Impact of Osteophytectomy on Swallowing Function in a Patient with Chronic Dysphagia
Abstract
1723 14408
Impact of Osteophytectomy on Swallowing Function in a Patient with Chronic DysphagiaAbstract
Anterior cervical osteophytes are common in the geriatric population. Dysphagia can occur in individuals suffering from these spinal abnormalities. Surgical intervention is an uncommon course of treatment for these patients, but is often utilized as a last resort with the hope of swallow recovery. The purpose of this article is to highlight a unique case study documenting the required treatment course for dysphagia associated with osteophytes and subsequent osteophytectomy. We review current literature of both cons [...] 1723 14408 |
Dysphagia in the Older Age SettingAbstract
Dysphagia, or difficulty swallowing, is a common condition, especially among the elderly population and can become debilitating. As we age, there are subtle changes in esophageal motility, but by no means is dysphagia ever considered to be a normal result of aging. Dysphagia usually presents with a variety of accompanying symptoms ranging from regurgitation during meals, mild discomfort, to severe chest pain. It can be challenging to localize the dysphagia from the history. The underlying etiology may become eviden [...] 1923 17718 |
Osteoporosis in Postmenopausal Women with Breast CancerAbstract
Breast cancer and osteoporosis are both diseases of aging. The "one in eight" lifetime risks of breast cancer occur primarily in the sixth, seventh, eighth, and ninth decades of life. One-third of postmenopausal women will experience an osteoporotic fracture. It is the coalescence of osteoporosis, breast cancer, and breast cancer treatments that, in some cases, increases the risks of osteoporotic fracture. That makes it imperative to assess risk factors, screen, and prevent or treat osteoporosis in postmenopausal w [...] 1722 10842 |
The PBAR Protocol: Antipsychotic Medication Reduction in the Nursing HomeAbstract
Neuropsychiatric symptoms (NPS) occur in almost all persons living with dementia. Antipsychotic medications are often prescribed inappropriately for persons living with dementia who experience NPS. Adverse side effects of antipsychotic medications include falls, sedation, cognitive dysfunction, prolonged QTc interval, extrapyramidal side effects, cerebrovascular events, metabolic changes, infection, and mortality. The purpose of this descriptive quality improvement project was to test the feasibility and preliminar [...] 1741 325973 |
Stenting of the esophagus in the course of the malignant dysphagia in elderly patientsAbstract
Esophageal cancer is a disease with difficult clinical management, and palliative therapy is the only predominant treatment. This retrospective study analyses the results of clinical management of elderly patients (>75 years of age) who were treated with esophageal stenting for malignant dysphagia due to primary esophageal cancer, including squamous cell carcinoma (SCC), esophageal adenocarcinoma (EAC), as well as secondary esophageal malignant strictures due to non-small cell lung cancer (NSCLC). Patients with [...] 1559 11386 |
Deep Brain Stimulation – Therapeutic Possibilities in Alzheimer's DiseaseAbstract
Alzheimer’s Disease (AD) is the leading cause of dementia worldwide, and represents a significant cause of cognitive decline, disability, and mortality. Ongoing clinical trials continue to investigate β-amyloid targeted therapy with unclear benefit, and we are currently limited to symptomatic treatment. Therefore, there is a salient need for the development of novel, potentially disease-modifying therapeutic strategies such as deep brain stimulation. This manuscript reviews Deep Brain Stimulation in Alzheimer’s Dis [...] 1466 9989 |
Promoting Quality of Life in Advanced Dementia Care: Reading Buddies Program as Service-learningby
Abstract
The Reading Buddies Program was developed as a service-learning component of an Occupational Therapy Practice with Older Adults course as a collaboration between Tufts University and the VA Bedford Health Care System. The purpose of this service-learning program was to challenge graduate students’ implicit biases and improve communication skills when working with older adults with significant cognitive impairments. Through this collaboration, occupational therapy students provided individualized, activity-based car [...] 1992 10024 |
Double-Blind, Placebo-Controlled, Randomized Clinical Trial Demonstrates Telomerase Activator TA-65 Decreases Immunosenescent CD8+CD28- T Cells in Humansby
Abstract
TA-65 is a small molecule telomerase activator extracted from Astragalus species. A previous observational study suggested that TA-65 decreased the number of immunosenescent cells in healthy subjects. Here we examined the impact of TA-65 in a much larger randomized, double-blind, and placebo-controlled study. This study aims to evaluate the effects of TA-65 on senescent CD8+CD28- T cells in healthy subjects. This was a randomized, double-blind, placebo-controlled, and multi-arm parallel trial in 500 healthy subject [...] 2668 48489 |
Admiral Nurse Case Management within Enhanced Health in Care HomesAbstract
The United Kingdom’s (UK) older population is higher than the global average. Over the next 20 years, England will see an increase in the number of older people who have higher levels of dependency, dementia, and comorbidity many of whom may require 24-hour care. Currently It is estimated that 70% of residents in nursing and residential care homes either have dementia on admission or develop it whilst residing in the care home. The provision of high-quality care for this population is a challenge with a lack of con [...] 1828 12649 |
The Role of Fatigue in the Aging Swallow: A ReviewAbstract
Fatigue is a term commonly used to describe patient performance and/or subjective experience in the evaluation and management of swallowing disorders (known as dysphagia). There is an association between fatigue and aging, as well as fatigue and many dysphagia-causing diseases/disorders. Therefore, speech-language pathologists (SLPs) are justifiably aware of and concerned about the potential impact of fatigue on swallowing performance and mealtime behavior. However, there is minimal agreement on and understanding o [...] 2540 24333 |
Translation and Validation of “Brief Bedside Dysphagia Screening Test” in a Greek Sample of Neurological Patientsby
Abstract
Dysphagia may become a threatening condition if not diagnosed and treated at an early stage. Healthcare professionals require simple, rapid, and reliable tools for the immediate evaluation of dysphagia in their daily clinical practice. The aim of the present study was the translation and validation of the “Brief Bedside Dysphagia Screening Test-Revised (BBDST-R)” tool in the Greek language in a sample of patients with neurological disorders. The present study was designed as a cross-sectional study cond [...] 1590 9252 |
Molecular Basis of Allogeneic Pluripotent Stem Cell Treatment of a Patient with Sporadic ALSby
Abstract
There are no curative strategies for ALS, and as a result the alternative therapies are gaining ground, in particular the stem cell-based therapies which hold a promising future. Here we describe an ALS patient, who by choice, received allogeneic human cord-blood derived multipotent stem cells (MSC) intravenously and intrathecally. This is the first snapshot of pre-and post-stem cell transplantation in an ALS patient through transcriptomic, epigenomic, and proteomic follow-up elucidating the effect of stem cells in [...] 1560 11256 |
Routines and Structure in the Assessment of Visuospatial Neglect in Rehabilitation Facilities: Current Practice in the Netherlands and the United Kingdomby
Abstract
Visuospatial neglect (VSN) adversely impacts both the length of rehabilitation and activities of daily living (ADL) of patients after stroke and can reduce their participation in community activities. Therefore, it is important to assess VSN after stroke in neurorehabilitation facilities. The process of assessing VSN comprehensively in current geriatric rehabilitation remains unclear. This study examined the process of VSN in post-stroke assessment emphasizing the details of the (systematic) routines and structure [...] 2119 11846 |
Research Recommendations to Address Dementia Workforce Development Needsby
Abstract
This policy paper presents workforce development recommendations for research, clinical care and public stakeholders as they plan future research activities to strengthen the workforce to support the healthcare and social needs of persons living with dementia and their families and caregivers. To create these recommendations, the 2020 National Research Summit on Care, Services and Supports for Persons with Dementia and Their Caregivers (2020 Summit) convened a Workforce Development Stakeholder Workgroup. The Stakeh [...] 1999 13671 |
Pharmacological Management of Spontaneous Intracerebral Hemorrhage in Older AdultsAbstract
Pharmacological management of intracerebral hemorrhage in adult patients over 65 years of age requires special considerations due to differing clinical presentations, underlying organ dysfunction, and more complex medical histories and medication profiles. A literature review of articles focusing on the age-specific pharmacological management of intracerebral hemorrhage was conducted. Treatment approaches and clinical outcomes specific to older adults were evaluated and therapeutic considerations for this populatio [...] 1615 12990 |
Spousal Dementia Grief: A Research Report from the Two-Track Model of Dementia Grief Projectby
Abstract
Caregiving for a loved one suffering from cognitive decline involves coping with many challenges and losses. This experience increases the risk of worsening the physical and mental health of the caregiver and has been the subject of a substantial number of studies focusing on the stress and burden of the primary caretaker. Theory and research on the grief reactions experienced by the family members, however, continues to lag in terms of the attention given to the behavioral and psychological burden of caregivers. T [...] 1894 16010 |
Acute Care Decision-Making for Patients with Advanced Dementia: An Exploratory Study Using Cognitive Task AnalysisAbstract
Decision-making by medical and health care staff forms the core of professional practice. Thought processes, including non-clinical considerations, significantly impact how clinical decisions are made. Such considerations become more relevant when addressing end-of-life care decisions for patients with advanced dementia (PAD). Though palliative care is recommended for this population, its implementation tends to vary. Given the medical staff’s significant influence in guiding clinical decisions, we examined thought [...] 1655 10959 |
A Preliminary Investigation of Relationships among Pharyngeal Acidity, Dysphagia, and Pneumonia in Acute StrokeAbstract
Individuals with acute stroke on nonoral feeding regimens frequently develop pneumonia, questioning the long-held belief that pneumonia in stroke patients is a caused by food and liquid aspiration alone. Refluxate and colonized oral secretions are thought to contribute to an acidic oropharyngeal environment. If aspirated, these colonized oral secretions with increased acidity, can result in increased risk to the respiratory system. This study aimed to investigate the relationship between pharyngeal acidity, dysphag [...] 1699 9749 |
Dysphagia Aortica: A Case Report and Review of Treatment OptionsAbstract
A 64-year-old, cachectic man with body mass index (BMI) 1525 13242 |
Telomerase and Cancer: A Complex Relationshipby
Abstract
Telomere elongation is protective of genomic stability, whereas telomere shortening increases genomic instability and thereby increases cancer risk. Long telomeres lower the risk of clinical cancer, while short telomeres are part of a causal cascade of intracellular events that result in oncogenesis and, ultimately, clinical cancer. Telomerase therapy is not only unlikely to result in an increased risk of cancer but is likely to lower the risk of cancer compared to age-matched patients not treated with telomerase t [...] 1777 23772 |
Yoga: A Potential Adjunct Therapy to Current Rehabilitation Pathways in Cardiac Conditions and StrokeAbstract
Yoga is a form of movement-based mindfulness practice that enhances the mind-body connection to benefit overall health and well-being. Although the practices of yoga are ancient traditions in the Buddhist and Hindu philosophies, scientific research regarding the impacts of yoga among people with poor cardiovascular and cerebrovascular health has only recently been undertaken. In this article, we highlight the current evidence on the potential impact of yoga on physical and psychological well-being for older adults [...] 1535 9840 |
Dysphagia in Inclusion Body Myositis, A Disease of the Elderlyby
Abstract
Inclusion body myositis is one of the most common acquired myopathies seen in the aging population. The muscle weakness is of insidious onset, frequently starting in the legs, but over time gradually progresses to eventually involve all skeletal muscles of the limbs, face, swallowing and respiratory muscles, leading to significant morbidity and mortality. Complications resulting from dysphagia are the leading cause of poor quality of life and mortality, while highly prevalent, are still underappreciated and underre [...] 2118 19013 |
Which Physiological Swallowing Parameters Change with Healthy Aging?Abstract
Research suggests there are age-related changes in swallowing that do not constitute impairment (“presbyphagia”). The goal of this study was to explore the influence of age on quantitative measures of healthy swallowing by controlling for the effects of sex and sip volume in order to determine the specific characteristics of presbyphagia. Videofluoroscopy recordings of thin liquid swallows from 76 healthy adults (38 male), aged 21-82 were analysed. Blinded duplicate ratings of swallowing safety, efficiency, kinemat [...] 3703 49233 |
Knowledge of Osteoporosis and Lifestyle Behaviours Impacting Peak Bone Mass among Young AdultsAbstract
Osteoporosis is a major public health problem through its association with fragility fracture. Low peak bone mass (PBM) is a major contributor to later osteoporosis risk. Despite this, most studies concentrate on older people when the window of opportunity to impact PBM has passed. This study aimed to understand what adolescents and young adults understand about PBM, the risk of osteoporotic fracture and how lifestyle factors impact PBM. Such information may inform educational interventions to reduce future risk of [...] 1654 11736 |
Stepping Out: A Pilot Program to Reduce Falls Risk in People with Mild Cognitive Impairmentby
Abstract
Cognitive impairment significantly increases the risk of accidental falls in older adults, and falls outcomes are more severe in this population. However, few interventions exist to reduce falls among individuals with cognitive impairment. To address this gap, we developed Stepping Out, by modifying the evidenced-based falls prevention program, Stepping On, tailoring it to meet the cognitive needs of individuals with mild cognitive impairment (MCI) who are at risk for falls. Our objectives were to determine whether [...] 1850 11006 |
Relax into Yoga for Seniors: An Evidence-Informed Update for Enhancing Yoga Practice Benefits by Reducing Risk in a Uniquely Vulnerable Age GroupAbstract
Teaching yoga to seniors is often considered an entry-level job for a yoga instructor since older adults are unlikely to attempt complicated, “advanced” postures. Unfortunately, this ill-informed attitude puts the most vulnerable students with the least-trained instructors who may unknowingly put their students at risk. Even experienced yoga instructors often do not understand the vulnerabilities of older adults, and many commonly taught yoga poses may present risks for seniors. This could explain why participants [...] 3140 138020 |
Acknowlegement to Reviewers of OBM Geriatrics in 2020Abstract
The editors of OBM Geriatrics would like to express their sincere gratitude to the following reviewers for assessing manuscripts in 2020. We greatly appreciate the contribution of expert reviewers, which is crucial to the journal's editorial process. We aim to recognize reviewer contributions through several mechanisms, of which the annual publication of reviewer names is one. Reviewers receive a voucher entitling them to a discount on their next LIDSEN publication and can download a certificate of recognition [...] 1490 6718 |
Feasibility of Implementing Therapeutic Yoga in Assisted Living Facilitiesby
Abstract
The purpose of this convergent mixed methods study was to explore the feasibility of implementing a chair yoga intervention in assisted living facilities (ALFs), evaluating reach, demand, acceptability, practicality, treatment fidelity, and safety. A yoga intervention was implemented twice a week for eight weeks at four different ALFs. Feasibility data were collected in the form of observational data, reflective field notes, and focus groups. Quantitative and qualitative data strands were compared to determine if r [...] 2037 11350 |
Yoga Training Impacts Physical Function 12 Months Post Intervention for Care Partners of those with Mild Cognitive Impairmentby
Abstract
Physical exercise has been demonstrated to help maintain cognition in people with Mild Cognitive Impairment (pwMCI). We previously demonstrated yoga’s benefit in maintenance of memory related activities of daily living in pwMCI. Our research also has shown yoga helps sustain positive psychological well-being of care partners at 12 months. In this analysis, we sought to examine the impact of yoga training on physical performance in pwMCI and their care partners. In this multisite, randomized clinical trial, we enrol [...] 1804 11078 |
Spotlight on Older Adults in Swallowing ResearchAbstract
Generalisations and misconceptions about ageing and swallowing can influence clinical opinion. Assumptions about swallowing function based on someone’s age risk overmedicalising or, conversely, undertreating older patients. Evidence suggests that increased prevalence of swallowing problems in older age is attributed to pathology known to affect swallowing function, or an unrelated serious illness and combination of health factors, and not ageing itself. This review highlights factors clinicians should consider when [...] 2142 14911 |
Anticoagulation Rationale in an Elderly Patient with Stroke, Cerebral Amyloid Angiopathy, and Antiphospholipid Syndrome: A Case ReportAbstract
We present a case of a 74-year-old woman with deep intracerebral hemorrhage (ICH), probable cerebral amyloid angiopathy (CAA), and probable antiphospholipid syndrome (APS). Due to the high hemorrhagic risk, it was decided not to use anticoagulants. In a period of three months, she had two separate cerebral ischemic events and died of stroke-related complications. The use of oral anticoagulation (OAC) in this patient is neither supported nor contra-indicated by current literature, even though past medical history su [...] 1774 7954 |
Perceived Psychosocial Benefits for Individuals with Parkinson’s Disease Following Therapeutic Yoga: A Qualitative AnalysisAbstract
Using a qualitative approach, this study explored the perceived impacts of a therapeutic yoga intervention for individuals with Parkinson’s disease (PD), and examined the beneficial components of the intervention. Eighteen individuals with PD who completed an eight-week yoga intervention participated in focus groups to determine the general effects, transference of effects, and psychosocial impact of the intervention. Additionally, programmatic aspects of the intervention were explored. A conventional content analy [...] 1828 11073 |
Post-mortem 7.0-Tesla Magnetic Resonance Imaging of the Hippocampus in Amyotrophic Lateral Sclerosisby
Abstract
Amyotrophic lateral sclerosis (ALS) is reported to be probably linked to frontotemporal lobar degeneration (FTLD). Since FTLD is characterized by severe frontotemporal degeneration along with hippocampal atrophy (HA), the present study used post-mortem 7.0-tesla magnetic resonance imaging to investigate whether a certain degree of HA occurs in the ALS brains as well. The examined post-mortem brain samples comprised 9 from the ALS cases and 17 from the age-matched controls. The hippocampus samples were examined on t [...] 1439 8703 |
Comparison of Post-mortem 7.0-Tesla Magnetic Resonance Imaging of the Brains of Alzheimer Patients with and without Cerebral Amyloid Angiopathyby
Abstract
The influence of cerebral amyloid angiopathy (CAA) in Alzheimer’s disease (AD) remains unexplored. The present post-mortem study investigated possible differences in the degree of hippocampal atrophy (HA) between AD patients with and without CAA using 7.0-tesla magnetic resonance imaging (MRI). Also, the incidence of the hippocampal cortical micro-infarcts (HCoMIs) and hippocampal cortical micro-bleeds (HCoMBs) is compared to those in the neocortex. The examined post-mortem brains included 30 AD-CAA cases and 20 AD [...] 1476 7721 |
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Open Access Short Communication An Algorithm to Optimize Pain Detection and Management in Older Patients in Routine PracticeAbstract
Acute or persistent pain is a common occurrence and is often undertreated in older patients, especially those with an inability to communicate verbally (ICV). Regular comprehensive pain assessment, including self-rating and/or behavior scales, is critical but difficult to implement in routine clinical practice. The choice of the most appropriate scale for each patient is not easy, even for trained and skilled medical personnel. Indeed, the use of scales for short pain-behavior exposes to pain under-detection due to [...] 1849 11440 |
Bridging Biomedical and Person-centered Care Approaches via Namaste Care with Family Participation: An Asian Experience in Advanced Dementia Treatmentby
Abstract
A locally-adapted, multisensory, psychosocial intervention called Namaste Care program was developed to improve the daily life of persons with advanced dementia (PwAD) through arranging meaningful activities and physical interactions by healthcare staff (Namaste Carers). Congruent with Asian values, the families of PwAD were invited to participate in Namaste Care sessions. The study aimed to explore the influence of Namaste Care on cognitive status and quality of life (QOL) of PwAD, and perceptions and attitudes of [...] 2273 14067 |
Rheumatic Diseases in the Elderlyby
Abstract
Musculoskeletal conditions represent one-third to more than one-half of all non-communicable disease multimorbidities in the elderly, worsening their disability because of pain and limited physical function, often concurring with their mental decline. Musculoskeletal conditions significantly contribute to frailty and global disability, second only to mental health conditions. Furthermore, premature mortality, generally due to an increased risk of developing cardiovascular disease, has been documented in several rhe [...] 2408 18128 |
Effects of a Six-Week Progressive Resistance Training Program on Functional Fitness among Community-Dwelling Older AdultsAbstract
Research has indicated that older adult participation in resistance training provides foundational strength for performance of activities of daily living. The purpose of this study was to investigate the effects of a six-week progressive resistance training intervention on functional fitness among community-dwelling older adults. From 2010–2015, twelve sessions of a six-week resistance training intervention included 95 community-dwelling older adult participants (37 male, 58 female; Mage=73.5+7.2). Resistance [...] 2028 10619 |
Feasibility of an 8-week Yoga Intervention among Middle-aged and Older Adultsby
Abstract
Feasibility studies play a critical role in determining whether the target population is likely to engage with larger scale efficacy and effectiveness trials. Feasibility data for yoga interventions designed and conducted with older adults is limited. In this paper we present feasibility and acceptability data from an 8-week randomized controlled trial (RCT) conducted with middle aged and older adults. Participants n=118 (Mean age: 62.0 years) were randomized to either a Hatha yoga or Stretching Control group with [...] 1785 11617 |
Aspiration Pneumonia and the Traditional Chinese Medicine Banxia Houpu Tangby
Abstract
Aspiration pneumonia is one of the most common reasons for death in stroke patients. Recently, a traditional herbal medicine banxia houpu tang is remarked to prevent the aspiration pneumonia. This review tells the history of study of banxia houpu tang for prevent aspiration pneumonia. 2581 11884 |
Yoga to Reduce Leisure Constraints for Residents of Assisted Living FacilitiesAbstract
Residents of assisted living facilities face leisure constraints (barriers to leisure activities) at higher rates than their community-dwelling peers. Past research suggests yoga may be an effective intervention to decrease leisure constraints to physical activity. Therefore, the purpose of this study was to evaluate the impact of an eight-week yoga intervention on the leisure constraints of residents of assisted living facilities. The study employed a convergent mixed methods design to assess the impact of a 50-mi [...] 1862 11095 |
What Makes Us Walk: Predictors and the Interplay of Physical and Cognitive Factors on Gait Speed in Community Dwelling Older AdultsAbstract
This study investigated the predictors of gait speed in community dwelling older adults while examining interplay between physical performance and cognition on comfortable and fast gait speed. Sixty-six community-dwelling older adults (mean age 80.8 71% female) completed the following: 30-Second Chair Stand (30-SCS), Functional Reach (FR), Flanker Task, Digit Symbol Substitution Test (DSST), and gait speed (comfortable and fast). Hierarchical linear regression examined the relationship of comfortable and fast gait [...] 2073 9681 |
Physical Activity’s Impact on Quality of Life in Older Adults with Dementia: A Systematic ReviewAbstract
Individuals with dementia frequently report poor quality of life (QOL), which declines as their disease progresses. Some evidence suggests that physical activity may help maintain cognitive function in older age, but it is unclear whether physical activity affects quality of life in older adults with dementia. The purpose of this review paper is to explore whether and how physical activity impacts QOL in patients with diagnosed dementia in different residential settings. To conduct this systematic review, the follo [...] 1557 12972 |
Immune Senescence and Covid-19 PandemicAbstract
Covid-19 pandemic has been infecting a substantial portion of the world population, thereby revealing quality deficits in health care in the majority of the countries around the globe. Severe illness and mortality from Covid-19 infection are present predominantly in minorities; especially they are more frequent in geriatric patients. Unfortunately, our knowledge is limited about what accounts for the variability in immune response from one person to another. This question is far from being merely academic, and find [...] 1709 8130 |
Parkinson’s Disease Motor and Non-Motor Features Accompanying Insomnia and Excessive Daytime Sleepiness Symptoms, a Large Population-Based Studyby
Abstract
Insomnia and excessive daytime sleepiness are the most common sleep disturbances in Parkinson’s disease. This study aims at better understanding how severity of PD motor and non-motor features and dopaminergic treatments contribute to these sleep symptoms in the first decade of PD. Data from a community-based cohort of PD patients was used to model cross-sectional PD-related risk factors for insomnia and EDS sleep scores using linear regression models adjusted for age, gender, and PD duration. Longitudinal changes [...] 1725 9778 |
Establishing a Method for Quantifying Spinal Curvature during Videofluoroscopic Swallow Studies: Applying the Modified Cobb Angle to Healthy Young and Older AdultsAbstract
The Cobb angle is traditionally used for quantifying the degree of spinal curvature through evaluation of the full spinal cord. When conducting measurements on videofluoroscopy swallowing studies (VFSS), the Cobb angle can measure degree of cervical vertebrae curvature, which may have implications for swallowing. Given that this measure may have utility in dysphagia research, the reliability of this measure taken from C2-C4 and establishing the presence of changes with age were the focus of the current, proof-of-pr [...] 2081 11724 |
A Delirium Monitoring Program for Hospitalized Older Adults: An Approach to Age-Friendly Health SystemsAbstract
Delirium is an acute change in mental status with key features of inattention and disorganized thinking. It is particularly common in older adults, with multiple and varied causes. Delirium increases the risk of morbidity, mortality, institutionalization, and healthcare costs; however, it is often missed because it is difficult to recognize without the use of a validated screening tool. The Age-Friendly Health Systems (AFHS) initiative highlights the need for implementation of a delirium monitoring program in hospi [...] 2205 15631 |
Ageing, Comorbidity and Frailty-Synergistic Risk Factors for Covid-19 Adverse OutcomesAbstract
With life-expectancy rising globally, the prevalence of ageing, comorbidity and frailty is likely to increase especially in the low and middle income countries. The emergence of the new COVID-19 pandemic has been concentrated in this group of patients and has led to worse outcomes compared to younger and less comorbid populations. This group of patients is at an increased risk of multi-organ consequences of systemic disease. Therefore, systemic assessment of these patients from the outset and optimisation of their [...] 2004 12606 |
Bone Mineral Density in Male Hospital Physicians over the Age of 65 YearsAbstract
Hospitalists are at risk for vitamin D deficiency during their active years due to indoor working conditions and insufficient sunlight exposure. The impairment of bone mineral density (BMD) in this group has not been studied. A total of 50 male hospitalists aged ≥ 65 years were enrolled. Their BMD was measured at the femoral neck (FN), lumbar spine (LS), and distal radius (DR), and their medical history and risk factors were assessed through a detailed questionnaire. The FRAX® (Fracture risk assessment tool) [...] 1727 8639 |
The Effect of Live Bedside Music on Pain in Elderly Surgical Patients. A Unique CollaborationAbstract
Postoperative pain has a negative influence on physical and mental recovery and may result in a variety of postoperative complications. Listening to recorded music has been revealed to reduce pain, but in addition to that, live bedside music further offers the possibility to interact with the patient, respond to their emotions, and help them in adapting their conditions. It, therefore, seems appropriate for older surgical patients. This study examines the effect of live bedside music on postoperative elderly patien [...] 1673 10353 |
On the Face of It: Social Heuristics Are Mediated by Age and Sex, But Not by FaciometricsAbstract
The ability to situate individuals within social categories provides an important social function, allowing people to navigate problems of survival and reproduction within highly complex social structures. This categorization of people with apparently shared characteristics is facilitated by various cues, one of the most important being facial information. There has been a wealth of literature that reports on perceptions of characteristics informed by faciometrics (or the measurement of facial features and associat [...] 1776 9362 |
Bone Health in the Elderly with Type 2 Diabetes Mellitus–A Systematic Reviewby
Abstract
Type 2 diabetes mellitus (T2DM) and osteoporosis are two major public health concerns worldwide, contributing to morbidity and mortality in the elderly. Aging is one of the most significant risk factors for low bone mass, bone fragility, and fractures. Among the several comorbidities that affect the elderly with diabetes, increased fracture risk is a relatively recently discovered complication. Generally, individuals with T2DM exhibit higher bone mineral density, which complicates the assessment of fracture risk. D [...] 1836 13035 |
Post-Mortem Comparison of the Incidence and the Distribution of Cerebrovascular Lesions Using Additional 7.0-Tesla Magnetic Resonance Imaging in Cognitive Normal Young, Middle-Aged, and Elderly Personsby
Abstract
Regional brain atrophy and an escalation in vascular risk are associated to increasing age in normal cognitive healthy persons. The present post-mortem study compares the incidence of cerebrovascular lesions between young-aged, middle-aged, and elderly cognitive normal persons with additional 7.0-tesla MRI). The patients consisted of 10 young adults, 20 middle-aged adults, and 14 elderly ones. In addition to the macroscopic visible cerebrovascular lesions, a whole coronal section of a cerebral hemisphere was taken [...] 1546 9359 |
Intermittent Fasting and Brain Health: Efficacy and Potential Mechanisms of ActionAbstract
Despite continuous efforts to combat neurodegenerative diseases, researchers have been unable to find an intervention that reverses degeneration and/or improves cognition in dementia or healthy aging. Therefore, it is considerably important to identify lifestyle factors that could potentially aid in healthy brain aging and prevent or delay neurodegenerative diseases. The emerging interest in the ancient practice of fasting has inclined researchers to study the physiological and behavioral effects of this practice. [...] 2463 32944 |
Association between Very Low Dietary Protein Intake and Subsequent Falls in Community-Dwelling Older Adults in the United Statesby
Abstract
Poor nutrition is linked to frailty and both poor nutrition and frailty are recognized risk factors for falls. This study examined the association between dietary protein intake and subsequent reported falls in community-dwelling older Americans with a history of falls. Other nutritional, functional, and sociodemographic-related variables were also considered in our model. This was a retrospective analysis using data from the U.S. Health and Retirement Study (HRS) and Health Care and Nutrition Study (HCNS), both fu [...] 1427 68689 |
Adoption of a Patient-Tailored Fall Prevention Program in Academic Health Systems: A Qualitative Study of Barriers and Facilitatorsby
Abstract
Falls represent a persistent and costly patient safety issue. Fall TIPS (Tailored Interventions for Patient Safety) is a patient-centered and clinical decision-supported, fall prevention program that has led to fewer falls and related injuries among hospitalized patients. We aimed to identify dominant facilitators and barriers to Fall TIPS adoption. This multisite qualitative study was conducted in 11 hospitals representing three academic health systems, where Fall TIPS had been implemented for at least one year. I [...] 2938 34156 |
Towards Positive Aging: Links between Forgiveness and HealthAbstract
Forgiveness may serve as an essential positive resource to help individuals cope emotionally with stressful events, ultimately influencing health. Examination of how individuals forgive within the context of close relationships can provide useful information about positive aging. In this study, we examine how the severity of a recent transgression committed by a spouse/partner or other close social relationship is associated with self-reported physical health among older adults. We also examine how state forgivenes [...] 1943 11858 |
Glial Alterations in Aging and Alzheimer’s Disease: A Novel Basis to Understand, Prevent and Treat the Degenerative ProcessAbstract
Neurons, from the time of their birth until their death, are always accompanied by neuroglial cells, maintaining very close morphological and functional relationships among themselves. Classically three main neuroglial families have been considered within the central nervous system (CNS): astroglia, oligodendroglia, and microglia. However, using morphological and immuno-cytochemical criteria, several different types/subtypes of neuroglial cells have been identified, each exerting specific physiological and patholog [...] 1639 10342 |
New Horizons in Alzheimer Research from Amyloid and Beyondby
Abstract
The Amyloid and Tau Hypothesis of Alzheimer’s disease once thought to be the key have shown marginal results but are bolstered by the recent revival of the Aducanumab study and some positive data on some anti-Tau drugs. It still behoves us to look at other mechanisms which include whole blood transfusions, an Epigenetic approach, a-derivative of a Parkinson's drug a low dose of an anti-epileptic drug, an antibiotic against P Gingivitis and many new approaches not directly involving Amyloid and Tau. Other newer appr [...] 2097 69305 |
Intestinal Necrosis Due to Digoxin IntoxicationAbstract
The knowledge about digoxin, the associated cardiac and extracardiac effects, its pharmacokinetics and dynamics, indications, dosing, and side effects is important with the objective of deriving its maximum benefit without the risk of intoxication. Although the dosing of digoxin has been standardized and its usage has declined, digoxin intoxication still occurs frequently. Due to the risk of fatal complications, it has a negative prognosis. The knowledge about the etiology and symptoms of intoxication is critical f [...] 1956 11127 |
Using a Rocking Chair in the Care of People with Dementia: A Single-Case Research StudyAbstract
The people with dementia experience a progressive loss of cognition, while more than 90% of them develop behavioral and psychological symptoms of dementia (BPSD). BPSD may result in physical injuries and psychological distress among people with dementia and their family/caregivers. First-line care strategies in dementia care should not unthinkingly involve pharmacological interventions to avert or reduce the behavior, and should rather consider the person and their unique requirements. Therefore, a combination of p [...] 2557 18314 |
Management of Older People With Diabetes - A Focus On Mental FunctionsAbstract
The prevalence of diabetes in older people is increasing. Diabetes in old age is associated with increased risk of mental dysfunction. Cognitive dysfunction and mood disorders such as depression, anxiety and diabetes-related distress tend to coexist in older people with diabetes and appear to have bidirectional relationship acting as a risk factor and, at the same time, as a consequence of diabetes. To break the vicious circle of this complex reciprocal relationship between diabetes and mental dysfunction, early id [...] 1550 10748 |
Known–Unknowns in Geriatric Cardiologyby
Abstract
The present article summarizes the current state of understanding in geriatric cardiology in terms of the main developments in the field. The focus of the present review is on the therapeutics, into the specific characteristics of the elderly patients dealing with the prevention of arterial hypertension, bradycardic arrhythmias, atrial fibrillation, coronary artery syndromes, valve heart diseases, and heart failure. Progress in the field of medicine has rendered possible to treat lethal cardiac diseases in the [...] 1666 9658 |
Biomaterial to Improve Drug Delivery in Alzheimer's Disease: Linking Major Pathogenic PathwaysAbstract
Aging, hypertension, diabetes, obesity, atherosclerosis, traumatic brain injury, and other factors can all synergistically promote diverse pathological mechanisms. These risk factors trigger widespread inflammation and oxidative stress, both of which can lead to blood-brain barrier (BBB) disruption. These pathological cascades lead to neuronal Ca2+ increase, neurodegeneration, gradual cognitive/memory decline, and eventually Alzheimer's disease. In particular, more recent research indicates that chronic inflamm [...] 1532 9686 |
Dysphagia and Oral Health in Older PeopleAbstract
Dysphagia is a term that is used for the difficulty in moving liquid/food from mouth to the stomach. Dysphagia is very common in elders, which makes them susceptible to malnutrition, infection, institutionalization, and death. Consequently, it is categorized as a geriatric syndrome. Therefore, multidisciplinary teams need to work together to determine the correct etiology and implement an appropriate care plan. Oral care is crucial in managing dysphagia and dental hygienists and dentists serve as the key members. I [...] 2158 17055 |
Exploring the Effects of Aerobic Exercise on Blood Coagulability in Caregivers of Patients with Dementia: A Randomized Controlled Trialby
Abstract
The incidence of vascular diseases among caregivers of dementia patients is high, and one potential cause is the exacerbation of blood coagulability due to mental strain from caregiving. This study aimed to examine the effects of aerobic exercise on blood coagulability, from the perspective of improving the health of caregivers. Thirty-one healthy elderly caregivers, residing with patients suffering from Alzheimer’s-type dementia, were randomly divided into two groups. In the intervention group, moderate walk [...] 1462 10576 |
Alzheimer's Disease: Parsing the Pathways Leading to the Disease Based on the Spirochete/Biofilm HypothesisAbstract
A pathway which highlighted spirochetes (Borrelia burgdorferi and dental treponemes) that made biofilms which led to Alzheimer’s disease has recently been promulgated. All the Alzheimer’s disease, on which this pathway was based, had been specifically confirmed both clinically and pathologically. This current work will show putative and plausible individual pathways that were studied. First and foremost, intracellular spirochetes make biofilms and concurrently make beta amyloid; this has been shown in v [...] 1521 9198 |
Problems Associated with the Measurement of Neuropsychiatric Symptoms of DementiaAbstract
Neuropsychiatric symptoms (NPS) affect nearly all persons living with dementia (PLWD) at some point during the course of the disease. Given the absence of a cure or effective pharmacotherapy for dementia, it is particularly important to prevent, measure, track, and manage NPS in dementia care. Unfortunately, these efforts are hindered by inconsistent operational definitions and measurement tools for numerous neuropsychiatric symptoms. This review examines agitation, aggression, restlessness, and rejection of care a [...] 1947 12011 |
Cortical Activity and Rhythmic Patterns in Mouse Models of Aging and Alzheimer’s DiseaseAbstract
Aging and Alzheimer’s disease (AD) have been reported to induce changes in the cerebral cortex circuits. The present review aims to study these alterations by reviewing emergent cortical activity with a focus on the rhythmic patterns. The rationale for this approach was two-fold: (i) emergent rhythmic activity integrates cellular and network properties of these underlying circuits; and (ii) alterations in rhythmic patterns reflect the functional impact of changes on the network induced by the pathophysiology of the [...] 1365 10482 |
Behaviors of Persons with Dementia: A Review and New Perspective for Future ResearchAbstract
Through the assessment of previous and current literature on the behaviors experienced by persons with dementia, this review discusses the terminology, conceptual models, measurement techniques, and non-pharmacological interventions employed within behavioral research. Additionally, this review considers the illness experience and the need for more research using self-report methodology with persons with dementia in order to address the current gaps within the behaviour literature. With three main objectives, this [...] 1860 15988 |
Target Tau, not Amyloid, to Prevent and Treat Alzheimer’s DiseaseAbstract
In this article I wish to put the case for a change of emphasis in the approach to finding a prevention/treatment for Alzheimer’s disease from a focus on beta amyloid to one on tau. In particular, I make the case for aiming to prevent the spread of abnormal tau from the medial temporal lobe to widespread areas of association cortex that are anatomically linked to this critical region. I pose an analogy with cardiovascular disease in which the initiating pathology, lipid streaks, are left untreated until they are so [...] 1564 9375 |
Views of Conventional Medicine and Integrative Medicine among Informal Dementia Caregivers and Healthcare Professionals in NW EnglandAbstract
The urgent need for innovative approaches to dementia treatment that are acceptable, effective and affordable underlies this research. Growing evidence supports ‘integrative medicine’ as a potential treatment approach aligned with and including conventional medicine. However, success will depend on addressing barriers, recognising needs of diverse communities and involving people in co-creating desired interventions. The three aims of this study were to, 1) describe conventional allopathic medicine and integrative [...] 1599 12874 |
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Implications of Clozapine Complications in Geriatric Patients with Type II Diabetes MellitusAbstract
Second-generation antipsychotics, have known metabolic side effects; specifically, clozapine is implicated in worsening or causing hyperglycemia, hypercholesterolemia and weight gain. Recently, there has been an increased interest in the safe use of clozapine in patients with diabetes. In March 2018, a 65-year-old female with a diagnosis of schizophrenia was admitted for inpatient hospitalization to a psychiatric hospital in Buffalo, NY for further stabilization after receiving two months of treatment at a comprehe [...] 1637 11421 |
Using Mixed Methods to Explore Older Residents' Physical Activity and Experiences of Community Active Aging FriendlinessAbstract
Physical inactivity is the fourth leading risk factor for global mortality and as such, it is critical that physical activity guidelines for health consider equitable access to physical activity opportunities for all, including those aged 65 years and older. The purpose of this study was to examine the intersections of attributes of older people (e.g. income, gender, age, health, physical activity) and attributes of the places they live (e.g. rurality, public transit, sidewalks, parks, community centre) to explain [...] 1534 9692 |
A Novel Approach to Fall Risk Reduction: Combining Education and Therapeutic Yogaby
Abstract
Falls have negative consequences for older adults, but falls can be reduced through interventions that target the reduction of fall risk factors. Cognitive behavioral education programs and therapeutic yoga are two interventions that have independently been used as a means to reduce the risk of falls. The purpose of this study was to determine if adding therapeutic yoga following an education intervention improved well known fall risk factors. Potential participants were recruited through a senior center for a 12-w [...] 1958 10828 |
Social Connectedness in Preventing Suicide among Older AdultsAbstract
Social isolation and social disconnectedness have resulted in some older adults ending their lives by suicide; therefore, improving social connectedness has become an integral part of suicide prevention programmes. The purpose of this literature review was to assess the impact of social connectedness interventions for preventing suicide in older adults. It is evident that interventions aimed at promoting social connectedness are intended to alleviate stress and depressive symptoms due to social separation and traum [...] 2171 12567 |
Design Guidelines to Reduce Extrinsic Fall Risks in the Built EnvironmentAbstract
As people age, environments supporting changing needs can potentially impact their quality of life. Aging often leads to a decrease in the ability of people to interpret sensory cues within their environment. Using Pastalan's Empathic Model as a framework, a list of guidelines for the physical environment was established to address the extrinsic risk factors affecting falls. Attention to these items may not prevent all falls but will mitigate some of the external risks that cause falls for older adults.
It is the g [...] 1625 12687 |
Successful Aging and Positive Psychology: Two Empirically Related PerspectivesAbstract
Background: In the last two decades, successful aging (SA) and positive psychology (PP), the two paradigms of health have received great attention. They originate from different approaches, theoretical background, and objectives. Although they share many characteristics, their association remains understudied. This article aims to empirically analyze their possible interrelation.
Methods: In this cross-sectional study, 169 healthy, old adults completed several questionnaires to assess the central framework for succ [...] 2393 17297 |
Women’s Perceptions of the Embodied Experience of Osteoporosis across the Lifecourseby
Abstract
Beliefs about the daily experience of a disease are used to identify risk and motivate participation in prevention. For osteoporosis, a disease that is affected by health behaviours throughout the lifecourse, individual perceptions of the disease can affect health decisions and future disease prevalence. Understanding how the experience of osteoporosis is perceived by women at different stages of life can illuminate factors that influence engagement in prevention. Women representing three life stages - young adults [...] 1332 8818 |
Effects of Enriched Thematic Multi-Sensory Stimulation on BPSD in A Beach Room: A Pilot Study among Nursing-Home Residents with Dementiaby
Abstract
Background: Studies conducted on the effectiveness of psychosocial interventions have indicated that sensory stimulation represents a promising approach to reduce the psychological and behavioral disturbances in people with dementia. Multi-sensory stimulation involves the simultaneous stimulation of multiple senses, through the use of various methods, for example, by using a variety of lights, gentle stimulating music, aromas, and tactile objects, among others. A relatively novel approach is the enriched thematic m [...] 2480 14016 |
Depression in the Elderly–Epidemiology, Diagnosis, Special Aspects, and Treatment OptionsAbstract
The prevalence of Late-life Depression (LLD) has been estimated between 10% and 15%. Therefore, it is a considerable worldwide problem. The psychopathology is not substantially different from that of depressive episodes in young adults but somatic complaints in combination with end-of-life perspective leave an imprint on emotional experience. The frequent suicidal tendency, especially in old unmated men, remains a particular challenge. It is important to combine psychiatric and somatic diagnostics using modern meth [...] 1721 12469 |
The Association between Bone Turnover Markers and Fracture in People with Diabetes: A Systematic Review and Meta-AnalysisAbstract
Background: The increased risk of fractures in individuals with diabetes has been underestimated by conventional fracture predictors such as the bone mineral density T-score or the Fracture Risk Assessment Tool. The present study conducted a systematic review and a meta-analysis to investigate the association between the levels of bone turnover markers (BTMs) and fractures in patients with diabetes.
Methods: We conducted a systematic literature search. Eligibility criteria were studies investigating BTMs in patient [...] 1367 9664 |
Automated Movement Feedback for Recovering Independence in the Sit-to-Stand Movement in an Older Population: A Pilot Randomised Controlled Trial of a Novel SystemAbstract
Background: The sit-to-stand (StS) movement is a frequently performed task critical to independent living that is both difficult to perform and associated with falls in older populations. Consequently, the recovery of this movement through supervised practice is a priority during the rehabilitation of older people. Technology may enable self-practice, potentially improving rehabilitation outcomes. The purpose of this study was to evaluate the clinical feasibility and effectiveness of an automated movement feedback [...] 1879 11548 |
Physical Illness and Emotional Expression in Late LifeAbstract
Louise H., Ph.D was referred to me by her long-term primary care physician (PCP) who was certain that his patient was seriously depressed and in need of medication and possibly psychotherapy. My own assessment, in consultation with a neurologist, was that Louise’s problems with coping were primarily neurological, and that her issues were due to serious (and in one case embarrassing) symptoms. Her neurological problems (mild Parkinsonism and PseudoBulbar Affect, or PBA) are currently being addressed by the neurologi [...] 1307 8258 |
Balance and Fall Rates are Associated with Chronic Pain, and Improve with Yogaby
Abstract
Background: Falls are relatively common in older adults and are associated with chronic pain. Chronic pain may even be a predictor of falls in older adults. However, this relationship has not been studied in adults 1726 10206 |
Evaluation of the Prevalence of Screening for Dysphagia among Older People Admitted to Medical Services – An International SurveyAbstract
Background: With the increasing age of the world population, the number of old and frail people is increasing. Respiratory disease is a common reason for hospital admission for older people. Aspiration of saliva, which is probably infected, is the likely etiological agent. The incidence of an abnormal swallow is high in frail older people. Despite the high incidence of swallow problems among older people, many hospital services do not routinely screen older people for dysphagia.
Methods: A survey, using Research El [...] 2353 29662 |
Qualitative Evaluation of Interdisciplinary Service Learning Experience to Assess and Manage Fall Risk in Community-Dwelling Older Adultsby
Abstract
Aim: The purpose of this study was to evaluate faculty and student perceptions of a fall risk assessment and prevention activity for older adults offered in multiple community settings by health professional faculty and students.
Background: In the US, the percentage of adults 65 and older who fell was more than 29% in 2018. Among states, Arkansas ranks 48th with 35.2% of older adults reporting a fall (CDC Behavioral Risk Factor Surveillance System, 2018).
Methods: Four senior centers in Northwest Arkansas hosted a [...] 1727 10704 |
Ageing: The Role of Ageismby
Abstract
Worldwide, people are living longer but not necessarily experiencing optimal health since healthy ageing stems from a combination of biological, psychological, and social factors. The growing interdisciplinary literature on ageism from fields such as education, medicine, psychology, and social work increasingly highlights the pivotal role that ageism plays in ageing. Ageism is generally an overlooked factor in understanding and fostering healthy ageing. Ageism creates a negative view of the ageing process as marked [...] 4664 36062 |
Using Health-Related Quality of Life (SF-36v2®) to Predict Falls in Community-Dwelling Older Adultsby
Abstract
Background: Falls are the leading cause of hospitalization and death among older adults; therefore, the ability to predict fall risk among older adults is critical. Several performance-based outcome measures exist to assess fall risk. Psychological factors are also associated with fall risk yet can be difficult to assess and are often overlooked. In this study, we investigated whether the Short Form 36 Item Health Survey (SF-36v2®), a measure of health-related quality of life (HRQOL), predicted future falls in [...] 1627 11081 |
Admiral Nursing in Primary Care: Peri and Post-Diagnostic Support for Families Affected by Dementia within the UK Primary Care Network ModelAbstract
The population of the United Kingdom is ageing. In 2017 approximately 18% of the UK population were aged 65 years or over and projected to grow to almost 21% by 2027 according to the Office of National Statistics. Increased age is the greatest risk factor for developing dementia. It is estimated that there are 850,000 people living with dementia in the UK and if current figures relating to incidence and prevalence are realised, this will increase to 1 million people by 2025 and 2 million by 2051.
The National Healt [...] 1730 14694 |
Naming and Framing the Behavioural and Psychological Symptoms of Dementia (BPSD) Paradigm: Professional Stakeholder PerspectivesAbstract
Background: Behavioural and Psychological Symptoms of Dementia and Challenging Behaviour in dementia are just two of a variety of terms for a complex paradigm that covers the most distressing and costly aspects of the condition. The terminology used to describe these aspects can influence what is measured as outcomes and what is considered as evidence of improvement. Unhelpful or outmoded narratives could be a barrier to developing innovative interventions or in determining what works for whom. This UK study explor [...] 2412 19578 |
Behavioral versus Biological Definitions of Dementia Symptoms: Recognizing that Worthwhile Interventions already ExistAbstract
Background: The 2018 Alzheimer's Disease Facts and Figures special report includes two new guidelines for measuring dementia symptoms. The first requires that a biomarker (biological factor) be added to a doctor's clinical judgment of the cause of symptoms when determining whether dementia is present. The second involves identifying four stages of dementia: normal cognition, preclinical, MCI and dementia. Now only those with defining brain pathologies and significant symptoms will be judged to be persons with stage [...] 3244 14679 |
GAPcare: The Geriatric Acute and Post-Acute Fall Prevention Intervention for Emergency Department Patients – A Qualitative EvaluationAbstract
Background: Three million US emergency department (ED) visits occur for falls each year. The mortality of falls is increasing and only one fourth of older adults report their fall to their primary care provider, suggesting that valuable preventative opportunities are missed. A fall prevention intervention initiated in the ED immediately after a fall has the potential to reduce subsequent falls, but ED providers lack the time and resources to complete fall risk assessments on their patients. GAPcare, the Geriatric A [...] 3144 14388 |
Aging in A Changing World – the Impact of Social Contact and Physical Activity on Health-Related Quality among Older People from Austria – A Biological PerspectiveAbstract
Background: All over the world we are confronted with an absolute and relative increase in the proportion of older people. In order to develop strategies to keep older people healthy and independent as long as possible, analyses of factors influencing health related quality of life (HRQL) during old age are necessary. The aim of this review is to present the results of three projects carried out in Austria by the author focusing on the impact of social contact and physical activity on HRQL.
Methods: The standardize [...] 1655 10350 |
The “PRIMING, TIMING, MIMING” Model of Individualized Behavioural Care Planning for Residents with DementiaAbstract
The current paper introduces the “Priming/Timing/Miming” Model of Behavioural Care Planning for persons with Dementia. This simple heuristic provides a quick, easy and systematic way to select from the vast number of behavioural strategies offered in the BPSD literature and to organize these in a way that can be incorporated into an individualized Behaviour Care Plan to deliver personal care to persons with dementia and also to develop a larger plan of care. An entire care plan is captured on one double-sided sheet [...] 1713 13305 |
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