Acopia: Difference between revisions

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==What is 'Acopia'?==
==Introduction==
[[File:Pain stress brain.png|right|frameless|200x200px]]
[[File:Pain stress brain.png|right|frameless|200x200px]]


The word 'acopia' is often used to describe a patient’s inability to cope with [[ADLs|activities of daily living]].Theterm'acopia'isnot found intheEnglish dictionary, yet it is often seen withintheinitial triage notes from Emergency Departments。This diagnosis followspatientsthroughout their hospital admission.Keel YK, Rippingale C. [https://r.search.yahoo.com/_ylt=Awr9DuCDy6lhcicAzwFXNyoA;_ylu=Y29sbwNncTEEcG9zAzEEdnRpZANEMTExMF8xBHNlYwNzcg--/RV=2/RE=1638546435/RO=10/RU=https%3a%2f%2facademic.oup.com%2fageing%2farticle-abstract%2f38%2f1%2f103%2f40975/RK=2/RS=NSImf_v.wT7MSgRfOWmyIpx90qc- The prevalence and characteristic of patients with ‘acopia]'. Age Ageing 2009; 38(1): 103-105. The term has been shownto belinkedwith anolder population and is used to describe either patients with noacutemedical problems or for individuals who are categorised as inappropriate admissions.Richardson DB. [https://r.search.yahoo.com/_ylt=AwrgDmnry6lhfGgAmh1XNyoA;_ylu=Y29sbwNncTEEcG9zAzIEdnRpZANEMTExMF8xBHNlYwNzcg--/RV=2/RE=1638546539/RO=10/RU=https%3a%2f%2feuropepmc.org%2farticle%2fMED%2f1435437/RK=2/RS=Ruh8OC7XOZLNh84PJrH7d1_JxkM- Elderly patients in the emergency department: a prospective study of characteristics and outcome]. Medical Journal of Australia 1992; 157:234-9. David Oliver(a former government adviser on the elderly)has argued thattheterm is not a diagnosisHodges Z. Diagnosisof“acopia”: prescription for neglect?.[https://www.emerald.com/insight/content/doi/10.1108/JAP-01-2021-0005/full/html The Journal of Adult Protection]。2021 May 18. and that the inappropriate terminology is unhelpful towards ensuring quality patient care.[https://r.search.yahoo.com/_ylt=AwrT4axCzKlh6ssAwgpXNyoA;_ylu=Y29sbwNncTEEcG9zAzIEdnRpZANEMTExMF8xBHNlYwNzcg--/RV=2/RE=1638546626/RO=10/RU=https%3a%2f%2fjournals.sagepub.com%2fdoi%2ffull%2f10.1258%2fjrsm.2008.080017/RK=2/RS=5hQDUljC7txMdsp9Jka3ZaINuIc- Oliver D. ‘Acopia’ and ‘social admission’ are not diagnoses: why older people deserve better.]Journalof theRoyal SocietyofMedicine 2008; 101(4): 168–174. David Oliver argued that the term is subconsciously prejudicial against age and subconsciously allows doctors to brand [//m.houseofhawgs.com/Older_People_-_An_Introduction geriatric] patients with the inability to cope, when in reality this patient population are most likely suffering from multiple co-morbiditiesand geriatric syndromes,such as acute confusion, [[dementia]],[[Falls in elderly|falls]] and[[Urinary Incontinence]]. As therapists we must work alongside our medical colleagues to provide holistic care, ensuring patients receive appropriate and effective treatment, identifying the problems that can be reversed and [[Rehabilitation Interventions|rehabilitating]] individuals to maintain their independence and quality of life. The term 'acopia' may bias clinicians thought processes and cause diagnosis to be missed and reversible pathology to be underdiagnosed.Obeid J, Ogle S. Acopia: a useful term or not? Australasian Journal of Aging 2000;19:195-8。
The word 'acopia' is often used to describe a patient’s inability to cope with [[ADLs|activities of daily living]].Thisterm isdisrespectful, implying fault onthepart ofthepatient。Suchpatientsare likelyto befrailwithco-morbidities and havean acute (potentially reversible)illness. Frail older persons should be assessed usingtheprinciplesof [[Comprehensive Geriatric Assessment]], informed by an understandingof theconceptoffrailtyandofgeriatric syndromes,for example[[falls]] anddelirium。


A study carried out within an NHS District General Hospital found that nearly halfofpatients described as having ‘acopia’ presented with geriatric syndromes, such as[https://www.physio-pedia。com/Falls falls], immobility and confusion。name="Keel and Rippingale" />The authors argued that the definition of acopia should be an inclusive term to describe the frail elderly patient with multiple medical problems, enabling health professionals to identify when specialist intervention is needed within the multi-disciplinary team. This particular study also found a number of interesting facts:
The term 'acopia' may bias clinicians thought processes and cause diagnosis to be missed and reversible pathology to be underdiagnosed.Obeid J, Ogle S. Acopia: a useful term or not? Australasian Journal of Aging 2000;19:195-8.Hodges Z. Diagnosisof“acopia”: prescription for neglect?.[https://www.emerald。com/insight/content/doi/10.1108/JAP-01-2021-0005/full/html The Journal of Adult Protection]。2021 May 18。</ref>


•The term 'acopia' is most commonly used in elderlypatients.The majority of these patients had acute medical illnesses or co-morbidities。<br>•Over halfofthepatientsdescribed as having'acopia' did not previously receive social service input。<br>•The results suggestedthat aninabilitytocope at home is an indicator formedicalillness. These patients also had a mortality rate higher than average,suggesting that urgent medical treatmentisrequiredwithinthis population。
A study carried out within an NHS District General Hospital found that nearly half ofpatientsdescribed as having ‘acopia’ presented with geriatric syndromes, such as [https://www。physio-pedia.com/Falls falls], immobility and confusion。<ref name="Keel and Rippingale">Keel YK, Rippingale C. [https://r.search.yahoo.com/_ylt=Awr9DuCDy6lhcicAzwFXNyoA;_ylu=Y29sbwNncTEEcG9zAzEEdnRpZANEMTExMF8xBHNlYwNzcg--/RV=2/RE=1638546435/RO=10/RU=https%3a%2f%2facademic.oup.com%2fageing%2farticle-abstract%2f38%2f1%2f103%2f40975/RK=2/RS=NSImf_v.wT7MSgRfOWmyIpx90qc- The prevalence and characteristicof patientswith ‘acopia]'。Age Ageing 2009; 38(1): 103-105。</ref>The authors arguedthatthe definition of acopia should beaninclusive termtodescribe the frail elderly patient with multiplemedicalproblems,enabling health professionals to identify when specialist interventionisneededwithinthe multi-disciplinary team。< br > {{# ev: youtube | https://www.youtube.com/watch?v=f53F-dAg_5Q|width}}Association for elderly education. Acopia- the diagnosis for doctors who can't cope. Available from: https://www.youtube.com/watch?v=f53F-dAg_5Q (last accessed 5.5.2019)
{{#ev:youtube|https://www.youtube.com/watch?v=f53F-dAg_5Q|width}}Association for elderly education. Acopia- the diagnosis for doctors who can't cope. Available from: https://www.youtube.com/watch?v=f53F-dAg_5Q (last accessed 5.5.2019)


==Elements of a [[Comprehensive Geriatric Assessment]]==
Elements of a [[Comprehensive Geriatric Assessment]]:进行一个全面的评估的好处sment for this population include lower mortality rates, increased physical function, greater ability to remain at home, reduced readmission's to hospital and overall improved quality of life.British Geriatrics Society. Comprehensive Geriatric Assessment for Frail Older People in Hospital. London: BGS; 2005.
进行一个全面的评估的好处sment for this population include lower mortality rates, increased physical function, greater ability to remain at home, reduced readmission's to hospital and overall improved quality of life.British Geriatrics Society. Comprehensive Geriatric Assessment for Frail Older People in Hospital. London: BGS; 2005.>
{| class="wikitable" width="507" cellspacing="1" cellpadding="1" border="1"
|-
! scope="col" | Components
! scope="col" | Elements
|-
| rowspan="4" | Medical Assessment
| Problem List
|-
| Co-morbid Conditions and disease severity
|-
| Medication review
|-
| Nutritional Status
|-
| rowspan="4" | Assessment of Functioning
| Basic Activities of Daily Living
|-
| Instrumental Activities of Daily Living
|-
| Activity / Exercise Status
|-
| Gait & Balance
|-
| rowspan="2" | Psychological Assessment
| Mental Status (Cognitive Testing)
|-
| Mood / Depression Testing
|-
| Social Assessment
| Informal Support Needs and Assets
|-
| rowspan="3" | Environmental Assessment
| Care resource eligibility / financial assessment
|-
| Home Safety
|-
| Transportation and Telehealth
|}
The table above shows the key stages to completing a comprehensive assessment by a multi-disciplinary team within acute health care. Assessment of functioning is not the only element that a physiotherapist needs to consider when treating patients holistically. A therapist needs to consider all of the above elements to provide effective care, referring to or getting advice from other colleagues as needed. >


== References ==
== References ==

Revision as of 07:34, 19 November 2022

Original Editor-Alex Palmer

Top Contributors-Alex Palmer,Kim Jackson,Lucinda hampton,Lauren Lopez,Chrysolite Jyothi Kommu,Chelsea McleneandAminat Abolade

Introduction[edit|edit source]

Pain stress brain.png

The word 'acopia' is often used to describe a patient’s inability to cope withactivities of daily living。This term is disrespectful, implying fault on the part of the patient. Such patients are likely to be frail with co-morbidities and have an acute (potentially reversible) illness. Frail older persons should be assessed using the principles ofComprehensive Geriatric Assessment, informed by an understanding of the concept of frailty and of geriatric syndromes, for examplefallsand delirium.

The term 'acopia' may bias clinicians thought processes and cause diagnosis to be missed and reversible pathology to be underdiagnosed.[1][2]

A study carried out within an NHS District General Hospital found that nearly half of patients described as having ‘acopia’ presented with geriatric syndromes, such asfalls, immobility and confusion.[3]The authors argued that the definition of acopia should be an inclusive term to describe the frail elderly patient with multiple medical problems, enabling health professionals to identify when specialist intervention is needed within the multi-disciplinary team.

[4]

Elements of aComprehensive Geriatric Assessment: The benefits of carrying out a comprehensive assessment for this population include lower mortality rates, increased physical function, greater ability to remain at home, reduced readmission's to hospital and overall improved quality of life.[5]

References[edit|edit source]

  1. ↑奥贝德J,媚眼s Acopia:一个有用的术语吗?来自tralasian Journal of Aging 2000;19:195-8.
  2. ↑Hodges Z. Diagnosis of “acopia”: prescription for neglect?.The Journal of Adult Protection。2021 May 18.
  3. ↑Keel YK, Rippingale C.The prevalence and characteristic of patients with ‘acopia'. Age Ageing 2009; 38(1): 103-105.
  4. ↑Association for elderly education. Acopia- the diagnosis for doctors who can't cope. Available from:https://www.youtube.com/watch?v=f53F-dAg_5Q(last accessed 5.5.2019)
  5. ↑British Geriatrics Society. Comprehensive Geriatric Assessment for Frail Older People in Hospital. London: BGS; 2005.
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