Day 3 :
- Track 9: Social Gerontology, Track 11: Pharmacotherapy & Track 12: End-of-Life
Location: Salon-D
Chair
Ilene Warner-Maron
Institute for Continuing Education and Research, USA
Co-Chair
Elizabeth Andersen
University of British Columbia, Canada
Session Introduction
Lillian Mwanri
Flinders University, Australia
Title: Ageing in a foreign environment for new migrants: The case of newly arrived African migrants in South Australia
Biography:
Lillian Mwanri is a public Health Physician and a Fellow of the Australasian Faculty of Public Health Medicine. She is currently the Coordinator of the Master of Health and International Development program at Discipline of Public Health, Flinders University, South Australia. She has published more than 40 papers in reputed journals and has been serving in different committees for culturally and linguistically diverse communities in South Australia
Abstract:
Over the past few years, a large number of Africa migrants have settled in Australia. The majority of this population has been re-settled under the humanitarian program. Usually, resettlement occurs after many years of living in refugee camps, in different countries away from the country of origin. As a result of this surge in migration of Africans, ageing and frailty are gradually becoming a public health issue for Africans living in Australia. It is well understood that people from developing countries who migrate to developed countries originate from an environment where family members care for them during the old age. At the same time information about experiences of ageing and frailty of Africans in Australia is generally limited. Despite the wide variety of origins, most studies of ageing have mainly focused on experiences of old migrant populations e.g. Greeks and Italians and the mainstream Australian population. Information and discussions on new and emerging communities including the Africans is limited, yet their number and the proportion are increasingly becoming a significant part of the Australian population. The main aim of this paper is to provide some insight into the socio-cultural experiences of ageing for African migrants in South Australia and the challenges and opportunities faced by the ageing African migrants in interacting with the Australian health services. The paper provides some insights as to how some African communities relate with the provision of health care especially ageing care and calls for more research to understand the ageing challenges of the community. It also provides some points for discussion to enhance the capacity of current health services to provide more culturally competent services. The paper contributes to the knowledge of the provision of culturally competent care to African patients and their families by enabling the learning of health services and health service providers to improve the competence of ageing care services for newly arrived migrants in Australia.
Veronique Provencher
University of Sherbrooke, Canada
Title: Improving home safety in people with dementia following hospital discharge
Biography:
Véronique Provencher is an occupational therapist who has completed his PhD in geriatric rehabilitation from the University of Montreal in 2012. She is professor at the University of Sherbrooke and researcher at the Research Center on Aging (Quebec, Canada).
Abstract:
Health professionals practicing in geriatric units routinely assess their patients with dementia prior to hospital discharge for their ability to perform safely their daily living activities. The aim of this assessment is to know what type of home care services are needed when they will return in their living environment. Because of a home visit cannot usually be done prior to discharge, this assessment is performed in hospital. This situation raised two questions: 1-to what extent the risks assessed and the home care services recommended in hospital setting prior to discharge truly reflect and predict home safety; 2-how can we improve home safety in people with dementia following hospital discharge. Based on a systematic review and an international panel of experts, our data suggest that some risks (such as fire) may be overestimated, while others (such inappropriate medication intake) may be underestimated before hospital discharge. These results may be explained by: 1) characteristics of the assessment setting (unfamiliarity of the context); 2) differences in clinicians, patients and caregivers’ perceptions and values toward ethical challenges (safety vs autonomy); 3) difficulty to predict how safety issues will change in the months following hospital discharge (progression of the disease, reduction of delirium). Developing a clinical decision tool to support assessment and management of risks by health professionals as well as optimizing transitions of care (through case manager and technological aid) may help to improve home safety in people with dementia following hospital discharge.
Mirian Ueda Yamaguchi
Centro Universitário de Maringá - UniCesumar,
Brazil
Title: Sexually Transmitted Diseases in the Elderly: A Current Challenge
Biography:
Mirian Ueda Yamaguchi is a Pharmacist and Professor of Post-Graduate Course in the Promotion of Health, Centro Universitário de Maringá-UNICESUMAR–Maringá, Paraná, Brazil
Abstract:
In Brazil there are more than 20 million people aged 60 or over and estimates indicate that the number will triple in the next 40 years1. In this context, the aim of this study was to analyze the evolutionary trend of STDs among the elderly in Brazil and around the world. The study consisted of a systematic review (PRISMA)2 in LILACS, IBECS, Cochrane, MEDLINE, PubMed and SciELO. In total, 979 articles were identified, 44 of which met the inclusion criteria for this study. Among the works selected, 77% of the research related to HIV / AIDS and only 23% to other STDs. It was found that currently seniors remain sexually active into their later years, a fact related to the advent of drugs for erectile dysfunction. It was also found that a notable characteristic of this age group was the practice of sex without protection, which is reflected in the increase in STDs in this population. Other relevant data found in this review refers to the failure to diagnose STDs in elderly patients due to the fact that health professionals are unaware of, or ignore, the sexual practices of the elderly population, confusing the symptoms with comorbidities associated with old age. Furthermore, it was found that the elderly are generally excluded from public policy promoting health and the prevention of STDs. It is concluded that there is a need for awareness among health professionals of STD and geriatric services about changes in the behavior and epidemiological profile of this population. KEYWORDS: Sexually Transmitted Diseases; HIV/AIDS; Public Policy.
Biography:
Margaret Decker is a Clinical Assistant Professor for the Decker School of Nursing and is a Certified Nurse Educator. She is currently pursuing her PhD from the Decker School of Nursing. Her areas of specialty are leadership and management, geriatrics and orthopedics. She is a 2015-2016 Faculty Fellow for Community Engagment at Binghamton University. She engages students through flipped classroom style learning. She advises students from the Watson School of Engineering with interests in bioengineering. For the Decker School of Nursing, she serves as a board member for the Broome County Community Organizations Active in Disaster.
Abstract:
Community Engaged Learning (CEL) at Binghamton University is a course designation in which students are involved in community partnerships and through these engagments and experiential learning meet course objectives. The purpose is to enrich learning and provide a service learning opportunity for the student. In this presentation, the students in the introductory nursing course, Socialization to the Professional Role I are meeting the course objectives of communication and interviewing elders for their introduction into a health history. Their primary objective for their assignment is to gather data for demographic information. However, in realizing the valuable information in social gerontology, the rich history to be shared through oral histories is realized when the student interviews the residents of the facility to gather an oral history. The Veterans of the United States shared their experiences with the nursing students through oral histories of their lives. In return, the nursing students gathered demographic information for the purposes of their nursing assignment and later wrote their own reflections of the interviews. When reflecting upon the community engagement, we felt it was important to give back to the Veterans so in return they spent time writing poetry, trascribing the interviews, preparing memory boxes and giving momentoes of the interview to the Veterans to keep as a remembrance of their history they shared. This presentation will discuss the experience of social gerontology and the benefit to the health care team through oral histories.
Briony Jane Murphy
Monash University, Australia
Title: Investigating intentional cause deaths among nursing home residents
Biography:
Briony Jane Murphy is a PhD scholar (March 2014) with the Department of Forensic Medicine, Monash University. She is using existing medico-legal death investigation information to describe the frequency, nature and potential risk or protective factors of intentional deaths among nursing home residents in Australia. The expected completion date is March 2017. She has a background in criminal justice administration and injury prevention research after graduating from RMIT in 2013 with first class honours in Criminal Justice Administration (BA) completing a thesis titled ‘Service contacts proximate to intimate partner homicide’. Her research interests include Epidemiology, Injury Prevention, Public Health and Aged Care.
Abstract:
With an ageing global population, there is an increasing demand for health and aged care services including nursing homes. As such, improving the quality of care and quality of life for residents in these settings is an internationally recognised imperative. Despite the vast amount of research and prevention initiatives for suicide and violence-related deaths among younger populations, little is known about how older adults die in nursing homes from intentional causes including suicide and resident-to-resident aggression. Medico-legal death investigation information is a highly valuable yet underused data source for public health research which can help to further our understanding of intentional deaths in this vulnerable population. To address this gap, doctoral research is currently examining the frequency, nature and potential risk (or protective factors) of intentional cause deaths among nursing home residents using existing medico-legal death investigation information. Systematic reviews conducted in 2014, reveal a paucity of research on intentional deaths in nursing homes and highlight gaps in our understanding of these deaths, providing a guide for future research in this area. Preliminary data collection commenced in 2015 has encountered a number of methodological issues associated with the use of existing medico-legal death investigation informationas a data source for research on intentional deaths among nursing home residents. Despite this, early evidence suggests that the analysis of this information has the potential to address many of the gaps in knowledge identified by the systematic reviews. It is anticipated this research will help to build a greater knowledge base and improve current understanding of these deaths to inform prevention strategies and alter attitudes towards intentional deaths among nursing home residents to equal those afforded to similar deaths in younger populations. A truly ageless era is one where each individual’s life is valued equally and irrespective of age.
Ilene Warner-Maron
Institute for Continuing Education and Research
USA
Title: Preventing Medication Errors in Long-Term Care Facilities
Biography:
Ilene Warner-Maron completed her PhD in health policy in 2007 at the University of the Sciences in Philadelphia, where her dissertation focused on HIV and aging. She holds masters degrees in gerontology from the University of Pennsylvania (1985), health care administration from St. Joseph’s University (1989) and law and social policy from Bryn Mawr College (1995); a bachelors in sociology from Philadelphia University (1983) and a diploma in nursing from the Albert Einstein Medical Center School of Nursing in 1980. She is the president of the Institute for Continuing Education and Research, a federal monitor of nursing homes in the US, a member of the board of directors of the Alzheimer’s Association and a Fellow in the College of Physicians in Philadelphia.
Abstract:
Medication errors are frequent occurrences in hospitals and long-term care settings, estimated in one out of every five doses administered in an institutional setting. Issues of medication errors have been highlighted and studied since the Institute of Medicine’s 1999 report, To Err is Human was released, however medication administration has become increasingly complex and prone to errors despite advances in the electronic medical record and automated dispensing systems. Errors frequently include administration failures (wrong dose, drug, time, route, patient); pharmacy dispensing and delivery issues; technique errors and monitoring problems. A review of citations for medical errors by the Pennsylvania Department of Health from 2009-2012 identified specific categories of errors in medication administration. This presentation will use a systems approach to address the patterns of deficiencies and offer recommendations to decrease errors in all areas of identified deficient practice.