Changes in Physical and Psychological States with Respect to the Gender of Outpatients Receiving Rehabilitation at Geriatric Health Services Facilities during the COVID-19 State of Emergency

This study was a sub-analysis of 20 consecutive elderly participants who underwent outpatient rehabilitation at a geriatric health services facility from January 2020 to the end of May 2020, based on our previous report. This study aimed to evaluate the longitudinal changes in their physical and psychological states with respect to gender in rehabilitation outpatients between the pre-nationwide (T1) and post-nationwide state of emergency (T2) caused by the Coronavirus disease 2019 (COVID-19). Gait speed (GS), timed up and go (TUG), handgrip strength (HG), and maximum phonation time (MPT) were measured as indices of physical status. The Japanese version of the Apathy Scale and five-level EuroQoL five-dimensional questionnaire (EQ-5D-5L) were used to assess the psychological state. Both states were measured in the male and female groups at T1 and T2 and then were compared. The final analysis was comprised of 13 outpatients. In males, the physical (GS, p = 0.463; TUG, p = 0.600; HG, p = 0.753; and MPT, p = 0.249) and psychological (Apathy Scale, p = 0.891 and EQ-5D-5L, p = 0.249) states did not change significantly between T1 and T2. In the females, the physical (GS, p = 0.600; TUG, p = 0.735; HG, p = 1.000; and MPT, p = 0.310) and psychological (Apathy Scale, p = 0.588 and EQ-5D-5L, p = 0.176) states also did not show significant change between T1 and T2. In both sexes, the continuance of outpatient rehabilitation might be recommended as one activity that can maintain physical and psychological states during a COVID-19-related state of emergency.

Did the Physical and Psychological States of Outpatients Receiving Rehabilitation at a Geriatric Health Services Facility Decline during the State of Emergency Caused by the COVID-19 Pandemic?

Many Geriatric Health Services Facilities in Japan may have continued outpatient rehabilitation by taking measures against infection even during the state of emergency caused by Coronavirus disease 2019 (COVID-19). The present study aimed to determine differences in physical and psychological states in rehabilitation outpatients (age, 83.5 ± 8.4 years) at a Geriatric Health Services Facility between the pre- and post-nationwide state of emergency in Japan. Physical outcomes were assessed with gait speed (GS), timed up and go test (TUG), handgrip strength (HG), and maximum phonation time (MPT). We used the Japanese version of the five-level EuroQoL five-dimensional questionnaire (EQ-5D-5L) to assess patients’ quality of life (QoL) as the psychological state. The physical (GS, pre, 0.92, post, 0.92 s, p = 0.875; TUG, pre, 14.09, post, 14.14 s, p = 0.552; HG, pre, 19.42, post 19.70 kgf, p = 0.807; MPT, pre, 13.6, post, 13.8 s, p = 0.861) and psychological (EQ-5D-5L, pre, 0.73, post, 0.81, p = 0.064) states of the participants did not change significantly between the pre- and post-nationwide state of emergency. This was likely due to the continuance of outpatient rehabilitation in accordance with the facility’s policy while taking adequate safety precautions against COVID-19 infection.

Deprescribing in Older Adults: Is Evidence for Continued Medication Use Generalizable Beyond Age 75?

Older adults over the age of 75 are severely underrepresented in many of the clinical trials used to justify the continued use of medications for chronic disease prevention in advanced age. The gaps in evidence in this population have fueled an interest in research to better understand the potential benefits and harms associated with the continued use of medications with uncertain benefit in advanced age. Deprescribing, the intentional reduction or discontinuation of medications, has recently gained traction as an important component of the prescribing process, but raises questions about the safety of stopping medications. This presentation will provide an overview of the evolution of deprescribing research and how this has shaped my career as a geriatric health services researcher. Specifically, I will address early studies that defined the field, challenges and opportunities for studying deprescribing in older adults, and future directions and priorities in deprescribing research.

PELAKSANAAN PELAYANAN KESEHATAN GERIATRI BAGI NARAPIDANA LANJUT USIA DI LEMBAGA PEMASYARAKATAN DENGAN PEMERIKSAAN RUTIN

This paper aims to determine the provision of geriatric health services to elderly prisoners. This study uses a descriptive qualitative approach, the data collected by researchers by conducting field studies is conducting interviews with several correctional officers to obtain data through interviews, field studies and literature reviews in explaining the provision of geriatric health services to elderly prisoners. The results showed that service delivery was constrained by costs, facilities and infrastructure as well as a lack of human resources who were experts in the health sector. Elderly prisoners do not get the geriatric care that should be done so that elderly prisoners receive treatment and prevention of diseases and health problems due to ageing. This can be handled by carrying out routine checks on inmates. Not only examinations but also counselling activities about the health experienced by elderly prisoners. This examination is carried out by the prison in collaboration with the regional health office and is carried out regularly every week. With this routine check-up, elderly prisoners can overcome their health problems and prevent diseases that usually attack a person due to ageing.

Will the Conversion from Sanatorium Medical Facilities into New Facilities Progress in Japan?

In Japan, under the Long-Term Care Insurance Act of 2018, the Integrated Facility for Medical and Long-Term Care was established as a new long-term care insurance facility into which Sanatorium Medical Facilities could be converted, and this conversion has taken place gradually; in this study, we compared the management policies between existing Sanatorium Medical Facilities and Integrated Facilities. We also examined the management policies of Geriatric Health Services Facilities. For the management policies of individual facilities, published data on the “Long-Term Care Service Information Publication System” website were used; the study included 142 Integrated Facilities, 245 Sanatorium Medical Facilities, and 237 Geriatric Health Services Facilities. The percentage of facilities in each facility group that included specific keywords was compared. There were no significant differences in the percentage of facilities including “Return,” “Long-term,” “Management,” “Care,” and “Coordination” in their management policies between Sanatorium Medical Facilities and Integrated Facilities. Compared with Geriatric Health Services Facilities, Sanatorium Medical Facilities had a significantly lower rate of including “Return” and a significantly higher rate of including “Long-term,” “Management,” “Care,” and “Coordination.” As seen from the above, the management policies of Sanatorium Medical Facilities were similar to those of Integrated Facilities, rather than Geriatric Health Services Facilities. When Geriatric Health Services Facilities and Integrated Facilities were compared as candidates for conversion from Sanatorium Medical Facilities, it was suggested that the barrier to entry is lower for the Integrated Facilities than for Geriatric Health Services Facilities in terms of necessity of major change in management policies.