European Geriatric Medicine - Supplement 1 - Volume 6

Late-breaking abstracts / European Geriatric Medicine 6S1 (2015) S177

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S187

S183

strengthen the lumbar paraspinal musculature. Data are collected

in an Excel spreadsheet and analyzed using SPSS 9.0 for Windows.

Results:

Mean age 61.5

10.2SE. Percentage of patients with anxiety

or depression was 14%. The average score on the VAS (range 0–10)

decreased from 4.5

1.9SE to 3.9

2.4SE (p = 0.02). The mediates

the Spanish version of the Roland-Morris (ERM), initial score

was 12.7

2SD and after 3 months of 8.1

2SD (p

0.001). The

impact of hygiene and postural care in everyday domestic activities

to consider and a table of basic daily exercises to tone and

strengthen the lumbar paravertebral muscles in daily domestic

activities (catch weight, social activities, lead, etc.) evaluated by

reducing the score ERM, which occurred in 49.6% of patients.

This reduction was significantly higher (p

0.05) in patients with

shorter evolution of the painful picture and continuous, higher

intensity on the VAS, without concomitant depression and previous

consumption of analgesics. Perception of improvement in 58.9% of

patients. A moderate correlation between EVA and ERM (r = 0.685,

0.001).

P-473

The feasibility of chemotherapy in cancer of oldest-old patient

after comprehensive geriatric assessment

E. Mercaider

, A. Djender

, L. Duco

, K. Maley

, O. Saint Jean

M. Gisselbrecht

HEGP, Paris, France;

Henri Mondor, Creteil, France;

Hˆopital de la

Croix St Simon, Paris, France

Introduction:

Impact of cooperation between oncologist and

geriatricians is supposed to benefit to older patients with cancer,

despite any evidence-based proof of it. Frailty, revealed by

comprehensive geriatric assessment (CGA), leads to modification of

cancer treatment in about one quarter of elderly patients according

to the literature. But very few data are available about feasibility of

these modified treatments taking account of frailty.

Objectives:

Our objectives are to evaluate feasibility of

chemotherapy after modifications according to CGA results and

factors related to it.

Methods:

In our Unit for Coordinated OncoGeriatrics, chemo-

therapy for the oldest-old patients is realized in the geriatric unit or

geriatric day hospital, meaning that the geriatricians are responsible

of cancer treatment. Protocols of chemotherapy are decided

by multidisciplinary staff including geriatricians and oncologists.

Retrospectively, we reviewed the feasibility of chemotherapy for

all patients treated from 2011 to 2013. Feasibility of chemotherapy

was defined by the respect of doses of antineoplastic drugs and

rhythm of administration, until the time of the first evaluation

of efficiency according to the professional recommendations. In

case of infeasibility, a percentage of ideal treatment was calculated

according to doses and rhythm modifications. The Hurria’s score

was calculated for all patients and correlated to clinical toxicities

observed.

Results:

140 patients were evaluable (90 women, 50 men, mean

age: 84 years old). The majority were frail according to G8 (97%)

or VES-13 (86%). Frailty was due to IADL (39%) or ADL (15%)

alteration, symptomatic comorbidity (52%), cognitive decline (25%),

malnutrition (66%) or depression (16%). Cancers were lymphoma

(13%), multiple myeloma (4%), solid tumors mainly metastatic (81%)

and which localization were digestive (43%), lung (14%), ovarian

(9%), bladder (6%), breast (6%), prostatic (3%). Full feasibility of

chemotherapy was observed in 45% of the patients. In the 55% of

unfeasibility, only one third benefited of 70% of protocol. Alteration

of protocol of chemotherapy was due to evident progression of

cancer (60%), excessive toxicity (55%) or wishes of patients (6%). It

seems to be correlated to previous malnutrition, alteration of ADL,

or symptomatic comorbidity but it was not significant.

Conclusion:

These data suggest that, despite CGA and careful

follow-up by geriatricians, the feasibility of protocols of

chemotherapy decided after consultation between oncologists

and geriatricians remains weak. Evidence-based adaptations of

protocols for the oldest-old cancer patients are strongly needed.

P-474

‘Doctors don’t talk to me’

I. Tomczak Silva

, P. Ars ´enio

, J.P. Pereira Gorj˜ao Clara

Geriatric University Unit, Lisbon, Portugal

Objectives:

Effective communication skills and a bio-psycho-social

basis allow health care professionals to improve understanding

of patients and their diseases, improve their acceptance of the

treatment regimen, have a more efficient management of time,

avoid burnout and increase their professional achievement.

Professional practice requires a lot of technical concentration and

have very little time to act so it becomes easier and faster to know

what’s wrong if they ask the patient’s companions.

Methods:

The article it’s an outburst we hear of elderly

patients about health professionals at hospitals or health centers.

Professionals ask for clarifications and hear complaints asking their

companions without the person concerned can express how he/she

feels and without being clarified about their fears and anxieties and

then look for solutions for the problem in literature.

Results:

The most common communication pitfalls include

conversation blockers, silence, cross talk, technical dialogues that

are difficult to understand by the patient or extensive dialogues

without content. No one will be able to convey accurately

complaints but the person concerned, the person who feels the

physical and mental pain can convey trustworthiness.

Conclusions:

This article provides a cognitive map suggesting

important communication skills to enrich health professionals in a

human and emotional way in their daily practice in caring for the

elderly. Interpersonal relations is very important and can result on

a bilateral basis of trust, a correct identification of the cause of the

problem and to increase the diagnostic efficiency and consequently

to create a more appropriate and effective therapy.

P-475

The VIPS practice model for dementia care

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Do you want

person centered care in your nursing home?

M. Mjørud

, J. Røsvik

Norwegian National Advisory Unit Aging and Health, Oslo, Norway

The VIPS practice model (VPM) is an easy way to implement person

centered care in nursing homes. The model provides a permanent

structure for building a shared value base in the staff. The VPM

provides health care staff with knowledge on how to use person

centered care in daily practical care.

The VPM works well in combination with Dementia care mapping

Based on Tom Kitwood’s theory summed up in Dawn Brooker’s VIPS

framework, the VIPS practice model is a staff training intervention

for person centered care, which can be used in both nursing homes

and in-home nursing.

The VIPS framework consists of four elements

•

V – that all human beings have the same Value

•

I – the care should be Individualized

•

P – taking the Perspective of the person with dementia

•

S – the psycho-Social environment, in which the person with

dementia lives

Each element has 6 indicators giving concrete descriptions of the

content of the elements.

The four elements in the VIPS framework are used in a weekly

meeting structured to help staff reach consensus on how to

meet a challenging patient-nurse situation. The discussion in the

meeting has particular focus on the perspective of the person with

dementia.

The VPM has set roles to ensure that all staff is involved in the

decision making process and implementation of person centered