The booklet, End of Life: Helping with Comfort and Care produced by the National Institute on Aging and the National Institute of Health provides an overview of issues commonly affecting caregivers and families at the end of life.
The pamphlet covers topics such as how to find care, how to provide emotional and spiritual support, dementia at the end of life and finally advice on grieving. The pamphlet was written using current research and with suggestions from caregivers and families.
To access a copy of the booklet, please click here.
Try my Google Co-op search engine to search authoritative health and geriatric/gerontology sites on the WWW
Friday, May 24, 2013
Thursday, May 23, 2013
Article of Interest: How do GPs identify a need for palliative care in their patients? An interview study
Claessen, S J J; Francke, A L; Engels, Y; Deliens, L. (2013). How do GP's identify a need for palliative care in their patients? And interview study. BMC Family Practice 14, 42. http://www.biomedcentral.com/1471-2296/14/42
The article, How do GPs identify a need for palliative care in their patients? An interview study interviewed 20 General Practitioner's in the Netherlands to determine at what stage in the illness does the GP determine that a patient should be transitioned to palliative care.
For more information on this article, please see the abstract below or access the article here. This is an open-access article.
Background: Little is known about how GPs determine whether and when patients need palliative care. Little research has been done regarding the assumption underpinning Lynn and Adamson’s model that palliative care may start early in the course of the disease. This study was conducted to explore how GPs identify a need for palliative care in patients.
Methods: A qualitative interview study was performed among 20 GPs in the Netherlands.
Results: GPs reported that a combination of several signals, often subtle and not explicit, made them identify a need for palliative care: signals from patients (increasing care dependency and not recuperating after intercurrent diseases) and signals from relatives or reports from medical specialists. GPs reported differences in how they identified a need for palliative care in cancer patients versus those with other diseases. In cancer patients, the need for palliative care was often relatively clear because of a relatively strict demarcation between the curative and palliative phase. However, in patients with e.g. COPD or in the very old, GPs' awareness of palliative care needs often arises gradually, relatively late in the disease trajectory. GPs consider the diagnosis of a life-threatening illness as a key point in the disease trajectory. However, this does not automatically mean that a patient needs palliative care at that point.
Conclusions: GPs recognize a need for palliative care on the basis of various signals. They do not support the idea underlying Lynn and Adamson’s model that palliative care always starts early in the course of the disease.
The article, How do GPs identify a need for palliative care in their patients? An interview study interviewed 20 General Practitioner's in the Netherlands to determine at what stage in the illness does the GP determine that a patient should be transitioned to palliative care.
For more information on this article, please see the abstract below or access the article here. This is an open-access article.
Background: Little is known about how GPs determine whether and when patients need palliative care. Little research has been done regarding the assumption underpinning Lynn and Adamson’s model that palliative care may start early in the course of the disease. This study was conducted to explore how GPs identify a need for palliative care in patients.
Methods: A qualitative interview study was performed among 20 GPs in the Netherlands.
Results: GPs reported that a combination of several signals, often subtle and not explicit, made them identify a need for palliative care: signals from patients (increasing care dependency and not recuperating after intercurrent diseases) and signals from relatives or reports from medical specialists. GPs reported differences in how they identified a need for palliative care in cancer patients versus those with other diseases. In cancer patients, the need for palliative care was often relatively clear because of a relatively strict demarcation between the curative and palliative phase. However, in patients with e.g. COPD or in the very old, GPs' awareness of palliative care needs often arises gradually, relatively late in the disease trajectory. GPs consider the diagnosis of a life-threatening illness as a key point in the disease trajectory. However, this does not automatically mean that a patient needs palliative care at that point.
Conclusions: GPs recognize a need for palliative care on the basis of various signals. They do not support the idea underlying Lynn and Adamson’s model that palliative care always starts early in the course of the disease.
Wednesday, May 22, 2013
Prevention and Early Intervention of Malnutrition in Later Life: Best Practice & Implementation Guide
The report, Prevention
and Early Intervention of Malnutrition in Later Life: Best Practices &
Implementation Guide jointly written by the Malnutrition Task Force and
the British Dietetic Association is meant
to bring awareness to the issue of malnutrition and dehydration and how it can
be resolved.
The Malnutrition
Task Force is an independent group of experts from the UK who have united
to address the prevention of malnutrition and dehydration of older adults in
hospitals, care homes and in the community. They have identified the
social and psychological reasons why malnutrition and dehydration happens, and
have created best practice guidelines on how this problem can be
corrected. It provides real, practical advice and support for health care
and social care groups to better tackle the problem.
To view the report, please click here.
Tuesday, May 21, 2013
Article of Interest: Wound Cleansing for Pressure Ulcers
Moore, Z E H & Cowman, S. (2013). Wound cleansing for Pressure Ulcers. Cochrane Database of Systematic Reviews, issue 3. Art. No.: CD004983. Retrieved from http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD004983.pub3/abstract
This latest systematic review from the Cochrane Wound Group Editorial Group at Cochrane wants to answer the question: what is the effect of wound cleansing techniques on the rate of healing pressure ulcers? The group looked at the latest Randomized Controlled Trials (RCT's) published in this area of research and made their recommendations.
To see their recommendations please see the abstract below, or link to the article here. Please note, this is not an open access article. University of Manitoba library card holders may click here to access the article.
ABSTRACT
Background: Pressure ulcers (also called pressure sores, bed sores and decubitus ulcers) are areas of tissue damage that occur in the elderly, malnourished or acutely ill, who cannot reposition themselves. Pressure ulcers impose a significant financial burden on health care systems and negatively affect quality of life. Wound cleansing is considered an important component of pressure ulcer care.
Objectives: This systematic review seeks to answer the following question: what is the effect of wound cleansing solutions and wound cleansing techniques on the rate of healing of pressure ulcers?
Search methods: For this third update, we searched the Cochrane Wounds Group Specialised Register (searched 3 January 2013); The Cochrane Central Register of Controlled Trials (CENTRAL) The Cochrane Library; Ovid MEDLINE (2010 to November Week 3 2012); Ovid MEDLINE (In-Process & Other Non-Indexed Citations December 31, 2012); Ovid EMBASE (2010 to 2012 Week 52); and EBSCO CINAHL (2010 to 21 December 2012).
Selection criteria: Randomised controlled trials (RCTs) comparing wound cleansing with no wound cleansing, or different wound cleansing solutions, or different cleansing techniques, were eligible for inclusion if they reported an objective measure of pressure ulcer healing.
Data collection and analysis: Two review authors extracted data independently and resolved disagreements through discussion. A structured narrative summary of the included studies was conducted. For dichotomous outcomes, risk ratio (RR), plus 95% confidence intervals (CI) were calculated; for continuous outcomes, mean difference (MD), plus 95% CI were calculated. Meta analysis was not conducted because of the small number of diverse RCTs identified. Two review authors independently assessed each included study using the Cochrane Collaboration tool for assessing risk of bias.
Main results: One additional eligible study was identified from the updated searches, one study was added to the table of excluded studies. A total of three studies (169 participants) met the inclusion criteria for the review. No studies compared cleansing with no cleansing. Two studies compared different wound cleansing solutions. A statistically significant improvement in Pressure Sore Status Tool scores occurred for wounds cleansed with saline spray containing Aloe vera, silver chloride and decyl glucoside (Vulnopur) compared with isotonic saline (P value = 0.025), but no statistically significant change in healing was seen when water was compared with saline (RR 3.00, 95% CI 0.21 to 41.89). One study compared cleansing techniques; for pressure ulcers cleansed with pulsatile lavage, compared with sham (the lavage flow was directed into a wash basin positioned adjacent to the wound and not visible to the participants), there was a statistically significant reduction in ulcer volume at the end of the three week study period in the lavage group compared with the sham group (MD -6.60, 95% CI-11.23, -1.97).
Authors' conclusions: We identified three small studies addressing cleansing of pressure ulcers. One reported a statistically significant improvement in pressure ulcer healing for wounds cleansed with saline spray containing Aloe vera, silver chloride and decyl glucoside (Vulnopur) compared with isotonic saline solution, a further study reported no statistically significant change in healing was seen when wounds were cleaned with water was compared with saline. A final study compared pulsatile lavage with sham and found a significantly greater reduction in ulcer volume at the end of the study period in the lavage group compared with the sham group. The authors conclude that there is no good trial evidence to support use of any particular wound cleansing solution or technique for pressure ulcers.
This latest systematic review from the Cochrane Wound Group Editorial Group at Cochrane wants to answer the question: what is the effect of wound cleansing techniques on the rate of healing pressure ulcers? The group looked at the latest Randomized Controlled Trials (RCT's) published in this area of research and made their recommendations.
To see their recommendations please see the abstract below, or link to the article here. Please note, this is not an open access article. University of Manitoba library card holders may click here to access the article.
ABSTRACT
Background: Pressure ulcers (also called pressure sores, bed sores and decubitus ulcers) are areas of tissue damage that occur in the elderly, malnourished or acutely ill, who cannot reposition themselves. Pressure ulcers impose a significant financial burden on health care systems and negatively affect quality of life. Wound cleansing is considered an important component of pressure ulcer care.
Objectives: This systematic review seeks to answer the following question: what is the effect of wound cleansing solutions and wound cleansing techniques on the rate of healing of pressure ulcers?
Search methods: For this third update, we searched the Cochrane Wounds Group Specialised Register (searched 3 January 2013); The Cochrane Central Register of Controlled Trials (CENTRAL) The Cochrane Library; Ovid MEDLINE (2010 to November Week 3 2012); Ovid MEDLINE (In-Process & Other Non-Indexed Citations December 31, 2012); Ovid EMBASE (2010 to 2012 Week 52); and EBSCO CINAHL (2010 to 21 December 2012).
Selection criteria: Randomised controlled trials (RCTs) comparing wound cleansing with no wound cleansing, or different wound cleansing solutions, or different cleansing techniques, were eligible for inclusion if they reported an objective measure of pressure ulcer healing.
Data collection and analysis: Two review authors extracted data independently and resolved disagreements through discussion. A structured narrative summary of the included studies was conducted. For dichotomous outcomes, risk ratio (RR), plus 95% confidence intervals (CI) were calculated; for continuous outcomes, mean difference (MD), plus 95% CI were calculated. Meta analysis was not conducted because of the small number of diverse RCTs identified. Two review authors independently assessed each included study using the Cochrane Collaboration tool for assessing risk of bias.
Main results: One additional eligible study was identified from the updated searches, one study was added to the table of excluded studies. A total of three studies (169 participants) met the inclusion criteria for the review. No studies compared cleansing with no cleansing. Two studies compared different wound cleansing solutions. A statistically significant improvement in Pressure Sore Status Tool scores occurred for wounds cleansed with saline spray containing Aloe vera, silver chloride and decyl glucoside (Vulnopur) compared with isotonic saline (P value = 0.025), but no statistically significant change in healing was seen when water was compared with saline (RR 3.00, 95% CI 0.21 to 41.89). One study compared cleansing techniques; for pressure ulcers cleansed with pulsatile lavage, compared with sham (the lavage flow was directed into a wash basin positioned adjacent to the wound and not visible to the participants), there was a statistically significant reduction in ulcer volume at the end of the three week study period in the lavage group compared with the sham group (MD -6.60, 95% CI-11.23, -1.97).
Authors' conclusions: We identified three small studies addressing cleansing of pressure ulcers. One reported a statistically significant improvement in pressure ulcer healing for wounds cleansed with saline spray containing Aloe vera, silver chloride and decyl glucoside (Vulnopur) compared with isotonic saline solution, a further study reported no statistically significant change in healing was seen when wounds were cleaned with water was compared with saline. A final study compared pulsatile lavage with sham and found a significantly greater reduction in ulcer volume at the end of the study period in the lavage group compared with the sham group. The authors conclude that there is no good trial evidence to support use of any particular wound cleansing solution or technique for pressure ulcers.
Friday, May 17, 2013
How Would I Know? What Can I Do? How to Help someone with Dementia who is in Pain or Distress
Created by the National Council for Palliative Care , the How Would I Know? What Can I do? pamphlet gives tips and advice to caregivers and health care professionals when dealing with dementia patients who are in pain or distress and become agitated or angry. The leaflet is a quick reference guide that includes tips that will help the caregiver remain calm and provide support for the patient. It also gives advice as to why the person might be in pain, and how to solve it. Similar tips and advice are given to health care professionals.
To access a copy, please click here.
To access a copy, please click here.
Thursday, May 16, 2013
Not if but when:helping drivers with dementia hang up the keys
This website provides Nova Scotia specific information about the issue of driving and dementia.
The site provides helpful information for physicians and caregivers including a public service video; FAQs on driving with dementia; and links.
The site provides helpful information for physicians and caregivers including a public service video; FAQs on driving with dementia; and links.
Wednesday, May 15, 2013
Bandwidth
|
Bandwidth is
an online communication resource created by the John A. Hartford Foundation (the people
behind ConsultGeriRN) that provides
communication tools and support for healthcare professionals in long-term
care.
Bandwidth believes that “effective communication is vital
to promoting programs, changing healthcare practice and advocating policy
change.” The site provides resources that help long-term care
professionals create a cohesive message and how and who to communicate that
message to. The tools on the site include help to create eye-catching presentations
or posters; improving
oral presentations; tips on how to
deliver concise messages to the media and stakeholders; appropriately
using social media at work and much more.
The website also has searchable databases of images,
quotes and stories related to geriatric care that users can use in
presentations or other communication tools.
To visit Bandwidth, please click here.
|
Subscribe to:
Posts (Atom)
