Zeitschrift Fur Gerontologie Und Geriatrie最新文献

Background: Oropharyngeal dysphagia is a common geriatric syndrome associated with an increased risk of aspiration pneumonia, malnutrition, functional decline and mortality.

Objective: Presentation of the neurogeriatric syndromology of dysphagia by integrating disease-specific neurological and transdiagnostic geriatric aspects, including diagnostic and therapeutic approaches.

Material and methods: A literature review and analysis of current clinical guidelines were conducted.

Results: Dysphagia presents as a multietiological syndrome with heterogeneous clinical phenotypes identifiable by instrumental assessment, particularly flexible endoscopic evaluation of swallowing (FEES). Besides disease-specific neurological mechanisms, transdiagnostic factors, such as presbyphagia with reduced pharyngeal sensation, sarcopenia and decreased neuroplasticity play a crucial role. Multimodal therapeutic approaches have proven to be effective. In various neurological disorders, disease-specific treatment also leads to an improvement in swallowing function. Across different conditions, protective measures (e.g., nutritional therapy and oral hygiene) as well as rehabilitative interventions have been shown to be effective.

Discussion: Geriatric-specific adapted assessment tools and care pathways are required to improve clinical outcomes and quality of life.

Older people need a specialized preoperative risk assessment to reliably identify those highly vulnerable risk patients who are in danger of a poor postoperative outcome. In this way these vulnerable risk patients can be separated from those who have successfully and healthily aged and therefore still show a high resilience even in old age. Careful planning of the perioperative management with integration of all disciplines and professions involved can ensure a safe perioperative treatment even for high-risk patients. The corresponding possibilities are presented in this article. The perioperative geriatric anesthesiological treatment pathway must be individually adapted and conceived to specifically address the risks of those patients who are particularly in danger of functional decline and complications.

Background: The article focuses on the perspectives of residents in assisted living facilities (BBW) on digitality, social space and biography and triangulates them.

Objective: To what extent is digitality addressed in the representation of social spaces and in biographical narratives and placed in relation to each other?

Material and methods: A comparison of 2 cases from a sample of 10 people in old and very old age (female = 8, male = 2; 77-95 years old) forms the basis for the analysis of sociospatial maps and the accompanying problem-centered interviews and biographical narrative interviews. Crucial to the triangulation of the data is the guiding perspective of the pervasion of social spaces by digitality and the reconstruction of narrative identities.

Results: In the first case, there is a close interconnection between sociospatial and biographical aspects throughout the entire life course of the person interviewed. In the other case, the biographical narratives are much more focused on the past and the sociospatial orientation of the person interviewed is more strongly rooted in the present. With respect to digitality, in both cases the result is that a sociospatial and biographical anchoring strengthens the sustainable use of digital devices.

Conclusion: The combination of both perspectives provides an in-depth approach to the living environment and subjective experiences of the target group. Combining both survey approaches provides greater insight into the resources and needs of the interviewees. This creates valuable points of reference for experts in assisted living facilities.

Background: The proportion of older people in Germany is steadily increasing; by 2030, around one third of the population will be over 60 years old. Education and digital literacy are essential for their participation but many institutions lack WLAN and a digitalization strategy.

Objective: The DiBiWohn project investigated the framework conditions and success factors that enable digital education offers through volunteer technical and digital support in various geriatric care settings.

Material and methods: As part of an evaluation, eight project staff members were interviewed in guided expert interviews about their experiences in the implementation. This was supplemented by six interviews with facility managers from inpatient and outpatient geriatric care facilities. The evaluation was carried out using qualitative content analysis according to Mayring.

Results: Openness, motivation and support from facility management have a decisive influence on the success of technical and digital support. Obstacles include a lack of WLAN, inadequate end devices, staff shortages and low technical affinity. In assisted living, greater autonomy and peer-to-peer concepts enable more successful implementation, while in inpatient facilities, structural and health limitations pose greater challenges.

Discussion: Digital education processes in geriatric care require a suitable technical infrastructure, qualified technical support and institutional backing. The results underscore the need for flexibly adapted context-sensitive concepts that take the different conditions and needs of residents in various geriatric care settings into account.

Background: Addiction and violence issues in residential care facilities pose significant health risks for residents. Addiction and violence are often closely linked. Preventive and health-promoting approaches offer potential for effectively addressing both problems.

Objective: The aim of the "Prävention Kreativ!" (Creative prevention!) project was to promote the health of older people in residential care facilities using an innovative approach to addiction and violence prevention. To this end, complementary socio-artistic and mentally oriented group activities were developed, tested and their effectiveness examined.

Methods: The article presents the results of the accompanying evaluation in four nursing homes. The study is based on a mixed methods design with participant observation, (partially) standardized surveys, interviews and focus groups.

Results: The results show positive effects in several prevention-related dimensions, most pronounced in the dimensions of well-being and group feeling/togetherness, followed by the dimensions of mental activity and physical activity. The programs developed promote resilience as an overarching goal of addiction and violence prevention.

Conclusion: It is evident that mentally oriented and socio-artistic programs have complementary effects and together strengthen protective factors against addiction and violence. The results underscore the relevance of resource-oriented prevention approaches that holistically promote emotional stability, social belonging and cognitive and physical activation.

Half of all people aged 65 years and over who fall cannot free themselves from the fall situation, have to wait for help and suffer a long lie. Those affected have an increased risk of restricting the daily activities, becoming increasingly dependent and moving into a nursing home within 1 year. There is currently little evidence on the consequences, diagnostics and treatment of fall-related long lies. This paper aims to provide an overview of the current state of research. The results indicate that long lies are associated with physical, psychological, social and spiritual consequences, whereby the severity is not only influenced by the duration of immobility. It is recommended that individuals affected by this condition be diagnosed and treated on an interdisciplinary basis to comprehensively assess all aspects. The aim should be to reflect on the experience with those affected, strengthen their self-confidence and prevent further falls and prepare them for possible further long lie falls.

Fluid therapy is an integral component of perioperative management in geriatric trauma surgery. Sufficient evidence-based medicine in perioperative fluid management in older patients is still lacking. Our aim is to present practical algorithms for the perioperative phases of fluid management reflecting the current state of scientific knowledge, expert opinions and best clinical practices. These algorithms follow the rules of practical applicability. The final assessment as the basis for the targeted fluid management is always a synoptic view of the clinical findings, medical history, laboratory findings and diagnostic tests. Ongoing and prospective evaluation of the presented criteria and procedures is necessary.

Management of perioperative pain in older adults can be challenging. Multimorbidity, functional decline or diminished physiological reserves, the corresponding polypharmacy, age-related pharmacodynamic and pharmacokinetic changes need to be considered. Pain assessment can be complicated by cognitive impairment and communication barriers. Older adults are at high risk of adverse consequences from surgery and undertreated pain as well as pharmacological overtreatment. Effective pain control in the perioperative period needs to be balanced against potential pharmacological harm. The aim of the orthogeriatric working group is to provide a practical guide for pain management in the perioperative orthogeriatric setting. It is supposed to be safe, effective and patient-centered. The set of expert recommendations is based on a current literature review, on the fit for the aged (FORTA )list expert consensus validation 2021 (4th edition), the PRISCUS list 2.0 of potentially inappropriate medications for older patients as well as on expert opinion and best clinical practice. Adequate analgesia is best achieved by applying multimodal analgesia. Various groups of analgesics are combined with interprofessional nonpharmacological treatment approaches. This article focuses on the pharmacological management of perioperative pain. Adequate analgesia can improve the overall outcome of orthogeriatric patients.