Acopia: Difference between revisions

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<div class="editorbox">'''Original Editor '''- [[User:Alex Palmer|Alex Palmer]]
'''Original Editor '''- [[User:Alex Palmer|Alex Palmer]],


'''Top Contributors''' - {{Special:Contributors/{{FULLPAGENAME}}}};
'''Top Contributors''' - {{Special:Contributors/{{FULLPAGENAME}}}}
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== What is 'Acopia' ==
== Introduction ==
[[File:Dementia lady.jpeg|thumb|Frail elderly person]]
The word 'acopia' is often used to describe a patient’s inability to cope with [[Activities of Daily Living|activities 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. [[Introduction to Frailty|Frail]] older persons should be assessed using the principles of [[Comprehensive Geriatric Assessment]], informed by an understanding of the concept of frailty and of geriatric syndromes, for example, [[falls]] and delirium.


The word 'acopia' is often used to describe a patient’s inability to cope with activities of daily living. The term 'acopia' is not found in the English dictionary, yet it is often seen within the initial triage notes from Emergency Departments. This diagnosis follows patients throughout their hospital admission.<ref name="Keel and Rippingale">Keel YK, Rippingale C. The prevalence and characteristic of patients with ‘acopia'. Age Ageing 2009; 38(1): 103-105.</ref> The term has been shown to be linked with an older population and is used to describe either patients with no acute medical problems or for individuals who are categorised as inappropriate admissions.<ref name="Richardson">Richardson DB. Elderly patients in the emergency department: a prospective study of characteristics and outcome. Medical Journal of Australia 1992; 157:234-9.</ref> David Oliver (a former government adviser on the elderly) has argued that the term is not a diagnosis and that the inappropriate terminology is unhelpful towards ensuring quality patient care.<ref name="Oliver">Oliver D. ‘Acopia’ and ‘social admission’ are not diagnoses: why older people deserve better. Journal of the Royal Society of Medicine 2008; 101(4): 168–174.</ref> David Oliver argued that the term is subconsciously prejudicial against age and subconsciously allows doctors to brand geriatric patients with the inability to cope, when in reality this patient population are most likely suffering from multiple co-morbidities and geriatric syndromes, such as acute confusion, dementia, falls and 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 rehabilitating individuals to maintain their independence and quality of life. The term 'acopia' may bias clinicians thought processes and cause diagnoses to be missed and reversible pathology to be underdiagnosed.<ref name="Obeid">Obeid J, Ogle S. Acopia: a useful term or not? Australasian Journal of Aging 2000;19:195-8.</ref><br>
* The term 'acopia' may bias clinicians thought processes and cause diagnosis to be missed and reversible pathology to be underdiagnosed.<ref name="Obeid">Obeid J, Ogle S. Acopia: a useful term or not? Australasian Journal of Aging 2000;19:195-8.</ref><ref name=":0">Hodges Z. Diagnosis of “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>
* 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 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 characteristic of patients with ‘acopia]'. Age Ageing 2009; 38(1): 103-105.</ref> 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. 


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 as falls, immobility and confusion.<ref 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:
== Viewing ==


•The term 'acopia' is most commonly used in elderly patients. The majority of these patients had acute medical illnesses or co-morbidities. <br>•Over half of the patients described as having 'acopia' did not previously receive social service input.<br>•The results suggested that an inability to cope at home is an indicator for medical illness. These patients also had a mortality rate higher than average, suggesting that urgent medical treatment is required within this population. <br><br>
This 6 minute video highlights the negative aspects of using Acopia as a word. {{#ev:youtube|https://www.youtube.com/watch?v=f53F-dAg_5Q|width}}<ref>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)</ref>
{{#ev:youtube|https://www.youtube.com/watch?v=f53F-dAg_5Q|width}}<ref>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)</ref>
== Elements of a [[Comprehensive 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.<ref name="British Geriatrics Society">British Geriatrics Society. Comprehensive Geriatric Assessment for Frail Older People in Hospital. London: BGS; 2005.</ref><br>
 
{| width="507" cellspacing="1" cellpadding="1" border="1"
|-
! scope="col" | Components<br>
! scope="col" | Elements<br>
|-
| Medical Assessment<br>
| Problem List<br>
|-
| <br>
| Co-morbid Conditions and disease severity<br>
|-
| <br>
| Medication review<br>
|-
| <br>
| Nutritional Status<br>
|-
| Assessment of Functioning<br>
| Basic Activities of Daily Living<br>
|-
| <br>
| Instrumental Activities of Daily Living<br>
|-
| <br>
| Activity / Exercise Status<br>
|-
| <br>
| Gait &amp;&nbsp;Balance<br>
|-
| Psychological Assessment<br>
| Mental Status (Cognitive Testing)<br>
|-
| <br>
| Mood / Depression Testing<br>
|-
| Social Assessment<br>
| Informal Support Needs and Assets<br>
|-
| Environmental Assessment<br>
| Care resource eligibility / financial assessment<br>
|-
| <br>
| Home Safety<br>
|-
| <br>
| Transportation and&nbsp;Telehealth<br>
|}
 
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. <br>  


== References  ==
== References  ==
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[[Category:Falls]]
[[Category:Falls]]
[[Category:Older People/Geriatrics]]
[[Category:Older People/Geriatrics]]
[[Category:Older People/Geriatrics - Conditions]]
[[Category:Older People/Geriatrics - Assessment and Examination]]
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Latest revision as of 17:17, 17 January 2023

Original Editor - Alex Palmer

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

Introduction[edit | edit source]

Frail elderly person

The word 'acopia' is often used to describe a patient’s inability to cope with activities 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 of Comprehensive Geriatric Assessment, informed by an understanding of the concept of frailty and of geriatric syndromes, for example, falls and 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 as falls, 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.

Viewing[edit | edit source]

This 6 minute video highlights the negative aspects of using Acopia as a word.

[4]

References[edit | edit source]

  1. ↑ Obeid J, Ogle S. Acopia: a useful term or not? Australasian 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)
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