How to Conduct International Geriatric Rehabilitation Research?

With an ageing global population and an increasing focus on aging in place, the number of people in need of geriatric rehabilitation (GR) is rapidly increasing. As current GR practice is very heterogenous, cross-country comparisons could allow us to learn from each other and optimise the effectiveness of GR. However, international GR research comes with many challenges. This article summarises the facilitators and barriers relating to the recruitment of rehabilitation centres, the inclusion of patients, and data collection, as experienced by experts in the field of international GR research. The three most important methodological recommendations for conducting cross-national collaborative research in the field of GR are (1) make use of existing (inter)national networks and social media to aid recruitment of GR centres; (2) clearly define the GR treatment, setting, and patient characteristics in the inclusion criteria; and (3) use a hierarchical study structure to communicate transparently and regularly with both national and local coordinators. International GR research would greatly benefit from the implementation of a core dataset in regular GR care. Therefore, future studies should focus on developing an international consensus regarding the outcomes and corresponding cross-culturally validated measurement instruments to be used during GR

Management of post-acute COVID-19 patients in geriatric rehabilitation: EuGMS guidance

PurposeTo describe a guidance on the management of post-acute COVID 19 patients in geriatric rehabilitation.MethodsThe guidance is based on guidelines for post-acute COVID-19 geriatric rehabilitation developed in the Netherlands, updated with recent insights from literature, related guidance from other countries and disciplines, and combined with experiences from experts in countries participating in the Geriatric Rehabilitation Special Interest Group of the European Geriatric Medicine Society.ResultsThis guidance for post-acute COVID-19 rehabilitation is divided into a section addressing general recommendations for geriatric rehabilitation and a section addressing specific processes and procedures. The Sect. “General recommendations for geriatric rehabilitation” addresses: (1) general requirements for post-acute COVID-19 rehabilitation and (2) critical aspects for quality assurance during COVID-19 pandemic. The Sect. “Specific processes and procedures”, addresses the following topics: (1) patient selection; (2) admission; (3) treatment; (4) discharge; and (5) follow-up and monitoring.ConclusionProviding tailored geriatric rehabilitation treatment to post-acute COVID-19 patients is a challenge for which the guidance is designed to provide support. There is a strong need for additional evidence on COVID-19 geriatric rehabilitation including developing an understanding of risk profiles of older patients living with frailty to develop individualised treatment regimes. The present guidance will be regularly updated based on additional evidence from practice and research

Prevalence and Risk Factors of Dehydration Among Nursing Home Residents: A Systematic Review

Objectives: To provide an overview of the prevalence rates and risk factors of dehydration among nursing home residents. Design: Systematic literature review. Setting: Nursing homes. Participants: Nursing home residents or institutionalized long-term care residents. Measurements: A systematic literature review was executed on March 15, 2018, using the databases PubMed, CINAHL, and EMBASE to retrieve all articles focused on the prevalence rates and risk factors for acute and chronic dehydration. Studies were included if the target population involved nursing home residents or institutionalized long-term care residents. Results: Nineteen studies were included in this systematic review. Prevalence rates of dehydration varied between 0.8% and 38.5% and were measured using different methods. Furthermore, 49 potential risk factors for dehydration were identified. Of the 12 potential risk factors that were investigated in more than 1 study, cognitive impairment and fever were significantly associated with dehydration among nursing home residents. Conclusions/implications: Dehydration is a relevant and frequently occurring problem among nursing home residents. This systematic review shows that a wide variety of methods are used to assess dehydration and that it is often unclear which type of dehydration (chronic or acute) is measured. This makes it difficult to compare prevalence rates among studies. Moreover, only 2 of 49 potential risk factors (fever and cognitive impairment) were more than once significantly associated with dehydration in the respective studies. Most of the other risk factors were assessed by only 1 study or showed inconsistent results. Therefore, more research into dehydration among nursing home residents is needed. (C) 2018 AMDA - The Society for Post-Acute and Long-Term Care Medicine

Building Consensus on an Integrated Care Pathway in Geriatric Rehabilitation:A Modified Delphi Study Among Professional Experts

To improve continuity and coordination of care in geriatric rehabilitation, an integrated care pathway was developed in the south of the Netherlands. This study aims to reach nationwide consensus on the content and structure of this locally developed pathway using a two-round Delphi study with specialized elderly care physicians (n = 37) as experts. In the first round, experts indicated their level of agreement on 65 statements representing the pathway on a 5-point Likert-type scale. Statements that did not gain consensus (interquartile range > 1) were redistributed to participants in Round 2. Consensus was reached on 56 statements (86%) after Round 1 and on 60 statements (92%) after Round 2. In total, 53 statements were assessed as relevant, seven statements were considered irrelevant, and five statements did not reach consensus. We conclude that there is broad nationwide consensus on the pathway, which therefore has the potential to be disseminated and implemented on a wider scale

Measuring the quality of care in nursing home residents with early-onset neurodegenerative diseases:a scoping review

Background Nursing home residents with early-onset neurodegenerative diseases are often younger in comparison with other residents, and need different, often more complex care. Accordingly, the measurements currently used for measuring quality of care in nursing homes may not be suitable for use in this target group. Little is known about the experiences of these residents and of their (in) formal caregivers regarding the quality of care they receive. Therefore, the aim of this scoping review is to explore which instruments are available for measuring the quality of care for nursing home residents with early-onset neurodegenerative diseases (excluding dementia), from the perspective of the resident and of (in) formal caregivers. Methods A literature search was performed in the databases Pubmed, Embase, Web of Science and Cinahl. The search strategy consisted of four main concepts: neurodegenerative diseases, quality of care, nursing homes and perspectives of residents, (in) formal caregivers. Studies were included if they used instruments and/or strategies to measure quality of care, focused on nursing home residents with early-onset neurodegenerative diseases and the perspective of either the resident or (in) formal caregiver. Results From a total of 809 identified articles, 87 full text articles were screened for eligibility. Five studies were included, only one of which described an instrument. The other four used topic lists and/or themes to measure quality of care. In total, 60 items related to quality of care could be derived. From these 60 items, eight overarching domains were found, with a subdivision into items derived, respectively, from the residents', informal and formal caregivers' perspective: 'emotional support', 'physical support', 'social support', 'care', 'care content', 'expertise', 'communication' and 'organization of care'. Conclusions Currently, there are no methods for assessing the quality of care specifically focused on nursing home residents with early-onset neurodegenerative diseases. Therefore, the items retrieved in this review give an overview of important topics for measuring the quality of care for this target group, from the perspective of the resident, and of the informal and formal caregivers. These items might be used to develop a tailored instrument for assessing the quality of care for nursing home residents with early-onset neurodegenerative diseases

Instruments used to assess quality of life of older adults in African countries:a scoping review

BACKGROUND: Over 60% of the population in sub-Saharan Africa, live in informal settlements (slums) with little or no resources. To be prepared to meet the needs of older people living in slums, it is necessary to know more about their quality of life (QoL). The objective of this review is to identify instruments, which can be used by researchers to assess the QoL of older adults living in African countries, especially those dwelling in slums. METHODS: A scoping review was performed using the databases Scopus, PubMed, and ISI Web of Science to retrieve studies published from January 2008 – September 2020. Studies were included if they reported generic QoL instruments, focused on adults with a mean age ≥ 50 and were conducted in African countries. RESULTS: In total, 18 studies were included using 7 unique instruments to measure QoL (EUROHIS-QOL-8, SWLS, WHOQOL-OLD, the WHOQOL-BREF, SF-36, SF-12 and RAND-38). All instruments could be interviewer-administered and had 5–36 items. However, little is known about their psychometric properties (validity and reliability), time-investment and cultural sensitivity of the domains included in the instruments. CONCLUSIONS: Even though this review retrieved instruments used to assess QoL of older adults in African countries, there is a need for further research on adjustment and validation of currently existing QoL instruments. In addition, the development and validation of a new instrument which can be used in (illiterate) older populations, living in slums in Africa should be considered

Potential of Electronic Medical Record Data for National Quality Measurement

National quality measurements with risk-adjusted provider comparison in health care nowadays usually require administrative or clinically measured data. However, both data sources have their limitations. Due to the digitalisation of institutions and the resulting switch to electronic medical records, the question arises as to whether these data can be made usable for risk-adjusted quality comparisons from both a content and a technical point of view. We found that most of the relevant information can be exported with little effort from the electronic medical records. In using this data source an even more sophisticated operationalization of the data of interest is needed

Factors influencing home discharge after inpatient rehabilitation of older patients: a systematic review

BACKGROUND: Although rehabilitation for older patients has the potential to improve function and prevent admission to nursing homes, returning home after discharge is not possible for all patients. Better understanding of patient factors related to discharge home may lead to more realistic rehabilitation goals, more targeted rehabilitation interventions and better preparation of both patient and informal caregiver for discharge. Various studies provided insight into factors related to home discharge after stroke rehabilitation, but we still lack insight into factors related to home discharge in non-stroke patients. Therefore, the aim of this review is to provide an overview of factors influencing home discharge in older non-stroke patients admitted to an inpatient rehabilitation unit. METHODS: A systematic literature search was executed in the databases PubMed, EMBASE, CINAHL and Web of Science to retrieve articles published between January 2000 and October 2015. The search focused on factors related to home discharge after rehabilitation for older patients. Studies were included if home discharge after rehabilitation was assessed as an outcome measure and if the non-stroke population was, on average, 65 years or older and admitted to an inpatient rehabilitation unit. RESULTS: Eighteen studies were included. The methodological quality was moderate to good in 15 studies. The factors significantly associated with home discharge are younger age, non-white ethnicity, being married, better functional and cognitive status, and the absence of depression. CONCLUSIONS: Because various factors are significantly associated with home discharge of older non-stroke patients after rehabilitation, we recommend assessing these factors at admission to the rehabilitation unit. Further research into the factors that lack sufficient evidence concerning their association with home discharge is recommended. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12877-016-0187-4) contains supplementary material, which is available to authorized users