Background: The periprosthetic femoral fractures after hip arthroplasty represent a challenge for orthopedic surgeons in the oldest patients. The type B2 fracture with stem loosening is usually treated by revision of the implant. We assessed if internal fixation alone could be an alternative for treating the elderly population. This surgical procedure is less complex and can provide enough stability, thus allowing patients to recover their mobility.

Methods: Twenty six patients with type B2 fracture were treated. 16 patients had a revision surgery while 10 received internal fixation. The Parker Score, the Functional Ambulation Classification and ambulatory scores were all used before and after surgery.

Results: The two groups were homogeneous in terms of demographic data, preoperative status and perioperative data. Only the duration of surgery was significantly lower in the internal fixation group. In postoperative, no scores showed differences between groups. In both groups, we observed significant difference in pre vs early post-operative scores with a decrease of the functional status. At the late postoperatively stage, no significant differences were observed compared to pre-operative scores. The occurrence of complications was similar between the groups. 20% of patients died after internal fixation procedure and 13% after revision.

Conclusions: There are no differences in terms of autonomy recovery between both procedures. We thus can envision internal fixation as an adequate alternative in elderly patients.

This study examined the relationship between the olfactory function and the prefrontal function decline using longitudinal data. An individual linear regression coefficient (developmental decline slope) from 65 to 75 years of age for performance on the Digit Cancellation test (D-CAT), a personal function test, was calculated from the Yakumo study database (N=2,972; 36.8% males, 63.2% females), and the Odor Stick Identification Test was administered to healthy elderly people. The results showed that performance on odor identification was highly correlated with the longitudinal decline slope of attention performance, but not with that of logical memory performance. These results are consistent with the view that odor identification defects could be associated with aging-related decline in the prefrontal region, especially in elementary perceptual speed and executive function.

We report on an elderly patient with dilated cardiomyopathy and class IV Heart Failure (HF). He was intolerant to Sacubitril-Valsartan (S-V) due to prolonged symptomatic hypotension - in our means induced by an interaction between Tamsulosin (TAM) and S-V. After cessation of TAM the S-V could be administered followed by a great improvement in the patient’s HF status to NYHA class II. Elderly patients with HF have to be checked carefully for drug interactions, especially for those influencing blood pressure. It is important to establish S-V in symptomatic HF, because this could improve findings and symptoms even in the sickest and oldest patients.

Study Background: The telehealth in home health care study aimed to determine patients’ satisfaction with or without the use of telehealth technology in home health care. As the population continues to age and manage chronic disease, the use of tools such as telehealth assists the home health or visiting nurse to provide the best care and education to patients. Understanding patients’ perceptions regarding telehealth technologies in home care allows the practitioner to further understand one’s health belief and facilitate cues to changes in health behaviors toward management of chronic disease. The results of this study provide strength for the use of telehealth in home care and potentially contribute to the demand for reimbursement of telehealth.

Methods: Patient satisfaction was examined in older adult patients with heart failure in home health care. Eighty-six participants ranging in ages 59-99 with a mean age of 80.7 (sd = 8.9), voluntarily completed a questionnaire (HCSSI-R) of fifteen items. A comparison was made between and telehealth home health services and usual home health care. To answer the research question regarding the difference in patient satisfaction for patients using either telehealth vs. usual home health services in patients diagnosed with heart failure; an analysis of covariance, frequency distributions and descriptive statistics were completed to answer the research question.

Results: The dependent variable, total patient satisfaction score, was determined for the UHH group (n = 53), as 54.96 (sd = 5.2) and the TELE group (n = 33), as 56. 94 (sd = 3.8). Furthermore, an independent t-test comparing the mean patient satisfaction scores of the UHH and TELE groups found a statistically significant difference between the two groups (t (81.469) = -1.991, p<0.05) indicating that the telehealth home health group was more satisfied. When controlling for the demographic information of age, gender, prior home health services and living alone status, there was no significant impact on the patient satisfaction score.

Conclusion: It has been proven that telehealth in home care is cost-effective and produces favorable clinical outcomes in the management of chronic disease [1-3]. This study concludes that telehealth in home health care provides for a highly satisfied home health client managing chronic disease thereby contributing to the call for use and reimbursement of telehealth in home health care

“End of life” is typically a code for ending life, either by physician-assisted (or directed) termination or the withdrawal of hydration and nutrition. Here “end of life decision care” is critiqued not only for its imprecision-what does it mean, really? but because it permits ethicists and gerontologists to ignore the potential for care that can be provided those with chronic progressive conditions. Understanding the bias inherent in the phrase may result in different outcomes, and additional treatments, as cases cited by the author attempt to demonstrate.