Search Results (7)

Background/Objectives: The INTegRated InterveNtion of pSychogerIatric Care (INTRINSIC) network introduces an innovative model of psychogeriatric care, combining tertiary mental healthcare with primary care for older adults in low-resource settings in Greece via telemedicine. This study explores viewpoints of healthcare professionals on care delivery within the frames of old-age mental telehealth services in low-resource settings. Methods: All healthcare professionals, including 13 medical and 11 non-medical professionals from diverse healthcare units in urban, rural, and insular areas, participated in a semi-structured survey. Thematic analysis identified key insights. Results: Most participants (N = 19) highlighted the high usability of the INTRINSIC services and their high satisfaction for being members of the network (N = 17) was attributed to the collaborative delivery of integrated, specialized healthcare services in primary healthcare (N = 17). Further identified advantages of the services included the positive impact on timely care delivery (N = 6), cost effectiveness, and alleviation of hospital strain. Healthcare professionals valued the holistic approach of the INTRINSIC services to psychogeriatric care (N = 8) and their role in the improvement of it in communities in low-resource settings (N = 13). However, challenges were also reported, including the low openness and reluctance of service users (N = 7), difficulties in using the INTRINSIC digital platform (N = 5), and increased workload (N = 5). Conclusions: Despite these issues, the INTRINSIC services embody an innovative telehealth model for delivering high-quality, tertiary, mental, and cognitive healthcare services to older adults in underserved areas. Full article

(1) Background: It is important to evaluate the attention in the basic activities of daily life in the early hours of the day to evaluate the quality of care and to be able to increase the attention of human resources in case of observing an increase in dependency. The purpose was to improve healthcare quality in nursing homes, correctly identifying the work burden and incidents of daily planning, and completing the work plan by nursing assistant staffing. (2) Methods: The sample is based on 70 elderly people. The analysis used an observational trial every workday over a six-month period. An ad hoc sheet was prepared to collect socio-demographic data on each participant, and the Barthel Index was applied to the study subjects. A daily record of three basic activities of daily living (BADL), such as dressing, bathing, and eating, was kept. (3) Results: Our results showed a significant evolution in both units, but it was in the psychogeriatric unit in which higher compliance with the schedule and higher maintained stability was reached. (4) Conclusions: The use of some BADL registers helped us address situations of imbalance in terms of user assistance and establish an interdisciplinary communication with the nursing team as a way of achieving better organization and compliance with care protocols. Full article

Alzheimer’s disease (AD) is an incurable neurodegenerative disease. It is the most common form of dementia among the elderly population. So far, no effective methods of its treatment have been found. Research to better understand the mechanism of pathology may provide new methods for early diagnosis. This, in turn, could enable early intervention that could slow or halt disease progression and improve patients’ quality of life. Therefore, minimally invasive markers, including serum-based markers, are being sought to improve the diagnosis of AD. One of the important markers may be the concentration of UCHL1 and the proteasome in the blood serum. Their concentration can be affected by many factors, including eating habits. This study was conducted in 110 patients with early or moderate AD, with a mean age of 78.0 ± 8.1 years. The patients were under the care of the Podlasie Center of Psychogeriatrics and the Department of Neurology (Medical University of Białystok, Poland). The control group consisted of 60 healthy volunteers, matched for gender and age. The concentration of UCHL1 and the 20S proteasome subunit were measured by surface plasmon resonance imaging (SPRI). In addition, a nutritional interview was conducted with patients with AD, which assessed the frequency of consumption of 36 groups of products. In the group of patients with AD, compared to the control group, we showed a significantly higher concentration of UCHL1 (56.05 vs. 7.98 ng/mL) and the proteasome (13.02 vs. 5.72 µg/mL). Moreover, we found a low negative correlation between UCHL1 and the proteasome in the control group, and positive in the AD group. The analysis of eating habits showed that the consumption of selected groups of products may affect the concentration of the tested components, and therefore may have a protective effect on AD. Full article

Physical restraints in the long-term care setting are still commonly used in several countries with a prevalence ranging from 6% to 85%. Trying to have a broad and extensive overlook on the physical restraints use in long-term care is important to design interventions to prevent and/or reduce their use. Therefore, the aim of this scoping review was to analyze the range of occurrence of physical restraint in nursing homes, long-term care facilities, and psychogeriatric units. Pubmed, CINAHL, Ovid PsycINFO- databases were searched for studies with concepts about physical restraint use in the European long-term care setting published between 2009 and 2019, along with a hand search of the bibliographies of the included studies. Data on study design, data sources, clinical setting and sample characteristics were extracted. A total of 24 studies were included. The median occurrence of physical restraint in the European long-term care setting was still high (26.5%; IQR 16.5% to 38.5%) with a significant variability across the studies. The heterogeneity of data varied according to study design, data sources, clinical setting, physical restraint’s definition, and patient characteristics, such as ADLs dependence, presence of dementia and psychoactive drugs prescription. Full article

The Cognitive Performance Scale (CPS) in the widely used interRAI suite of instruments is of interest to clinicians and policy makers as a potential screening mechanism for detecting dementia. However, there has been little evaluation of the CPS in home care settings. This retrospective diagnostic study included 134 older adults (age ≥ 65) who were discharged from two acute psychogeriatric inpatient units or assessed in two memory clinics. The reference test was a diagnosis of clinical dementia, and the index test was interRAI CPS measured within 90 days of discharge. The overall accuracy of the CPS was good, with an area under the Receiver Operating Characteristic curve of 0.82 (95% CI = 0.75–0.89). The optimal cut point was 1/2, coinciding with the recommended cut point, with good sensitivity (0.90, 95% CI = 0.81–0.96) but poor specificity (0.60, 95% CI = 0.46–0.72). Positive predictive value improved from 0.72 (95% CI = 0.66–0.78) to 0.89 (95% CI = 0.75–0.96) when using a cut point of 2/3 instead of 1/2. If the results of the present study are replicated with more generalisable interRAI samples, older adults with a CPS of 3 or above, but without a formal diagnosis of dementia, should be referred for further cognitive assessment. Full article

Australia has a population of around 4 million people aged 65 years and over, many of whom are at risk of developing cognitive decline, mental illness, and/or psychological problems associated with physical illnesses. The aim of this study was to describe the pattern of specialised mental healthcare provision (availability, placement capacity, balance of care and diversity) for this age group in urban and rural health districts in Australia. The Description and Evaluation of Services and DirectoriEs for Long Term Care (DESDE-LTC) tool was used in nine urban and two rural health districts of the thirty-one Primary Health Networks across Australia. For the most part service provision was limited to hospital and outpatient care across all study areas. The latter was mainly restricted to health-related outpatient care, and there was a relative lack of social outpatient care. While both acute and non-acute hospital care were available in urban areas, in rural areas hospital care was limited to acute care. Limited access to comprehensive mental health care, and the uniformity in provision across areas in spite of differences in demographic, socioeconomic and health characteristics raises issues of equity in regard to psychogeriatric care in this country. Comparing patterns of mental health service provision across the age span using the same classification method allows for a better understanding of care provision and gap analysis for evidence-informed policy. Full article

Sleep disorders are very frequent in the elderly and it affects health and well-being of older people. Some authors estimate that the prevalence of insomnia in the elderly is very high, close to 60%. Sleep disorders in the elderly are frequent and it causes high demand for care. Some authors think that it will affect a lot in health of older people and those who take care of them. This could bring an increase of institutionalization. With this work we wanted to measure prevalence of insomnia in those chronic and psychogeriatric patients who are in nursing-homes, and which psychotropic drugs are prescribed for control it. In addition, we have studied if there is significant relationship between psychiatric diagnosis, neurologic diagnosis, age or sex, medical comorbidity, and the presence of insomnia. Full article