Establecimiento y desarrollo de un programa de coordinación entre el servicio de urgencias hospitalario y el ámbito residencial
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2017
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03/02/2016
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Universidad Complutense de Madrid
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Abstract
Existe un crecimiento progresivo de la demanda de centros residenciales que no se relaciona con el envejecimiento de la población, sino con otras variables sociodemográficas. Países como Japón o Suecia tienen poblaciones muy envejecidas con bajo porcentaje de institucionalización y países jóvenes como Islandia tienen una de las mayores tasas de institucionalizados. Factores como la estructura familiar, las preferencias personales, la disponibilidad de recursos o las ayudas estatales hace que la institucionalización sea variable en cada país independientemente del envejecimiento de la población (Miel W, 1997; Onder G, 2012). Los ancianos institucionalizados son diferentes de los ancianos de la comunidad presentando mayor grado de dependencia (81,3%), mayor prevalencia de demencia (68%), mayor probabilidad de tener dolor (36%), caídas (18,6%) y úlceras por presión (10,4%) (Stephens CE, 2012). Al ser una población con tanta comorbilidad, fragilidad y vulnerabilidad precisan acudir frecuentemente a urgencias hospitalarias. Se calcula que un 62% de los residentes son derivados al menos una vez al año a urgencias y un 8% han estado los 90 días previos (Caffrey C, 2010)...
There is a striking growth in the demand for nursing home (NH) residents but this does not seem to be related with ageing. No relation appears to exist between the ageing status of a country and the number of nursing home beds. Countries like Japan or Sweden have high ageing rates but have the lowest rates of institutionalization. Interestingly young countries like Iceland has one of the highest rates of institutionalization. Age-related morbidity rates is not the only determinant of the need for nursing homes. Demographic trends like the structure of families and their preferences, the availability and type of housing are important factors that explain these differences, as well as the organization of care systems. Payment facilities show great variation in each country (Miel W, 1997; Onder G, 2012). Nursing home residents differ from community elderly. Generally NH residents are very dependant, very frail and have complex care needs. They are more likely to require assistance for activity daily living activities (41,5%) or even dependant (39,8%). High proportion of NH residents have cognitive impairment (68%) and almost a third of them (30,4%) have severe dementia. There are some diseases which are more frequent like depression (32%), behavioural symptoms (27,5%) and urinary incontinence(73,5%). This group of elderly are more likely to suffer from pain (36%), falls (18,6%) and pressure ulcers (10,4%). (Stephens CE, 2012)...
There is a striking growth in the demand for nursing home (NH) residents but this does not seem to be related with ageing. No relation appears to exist between the ageing status of a country and the number of nursing home beds. Countries like Japan or Sweden have high ageing rates but have the lowest rates of institutionalization. Interestingly young countries like Iceland has one of the highest rates of institutionalization. Age-related morbidity rates is not the only determinant of the need for nursing homes. Demographic trends like the structure of families and their preferences, the availability and type of housing are important factors that explain these differences, as well as the organization of care systems. Payment facilities show great variation in each country (Miel W, 1997; Onder G, 2012). Nursing home residents differ from community elderly. Generally NH residents are very dependant, very frail and have complex care needs. They are more likely to require assistance for activity daily living activities (41,5%) or even dependant (39,8%). High proportion of NH residents have cognitive impairment (68%) and almost a third of them (30,4%) have severe dementia. There are some diseases which are more frequent like depression (32%), behavioural symptoms (27,5%) and urinary incontinence(73,5%). This group of elderly are more likely to suffer from pain (36%), falls (18,6%) and pressure ulcers (10,4%). (Stephens CE, 2012)...
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Tesis inédita de la Universidad Complutense de Madrid, Facultad de Medicina, Departamento de Medicina, leída el 03/02/2016