European Geriatric Medicine - Supplement 1 - Volume 6

Symposia / European Geriatric Medicine 6S1 (2015) S157

–

S176

S175

spiritual needs requires state-of-the-art palliative care and adequate

structures.

Chairs:

Prof. Nele Van den Noortgate (University Hospital

Gent, Belgium); Dr Sophie Pautex, University Hospital Geneva,

Switzerland)

1. Care co-ordination at the end of life in severe dementia

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the case of pneumonia

(Kirsten Moore, University College London,

Great-Britain): A growing number of people are living and dying

with dementia, however, there is limited evidence regarding the

best approach to providing palliative care in various care settings.

This study aimed to develop a complex model of integrated

palliative care for people with advanced dementia across different

care settings and to pilot it in two care homes. Using a realist

approach and based on multiple qualitative and quantitative

data sources and international literature a set of statements

were developed to inform the development of an integrated

palliative dementia care model. Each statement was evaluated

for appropriateness and necessity, irrespective of costs, using

the RAND/UCLA Appropriateness method. Twenty-nine statements

were agreed upon and were then developed into a model of care.

The model of care was piloted in two care homes in two Clinical

Commission Groups in London and adapted to local needs and

resources. The results of this model will be presented.

2. The interRAI Palliative Care assessment tool. An added value

for the patient, the health care provider or the researcher?

(Aline Sevenants, Belgium): The interRAI Palliative Care instrument

(interRAI PC) is a CGA which evaluates the needs of adults requiring

palliative care in all healthcare settings. Health care providers can

use the outcomes (scales and clinical assessment protocols) that

can be calculated from the assessment for designing, evaluating

and adjusting care plans. The data can also be used for research. In

this presentation, we will look at opportunities and pitfalls for all

of these potential users of the instrument

3. Propositions to promote collaboration and integration

between geriatric and palliative medicine/care in Europe: results

of focus groups

(Sophie Pautex, University Hospital Geneva,

Switzerland): Closer interaction between geriatric medicine and

palliative care is an important precondition in order to realize

high quality palliative care for older people. An interest group

consisting of active members of the EUGMS and EAPC has been

set up and started working out the objectives formulated in

the manifesto “Palliative Care for older people in the European

Union”. This European-level working group aims to ultimately

make recommendations on how to improve palliative care for

older people in Europe that can be used by policy-makers and

national organizations in order to change to their circumstances

for organizing better palliative care for older people. A first step

(STEP1) in reaching this goal is to identify and describe ways to

promote collaborations and possibly better integration between

geriatric and palliative medicine/care in Europe by organizing four

focus groups during the EAPC-EUGMS congresses. The results will

be presented.

Symposium: Cognition and dementia

S-22

Falls in cognitive impairment and dementia: identifying those

at risk and developing novel interventions

F. Kearney

, R. Harwood

, V. Booth

, K. Pitk¨al¨a

, J. Ryg

Nottingham University Hospitals, Nottingham, United Kingdom;

Nottingham University Hospitals NHS Trust, Nottingham, United

Kingdom;

University of Nottingham, Nottingham, United Kingdom;

University of Helsinki, University of Helsinki, Finland;

Odense

University Hospital, Odense, Denmark

Chairpersons:

Dr Jesper Ryg MD, PhD. Department of Geriatric

Medicine, Lillebaelt Hospital Kolding, Denmark; Dr Fiona Kearney,

Department of Geriatric Medicine, Nottingham University Hospitals

NHS Trust, UK.

Introduction:

Older adults with cognitive impairment and

dementia have an increased risk of falling compared with age-

matched individuals without a cognitive impairment, equating to

a 70–80% chance of falling within a year. The economic impact on

health services from the falls experienced by these individuals

and the carers and families of older adults with dementia is

considerable. In the 12 months following a fall health and social

care costs can increase by as much as 4 times. Preventing falls in

this group is now a pressing matter for both health and social care

economies. However standard falls prevention strategies, effective

in non-cognitively impaired populations fail to reduce falls in older

adults with cognitive impairment and dementia.

Objectives:

This symposium will explore why such interventions

are inadequate in those with cognitive impairment, detail

neuropsychological assessment batteries to help with risk

stratification, and identify potential treatment targets, adaptive

strategies and novel approaches to preventing falls in this group.

This symposium will also explore the evidence for fracture

prevention interventions, specific to those with dementia.

Presentations:

1. Evaluation of neuropsychological deficits and gait abnor-

malities in older adults with mild cognitive impairment

(25

minutes, 5 minutes for questions), Professor Rowan Harwood,

Professor of Geriatric Medicine, Nottingham University Hospitals,

UK: This presentation will summarise the latest literature on

neuropsychological risk factors and gait irregularities relevant to

older adults with mild cognitive impairment who fall. This will also

be informed by the results of a National Institute of Health Research

study which is drawing to a close in Nottingham, UK measuring

neuropsychological deficits and gait abnormalities in older adults

with mild cognitive impairment undergoing assessment through

the memory services. The results of this study will provide

information on prevalence of deficits in this group, feasibility of

delivering neuropsychological evaluation in a real world clinical

setting, in addition to the tests most likely to yield relevant

information (both computer based tests, and paper based tests).

This will be informative to a wide audience managing falls in older

adults with cognitive impairment where significant gaps currently

exist with regard to assessment and adequate risk stratification of

this group.

2. Development of an intervention to reduce falls in older adults

with mild cognitive impairment

(25 minutes, 5 minutes for

questions), Ms Vicky Booth, Research Physiotherapist, University of

Nottingham, UK: Evidence for effective falls prevention strategies

for older adults with cognitive impairment remains sparse.

Proposed reasons for this include failure to recognise specific

cognitive deficits that predispose to falls in addition to failure

to adapt falls prevention strategies to the specific cognitive

deficits of the individual. Exercise has been demonstrated to