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P-294: Music as psychosocial intervention in dementia care – why and how?
S110
Poster presentations / European Geriatric Medicine 6S1 (2015) S32–S156
transferred to the Geratology wards while waiting for dedicated stroke rehabilitation beds in two Oxfordshire community hospitals (Witney and Abingdon). We explored their care. Method: Discharge letters and electronic records of physiotherapy sessions for patients transferred to the Geratology wards while remaining on the “stroke pathway” were retrospectively examined for diagnosis, co-morbidities, age, dates of transfer, length of stay, discharge destination and physiotherapy input between January 2014 and January 2015. Results: 40 stroke patients were transferred in the period reviewed. At the time of discharge from the Geratology wards, the average age was 86 years (45% were >90 years old). 60% had a nasogastric tube in situ and 12% End of Life care. Their average stay in the Geratology wards was 8.5 days. 25% of patients received physiotherapy upon transfer, 25% waited between 1 and 6 days for physiotherapy and 50% received none during their stay. Only 44% of all transferred patients reached the designated stroke rehabilitation beds. Conclusions: On average 3 patients per month were transferred from the Stroke unit to the Geratology wards while waiting for dedicated community stroke rehabilitation beds. We identified a need for increased provision of the appropriate rehabilitation services on the Geratology wards or the capacity in stroke pathway beds, to make this overflow unnecessary. P-293 Individualized music in nursing home medicine: A hands-on workshop A. Myskja National Competence Center for Arts & Health, Ski, Norway The workshop will be practically oriented, with the aim of enabling participants to apply the main skills taught in everyday clinical work. Main topics: • Individualized music: Assessing preference • Individualized music in practice • Evaluating effects and adjusting therapeutic programs • Care singing – a tool for procedures • Rhythmic auditory stimulation: Aiding gait and sensorimotor function • Integrating new therapeutic strategies in a nursing home setting: Success factors and obstacles P-294 Music as psychosocial intervention in dementia care – why and how? A. Myskja National Competence Center for Arts & Health, Ski, Norway The lecture will provide an overview of the field, presenting and evaluating the research status of the main music modalities: Music therapy, individualized music, care singing and therapeutic movement with music accompaniment. In addition, core findings from Norwegian projects studying the application of music based methods in geriatric settings are presented. A discussion of key factors in successful implementation of music as therapeutic modality in a dementia care setting will conclude the presentation. Video samples will illustrate the key points of the lecture. P-295 Driver licence restriction: effective to improve older driver safety without unduly impairing mobility? A. Naughton1 , C. O’Byrne2 , D. O’Neill3 1 School of Medicine, Trinity College Dublin, Dublin, Ireland; 2 Trinity College, Dublin, Dublin, Ireland; 3 Trinity College Dublin, Dublin, Ireland Objective: While medical conditions have been recognised as a minor contributing factor to road traffic crashes, clinicians and
driver licencing agencies need mechanisms for promoting safe mobility for those with age-related illnesses which can impact on driving safety. Restrictive licensing has been proposed as a possible intervention for decreasing the risk of crashes associated with medical crashes, whilst not unduly affecting patient mobility. We analyzed how the term ‘restrictive licensing’ is defined in the literature, and to determine the effectiveness of this mechanism in improving driver safety. Method: A systematic literature review of MedLine and Transport Research International Documentation (TRID), is the largest online bibliographic database of transportation research. Results: Medline returned 42 papers, and TRID 110: excluding those which overlapped, we reviewed a total of 21 papers which met inclusion criteria. Restrictive licensing is most commonly defined as a geographical, time of day or speed restriction placed on the driver. Personal and vehicle modifications are considered by some to also be a form of restrictive licensing. Existing studies are supportive of the efficacy of restrictive licensing programs, with reduced crash rates for drivers carrying restricted licences compared to controls. Conclusions: Restrictive licensing has consistently been shown to be an effective mechanism of increasing driver safety without unduly impacting driver mobility. It has significant potential to have a positive impact on the ability of those with age-related medical conditions to drive safely, provided that it is implemented and policed in the correct manner. P-296 Treatment of non-healing two diabetic foot ulcers with N-acetylcysteine H. Ozkaya Istanbul Metropolitan Municipality Kayısda˘ ¸ gı Darulaceze Nursing Home.kayısda˘ ¸ gı/Atasehir, ¸ Turkey Diabetes mellitus (DM) is a complex, chronic metabolic disorder; affects almost all age group of patients which requires continuous medical care with multifactorial risk reduction strategies beyond glycemic control. Diabetic foot is the major health problem causing serious morbidity and mortality.N-acetylcysteine (NAC), an aminothiol and synthetic precursor of intracellular cysteine and glutathione.NAC has anti-inflammatuary, and antioxidant features.In our study, we apply local NAC to two diabetic foot ulcers.The patient was 66 six years old woman and had Diabetes Mellitus type II and also poor glycemic control.She had bilateral diabetic foot ulcers on the sole of her feet.One of them was Stage II-a and the other was Stage II-b according to Wagner classification.We applied local NAC with wet dressing to ulcers twice a day.On the 50th day, both of the ulcers have healed completely.Local Nac therapy may be effective in diabetic foot ulcers. P-297 Retrospective cross-sectional study of next-of-kin demographics and community hospital length of stay N. Read1 , R. Bloxham1 , P. Wearing2 1 Oxford University Hospitals, Surrey, United Kingdom; 2 United Kingdom Introduction: Hospital discharges can be complex and lengthy. It is recognised that family issues, or involvement, influence length of stay (LOS). Anecdotally, at a geriatric community hospital with regular complex discharges, there are varying levels of engagement of the next of kin (NOK). We have observed female NOK are often more engaged in their relatives care but this has not been examined in the literature. Objectives: The study aimed to determine whether NOK demographics (gender, civil status, distance from relative) influences LOS.
Poster presentations / European Geriatric Medicine 6S1 (2015) S32–S156
transferred to the Geratology wards while waiting for dedicated stroke rehabilitation beds in two Oxfordshire community hospitals (Witney and Abingdon). We explored their care. Method: Discharge letters and electronic records of physiotherapy sessions for patients transferred to the Geratology wards while remaining on the “stroke pathway” were retrospectively examined for diagnosis, co-morbidities, age, dates of transfer, length of stay, discharge destination and physiotherapy input between January 2014 and January 2015. Results: 40 stroke patients were transferred in the period reviewed. At the time of discharge from the Geratology wards, the average age was 86 years (45% were >90 years old). 60% had a nasogastric tube in situ and 12% End of Life care. Their average stay in the Geratology wards was 8.5 days. 25% of patients received physiotherapy upon transfer, 25% waited between 1 and 6 days for physiotherapy and 50% received none during their stay. Only 44% of all transferred patients reached the designated stroke rehabilitation beds. Conclusions: On average 3 patients per month were transferred from the Stroke unit to the Geratology wards while waiting for dedicated community stroke rehabilitation beds. We identified a need for increased provision of the appropriate rehabilitation services on the Geratology wards or the capacity in stroke pathway beds, to make this overflow unnecessary. P-293 Individualized music in nursing home medicine: A hands-on workshop A. Myskja National Competence Center for Arts & Health, Ski, Norway The workshop will be practically oriented, with the aim of enabling participants to apply the main skills taught in everyday clinical work. Main topics: • Individualized music: Assessing preference • Individualized music in practice • Evaluating effects and adjusting therapeutic programs • Care singing – a tool for procedures • Rhythmic auditory stimulation: Aiding gait and sensorimotor function • Integrating new therapeutic strategies in a nursing home setting: Success factors and obstacles P-294 Music as psychosocial intervention in dementia care – why and how? A. Myskja National Competence Center for Arts & Health, Ski, Norway The lecture will provide an overview of the field, presenting and evaluating the research status of the main music modalities: Music therapy, individualized music, care singing and therapeutic movement with music accompaniment. In addition, core findings from Norwegian projects studying the application of music based methods in geriatric settings are presented. A discussion of key factors in successful implementation of music as therapeutic modality in a dementia care setting will conclude the presentation. Video samples will illustrate the key points of the lecture. P-295 Driver licence restriction: effective to improve older driver safety without unduly impairing mobility? A. Naughton1 , C. O’Byrne2 , D. O’Neill3 1 School of Medicine, Trinity College Dublin, Dublin, Ireland; 2 Trinity College, Dublin, Dublin, Ireland; 3 Trinity College Dublin, Dublin, Ireland Objective: While medical conditions have been recognised as a minor contributing factor to road traffic crashes, clinicians and
driver licencing agencies need mechanisms for promoting safe mobility for those with age-related illnesses which can impact on driving safety. Restrictive licensing has been proposed as a possible intervention for decreasing the risk of crashes associated with medical crashes, whilst not unduly affecting patient mobility. We analyzed how the term ‘restrictive licensing’ is defined in the literature, and to determine the effectiveness of this mechanism in improving driver safety. Method: A systematic literature review of MedLine and Transport Research International Documentation (TRID), is the largest online bibliographic database of transportation research. Results: Medline returned 42 papers, and TRID 110: excluding those which overlapped, we reviewed a total of 21 papers which met inclusion criteria. Restrictive licensing is most commonly defined as a geographical, time of day or speed restriction placed on the driver. Personal and vehicle modifications are considered by some to also be a form of restrictive licensing. Existing studies are supportive of the efficacy of restrictive licensing programs, with reduced crash rates for drivers carrying restricted licences compared to controls. Conclusions: Restrictive licensing has consistently been shown to be an effective mechanism of increasing driver safety without unduly impacting driver mobility. It has significant potential to have a positive impact on the ability of those with age-related medical conditions to drive safely, provided that it is implemented and policed in the correct manner. P-296 Treatment of non-healing two diabetic foot ulcers with N-acetylcysteine H. Ozkaya Istanbul Metropolitan Municipality Kayısda˘ ¸ gı Darulaceze Nursing Home.kayısda˘ ¸ gı/Atasehir, ¸ Turkey Diabetes mellitus (DM) is a complex, chronic metabolic disorder; affects almost all age group of patients which requires continuous medical care with multifactorial risk reduction strategies beyond glycemic control. Diabetic foot is the major health problem causing serious morbidity and mortality.N-acetylcysteine (NAC), an aminothiol and synthetic precursor of intracellular cysteine and glutathione.NAC has anti-inflammatuary, and antioxidant features.In our study, we apply local NAC to two diabetic foot ulcers.The patient was 66 six years old woman and had Diabetes Mellitus type II and also poor glycemic control.She had bilateral diabetic foot ulcers on the sole of her feet.One of them was Stage II-a and the other was Stage II-b according to Wagner classification.We applied local NAC with wet dressing to ulcers twice a day.On the 50th day, both of the ulcers have healed completely.Local Nac therapy may be effective in diabetic foot ulcers. P-297 Retrospective cross-sectional study of next-of-kin demographics and community hospital length of stay N. Read1 , R. Bloxham1 , P. Wearing2 1 Oxford University Hospitals, Surrey, United Kingdom; 2 United Kingdom Introduction: Hospital discharges can be complex and lengthy. It is recognised that family issues, or involvement, influence length of stay (LOS). Anecdotally, at a geriatric community hospital with regular complex discharges, there are varying levels of engagement of the next of kin (NOK). We have observed female NOK are often more engaged in their relatives care but this has not been examined in the literature. Objectives: The study aimed to determine whether NOK demographics (gender, civil status, distance from relative) influences LOS.