Geriatric Nursing最新文献

Constipation is common among older adults and significantly impacts their quality of life (QoL). Prior studies have extensively detailed constipation, but conceptualization of constipation as a geriatric syndrome is lacking. In this review, we provide an overview of constipation in the geriatric population and conceptualize constipation as a geriatric syndrome given its high prevalence, under-recognized status, and association with poor QoL and adverse outcomes among older adults. The conceptualization of constipation as a geriatric syndrome, as with frailty and delirium, highlights its importance and need for a multi-faceted approach. Future research is needed to 1) better define constipation, 2) explore the multifactorial nature of constipation in older adults and relationship with other geriatric syndromes, 3) include more older adults in pharmacological and non-pharmacological interventions for constipation, and 4) curate multidisciplinary care models. Appreciating constipation as a geriatric syndrome will yield tailored management strategies, ensure timely intervention, and avoid adverse outcomes.

Objective: To assess muscle loss via ultrasound in the elderly and its link to clinical outcomes and risk factors.

Methods: This retrospective cohort study assessed muscle loss in hospitalized elderly via ultrasound, comparing bilateral anterior thigh thickness (BATT) at admission and after seven days, exploring its relation to hospital-acquired complications (HACs).

Results: In 86 patients (mean age 83.6), a 4.2% BATT decline over a week was seen, with 39.5% losing more than 10%. BATT changes correlated with HACs, with a -10% change as a predictive threshold. Risk factors for severe muscle loss in elderly hospitalized patients include female gender, higher baseline nutrition risk screening 2002 (NRS2002) scores and higher level of coefficient of variation of red blood cell distribution width (RDW-CV).

Conclusions: Elderly hospitalized patients were at risk of acute muscle loss during their hospital stay. Severe BATT decline during hospitalization in elderly patients was independently associated with HACs.

The age-friendly approach ensures older adults receive care that optimizes their well-being, particularly through episodes of illness and at end-of-life. Geriatric clinical quality organizations, including NICHE, establish age-friendly standards and provide education and implementation resources to healthcare organizations. The Centers for Medicare and Medicaid Services will require organizations participating in the inpatient prospective payment system and the long-term care hospital payment system to submit data about compliance with the Age-Friendly Measure starting in 2025. This month's NICHE column discusses the measure's alignment with quality programs, their resources, and a case example of a health system leveraging these programs.

The older incarcerated adult is a vulnerable and overlooked demographic within the U.S. healthcare system, facing high mortality rates due to chronic conditions and age-related issues such as cognitive decline, mobility impairments, and sensory deficits. The National Commission on Correctional Health Care's (NCCHC) position statement on "Care for Aging Patients in the Correctional Setting" is a pivotal step in addressing healthcare gaps for this population. In this article, we underscore the urgent need for a holistic, age-appropriate care model in correctional settings to ensure equitable care. Aging while incarcerated accelerates physical and psychological decline, with research suggesting each year in prison reduces life expectancy by two years. The correctional environment exacerbates this process, making individuals appear older than their non-incarcerated counterparts. The lack of age-appropriate healthcare, coupled with pre-incarceration health disparities, highlights the need for targeted interventions. The NCCHC's recommendations for comprehensive assessments, early identification of cognitive decline, and preventive measures are vital for improving outcomes and reducing healthcare costs. Equity and personalized care for the aging incarcerated population are essential, emphasizing the ethical need to restore dignity and autonomy. This requires patient-centered care, respecting treatment preferences, and aligning end-of-life care with individual wishes. Environmental modifications to enhance mobility, prevent injuries, and standardized health screenings at intake are also crucial for proactive care. In conclusion, the NCCHC's recommendations offer a framework to address the healthcare needs of older incarcerated adults, but implementation requires systemic changes, adequate funding, and a trained workforce in geriatric and correctional health.

Cognitive frailty is increasingly prevalent among elderly patients, heightening the risks of dementia, disability, and mortality. This demographic also faces a rising incidence of lung cancer, and cognitive frailty complicates rehabilitation efforts. Research on cognitive frailty in elderly lung cancer patients is still emerging. This review examines the definition and assessment of cognitive frailty, its the current prevalence in this population, and nursing management strategies. While tools for assessing cognitive frailty are not standardized, the incidence remains high, leading to adverse health outcomes. Comprehensive interventions for elderly lung cancer patients with cognitive frailty are insufficient, highlighting the need for more effective strategies to mitigate this issue. The goal is to enhance both research and clinical practices in identifying and diagnosing cognitive frailty in this vulnerable population.

Objectives: To explore whether family guidance regarding Internet (FGI) mitigates the effect of educational attainment on older adults' eHealth literacy through different Internet uses and identify which types of FGI improve eHealth literacy among low-educated older adults effectively.

Methods: A total of 490 Chinese adults aged 60 and above completed the eHealth Literacy Scale, an Internet use checklist, and self-reported their educational attainment and FGI frequency.

Results: With adequate FGI, educational attainment was not related to informational Internet use, recreational Internet use, and eHealth literacy. Instrumental, informational, and recreational FGI predicted low-educated older adults' Internet uses and eHealth literacy positively.

Conclusions: FGI mitigates older adults' eHealth literacy inequality due to educational attainment and indirectly narrows this gap through the mediations of informational and recreational Internet use. Informational, instrumental, and recreational FGI play key roles in improving eHealth literacy among low-educated older adults.

Objective: This study aimed to measure health literacy and successful aging level and their predisposing factors among older adults.

Methods: A predictive correlational design was performed. The study was completed with 450 older individuals, resulting in a participation rate of 94.9 %.

Results: The risk of inadequate and limited health literacy was higher in older adults who were single (3.4 times), those with chronic diseases (2.93 times), and those with medium/poor health perception (3.1 times). A multiple regression model consisting of age, health perception, and health literacy level explained 22 % of the variance in successful aging.

Conclusion: The study concluded that health literacy and successful aging were predictive factors of each other. Marital status, education level, having chronic disease, regular medication use, and health perception predicted the health literacy level. Moreover, age, health perception, and health literacy level are significant predictors of successful aging.

Alzheimer's disease (AD) is a progressive neurodegenerative disease. Treatments include disease-modifying therapies (DMTs), which studies showed are most effective when initiated during the early disease stages. Timely AD diagnosis is therefore important, as DMTs can potentially extend an acceptable quality of life for people with this condition. This scoping review presents the current role of nurse practitioners (NPs) in AD care and describe the current and potential future role NPs can play in timely AD diagnosis and management. A systematic search of the PubMed and CINAHL databases identified 15 relevant articles. The literature review revealed that NPs play an active role in the initial assessment of cognitive disorders; however, there is a lack of evidence for NPs acting autonomously to diagnose and treat AD. Several opportunities to increase the autonomous role of NPs are described, which could reduce barriers to timely AD diagnosis and management.

Advance Care Planning (ACP) is a process that supports decision-making about end-of-life goals. Dementia ACP is recommended during the early stages of the disease to empower the individual living with dementia to express wishes for quality of life before experiencing significant cognitive decline. ACP during early dementia is rare, and hesitancy to initiate difficult and emotional conversations may be a contributing factor to delaying ACP. Effective ACP includes input from the clinician, patient, and family; however, there is limited dementia ACP research that includes all three perspectives. This secondary qualitative data analysis, guided by Social Cognitive Theory, aims to better understand the convergent and divergent views of ACP among dementia clinicians, caregivers, and individuals living with pre-clinical dementia. Study findings support the need for early, frequent, compassionate, and patient-centered ACP conversations that are considerate of the interests, perspectives, and wishes of the individual with dementia and their caregiver.