scholarly journals 513 - Lithium monitoring in Old Age Psychiatry – a quality improvement project

2021 ◽  
Vol 33 (S1) ◽  
pp. 63-64
Author(s):  
E. Herridge ◽  
L. Valentine ◽  
J. Cannon ◽  
R. Novac ◽  
S. Marmion ◽  
...  
Keyword(s):  
Old Age ◽  
Clinical Excellence ◽  
The Elderly ◽  
Management Programme ◽  
Lithium Therapy ◽  
Layered System ◽  
Improvement Project ◽  
Nice Guidelines ◽  
North West ◽  
Practice Standards

INTRODUCTION:Lithium has a narrow therapeutic index with a risk of toxicity and potential to increase morbidity and mortality, particularly in the elderly with co-morbid illness and polypharmacy. Lithium therapy and monitoring of lithium levels require precision and several guidelines have been issued including recommendations for strict control of lithium levels in the elderly population.RESEARCH OBJECTIVE:We evaluated the effect of implementation of a multifaceted management programme on the compliance with international practice standards for lithium monitoring in patients under the care of Psychiatry of Old Age (POA), Sligo Leitrim Mental Health Services in the North West of Ireland.METHODS:Results from a prior audit performed in February 2020 involving a cohort of 18 patients prescribed lithium under the care of POA were analysed and compared to accepted standards. The guideline used as the benchmark for compliance was the National Institute for Clinical Excellence (NICE) guidelines on the use and monitoring of lithium therapy, as published in 2014. Several deficits were found and therefore a designated Lithium Management Programme was established. A subsequent audit, performed using a simplified audit tool incorporating the NICE guidelines, delivered results which were directly compared to the initial findings and analysed to evaluate the effect of the implemented management programme.PRELIMINARY RESULTS OF THE ONGOING STUDY:In comparison with findings from 2020, there had been a significant improvement in most facets of lithium management and compliance to practice standards. Of particular note was the improvement of biochemical monitoring, side effect screening, polypharmacy surveillance, patient education and interdisciplinary communication.CONCLUSION:The launch of a dedicated Lithium Management Programme with specific features aimed at identifying and addressing poor compliance with monitoring guidelines has led to improved adherence to accepted international practice standards. Our model provides a dynamic, multi-layered system which paves the way for better patient outcomes, timely access to care and furthering education for patients and staff members.

‘Strength in What Remains Behind’: Wordsworth and the Question of Ageing

Romanticism ◽  
2019 ◽  
Vol 25 (3) ◽  
pp. 261-270
Author(s):  
Mark Sandy
Keyword(s):  
Old Age ◽  
The Elderly ◽  
Frequent Pattern ◽  
Younger Generation ◽  
Old Men ◽  
Poetic Vision

Attending to the hoped-for connection between young and older generations, this essay revisits Wordsworth's poetic fascination with the elderly and the question of what, if any, consolation for emotional and physical loss could be attained for growing old. Wordsworth's imaginative impulse is to idealise the elderly into transcendent figures, which offers the compensation of a harmonious vision to the younger generation for the losses of old age that, in all likelihood, they will themselves experience. The affirmation of such a unified and compensatory vision is dependent upon the reciprocity of sympathy that Wordsworth's poetry both sets into circulation and calls into question. Readings of ‘Simon Lee’, ‘I know an aged Man constrained to dwell’, and ‘The Old Cumberland Beggar’ point up the limitations of sympathy and vision (physical and poetic) avowed in these poems as symptomatic of Wordsworth's misgivings about the debilitating effects of growing old and old age. Finally, Wordsworth's unfolding tragedy of ‘Michael’ is interpreted as reinforcing a frequent pattern, observed elsewhere in his poetry, whereby idealised figures of old men transform into disturbingly spectral second selves of their younger counterparts or narrators. These troubling transformations reveal that at the heart of Wordsworth's poetic vision of old age as a harmonious, interconnected, and consoling state, there are disquieting fears of disunity, disconnection, disconsolation, and, lastly, death.

scholarly journals The Effect of Loneliness on Death Anxiety in the Elderly During the COVID-19 Pandemic

2021 ◽  
pp. 003022282110105
Author(s):  
Türkan Akyol Guner ◽  
Zeynep Erdogan ◽  
Isa Demir
Keyword(s):  
Death Anxiety ◽  
The Elderly ◽  
Average Score ◽  
City Center ◽  
Cross Sectional ◽  
North West ◽  
Significant Difference ◽  
Scale Scores ◽  
Education Status ◽  
At Home

The aim of the study is to determine the effect on death anxiety of loneliness in the elderly during the COVID-19 pandemic. The population of this study that is descriptive and cross-sectional type consist of 354 elderly who meet the inclusion criteria from three different associations operating for charitable purposes in a city center located in north-west Turkey. The average score of Loneliness Scale of Elderly (LSE) of the elderly was determined as 11.39 ± 5.31, and the average score of Death Anxiety Scale (DAS) of the elderly was determined as 8.54 ± 4.82. According to these results, it was found that the elderly experienced acceptable levels of loneliness and moderate death anxiety. A statistically significant difference was found in the LSE and DAS scores of the elderly according to their age, marital status, education status, chronic illness status and living at home with relatives. In addition, during the COVID-19 epidemic, the scale scores of the elderly who have increased worries, who have a hobby at home, and who communicate with their relatives via social media/mobile phones were found to be statistically significant (p < 0.05).

Effectiveness of neurobic exercise program on memory and depression among elderly residing at old age home

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Divya Raj ◽  
Subramaniam Santhi ◽  
G. J. Sara Sapharina
Keyword(s):  
Old Age ◽  
Depression Scale ◽  
Exercise Program ◽  
The Elderly ◽  
Control Group ◽  
Study Group ◽  
Significant Difference ◽  
The Mean ◽  
Interventional Group ◽  
Old Age Homes

AbstractObjectivesThis study finds out the effectiveness of neurobic exercise program on memory and depression among elderly residing in old age homes.MethodsThe non-probability purposive sampling technique was used for sample selection. Wechsler's memory scale (WMS-IV) and Geriatric depression scale (GDS) were the instruments used to assess the memory and depression among elderly during the pretest and posttest, respectively and the researcher had developed data sheet to collect information about the background variables using interview technique.ResultsThe neurobic exercise program was found to be effective in reducing depression among elderly residing in old age homes. There was a significant difference (p<0.001) in the level of depression had been found during the pretest and posttest in the interventional group. There was a statistically significant difference (p<0.001) found between the study group and in the control group. There was significant correlation (r=0.417, p<0.05) found between the memory and depression during the pretest in the study group among the elderly. A statistically significant association (p<0.05) found in the mean scores of depression and marital status of the elderly during the pretest in the study group and there was a significant association (p<0.01) found in the mean scores of depression and the gender of the elderly during the pretest and posttest in the non interventional group were found.ConclusionsThe findings suggested that neurobic exercise program is an effective intervention in improving memory and reducing depression.

scholarly journals A decade of road traffic fatalities among the elderly in north-West Iran

2018 ◽  
Vol 18 (1) ◽  
Author(s):  
Homayoun Sadeghi-Bazargani ◽  
Bahram Samadirad ◽  
Farnaz Moslemi
Keyword(s):  
Road Traffic ◽  
The Elderly ◽  
Traffic Fatalities ◽  
North West

Provision of public services by Slovak local governments - Case study social protection – old age: A supply demand mismatch?

2021 ◽  
Author(s):  
Tomáš Černěnko ◽  
Klaudia Glittová
Keyword(s):  
Regression Analysis ◽  
Old Age ◽  
Local Governments ◽  
Public Services ◽  
Social Protection ◽  
Supply And Demand ◽  
Descriptive Analysis ◽  
The Elderly ◽  
Provision Of Services

The aim of the paper is to describe the supply of public services in the field of social protection - old age (represented by expenditures in group 10, class 2 of COFOG classification) in relation to the demand for these services represented by the population in the age group 62+ related to the size and region of the local government unit. The analysis of supply and demand takes place at the level of individual local governments and the results are then presented in relation to the size of the municipality and the region. Two approaches were used for the analysis. The first focuses on the description of the current situation through the categorization of local governments according to the approach to the provision of services, and the second consists in regression analysis. The results of the regression analysis suggest that the size of the municipality and the region do not play as important a role in terms of access to the provision of the examined services as indicated by the first, descriptive analysis. To find a "pattern" for local authorities to decide on access to services for the elderly, further research will be needed that takes into account several socio-economic indicators.

ACTIVE LONGEVITY: WAYS TO ACHIEVE IN THE CONTEXT OF THE DEVELOPMENT OF INFORMATIONAL-ENERGETIC MEDICINE

Fitoterapia ◽  
2021 ◽  
Vol 2 (2) ◽  
pp. 55-61
Author(s):  
V. V. Krutov ◽  
Keyword(s):  
Traditional Medicine ◽  
Old Age ◽  
The Elderly ◽  
The Body ◽  
Comprehensive Approach ◽  
Allopathic Medicine ◽  
Active Aging ◽  
Synergistic Approach ◽  
Systemic Problems ◽  
Information Energy

Keywords: health, Spirit, energy, synergistic approach, gerontology, quality longevity, allopathic medicine, informational-energetic medicine. The article discusses the issue of active aging strategies that differ from those used in traditional medicine. Practice shows that the resources of the latter are insufficient for successfully overcoming the systemic problems of people, growing with aging and maximum in old age. The accumulation of the problematic nature of the physical body in long-lived people requires a special, comprehensive approach to treatment with penetration into the root nature of a person. Based on innovative knowledge, including data from his own research, the author is talking about a synergistic approach that includes, along with the existing practice of treating the elderly, methods of informational- energetic medicine. Medicine, working at the level of the subtle, causal sphere of a person, where the roots of all his diseases lie and are revealed. This way of solving, the author believes, bears the maximum healing effect for the body on all levels of its multidimensionality – substance, information, energy.

Is There a Need for Elderly Forensic Psychiatric Services?

2005 ◽  
Vol 45 (2) ◽  
pp. 154-160 ◽  
Author(s):  
I O Nnatu ◽  
F Mahomed ◽  
A Shah
Keyword(s):  
Mental Illness ◽  
Old Age ◽  
The Elderly ◽  
Mentally Disordered Offenders ◽  
Mentally Disordered ◽  
Court Diversion ◽  
Mental Health Difficulties ◽  
Old Age Psychiatry ◽  
Forensic Psychiatric ◽  
Developed Nations

The population of the elderly in most developed nations is on the increase. Furthermore, the prevalence of mental disorder amongst elderly offenders is high. The true extent of `elderly' crime is unknown because much of it goes undetected and unreported. This leads to a failure to detect mental illness in such offenders. Court diversion schemes may improve recognition of mental illness but these schemes usually tend to deal with the more severe crimes. This may result in an overestimation of the amount of serious crime committed by the elderly and a failure to detect mental illness amongst those who commit less serious crimes. Efforts to service this hidden morbidity call for multi-agency collaboration. Improved detection and reporting of crimes is essential if mental health difficulties in the elderly are not to go unnoticed. The needs of elderly mentally-disordered offenders are complex and fall within the expertise of old age and forensic psychiatry, without being adequately met by either one. Therefore, consideration should be given to the development of a tertiary specialist forensic old-age psychiatry service.

Systematic Review of Preventing Suicide in Old Age: 2005–2010

2011 ◽  
Vol 26 (S2) ◽  
pp. 2020-2020
Author(s):  
C.A. de Mendonça Lima ◽  
R.M. Rodrigues
Keyword(s):  
Health Care ◽  
Old Age ◽  
Health Care Providers ◽  
The Elderly ◽  
Educational Interventions ◽  
List Type ◽  
Care Providers ◽  
Individual Level ◽  
Survivors Of Suicide ◽  
Somatic Disorders

Suicide is a typical phenomenon of the elderly and mainly among men. Besides the importance of suicide in terms of public health there is fewer interest to prevent suicide in old age. This can be explained by stigma, poor evaluation of the dimension of the problem and lack of politic will.Suicide prevention and the care of survivors of suicide depend on the mental health network of care. Interventions to reduce suicide can be made at individual level and at level of the development of policies and strategies. The detection of the persons at risk of suicide and the management of the suicide attempt are two main strategies to prevent suicide. Both received recently an important support from WHO with its publication mhGAP Intervention Guide which was conceived to be used in non-specialized health-care settings by health-care providers working at first- and second-level facilities. It includes guidance on evidence-based interventions to make the diagnosis and manage a number of priority conditions, including suicide.Our review of the literature pointed to the necessity to develop additional research to determine:•the role of somatic disorders as precipitant factor;•the role on suicide of the pre-morbid personality, cognitive functioning, social support and recent and chronic stressing events;•the participation of normal and pathological ageing on the expression of the suicide behavior;•the biological markers of suicide in old age;•the potential impact on suicide rates of educational interventions for the general public and for caregivers.

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