medigraphic.com
Revista Médica Sinergia

2020, Number 11

<< Back Next >>

Revista Médica Sinergia 2020; 5 (11)

Profile of the patient with dementia of the geriatric home care program of the National Hospital of Geriatrics and Gerontology Doctor Raúl Blanco Cervantes – San José, Costa Rica

Picado OJE, Sandí JA

Language: Spanish
References: 25
Page: 1-10
PDF size: 203.99 Kb.


ABSTRACT

The geriatric community care unit of the Hospital Nacional de Geriatría y Gerontología visits older adults with dementia by an interdisciplinary team. Each patient is assessed by a multidisciplinary team. This is a descriptive study that describe the profile of the patients with dementia who have entered the ACG program, from January 2012 to June 2020. An exploratory analysis is performed of 2079 patients evaluated by the Unit. Most patients come from the city of Desamparados. The age ranges from 60 to 105 years, with an average of 84,3 years. The average Barthel is 11,77; Most are women widows. Vascular dementia syndromes represent the most prevalent cause of admission, followed by mixed dementia. Most patients have polypharmacy, neurobehavioral disorders, dysphagia and nutritional disturbances predominating “nutritional risk” category. A minority group have bladder catheter and nasogastric tube and had grade 3 and 4 pressure ulcers. A compromised network is identified in most cases. Most of the caregivers are their children, with ages ranging from 19 to 88 years old with an average of 53,4 years. The patients in this study are mainly female, widowers, over 80 years of age, with severe dependence, nutritional disturbances polypharmacy, neurobehavioral disorders and dysphagia. In addition, they have nutritional alterations and polypharmacy and are mainly cared for by their children in a committed way.


REFERENCES

  1. United Nations, Department of Economic and Social Affairs, Population Division (2015). World Population Ageing 2015 (ST/ESA/SER.A/390).

  2. Disability-adjusted life years (DALYs) for 291 diseases and injuries in 21 regions, 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010.

  3. Alzheimer's Disease International: World Alzheimer Report 2015 https://www.alz.co.uk/research/WorldAlzheimerReport2015.pdf

  4. WHO Global Atlas of Palliative Care at the End of Life, 2014 https://www.who.int/nmh/Global_Atlas_of_Palliative_Care.pdf (accesado el 20 de abril del 2019).

  5. Jenny T van der Steen et al. White paper defining optimal palliative care in older people with dementia: A Delphi study an recommendations from European Association for Palliative Care. Palliat Med July 4, 2013. https://doi.org/10.1177/0269216313493685

  6. Merel S, et al, Palliative Care in Advanced Dementia Clin Geriatr Med (2014) https://doi.org/10.1016/j.cger.2014.04.004

  7. Susan L. Mitchell, The Clinical Course of Advanced Dementia. N Engl J Med 361;16 october 15, 2009. https://doi.org/10.1056/NEJMoa0902234

  8. Radbruch, L, Payne, S and Board of Directors of the EAPC. White paper on standards and norms for hospice and palliative care in Europe, part 1: recommendations from the European Association for Palliative Care. Eur J Palliat Care 2009; 16: 278-289.

  9. Ellen E. Lee, Beverly Chang, Steven Huege, Jeremy Hirst, A Complex Clinical Intersection: Palliative Care in Patients with Dementia, Am J Geriatr Psychiatry 2017; 26(2): 224-234. https://doi.org/10.1016/j.jagp.2017.06.015

  10. Stewart JT, Schultz SK. Palliative Care for Dementia. Psychiatr Clin North Am. 2018 Mar; 41(1): 141-151. https://doi.org/10.1016/j.psc.2017.10.011

  11. Yumoto, Yoshie & Kernohan, Wgeorge & Morioka, Noriko & Ogata, Yasuko. International reflections on caring for people with advanced dementia. Public Health Nurs. 2018; 36:192-198. https://doi.org/10.1111/phn.12572

  12. Bartley, MM. Dementia Care at End of Life: Current Approaches. Curr Psychiatry Rep. 2018 Jun 23; 20(7): 50. https://doi.org/10.1007/s11920-018-0915-x

  13. van Oostrom SH, Gijsen R, Stirbu I, Korevaar JC, Schellevis FG, Picavet HSJ, et al. Time trends in prevalence of chronic diseases and multimorbidity not only due to aging: data from general practices and health surveys. PLoS One. 2016;11(8):e0160264. https://doi.org/10.1371/journal.pone.0160264

  14. Harrison C., Britt H., Miller G., Henderson J. Examining different measures of multimorbidity, using a large prospective cross-sectional study in Australian general practice. BMJ Open. 2014;4(7):e004694-e004694. https://doi.org/10.1136/bmjopen-2013-004694

  15. Sambamoorthi U, Tan X, Deb A. Multiple chronic conditions and healthcare costs among adults. Expert Rev Pharmacoeconomics Outcomes Res. 2015;15(5):823-832. https://doi.org/10.1586/14737167.2015.1091730

  16. Bodenheimer T, Ghorob A, Willard-Grace R, Grumbach K. The 10 building blocks of high-performing primary care. Ann Fam Med. 2014;12(2):166-171. https://doi.org/10.1370/afm.1616

  17. Australian Medical Association. AMA Position Statement on the Medical Home - 2015. 2015. https://ama.com.au/position-statement/ama-position-statement-medical-home. Accexado el 20 abril del 2019.

  18. The Royal Australian College of General Practitioners. Standards for Patient-Centred Medical Homes: Patient-centred, comprehensive, coordinated, accessible and quality care. 2016. https://www.racgp.org.au/FSDEDEV/media/documents/Running%20a%20practice/Practice%20standards /Patient-centered-medical-homes.pdf. Accexado el 6 junio del 2020.

  19. Maeng DD, Graf TR, Davis DE, Tomcavage J, Bloom FJ., Jr Can a patient-centered medical home lead to better patient outcomes? The quality implications of Geisinger's ProvenHealth Navigator. Am J Med Qual. 2012;27(3):210-216. https://doi.org/10.1177/1062860611417421

  20. The Group Health Medical Home At Year Two: Cost Savings, Higher Patient Satisfaction, And Less Burnout For Providers doi: 10.1377/hlthaff.2010.0158 HEALTH AFFAIRS 29, NO. 5 (2010): 835- 843.https://doi.org/10.1377/hlthaff.2010.0158

  21. Picado-Ovares, J., Hernández-Zamora, P., & Escobar-Salas, A. (2016). Atención Comunitaria Geriátrica. En Tratado de Geriatría y Gerontología (2.ª ed., pp. 187-207). San Jose.: EDNASS. San Jose.: EDNASS.

  22. Blanquer JJ, Jiménez AI, Del Pozo K, García R, Blanes D. Características socioeconómicas, problemas y necesidades de salud de los pacientes en programa de atención a domicilio. Revista Valenciana Medicina de Familia. 2000;7;46-56.

  23. Bilbao I, Gastaminza AM, García JA, Quindimil JA, López JL, Huidobro L. Los enfermos domiciliarios crónicos y su entorno en atención primaria de salud. Aten Primaria 1994; 13(4): 188-190.

  24. Fernández, X. y Robles, A. (2008). I Informe estado de situación de la persona adulta mayor en Costa Rica. Universidad de Costa Rica: San José, C.R.HelpAge International. (2015). Global AgeWatch Index 2015. Recuperado de http://www.helpage.org/global-agewatch/ el 6 de julio 2020

  25. Mitchell, S Care of patients with advanced dementia UpToDate [internet] 2019 [citado 20 abr. 2019] Disponible en: https://www.uptodate.com/contents/care-of-patients- with-advanceddementia# H423254626




2020     |     www.medigraphic.com