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care. As a representative of the majority of staff, an auxiliary nurse
holds the leading role as leader of the consensus meeting supported
by the head nurse. The primary nurse is the spokesperson for
the person with dementia, presenting the situation from the
perspective of the person with dementia. The registered nurse
responsible for the professional development in the institution has
the role as an internal coach, and trains new members of staff.
The VPM has been tested in a large RCT in Norwegian nursing
homes, and is found to reduce depression, psychosis and agitation.
The model has also been tried out in several municipalities in in-
home nursing, and clinical workers reported it was very useful in
this setting as well.
We provide training for course instructors who train the staff in
the nursing home or in-home nursing.
During a two day course, the VIPS practice model is presented
and you are trained in conducting the model’s introduction course.
All the material for the course, including educational lectures on
memory-sticks and written manuals are available in a starting-kit
in English, Portuguese or Norwegian.
The course for the course instructors are available for RNs,
psychologists and others who are interested in being resource
persons for implementation of the VIPS practice model in their
country.
P-476
New Profile of elderly patients with hip fracture and low
impact preview fracture
T. Parajes V ´azquez
1
, A.M. G ´omez Mosquera
1
1
Sergas, Vigo, Spain
Objectives:
1. To determine the incidence of osteoporotic fractures or low
impact on previous patients admitted with hip fracture.
2. To analyze the degree of implementation of anti-resorptive
therapies in these patients.
Methods:
Retrospective and descriptive study of a random series of
120 patients over 75 years attending emergencies in the University
Hospital of Vigo in the year 2013 with a diagnosis of hip fracture.
Results:
Of the 120 elderly analyzed in the study, 92 were women
(76.6%) and 28 males (23.3%) with a mean age of 84.53 years..
Twenty-nine patients (24%) had suffered a fracture on prior impact:
28.95% hip, 13.16% vertebral, 10.52% Colles and 47.37% in other
locations. Of the 29 patients with previous fractures, 13.8% vitaminD
levels were collected, densitometry performed percentage was 3.5%
and only 34.5% patientes had received treatment before hip fracture
(4 were being treated at the time of the fracture and 6 were
treated).
Conclusions:
Although most predictive factor of risk in the
development of fracture are age, personal or family history of
fracture and BMD determination, in the series of patients analyzed,
low implementation of management protocols in patients with
established osteoporosis leading to the appearance of second low
impact fracture is noted.
P-477
New Scales Elderly Patient Global Assessment applied to elderly
patients with hip fracture
A.M. G ´omez Mosquera
1
, T. Parajes V ´azquez
1
1
Sergas, Vigo, Spain
Objectives:
Analyze the potential relationship between the risk of
hip fracture and the results of the scales Elderly Patient Global
Rating geriatric patients.
Methods:
Retrospective and descriptive study of a random series of
120 patients over 75 years attending emergencies in the University
Hospital of Vigo in the year 2013 with a diagnosis of hip fracture.
Results:
Of the 120 patients analyzed in the study, 92 were women
(76.6%) and 28 males (23.3%) with a mean age of 84.53 years.
Considering the Elderly Patient Global Assessment in the functional
area, we found: grade 0 (normal walking) 30.83% of patients;
Grade 1 (walks with some difficulty) 27.5%; Grade 2 (cane or
similar) 17.5%; Grade 3 (helped by at least one person) 10.83%;
Grade 4 (two people) 6.67%; and grade 5 (immobilization in bed or
chair) 6.67%. Regarding the mental sphere in 75% of our patients
any cognitive decline is not evidence. Only 10% of them were
institutionalized.
Conclusions:
In this series, a direct relationship between hip
fracture, and functional, mental and social situation is evident;
being at greatest percentage of fractures, those elderly with little
functional impairment, without cognitive impairment and who live
in home.
P-478
Falls and old age: results from a qualitative study carried out
in a rural area of Turkey
S. Yazici
1
, M.S. Karakus
1
1
Akdeniz University, Antalya, Turkey
Objectives:
Falls are the leading cause of morbidity and mortality
in old age. It is possible to decrease the rate of accidents and falls by
home modifications and individual education. Rural areas are often
deprived from resources. The aim of this study is to evaluate rural
houses regarding the risk of falls and home accidents, to identify
the risky areas at home and to advise recommendations of home
adaptation.
Methods:
Qualitative methodology has been used. 15 interviews
have been done in Adıyaman, G ¨olba ¸sı district. The Ergonomic
Evaluation form has been used to evaluate the houses. The fall
history has been taken. Interviews were audio-taped and pictures
were taken. The elderly have been informed about risky areas at
their homes and advises were given.
Results:
The majority of the houses had major fall-risky areas and
was not suitable concerning the physical limitations of the elderly.
The stairs have been found as the main place of previous falls.
Some participants experienced multiple falls at the same location
however didn’t do any change to prevent future falls.
Conclusion:
Building a safe environment in old age is crucial for
the prevention of falls and for an independent life. The older people
living in rural areas often lack of resources available for in-home
adaptations. Resources need to be allocated to rural areas in order
to support aging in place.
P-479
Awareness and decision-making to advance directives among
the elderly patients admitted at intensive care units in middle
Taiwan
C.-M. Chang
1
, H.-C. Lin
2
, C.-L. Lee
2
1
Department of Internal Medicine, National Cheng Kung University
Hospital, Tainan, Taiwan;
2
Chung Shan Medical University Hospital,
Taichung, Taiwan
Objectives:
To understand awareness and intentions of advance
directives (ADs) among the elderly patients admitted in the
intensive care units (ICUs).
Methods:
A cross-sectional questionnaire survey with purposive
sampling among patients aged ≥55 years admitted at medical ICUs
was conducted at a medical center in middle Taiwan. A structured
questionnaire was designed for asking consideration of determining
ADs.
Results:
A total of 30 patients were enrolled, their mean age of was
70.4
±
11.64 years, 22(73.3%) were male. Only 10(33.3%) patients
understood that they could decide ADs before the ICU admission,
13(43.3%) signed DNR. Although 20(66.6%) patients knew what
endotracheal intubation is, 28(93.3%) did not know tracheostomy
will be performed if difficult weaning of intubation occurs. The
willings of patients themselves in the considerations of ADs were