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Biomedical subjects

Valerie T Cotter

Publications and source records attributed to Valerie T Cotter.

4 recordsLinked to original sources
PubMed2006

Alzheimer's disease: issues and challenges in primary care.

The challenge in primary care practice is identifying persons with symptoms of Alzheimer's Disease (AD) who often have limited capacity to recognize their own symptoms and attribute cognitive decline to chronic illness or aging. Brief office visit communications without an informant,such as a spouse or adult child rarely uncover mild stage AD. Clinicians in primary care fail to screen older adults for AD on a routine basis be-cause of insufficient time, inadequate reimbursement for services, and uncertainty about the value of an early diagnosis. Although current pharmacologic and behavioral interventions and patient education do not prevent eventual disease progression, they arguably lead to improvements in understanding, self-efficacy, and quality of life for the patient and family.

Activities of Daily Living↗
PubMed2005

Restraint free care in older adults with dementia.

During the past two decades, significant research and several government and health care quality groups have advised against the use of physical restraints in hospitals and nursing homes, yet older adults are continuing to die, become injured or experience the iatrogenic complications associated with this practice. Deaths are usually caused by asphyxiation, but also occur from strangulation, or cardiac arrest. Older adults with dementia are at high risk for restraint use because of impaired memory, language, judgment and visual perception. In moderate to severe dementia, the risk of falls is greater because of gait apraxia and unsteadiness. Agitation, disorientation, and pacing behaviors from delirium or dementia can precipitate staff to use restraints to prevent harm to the older adult or to others. Physical restraints should be eliminated as an intervention in older adults with dementia because they are also very likely to cause acute functional decline, incontinence, pressure ulcers and regressive behaviors in a short period of time. The purpose of this paper is to disseminate the dangers of this clinical practice and to summarize the latest research in restraint free care and restraint alternatives in the United States.

Accidental Falls↗
PubMed2003

Cognitive function assessment in individuals at risk for Alzheimer's disease.

PURPOSE: To describe brief assessments of functional performance and cognition to detect Alzheimer's disease (AD) and depression in older adults for the primary care provider. DATA SOURCES: Review of the literature. CONCLUSIONS: It is important for the clinician to interview both the patient and a knowledgeable informant to assess changes in the patients' functioning in daily life tasks and to administer brief screening tests to detect cognitive impairment and depression in older adults. Several suggested instruments for use in the primary care setting are included. IMPLICATIONS FOR PRACTICE: Standardized assessments of functional performance and brief cognitive tests identify individuals with clinically meaningful cognitive impairment and provide baseline measurement against which to compare future assessments.

Age Factors↗