796 older adult populations in the communities of Tianjin jizhou and Xiamen jimei of China. Descriptive analysis, univariate regression, and all statistics were conducted in IBM SPSS v22. The count data were analyzed by chi-square test. P < 0.05 was considered statistically significant.Results: In the total investigated population, the prevalence of frequent or urgent urination was found in 1,164 patients (24.3%) where 31.7% (664/2,097) were male patients and 18.7% (500/2,699) were female patients, having a male-to-female ratio of 1.7:1. The prevalence was higher in the 70- to 84-year-old group (men: 33.3–34.8%, women 19.5–20.8%), whereas it was relatively low in the 65- to 69-year-old group and in older adults over 85 years of age (men 28.8, 30.3%, women 16.7, 18.5%, respectively). In terms of the course of the disease, among the population aged 65 years and above, 17.3% men and 9.9% women had frequent urination/urgency lasting for 1–4 years; 5–9 years in about 4.5% population (7.4% men and 4.2% women); 10–19 years in 4.9% men and 2.3% women; and more than 20 years duration in 1.6% men and 1.9% women. On the severity scale, mild frequent/urgent urination was observed in 24.6% of men and 15.4% women of Chinese older adults. Moderate cases were observed in 6.3% of men and 2.9% of women, whereas severe cases were found in 0.8% men and 0.2% women. Benign prostatic hyperplasia (BPH)/hypertrophy was the main risk factor for frequent/urgent urination in Chinese older adult men (P < 0.001). Obesity, hypertension, diabetes, heart disease, anxiety, depression, constipation, and brain injury were the other risk factors for frequent/urgent urination in Chinese older adult men and women. The results of this survey showed that smoking or drinking habits did not increase the prevalence of frequent/urgent urination in Chinese older adults.Conclusions: According to the results of this survey, the prevalence rate of frequent/urgent urination is high, and the course of the disease is long in Chinese older adults. BPH and depression, anxiety, and age-related chronic diseases increase the risk of frequent/urgent urination in Chinese older adults.

Older Adult Factors Associated With Identified Need for Family Caregiver Assistance During Home Health Care

2019 ◽  
Vol 32 (2) ◽  
pp. 67-75 ◽  
Author(s):  
Julia Burgdorf ◽  
Alicia Arbaje ◽  
Jennifer L. Wolff
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Activities Of Daily Living ◽  
Family Caregivers ◽  
Older Adult ◽  
Home Health Care ◽  
Family Caregiver ◽  
Daily Living ◽  
Home Health ◽  
Clinical Severity

Family caregivers make important contributions to home health care for older adults, but knowledge of the specific roles they assume is lacking. We analyzed data from 1,758 community-dwelling Medicare beneficiaries aged 65+ receiving Medicare-funded home health care between 2011 and 2016, using linked National Health and Aging Trends Study and Outcomes and Assessment Information Set data. Most (86.7%) beneficiaries receiving home health care had an identified need for family caregiver assistance, and nearly 6 in 10 (57.9%) had identified need for caregiver assistance with five or more tasks. After examining significant associations between older adult characteristics and identified needs for caregiver assistance with specific tasks, we identified three profiles of older adults who demonstrate similar patterns of identified need for family caregiver assistance during home health. These profiles include: (1) older adults with greater functional impairment who more often had identified need for assistance with Instrumental Activities of Daily Living, advocacy, or Activities of Daily Living; (2) older adults with cognitive impairment who more often had identified need for assistance with medication administration or supervision; and (3) older adults with greater clinical severity who more often had identified need for assistance with medical procedures and equipment. Findings support calls to develop training interventions and strengthen the partnership between home health providers and family caregivers. These three profiles present a potential framework for the development of family caregiver training programs.

scholarly journals Interprofessional Healthcare Education on Aging Increases Students' Confidence in Medication Management Skills

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 14-14
Author(s):  
Laura Finn ◽  
Deborah Summers
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Physician Assistant ◽  
Medication Use ◽  
Care Plan ◽  
Safe Medication ◽  
Physician Assistant Students ◽  
Age Related ◽  
Survey Results ◽  
The Impact

Abstract Students studying for health care professions have limited opportunities to learn about medication use and aging in an interprofessional experience. Health Care students who interact in a simulation of age-related sensory changes can identify adaptations for safe medication use and counseling necessary to promote healthy aging. This research assessed the impact of a simulated team experience on pharmacy and physician assistant students’ confidence in understanding age related changes and in learning adaptations to promote safe medication use for older adults who may experience those changes. 63 pharmacy and 113 Physician Assistant students participated in 2-hour Interprofessional Education (IPE) sessions. The teams of pharmacy/physician assistant students utilized glasses to simulate changes in vision and gloves to simulate conditions of arthritis and neuropathy which increase in prevalence with age. Teams practiced skills of medication counseling and empathy towards their peers experiencing the simulations and learned medication administration adaptations for aging well. Pre survey results show a deficit of Pharmacist-Physician Assistant IPE with less than 20% of students reporting a strong understanding of the other profession’s role in developing an older adult’s care plan. Post survey results demonstrate an increase in students’ confidence in both understanding how sensory impairments may affect a patient’s ability to properly administer medication and confidence in counseling older adults on safe medication use. Descriptive data on learning in Interprofessional teams, Pre/Post comparison data and application to students studying other majors will be presented.

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