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At least 307 records · Page 17Linked to original sources
PubMed1999

An in-home nurse-administered geriatric assessment for hypoalbuminemic older persons: development and preliminary experience.

BACKGROUND: Although malnutrition in older persons is a common, potentially treatable condition, few data indicate that treatments for this disorder can be effective. OBJECTIVE: To develop and preliminarily evaluate a two-component intervention that includes a nurse-administered, in-home assessment to identify potentially remediable causes of hypoalbuminemia and protocols to treat these problems. DESIGN: A pre-test post-test case-series. SETTING: An academic geriatrics practice. PARTICIPANTS: Seventeen persons aged 65 and older with serum albumin levels < or = 3.8 g/dL; eight of the participants received pre-and post-test outcome measures. INTERVENTION: Nurse-administered standardized assessment and intervention protocols. MEASUREMENTS: Serum albumin, Medical Outcome Study (MOS) SF-36, serum IL-1a and b, TNF alpha, IL-6, and lymphocyte markers of immune function. RESULTS: The assessment took 87 minutes, on average, and generated a mean 4.2 recommendations. Among the eight subjects with pre- and post-test measures, serum albumin increased by 0.2 g/dL (P = .035). Compared with baseline, two T cell markers of immune function demonstrated changes consistent with better function. CONCLUSIONS: These preliminary data support the potential benefit of a nurse-administered assessment coupled with protocols to address remediable contributors to hypoalbuminemia.

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PubMed1998

[A sociomedical geriatric assessment in the emergency units: an alternative to the hospitalization of aged patients?].

BACKGROUND: Elderly patients admitted to the emergency unit are usually hospitalized in medical units. Could a gerontologic evaluation in the emergency room lead to another solution than hospitalization? METHODS: Since January 1993, a sociomedical geriatric reception has been operating in the emergency unit of the university hospital in Brest, France, every day from 10 AM. to 6 PM. Patients older than 75 years, dependent or at risk of dependence are examined by a geriatrician. The medical situation is evaluated. The nutrition status, the cognitive functions, the thymic functions, the gait, and the functional abilities are systematically studied. In the same time the social evaluation is realised by a social worker. RESULTS: From January 1993 to December 1996, 1,514 patients have been cared for by the social medical team. Once the assessment of each patient was made only 49% of them actually had to be hospitalized in a medical department. The outcome of 100 patients discharged between January 1994 and June 1994 was evaluated one year after their discharge at home, 11 patients were rehospitalized. The reason for rehospitalization were different from the reasons for the first hospitalization. CONCLUSION: A gerontologic assessment in the emergency room permits to avoid hospitalization in 50% of the cases. One year after discharge at home only 11% of the patients were rehospitalized.

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PubMed1987

Geriatric assessment on a subacute hospital ward.

The authors collected data on all patients admitted to the Sepulveda Veterans Administration Geriatric Evaluation Unit (GEU) during its first 6 years of operation. Analysis of these data indicate several beneficial effects associated with this type of specialized geriatric care: improved diagnostic accuracy, reduced use of drugs, improved functional status, and improved placement location. The authors also analyzed additional data from a previously published, randomized controlled trial to compare better process of care between patients randomized to the GEU and those receiving usual services. During their initial hospitalizations, GEU patients received significantly more specialty evaluations than controls (4.9 versus 1.7, p less than .001), had longer lengths of stay (85.1 days versus 44.3 days, p less than .001), had more new diagnoses discovered (2.9 versus 0.6, p less than .001), and had more drugs discontinued from their regimens (4.6 versus 2.3 p less than .001). These process differences were probably related to the previously reported outcome differences: GEU patients were more likely than controls to show improvements in functional status, affect, placement location, use of institutional services, and survival.

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PubMedDate not supplied

Geriatric assessment (continuing education credit).

This article will increase the already knowledgeable nurse's awareness of subtle assessment differences for elderly clients. This increased awareness will help with early identification of deviations from health of the geriatric client, resulting in improved, holistic nursing care.

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PubMedDate not supplied

[Sandoz Clinical Assessment Geriatric Scale: a transcultural factor-analytic study].

To date only a few scales claimed to be valid and reliable exist that are designed to assess symptoms and signs of mental deterioration in the aging patient. One such scale, the SCAG, was presented by Venn et al. in the early seventies in the USA as an instrument designed to provide a picture of the cognitive, affective, social and somatic functions of the patient and to measure the effects induced by geriatric drugs on this picture. It consists of 18 items that have to be rated on a scale from 1 to 7. Along with the English original, German and French translations of this scale have been widely used in clinical trials in Europe. Their properties would not be assumed to be the same, especially when they are used in countries with different cultural backgrounds. Thus, a comparative study of the construct validity (by means of factor analyses) of the English, German and French versions of the SCAG, using 5 samples from different European countries, has been performed. As reference served a factor analysis of the SCAG based on 1165 pre-treatment values from 21 American trials. In all but one sample essentially the same structure with five factors emerged (in one case two factors were confounded).

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