46 research outputs found
Preparation Matters: What We Can Learn From an Olympic Swimmer About the Value of Advance Care Planning Interventions
Gun Access and Safety Practices among Older Adults
Background. Given high rates of gun ownership among older adults, geriatric providers can assess firearm safety practices using a β5βLsβ approach: Locked; Loaded; Little children; feeling Low; and Learned owner. This study describes gun access and the β5βLsβ among US older adults. Methods. Data on the β5βLsβ from the Second Injury Control and Risk Survey (ICARIS-2), a national telephone survey conducted by the Centers for Disease Control and Prevention, were analyzed. Weighted variables were used to generate national estimates regarding prevalence of gun ownership and associated gun safety among older adults (β₯55 years). Results. Of 2939 older adults, 39% (95% CI 37%β42%) reported β₯1 gun stored at home. Among those with guns at home, 21% (95% CI 18β24%) stored guns loaded and unlocked; 9.2% (95% CI 6.6β12%) had β₯1 child in household; 5.1% (95% CI 3.5β6.8%) reported past-year suicidal ideation and 3.6% (95% CI 2.1β5.2%) reported history of a suicide attempt; and 55% (95% CI 51β59%) stated that β₯1 adult had attended firearm safety workshop. Conclusion. Some older adults may be at elevated risk of firearm injury because of storage practices, suicidal thoughts, or limited safety training. Future work should assess effective approaches to reduce the risk of gun-related injuries among older adults
POLST Is More Than a Code Status Order Form: Suggestions for Appropriate POLST Use in Long-Term Care
POLST (Physician Orders for Life-Sustaining Treatment) is a medical order form used to document preferences about cardiopulmonary resuscitation (CPR), medical interventions such as hospitalization, care in the intensive care unit, and/or ventilation, as well as artificial nutrition. Programs based on the POLST paradigm are used in virtually every state under names that include POST (Physician Orders for Scope of Treatment), MOLST (Medical Orders for Life-Sustaining Treatment), and MOST (Medical Orders for Scope of Treatment), and these forms are used in the care of hundreds of thousands of geriatric patients every year. Although POLST is intended for persons who are at risk of a life-threatening clinical event due to a serious life-limiting medical condition, some nursing homes and residential care settings use POLST to document CPR preferences for all residents, resulting in potentially inappropriate use with patients who are ineligible because they are too healthy. This article focuses on reasons that POLST is used as a default code status order form, the risks associated with this practice, and recommendations for nursing homes to implement appropriate use of POLST
Defining Advance Care Planning for Adults: A Consensus Definition From a Multidisciplinary Delphi Panel
Despite increasing interest in advance care planning (ACP) and prior ACP descriptions, a consensus definition does not yet exist to guide clinical, research, and policy initiatives
Improving a Full Range of Advance Care Planning Behavior Change and Action Domains: The PREPARE Randomized Trial
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Advance Care Planning and Goals of Care Communication in Older Adults with Cardiovascular Disease and Multi-Morbidity.
This article provides an approach to advance care planning (ACP) and goals of care communication in older adults with cardiovascular disease and multi-morbidity. The goal of ACP is to ensure that the medical care patients receive is aligned with their values and preferences. In this article, the authors outline common benefits and challenges to ACP for older adults with cardiovascular disease and multimorbidity. Recognizing that these patients experience diverse disease trajectories and receive care in multiple health care settings, the authors provide practical steps for multidisciplinary teams to integrate ACP into brief clinic encounters
Recommended from our members
Advance Care Planning and Goals of Care Communication in Older Adults with Cardiovascular Disease and Multi-Morbidity.
This article provides an approach to advance care planning (ACP) and goals of care communication in older adults with cardiovascular disease and multi-morbidity. The goal of ACP is to ensure that the medical care patients receive is aligned with their values and preferences. In this article, the authors outline common benefits and challenges to ACP for older adults with cardiovascular disease and multimorbidity. Recognizing that these patients experience diverse disease trajectories and receive care in multiple health care settings, the authors provide practical steps for multidisciplinary teams to integrate ACP into brief clinic encounters