Abstract:
:Care home medicine has been an under-researched area, but over the last decade there has been a substantial growth in publications. Most of these have focused on the 'geriatric giants' of falls, incontinence and mental health issues (especially dementia, behavioural disturbance and depression) as well as other key topics such as medication use and issues related to death and dying. Other areas of recent interest are around access to health services for care home residents, how such services may most effectively be developed and how the quality of life for residents can be enhanced. While many of the reported studies are small and not always well designed, evidence in several areas is emerging which begins to guide service developments. A common theme is that multi-disciplinary interventions are the most effective models of delivery. The role of care home staff as members of these teams is key to their effectiveness. Recent consensus guidelines around falls prevention in care homes synthesise the evidence and recommend multi-disciplinary interventions, and clarify the role of vitamin D and of exercise in certain populations in the care home. The benefits of pharmacist led medication reviews are beginning to emerge; although studies reviewed to date have not yet led to the 'holy grail' of hospital admission avoidance they point to benefits in reduction of drug burden. Effectiveness may be enhanced when working with GPs and care home nurses. Welcome evidence is emerging that in the UK the rate of prescription of anti-psychotics has fallen. This is clear evidence that changes in practice around care homes can be effected. The poor access to non-pharmacological therapies for care home residents with behavioural disturbance remains a significant gap in service. End-of-life care planning and delivery is an important part of care in care homes, and there is evidence that integrated pathways can improve care; however, the use of palliative care medications was limited unless specialist care staff were involved. Integrated models of care that focus on resident-centred goals and which value the role of care home staff as members of the team working to deliver these goals are most likely to result in improvements in the quality of care experienced by care home residents.
journal_name
Age Ageingjournal_title
Age and ageingauthors
Burns E,Nair Sdoi
10.1093/ageing/aft186subject
Has Abstractpub_date
2014-01-01 00:00:00pages
2-7issue
1eissn
0002-0729issn
1468-2834pii
aft186journal_volume
43pub_type
杂志文章相关文献
AGE AND AGEING文献大全abstract:Objective:to investigate whether cognitive impairment, measured early after Emergency Department (ED) arrival and irrespective of its cause, is independently associated with functional decline or mortality after 3 and 12 months in older ED patients. Design and setting:a prospective multi-centre cohort study in all Acu...
journal_title:Age and ageing
pub_type: 杂志文章,多中心研究
doi:10.1093/ageing/afx174
更新日期:2018-09-01 00:00:00
abstract::The aim of this prospective study was to investigate whether an immunological double faecal occult blood test (Fecatwin-S/FECA-EIA) can be used in screening patients with symptoms suggestive of colonic or rectal origin in primary health care. Altogether 523 patients were referred to the study by general practitioners....
journal_title:Age and ageing
pub_type: 杂志文章
doi:10.1093/ageing/23.5.365
更新日期:1994-09-01 00:00:00
abstract::Many studies have shown the indigenous elderly population and Asian immigrants to be groups at particular risk of vitamin D deficiency and osteomalacia, but there are no data on the risks in elderly Asians. In this community-based study a group of elderly Asians was compared with control groups of elderly and young wh...
journal_title:Age and ageing
pub_type: 杂志文章
doi:10.1093/ageing/24.2.103
更新日期:1995-03-01 00:00:00
abstract::Two hundred and eighteen subjects, out of 250 individuals taken from a general practice register, returned completed questionnaires giving details about rest cramps, and a further 15 were contacted by telephone. The overall prevalence of rest cramps in the survey population was 37%. The symptom was more prevalent in o...
journal_title:Age and ageing
pub_type: 杂志文章
doi:10.1093/ageing/23.5.418
更新日期:1994-09-01 00:00:00
abstract::In this study we examine whether the introduction of a clerking pro forma improves the completeness of the recording of the management of stroke patients and we review methodological issues important in this type of audit. We prospectively identified 244 consecutive stroke patients before and after the introduction of...
journal_title:Age and ageing
pub_type: 杂志文章
doi:10.1093/ageing/24.1.43
更新日期:1995-01-01 00:00:00
abstract::Fifty-eight carers and their dependents who received inpatient respite care were studied before and during the admission period. Although there was no observable improvement in the carers' emotional well-being the majority of the patients showed an improvement in functioning, particularly those who were being looked a...
journal_title:Age and ageing
pub_type: 杂志文章
doi:10.1093/ageing/23.4.274
更新日期:1994-07-01 00:00:00
abstract::We measured calcium regulating hormones and bone mineral density (BMD) in 66 men (aged 24-88 years). Vitamin D (1,25(OH)2D) does not vary with age, parathyroid hormone (PTH) increases after the age of 65 (p < 0.01) together with a parallel increase in urinary (r = 0.46, p < 0.05) and nephrogenic cAMP (r = 0.63, p < 0....
journal_title:Age and ageing
pub_type: 杂志文章
doi:10.1093/ageing/23.2.127
更新日期:1994-03-01 00:00:00
abstract:Introduction:identifying the most at risk older people in Emergency Departments (EDs) may help guide clinical practice, and service improvement in emergency care, but little is known about how to implement such tools in practice. Methods:consensus building was used to determine the desirable characteristics of a risk ...
journal_title:Age and ageing
pub_type: 杂志文章
doi:10.1093/ageing/afx089
更新日期:2017-09-01 00:00:00
abstract:BACKGROUND:COVID-19 has disproportionately affected older people. OBJECTIVE:The objective of this paper to investigate whether frailty is associated with all-cause mortality in older hospital inpatients, with COVID-19. DESIGN:Cohort study. SETTING:Secondary care acute hospital. PARTICIPANTS:Participants included ar...
journal_title:Age and ageing
pub_type: 杂志文章
doi:10.1093/ageing/afaa184
更新日期:2020-10-23 00:00:00
abstract:BACKGROUND:The Timed Up and Go Test (TUGT) has been recommended as a simple screening tool to identify those at risk of falling. However, subsequent detailed assessment is required to identify underlying falls risk factors to provide direction for optimal targeted intervention strategies. METHODS:110 consecutive falls...
journal_title:Age and ageing
pub_type: 杂志文章
doi:10.1093/ageing/afi178
更新日期:2005-11-01 00:00:00
abstract::Cellular immune function declines with age and is implicated in the increased incidence of cancer, and morbidity and mortality associated with infections in elderly people. Elderly people are at risk of nutritional depletion, including of zinc, and zinc is known to influence immunity. The present study assessed zinc s...
journal_title:Age and ageing
pub_type: 杂志文章
doi:10.1093/ageing/20.5.345
更新日期:1991-09-01 00:00:00
abstract:OBJECTIVES:to determine the safety and effect of intravenous iron sucrose on functional outcomes, delirium, nosocomial infections and transfusion requirements in older patients with hip fracture. DESIGN:single-centre randomised, double-blind, placebo-controlled clinical trial. SETTING AND PARTICIPANTS:orthogeriatric ...
journal_title:Age and ageing
pub_type: 杂志文章
doi:10.1093/ageing/afaa107
更新日期:2021-01-08 00:00:00
abstract:BACKGROUND:STOPP/START was formulated to identify potentially inappropriate prescribing (PIP) and potential prescribing omissions (PPOs) in older people. The purpose of this study was to determine the prevalence of PIP and PPO in older Irish patients in residential care using STOPP/START. METHODS:data were collected p...
journal_title:Age and ageing
pub_type: 杂志文章
doi:10.1093/ageing/afs068
更新日期:2013-01-01 00:00:00
abstract::Chronic simple glaucoma is a common disease in old age and lowering intraocular pressure is the treatment strategy. Although this can be achieved surgically, medical treatment with eye drops is more often prescribed. Beta-antagonists are the class of drug most often chosen, although other medical therapies are availab...
journal_title:Age and ageing
pub_type: 杂志文章,评审
doi:10.1093/ageing/26.2.63
更新日期:1997-03-01 00:00:00
abstract::Prolonged head-up tilt is increasingly used as a diagnostic test for vasovagal syncope. Its sensitivity is reported to increase with the concurrent administration of intravenous isoprenaline. False-positive responses are common in young controls particularly following intravascular instrumentation. We studied the infl...
journal_title:Age and ageing
pub_type: 杂志文章
doi:10.1093/ageing/23.4.317
更新日期:1994-07-01 00:00:00
abstract:BACKGROUND:older people aged 80 and over are increasingly providing end-of-life care to spouses at home and often do so for long periods of time, while also trying to manage their own illnesses and disabilities. Little of the research on older spousal carers has focussed on the oldest carers; hence, the needs of this p...
journal_title:Age and ageing
pub_type: 杂志文章
doi:10.1093/ageing/afw047
更新日期:2016-05-01 00:00:00
abstract::Vaginal pessaries are widely considered to be a safe alternative to surgery in older women. We report a case of near fatal septicaemia in a 75-year-old woman associated with a shelf pessary, the presence of which was identified during an exploratory laparotomy. This case highlights the importance of the gynaecological...
journal_title:Age and ageing
pub_type: 杂志文章
doi:10.1093/ageing/afh170
更新日期:2004-09-01 00:00:00
abstract:BACKGROUND:animal studies suggest a neuroprotective role for leptin, but human studies have shown mixed results. We examined whether plasma leptin levels in individuals with mild cognitive impairment (MCI) were related to cognitive function at baseline and whether higher leptin levels were associated with reduced risk ...
journal_title:Age and ageing
pub_type: 杂志文章
doi:10.1093/ageing/afu160
更新日期:2015-01-01 00:00:00
abstract:BACKGROUND:Delirium is a disorder affecting consciousness, which gives rise to core clinical features and associated symptoms. Older patients are particularly prone, owing to higher rates of pre-existing cognitive impairment, frailty, co-morbidity and polypharmacy. OBJECTIVES:The aim of this study was to investigate t...
journal_title:Age and ageing
pub_type: 杂志文章
doi:10.1093/ageing/afq052
更新日期:2010-07-01 00:00:00
abstract::The frequency of snoring was studied in 46 patients with Alzheimer's disease (AD), 37 with multiinfarct dementia (MID), and in a random sample of 124 elderly community residents without known diseases affecting higher cortical functions. The demented patients were reported to snore twice as frequently as the control s...
journal_title:Age and ageing
pub_type: 杂志文章
doi:10.1093/ageing/16.5.305
更新日期:1987-09-01 00:00:00
abstract::Inappropriate prescribing (IP) is a common and serious global healthcare problem in elderly people, leading to increased risk of adverse drug reactions (ADRs), polypharmacy being the main risk factor for both IP and ADRs. IP in older people is highly prevalent but preventable; hence screening tools for IP have been de...
journal_title:Age and ageing
pub_type: 杂志文章,评审
doi:10.1093/ageing/afm189
更新日期:2008-03-01 00:00:00
abstract::This study aimed to determine the prevalence of the wish to die in elderly people and investigate the factors associated with it, in particular, whether factors other than depression contribute to the wish to die. Data were obtained from an Australian epidemiological survey of people aged 70 or more. Survey participan...
journal_title:Age and ageing
pub_type: 杂志文章
doi:10.1093/ageing/24.5.389
更新日期:1995-09-01 00:00:00
abstract:Background:screening for cognitive impairment in Emergency Department (ED) requires short, reliable tools. Objective:to validate the 4AT and 6-Item Cognitive Impairment Test (6-CIT) for ED dementia and delirium screening. Design:diagnostic accuracy study. Setting/subjects:attendees aged ≥70 years in a tertiary care ...
journal_title:Age and ageing
pub_type: 杂志文章
doi:10.1093/ageing/afx149
更新日期:2018-01-01 00:00:00
abstract:BACKGROUND:whether socioeconomic position over the life course influences the wellbeing of older people similarly in different societies is not known. OBJECTIVE:to investigate the magnitude of socioeconomic inequalities in life satisfaction among individuals in early old age and the influence of the welfare state regi...
journal_title:Age and ageing
pub_type: 杂志文章
doi:10.1093/ageing/afu004
更新日期:2014-05-01 00:00:00
abstract::Four hundred and fifty patients aged 75 years or older were followed up after discharge from an accident and emergency department. Forty-three per cent of all patients experienced some loss of functional independence. A small number, 5.6%, were readmitted to hospital within 14 days. This group were significantly less ...
journal_title:Age and ageing
pub_type: 杂志文章
doi:10.1093/ageing/19.6.415
更新日期:1990-11-01 00:00:00
abstract:BACKGROUND:exercise therapy is highly recommended for falls prevention in older adults; however, poor exercise adherence may limit treatment effectiveness. OBJECTIVE:to assess the effectiveness of interventions to improve exercise adherence for community-dwelling adults (aged over 65 years), at risk of falling. METHO...
journal_title:Age and ageing
pub_type: 杂志文章,meta分析
doi:10.1093/ageing/afy164
更新日期:2019-03-01 00:00:00
abstract::Seventy-nine patients with probable Alzheimer's disease were enrolled into a double-blind, placebo-controlled cross-over study to assess the therapeutic effect and safety of THA (tetrahydroaminoacridine; tacrine) without concomitant lecithin administration. Forty-one patients completed the trial which consisted of two...
journal_title:Age and ageing
pub_type: 杂志文章
doi:10.1093/ageing/22.5.316
更新日期:1993-09-01 00:00:00
abstract:INTRODUCTION:observational studies do not always find positive associations between physical activity and muscle strength despite intervention studies consistently showing that exercise improves strength in older adults. In previous analyses of the MRC National Survey of Health and Development (NSHD), the 1946 British ...
journal_title:Age and ageing
pub_type: 杂志文章
doi:10.1093/ageing/aft124
更新日期:2013-11-01 00:00:00
abstract:OBJECTIVES:to identify the factors associated with hospital admission and the differences in management and outcome of stroke patients between hospital and home. DESIGN:a prospective community stroke register (1995-8) with multiple notification sources. SETTING:an inner city multi-ethnic population of 234 533 in Sout...
journal_title:Age and ageing
pub_type: 杂志文章
doi:10.1093/ageing/30.3.197
更新日期:2001-05-01 00:00:00
abstract:OBJECTIVE:To compare cognitive performance in participants with and without syncope and unexplained falls in a large population representative sample aged 50 years or older. METHODS:Participants of the Irish longitudinal study on ageing (TILDA) were studied. Participants with a history of syncope and/or unexplained fa...
journal_title:Age and ageing
pub_type: 杂志文章
doi:10.1093/ageing/afu191
更新日期:2015-03-01 00:00:00