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VULNERABILITE

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Accueillir la vulnérabilité - approches pratiques et questions philosophiques

DOAT, David ; RIZZERIO, Laura
Erès , 2020 , 252 p.

Advance care planning and decision-making in a home-based primary care service in a Canadian urban centre

HUGGINS, Madison ; MCGREGOR, Margaret J. ; COX, Michelle B. ; BAUDER, Katie ; SLATER, Jay ; YAP, Clarissa ; MALLERY, Laurie ; MOORHOUSE, Paige ; RUSNAK, Conrad
Canadian geriatrics journal, 12/2019, vol.22, n°4, p. 182-189

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Deprescribing in older people approaching end of life - a randomized controlled trial using STOPPFrail criteria

CURTIN, Denis ; JENNINGS, Emma ; DAUNT, Ruth ; CURTIN, Sara ; RANDLES, Mary ; GALLAGHER, Paul ; O'MAHONY, Denis
Journal of the American Geriatrics Society, 23/12/2019, Pagination inconnue

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Evaluating person-centredness for frail older persons in nursing homes before and after implementing a palliative care intervention

BOKBERG, Christina ; BEHM, Lina ; WALLERSTEDT, Birgitta ; AHLSTROM, Gerd
Nursing open, 01/2020, vol.7, n°1, p. 439-448

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Preventing frailty in older people - an exploration of primary care professionals' experiences

OBBIA, Paola ; GRAHAM, Clair ; DUFFY, F. J. Raymond ; GOBBENS, Robbert J. J.
International journal of older people nursing, 24/12/2019, Pagination inconnue

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Caring for frail older patients in the last phase of life - challenges for general practitioners in the integration of geriatric and palliative care

STIEL, Stephanie ; KRAUSE, Olaf ; BERNDT, Carolin Sophie ; EWERTOWSKI, Helen ; MULLER-MUNDT, Gabriele ; SCHNEIDER, Nils
Zeitschrift fur gerontologie und geriatrie, 11/12/2019, Pagination inconnue

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Advance care planning for vulnerable older adults within an accountable care organization - study protocol for the impact randomised controlled trial

GABBARD, Jennifer ; PAJEWSKI, N. M. ; CALLAHAN, Kathryn E. ; DHAROD, Ajay ; FOLEY, Kristie ; FERRIS, Keren ; MOSES, Adam ; GREY, Carl ; WILLIAMSON, Jeff
BMJ Open, 15/12/2019, vol.9, n°12, p. 1-8

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

PROJET SOIN ANTICIPE ; PERSONNE AGEE ; VULNERABILITE ; ESSAI CONTROLE RANDOMISE

INTRODUCTION: Patients with multimorbidity plus additional impairments (eg, mobility limitations, disability, cognitive impairments or frailty) are at the highest risk for poor healthcare outcomes. Advanced care planning (ACP) provides patients and their surrogates the opportunity to discuss their goals, values and priorities for healthcare-particularly in the context of end-of-life care. ACP discussions promote more person-centred care; however, it is currently underused. There is a tremendous need for systematic, scalable approaches to individualised ACP that promotes patient and family engagement. Here we describe the study protocol for a randomised effectiveness trial of a nurse navigator and informatics intervention designed to improve the documentation and quality of ACP discussions.
METHODS AND ANALYSIS: This is a randomised, pragmatic, effectiveness trial; patients aged 65 years and older who have multimorbidity plus impairments in either physical function (eg, mobility limitations or disability) or cognition, and/or frailty within an affiliated Accountable Care Organization were eligible. The electronic health record was used to develop an automatic prescreening system for eligible patients (n=765) and participants were randomised in a 1:1 ratio to either the nurse navigator-led ACP pathway or usual care. Our primary outcomes are documentation of ACP discussions within the EHR along with the quality of ACP discussions. Secondary outcomes include a broad range of ACP actions (eg, usage of ACP billing codes, choosing a surrogate decision-maker and advance directive documentation). Outcomes will be measured over 12 months of follow-up.
ETHICS AND DISSEMINATION: This study has been approved by the appropriate Institutional Review Boards and is guided by input from patient and clinical advisory boards. The results of this study will inform a scalable solution to ACP discussions throughout our healthcare system and statewide.

Origine : PubMed

Se sentir vivant en long séjour

LEBLANC-BRIOT, Marie-Thérèse
JALMALV JUSQU A LA MORT ACCOMPAGNER LA VIE, PUG, 09/2019, n°138, p. 57-64

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Interstices du droit et distorsions des pratiques dans l’univers du grand âge

AMYOT, Jean-Jacques
JALMALV JUSQU A LA MORT ACCOMPAGNER LA VIE, PUG, 09/2019, n°138, p. 13-24

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Reply to the letter to the editor 'geriatric-oncology and palliative care: cautionary on using geriatric assessment as a sole basis to limit care'

KIRKHUS, Lene ; SALTYTE BENTH, Jurate ; GRONBERG, Bjørn Henning ; HJERMSTAD, Marianne J. ; ROSTOFT, Siri ; HARNESHAUG, Magnus ; SELBÆK, Geir ; WYLLER, Torgeir Bruun ; SLAAEN, Marit
PALLIATIVE MEDICINE, 19/11/2019, Pagination inconnue

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Marital status and risk of physical frailty - a systematic review and meta-analysis

KOJIMA, Gotaro ; WALTERS, Kate ; ILIFFE, Steve ; TANIGUCHI, Yu ; TAMIYA, Nanako
Journal of the American Medical Directors Association, 15/11/2019, Pagination inconnue

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

REVUE SYSTEMATIQUE ; META-ANALYSE ; MARIAGE ; VULNERABILITE ; PERSONNE AGEE

OBJECTIVES: Evidence on associations between marital status and frailty is limited. The objectives of this study were to perform a systematic review for associations between marital status and physical frailty and to perform a meta-analysis to combine findings.
DESIGN: Systematic review and meta-analysis.
SETTING AND PARTICIPANTS: Community-dwelling older people with mean age =60 years.
METHODS: Systematic literature search using 5 databases was conducted in February 2019 to identify longitudinal and cross-sectional studies examining associations between marital status and Fried's phenotype-based frailty status. Additional studies were searched for by reviewing the reference lists of relevant articles and conducting forward citation tracking of included articles. Odds ratio (OR) of marital status and frailty was pooled using a random-effects meta-analysis. Subgroup analysis and analyses stratified by gender and marital status (married, widowed, divorced or separated, and never married) were completed.
RESULTS: A total of 1565 studies were found, from which 3 studies with longitudinal data and 35 studies with cross-sectional data were included. Although longitudinal studies suggested that married men had lower frailty risks than unmarried men while married women had higher frailty risks than widowed women, meta-analysis was not possible because of different methodologies. Meta-analyses of cross-sectional data from 35 studies including 80,754 individuals showed that unmarried individuals were almost twice more likely to be frail than married individuals (pooled odds ratio = 1.88, 95% confidence interval = 1.70-2.07). A high degree of heterogeneity was observed (I2 = 69%) and was partially explained by reasons for not being married and study location. Stratified analyses showed that pooled risks of frailty in the unmarried compared with the married were not statistically different between women and women (P for difference = .62).
CONCLUSIONS AND IMPLICATIONS: Three and 35 studies, respectively, were found providing longitudinal and cross-sectional data regarding associations between marital status and frailty among community-dwelling older people. A meta-analysis of cross-sectional data showed almost twice higher frailty risk in unmarried individuals compared with married individuals. Marital status should be recognized as an important factor, and more longitudinal studies controlling for potential confounding factors are needed.

Origine : PubMed

The clinical frailty scale predicts inpatient mortality in older hospitalised patients with idiopathic Parkinson's disease

TORSNEY, K. M. ; ROMERO-ORTUNO, R.
The journal of the Royal College of Physicians of Edinburgh, 06/2018, vol.48, n°2, p. 103-107

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End-of-life care for frail older people

HARWOOD, Rowan H. ; ENGUELL, Hannah
BMJ supportive and palliative care, 15/11/2019, Pagination inconnue

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Commonly used screening instruments to identify frailty among community-dwelling older people in a general practice (primary care) setting - a study of diagnostic test accuracy

AMBAGTSHEER, Rachel C. ; VISVANATHAN, Renuka ; DENT, Elsa ; YU, Solomon ; SCHULTZ, Timothy J. ; BEILBY, Justin M. D.
The journals of gerontology. Series A, biological sciences and medical sciences, 05/11/2019, Pagination inconnue

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The need for cultural inclusivity in global palliative nursing - caring for selected underserved populations in the United States

MAZANEC, Polly ; VERGA, Sarah ; FOLEY, Helen ; MEHTA, Ambereen K.
JOURNAL OF HOSPICE AND PALLIATIVE NURSING, 12/2019, vol.21, n°6, p. E1-E8

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Reducing inappropriate prescribing for older adults with advanced frailty - a review based on a survey of practice in four countries

O'CAOIMH, Ronan ; CORNALLY, Nicola ; MCGLADE, Ciara ; GAO, Yang ; O'HERLIHY, Eileen ; SVENDROVSKI, Anton ; CLARNETTE, Roger ; LAVAN, Amanda Hanora ; GALLAGHER, Paul ; WILLIAM MOLLOY, D.
Maturitas, 08/2019, vol.126, p. 1-10

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Frailty increases mortality among patients >= 80 years old treated in Polish ICUs

FRONCZEK, Jakub ; POLOK, Kamil Jurand ; NOWAK-KOZKA, Ilona ; WLUDARCZYK, Anna ; GORKA, Jacek ; CZUCZWAR, Miroslaw ; KRAWCZYK, Pawel ; ZIETKIEWICZ, Miroslaw ; NOWAK, Lukasz R. ; ZUKOWSKI, Maciej ; KOTFIS, Katarzyna ; CWYL, Katarzyna ; GAJDOSZ, Ryszard ; BOHATYREWICZ, Romuald ; BIERNAWSKA, Jowita ; GRUDZIEN, Pawel ; NASILOWSKI, Pawel ; POPEK, Natalia ; CYRANKIEWICZ, Waldemar ; WAWRZYNIAK, Katarzyna ; WNUK, Marek ; MACIEJEWSKI, Dariusz ; STUDZINSKA, Dorota ; BERNAS, Szymon ; PIECHOTA, Mariusz ; MACHALA, Waldemar ; SERWA, Marta ; WUJTEWICZ, Maria ; STEFANIAK, Jan ; SZYMKOWIAK, Malgorzata ; GAWDA, Ryszard ; ADAMIK, Barbara ; KOZERA, Natalia ; GOZDZIK, Waldemar ; FLAATTEN, Hans ; SZCZEKLIK, Wojciech
Anaesthesiology intensive therapy, 2018, vol.50, n°4, p. 245-251

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Leveraging in-home supportive services programs to engage people in advance care planning - input from staff, providers, and client stakeholders

FEUZ, Mariko A. ; ODIERNA, Donna H. ; KATEN, Mary ; VOLOW, Aiesha ; MCMAHAN, Ryan D. ; RITCHIE, Christine S. ; MCSPADDEN, Shireen ; DEARMAN, Kelly ; SUDORE, Rebecca L.
JOURNAL OF PALLIATIVE MEDICINE, 11/2019, vol.22, n°11, p. 1430-1438

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"Alive by default" - an exploration of Velleman's unfair burdens argument against state sanctioned euthanasia

SYMONS, Xavier ; CHUA, Reginald
Bioethics, 02/10/2019, Pagination inconnue

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Améliorer l’accès aux soins palliatifs pédiatriques pour les populations vulnérables du sud

CHOUDJA OUABO JEROME, Cecile ; CLERC, Valérie ; ROUSSEAU, Morgane ; HUMBERT, Nago
MEDECINE PALLIATIVE, 09/2019, vol.18, n°4-5, p. 230-233

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