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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.

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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A nurse-led model of care within an emergency department reduces representation rates for frail aged care residents

SHRAPNEL, Sophie ; DENT, Elsa ; NICHOLSON, Caroline
Aging clinical and experimental research, 11/2019, vol.31, n°11, p. 1695-1698

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Incidence of frailty among community-dwelling older adults - a nationally representative profile in China

XU, Weihao ; LI, Ya-Xi ; WU, Chenkai
BMC GERIATRICS, 30/12/2019, vol.19, n°1, p. 1-9

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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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