Slides for a class to Nursing College at UAH, Alabama on Sept 22nd 2022.
- Importance of assessing physical function in older-adults
- Integrated care for Older Adults
- Multicomponent Physical Activity (ViviFrail)
Role of Physical Therapy in Pediatric Oncology.pptMarkoMedi3
This presentation template provides guidance on the role of physical therapy for children with cancer. It outlines common side effects of cancer treatment that necessitate physical therapy, such as neuropathy and cardiotoxicity. Typical motor development milestones are reviewed to aid in screening and evaluating patients. The presentation recommends screening patients for physical therapy services and provides criteria for rehabilitation referrals. An interdisciplinary team approach is emphasized to optimize rehabilitation outcomes.
This document discusses issues relating to aging and frailty in general practice. It provides data from the BEACH study showing older patients have more consultations per year that are longer in length. It recommends general practices develop health and social summaries, care plans, and escalation plans for older patients to improve coordination of care. This includes documenting goals, responsibilities, review timelines, and preferences for urgent or end of life care situations. Screening tools like FRAIL can help identify patients at risk of frailty who may need additional support. Quality improvement efforts should focus on improving systems to better meet the needs of older patients.
exercise for special populations document.pptxaggreykataka
Special populations are those groups of individuals that may need some adaptation or modification to an exercise prescription or programme, to take into consideration a limitation, whether that be physiological, biological or psychosocial. The emphasis is on promoting health, fitness and safety in exercise, as well as some consideration being given to performance environments.
This document provides an overview of gerontological nursing and care of the elderly. It defines key terms related to aging and discusses the aging process. The roles of gerontological nurses are described, including providing care, education, advocacy, and leadership. Physiological changes in aging are reviewed along with theories of aging. Standards and scopes of practice for gerontological nursing are discussed.
This document provides an overview of geriatrics and aging. It defines geriatrics as the care of aged people and notes it is a subspecialty of internal medicine focused on prevention and treatment of age-related disabilities. Key points include:
- Geriatrics aims to address common problems in old age like immobility, instability, intellectual impairment, incontinence, and multiple medical issues.
- Comprehensive Geriatric Assessment is a multidisciplinary approach to evaluate older patients' medical, psychological and functional status to maximize health and quality of life.
- Research seeks to understand aging processes to develop interventions that may slow or stop aging through approaches like modifying gene expression, repairing telomeres, or
2. Special consideration in cardiac rehabilitation program for older adults.ShagufaAmber
An increasing number of cardiac patients are above the age of 65 years . They are susceptible to the adverse effect of bed rest . So early mobilization is especially important to return them to active and independent lifestyle.
- Most of the patients with heart failure, are elderly patients, shooting up to 80% in both incidence and prevalence.This is due to improved and better survival after cardiac insults, such as myocardial infarction, especially in developed countries.(AHA,2013).
-The safety and efficacy of cardiac rehabilitation have been demonstrated in the elderly (age >65 years) .(Pasquali ,et al.,2001)
-CR has a class IA recommendation by the AHA and ACSM for secondary prevention after any coronary heart disease
The Wessex Acute Frailty Audit found variability in how hospitals screen for and manage frailty. Screening for frailty sometimes occurred in emergency departments and acute medical units, but practices were inconsistent across sites. The audit aims to improve standards of care for frail patients in hospitals by identifying gaps and encouraging quality improvement. Further work is needed to drive consistency in frailty screening, management and care transitions.
Physical Activity and Cancer, a review of innovative current research. Dr. Ni...Irish Cancer Society
Physical activity guidelines exist in many EU countries to reduce cancer risk, though only a minority meet them. Research shows physical activity lowers breast, colon, and endometrial cancer risk by 25-30%, and likely other cancers, through mechanisms like reduced body fat and inflammation. Randomized trials show exercise improves outcomes for breast cancer survivors. More research is needed on optimal dose and type of activity. Ongoing studies examine biological mechanisms and effects on recurrence, survival, and quality of life.
Role of Physical Therapy in Pediatric Oncology.pptMarkoMedi3
This presentation template provides guidance on the role of physical therapy for children with cancer. It outlines common side effects of cancer treatment that necessitate physical therapy, such as neuropathy and cardiotoxicity. Typical motor development milestones are reviewed to aid in screening and evaluating patients. The presentation recommends screening patients for physical therapy services and provides criteria for rehabilitation referrals. An interdisciplinary team approach is emphasized to optimize rehabilitation outcomes.
This document discusses issues relating to aging and frailty in general practice. It provides data from the BEACH study showing older patients have more consultations per year that are longer in length. It recommends general practices develop health and social summaries, care plans, and escalation plans for older patients to improve coordination of care. This includes documenting goals, responsibilities, review timelines, and preferences for urgent or end of life care situations. Screening tools like FRAIL can help identify patients at risk of frailty who may need additional support. Quality improvement efforts should focus on improving systems to better meet the needs of older patients.
exercise for special populations document.pptxaggreykataka
Special populations are those groups of individuals that may need some adaptation or modification to an exercise prescription or programme, to take into consideration a limitation, whether that be physiological, biological or psychosocial. The emphasis is on promoting health, fitness and safety in exercise, as well as some consideration being given to performance environments.
This document provides an overview of gerontological nursing and care of the elderly. It defines key terms related to aging and discusses the aging process. The roles of gerontological nurses are described, including providing care, education, advocacy, and leadership. Physiological changes in aging are reviewed along with theories of aging. Standards and scopes of practice for gerontological nursing are discussed.
This document provides an overview of geriatrics and aging. It defines geriatrics as the care of aged people and notes it is a subspecialty of internal medicine focused on prevention and treatment of age-related disabilities. Key points include:
- Geriatrics aims to address common problems in old age like immobility, instability, intellectual impairment, incontinence, and multiple medical issues.
- Comprehensive Geriatric Assessment is a multidisciplinary approach to evaluate older patients' medical, psychological and functional status to maximize health and quality of life.
- Research seeks to understand aging processes to develop interventions that may slow or stop aging through approaches like modifying gene expression, repairing telomeres, or
2. Special consideration in cardiac rehabilitation program for older adults.ShagufaAmber
An increasing number of cardiac patients are above the age of 65 years . They are susceptible to the adverse effect of bed rest . So early mobilization is especially important to return them to active and independent lifestyle.
- Most of the patients with heart failure, are elderly patients, shooting up to 80% in both incidence and prevalence.This is due to improved and better survival after cardiac insults, such as myocardial infarction, especially in developed countries.(AHA,2013).
-The safety and efficacy of cardiac rehabilitation have been demonstrated in the elderly (age >65 years) .(Pasquali ,et al.,2001)
-CR has a class IA recommendation by the AHA and ACSM for secondary prevention after any coronary heart disease
The Wessex Acute Frailty Audit found variability in how hospitals screen for and manage frailty. Screening for frailty sometimes occurred in emergency departments and acute medical units, but practices were inconsistent across sites. The audit aims to improve standards of care for frail patients in hospitals by identifying gaps and encouraging quality improvement. Further work is needed to drive consistency in frailty screening, management and care transitions.
Physical Activity and Cancer, a review of innovative current research. Dr. Ni...Irish Cancer Society
Physical activity guidelines exist in many EU countries to reduce cancer risk, though only a minority meet them. Research shows physical activity lowers breast, colon, and endometrial cancer risk by 25-30%, and likely other cancers, through mechanisms like reduced body fat and inflammation. Randomized trials show exercise improves outcomes for breast cancer survivors. More research is needed on optimal dose and type of activity. Ongoing studies examine biological mechanisms and effects on recurrence, survival, and quality of life.
On-offline Total Service of Community-based Healthcare Smart HomeSNUCHIC
The document describes a healthcare smart home service that aims to support chronic disease self-management and improve quality of life through remote health monitoring and tailored health programs. The service monitors vital signs in residential spaces and uses a clinical decision support system to classify participants' health risk levels. It then provides online and offline health education, counseling, and programs. An evaluation of 160 elderly participants found improvements in some health-related habits and quality of life after 6 months of using the service.
Physical activity and Successful agingSMVDCoN ,J&K
The single most effective means by which older adults can influence their own health and functional abilities and therefore, maintain a high quality in the old age.
Improvement U Adult Mock Code PresentationKim Nelson
This document describes a quality improvement project to improve pediatric residents' competence and confidence in assessing and stabilizing adult patients presenting with chest pain or stroke. It involved implementing mock code simulations with debriefing and distributing learning guides. Results showed pediatric residents demonstrated a 34-46% increase in confidence and a 30-41% increase in medical knowledge regarding adult chest pain and stroke treatment. Adherence to checklist items during simulations also increased. The project concluded educational interventions like simulations can effectively address knowledge gaps pediatric providers have in treating adult patients.
This document provides information about Boston University's Well program (GTK) which aims to promote student wellness. It discusses the different dimensions of wellness - physical, social, spiritual, intellectual, environmental, and emotional wellness. There are tips provided on preventing and treating colds and flu, identifying the differences between colds and flu, information on student health services, healthy sleep, safe alcohol consumption, safe sex practices, nutrition, and campus resources that support student wellness.
1. The document presents research on the effectiveness of an online prescribed exercise program for treating depression in older adults.
2. The study found that participants who completed the 8-week, 3 times per week exercise program showed reduced depression scores based on a standardized depression scale questionnaire.
3. The results provide evidence that a regular online exercise program can successfully treat depression in older adults.
The document summarizes a study that provided training to caregivers on positioning, lifting, and transferring physically and mentally disabled people at a nursing home. It found that 92.2% of caregivers lacked proper training. The study involved interviewing caregivers to understand their needs, then providing an educational workshop and skills assessment. Caregivers showed significant knowledge and skills gains after training in areas like positioning, lifting techniques, and back safety. The study recommends ongoing training for caregivers on these skills to improve patient care and prevent workplace injuries.
The comprehensive geriatric assessment pcp slidesMarc Evans Abat
This document discusses the comprehensive geriatric assessment (CGA). It begins by defining the CGA as a multidimensional, interdisciplinary diagnostic process that develops a coordinated treatment plan emphasizing quality of life, functional status, and prognosis.
It then identifies the key components of a CGA as including medical history, physical and functional status, behavioral and emotional status, environmental and social support, and spiritual well-being. Common tools used include assessments of activities of daily living, cognition, nutrition, and fall risk.
The document explains that a CGA is recommended for older adults who are frail or have geriatric syndromes like falls or polypharmacy. Evidence shows that CGA can reduce mortality, institutionalization
This document provides an overview of strength training for older adults. It discusses the aging population and benefits of strength training for health, physical function, and quality of life. Strength declines significantly with age starting at 45 years old. Inactivity leads to further losses. The document recommends progressive strength training targeting all major muscle groups using varied exercises and resistance. It emphasizes the need for clinical guidelines on strength training for older adults to improve health outcomes and reduce healthcare costs.
Trulance is a prescription medication indicated for adults with irritable bowel syndrome with constipation (IBS-C) or chronic idiopathic constipation (CIC). Trulance works by activating guanylate cyclase-C receptors in the intestines to increase fluid secretion and accelerate gastrointestinal transit in a pH-dependent manner similar to the natural hormone uroguanylin. Clinical trials demonstrated the efficacy and safety of Trulance for the treatment of symptoms associated with IBS-C and CIC such as constipation, straining, abdominal pain and bloating. A boxed warning indicates Trulance is contraindicated in patients under 6 years old due to the risk of serious dehydration
HOW TO SAVE MONEY ON YOUR HEALTHCARE: An Integrative Medicine ApproachLouis Cady, MD
In this webinar, the fourth in a series of five from Dr. Louis Cady and the Cady Wellness Institute, we focus on the actual dollars and cents of health care expenditures, and the societal and PERSONAL costs of poor health maintenance behavior. We examine the essentially passive US medical system, that would rather drug a symptom than fix the underlying problem.
Great attention is paid on not shaming the patient or the doctors as they exist in the current system. Both groups "do not know what they do not know." Confirmation bias is rampant.
This webinar points the way to living a more vital, energetic life, with a minimum of cost, grief, and misery.
The document discusses definitions and concepts related to impairment, disability, and handicap from the International Classification of Impairments, Disabilities and Handicaps. It defines impairment as any loss or abnormality of body structure or function, disability as any restriction resulting from impairment in performing activities, and handicap as a disadvantage resulting from impairment or disability that limits fulfilling social roles. The document also discusses the World Health Organization's community-based approach to rehabilitation, which aims to enhance quality of life for people with disabilities through community participation and mobilizing local resources.
The document discusses definitions and concepts related to impairment, disability, and handicap from the WHO and ICIDH models. It defines impairment as an abnormality of structure or function, disability as a restriction resulting from impairment, and handicap as a social disadvantage faced due to impairment or disability. Community-based rehabilitation (CBR) is described as an approach that provides rehabilitation services within communities using their existing resources, with the goals of equalizing opportunities and socially integrating people with disabilities. The roles of the rehabilitation team, which includes nurses, physiotherapists, psychologists and others, are also summarized.
Ts wo es_validation+of+braden+sub+scale+scoresLaurie Crane
This document discusses validating the use of individual subscale scores from the Braden Scale for pressure ulcer risk assessment rather than just the cumulative score. It provides opinions from staff that the current use of the Braden Scale and Skin Bundle focuses more on documentation than interventions. The document recommends enhancing the Braden Scale in the EPIC electronic health record to flag low individual subscale scores and provide specific intervention recommendations tailored to each subscale. Examples are provided for interventions aimed at low friction/shear and nutrition subscale scores. Overall, the goal is to improve pressure ulcer prevention by guiding intervention selection based on assessment of individual risk factors.
1. Geriatric rehabilitation aims to help the elderly regain independence by recovering physical, psychological, or social skills lost due to aging or disability.
2. The key principles of geriatric rehab are addressing the variability in aging, preventing the effects of inactivity, and maintaining optimal health.
3. Interventions include a variety of exercises, assistive devices, and environmental adaptations delivered through different settings and providers.
Michigan HealthTech Market Map 2024. Includes 7 categories: Policy Makers, Academic Innovation Centers, Digital Health Providers, Healthcare Providers, Payers / Insurance, Device Companies, Life Science Companies, Innovation Accelerators. Developed by the Michigan-Israel Business Accelerator
The best massage spa Ajman is Chandrima Spa Ajman, which was founded in 2023 and is exclusively for men 24 hours a day. As of right now, our parent firm has been providing massage services to over 50,000+ clients in Ajman for the past 10 years. It has about 8+ branches. This demonstrates that Chandrima Spa Ajman is among the most reasonably priced spas in Ajman and the ideal place to unwind and rejuvenate. We provide a wide range of Spa massage treatments, including Indian, Pakistani, Kerala, Malayali, and body-to-body massages. Numerous massage techniques are available, including deep tissue, Swedish, Thai, Russian, and hot stone massages. Our massage therapists produce genuinely unique treatments that generate a revitalized sense of inner serenely by fusing modern techniques, the cleanest natural substances, and traditional holistic therapists.
On-offline Total Service of Community-based Healthcare Smart HomeSNUCHIC
The document describes a healthcare smart home service that aims to support chronic disease self-management and improve quality of life through remote health monitoring and tailored health programs. The service monitors vital signs in residential spaces and uses a clinical decision support system to classify participants' health risk levels. It then provides online and offline health education, counseling, and programs. An evaluation of 160 elderly participants found improvements in some health-related habits and quality of life after 6 months of using the service.
Physical activity and Successful agingSMVDCoN ,J&K
The single most effective means by which older adults can influence their own health and functional abilities and therefore, maintain a high quality in the old age.
Improvement U Adult Mock Code PresentationKim Nelson
This document describes a quality improvement project to improve pediatric residents' competence and confidence in assessing and stabilizing adult patients presenting with chest pain or stroke. It involved implementing mock code simulations with debriefing and distributing learning guides. Results showed pediatric residents demonstrated a 34-46% increase in confidence and a 30-41% increase in medical knowledge regarding adult chest pain and stroke treatment. Adherence to checklist items during simulations also increased. The project concluded educational interventions like simulations can effectively address knowledge gaps pediatric providers have in treating adult patients.
This document provides information about Boston University's Well program (GTK) which aims to promote student wellness. It discusses the different dimensions of wellness - physical, social, spiritual, intellectual, environmental, and emotional wellness. There are tips provided on preventing and treating colds and flu, identifying the differences between colds and flu, information on student health services, healthy sleep, safe alcohol consumption, safe sex practices, nutrition, and campus resources that support student wellness.
1. The document presents research on the effectiveness of an online prescribed exercise program for treating depression in older adults.
2. The study found that participants who completed the 8-week, 3 times per week exercise program showed reduced depression scores based on a standardized depression scale questionnaire.
3. The results provide evidence that a regular online exercise program can successfully treat depression in older adults.
The document summarizes a study that provided training to caregivers on positioning, lifting, and transferring physically and mentally disabled people at a nursing home. It found that 92.2% of caregivers lacked proper training. The study involved interviewing caregivers to understand their needs, then providing an educational workshop and skills assessment. Caregivers showed significant knowledge and skills gains after training in areas like positioning, lifting techniques, and back safety. The study recommends ongoing training for caregivers on these skills to improve patient care and prevent workplace injuries.
The comprehensive geriatric assessment pcp slidesMarc Evans Abat
This document discusses the comprehensive geriatric assessment (CGA). It begins by defining the CGA as a multidimensional, interdisciplinary diagnostic process that develops a coordinated treatment plan emphasizing quality of life, functional status, and prognosis.
It then identifies the key components of a CGA as including medical history, physical and functional status, behavioral and emotional status, environmental and social support, and spiritual well-being. Common tools used include assessments of activities of daily living, cognition, nutrition, and fall risk.
The document explains that a CGA is recommended for older adults who are frail or have geriatric syndromes like falls or polypharmacy. Evidence shows that CGA can reduce mortality, institutionalization
This document provides an overview of strength training for older adults. It discusses the aging population and benefits of strength training for health, physical function, and quality of life. Strength declines significantly with age starting at 45 years old. Inactivity leads to further losses. The document recommends progressive strength training targeting all major muscle groups using varied exercises and resistance. It emphasizes the need for clinical guidelines on strength training for older adults to improve health outcomes and reduce healthcare costs.
Trulance is a prescription medication indicated for adults with irritable bowel syndrome with constipation (IBS-C) or chronic idiopathic constipation (CIC). Trulance works by activating guanylate cyclase-C receptors in the intestines to increase fluid secretion and accelerate gastrointestinal transit in a pH-dependent manner similar to the natural hormone uroguanylin. Clinical trials demonstrated the efficacy and safety of Trulance for the treatment of symptoms associated with IBS-C and CIC such as constipation, straining, abdominal pain and bloating. A boxed warning indicates Trulance is contraindicated in patients under 6 years old due to the risk of serious dehydration
HOW TO SAVE MONEY ON YOUR HEALTHCARE: An Integrative Medicine ApproachLouis Cady, MD
In this webinar, the fourth in a series of five from Dr. Louis Cady and the Cady Wellness Institute, we focus on the actual dollars and cents of health care expenditures, and the societal and PERSONAL costs of poor health maintenance behavior. We examine the essentially passive US medical system, that would rather drug a symptom than fix the underlying problem.
Great attention is paid on not shaming the patient or the doctors as they exist in the current system. Both groups "do not know what they do not know." Confirmation bias is rampant.
This webinar points the way to living a more vital, energetic life, with a minimum of cost, grief, and misery.
The document discusses definitions and concepts related to impairment, disability, and handicap from the International Classification of Impairments, Disabilities and Handicaps. It defines impairment as any loss or abnormality of body structure or function, disability as any restriction resulting from impairment in performing activities, and handicap as a disadvantage resulting from impairment or disability that limits fulfilling social roles. The document also discusses the World Health Organization's community-based approach to rehabilitation, which aims to enhance quality of life for people with disabilities through community participation and mobilizing local resources.
The document discusses definitions and concepts related to impairment, disability, and handicap from the WHO and ICIDH models. It defines impairment as an abnormality of structure or function, disability as a restriction resulting from impairment, and handicap as a social disadvantage faced due to impairment or disability. Community-based rehabilitation (CBR) is described as an approach that provides rehabilitation services within communities using their existing resources, with the goals of equalizing opportunities and socially integrating people with disabilities. The roles of the rehabilitation team, which includes nurses, physiotherapists, psychologists and others, are also summarized.
Ts wo es_validation+of+braden+sub+scale+scoresLaurie Crane
This document discusses validating the use of individual subscale scores from the Braden Scale for pressure ulcer risk assessment rather than just the cumulative score. It provides opinions from staff that the current use of the Braden Scale and Skin Bundle focuses more on documentation than interventions. The document recommends enhancing the Braden Scale in the EPIC electronic health record to flag low individual subscale scores and provide specific intervention recommendations tailored to each subscale. Examples are provided for interventions aimed at low friction/shear and nutrition subscale scores. Overall, the goal is to improve pressure ulcer prevention by guiding intervention selection based on assessment of individual risk factors.
1. Geriatric rehabilitation aims to help the elderly regain independence by recovering physical, psychological, or social skills lost due to aging or disability.
2. The key principles of geriatric rehab are addressing the variability in aging, preventing the effects of inactivity, and maintaining optimal health.
3. Interventions include a variety of exercises, assistive devices, and environmental adaptations delivered through different settings and providers.
Similar to Assessing Health in Older-adults.pptx (20)
Michigan HealthTech Market Map 2024. Includes 7 categories: Policy Makers, Academic Innovation Centers, Digital Health Providers, Healthcare Providers, Payers / Insurance, Device Companies, Life Science Companies, Innovation Accelerators. Developed by the Michigan-Israel Business Accelerator
The best massage spa Ajman is Chandrima Spa Ajman, which was founded in 2023 and is exclusively for men 24 hours a day. As of right now, our parent firm has been providing massage services to over 50,000+ clients in Ajman for the past 10 years. It has about 8+ branches. This demonstrates that Chandrima Spa Ajman is among the most reasonably priced spas in Ajman and the ideal place to unwind and rejuvenate. We provide a wide range of Spa massage treatments, including Indian, Pakistani, Kerala, Malayali, and body-to-body massages. Numerous massage techniques are available, including deep tissue, Swedish, Thai, Russian, and hot stone massages. Our massage therapists produce genuinely unique treatments that generate a revitalized sense of inner serenely by fusing modern techniques, the cleanest natural substances, and traditional holistic therapists.
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This slide is very helpful for physiotherapy students and also for other medical and healthcare students.
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Assessing Health in Older-adults.pptx
1. Assessing Health in Older-adults
Angelo J. G Bós, MD PhD
Professor at School of Medicine
Researcher at Institute of Geriatrics and Gerontology
Pontifical Catholic University of Rio Grande do Sul
Porto Alegre, Brazil
angelo.bos@pucrs.br
2. What are the most important health problems in
older-adults and oldest-old people?
Go to www.menti.com and use the code: 87 95 84 1
3. Geriatric age-groups
Age-group
Countries
Developed |
Developing
Characteristics intervention
Young adults 18-39 Period of developing good and bad life styles Primary prevention
Middle aged 40-64 40-59 Identifiable asymptomatic chronic
conditions
Secondary prevention
Young older-adults 65-84 60-79 Clinical manifestation of chronic conditions,
light functional decline
Tertiary prevention
Oldest old 85 + 80 + Higher clinical and functional vulnerability
Quartenary prevention
(focus in the quality of life)
Centenarians 100+ Example of longevity
Supercentenarians 110+ Exceptional longevity
5. Frequency of Chronic Non-Communicable Diseases(CNCD)
in Older-adults and Oldest-old Brazilians
Has a doctor ever diagnosed you
with:
Age group*
Younger Older-adults Oldest-old Total
High blood pressure 10621(54.2%) 1807(60.4%) 12428(55.1%)
Diabetes 3766(19.7%) 539(18.5%) 4305(19.5%)
High cholesterol 5208(27.4%) 659(22.7%) 5867(26.8%)
Heart disease 2208(11.2%) 516(17.1%) 2724(12%)
Asthma 858(4.4%) 125(4.1%) 983(4.3%)
Arthritis 3407(17.3%) 618(20.5%) 4025(17.7%)
Chronic back pain 5811(29.5%) 806(26.7%) 6617(29.1%)
Depression 2122(10.8%) 244(8.1%) 2366(10.4%)
Chronic lung disease 474(2.4%) 113(3.7%) 587(2.6%)
Chronic kidney disease 437(2.2%) 92(3.1%) 529(2.3%)
* Age groups: younger older-adults: 60-79, Oldest-old: 80+
6. Frequency of Difficulties of preforming Basic Activities of
Daily Living (ADL) in Older-adults and Oldest-old Brazilians
Is it difficult for you to
Age group *
Younger Older-adults Oldest-old Total
Eat alone 695(3.5%) 420(13.9%) 1115(4.9%)
Bath or shower alone 995(5.0%) 672(22.3%) 1667(7.3%)
Go to the bathroom alone? 1378(7.0%) 669(22.2%) 2047(9.0%)
Dress yourself? 1840(9.3%) 836(27.7%) 2676(11.8%)
Walk around the house alone from room to
room?
1625(8.2%) 814(27.0%) 2439(10.7%)
Get into or out of bed by yourself? 2041(10.4%) 804(26.7%) 2845(12.5%)
Get into or out of a chair by yourself? 1901(9.6%) 812(26.9%) 2713(11.9%)
* Age groups: younger older-adults: 60-79, Oldest-old: 80+
12. Functional Ability and Intrinsic Capacity (IC)
Functional ability Domains of Intrinsic Capacity
• WHO:
• “Health-related atributes that enable
people to be and to do what they have
a reason to value”
• Functional ability =
• Instrinsic capacity + environment
• Intrinsic capacity is the composite of
all the physical and mental capacities
that an individual can use.
• Enviroment (good or bad)
13. Add a Slide Title - 3
https://apps.who.int/iris/rest/bitstreams/1257934/retrieve
22. VIVIFRAIL PROJECT (WWW.VIVIFRAIL.COM)
That is it
• A program for the Promotion of
Physical Exercise that is an
international reference for
community and hospital
intervention for the prevention of
frailty and falls in the elderly. It is
currently being used by more
than 5000 health professionals
reaching an impact on the
effective population of more than
15,000 people.
Aims
• This whole project is based on
the idea that health in older
people should be measured in
terms of its function and not as a
disease that determines life
expectancy, quality of life, and
resources or supports that need
each population. The objective is
to maintain a level of
functionality that maintains the
highest degree of autonomy
possible in each case.
23. Scientific evidences for ViviFrail
• Cadore EL, Millor N, Gomez M, Rodriguez-Manas L, Izquierdo M (2013) Multicomponent exercises
including muscle power training enhance muscle mass, power output, and functional outcomes in
institutionalized frail nonagenarians." Age 36: 773-785. https://DOI.org/10.1007/s11357-013-
9586-z
• Martínez-Velilla N, Casas-Herrero A, Zambom-Ferraresi F, Sáez de Asteasu ML, Lucia A, Galbete A,
García-Baztán A, et al. (2019) Exercise Intervention on Functional Decline in Very Elderly Patients
During Acute Hospitalization: A Randomized Clinical Trial. JAMA Intern Med. 179(1):28-36.
https://doi.org/ 10.1001/jamainternmed.2018.4869.
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e1002852. https://doi.org/10.1371/ journal.pmed.1002852
• Casas-Herrero, Á., de Asteasu, M. L. S., Antón-Rodrigo, I., Sánchez-Sánchez, J. L., Montero-Odasso,
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24.
25. Establish the weight of the bottle
Exercise Lift a bottle is a strength exercise for which it is
necessary to establish an adequate weight for each person:
• Fill 2 500 ml (16.9on) water bottles.
• Check whether the person is able to perform about 30 repetitions
with the 500 ml bottle.
• Adjust the amount of water in the bottle until the person is able to
do about 30 repetitions with some effort.
• Make a note of the amount of water on page 4 and on the exercise
page of the passport.
• It is recommended that this weight is recalculated after 6 weeks
and the new quantity of water in the bottle adjusted accordingly.
26. PRESCRIPTION OF PASSPORT TYPE A
• PASSPORT DELIVERY
• Let the person know that passport type A is for an elderly person who cannot
rise from a chair or a bed. Explain that by carrying out the program, they may be
able to get up again or, at least, gain safety and autonomy and decrease their risk
of falls. Let them know that the program lasts 12 weeks and that they must do a
daily round of approximately 30–45 minutes.
• The walking exercise will start only when the elderly person has improved their
muscle strength.
• Check the passport with the elderly person, section by section, and complete the
personal data section.
• Encourage them to make an effort to stay on the program until the end, and make
an appointment for that moment.
27. PRESCRIPTION OF PASSPORT
TYPE B and B+
• PASSPORT DELIVERY
• Let the person know that passport type B (frail) is for an elderly people who can
walk with difficulty or help. Explain that by carrying out the program they may
be able to walk again without help or, at least, gain autonomy and balance.
• Let them know that the program lasts 12 weeks and that they must do a daily
round of approximately 45–60 minutes.
• For passport type B+, it is recommended to review the recommendations for people
at risk of falls.
• Check the passport, section by section, with the elderly person and complete the
personal data section.
• Encourage them to make an effort to stay on the program until the end, and make
an appointment for that moment.
28. PRESCRIPTION OF PASSPORT
TYPE C and C+
• PASSPORT DELIVERY
• Let the person know that passport type C (pre-frail) is for an elderly person who
has slight difficulties when walking and also has difficulty getting up or with
balance. It is very important that they exercise to continue enjoying their walks.
Let them know that the program lasts 12 weeks and that they must do a daily
round of approximately 45–60 minutes.
• For passport type C+, it is recommended to review the recommendations for people
at risk of falls.
• Check the passport with the elderly person, section by section, and complete the
personal data section.
• Encourage them to make an effort to stay on the program until the end, and make
an appointment for that moment.
29. PRESCRIPTION OF PASSPORT TYPE D
• PASSPORT DELIVERY
• Let the person know that the passport type D (robust) is for elderly
person who has minimal physical limitations or no limitations. It is very
important that they perform physical exercise so that they are able to
preserve their autonomy for many years. Let them know that the program
lasts 12 weeks and that they must do a daily round of approximately 45–
60 minutes.
• Check the passport with the elderly person, section by section, and
complete the personal data section.
• Encourage them to make an effort to stay on the program until the end,
and make an appointment for that moment.
30. TIPS AND RECOMMENDATIONS FOR PEOPLE AT
RISK OF FALLS
• If there is a vitamin D deficiency (<20 ng / ml), its supplementation with at least 800 IU should be assessed if there are no
contraindications. It is necessary to ensure an adequate oral intake of calcium.
• In patients with diabetes it will be necessary to readjust the treatment of low blood sugar.
• If there are symptoms compatible with postural hypotension, review the number and doses of antihypotensive drugs.
• Overmedication should be reviewed and minimized with special attention to psychotropic drugs.
• A nutritional assessment should be carried out in frail patients.
• Protein-calorie supplements should be taken after the training session to optimize their benefits.
• It is essential to assess the risk of falls in patients with cognitive problems, as they have a high risk of falling and fractures.
• Patients with a previous fracture must be treated for osteoporosis. The main objectives in a patient with a previous fracture
should be preventing any deterioration of functional capacity and preventing new falls and fractures.
• Concerning patients with recurrent falls, it is essential to evaluate and intervene on environmental risks at home (adaptation of
bathrooms, carpets, footwear, etc.).
• All older adults should undergo a comprehensive geriatric assessment, especially those who are frail, since it is the main tool to
detect problems and make decisions.