Soins Gerontologie最新文献

Geriatrics is a recent medical specialty in France, and private practice, possible, is still a minority. The specialized studies diploma, created in 2017, provides for the possibility of completing a semester of internship in private practice. According to our study, 62% of geriatric interns in training would consider doing a semester outside the hospital and 42.7% would consider setting up in private practice. Proportions which vary according to the year in which the national qualifying tests were taken and the internship subdivision.

Breast cancer is the most common cancer in women. The elderly, whose numbers have been increasing, constitute a population in their own right, because of the many co-morbidities they suffer from. The epidemiology of breast cancer, particularly in elderly women, is described here, as well as the diagnosis and the assessment of extension, which do not differ from the rest of the population.

Although patients over 65 years of age represent the majority of breast cancer patients, we have limited data on the safety and efficacy of medical oncology treatments in this population. Their indications are based primarily on expert agreement. This literature review discusses the known data on the safety and efficacy of the main medical treatments for breast cancer: chemotherapy, cytokine-dependent kinase inhibitors 4/6, agents targeting human epidermal growth factor receptor-2, novel antibody conjugates, and immunotherapy.

Supportive care, in the context of breast cancer in the elderly, is part of standard oncogeriatric care. Nevertheless, the multidisciplinary reinforcement of the different transversal teams can support the global approach, that is essential to the quality of care and the life course. Evaluation is the basis of this management. As a result of this evaluation, the approach to sexual health is a novelty that is often insufficiently considered with elderly patients suffering from breast malignancy.

Many ethical issues were raised by the pandemic crisis. Caregivers were under great pressure and stress in their work in residential care facilities for the dependent elderly (Ehpad), both with residents and their families. The implementation of ethical support tools was only gradual, particularly for the management of residents' deaths. Anxiety has set in among all the people working or living in the Ehpad, blurring interpersonal relations and increasing tensions and professional exhaustion.

The sexual life of elderly people living in residential institutions for the dependent elderly (Ehpad) is a sensitive subject that is rarely discussed. Particular difficulties sometimes arise when they have cognitive problems. Affectivity and sexuality in old people's homes must be approached with tact and maturity by the carers. Sexuality belongs to private life, but its excesses are difficult to reconcile with collective life. Some proposals can be made on ethical issues and on the relationship with residents and their families.

The Ti-Sage mobile geronto-psychiatry team provides semi-emergency care in the Sud Bretagne public mental health establishment sector. The system favours fluidity and responsiveness. Requests can be made by telephone without filling in a form. The multidisciplinary team assesses the disorders, directs and ensures follow-up as close as possible (living and care areas), quickly (within forty-eight hours), with the aim of forging links and avoiding inappropriate hospitalisations. Interventions are carried out in all the geriatric care structures in the area, by visit or telemedicine. The team works in a network to coordinate care with care partners and offer support to carers.

Outpatient psychiatry and its health action for the elderly has taken a certain boom in the 2010s. The health policies wanted undoubtedly to mitigate the will to close hospital beds, and to limit hospitalizations in a good way. Ambulatory teams and governments have often provided the means in terms of personnel and logistics to meet the demands in urban and rural areas. Probably, in the image of the clinical history, this ambulatory effort is necessary and positive for the patient, even if these actions will not be able to replace the hospital care in complex cases.

Falls are a major problem in the elderly population. It is important to be able to effectively estimate the risk in order to implement appropriate actions. The large number of existing tools and the sometimes divergent or contradictory data make clinical assessment of this risk difficult. A review of the literature helps to determine the most relevant methods.