Age and ageing
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Delirium is a serious and common disorder especially among older people on inpatients units. Numerous modifiable or manageable delirium risk factors have been identified. As a result, there is now a widespread notion that many cases of delirium can be prevented. ⋯ Nevertheless, the majority of these support a role for non-pharmacological interventions in delirium prevention. While more research is certainly needed, the majority of available data are based on best practice protocols, guidelines and interventions. Hence, a consistent and concerted effort is now justified to introduce non-pharmacological prevention strategies across units to help tackle the increasingly prevalent delirium among older people.
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The number of people over 65 is increasing and those over 65 requiring surgery will likewise increase. Post-operative delirium (POD) affects up to 47% of patients undergoing surgery and is more prevalent in older people. ⋯ Many factors have been associated with increased risk of POD, including age, cognitive impairment, gender, depression, alcohol, drug use, smoking, co-morbidity, functional status, ASA score and pre-operative biochemical and haematological abnormalities. This article reviews the literature associated with the above factors, considers frailty as a factor and also suggests that POD may be associated with rapidity of onset and severity of the insult to the patient.
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most older people living in nursing homes die there. An empirically based model of dignity has been developed, which forms the basis of a brief psychotherapy to help promote dignity and reduce distress at the end of life. ⋯ these findings add to our understanding of the concerns of older people in care homes on maintaining dignity and suggest that dignity therapy may bolster their sense of dignity.
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Randomized Controlled Trial
Falls and fear of falling: burden, beliefs and behaviours.
this study estimated the frequency of recent falls and prevalence of fear of falling among adults aged 65 and older. ⋯ the high prevalence of falls and fear of falling among US older adults is of concern. Both can result in adverse health outcomes including decreased quality of life, functional limitations, restricted activity and depression. Older adults' fear of falling and their reluctance to adopt behaviours that could prevent future falls should be considered when designing fall prevention programmes.