HAEL. HEALTH, AGING & END OF LIFE

Tiempo de nuevos comienzos, fijar prioridades y esclarecer propósitos

Ester Villanueva Álvarez — 2022-12-16

Forming New Orthographic Representations in Alzheimer’s Disease and Mild Cognitive Impairment

María del Carmen Pérez-Sánchez — 2022-12-16

When we read the same word several times, we end up forming an orthographic representation of it that allows us to read it in a fluid way. Several investigations were aimed at how healthy people, children or dyslexic adults learn new words, but little is known on how this process works on patients with neurodegenerative diseases, for example Alzheimer’s disease (AD) and mild cognitive impairment (MCI). Hence, the aim of this project was to analyze the formation of new orthographic representations in these people. For that purpose, eight words of a very low frequency were selected, half of them short and half of them long, and were presented six times to the participants, 4 of them in a narrative context. The learning process was measured according to the elimination of the length effect that indicates the crossing from a sublexical reading to a lexical one. The results showed the disappearance of the length effect in the control group, as well as a reduction in RTs in MCI participants and AD patients, without a disappearance of length effect in these groups. All this indicates that learning was consolidated in the control group, whereas in the MCI and the AD group it cannot be said that a new representation has formed.

Functional Recovery of the Geriatric Patient after Hip Fracture Surgery

Sara Llamas Fernández — 2022-12-16

Hip fractures pose a high risk to the health of elderly patients since they present a large number of complications that alter the normal course of recovery. The functional capacity and the level of complexity of the patients admitted to the Monte Naranco Hospital’s geriatrics Unit between January and May 2022 have been analyzed, evaluating the changes in the score of the Barthel and RUG scales at admission and discharge. The results for the Barthel scale have shown that the elderly undergoing surgery have a lower functional capacity and require a long-term rehabilitation period. The RUG scale evidenced the rapid change in the complexity of the users, requiring rehabilitation in a high percentage. Finally, it was proposed to analyze whether gender influenced functional recovery capacity, the result obtained not being significant. Therefore, the importance of long-term care of geriatric patients for optimal recovery after a necessary intervention to save their lives is concluded.

End of Life: Identification and Coping

Juan Santos Suárez — 2022-12-16

The term end of life is widely used in the scientific literature but lacks a definition that accurately identifies those signs which appear in that situation of last days which precedes death and to whom is incorporated the most prevalent item employed in those prognostic models in cancer disease, such as functionality.Terminal illness and dying make up a process suffered by the sick person but also by the family, which is a basic pillar in provision of care to the patient. A descriptive and exploratory review is made of the meanings about the scientific english literature uses when refers to end of life, of the different patterns of death that present into distinct diseases; of the most used items in prognostic scales, already validated, in cancer, and finally the more frequent used drugs in a situation of imminent end of life. Identification an end of life allows us to use some medicines, at a higher doses than before and through an oral alternative route, the subcutaneous, which permits the control of symptoms that appear in this end-of-life situation to thus facilitate the death of the dying person with family, and relatives, over there. This paper tries to minimize the problem of identifying a person actively dying in which keys are given for its recognition and treatment, not only pharmacological, which can be of interest to all those professionals who face the end of life of any person in this circumstance.

The Maladaptable Conspiracy of Silence. Its Management by Experts in Palliative Care

Adrian Valentini Ceferino — 2022-12-16

El concepto de Conspiración de Silencio (CS) hace referencia al acuerdo expreso otácito entre el equipo médico y los familiares y cuidadores de ocultar al paciente,parcialtotalmente, la información diagnóstica y más a menudo pronóstica de una enfermedad grave. Puede ser adaptativa, cuando el paciente expresa su deseo inequívoco de no saber, odesadaptativa (con posibilidad de intervención por parte del equipo médico) encualquier otra circunstancia.
La comunicación al final de la vida entre el equipo médico, el paciente y sus familiares es compleja. A veces, la conspiración de silencio desadaptativa se presenta como una barrera infranqueable que impide o dificulta el manejo óptimodel paciente en las cuatro esferas (física, emocional, social y espiritual), un verdadero reto en la práctica al que deben enfrentarse los profesionales y que no siempre tiene resultados satisfactorios.
La CS no solo tiene implicaciones éticas sino también legales. Además de repercutir negativamente en la relación médico-paciente y, consecuentemente, en el abordaje sintomático y tratamiento integral, impide al paciente la preparación para asumir y vivir conlibertad, en el sentido más amplio de la palabra, el último capítulo de su vida.
Es indudable que la actitud y los conocimientos del equipo médico pueden influir en la aparición o mantenimiento de la CS; por tanto, un conocimiento enprofundidad de este fenómeno y de las estrategias utilizadas para su tratamiento pueden proveer herramientas válidas para su manejo.

Cultural Competence in End-of-Life Care, a Pending Task

Alba Romero Gangonells — 2022-12-16

Objectives: To understand the causes of health disparities suffered by ethnic minorities in Western countries in end-of-life care, especially in the South Asian community.
Material and methods: Literature review of 44 articles published between 2015- 2022 from a total of 193, selected from PubMed and CINAHL databases, using MESH descriptors and free search.
Results: Cultural diversity is a growing reality in our setting and brings with it important healthcare challenges. Beliefs, decision-making processes, autonomy,meaning of suffering and symptom management are important factors in the approach to a sick person and their family and depend, to a large extent, on culture and values. Health inequalities are present in our health care system and ethnicminorities are part of the affected population. The health system is structured from Western culture, so its professionals act, by inertia, from this stance.
Conclusions: In order to offer quality palliative care, it is essential to know the experiences of people belonging to ethnic minorities; to be able to make changes in approach and to educate care staff in cultural competence in order to provide fair and holistic care, appropriate to the values and needs of all people. Studies areneeded in our setting to assess the situation.

¿Y yo, también me moriré?

Noelia Calvillo Nuñez — 2022-12-16

Summary

Ester Villanueva Álvarez — 2022-12-16