Zeitschrift Fur Gerontologie Und Geriatrie最新文献

Background: The prevention of postoperative delirium (POD) in older adults requires interprofessional collaboration among all healthcare professionals (HCP) involved in the continuum of care.

Objective: This study investigated the question of how HCPs experience the interprofessional prevention of POD in older adults within the continuum of care. Additionally, it examined the challenges and desired changes in the intersectoral communication and collaboration for prevention of POD.

Methods: This multicenter study was carried out with a qualitative research approach. To explore the experiences of HCPs a total of 21 semistructured expert interviews were conducted with general practitioners, geriatricians, anesthesiologists, surgeons and nurses across the 2 study regions Salzburg County and South Tyrol. The interviews were analyzed using content analysis.

Results: The results show that the interviewed HCPs already implement measures to prevent POD but these predominantly focus on identifying patients at risk in the inpatient sector. Information about risk factors is not systematically shared between disciplines or across the intersectoral continuum of care. Structures and processes for intersectoral communication and collaboration in the prevention of POD over the continuum of care are largely missing.

Conclusion: To improve the prevention of POD in older adults efforts should be made to enhance intersectoral and interprofessional collaboration and communication between the HCPs involved. The development of a shared instrument for the systematic identification and documentation of relevant risk factors across the continuum of care could support the prevention of POD.

Music-based intervention is an integral part of geriatric psychiatry but the use of Boomwhackers, colorful plastic percussion tubes, with older people has not yet been investigated. For this purpose, a total of 47 patients (33 female, 14 male) from a geriatric day clinic, aged 61-91 years (M = 79.4 years, SD = 6.06 years), took part in a pilot study. Group 1 consisted of cognitively unimpaired patients with mental health problems, group 2 included cognitively impaired patients. Each of them received a 30-40-min group music intervention with the Boomwhackers twice a week. A standardized behavioral observation was carried out before and after the group session, where well-being as well as psychological symptoms (anxiety, depression, pain) were assessed. All participants were actively playing music and well-being improved and complaints significantly decreased. Considering the demonstrated results, the use of Boomwhackers among older adults should be further researched.

Background: Violence in caregiving settings is a complex and increasingly prevalent issue, rooted in both structural and individual factors. To date, systematic analyses of police responses to such cases have been largely absent.

Objective: This study explores which risk factors and offense patterns are associated with abuse in care as well as the challenges faced by law enforcement agencies. The aim is to identify actionable strategies for improving the handling of violence in caregiving contexts.

Material and methods: The research is based on an analysis of 106 documented cases and 64 expert interviews across multiple disciplines. The findings were further discussed in interdisciplinary workshops to develop practical solutions for enhancing protection of care-dependent individuals. Various limitations reduce the significance and generalizability of the findings.

Results: Most victims were female (69%) with an average age of 80 years and equally represented in home and institutional care. In 73% of cases the perpetrators were professional caregivers. The offenses primarily involved physical violence and unlawful deprivation of liberty. The case dismissal rate was 89%, often due to limited testimonial capacity and insufficient legal documentation. Police procedures were optimized and the interdisciplinary network violence-free care was established.

Conclusion: Key insights of the network emphasize the need for cross-sectoral collaboration, ongoing awareness training and professional development. The network advocates clear reporting pathways, targeted protective services and structured case management for vulnerable care recipients.

Background and objective: Violence in nursing care is a frequent phenomenon both towards nurses and towards care recipients. In Germany, there is a lack of scientifically developed and evaluated interventions and concepts for the prevention of violence. The aim of this study is to analyze the implementation of the participative development and evaluation of a multimodal concept for violence prevention (PEKo) project in three settings.

Intervention and methods: The aim of the project is to develop and implement facility-specific measures by multiprofessional teams. To evaluate the success of the implementation, quantitative data from an employee survey and process data regarding implementation fidelity, dose and outreach of PEKo were analyzed.

Results: The PEKo was implemented between 2021 and 2023 in 42 nursing homes, 7 outpatient care services and 12 hospitals. All components were offered and were implemented in the majority of outpatient care services and hospitals and in approximately half of the nursing homes. A total of 91 measures were implemented in the facilities during the intervention period, 443 employees took part in the survey and reported more exchange and changes in dealing with violence.

Discussion: The PEKo appears to promote awareness and confidence in all settings. Limitations were observed in terms of fidelity in the long-term inpatient care. The results suggest that continuous external support is crucial for sustainable implementation. The active involvement of care recipients should be given greater consideration in interventions.

Background: The increase in age-associated cognitive disorders presents particular challenges for inpatient care. An effective interprofessional collaboration is fundamental for patient care and is particularly crucial for the management of patients with delirium. Interprofessional education (IPE) can improve the understanding of other professions and one's own role during training.

Objectives: The development of an interprofessional teaching course (LV) in the interdisciplinary area (QB) 7 "Medicine of aging and elderly people" aims to introduce various healthcare professions to the care of older adults with dementia and delirium.

Methods: The development of the course is based on the National Competence-Based Learning Objectives Catalogue for Medicine (NKLM 2.0). The Interactive, constructive, active, passive (ICAP) model was used to structure the teaching methods. The evaluation was carried out using questionnaires consisting of 23 Likert-scaled items on the organization, structure, interprofessionalism and overall assessment of the course.

Results: An interprofessional course with a duration of 240 min for up to 40 participants from 5 professional groups was developed and implemented in 12 courses. A total of 358 students and trainees participated. Of the participants 281 (78.5%) completed the questionnaire. Based on the German grading system, the course received an overall grade of 2.0 ("good").

Discussion: The topic of "dementia and delirium" is well suited for IPE, as all participating professions care for this patient population and could enrich each other with their expertise. Structural optimization is needed regarding time management and didactics.

Background: Calcium is critically involved in bone metabolism and stability, nerve excitability and intercellular signal transduction.

Methods: In this retrospective study, calcium plasma concentrations of all patients treated in 2018 at our institution were evaluated. As approximately 50% of the plasma calcium is bound to plasma proteins, in particular albumin, additionally the respective plasma albumin concentration was determined and the albumin-corrected calcium plasma concentration was estimated.

Results: In 1246 of 1721 cases the plasma calcium concentration on admission was normal (2.15-2.55 mmol/l), in 421 cases hypocalcemia (< 2.15 mmol/l) and in 38 cases hypercalcemia (> 2.55 mmol/l) were detected. In 1226 of 1543 cases (79.5%) hypoalbuminemia was noted. After correction of the plasma calcium levels for plasma albumin by the modified Payne equation, the corrected plasma calcium was normal in 1272 cases (73.9%), decreased in 15 cases (0.9%), and elevated in 256 cases (14.9%). The frequency of hypercalcemia > 2.8 mmol/l requiring rapid clinical interventions without correction for plasma albumin was 6 of 1705 patients (0.4%), after correction for albumin 24 of 1543 patients (1.6%). In logistic regression analysis, higher albumin was strongly associated with a decreased mortality (odds ratio, OR = 0.88, 95% confidence interval, CI 0.83-0.94, p < 0.001), whereas the plasma calcium concentration had no independent influence on mortality.

Conclusion: Without correction for plasma albumin, approximately 25% of the patients were hypocalcemic on admission. After correction for plasma albumin, this rate fell to < 1%. We suggest that the determination of plasma albumin should be included in the clinical routine on admission in all geriatric patients.

Objective: Malnutrition and pressure ulcers are major geriatric syndromes that reduce the quality of life and increase complication risk. The aim of this study was to investigate the association between pressure ulcers and malnutrition in hospitalized geriatric patients and to evaluate the relationship between serum albumin and vitamin D levels and pressure ulcers.

Material and methods: This cross-sectional analytical study included 60 geriatric patients (≥ 65 years) hospitalized in an internal medicine clinic in 2015 and 30 patients with pressure ulcers were matched with 30 controls. Nutritional status was assessed using the Mini Nutritional Assessment (MNA). Laboratory tests (albumin, vitamin D, hemoglobin, etc.) and functional scores (Barthel Index of Activities of Daily Living [Barthel ADL], Lawton Instrumental Activities of Daily Living Scale [Lawton IADL]) were recorded. Logistic regression analysis was performed to examine the factors associated with the development of pressure ulcers.

Results: A total of 60 geriatric patients were included in the study, with 30 in the pressure ulcer group and 30 in the control group. Malnutrition, low body mass index (BMI), reduced MNA scores, hypoalbuminemia and vitamin D deficiency were significantly more common among patients with pressure ulcers (p < 0.01). The Barthel and Lawton ADL scores were also notably lower in this group. Logistic regression analysis revealed that an MNA score < 17 was an independent risk factor for the development of pressure ulcers.

Conclusion: In this study, malnutrition, hypoalbuminemia, vitamin D deficiency and reduced functional capacity emerged as potential risk factors for the development of pressure ulcers in hospitalized geriatric patients. These findings emphasize the need for early identification of individuals at risk and the implementation of preventive strategies.

Background: Caring for individuals with dementia at home poses significant challenges for family caregivers, particularly in families with a migration background. Previous studies have primarily relied on interviews and surveys, which may be biased by shame and social desirability. In contrast, caregivers often express themselves more spontaneously and less filtered on social media, potentially providing new insights into their reality of life.

Objective: This study aims to examine social media posts from Turkish origin family caregivers regarding their experiences in the context of home care.

Methods: A total of 123 posts from Instagram, Facebook, TikTok, YouTube and online forums were analyzed using qualitative content analysis.

Results: Overall, three main themes were identified: (1) psychological and physical burdens, (2) criticism of the healthcare system, and (3) managing caregiving responsibilities.

Discussion: Social media offer a space for exchange and support for family caregivers, while structural deficits, lack of culturally sensitive services and bureaucratic barriers complicate care. The often culturally embedded responsibility for family-based care can be both a source of overload and a resource. Future measures should promote structural improvements and diversity-sensitive support services.

Background: Although the population of older adults in our society is significantly older and more resilient than before, they also show age-related limitations in performance in all areas of motor function. Hand dexterity and eye-hand coordination are important factors for leading an independent life.

Aim: This study investigates gender-related and age-related differences in hand dexterity and examines whether hand dexterity declines with age similar to upper extremity strength.

Methods: Among 198 older adults (male = 61, aged 60-81 years), hand dexterity was assessed using 4 subtests of the motor performance series (MLS) by Schoppe, focusing on motor speed and eye-hand coordination accuracy. Strength was measured via hand dynamometry and a biceps curl test.

Results: Gender-specific differences emerged in tasks involving grasping small objects (ANOVA test statistic: F (1, 190) = 4.52; p = 0.035; η² = 0.023) despite their markedly different strength ratios between sexes (F (1, 190) = 254.09; p < 0.001; η² = 0.572). Women aged 65 years and over showed age-associated declines in motor speed and finger dexterity with low (p < 0.05; Cohen's f = 0.23) and moderate precision pressure (p = 0.034; Cohen's f = 0.25), whereas men's hand strength significantly decreased.

Conclusion: It remains uncertain whether these declines of hand dexterity are attributable to strength ratios or the natural processes of aging. In addition to strength training, interventions specifically targeting manual dexterity should be implemented to help preserve both movement speed and fine motor precision in older adults.