INTRODUCTION: Due to the morbidity and mortality profile observed in nursing homes, there is a need to insert guidelines to screen palliative care in this context.
METHODS: We applied the Palliative Care Screening Tool (PCST) in order to identify potential candidates for palliative care in hospitalized aged > 60 years in a large nursing home.
RESULTS: 276 residents were evaluated; 86% presented score > 4 points - selected for palliative care. The most prevalent comorbidities for palliative care inclusion were cerebrovascular diseases and dementia.
CONCLUSION: Palliative care in nursing homes doesn't necessary mean attention only for oncologic patients but also to neuropsychiatric patients with lost of the functional status. The PCST, despite high sensitivity, has potential to overestimate the necessary care of such patients. More studies are needed in order to create adaptations or specific scales for the Brazilian needs, such as scales dealing with nursing homes residents.
Keywords: Aged, homes for the aged, hospice care.
OBJECTIVE: To describe the commitment on the benefits of retirement with continuous use of medications in the elderly and retirees aged over 65 living in the area of coverage of the Unidade de Saúde da Família of the neighborhood "Jardim Santa Gertrudes" in Jundiaí, São Paulo.
METHODS: 181 household interviews were conducted with application of a questionnaire with closed questions and precoded about income and use of medicines. Among those who responded to the questionnaire, 117 fit the criteria for inclusion.
RESULTS: Most of the sample is composed of women (59.8%), 62.4% have a pension as the only source of income, while the average pension was 1.53 minimum wage. The average income of the involvement of retirees who purchase at least one product is 23.57%. Among the diseases reported, there are hypertension (75.21 %), dyslipidemia (29.05%), diabetes mellitus (26.49%), arthritis (20.51 %) and depression (9.40%).
CONCLUSION: Significant percentage of the retirement is for the purchase of medicines, showing that there is much to be built especially with regard to public policies and programs for retirement planning.
Keywords: Elderly, retirees, medications.
OBJECTIVE: The objective of this systematic review was to investigate the effect of Physical Therapy on reversing the elderly frailty and provide evidence for the benefits of this intervention.
METHODS: Randomized clinical trials were selected and retrieved on databases MedLine, SciELO, Lilacs and PEDro. The quality of the studies was analyzed and data extraction was done independently.
RESULTS: The results demonstrated a positive effect of Physical Therapy intervention on physical and functional ability of frail elderly, however there is no evidence of the reversibility of frailty.
CONCLUSION: The implementation of effective interventions can minimize the adverse effects of the syndrome in the population at risk. These findings suggest that efforts are more important for the prevention of frailty than for its reversibility.
Keywords: Frailty, elderly, physical therapy, rehabilitation.
OBJECTIVE: The purpose of this study was to examine the effects of the rehabilitation process on gait outcomes of older subjects undergoing total hip arthroplasty (THA).
METHOD: A systematic review of the literature was conducted analyzing MedLine, SciELO, PEDro and Cochrane databases. The identified manuscripts were analyzed according the following inclusion criteria: (1) study design: randomized clinical trial (RCT), (2): population composed of elderly subjects with mean age above 60 years old, undergoing THA, (3) analysis of the effects of intervention comparing two or more groups, (4) outcomes related to gait analysis.
RESULTS: There were found 6RCTs whose methodological quality ranged between 3 and 7 (4,33 ± 1,37) according to the PEDro scale. The rehabilitation process and key outcomes showed considerable variation between studies, but it was possible to observe that the experimental group, in all reviewed studies, showed superior results to those obtained by the control group in variables related to gait such as: pain, walking distance and physical capacity.
CONCLUSION: Despite the limited number of studies and their methodological differences, there is evidence to support the use of varied therapeutic exercises during the rehabilitation process of this population.
Keywords: Elderly, gait, total hip arthroplasty, rehabilitation.
It is known that in many countries, particularly in Brazil, there is a movement toward the implementation of home care in the provision of health services provided to citizens. The aim of this paper is to question this movement and its effects in promoting the health of the elderly. The focus will be directed to the home care services provided by an interdisciplinary team of a public hospital located in the city of São Paulo. More particularly we will put emphasis on the odontological home care. It is worth saying, initially that the reconfiguration of hospital medical care done through the home service is motivated by a number of factors which are, as we will see ahead related to financial/administrative problems (public policies), subjective and social. To address the specifities that are in play in this mode of medical care provided to the elderly we present at first a historical retrospective, in an attempt to clarify how, why and when the hospital opened to: 1) a medical care proposal done outside the hospital premises, 2) professionals not only of medical background - thus forming the teams. Next we will specifically look at the organization/structure of the Home Care Service of Hospital do Servidor Público Municipal de São Paulo and the odontological care of the elderly, users of this service.
Keywords: Home, patients, elderly.
OBJECTIVE: Report, through a clinical case, intervention at dental office under medication for sedation in a patient with Alzheimers disease.
CASE DESCRIPTION: Elderly dependent patient, 86 y-o, leukoderma, in a advanced stage of Alzheimer disease, was submitted to dental intervention in two phases: a stage of adaptation in the oral environment and the surgical step through a medication for sedation, both did in dental office regarding disposal of infections focci and oral painful symptoms. The dental actions aimed to promote oral well-being and quality of life by eliminating the factors mentioned which could worsting her systemic condition.
CONCLUSIONS: The dentist should be able to plan the treatment directed to these persons by interdisciplinary approach, using auxiliary resources and dealing with alternative interventions. The objectives including also provide a greater security to the service, respecting the patient's individuality and the medical procedures and family decisions regarding this case.
Keywords: Geriatrics, Alzheimers disease, geriatric dentistry.