Zeitschrift Fur Gerontologie Und Geriatrie最新文献

Background: Older and very old persons have an increased risk of traumatic injuries as well as comorbidities and multimorbidities. The standardized workflow in hospitals can increase the occurrence of typical geriatric complications, such as challenging behavior and delirium, which can result in highly complex care situations. The application of advanced practice nurses (APN) is an international response to such challenges. In Germany, the scientifically based development of APN has so far lagged behind the international standard.

Method: For this scoping review, a systematic search in the databases PubMed and CINAHL and a supplementary hand search was conducted for the period 2010-2022.

Results: Tasks and role profiles for the scope of practice of APN in geriatrics and traumatology already exist in the literature. There is a lack of scientifically proven tasks and role profiles for APN in geriatric traumatology in the literature.

Discussion: Based on the current state of research it is not yet possible to derive specific tasks and role profiles for APN in geriatric traumatology. The transferability of tasks and profiles from geriatrics and traumatology seem to be possible. The development of tasks and role profiles for geriatric traumatology APN requires further research, especially to identify the specific needs of geriatric traumatology patients.

Background: Actors from the community (CAs) play a fundamental role in the support of caring relatives (CRs) of people with dementia (PWD). As their support is not sufficient, the implementation of support services needs to be optimized; however, little is known about the factors associated with the implementation behavior of CAs.

Aim: This study aimed to investigate the association of person-related factors with the implementation behavior of CAs.

Methods: In a cross-sectional study, 205 CAs from 16 German communities were surveyed with the community implementation behaviour questionnaire (CIBQ), which is based on the theoretical domains framework. Logistic regression analyses were conducted to identify person-related factors associated with the implementation behavior regarding support services for CRs of PWD.

Results: Implementing support services for CRs of PWD is positively and significantly (p < 0.001) associated with the agreement of CAs with the CIBQ domains. Higher scores in the CIBQ increase the chance that CAs implemented support services for the target group.

Conclusion: The CIBQ is a tool to determine the status of implementation behavior of communities. This enables an analysis of the areas CAs need to work on in order to optimize the implementation of support services for CRs of PWD or other health and care-related topics.

Due to increasing life expectancy and the associated demographic changes, more and more people are dependent on care. To identify a possible need for dental treatment, chewing function tests as assessment instruments have proven their effectiveness. In this article, the reader is given an overview of existing chewing function tests and their implementation. It is important that a patient with pain should be presented to a dentist immediately, regardless of whether a chewing function test is performed. Furthermore, chewing function tests are not a substitute for routine dental examinations, but they could provide information to (dental) laypersons as to whether an appointment should be arranged in a dental practice or whether a dental consultation is necessary.

The numbers of osteoporotic fractures will increase due to the demographic change, which particularly affects the proximal femur, pelvis, proximal humerus, wrist and vertebral column. Surgical treatment is superior to conservative treatment of proximal femoral fractures. Non-dislocated fractures of the wrist can also be treated with a plaster cast but studies suggest that the results in the first 12 months are better after surgical treatment. The situation is similar for fractures of the proximal humerus and non-dislocated fractures in particular can also be treated conservatively. A score and classification were recently developed for making decisions on the treatment of osteoporotic vertebral fractures. Fractures of the anterior and posterior pelvic ring can be treated conservatively with the patient under sufficient analgesia as long as there is no substantial dislocation. The highest priority in geriatric traumatology is fast remobilization.

Narrative gerontology considers how people age biographically as well as socially and biologically. Vulnerability as a process category and state of being remains undertheorized in the context of narratives of later life. It is argued that the narrative space for stories from old age privilege backward-looking stories that focus on positive milestones and support cultural narratives of a "life well lived." Sad, emotionally laden or uncertain/unfinished stories that reveal vulnerabilities are rejected and potentially viewed as problematic. Using an illustrative case example of a study of resilience narratives and aging, this paper considers how the study authors position and identify resilience. Some interpretative judgements used in the research regarding who is resilient based on expressions of vulnerability are highlighted. Overall, the tensions between cultural and personal narratives that position older people as vulnerable subjects are considered and it is argued that vulnerability can be a great source of strength and meaning in later life.

Background: Older migrants are considered a vulnerable population group in many ways. Marginalization and social exclusion lead to unequal opportunities for social participation.

Aim: In order to break down barriers for older migrants, the perspectives of people with migration biographies should be given greater consideration.

Material and methods: To this end, the results of an explorative intersectional ethical analysis of care narratives of older migrants are discussed in the light of aging studies research. The focus is on the ethical analysis of five guided interviews with older migrants between 65 and 80 years old, who have migrated from different countries in southeastern Europe.

Results and discussion: In contrast to the prevalent expert perspective, the narratives of the older migrants interviewed revealed not only resistance to vulnerabilization but also multiple negotiations of autonomy and dependency. By making ambivalent narrative and action strategies visible and linking them to narratives of intergenerational care relationships, the significance of care-ethical interpretations of vulnerability and characterization of vulnerability as "a universal, inevitable, and anthropological feature of humanity resulting from the embodied, finite, and socially contingent structure of human existence" [4] can be demonstrated.

Background: Geriatric patients after hospitalization often utilize subacute inpatient care (SC); however, little is known about their care and further health status.

Objective: To identify persons in SC with rehabilitation needs and improvement potential after hospitalization and to describe the care, relevant parameters of the health status as well as use of medical/nursing services in and after SC.

Methods: After positive screening for previous hospitalization and need of rehabilitation with improvement potential in 13 nursing homes, the length of stay, therapeutic treatments and physician contacts in SC as well as functional parameters, pain, quality of life and the utilization of services according to the Social Security Code V (SGB V) and SGB XI were assessed at baseline, at the end and 3 months after SC.

Results: A total of 108 (44%) out of 243 screened persons with previous hospitalization had a need of rehabilitation with improvement potential, of whom 57 participated in the study. In SC (median = 26 days) 35% received no therapeutic treatments and 28% had no physician contact. After SC 40% were transferred to rehabilitation. Participants with rehabilitation transition more frequently received therapeutic treatments in SC (p = 0.021) and were less frequently in long-term care 3 months after SC (p = 0.015).

Conclusion: This study suggests that a high proportion of persons in SC after hospitalization are in need of rehabilitation with improvement potential, which is not sufficiently treated. Regular therapeutic treatments in SC could improve the transition rate to rehabilitation and subsequent home environment.

Background: The reason-related identification of mild cognitive impairment (MCI) in primary care is helpful to treat reversible causes or decelerate progression to dementia by optimal management of existing risk factors. In this process general practitioners are in a key position. The present feasibility study investigated the practicability of a diagnostic algorithm (brain check-up), comprising neuropsychological examinations, differential diagnoses and follow-up measures.

Method: By means of a standardized questionnaire, the utilization and practicability of the brain check-up was surveyed in n = 37 medical practices of general practitioners and internists in Germany.

Results: The brain check-up was performed by n = 37 physicians in 389 patients (66%). The main barriers to implementation included patients' fear of facing the results, the professionals' lack of time, and costs. Overall, 73% of the participants agreed that the brain check-up was practical in everyday treatment. Long waiting times for an appointment with a neurological/psychiatric specialist were perceived as a barrier for optimal care.

Conclusion: The structured algorithm is convenient in physician's everyday practice and can contribute to identify patients with MCI more easily. Therefore, it appears to be a helpful tool in primary care. To achieve sustainability in everyday use, identified barriers need to be addressed during the implementation phase.