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A frailty index derived from a standardized comprehensive geriatric assessment predicts mortality and aged residential care admission

Frailty in older adults is a condition characterised by a loss or reduction in physiological reserve resulting in increased clinical vulnerability. However, evidence suggests that frailty may be modifiable, and identifying frail older people could help better target specific health care interventions and services. Sigue leyendo

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Appropriateness of transferring nursing home residents to emergency departments: a systematic review | BMC Geriatrics | Full Text

Elderly living in a Nursing Home (NH) are frequently transferred to an Emergency Department when they need acute medical care. A proportion of these transfers may be considered inappropriate and may be avoidable. Systematic review. Literature search performed in September 2018 using PubMed, Web of Science, the Cochrane Library and the Cumulative Index to Nursing… Sigue leyendo

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Predictors of emergency room visits or acute hospital admissions in Palliative Home Care Clients

Hospitals are considered a setting ill-prepared for end of life issues; therefore, use of such acute care services has to be considered an indicator of poor quality end of life care. This study examines predictors of ERVH prior to death among HPC home care clients. 

Methods: A retrospective cohort study of a sample of 764 HPC home care clients who received services from a community care access centre (CCAC) in southern Ontario, Canada.

All clients were assessed using the Resident Assessment Instrument for Palliative Care (interRAI PC) as part of normal clinical practice between April 2008 and July 2010. The Andersen-Newman framework for health service utilization was used as a conceptual model for the basis of this study.

Logistic regression and Cox regression analyses were carried out to identify predictors of ERVH. 

Results: Half of the HPC clients had at least one or more ERVH (n = 399, 52.2%). Wish to die at home (OR = 0.54) and advanced care directives (OR = 0.39) were protective against ERVH.

Unstable health (OR = 0.70) was also associated with reduced probability, while infections such as prior urinary tract infections (OR = 2.54) increased the likelihood of ERVH. Clients with increased use of formal services had reduced probability of ERVH (OR = 0.55). 

Conclusions: Findings of this study suggest that predisposing characteristics are nearly as important as need variables in determining ERVH among HPC clients, which challenges the assumption that need variables are the most important determinants of ERVH.

Ongoing assessment of HPC clients is essential in reducing ERVH, as reassessments at specified intervals will allow care and service plans to be adjusted with clients’changing health needs and end of life preferences.

Source: 7thspace.com

Author: Lialoma Salam-WhiteJohn P HirdesJeffrey W PossJane Blums
Source: BMC Palliative Care 2014, 13:35

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The interRAI Acute Care instrument incorporated in an eHealth system for standardized and web-based geriatric assessment..

The BelRAI-software allows standardized transmural information transfer and the centralization of medical, allied health professionals and nursing data. It is strictly secured and follows strict privacy regulations, allowing hospitals to optimize (transmural) communication and interaction. Howeve… Sigue leyendo

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On the front lines of mental health. Waterloo Stories

Starting this spring, frontline officers with the Ontario Provincial Police (OPP) will use a screening tool developed at Waterloo to assess mental health issues, allowing for improved transitions from police custody to hospital care. The Brief Mental Health Screener (BMHS) is a standardized, scie… Sigue leyendo

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