BACKGROUND: Depression is a leading cause of disability and contributes significantly to the overall burden of any disease. In Saudi Arabia, the geriatric population over 65 is continuing to expand and will contribute to a significant portion of the Saudi community. As the population of the elderly continues to grow as a result of longer lifespans, there will be an increase in the number of individuals in this population suffering from undiagnosed geriatric depression.
OBJECTIVE: This study aims to assess the general population\'s attitude and knowledge about the symptoms, signs, and complications of geriatric depression to improve the quality of life of the elderly.
METHODS: This is a cross-sectional study, using a convenience sample of 2,320 participants, between March to September 2022. However, due to age, nationality, and incomplete responses that did not meet our inclusion criteria, 629 participants were excluded, and the sample size narrowed to 1,691. A structured questionnaire was designed to collect data based on a comprehensive literature review. An online survey was distributed to Saudi citizens. The participants were between 18 and 50, both women and men and only Saudi nationals were included. This age group was selected as a convenient, purposeful sample, assuming that this portion of the population will be able to be enrolled in an electronic survey in addition to their direct contact with elderlies as possible caregivers. All analyses were performed using IBM SPSS Statistics software for Windows, version 26.0 (IBM Corp., Armonk, NY). The data were analyzed using a nonparametric test because they were not normally distributed.
RESULTS: The study comprised 1,691 participants from diverse regions of Saudi Arabia, with a significant gender disparity observed, including 1,249 females (73.9%) and 442 males (26.1%). The majority of our participants were between 18-29 years, accounting for 55.2% of the sample. Descriptive statistics revealed prevalent beliefs among participants regarding geriatric depression. Notably, 35.1% strongly agreed and 19.3% agreed that depression affects individuals of particular ages, while a significant portion (47.1%) disagreed with the statement that depression in the elderly is a health problem. Additionally, 33.9% disagreed that geriatric depression can lead to suicide, and 33.8% believed it can be prevented. Analysis of actions and behaviors highlighted avoidance tendencies, with only 1.5% of the population strongly agreeing to treat a family member with geriatric depression and a majority (63.7%) avoiding interaction due to fear of harm, including 29.5% who strongly agreed and 34.2% who agreed. Gender differences were evident in emotional responses and knowledge levels, with females exhibiting higher emotional responses (mean score 15.63±2.92) and males displaying greater knowledge (mean score 14.90±3.36).
CONCLUSIONS: In this study, we investigated the knowledge and attitudes of Saudis toward depression in the elderly. Findings revealed an inadequate understanding of geriatric depression, with many not recognizing it as a health condition and underestimating its severity. Negative emotions and behaviors, such as shame and reluctance to provide support, were prevalent. Gender, education level, and region influenced attitudes and knowledge. These results underscore the need for targeted interventions to raise awareness and challenge the stigma surrounding geriatric depression in Saudi Arabia.

BACKGROUND: The oral health of older people is closely related to their overall health. Timely and effective intervention in oral issues is necessary to maintain their overall health. This study aimed to evaluate the feasibility and effectiveness of an Oral Health Promotion Program (OHPP) in Geriatric Care Facilities (GCFs).
METHODS: The OHPP was implemented in two GCFs and evaluated using a pre/post-design. Questionnaires on self-efficacy and attitude for providing oral care were sent to 42 nurse participants before and three months after the implementation of the OHPP. Outcomes of 295 patient participants were assessed at four time points (T1-baseline, T2-one month, T3-two months, and T4-three months post-implementation) including Activities of Daily Living (ADL), Mini-Mental State Examination (MMSE), and Oral Health Assessment Tool (OHAT).
RESULTS: The oral health and daily activity ability of patient participants showed an improving trend at four time points pre/post-implementation of the OHPP. The proportion of patients with healthy mouths (OHAT: 0-3 points) increased from 29.8 to 67.8% and their scores of OHAT and ADL were significantly better at T4 compared to T1, T2, and T3 (p < 0.001). Self-efficacy (SE-PMC: T1 = 18.93 ± 3.18, T4 = 28.83 ± 6.56, p < 0.001) and attitude (A-PMC: T1 = 18.78 ± 3.09, T4 = 28.20 ± 6.03, p < 0.001) for oral care among nurse participants improved after the implementation of the OHPP.
CONCLUSIONS: This study highlights the feasibility of implementing OHPP within GCFs, potentially enhancing the oral health and daily living activities of older individuals. Integrating the OHPP into routine care in geriatric settings is not only practical but also widely acceptable, offering a proactive approach to address oral health disparities among older residents. Stakeholders can maximize the impact of the OHPP by fostering collaboration among healthcare professionals, administrators, and residents, ultimately improving oral health outcomes and overall quality of life of older residents.
BACKGROUND: ChiCTR2000035236 (registration date: 04/08/2020).

The present non-randomized clinical trial examined the short-term outcomes of one-on-one chaplaincy interventions with 416 geriatric patients in Belgium. Participants were interviewed one or two days before a potential chaplaincy intervention (baseline measurement), and one or two days after a potential intervention (post-measurement). Patients in the non-randomized intervention group received an intervention by the chaplain, while the non-randomized comparison group did not. Patients in the intervention group showed a significant decrease in state anxiety and negative affect, and a significant improvement in levels of hope, positive affect, peace, and Scottish PROM-scores, compared to the comparison group. Levels of meaning in life and faith did not significantly change after the chaplaincy intervention. This study suggests that geriatric patients may benefit from chaplaincy care and recommends the integration of chaplaincy care into the care for older adults.

This 1-year multicenter prospective cohort study aimed to determine the association between observable eating and swallowing function factors and outcomes (death/hospitalization or survival) among elderly persons in long-term care insurance facilities in Japan. Baseline assessments of factors, such as language, drooling, halitosis, hypersalivation, tongue movement, perioral muscle function, coughing, respiration after swallowing, rinsing, and oral residue, among others, were conducted. A score of 0 was considered positive, and a score of 1 or 2 was considered negative. Patient age, sex, body mass index, Barthel index, and Clinical Dementia Rating were recorded. The death/hospitalization or survival rates over 1 year were recorded, and patients were allocated into groups depending on the respective outcome (death/hospitalization group or survival group) and baseline characteristics. A total of 986 residents from 32 facilities were included, with 216 in the death/hospitalization group and 770 in the survival group. Language, salivation, halitosis, perioral muscle, coughing, respiration after swallowing, rinsing, and oral residue were significantly associated with the outcomes (p < 0.05). Therefore, routine performance of these simple assessments by caregivers may allow early detection and treatment to prevent death, pneumonia, aspiration, and malnutrition in elderly persons.

OBJECTIVE: To explore healthcare professionals\' experiences and reflections about narration in their everyday work.
BACKGROUND: The need for integrated and people-centred healthcare for older adults has highlighted the relevance of narration in healthcare practice. Although theoretical foundations vary, different frameworks building on narration have been proposed for translating person-centredness philosophies into practice. However, to understand how theoretical knowledge on narration can be adopted into clinical work, we need to learn how healthcare staff understand narration from their experiential knowledge and practice.
METHODS: The research process followed guidelines from Constructivist Grounded Theory as described by Charmaz. The study adheres to the COREQ guidelines.
METHODS: Data collection entailed interprofessional focus groups discussions with healthcare staff (n = 31). Vignettes depicting realistic scenarios were used to encourage participants to reflect on clinical practice. Data were analysed via a constant comparative method.
RESULTS: One core theme arose from the analysis. The core theme showed how narration was a relational process that people engaged in to pursue and uphold several foundational qualities in healthcare practice presented in the following subthemes: preventing simplistic understandings of people and situations; supporting trustful relations; supporting continuity and coherence; and learning from coworkers. However, a minor theme raised awareness of narrative relations as a double-edged sword.
CONCLUSIONS: By acknowledging the mutual and multifacetted nature of narration in everyday practice, this study shows how healthcare professionals\' engagement in narrative relations may contribute to upholding several foundational qualities which resonate with philosophies of person-centredness in everyday healthcare practice.
CONCLUSIONS: Recognition of both the advantages and possible risks embedded in narrative relations in healthcare practice emphasises the obligation to collectively reflect on the repercussions of narrative relations in any local context.
UNASSIGNED: Healthcare professionals contributed by sharing their experiential knowledge and reflections on narration in practice.

The number of nonagenarians is growing globally. The promotion of mental wellbeing is increasingly important. The aim of this study was to explore mental wellbeing and psychological experiences of older adults in their early 90 s who were living at home.
We conducted a qualitative study using semi-structured face-to-face interviews with 20 older adults in their early 90 s. A thematic analysis, according to Braun and Clarke, was used to analyze data.
An inner process of older adults in their early 90 s was revealed; its three themes were the \"reality of aging,\" \"seeking emptiness of the mind,\" and \"still moving on.\" Older adults in this study experienced functional decline, regret, and loneliness. They were tired of life and nearly gave up. Emptying their minds helped them reset their attitudes and find a way to move on. After realizing that negative thinking did not help anything, they focused on what they could do and their daily routines. Perceived social usefulness validated participants\' self-worth. However, a few were consistently active without negative perceptions of aging.
Understanding the psychological process and mental wellbeing in later life aids in the development of practical healthcare policies to assist the growing oldest-old population in cope with age-related challenges and improve their mental wellbeing.

BACKGROUND: A growing number of older adults require complex care, but coordination among professionals to provide comprehensive and high-quality care is perceived to be inadequate. Opportunities to gain the knowledge and skills important for interprofessional collaboration in the context of geriatric care are limited, particularly for those already in the workforce. A short-term training programme in interprofessional collaboration for health and social care workers in the Philippines was designed and pilot tested. The programme was devised following a review of the literature about geriatric care education and group interviews about training needs. The objectives of this paper are to introduce the training programme and to evaluate its influence on attitudes and readiness to collaborate among participants using both quantitative and qualitative methodologies.
METHODS: A total of 42 community health workers and 40 health institution workers participated in the training in July 2019. Quantitative indicators were used to evaluate attitudes towards and readiness for collaboration before and after the training. Content analysis was performed of responses to open-ended questions asking participants to evaluate the training. A convergent parallel mixed-methods design was applied to determine the patterns of similarities or differences between the quantitative and qualitative data.
RESULTS: Significant improvements were seen in scores on the Attitudes Towards Health Care Teams Scale among community health (P < 0.001) and health institution (P < 0.001) staff after the training. Scenario-based case studies allowed participants to work in groups to practise collaboration across professional and institutional boundaries; the case studies fostered greater collaboration and continuity of care. Exposure to other professionals during the training led to a deeper understanding of current practices among health and social care workers. Use of the scenario-based case studies followed by task-based discussion in groups was successful in engaging care professionals to provide patient-centred care.
CONCLUSIONS: This pilot test of in-service training in interprofessional collaboration in geriatric care improved community and health institution workers\' attitudes towards such collaboration. A 3-day training attended by health and social care workers from diverse healthcare settings resulted in recommendations to enhance collaboration when caring for older adults in their current work settings.

Among patients over 75 years, little is known about functional decline due to COVID-19. The aim of this study was to explore this functional decline, compare to other infectious pneumonia.
This case-control study included all COVID-19 patients hospitalized from March to December 2020 in Acute Geriatric Ward in Nantes University Hospital matched 1/1 with patients with pneumonia hospitalized in geriatric department between March 2017 and March 2019 (controls) on sex, age. Functional decline was assessed at 3 month follow up as it is routinely done after hospitalization in geriatric ward. We performed multivariable analyses to compare clinical outcomes between patients with COVID-19 vs controls.
132 pairs were matched on age (mean: 87 y-o), and sex (61% of women). In multivariable logistic regression analysis, there were no statistical significant association between COVID-19 infection and functional decline (OR=0.89 p=0.72). A statistical significant association was found between functional decline and Charlson comorbidity index (OR=1.17, p=0.039); prior fall (OR=2.08, p=0.012); malnutrition (OR=1.97, p=0.018); length of hospital stay (OR=1.05, p=0.002) and preadmission ADL(OR=1.25, p=0.049).
COVID-19 does not seem to be responsible for a more frequent or severe functional decline than other infectious pneumonia in older and comorbid population after 3 month follow up. In this population, pneumonia is associated with functional decline in almost 1 in 2 cases. The individual preadmission frailty seems to be a more important predictor of functional decline, encouraging multidimensional care management for this population.

BACKGROUND: Geriatric care professionals were forced to rapidly adopt the use of telemedicine technologies to ensure the continuity of care for their older patients in response to the COVID-19 pandemic. However, there is little current literature that describes how telemedicine technologies can best be used to meet the needs of geriatric care professionals in providing care to frail older patients, their caregivers, and their families.
OBJECTIVE: This study aims to identify the benefits and challenges geriatric care professionals face when using telemedicine technologies with frail older patients, their caregivers, and their families and how to maximize the benefits of this method of providing care.
METHODS: This was a mixed methods study that recruited geriatric care professionals to complete an online survey regarding their personal demographics and experiences with using telemedicine technologies and participate in a semistructured interview. Interview responses were analyzed using the Consolidated Framework for Implementation Research (CFIR).
RESULTS: Quantitative and qualitative data were obtained from 30 practicing geriatric care professionals (22, 73%, geriatricians, 5, 17%, geriatric psychiatrists, and 3, 10%, geriatric nurse practitioners) recruited from across the Greater Toronto Area. Analysis of interview data identified 5 CFIR contextual barriers (complexity, design quality and packaging, patient needs and resources, readiness for implementation, and culture) and 13 CFIR contextual facilitators (relative advantage, adaptability, tension for change, available resources, access to knowledge, networks and communications, compatibility, knowledge and beliefs, self-efficacy, champions, external agents, executing, and reflecting and evaluating). The CFIR concept of external policy and incentives was found to be a neutral construct.
CONCLUSIONS: This is the first known study to use the CFIR to develop a comprehensive narrative to characterize the experiences of Ontario geriatric care professionals using telemedicine technologies in providing care. Overall, telemedicine can significantly enable most of the geriatric care that is traditionally provided in person but is less useful in providing specific aspects of geriatric care to frail older patients, their caregivers, and their families.

Aging is one of the most important prognostic factors increasing the risk of clinical severity and mortality of COVID-19 infection. However, among patients over 75 years, little is known about post-acute functional decline.
The aim of this study was to identify factors associated with functional decline 3 months after COVID-19 onset, to identify long term COVID-19 symptoms and transitions between frailty statesafter COVID-19 onset in older hospitalized patients.
This prospective observational study included COVID-19 patients consecutively hospitalized from March to December 2020 in Acute Geriatric Ward in Nantes University Hospital. Functional decline, frailty status and long term symptoms were assessed at 3 month follow up. Functional status was assessed using the Activities of Daily Living simplified scale (ADL). Frailty status was evaluated using Clinical Frailty Scale (CFS). We performed multivariable analyses to identify factors associated with functional decline.
Among the 318 patients hospitalized for COVID-19 infection, 198 were alive 3 months after discharge. At 3 months, functional decline occurred in 69 (36%) patients. In multivariable analysis, a significant association was found between functional decline and stroke (OR = 4,57, p = 0,003), history of depressive disorder (OR = 3,05, p = 0,016), complications (OR = 2,24, p = 0,039), length of stay (OR = 1,05, p = 0,025) and age (OR = 1,08, p = 0,028). At 3 months, 75 patients described long-term symptoms (49.0%). Of those with frailty (CFS scores ≥5) at 3-months follow-up, 30% were not frail at baseline. Increasing frailty defined by a worse CFS state between baseline and 3 months occurred in 41 patients (26.8%).
This study provides evidence that both the severity of the COVID-19 infection and preexisting medical conditions correlates with a functional decline at distance of the infection. This encourages practitioners to establish discharge personalized care plan based on a multidimensional geriatric assessment and in parallel on clinical severity evaluation.