Considerations of Intersectionality for Older Adults with Palliative Care Needs in the Emergency Department: An Integrative Review
AbstractPurpose of ReviewWe sought to identify current interventions, research, or non-research evidence that has direct or indirect consideration of intersectionality in the care of older adults in the emergency department (ED). An integrative review informed by Crenshaw ’s Theory of Intersectionality was conducted in accordance with Whittemore and Knafl’s five-stage methodology. A rigorous review process determined appropriateness for inclusion, and articles were analyzed for areas related to direct or indirect relationship to intersectionality.Recent FindingsOlder adults aged 60 and above in the United States (US) a...
Source: Current Geriatrics Reports - September 23, 2023 Category: Geriatrics Source Type: research
A Contemporary Review of Psychosocial Resilience in Heart Failure Using the Society to Cells Resilience Theory
AbstractPurpose of ReviewThis scoping review critically evaluates the psychosocial resilience literature in heart failure (HF), utilizing the Society to Cells Resilience Theory. We reviewed studies published in the last five years with the following inclusion criteria: (1) studied resilience or concepts related to resilience including psychological stress or coping; (2) observational, retrospective or prospective, or clinical trials; (3) included adults with HF, their caregivers or providers; and (4) were written in English.Recent FindingsSeventeen studies met inclusion criteria; most studies were observational (n = 1...
Source: Current Geriatrics Reports - September 8, 2023 Category: Geriatrics Source Type: research
Adult Congenital Heart Disease in the Aging and Elderly Population
AbstractPurpose of ReviewSince the turn of the 21st century, there have been more adults than children living with congenital heart disease. Owing to advances in care, this population of patients with adult congenital heart disease (ACHD) is now living to older ages. Despite improved survival, however, elderly patients with ACHD and providers together face unique challenges given the limited knowledge and experience in caring for this cohort. In this review, we describe some of these challenges and highlight important aspects in the care of aging and elderly patients with congenital heart disease.Recent FindingsIn adulthoo...
Source: Current Geriatrics Reports - August 25, 2023 Category: Geriatrics Source Type: research
The Potential for Psychedelics to Improve Coping Skills and Resilience in Persons With Newly Diagnosed Mild Cognitive Impairment or Early Alzheimer ’s Disease
This article will summarize research to date of psychedelic use in depression and terminal illness and discuss pre-clinical evidence suggesting that these benefits may also extend to Mild Cognitive Impairment and mild Alzheimer’s disease as well as important saf ety caveats in older patients.Recent FindingsFrom the early 1950s to the 1960s, and then since the mid 2000s, hundreds of studies have suggested benefit of psychedelics in treating numerous psychiatric conditions, including depression and existential distress in terminal illness. Psychedelics appear to be well tolerated, and the use of careful screening and pre-,...
Source: Current Geriatrics Reports - July 27, 2023 Category: Geriatrics Source Type: research
Perioperative Assessment in the Older Woman Undergoing Pelvic Floor Surgery
AbstractPurpose of ReviewThis review aims to summarize the data currently available on perioperative issues pertinent to the aging adult to help provide a resource for surgical caregivers.Recent FindingsOlder adults can safely undergo pelvic surgery and expect improvements in their quality of life. Preoperative evaluation may need to consider an individual ’s risk based on their medical comorbidities and baseline functional status, rather than age alone. Frailty has been identified as an important factor when determining a patient’s risk of complications from pelvic floor surgery and their expected course of recovery.S...
Source: Current Geriatrics Reports - July 12, 2023 Category: Geriatrics Source Type: research
Primary Palliative Care Education for Geriatricians: Lessons Learned
The objective of this review was to determine the current resources and advances in primary palliative care education for geriatricians.Recent findingsThe review encompassed literature written between 2018 –2022 accessed via PubMed and Google Scholar. From the review process itself, we learned that there is no standard definition of primary palliative care (PPC) and that different domains of PPC are often taught and studied separately. While many aspects of palliative care are now incorporated into the geriatric medicine fellowship educational milestones, the PPC competencies for practicing geriatricians remains ill-defi...
Source: Current Geriatrics Reports - June 30, 2023 Category: Geriatrics Source Type: research
Distinguishing Distress in the Context of Aging: Demoralization vs. Depression
AbstractPurpose of ReviewOlder adults face unique age-related challenges that evoke existential themes. Demoralization and depression are clinical concerns at the interface of the physiological and psychosocial worlds. This review highlights the utility of demoralization as a clinical construct distinct from depression, as well as common tools for measuring it; discusses the prevalence of demoralization in the clinical context and related sociodemographic factors; and outlines potential treatment approaches for restoring morale in demoralized patients.Recent FindingsDemoralization is characterized by a sense of hopelessn...
Source: Current Geriatrics Reports - June 29, 2023 Category: Geriatrics Source Type: research
Impact of Social Isolation and Loneliness in Older Adults: Current Understanding and Future Directions
AbstractPurpose of ReviewThe negative health impacts of social isolation and loneliness (SI/L) on older adults underscores the importance of evaluation and intervention to target SI/L in this vulnerable population. This review distinguishes social isolation from loneliness, highlights the epidemiology, risk factors and poor health outcomes associated with SI/L and identifies protective factors, interventions and future directions to address SI/L in the geriatric population.Recent FindingsMediators and moderators of SI/L in older adults are multi-faceted and encompass various biopsychosocial factors associated with aging. T...
Source: Current Geriatrics Reports - June 24, 2023 Category: Geriatrics Source Type: research
Cultural Psychiatry – Specific Considerations in the Mental Health Evaluation of Older Hispanics
AbstractPurpose of ReviewCultural competency is integral for the mental health evaluation and treatment of minoritized populations. The older adult Latino population in the United States is a unique multicultural ethnic group representing myriad countries of origin with specific values, styles of communication and attitudes related to mental health that are important to understand in order to provide optimal care. In this review we provide practical recommendations to facilitate the culturally sensitive care of this vulnerable population.Recent FindingsThe population of older adult Hispanic adults in the United States is e...
Source: Current Geriatrics Reports - June 21, 2023 Category: Geriatrics Source Type: research
Assessment and Management of Dementia-Related Agitation
AbstractPurpose of ReviewAgitation is a serious complication of dementia for many patients and can be a challenging clinical problem for medical providers. With the information provided in this review, it is hoped that readers are equipped with up-to-date knowledge to implement effective treatments for their patients with this significant medical problem.Recent FindingsThis review provides an overview of the assessment and management of dementia-related agitation, including nonpharmacologic and pharmacologic approaches. These include guidelines on antipsychotic use in patients with dementia, two recently published medicati...
Source: Current Geriatrics Reports - June 17, 2023 Category: Geriatrics Source Type: research
Botox Use in the Older Woman: An Advanced Bladder Treatment Option
This article focuses on challenges of caring for older women with urgency urinary incontinence (UUI), and asks how treatment algorithms for UUI could be tailored to the needs of older women.Recent FindingsUrgency urinary incontinence is highly prevalent among older women, and has significant health, social and economic impact for patients, caregivers and society. It is more difficult to treat among older women in part due to interaction with other geriatric syndromes and comorbidities. Also, the existing treatment algorithm, including anticholinergic medications as a mainstay of therapy, is less relevant to older patients ...
Source: Current Geriatrics Reports - June 2, 2023 Category: Geriatrics Source Type: research
Neuroleptic Malignant-Like Syndrome as a Potential Etiology for Donepezil Related Rhabdomyolysis
AbstractPurpose of ReviewDonepezil is widely prescribed to slow the progression of Alzheimer ’s Disease through its cholinomimetic property as an acetylcholinesterase inhibitor. There is an inverse relationship between acetylcholine and dopamine. Neuroleptic malignant syndrome (NMS), typically associated with dopamine antagonists, could theoretically and inversely be associated with choli nomimetic drugs such as donepezil. This literature review seeks to summarize the body of case reports from the extant literature of temporal associations between donepezil and neuroleptic malignant-like syndromes.Recent FindingsWhile th...
Source: Current Geriatrics Reports - May 23, 2023 Category: Geriatrics Source Type: research
A New Solution to an Age-old Problem: A Review of Ketamine and Esketamine for Treatment-resistant Depression in Late Life
AbstractPurpose of ReviewTreatment-resistant depression in the elderly has been associated with increased disability, hospitalization, functional and cognitive decline, caregiver burden, frailty, healthcare utilization, and overall mortality. Current treatment strategies have significant limitations in this vulnerable population. The purpose of this review is to summarize and report the latest data on the safety and efficacy of ketamine and esketamine in older adults with treatment-resistant major depressive disorder (TRD).Recent FindingsEarly case report and case series data on the use of ketamine in patients over 65 set ...
Source: Current Geriatrics Reports - May 18, 2023 Category: Geriatrics Source Type: research
A Review of Medicare Advantage Policy Through the Lens of Geriatrics and Palliative Care
AbstractPurpose of ReviewMedicare Advantage (MA), or Medicare Part C, is the program that allows private health insurance companies to provide Medicare services. MA is growing exponentially with increasing enrollment of older adults who are more medically and socially complex and more racially and ethnically diverse. Legislative and regulatory oversight of MA has lagged behind its growth. Here we review key aspects of MA pertinent to older adults and those with serious illness, and we highlight recent major federal policies shaping MA.Recent FindingsWhile MA was initially developed to provide cost savings, generate innovat...
Source: Current Geriatrics Reports - May 18, 2023 Category: Geriatrics Source Type: research
Functional Nonepileptic Seizures: Diagnosis, Comorbidity, Pathophysiology, and Management
AbstractPurpose of ReviewThe diagnosis and treatment of functional nonepileptic seizures are challenging, in part related to a lack of familiarity with the diagnosis, clinician discomfort with delivering the diagnosis, and a need for more effective and multidisciplinary treatment interventions. The purpose of this report is to describe relevant risk factors, diagnostic workup, comorbidity, proposed pathophysiological mechanisms, and management strategies.Recent FindingsAdvances in neuroimaging are shedding light on structural and functional differences in the brains of those living with functional nonepileptic seizures. Ps...
Source: Current Geriatrics Reports - May 16, 2023 Category: Geriatrics Source Type: research
