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The assessment of nutritional status in the comprehensive diagnosis and management of geriatric frailty
Klbíková, Tereza ; Topinková, Eva (advisor) ; Meisnerová, Eva (referee)
Objectives: The aim of this non-interventional observational study was to determine the prevalence of frailty in a cohort of 200 elderly patients and its correlation and dependence in relation to nutritional status and to evaluate the correlation of the items in the MNA - SF and SPPB test batteries and determine whether the weight loss is related to poor results in the evaluation of geriatric frailty, and to evaluate whether cognitive function affects nutritional status and if nutritional status in such circumstances affects subjects' self- sufficiency. Methods: Data was sourced from the results of standardized tests in Comprehensive Geriatric, Assessment, CGA at the 1. LF UK Geriatric Clinic, which include the assessment of selfsufficiency (ADL) and condition (SPPB), cognitive functions (MMSE) and the assessment of nutritional status (MNA - SF). Patients were also measured for bodyweight, height and BMI. Results: The study included a total of 200 patients, of whom 46 (23%) were men and 154 women (77%). Geriatric frailty was diagnosed in 59.5% of patients, with 21.5% of patients being classified as "pre-frailty" and 19 % of good physical condition. In this group 15.5% of patients were malnourished, 37.5% were at risk of malnutrition and 47 % were in a good nutritional condition. A statistically...
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The Specificity of Geriatric Patients' Nutritional Needs
Parmová, Eva ; Starnovská, Tamara (advisor) ; Bielaková, Katarína (referee)
The final thesis The Specificity of Geriatric Patients' Nutritional Needs deals with the issue of nutrition at old age and foremost of nutrition of geriatric individuals. These form a special group of patients. The main meaning of this thesis is to report on the investigated issue. This is nowadays due to the ri- sing number of the geriatric patients a very current topic. The thesis has two parts - the theoretical and the practical one. The theoretical part deals with the elucidation of the key terms, description of the diet systems and outlining of the demographical development in the Czech Republic. The thesis also describes the hospital bed capacities for geriatric patients. The practical part compares the approaches to the geriatric patients nutrition described in the domes- tic publications and the diets really provided to the geriatric patients in the Czech Republic. For these pur- poses, two geriatric workplaces were chosen - Clinic of Geriatrics of General University Hospital in Prague and The Department of Geriatrics at the Thomayer Hospital. The focus of the comparison was mainly on the values related to the intake of energy, proteins, saccharides, fats, vitamin D and calcium, iron and zinc mine- rals. In the conclusion and discussion the results of the practical part are summarized and...
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Using of Restraints in the Geriatrics
Lorencovičová, Eva ; Doskočil, Ondřej (advisor) ; Petr, Tomáš (referee)
In consideration of the demographic trends of our population, it is necessary to deal with the old age problems and problems of geriatric patients. The controversial topic of restraints, especially sensitive in association with old frail people, is closely related. The issue of restraints is defined by law. However, the ethical aspects of their application should also be considered. The theoretical part of this thesis deals with the topic of old age and serious problems of this period of life, including mental disorders. It introduces the field of geriatrics and geriatric patients. In further chapters, this thesis discusses the restraints and ethical issues related to their use. By using qualitative research methods, the empirical part of this thesis surveys the attitudes of healthcare professionals towards this issue. It discusses specific restraints and the reasons for which they are used. The results show that the most important value of healthcare professionals is health and the most respected ethical principle is the principle of beneficence. Key Words: old age, geriatric patient, health risk, restraints, ethical principle
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The first case of integration of specialized palliative care in nursing home for the elderly
Pochmanová, Karolína ; Tollarová, Blanka (advisor) ; Loučka, Martin (referee)
In my thesis I focus on integration of the palliative care in the retirement home describing it through the practical cooperation of two organisations - The Homecoming and Domov Sue Ryder. In the theoretical part I deal with the term of palliative care first, and I also introduce the specifications of the geriatric palliative care. In the subsequent part I describe the residential institutions of social care and professions that are employed in them, as well as, the multi-disciplinary team offering specialised palliative care. I also present the term of shared care existing abroad together with the foreign models of palliative care integration in the retirement homes already used in Austria and Great Britain. The conclusion of the theoretical part explores the actual project of palliative care integration called that is currently taking place in the Czech Republic. In the practical part I offer the description of an actual cooperation, for which I used the notes put down by the employees of The Homecoming after each visit; interviews with the employees of the Sur Ryder home and The Homecoming; a so-called timeline created for each shared care patient; experience from the meetings; my own experience from the meetings and educational activities; formal and informal discussions; guidelines and...
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The possibilities of influencing the stability of walking in geriatric patients
Hloušková, Pavlína ; Čápová, Eva (advisor) ; Homolková, Alena (referee)
Title of thesis: The possibilities of influencing the stability of walking in geriatric patients Abstract: This bacherol thesis addresses gait disorder therapy in geriatric patients. Good stability is a fundamental prerequisite for quality gait. The stable and quality gait is key to preserve the self-sufficiency, therefore the physiotherapy bears great importance. The theoretic part aims at the geriatric patient and lists possibilities how we can influence the stability. The practical part contains the case study of two patients with the goal to verify one of the possibilities how to influence stability in the real life. The method of senzimotor stimulation was choosen. The terapies were going on in two weeks. Both patients had undergone ten therapies and every took approximately 30 minutes. For comparison, we have used standardized tests which are described in the theoretical part. The output testing confirm the improvement, was achieved better gait stability and certainty in both cases. Key words: geriatric patient, stability, gait, walking investigation, sensorimotor
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Particularities of physiotherapy of geriatric patient at outpatient's department also with focus on the dance therapy
Doláková, Klára ; Dědková, Miriama (advisor) ; Pianelli Jahodová, Ivana (referee)
Title of bachelor thesis: Particularities of physiotherapy of geriatric patient at outpatient's department also with focus on the dance therapy Abstract: This bachelor thesis deals with particularities of physiotherapy of geriatric patient. It focuses also on the possibility of using elements of the dance therapy as a part of the physiotherapeutic intervention of elderly patients. The work consists of two parts, theoretical and practical. The theoretical part includes the main issues of the geriatric stage of life, physiotherapeutic methods that could be used with geriatric patients and there is also further description of studies that are focusing on the use of dance therapy in elderly patients. The practical part includes methodology, selection of the patients and one of the three case studies. The case study consists of: anamnesis, detailed input and output kinesiology analysis and the evaluation of the standardized tests. Based on the comparison of the output and input figures of all three patients, it has been discovered that physiotherapeutic intervention with elements of dance therapy is beneficial not only physically but also mentally. Key words: gerontology, geriatrics, geriatric patient, physiotherapy, dance therapy
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Transfemoral prostheses and their importance for geriatric patients
Ďurický, Michal ; Bachura, Marek (advisor) ; Šolc, Zdeněk (referee)
Title: Transfemoral prothesis and their importance with geriatric patients Objective: The objective of my work is to gain an overview about transfemoral prothesis and summarize the information about their importance with geriatric patients due to their polymorbid status. Methods: The first part, theoretical, is of finding character, and the second part, practical, gathers information from geriatric patients. Publications, articles and counceling with specialists in prosthetics were used when creating this work. Results: Using transfemoral prothesis with geriatric patients is strongly influenced by their health status and proper rehabilitation. Keywords: geriatric patient, amputation, stump, prothesis, knee joint, sole of foot
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Nursing care of geriatric patient
MUŠKOVÁ, Simona
Current status Old age is late phase of the ontogenetic proces, which completes the human life and carries with itself a lot of changes. These changes are inevitable for each of us (Čevela, Kalvach, Čeledová, 2012). When we speak of geriatric patient, we mean a patient older than 75 years. This is the classification of World Health Organisation (WHO). Aging leads to loss of physical and mental strength and to somatic changes some of which are highly visible at first sight (Haškovcová, 2010). General nurse with knowledge about the issues of geriatric patients can get them the optimal nursing care to be able to support their bodily functions and maintain functional fitness. Evaluating the abilities of geriatric patient, then enables general nurse to set reasonable care and then perform preventive and therapeutic interventions (Pokorná, 2013). Aim of the study The aim was to map the issue of nursing care for geriatric patients in acute beds and beds for long-term care from the perspective of nurses and also from the perspective of patients. Four research questions (RQ) were then assembled for these goals. RQ 1: How nurses perceive the problems of nursing care for geriatric patients in acute beds? RQ 2: How nurses perceive problems of nursing care for geriatric patients on long-term care beds? RQ 3: How geriatric patients perceive nursing care received from nurses in acute beds? RQ 4: How geriatric patients perceive nursing care received from nurses on long-term care beds? Methods For the empirical part of the bachelor thesis was used qualitative research. For the purpose of the data collection were used interviews, which consisted of pre-built key questions and according to willingness of the individual respondents to share their opinions were inserted additional questions. The survey consisted a total of 20 respondents, of which 10 respondents were from the Department of aftercare and 10 respondents from the orthopedic department. Of these ten respondents were 5 nurses and 5 patients in each ward. The research was carried out in the hospital bed area of the department of aftercare and orthopedic department. The interviews were transcribed verbatim and then categories were created to methodology, which showed what troubled the patients during hospitalization the most, and what nurses see as the biggest challenge when working with geriatric patients. The results By the nurses from the department of aftercare, patient immobility, lack of cooperation with disoriented patients, problems with emptying, usually constipation, change in the environment as a factor disturbing the sleep of the patient, not keeping the drinking regime, despite the patient claiming otherwise and not least the patient's hearing loss that nuisance communication between staff and patient and finally the patient's hearing loss that nuisance communication between staff and patient are seen as the biggest problems. Nurses from the orthopedic department see the biggest problem in the movement impairment of the patients, the pain that patients experience after surgery and the stress that accompanies the patient before surgery. Furthermore, problems with emptying, difficulty sleeping, patient's non-compliance and hearing loss. All interviewed patients complained the most about the lack of privacy during hospitalization, especially during their personal hygiene, about the fellow patients who disturb their sleep, as well as the lack of communication on the part of nurses. Furthermore, patients from the department of aftercare most complained about lack of information told to them when received at the department. Patients from the orthopedic department were complaining about the way in which personal hygiene is performed.
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Treatment of a dependent geriatric pacient in domestic environment
ŠULISTOVÁ, Veronika
The issue of the treatment of geriatric patients in a home environment is due to the more current demographic trends. The treatment of these patients is not easy and brings a number of problematic situations. Therefore, it is necessary to think, what the quality of care is in a home environment and how the family of geriatric patients on changes in his health will adapt. It is also important the education and the support of the lay family caregivers in the theoretical and practical knowledge and skills necessary to provide high-quality care. In the theoretical part of the outlined the division of age, characteristics of the geriatric patient, problems that can affect the patients and the carings and the home care. For geriatric patients are mainly the geriatric syndromes and the geriatric frailty. The carings and health professionals talk often about burnout. The main objective of the Bachelor thesis was to map the treatment of the infirm geriatric patients in a home environment. The singular targets have been set as follows: The experience of the non professional caregivers care of geriatric patients infirm in the domestic environment. To find out the problem situation in connection with the care of geriatric patients infirm in the domestic environment. Find out ways to resolve problem situations in the care of geriatric patients infirm in the domestic environment. To find out the needs of non professional carers in care of geriatric infirm patients in a home environment. To find out, how is the cooperation between doctors, nurses and lay carers to ensure the care of geriatric patients in a home environment. Research file was consisted of the geriatric infirm patients older 65 years in home care of the non professional lay carers, their family members and the professional nurses of the home care agencies. For the Bachelor thesis was used qualitative research strategy. To obtain the requisite information has been used polling method, technique of data collection was a free interview. The obtained data was processed by the technique of open coding, method of pencil and paper. Subsequently, the reduction was carried out with the data organized into categories and subcategories. There were created seven categories and sixteen subcategories. Some caregivers suffer from economic, social, psychological and health problems. It was found that the caregivers were forced to do in their lives many fundamental changes. They all had to adjust the housing, in some cases they had to move or even leave their jobs. Furthermore, it was found that the family is not whole in all patients, and therefore in two cases, there is nobody who could who rotates in the care of the infirm member of the family. Many of the problems were turned out as well for example, that many patients suffer from the diaper rashes, problems with defecation, obesity, depression, and other. Lay caregivers do not have enough information about the care or compensatory utilities. Often they suffer from health problems, such as back pain, depression, burnout, insomnia and other. The work can be used as a source of information for students of nursing and professional nurses. Many of the shortcomings are evident after charting nursing home care. The most alarming is the lack of information. Therefore it is necessary to develop care and ensure that most patients could be treated at home. The economic and psychological support of the non professional caregivers and especially the prevention of burnout are highly important. Home care can lead to the better medical outcomes and the lower costs for care.
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Prejudice of some geriatric patients and their relatives against hospitalization at the long-term care unit of the Tábor hospital.
BIDMONOVÁ, Alena
Basic theoretical background The opening parts deals with the issues of old age and characterize aging and old age in general. It specifies changes and needs of the old age, acceptance of the old age and describes a senior as a patient. The next part describes communication in general and specifics of communication with seniors and their relatives. The theory is then focused on the most frequent old age diseases, their specifics and on nursing care typically provided at a long-term care unit. Special attention is paid to nursing rehabilitation, palliative care and treatment of patients with pains. An insight into approach of a nurse to provision of nursing care to seniors is also important. The other part deals with health-social services provided to patients at the long-term care unit (LTC). Chapters on personality of a nurse caring about geriatric patients, on nursing ethics and the basic points of Seniors' Rights Charter close the theoretical part. The aim of the thesis The first aim of the thesis is to find out the reasons why geriatric patients refuse hospitalization at aftercare wards. The second aim is to determine why patients' relatives are afraid of hospitalization at LTC. The third aim is to determine whether the reasons for refusing hospitalization are substantiated or whether they are just baseless prejudice. Applied methods Qualitative research form, the method of interview was applied to the research. Data collection was performed by means of semi-structured interviews with geriatric patients and their family members. Three areas of interviews were applied to the research. The patients were first asked at the beginning of hospitalization. The second interview was performed with the same patients after some time of hospitalization, when they were already able to assess quality of the care provided. The third area of research questions was aimed at senior's family members during hospitalization at LTC. The interviews were analysed and categorized. The selection of respondents was intentional, oriented at patients and their families that first refused hospitalization at LTC for some reasons, but finally they were hospitalized. The research sample consisted of 6 patients and 6 members of their families. Results The results of the research have shown that geriatric patients mostly refuse hospitalization at long-term care units as they do not know the nature of the department. Patients themselves refuse hospitalization more often than their family members. Patients have incorrect ideas of the department caused by ignorance or maybe based on negative experience of people around them. Only when the respondents had used to the new environment of the LTC and had got familiarized with it they were able to assess the nursing care quality independently. The respondents and their families appreciated individual approach of the healthcare staff, complex nursing care, rehabilitation care, services of social workers as well as voluntary activity performed at the LTC. Already during hospitalization the patients admitted that they had had negative prejudice against long-term care unit not backed by negative personal experience. Respondents' families did not refuse hospitalization; they mostly welcomed it because of provision of care, professional rehabilitation, self-sufficiency improvement and compensation of health condition of their senior. Conclusion This bachelor thesis focuses on the problems and specifics of the care of geriatric patients that a nurse of a long-term care unit faces every day. Particular outputs from the thesis will be integrated into a lecture for LTC staff that will be presented at an operation meeting. The results may help the healthcare staff of the long-term care unit as feedback for continuous improvement of healthcare quality.
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