Tijdschrift voor Gerontologie en Geriatrie最新文献

The use of telemedicine (telephone and video consultations) has increased over the past decades and has grown substantially during the COVID-19 pandemic. Multimorbidity, visual - and hearing impairment, cognitive impairment and lack of technical skills might complicate the use of telemedicine in frail elderly patients. Limited research on this topic is has been performed. The aim of this article is to investigate which elements of care could be performed by telemedicine and what patient characteristics are useful in selecting patients for telemedicine. To get more information about the use of telemedicine in frail elderly patients, an online survey was conducted amongst caregivers working in geriatric outpatient care departments in the Netherlands. 67 caregivers completed the survey. The results indicate there is limited experience in video consultations in this population. The experience so far is mainly positive. Caregivers indicate the following elements of care could be performed by telemedicine: follow-up consultations, taking an (hetero)anamnesis, medication review, conversations with multiple contacts or caregivers and informing about test results. Our advice is to decide in dialogue with patient and caregiver, which form of consultation is feasible, desirable and appropriate for every individual process and consultation.

A part of the residents of nursing homes drink alcohol. This regularly leads to moral questions and discussions. An explorative qualitative study has been done to gather insight into the experiences and views of residents and staff regarding alcohol consumption in nursing homes. Aim of this publication was to support care professionals in nursing homes to deal with moral challenges related to alcohol consumption. With interviews and a focus group with residents and staff, experiences, values and moral dilemmas were collected. While residents viewed alcohol consumption as a private matter, opinions of staff were not uniform. Staff is confronted with various moral questions based on different values, such as Respect for Autonomy, Quality of Life, Authenticity and (collective) Safety. This study advises staff to use the value scheme in case of concrete moral questions as a tool to careful analyse which values and norms are at stake and balance what could be an appropriate response.

Background Aged care homes have been substituted by homecare to reduce the increasing Dutch healthcare costs. Ageing in place has led to a growing demand on formal and informal caregivers. The aim of this study was to examine: 1) the trends in formal and informal care, 2) whether care needs of community-living older adults are met, and 3) the association between care needs and quality of life (QoL). Methods Baseline data were used from 'The Older Persons and Informal Caregivers Survey - Minimum DataSet', which combines 54 studies conducted in 2008-2014. 12,735 participants met the inclusion criteria (age ≥65 years, living independently, needing assistance with washing, dressing, medication or household chores). Proportions of participants receiving formal or informal care were reported and associations with QoL were examined using ordinal (self-rated QoL) and linear (EQ-5D) regression. Results Formal care decreased from 75% to 63% and informal care increased from 16% to 28% between 2009 and 2013 (P < .001). Approximately one in four participants received no formal or informal care. Receiving no formal care was associated with a better QoL (self-rated QoL OR=1.39, CI=[1.251-1.544]; EQ-5D regression coefficient=0.038 CI=[0.023-0.053]). Conclusion The shift from formal to informal care together with the unmet care needs of community-living older adults in the Netherlands underlines the need for more support and a higher demand on informal caregivers.

Sharing data offers opportunities to make research into older person care more efficient. However, this is not yet common practice in the Netherlands. To optimally utilize the potential of data sharing, insight into factors that promote the implementation of data sharing in older person care research is important. In the TOPICS-MDS project, research data from the National Program for Older Person Care (NPO) was collected, managed and reused on a large scale. The experiences of stakeholders involved in this project can teach us more about the needs researchers have when sharing their data. For this study, we interviewed 23 people involved in different ways in data sharing in TOPICS-MDS about their experiences in the data sharing process. Thematic analysis yielded four overarching themes, which we converted into the following lessons: those who want to promote data sharing must ensure 1) visibility of the added value of data sharing, 2) trust in the database, 3) transparency of the process and 4) communication. These lessons complement the results of previous research with concrete advice. Optimizing data sharing in older person research is both promising and challenging. It requires dedication and involvement from both the researcher and the research participant, and appreciation for both.

Periprosthetic joint infections at an advanced age can lead to significant diagnostic and therapeutic challenges, mostly related to an atypical form of presentation in this population. We describe in this case the delayed diagnostic process of a disseminated invasive Staphylococcus aureus infection in a frail patient with a total hip prosthesis. The detection of Staphylococcus aureus in a urine sample was a supplementary hint towards the possible existence of a Staphylococcus aureus bacteraemia. The course of this case shows that teleconsultation and ambulatory based diagnostics are not appropriate for frail older patients with (sub)acute bone and joint infections, even in times of pandemic and constrainedly deferred care.