Optimising care of the hospitalised elderly. A literature review and suggestions for future research

Scott, Ian A

doi:10.1111/j.1445-5994.1999.tb00693.x

Cited by 18 publications

(6 citation statements)

References 65 publications

(5 reference statements)

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“…The specific features of these interventions are patient education on specific issues, close follow-up, home monitoring, adjustment of medication and regular communication with clinical experts [44]. Therapeutic success in many instances rests more on effective patient targeting than on setting, intensity or duration of the interventions [45].…”

Section: Discussionmentioning

confidence: 99%

Interventions to reduce hospital readmissions in the elderly: in-hospital or home care. A systematic review

Linertová

García-Pérez

Díaz³

et al. 2010

Journal of Evaluation in Clinical Practice

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Section: Discussionmentioning

confidence: 99%

Interventions to reduce hospital readmissions in the elderly: in-hospital or home care. A systematic review

Linertová

García-Pérez

Díaz³

et al. 2010

Journal of Evaluation in Clinical Practice

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“…The older people occupy around two-thirds of acute hospital beds and emergency admissions have been rising for several years [7]. The healthcare cost and the proportion of hospital bed days used by older people are likely to increase further due to ageing population [8].…”

Section: Impact Of Ageing On Hospitalsmentioning

confidence: 99%

Assessment and Management of Older People in the General Hospital Setting

Singh¹

2016

Challenges in Elder Care

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Worldwide, populations are ageing. Older people, particularly centurions, represent the fastest growing sector and are counted as the success of the society. But not everyone ages successfully and enjoys good health. Many older people have multiple long-term medical, physical, mental, psychological and social problems. This can result in reduced quality of life, higher cost and poorer health outcome including increased mortality. Chronic diseases are associated with disability and low self-reported general health. In addition, physiological changes of ageing and consequent loss of functional reserve of the organ systems lead to the increased physical disability and dependency. Therefore, geriatric medicine could warrant a more holistic approach than general adult medicine. Nearly two-thirds of people admitted to hospital are over 65 years old and an increasing number are frail or have a diagnosis of dementia [1]. Our current training not only generates relatively low number of geriatricians but there also remains a huge need for better staff training and support to provide safe, holistic and dignified care. The cornerstone of modern geriatric medicine is the comprehensive geriatric assessment (CGA). This is defined as multidimensional, interdisciplinary diagnostic process that aims to determine a frail older person's medical conditions, mental health, functional capability and social circumstances in order to develop a coordinated and integrated plan for treatment, rehabilitation and long-term follow-up [2]. All older people admitted to hospital with an acute medical illness, geriatric syndromes including falls, incontinence, delirium or immobility, unexplained functional dependency or need for rehabilitation warrant CGA. CGA could screen for treatable illnesses, establish the key diagnosis leading to hospital admission and formulate a rational therapeutic plan thus resulting in the improved outcome. This chapter starts with an introduction to the ageing nation and impact of ageing on hospitals. This will be followed by discussing physiological changes of ageing and the various components of multidisciplinary assessment for older people admitted to hospital with an acute illness that could lead to high-level holistic care. It also covers a wide range of issues and challenges which medical team/multidisciplinary teams often come across during routine care of acutely

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“…Both components of this intervention (algorithms and review process) were designed to conform to the necessary components of geriatric care 22 and were developed in consultation with health professionals and consumers from within the project hospital, including two geriatricians (SJO), one clinical pharmacologist (GMS), two cardiologists, one general medicine clinician, one neurologist, three clinical pharmacists, one physiotherapist, one occupational therapist, one social worker, three GPs, and one consumer representative. Additionally, the intervention was subject to review by practitioners external to the project and the hospital, including a neurologist, a geriatrician, a visiting international clinician with research interests in this setting, and an independent consumer advocate.…”

Section: Design and Implementation Of The Review Processmentioning

confidence: 99%

“…Opinions about warfarin therapy were elicited in the 39 patients who were deemed postreview to be eligible candidates for it (new and existing users). For those with mildly impaired cognition (MMSE score [15][16][17][18][19][20][21][22][23][24], the opinion of the primary caregiver was also obtained. In general, patients and caregivers were reluctant to express a preference for any therapy.…”

Section: Patient Preferencesmentioning

confidence: 99%

Optimizing the Use of Antithrombotic Therapy for Atrial Fibrillation in Older People: A Pharmacist‐Led Multidisciplinary Intervention

Bajorek

Krass

Ogle

et al. 2005

J American Geriatrics Society

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A pharmacist-led multidisciplinary process was successfully developed and implemented within the hospital setting to increase overall antithrombotic use. Having addressed some of the known barriers and limitations to warfarin use, these algorithms may allow allied health workers, patients, and clinicians to work collaboratively to achieve optimal and, importantly, appropriate (i.e., safe and effective) antithrombotic use in at-risk elderly patients.

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Optimising care of the hospitalised elderly. A literature review and suggestions for future research

Cited by 18 publications

References 65 publications

Interventions to reduce hospital readmissions in the elderly: in-hospital or home care. A systematic review

Interventions to reduce hospital readmissions in the elderly: in-hospital or home care. A systematic review

Assessment and Management of Older People in the General Hospital Setting

Optimizing the Use of Antithrombotic Therapy for Atrial Fibrillation in Older People: A Pharmacist‐Led Multidisciplinary Intervention

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