Zeitschrift für Gerontologie und Geriatrie
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Dementia is an increasing challenge for care providers in nursing homes and hospitals. Since the 1980s, special acute care units in nursing homes have developed rapidly. In Germany, the first unit in a hospital opened in 1990. In 2013, there were 22 units. ⋯ The basic standards for these wards include the following: a maximum of 20 beds, an area physically separated from the geriatric hospital department, their own dayroom and therapy room, a structured daily routine suitable for patients with dementia, the selection of permanent staff on a voluntary basis, specialized training, extended geriatric assessment, and special consideration of the background and social situation of the patients.
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Demographic change has also caused changes in perioperative intensive care because the proportion of geriatric patients who must undergo surgical procedures is increasing. With the current preoperative assessment instruments, it is still not possible to identify high-risk patients of this collective or to make a reliable prognosis concerning postoperative course. ⋯ The perioperative intensive care treatment of geriatric patients requires the readiness to engage in interdisciplinary collaboration because only with this close dialog can the treatment results be sustained.
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Establishing a trustful therapeutic relationship and reflecting on attitudes and behavior is essential in caring for patients with functional pain syndromes. Hope-disappointment circles are common and can be intensified by unfavorable caregiver behavior. A biopsychosocial, empathetic and coping-oriented attitude has proved to be useful. A motivating communication is recommended that carefully explores the pain and its interactions with psychosocial factors following the three typical phases of accepting complaints, establishing biopsychosocial understanding and developing coping strategies.
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There is currently no adequate tool in the literature for assessing the quality of care in nursing homes. Therefore, we developed and tested a new instrument the Nursing Home Care Index (NCI). ⋯ The NCI has a double function. Nursing staff and management can now use the NCI to conduct internal quality assurance regarding their caring efforts. In the future, the NCI can become a useful tool for families and residents to compare the quality of care in different nursing homes.