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Commentary on: Crocker TF, Ensor J, Lam N, et al. Community based complex interventions to sustain independence in older people: systematic review and network meta-analysis. BMJ 2024 Mar 21;384.
Individualised care planning and effective and regular medication review are fundamental to ensuring the independence of older people living in the community. More research is needed to identify the particular health and social care interventions which are most beneficial to the ageing population.
Globally, by 2025, the proportion of older people ≥60 years will double to one-fifth of the total world population.
Commentary on: Chua M, Lau XK, Ignacio J. Facilitators and barriers to implementation of telemedicine in nursing homes: A qualitative systematic review and meta-aggregation. Worldviews Evid Based Nurs. 2024 Feb 10.
Implications for practice and research Telemedicine seems to hold a lot of promise, especially in nursing homes where patients are in desperate need of prompt medical attention. Lack of experience among healthcare professionals, as well as a lack of knowledge about process flows and organisational readiness, may be barriers to the introduction of telemedicine into nursing homes. Further research that examines the work system from the perspective of nursing homes will be necessary to improve the effectiveness and efficiency of telemedicine connections in these settings.
One of the biggest issues facing society is the growing number of elderly people who require care, which in turn is driving up demand for...
Commentary on: Ren, LH., Wong, KLY., Wong, J., Kleiss, S., Berndt, A., Mann, J., Hussein, A., Hu, G., Wong, L., Khong, R., Fu, J., Ahmed, N., Nolte, J., Hung, L. (2024) Working with a robot in hospital and long-term care homes: staff experience BMC Nursing 23:317 https://doi.org/10.1186/s12912-024-01983-0
Implications for practice and research When implementing welfare technology, staff education needs to consider relational and cultural factors, including positivity in leadership, teamwork and staff-family relationships to facilitate use. As technological possibilities are increasing, while older populations are growing and working populations are decreasing, user-based research in implementation of welfare technology is urgently needed.
The interest of using digital technologies, robots etc in supporting old age care is growing, due to the fact that the technological possibilities are also increasing. The fact that older populations are growing while working populations are decreasing in...
Commentary on: Perrella A, Geen, O, Ahuja, M, et al. Exploring the Impact of Age, Frailty, and Multimorbidity on the Effect of ICU Interventions: A Systematic Review of Randomized Controlled Trials. Critical Care Med. 2024 September. doi: 10.1097/CCM.0000000000006315
Implications for practice and research More information on how age, frailty, and multimorbidity affect responses to interventions in critically ill older adults would be important and beneficial for shared decision-making. Future studies should focus more on these understudied populations of older patients with frailty or multimorbidity and examine how they respond to intensive care unit interventions.
Recent data show that there has been an increase in the older populations admitted to intensive care unit (ICU).
Commentary on: Miller LG, McKinnell JA, Singh RD et al. Decolonization in Nursing Homes to Prevent Infection and Hospitalization. N Engl J Med. 2023 Nov 9;389(19):1766-1777.
Universal decolonisation of nursing home residents can reduce infection-related hospitalisations and overall hospitalisations. This may translate in the long term into potential reduction in healthcare costs of residents in nursing homes.
Nursing homes have a big role in healthcare delivery in the USA, thanks to the dramatic increase in population of older persons. Social interactions, indwelling devices, comorbidities and long stays predispose these residents to infections, particularly from multidrug-resistant organisms (MDRO), which in turn increase hospital admissions and deaths.
This cluster randomised trial
Commentary on: Yeji Hwang, Miranda V. McPhillips, Liming Huang, G. Adriana Perez and Nancy A. Hodgson, Better caregiver mastery is associated with less anxiety in individuals with cognitive impairment, BMC Nursing. 2023; 22:307.
Implications for practice and research Anxiety is one of the common neuropsychiatric symptoms (NPs) in individuals with cognitive impairment. Considering the fluctuating and variable course of NPs in dementia, studies with longer follow-up periods are required to understand the relationship between caregiver mastery and anxiety in patients with dementia. Dementia, an umbrella condition, encompasses various neurogenerative diseases that can cause behavioural problems, movement problems, autonomic dysfunction, gait and balance problems, as well as cognitive impairment. Hence, it is important to develop caregiver skills with different strategies for each type of dementia.
As the population ages, the prevalence of dementia has increased.
Commentary on: Pomeroy ML, Cudjoe TKM, Cuellar AE, et al. Association of social isolation with hospitalization and nursing home entry among community-dwelling older adults. JAMA Int Med. 2023; 183(9): 955–62. https://doi.org/10.1001/jamainternmed.2023.3064
Social isolation is a significant risk factor for nursing home placement for older adults, and public health interventions to improve social connections are urgently needed. Future research should address interventions across the lifespan and for those more vulnerable to isolation and loneliness, testing practical ways to improve social connectiveness.
The quality of our lives is the quality of our relationships. As we approach a challenging time of the year for loneliness and isolation, what do we know about social isolation and healthcare utilisation in older adults? Almost a quarter of community-dwelling older adults experience social isolation.
Commentary on: Roussel M, Teissandier D, Yordanov Y, et al. Overnight stay in the emergency department and mortality in older patients. JAMA Intern Med. 2023 Dec 1;183(12):1378-1385.
Healthcare leaders should place high importance on organisational solutions to prioritise the admission of older patients from emergency departments (EDs) to wards to reduce risks associated with overnight stays. Further evidence is needed to understand if increased risks to older patients in ED also occur at other times and to establish the most effective interventions to mitigate risks.
Crowding and access block in emergency departments (EDs) are pervasive problems of international concern.
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