Care Transitions in the Psychiatric Hospital: Focus on Older Adults

Conlon, Matthew; Tew, James D.; Solai, LalithKumer K.; Gopalan, Priya; Azzam, Pierre N.; Karp, Jordan F.

doi:10.1016/j.jagp.2019.07.006

Cited by 7 publications

(6 citation statements)

References 35 publications

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“…6 Several sponsors advised the GPRP to conduct phone visits if in-person visits were unable to continue, emphasizing participant safety, and changes in concomitant medications. Beyond obvious limitations imposed by the virtual visit, such as performing physical exams, geriatric subjects offer additional challenges, such as lack of access or discomfort or inexperience with technology, challenges with the transitions in care, 7 and population-specific comorbidities, such as hearing or vision loss. Another issue specific to these geriatric studies is the role of the study partner/caregiver: Isolation strategies have, in some cases, prevented study partners from connecting with subjects.…”

Section: Work-aroundsmentioning

confidence: 99%

Clinical Trials and Tribulations in the COVID-19 Era

Weinberg

Patrick

Schwab

et al. 2020

The American Journal of Geriatric Psychiatry

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Advances in treating and preventing Alzheimer disease and other neurocognitive disorders of aging arise from rigorous preclinical and clinical research, with randomized controlled treatment trials as the last and definitive test. The COVID-19 pandemic has greatly disrupted ongoing interventional studies and researchers are scrambling to find ways to safely continue this critical work amidst rapidly shifting guidelines from sponsors, institutions, and state and federal guidelines. Here the authors describe novel approaches and work-flow adaptations to study visits, drug delivery and interim and endpoint safety and outcomes assessments to avoid sacrificing years of preparation and substantial financial investments, to work in the best interest of participants and their caregivers, and to continue on the path toward discovering disease-modifying treatments for the millions of individuals impacted by major neurocognitive disorders.

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Section: Work-aroundsmentioning

confidence: 99%

Clinical Trials and Tribulations in the COVID-19 Era

Weinberg

Patrick

Schwab

et al. 2020

The American Journal of Geriatric Psychiatry

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“…First, participants in the present study were community-dwelling participants and outpatients’ elderly with GAD diagnosis. There is also evidence that medically ill samples of older adults experienced severe levels of anxious distress [ 23 , 77 ], and were most likely to overburden healthcare services [ 46 , 78 , 79 ]. Thus, further studies could address GAS-10 diagnostic accuracy in samples of older adults with GAD diagnosis in comorbidity with medically ill patients.…”

Section: Discussionmentioning

confidence: 99%

Psychometric properties and diagnostic accuracy of the short form of the geriatric anxiety scale (GAS-10)

Carlucci

Balestrieri

Maso³

et al. 2021

BMC Geriatr

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Background Anxious symptoms have a negative impact on different aspects of the elderly’s quality of life, ranging from the adoption of unhealthy lifestyle behaviours to an increased functional impairment and a greater physical disability. Different brief assessment instruments have been developed as efficacy measures of geriatric anxiety in order to overcome psychometric weaknesses of its long form. Among these, the 10-item Geriatric Anxiety Scale (GAS-10) showed strong psychometric properties in community-dwelling samples. However, its diagnostic accuracy is still unexplored, as well as its discriminative power in clinical samples. Methods In the present study, we explored the psychometric performance of the GAS-10 in the elderly through Item Response Theory in a sample of 1200 Italian community-dwelling middle-aged and elderly adults (53.8% males, mean age = 65.21 ± 9.19 years). Concurrent validity, as well as diagnostic accuracy, was examined in a non-clinical sample (N = 229; 46.72% males) and clinical sample composed of 35 elderly outpatients (74.28% females) with Generalized Anxiety Disorder (GAD). Results The GAS-10 displayed good internal construct validity, with unidimensional structure and no local dependency, good accuracy, and no signs of Differential Item Functioning (DIF) or measurement bias due to gender, but negligible due to the age. Differences in concurrent validity and diagnostic accuracy among the long form version of the GAS and the GAS-10 were not found significant. The GAS-10 may be more useful than the longer versions in many clinical and research applications, when time constraints or fatigue are issues. Conclusion Using the ROC curve, the GAS-10 showed good discriminant validity in categorizing outpatients with GAD disorder, and high anxiety symptoms as measured by the GAS-SF cut-off. The stable cut-off point provided could enhance the clinical usefulness of the GAS-10, which seems to be a promising valid and reliable tool for maximize diagnostic accuracy of geriatric anxiety symptoms.

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“…Throughout the health‐care journey for older adults, maintaining a continuum of care is vital to ensure adequate health, high levels of satisfaction and reduction of costs, particularly during periods of care transitions (Jeffs et al., 2013). Care transitions are defined as transfers between different levels of care within the same location or different locations, including transfers to and from hospitals, nursing facilities, home, assisted living and long‐term care facilities (Conlon et al., 2019). During these care transitions, older adults are at risk of duplication of services, medical errors and lack of follow‐up, which could lead to poor health outcomes, hospital re‐admissions and dissatisfaction (Conlon et al., 2019).…”

Section: Introductionmentioning

confidence: 99%

“…Care transitions are defined as transfers between different levels of care within the same location or different locations, including transfers to and from hospitals, nursing facilities, home, assisted living and long‐term care facilities (Conlon et al., 2019). During these care transitions, older adults are at risk of duplication of services, medical errors and lack of follow‐up, which could lead to poor health outcomes, hospital re‐admissions and dissatisfaction (Conlon et al., 2019). To mitigate these risks, implementation of patient‐centred follow‐up programs that facilitate adjustment to the new situation following a care transition, are suggested (Conlon et al., 2019; Rustad, Furnes, Cronfalk, & Dysvik, 2016; Szanton, Leff, Wolff, Roberts, & Gitlin, 2016; Zakrajsek, Schuster, Guenther, & Lorenz, 2013).…”

Section: Introductionmentioning

confidence: 99%

Changes in older adults’ impairment, activity, participation and wellbeing as measured by the AusTOMs following participation in a Transition Care Program

Smith

Fields

2020

Aus Occup Therapy J

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Introduction: Maintaining a continuum of care is vital to ensure adequate health among older adults, particularly during periods of care transitions, when they are vulnerable and at risk of poor health outcomes. The Transition Care Program in Australia is designed to support older adults following the conclusion of a hospital episode. Using the Australian Therapy Outcome Measures for Occupational Therapy (AusTOMs-OT), this study aimed to understand how the Transition Care Program impacts an older adult's occupational performance during care transitions. Methods: Data were collected as a part of usual occupational therapy care from March 2016 to August 2017 from clients admitted to a Gold Coast Health Transition Care Program. Data from 110 clients were analysed on 5 AusTOMs-OT scales: functional walking and mobility, upper limb use, self care, domestic life-home, and community life/recreation/leisure/play. Change data from these scales were analysed using the Wilcoxon Signed Ranks Test. Results: Clients in the Transition Care Program experienced statistically and clinically significant improvements in all AusTOMs-OT scales analysed as well as in each domain of impairment, activity limitation, participation restriction and distress/ wellbeing. Conclusion: These results are meaningful for clients, occupational therapists and Australian Transition Care Programs. Clients demonstrated progress towards their goals, indicating maintenance or improvements in their occupational performance, confirming for occupational therapists that the provision of services is promoting goal achievement and leading to improved occupational performance. The study also highlighted the benefits for the use of outcome measures such as the AusTOMs-OT to quantify and validate client change. K E Y W O R D S community participation, occupational therapy, outcome measure, patient-centred care, transition care How to cite this article: Smith HN, Fields SM. Changes in older adults' impairment, activity, participation and wellbeing as measured by the AusTOMs following participation in a Transition Care Program.

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Care Transitions in the Psychiatric Hospital: Focus on Older Adults

Cited by 7 publications

References 35 publications

Clinical Trials and Tribulations in the COVID-19 Era

Clinical Trials and Tribulations in the COVID-19 Era

Psychometric properties and diagnostic accuracy of the short form of the geriatric anxiety scale (GAS-10)

Changes in older adults’ impairment, activity, participation and wellbeing as measured by the AusTOMs following participation in a Transition Care Program

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