Tijdschrift voor Gerontologie en Geriatrie最新文献

Older, frail patients have an increased risk of post-operative complications resulting in loss of function, dependency, reduced quality of life and mortality. Possibly, prehabilitation can improve postoperative outcomes. The aim of this clinical lesson was to present the current evidence for prehabilitation in abdominal surgery with a specific focus on the geriatric population. Prehabilitation seems to be acceptable and feasible for older patients. Especially multidimensional prehabilitation programs seem promising. Moreover, tailor-made exercise programs have been shown to have a positive effect on postoperative complications. However, none of this has yet been conclusively proven. More studies are needed to evaluate the effect of prehabilitation in the frail surgical population.

To examine the impact of COVID-19 measures on residents of long-term care institutions, two surveys were conducted in the spring of 2020. Leontjevas et al. (study 1) inventoried practitioners' opinions, Van der Roest et al. (study 2) opinions of care workers, family, and residents without severe cognitive impairments. This article describes the combined results on social interaction and loneliness, challenging behaviour and mood, and lessons learned. In study 1, an online survey distributed to nursing home psychologists, they were asked to complete it anonymously and share the link with their fellow elderly care physicians and nurse specialists. 16 participants were then interviewed via video calling. In study 2, three hundred and fifty-seven care organizations were invited to recruit residents without severe cognitive impairments, family members and care workers for participating in a digital, anonymous survey (Study 2). The completed surveys of 323 practitioners (study 1) and 193 residents, 1609 family members and 811 employees (study 2) were included in the analyses. Social contacts of residents had changed in frequency and form compared to before the COVID-measures. Many residents experienced some loneliness during the visit ban, especially residents without cognitive impairments. There were both an increase and a decrease in challenging behaviour and affect. Several strategies used to reduce the effects of COVID-19 measures on well-being, were considered maintainable. Our studies confirmed a major impact of the COVID-19 measures on the wellbeing of long-term care residents, but also showed successful strategies of practitioners that can benefit future practice.

We describe three subgroups of older lonely people (Persona), and design different approaches to loneliness that directly address their specific needs and circumstances: the combination approach. The use of Persona is a middle ground between 'one approach appropriate for all' and 'each person's own approach'. A Persona is described using various risk factors for loneliness. These are advanced age, living alone, small network, low perceived control, and low income. Based on this, we explore the potential effect of improving some of these situations for reducing loneliness (Cohen's d ranges between -0.33 and -0.58). For two approaches we report what the realized effect was (d=-0.83 in both interventions). The three Persona and the approaches are examples that designers of a loneliness approach can use by analogy to elaborate and substantiate their approach.

Due to social, political, and demographic developments in Dutch healthcare, the pressure on informal carers of vulnerable, senior citizens living at home continues to increase. To relieve this pressure, people in the senior citizens' social network are looking for ways to share care tasks with others. However, many informal caregivers seem to experience a threshold in this respect. This pilot study focuses on understanding the considerations involved in sharing caregiving tasks with others. Therefore, semi-structured interviews were conducted with six informal caregivers of single, senior citizens living at home. This study shows that these considerations are characterised by a relationship between informal caregivers' workload, their shyness to ask others for help, and the perception of care recipients' demand, combined with informal caregivers' natural inclination to do it themselves. Feelings of being responsible for the care and behaviour of care recipients, and the choices that must be made for them seem to play an additional role. To develop adequate solutions that lead to sharing informal care with others, and relieving the pressure on informal caregivers, more insight into the (personal) mechanisms behind this sense of responsibility seems necessary.