Journal of aging and health
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Objectives: An expert panel reviewed and summarized the literature related to the evidence for the 4Ms-what matters, medication, mentation, and mobility-in supporting care for older adults. Methods: In 2017, geriatric experts and health system executives collaborated with the Institute for Healthcare Improvement (IHI) to develop the 4Ms framework. Through a strategic search of the IHI database and recent literature, evidence was compiled in support of the framework's positive clinical outcomes. ⋯ Mentation strategies aided in prevention and treatment. Fall risk and physical function assessment with early goals and safe environments allowed for safe mobility. Discussion: Through a framework that reduces cognitive load of providers and improves the reliability of evidence-based care for older adults, all clinicians and healthcare workers can engage in age-friendly care.
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Objectives: Commentaries have suggested that initial emphasis on the higher susceptibility and mortality rates of older adults to COVID-19 has instigated ageism within the public discourse and policy decisions. Using the health belief model, the current study examined ageism in interaction with other factors influencing intention to social distance. ⋯ Discussion: The current study demonstrates how ageism influences behavior during a pandemic. With initial reports of COVID-19 presenting older adults as a homogenous group, ageism negatively interacted with intention to social distance and may place older adults at greater risk.
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Objectives: This study examined differences in physical function, delirium, depressive symptoms, and behavioral and psychological symptoms of dementia (BPSD) in hospitalized African American and white older adults with dementia. Methods: This secondary data analysis using baseline data from an ongoing trial testing family-centered function-focused care included African American (n = 159) and white persons (n =135) with dementia. ⋯ Discussion: To our knowledge, this is the first study to examine racial differences in admission symptoms of hospitalized persons with dementia. While the findings are preliminary, they can be used to inform the design of future research, including identifying the causes of disparities.
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Association of Multimorbidity on Healthcare Expenditures Among Older United States Adults With Pain.
Objectives: This cross-sectional study compared the healthcare expenditures associated with multimorbidity (having ≥2 chronic conditions) versus no multimorbidity among older United States (US) adults (aged ≥ 50 years) with self-reported pain in the past 4 weeks. Methods: This research used data from the 2018 Medical Expenditure Panel Survey. ⋯ Multimorbidity had 75.8% greater annual total health expenditures (p = 0.0083), 40.6% greater office-based expenditures (p = 0.0224), 100.6% greater prescription medication costs, (p = 0.0268), yet 47.3% lower inpatient expenditures (p = 0.0158), and 56.6% lower home healthcare expenditures (p < 0.0001) than no multimorbidity. Discussion: This study found greater healthcare expenditures among older US adults with pain and multimorbidity, which captures the financial burden of comorbidity in this population.
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Objective: The objective of this study was to examine the effects of dementia and Medicare-Medicaid dual eligibility on unplanned facility admission among older Medicare home health (HH) recipients. Method: This study involves a secondary analysis of data from the Outcome and Assessment Information Set (OASIS) and billing records (i.e., International Classification of Diseases, 10th Revision [ICD-10] codes) of 6,153 adults ≥ 65 years receiving HH from a nonprofit HH agency in CY 2017. ⋯ Discussion: Low income and dementia have interactive effects on facility admissions. Among Medicare HH recipients, dual eligible patients with dementia are the most vulnerable group for unplanned facility admission.