Exploring Antipsychotic Use for Delirium Management in Adults in Hospital, Sub-Acute Rehabilitation and Aged Care Settings: A Systematic Literature Review.

Background: International guidelines discourage antipsychotic use for delirium; however, concerns persist about their continued use in clinical practice.

Objectives: We aimed to describe the prevalence and patterns of antipsychotic use in delirium management with regard to best-practice recommendations. Primary outcomes investigated were prevalence of use, antipsychotic type, dosage and clinical indication.

Delirium detection in the emergency department: A diagnostic accuracy meta-analysis of history, physical examination, laboratory tests, and screening instruments.

Introduction: Geriatric emergency department (ED) guidelines emphasize timely identification of delirium. This article updates previous diagnostic accuracy systematic reviews of history, physical examination, laboratory testing, and ED screening instruments for the diagnosis of delirium as well as test-treatment thresholds for ED delirium screening.

Methods: We conducted a systematic review to quantify the diagnostic accuracy of approaches to identify delirium.

Advance planning for research participation: Time to translate this innovation into practice.

Objectives: Advance planning for research is a process that involves thinking about, discussing and expressing preferences for taking part in research during future periods of incapacity. The process may include making an advance research directive and naming trusted people to be involved in decisions about research participation. Advance research planning could help to overcome barriers to including people with dementia in research.

Clinical indicators of acute deterioration in persons who reside in residential aged care facilities: A rapid review.

Purpose: To identify the clinical indicators of acute deterioration in residents and the factors that influence residential aged care facility staff's identification of these.

Design: Rapid review and narrative synthesis.

Methods: The WHO and Cochrane Rapid Review Methods Group recommendations guided the review processes.

Advocating the rights of people with dementia to contribute to research: Considerations for researchers and ethics committees.

Objective: Research involving people with dementia is vital to appropriately inform policy and practice decisions affecting this population. As dementia-care researchers, we frequently advocate to Human Research Ethics Committees for the right of people with dementia to choose whether to participate in research. This brief report provides some considerations for researchers and ethics committees.

Prevention of Delirium in Older Adults With Dementia: A Systematic Literature Review.

Although dementia is the largest independent risk factor for delirium and leads to poor health outcomes, we know little about how to prevent delirium in persons with dementia (PWD). The purpose of the current systematic literature review was to identify interventions designed to prevent delirium in older PWD. Seven studies meeting inclusion criteria were extracted.

The effects of therapeutic activity kits in emergency department patients with dementia: Study protocol for a pragmatic randomized control trial.

Aim: To determine the effectiveness of therapeutic activity kits on health service use and treatment delivered in the emergency department (ED) in patients with pre-morbid dementia.

Design: Pragmatic randomized control trial with equal parallel groups.

Methods: Participants with dementia will be randomly assigned to the control group (N = 56) or the intervention group (N = 56).

A national survey of aged care facility managers' views of preparedness for natural disasters relevant to residents with dementia.

Objective: The aim was to explore the natural disaster preparedness strategies of Australian residential aged care facilities (RACFs), focussing on aspects relevant to people with dementia.

Methods: An online survey was sent to 2617 RACF managers, with 416 responding. Questions included the following: (a) demographics; (b) presence and detail level of disaster/evacuation plans; and (c) references to people with dementia.

Accuracy of Dementia Screening Instruments in Emergency Medicine: A Diagnostic Meta-analysis.

Background: Dementia is underrecognized in older adult emergency department (ED) patients, which threatens operational efficiency, diagnostic accuracy, and patient satisfaction. The Society for Academic Emergency Medicine geriatric ED guidelines advocate dementia screening using validated instruments.

Objectives: The objective was to perform a systematic review and meta-analysis of the diagnostic accuracy of sufficiently brief screening instruments for dementia in geriatric ED patients.

People with dementia getting lost in Australia: Dementia-related missing person reports in the media.

Objective: This study aimed to understand the circumstances in which people with dementia become lost, and the outcomes of these incidents.

Methods: A search was conducted of news articles published in Australia between 2011 and 2015 reporting a missing person with a diagnosis of dementia.

Results: Over the five-year period, 130 missing person cases were reported.

Characteristics of older people with cognitive impairment attending emergency departments: A descriptive study.

Objective: The objective of this paper is to describe the profile of older people with cognitive impairment (CI) presenting to emergency departments (EDs).

Methods: This was a multi-centre (n=8) observational study of a convenience sample of older (≥70y) ED patients (n=579). Participants were prospectively assessed for CI and surveyed for the duration of their ED stay (n=191).

Process quality indicators targeting cognitive impairment to support quality of care for older people with cognitive impairment in emergency departments.

Objectives: The objective of this study was to develop process quality indicators (PQIs) to support the improvement of care services for older people with cognitive impairment in emergency departments (ED).

Methods: A structured research approach was taken for the development of PQIs for the care of older people with cognitive impairment in EDs, including combining available evidence with expert opinion (phase 1), a field study (phase 2), and formal voting (phase 3). A systematic review of the literature identified ED processes targeting the specific care needs of older people with cognitive impairment.

Structural quality indicators to support quality of care for older people with cognitive impairment in emergency departments.

Objectives: The purpose of this study was to identify the structural quality of care domains and to establish a set of structural quality indicators (SQIs) for the assessment of care of older people with cognitive impairment in emergency departments (EDs).

Methods: A structured approach to SQI development was undertaken including: 1) a comprehensive search of peer-reviewed and gray literature focusing on identification of evidence-based interventions targeting structure of care of older patients with cognitive impairment and existing SQIs; 2) a consultative process engaging experts in the care of older people and epidemiologic methods (i.e.

Methodology for developing quality indicators for the care of older people in the Emergency Department.

Background: Compared with younger people, older people have a higher risk of adverse health outcomes when presenting to emergency departments. As the population ages, older people will make up an increasing proportion of the emergency department population. Therefore it is timely that consideration be given to the quality of care received by older persons in emergency departments, and to consideration of those older people with special needs.

What is the evidence to guide best practice for the management of older people with cognitive impairment presenting to emergency departments? A systematic review.

The aim of this study was to conduct a systematic literature review of research-based studies to identify practices designed to meet the specific care needs of older cognitively impaired patients in emergency departments (ED). A systematic literature review of studies was completed using PRIMSA methodology. The search criteria included articles from both emergency and acute care settings.

Appraisal of the quality of care of older adults with cognitive impairment in the emergency department.

The medical records of 273 patients 75 years and older were reviewed to evaluate quality of emergency department (ED) care through the use of quality indicators. One hundred fifty records contained evidence of an attempt to carry out a cognitive assessment. Documented evidence of cognitive impairment (CI) was reported in 54 cases.