While the prevalence of malnutrition in the free-living elderly population is relatively low, the risk of
malnutrition increases dramatically in the institutionalized and hospitalized elderly.
The prevalence of
malnutrition is even higher in cognitively impaired elderly individuals and is associated with cognitive
Patients who are malnourished when admitted to the hospital tend to have longer hospital stays,
experience more complications, and have greater risks of morbidity and mortality than those whose
nutritional state is normal.
The full MNA® is a validated screening tool that identifies elderly persons who are malnourished or
at risk for malnutrition. The full MNA® is the original version of the MNA® and takes 10-15 minutes
to complete. The revised MNA®-SF is a short form of the MNA® that takes less than 5 minutes
to complete. It retains the accuracy and validity of the full MNA®.
Currently, the MNA®-SF is the
preferred form of the MNA® for clinical practice in community, hospital, or long term care settings,
due to its ease of use and practicality. ...
In general, the health status at old age has an important individual and social relevance. The
vulnerability is increasing by physiological and morphological changes in the organism and
central nervous system during the ageing process. The indicators of physiological health are
based on prevalence of disabilities and causes of death. In Germany the main causes of death
are circulatory diseases, neoplasms, diseases of respiratory system and diseases of digestive
system (Statistisches Bundesamt 2007a; Nolte, Shkolinikov & McKee 2000).
We have mainly regarded elderly people’s use of information technology in their daily lives
as ICT training of elderly people. We have also discussed the possibilities and limitations
that technology raises for information, activity and for better contact with others.
The use of ICT in nursing and care of elderly people mainly implies in this connection the use
of smart-home technology in houses for old people and people with dementia. This
technology involves the use of integrated ICT components.
This hesitancy on
the part of patients to seek the information needed may have resulted from feeling helpless due to
hospitalization. How can seniors feel more proactive about their health care and less like victims?
The Internet may not be able to help the elderly when they are already hospitalized, but it could be a
useful resource to help them before they enter the hospital.
Stroke is a vascular disease for which mortality and morbidity are relatively
well-documented because most stroke victims are admitted to hospitals. Trends in
stroke mortality, incidence, and prevalence are somewhat similar to those for other
cardiovascular conditions. Stroke mortality has been decreasing since the 1960s,
but without a consistent decrease in stroke incidence. Stroke incidence has even
been reported to have been higher in the 1980s than during the 1970s, and there
was no sustained decline in incidence during the 1990s....
In a seminal study in New Haven, CT, United
States, data from a comprehensive annual health
and welfare study of a representative sample of
2812 older people were merged with the database
of the local agency concerned with adult abuse
for each year over a 9-year period (50). Information
for the health survey was recorded by nurses,
who saw the older people at a hospital for the first
year’s data collection and every third year after that.
In the intervening years, data were updated
In an effort to modernize Medicare insurance, the Federal
government has allowed private insurers who meet strict
requirements to sell private insurance to the elderly, as a
substitute for 'traditional' Medicare insurance. There are
many forms of private insurance now being sold to the
elderly, including some managed care plan types. Managed
care plans restrict the choice of physicians and hospitals
to include a set selected by the insurance plan, over
whom the plan has more control in terms of utilization
Strategic actions aiming at elderly health are:
implementing the Caderneta de Saúde for the elderly, with
relevant information about their health, permitting better
follow-ups by healthcare workers; Family Health Strategy;
stimulating the Permanent Distance Education Program,
implementing permanent education activities in the field
of aging and elderly health, focused on workers in the
basic healthcare network; establishing the Welcoming, by
reorganizing the process of welcoming elderly patients in
healthcare units; establishing Pharmaceutical Care,
developing actions that aim at...
In addition, Kaiser CDSMP participants had 0.2 fewer
visits to the emergency room and 0.97 fewer hospital days
compared to the year prior to completing the CDSMP. As a
result, they reduced their health care costs. For example, if
the average cost per day of hospitalization were $1,000 and
the average cost of an emergency room visit were $100, the
potential savings would be $990 per participant for the first
year following completion of the program (0.97 days of
hospitalization multiplied by $1,000 plus 0.2 emergency
visits multiplied by $100).
significant ramifications for the overall health of seniors. Firstly, seniors tend to turn to their doctors as
their primary source of medical information. Secondly, they have, in general, resisted turning to the
Internet for their primary medical information seeking needs. These two characteristics are significant due
to changing trends in medicine. With HMO’s and hospitals demanding that doctors see a certain number
of patients each day, the average amount of time a doctor spends with her patient is fifteen minutes
(Belzer 1999, n.p.).
Several community health centers operate a PACE program, a home and community based service that
allows severely disabled elders who are eligible for nursing home placement to remain in the community.
PACE is usually based in adult day health centers and operates as a small Medicare Advantage capitated
managed care plan at risk for providing all Medicare and Medicaid covered services including long
term care and acute hospital care. Primary care services are also provided by the PACE program in a
clinic setting utilizing employed or contracted medical providers.
Testing was performed in the gait laboratory of the City
Hospital Waid in Zurich, Switzerland. To measure
steady state walking, the central 7.32 m active sensor
area of the GAITRite® system was used as the test distance.
During the measurements, the subjects walked on
the walkway while wearing their own comfortable clothing
and low-heeled habitual shoes.
The use of hospital admission rates for ambulatory care
sensitive conditions (ACSCs) has become an established
tool for analyzing access to care [1,2]. ACSCs are conditions
for which good outpatient care can potentially prevent
the need for hospitalization. High rates of hospital
admissions for ACSCs may provide evidence of problems
with patient access to primary healthcare, inadequate
skills and resources, or a mismatch in services.
A quarter of a century ago, the proportion of older
people living in institutions in developed countries
had reached an estimated 9% (22). Since that time,
there has been a shift in emphasis towards care in
the community and the use of less restrictive
residential settings. Current rates of use of nursing
homes are in the range of 4–7% in countries such as
Canada (6.8%), Israel (4.4%), South Africa (4.5%)
and the United States (4%).
Mistreatment of older people has been identified in
facilities for continuing care (such as nursing
homes, residential care, hospitals and day care
facilities) in almost every country where such
institutions exist. Various people may be responsible
for the abuse: a paid member of the staff,
another resident, a voluntary visitor, or relatives or
friends. An abusive or neglectful relationship
between the older person and their caregiver at
home may not necessarily end once the older
person has entered institutional care; the abuse may
sometimes continue in a new setting.
Ageing tends to be associated with a growing burden of disease and prolonged heavy
drinking is itself a cause of health problems such as liver disease, raised blood pressure,
and some forms of cancer. Alcohol misuse may also lead to an increased likelihood of
falls, incontinence, cognitive impairment, hypothermia and self-neglect. These sorts of
problems may be regarded by health professionals and members of the family merely as
signs of ageing.
In November 1999, the Department of Dental Surgery at Chubu National Hospital,
National Institute of Longevity Science (Now: National Center for Geriatrics and
Gerontologyʣ, established the first oral care outpatient clinic in the nation. We have instructed
many people in methods of systematic oral care, and the service has earned a good reputation.
A substantial number of older persons report insecure balance and experience falls and fear of falling. Prospective studies indicate that 20–30% of those over age 65 fall each year, and the proportion is even higher in hospitalized elderly and nursing home patients. Each year 8% of individuals 75 suffer a serious fall-related injury. Hip fractures often result in hospitalization and nursing home admission. For each person who is physically disabled, there are others whose functional independence is constrained by anxiety and fear of falling.
It is innately human to comfort and provide care to those suffering
from cancer, particularly those close to death. Yet what seems self-evident
at an individual, personal level has, by and large, not guided policy at the
level of institutions in this country. There is no argument that palliative care
should be integrated into cancer care from diagnosis to death.