Zeitschrift Fur Gerontologie Und Geriatrie最新文献

Background: Central venous catheters (CVC) in the internal jugular vein are established in perioperative care; however, the incidence of catheter-associated thrombosis (CAT) and catheter-related thromboembolic complications (CTEC) remains insufficiently studied.

Objective: This study aimed to assess the incidence and characteristics of CAT with a focus on differences between geriatric and nongeriatric patients. Among the guiding questions were do the risk and incidence of CAT fundamentally differ between geriatric and nongeriatric patients and is the catheter dwell time associated with increased thrombotic risk?

Methods: In this 6‑month prospective study, consecutive patients from orthopedic, trauma and vascular surgery with CVC in the internal jugular vein were examined. Patients were categorized into a geriatric group and a non-geriatric group. Sonographic assessments were performed initially and weekly during which CATs were measured and analyzed.

Results: Out of 117 patients 90 (77%) developed CAT. No significant differences were found between geriatric (78.9%) and nongeriatric patients (76.7%, p = 0.767). The mean thrombus size was similar. A significant correlation existed between catheter dwell time and CAT incidence.

Discussion: The incidence of CAT was high regardless of the geriatric status. Catheter dwell time emerged as a relevant risk factor. Standardized and systematic sonographic monitoring and critical CVC indications should be considered.

Background: Parkinson's disease (PD) is a neurodegenerative disorder that causes motor and nonmotor symptoms including cognitive symptoms. This study examines cognition, in particular visuoconstruction with fine motor skills, visuospatial relations and memory. The Vienna Visuoconstructive Test 3.0 (VVT 3.0) using three tasks (VVT3.0 Screening Copy - VVT3.0-SCO, VVT3.0 Screening Delayed Recall - VVT3.0 - SDR, VVT3.0 Screening Quotient - VVT3.0SQU) to test these abilities. The aim of the study was to evaluate the potential of the VVT 3.0 screening by comparing the visuoconstructive abilities of PD patients and control subjects (HC) and examining differences in other neuropsychological tests and sociodemographic characteristics.

Material and methods: A retrospective study with 287 participants (74 PD, 213 HC) was conducted. Descriptive and inferential statistical analyses were performed. An ROC analysis assessed the discriminatory power of the VVT 3.0 screening scores.

Results: A significant difference in VVT3.0-SCO was found between the groups (r=0.25). The difference showed a small effect (r=0.23). VVT3.0-SQU showed a large effect (d=0.74).

Conclusion: The main finding of the present study was that PD leads to a decrease in test performance in VVT3.0-SQU.

Background: The Functional Independence in Daily Activities (FIDA) is an assessment with 20 items to measure functional independence in activities of daily living. Each item uses a 5-point scale to assess how independently the person can perform the described function. The grading ranges from 'independent/ability present' to 'dependent/ability absent'.

Material and methods: 1593 rehabilitants were included in the study. The FIDA and Barthel Index (BI) assessments were used to measure functional independence at the beginning and at the end of rehabilitation. Item difficulty, discriminatory power (r_it = item total correlation) and internal consistency (Cronbach's α) were calculated. The factor structure was tested using a confirmatory factor analysis. Convergent validity was tested by correlating the sum values of the FIDA and the BI.

Results: The item difficulties (p_i) were in the range between 0.17 ≤ p_i ≤ 0.89. The internal consistency was α = 0.94 with item-scale correlations between 0.45 < r_it < 0.80. The agreement between FIDA and BI at the start of rehabilitation was r = 0.75. The standardised comparison of the sensitivity to change showed slight advantages for the FIDA. The functional areas that were more severely impaired at the start of rehabilitation showed greater improvements.

Conclusion: The FIDA is a change-sensitive assessment instrument that is suitable for assessing functional independence in geriatric patients. The psychometrics and analyses on the validity showed good results.

Background: Of the people with dementia in Germany, two thirds are cared for by relatives. The Dementia Support Center in Ammerland and the surrounding area offers these relatives counselling on nursing and social issues.

Objective: The purpose of the study was to evaluate the Dementia Support Center in Ammerland by investigating the expectations, experiences and wishes of relatives in relation to the Dementia Support Center.

Material and methods: Guided interviews were conducted with relatives of people suffering from dementia who made use of the counselling service of the Dementia Support Center. The 12 individual interviews were conducted by telephone between March and December 2023 and transcribed verbatim. The contents of the interviews were summarized using the qualitative content analysis according to Mayring in the data analysis software MAXQDA12.

Results: The relatives reported a high level of satisfaction with the counselling offered by the Dementia Support Center. Through the counselling they experienced a relief in caring for people with dementia. The good accessibility, high professional competence and empathetic demeanor of the care coordinators were perceived as positive. With respect to the further development of the Dementia Support Center, the relatives wanted the center to be more present and have regular events, such as family meetings.

Conclusion: In view of demographic changes and the predicted increase in people with dementia, appropriate counselling services should be expanded and further developed in line with the needs.

Background: Hearing loss (HL) is a chronic disease with high prevalence in older adults and with negative impact on quality of life. The primary intervention is hearing aids (HAs); however, HA acceptance and usage stay low and the psychological mechanisms of HL adaptation remain poorly understood. To address this knowledge gap, we developed a psychometric instrument to assess hearing-related adaptive strategies (AStra).

Material and methods: The study was administered via self-report in three different samples (online, paper-pencil, app-based). In total, 169 individuals with subjective HL (mean age 62.51 years; 49.11% female; 57.40% HA users) participated. We included coping measures, subjective HL and HA satisfaction to assess AStra's construct validity, and HA use for criterion-related validity.

Results: The AStra demonstrated robust psychometric properties, yielding a three-factor solution with strong internal consistency. AStra showed good construct validity with coping measures and was associated with HA use independently of traditional factors such as age and education.

Discussion: The results highlight AStra's utility in understanding hearing-related adaptive strategies and emphasize the proactive role of older adults when dealing with HL. Further research is needed on when, how, and why adaptive strategies are used.

Practical recommendations: Adaptive strategy use may be translated into behavioral interventions for people with HL.

Background: While institutional protection concepts in child and youth welfare are legally established, there are no comparable regulations for facilities for older adults.

Research question: This study examined who is protected in day care centers for older adults, how they are protected and from what.

Material and methods: Focus group interviews with management personnel were evaluated using constructivist grounded theory to record protection practices and their perception in the facilities.

Results: Protection practices are not only directed at older people but also at employees. The protection measures described range from everyday borderline situations to sexualized violence. Protection concepts are perceived as particularly helpful in serious cases, while team communication is described as effective in smaller transgression situations.

Current demographic trends are leading to an increase of older multimorbid chronically ill patients. The resulting complexity of treatment (age-related physiological changes, polypharmacy, cognitive and sensory impairments, reduced ability to communicate) is associated with major challenges for the healthcare and social services systems. Geriatric palliative care represents an important, specialized field of modern medicine. Its focus is on continuous multidisciplinary care to preserve the quality of life. The treatment is holistic, combining pharmacological and nonpharmacological approaches. Key aspects are rapid symptom relief and preserving the patient's dignity. Hence, the management of medical emergencies in the context of palliative care differs markedly from curative emergencies. Legal and ethical aspects such as advance directives and weighing up the benefits and risks of treatment are essential.

Background: Safety risks in residential long-term care arise from complex care situations and the vulnerability of residents. Simulation-based methods, such as a room of horrors (RoH) intervention, can enhance staff awareness of these risks. This study aimed to investigate how staff attitudes toward resident safety in long-term care develop in the context of a RoH intervention.

Method: A written standardized pre-post survey with 176 participants was conducted, measuring attitudes toward safety risks using the German short version of the attitudes to patient safety questionnaire (G-APSQshort).

Results: The G‑APSQshort score significantly increased from 5.4 to 5.6 points (p < 0.001), with care assistants showing the greatest improvement (p < 0.001). Additionally, 77.3% of participants would recommend the RoH concept further and 80.2% expressed a desire for regular RoH interventions.

Conclusion: The RoH intervention enhances staff awareness and attitudes toward resident safety, fostering a safety culture and improving care quality in long-term care; however, the practical relevance of the findings requires further evaluation.