Facilitate evidence-based shared decision-making with patients and caregivers using a tool (i.e. rank-heat plot) that ranks the comparative efficacy of pharmacologic and nonpharmacologic interventions across multiple treatment choices and outcomes of interest (i.e. agitation, aggression, depression, fractures, falls, stroke, and death) Update of the Canadian Coalition for Seniors Mental Health Guidelines on the Assessment and Treatment of Depression David Conn, Robert Madan, Cindy Grief, Chris Frank, Lori Amdam, Daniel Blumberger, Kiran Rabheru, Anar Dilara Background: In 2006 the Canadian Coalition for Seniors Mental Health (CCSMH) released four sets of national clinical guidelines focused on older adults. Sivan Klil-Drori, Natalie Phillips, Alita Fernandez, Shelly Solomon, Howard Chertkow Background: Progression of Alzheimer's disease and other types of dementia are commonly conceptualized in a specific order: (1) subjective cognitive impairment: subjective complaints without objective cognitive decline, (2) mild cognitive impairment (MCI): subjective complaints and objective cognitive decline, (3) dementia: objective cognitive decline and functional impairment. False-positive presentation of a person with cognitive decline (e.g., lack of insight, various personality characteristics, etc.). [...]over relying on subjective complaints should be considered in cognitive screening. Standardizing Care for Neuropsychiatric Symptoms and Quality of Life in Dementia (StaN): Opportunities and Challenges of Implementing Algorithmic Care Pathway in Long Term Care Setting Nilah Ahimsadasan, Steve Crawford, Sarah Colman, Peter Derkach, Nancy McKeough, Aviva Rostas, Zahinoor Ismail, Amer M Burhan, The StaN Study Group Background: 80% of patients with Alzheimer's disease experience neuropsychiatric symptoms, with Alzheimer disease agitation and aggression (AD-AA) being the most burdensome of these symptoms.
{"title":"CAGP-CCSMH Annual Scientific Meeting: Book of Abstracts","authors":"V. Authors","doi":"10.5770/cgj.25.595","DOIUrl":"https://doi.org/10.5770/cgj.25.595","url":null,"abstract":"Facilitate evidence-based shared decision-making with patients and caregivers using a tool (i.e. rank-heat plot) that ranks the comparative efficacy of pharmacologic and nonpharmacologic interventions across multiple treatment choices and outcomes of interest (i.e. agitation, aggression, depression, fractures, falls, stroke, and death) Update of the Canadian Coalition for Seniors Mental Health Guidelines on the Assessment and Treatment of Depression David Conn, Robert Madan, Cindy Grief, Chris Frank, Lori Amdam, Daniel Blumberger, Kiran Rabheru, Anar Dilara Background: In 2006 the Canadian Coalition for Seniors Mental Health (CCSMH) released four sets of national clinical guidelines focused on older adults. Sivan Klil-Drori, Natalie Phillips, Alita Fernandez, Shelly Solomon, Howard Chertkow Background: Progression of Alzheimer's disease and other types of dementia are commonly conceptualized in a specific order: (1) subjective cognitive impairment: subjective complaints without objective cognitive decline, (2) mild cognitive impairment (MCI): subjective complaints and objective cognitive decline, (3) dementia: objective cognitive decline and functional impairment. False-positive presentation of a person with cognitive decline (e.g., lack of insight, various personality characteristics, etc.). [...]over relying on subjective complaints should be considered in cognitive screening. Standardizing Care for Neuropsychiatric Symptoms and Quality of Life in Dementia (StaN): Opportunities and Challenges of Implementing Algorithmic Care Pathway in Long Term Care Setting Nilah Ahimsadasan, Steve Crawford, Sarah Colman, Peter Derkach, Nancy McKeough, Aviva Rostas, Zahinoor Ismail, Amer M Burhan, The StaN Study Group Background: 80% of patients with Alzheimer's disease experience neuropsychiatric symptoms, with Alzheimer disease agitation and aggression (AD-AA) being the most burdensome of these symptoms.","PeriodicalId":56182,"journal":{"name":"Canadian Geriatrics Journal","volume":"25 1","pages":"88 - 109"},"PeriodicalIF":3.9,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45189308","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
FINALISTS FOR THE WILLARD AND PHOEBE THOMPSON AWARD Evaluation of a Student-Older Adult Telephone Befriending Program to Reduce Social Isolation during the COVID-19 Pandemic: A Pilot Evaluation Manan Ahuja, Kaitlin Lewis, Leanne Kim, Sawayra Owais, Jordana Compagnone, Laura Fallico, Francine Fishbein, Isabella Stefanova, Kai Man Xu, Mary Boulos, Shannon Gui Michael G. DeGroote School of Medicine, McMaster University Background: Social isolation and loneliness are associated with many adverse health outcomes. University of Ottawa and Ottawa Hospital Department of Medicine, 7Home Based Primary Care Program, Unison Health and Community Services, 8Division of Geriatric Medicine, Schulich School of Medicine & Dentistry, Western University Background: Geriatric physician resource planning for the predicted growth of Canadians aged 65+ and demand for specialized health services is needed. [...]the reverse stethoscope technique decreases, rather than improves, Speech Intelligibility Index scores. Fear of Falling Among Older Adults: A Scoping Review of Recent Literature Scott MacKay1, Patricia Ebert2, Cathy Harbridge3, David Hogan4 1Cumming School of Medicine, University of Calgary, 2Department of Psychology & the Hotchkiss Brain Institute, University of Calgary;Seniors Health, Specialized Geriatric Services, Alberta Health Services, 3Calgary Fall Prevention Clinic, Specialized Geriatric Services, Calgary Regional Health Authority, 4Division of Geriatric Medicine, Department of Medicine, Cumming School of Medicine, University of Calgary Background: Fear of falling (FOF) is prevalent among older adults and associated with adverse health outcomes.
威拉德和菲比·汤普森奖学生-老年人电话友谊项目评估以减少COVID-19大流行期间的社会隔离:试点评估Manan Ahuja, Kaitlin Lewis, Leanne Kim, Sawayra owis, Jordana Compagnone, Laura Fallico, Francine Fishbein, Isabella Stefanova, Kai Man Xu, Mary Boulos, Shannon Gui社会孤立和孤独与许多不利的健康结果有关。渥太华大学和渥太华医院医学部，7以家庭为基础的初级保健计划，Unison健康和社区服务，8老年医学部，舒利希医学与牙科学院，西部大学背景:老年医生资源规划，以预测加拿大65岁以上人口的增长和对专业医疗服务的需求。[…反向听诊器技术会降低而不是提高语音清晰度指数得分。老年人害怕跌倒:Scott MacKay1, Patricia eber2, Cathy Harbridge3, David Hogan4 1卡尔加里大学卡明医学院，2卡尔加里大学心理学系和Hotchkiss脑研究所;老年健康，老年专科服务，阿尔伯塔卫生服务，3卡尔加里跌倒预防诊所，老年专科服务，卡尔加里地区卫生局，4卡尔加里医学院老年医学部，医学系，卡明医学院，背景:害怕跌倒(FOF)在老年人中很普遍，并与不良的健康结果有关。
{"title":"CGS 41st Annual Scientific Meeting: Book of Abstracts","authors":"V. Authors","doi":"10.5770/cgj.24.547","DOIUrl":"https://doi.org/10.5770/cgj.24.547","url":null,"abstract":"FINALISTS FOR THE WILLARD AND PHOEBE THOMPSON AWARD Evaluation of a Student-Older Adult Telephone Befriending Program to Reduce Social Isolation during the COVID-19 Pandemic: A Pilot Evaluation Manan Ahuja, Kaitlin Lewis, Leanne Kim, Sawayra Owais, Jordana Compagnone, Laura Fallico, Francine Fishbein, Isabella Stefanova, Kai Man Xu, Mary Boulos, Shannon Gui Michael G. DeGroote School of Medicine, McMaster University Background: Social isolation and loneliness are associated with many adverse health outcomes. University of Ottawa and Ottawa Hospital Department of Medicine, 7Home Based Primary Care Program, Unison Health and Community Services, 8Division of Geriatric Medicine, Schulich School of Medicine & Dentistry, Western University Background: Geriatric physician resource planning for the predicted growth of Canadians aged 65+ and demand for specialized health services is needed. [...]the reverse stethoscope technique decreases, rather than improves, Speech Intelligibility Index scores. Fear of Falling Among Older Adults: A Scoping Review of Recent Literature Scott MacKay1, Patricia Ebert2, Cathy Harbridge3, David Hogan4 1Cumming School of Medicine, University of Calgary, 2Department of Psychology & the Hotchkiss Brain Institute, University of Calgary;Seniors Health, Specialized Geriatric Services, Alberta Health Services, 3Calgary Fall Prevention Clinic, Specialized Geriatric Services, Calgary Regional Health Authority, 4Division of Geriatric Medicine, Department of Medicine, Cumming School of Medicine, University of Calgary Background: Fear of falling (FOF) is prevalent among older adults and associated with adverse health outcomes.","PeriodicalId":56182,"journal":{"name":"Canadian Geriatrics Journal","volume":"24 1","pages":"258 - 291"},"PeriodicalIF":3.9,"publicationDate":"2021-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46422430","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"CAGP-CCSMH Annual Scientific Meeting Book Of Abstracts. Building Resilience In Seniors’ Mental Health In Canada, October 25–26, 2019, Banff Alberta","authors":"V. Authors","doi":"10.5770/cgj.23.415","DOIUrl":"https://doi.org/10.5770/cgj.23.415","url":null,"abstract":"<jats:p>-</jats:p>","PeriodicalId":56182,"journal":{"name":"Canadian Geriatrics Journal","volume":"23 1","pages":"88 - 115"},"PeriodicalIF":3.9,"publicationDate":"2020-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47581881","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-09-30eCollection Date: 2019-09-01DOI: 10.5770/cgj.22.374
Penny A Gosselin, Zahinoor Ismail, Peter D Faris, Carmen L Benkoczi, Tammy L Fraser, Steven W Cherry, Tracey I Faulkner, Md Shariful Islam
Background: The life-course model of modifiable risk factors for dementia now recognizes managing hearing loss and addressing social isolation.
Objective: To investigate the contribution and inter-relationship of hearing ability and behaviour change on cognitive ability.
Methods: We present the preliminary findings from a prospective longitudinal study of 35 non-demented participants ages 60-93, recruited from community rehabilitation and acute-care programs of Geriatric Medicine, who underwent baseline hearing, behavioural, and cognitive testing.
Results: After controlling for age and hearing impairment, the left ear Dichotic Digit Test (DDT) score accounted uniquely for 20% of the variance in MoCA Memory Index (p = .016 with β = .598). Mild Behavioural Impairment (MBI) was highly prevalent, with 80% of older adults reporting at least one MBI symptom. People with hearing impairment had greater global MBI burden than people with normal hearing, especially in the domains of apathy and impulse dyscontrol; however, greater severity of hearing impairment was not associated with a higher number of neuropsychiatric symptoms (NPS).
Conclusions: Low left DDT contributed to lower memory index and greater MBI burden is associated with hearing impairment. Our findings demonstrate the value of early non-invasive hearing and behavioural assessments as part of dementia risk assessment in older adults.
{"title":"Effect of Hearing Ability and Mild Behavioural Impairment on MoCA and Memory Index Scores.","authors":"Penny A Gosselin, Zahinoor Ismail, Peter D Faris, Carmen L Benkoczi, Tammy L Fraser, Steven W Cherry, Tracey I Faulkner, Md Shariful Islam","doi":"10.5770/cgj.22.374","DOIUrl":"https://doi.org/10.5770/cgj.22.374","url":null,"abstract":"<p><strong>Background: </strong>The life-course model of modifiable risk factors for dementia now recognizes managing hearing loss and addressing social isolation.</p><p><strong>Objective: </strong>To investigate the contribution and inter-relationship of hearing ability and behaviour change on cognitive ability.</p><p><strong>Methods: </strong>We present the preliminary findings from a prospective longitudinal study of 35 non-demented participants ages 60-93, recruited from community rehabilitation and acute-care programs of Geriatric Medicine, who underwent baseline hearing, behavioural, and cognitive testing.</p><p><strong>Results: </strong>After controlling for age and hearing impairment, the left ear Dichotic Digit Test (DDT) score accounted uniquely for 20% of the variance in MoCA Memory Index (<i>p</i> = .016 with β = .598). Mild Behavioural Impairment (MBI) was highly prevalent, with 80% of older adults reporting at least one MBI symptom. People with hearing impairment had greater global MBI burden than people with normal hearing, especially in the domains of apathy and impulse dyscontrol; however, greater severity of hearing impairment was not associated with a higher number of neuropsychiatric symptoms (NPS).</p><p><strong>Conclusions: </strong>Low left DDT contributed to lower memory index and greater MBI burden is associated with hearing impairment. Our findings demonstrate the value of early non-invasive hearing and behavioural assessments as part of dementia risk assessment in older adults.</p>","PeriodicalId":56182,"journal":{"name":"Canadian Geriatrics Journal","volume":"22 3","pages":"165-170"},"PeriodicalIF":3.9,"publicationDate":"2019-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/24/4a/cgj-22-165.PMC6715413.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41221136","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background Patients who have suffered fragility fractures are at an increased risk for subsequent fractures. The Osteoporosis (OP) Clinic at Markham Stouffville Hospital (MSH) was set up in July 2015 to screen, diagnose, and treat patients with fragility fractures. The goal of this study was to identify differences in OP screening and treatment initiation between patients seen in the OP clinic versus usual care. Methods A retrospective cohort study and telephone interview was conducted on 40 patients who had sustained a hip fragility fracture between September 2015 and July 2016. 20 of those patients were referred to the OP clinic, while the remaining patients received usual care. Results At the end of the intervention, 16/20 patients in the OP clinic group were appropriately placed on a bisphosphonate/RANKL inhibitor versus only 6/20 patients in the usual care group (p < .01). Conclusions A significant care gap exists in secondary fracture prevention between the osteoporosis clinic and usual care groups. Better screening and subsequent intervention are needed for patients with fragility fractures. This study highlights the efficacy of an outpatient OP clinic in a community hospital setting.
{"title":"The Evaluation of an Osteoporosis Clinic in a Community Hospital Setting: a Retrospective Chart Review and Telephone Survey","authors":"Timothy S. H. Kwok, N. Gakhal, T. Ruban","doi":"10.5770/cgj.22.359","DOIUrl":"https://doi.org/10.5770/cgj.22.359","url":null,"abstract":"Background Patients who have suffered fragility fractures are at an increased risk for subsequent fractures. The Osteoporosis (OP) Clinic at Markham Stouffville Hospital (MSH) was set up in July 2015 to screen, diagnose, and treat patients with fragility fractures. The goal of this study was to identify differences in OP screening and treatment initiation between patients seen in the OP clinic versus usual care. Methods A retrospective cohort study and telephone interview was conducted on 40 patients who had sustained a hip fragility fracture between September 2015 and July 2016. 20 of those patients were referred to the OP clinic, while the remaining patients received usual care. Results At the end of the intervention, 16/20 patients in the OP clinic group were appropriately placed on a bisphosphonate/RANKL inhibitor versus only 6/20 patients in the usual care group (p < .01). Conclusions A significant care gap exists in secondary fracture prevention between the osteoporosis clinic and usual care groups. Better screening and subsequent intervention are needed for patients with fragility fractures. This study highlights the efficacy of an outpatient OP clinic in a community hospital setting.","PeriodicalId":56182,"journal":{"name":"Canadian Geriatrics Journal","volume":"22 1","pages":"143 - 147"},"PeriodicalIF":3.9,"publicationDate":"2019-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43641367","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
K. Clemens, A. Ouédraogo, M. Speechley, L. Richard, J. Thain, S. Shariff
Background In older adults, hip fractures have been described to peak in cooler months. Seasonal differences in patient vulnerability to fracture and social/behavioural factors might contribute to these trends. Methods Using linked health-care databases in Ontario Canada, we examined monthly variation in hip fracture hospitalizations in those > 65 years (2011–2015). We stratified results by age category (66–79, ≥80 years). We then examined for variation in the demographic and comorbidity profiles of patients across the months, and as an index of contributing social/behavioural factors, noted variation in health-care behaviours. Results There were 47,971 and 52,088 hospitalizations for hip fracture in those 66–79, and ≥80 years, respectively. There was strong seasonality in fractures in both groups. Peaks occurred in October and December when patients appeared most vulnerable. Rates fell in the summer in those 66–79 years, and in the late winter in those ≥80 years (when health-care utilization also declined). A smaller peak in fractures occurred in May in both groups. Conclusions Hip fractures peak in the autumn, early winter, and spring in Canada. A dip in fractures occurs in the late winter in the oldest old. Environmental factors might play a role, but seasonal vulnerability to fracture and winter isolation might also be influential.
{"title":"Hip Fractures in Older Adults in Ontario, Canada—Monthly Variation, Insights, and Implications","authors":"K. Clemens, A. Ouédraogo, M. Speechley, L. Richard, J. Thain, S. Shariff","doi":"10.5770/cgj.22.341","DOIUrl":"https://doi.org/10.5770/cgj.22.341","url":null,"abstract":"Background In older adults, hip fractures have been described to peak in cooler months. Seasonal differences in patient vulnerability to fracture and social/behavioural factors might contribute to these trends. Methods Using linked health-care databases in Ontario Canada, we examined monthly variation in hip fracture hospitalizations in those > 65 years (2011–2015). We stratified results by age category (66–79, ≥80 years). We then examined for variation in the demographic and comorbidity profiles of patients across the months, and as an index of contributing social/behavioural factors, noted variation in health-care behaviours. Results There were 47,971 and 52,088 hospitalizations for hip fracture in those 66–79, and ≥80 years, respectively. There was strong seasonality in fractures in both groups. Peaks occurred in October and December when patients appeared most vulnerable. Rates fell in the summer in those 66–79 years, and in the late winter in those ≥80 years (when health-care utilization also declined). A smaller peak in fractures occurred in May in both groups. Conclusions Hip fractures peak in the autumn, early winter, and spring in Canada. A dip in fractures occurs in the late winter in the oldest old. Environmental factors might play a role, but seasonal vulnerability to fracture and winter isolation might also be influential.","PeriodicalId":56182,"journal":{"name":"Canadian Geriatrics Journal","volume":"22 1","pages":"148 - 164"},"PeriodicalIF":3.9,"publicationDate":"2019-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44646455","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
J. Muscedere, Amber Hastings Truelove, Denise Stockley, J. Fowler, Carol Barrie, A. Hafid, D. Guenter, E. Gallagher, M. Howard, J. You, A. Nidumolu, A. Lagrotteria, A. Motehayerarani, N. Virk, A. Sinnarajah, T. Human, I. Ying, H. Wong, G. Cummings, A. Pattullo, J. Wang, J. Lee, D. Moffat, M. Grinman, C. Montgomery, D. Rolfson, H. Stelfox, D. Zuege, D. Zygun, D. Hudson, D. Opgenorth, S. Bagshaw, C. Laur, J. Bell, R. Valaitis, S. Ray, H. Keller, C. Prevett, H. Fang, D. Shkredova, F. Xie, M. Zoratti, C. Gordon, J. Adachi, S. Phillips, J. Richardson, A. Tang, C. Ma, L. Riehm, C. Kendell, R. Urquhart, F. Burge, J. Kotecha, M. Martin, M. Jorgensen, H. Han, D. Dubé, G. Gutman, T. Sussman, B. DeVries, J. Gahagan, S. Brotman, E. Koo, P. Wegier, G. Embuldeniya, S. Ansari, D. Kobewka, E. O'Connor, P. Wu, L. Steinberg, C. Bell, T. Walton, J. Colstello, C. van Walraven, J. Downar, P. Wu, J. Costello, R. Wu, D. Frost, S. Kawaguchi, R. Mahtani, H. Toor, R. Goldman, J. Myers, A. Forster, E. Hladkowicz, M. Taljaard, G. Br
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{"title":"Highlights of the Canadian Frailty Network (CFN) Highly Qualified Personnel Poster Session","authors":"J. Muscedere, Amber Hastings Truelove, Denise Stockley, J. Fowler, Carol Barrie, A. Hafid, D. Guenter, E. Gallagher, M. Howard, J. You, A. Nidumolu, A. Lagrotteria, A. Motehayerarani, N. Virk, A. Sinnarajah, T. Human, I. Ying, H. Wong, G. Cummings, A. Pattullo, J. Wang, J. Lee, D. Moffat, M. Grinman, C. Montgomery, D. Rolfson, H. Stelfox, D. Zuege, D. Zygun, D. Hudson, D. Opgenorth, S. Bagshaw, C. Laur, J. Bell, R. Valaitis, S. Ray, H. Keller, C. Prevett, H. Fang, D. Shkredova, F. Xie, M. Zoratti, C. Gordon, J. Adachi, S. Phillips, J. Richardson, A. Tang, C. Ma, L. Riehm, C. Kendell, R. Urquhart, F. Burge, J. Kotecha, M. Martin, M. Jorgensen, H. Han, D. Dubé, G. Gutman, T. Sussman, B. DeVries, J. Gahagan, S. Brotman, E. Koo, P. Wegier, G. Embuldeniya, S. Ansari, D. Kobewka, E. O'Connor, P. Wu, L. Steinberg, C. Bell, T. Walton, J. Colstello, C. van Walraven, J. Downar, P. Wu, J. Costello, R. Wu, D. Frost, S. Kawaguchi, R. Mahtani, H. Toor, R. Goldman, J. Myers, A. Forster, E. Hladkowicz, M. Taljaard, G. Br","doi":"10.57700/cgj.22.369","DOIUrl":"https://doi.org/10.57700/cgj.22.369","url":null,"abstract":"<jats:p>-</jats:p>","PeriodicalId":56182,"journal":{"name":"Canadian Geriatrics Journal","volume":"22 1","pages":"75 - 98"},"PeriodicalIF":3.9,"publicationDate":"2019-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45100408","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-03-30eCollection Date: 2019-03-01DOI: 10.5770/cgj.22.272
Lynn Haslam, Vincent DePaul
In Canada, up to 32,000 older adults experience a fragility hip fracture. In Ontario, the Ministry of Health and Long Term Care has implemented strategies to reduce surgical wait times and improve outcomes in target areas. These best practice standards advocate for immediate surgical repair, within 48 hours of admission, in order to achieve optimal recovery outcomes. The majority of patients are good candidates for surgical repair; however, for some patients, given the risks of anesthetic and trauma of the operative procedure, surgery may not be the best choice. Patients and families face a difficult and hurried decision, often with no time to voice their concerns, or with little-to-no information on which to guide their choice. Similarly, health-care providers may experience moral distress or hesitancy to articulate other options, such as palliative care. Is every fragility fracture a candidate for surgery, no matter what the outcome? When is it right to discuss other options with the patient? This article examines a case study via an application of a framework for ethical decision-making.
{"title":"Case Study Application of an Ethical Decision-Making Process for a Fragility Hip Fracture Patient.","authors":"Lynn Haslam, Vincent DePaul","doi":"10.5770/cgj.22.272","DOIUrl":"https://doi.org/10.5770/cgj.22.272","url":null,"abstract":"<p><p>In Canada, up to 32,000 older adults experience a fragility hip fracture. In Ontario, the Ministry of Health and Long Term Care has implemented strategies to reduce surgical wait times and improve outcomes in target areas. These best practice standards advocate for immediate surgical repair, within 48 hours of admission, in order to achieve optimal recovery outcomes. The majority of patients are good candidates for surgical repair; however, for some patients, given the risks of anesthetic and trauma of the operative procedure, surgery may not be the best choice. Patients and families face a difficult and hurried decision, often with no time to voice their concerns, or with little-to-no information on which to guide their choice. Similarly, health-care providers may experience moral distress or hesitancy to articulate other options, such as palliative care. Is every fragility fracture a candidate for surgery, no matter what the outcome? When is it right to discuss other options with the patient? This article examines a case study via an application of a framework for ethical decision-making.</p>","PeriodicalId":56182,"journal":{"name":"Canadian Geriatrics Journal","volume":"22 1","pages":"7-12"},"PeriodicalIF":3.9,"publicationDate":"2019-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5770/cgj.22.272","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41221137","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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