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Exploring a new model of end-of-life care for older people that operates in the space between the life world and the healthcare system - a qualitative case study

DODD, Steven ; PRESTON, Nancy ; PAYNE, Sheila ; WALSHE, Catherine
International journal of health policy and management, 01/08/2020, vol.9, n°8, p. 344-351

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Frailty status predicts futility of cardiopulmonary resuscitation in older adults

IBITOYE, Sarah E ; RAWLINSON, Sadie ; CAVANAGH, Andrew ; PHILLIPS, Victoria ; SHIPWAY, David J H
Age and ageing, 05/06/2020, Pagination inconnue

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The effectiveness of a modified advance care planning programme

DENG, Renli ; ZHANG, Jianghui ; CHEN, Liuliu ; MIAO, Jiarui ; DUAN, Jiazhong ; QIU, Yeyin ; LEUNG, Doris ; CHAN, Helen ; LEE, Diana TF
Nursing ethics, 26/06/2020, Pagination inconnue

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Thème : Age de la vie, situations spécifiques liées à la fin de vie.

PROJET SOIN ANTICIPE ; CHINE ; PERSONNE AGEE ; VULNERABILITE ; EFFICACITE

Background: Frailty is a natural consequence of the aging process. With the increasing aging population in Mainland China, the quality of life and end-of-life care for frail older people need to be taken into consideration. Advance Care Planning has also been used worldwide in long-term facilities, hospitals and communities to improve the quality of end-of-life care, increase patient and family satisfaction, and reduce healthcare costs and hospital admissions in Western countries. However, it has not been practiced in China.
Research objective: This study aimed to evaluate the effectiveness of a modified Advance Care Planning intervention in certainty of end-of-life care, preferences for end-of-life care, quality of life concerns, and healthcare utilization among frail older people.
Research design: This study used a quasi-experimental design, with a single-blind, control group, pretest and repeated posttest approach.
Participants and research context: A convenience sample of 74 participates met the eligibility criteria in each nursing home. A total of 148 frail older people were recruited in two nursing homes in Zhejiang Province, China.
Ethical considerations: The study received ethical approval from the Clinical Research Ethics Committee, the Faculty of Medicine, and The Chinese University of Hong Kong, CREC Ref. No: 2016.059.
Findings: The results indicated the Advance Care Planning programme was effective at increasing autonomy in decision making on end-of-life care issues, decreasing decision-making conflicts over end-of-life care issues, and increasing their expression about end-of-life care.
Discussion: This study promoted the participants’ autonomy and broke through the inherent custom of avoiding talking about death in China.
Conclusion: The modified Advance Care Planning intervention is effective and recommended to support the frail older people in their end-of-life care decision in Chinese society.

Origine : DOI.org (Crossref

Prehospital frailty and screening criteria for palliative care services in critically ill older adults - an observational cohort study

HOPE, Aluko A. ; ENILARI, Oladunni M. ; CHUANG, Elizabeth ; NAIR, Rahul ; GONG, Michelle Ng
JOURNAL OF PALLIATIVE MEDICINE, 23/06/2020, Pagination inconnue

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Prendre soin de la personne - pour une éthique de la personnalisation dans les pratiques soignantes

HONORE, Bernard
Seli Arslan , 05/2020 , 155 p.

"Everybody in this community is at risk of dying" - an ethnographic exploration on the potential of integrating a palliative approach to care among workers in inner-city settings

STAJDUHAR, Kelli ; GIESBRECHT, Melissa ; MOLLISON, Ashley ; D'ARCHANGELO, Margo
Palliative and supportive care, 07/05/2020, p. 1-6

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Palliative care and end-of-life considerations for the frail patient

CROOMS, Rita C. ; GELFMAN, Laura P.
Anesthesia and analgesia, 06/2020, vol.130, n°6, p. 1504-1515

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Study protocol for a cluster randomised controlled feasibility trial evaluating personalised care planning for older people with frailty - PROSPER V2 27/11/18

HEAVEN, Anne ; BOWER, Peter ; CUNDILL, Bonnie ; FARRIN, Amanda ; FOSTER, Marilyn ; FOY, Robbie ; HARTLEY, Suzanne ; HAWKINS, Rebecca ; HULME, Claire ; HUMPHREY, Sara ; LAWTON, Rebecca ; PARKER, Catriona ; PENDLETON, Neil ; WEST, Robert ; YOUNG, John ; CLEGG, Andrew
Pilot and feasibility studies, 2020, vol.6, p. 1-11

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Caregiving at the margins - an ethnographic exploration of family caregivers experiences providing care for structurally vulnerable populations at the end-of-life

STAJDUHAR, Kelli ; GIESBRECHT, Melissa ; MOLLISON, Ashley ; DOSANI, Naheed ; MCNEIL, Ryan
PALLIATIVE MEDICINE, 27/04/2020, p. 1-8

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Covid-19 - a geriatric emergency

BOCCARDI, Virginia ; RUGGIERO, Carmelinda ; MECOCCI, Patrizia
Geriatrics, 26/04/2020, vol.5, n°2, p. 1-2

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A dual-centre observational review of hospital based palliative care in patients dying with covid-19

TURNER, Jennifer ; HODGSON, Luke Eliot ; LECKIE, Todd ; EADE, Lisa ; FORD-DUNN, Suzanne
JOURNAL OF PAIN AND SYMPTOM MANAGEMENT, 05/05/2020, p. 1-4

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Redefining vulnerability in the era of Covid-19

The Lancet, 04/04/2020, vol.395, n°10230, p. 1089

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What does it mean to be made vulnerable in the era of Covid-19?

AHMAD, Ayesha ; CHUNG, Ryoa ; ECKENWILER, Lisa ; GANGULI, Agomani Mitra ; HUNT, Matthew ; RICHARDS, Rebecca ; SAGHAI, Yashar ; SCHWARTZ, Lisa ; SCULLY, Jackie Leach ; WILD, Verina
The Lancet, 09/05/2020, vol.395, n°10235, p. 1481-1482

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Preferences for end-of-life care - a study protocol for a cross-sectional survey of Chinese frail elderly home residents in Hong Kong

YAN, Bo ; XU, Xinyi ; CHAU, Patsy PH ; TAKEMURA, Naomi ; CHEUNG, Derek YT ; CHAN, Felix HW ; LIN, Chia-Chin
BMJ Open, 03/2020, vol.10, n°3, p. 1-6

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Advance care plans and hospitalized frail older adults - a systematic review

HOPKINS, Sarah A ; BENTLEY, Allison ; PHILLIPS, Veronica ; BARCLAY, Stephen
BMJ supportive and palliative care, 02/04/2020, p. 1-11

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The emergence and utilisation of frailty in the United Kingdom - a contemporary biopolitical practice

TOMKOW, Louise
Ageing and society, 04/2020, vol.40, n°4, p. 695-712

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Thème : Age de la vie, situations spécifiques liées à la fin de vie. Cote : eD05.04

VULNERABILITE ; ROYAUME UNI ; SANTE PUBLIQUE ; GERIATRIE

Frailty has recently emerged as a dominant concept against a backdrop of media and governmental narratives that frame the growing ageing population as an economic threat to the current configuration of health care in the United Kingdom (UK). Despite frailty's popularity amongst geriatricians and policy makers, the concept faces resistance from other health-care professionals and older people themselves. This paper draws on the Foucauldian idea of biopower; by suggesting that the contemporary emergence and utilisation of frailty represents a biopolitical practice a number or critical observations are made. First, despite biomedical experts acknowledging ambiguities in the definition of frailty, the concept is presented as a truth discourse. This is driven by the ability of frailty measurements to predict risk of costly adverse outcomes; the capability of frailty scores to enumerate complex needs; and the scientific legitimacy frailty affords to geriatric medicine. Consequently, frailty has become pervasive, knowable and measurable. Second, the routine delineation between frail and robust objectifies older people, and can be said to benefit those making the diagnosis over those being labelled frail, with the latter becoming disempowered. Last, studies show that frailty is associated with increasing wealth inequalities in the UK; however, experts’ suggested management of frailty shifts the focus of responsibility away from ideologically driven structural inequalities towards the frail older person, attempting to encourage individuals to modify lifestyle choices. This neglects the association between lifestyle opportunities and socio-economic deprivation, and the impact of long-term poverty on health. These observations, set against the contemporary political climate of economic austerity, cuts to public services and rationalisation of health resources, bring the urgency of a critical consideration of frailty to the fore.

Origine : Cambridge Core

Older adults' understandings and perspectives on frailty in community and residential aged care - an interpretive description

ARCHIBALD, Mandy ; LAWLESS, Michael ; AMBAGTSHEER, Rachel C. ; KITSON, Alison
BMJ Open, 18/03/2020, vol.10, n°3, p. 1-9

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Thème : Age de la vie, situations spécifiques liées à la fin de vie. Cote : eD05.04

PERSONNE AGEE ; VULNERABILITE ; RECHERCHE QUALITATIVE ; AUSTRALIE

OBJECTIVES: Despite growing interest in frailty as a significant public health challenge, comparatively little is known about how older adults perceive and experience frailty, limiting the effectiveness of strategies to improve frailty management and prevention. The objective of this study was to understand how older people, including frail older persons in residential aged care, perceive and understand frailty through an interpretive-descriptive qualitative study.
SETTING: Aged care facility, community-based university for older persons and an aged care auxiliary care group in a large metropolitan centre in South Australia.
PARTICIPANTS: 39 non-frail, prefrail, frail and very frail South Australian older adults.
METHODS: Seven focus groups were conducted. Participants completed one of two frailty instruments depending on setting and indicated whether they self-identified as frail. Data were analysed inductively and thematically by two independent investigators.
RESULTS: Frailty was described according to three schemas of (1) the old and frail: a static state near the end of life; (2) frailty at any age: a disability model; and (3) frailty as a loss of independence: control, actions and identity. In addition, a theme was identifying linking mindset, cognition and emotion to frailty. The term frailty was viewed negatively and was often implicated with personal choice. There was little correlation between frailty assessments and whether participants self-identified as frail.
CONCLUSIONS: Aside from a disability model, views of frailty as unmodifiable permeated older persons' diverse perspectives on frailty and are likely to impact health behaviours. To our knowledge, this is among the largest qualitative studies examining consumer perceptions of frailty and contributes a clinically relevant schema linking age, prevention and modifiability from a consumer perspective.

Origine : PubMed

Association of hospital readmissions and survivability with frailty and palliative performance scores among long-term care residents

ARANHA, Anil N. F. ; SMITHERMAN, Herbert C. ; PATEL, Dhaval ; PATEL, Pragnesh J.
The American journal of hospice and palliative care, 01/03/2020, Pagination inconnue

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Frailty differences in older adults’ use of informal and formal care

LAMBOTTE, Deborah ; DE DONDER, Liesbeth ; VAN REGENMORTEL, Sofie ; FRET, Bram ; DURY, Sarah ; SMETCOREN, An-Sofie ; DIERCKX, Eva ; DE WITTE, Nico ; VERTE, Dominique ; KARDOL, Martinus J. M.
Archives of gerontology and geriatrics, 01/11/2018, vol.79, p. 69-77

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Development of frailty subtypes and their associated risk factors among the community-dwelling elderly population

ZHANG, Yan ; XU, Xiu-Juan ; LIAN, Ting-Yu ; HUANG, Ling-Feng ; ZENG, Jin-Mei ; LIANG, Dong-Mei ; YIN, Ming-Juan ; HUANG, Jing-Xiao ; XIU, Liang-Chang ; YU, Zu-Wei ; LI, Yu-Lian ; MAO, Chen ; NI, Jin-Dong
Aging, 17/01/2020, vol.12, p. 1128-1140

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