Risks, consequences, and prevention of falls of older people in oral healthcare centers.

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de Baat, Cees; de Baat, Paul; Gerritsen, Anneloes E; Flohil, Karien A; van der Putten, Gert-Jan; van der Maarel-Wierink, Claar D

2017-03-01

One-third of community-dwelling people older than 65 years of age fall each year, and half of them fall at least twice a year. Older care home residents are approximately three times more likely to fall when compared to community-dwelling older people. Risk indicators for falls are related to the older people's body, environment, behavior, and activities. An important health risk indicator is (orthostatic or postprandial) hypotension, which may induce cerebral hypoperfusion. Although the majority of falls remain without major consequences, 10% to 25% of falls in care homes result in bodily trauma. Prevalent fall-related injuries are brain injury, lower extremity fracture including hip fracture and forearm/wrist fracture, facial fracture, humeral fracture, and rib/scapular fracture. As fall accidents by older people can have severe consequences, prevention of falls is of paramount importance. Healthcare providers, including oral healthcare providers, should inform older people on risks of falling and draw attention to potentially hazardous arrangements. © 2016 Special Care Dentistry Association and Wiley Periodicals, Inc.

A narrative exploration of older people's transitions into residential care.

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Lee, Victoria S P; Simpson, Jane; Froggatt, Katherine

2013-01-01

Moving into residential care has been argued to be a significant life transition for older people, often resulting in stress and anxiety. This research aimed to explore qualitatively older people's experiences of this transition, including how relocation is reflected upon and incorporated into their personal narratives. Eight older adults (65-97 years) living in a residential facility for between three and 12 months participated in interviews focussed on their experiences of relocating to a residential care home. Narrative analysis revealed that rather than depicting time bound stages of transition, participants' experiences reflected key plots of 'control', 'power', 'identity' and 'uncertainty' interwoven throughout their narratives. Participants experienced some difficulties in incorporating this transition into their life stories. Furthermore, participants discussed not feeling confident in their decision to move, living in constant fear of losing their memory, and limited expectations for their future. Professionals should move away from considering transition as a stage-based process ending in acceptance, instead focussing on how residents perceive relocation in relation to previous life experiences, unspoken fears evoked by moving and how the environment and relationships with staff may be altered to assist residents in maintaining their identity and sense of control.

What's different about older people.

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Crome, Peter

2003-10-01

Older people can be regarded as a marginalised group within society from a number of perspectives including that of health. When it comes to the use of medication older people have suffered from a double whammy. Not only are they more at risk from the adverse effects of drugs but also their involvement in clinical trials has been limited so that rational prescribing both to maximise benefit and to reduce risk has been problematic. Their special problems have been recognised formerly by the Department of Health in its NSF for Older People [National Service Framework for Older People. Department of Health, London (2001a)], [Medicines and Older People. Implementing medicines-related aspects of the NSF for Older People. Department of Health (2001b)]. Early studies focussed on compliance, the avoidance of poly-pharmacy and the high prevalence of adverse effects of drugs and the reasons for this. Studies in long-stay patients showed dramatic differences in pharmacokinetics between such older people and young healthy volunteers. Initially such differences were ascribed to age alone and the overall message became "start low and go slow". Studies in healthy older people then revealed that age differences in drug metabolism were, as a rule, not so marked although clearance of renally excreted drugs was reduced in line with the age associated decline in renal function. Including older people in clinical trials poses challenges. Many traditional trialists do not have ready access to older people, co-morbidity and poly-pharmacy are common and most people feel reluctant to ask older people to take part in complex and potentially hazardous trials. Concern about compliance is unwarranted. Adverse events may be more serious. Thus in a younger patient postural hypotension may make a subject unsteady but in an older subject the unsteadiness may lead to a fall, the fall to a fracture, and the fracture to poor recovery. The choice of end-points is crucial. Although reduction of

Sarcopenia and mortality in older people living in a nursing home in Turkey.

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Yalcin, Ahmet; Aras, Sevgi; Atmis, Volkan; Cengiz, Ozlem Karaarslan; Cinar, Esat; Atli, Teslime; Varli, Murat

2017-07-01

The aim of the present study was to evaluate the relationship between mortality and sarcopenia defined by the criteria of the European Working Group on Sarcopenia in Older People in older nursing home residents in Turkey. This was an observational prospective study. Nursing home residents who were aged older than 65 years and living in the Seyranbagları Nursing Home and Rehabilitation Center (Ankara, Turkey) were recruited for the study. The main outcome measure was the relationship between sarcopenia and mortality. Diagnosis of sarcopenia was carried out according to the European Working Group on Sarcopenia in Older People criteria. Bioelectrical impedance analysis was used for skeletal muscle mass measurement. Muscle strength and muscle performance were evaluated by handgrip testing and gait speed, respectively. Mortality was assessed at the end of 2 years. The Kaplan-Meier method and Cox regression analysis were used to evaluate the relationship between sarcopenia and all-cause mortality. The prevalence of sarcopenia and severe sarcopenia were 29% and 25.4%, respectively. A total of 44% (18) of sarcopenic participants died, whereas 15% (15) of participants without sarcopenia died after 2 years of follow up (P sarcopenia was associated with all-cause mortality among older nursing home residents in Turkey (HR 2.38, 95% CI 1.04-5.46; P = 0.039). However, sarcopenia was not significantly related with mortality after adjustment of MNA score (HR 2.04, 95% CI 0.85-4.9; P = 0.1). Sarcopenia independently increases all-cause mortality in older nursing home residents in Turkey. Nutritional status plays a role in sarcopenia-related mortality. Geriatr Gerontol Int 2017; 17: 1118-1124. © 2016 Japan Geriatrics Society.

Comparison of Self-Efficacy and Loneliness Between Community-Dwelling & Institutionalized Older People

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Mohammad Heidari

2016-04-01

Conclusion: With regard to the low mean score of self-efficacy of older adults residing in nursing homes, the authorities of nursing homes should pay attention to the needs of older adults and provide general education about promoting the tradition of caring older people by their families. Furthermore, all institutions and organizations that have important goals such as healthy older adults should advance toward their goals by planning, education, and consultation with families that care about their older adults. Finally, with regard to the results about the association of self-efficacy with loneliness, self-efficacy assessment should be considered one of the effective factors in psychological dimensions of the people and a way to support the self-care of older adults because promoting self-efficacy will result in managing stress and improving the mental health. 

Caring for the new uninsured: Hospital charity care for older people without coverage.

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DeLia, Derek

2006-12-01

Despite near-universal coverage through Medicare, a number of elderly residents in the United States do not have health insurance coverage. To the author's knowledge, this study is the first to document trends in the use of hospital charity care by uninsured older people. Data from the New Jersey Charity Care Program, which subsidizes hospitals for services provided to low-income uninsured people, were used to analyze trends in charity care utilization by older people from 1999 to 2004. Charity care charges are standardized to uniform Medicaid reimbursement rates and inflation adjusted using the Medical Care Consumer Price Index. From 1999 to 2004, use of charity care by older people grew much faster than it did for younger patients. As a result, older people now account for a greater share of hospital charity care in New Jersey than children. Elderly users of charity care generated higher costs per patient than their younger counterparts. Cost differences were especially salient at the upper end of the distribution, where high-cost elderly patients used significantly more resources than high-cost patients in other age groups. These results highlight an emerging source of strain on the healthcare safety net and point to a growing population of uninsured residents who have costly and complex medical needs. Similar experiences are likely to be found in other states, especially those that have growing populations of elderly immigrants who are likely to lack health insurance.

Cultural perspectives of older nursing home residents regarding signing their own DNR directives in Eastern Taiwan: a qualitative pilot study.

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Lee, Hsin-Tzu Sophie; Cheng, Shu-Chen; Dai, Yu-Tzu; Chang, Mei; Hu, Wen-Yu

2016-05-06

Chinese tradition and culture developed from Taoism, Confucianism, and Buddhism and have influenced ethnic Chinese for thousands of years, particularly thoughts on death. Many ethnic Chinese, particularly older people, refrain from discussing death-related concerns, making it difficult to obtain advance directives, including do-not-resuscitate (DNR) directives, signed independently by older people. This study explored the attitudes of older nursing home residents in Taiwan toward signing their own DNR directives. This study adopted purposive sampling and collected data through in-depth interviews. The data were analysed using qualitative inductive content analysis, and the study location was a nursing home in Eastern Taiwan. A total of 11participants were recruited from a sample of 12 eligible participants. Most of the older residents in this study refused to make decisions independently regarding DNR directives. Content analysis of the interviews revealed four themes concerning refusing to sign DNR directives independently: not going against nature, accepting the results of cause and effect, viewing the family as a decision-making system, and practising self-effacement. Chinese cultural aspects, including Taoist, Buddhist, and Confucian philosophy, affected the autonomy of the older residents, and they relied on others to make decisions for them. Professionals must respect this family-oriented decision-making thinking of older residents because it reflects personal choice. Otherwise, healthcare providers may play a mediating role in coordinating and communicating between older residents and their families regarding EOL-care-related concerns, replacing the traditional practice of holding a family meeting.

The physical environment, activity and interaction in residential care facilities for older people: a comparative case study.

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Nordin, Susanna; McKee, Kevin; Wallinder, Maria; von Koch, Lena; Wijk, Helle; Elf, Marie

2017-12-01

The physical environment is of particular importance for supporting activities and interactions among older people living in residential care facilities (RCFs) who spend most of their time inside the facility. More knowledge is needed regarding the complex relationships between older people and environmental aspects in long-term care. The present study aimed to explore how the physical environment influences resident activities and interactions at two RCFs by using a mixed-method approach. Environmental assessments were conducted via the Swedish version of the Sheffield Care Environment Assessment Matrix (S-SCEAM), and resident activities, interactions and locations were assessed through an adapted version of the Dementia Care Mapping (DCM). The Observed Emotion Rating Scale (OERS) was used to assess residents' affective states. Field notes and walk-along interviews were also used. Findings indicate that the design of the physical environment influenced the residents' activities and interactions. Private apartments and dining areas showed high environmental quality at both RCFs, whereas the overall layout had lower quality. Safety was highly supported. Despite high environmental quality in general, several factors restricted resident activities. To optimise care for older people, the design process must clearly focus on accessible environments that provide options for residents to use the facility independently. © 2016 The Authors. Scandinavian Journal of Caring Sciences published by John Wiley & Sons Ltd on behalf of Nordic College of Caring Science.

Garden greenery and the health of older people in residential care facilities: a multi-level cross-sectional study.

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Dahlkvist, Eva; Hartig, Terry; Nilsson, Annika; Högberg, Hans; Skovdahl, Kirsti; Engström, Maria

2016-09-01

To test the relationship between greenery in gardens at residential facilities for older people and the self-perceived health of residents, mediated by experiences of being away and fascination when in the garden and the frequency of visitation there. To examine how these indirect effects vary with the number of physical barriers to visiting the garden. Many older people in residential facilities suffer from complex health problems. Access to a green outdoor environment may enable psychological distance, engage effortless attention, encourage more frequent visitation and promote resident health. A multi-level, cross-sectional, correlational design. Questionnaires were administered June-August, 2011 to convenience samples of residents at 72 facilities for older people with complex healthcare needs. One to 10 eligible residents were sampled during self-motivated garden visits at each facility (n = 290). They reported on their garden experiences and health. Facility staff reported on objective garden characteristics and barriers to access. A serial mediation model was tested with multiple linear regression analysis. The total indirect effect of greenery on self-perceived health was positive and significant. Garden greenery appears to affect health by enhancing a sense of being away, affording possibilities to experience the outdoor environment as interesting and encouraging visitation. Among residents in homes with multiple barriers, only fascination mediated the relationship between greenery and self-perceived health. Ample greenery in outdoor space at residential facilities for older people appears to promote experiences of being away and fascination, more frequent visitation and better health. © 2016 The Authors. Journal of Advanced Nursing Published by John Wiley & Sons Ltd.

Which Frail Older People Are Dehydrated? The UK DRIE Study.

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Hooper, Lee; Bunn, Diane K; Downing, Alice; Jimoh, Florence O; Groves, Joyce; Free, Carol; Cowap, Vicky; Potter, John F; Hunter, Paul R; Shepstone, Lee

2016-10-01

Water-loss dehydration in older people is associated with increased mortality and disability. We aimed to assess the prevalence of dehydration in older people living in UK long-term care and associated cognitive, functional, and health characteristics. The Dehydration Recognition In our Elders (DRIE) cohort study included people aged 65 or older living in long-term care without heart or renal failure. In a cross-sectional baseline analysis, we assessed serum osmolality, previously suggested dehydration risk factors, general health, markers of continence, cognitive and functional health, nutrition status, and medications. Univariate linear regression was used to assess relationships between participant characteristics and serum osmolality, then associated characteristics entered into stepwise backwards multivariate linear regression. DRIE included 188 residents (mean age 86 years, 66% women) of whom 20% were dehydrated (serum osmolality >300 mOsm/kg). Linear and logistic regression suggested that renal, cognitive, and diabetic status were consistently associated with serum osmolality and odds of dehydration, while potassium-sparing diuretics, sex, number of recent health contacts, and bladder incontinence were sometimes associated. Thirst was not associated with hydration status. DRIE found high prevalence of dehydration in older people living in UK long-term care, reinforcing the proposed association between cognitive and renal function and hydration. Dehydration is associated with increased mortality and disability in older people, but trials to assess effects of interventions to support healthy fluid intakes in older people living in residential care are needed to enable us to formally assess causal direction and any health benefits of increasing fluid intakes. © The Author 2015. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

The association between the physical environment and the well-being of older people in residential care facilities: A multilevel analysis.

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Nordin, Susanna; McKee, Kevin; Wijk, Helle; Elf, Marie

2017-12-01

To investigate the associations between the quality of the physical environment and the psychological and social well-being of older people living in residential care facilities. Many older people in care facilities have cognitive and physical frailties and are at risk of experiencing low levels of well-being. High-quality physical environments can support older people as frailty increases and promote their well-being. Although the importance of the physical environment for residents' well-being is recognized, more research is needed. A cross-sectional survey of 20 care facilities from each of which 10 residents were sampled. As the individual resident data were nested in the facilities, a multilevel analysis was conducted. Data were collected during 2013 and 2014. The care facilities were purposely sampled to ensure a high level of variation in their physical characteristics. Residents' demographic and health data were collected via medical records and interviews. Residents' well-being and perceived quality of care were assessed via questionnaires and interviews. Environmental quality was assessed with a structured observational instrument. Multilevel analysis indicated that cognitive support in the physical environment was associated with residents' social well-being, after controlling for independence and perceived care quality. However, no significant association was found between the physical environment and residents' psychological well-being. Our study demonstrates the role of the physical environment for enhancing the social well-being of frail older people. Professionals and practitioners involved in the design of care facilities have a responsibility to ensure that such facilities meet high-quality specifications. © 2017 The Authors. Journal of Advanced Nursing Published by John Wiley & Sons Ltd.

The Impact of the Physical Environment on Depressive Symptoms of Older Residents Living in Care Homes: A Mixed Methods Study.

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Potter, Rachel; Sheehan, Bart; Cain, Rebecca; Griffin, James; Jennings, Paul A

2018-05-08

Forty percent of residents living in care homes in the United Kingdom have significant depressive symptoms. Care homes can appear to be depressing places, but whether the physical environment of homes directly affects depression in care home residents is unknown. This study explores the relationship between the physical environment and depressive symptoms of older people living in care homes. In a prospective cohort study the physical environment of 50 care homes were measured using the Sheffield Care Environment Assessment Matrix (SCEAM) and depressive symptoms of 510 residents measured using the Geriatric Depression Scale (GDS-15). The study was supplemented with semi-structured interviews with residents living in the care homes. Quantitative data were analyzed using multi-level modeling, and qualitative data analyzed using a thematic framework approach. The overall physical environment of care homes (overall SCEAM score) did not predict depressive symptoms. Controlling for dependency, social engagement, and home type, having access to outdoor space was the only environmental variable to significantly predict depressive symptoms. Residents interviewed reported that access to outdoor space was restricted in many ways: locked doors, uneven foot paths, steep steps, and needing permission or assistance to go outside. We provide new evidence to suggest that access to outdoor space predicts depressive symptoms in older people living in care home. Interventions aimed at increasing access to outdoor spaces could positively affect depressive symptoms in older people.

Motivators for physical activity among ambulatory nursing home older residents.

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Chen, Yuh-Min; Li, Yueh-Ping

2014-01-01

The purpose of this study was to explore self-identified motivators for regular physical activity among ambulatory nursing home older residents. A qualitative exploratory design was adopted. Purposive sampling was performed to recruit 18 older residents from two nursing homes in Taiwan. The interview transcripts were analyzed by qualitative content analysis. Five motivators of physical activity emerged from the result of analysis: eagerness for returning home, fear of becoming totally dependent, improving mood state, filling empty time, and previously cultivated habit. Research on physical activity from the perspectives of nursing home older residents has been limited. An empirically grounded understanding from this study could provide clues for promoting and supporting lifelong engagement in physical activity among older residents. The motivators reported in this study should be considered when designing physical activity programs. These motivators can be used to encourage, guide, and provide feedback to support older residents in maintaining physical activity.

Dentition status, malnutrition and mortality among older service housing residents.

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Saarela, R K T; Soini, H; Hiltunen, K; Muurinen, S; Suominen, M; Pitkälä, K

2014-01-01

Oral health status and oral health problems can affect eating habits and thus consequently the nutritional status of frail older people. To assess older service house residents' dentition and its associations with nutritional status and eating habits, and as well as to explore the prognostic value of dentition status for mortality. A cross-sectional study with a three-year follow-up. In 2007, we assessed the nutritional status of all residents in service houses in the two cities of Helsinki and Espoo in Finland (N=2188). Altogether 1475 subjects (67%) participated in the study; dentition status data were available for 1369 of them. Using a personal interview and assessment, trained nurses familiar to the resident collected the subjects' demographic data, medical history, functional and cognitive status, information on dentition status, oral symptoms, eating habits and diets. We assessed nutritional status with the Mini Nutritional Assessment (MNA), and retrieved information on mortality from central registers on 6 July 2010. Edentulousness was common; more than half of the residents (52%) had lost all their teeth: 7% (n=94) were totally edentulous without prosthesis (Group 1), 45% (n=614) had removable dentures (Group 2), and 48% (n = 661) of the residents, had some natural teeth left (Group 3). Dentition status was associated with age, gender, education and disability. According to the MNA, 13% were malnourished, 65% were at risk for malnutrition, and 22% were well nourished. Edentulousness without prosthesis was associated with malnutrition, oral symptoms and infrequent use of oral care services. In Group 1, 52% were deceased during follow-up period. The respective figures for Groups 2 and 3 were 48% and 40% (p=0.004). However, in Cox regression analysis adjusted for age, gender, comorbidity and MNA score, dentition status no longer predicted mortality. Edentulousness is still common among older service housing residents. Edentulousness without prosthesis was

Perceptions of effective relationships in an institutional care setting for older people

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Vera Roos

2014-10-01

Research purpose: This article reports older residents’ perceptions of effective relationships. Motivation for the study: Effective relationships protect against loneliness and depression and contribute to well-being. The facility was identified by a social worker as a showcase for effective relationships, but it was not clear what these consist of. Research approach, design and method: The World Café, a qualitative, participatory action research method, was applied to an economically deprived, urban facility caring for older people in Gauteng, South Africa. Three positively framed questions elicited perceptions from participants (nine men, ten women, aged 65–89. Visual and textual data were obtained and thematically analysed until saturation had been achieved. Themes were then subjected to deductive direct content analysis in terms of Self-Interactional Group Theory (SIGT. Main findings: Older residents perceive care managers as friendly and trustworthy and co-residents as caring. Care managers were seen as flexible, empathetic and congruent leaders and they confirmed residents. Relationships between residents were parallel-defined with relational qualities such as empathy and unconditional acceptance. Residents’ needs for privacy were honoured and they felt confirmed. Group dynamics were underpinned by caring and a stimulating environment provided opportunities for engagement. Practical/managerial implications: Relationships between managers and consumers are facilitated by flexibility, empathy, congruence and unconditional acceptance. Supportive group dynamics develop when people confirm and accept one another. A stimulating environment that encourages continuous and close interpersonal contact contributes to effective relationships. Contribution/value-add: Effective relationships should be understood on different levels.

Multidimensional Attitudes of Emergency Medicine Residents Toward Older Adults

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Teresita M. Hogan

2014-07-01

Full Text Available Introduction: The demands of our rapidly expanding older population strain many emergency departments (EDs, and older patients experience disproportionately high adverse health outcomes. Trainee attitude is key in improving care for older adults. There is negligible knowledge of baseline emergency medicine (EM resident attitudes regarding elder patients. Awareness of baseline attitudes can serve to better structure training for improved care of older adults. The objective of the study is to identify baseline EM resident attitudes toward older adults using a validated attitude scale and multidimensional analysis. Methods: Six EM residencies participated in a voluntary anonymous survey delivered in summer and fall 2009. We used factor analysis using the principal components method and Varimax rotation, to analyze attitude interdependence, translating the 21 survey questions into 6 independent dimensions. We adapted this survey from a validated instrument by the addition of 7 EM-specific questions to measures attitudes relevant to emergency care of elders and the training of EM residents in the geriatric competencies. Scoring was performed on a 5-point Likert scale. We compared factor scores using student t and ANOVA. Results: 173 EM residents participated showing an overall positive attitude toward older adults, with a factor score of 3.79 (3.0 being a neutral score. Attitudes trended to more negative in successive post-graduate year (PGY levels. Conclusion: EM residents demonstrate an overall positive attitude towards the care of older adults. We noted a longitudinal hardening of attitude in social values, which are more negative in successive PGY-year levels. [West J Emerg Med. 2014;15(4:511–517.

Living and dying with dignity: a qualitative study of the views of older people in nursing homes.

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Hall, Sue; Longhurst, Susan; Higginson, Irene

2009-07-01

most older people living in nursing homes die there. An empirically based model of dignity has been developed, which forms the basis of a brief psychotherapy to help promote dignity and reduce distress at the end of life. to explore the generalisability of the dignity model to older people in nursing homes. qualitative interviews were used to explore views on maintaining dignity of 18 residents of nursing homes. A qualitative descriptive approach was used. The analysis was both deductive (arising from the dignity model) and inductive (arising from participants' views). the main categories of the dignity model were broadly supported: illness-related concerns, social aspects of the illness experience and dignity conserving repertoire. However, subthemes relating to death were not supported and two new themes emerged. Some residents saw their symptoms and loss of function as due to old age rather than illness. Although residents did not appear to experience distress due to thoughts of impending death, they were distressed by the multiple losses they had experienced. these findings add to our understanding of the concerns of older people in care homes on maintaining dignity and suggest that dignity therapy may bolster their sense of dignity.

'The Taste Buddies': Participation and empowerment in a residential home for older people

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Baur, V.E.; Abma, T.A.

2012-01-01

The active participation and autonomy of older people living in residential homes is considered to be problematic. However, in our action research project conducted in a Dutch residential care organisation we found ways to enhance residents' direct participation. This form of participation is

Older people in the information society

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Aleksandra Marcinkiewicz-Wilk

2016-06-01

Full Text Available This paper focuses on the situation of older people in the information society. In the theoretical part of article phenomena of aging population and information society were described. This paper includes results of research conducted in qualitative strategy. The method of collecting data was biographical method. The method for data processing was qualitative content analysis. In the research 2 older, educationally active people took part. Results of research shows how older people understand the information society and what risk and opportunities they notice in this new reality. Narratives of the respondents indicated that education is of crucial importance for participation in the information society. Older people who take part in lifelong learning cope better with the new reality than people who do not learn. Based on the research results we can point out areas of education which should be development. Moreover, it is visible that educational activity of older people is very important in adaptation to the information society. Narratives of seniors indicate reasons for the lack of educational activity of other seniors. According to this, it can be specified what action should be undertaken to prevent the exclusion of older people in this new reality

Active Life Expectancy and Functional Health Transition among Filipino Older People

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Grace T. Cruz

2007-12-01

Full Text Available The study provides a baseline information on the functional health transition patterns of older people and computes for the Active Life Expectancy (ALE using a multistate life table method. Findings on ALE demonstrate that females and urban residents live longer and have a greater proportion of their remaining life in active state compared to their counterparts. Health transition analysis indicates a significant proportion experiencing recovery. Age, sex, place of residence and health status/behavior indicators (self-assessed health, drinking and exercise display a significant influence on future health and mortality trajectories although surprisingly, education did not show any significant effect.

Valuing narrative in the care of older people: a framework of narrative practice for older adult residential care settings.

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Buckley, Catherine; McCormack, Brendan; Ryan, Assumpta

2014-09-01

To report on the development of a framework of narrative practice, in residential care settings for older people. Residential care settings for older people provide care for people who are no longer able to live in their own home. To date, the impact and structure of nursing practice on care provision in these settings has proved difficult to conceptualise within a specific nursing theory framework. A hermeneutic approach incorporating narrative methods was used. Forty-six narrative interviews with older people in residential care were secondary-analysed for key themes through a three-stage process: by the first author, four focus groups of 12 clinical nurse managers and two independent experts. Themes were also derived from a focus group of eight residents who explored person-centredness and narrative. Finally, the combined findings were used to derive a single set of themes. The secondary data analysis process led to the development of a framework of narrative practice for the care of older people in residential settings. The framework is influenced by narrative enquiry, person-centred practice and practice development. It has four pillars, prerequisites, care processes, care environment and narrative aspects of care. To operationalise the framework of narrative practice, three narrative elements, narrative knowing, narrative being and narrative doing, need to be considered. Working with the foundational pillars and the narrative elements would enable staff to 'work in a storied way' and provide person-centred outcomes and a narrative informed philosophy of care for older adults in residential care. This framework provides nurses with a template that confirms the identity of the older person taking account of their biography. The framework outlines an approach that provides staff with a template on how to provide person-centred care in a narrative way. © 2013 John Wiley & Sons Ltd.

Therapeutic effects of an indoor gardening programme for older people living in nursing homes.

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Tse, Mimi Mun Yee

2010-04-01

To explore the activities of daily living and psychological well-being of older people living in nursing homes and also to examine the effectiveness of a gardening programme in enhancing socilaisation and life satisfaction, reducing loneliness and promoting activities of daily living for older people living in nursing homes. Life in nursing homes can mean very limited physical and social activity, leading to further decline in function for many older people. This was a quasi-experimental pre and posttest control group design. Older people from nursing homes were invited to join the eight week indoor gardening programme (experimental group), while older people in other nursing homes were treated as the control group; they received regular care without the eight week indoor gardening programme. There were 26 older people (25 female and one male; mean age 85 years) in the experimental group and 27 (20 female and seven male; mean age 82 years) in the control group. Demographic data including age, gender, educational level and financial situation were collected, in addition to information regarding life satisfaction, loneliness, physical activity and social network situation, before and after the eight week indoor gardening programme for both the experimental and control groups. Also, details of experimental group subjects' experience of the indoor gardening programme were elicited using open-ended questions. There were significant improvements in life satisfaction and social network and a significant decrease in perception of loneliness for older people in the experimental group after the eight week indoor gardening programme, while the activities of daily living were unchanged for both groups after the programme. Given the positive effects of gardening activities, it is suggested that they be promoted more widely among nursing home residents.

Comparison of anxiety as reported by older people with intellectual disabilities and by older people with normal intelligence

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Hermans, H.; Beekman, A.T.F.; Evenhuis, H.M.

2014-01-01

Objectives Older people with intellectual disabilities (ID) may experience more and different symptoms of anxiety than older people with normal intelligence. Study questions: (1) Is the reported severity of anxiety in this group similar to that in the general older population; (2) Are specific

Older People with Learning Disabilities:Workforce issues

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Hussein, S; Manthorpe, J

2005-01-01

The life expectancy of people with learning disabilities has increased substantially. Services for older people with learning disabilities are provided by various sectors and practitioners (generic health and social care, or specialist learning disability or old age). The literature suggests that practitioners do not feel well-equipped to support people with learning disabilities as they grow older, and older people's services do not always have the opportunity to share experiences and skills...

Cognitive assessment of older people

OpenAIRE

Young, John; Meagher, David; MacLullich, Alasdair J

2011-01-01

peer-reviewed Cognitive assessment involves examination of higher cortical functions, particularly memory, attention, orientation, language, executive function (planning activities), and praxis (sequencing of activities). This article will focus on cognitive assessment of older people (those aged over about 65 years) in the context of possible dementia, delirium, and depression. These are common and serious clinical syndromes affecting older people, and accurate cognit...

Measuring frailty in Dutch community-dwelling older people : Reference values of the Tilburg Frailty Indicator (TFI)

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van Assen, M.A.L.M.; Pallast, Esther; El Fakiri, Fatima; Gobbens, R.J.J.

2016-01-01

Objectives: The objectives of this study were to provide reference values of the Tilburg Frailty Indicator (TFI) for community-dwelling older people by age, sex, marital status, ethnicity, education, income, and residence, and examine the effects of these seven socio-demographic variables on

Sexual Abuse of Older Nursing Home Residents: A Literature Review

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Wenche Malmedal

2015-01-01

Full Text Available Despite an increasing literature related to elder abuse, sexual abuse of older persons in general and of vulnerable adults living in nursing homes in particular is still sparsely described. The purpose of this study was to assess the state of knowledge on the subject of sexual abuse against older nursing home residents through a literature review. Systematic searches in reference databases including Cinahl, Medline, OVID Nursing Database, ISI Web of Science, PsycINFO, Cochrane Library, and SveMed + were conducted. Through several phases of selection of the articles, using strict inclusion and exclusion criteria, six articles were chosen for a deeper examination. Findings from the review show that sexual abuse occurs in nursing homes and that both older women and men are victims of sexual abuse. Perpetrators appear mainly to be staff and other residents and mainly to be men, but also women abuse both older men and older women. Findings from the literature review show that there is a need for knowledge and further research on the topic of sexual abuse against older residents in nursing homes. Furthermore, there is a need for good policies and reporting systems, as an important step in seriously addressing sexual abuse against older persons.

Silver Memories: implementation and evaluation of a unique radio program for older people.

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Travers, Catherine; Bartlett, Helen P

2011-03-01

A unique radio program, Silver Memories, specifically designed to address social isolation and loneliness in older people by broadcasting music (primarily), serials and other programs relevant to the period when older people grew up--the 1920-1950s--first aired in Brisbane, Australia, in April 2008. The impact of the program upon older listeners' mood, quality of life (QOL) and self-reported loneliness was independently evaluated. One hundred and thirteen community-dwelling persons and residents of residential care facilities, aged 60 years and older participated in a three month evaluation of Silver Memories. They were asked to listen to the program daily and baseline and follow-up measures of depression, QOL and loneliness were obtained. Participants were also asked for their opinions regarding the program's quality and appeal. The results showed a statistically significant improvement in measures of depression and QOL from baseline to follow-up but there was no change on the measure of loneliness. The results did not vary by living situation (community vs. residential care), whether the participant was lonely or not lonely, socially isolated or not isolated, or whether there had been any important changes in the participant's health or social circumstances throughout the evaluation. It was concluded that listening to Silver Memories appears to improve the QOL and mood of older people and is an inexpensive intervention that is flexible and readily implemented.

Gender and rural-urban differences in reported health status by older people in Bangladesh.

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Kabir, Zarina Nahar; Tishelman, Carol; Agüero-Torres, Hedda; Chowdhury, A M R; Winblad, Bengt; Höjer, Bengt

2003-01-01

The study aims to (i) describe regional variation and gender differences in health status of older people (60 years and older) in Bangladesh, indicated by self-reported health problems and functional ability; (ii) explore influence of socio-economic factors on health status of older people. In a cross-sectional study in rural and urban Bangladesh, 696 older persons were asked about their health problems and ability to manage activities of daily living (ADL). More than 95% of older people reported health problems. Approximately 80% of elderly women in both the regions reported having four or more health problems compared with 42% and 63% elderly men in the urban and rural regions, respectively. More women (urban: 55%; rural: 36%) than men (urban: 32%; rural: 22%) also reported difficulties with ADL. Irrespective of age, sex and area of residence, those reporting greater number of health problems were more likely to report difficulty with at least one ADL task. Reporting pattern of specific health problems varied between urban and rural regions. Socio-economic indicators were found to have little influence on reporting of health problems, particularly in the rural region. Observed regional difference may be related to the influence of social and environmental factors, and level of awareness concerning certain health conditions.

The use of potentially inappropriate medications and changes in quality of life among older nursing home residents.

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Al Aqqad, Saná M H; Chen, Li Li; Shafie, Asrul Akmal; Hassali, Mohamed Azmi; Tangiisuran, Balamurugan

2014-01-01

Nursing home residents are mainly older people with multiple diseases and taking multiple medications. The quality use of medication and its association with health related quality of life (HRQoL) have not been reported in Malaysia. This study aims to investigate the association between the use of potentially inappropriate medications (PIMs) and the changes observed in the HRQoL among older nursing home residents. A prospective follow up study was conducted at four nongovernmental organization nursing homes in Penang, Malaysia. Older residents (≥65 years old) taking at least one prescribed medication were included. Residents with PIMs were identified by using Screening Tool of Older Person's potentially inappropriate Prescriptions (STOPP) criteria. HRQoL was assessed using EuroQol-5 dimension (EQ-5D) and EuroQol-visual analog scale (EQ-VAS) at baseline and after a 3-month follow up. The association of PIMs with HRQoL was analyzed using Mann-Whitney U test. The median age of the 211 participants was 77 years (interquartile range 72-82 years) and the median number of prescription medicines was four (interquartile range three to six). The prevalence of PIMs was 23.7% and 18.6% at baseline and 3 months later, respectively. The most commonly prescribed PIMs in decreasing order were first generation antihistamine, prescriptions of duplicate drug class, glibenclamide with type 2 diabetes mellitus, and anticholinergic to treat extrapyramidal side effects of neuroleptic medications. At baseline, there was no significant difference among residents with or without PIMs in each bracket of EQ-5D, EQ-5D index, or EQ-VAS scores. Comparison of the differences in the mean score index of EQ-5D between baseline and after 3 months also showed no statistically significant differences. PIMs were found to be relatively common among older nursing home residents. However, no significant changes were observed in HRQoL among these residents. Further studies with a bigger sample size and

The 'unnecessary' use of emergency departments by older people: findings from hospital data, hospital staff and older people.

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Faulkner, Debbie; Law, Julia

2015-11-01

Increasing demands are being placed on emergency departments in Australia and there is a view that older Australians are more likely than other age groups to attend for non-urgent conditions. The objective of this paper is to compare and contrast administrative data with the views of hospital staff and older people with regard to their presentation at two emergency departments in metropolitan Adelaide and how this aligns with the Australian Institute of Health and Welfare definition of 'potentially avoidable general practitioner-type presentations'. The study used three sources of data from two emergency departments: hospital data for the financial year 2010-11 for patients aged 65 years and over and identified as triage category four or five; three focus groups with medical, nursing and allied staff from these two hospitals; and interviews with 58 older people who presented at the two emergency departments over a two-week period. The hospital administrative data provided a very limited insight into why older people attended the emergency department, other than the medical diagnosis. Professional staff identified individual determinants, societal determinants and the health services system as explanations. Older people attended the emergency department for a range of reasons that may not necessarily reflect the opinions of health professionals. For many older people the emergency department was an appropriate place to attend considering their condition, though some presentations could be circumvented with appropriate and increased services in the community. However, as many older people suffer comorbidities, careful consideration needs to be given as to the best possible practices to achieve this.

Dietary management of older people with diabetes.

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McClinchy, Jane

2018-05-02

Diabetes UK's revised nutrition guidelines for the prevention and management of diabetes, published recently, encourage education in self-management and include additional guidance for older people with diabetes. The incidence of diabetes in older people is increasing. Many older people with diabetes are healthy and mobile, and live in the community, but a number are frail and living in care homes. Those who are frail are at increased risk of malnutrition from a range of causes. Older people with diabetes should be assessed for malnutrition risk and referred to a dietitian if required. Management of these patients focuses on foods that are high in protein and energy foods. A case study gives an example of how a community nurse may be involved.

Deprescribing for frail older people - Learning from the case of Mrs. Hansen.

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Granas, Anne Gerd; Stendal Bakken, Marit; Ruths, Sabine; Taxis, Katja

2017-07-13

Drug treatment is often an essential part in treatment and prevention of diseases in older people, but there is much concern about inappropriate medication use. This paper aims to describe the complexity of medication safety issues and clinical judgments when optimizing prescribing in older individuals. It uses the case of Mrs. Hansen, an aged nursing home resident, to illustrate the facilitators and barriers of this process. With decreasing life expectancy, medication use should shift from cure to care, focusing on symptomatic treatment to increase the patient's well-being. In Mrs. Hansen's case, the number of (potentially) dangerous medications were reduced, and non-pharmacological alternatives were considered. There were some medicines added, as underprescribing can also be a problem in older people. Deprescribing long-standing treatment can be interpreted by the patient and family as "giving up hope". More clinical evidence and practical communication tools are needed to guide deprescribing decisions, taking medical and patient-centered priorities into account. Studies evaluating such interventions should select outcome measures that are particularly relevant for frail old individuals. Copyright © 2017. Published by Elsevier Inc.

Older residents' perspectives on aged sexuality in institutionalized elderly care: a systematic literature review.

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Mahieu, Lieslot; Gastmans, Chris

2015-12-01

The aim of this systematic literature review is to investigate older residents' thoughts on, experiences of and engagement in sexual behavior and aged sexuality within institutionalized elderly care. Systematic literature review. We conducted an extensive search of the electronic databases Cinahl, Medline, Pubmed, Embase, Web of Science and Invert for papers published between January 1980 and October 2014 when the searches were closed. Additional papers were identified through forward and backward citation chasing. Data from relevant studies were extracted by means of a data extraction form. Relevant data were isolated, summarized, compared, related and categorized according to theme. Quality assessment of the included studies focused on their adequacy of reporting the study's research aim, sampling, collection, and analysis procedures, ethical considerations and results. Twenty-five appropriate studies were identified. These studies varied in research design (using surveys, vignettes, focus groups, interviews, or observation), objectives, quality of reporting, and sample characteristics (i.e. male and/or female long-term care residents with and/or without dementia). Yet, they all point to the relevance of sex and sexuality in old age and emphasize the highly individual character of both sexual interest and expression. Older residents who wish to sexually express themselves, might do this in a wide variety of ways, including, but not limited to, daydreaming, dressing-up, looking for emotional and intellectual intimacy, stroking, caressing, kissing, and engaging in sexual intercourse. Overall, residents appear to have a rather positive attitude toward aged sexuality as such. When it comes to specific sexual behaviors or homosexuality, however, attitudes tend to be more negative. The perceived appropriateness of the displayed behavior is a predominant factor in determining older people's reactions to the sexual behavior of co-residents, rather than the potential

National stereotypes of older people's competence are related to older adults' participation in paid and volunteer work.

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Bowen, Catherine E; Skirbekk, Vegard

2013-11-01

Why are older people perceived as more competent in some countries relative to others? In the current study, we investigate the extent to which national variation in perceptions of older people's competence is systematically related to national variation in the extent to which older people participate in paid and volunteer work. We used multilevel regression to analyze data from the European Social Survey and test the relationship between perceptions of older people's competence and older people's participation in paid and volunteer work across 28 countries. We controlled for a number of potentially confounding variables, including life expectancy as well as the gender ratio and average education of the older population in each country. We controlled for the average objective cognitive abilities of the older population in a subsample of 11 countries. Older people were perceived as more competent in countries in which more older people participated in paid or volunteer work, independent of life expectancy and the average education, gender makeup, and average cognitive abilities of the older population. The results suggest that older people's participation in paid and volunteer work is related to perceptions of older people's competence independent of older people's actual competence.

Seniors-on-line: introducing older people to technology.

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Irizarry, C; Downing, A; Elford, C

1997-03-01

Retired Engineers are playing an important role in ensuring that older people are not excluded from the benefits of technological advances. Technology is playing an increasingly important role in the lives of older people as it is incorporated into assistive devices, home security, access to health care, banking, communication and many other areas. However, if older people are unfamiliar with new technologies and find them daunting, they may not benefit fully from these advances. In order to minimize difficulties arising from unfamiliarity with technology, an introductory computer course was offered to people aged 55 and over. Teaching methods appropriate to the needs of older people were used: small classes, students and instructors from same age cohort, slow pace of presentation and ample opportunity to ask questions. Retired Engineers make up the majority of instructors. Three hundred and sixty nine older people have participated in the course and most plan to continue using a computer.

Associations between self-assessed masticatory disability and health of community-residing elderly people.

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Nakanishi, N; Hino, Y; Ida, O; Fukuda, H; Shinsho, F; Tatara, K

1999-10-01

To examine the relationship between the self-assessed masticatory disability and the health of community-residing older people. Of 1473 randomly selected people aged 65 years and older living in Settsu, Osaka Prefecture, in October 1992, data on general health status, history of health management, psychosocial conditions, and dental conditions were obtained from 1405 people by interviews made during home visits. Follow-up for 54 months was completed for 1306 subjects (93.0%; 1072 living, 234 deceased). Being over 75 years of age, having poor general health and poor dental status, not using dental health checks, not using general health checks, not participating in social activities, not feeling that life is worth living (no "ikigai"), and feeling anxious about the future were univariately and significantly associated with self-assessed masticatory disability. Logistic regression analyses indicated that being older than 75 years, having poor general health and poor dental status, not using dental health checks, and not participating in social activities were independently associated with self-assessed masticatory disability. The Cox proportional hazards model showed that being male, over 75 years of age, and in poor general health, as well as not using general health checks, and not participating in social activities were independently associated with mortality. Self-assessed masticatory disability was univariately and significantly related to mortality, but by itself was not a significant risk factor for mortality, because of the potential influence of other variables. Certain health and psychosocial factors are closely associated with self-assessed masticatory disability among older people. Further investigations are needed to determine whether masticatory disability is a significant risk factor for mortality.

Nurses' understandings of suitable footwear for older people.

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Borland, Andrea; Martin, Caroline Hollins; Locke, John

2013-01-01

The purpose of this paper is to gain insight into nurses' understandings of what constitutes suitable footwear for older people in care homes. An exploratory descriptive qualitative survey was carried out of 20 registered nurses employed in six Scottish care homes for older people. Data were collected using a semi-structured questionnaire that included five open-ended questions. Content analysis was used to theme footwear perceptions. Participants had several views about what encompasses safe footwear; some were erroneous. The link between inappropriate footwear and falls was recognised by 80 per cent of respondents, but some were unclear about the features that effect or inhibit safety. No UK or international standardised guidelines were identified that advise nurses about appropriate footwear for older people. It is unknown whether respondents represent the nurse population because findings are restricted by a small sample size. Nonetheless, the group showed variable understanding of what constitutes safe footwear for older people and links with fall prevention. Improved nurse-education about what comprises safe footwear and the links with falls prevention in older people is required. Structured guidelines to direct nurse educators about what to teach student nurses about appropriate footwear for older people may work towards reducing falls. No guidelines to direct nurses about appropriate footwear for older people in care homes have been written. Key points have been developed.

Perceptions of disaster preparedness among older people in South Korea.

Science.gov (United States)

Yoo, Myoungran; Lee, Mijung; Tullmann, Dorothy

2016-03-01

Older people are a major vulnerable population. During disasters, given their physical frailty, lower social status, loss of medications and medical care, the vulnerability of older people increases. The purpose of this study was to examine the perceptions of older people in Korea on various aspects of disaster preparedness to better understand their special needs and to facilitate appropriate disaster planning. The study was qualitative and used focus group interviews with 12 older people in one major city and one rural area of South Korea. Four themes were identified by the analysis of the interviews: defenceless state, reality of accepting limitations, strong will to live, importance of disaster preparedness governmental efforts for the older people. Findings indicated that preparation of shelters and transportation was critical to help older people survive in times of disasters and suggested that there should be active involvement of the government in terms of disaster planning, managing and preparing older people for disasters. In addition, healthy older people can be assets to disaster relief efforts by providing practical and emotional support for the most fragile older people. Older people can also provide knowledge of their special needs to the government to improve their disaster response policy. © 2015 John Wiley & Sons Ltd.

Why Social Exclusion Persists among Older People in Australia

Directory of Open Access Journals (Sweden)

Riyana Miranti

2015-07-01

Full Text Available The existing literature on social exclusion among older people, though relatively limited, suggests that disadvantage among older people is cumulative in nature. Some aspects of disadvantage starting at early life stages have long-term consequences. As such, older people with disadvantages may be subject to higher risks of persistent social exclusion. This article aims to improve understanding of social exclusion and its persistence among senior Australians in three ways. Firstly, the incidence of social exclusion among older people is analysed using selected indicators. Secondly, the study examines whether an older person experiencing social exclusion at one time is more likely to experience it again (persistence. Thirdly, it investigates what factors may be protecting older people from social exclusion. The analysis is conducted using the first eight waves of the Household, Income and Labour Dynamics in Australia (HILDA Survey. The sample of older people is disaggregated into a younger group (55–64 years at wave 1 and an older group (65+ years. The article suggests that higher education and income, as well as better health conditions and previous employment experiences, are important protective factors from social exclusion for older Australians.

The effects of small-scale, homelike facilities for older people with dementia on residents, family caregivers and staff: design of a longitudinal, quasi-experimental study.

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Verbeek, Hilde; van Rossum, Erik; Zwakhalen, Sandra M G; Ambergen, Ton; Kempen, Gertrudis I J M; Hamers, Jan P H

2009-01-20

Small-scale and homelike facilities for older people with dementia are rising in current dementia care. In these facilities, a small number of residents live together and form a household with staff. Normal, daily life and social participation are emphasized. It is expected that these facilities improve residents' quality of life. Moreover, it may have a positive influence on staff's job satisfaction and families involvement and satisfaction with care. However, effects of these small-scale and homelike facilities have hardly been investigated. Since the number of people with dementia increases, and institutional long-term care is more and more organized in small-scale and homelike facilities, more research into effects is necessary. This paper presents the design of a study investigating effects of small-scale living facilities in the Netherlands on residents, family caregivers and nursing staff. A longitudinal, quasi-experimental study is carried out, in which 2 dementia care settings are compared: small-scale living facilities and regular psychogeriatric wards in traditional nursing homes. Data is collected from residents, their family caregivers and nursing staff at baseline and after 6 and 12 months of follow-up. Approximately 2 weeks prior to baseline measurement, residents are screened on cognition and activities of daily living (ADL). Based on this screening profile, residents in psychogeriatric wards are matched to residents living in small-scale living facilities. The primary outcome measure for residents is quality of life. In addition, neuropsychiatric symptoms, depressive symptoms and social engagement are assessed. Involvement with care, perceived burden and satisfaction with care provision are primary outcome variables for family caregivers. The primary outcomes for nursing staff are job satisfaction and motivation. Furthermore, job characteristics social support, autonomy and workload are measured. A process evaluation is performed to investigate to

Urinary and fecal incontinence in a community-residing older population in Japan.

Science.gov (United States)

Nakanishi, N; Tatara, K; Naramura, H; Fujiwara, H; Takashima, Y; Fukuda, H

1997-02-01

To estimate the prevalence and risk factors of urinary and fecal incontinence among a community-residing older population in Japan. Population-based cross-sectional study. A randomly selected sample of 1473 people aged 65 years and older living in the City of Settsu, Osaka, in 1992. Data collected via in-home visits were used to estimate the prevalence of urinary and fecal incontinence and to provide information regarding potential risk factors of urinary and fecal incontinence. Data were obtained from 1405 older adults, a response rate of 95.4%. The prevalence of any degree of urinary incontinence was 98/1000 in both sexes, and 87/ 1000 men and 66/1000 women admitted to some degree of fecal incontinence. Daily, 34/1000 and 20/1000 of the population were incontinent of urine and feces, respectively. There was an increasing prevalence of urinary and fecal incontinence with age in both sexes, but the expected greater prevalence in women was not found. By univariate analyses, age older than 75 years, poor general health as measured by Activities of Daily Living, stroke, dementia, no participation in social activities, and lack of life worth living (Ikigai) were associated significantly with both urinary and fecal incontinence. In the multivariate analyses using logistic regression, age older than 75 years, poor general health, and stroke were independent risk factors for any type of incontinence. Diabetes was an independent risk factor for isolated fecal incontinence, and dementia and no participation in social activities were independent risk factors for double incontinence. Incontinence of urine and feces is a prevalent condition among very old people living in the community in Japan and is associated highly with health and psychosocial conditions.

Overcoming Recruitment Barriers in Urban Older Adults Residing in Congregate Living Facilities

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Adam Simning

2015-01-01

Full Text Available Background. Participation of minority older adults in mental health research has been limited by mistrust, transportation difficulties, lack of knowledge, and insufficient community partnership. We describe strategies utilized to overcome these recruitment barriers. Methods. Our target population included 553 public housing residents of older adult high-rise buildings in Rochester, NY. We had a two-stage cross-sectional study: Stage 1 was a health survey for all residents and Stage 2 was a psychiatric interview of English-speaking residents aged 60 years and older. Recruitment occurred through mailings, onsite activities, and resident referrals. Results. Stage 1 had 358 participants (64.7% response and Stage 2 had 190 (61.6% target population response, with higher participation among African Americans. We found some strategies effective for overcoming recruitment barriers. First, we partnered with a community agency and organized onsite educational activities to improve residents’ trust. Second, the study occurred entirely onsite, which facilitated participation of functionally impaired residents. Third, onsite activities allowed the residents to learn about the study and complete surveys in person. Fourth, we provided immediate incentives that resulted in many study referrals. Conclusions. Although recruitment of minority older adults presents unique challenges, a multifaceted community-tailored approach mitigated several recruitment barriers in this mental health study.

Body weight, anorexia, and undernutrition in older people.

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Soenen, Stijn; Chapman, Ian M

2013-09-01

Ideal body weight for maximum life expectancy increases with advancing age. Older people, however, tend to weigh less than younger adults, and old age is also associated with a tendency to lose weight. Weight loss in older people is associated with adverse outcomes, particularly if unintentional, and initial body weight is low. When older people lose weight, more of the tissue lost is lean tissue (mainly skeletal muscle) than in younger people. When excessive, the loss of lean muscle tissue results in sarcopenia, which is associated with poor health outcomes. Unintentional weight loss in older people may be a result of protein-energy malnutrition, cachexia, the physiological anorexia of aging, or a combination of these. The physiological anorexia of aging is a decrease in appetite and energy intake that occurs even in healthy people and is possibly caused by changes in the digestive tract, gastrointestinal hormone concentrations and activity, neurotransmitters, and cytokines. A greater understanding of this decrease in appetite and energy intake during aging, and the responsible mechanisms, may aid the search for ways to treat undernutrition and weight loss in older people. Copyright © 2013 American Medical Directors Association, Inc. Published by Elsevier Inc. All rights reserved.

Constructing the meaning of quality of life for residents in care homes in the Lebanon: perspectives of residents, staff and family.

Science.gov (United States)

Adra, Marina Gharibian; Hopton, John; Keady, John

2015-12-01

Located in two care homes in Lebanon, the study explores the perspectives of quality of life for a sample of older residents, care staff and family caregivers. Quality of life for older people living in care homes is traditionally reported in the literature as a Westernised construct and so far little is known about its meanings from an Arabic cultural perspective and context. There is also a knowledge gap about the conditions of older people living in care homes in Lebanon. The study was a qualitative exploration of perspectives of quality of life of older residents, care staff and family caregivers. Two care homes for older people situated in Beirut took part in the study. Between 2010 and 2011 semi-structured interviews were undertaken with a sample of 20 residents, eight family caregivers and 11 care staff. Data were analysed using the constant comparative method. Four categories emerged from this analytical process: (i) maintaining family connectedness; (ii) engaging in worthwhile activities; (iii) maintaining and developing significant relationships; and (iv) holding and practicing spiritual beliefs. The emergence of these categories confirmed the complex, interrelated and multidimensional nature of quality of life for residents and other stakeholders. The findings supplement an emerging body of knowledge about the composition of quality of life for older residents in Lebanon. Improving the quality of life of older residents will require action in respect of all of the domains identified in study. Moving nursing practice from task-based care to relationship-centred approaches was seen as pivotal in helping to develop quality of life for residents living in the participating care homes. The findings have implications for education, nursing practice and research in Lebanon and help start an evidence base for care. © 2015 John Wiley & Sons Ltd.

The use of potentially inappropriate medications and changes in quality of life among older nursing home residents

Directory of Open Access Journals (Sweden)

Al Aqqad S MH

2014-01-01

Full Text Available Sana’ MH Al Aqqad, Li Li Chen, Asrul Akmal Shafie, Mohamed Azmi Hassali, Balamurugan Tangiisuran Pharmacy Practice Research Group, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, Malaysia Background: Nursing home residents are mainly older people with multiple diseases and taking multiple medications. The quality use of medication and its association with health related quality of life (HRQoL have not been reported in Malaysia. This study aims to investigate the association between the use of potentially inappropriate medications (PIMs and the changes observed in the HRQoL among older nursing home residents. Methods: A prospective follow up study was conducted at four nongovernmental organization nursing homes in Penang, Malaysia. Older residents (≥65 years old taking at least one prescribed medication were included. Residents with PIMs were identified by using Screening Tool of Older Person's potentially inappropriate Prescriptions (STOPP criteria. HRQoL was assessed using EuroQol-5 dimension (EQ-5D and EuroQol-visual analog scale (EQ-VAS at baseline and after a 3-month follow up. The association of PIMs with HRQoL was analyzed using Mann-Whitney U test. Results: The median age of the 211 participants was 77 years (interquartile range 72–82 years and the median number of prescription medicines was four (interquartile range three to six. The prevalence of PIMs was 23.7% and 18.6% at baseline and 3 months later, respectively. The most commonly prescribed PIMs in decreasing order were first generation antihistamine, prescriptions of duplicate drug class, glibenclamide with type 2 diabetes mellitus, and anticholinergic to treat extrapyramidal side effects of neuroleptic medications. At baseline, there was no significant difference among residents with or without PIMs in each bracket of EQ-5D, EQ-5D index, or EQ-VAS scores. Comparison of the differences in the mean score index of EQ-5D between baseline and after 3 months

Older peoples' lived experiences after hip fracture

DEFF Research Database (Denmark)

Rasmussen, Birgit; Uhrenfeldt, Lisbeth

add to the load of wellbeing-challenges after HF. Evidence-based knowledge in order to address the wellbeing of older people and the challenges they meet in changing times after HF is needed for professionals. Aim To explore the support older people with HF may need to optimize their wellbeing during...... striving for wellbeing in an active daily life after HF; steering-group meetings clarify clinical questions regarding functional ability after HF. This knowledge is the basis for developing the interview guide used when interviewing 13 at-home-living older people with limited functional ability prior...

Communication Skills Training for Surgical Residents: Learning to Relate to the Needs of Older Adults.

Science.gov (United States)

Roberts, Linda; Cornell, Charles; Bostrom, Mathias; Goldsmith, Sandra; Ologhobo, Titilayo; Roberts, Timothy; Robbins, Laura

2018-03-30

It is vital for physicians and surgeons to communicate successfully with older adults, who will constitute one-fifth of the US population by 2030. Older adults often perceive themselves as stigmatized and powerless in healthcare settings. Effective communication leads to better patient compliance and satisfaction, which is now a component of Medicare hospital reimbursement and physician and surgeon compensation from hospitals and networks. To increase orthopaedic surgery resident understanding of the unique needs of older adults in order to maintain effective and sensitive communication with this vulnerable population. A two-part training program (ongoing for 8 years) comprised of: 1) small-group interactive didactic sessions on aging issues; and 2) workshop demonstrations given by the residents to a group of older adults, followed by a Question & Answer session. Residents were assessed using a 22-item pre-post questionnaire covering medical knowledge of aging, attitudes toward older adults, and personal anxiety about aging. Older adult participants were surveyed for perceptions of residents' sensitivity toward them. Hospital for Special Surgery in New York City, a specialized urban academic center, with a 5-year Orthopedic Surgery Residency program. 70 PGY3 residents, for whom the program is a requirement, and 711 older adult participants recruited from a community convenience sample. Older adult participants: Of 711 participants, 672 (95%) responded; 96% strongly agreed/agreed that the residents had demonstrated sensitivity toward them. Residents: Of 70 residents, 35 (50%) were assessed. Mean knowledge scores increased significantly (p ≤ 0.001); five of nine attitude items (p ≤ 0.05) and one of four anxiety items improved significantly (p ≤ 0.001). Significant change was seen in residents' attitudes and anxiety levels toward older adults, attributes that are usually deep seated and hard to change. Residents moved along the Accreditation Council for Graduate

Prevalence of depressive symptoms in older nursing home residents with intact cognitive function in Taiwan.

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Hu, Sophia H; Chuang, Yeu-Hui; Ting, Yeh-Feng; Lin, Kuan-Yu; Hsieh, Chia-Jung

2018-03-25

The investigators aimed to explore the prevalence of depressive symptoms and associated factors among older residents with intact cognitive function in nursing homes in Taiwan. A cross-sectional descriptive and correlational research design was used. A convenience sample of 178 older residents without cognitive impairment was recruited from 36 nursing homes in Southern Taiwan. The questionnaires included demographic data; the Barthel Index, which assesses the ability to perform activities of daily living; and the Geriatric Depression Scale Short Form. Among older residents in nursing homes with intact cognitive function, 39.3% had depressive symptoms. Age, religion, previous living status, previous working status, being totally dependent in physical function, and being severely dependent in physical function were significant predictors of depressive symptoms among cognitively intact older residents. The findings highlight the critical mental healthcare issues among older residents with intact cognitive function in nursing homes. Practical strategies for preventing the occurrence of depressive symptoms and caring for those who have depressive symptoms should be developed, especially for younger or dependent older residents or residents who have never been employed, have no religious beliefs, or have lived alone before they moved into an institution. © 2018 Wiley Periodicals, Inc.

Older people. Courtesy entitles.

Science.gov (United States)

Calnan, Michael; Woolhead, Gillian; Dieppe, Paul

2003-02-20

A study of 72 people, with an average age of 72, showed that dignity--and lack of it--were key issues in their estimation of care. Concerns about lack of dignity centred on lack of privacy, mixed sex wards, forms of address and loss of independence. The study suggested that older people do not complain about care for fear of retaliation.

Factors associated with self-rated health in older people living in institutions

Directory of Open Access Journals (Sweden)

Pastor-Barriuso Roberto

2008-02-01

Full Text Available Abstract Background Although self-rated health has been extensively studied in community older people, its determinants have seldom been investigated in institutional settings. We carried out a cross-sectional study to describe the physical, mental, and social factors associated with self-rated health in nursing homes and other geriatric facilities. Methods A representative sample of 800 subjects 65 years of age and older living in 19 public and 30 private institutions of Madrid was randomly selected through stratified cluster sampling. Residents, caregivers, physicians, and nurses were interviewed by trained geriatricians using standardized instruments to assess self-rated health, chronic illnesses, functional capacity, cognitive status, depressive symptoms, vision and hearing problems, and social support. Results Of the 669 interviewed residents (response rate 84%, 55% rated their health as good or very good. There was no association with sex or age. Residents in private facilities and those who completed primary education had significantly better health perception. The adjusted odds ratio (95% confidence interval for worse health perception was 1.18 (1.07–1.28 for each additional chronic condition, 2.37 (1.38–4.06 when comparing residents with moderate dependency to those functionally independent, and 10.45 (5.84–18.68 when comparing residents with moderate/severe depressive symptoms to those without symptoms. Visual problems were also associated with worse health perception. Similar results were obtained in subgroup analyses, except for inconsistencies in cognitively impaired individuals. Conclusion Chronic conditions, functional status, depressive symptoms and socioeconomic factors were the main determinants of perceived health among Spanish institutionalized elderly persons. Doubts remain about the proper assessment of subjective health in residents with altered cognition.

The economic status of older people's households in urban and rural settings in Peru, Mexico and China: a 10/66 INDEP study cross-sectional survey.

Science.gov (United States)

Prince, Martin J; Lloyd-Sherlock, Peter; Guerra, Mariella; Huang, Yueqin; Sosa, Ana Luisa; Uwakwe, Richard; Acosta, Isaac; Liu, Zhaorui; Gallardo, Sara; Guerchet, Maelenn; Mayston, Rosie; de Oca, Veronica Montes; Wang, Hong; Ezeah, Peter

2016-01-01

Few data are available from middle income countries regarding economic circumstances of households in which older people live. Many such settings have experienced rapid demographic, social and economic change, alongside increasing pension coverage. Population-based household surveys in rural and urban catchment areas in Peru, Mexico and China. Participating households were selected from all households with older residents. Descriptive analyses were weighted back for sampling fractions and non-response. Household income and consumption were estimated from a household key informant interview. 877 Household interviews (3177 residents). Response rate 68 %. Household income and consumption correlated plausibly with other economic wellbeing indicators. Household Incomes varied considerably within and between sites. While multigenerational households were the norm, older resident's incomes accounted for a high proportion of household income, and older people were particularly likely to pool income. Differences in the coverage and value of pensions were a major source of variation in household income among sites. There was a small, consistent inverse association between household pension income and labour force participation of younger adult co-residents. The effect of pension income on older adults' labour force participation was less clear-cut. Historical linkage of social protection to formal employment may have contributed to profound late-life socioeconomic inequalities. Strategies to formalise the informal economy, alongside increases in the coverage and value of non-contributory pensions and transfers would help to address this problem.

Resourcefulness, positive cognitions, relocation controllability and relocation adjustment among older people: a cross-sectional study of cultural differences.

Science.gov (United States)

Bekhet, Abir K; Zauszniewski, Jaclene A

2013-09-01

The population of older people in both the United States and Egypt is expected to double by the year 2030. With ageing, chronic illnesses increase and many older people need to relocate to retirement communities. Research has shown that positive cognitions and resourcefulness are positively correlated with adaptive functioning and better adjustment. The purpose of this study was to examine and compare relocation controllability, positive cognitions, resourcefulness and relocation adjustment between American and Egyptian older people living in retirement communities. The purpose of this cultural comparison is to gain insight into influencing factors in each culture that might lead to interventions to help relocated older adults in both cultures adjust to their new surroundings. A cross-sectional, descriptive design was used to compare relocation controllability, positive cognitions, resourcefulness and relocation adjustment of a convenience sample of American older people (n = 104) and a convenience sample of Egyptian older people (n = 94). The study was a secondary analysis of two studies of older people residing in six retirement communities in Northeast Ohio and in five retirement communities in Alexandria, Egypt. Examination of mean scores and standard deviations on the measure of positive cognitions using independent sample t-tests indicated that on average, the American older people reported more positive cognitions (t (131.16) = 11.29, P difference between Egyptians and Americans in resourcefulness (t (174.16) = -0.97, P > 0.05). The results provide direction for the development of positive cognition interventions and engaging older people in the decision-making process to help them to adjust to relocation. Implications for practice.  Positive thinking and resourcefulness training interventions can be used by nurses to help relocated older people to adjust to the stress of relocation to retirement communities. These interventions can be used on primary

How older people with learning disabilities perceive ageing.

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Jenkins, Robert

2010-07-01

This article discusses the author's use of reflexivity in trying to gain a better understanding of ageing in older people with learning disabilities. In the general population ageing is viewed in rather negative terms and as a significant life transition. However, for some older people with learning disabilities this transition may go unnoticed because of their past negative life experiences and lack of opportunities. Reflexivity has the potential to provide nurses with greater understanding of the personal perspectives of older people with learning disabilities.

Embodied thermal environments: an examination of older-people's sensory experiences in a variety of residential types

International Nuclear Information System (INIS)

Henshaw, Victoria; Guy, Simon

2015-01-01

Thermal sensations of space, namely temperature, humidity and the movement of air, can be difficult to separate from other sensory information such as the sound of fans or ventilation equipment, or the smell of damp or cool fresh air. Despite this factor, efforts to reduce the consumption of energy through the installation of low-carbon technologies including sealed whole-building systems frequently isolate the thermal environment and fail to recognise and respond to the influence of other sensory information on personal preferences and behaviours. Older people represent an increasing proportion of the UK's population, can be faced with a range of physiological challenges associated with ageing, and sometimes have long-established personal preferences. Drawing from data collected across the Conditioning Demand Project, this paper explores the embodied nature of older people's experiences of low-carbon and more traditional thermal technologies in private residences, extra-care housing and residential care-homes, focussing specifically upon auditory and olfactory stimulus. Exploring the management of the sensory experience across these settings, we analyse each case to inform the development of new design and policy approaches to tackling housing for older people. In doing so, we further build connections between energy research and debates around sensory urbanism. -- Highlights: •Some thermal technologies present particular sensory issues and problems for older people. •Older people use a range of sensory stimuli in evaluating and controlling thermal environments. •Older people use non-thermal sensory information when selecting between thermal technologies. •Sensory information plays an important role in thermal technology maintenance

Anybody Hear Us? Attempting to Meet the Psychological Care Needs of Older People: an Ethnographic Approach

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Seyed Zia Tabatabaei

2016-07-01

Full Text Available Older people who live in residential settings need some psychological support because of vicissitudes of life they faced with. The aim of this study is to explore psychological care needs of older people in a residential home. We used an ethnographic approach from May 2011 till January 2012. Through purposeful sampling, 14 knowledgeable participants were selected. Data were gathered from participant observations, in-depth interviews, review of related documents and field notes. Thematic analysis revealed three key themes including: (a Feelings of sadness (b Emotional desires and (c Choice and control. Findings of current study provided rich and useful information that is useful in charting new guideline for policy makers and care providers in order to support elderly residents' psychological care needs.

Destination Memory Impairment in Older People

OpenAIRE

Gopie, Nigel; Craik, Fergus I. M.; Hasher, Lynn

2010-01-01

Older adults are assumed to have poor destination memory— knowing to whom they tell particular information—and anecdotes about them repeating stories to the same people are cited as informal evidence for this claim. Experiment 1 assessed young and older adults’ destination memory by having participants tell facts (e.g., “A dime has 118 ridges around its edge”) to pictures of famous people (e.g., Oprah Winfrey). Surprise recognition memory tests, which also assessed confidence, revealed that o...

Better housing and living conditions for older people

DEFF Research Database (Denmark)

housing stock and local neighbourhood facilites be made more responsive to the demands of older people? How can housing and planning measures contribute to the integration of older people in local communities? How can urban renewal be implemented in elderly-friendly forms? What forms of coordination......There is an increasing emphasis on strategies designed to combat the exclusion of older people from society. The development of social policies oriented towards community care and community living has important consequences for housing policies and urban planning policies. How can the general...

Alcohol and older people: A systematic review of barriers, facilitators and context of drinking in older people and implications for intervention design.

Science.gov (United States)

Kelly, Sarah; Olanrewaju, Olawale; Cowan, Andy; Brayne, Carol; Lafortune, Louise

2018-01-01

Harmful alcohol consumption in older people has increased and effective approaches to understanding and addressing this societal concern are needed. Systematic review of qualitative studies in older populations (55+ years) to identify barriers, facilitators or context of drinking in older people. Multiple databases (MEDLINE, EMBASE, PsycINFO, CINAHL, CENTRAL, Social Sciences Citation Index, York Centre for Reviews and Dissemination, Cochrane database and grey literature) were searched from 2000 to February 2017 for studies in English, from OECD countries using MeSH terms and text words relating to alcohol combined with older age terms. Study quality was assessed using NICE methodology. The review is reported according to PRISMA. Drinking in older people is strongly linked to social engagement and there is scepticism about the health risks of alcohol. Drinking was also linked to difficulties such as social isolation, illness or bereavement. Alcohol can be related to routines and identity. However, older people often regulate their own drinking and strategies that emphasise the life experience of older people to drink wisely could be helpful. To be effective societal approaches need to take into account contexts of risks for harmful drinking. The evidence supports a strong social role for drinking alcohol which should be taken into account in any policy development with the potential benefits of social participation for cognitive health. Approaches to reducing alcohol use in older people need to avoid paradoxical harm, with a need for approaches that reduce harm from drinking alcohol but retain the benefit of socialising.

Alcohol and older people: A systematic review of barriers, facilitators and context of drinking in older people and implications for intervention design.

Directory of Open Access Journals (Sweden)

Sarah Kelly

Full Text Available Harmful alcohol consumption in older people has increased and effective approaches to understanding and addressing this societal concern are needed.Systematic review of qualitative studies in older populations (55+ years to identify barriers, facilitators or context of drinking in older people. Multiple databases (MEDLINE, EMBASE, PsycINFO, CINAHL, CENTRAL, Social Sciences Citation Index, York Centre for Reviews and Dissemination, Cochrane database and grey literature were searched from 2000 to February 2017 for studies in English, from OECD countries using MeSH terms and text words relating to alcohol combined with older age terms. Study quality was assessed using NICE methodology. The review is reported according to PRISMA.Drinking in older people is strongly linked to social engagement and there is scepticism about the health risks of alcohol. Drinking was also linked to difficulties such as social isolation, illness or bereavement. Alcohol can be related to routines and identity. However, older people often regulate their own drinking and strategies that emphasise the life experience of older people to drink wisely could be helpful.To be effective societal approaches need to take into account contexts of risks for harmful drinking. The evidence supports a strong social role for drinking alcohol which should be taken into account in any policy development with the potential benefits of social participation for cognitive health. Approaches to reducing alcohol use in older people need to avoid paradoxical harm, with a need for approaches that reduce harm from drinking alcohol but retain the benefit of socialising.

The Representation of Older People in East Asian Television Advertisements.

Science.gov (United States)

Prieler, Michael; Ivanov, Alex; Hagiwara, Shigeru

2017-06-01

In this study, 432 television advertisements from Hong Kong, Japan, and South Korea were analyzed to determine their representations of older people. Findings demonstrate that in East Asian advertisements, older people are highly underrepresented, appear in major roles, mostly alongside younger people, and older men clearly outnumber older women. The other variables investigated (i.e., setting and product categories) led to no conclusive findings for the three societies. In short, our study, employing ethnolinguistic vitality theory to analyze television advertisements, demonstrates how East Asian societies greatly marginalize older people. Potential effects of such representations are discussed using social cognitive theory and cultivation theory.

Ageing well? A cross-country analysis of the way older people are visually represented on websites of organizations for older people

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Eugène Loos

2017-12-01

Full Text Available The ‘aging well’ discourse advances the idea of making older people responsible for their capability to stay healthy and active. In the context of an increased ageing population, which poses several challenges to countries’ government, this discourse has become dominant in Europe. We explore the way older people are visually represented on websites of organizations for older people in seven European countries (Finland, UK, the Netherlands, Spain, Italy, Poland and Romania, using an analytical approached based on visual content analysis, inspired by the dimensional model of national cultural differences from the Hofstede model (1991; 2001; 2011. We used two out of the five Hofstede dimensions: Individualism/Collectivism (IDV and Masculinity/Femininity (MAS. The results demonstrated that in all seven countries older people are mostly visually represented as healthy/active, which reflects a dominant ‘ageing well’ discourse in Europe. The results also demonstrated that in most cases older people tend to be represented together with others, which is not consonant with the dominant ‘ageing well’ discourse in Europe. A last finding was that the visual representation of older people is in about half of the cases in line with these Hofstede dimensions. We discuss the implications of these findings claiming that the ‘ageing well’ discourse might lead to ‘visual ageism’. Organizations could keep this in mind while using pictures for their website or in other media and consider to use various kind of pictures, or to avoid using pictures of older people that stigmatize, marginalize or injure. They could look into the cultural situatedness and intersectional character of age relations and consider alternative strategies of both visibility and invisibility to talk with and about our ageing societies.

Psychosocial and Mental Health Problems of Older People in Postearthquake Nepal.

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Adhikari, Ramesh P; Upadhaya, Nawaraj; Paudel, Sasmita; Pokhrel, Ruja; Bhandari, Nagendra; Cole, Laura; Koirala, Suraj

2017-03-01

To identify community perceptions on psychosocial and mental health problems of older people in postearthquake situation in Nepal. A qualitative methodology was adopted to explore the experience and opinions of older people, social workers, school teachers, health workers, and nongovernmental organization workers on the psychosocial and mental health problems of older people in Nepal, using key informant interviews. Major local vocabulary for older peoples' psychosocial and mental health problems were "bichalan" (variation in mood and feeling), "ekohoro" (becoming single minded), "athmabiswasko kami" (low self-esteem), and "bina karan rune" (crying without any reason). The major causes attributed to older people's problems were physical injury, disability, family conflict, and economic problems. Forgetfulness, tiredness, loss of concentration, restlessness, and isolation were observed in older people since the 2015 earthquake. The findings suggest that earthquake had negative impact on older people's psychosocial well-being; however, little support or treatment options have been made available to these individuals. The tailor-made community-based psychosocial and mental health programs for older people are needed.

Neighbors Connected; Exploring Recruitment of Dutch Older People for Activities

NARCIS (Netherlands)

Lezwijn, J.; Vaandrager, L.; Wagemakers, A.; Koelen, M.; Woerkum, van C.

2015-01-01

The recruitment of older people to engage in actions aimed at promoting health is an issue that does not receive much attention within health promotion practice. Many activities for older people are organized; however, less socially active older people do not participate in such activities. The aim

Access to mobile communications by older people.

Science.gov (United States)

Nguyen, Toan; Irizarry, Carol; Garrett, Rob; Downing, Andrew

2015-06-01

To investigate how older people effectively identify, select and learn to use mobile communications technologies to enhance communication and safety, and support independent living. One hundred and fifty-three older South Australians participated in a purpose-designed survey questionnaire. Older people relied on family and friends for information and advice (76%), and their children's assistance with buying (45%) and learning to use (48%) new technology. The most preferred learning method was face-to-face training (56%). Less than half (44%) were interested in trying out new designs/applications, functions and capabilities that could assist with independent living. The highest need was for personal security and emergencies (88%). Findings suggest that the family and friends of older people play an important role in identifying, selecting and learning to use mobile communication technologies. The safety and emergency capabilities of mobile communications technologies were more important than having functions that could assist with independent living. © 2014 ACOTA.

Diabetes in older people: position statement of The Hong Kong Geriatrics Society and the Hong Kong Society of Endocrinology, Metabolism and Reproduction.

Science.gov (United States)

Wong, C W; Lee, J Sw; Tam, K F; Hung, H F; So, W Y; Shum, C K; Lam, C Y; Cheng, J N; Man, S P; Auyeung, T W

2017-10-01

Following a survey on the clinical practice of geriatricians in the management of older people with diabetes and a study of hypoglycaemia in diabetic patients, a round-table discussion with geriatricians and endocrinologists was held in January 2015. Consensus was reached for six domains specifically related to older diabetic people: (1) the considerations when setting an individualised diabetic management; (2) inclusion of geriatric syndrome screening in assessment; (3) glycaemic and blood pressure targets; (4) pharmacotherapy; (5) restrictive diabetic diet; and (6) management goals for nursing home residents.

Mental health issues and discrimination among older LGBTI people.

Science.gov (United States)

Tinney, Jean; Dow, Briony; Maude, Phillip; Purchase, Rachel; Whyte, Carolyn; Barrett, Catherine

2015-09-01

LGBT is an acronym used to describe people from diverse sexual orientation or gender identity, people that are gay, lesbian, bisexual, or transgender. LGBT people do not constitute a single group nor does each individual "group" constitute a homogeneous unity. However, as higher rates of depression and/or anxiety have been observed in older LGBT people, compared to their heterosexual counterparts (Guasp, 2011) there is a need to raise the profile of mental health issues amongst these groups. The additional letter I is also often included in the acronym LGBTI as intersex people are often included as another gender diverse group. However, there is very little research that includes intersex people and none on older intersex people's mental health so this editorial is restricted to consideration of older LGBT people.

Self-determination and older people--a concept analysis.

Science.gov (United States)

Ekelund, Christina; Dahlin-Ivanoff, Synneve; Eklund, Kajsa

2014-03-01

Self-determination has emerged as an important concept within health care, used to emphasize clients' control and independence as they participate in rehabilitation. To strengthen clients' self-determination is a central aim in occupational therapy. However, there is a lack of a clear definition of self-determination concerning community-dwelling older people. The definition should be flexible in different contexts, such as cultural. To define and clarify the concept of self-determination in relation to community-dwelling frail older people. Walker & Avant's analysis procedure was carried out to identify textual attributes to the concept of self-determination, supplemented by a content analysis of 21 articles that were used to define and further justify the textual attributes. Self-determination was used in diverse contexts for community-dwelling older people, concerning: decision-making in everyday life, professionals' views, health, and legal/ethical rights. Different textual attributes were identified, to propose a conceptual definition of self-determination in relation to community-dwelling frail older people: A process in which a person has control and legal/ethical rights, and has the knowledge and ability to make a decision of his/her own free choice. This concept analysis has contributed to clarifying the concept for the convenience of research with community-dwelling frail older people.

Health, wellbeing, and disability among older people infected or affected by HIV in Uganda and South Africa

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Makandwe Nyirenda

2013-01-01

Full Text Available Objective: To describe and compare the health status, emotional wellbeing, and functional status of older people in Uganda and South Africa who are HIV infected or affected by HIV in their families. Methods: Data came from the general population cohort and Entebbe cohort of the Medical Research Council/Uganda Virus Research Institute, and from the Africa Centre Demographic Information System through cross-sectional surveys in 2009/10 using instruments adapted from the World Health Organization (WHO Study on Global Ageing and adult health (SAGE. Analysis was based on 932 people aged 50 years or older (510 Uganda, 422 South Africa. Results: Participants in South Africa were slightly younger (median age − 60 years in South Africa, 63 in Uganda, and more were currently married, had no formal education, were not working, and were residing in a rural area. Adjusting for socio-demographic factors, older people in South Africa were significantly less likely to have good functional ability [adjusted odds ratio (aOR 0.72, 95% CI 0.53–0.98] than those in Uganda, but were more likely to be in good subjective wellbeing (aOR 2.15, 95% CI 1.60–2.90. South Africans were more likely to be obese (aOR 5.26, 95% CI 3.46–8.00 or to be diagnosed with hypertension (aOR 2.77, 95% CI 2.06–3.73. Discussion and conclusions: While older people's health problems are similar in the two countries, marked socio-demographic differences influence the extent to which older people are affected by poorer health. It is therefore imperative when designing policies to improve the health and wellbeing of older people in sub-Saharan Africa that the region is not treated as a homogenous entity.

The nutritional status of 1081 elderly people residing in publicly funded shelter homes in Peninsular Malaysia.

Science.gov (United States)

Visvanathan, R; Zaiton, A; Sherina, M S; Muhamad, Y A

2005-03-01

The aim of this study was to determine the: (1) prevalence of undernutrition as determined by the 'DETERMINE Your Nutritional Health Checklist' (NHC) and (2) factors independently associated with undernutrition among the older residents of these publicly funded shelter homes in Peninsular Malaysia. A total of 1081 elderly people (59%M) over the age of 60 y were surveyed using questionnaires determining baseline demographics, nutritional and cognitive status, physical function and psychological well-being. Shelter homes, Peninsular Malaysia. In all, 41.4% (n = 447) were nourished (score 5) according to the NHC. A large proportion of subjects were underweight with 14.3% of subjects recording a low body mass index (BMI) or = 3). Using a BMI people residing in publicly funded shelter homes in Malaysia may be at-risk of undernutrition, and were underweight. The NHC is better used as an awareness tool rather than as a screening tool.

Older people's experiences of dream coaching.

Science.gov (United States)

Wadensten, Barbro

2009-12-01

Recalling and talking about dreams could initiate dream work among older people and provide an opportunity for self-confrontation and personal growth, which could in turn promote gerotranscendental development. The present article describes older people's opinions about participating in a dream-coaching group; it also briefly describes the theoretical foundation of dream coaching. The study aim was to investigate older people's experience of participating in a dream-coaching group based on Jungian psychology. A descriptive design was used. Retrospective interviews were explored using qualitative content analysis. The participants were satisfied with the arrangement of the dream-coaching groups. All participants believed that they had recalled their dreams and thought much more about their dreams during the period in which the dream-coaching group met. Three diverse appraisals of participating in a dream-coaching group, which had different effects on the participants, were identified: "An activity like any other activity," "An activity that led to deeper thoughts about the meaning of dreams," and "An activity that led to deeper thoughts both about the meaning of dreams and about how dreams can improve one's understanding of the life situation." It is possible to arrange dream-coaching groups for older people and could be a way to promote personal development using this type of intervention. The study provides some guidance as to how such a group could be organized, thus facilitating use of dream-coaching groups in gerontological care.

Dry mouth and older people.

Science.gov (United States)

Thomson, W M

2015-03-01

Dry mouth is more common among older people than in any other age group. Appropriate definition and accurate measurement of dry mouth is critical for better understanding, monitoring and treatment of the condition. Xerostomia is the symptom(s) of dry mouth; it can be measured using methods ranging from single questions to multi-item summated rating scales. Low salivary flow (known as salivary gland hypofunction, or SGH) must be determined by measuring that flow. The relationship between SGH and xerostomia is not straightforward, but both conditions are common among older people, and they affect sufferers' day-to-day lives in important ways. The major risk factor for dry mouth is the taking of particular medications, and older people take more of those than any other age group, not only for symptomatic relief of various age-associated chronic diseases, but also in order to reduce the likelihood of complications which may arise from those conditions. The greater the number taken, the greater the associated anticholinergic burden, and the more likely it is that the individual will suffer from dry mouth. Since treating dry mouth is such a challenge for clinicians, there is a need for dentists, doctors and pharmacists to work together to prevent it occurring. © 2015 Australian Dental Association.

Intersectoral interagency partnerships to promote financial capability in older people.

Science.gov (United States)

Hean, Sarah; Fenge, Lee Ann; Worswick, Louise; Wilkinson, Charlie; Fearnley, Stella

2012-09-01

From the second quarter of 2008, the UK economy entered a period of economic decline. Older people are particularly vulnerable during these times. To promote ways in which older people can be better supported to maintain their financial well-being, this study explored the sources older people utilize to keep themselves financially informed. Interviews with older people (n = 28) showed that older people access trusted sources of information (e.g. healthcare professionals) rather than specialist financial information providers (e.g. financial advisors) which highlighted the need for interagency working between financial services in the private, public and voluntary sectors. An example of how such interagency partnerships might be achieved in practice is presented with some recommendations on directions for future research into interagency working that spans public, private and voluntary sectors.

OLDER PEOPLE AND SPORT, LOOKING BEYOND THE HEALTH PERSPECTIVE

Directory of Open Access Journals (Sweden)

Eva VONCK

2010-01-01

Full Text Available This paper explores some important theoretical questions on the relationship between sports and older people, beyond the health perspective. Sport has been attributed numerous social functions and meanings. Also policymakers have experimented with the use of sport for social purposes. However, both research and poli cy initiatives are in general cons idered from a functional and instrumental point of view. Especially considering older people sport is mainly approached from a health perspective. A combination of insights from gerontology and sport sciences should help us gain a better view on how sport can contribute to the social integration of older people. This paper offers an extensive literature review focusing on formulating opportunities for further research about sport participation among older people.

A cross-sectional survey of the access of older people in the Scottish Highlands to general medical practices, community pharmacies and prescription medicines.

Science.gov (United States)

Rushworth, Gordon F; Cunningham, Scott; Pfleger, Sharon; Hall, Jenny; Stewart, Derek

2018-01-01

Access to medicines and healthcare is more problematic in remote and rural areas. To quantify issues of access to general practitioners (GPs), community pharmacies and prescribed medicines in older people resident in the Scottish Highlands. Anonymized questionnaires were mailed to a random sample of 2000 older people (≥60 years) resident in the Scottish Highlands. Questionnaire items were: access and convenience to GP and pharmacy services (10 items); prescribed medicines (13 items); attitudinal statements based on the Theoretical Domains Framework (12 items); quality of life (SF8, 8 items); and demographics (12 items). Results were analysed using descriptive, inferential and spatial statistics, and principal component analysis (PCA) of attitudinal items. With a response rate of 54.2%, the majority reported convenient access to GPs (89.1%) and community pharmacies (84.3%). Older age respondents (p rural areas to community pharmacies (p rural areas and taking five or more prescribed medicines. Copyright © 2017 Elsevier Inc. All rights reserved.

Destination memory impairment in older people.

Science.gov (United States)

Gopie, Nigel; Craik, Fergus I M; Hasher, Lynn

2010-12-01

Older adults are assumed to have poor destination memory-knowing to whom they tell particular information-and anecdotes about them repeating stories to the same people are cited as informal evidence for this claim. Experiment 1 assessed young and older adults' destination memory by having participants tell facts (e.g., "A dime has 118 ridges around its edge") to pictures of famous people (e.g., Oprah Winfrey). Surprise recognition memory tests, which also assessed confidence, revealed that older adults, compared to young adults, were disproportionately impaired on destination memory relative to spared memory for the individual components (i.e., facts, faces) of the episode. Older adults also were more confident that they had not told a fact to a particular person when they actually had (i.e., a miss); this presumably causes them to repeat information more often than young adults. When the direction of information transfer was reversed in Experiment 2, such that the famous people shared information with the participants (i.e., a source memory experiment), age-related memory differences disappeared. In contrast to the destination memory experiment, older adults in the source memory experiment were more confident than young adults that someone had shared a fact with them when a different person actually had shared the fact (i.e., a false alarm). Overall, accuracy and confidence jointly influence age-related changes to destination memory, a fundamental component of successful communication. (c) 2010 APA, all rights reserved).

The effect of a music programme during lunchtime on the problem behaviour of the older residents with dementia at an institution in Taiwan.

Science.gov (United States)

Chang, Fang-Yu; Huang, Hui-Chi; Lin, Kuan-Chia; Lin, Li-Chan

2010-04-01

To study the effect of a music programme during lunchtime on problem behaviour among institutionalised older residents with dementia. Symptoms of dementia among older people include depression, problems with memory, insomnia and problem behaviours. Problem behaviour has been identified by families and nurses as the greatest challenge that needs to be addressed. Several studies have found that music therapy can reduce problem behaviours among dementia sufferers and, based on this finding, music has been recommended for incorporation as part of dementia management. This study used a quasi-experimental design with an eight-week time series follow-up. The intervention was background music when residents had their lunch meal. A purposive sampling technique was used. Forty-one participants were selected from an institution housing residents with dementia located in a city in Taiwan. The mean age of participants was 81.68 (SD 6.39) years old. The mean score for Mini-Mental State Examination (MMSE) was 10.66 (SD 6.85). The mean of Barthel Activity of Daily Living score was 56.83 (SD 38.12). The results showed that the music programme reduced, significantly, physical and verbal aggressive behaviour among the older residents with dementia. The study identified that there was a one-week time lag between the implementation of the music programme and a significant effect on the residents. The results from this study suggested that music is able to reduce the degree of problem behaviours among the older residents with dementia and this helps to ease work-load of nurse aides and nurses during meal times. The results may serve as a reference for the future treatment of problem behaviour among the older with dementia.

Older people, food and satisfaction with life

DEFF Research Database (Denmark)

Dean, Moira; Raats, Monique M.; Grunert, Klaus G.

2009-01-01

This chapter discusses food-related satisfaction with life of older people, identifying some of the determinants and barriers to satisfaction with food-related quality of life, and discusses possible ways of enhancing older people's quality of life in the domain of food. Despite being strongly...... associated with life, and heavily contributing to the quality of life, food has so far been neglected and not much research has been conducted into people's satisfaction with their food-related life and its relationship to overall life satisfaction. As people age, their goals and available resources in terms...... of health, social networks, income and skills change. Changes in resources can be expected to have an impact on satisfaction with life....

Older People and Social Connectedness: How Place and Activities Keep People Engaged

Directory of Open Access Journals (Sweden)

Irene H. Yen

2012-01-01

Full Text Available To understand how older adults perceive and navigate their neighborhoods, we examined the implications of activity in their neighborhoods for their health. We interviewed 38 adults (ages 62–85 who lived in San Francisco or Oakland, California. Seven key themes emerged: (1 people express a wide range of expectations for neighborliness, from “we do not bother each other” to “we have keys to each other’s houses”, (2 social distance between “other” people impede a sense of connection, (3 ethnic differences in living arrangements affect activities and activity locations, (4 people try to stay busy, (5 people able to leave their homes do many activities outside their immediate residential neighborhoods, (6 access to a car is a necessity for most, and (7 it is unusual to plan for the future when mobility might become limited. Multiple locations influence older adults’ health, including residential neighborhoods. Older adults value mobility, active lives, and social connections.

Qualitative Assessment of the Impact of Implementing Reiki Training in a Supported Residence for People Older Than 50 Years with HIV/AIDS

Science.gov (United States)

Mehl-Madrona, Lewis; Renfrew, Nita M; Mainguy, Barbara

2011-01-01

Introduction: Reiki is a Japanese form of energy healing that has become popular in the US. Reiki training involves three stages—levels I, II, and III—to a master practitioner level and requires both giving and receiving Reiki. We set out to implement a program to train clients of a supported residence in Brooklyn, NY. They were all older than age 50 years and had HIV/AIDS and substance-abuse and/or mental-health disorders. Methods: A qualitative, narrative-inquiry study was conducted. The Reiki master kept a journal of her 3 years of providing 90 minutes of Reiki treatment and/or training once weekly at the residence. Forty-five of 50 potential participants attended these sessions with various frequencies. Stories were collected from 35 participants regarding their experience of Reiki training. We posited success as continued involvement in the program. Results: All 35 participants reported receiving benefit from participation in Reiki. Participants first took part in training because of the offered subway tokens; however, 40 continued their involvement despite a lack of compensation. When asked why they continued, participants reported life-changing experiences, including a greater ability to cope with addictions, a greater ability to manage counseling, healing of wounds, improvement of T-cell counts, and improved skills of daily living. Conclusion: Reiki training can be successfully implemented in a supported housing facility with people with HIV/AIDS and comorbid disorders. Some people in our study population reported areas of improvement and life-changing experiences. Our study did not establish the efficacy of Reiki, but our findings support the effect of the entire gestalt of implementing a program related to spirituality and healing and supports the goal of implementing a larger randomized, controlled trial in this setting to establish the efficacy of Reiki. PMID:22058669

Understanding Older People's Readiness for Receiving Telehealth: Mixed-Method Study.

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van Houwelingen, Cornelis Tm; Ettema, Roelof Ga; Antonietti, Michelangelo Gef; Kort, Helianthe Sm

2018-04-06

The Dutch Ministry of Health has formulated ambitious goals concerning the use of telehealth, leading to subsequent changes compared with the current health care situation, in which 93% of care is delivered face-to-face. Since most care is delivered to older people, the prospect of telehealth raises the question of whether this population is ready for this new way of receiving care. To study this, we created a theoretical framework consisting of 6 factors associated with older people's intention to use technology. The objective of this study was to understand community-dwelling older people's readiness for receiving telehealth by studying their intention to use videoconferencing and capacities for using digital technology in daily life as indicators. A mixed-method triangulation design was used. First, a cross-sectional survey study was performed to investigate older people's intention to use videoconferencing, by testing our theoretical framework with a multilevel path analysis (phase 1). Second, for deeper understanding of older people's actual use of digital technology, qualitative observations of older people executing technological tasks (eg, on a computer, cell phone) were conducted at their homes (phase 2). In phase 1, a total of 256 people aged 65 years or older participated in the survey study (50.0% male; median age, 70 years; Q1-Q3: 67-76). Using a significance level of .05, we found seven significant associations regarding older people's perception of videoconferencing. Older people's (1) intention to use videoconferencing was predicted by their performance expectancy (odds ratio [OR] 1.26, 95% CI 1.13-1.39), effort expectancy (OR 1.23, 95% CI 1.07-1.39), and perceived privacy and security (OR 1.30, 95% CI 1.17-1.43); (2) their performance expectancy was predicted by their effort expectancy (OR 1.38, 95% CI 1.24-1.52); and (3) their effort expectancy was predicted by their self-efficacy (OR 1.55, 95% CI 1.42-1.68). In phase 2, a total of 6 men and 9

Re-Imagining the Care Home: A Spatially Responsive Approach to Arts Practice with Older People in Residential Care

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Hatton, Nicola

2014-01-01

This paper considers some of the spatial challenges of doing arts projects with older people in care homes, including those living with dementia. It reflects on the author's own experience of running a performance project with residents with at a care home in North London. Drawing on Lefebvre's concept of socially produced space, it argues that…

Perceived autonomy and activity choices among physically disabled older people in nursing home settings: a randomized trial

DEFF Research Database (Denmark)

Andresen, Mette; Runge, Ulla; Hoff, Morten

2009-01-01

OBJECTIVE. To evaluate the effect of individually tailored programs on perceived autonomy in institutionalized physically disabled older people and to describe participants' activity wishes and content of the programs. METHOD. This blinded randomized trial with follow up included a total of nine...... the correspondence between the individual wishes for activities and the concrete content of the programs was not obvious, results indicate potential for enabling the perception of autonomy among physically disabled older nursing home residents. The clinical consequences may suggest a focus on existing traditions...... nursing homes and 50 nursing home residents who were randomized into either a control group or an intervention group. Perceived autonomy was measured at baseline (T1), after 12 weeks (T2) of intervention and after 24 weeks (T3) Wishes for daily activities was identified at T1. Weekly reports of individual...

Labor Force Nonparticipation of Older People: United States, 1890-1970.

Science.gov (United States)

Graney, Marshall J.; Cottam, Doris M.

1981-01-01

Analysis of U.S. census data provides evidence that decreased labor force participation of older people, 1980 to 1970, was due to the disproportionate growth in numbers of persons aged 65 or older and the growing economic dominance of industries that provide relatively few opportunities for older people's participation. (Author)

The effectiveness of crisis resolution/home treatment teams for older people with mental health problems: a systematic review and scoping exercise.

Science.gov (United States)

Toot, Sandeep; Devine, Mike; Orrell, Martin

2011-12-01

To assess the effectiveness of crisis resolution/home treatment services for older people with mental health problems. A systematic review was conducted to report on the effectiveness of crisis resolution/home treatment teams (CRHTTs) for older people with mental health problems. As part of the review, we also carried out a scoping exercise to assess the typologies of older people's CRHTTs in practice, and to review these in the context of policy and research findings. The literature contains Grade C evidence, according to the Oxford Centre of Evidence Based Medicine (CEBM) guidelines, that CRHTTs are effective in reducing numbers of admissions to hospitals. Outcomes such as length of hospital stay and maintenance of community residence were reviewed but evidence was inadequate for drawing conclusions. The scoping exercise defined three types of home treatment service model: generic home treatment teams; specialist older adults home treatment teams; and intermediate care services. These home treatment teams seemed to be effectively managing crises and reducing admissions. This review has shown a lack of evidence for the efficacy of crisis resolution/home treatment teams in supporting older people with mental health problems to remain at home. There is clearly a need for a randomised controlled trial to establish the efficacy of crisis resolution/home treatment services for older people with mental health problems, as well as a more focussed assessment of the different home treatment service models which have developed in the UK. Copyright © 2011 John Wiley & Sons, Ltd.

The relationship between older Americans act in-home services and low-care residents in nursing homes.

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Thomas, Kali S

2014-03-01

The aim of the study was to investigate the relationship between supportive services provided under Title III-B of the Older Americans Act (OAA) and the prevalence of low-care residents in nursing homes (NHs). State Program Reports (state-level expenditure and utilization data for each OAA service) and NH facility-level data were analyzed using a two-way fixed effects model. Results suggest that every additional 1% of the population age 65+ that receives personal care services is associated with a 0.8% decrease in the proportion of low-care residents in NHs. Despite efforts to rebalance long-term care, there are still many NH residents who have the functional capacity to live in a less restrictive environment. This is among the first studies to suggest that states that have invested in their in-home supportive services, particularly personal care services provided through the OAA, have proportionally fewer of these people.

Health Needs Assessment of Older People in an Agricultural Plantation

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Normah Che Din

2014-09-01

Conclusion: Psychological factors had the main influence on health functioning of the older people of FELDA. Physical health needs of the older people in FELDA were determined mainly by psychological, nutritional, and lifestyle factors, whereas mental health needs were determined mainly by psychological, socioeconomic, and social factors. FELDA has vast resources to utilize for the running and maintaining of health programs for their older people as well as for evaluating and monitoring the effectiveness of health programs.

The new caring: financial asset management and older people.

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Tilse, Cheryl; Wilson, Jill; Setterlund, Deborah; Rosenman, Linda

2007-10-01

Increasing longevity and the growing proportion of the aged in the population in most countries have served to focus on the question of how governments and older people can finance living, health, and care options in retirement. Prudent management of income and assets is an increasingly complex and important aspect of aging as assets and expectations of self-financing increase. Although many informal caregivers act as asset managers and/or substitute decision-makers for older people, little attention has been paid to this increasingly important aspect of care. This paper summaries key findings of a broad research program exploring family involvement in the management of older people's assets and the practices that constitute good practice as well as financial mismanagement and abuse. It identifies multi-level and multi-strategy responses needed to address the issues raised by the research and outlines an innovative community demonstration project aimed at improving financial management practices in relation to older people's assets.

Supporting the long-term residential care needs of older homeless people with severe alcohol-related brain injury in Australia: the Wicking Project.

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Rota-Bartelink, Alice; Lipmann, Bryan

2007-01-01

For years, community service providers have been frustrated with the lack in availability of long-term, specialized supported accommodation for older people, particularly older homeless people, with severe acquired brain injury (ABI) and challenging behaviors. Although the incidence of ABI (particularly alcohol-related brain injury) is far wider than being confined to the homeless population, it is frequently misdiagnosed and very often misunderstood Wintringham is an independent welfare company in Melbourne, Australia, that provides secure, affordable, long-term accommodation and high quality services to older homeless people. The high incidence of alcohol abuse among the resident population has led us to adapt our model ofcare to accommodate a complexity of need. However, there are some individuals with severely affected behaviors that continue to challenge Wintringham's capacity to provide adequate support. The deficiency in highly specialized, long-term supported accommodation for older people with severe alcohol-related brain injury (ARBI) is the driving force behind this project. We aim to further develop and improve the current Wintringham model of residential care to better support people with these complex care needs. We will report on the synthesis of this project which aims to test a specialized model that can be reproduced or adapted by other service providers to improve the life circumstances of these frequently forgotten people.

Optimising nutrition for older people with dementia.

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Cole, Delwyn

This article explores interventions that can be undertaken to establish and maintain adequate nutritional intake in older people with dementia. This is often a problem, particularly in the later stages of the disease. A literature review was conducted, which identified 12 articles for inclusion. Most of these articles described interventions to maintain adequate nutritional intake in older adults with dementia. Although no standardised intervention was reported, some approaches did appear to be more successful than others. Further research is required on how nurses and nursing assistants can help older people with dementia to maintain adequate nutrition. Staff need more time and training to improve nutritional intake in this group of patients. In addition, enhanced vigilance with respect to eating difficulties and food consumption is necessary.

Health professionals’ knowledge and attitudes toward older people in primary care in Saudi Arabia

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Alamri, Badrya H.; Xiao, Lily D.

2017-01-01

Previous international studies have indicated that a range of factors influence knowledge and attitudes toward older people were education, past work experiences, and social contact with healthy older people. This article reports on the findings of a literature review in relation to attitudes toward older people among health professionals working in primary healthcare centers in Saudi Arabia. The findings of this narrative literature are reported through 5 themes: the instruments used in the selected studies to measure attitudes toward older people; the instruments used to measure knowledge on ageing; attitudes toward older people; knowledge of the care of older people; and factors that influence knowledge and attitudes toward older people. Further investigation is needed to identify the level of knowledge on ageing, attitudes toward older people, and the factors which affect health professionals’ knowledge and attitudes toward older people in primary healthcare centers in Saudi Arabia. PMID:28251216

Health professionals' knowledge and attitudes toward older people in primary care in Saudi Arabia.

Science.gov (United States)

Alamri, Badrya H; Xiao, Lily D

2017-03-01

Previous international studies have indicated that a range of factors influence knowledge and attitudes toward older people were education, past work experiences, and social contact with healthy older people. This article reports on the findings of a literature review in relation to attitudes toward older people among health professionals working in primary healthcare centers in Saudi Arabia. The findings of this narrative literature are reported through 5 themes: the instruments used in the selected studies to measure attitudes toward older people; the instruments used to measure knowledge on ageing; attitudes toward older people; knowledge of the care of older people; and factors that influence knowledge and attitudes toward older people. Further investigation is needed to identify the level of knowledge on ageing, attitudes toward older people, and the factors which affect health professionals' knowledge and attitudes toward older people in primary healthcare centers in Saudi Arabia.

Social support and mental health status of older people: a population-based study in Iran-Tehran.

Science.gov (United States)

Tajvar, Maryam; Grundy, Emily; Fletcher, Astrid

2018-03-01

To investigate direct and stress-buffering associations between social support from family and the mental health of older people in Iran, a country which has recently undergone an exceptionally fast fertility transition and is consequently experiencing rapid population ageing. A cross-sectional stratified random survey of 800 people aged 60+ years resident in Tehran was conducted. In total, 644 people responded. The Social Provisions Scale and the General Health Questionnaire were used to measure perceived social support and mental health, respectively. Multilevel mixed-effects models were used to examine the hypotheses. The findings supported the hypothesis of a direct association between perceived and received social support and mental health. However, we did not find strong evidence to suggest that social support buffered the effects of stress arising from limitations of physical functioning. Lack of help doing paperwork was associated with worse mental health for women but not men. Source of support did not seem to be important. Our results indicated that in Tehran, as in Western settings, social support is important for the mental well-being of older people. Recommendations for policy and further research priorities based on the study findings were provided.

Tackling malnutrition among older people in the community.

Science.gov (United States)

Denny, Anna

2007-03-01

Undernutrition - of both macronutrients and micronutrients - is still a surprisingly common problem among older people in the UK. There is a variety of nutritional supplements that community nurses need to be aware of in managing their patients' nutritional requirements. Different supplements are taken for different disease states. This article looks at the various nutrient and energy requirements that relate directly to clients on the district nurse's caseload. Some of the negative consequences of malnutrition of the older adult are discussed, as are the NICE guidelines for nutrition. Factors affecting dietary intake in older people are considered.

[Dissertations 25 year after date 41. Older people's adaptability].

Science.gov (United States)

de Baat, C; Gerritsen, A E; van der Putten, G J; van der Maarel-Wierink, C D

2015-09-01

In 1990, the thesis 'Removable complete dentures in older people, an issue dealing with adaptability?' was published. Among other things, this thesis aimed at finding a method of measuring older people's adaptability to removable complete dentures. Its conclusion was that a subscale of the "Beoordelingsschaal voor Oudere Patiënten" (Rating scale for older patients) had predictive value. Subsequently, only a few research projects on this topic have been carried out. They dealt with demonstrated adaptation achieved after treatment, the realised adaptation. The results were disappointing. Ever since the availability of endosseous oral implants, research into adaptability to conventional removable complete dentures seems less relevant. During the last decades, inquiries into a method of measuring treatment effectiveness has focused on older people's quality of life and general health condition. However, to assess with respect to oral health care an older person's general health condition and load-taking capacity adequately, some experience is indispensable.

Pressure ulcer prevention in frail older people.

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Barry, Maree; Nugent, Linda

2015-12-16

Pressure ulcers are painful and cause discomfort, have a negative effect on quality of life, and are costly to treat. The incidence and severity of preventable pressure ulcers is an important indicator of quality of care; it is essential that healthcare providers monitor prevalence and incidence rates to ensure that care strategies implemented are effective. Frail older people are at increased risk of developing pressure ulcers. This article discusses the complexities of preventing pressure ulcers in frail older people and emphasises the importance of structured educational programmes that incorporate effective clinical leadership and multidisciplinary teamwork.

Older people living with HIV in Uganda: understanding their ...

African Journals Online (AJOL)

HIV-prevention, treatment and care programmes should seek to meet the special needs of older people through focused and innovative approaches. Further research with larger samples is needed to explore the impact of these healthcare needs on the quality of life of older people living with HIV. Keywords: ageing ...

The Importance of Trust in Successful Home Visit Programs for Older People

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Maaike E. Muntinga

2016-11-01

Full Text Available Outcomes of proactive home visit programs for frail, older people might be influenced by aspects of the caregiver–receiver interaction. We conducted a naturalistic case study to explore the interactional process between a nurse and an older woman during two home visits. Using an ethics of care, we posit that a trusting relationship is pivotal for older people to accept care that is proactively offered to them. Trust can be build when nurses meet the relational needs of older people. Nurses can achieve insight in these needs by exploring older people’s value systems and life stories. We argue that a strong focus on older people’s relational needs might contribute to success of proactive home visits for frail, older people.

A Phase II randomised controlled trial assessing the feasibility, acceptability and potential effectiveness of Dignity Therapy for older people in care homes: Study protocol

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Richardson Alison

2009-03-01

Full Text Available Abstract Background Although most older people living in nursing homes die there, there is a dearth of robust evaluations of interventions to improve their end-of-life care. Residents usually have multiple health problems making them heavily reliant on staff for their care, which can erode their sense of dignity. Dignity Therapy has been developed to help promote dignity and reduce distress. It comprises a recorded interview, which is transcribed, edited then returned to the patient, who can bequeath it to people of their choosing. Piloting has suggested that Dignity Therapy is beneficial to people dying of cancer and their families. The aims of this study are to assess the feasibility, acceptability and potential effectiveness of Dignity Therapy to reduce psychological and spiritual distress in older people reaching the end of life in care homes, and to pilot the methods for a Phase III RCT. Methods/design A randomised controlled open-label trial. Sixty-four residents of care homes for older people are randomly allocated to one of two groups: (i Intervention (Dignity Therapy offered in addition to any standard care, and (ii Control group (standard care. Recipients of the "generativity" documents are asked their views on taking part in the study and the therapy. Both quantitative and qualitative outcomes are assessed in face-to-face interviews at baseline and at approximately one and eight weeks after the intervention (equivalent in the control group. The primary outcome is residents' sense of dignity (potential effectiveness assessed by the Patient Dignity Inventory. Secondary outcomes for residents include depression, hopefulness and quality of life. In view of the relatively small sample size, quantitative analysis is mainly descriptive. The qualitative analysis uses the Framework method. Discussion Dignity Therapy is brief, can be done at the bedside and could help both patients and their families. This detailed exploratory research shows if

A Phase II randomised controlled trial assessing the feasibility, acceptability and potential effectiveness of dignity therapy for older people in care homes: study protocol.

Science.gov (United States)

Hall, Sue; Chochinov, Harvey; Harding, Richard; Murray, Scott; Richardson, Alison; Higginson, Irene J

2009-03-24

Although most older people living in nursing homes die there, there is a dearth of robust evaluations of interventions to improve their end-of-life care. Residents usually have multiple health problems making them heavily reliant on staff for their care, which can erode their sense of dignity. Dignity Therapy has been developed to help promote dignity and reduce distress. It comprises a recorded interview, which is transcribed, edited then returned to the patient, who can bequeath it to people of their choosing. Piloting has suggested that Dignity Therapy is beneficial to people dying of cancer and their families. The aims of this study are to assess the feasibility, acceptability and potential effectiveness of Dignity Therapy to reduce psychological and spiritual distress in older people reaching the end of life in care homes, and to pilot the methods for a Phase III RCT. A randomised controlled open-label trial. Sixty-four residents of care homes for older people are randomly allocated to one of two groups: (i) Intervention (Dignity Therapy offered in addition to any standard care), and (ii) Control group (standard care). Recipients of the "generativity" documents are asked their views on taking part in the study and the therapy. Both quantitative and qualitative outcomes are assessed in face-to-face interviews at baseline and at approximately one and eight weeks after the intervention (equivalent in the control group). The primary outcome is residents' sense of dignity (potential effectiveness) assessed by the Patient Dignity Inventory. Secondary outcomes for residents include depression, hopefulness and quality of life. In view of the relatively small sample size, quantitative analysis is mainly descriptive. The qualitative analysis uses the Framework method. Dignity Therapy is brief, can be done at the bedside and could help both patients and their families. This detailed exploratory research shows if it is feasible to offer Dignity Therapy to residents of

Protein Requirements and Recommendations for Older People: A Review

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Caryl Nowson

2015-08-01

Full Text Available Declines in skeletal muscle mass and strength are major contributors to increased mortality, morbidity and reduced quality of life in older people. Recommended Dietary Allowances/Intakes have failed to adequately consider the protein requirements of the elderly with respect to function. The aim of this paper was to review definitions of optimal protein status and the evidence base for optimal dietary protein. Current recommended protein intakes for older people do not account for the compensatory loss of muscle mass that occurs on lower protein intakes. Older people have lower rates of protein synthesis and whole-body proteolysis in response to an anabolic stimulus (food or resistance exercise. Recommendations for the level of adequate dietary intake of protein for older people should be informed by evidence derived from functional outcomes. Randomized controlled trials report a clear benefit of increased dietary protein on lean mass gain and leg strength, particularly when combined with resistance exercise. There is good consistent evidence (level III-2 to IV that consumption of 1.0 to 1.3 g/kg/day dietary protein combined with twice-weekly progressive resistance exercise reduces age-related muscle mass loss. Older people appear to require 1.0 to 1.3 g/kg/day dietary protein to optimize physical function, particularly whilst undertaking resistance exercise recommendations.

The Appropriateness of Canine-Assisted Interventions (CAIs) on the Health and Social Care of Older People Residing in Long Term Care: A Systematic Review.

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Stern, Cindy; Pearson, Alan; Chur-Hansen, Anna

2011-01-01

Background: Canine-assisted interventions are used frequently in long term care settings, even though their effectiveness has not been definitively proven. One concern commonly described in the literature is the risk of zoonotic infection or animal-related injury/allergy associated with this type of interaction. To date, no systematic review has been undertaken to determine the appropriateness of canine-assisted interventions in relation to these issues. The aim of the review was to synthesise the best available evidence on the appropriateness of canine-assisted interventions on the health and social care of the older population residing in long term care with regards to zoonotic infection or animal-related injury/allergy. A comprehensive search was undertaken on 32 electronic databases and two reputable websites from their inception to 2009. The search was restricted to English language and both published and unpublished studies and papers were considered. The review took an inclusive approach and considered quantitative and qualitative studies that focussed on zoonotic risk/exposure/infection or animal-related injury/allergy from canine-assisted interventions used in long term care settings. In the absence of research studies, text and opinion were also considered. Critical appraisal of papers was to be undertaken using the appropriate Joanna Briggs Institute critical appraisal instrument and data extraction was to be via the Joanna Briggs Institute data extraction forms, dependant on design. There were no studies located the met the inclusion requirements of this review. There were also no text and opinion pieces that were specific to long term care, older people and canines. There is currently no evidence available to determine the appropriateness of canine-assisted interventions used for older people in long term care in regards to zoonotic risk/exposure/infection or animal-related injuries/allergies. There is a small body of literature available that focuses

Visual risk factors for falls in older people.

Science.gov (United States)

Lord, Stephen R

2006-09-01

Poor vision reduces postural stability and significantly increases the risk of falls and fractures in older people. Most studies have found that poor visual acuity increases the risk of falls. However, studies that have included multiple visual measures have found that reduced contrast sensitivity and depth perception are the most important visual risk factors for falls. Multifocal glasses may add to this risk because their near-vision lenses impair distance contrast sensitivity and depth perception in the lower visual field. This reduces the ability of an older person to detect environmental hazards. There is now evidence that maximising vision through cataract surgery is an effective strategy for preventing falls. Further randomised controlled trials are required to determine whether individual strategies (such as restriction of use of multifocal glasses) or multi-strategy visual improvement interventions can significantly reduce falls in older people. Public health initiatives are required to raise awareness in older people and their carers of the importance of regular eye examinations and use of appropriate prescription glasses.

Transforming Practice with Older People through an Ethic of Care.

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Ward, Lizzie; Barnes, Marian

2016-06-01

This article explores the relevance of deliberative practices framed by feminist care ethics to social work practice with older people. It draws on two connected projects which brought together older people: practitioners and academics. The first was a participatory research project in which the significance of care to well-being in old age emerged. The second was a knowledge exchange project which generated learning resources for social care practice based on the research findings of the first project. Here we analyse selected transcripts of recordings from meetings of both projects to consider the ways that discussions about lived experiences and everyday lives demonstrate care through this dialogue. Using this analysis, we propose that care ethics can be useful in transforming relationships between older people and those working with them through the creation of hybrid spaces in which 'care-full deliberation' can happen. We argue that such reflective spaces can enable transformative dialogue about care and its importance to older people and offer a counterbalance to the procedurally driven environments in which much social work practice takes place and can support practice more attuned to the circumstances and concerns of older people.

Fall-related hospitalisations of older Aboriginal and Torres Strait Islander people and other Australians.

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Lukaszyk, Caroline; Harvey, Lara A; Sherrington, Catherine; Close, Jacqueline Ct; Coombes, Julieann; Mitchell, Rebecca J; Moore, Robyn; Ivers, Rebecca

2017-07-03

To compare the socio-demographic characteristics and type of injury sustained, the use of hospital resources and rates of hospitalisation by injury type, and survival following fall injuries to older Aboriginal people and non-Indigenous Australian people hospitalised for fall-related injuries. Population-based retrospective cohort data linkage study. Setting, participants: New South Wales residents aged 50 years or more admitted to a public or private NSW hospital for a fall-related injury during 1 January 2003 - 31 December 2012. Proportions of patients with defined injury types, mean hospital length of stay (LOS), 30-day mortality, age-standardised hospitalisation rates and age-adjusted rate ratios, 28-day re-admission rates. There were 312 758 fall-related injury hospitalisations for 234 979 individuals; 2660 admissions (0.85%) were of Aboriginal people. The proportion of hospitalisations for fall-related fracture injuries was lower for Aboriginal than for non-Indigenous Australians (49% v 60% of fall-related hospitalisations; P Aboriginal patients was non-fracture injury to head or neck (19% of hospitalisations); for non-Indigenous patients it was hip fractures (18%). Age-adjusted LOS was lower for Aboriginal than for non-Indigenous patients (9.1 v 14.0 days; P Aboriginal people, fall injury hospitalisations increased at an annual rate of 5.8% (95% CI, 4.0-7.7%; P Aboriginal people and other older Australians, suggesting that different approaches are required to prevent and treat fall injuries.

GPs' perspectives on preventive care for older people: a focus group study.

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Drewes, Yvonne M; Koenen, Julia M; de Ruijter, Wouter; van Dijk-van Dijk, D J Annemarie; van der Weele, Gerda M; Middelkoop, Barend J C; Reis, Ria; Assendelft, Willem J J; Gussekloo, Jacobijn

2012-11-01

Preventive care traditionally aims to prevent diseases or injuries. For older people, different aims of prevention, such as maintenance of independence and wellbeing, are increasingly important. To explore GPs' perspectives on preventive care for older people. Qualitative study comprising six focus groups with GPs in the Netherlands. The focus-group discussions with 37 GPs were analysed using the framework analysis method. Whether or not to implement preventive care for older people depends on the patient's individual level of vitality, as perceived by the GP. For older people with a high level of vitality, GPs confine their role to standardised disease-oriented prevention on a patient's request; when the vitality levels in older people fall, the scope of preventive care shifts from prevention of disease to prevention of functional decline. For older, vulnerable people, GPs expect most benefit from a proactive, individualised approach, enabling them to live as independently as possible. Based on these perspectives, a conceptual model for preventive care was developed, which describes GPs' different perspectives toward older people who are vulnerable and those with high levels of vitality. It focuses on five main dimensions: aim of care (prevention of disease versus prevention of functional decline), concept of care (disease model versus functional model), initiator (older persons themselves versus GP), target groups (people with requests versus specified risk groups), and content of preventive care (mainly cardiovascular risk management versus functional decline). GPs' perspectives on preventive care are determined by their perception of the level of vitality of their older patients. Preventive care for older people with high levels of vitality may consist of a standardised disease-oriented approach; those who are vulnerable will need an individualised approach to prevent functional decline.

Pedestrian fatalities and injuries involving Irish older people.

LENUS (Irish Health Repository)

Martin, A J

2012-02-01

BACKGROUND: It has been established internationally that road traffic accidents (RTAs) involving older drivers follow clearly different patterns of timing, location and outcomes from those of younger age groups. Older pedestrians are also a vulnerable group and fewer analyses have been undertaken of the phenomenology of their injuries and fatalities. We studied the pattern of pedestrian RTAs in Ireland over a five-year period with the aim of identifying differences between older pedestrians (aged 65 or older) and younger adults. METHODS: We examined the datasets of the Irish National Road Authority (now the Road Safety Authority) from 1998-2002. We analysed patterns of crashes involving older pedestrians (aged 65) and compared them with younger adults (aged 18-64). RESULTS: Older people represented 36% (n = 134) of pedestrian fatalities and 23% of serious injuries while they only account for 19% of total RTAs. Mortality in RTA is more than doubled for older pedestrians compared to younger adults (RR 2.30). Most accidents involving older pedestrians happen in daylight with good visibility (56%) and in good weather conditions (77%). CONCLUSIONS: Older pedestrians are particularly vulnerable in RTAs. These occur more frequently during daylight hours and in good weather conditions. This may point to a need for prevention strategies that are targeted at the traffic environment and other road users rather than at older people.

Relationships of Assertiveness, Depression, and Social Support Among Older Nursing Home Residents

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Segal, Daniel

2005-01-01

This study assessed the relationships of assertiveness, depression, and social support among nursing home residents. The sample included 50 older nursing home residents (mean age=75 years; 75% female; 92% Caucasian). There was a significant correlation between assertiveness and depression (r=-.33), but the correlations between social support and…

Health and functional status among older people with HIV/AIDS in Uganda

Directory of Open Access Journals (Sweden)

Scholten Francien

2011-11-01

Full Text Available Abstract Background In sub-Saharan Africa, little is known about the health and functional status of older people who either themselves are HIV infected or are affected by HIV and AIDS in the family. This aim of this study was to describe health among older people in association with the HIV epidemic. Methods The cross-sectional survey consisted of 510 participants aged 50 years and older, equally divided into five study groups including; 1 HIV infected and on antiretroviral therapy (ART for at least 1 year; 2 HIV infected and not yet eligible for ART; 3 older people who had lost a child due to HIV/AIDS; 4 older people who have an adult child with HIV/AIDS; 5 older people not known to be infected or affected by HIV in the family. The participants were randomly selected from ongoing studies in a rural and peri-urban area in Uganda. Data were collected using a WHO standard questionnaire and performance tests. Eight indicators of health and functioning were examined in an age-adjusted bivariate and multivariate analyses. Results In total, 198 men and 312 women participated. The overall mean age was 65.8 and 64.5 years for men and women respectively. Men had better self-reported health and functional status than women, as well as lower self-reported prevalence of chronic diseases. In general, health problems were common: 35% of respondents were diagnosed with at least one of the five chronic conditions, including 15% with depression, based on algorithms; 31% of men and 35% of women had measured hypertension; 25% of men and 21% of women had poor vision test results. HIV-positive older people, irrespective of being on ART, and HIV-negative older people in the other study groups had very similar results for most health status and functioning indicators. The main difference was a significantly lower BMI among HIV-infected older people. Conclusion The systematic exploration of health and well being among older people, using eight self-reported and

Rehabilitation and older people.

OpenAIRE

Young, J.

1996-01-01

Rehabilitation is concerned with lessening the impact of disabling conditions. These are particularly common in older people and considerable health gain can be achieved by successful rehabilitation. Hospital doctors and general practitioners should be aware of the core principles of rehabilitation, be able to recognise rehabilitation need in their patients, and have sufficient knowledge of their local rehabilitation services to trigger the referral process.

Prevention of Fractures in Older People with Calcium and Vitamin D

Directory of Open Access Journals (Sweden)

Caryl A. Nowson

2010-09-01

Full Text Available The greatest cause of fracture in older people is osteoporosis which contributes to increased morbidity and mortality in older people. A number of meta-analyses have been performed assessing the effectiveness of calcium supplementation alone, vitamin D supplementation alone and the combined therapy on bone loss and fracture reduction in older people. The results of these meta-analyses indicate that vitamin D supplementation alone is unlikely to reduce fracture risk, calcium supplementation alone has a modest effect in reducing total fracture risk, but compliance with calcium supplements is poor in the long term. The combination of calcium supplementation with vitamin D supplementation, particularly in those at risk of marginal and low vitamin D status reduces total fractures, including hip fractures. Therefore older people would be recommended to consume adequate dietary calcium (>1100 mg/day together with maintaining adequate vitamin D status (>60 nmol/L 25(OHD to reduce risk of fracture. It is a challenge to consume sufficient dietary calcium from dietary sources, but the increasing range of calcium fortified foods could assist in increasing the dietary calcium intake of older people. In addition to the usual dairy based food sources, vitamin D supplements are likely to be required for older people with reduced mobility and access to sunlight.

Improving the oral health of older people

DEFF Research Database (Denmark)

Petersen, Poul Erik; Yamamoto, Tatsuo

2005-01-01

changing burden of chronic diseases in old age. Chronic disease and most oral diseases share common risk factors. Globally, poor oral health amongst older people has been particularly evident in high levels of tooth loss, dental caries experience, and the prevalence rates of periodontal disease, xerostomia...... and oral precancer/cancer. The negative impact of poor oral conditions on the quality of life of older adults is an important public health issue, which must be addressed by policy-makers. The means for strengthening oral health programme implementation are available; the major challenge is therefore...... to translate knowledge into action programmes for the oral health of older people. The World Health Organization recommends that countries adopt certain strategies for improving the oral health of the elderly. National health authorities should develop policies and measurable goals and targets for oral health...

Self-worth therapy used to help older people manage depression.

Science.gov (United States)

2009-02-05

Depression is very common in older people in western countries. It can be treated with anti-depressants but the safety of drug therapy in older people is questionable due to age-related changes in the way drugs are stored and eliminated by the body.

Older people dying with dementia: a nationwide study

NARCIS (Netherlands)

Meeussen, K.; van den Block, L.; Echteld, M.; Boffin, N.; Bilsen, J.; van Casteren, V.; Deliens, L.

2012-01-01

Background: Large-scale nationwide data describing the end-of-life characteristics of older people with dementia are lacking. This paper describes the dying process and end-of-life care provided to elderly people with mild or severe dementia in Belgium. It compares with elderly people dying without

Exploring the Housing Needs of Older People in Standard and Sheltered Social Housing.

Science.gov (United States)

Fox, Siobhan; Kenny, Lorna; Day, Mary Rose; O'Connell, Cathal; Finnerty, Joe; Timmons, Suzanne

2017-01-01

Objective: Our home can have a major impact on our physical and mental health; this is particularly true for older people who may spend more time at home. Older people in social (i.e., public) housing are particularly vulnerable. Housing options for older people in social housing include standard design dwellings or specially designed "sheltered housing." The most suitable housing model should be identified, with older people consulted in this process. Method: Survey of older people (aged ≥60) living in standard or sheltered social housing. Data were analyzed using descriptive and inferential statistics in SPSS Version 22. Results: Overall, 380 surveys were returned (response rate = 47.2%). All older people had similar housing needs. Those in sheltered housing were more satisfied with the physical home design and reported more positive outcomes. Older people in standard housing were less likely to have necessary adaptations to facilitate aging-in-place. Discussion: Older people in standard housing reported more disability/illnesses, are worried about the future, and felt less safe at home. However, few wanted to move, and very few viewed sheltered housing as an alternative, suggesting limited knowledge about their housing options. Future social housing designs should be flexible, that is, adaptable to the needs of the tenants over time.

Engagement in intergenerational learning by experienced older people

OpenAIRE

Patrício, Maria Raquel; Osório, António

2013-01-01

Fast technological and social change ask for older people who hold competences and knowledge for living in a world of persistent change and are also prepared to constantly learn how to use new technologies, able to deal with new transformations in society and to be involved in family and community active life. Demographic changes have had a lot to do with continuous lifelong learning by adults and older people. They have to have knowledge and digital skills which are necessa...

Older People of Tomorrow: A Psychosocial Profile.

Science.gov (United States)

Silverstone, Barbara

1996-01-01

Attempts to narrow the scope of present uncertainties about the older population by sketching a psychosocial profile of the older people of tomorrow based on what is known today. Focuses on the baby boom generation and the interplay between personal attributes they could bring to late life and the social and physical environment in which they…

Powerlessness of older people in Hong Kong: a political economy analysis.

Science.gov (United States)

Kam, Ping-kwong

2003-01-01

Gerontologists agree that old age can be associated with an increase in powerlessness both in the personal domain and in the social and political fields. This paper is an attempt to understand the concept of powerlessness in old age within a political economy theoretical framework. The paper argues that the powerlessness of older people is not biologically determined. Rather, it is socially constructed. It has its roots in the social, economic, and political structure of society. For this reason, the paper argues that (a) the capitalist economic system discriminates against and marginalizes older people in the labor market. The current unfavorable economic climate will make the economic situation of older people worse. (b) The residual welfare system does not counteract the unfavorable impact of the economic system. Rather, it deprives older people of the necessary financial resources and social service supports that would enable them to lead independent and dignified lives. (c) The authoritarian political system creates adverse conditions that make it very difficult for older people to participate in the decision-making process on issues that affect their lives, as well as on broader political issues that affect the whole of society. It is the interplay among these economic, social, and political forces in Hong Kong that creates the political economy of powerlessness in old age and prevents older people from using their powers to master and control their lives.

Robotic and Sensor Technologies for Mobility in Older People.

Science.gov (United States)

Penteridis, Lazaros; D'Onofrio, Grazia; Sancarlo, Daniele; Giuliani, Francesco; Ricciardi, Francesco; Cavallo, Filippo; Greco, Antonio; Trochidis, Ilias; Gkiokas, Alexander

2017-10-01

Maintaining independent mobility is fundamental to independent living and to the quality of life of older people. Robotic and sensor technologies may offer a lot of potential and can make a significant difference in the lives of older people and to their primary caregivers. The aim of this study was to provide a presentation of the methods that are used up till now for analysis and evaluation of human mobility utilizing sensor technologies and to give the state of the art in robotic platforms for supporting older people with mobility limitations. The literature was reviewed and systematic reviews of cohort studies and other authoritative reports were identified. The selection criteria included (1) patients with age ≥60 years; (2) patients with unstable gait, with or without recurrent falls; (3) patients with slow movements, short strides, and little trunk movement; (4) sensor technologies that are currently used for mobility evaluation; and (5) robotic technologies that can serve as a supporting companion for older people with mobility limitations. One hundred eighty-one studies published up until February 2017 were identified, of which 36 were included. Two categories of research were identified from the review regarding the robot and sensor technologies: (1) sensor technologies for mobility analysis and (2) robots for supporting older people with mobility limitations. Potential for robotic and sensor technologies can be taken advantage of for evaluation and support at home for elder persons with mobility limitations in an automated way without the need of the physical presence of any medical personnel, reducing the stress of caregivers.

Physical Activity among Older People Living Alone in Shanghai, China

Science.gov (United States)

Chen, Yu; While, Alison E; Hicks, Allan

2015-01-01

Objective: To investigate physical activity among older people living alone in Shanghai, People's Republic of China, and key factors contributing to their physical activity. Methods: A cross-sectional questionnaire survey was administered in nine communities in Shanghai, using a stratified random cluster sample: 521 community-dwelling older people…

HIV/AIDS and the health of older people in the slums of Nairobi, Kenya: results from a cross sectional survey.

Science.gov (United States)

Kyobutungi, Catherine; Ezeh, Alex C; Zulu, Eliya; Falkingham, Jane

2009-05-27

The proportion of older people is increasing worldwide. Globally, it is estimated that older people (those 60 years or older) constitute more than 11% of the population. As the HIV/AIDS pandemic rages in sub-Saharan Africa (SSA), its impact on older people needs closer attention given the increased economic and social roles older people have taken on as a result of increased mortality among adults in the productive age groups. Few studies have looked at older people and their health in SSA or indeed the impact of HIV/AIDS on their health. This study aims to assess the effect of being directly or indirectly affected by HIV/AIDS on the health of older people in two Nairobi slums. Data were collected from residents of the Nairobi Urban Health and Demographic Surveillance area aged 50 years and above on 1st October 2006. Health status was assessed using the short SAGE (Study on Global AGEing and Adult Health) form and two outcome measures--self-rated health and a composite health score--were generated. To assess HIV/AIDS affected status, respondents were asked: Have you personally been affected by HIV/AIDS? If yes, a follow up question: "How have you been personally affected by HIV/AIDS?" was asked. Ordinallogistic regression was used in models with self-rated health and linear regression in models with the health score. About 18% of respondents reported being affected by HIV/AIDS in at least one way, although less than 1% reported being infected with HIV. Nearly 60% of respondents reported being in good health, 27% in fair health and 14% in poor health. The overall mean health score was 70.6 (SD: 13.9) with females reporting worse health outcomes than males. Respondents directly or indirectly affected by HIV/AIDS reported worse health outcomes than those not affected: mean health score: 68.5 and 71.1 respectively (t = 3.21, p = 0.0007), and an adjusted odds ratio of reporting poor health of 1.42 (95%CI: 1.12-1.80). Poor health outcomes among older people affected by

Sociolegal and practice implications of caring for LGBT people with dementia.

Science.gov (United States)

Peel, Elizabeth; Taylor, Helen; Harding, Rosie

2016-11-30

The needs of lesbian, gay, bisexual and trans (LGBT) people with dementia are poorly recognised. This is due partly to assumptions that all older people are heterosexual or asexual. One quarter of gay or bisexual men and half of lesbian or bisexual women have children, compared with 90% of heterosexual women and men, which means LGBT older adults are more likely to reside in care homes. Older LGBT people may be unwilling to express their sexual identities in care settings and this can affect their care. Members of older people's informal care networks must be recognised to ensure their involvement in the lives of residents in care settings continues. However, healthcare professionals may not always realise that many LGBT people rely on their families of choice or wider social networks more than on their families of origin. This article explores sociolegal issues that can arise in the care of older LGBT people with dementia, including enabling autonomy, capacity and applying legal frameworks to support their identities and relationships. It also highlights implications for practice.

Medication Exposure and Risk of Recurrent Clostridium difficile Infection in Community-Dwelling Older People and Nursing Home Residents.

Science.gov (United States)

Haran, John P; Bradley, Evan; Howe, Emily; Wu, Xun; Tjia, Jennifer

2018-02-01

It is unclear how medication exposures differ in their association with recurrent Clostridium difficile infection (rCDI) in elderly nursing home (NH) residents and community-dwelling individuals. This study examined these exposures to determine whether the risk of rCDI differs according to living environment. Retrospective. Academic and community healthcare settings. Individuals aged 65 and older with CDI (N = 616). Information on participant characteristics and medications was extracted from the electronic medical record (EMR). We used separate extended Cox models according to living environment to identify the association between medication use and risk of rCDI. Of the 616 elderly adults treated for CDI, 24.1% of those living in the community and 28.1% of NH residents experienced recurrence within 1 year. For community-dwelling participants, the risk of rCDI was 1.6 times as high with antibiotic exposure and 2.5 times as high with acid-reducing medication exposure, but corticosteroid exposure was associated with a 39% lower risk of recurrence. For NH residents, the risk of rCDI was 2.9 times as high with acid-reducing medication exposure and 5.9 times as high with corticosteroid medication exposure. Antibiotic exposure was associated with an increased risk of recurrence only in community-dwelling participants (adjusted hazard ratio = 1.63, 95% confidence interval = 1.00-2.67). Risk of rCDI is greater with acid-reducing medication use than antibiotic use after initial CDI treatment, although the risk varied depending on living environment. Corticosteroid use is associated with greater risk of recurrence in NH residents but lower risk in community-dwelling elderly adults. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.

Sexual knowledge, attitudes and activity of older people in Taipei, Taiwan.

Science.gov (United States)

Wang, Tze-Fang; Lu, Chwen-Hwa; Chen, I-Ju; Yu, Shu

2008-02-01

We examined sexual activity and predictive factors among older people in Taipei, Taiwan. We aimed to characterize the older population engaged in sexual activity and determine influencing factors, exploring aspects of sexuality that may influence elders' health and quality of life (QOL). Studies of sexual attitudes and behaviour have found that sexual difficulties are common among mature adults worldwide, influenced in men and women by physical health, ageing, psychosocial and cultural factors. We conducted a community-based retrospective study involving a random sample of 412 men and 204 women over age 65. A questionnaire on demographics and social situations was administered, along with a Sexuality Knowledge and Attitudes Scale; 34 questions evaluated sexual knowledge and 18 evaluated sexual attitudes. Two-hundred and twenty participants were sexually active (35.7%), 185 mainly with spouses (84.1%); frequency was 21.4 (SD 16.9) times per year (range: 1-120). Multiple logistic regressions identified five significant predictors of sexual activity: gender, age, being with spouse, sexual knowledge and sexual attitudes. Sexual activity was significantly associated with higher education levels, lower stress and more self-reported daily activities. Our results agreed with Western studies linking sexual activity with better health and higher QOL in older adults. Older peoples' stress and daily activity levels are recognized quality-of-life measures; lower stress and more daily activities among sexually active older people suggests a connection between sexual activity and higher QOL. Increasing knowledge and improving attitudes about sexuality may help older people build healthier relationships and enhance health and QOL. Relevance to clinical practice. If healthcare professionals possess greater understanding of older peoples' sexuality, healthcare systems may find ways to increase sexual knowledge and foster healthier attitudes and relationships to improve older peoples

brief communication giving older people a voice in liberia, west africa

African Journals Online (AJOL)

Mugumbate

In Liberia, March 2015 marked Social Work Month which was celebrated under the global theme: ... was the government doing specifically for older people amidst the Ebola ... network to enhance its capacity to effectively serve older people in ...

Improving early detection initiatives: a qualitative study exploring perspectives of older people and professionals.

Science.gov (United States)

Lette, Manon; Stoop, Annerieke; Lemmens, Lidwien C; Buist, Yvette; Baan, Caroline A; de Bruin, Simone R

2017-06-23

A wide range of initiatives on early detection and intervention have been developed to proactively identify problems related to health and wellbeing in (frail) older people, with the aim of supporting them to live independently for as long as possible. Nevertheless, it remains unclear what the best way is to design such initiatives and how older people's needs and preferences can be best addressed. This study aimed to address this gap in the literature by exploring: 1) older people's perspectives on health and living environment in relation to living independently at home; 2) older people's needs and preferences in relation to initiating and receiving care and support; and 3) professionals' views on what would be necessary to enable the alignment of early detection initiatives with older people's own needs and preferences. In this qualitative study, we conducted semi-structured interviews with 36 older people and 19 professionals in proactive elderly care. Data were analysed using the framework analysis method. From the interviews with older people important themes in relation to health and living environment emerged, such as maintaining independence, appropriate housing, social relationships, a supporting network and a sense of purpose and autonomy. Older people preferred to remain self-sufficient, and they would rather not ask for help for psychological or social problems. However, the interviews also highlighted that they were not always able or willing to anticipate future needs, which can hinder early detection or early intervention. At the same time, professionals indicated that older people tend to over-estimate their self-reliance and therefore advocated for early detection and intervention, including social and psychological issues. Older people have a broad range of needs in different domains of life. Discrepancies exist between older people and professionals with regard to their views on timing and scope of early detection initiatives. This study aimed

The impact of oral health on the quality of life of nursing home residents

OpenAIRE

Porter, Jessie; Ntouva, Antiopi; Read, Andrew; Murdoch, Mandy; Ola, Dennis; Tsakos, Georgios

2015-01-01

Background Good oral health in older residents of nursing homes is important for general health and quality of life. Very few studies have assessed how oral symptoms affect residents? quality of life. Objective To assess the clinical and subjective oral health, including oral health related quality of life (OHRQoL), and the association of oral symptoms with OHRQoL in older people residing in nursing homes in Islington, London. Method Overall, 325 residents from nine nursing homes were clinica...

Suicide among Older People: Projections for the Future.

Science.gov (United States)

Haas, Ann Pollinger; Hendin, Herbert

1983-01-01

Demonstrates the relationship between cohort size and longitudinal suicide rates, with reference to four particular cohorts. Combines this perspective with projected population increases among older age groups to estimate the scope of the problem of suicide among older people during the early decades of the next century. (Author/JAC)

The Relationship of Frailty and Hospitalization Among Older People: Evidence From a Meta-Analysis.

Science.gov (United States)

Chang, Shu-Fang; Lin, Hsiang-Chun; Cheng, Chih-Ling

2018-06-06

This research explored the relationship between the stages of frailty and risk for hospitalization in older adults and evaluated the risk for hospitalization among the elderly in relation to various frailty assessment indexes. A systematic literature review and meta-analysis were carried out. A total of 32,998 older people, 8,666 of whom were hospitalized, were included in this study. Two of the researchers independently collected and reviewed the literature. The key search terms used were "frailty" or "frail," "hospitalization," and "older people" or "older" or "geriatric" or "senior." Data were recorded from January 2001 to July 2016. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were adopted for quality assessment. A systematic search was carried out using Embase and Scopus to analyze the collected literature. A meta-analysis was conducted on eight studies that discussed the relationship between frailty and hospitalization risk in older adults 65 years of age or older. The results showed that frail older people exhibited the highest risk for hospitalization, following by prefrail and robust older people. Next, different frailty assessment indicators were used to predict the risk for hospitalization among older people. All of these indexes also showed that older persons with frailty had the highest risk for hospitalization, followed by prefrail older people. Frailty is a vital issue in geriatric care and is a crucial factor in the hospitalization of older people. Frail older people were at the highest risk for hospitalization, following by prefrail and robust older people. Assessing frailty as early as possible can reduce the hospitalization risk among older people. Professional nursing staff should use frailty indicators in a timely fashion to assess the status of frailty in older people and should effectively develop frailty prevention strategies to decrease the risk for hospitalization and to enhance quality of life

Perspectives of nursing professionals and older adults differ on aspects of care for older people after a nationwide improvement program.

Science.gov (United States)

Verweij, Lisanne Marlieke; Wehrens, Rik; Oldenhof, Lieke; Bal, Roland; Francke, Anneke L

2018-05-02

The perspectives of nursing professionals might differ from those of older adults when it comes to care for older people. This cross-sectional study compares the views of older adults with the views of nursing professionals on the quality of care after a nationwide improvement program for care for older people was implemented (2008-2016) in the Netherlands. Questionnaire data were used from 385 nursing professionals (response rate 51%) that were part of the Nursing Staff Panel, a nationwide representative group of nursing staff, and working in home care, hospitals or general practices. Additionally, questionnaire data were used from 73 older adults (response rate 81%) who were involved in regional networks to discuss project proposals and to represent the voice of older adults in the nationwide improvement program. Participants were asked to evaluate care for older people with regard to collaboration between healthcare organizations and with regard to the tailored service, accessibility, and quality of care within their organizations and in the region in which they lived. A majority of older adults (54%) and nursing professionals (61%) felt that collaboration with others had improved over the last few years. Approximately one third of the older adults stated that care for older people was tailored to fit individual needs and was accessible most of the time or always, as opposed to approximately two thirds of the professionals. Moreover, 17% older adults thought that the quality of care was good, compared with 54% of the nursing professionals. 77% of the nursing professionals and 94% of the older adults thought that improvements were still needed in care for older people, for example better integration of the different aspects of care and a more patient-centered approach. Older adults who were involved in networks of the improvement program generally gave a less positive evaluation of aspects of care for older people and its development than nursing professionals

ICT, Education and Older People in Australia: A Socio-Technical Analysis

Science.gov (United States)

Tatnall, Arthur

2014-01-01

People over 65 (or older people) are a growing proportion of the population in many developed countries including Australia. In the last 10 to 12 years interest from this group in the use of Information and Communication Technologies (ICT) and the Internet has also grown considerably. ICT has much to offer older people as a means of keeping in…

Older people and digital disengagement: a fourth digital divide?

Science.gov (United States)

Olphert, Wendy; Damodaran, Leela

2013-01-01

Digital technologies are becoming more pervasive in all areas of society. Enabling everyone to have access and capability to use the Internet and associated digital technologies, summed up in the term 'digital inclusion', is seen to have wide-ranging benefits to the individual, to the economy and to society. For older people, being digitally included can help them to maintain their independence, social connectedness and sense of worth in the face of declining health or limited capabilities, as well as also offering new opportunities to improve their quality of life. At present however, access to the technology and to the benefits is not equally distributed either between or within nations, and older people tend to be on the 'wrong' side of what is termed the 'digital divide'. Governments globally are developing strategies to promote digital inclusion and indeed Internet uptake is increasing steadily, including amongst older people. However, such strategies have focussed on getting people online, and there appears to be an assumption that once someone is online they will remain 'digitally engaged'. In fact statistics show that some users give up using the Internet, and there is emerging evidence that older people are more vulnerable to the factors which can lead to this outcome. The authors see this phenomenon as a potential but largely unrecognised 'fourth digital divide' which has serious implications for social inclusion. The objectives of this article are (a) to raise awareness of the phenomenon of digital disengagement by considering some of the emerging evidence, (b) to explore some of the potential implications of not recognising and therefore not addressing the needs of the digitally disengaged older population, and (c) to reveal the prevailing gap in knowledge which future research should address. Copyright © 2013 S. Karger AG, Basel.

Smart Homes for Older People: Positive Aging in a Digital World

Directory of Open Access Journals (Sweden)

Tony Barnett

2012-06-01

Full Text Available Smart homes are homes with technologically advanced systems to enable domestic task automation, easier communication, and higher security. As an enabler of health and well-being enhancement, smart homes have been geared to accommodate people with special needs, especially older people. This paper examines the concept of “smart home” in a technologically driven society and its multi-functional contribution to the enhancement of older people’s lives. Discussion then focuses on the challenges in the use of smart homes among older people such as accessibility and ethical issues. Finally, some implications and recommendations are provided.

FACTORS RELATING TO DEPRESSION AMONG OLDER PEOPLE LIVING IN CIMAHI, WEST JAVA PROVINCE, INDONESIA

OpenAIRE

Kiki Gustryanti; Sunanta Thongpat; Sonthaya Maneerat

2017-01-01

Background: Depression is commonly found in older people. The prevalence of depression among older people, particularly in Indonesia is increasing worldwide. Objective: This study was aimed to identify the factors relating to depression among older people living in Cimahi, West Java Province, Indonesia. Method: A cross sectional design was used with a total of 267 older people aged from 60 to 79 years old. A multi-stage random sampling has been used in five Public Health Centers in Cima...

Care planning at home: a way to increase the influence of older people?

Directory of Open Access Journals (Sweden)

Helene Berglund

2012-08-01

Full Text Available Introduction: Care-planning meetings represent a common method of needs assessment and decision-making practices in elderly care. Older people's influence is an important and required aspect of these practices. This study's objective was to describe and analyse older people's influence on care-planning meetings at home and in hospital. Methods: Ten care-planning meetings were audio-recorded in the older people's homes and nine were recorded in hospital. The study is part of a project including a comprehensive continuum-of-care model. A qualitative content analysis was performed.  Results: Care-planning meetings at home appeared to enable older people's involvement in the discussions. Fewer people participated in the meetings at home and there was less parallel talking. Unrelated to the place of the care-planning meeting, the older people were able to influence concerns relating to the amount of care/service and the choice of provider. However, they were not able to influence the way the help should be provided or organised.  Conclusion: Planning care at home indicated an increase in involvement on the part of the older people, but this does not appear to be enough to obtain any real influence. Our findings call for attention to be paid to older people's opportunities to receive care and services according to their individual needs and their potential for influencing their day-to-day provision of care and service.

Interrelations of stress, optimism and control in older people's psychological adjustment.

Science.gov (United States)

Bretherton, Susan Jane; McLean, Louise Anne

2015-06-01

To investigate the influence of perceived stress, optimism and perceived control of internal states on the psychological adjustment of older adults. The sample consisted of 212 older adults, aged between 58 and 103 (M = 80.42 years, SD = 7.31 years), living primarily in retirement villages in Melbourne, Victoria. Participants completed the Perceived Stress Scale, Life Orientation Test-Revised, Perceived Control of Internal States Scale and the World Health Organisation Quality of Life-Bref. Optimism significantly mediated the relationship between older people's perceived stress and psychological health, and perceived control of internal states mediated the relationships among stress, optimism and psychological health. The variables explained 49% of the variance in older people's psychological adjustment. It is suggested that strategies to improve optimism and perceived control may improve the psychological adjustment of older people struggling to adapt to life's stressors. © 2014 ACOTA.

Acute stress and working memory in older people.

Science.gov (United States)

Pulopulos, Matias M; Hidalgo, Vanesa; Almela, Mercedes; Puig-Perez, Sara; Villada, Carolina; Salvador, Alicia

2015-01-01

Several studies have shown that acute stress affects working memory (WM) in young adults, but the effect in older people is understudied. As observed in other types of memory, older people may be less sensitive to acute effects of stress on WM. We performed two independent studies with healthy older men and women (from 55 to 77 years old) to investigate the effects of acute stress (Trier Social Stress Test; TSST) and cortisol on WM. In study 1 (n = 63), after the TSST women (but not men) improved their performance on Digit Span Forward (a measure of the memory span component of WM) but not on Digit Span Backward (a measure of both memory span and the executive component of WM). Furthermore, in women, cortisol levels at the moment of memory testing showed a positive association with the memory span component of WM before and after the TSST, and with the executive component of WM only before the stress task. In study 2 (n = 76), although participants showed a cortisol and salivary alpha-amylase (sAA) response to the TSST, stress did not affect performance on Letter-Number Sequencing (LNS; a task that places a high demand on the executive component of WM). Cortisol and sAA were not associated with WM. The results indicate that circulating cortisol levels at the moment of memory testing, and not the stress response, affect memory span in older women, and that stress and the increase in cortisol levels after stress do not affect the executive component of WM in older men and women. This study provides further evidence that older people may be less sensitive to stress and stress-induced cortisol response effects on memory processes.

Variation in Older Adult Characteristics by Residence Type and Use of Home- and Community-Based Services

Directory of Open Access Journals (Sweden)

Heidi H. Ewen

2017-03-01

Full Text Available Background: The majority of older adults prefer to remain in their homes, or to “age-in-place.” To accomplish this goal, many older adults will rely upon home- and community-based services (HCBS for support. However, the availability and accessibility of HCBS may differ based on whether the older adult lives in the community or in a senior housing apartment facility. Methods: This paper reports findings from the Pathways to Life Quality study of residential change and stability among seniors in upstate New York. Data were analyzed from 663 older adults living in one of three housing types: service-rich facilities, service-poor facilities, and community-dwelling in single-family homes. A multinomial logistic regression model was used to examine factors associated with residence type. A linear regression model was fitted to examine factors associated with HCBS utilization. Results: When compared to community-dwelling older adults, those residing in service-rich and service-poor facilities were more likely to be older, report more activity limitations, and provide less instrumental assistance to others. Those in service-poor facilities were more likely to have poorer mental health and lower perceived purpose in life. The three leading HCBS utilized were senior centers (20%, homemaker services (19%, and transportation services (18%. More HCBS utilization was associated with participants who resided in service-poor housing, were older, were female, and had more activity limitations. More HCBS utilization was also associated with those who received instrumental support, had higher perceived purpose in life, and poorer mental health. Conclusions: Findings suggest that older adults’ residential environment is associated with their health status and HCBS utilization. Building upon the Person–Environment Fit theories, dedicated efforts are needed to introduce and expand upon existing HCBS available to facility residents to address physical and

Variation in Older Adult Characteristics by Residence Type and Use of Home- and Community-Based Services

Science.gov (United States)

Ewen, Heidi H.; Washington, Tiffany R.; Emerson, Kerstin G.; Carswell, Andrew T.; Smith, Matthew Lee

2017-01-01

Background: The majority of older adults prefer to remain in their homes, or to “age-in-place.” To accomplish this goal, many older adults will rely upon home- and community-based services (HCBS) for support. However, the availability and accessibility of HCBS may differ based on whether the older adult lives in the community or in a senior housing apartment facility. Methods: This paper reports findings from the Pathways to Life Quality study of residential change and stability among seniors in upstate New York. Data were analyzed from 663 older adults living in one of three housing types: service-rich facilities, service-poor facilities, and community-dwelling in single-family homes. A multinomial logistic regression model was used to examine factors associated with residence type. A linear regression model was fitted to examine factors associated with HCBS utilization. Results: When compared to community-dwelling older adults, those residing in service-rich and service-poor facilities were more likely to be older, report more activity limitations, and provide less instrumental assistance to others. Those in service-poor facilities were more likely to have poorer mental health and lower perceived purpose in life. The three leading HCBS utilized were senior centers (20%), homemaker services (19%), and transportation services (18%). More HCBS utilization was associated with participants who resided in service-poor housing, were older, were female, and had more activity limitations. More HCBS utilization was also associated with those who received instrumental support, had higher perceived purpose in life, and poorer mental health. Conclusions: Findings suggest that older adults’ residential environment is associated with their health status and HCBS utilization. Building upon the Person–Environment Fit theories, dedicated efforts are needed to introduce and expand upon existing HCBS available to facility residents to address physical and mental health needs

[Physical and mental dimensions of quality of life of frail older people].

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Gobbens, Robbert J J

2017-09-01

Frail older people have an increased risk of limitations in performing activities of daily living, hospitalization, nursing home admission, and premature death. In this study we determined the difference in experiencing quality of life between frail and non-frail older people. We also investigated the associations between physical, psychological and social components of frailty and the physical and mental dimensions of quality of life. 374 people of 75 years and older filled in a questionnaire, the Senioren Barometer. This questionnaire contained the Tilburg Frailty Indicator (TFI) to assess frailty and the SF-12 for assessing quality of life. The study showed that frail older people on average experience a lower quality of life than non-frail older people. A considerable part of the variance of the physical and mental dimensions of quality of life could be explained by the fifteen components of frailty, after controlling for the background characteristics of the respondents, 33.2% and 36.5%, respectively. The frailty components physical inactivity, physical tiredness, and depressive symptoms were associated with the physical dimension as well as the mental dimension of quality of life. The results confirm the importance of multidimensional assessment of frailty. In addition, they provide a direction to healthcare and welfare professionals in performing interventions with the aim of increasing the quality of life of older people.

Causes of homelessness among older people in Melbourne, Australia.

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Rota-Bartelink, Alice; Lipmann, Bryan

2007-06-01

A comparative study of the causes of new episodes of homelessness among people aged 50 years and over has been undertaken in Australia, the United States and England. Semi-structured questionnaires were used to collect information on the circumstances and problems that contributed to homelessness. This paper presents the findings from Australia, where information was obtained from 125 older homeless people (aged 50+ years) and their key workers in Melbourne. All three participating nations followed identical research methodologies. The factors most frequently reported by respondents as contributing to their homelessness were problems with people with whom they lived, followed by physical and mental ill-health and problems associated with the housing itself. The most frequently reported factors by case workers were problems with alcohol, followed by physical and mental health factors. This study demonstrates a significant under-utilisation of housing and support services among recently homeless older people and provides evidence that people who had previously been homeless appear to be more resigned to their homelessness than do those who had not experienced homelessness before. Significant issues relating to depression and gambling were also noted. The findings support the need for more targeted, specialised services to be developed or improved such that older homeless people can readily gain access to them and for improved collaboration or information exchange among housing providers and welfare agencies.

Pathways into chronic multidimensional poverty amongst older people: a longitudinal study.

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Callander, Emily J; Schofield, Deborah J

2016-03-07

The use of multidimensional poverty measures is becoming more common for measuring the living standards of older people. However, the pathways into poverty are relatively unknown, nor is it known how this affects the length of time people are in poverty for. Using Waves 1 to 12 of the nationally representative Household, Income and Labour Dynamics in Australia (HILDA) survey, longitudinal analysis was undertaken to identify the order that key forms of disadvantage develop - poor health, low income and insufficient education attainment - amongst Australians aged 65 years and over in multidimensional poverty, and the relationship this has with chronic poverty. Path analysis and linear regression models were used. For all older people with at least a Year 10 level of education attainment earlier mental health was significantly related to later household income (p = 0.001) and wealth (p = 0.017). For all older people with at less than a Year 10 level of education attainment earlier household income was significantly related to later mental health (p = 0.021). When limited to those in multidimensional poverty who were in income poverty and also had poor health, older people generally fell into income poverty first and then developed poor health. The order in which income poverty and poor health were developed had a significant influence on the length of time older people with less than a Year 10 level of education attainment were in multidimensional poverty for. Those who developed poor health first then fell into income poverty spend significantly less time in multidimensional poverty (-4.90, p poverty then developed poor health. Knowing the order that different forms of disadvantage develop, and the influence this has on poverty entrenchment, is of use to policy makers wishing to provide interventions to prevent older people being in long-term multidimensional poverty.

Engaging older people with participatory design

NARCIS (Netherlands)

Iacono, I.; Marti, P.

2014-01-01

We present a design case focusing on participatory design (PD) with older people. We experimented with PD techniques to foster engagement with participants in development of a graphical user interface (GUI) for controlling a robotic system in a smart home environment. The tenet of our approach is

HIV/AIDS and the health of older people in the slums of Nairobi, Kenya: results from a cross sectional survey

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Zulu Eliya

2009-05-01

Full Text Available Abstract Background The proportion of older people is increasing worldwide. Globally, it is estimated that older people (those 60 years or older constitute more than 11% of the population. As the HIV/AIDS pandemic rages in sub-Saharan Africa (SSA, its impact on older people needs closer attention given the increased economic and social roles older people have taken on as a result of increased mortality among adults in the productive age groups. Few studies have looked at older people and their health in SSA or indeed the impact of HIV/AIDS on their health. This study aims to assess the effect of being directly or indirectly affected by HIV/AIDS on the health of older people in two Nairobi slums. Methods Data were collected from residents of the Nairobi Urban Health and Demographic Surveillance area aged 50 years and above on 1st October 2006. Health status was assessed using the short SAGE (Study on Global AGEing and Adult Health form and two outcome measures – self-rated health and a composite health score – were generated. To assess HIV/AIDS affected status, respondents were asked: Have you personally been affected by HIV/AIDS? If yes, a follow up question: "How have you been personally affected by HIV/AIDS?" was asked. Ordinallogistic regression was used in models with self-rated health and linear regression in models with the health score. Results About 18% of respondents reported being affected by HIV/AIDS in at least one way, although less than 1% reported being infected with HIV. Nearly 60% of respondents reported being in good health, 27% in fair health and 14% in poor health. The overall mean health score was 70.6 (SD: 13.9 with females reporting worse health outcomes than males. Respondents directly or indirectly affected by HIV/AIDS reported worse health outcomes than those not affected: mean health score: 68.5 and 71.1 respectively (t = 3.21, p = 0.0007, and an adjusted odds ratio of reporting poor health of 1.42 (95%CI: 1.12–1

Effects of integrated dental care on oral treatment needs in residents of nursing homes older than 70 years

NARCIS (Netherlands)

Gerritsen, Paul; Cune, Marco; van der Bilt, Andries; Abbink, Jan; de Putter, Cornelis

2015-01-01

Aim: To determine effects of integrated dental care in older nursing home residents. Methods: In three nursing homes offering integrated dental care, we studied the oral treatment need of 355 residents older than 70 years. To determine effects of integrated care, we discriminated between short-stay

A Systematic Review of Behavioural Interventions Promoting Healthy Eating among Older People

DEFF Research Database (Denmark)

Zhou, Xiao; Perez-Cueto, Armando; dos Santos, Quenia

2018-01-01

Because eating habits are inseparably linked with people’s physical health, effective behaviour interventions are highly demanded to promote healthy eating among older people. The aim of this systematic review was to identify effective diet interventions for older people and provide useful evidence...... and direction for further research. Three electronic bibliographic databases—PubMed, Scopus and Web of Science Core Collection were used to conduct a systematic literature search based on fixed inclusion and exclusion criteria. English language peer-reviewed journal articles published between 2011 and 2016 were...... of chronic disease. The results supported that older people could achieve a better dietary quality if they make diet-related changes by receiving either dietary education or healthier meal service. Further high-quality studies are required to promote healthy eating among older people by taking regional diet...

Organizing integrated health-care services to meet older people's needs.

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Araujo de Carvalho, Islene; Epping-Jordan, JoAnne; Pot, Anne Margriet; Kelley, Edward; Toro, Nuria; Thiyagarajan, Jotheeswaran A; Beard, John R

2017-11-01

In most countries, a fundamental shift in the focus of clinical care for older people is needed. Instead of trying to manage numerous diseases and symptoms in a disjointed fashion, the emphasis should be on interventions that optimize older people's physical and mental capacities over their life course and that enable them to do the things they value. This, in turn, requires a change in the way services are organized: there should be more integration within the health system and between health and social services. Existing organizational structures do not have to merge; rather, a wide array of service providers must work together in a more coordinated fashion. The evidence suggests that integrated health and social care for older people contributes to better health outcomes at a cost equivalent to usual care, thereby giving a better return on investment than more familiar ways of working. Moreover, older people can participate in, and contribute to, society for longer. Integration at the level of clinical care is especially important: older people should undergo comprehensive assessments with the goal of optimizing functional ability and care plans should be shared among all providers. At the health system level, integrated care requires: (i) supportive policy, plans and regulatory frameworks; (ii) workforce development; (iii) investment in information and communication technologies; and (iv) the use of pooled budgets, bundled payments and contractual incentives. However, action can be taken at all levels of health care from front-line providers through to senior leaders - everyone has a role to play.

The Human Rights Act: What are the implications for older people?

Science.gov (United States)

2001-06-01

Help the Aged is launching a report outlining the terms of the Human Rights Act and its implications both for older people themselves and for public bodies responsible for providing services to them. Tessa Harding, head of policy at Help the Aged said: 'The Human Rights Act is an important turning point for older people. Not only does it establish key rights of individuals to freedom from inhuman and degrading treatment, to private and family life and so on; it also prohibits discrimination in accessing these rights.We expect older people and their advocates to use the Act to ensure greater fairness and equality in our society.'

Guidance on the management of pain in older people.

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Abdulla, Aza; Adams, Nicola; Bone, Margaret; Elliott, Alison M; Gaffin, Jean; Jones, Derek; Knaggs, Roger; Martin, Denis; Sampson, Liz; Schofield, Pat

2013-03-01

This guidance document reviews the epidemiology and management of pain in older people via a literature review of published research. The aim of this document is to inform health professionals in any care setting who work with older adults on best practice for the management of pain and to identify where there are gaps in the evidence that require further research. The assessment of pain in older people has not been covered within this guidance and can be found in a separate document (http://www.britishpainsociety.org/pub_professional.htm#assessmentpop). Substantial differences in the population, methods and definitions used in published research makes it difficult to compare across studies and impossible to determine the definitive prevalence of pain in older people. There are inconsistencies within the literature as to whether or not pain increases or decreases in this age group, and whether this is influenced by gender. There is, however, some evidence that the prevalence of pain is higher within residential care settings. The three most common sites of pain in older people are the back; leg/knee or hip and 'other' joints. In common with the working-age population, the attitudes and beliefs of older people influence all aspects of their pain experience. Stoicism is particularly evident within this cohort of people. Evidence from the literature search suggests that paracetamol should be considered as first-line treatment for the management of both acute and persistent pain, particularly that which is of musculoskeletal origin, due to its demonstrated efficacy and good safety profile. There are few absolute contraindications and relative cautions to prescribing paracetamol. It is, however, important that the maximum daily dose (4 g/24 h) is not exceeded. Non-selective non-steroidal anti-inflammatory drugs (NSAIDs) should be used with caution in older people after other safer treatments have not provided sufficient pain relief. The lowest dose should be provided

Healthcare professionals' perceptions of neglect of older people in Mexico: A qualitative secondary analysis.

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Caceres, Billy A; Bub, Linda; Negrete, Maria Isabel; Giraldo Rodríguez, Liliana; Squires, Allison P

2018-03-01

To describe healthcare professionals' perceptions of neglect of older people in Mexico. Mistreatment of older people, particularly neglect, has emerged as a significant public health concern worldwide. However, few studies have been conducted to examine neglect of older people in low- and middle-income countries. Most research has focused on estimating the prevalence of neglect in older populations with little emphasis on the perceptions of healthcare professionals and their role in addressing neglect of older people. Qualitative secondary analysis. The parent study consisted of nine focus groups conducted with healthcare professionals at five public hospitals in Mexico. The purpose of the parent study was to perform a needs assessment to determine the feasibility of adapting the Nurses Improving Care for Healthsystem Elders programme to Mexico. A qualitative secondary analysis with directed content analysis approach was used to extract data related to neglect of older people. A total of 89 participants representing healthcare professionals from several disciplines were interviewed. Three themes emerged: (i) The main point is not here; (ii) We feel hopeless; and (iii) We need preparation. Participants reported distress and hopelessness related to neglect of older people. Lack of community-based resources was noted as contributing to neglect. Increased education regarding care of older people for both caregivers and healthcare professionals and greater interdisciplinary collaboration were identified as potential solutions to combat neglect. Community-based services and resource allocation need to be re-evaluated to improve the care of older Mexicans. Interdisciplinary models of care should be developed to address concerns related to neglect of older people. Neglect negatively impacts healthcare professionals' ability to adequately care for older patients. There is a need to invest in community-based services and models of care to address these concerns. © 2017

The impact of foreign caregiving on depression among older people in Taiwan: model testing.

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Chiao, Chia-Yi; Schepp, Karen G

2012-05-01

  This article is a report of a study of predicting the factors that influence depression in the older people in Taiwan. Background.  In 1991, Taiwan opened the labour market to foreign caregivers for the older people who needed long-term care. With the differences in language, culture and lifestyle between foreign caregivers and older people in Taiwan, it was hypothesized that the older people would not be able to relate to them, and therefore become depressed.   The data were collected from 116 Taiwanese older people from July to September, 2005. Path analysis using multiple regression analyses was conducted to estimate the direct and indirect effects of caregiving communication, activities of daily living, income and social support on depression among older people in Taiwan. To evaluate the hypotheses for this research, bi-variate linear regression and multiple regression analyses were used.   The results indicated that the level of activities of daily living (β = -0·201, P = 0·010), care-giving communication (β = -0·272, P = 0·002) income (β = -0·305, P = 0·000) and social support (β = -0·276, P = 0·002) were the predictors of depression in older people in Taiwan. Social support was a mediating factor for caregiving communication and depression. Furthermore, foreign caregiver care was not correlated with depression among older people in Taiwan.   The findings influence the public awareness of depression in older people, and provide the foundational information to influence the policy makers of Taiwan to evaluate the foreign caregiver policy. © 2011 The Authors. Journal of Advanced Nursing © 2011 Blackwell Publishing Ltd.

Factors related to tinnitus and hyperacusis handicap in older people.

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Aazh, Hashir; Lammaing, Karen; Moore, Brian C J

2017-09-01

The aim was to assess factors related to tinnitus and hyperacusis handicap in older people. Retrospective cross-sectional. Data were gathered for 184 patients with an average age of 69 years. Tinnitus handicap as measured via the Tinnitus Handicap Inventory (THI) was significantly predicted by tinnitus annoyance as measured via the visual analogue scale (VAS) (regression coefficient, b = 2.9, p tinnitus on the patient's life as measured via the VAS (b = 3.9, p tinnitus annoyance significantly predicts tinnitus handicap, it is important to explore factors associated with annoyance that may be useful in designing appropriate rehabilitative interventions aimed at reducing tinnitus handicap in older people. Future studies should explore whether hyperacusis and insomnia in older people with tinnitus need to be managed in conjunction with treatment for depression.

Measuring the value of older people's production: a diary study

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Sahlen Klas-Göran

2012-01-01

Full Text Available Abstract Background The productive capacity of retired people is usually not valued. However, some retirees produce much more than we might expect. This diary-based study identifies the activities of older people, and suggests some value mechanisms. One question raised is whether it is possible to scale up this diary study into a larger representative study. Methods Diaries kept for one week were collected among 23 older people in the north of Sweden. The texts were analysed with a grounded theory approach; an interplay between ideas and empirical data. Results Some productive activities of older people must be valued as the opportunity cost of time or according to the market value, and others must be valued with the replacement cost. In order to make the choice between these methods, it is important to consider the societal entitlement. When there is no societal entitlement, the first or second method must be used; and when it exists, the third must be used. Conclusions An explicit investigation of the content of the entitlement is needed to justify the choice of valuation method for each activity. In a questionnaire addressing older people's production, each question must be adjusted to the type of production. In order to fully understand this production, it is important to consider the degree of free choice to conduct an activity, as well as health-related quality of life.

Competences for Working with Older People: The Development and Verification of The European Core Competence Framework for Health and Social Care Professionals Working with Older People

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Dijkman, Bea; Reehuis, Lidwien; Roodbol, Petrie

2017-01-01

Universities of applied sciences in Europe face the challenge of preparing students in health and social care for working with older people and contributing to the innovations needed in light of the ageing of society, along with changes in the health and social care systems in many countries. Dealing with the special needs of older people and the…

Beyond WhatsApp: Older people and smartphones

Directory of Open Access Journals (Sweden)

Andrea Rosales

2016-06-01

Full Text Available This paper analyzes how older people, living in Spain, use smartphones and smartphone applications. Using a mixed methods approach, we compare quantitative results obtained by tracking mobile app usage amongst different generational samples with qualitative, focus-group discussions with active smartphone users. A sample of Spanish smartphone users were tracked during one month in the winter of 2014 (238 individuals, aged 20 to 76 years-old. This was followed by three focus group sessions conducted in the spring of 2015, with 24 individuals aged 55 to 81. As we learned, WhatsApp is currently the most popular application used by people of all ages, including older adults. Smartphones increasingly are playing a central role in the life of older participants, although the frequency of app access is negatively correlated with age. On the other hand, as our data indicates, older adults also use a number of different types of apps that are distinct from that of younger users. Older participants access personal information manager apps (calendar, address book and notes more often than other age groups. And comparatively, older participants use the smartphone less often in stable locations (home, office, relatives’ home with Wifi than somewhere else and with mobile data. As we argue, differences in age seem to reflect the evolution in personal interests and communication patterns that change as we grow older. Our study captures new trends in smartphone usage amongst this cohort. It also indicates how a combination of methods may help to assess the validity of the log and qualitative data. We highlight the relevance of conducting careful generational studies in smartphone use and some of the potentials and limitations of making predictive studies of ICT use as we change throughout the life course. Finally, we assert the value of the inclusion of older representatives within research, which ultimately may influence public decisions and the design of new

Malnutrition and nutritional care practices in hospital wards for older people.

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Vanderwee, Katrien; Clays, Els; Bocquaert, Ilse; Verhaeghe, Sofie; Lardennois, Miguel; Gobert, Micheline; Defloor, Tom

2011-04-01

This paper is a report of a study conducted to gain a better insight into the current nutritional care practices in Belgian hospital wards for older people, and to study the association between these practices and the prevalence of malnutrition. In 1999, the Council of Europe assessed nutritional care practices and support in 12 European countries and showed them to be sparse and inconsistent. At the time of research, no studies had described the association between nutritional care practices and malnutrition prevalence in Belgium. In 2007, a cross-sectional survey was carried out in a representative sample of Belgian hospital wards for older people. In total, 2094 patients from 140 wards for older people were included. The overall prevalence rate of malnutrition in wards for older people was 31.9%. Nutritional care practices such as nutritional screening and assessment, use of a standardized screening instrument and a nutritional protocol were suboptimal. Multilevel analysis revealed that ward characteristics explained for 9.1% whether a patient was malnourished or not. None of the registered nutritional care practices could explain a patient's individual risk. Malnutrition is a frequently occurring problem on hospital wards for older people. Increased consciousness among healthcare professionals and hospital policy makers of the importance of nutritional care will contribute to further improvement in care quality. © 2010 The Authors. Journal of Advanced Nursing © 2010 Blackwell Publishing Ltd.

Subjective memory complaints and their relation with verbal fluency in active older people.

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Bernardes, Flavia Rodrigues; Machado, Camila Kretzer; Souza, Monique Coan; Machado, Marcos José; Belaunde, Aline Megumi Arakawa

2017-05-22

To verify subjective memory complaints and their relation to verbal fluency in older people participating in community groups. An epidemiological quantitative study performed in community groups for older people in Florianópolis, state of Santa Catarina, Brazil. Data were collected by structured interview using the Memory Complaint Questionnaire (MAC-Q) and the Verbal Fluency Test (VFT) by semantic categories "animals/minute". For an inferential descriptive analysis, data with p people in question and added to the questionnaire). We found no relation between subjective memory complaints and verbal fluency of active older people. Mnemonic complaints were correlated to the negative perception of memory and to the duration of the complaint. However, subjective memory complaints were an indicator for those individuals with negative perception of memory, being one aspect that must be considered in older people's speech when investigating a possible cognitive deterioration. Such data can assist in formulating public health care policies aimed at older people in the city, which emphasizes the importance of verifying subjective memory complaints in this population.

Disaster preparedness networks in rural Midwest communities: Organizational roles, collaborations, and support for older residents.

Science.gov (United States)

Ashida, Sato; Zhu, Xi; Robinson, Erin L; Schroer, Audrey

2018-05-17

This study investigated the roles and interconnections among community organizations belonging to local disaster coalitions in Midwest in supporting older residents. Representatives from 44 organizations participated in one-time survey. Most were non-profit (68%) or federal/state/local government agencies (23%). The analyses of 761 relationships showed stronger collaborations in assessment (average strength=2.88 on a 5-point scale), emergency response (2.72), and planning (2.61); and weaker collaborations in co-sponsoring programs (1.71) and supporting older residents (2.03). The extent of collaboration (network density) to support older adults was also low. Coalitions may enhance network density and centralization by developing sub-committee structure and strengthening existing collaborations.

Self-rated health and health-strengthening factors in community-living frail older people.

Science.gov (United States)

Ebrahimi, Zahra; Dahlin-Ivanoff, Synneve; Eklund, Kajsa; Jakobsson, Annika; Wilhelmson, Katarina

2015-04-01

The aim of this study was to analyse the explanatory power of variables measuring health-strengthening factors for self-rated health among community-living frail older people. Frailty is commonly constructed as a multi-dimensional geriatric syndrome ascribed to the multi-system deterioration of the reserve capacity in older age. Frailty in older people is associated with decreased physical and psychological well-being. However, knowledge about the experiences of health in frail older people is still limited. The design of the study was cross-sectional. The data were collected between October 2008 and November 2010 through face-to-face structured interviews with older people aged 65-96 years (N = 161). Binary logistic regression was used to analyse whether a set of explanatory relevant variables is associated with self-rated health. The results from the final model showed that satisfaction with one's ability to take care of oneself, having 10 or fewer symptoms and not feeling lonely had the best explanatory power for community-living frail older peoples' experiences of good health. The results indicate that a multi-disciplinary approach is desirable, where the focus should not only be on medical problems but also on providing supportive services to older people to maintain their independence and experiences of health despite frailty. © 2014 John Wiley & Sons Ltd.

Infection control strategies for preventing the transmission of meticillin-resistant Staphylococcus aureus (MRSA) in nursing homes for older people.

Science.gov (United States)

Hughes, Carmel; Tunney, Michael; Bradley, Marie C

2013-11-19

Nursing homes for older people provide an environment likely to promote the acquisition and spread of meticillin-resistant Staphylococcus aureus (MRSA), putting residents at increased risk of colonisation and infection. It is recognised that infection prevention and control strategies are important in preventing and controlling MRSA transmission. To determine the effects of infection prevention and control strategies for preventing the transmission of MRSA in nursing homes for older people. In August 2013, for this third update, we searched the Cochrane Wounds Group Specialised Register, the Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library), Database of Abstracts of Reviews of Effects (DARE, The Cochrane Library), Ovid MEDLINE, OVID MEDLINE (In-process and Other Non-Indexed Citations), Ovid EMBASE, EBSCO CINAHL, Web of Science and the Health Technology Assessment (HTA) website. Research in progress was sought through Current Clinical Trials, Gateway to Reseach, and HSRProj (Health Services Research Projects in Progress). All randomised and controlled clinical trials, controlled before and after studies and interrupted time series studies of infection prevention and control interventions in nursing homes for older people were eligible for inclusion. Two review authors independently reviewed the results of the searches. Another review author appraised identified papers and undertook data extraction which was checked by a second review author. For this third update only one study was identified, therefore it was not possible to undertake a meta-analysis. A cluster randomised controlled trial in 32 nursing homes evaluated the effect of an infection control education and training programme on MRSA prevalence. The primary outcome was MRSA prevalence in residents and staff, and a change in infection control audit scores which measured adherence to infection control standards. At the end of the 12 month study, there was no change in MRSA

Methods for Involving Older People in Health Research-A Review of the Literature.

Science.gov (United States)

Schilling, Imke; Gerhardus, Ansgar

2017-11-29

Demographic change has increased the need for research on healthcare for older people. Recently there has been a growing awareness that research might benefit from actively involving patients and the public in study design and conduct. Besides empowering patients and democratizing research, involvement enhances the quality of research and the development of equitable healthcare solutions. Little is known about how to involve older people. This review aims to support scientists intending to involve older people in health research by systematically identifying and describing studies involving older people and analyzing associated facilitators and challenges. Old people were operationalized as people living with old-age-related conditions. We conducted a systematic search in PubMed, CINAHL (Cumulative Index to Nursing and Allied Health Literature), and Cochrane library for the period 2007 to July 2017 and also manually searched reference lists of the nine retrieved articles and other relevant sources. While involvement of older people in research is feasible, specific challenges related to this group need be taken into account. Strategies to enhance effective involvement comprise a thoughtful choice of location, use of visualization and accessible communication, building good relationships and flexible approaches. Further research is needed on the involvement of people in care homes or with vision, hearing or mobility limitations.

Methods for Involving Older People in Health Research—A Review of the Literature

Directory of Open Access Journals (Sweden)

Imke Schilling

2017-11-01

Full Text Available Demographic change has increased the need for research on healthcare for older people. Recently there has been a growing awareness that research might benefit from actively involving patients and the public in study design and conduct. Besides empowering patients and democratizing research, involvement enhances the quality of research and the development of equitable healthcare solutions. Little is known about how to involve older people. This review aims to support scientists intending to involve older people in health research by systematically identifying and describing studies involving older people and analyzing associated facilitators and challenges. Old people were operationalized as people living with old-age-related conditions. We conducted a systematic search in PubMed, CINAHL (Cumulative Index to Nursing and Allied Health Literature, and Cochrane library for the period 2007 to July 2017 and also manually searched reference lists of the nine retrieved articles and other relevant sources. While involvement of older people in research is feasible, specific challenges related to this group need be taken into account. Strategies to enhance effective involvement comprise a thoughtful choice of location, use of visualization and accessible communication, building good relationships and flexible approaches. Further research is needed on the involvement of people in care homes or with vision, hearing or mobility limitations.

Exercise Interventions for Preventing Falls Among Older People in Care Facilities: A Meta-Analysis.

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Lee, Seon Heui; Kim, Hee Sun

2017-02-01

Falls in older people are a common problem, often leading to considerable morbidity. However, the overall effect of exercise interventions on fall prevention in care facilities remains controversial. To evaluate the effectiveness of exercise interventions on the rate of falls and number of fallers in care facilities. A meta-analysis was conducted of randomized controlled trials published up to December 2014. Eight databases were searched including Ovid-Medline, Embase, CINAHL, Cochrane Library, KoreaMed, KMbase, KISS, and KisTi. Two investigators independently extracted data and assessed study quality. Twenty-one studies were selected, that included 5,540 participants. Fifteen studies included exercise as a single intervention, whereas the remaining six included exercise combined with two or more fall interventions tailored to each resident's fall risk (i.e., medication review, environmental modification or staff education). Meta-analysis showed that exercise had a preventive effect on the rate of falls (risk ratio [RR] 0.81, 95% CI 0.68-0.97). This effect was stronger when exercise combined with other fall interventions on the rate of falls (RR 0.61, 95% CI 0.52-0.72) and on the number of fallers (RR 0.85, 95% CI 0.77-0.95). Exercise interventions including balance training (i.e., gait, balance, and functional training; or balance and strength) resulted in reduced the rate of falls. Sensitivity analyses indicated that exercise interventions resulted in reduced numbers of recurrent fallers (RR 0.71, 95% CI 0.53-0.97). This review provides an important basis for developing evidence-based exercise intervention protocols for older people living in care facilities. Exercise programs, which are combined with tailored other fall interventions and challenge balance training to improve balance skills, should be applied to frail older people with functional limitations in institutional settings. © 2016 Sigma Theta Tau International.

Nutritional strategies to reduce falls risk in older people.

Science.gov (United States)

Nash, Louise; Bergin, Nick

2018-03-23

A literature review found an association between increased falls risk and malnutrition, sarcopenia, vitamin D deficiency and dehydration. Strategies to identify, prevent and treat these conditions can help to reduce falls risk in at-risk groups such as frail, older people. Nurses can reduce falls risk in older people by raising awareness of risk factors and embedding nutritional strategies in local falls reduction strategies. ©2018 RCN Publishing Company Ltd. All rights reserved. Not to be copied, transmitted or recorded in any way, in whole or part, without prior permission of the publishers.

Massage, a complementary therapy effectively promoting the health and well-being of older people in residential care settings: a review of the literature.

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McFeeters, Sarah; Pront, Leeanne; Cuthbertson, Lesley; King, Lindy

2016-12-01

To explore the potential benefits of massage within daily routine care of the older person in residential care settings. Globally, the proportion of people over 65 years is rapidly rising. Increased longevity means older people may experience a rise in physiological and psychological health problems. These issues potentially place an increased demand for quality long-term care for the older person. Complementary approaches such as massage appear to be needed in quality residential care. A critical literature review was undertaken. A literature review pertaining to massage in the older resident was conducted using a range of online databases. Fourteen studies dated 1993-2012 met the inclusion criteria and were critically evaluated as suitable resources for this review. Evidence suggests massage may be advantageous from client and nursing perspectives. Clients' perceive massage to positively influence factors such as pain, sleep, emotional status and psychosocial health. Evidence also demonstrates massage to benefit the client and organisation by reducing the necessity for restraint and pharmacological intervention. Massage may be incorporated into care provision and adopted by care providers and family members as an additional strategy to enhance quality of life for older people. Massage offers a practical activity that can be used to enhance the health and well-being of the older person in residential care. Massage offers benefit for promoting health and well-being of the older person along with potential increased engagement of family in care provision. Integration of massage into daily care activities of the older person requires ongoing promotion and implementation. © 2016 John Wiley & Sons Ltd.

Estimating Glomerular Filtration Rate in Older People

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Sabrina Garasto

2014-01-01

Full Text Available We aimed at reviewing age-related changes in kidney structure and function, methods for estimating kidney function, and impact of reduced kidney function on geriatric outcomes, as well as the reliability and applicability of equations for estimating glomerular filtration rate (eGFR in older patients. CKD is associated with different comorbidities and adverse outcomes such as disability and premature death in older populations. Creatinine clearance and other methods for estimating kidney function are not easy to apply in older subjects. Thus, an accurate and reliable method for calculating eGFR would be highly desirable for early detection and management of CKD in this vulnerable population. Equations based on serum creatinine, age, race, and gender have been widely used. However, these equations have their own limitations, and no equation seems better than the other ones in older people. New equations specifically developed for use in older populations, especially those based on serum cystatin C, hold promises. However, further studies are needed to definitely accept them as the reference method to estimate kidney function in older patients in the clinical setting.

Images of older people in UK magazine advertising: toward a typology.

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Williams, Angie; Wadleigh, Paul Mark; Ylänne, Virpi

2010-01-01

The use of images of older people in the British advertising media has been under-researched to date. Further, previous research in any country has tended to examine such images from an a priori framework of general impressions and stereotypes of older people. This study addresses these issues with British consumers' (n = 106) impressions, trait ascriptions, and similarity-between-images ratings of a representative sample of U.K. magazine advertisements featuring older characters. After a series of sorting task laboratory sessions, multidimensional scaling and hierarchical cluster analyses revealed four clearly defined groups representing types of portrayals. These types emerged from the advertisements and from the views of the consumers themselves. These emergent groupings are: (1) Frail and Vulnerable, (2) Happy and Affluent, (3) Mentors, (4) Active and Leisure-oriented older adults. These groupings seem to be a logical context-appropriate derivation from previous findings on generally held stereotypes of older persons. It is argued that the groupings have the potential to contribute to a reliable typology of advertising portrayals of older people, with potential heuristic leverage in social scientific research of intergenerational communication, lifespan concerns, and the aging process.

Older people's exclusion from healthcare services in Nepal: an analysis of the political economy of development aid, domestic policy and research.

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Bhattarai, Lok P Sharma

2013-04-01

The objective of this review was to contribute to the discussion on older people's access to healthcare in developing countries. Relevant research findings, survey reports, policy papers and planning documents were critically reviewed, placing a particular focus on their relevance in understanding issues of access, equity and justice. A number of factors are identified for their roles on the issue; that is, place of residence, economic factors/poverty, cultural stigma, situation and impact of research, and the prevalent policy framework in health and the approach of development assistance adopted by donor communities. In order to make healthcare facilities equitable for older people, the identified factors need to be addressed at different levels - at local policy work, in the allocation of funding for health service research and in designing overseas development work. © 2012 Japan Geriatrics Society.

Education for Older People in Italy

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Principi, Andrea; Lamura, Giovanni

2009-01-01

This article provides information on trends in formal and informal adult education in Italy, with a particular focus on the older learners (over 65). Main providers, programs, objectives/motivations, and financial and legal framework are described. In general, over-65-year-old people were found to be underrepresented in participation. They were…

Introducing older people to the theory of gerotranscendence.

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Wadensten, Barbro

2005-11-01

This paper reports a study whose aims were to introduce the theory of gerotranscendence to a group of older people; to give participants in the group an opportunity to discuss their ageing process; to study how participants described their ageing in relation to the theory; and to gather participants' opinions about discussing their ageing in a group. The theory of gerotranscendence states that human development is a process extending into old age. Guidelines had previously been derived for its practical use in the care of older people, aiming to promote their development towards gerotranscendence. A qualitative descriptive approach was taken, and older people were invited to participate in group sessions at a day centre. At the sessions, participants discussed their ageing, and a video presentation about the theory of gerotranscendence was shown at one of the sessions. They were encouraged to discuss the description of the ageing process presented in the video and to link this to their own experiences of growing old. The discussion in each session was tape-recorded and transcribed verbatim. Data were analysed and categorized using qualitative methods. The data were collected in 2002. All women had an experience of ageing that was in some way in line with the theory's description, and they more or less agreed that this description of ageing was in accordance with their own ageing. They considered that it was interesting and fruitful to discuss ageing in a group. They felt that introduction of the view of ageing offered by the theory of gerotranscendence was beneficial because it gave them a more positive view of ageing which also allowed them to be as they were. It is possible to arrange this type of group activity for older people, resulting in possibilities to use aspects of the theory of gerotranscendence as an intervention in gerontological nursing.

A longitudinal study of change in falls risk and balance and mobility in healthy older people and people with Alzheimer disease.

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Suttanon, Plaiwan; Hill, Keith D; Said, Catherine M; Dodd, Karen J

2013-08-01

The aim of this study was to determine the rate of change in falls risk and balance and mobility performance in people with Alzheimer disease (AD) compared with those of healthy older people over a 1-yr period. A 1-yr follow-up study of change in levels of falls risk, balance, and mobility performance in 15 community-dwelling older people with mild to moderate AD and 15 healthy age-matched older people was conducted. Each participant completed a comprehensive assessment of balance and mobility, falls and falls risk, and level of physical activity at baseline and 1 yr later. The rate of increase in the number of falls and risk of falling was greater in people with AD. The rate of deterioration on a number of balance and mobility measures was also significantly greater in people with AD compared with the healthy older people. People with mild to moderate AD have an increased rate of decline in falls risk, balance, and mobility over a 12-mo period compared with age-matched healthy older people. Given this increased rate of decline, intermittent review of falls, balance and mobility, and interventions to address identified contributory risk factors should be considered by health practitioners.

Influences of satisfaction with telecare and family trust in older Taiwanese people.

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Tsai, Chung-Hung; Kuo, Yu-Ming; Uei, Shu-Lin

2014-01-27

The level of trust given towards telecare by the family members of older people using the service is extremely important. Family trust may be an influential factor in deciding whether to use such services. This study focuses on older people's satisfaction with telecare and examines their family's trust in telecare services. Influences on intention to continue using telecare services are also explored. A questionnaire-based survey on 60 communities dwelling older people who had been receiving telecare services in the past two years was employed. This study developed a satisfaction and trust scale based on previous studies. Our results show that older people's satisfaction with telecare services and families' trust were influential in decided whether to continue to use of telecare services. These findings can help medical institutions to better insight into the user experience of telecare to help them provide future services that better comply with clients' desires and requirements.

A Systematic Review of Behavioural Interventions Promoting Healthy Eating among Older People.

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Zhou, Xiao; Perez-Cueto, Federico J A; Santos, Quenia Dos; Monteleone, Erminio; Giboreau, Agnès; Appleton, Katherine M; Bjørner, Thomas; Bredie, Wender L P; Hartwell, Heather

2018-01-26

Because eating habits are inseparably linked with people's physical health, effective behaviour interventions are highly demanded to promote healthy eating among older people. The aim of this systematic review was to identify effective diet interventions for older people and provide useful evidence and direction for further research. Three electronic bibliographic databases-PubMed, Scopus and Web of Science Core Collection were used to conduct a systematic literature search based on fixed inclusion and exclusion criteria. English language peer-reviewed journal articles published between 2011 and 2016 were selected for data extraction and quality assessment. Finally, a total of 16 studies were identified. The studies' duration ranged from three weeks to seven years. The majority of studies were carried out in European countries. Seven studies had a moderate quality while the remaining studies were at a less than moderate level. Three dietary educational interventions and all meal service related interventions reported improvements in older people's dietary variety, nutrition status, or other health-related eating behaviours. Multicomponent dietary interventions mainly contributed to the reduction of risk of chronic disease. The results supported that older people could achieve a better dietary quality if they make diet-related changes by receiving either dietary education or healthier meal service. Further high-quality studies are required to promote healthy eating among older people by taking regional diet patterns, advanced information technology, and nudging strategies into account.

Testing an app for reporting health concerns-Experiences from older people and home care nurses.

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Göransson, Carina; Eriksson, Irene; Ziegert, Kristina; Wengström, Yvonne; Langius-Eklöf, Ann; Brovall, Maria; Kihlgren, Annica; Blomberg, Karin

2017-12-05

To explore the experiences of using an app among older people with home-based health care and their nurses. Few information and communication technology innovations have been developed and tested for older people with chronic conditions living at home with home-based health care support. Innovative ways to support older people's health and self-care are needed. Explorative qualitative design. For 3 months to report health concerns, older people receiving home-based health care used an interactive app, which included direct access to self-care advice, graphs and a risk assessment model that sends alerts to nurses for rapid management. Interviews with older people (n = 17) and focus group discussions with home care nurses (n = 12) were conducted and analysed using thematic analysis. The findings reveal that a process occurs. Using the app, the older people participated in their care, and the app enabled learning and a new way of communication. The interaction gave a sense of security and increased self-confidence among older people. The home care nurses viewed the alerts as appropriate for the management of health concerns. However, all participants experienced challenges in using new technology and had suggestions for improvement. The use of an app appears to increase the older people's participation in their health care and offers them an opportunity to be an active partner in their care. The app as a new way to interact with home care nurses increased the feeling of security. The older people were motivated to learn to use the app and described potential use for it in the future. The use of an app should be considered as a useful information and communication technology innovation that can improve communication and accessibility for older people with home-based health care. © 2017 John Wiley & Sons Ltd.

Work satisfaction, stress, quality of care and morale of older people in a nursing home.

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Redfern, Sally; Hannan, Shirina; Norman, Ian; Martin, Finbarr

2002-11-01

The aim in the present study, which was carried out in one nursing home for older people, was to determine the feasibility of working with care workers and very frail service users to investigate links between the levels of work satisfaction and stress of the staff, and the quality of care and morale of the residents. Most of the 44 care staff (70%) and 22 cognitively intact residents (82%) participated willingly in completing rating scales through self-completion questionnaire or by interview. Well-validated scales were used to measure job satisfaction, work stress, organisational commitment, perceived quality of care, and morale and mental health. The findings revealed a staff group with a fairly high level of job dissatisfaction and stress, who were, nevertheless, very committed to the nursing home. The morale of the residents was good although the residents rated the home atmosphere lower than the staff did. Significant correlations emerged, in the expected direction, between satisfaction, commitment, stress and quality of care perceived by staff. The correlations between home atmosphere perceived by residents, and their morale and mental health were low; further investigation is needed with a larger sample. This feasibility study supports the need for further research using a case-study approach in a small number of homes because of the labour-intensive nature of the data collection and the importance of triangulating data from many sources.

Childlessness and vulnerability of older people in China.

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Feng, Zhixin

2018-03-01

the number of childless older people is increasing in China, but relatively little is known about the role of childlessness in health outcomes. This study investigates the relationship between childlessness and three health outcomes: difficulty with Instrumental Activities of Daily Living (IADLs), self-rated health and depression. this study includes 13,171 individuals aged 50 and above from national survey data of the second wave of the China Family Panel Study (2012). Binary/multinomial logistic and ordinary least squares regression models are presented. childless individuals whose children have all died exhibit worse health outcomes than individuals with children, but this effect is influenced by demographic characteristics, socio-economic status and social security. On the other hand, individuals who are childless due to other reasons (involuntary or voluntary) are less likely to report difficulty with IADLs and to report depression than older people with all children alive after controlling for demographic and socio-economic and social security factors. the death of a child has an adverse effect on people's health for both childless people whose children have all died and those who have lost a child but have other children alive. These two groups are in the most vulnerable position, which could also suggest that their children have died because they grew up in a vulnerable family. The government needs to improve the social security for these two groups and provide social services (particularly mental health services) to older people who have lost a child; these could contribute to alleviating some of the adverse effects of the death of a child. © The Author 2017. Published by Oxford University Press on behalf of the British Geriatrics Society.

Older people, personal hygiene, and skin care.

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Cowdell, Fiona

2011-01-01

Skin health is essential for well being in older people. Personal hygiene is fundamental to skin health, but a lack of evidence exists about effective practices. An evidence base, disseminated through nursing education and patient health promotion, must be developed.

Nurses' attitudes towards older people care: An integrative review.

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Rush, Kathy L; Hickey, Stormee; Epp, Sheila; Janke, Robert

2017-12-01

To examine hospital nurses' attitudes towards caring for older adults and delineate associated factors contributing to their attitudes. Population ageing is of international significance. A nursing workforce able to care for the ageing population is critical for ensuring quality older adult care. A synthesis of research related to nurses' attitudes towards older adult care is important for informing care quality and the nursing workforce issues. A systematic integrative review process guided the review. Cumulative Index of Nursing and Allied Health Literature and Medline databases were searched for primary research published between 2005-2017. A total of 1,690 papers were screened with 67 papers read in-depth and eight selected for this review that met the inclusion/exclusion criteria. Nurses' held coexisting positive and negative attitudes towards generic and specific aspects of older adult care. Negative attitudes, in particular, were directed at the characteristics of older adults, their care demands or reflected in nurses' approaches to care. Across jurisdictions, work environment, education, experience and demographics emerged as influences on nurses' attitudes. There is a paucity of research examining nurses' attitudes towards older adult care. The limited evidence indicates that attitudes towards older people care are complex and contradictory. Influences on nurses' attitudes need further study individually and collectively to build a strong evidence base. Interventional studies are needed as are the development of valid and reliable instruments for measuring nurses' attitudes towards older adult care. Bolstering postgraduate gerontological preparation is critical for promoting nurses' attitudes towards older adult care. Creating age-friendly work environments, including appropriate resource allocation, is important to support older people care and facilitate positive nursing attitudes. © 2017 John Wiley & Sons Ltd.

Food patterns of Polish older people

DEFF Research Database (Denmark)

Wadolowska, L.; Danowska-Oziewicz, M.; Niedzwiedzka, E.

2006-01-01

Food patterns of Polish older people were separated and described. The research included 422 people aged 65+ years, living in 5 geographical locations. Participants of the study were selected in quota sampling. Criteria for recruitment included sex, age (65-^74 or 75+ years) and family status...... (living alone or living with other people). Respondents were asked questions about consumption of 55 food products. The factor analysis allowed for separating 21 food patterns. They included from 1 to 3 groups of products, intake of which was mutually dependant. Big number of separated food patterns...... and small number of products fonning joint food patterns speak in advocacy of relatively small reciprocal relationship between different food items consumed by the seniors in Poland....

What older people want: evidence from a study of remote Scottish communities.

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King, Gerry; Farmer, Jane

2009-01-01

The growing proportions of older people in rural areas have implications for the provision of health and social care services. Older people are more likely to have complex health needs compared with other age groups, requiring a full range of primary, community and acute hospital services. The provision of services to older people in rural areas is challenged by diseconomies of scale, travel costs and difficulties in attracting staff. Policy-makers are requested to include the 'voice' of older people to help provide services that match needs and context. In spite of this, what older people want from health and social care services is a neglected area of investigation. The reported study was conducted in 2005/2006 as part of a European Union Northern Periphery Programme (EU NPP) project called Our Life as Elderly. Its aims were to explore the views of those aged 55 years and over and living in remote communities about current and future health and social care service provision for older people. Evidence was to be collected that could inform policy-makers about changing or improving service delivery. This article summarises emergent themes and considers their implications. The study selected two small remote mainland Scottish Highland communities for in-depth case study. Semi-structured interviews (n = 23), 10 'informal conversations' and 4 focus groups were held with community members aged 55 years and over, in order to provide different types of qualitative data and 'layers' of data to allow reflection. Data analysis was assisted by computerised data management software and performed using the 'framework analysis' approach. Participants did not consider themselves 'old' and expressed the need for independence in older age to be supported by services. Several aspects of services that were undergoing change or restructuring were identified, including arrangements for home care services, meals provision and technological support. Participants valued elements of the

Global oral health of older people--call for public health action

DEFF Research Database (Denmark)

Petersen, P E; Kandelman, D; Arpin, S

2010-01-01

The aim of this report is (1) to provide a global overview of oral health conditions in older people, use of oral health services, and self care practices; (2) to explore what types of oral health services are available to older people, and (3) to identify some major barriers to and opportunities...... for the establishment of oral health services and health promotion programmes....

Older people's experience of falls: understanding, interpretation and autonomy.

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Roe, Brenda; Howell, Fiona; Riniotis, Konstantinos; Beech, Roger; Crome, Peter; Ong, Bie Nio

2008-09-01

This paper is a report of a study to explore the experiences of older people who suffered a recent fall and identify possible factors that could contribute to service development. Falls in older people are prevalent and are associated with morbidity, hospitalization and mortality, personal costs to individuals and financial costs to health services. A convenience sample of 27 older people (mean age 84 years; range 65-98) participated in semi-structured taped interviews. Follow-up interviews during 2003-2004 were undertaken to detect changes over time. Data were collected about experience of the fall, use of services, health and well-being, activities of daily living, informal care, support networks and prevention. Thematic content analysis was undertaken. Twenty-seven initial interviews and 18 follow-up interviews were conducted. The majority of people fell indoors (n = 23) and were alone (n = 15). The majority of falls were repeat falls (n = 22) and five were a first-ever fall. People who reflected on their fall and sought to understand why and how it occurred developed strategies to prevent future falls, face their fear, maintain control and choice and continue with activities of daily living. Those who did not reflect on their fall and did not know why it occurred restricted their activities and environments and remained in fear of falling. Assisting people to reflect on their falls and to understand why they happened could help with preventing future falls, allay fear, boost confidence and aid rehabilitation relating to their activities of daily living.

Patterns of emergency ambulance use, 2009-13: a comparison of older people living in Residential Aged Care Facilities and the Community.

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Dwyer, R; Gabbe, B; Tran, T D; Smith, K; Lowthian, J A

2018-04-24

to examine demand for emergency ambulances by older people. retrospective cohort study using secondary analysis of routinely collected clinical and administrative data from Ambulance Victoria, and population data from the Australian Bureau of Statistics and the Australian Institute of Health and Welfare. Victoria, Australia. people aged 65 years and over, living in Residential Aged Care Facilities (RACF) and the community, attended by emergency ambulance paramedics, 2009-13. rates of emergency ambulance attendance. older people living in RACF experienced high rates of emergency ambulance attendance, up to four times those for age- and sex-matched people living in the community. Rates remained constant during the study period equating to a consistent, 1.45% average annual increase in absolute demand. Rates peak among the 80-84-year group where the number of attendances equates to greater than one for every RACF-dwelling person each year. Increased demand was associated with winter months, increasing age and being male. these data provide strong evidence of high rates of emergency ambulance use by people aged 65 years and over living in RACF. These results demonstrate a clear relationship between increased rate of ambulance use among this vulnerable group of older Australians and residence, sex, age and season. Overall, absolute demand continues to increase each year adding to strain on health resources. Additional research is needed to elucidate individual characteristics, illness and health system contributors to ambulance use to inform strategies to appropriately reduce demand.

FACTORS RELATING TO DEPRESSION AMONG OLDER PEOPLE LIVING IN CIMAHI, WEST JAVA PROVINCE, INDONESIA

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Kiki Gustryanti

2017-02-01

Full Text Available Background: Depression is commonly found in older people. The prevalence of depression among older people, particularly in Indonesia is increasing worldwide. Objective: This study was aimed to identify the factors relating to depression among older people living in Cimahi, West Java Province, Indonesia. Method: A cross sectional design was used with a total of 267 older people aged from 60 to 79 years old. A multi-stage random sampling has been used in five Public Health Centers in Cimahi. The instruments comprised socio-demographic questionnaires, General Health Perceptions questionnaire, Chula Activities of Daily Living Index (CADLI, and Geriatric Depression Scale-15 (GDS-15. Data analysis was conducted using descriptive statistic, chi-square, and point-biserial. Results: The result revealed that 56.2% respondents was no depression and 43.8% respondents was depression. The results also showed that age, marital status, family history of depression, perceived health status, and activities of daily living was significant relationship with depression a mong older people (p<.01; p<.05. Conclusion: This finding can be used as a reference to implement new strategies to decrease depression among older people.

Meeting American Geriatrics Society Competencies: Are Residents Meeting Expectations for Quality Care of Older Adults?

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Bynum, Debra L; Wilson, Lindsay A; Ong, Thuan; Callahan, Kathryn E; Dalton, Thomas; Ohuabunwa, Ugochi

2015-09-01

In order to determine how often internal medicine and family medicine residents performed specific actions related to the geriatric competencies established by the American Geriatrics Society (AGS) when caring for older hospitalized adults, a cross-sectional anonymous survey of residents at the University of North Carolina, University of Washington, Wake Forest University, Duke University, and Emory University was undertaken. Data on frequency of self-reported behaviors were analyzed, with comparisons made for different levels of training, institution, and program. A total of 375 residents responded for an overall response rate of 48%. Residents reported that they often do not demonstrate all of the AGS recommended core competencies when caring for older adults in the hospital setting. Residents report more frequently performing activities that are routinely integrated into hospital systems such as reviewing medication lists, working with an interdisciplinary team, evaluating for inappropriate bladder catheters, and evaluating for pressure ulcers. There were no consistent differences between institutions and only minor differences noted between Family Medicine and Internal Medicine residents. Operationalizing core competencies by integrating them into hospital systems' quality process indicators may prompt more consistent high-quality care and ensure systems support residents' competence. © 2015, Copyright the Authors Journal compilation © 2015, The American Geriatrics Society.

Health care for older people in Italy: The U.L.I.S.S.E. Project (Un link informatico sui servizi sanitari esistenti per l'anziano - a computerized network on health care services for older people).

Science.gov (United States)

Lattanzio, F; Mussi, C; Scafato, E; Ruggiero, C; Dell'Aquila, G; Pedone, C; Mammarella, F; Galluzzo, L; Salvioli, G; Senin, U; Carbonin, P U; Bernabei, R; Cherubini, A

2010-03-01

The U.L.I.S.S.E. study is aimed at describing older patients who are cared for in hospitals, home care or nursing homes in Italy. The U.L.I.S.S.E. study is an observational multicenter prospective 1-year study. Overall, 23 acute geriatric or internal medicine hospital units, 11 home care services and 31 nursing homes participated in the study. The patient's evaluation was performed using comprehensive geriatric assessment instruments, i.e. the interRAI Minimum Data Set, while data on service characteristics were recorded using ad-hoc designed questionnaires. The older subjects who are in need of acute and long term care in Italy have similar characteristics: their mean age is higher than 80 years, they have a high level of disability in ADL, an important multimorbidity, and are treated with several drugs. The prevalence of cognitive impairment is particularly high in nursing homes, where almost 70% of residents suffer from it and 40% have severe cognitive impairment. On the other hand, there is a shortage of health care services, which are heterogeneous and fragmented. Health care services for older people in Italy are currently inadequate to manage the complexity of the older patients. An important effort should be undertaken to create a more integrated health care system.

Food hygiene challenges in older people: Intergenerational learning as a health asset

OpenAIRE

Wythe, H.; Wilkinson, C.; Orme, J.; Meredith, L.; Weitkamp, E.

2013-01-01

Older people are more at risk of contracting foodborne infections, however the majority remain well despite the physical, social and cognitive challenges of older age. Future healthcare strategies targeting older people can be informed by exploring the food history and current context of their lives and what 'assets' they employ to successfully consume ‘safe’ food in the home. Phase I: Socio-demographic, health and asset related data collection through a researcher completed questionnaire i) ...

Older people's perspectives on an elderly-friendly hospital environment: an exploratory study

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Karki S

2015-05-01

Full Text Available Sushmita Karki,1 Dharma Nand Bhatta,1,2 Umesh Raj Aryal3 1Department of Public Health, Nobel College, Pokhara University, Kathmandu, Nepal; 2Faculty of Medicine, Epidemiology Unit, Prince of Songkla University, Songkhla, Thailand; 3Department of Community Medicine, Kathmandu Medical College, Kathmandu, Nepal Background: Many older people are vulnerable with multiple health problems and need of extensive care and support for quality of life. The main objective of this study was to explore the older people's perspectives on an "elderly-friendly" hospital. Methods: Hospital was stratified by four domains including government, semi-government, community, and private. We interviewed 33 hospitalized older patients and four hospital managers between June and December 2014 in Kathmandu, Nepal, using purposive sampling technique. We executed a qualitative content analysis step with extensive review of the interviews. Final name of the theme was given after the agreement between the research team and experts to improve trustworthiness. Elderly-friendly services, expectation from government and hospital, and health policy related to senior citizen were developed as main themes. Results: Most of the participants were satisfied with the behavior of health personnel. However, none of the health personnel were trained with geriatric health care. Elderly-friendly hospital guidelines and policy were not developed by any hospitals. Older people health card, advocacy for older people's health and benefit, and hospital environment were the common expectations of older patients. Government policy and budget constraint were the main obstacles to promote elderly-friendly health care services. Conclusion: Elderly-related health policies, physical environments of hospital, elderly-friendly health manpower, advocacy, and other facilities and benefits should be improved and developed. There are urgent needs to develop elderly-friendly hospital policies and guidelines that

Advertising Representations of Older People in the United Kingdom and Taiwan: A Comparative Analysis.

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Chen, Chin-Hui

2015-01-01

Cross-cultural studies of advertising representations of older people are relatively scarce. This article aims to fill in this gap via a comparison between Taiwan and the United Kingdom, employing a combination of quantitative content analysis and the qualitative grounded theory method. The content-analysis phase reveals underrepresentation of older people in both countries' advertising contexts, as well as representational differences between Taiwan and the United Kingdom in terms of older characters' role salience, the products, physical settings, and social networks they are associated with. The grounded-theory phase yields nine prototypes of older people along with subcategories to conceptualize the qualities of older people as they appear in TV ads in these countries. The findings are discussed in relation to the stereotyping of older people and transformed into hypothetical statements to be modified in future research. In conclusion, the Confucian tradition of filial piety is still found to be important in explaining the observed cross-cultural differences, but the emergence of new norms about aging in Taiwanese advertising also suggests that this tradition may be in decline. © The Author(s) 2015.

Systematic reviews: guidance relevant for studies of older people.

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Shenkin, Susan D; Harrison, Jennifer K; Wilkinson, Tim; Dodds, Richard M; Ioannidis, John P A

2017-09-01

Systematic reviews and meta-analyses are increasingly common. This article aims to provide guidance for people conducting systematic reviews relevant to the healthcare of older people. An awareness of these issues will also help people reading systematic reviews to determine whether the results will influence their clinical practice. It is essential that systematic reviews are performed by a team which includes the required technical and clinical expertise. Those performing reviews for the first time should ensure they have appropriate training and support. They must be planned and performed in a transparent and methodologically robust way: guidelines are available. The protocol should be written-and if possible published-before starting the review. Geriatricians will be interested in a table of baseline characteristics, which will help to determine if the studied samples or populations are similar to their patients. Reviews of studies of older people should consider how they will manage issues such as different age cut-offs; non-specific presentations; multiple predictors and outcomes; potential biases and confounders. Systematic reviews and meta-analyses may provide evidence to improve older people's care, or determine where new evidence is required. Newer methodologies, such as meta-analyses of individual level data, network meta-analyses and umbrella reviews, and realist synthesis, may improve the reliability and clinical utility of systematic reviews. © The Author 2017. Published by Oxford University Press on behalf of the British Geriatrics Society.

Theorising the Relationship between Older People and Their Immediate Social Living Environment

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Buffel, Tine; Verte, Dominique; De Donder, Liesbeth; De Witte, Nico; Dury, Sarah; Vanwing, Tom; Bolsenbroek, Anouk

2012-01-01

This article presents a theoretical framework for exploring the dynamics between older people and their immediate social living environment. After introducing a gerontological perspective that goes beyond "microfication," a literature review presents findings from studies that have explored the role of place and locality for older people. Next,…

Oral Health Conditions of Older People: Focus on the Balkan Countries

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Chatzopoulos Georgios S.

2015-07-01

Full Text Available Oral health plays a pivotal role in general health, especially in older people. Oral diseases may affect the development of systemic conditions, such as diabetes mellitus, cardiovascular disease, stroke and hypertension. The most important oral health conditions that have been recorded in dental literature for older population include tooth loss, dental caries, periodontal diseases, xerostomia (dry mouth and oral cancer. Edentulism influences social life, either causing aesthetic problems or affecting functional abilities, such as speaking, chewing and eating. Dental caries in older people is similar to that in people in their thirties. Socio-economic status and living area play a key role in the development of dental caries. In addition, the accumulation of several risk factors, such as plaque or systemic diseases, acts synergistically in the onset of periodontal disease in seniors. Furthermore, older people, mainly due to their medications, exhibit a reduced amount of saliva. Xerostomia causes difficulties in chewing, speaking and swallowing, and it has a substantial impact on older people’s lives. The prevalence of oral cancer is 1-10 per 100,000 patients, and several factors (smoking, alcohol, education, economic status play crucial role. Limited data exists today that evaluates oral health conditions of seniors in the Balkan countries. Aging and socio-economic status of seniors in the Balkans are significantly associated with oral health problems.

KNOWLEDGE AND ATTITUDES OF HEALTH CARE SCIENCE STUDENTS TOWARD OLDER PEOPLE.

Science.gov (United States)

Milutinović, Dragana; Simin, Dragana; Kacavendić, Jelena; Turkulov, Vesna

2015-01-01

Education of health science students in geriatrics is important in order to provide optimal care for the growing number of elderly people because it is the attitudes of health professionals toward the elderly that play the key role in the quality of care provided. Therefore, the aim of this study was to assess the knowledge and attitudes of health care science students towards ageing and care for the elderly. The present cross-sectional study was carried out on a sample of 130 students (medical, nursing and special education and rehabilitation) of the Faculty of Medicine, University of Novi Sad. The students were divided into two groups. The first group (E) included students having been taught geriatrics and nursing older adults and the other group (C) included students who had not been trained in this subject. The authors used Palmore's facts on Ageing Quiz for the knowledge evaluation and Kogan's Attitude toward Older People Scale for the attitude evaluation. The results of Facts on Aging Quiz showed the average level of students' knowledge and statistically significant difference between E and C group. The analysis of Kogan's Attitudes toward Old People Scale showed that both groups had neutral attitudes toward older people. Furthermore, a positive correlation between students' knowledge and attitudes was found. There is increasing evidence on the correlation between education, knowledge and attitudes toward older people which suggests that by acquiring better insights into all aspects of ageing through their education the students develop more positive attitudes and interest in working with older adults.

Older people with mild cognitive impairment -- their views about assessing driving safety.

Science.gov (United States)

Johnson, David A; Frank, Oliver; Pond, Dimity; Stocks, Nigel

2013-05-01

Driving is important for older people to maintain agency, independence and social connectedness. Little research has been conducted into the views of older people with mild cognitive impairment about who decides if they are safe to drive. This qualitative study investigates the views of older people with mild cognitive impairment about decision making on driving cessation. Participants value their agency; they wanted to decide when they should stop driving themselves. However, they were also prepared to accept their general practitioner's advice when they became unfit to drive. In the interim, they self regulated the timing and distance of their driving to reduce accident risk.

Insomnia Severity Index: psychometric properties with Chinese community-dwelling older people.

Science.gov (United States)

Yu, Doris S F

2010-10-01

This paper is a report of a study to evaluate the psychometric properties of the Chinese version of the Insomnia Severity Index. Despite the high prevalence of insomnia in older people and its detrimental impact on well-being and healthcare costs, this problem is almost always undetected and consequently under-treated. The Insomnia Severity Index is psychometrically sound in measuring perceived insomnia severity. However, it has had very limited application in non-White populations. An instrument validation study was carried out between October 2008 and April 2009. The Insomnia Severity Index was translated into Chinese using Brislin's model and administered to a convenience sample of 585 older Chinese people recruited from three community centres for elders. Other instruments were also administered, including the Chinese version of the Pittsburgh Sleep Quality Index and the Geriatric Depression Scale. Cronbach's alpha of the Chinese version of the Insomnia Severity Index was 0.81, with item-to-total correlations in the range of 0.34-0.67. Construct validity was supported by its moderate relationship with the Chinese Pittsburgh Sleep Quality Index and sleep efficiency. The Chinese version of the Insomnia Severity Index also indicated more severe level of insomnia in older people who reported depressed mood on the Geriatric Depression Scale. Discriminant validity was supported as the Chinese version of the Insomnia Severity Index could discriminate poorer sleepers from normal sleepers. Exploratory factor analysis identified a two-factor structure for the Chinese version of the Insomnia Severity Index in measuring the severity and impacts of insomnia on the Chinese older people. The Chinese version of the Insomnia Severity Index is a culturally-relevant and psychometrically-sound instrument for assessing severity and impact of insomnia in Chinese community-dwelling older people. Nurses can use this tool to assess older people's perceptions of insomnia. © 2010 The

Subjective dysphagia in older care home residents: a cross-sectional, multi-centre point prevalence measurement

NARCIS (Netherlands)

Maarel-Wierink, C.D. van der; Meijers, J.M.M.; Visschere, L.M. De; Baat, C. de; Halfens, R.J.; Schols, J.M.

2014-01-01

BACKGROUND: Dysphagia has been found to be strongly associated with aspiration pneumonia in frail older people. Aspiration pneumonia is causing high hospitalization rates, morbidity, and often death. Better insight in the prevalence of (subjective) dysphagia in frail older people may improve its

Experiences and perspectives of older people regarding advance care planning: A meta-synthesis of qualitative studies.

Science.gov (United States)

Ke, Li-Shan; Huang, Xiaoyan; Hu, Wen-Yu; O'Connor, Margaret; Lee, Susan

2017-05-01

Studies have indicated that family members or health professionals may not know or predict their older relatives' or patients' health preferences. Although advance care planning is encouraged for older people to prepare end-of-life care, it is still challenging. To understand the experiences and perspectives of older people regarding advance care planning. A systematic review of qualitative studies and meta-synthesis was conducted. CINAHL, MEDLINE, EMBASE, and PsycINFO databases were searched. A total of 50 articles were critically appraised and a thematic synthesis was undertaken. Four themes were identified: life versus death, internal versus external, benefits versus burdens, and controlling versus being controlled. The view of life and death influenced older people's willingness to discuss their future. The characteristics, experiences, health status, family relationship, and available resources also affected their plans of advance care planning. Older people needed to balance the benefits and burdens of advance care planning, and then judge their own ability to make decisions about end-of-life care. Older people's perspectives and experiences of advance care planning were varied and often conflicted; cultural differences amplified variances among older people. Truthful information, available resources, and family support are needed to enable older people to maintain dignity at the end of life. The views of life and death for older people from different cultures should be compared to assist health professionals to understand older people's attitudes toward advance care planning, and thus to develop appropriate strategies to promote advance care planning in different cultures.

Student's corner: potential implications of registered nurse attitudes towards caring for older people.

Science.gov (United States)

Marshall, Lynette C

2010-01-01

In discussing the potential implications of the attitudes of the registered nurse towards the work of caring for older people, it was helpful to highlight why this work is important, gain some understanding of quality care and how it can be facilitated or hindered. Patient centred care is essential as there is great diversity found amongst older people. It was found that attitudes held by registered nurses and students towards older people have a direct impact on the quality of care provided. Negative attitudes and stereotyping get in the way of quality care while positive attitudes enabled quality care. In identifying the factors that influence these attitudes, registered nurses can take on a leadership role in promoting positive attitudes and challenging negative attitudes towards the care of older people with the goal of providing patient centre care.

Getting help quickly: older people and community worker perspectives of contingency planning for falls management.

Science.gov (United States)

Charlton, Kimberly; Murray, Carolyn M; Kumar, Saravana

2018-01-01

Older people living in the community need to plan for getting help quickly if they have a fall. In this paper planning for falls is referred to as contingency planning and is not a falls prevention strategy but rather a falls management strategy. This research explored the perspectives of older people and community workers (CWs) about contingency planning for a fall. Using a qualitative descriptive approach, participants were recruited through a community agency that supports older people. In-depth interviews were conducted with seven older people (67-89 years of age) and a focus group was held with seven workers of mixed disciplines from the same agency. Older people who hadn't fallen were included but were assumed to be at risk of falls because they were in receipt of services. Thematic analysis and concept mapping combined the data from the two participant groups. Four themes including preconceptions about planning ahead for falling, a fall changes perception, giving, and receiving advice about contingency plans and what to do about falling. Both CWs and older people agree contingency planning requires understanding of individual identity and circumstances. CWs have limited knowledge about contingency planning and may be directive, informative, or conservative. Implications for Rehabilitation Falls can result in serious consequences for older people. There is an evidence-practice gap as availability of and access to contingency planning does not necessarily mean older people will use it in a falls emergency. Older people prefer community workers to be directive or informative about contingency planning options but they do want choice and control. Increased community workers knowledge of, and collaborative decision-making about, contingency planning may promote patient-centered services and assist in closing the evidence-practice gap.

Associations of Environmental Factors With Quality of Life in Older Adults.

Science.gov (United States)

Gobbens, Robbert J J; van Assen, Marcel A L M

2018-01-18

Environmental factors play an important role in the quality of life of older people who often have difficulty maintaining physical, psychological, and social functioning. In this study, we aimed at (a) developing a measurement instrument assessing the factors of older adults' perceptions of their environment, (b) examining the associations of these environmental factors with quality of life domains physical health, psychological, social relations, and environmental, controlling for background characteristics. Associations between environmental factors and quality of life domains were examined in a cross-sectional study using a sample of 1,031 Dutch people aged 65 years and older. Participants completed a Web-based questionnaire, the "Senioren Barometer." Forty-two questions on environmental factors were asked, and quality of life domains were assessed by the WHOQOL-BREF. Seven scales (comprising 3-9 items) of environment were constructed-housing, facilities, nuisance, residents, neighborhood, stench/noise, and traffic. All quality of life domains (physical, psychological, social, environmental) were associated with at least one environmental scale. Housing, residents, and nuisance were associated with 4, 3, and 2 domains, respectively. Facilities, neighborhood, stench/noise, and traffic were associated only with quality of life environmental. This study showed that multiple environmental factors are associated with quality of life in older people. To support independent living in older people health and social care professionals and policymakers may need to carry out interventions, in particular focusing on housing, residents, and nuisance. © The Author 2017. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Antipsychotic prescribing in older people.

Science.gov (United States)

Neil, Wendy; Curran, Stephen; Wattis, John

2003-09-01

older people. There is a need to redress this balance to ensure that the prescribing of antipsychotics in older people is evidence based.

Admissions to inpatient care facilities in the last year of life of community-dwelling older people in Europe.

Science.gov (United States)

Overbeek, Anouk; Van den Block, Lieve; Korfage, Ida J; Penders, Yolanda W H; van der Heide, Agnes; Rietjens, Judith A C

2017-10-01

In the last year of life, many older people rather avoid admissions to inpatient care facilities. We describe and compare such admissions in the last year of life of 5092 community-dwelling older people in 15 European countries (+Israel). Proxy-respondents of the older people, who participated in the longitudinal SHARE study, reported on admissions to inpatient care facilities (hospital, nursing home or hospice) during the last year of their life. Multivariable regression analyses assessed associations between hospitalizations and personal/contextual characteristics. The proportion of people who had been admitted at least once to an inpatient care facility in the last year of life ranged from 54% (France) to 76% (Austria, Israel, Slovenia). Admissions mostly concerned hospitalizations. Multivariable analyses showed that especially Austrians, Israelis and Poles had higher chances of being hospitalized. Further, hospitalizations were more likely for those being ill for 6 months or more (OR:1.67, CI:1.39-2.01), and less likely for persons aged 80+ (OR:0.54, CI:0.39-0.74; compared with 48-65 years), females (OR:0.74, CI:0.63-0.89) and those dying of cardiovascular diseases (OR:0.66, CI:0.51-0.86; compared with those dying of cancer). Although healthcare policies increasingly stress the importance that people reside at home as long as possible, admissions to inpatient care facilities in the last year of life are relatively common across all countries. Furthermore, we found a striking variation concerning the proportion of admissions across countries which cannot only be explained by patient needs. It suggests that such admissions are at least partly driven by system-level or cultural factors. © The Author 2017. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

Health Impact of Climate Change in Older People: An Integrative Review and Implications for Nursing.

Science.gov (United States)

Leyva, Erwin William A; Beaman, Adam; Davidson, Patricia M

2017-11-01

Older people account for the highest proportion of mortality from extreme weather events associated with climate change. This article aims to describe the health impacts of climate change on older people. An integrative review was conducted with 30 studies retrieved from PubMed, EBSCO, and the Cumulative Index to Nursing and Allied Health Literature (CINAHL) on climate stressors, determinants of resilient capacity, risk factors, and health outcomes. Heat, temperature variability, and air pollution increase mortality risk in older people, especially from cardiovascular and respiratory diseases. Floods are linked with increasing incidence of post-traumatic stress disorder, depression, and anxiety. Facing these adversities, older people exhibit both vulnerability and resilience. Research gaps exist in understanding the full spectrum of the resilience experience of older people, and appreciating areas wherein nursing can play a pivotal role. Recognizing the vulnerabilities of older people in the context of climate change is important. Identifying opportunities to promote resilience is an important focus for nurses to develop tailored and targeted nursing interventions. © 2017 Sigma Theta Tau International.

'Living within your limits': activity restriction in older people experiencing chronic pain.

Science.gov (United States)

Mackichan, Fiona; Adamson, Joy; Gooberman-Hill, Rachael

2013-11-01

although maintaining activity is key to successful pain management, and important to health and wellbeing, it is known that older people in pain frequently alter or reduce activity levels. A 'fear-avoidance' model is often used to explain avoidance of activity in the face of pain. However, this model is not intended to take account of the wider context in which activity changes take place, nor older people's own explanations for their behaviour. to investigate the reasons why older people in the community adjust their activity levels when living with chronic pain. thirty-one people aged between 67 and 92 were purposively sampled from respondents to a community-based cross-sectional survey. All participants had reported long-term pain and were interviewed about this. Data were collected and analysed using a qualitative constructivist grounded theory approach. explanations for deliberative reduction or ceasing of activities reflected a desire to prevent pain exacerbation, thereby avoiding medical intervention. It also reflected a desire to safeguard autonomy in the face of pain in older age. Restrictions were often rationalised as normal in older age, although co-existing accounts of perseverance and frustration with limitation were also evident. a rational desire to avoid pain exacerbation and medical intervention motivated restrictions to activity. However, deliberative limitation of activity has the potential to compromise autonomy by increasing social isolation and de-conditioning. Supporting older people with pain to be active requires sensitivity to the function of activity restriction, especially as a means of preventing deterioration.

Speech and Hearing Problems among Older People.

Science.gov (United States)

Carstenson, Blue

1978-01-01

Findings from speech and hearing tests of older people in South Dakota community senior programs indicate the need for better testing and therapy procedures. Lipreading may be more effective than hearing aids, and factors other than hearing may be involved. Some problems and needs are noted. (MF)

Managing effective partnerships in older people's services

NARCIS (Netherlands)

Nies, Henk

The integration of older people's services is a challenge to all countries with an ageing population. Although it is widely acknowledged that acute care, long-term care, social care, housing, leisure, education and other services should all operate in a more 'joined-up manner', achieving this in

Age-related practice effects across longitudinal neuropsychological assessments in older people with schizophrenia.

Science.gov (United States)

Granholm, Eric; Link, Peter; Fish, Scott; Kraemer, Helena; Jeste, Dilip

2010-09-01

The relationship between aging and practice effects on longitudinal neuropsychological assessments was investigated in middle-aged and older people with schizophrenia and healthy controls. Older people with schizophrenia (n = 107; M age = 56.1) and age-comparable nonpsychiatric controls (n = 107; M age = 57.7) were scheduled to receive annual assessments on a comprehensive battery of neuropsychological tests for an average of 2.5 years (range 11 months to 4 years). Mixed-model analyses were used to separately examine the effects of practice and age on test performance. Number of prior assessments (practice) was associated with significant performance improvement across assessments, whereas older age was associated with significant decline in performance. The groups did not differ significantly in extent of age-related cognitive decline, but a three-way interaction among group, age, and practice was found, such that greater age-related decline in practice effects were found for older people with schizophrenia relative to nonpsychiatric participants. This study did not find any evidence of neurodegenerative age-related decline in neuropsychological abilities in middle-aged and older people with schizophrenia, but older age was associated with diminished ability to benefit from repeated exposure to cognitive tasks in people with schizophrenia. Cognitive impairment in schizophrenia may combine with cognitive decline associated with normal aging to reduce practice effects in older patients. These findings have important implications for the design of studies examining the longitudinal trajectory of cognitive functioning across the life span of people with schizophrenia, as well as clinical trials that attempt to demonstrate cognitive enhancement in these individuals. Copyright 2010 APA, all rights reserved.

Health professionals? knowledge and attitudes toward older people in primary care in Saudi Arabia

OpenAIRE

Alamri, Badrya H.; Xiao, Lily D.

2017-01-01

Previous international studies have indicated that a range of factors influence knowledge and attitudes toward older people were education, past work experiences, and social contact with healthy older people. This article reports on the findings of a literature review in relation to attitudes toward older people among health professionals working in primary healthcare centers in Saudi Arabia. The findings of this narrative literature are reported through 5 themes: the instruments used in the ...

Correlates of lifetime alcohol misuse among older community residents in Brazil

Science.gov (United States)

Blay, Sergio Luis; Fillenbaum, Gerda G.; Andreoli, Sergio Baxter; Gastal, Fabio Leite

2009-01-01

Background Little is known about the sociodemographic correlates and health effects associated with lifetime alcohol misuse in community resident elderly in Brazil. Method Data came from a representative sample of 6961 residents aged 60+ in the State of Rio Grande do Sul, Brazil. The structured interview included a five-item lifetime alcohol use questionnaire addressing abuse and dependence, and enquiry regarding sociodemographic characteristics, lifestyle and social support, and health conditions. Results Of the sample, 10.6% (25.3% men, 2.9% women) endorsed at least one lifetime alcohol misuse question. Controlled analyses comparing a gradient of alcohol misuse (none, one, more than one item endorsed), found that men, people age 60–69 (compared to older persons), and tobacco users were more likely to endorse alcohol misuse items. Persons reporting lower income, and of nonWhite race/ethnicity did not differ from their comparison groups with respect to endorsing one item, but they were more likely to endorse two or more items. Endorsing more than one item was associated with impaired activities of daily living, the presence of respiratory problems and psychiatric disorder, but was protective against vascular conditions. Conclusions Major lifetime alcohol misuse (defined as endorsing more than one of five items reflecting alcohol abuse or dependence) is more common in certain sociodemographic groups (men, younger elderly, lower income, nonWhites). With the exception of vascular conditions, it is associated with smoking, poorer functional status, respiratory problems, and psychiatric disorder. Endorsing only one item has a reduced association, significant only for male gender, smoking, and psychiatric disorder. PMID:19141169

Cognitive status and analgesic provision in nursing home residents

OpenAIRE

Closs, S José; Barr, Bridget; Briggs, Michelle

2004-01-01

Background: Although it is becoming acknowledged that pain management is generally poor for older people, little is known about pain management for nursing home residents in the United Kingdom, and the specific problems for those with cognitive impairments.

Colour and inclusivity: a visual communication design project with older people.

Science.gov (United States)

da Silva, Fernando Moreira

2012-01-01

In an ideal world, inclusive products and services would be the standard and not the exception. This paper presents a systematic approach to an overlap between Visual Communication Design, Printed Colour and Inclusive Design, for older people, with the aim to develop of a set of research-based ageing and ergonomics-centred communication design guidelines and recommendations for printed material (analogical displays). The approach included an initial extensive literature review in the area of colour, older people and ergonomics issues and vision common diseases, communication design. The second phase was the implementation of an experiment to measure the different colour experiences of the participants in two sample groups (one in UK and another one in Portugal), using printed material, to find out the colours one should use in analogical communication material, being aware of the colour contrast importance (foreground versus background) and the difficulties experienced by older people to read and understand lettering, signs. As main contribution of this research project, we developed a set of guidelines and recommendations based on the reviewed literature and the sample groups' findings, trying to demonstrate the importance of these guidelines when conceiving a new communicational design project in a way this project will achieve vision comfort and understandability, especially for older people, in an inclusive design perspective.

[Nutrient intake of Chilean older people according to body mass index].

Science.gov (United States)

Durán, Samuel A; Ulloa, Alejandra A; Reyes, Sussanne G

2014-12-01

An adequate consumption of micro and macro nutrients is essential to maintain an adequate health among older people. To compare the consumption of micro- and macronutrients in older people from three Chilean cities, according to their nutritional status. Body mass index (BMI) was assessed and a food consumption tendency survey was applied to 976 non-disabled older people, living in the community. Thinness was defined as a BMI < 23 kg/m². Twenty percent of females and 17% of males had a BMI < 23 kg/m². Participants with a higher BMI had a greater intake of micro- and macronutrients. In females, micronutrient intake was adequate among those with higher BMI, although mean intake of calcium and vitamin B-12 were below recommendations. In males, iron, zinc, calcium, magnesium, vitamin A, vitamin B6, vitamin B12 and pantothenic acid intake were below recommendation. Thin older adults, regardless of sex, had a lower intake of calories and micro- and macronutrients. Additionally, an overall low consumption of zinc, calcium, magnesium and vitamin B12 was detected.

Role of income in intergenerational co-residence: Evidence from selected African and Asian countries.

Science.gov (United States)

Aziz, Nusrate; Hossain, Belayet; Emran, Masum

2018-06-01

The study investigates the macroeconomic determinants of co-residing arrangement between generations in selected developing countries with a focus on examining the effect of changing income level of the working generation. A reduced form model is specified for co-residence between the older generation and altruistic working generation. The fixed- and random-effects models are applied in two waves of data for 22 countries. Estimated results indicate that the income of the altruistic working generation has a negative effect on co-residence, suggesting that if the income of the working generation increases, co-residence decreases. This decrease is greater for older men compared with their female counterparts. Life expectancy, literacy and culture also have significant influences on co-residence. Co-residence is expected to fall in developing countries with economic growth over time. Consequently, a higher proportion of older citizens will be vulnerable in the future. Hence, governments of developing countries will face increasing pressure from their older people to provide appropriate planning and strategy to face this challenge. © 2018 AJA Inc.

The Meaning of Everyday Meals in Living Units for Older People

DEFF Research Database (Denmark)

Bundgaard, Karen Marie

2005-01-01

Even when frail older people become unable to live on their own and manage everyday activities, they can still experience a variety of meanings within meal-related activities that contribute to quality of life. This article reports research findings that focused on the meal, from preparation......, adjacent to which is a shared dining room and kitchen. If the residents choose to, and are capable, they are involved in everyday activities of the unit and eat together with staff. This way of organising meals seems to influence most of the everyday life in the unit by shaping a homely place. It also...... enables a living community that acts in and enlivens everyday existence. Meals themselves also make it possible to be somebody and be yourself in ordinary life and to make a place for valued occupations, things that give substance to everyday life. In sum, the study found that as an occupation, meals give...

From Advance Euthanasia Directive to Euthanasia: Stable Preference in Older People?

Science.gov (United States)

Bolt, Eva E; Pasman, H Roeline W; Deeg, Dorly J H; Onwuteaka-Philipsen, Bregje D

2016-08-01

To determine whether older people with advance directive for euthanasia (ADEs) are stable in their advance desire for euthanasia in the last years of life, how frequently older people with an ADE eventually request euthanasia, and what factors determine this. Mortality follow-back study nested in a cohort study. The Netherlands. Proxies of deceased members of a cohort representative of Dutch older people (n = 168) and a cohort of people with advance directives (n = 154). Data from cohort members (possession of ADE) combined with after-death proxy information on cohort members' last 3 months of life. Multiple logistic regression analysis was performed on determinants of a euthanasia request in individuals with an ADE. Response rate was 65%. One hundred forty-two cohort members had an ADE at baseline. Three months before death, 87% remained stable in their desire for euthanasia; 47% eventually requested euthanasia (vs 6% without an ADE), and 16% died after euthanasia. People with an ADE were more likely to request euthanasia if they worried about loss of dignity. The majority of older adults who complete an ADE will have a stable preference over time, but an advance desire for euthanasia does not necessarily result in a euthanasia request. Writing an ADE may reflect a person's need for reassurance that they can request euthanasia in the future. © 2016, Copyright the Authors Journal compilation © 2016, The American Geriatrics Society.

Nurses' perspectives on how operational leaders influence function-focused care for hospitalised older people.

Science.gov (United States)

Fox, Mary T; Butler, Jeffrey I

2016-11-01

To explore nurses' perspectives on how leaders influence function-focused care, defined as care that preserves and restores older people's functional abilities. Hospitalised older people are at risk of functional decline. Although leaders have the potential to influence function-focused care, few studies have explored nurses' perspectives on how leaders influence function-focused care. Thirteen focus groups were held with 57 acute care nurses. Semi-structured questions prompted discussion on nurses' perspectives, needs and strategies to meet their needs. Data were thematically analysed. Three themes were identified: (1) the emphasis in hospitals is on moving older people quickly through the system, not supporting their functioning; (2) leaders are generally seen as too disconnected from practice to design system efficiency initiatives that support older people's functioning and nurses' provisioning of function-focused care; and (3) leadership strategies to better support nurses in providing function-focused care to older people in the context of system efficiency. Leaders should connect with practice to devise age-sensitive efficiency initiatives that support function-focused care. Nurses need support from leaders in four areas to provide function-focused care to older people in the current hospital context. The findings provide direction on how leaders can facilitate function-focused care in the current health-care environment emphasising system efficiency. © 2016 John Wiley & Sons Ltd.

Knowledge and attitudes of radiation therapists and undergraduate students towards older people

International Nuclear Information System (INIS)

O'Donovan, A.; O'Herlihy, A.; Cunningham, M.

2015-01-01

Purpose: Rapidly changing demographics worldwide mean that there will be a significant increase in the number of older cancer patients requiring radiation therapy treatment in the coming decades. Education is regarded as a key factor in addressing attitudes towards older people among healthcare professionals and has been proven to influence the quality of care received. To our knowledge, there is only one previous study specifically in relation to radiation therapists (RTs), and this included a small sample of RTs. The aim of this study was to investigate the knowledge and attitudes of RTs and RT students towards older people. Methods: A cross-sectional survey design was used, consisting of: 1) demographics, 2) knowledge and 3) attitudes. Knowledge was assessed using the Facts of Aging Quiz (FAQ), while Kogan's Attitude towards Old People (KAOP) Scale was used to assess attitudes. The study population included radiation therapists (RTs) working in Ireland and undergraduate students. Results: Mean knowledge scores in this study were recorded as 11.82 (SD = 3.07)for RTs and 12.17 (SD = 2.55) for students out of a possible 24, i.e. 49% and 51%, respectively. Average attitude scores were documented as 126.12 (SD = 10.06) for RTs and 125.30 (SD = 10.28) for RT students, out of a possible 170 i.e. 74% for both qualified RTs and students. There were no significant differences between students and qualified RTs in relation to both knowledge and attitude scores. Only 44% of RTs stated that their undergraduate degree equipped them with the necessary skills to deal effectively with older patients. Conclusion: RTs have a prominent role in the provision of care to cancer patients, the majority of whom are aged 65 and older. Provision of optimal care to older people undergoing radiotherapy will require “age attuning” of the profession, both at undergraduate and postgraduate level. The findings of this research indicate that RTs and RT students have average

Physiological effects of a companion robot on blood pressure of older people in residential care facility: a pilot study.

Science.gov (United States)

Robinson, Hayley; MacDonald, Bruce; Broadbent, Elizabeth

2015-03-01

To investigate the effects of interacting with the companion robot, Paro, on blood pressure and heart rate of older people in a residential care facility. This study used a repeated measures design. Twenty-one residents in rest home and hospital level care had their blood pressure taken three times; before, during and after interacting with the seal robot. Four residents who did not interact with the robot were excluded from the final analysis (final n = 17). The final analysis found that systolic and diastolic blood pressure changed significantly over time as did heart rate. Planned comparisons revealed that systolic and diastolic blood pressure decreased significantly from baseline to when residents had Paro (systolic, P = 0.048; diastolic, P = 0.05). Diastolic blood pressure increased significantly after Paro was withdrawn (P = 0.03). Interacting with Paro has a physiological effect on cardiovascular measures, which is similar to findings with live animals. © 2013 ACOTA.

The Housing and Support Needs of People with an Intellectual Disability into Older Age

Science.gov (United States)

Shaw, K.; Cartwright, C.; Craig, J.

2011-01-01

Background: People with intellectual disabilities (IDs) are growing older as a population cohort. Many live at home with family members who are their carers but who are also becoming older and less able to provide care. The housing and support preferences of people with IDs and their carers into older age are poorly characterised in the…

Functional recovery of older people with hip fracture: does malnutrition make a difference?

Science.gov (United States)

Li, Hsiao-Juan; Cheng, Huey-Shinn; Liang, Jersey; Wu, Chi-Chuan; Shyu, Yea-Ing Lotus

2013-08-01

To report a study of the effects of protein-energy malnutrition on the functional recovery of older people with hip fracture who participated in an interdisciplinary intervention. It is not clear whether protein-energy malnutrition is associated with worse functional outcomes or it affects the interdisciplinary intervention program on the functional recovery of older people with hip fracture. A randomized experimental design. Data were collected between 2002-2006 from older people with hip fracture (N = 162) in Taiwan. The generalized estimating equations approach was used to evaluate the effect of malnutrition on the functional recovery of older people with hip fracture. The majority of older patients with hip fracture were malnourished (48/80, 60% in the experimental group vs. 55/82, 67% in the control group) prior to hospital discharge. The results of the generalized estimating equations analysis demonstrated that subjects suffering from protein-energy malnutrition prior to hospital discharge appeared to have significantly worse performance trajectories for their activities of daily living, instrumental activities of daily living, and recovery of walking ability compared with those without protein-energy malnutrition. In addition, it was found that the intervention is more effective on the performance of activities of daily living and recovery of walking ability in malnourished patients than in non-malnourished patients. Healthcare providers should develop a nutritional assessment/management system in their interdisciplinary intervention program to improve the functional recovery of older people with hip fracture. © 2012 Blackwell Publishing Ltd.

Improving older people's life satisfaction via social networking site use: Evidence from China.

Science.gov (United States)

Zhou, Junjie

2018-03-01

This study aimed to examine the pathways by which social networking sites (SNSs) can improve older people's life satisfaction. We conducted an online survey in China that lasted eight weeks. Respondents were required to report their demographic characteristics and feelings regarding SNS use. Data were analysed using SPSS 20 and Amos 21. We collected 596 valid samples. The empirical results show that SNS use improves older people's life satisfaction by reducing their loneliness and improving their self-efficacy. Social support alleviates the negative effect of loneliness and enhances the positive effect of self-efficacy on life satisfaction. Sex differences and education differences were significant. Men and less educated people had higher levels of life satisfaction. Policymakers should offer support to SNSs targeting older people and encourage them to provide more useful services. SNS operators should encourage social support among older users and pay attention to sex differences and education differences. © 2018 AJA Inc.

Motivators and Barriers for Older People Participating in Resistance Training: A Systematic Review.

Science.gov (United States)

Burton, Elissa; Farrier, Kaela; Lewin, Gill; Pettigrew, Simone; Hill, Anne-Marie; Airey, Phil; Bainbridge, Liz; Hill, Keith D

2017-04-01

Regular participation in resistance training is important for older people to maintain their health and independence, yet participation rates are low. The study aimed to identify motivators and barriers to older people participating in resistance training. A systematic review was conducted including quantitative, qualitative, and mixed-method studies. Searches generated 15,920 citations from six databases, with 14 studies (n = 1,937 participants) included. In total, 92 motivators and 24 barriers were identified. Motivators specific to participating in resistance training included preventing deterioration (disability), reducing risk of falls, building (toning) muscles, feeling more alert, and better concentration. Looking too muscular and thinking participation increased the risk of having a heart attack, stroke, or death, despite the minimal likelihood of these occurring, were barriers. The analysis indicates that increasing participation in resistance training among older people should focus on the specific benefits valued by older people and the dissemination of accurate information to counter misperceptions.

Alcohol service provision for older people in an area experiencing high alcohol use and health inequalities.

Science.gov (United States)

McCabe, Karen E; Ling, Jonathan; Wilson, Graeme B; Crosland, Ann; Kaner, Eileen F S; Haighton, Catherine A

2016-03-01

UK society is ageing. Older people who drink alcohol, drink more than those from previous generations, drink more frequently than other age groups and are more likely to drink at home and alone. Alcohol problems in later life however are often under-detected and under-reported meaning older people experiencing alcohol problems have high levels of unmet need. This study sought to identify existing services within South of Tyne, North East England to capture the extent of service provision for older drinkers and identify any gaps. The Age UK definition of 'older people' (aged 50 and over) was used. Services were contacted by telephone, managers or their deputy took part in semi-structured interviews. Forty six service providers were identified. Only one provided a specific intervention for older drinkers. Others typically provided services for age 18+. Among providers, there was no definitive definition of an older person. Data collection procedures within many organisations did not enable them to confirm whether older people were accessing services. Where alcohol was used alongside other drugs, alcohol use could remain unrecorded. To enable alcohol services to meet the needs of older people, greater understanding is needed of the patterns of drinking in later life, the experiences of older people, the scale and scope of the issue and guidance as to the most appropriate action to take. An awareness of the issues related to alcohol use in later life also needs to be integrated into commissioning of other services that impact upon older people. © Royal Society for Public Health 2015.

Specialist services for older people : issues of negative and positive ageism

OpenAIRE

Reed, Jan; Cook, Glenda; Cook, Margaret; Inglis, Pamela; Clarke, Charlotte

2006-01-01

This paper reports findings of a study in 2004 of the development of specialist services for older people in the National Health Service (NHS) in England, as recommended in the Department of Health's National Service Framework for Older People (NSF-OP). The study was funded by the Department of Health as part of a programme of research to explore the Framework's implementation. Information was collected through a questionnaire survey about the nature of specialist developments at three levels...

Educational intervention and functional decline among older people

DEFF Research Database (Denmark)

Poulsen, Tine; Siersma, Volkert Dirk; Lund, Rikke

2014-01-01

AIM: To analyse if social capital modifies the effect of educational intervention of home visitors on mobility disability. Earlier studies have found that educational intervention of home visitors has a positive effect of older peoples' functional decline, but how social capital might modify....... RESULTS: We found that 80-year-olds living in municipalities with high bonding (B=0.089, p=0.0279) and high linking (B=0.0929; p=0.0217) had significant better mobility disability in average at 3-year follow up if their municipality had received intervention. CONCLUSIONS: With the unique design...... of the Danish Intervention Study on Preventive Home Visits and with theory-based measures of social capital that distinguish between three aspects of social capital with focus on older people, this study contributes to the literature about the role of social capital for interventions on mobility disability....

Leisure-time physical activities for community older people with chronic diseases.

Science.gov (United States)

Lin, Yen-Chun; Huang, Lian-Hua; Yeh, Mei Chang; Tai, John Jen

2011-04-01

(1) To explore the types and three components (frequency, duration and caloric expenditure) of leisure-time physical activity in community older people with chronic diseases. (2) To identify leisure-time physical activity-related factors in these community older people. Previous research has focused primarily on measuring the actual physiological or psychological benefits of exercise or leisure-time physical activity, little is known about the factors that determine the frequency, intensity and duration of exercise or leisure-time physical activity. The identification of reliable predictors of the various components of leisure-time physical activity will enable healthcare providers to intervene and change the patterns of leisure-time physical activity in the sedentary older people more effectively. A cross-sectional design was used for this study. Participants were recruited from the Xinyi District in Taipei, Taiwan. A total of 206 older people were recruited and were asked to complete three questionnaires during a face-to-face interview with a researcher at the activity setting. The results showed that walking leisurely was the most frequent leisure-time physical activity for participants. The age, gender, living arrangement, affective feeling and environmental control were significant variables of leisure-time physical activity. The study constructs accounted for moderate amounts of variance (22% for leisure-time physical activity frequency, 27% for leisure-time physical activity duration and 24% for leisure-time physical activity caloric expenditure). This study also showed that different variables play different influential roles in the different components of LTPA. An effective intervention strategy for improving leisure-time physical activity of older people may involve tailoring the type, format, intensity, frequency and duration of a physical activity according to an individual's needs. This study described some environmental barriers to LTPA and

Risk of suicide according to the level of psychiatric contact in the older people: Analysis of national health insurance databases in Taiwan.

Science.gov (United States)

Yeh, Shin-Ting; Ng, Yee-Yung; Wu, Shiao-Chi

2017-04-01

Suicide in the older people is a serious problem worldwide; however the effect of psychiatric contact on the risk of suicide has not been fully explored. The aim of this study was to investigate the relationship between psychiatric contact and suicide in the older people in Taiwan. A population-based database was used in this national case-control study. Propensity score matching was used to match older people who did and did not commit suicide from 2010 to 2012 by calendar year, gender, age, and area of residence. The level of psychiatric contact in the preceding year was classified as "no psychiatric contact," "only outpatient psychiatric contact," "psychiatric emergency room contact," or "psychiatric hospital admission". Conditional logistic regression analysis was used to assess associations between variables and the risk of suicide. A total of 2528 older people committed suicide from 2010 to 2012, with a crude suicide mortality rate of 3.37/10,000. Compared to those who had no psychiatric contact in the preceding year, the adjusted odds ratios of suicide were 10.15 (95% CI=5.8-17.7) for those who had psychiatric emergency room contact, 6.57 (95% CI=3.7-11.6) for those who had psychiatric hospital admissions, and 3.64 (95% CI=3.0-4.4) for those with only outpatient psychiatric contact. The risk of suicide was higher in those who had depression (OR=3.49, 95% CI=2.2-5.4) and bipolar disorder (OR=1.98, 95% CI=1.1-3.6). Patients with cancer were associated with suicide (OR=8.96, 95% CI=5.6-14.4). The positive association with suicide and the level of psychiatric contact in the preceding year in older people indicated that the health personnel need to do a better job in determining possible risk for older people who had psychiatric contact, especially in emergency visit or psychiatric admission. A systematic approach to quality improvement in these settings is both available and necessary. Careful discharge planning and safe transitions of care to outpatient

A randomized controlled pilot study of home-based step training in older people using videogame technology.

Directory of Open Access Journals (Sweden)

Daniel Schoene

Full Text Available BACKGROUND: Stepping impairments are associated with physical and cognitive decline in older adults and increased fall risk. Exercise interventions can reduce fall risk, but adherence is often low. A new exergame involving step training may provide an enjoyable exercise alternative for preventing falls in older people. PURPOSE: To assess the feasibility and safety of unsupervised, home-based step pad training and determine the effectiveness of this intervention on stepping performance and associated fall risk in older people. DESIGN: Single-blinded two-arm randomized controlled trial comparing step pad training with control (no-intervention. SETTING/PARTICIPANTS: Thirty-seven older adults residing in independent-living units of a retirement village in Sydney, Australia. INTERVENTION: Intervention group (IG participants were provided with a computerized step pad system connected to their TVs and played a step game as often as they liked (with a recommended dose of 2-3 sessions per week for 15-20 minutes each for eight weeks. In addition, IG participants were asked to complete a choice stepping reaction time (CSRT task once each week. MAIN OUTCOME MEASURES: CSRT, the Physiological Profile Assessment (PPA, neuropsychological and functional mobility measures were assessed at baseline and eight week follow-up. RESULTS: Thirty-two participants completed the study (86.5%. IG participants played a median 2.75 sessions/week and no adverse events were reported. Compared to the control group, the IG significantly improved their CSRT (F31,1 = 18.203, p<.001, PPA composite scores (F31,1 = 12.706, p = 0.001, as well as the postural sway (F31,1 = 4.226, p = 0.049 and contrast sensitivity (F31,1 = 4.415, p = 0.044 PPA sub-component scores. In addition, the IG improved significantly in their dual-task ability as assessed by a timed up and go test/verbal fluency task (F31,1 = 4.226, p = 0.049. CONCLUSIONS: Step pad training can

Provision and perceived quality of mental health services for older care home residents in England: a national survey.

Science.gov (United States)

Stewart, Karen; Hargreaves, Claire; Jasper, Rowan; Challis, David; Tucker, Sue; Wilberforce, Mark

2018-02-01

This study examined the nature, extent and perceived quality of the support provided by community mental health teams for older people (CMHTsOP) to care home residents. A postal survey was sent to all CMHTsOP in England. Information was collected about teams' staffing and their involvement in case finding, assessment, medication reviews, care planning and training as well as team managers' rating of the perceived quality of the service they provided for care home residents. Data were analysed using chi-squared tests of association and ordinal regression. Responses were received from 225 (54%) CMHTsOP. Only 18 per cent of these teams contained staff with allocated time for care home work. Services for care home residents varied considerably between teams. Two-fifths of teams provided formal training to care home staff. Team managers were more likely to perceive the quality of their service to care homes as good if they had a systematic process in place for reviewing antipsychotic drugs or routine mental health reviews, including contact with a GP. The findings suggested that more evidence is needed on the best approach for supporting care home residents with mental health needs. Areas to consider are the potential benefits of training to care home staff and regular mental health reviews, utilising links between GPs and CMHTsOP. Copyright © 2017 John Wiley & Sons, Ltd. Copyright © 2017 John Wiley & Sons, Ltd.

Older people's use of powered wheelchairs for activity and participation

DEFF Research Database (Denmark)

Brandt, Ase; Iwarsson, Susanne; Ståhle, Agneta

2004-01-01

research were identified. CONCLUSION: The use of powered wheelchairs is a relevant societal intervention in relation to older people with limited walking ability in order to make activity and participation possible. It is likely that a larger proportion of older people could benefit from this intervention...... not use the wheelchair for visits, and supplementary travel modes are called for. Users who could not walk at all or who could not transfer without assistance were more likely not to be able to carry out prioritized activities. Furthermore, other risk factors for negative outcomes and need for further...

Ethnic differences in attitudes and bias toward older people comparing White and Asian nursing students.

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Lee, Young-Shin

2015-03-01

To identify attitudes and bias toward aging between Asian and White students and identify factors affecting attitudes toward aging. A cross-sectional sample of 308 students in a nursing program completed the measure of Attitudes Toward Older People and Aging Quiz electronically. There were no differences in positive attitudes and pro-aged bias between Asian and White groups, but Asian students had significantly more negative attitudes and anti-aged bias toward older people than White students. Multiple regression analysis showed ethnicity/race was the strongest variable to explain negative attitudes toward older people. Feeling uneasy about talking to older adults was the most significant factor to explain all attitudinal concepts. Asian students were uneasy about talking with older people and had negative attitudes toward older adults. To become competent in cross-cultural care and communication in nursing, educational strategies to reduce negative attitudes on aging are necessary. © The Author(s) 2014.

Community screening for visual impairment in older people.

Science.gov (United States)

Clarke, Emily L; Evans, Jennifer R; Smeeth, Liam

2018-02-20

Visual problems in older people are common and frequently under-reported. The effects of poor vision in older people are wide reaching and include falls, confusion and reduced quality of life. Much of the visual impairment in older ages can be treated (e.g. cataract surgery, correction of refractive error). Vision screening may therefore reduce the number of older people living with sight loss. The objective of this review was to assess the effects on vision of community vision screening of older people for visual impairment. We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (which contains the Cochrane Eyes and Vision Trials Register) (2017, Issue 10); Ovid MEDLINE; Ovid Embase; the ISRCTN registry; ClinicalTrials.gov and the ICTRP. The date of the search was 23 November 2017. We included randomised controlled trials (RCTs) that compared vision screening alone or as part of a multi-component screening package as compared to no vision screening or standard care, on the vision of people aged 65 years or over in a community setting. We included trials that used self-reported visual problems or visual acuity testing as the screening tool. We used standard methods expected by Cochrane. We graded the certainty of the evidence using GRADE. Visual outcome data were available for 10,608 people in 10 trials. Four trials took place in the UK, two in Australia, two in the United States and two in the Netherlands. Length of follow-up ranged from one to five years. Three of these studies were cluster-randomised trials whereby general practitioners or family physicians were randomly allocated to undertake vision screening or no vision screening. All studies were funded by government agencies. Overall we judged the studies to be at low risk of bias and only downgraded the certainty of the evidence (GRADE) for imprecision.Seven trials compared vision screening as part of a multi-component screening versus no screening. Six of these studies used self

Relationship between self-assessed masticatory disability and 9-year mortality in a cohort of community-residing elderly people.

Science.gov (United States)

Nakanishi, Noriyuki; Fukuda, Hideki; Takatorige, Toshio; Tatara, Kozo

2005-01-01

To examine the relationship between self-assessed masticatory disability and mortality. Prospective. Community based. Total of 1,405 randomly selected people aged 65 and older living in Settsu, Osaka Prefecture, in October 1992. Data on health status as indicated by disability scores, history of health management, self-assessed masticatory ability, and psychosocial conditions were collected by means of interviews during home visits at the time of enrollment. Nine-year follow-up was completed for 1,245 (88.6%; 398 deceased and 847 alive). Self-assessed masticatory disability was significantly associated with being 75 and older, having overall disability, not using dental health checks or general health checks, not participating in social activities, not feeling that life is worth living (no ikigai), and finding relationships with people difficult. As for the association between self-assessed masticatory disability and mortality, the estimated survival rate for those with self-assessed masticatory disability was lower than that for those without for each group stratified by sex and age (65-74 and >or=75), and the equality of survival curves according to self-assessed masticatory disability was significant for each group. After controlling for potential predictors of mortality, self-assessed masticatory disability remained as a significant predictor of mortality (adjusted hazard ratio=1.63, 95% confidence interval=1.30-2.03, P<.001). These results indicate that self-assessed masticatory disability may be associated with a greater risk of mortality in community-residing elderly people.

[How educating students in depression among older people can affect their motivation to work with this population].

Science.gov (United States)

Favier, S; Izaute, M; Teissèdre, F

2017-04-01

Negative representations of ageing are conveyed in our society. We see that people frequently avoid working with older people, due to a lack of motivation. Depressive signs in older people are more frequently associated with normal ageing, rather than a pathology, giving health professionals the feeling that therapeutic efforts are likely to be unproductive. Yet, depression is a major public health problem, particularly among older people. It is a real pathology, affecting 20% of people aged 65 and older. In retirement homes the percentage can be as high as 45%. To study and evaluate how theoretical knowledge about older people and depression affects the motivation of 2nd year psychology students to work with this population. The study involves two groups. One of the groups (experimental group) followed an 8hour course on depression in older people, whereas the other (control group) followed an 8hour course on a different topic. The study was conducted in two parts. First, the two groups answered an initial questionnaire which measured how motivated they were to work with older people and what they knew about depression in older people. Then, after the experimental phase, all of the students answered the same questionnaire a second time. The comparison shows a significant decline in knowledge between T1 and T2 for the control group (Pdepression, students are more motivated to work with older people. Moreover, we observe that the more knowledge students have in this field, the more motivated they will be to work with older people. Whereas there were no differences in knowledge before the course, we observed that the knowledge of the group who took part in the course about older people improved. Also, the evaluation showed that students who took the course were significantly more knowledgeable. Regarding motivation, our results vary according to the type of motivation. Overall, as regards intrinsic motivation, we observed an increase in motivation, insofar as the

Gotta survey somebody : Methodological challenges in population studies of older people

OpenAIRE

Kelfve, Susanne

2015-01-01

Conducting representative surveys of older people is challenging. This thesis aims to analyze a) the characteristics of individuals at risk of being underrepresented in surveys of older people, b) the systematic errors likely to occur as a result of these selections, and c) whether these systematic errors can be minimized by weighting adjustments.   In Study I, we investigated a) who would be missing from a survey that excluded those living in institutions and that did not use indirect interv...

Activity promotion for community-dwelling older people: a survey of the contribution of primary care nurses.

Science.gov (United States)

Goodman, Claire; Davies, Susan L; Dinan, Susie; See Tai, Sharon; Iliffe, Steve

2011-01-01

To discover the current level of nurse-led involvement in activity promotion for older people in primary care and to explore the knowledge and attitudes of primary care nurses about health benefits of activity promotion for older people. The importance of improving and maintaining activity levels in later life is well established. However, intervention studies show that the uptake of and adherence to physical activity programmes by older people are highly variable. The optimal approach to activity promotion for older people is not well understood. Although many activity promotion schemes and evaluations assume that specialist exercise trainers are needed, it remains unclear who is best placed to facilitate activity promotion for older people, and if this is something in which existing primary care practitioners (specifically nurses) could and should take a leading role. This study surveyed all nurses and health visitors working in five primary care organizations in an inner city area. A semi-structured postal questionnaire asked about their knowledge and attitudes to the benefits of exercise in later life, their current levels of involvement in promoting physical activity with older people, and their personal activity levels. The overall response rate was 54% (n=521). The responses of 391 district nurses and practice nurses are presented here. Nurses had the commitment and (depending on the focus of their work) different opportunities to promote physical activity with older patients. There were organizational and individual constraints on their ability to be involved in this aspect of health promotion work themselves, or to refer older people to local activity promotion schemes. Nurses did not have a structured approach when promoting physical activity with older people and had only a partial awareness of the limitations of their knowledge or skills when promoting activity with older people. For promotion of physical activity by older people to be meaningfully

How architectural design affords experiences of freedom in residential care for older people.

Science.gov (United States)

Van Steenwinkel, Iris; Dierckx de Casterlé, Bernadette; Heylighen, Ann

2017-04-01

Human values and social issues shape visions on dwelling and care for older people, a growing number of whom live in residential care facilities. These facilities' architectural design is considered to play an important role in realizing care visions. This role, however, has received little attention in research. This article presents a case study of a residential care facility for which the architects made considerable effort to match the design with the care vision. The study offers insights into residents' and caregivers' experiences of, respectively, living and working in this facility, and the role of architectural features therein. A single qualitative case study design was used to provide in-depth, contextual insights. The methods include semi-structured interviews with residents and caregivers, and participant observation. Data concerning design intentions, assumptions and strategies were obtained from design documents, through a semi-structured interview with the architects, and observations on site. Our analysis underlines the importance of freedom (and especially freedom of movement), and the balance between experiencing freedom and being bound to a social and physical framework. It shows the architecture features that can have a role therein: small-scaleness in terms of number of residents per dwelling unit, size and compactness; spatial generosity in terms of surface area, room to maneuver and variety of places; and physical accessibility. Our study challenges the idea of family-like group living. Since we found limited sense of group belonging amongst residents, our findings suggest to rethink residential care facilities in terms of private or collective living in order to address residents' social freedom of movement. Caregivers associated 'hominess' with freedom of movement, action and choice, with favorable social dynamics and with the building's residential character. Being perceived as homey, the facility's architectural design matches caregivers

[Medicaments and oral healthcare 4. Pharmacotherapy in (frail and care dependent) older people].

Science.gov (United States)

de Baat, C; van der Putten, G J; Visser, A; Vissink, A

2017-05-01

Polypharmacy is the consequence of multimorbidity. Both phenomena may cause functional limitations and/or frailty and/or care dependency in older people. In the human body, a medicament undergoes at least 3 important actions: absorption, distribution and elimination. These actions may proceed aberrantly in older people. Following interaction with receptors, a medicament triggers a chain reaction in the human body. The receptors and each link of the chain reaction may be subject to changes due to diseases as well as ageing. This, particularly, is the case with regard to medications directed towards the central nervous system and the cardiovascular system. Furthermore, interactions may occur between various medications mutually and between medications on the one hand and on the other hand food and water intake, self-medication with herbs, and diseases. Moreover, older people usually experience more adverse effects of medications when compared to younger people. This is due to altered body actions and reactions, polypharmacy and the many possible interactions. In older people, utilisation and intake of medications often give rise to problems that can be divided into medicament-related, patient-related, care- and care provider-related and other problems.

Effects of music on depression in older people: a randomised controlled trial.

Science.gov (United States)

Chan, Moon Fai; Wong, Zi Yang; Onishi, Hideaki; Thayala, Naidu Vellasamy

2012-03-01

To determine the effect of music on depression levels in older adults. Background.  Depression is a common psychiatric disorder in older adults, and its impacts on this group of people, along with its conventional treatment, merit our attention. Conventional pharmacological methods might result in dependence and impairment in psychomotor and cognitive functioning. Listening to music, which is a non-pharmacological method, might reduce depression. A randomised controlled study. The study was conducted from July 2009-June 2010 at participants' home in Singapore. In total, 50 older adults (24 using music and 26 control) completed the study after being recruited. Participants listened to their choice of music for 30 minutes per week for eight weeks. Depression scores were collected once a week for eight weeks. Depression levels reduced weekly in the music group, indicating a cumulative dose effect, and a statistically significant reduction in depression levels was found over time in the music group compared with non-music group. Listening to music can help older people to reduce their depression level. Music is a non-invasive, simple and inexpensive therapeutic method of improving life quality in community-dwelling older people. © 2011 Blackwell Publishing Ltd.

Association between indicators of dementia and nutritional status in institutionalised older people.

Science.gov (United States)

Galesi, Lilian Fernanda; Leandro-Merhi, Vânia Aparecida; de Oliveira, Maria Rita Marques

2013-09-01

Dementia weakens older people and can lead to malnutrition; therefore, the objective of this study was to assess the association between indicators of dementia and biochemical indicators, anthropometric indicators and food intake in institutionalised older people. A total of 150 older people of both genders participated in this study. Nutritional status was determined by body mass index and other anthropometric variables, and biochemical indicators were used to analyse the differences between individuals with and without dementia. Energy and nutrient intakes were determined by food records, and dementia was investigated with the Mini-Mental State Examination. The data were analysed by the chi-square test, Student's t-test and Mann-Whitney tests. Of the 150 individuals studied, 48% were men with a mean age of 73 ± 10 years and 52% were women with a mean age of 80 ± 9 years. Thirty-six per cent had some degree of malnutrition and 48% presented dementia, which was more prevalent in women (59%). The nutritional status of men and women individuals with and without dementia differed significantly (P people with dementia may have higher nutritional requirements. Implications for practice.  Investigation of dementia may contribute to the nutritional status assessment of older people and energy expenditure and immobility should be investigated for a more complete assessment. © 2012 Blackwell Publishing Ltd.

Motivational Determinants of Exergame Participation for Older People in Assisted Living Facilities: Mixed-Methods Study.

Science.gov (United States)

Meekes, Wytske; Stanmore, Emma Kate

2017-07-06

Exergames (exercise-based videogames) for delivering strength and balance exercise for older people are growing in popularity with the emergence of new Kinect-based technologies; however, little is known about the factors affecting their uptake and usage by older people. The aim of this study was to determine the factors that may influence the motivation of older people to use exergames to improve their physical function and reduce fall risk. Mixed methods were employed in which 14 semistructured interviews were conducted with older people (n=12, aged 59-91 years) from 2 assisted living facilities in the North West of the United Kingdom. The older people participated in a 6-week trial of exergames along with one manager and one physiotherapist; 81 h of observation and Technology Acceptance Model questionnaires were conducted. The findings suggest that the participants were intrinsically motivated to participate in the exergames because of the enjoyment experienced when playing the exergames and perceived improvements in their physical and mental health and social confidence. The social interaction provided in this study was an important extrinsic motivator that increased the intrinsic motivation to adhere to the exergame program. The findings of this study suggest that exergames may be a promising tool for delivering falls prevention exercises and increasing adherence to exercise in older people. Understanding the motivation of older people to use exergames may assist in the process of implementation. ©Wytske Meekes, Emma Kate Stanmore. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 06.07.2017.

Is the Nintendo Wii Fit really acceptable to older people?: a discrete choice experiment

Science.gov (United States)

2011-01-01

Background Interactive video games such as the Nintendo Wii Fit are increasingly used as a therapeutic tool in health and aged care settings however, their acceptability to older people is unclear. The aim of this study was to determine the acceptability of the Nintendo Wii Fit as a therapy tool for hospitalised older people using a discrete choice experiment (DCE) before and after exposure to the intervention. Methods A DCE was administered to 21 participants in an interview style format prior to, and following several sessions of using the Wii Fit in physiotherapy. The physiotherapist prescribed the Wii Fit activities, supervised and supported the patient during the therapy sessions. Attributes included in the DCE were: mode of therapy (traditional or using the Wii Fit), amount of therapy, cost of therapy program and percentage of recovery made. Data was analysed using conditional (fixed-effects) logistic regression. Results Prior to commencing the therapy program participants were most concerned about therapy time (avoiding programs that were too intensive), and the amount of recovery they would make. Following the therapy program, participants were more concerned with the mode of therapy and preferred traditional therapy programs over programs using the Wii Fit. Conclusions The usefulness of the Wii Fit as a therapy tool with hospitalised older people is limited not only by the small proportion of older people who are able to use it, but by older people's preferences for traditional approaches to therapy. Mainstream media portrayals of the popularity of the Wii Fit with older people may not reflect the true acceptability in the older hospitalised population. PMID:22011360

Is the Nintendo Wii Fit really acceptable to older people?: a discrete choice experiment

Directory of Open Access Journals (Sweden)

Burgess Leonie

2011-10-01

Full Text Available Abstract Background Interactive video games such as the Nintendo Wii Fit are increasingly used as a therapeutic tool in health and aged care settings however, their acceptability to older people is unclear. The aim of this study was to determine the acceptability of the Nintendo Wii Fit as a therapy tool for hospitalised older people using a discrete choice experiment (DCE before and after exposure to the intervention. Methods A DCE was administered to 21 participants in an interview style format prior to, and following several sessions of using the Wii Fit in physiotherapy. The physiotherapist prescribed the Wii Fit activities, supervised and supported the patient during the therapy sessions. Attributes included in the DCE were: mode of therapy (traditional or using the Wii Fit, amount of therapy, cost of therapy program and percentage of recovery made. Data was analysed using conditional (fixed-effects logistic regression. Results Prior to commencing the therapy program participants were most concerned about therapy time (avoiding programs that were too intensive, and the amount of recovery they would make. Following the therapy program, participants were more concerned with the mode of therapy and preferred traditional therapy programs over programs using the Wii Fit. Conclusions The usefulness of the Wii Fit as a therapy tool with hospitalised older people is limited not only by the small proportion of older people who are able to use it, but by older people's preferences for traditional approaches to therapy. Mainstream media portrayals of the popularity of the Wii Fit with older people may not reflect the true acceptability in the older hospitalised population.

Fall determinants in older long-term care residents with dementia: a systematic review.

Science.gov (United States)

Kröpelin, Tobias F; Neyens, Jacques C L; Halfens, Ruud J G; Kempen, Gertrudis I J M; Hamers, Jan P H

2013-04-01

Persons with dementia are two to three times more likely to fall compared to persons without dementia. In long-term care settings, the dementia prevalence is highest. Therefore, older long-term care residents with dementia can be considered a high-risk group for falls. Nevertheless, no systematic evaluation of fall determinants in this population was found. The purpose of this study was to identify fall determinants among older long-term care residents with dementia or cognitively impaired persons in long-term care, by conducting a systematic literature review. We searched English, French, Dutch, and German articles listed in: CINAHL, Cochrane Library, EMBASE, MEDLINE, PsycINFO, PubMed, and Web of Science. Additionally, references of included articles were screened. Studies were included if determinants or circumstances of falls in older persons with dementia living in long-term care were assessed. Eight studies met the inclusion criteria. Three studies were excluded from detailed analysis because of insufficient quality. Use of psychotropic drugs, a "fair or poor" general health, gait impairments, and age were associated with an increased fall risk. Also trunk restraints were associated with an increased number of falls while full bedrails and wandering behavior were protective against falls. Fall risk factors known from other populations, e.g. use of psychotropic drugs, physical restraints, and health conditions, are found in long-term care residents with dementia as well. Due to the limited evidence available, future studies with adequate sample sizes and prospective designs are required to determine specific fall risk factors and verify existing results in this population.

Hospitalisation of older people before and after long-term care entry in Auckland, New Zealand.

Science.gov (United States)

Boyd, Michal; Broad, Joanna B; Zhang, Tony Xian; Kerse, Ngaire; Gott, Merryn; Connolly, Martin J

2016-07-01

global population projections forecast large growth in demand for long-term care (LTC) and acute hospital services for older people. Few studies report changes in hospitalisation rates before and after entry into LTC. This study compares hospitalisation rates 1 year before and after LTC entry. the Older Persons' Ability Level (OPAL) study was a 2008 census-type survey of LTC facilities in Auckland, New Zealand. OPAL resident hospital admissions and deaths were obtained from routinely collected national databases. all 2,244 residents (66% = female) who entered LTC within 12 months prior to OPAL were included. There were 3,363 hospitalisations, 2,424 in 12 months before and 939 in 12 months after entry, and 364 deaths. In the 6 to 12 months before LTC entry, the hospitalisation rate/100 person-years was 67.3 (95% confidence interval [CI] 62.5-72.1). Weekly rates then rose steeply to over 450/100 person-years in the 6 months immediately before LTC entry. In the 6 months after LTC entry, the rate fell to 49.1 (CI 44.9-53.3; RR 0.73 (CI 0.65-0.82, P < 0.0001)) and decreased further 6 to 12 months after entry to 41.1 (CI 37.1-45.1; rate ratio [RR] 0.61 (CI 0.54-0.69, P < 0.0001)). increased hospitalisations a few months before LTC entry suggest functional and medical instability precipitates LTC entry. New residents utilise hospital beds less frequently than when at home before that unstable period. Further research is needed to determine effective interventions to avoid some hospitalisations and possibly also LTC entry. © The Author 2016. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Relationships of assertiveness, depression, and social support among older nursing home residents.

Science.gov (United States)

Segal, Daniel L

2005-07-01

This study assessed the relationships of assertiveness, depression, and social support among nursing home residents. The sample included 50 older nursing home residents (mean age = 75 years; 75% female; 92% Caucasian). There was a significant correlation between assertiveness and depression (r = -.33), but the correlations between social support and depression (r = -.15) and between social support and assertiveness (r = -.03) were small and nonsignificant. The correlation between overall physical health (a subjective self-rating) and depression was strong and negative (r = -.50), with lower levels of health associated with higher depression. An implication of this study is that an intervention for depression among nursing home residents that is targeted at increasing assertiveness and bolstering health status may be more effective than the one that solely targets social support.

Characteristics of communication with older people in home care: A qualitative analysis of audio recordings of home care visits.

Science.gov (United States)

Kristensen, Dorte V; Sundler, Annelie J; Eide, Hilde; Hafskjold, Linda; Ruud, Iren; Holmström, Inger K

2017-12-01

To describe the characteristics of communication practice in home care visits between older people (over 65 years old) and nurse assistants and to discuss the findings from a person-centered perspective. The older population is increasing worldwide, along with the need for healthcare services in the person's home. To achieve a high-quality care, person-centered communication is crucial. A descriptive design with a qualitative inductive approach was used. Fifteen audio recordings of naturally occurring conversations between 12 nurse assistants and 13 older people in Norway were analysed by qualitative content analysis. Four categories were revealed through analysis: (i) supporting older people's connection to everyday life; (ii) supporting older people's involvement in their own care; (iii) attention to older people's bodily and existential needs; and (iv) the impact of continuity and predictability on older people's well-being. The communication between the older people and the nurse assistants during home care visits was mainly task-oriented, but also related to the person. The older people were involved in the tasks to be carried out and humour was part of the communication. Greater attention was paid to bodily than existential needs. The communication was connected with the older people's everyday life in several ways. Time frames and interruptions concern the older people; hearing and speech impairments were a challenge to communication. To enhance person-centred communication, further studies are needed, especially intervention studies for healthcare professionals and students. Being responsive to older people's subjective experiences is important in meeting their needs in home care. Communication that addresses the need for trust and predictability is important for older people. Responding to existential needs require more attention. The home care setting has an impact on communication. © 2017 John Wiley & Sons Ltd.

Older People as a Developing Market for Cultural Heritage Sites

Science.gov (United States)

Hansen, Anna; Zipsane, Henrik

2014-01-01

Is it morally acceptable for the heritage sector to see the growing population of senior citizens as a developing market? Jamtli is an open air museum in the north of Sweden. The main target group is families with children, but an increasing number of activities for older adults are being offered. The growing population of older people is a…

Older peoples' perceptions of oral health: 'it's just not that simple'.

Science.gov (United States)

McKenzie-Green, B; Giddings, L S; Buttle, L; Tahana, K

2009-02-01

Little is known about older persons' perceptions of oral health and oral health care. The purpose of this study was to explore the viewpoint of older adults' regarding their oral health care practices. A qualitative interpretive methodology was employed comprising three analytic levels: coding of data into concepts, analysis of concepts into themes, followed by an in-depth analysis of relationships within concepts and between themes. In-depth individual interviews were conducted with 19 participants aged 65 to 87 years. Older people's decision to access oral health care involves complex and personally meaningful strategies. A dental visit surfaces hopes and fears based on past and present experiences. Mouth and teeth are not merely objects of dental care; they represent a person's social and relational self. Age-related changes challenge the relational self as represented in societal ideal images of youth and perfection (the perfect smile). This study highlights older peoples' resilience and determination when faced with the dilemmas in accessing oral health care--it costs, personally as well as financially. Contrary to the assumption that older peoples' oral health status is related to neglect, rather for many, it is the result of the intersection of their history with technological advances. These findings challenge oral health care practitioners to be sensitive to the contexts affecting their older client's oral health care status. They do not 'just go' to the dentist; they bring with them their past dental experiences and their hopes for the future. It matters how one is treated at this vulnerable time.

Housing Accessibility Methodology Targeting Older People

DEFF Research Database (Denmark)

Helle, Tina

accessibility problems before the planning of housing intervention strategies. It is also critical that housing standards addressing accessibility intended to accommodate people with functional limitations are valid in the sense that their definitions truly support accessibility. However, there is a paucity...... of valid and reliable assessment instruments targeting housing accessibility, and in-depth analysis of factors potentially impacting on reliability in complex assessment situations is remarkably absent. Moreover, the knowledge base informing the housing standards appears to be vague. We may therefore...... reasonably question the validity of the housing standards addressing accessibility. This thesis addresses housing accessibility methodology in general and the reliability of assessment and the validity of standards targeting older people with functional limitations and a dependence on mobility devices...

'Growing Old' in Shelters and 'On the Street': Experiences of Older Homeless People.

Science.gov (United States)

Grenier, Amanda; Sussman, Tamara; Barken, Rachel; Bourgeois-Guérin, Valerie; Rothwell, David

2016-01-01

Homelessness among older people in Canada is both a growing concern, and an emerging field of study. This article reports thematic results of qualitative interviews with 40 people aged 46 to 75, carried out as part of a mixed-methods study of older people who are homeless in Montreal, Quebec, Canada. Our participants included people with histories of homelessness (n = 14) and persons new to homelessness in later life (n = 26). Interviews focused on experiences at the intersections of aging and homelessness including social relationships, the challenges of living on the streets and in shelters in later life, and the future. This article outlines the 5 main themes that capture the experience of homelessness for our participants: age exacerbates worries; exclusion and isolation; managing significant challenges; shifting needs and realities; and resilience, strength, and hope. Together, these findings underscore the need for specific programs geared to the unique needs of older people who are homeless.

A Systematic Review of Behavioural Interventions Promoting Healthy Eating among Older People

Directory of Open Access Journals (Sweden)

Xiao Zhou

2018-01-01

Full Text Available Because eating habits are inseparably linked with people’s physical health, effective behaviour interventions are highly demanded to promote healthy eating among older people. The aim of this systematic review was to identify effective diet interventions for older people and provide useful evidence and direction for further research. Three electronic bibliographic databases—PubMed, Scopus and Web of Science Core Collection were used to conduct a systematic literature search based on fixed inclusion and exclusion criteria. English language peer-reviewed journal articles published between 2011 and 2016 were selected for data extraction and quality assessment. Finally, a total of 16 studies were identified. The studies’ duration ranged from three weeks to seven years. The majority of studies were carried out in European countries. Seven studies had a moderate quality while the remaining studies were at a less than moderate level. Three dietary educational interventions and all meal service related interventions reported improvements in older people’s dietary variety, nutrition status, or other health-related eating behaviours. Multicomponent dietary interventions mainly contributed to the reduction of risk of chronic disease. The results supported that older people could achieve a better dietary quality if they make diet-related changes by receiving either dietary education or healthier meal service. Further high-quality studies are required to promote healthy eating among older people by taking regional diet patterns, advanced information technology, and nudging strategies into account.

A Systematic Review of Behavioural Interventions Promoting Healthy Eating among Older People

Science.gov (United States)

Perez-Cueto, Federico J. A.; Santos, Quenia Dos; Monteleone, Erminio; Giboreau, Agnès; Bredie, Wender L. P.; Hartwell, Heather

2018-01-01

Because eating habits are inseparably linked with people’s physical health, effective behaviour interventions are highly demanded to promote healthy eating among older people. The aim of this systematic review was to identify effective diet interventions for older people and provide useful evidence and direction for further research. Three electronic bibliographic databases—PubMed, Scopus and Web of Science Core Collection were used to conduct a systematic literature search based on fixed inclusion and exclusion criteria. English language peer-reviewed journal articles published between 2011 and 2016 were selected for data extraction and quality assessment. Finally, a total of 16 studies were identified. The studies’ duration ranged from three weeks to seven years. The majority of studies were carried out in European countries. Seven studies had a moderate quality while the remaining studies were at a less than moderate level. Three dietary educational interventions and all meal service related interventions reported improvements in older people’s dietary variety, nutrition status, or other health-related eating behaviours. Multicomponent dietary interventions mainly contributed to the reduction of risk of chronic disease. The results supported that older people could achieve a better dietary quality if they make diet-related changes by receiving either dietary education or healthier meal service. Further high-quality studies are required to promote healthy eating among older people by taking regional diet patterns, advanced information technology, and nudging strategies into account. PMID:29373529

Developing person-centred practice in hip fracture care for older people.

Science.gov (United States)

Christie, Jane; Macmillan, Maureen; Currie, Colin; Matthews-Smith, Gerardine

2016-12-14

To facilitate a multidisciplinary collaborative approach to developing person-centred practice in hip fracture care for older people. Collaborative inquiry, a form of action research, was used to collect data for this study. It involved exploration of dilemmas, questions and problems that are part of human experience. Clinical leaders from different disciplines (n=16), who work with older people with hip fractures at different stages of the care pathway, participated in a series of facilitated action meetings. The practice development techniques used in this study included: identifying the strengths and limitations of the current service, values clarification, creating a shared vision, sharing clinical stories, reviewing case records, and reflecting on the experiences of three older people and two caregivers. Hip fracture care was based on meeting service targets, national guidelines and audits. Care was fragmented across different service delivery units, with professional groups working independently. This resulted in suboptimal communication between members of the multidisciplinary group of clinical leaders and care that was process-driven rather than person-centred. Spending time away from clinical practice enabled the multidisciplinary group to collaborate to understand care from the patients' and caregivers' perspectives, and to reflect critically on the care experience as a whole. To develop a person-centred workplace culture, the multidisciplinary team requires facilitated time for reflection. Ongoing facilitative leadership would enable the multidisciplinary team to collaborate effectively to deliver safe, effective person-centred practice in hip fracture care for older people.

What Do Older People Learn from Young People? Intergenerational Learning in "Day Centre" Community Settings in Malta

Science.gov (United States)

Spiteri, Damian

2016-01-01

This study analyses what motivates older people to attend "day centres" in Malta and what they believe that they derive from young people who carry out their placements at these day "centres" These young people, who are aged 16-17, attend a vocational college in Malta and are studying health and social care. The study is based…

Acute stress does not impair long-term memory retrieval in older people.

Science.gov (United States)

Pulopulos, Matias M; Almela, Mercedes; Hidalgo, Vanesa; Villada, Carolina; Puig-Perez, Sara; Salvador, Alicia

2013-09-01

Previous studies have shown that stress-induced cortisol increases impair memory retrieval in young people. This effect has not been studied in older people; however, some findings suggest that age-related changes in the brain can affect the relationships between acute stress, cortisol and memory in older people. Our aim was to investigate the effects of acute stress on long-term memory retrieval in healthy older people. To this end, 76 participants from 56 to 76 years old (38 men and 38 women) were exposed to an acute psychosocial stressor or a control task. After the stress/control task, the recall of pictures, words and stories learned the previous day was assessed. There were no differences in memory retrieval between the stress and control groups on any of the memory tasks. In addition, stress-induced cortisol response was not associated with memory retrieval. An age-related decrease in cortisol receptors and functional changes in the amygdala and hippocampus could underlie the differences observed between the results from this study and those found in studies performed with young people. Copyright © 2013 Elsevier Inc. All rights reserved.

Expanding the Circle of Knowledge: Reconceptualizing Successful Aging Among North American Older Indigenous Peoples.

Science.gov (United States)

Pace, Jessica E; Grenier, Amanda

2017-03-01

Indigenous older peoples' voices and experiences remain largely absent in the dominant models and critical scholarship on aging and late life. This article examines the relevance of the model of successful aging for Indigenous peoples in North America. This article presents the results of a review of the published conceptual literature on successful aging among Indigenous peoples. Our intent was to explore the current state of the field of successful aging among Indigenous peoples and suggest dimensions that may be more reflective of Indigenous voices and experiences that leads to a more inclusive model of successful aging. Based on our review, we suggest four dimensions that may broaden understandings of successful aging to be more inclusive of Indigenous older people: health and wellness, empowerment and resilience, engagement and behavior, and connectedness. Our review suggests that Indigenous peoples' voices and experiences are beginning to be included in academic literature on successful aging. However, we suggest that understandings of successful aging be broadened based on our summative findings and a process of community involvement. Such processes can lead to the development of models that are more inclusive to a wide range of older people, including Indigenous older peoples. © The Author 2016. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Ageing in an inconvenient paradise: the immigrant experiences of older Korean people in New Zealand.

Science.gov (United States)

Park, Hong-Jae; Kim, Chang Gi

2013-09-01

The purpose of this paper is to explore the immigrant experiences of older Korean people and their intergenerational family relationships in the New Zealand context. Data were collected from qualitative interviews with older people, community leaders and professionals in Christchurch and Auckland. Data analysis was conducted using concept mapping techniques in the cross-cultural context where two languages were simultaneously used. The findings of the study show that older Korean people in New Zealand were likely to face multiple challenges due to the combined effects of immigration and ageing in a new country. Some older people experienced difficulties in managing their immigrant lives and intergenerational relationships in the transnational family context in which their family members were dispersed across two or more nations. The immigrant experiences of older migrants might be affected by an 'invisible' source of isolation and exclusion at familial, community, societal and transnational levels. © 2013 The Authors. Australasian Journal on Ageing © 2013 ACOTA.

Interviews on end-of-life care with older people: reflections on six european studies

NARCIS (Netherlands)

Pleschberger, S.; Seymour, J.E.; Payne, S.; Deschepper, R.; Onwuteaka-Philipsen, B.D.; Rurup, M.L.

2011-01-01

Qualitative research provides important insights into the experiences and perspectives of older people on end-of-life issues, but such research is methodologically and ethically complex. We offer a set of reflections from six end-of-life care studies conducted with older people in four European

Perspectives of nursing professionals and older adults differ on aspects of care for older people after a nationwide improvement program.

NARCIS (Netherlands)

Verweij, L.M.; Wehrens, R.; Oldenhof, L.; Bal, R.; Francke, A.L.

2018-01-01

Background: The perspectives of nursing professionals might differ from those of older adults when it comes to care for older people. This cross-sectional study compares the views of older adults with the views of nursing professionals on the quality of care after a nationwide improvement program

Perspectives of nursing professionals and older adults differ on aspects of care for older people after a nationwide improvement program

NARCIS (Netherlands)

Verweij, L.M. (Lisanne Marlieke); R.L.E. Wehrens (Rik); L.E. Oldenhof (Lieke); R.A. Bal (Roland); Francke, A.L. (Anneke)

2018-01-01

textabstractBackground: The perspectives of nursing professionals might differ from those of older adults when it comes to care for older people. This cross-sectional study compares the views of older adults with the views of nursing professionals on the quality of care after a nationwide

Symptoms of delirium predict incident delirium in older long-term care residents.

Science.gov (United States)

Cole, Martin G; McCusker, Jane; Voyer, Philippe; Monette, Johanne; Champoux, Nathalie; Ciampi, Antonio; Vu, Minh; Dyachenko, Alina; Belzile, Eric

2013-06-01

Detection of long-term care (LTC) residents at risk of delirium may lead to prevention of this disorder. The primary objective of this study was to determine if the presence of one or more Confusion Assessment Method (CAM) core symptoms of delirium at baseline assessment predicts incident delirium. Secondary objectives were to determine if the number or the type of symptoms predict incident delirium. The study was a secondary analysis of data collected for a prospective study of delirium among older residents of seven LTC facilities in Montreal and Quebec City, Canada. The Mini-Mental State Exam (MMSE), CAM, Delirium Index (DI), Hierarchic Dementia Scale, Barthel Index, and Cornell Scale for Depression were completed at baseline. The MMSE, CAM, and DI were repeated weekly for six months. Multivariate Cox regression models were used to determine if baseline symptoms predict incident delirium. Of 273 residents, 40 (14.7%) developed incident delirium. Mean (SD) time to onset of delirium was 10.8 (7.4) weeks. When one or more CAM core symptoms were present at baseline, the Hazard Ratio (HR) for incident delirium was 3.5 (95% CI = 1.4, 8.9). The HRs for number of symptoms present ranged from 2.9 (95% CI = 1.0, 8.3) for one symptom to 3.8 (95% CI = 1.3, 11.0) for three symptoms. The HR for one type of symptom, fluctuation, was 2.2 (95% CI = 1.2, 4.2). The presence of CAM core symptoms at baseline assessment predicts incident delirium in older LTC residents. These findings have potentially important implications for clinical practice and research in LTC settings.

Ageing well? : A cross-country analysis of the way older people are visually represented on websites of organizations for older people

NARCIS (Netherlands)

Loos, E.F.|info:eu-repo/dai/nl/078758475; Ivan, Loredana; Fernández-Ardèvol, Mireia; Sourbati, Maria; Ekström, Maria; Wilińska, Monika; Carlo, Simone; Schiau, Ioana

2017-01-01

The ‘aging well’ discourse advances the idea of making older people responsible for their capability to stay healthy and active. In the context of an increased ageing population, which poses several challenges to countries’ government, this discourse has become dominant in Europe. We explore the way

Ageing well? A cross-country analysis of the way older people are visually represented on websites of organizations for older people

NARCIS (Netherlands)

Loos, E.; Ivan, L.; Fernández-Ardèvol, M.; Sourbati, M.; Ekström, M.; Wilińska, M.; Carlo, S.; Schiau, I.

2017-01-01

The ‘aging well’ discourse advances the idea of making older people responsible for their capability to stay healthy and active. In the context of an increased ageing population, which poses several challenges to countries’ government, this discourse has become dominant in Europe. We explore the way

Measures for Assessing Student Attitudes toward Older People

Science.gov (United States)

Lin, Xiaoping; Bryant, Christina; Boldero, Jennifer

2011-01-01

Measuring medical and allied health students' attitudes towards older people has been identified as an important research area. The present study compared the use of implicit and explicit attitude measures. Sixty-five undergraduates completed one explicit measure, the Fraboni Scale of Ageism (FSA), (Fraboni, Saltstone, & Hughes, 1990) and one…

Concern about HIV and AIDS among older people in the slums of Nairobi, Kenya.

Science.gov (United States)

Chepngeno-Langat, Gloria; Falkingham, Jane C; Madise, Nyovani J; Evandrou, Maria

2012-09-01

The article explores the way that social networks and personal experiences affect perceived HIV-related concerns among people aged 50 years or older living in a low resource neighborhood with high HIV prevalence in Nairobi, Kenya. Multiple logistic regression is used to model the association between the reporting of an HIV-related concern and individual-level characteristics, personal experiences, and social interaction. The main concerns regarding HIV reported by older people in the study included caring for orphaned children (65%), caring for people with AIDS (48%), and losing material and social support from adult children (36%). Interestingly, 38% of respondents voiced concerns about HIV infection among older people. Respondents who had been individually affected by HIV and AIDS, who were part of a wide social network, or who participated in community activities were frequently more likely to report a concern. The findings highlight the significance of the role of social interaction and social networks in the diffusion of information and knowledge. These findings have implications for HIV and AIDS policy and programs, highlighting the potential for social networks and community-level interventions to educate and increase awareness about HIV and AIDS among older people. Community leaders can make good peer educators and communication agents for HIV/AIDS campaigns. Additionally, the recognized high level of personal vulnerability to HIV infection among older people suggests the need for targeted sexual behavior change programs among this often neglected group. © 2012 Society for Risk Analysis.

Telecare and older people: who cares where?

Science.gov (United States)

Milligan, Christine; Roberts, Celia; Mort, Maggie

2011-02-01

'Telecare solutions' are seen as a potential means of addressing the future care needs of ageing societies in Western economies. The development of these remote care systems runs in parallel with policies aimed at 'ageing in place'; and is targeted at supporting the perceived care needs of frail older people within the home. Drawing on ethnographic and deliberative panel data from European Community funded research, we consider how these developments contribute to a reshaping of the place and experience of care for older people. We do so by addressing the ways in which remote care systems can, firstly, act to change the experience of home; and secondly, re-order the place of care-work and responsibilities to care as new actors become enrolled within the care network and existing care-givers take on differing roles and responsibilities. Finally, we consider how this paper contributes to conceptual debates around institution and extitution - that is, the de-territorialisation of the physical structure of the institution and its re-manifestation through new spaces and times that seek to end interior and exterior distinctions. Copyright © 2010 Elsevier Ltd. All rights reserved.

Falling off the bandwagon? Exploring the challenges to sustained digital engagement by older people.

Science.gov (United States)

Damodaran, L; Olphert, C W; Sandhu, J

2014-01-01

This study examines older people's use of information and communication technologies (ICTs) and identifies the factors which can prevent or promote their sustained use. A mixed methods approach was adopted. Quantitative and qualitative data were collected by a survey of 323 older ICT users (aged ≥50 years) between 2011 and 2012. These data were supplemented by qualitative data obtained through in-depth interviews, focus groups and storytelling. Quantitative data were analysed using PASW including bivariate and multivariate analyses. Qualitative data were analysed using an inductive, thematic approach. The findings show that, contrary to some stereotypes, many older people are enthusiastic, competent and confident users of ICTs. However, they report a range of challenges in reaching and maintaining this situation. These include technological complexity and change, age-related capability changes and a lack of learning and support mechanisms. Intrinsic motivation and social support are important in enabling older people to overcome these challenges. Getting older people online has been a high priority in many countries over the past decade. However, little attention has been paid to whether and how their usage can be sustained over time. We discuss the implications of the findings for policy and practice.

Assessment of Ethical Ideals and Ethical Manners in Care of Older People

OpenAIRE

Frilund, Marianne; Fagerström, Lisbeth; Eriksson, Katie; Eklund, Patrik

2013-01-01

The aim of this study is to establish structured clusters and well-defined ontological entities (nodes) describing ethical values as both ideal and opportunity for ethical manner as perceived by the caregiver. In this study, we use Bayesian Belief Networks (BBNs) to analyse ethical values (ethos) and ethical manners in daily work with older people. Material is based on questionnaire data collected by the instrument for the self-assessment of individual ethos in the care of older people (ISAEC...

[Subjective memory complaints in older people. Is it a symptom of dementia?

DEFF Research Database (Denmark)

Vogel, A.

2008-01-01

Subjective memory complaints are common in older people. They are inconsistently related to current cognitive impairment, but are more consistently correlated to future development of dementia. Subjective memory complaints are also related to depression and personality traits. Many patients...... with dementia have impaired awareness of deficits even in the early stages of dementia and therefore do not complain about memory problems. Reports about impaired memory in older people should lead to diagnostic examination Udgivelsesdato: 2008/5/12...

Using residents' perceptions to improve park-people relationships in Chatthin Wildlife Sanctuary, Myanmar.

Science.gov (United States)

Allendorf, Teri D; Aung, Myint; Songer, Melissa

2012-05-30

The complex and context-specific relationships that local residents have with neighboring protected areas present many challenges for protected area (PA) management. While long-term, interdisciplinary approaches may be necessary to fully understand park-people relationships within a particular PA, the reality is that management decisions for the majority of PAs in the world are made by protected area staff with little or no external assistance. One potential entry point for management to understand park-people relationships and improve management is through understanding people's perceptions of PAs. This paper presents a study from Chatthin Wildlife Sanctuary in central Myanmar designed to explore the impact of using residents' attitudes to directly inform management strategies. We conducted a survey to determine attitudes and determinants of attitudes toward CWS. In response to the survey, the warden made changes to the Sanctuary's management strategy to accommodate local needs and perceptions. Four years later, we repeated the survey to explore the effects of the management changes on people's perceptions and found that people were significantly more likely to like the sanctuary, less likely to mention problems, and more likely to mention benefits. People's negative perceptions of management conflicts and crop damage decreased and their positive perceptions of conservation and ecosystem service benefits and extraction benefits increased. This study demonstrates that residents' perceptions can be used by management as a starting point to improve park-people relationships through feasible and targeted interventions that are meaningful to local communities and their relationships with PAs. Copyright © 2012 Elsevier Ltd. All rights reserved.

From Right place--Wrong person, to Right place--Right person: dignified care for older people.

Science.gov (United States)

Tadd, Win; Hillman, Alex; Calnan, Michael; Calnan, Sian; Read, Simon; Bayer, Antony

2012-04-01

To examine: older people's and their relatives' views of dignified care; health care practitioners' behaviours and practices in relation to dignified care; the occupational, organizational and cultural factors that impact on care; and develop evidence-based recommendations for dignified care. An ethnography of four acute trusts in England and Wales involving semi-structured interviews with recently discharged older people (n = 40), their relatives (n = 25), frontline staff (n = 79) and Trust managers (n = 32), complemented by 617 hours of non-participant observation in 16 wards in NHS trusts. 'Right Place - Wrong Person' refers to the staffs' belief that acute wards are not the 'right place' for older people. Wards were poorly-designed, confusing and inaccessible for older people; older people were bored through lack of communal spaces and activities and they expressed concern about the close proximity of patients of the opposite sex; staff were demoralised and ill-equipped with skills and knowledge to care for older people, and organizational priorities caused patients to be frequently moved within the system. In none of the wards studied was care either totally dignified or totally undignified. Variations occurred from ward to ward, in the same ward when different staff were on-duty and at different times of the day. The failure to provide dignified care is often a result of systemic and organizational factors rather than a failure of individual staff and it is these that must be addressed if dignified care is to be ensured.

Inappropriate prescribing and adverse drug events in older people

Directory of Open Access Journals (Sweden)

Gallagher Paul F

2009-01-01

Full Text Available Abstract Inappropriate prescribing (IP in older patients is highly prevalent and is associated with an increased risk of adverse drug events (ADEs, morbidity, mortality and healthcare utilisation. Consequently, IP is a major safety concern and with changing population demographics, it is likely to become even more prevalent in the future. IP can be detected using explicit or implicit prescribing indicators. Theoretically, the routine clinical application of these IP criteria could represent an inexpensive and time efficient method to optimise prescribing practice. However, IP criteria must be sensitive, specific, have good inter-rater reliability and incorporate those medications most commonly associated with ADEs in older people. To be clinically relevant, use of prescribing appropriateness tools must translate into positive patient outcomes, such as reduced rates of ADEs. To accurately measure these outcomes, a reliable method of assessing the relationship between the administration of a drug and an adverse clinical event is required. The Naranjo criteria are the most widely used tool for assessing ADE causality, however, they are often difficult to interpret in the context of older patients. ADE causality criteria that allow for the multiple co-morbidities and prescribed medications in older people are required. Ultimately, the current high prevalence of IP and ADEs is unacceptable. IP screening criteria need to be tested as an intervention to assess their impact on the incidence of ADEs in vulnerable older patients. There is a role for IP screening tools in everyday clinical practice. These should enhance, not replace good clinical judgement, which in turn should be based on sound pharmacogeriatric training.

Inappropriate prescribing and adverse drug events in older people.

LENUS (Irish Health Repository)

Hamilton, Hilary J

2009-01-01

Inappropriate prescribing (IP) in older patients is highly prevalent and is associated with an increased risk of adverse drug events (ADEs), morbidity, mortality and healthcare utilisation. Consequently, IP is a major safety concern and with changing population demographics, it is likely to become even more prevalent in the future. IP can be detected using explicit or implicit prescribing indicators. Theoretically, the routine clinical application of these IP criteria could represent an inexpensive and time efficient method to optimise prescribing practice. However, IP criteria must be sensitive, specific, have good inter-rater reliability and incorporate those medications most commonly associated with ADEs in older people. To be clinically relevant, use of prescribing appropriateness tools must translate into positive patient outcomes, such as reduced rates of ADEs. To accurately measure these outcomes, a reliable method of assessing the relationship between the administration of a drug and an adverse clinical event is required. The Naranjo criteria are the most widely used tool for assessing ADE causality, however, they are often difficult to interpret in the context of older patients. ADE causality criteria that allow for the multiple co-morbidities and prescribed medications in older people are required. Ultimately, the current high prevalence of IP and ADEs is unacceptable. IP screening criteria need to be tested as an intervention to assess their impact on the incidence of ADEs in vulnerable older patients. There is a role for IP screening tools in everyday clinical practice. These should enhance, not replace good clinical judgement, which in turn should be based on sound pharmacogeriatric training.

Safer handling practice: influence of staff education on older people.

Science.gov (United States)

Wilson, Christine Brown

The purpose of this small-scale survey was to explore the level of moving and handling training undertaken by nurses within private sector continuing care environments and the potential this training had to influence the care of older people. This study uses a definition of safer handling practice derived from existing literature to examine how nurses report the application of this training and whether they observe changes to the mobility of older people within their care. The limitations of this study indicate that generalizations must be made cautiously. However, this study tentatively suggests that potential exists to influence positively the use of safer handling practice as defined within this study. Recommendations for further study are made.

A literature review to explore integrated care for older people

Directory of Open Access Journals (Sweden)

Jan Reed

2005-01-01

Full Text Available Purpose: This paper reports on some of the findings of a literature review commissioned to explore integrated care for older people. Methods: The process of revising included finding and selecting literature from multidisciplinary sources, and encompassed both published papers and ‘grey’ literature, i.e. material which had not been reviewed for publication. Results: The study found that thinking has moved on from a focus on the problems of accessing services to exploring ways in which they may function in an integrated way. Conclusions: The study shows how thinking on integrated care for older people has developed, and knowledge of micro, mezzo and macro strategies is now more available.

Neighborhood attributes security and solidarity promote the well-being of community-dwelling older people in the Netherlands.

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Cramm, Jane M; Nieboer, Anna P

2014-07-01

To determine whether the neighborhood attributes solidarity and security positively affect the well-being of community-dwelling older people in the Netherlands after accounting for individual characteristics, and to test if a higher level of security in combination with a stronger sense of neighborhood solidarity results in a higher level of well-being. The study sample for the cross-sectional study consisted of 869 out of 2212 (39% response rate) independently-living older adults (aged >70 years) in 92 neighborhoods of Rotterdam. We fitted a hierarchical random-effects model to account for the structure of the study design: 869 older people (level 1) nested in 92 neighborhoods (level 2) in 10 districts (level 3). Neighborhood security and solidarity among neighbors varied significantly among the 10 districts. Univariate analyses showed that education, income, neighborhood security and solidarity within neighborhoods (all P ≤ 0.001) were significantly related to the well-being of community-dwelling older people. Multilevel analyses showed neighborhood security and solidarity within neighborhoods predicted the well-being of community-dwelling older people. Furthermore, a positive interaction effect was found between neighborhood security and solidarity within neighborhoods, and well-being of community-dwelling older people. Neighborhood security and solidarity among neighbors are important for the well-being of community-dwelling older people. Furthermore, neighborhoods with high levels of perceived security in combination with stronger solidarity among neighbors are especially beneficial to the well-being of community-dwelling older people. © 2013 Japan Geriatrics Society.

Serum thyroid-stimulating hormone and cognition in older people.

Science.gov (United States)

Ojala, Anna K; Schalin-Jäntti, Camilla; Pitkälä, Kaisu H; Tilvis, Reijo S; Strandberg, Timo E

2016-01-01

high TSH concentrations and cognitive decline are both very common among older people and could be linked. to assess cognition in our cohort of 335 home-dwelling older people (75 years and older) and to cross-sectionally relate the results to thyroid-stimulating hormone (TSH) concentrations. Our special focus was on the upper normal TSH range and subclinical hypothyroidism. cognitive performance was evaluated using the Consortium to Establish a Registry for Alzheimer's disease neuropsychological battery (CERAD-nb). The Clinical Dementia Rating (CDR) scale was used to evaluate severity of cognitive disorder. The APOEε4 genotype was also defined. Subjects were divided into quartiles based on the TSH concentrations, and results were compared between these groups. expected relations were observed between CERAD domains and both educational level and APOEε4 genotype. Female sex significantly associated with better performance in Boston naming (OR = 0.48; 95% CI = 0.27-0.85). In the whole cohort, higher TSH concentrations tended to associate with better scores in most parts of the CERAD-nb tests, but differences were not statistically significant. However, subjects with the highest TSH concentration (90th TSH percentile, range 4.14-14.4 mU/l) had better CDR scores compared with subjects with the lowest TSH concentration (10th percentile, range 0.001-0.63 mIU/l; OR 0.10; 95% CI 0.014-0.76). our results do not support the notion that higher TSH concentrations, not even in the range of subclinical hypothyroidism, would adversely affect cognition among older people. © The Author 2015. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Involvement of older people in the development of fall detection systems: a scoping review.

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Thilo, Friederike J S; Hürlimann, Barbara; Hahn, Sabine; Bilger, Selina; Schols, Jos M G A; Halfens, Ruud J G

2016-02-11

The involvement of users is recommended in the development of health related technologies, in order to address their needs and preferences and to improve the daily usage of these technologies. The objective of this literature review was to identify the nature and extent of research involving older people in the development of fall detection systems. A scoping review according to the framework of Arksey and O'Malley was carried out. A key term search was employed in eight relevant databases. Included articles were summarized using a predetermined charting form and subsequently thematically analysed. A total of 53 articles was included. In 49 of the 53 articles, older people were involved in the design and/or testing stages, and in 4 of 53 articles, they were involved in the conceptual or market deployment stages. In 38 of the 53 articles, the main focus of the involvement of older people was technical aspects. In 15 of the 53 articles, the perspectives of the elderly related to the fall detection system under development were determined using focus groups, single interviews or questionnaires. Until presently, involvement of older people in the development of fall detection systems has focused mainly on technical aspects. Little attention has been given to the specific needs and views of older people in the context of fall detection system development and usage.

Constructing definitions of safety risks while nurses care for hospitalised older people: Secondary analysis of qualitative data.

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Dahlke, Sherry; Hall, Wendy A; Baumbusch, Jennifer

2017-09-01

The aim of this secondary qualitative descriptive analysis was to examine how nurses construct a definition of older peoples' safety risks and provide care while working within organisational contexts that are focused on diminishing patient risks. Numbers of older patients are increasing in acute hospital contexts-contexts that place their focus on patient safety. Nurses need to manage tensions between older peoples' risks, evidence-informed practice decisions, limited resources and organisational emphases on patient falls. To date, their practice dilemmas have not been well examined. A secondary qualitative descriptive analysis was conducted using data that were collected between June 2010 and May 2011 to examine nursing practice with hospitalised older people. All field notes and transcribed data were reviewed to generate themes representing 18 Registered Nurses' perceptions about safe care for hospitalised older people. The first author generated categories that described how nurses construct definitions of safety risks for older people. All authors engaged in an iterative analytic process that resulted in themes capturing nurses' efforts to provide care in limited resource environments while considering older peoples' safety risks. Nurses constructed definitions of patient safety risks in the context of institutional directives. Nurses provided care using available resources as efficiently as possible and accessing co-worker support. They also minimised the importance of older people's functional abilities by setting priorities for medically delegated tasks and immobilising their patients to reduce their risks. Nurses' definitions of patient risk, which were shaped by impoverished institutional resources and nurses' lack of valuing of functional abilities, contributed to suboptimal care for older adults. Nurses' definitions of risk as physical injury reduced their attention to patients' functional abilities, which nurses reported suffered declines as a result

Developing a framework for a novel multi-disciplinary, multi-agency intervention(s), to improve medication management in community-dwelling older people on complex medication regimens (MEMORABLE)--a realist synthesis.

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Maidment, Ian; Booth, Andrew; Mullan, Judy; McKeown, Jane; Bailey, Sylvia; Wong, Geoffrey

2017-07-03

Medication-related adverse events have been estimated to be responsible for 5700 deaths and cost the UK £750 million annually. This burden falls disproportionately on older people. Outcomes from interventions to optimise medication management are caused by multiple context-sensitive mechanisms. The MEdication Management in Older people: REalist Approaches BAsed on Literature and Evaluation (MEMORABLE) project uses realist synthesis to understand how, why, for whom and in what context interventions, to improve medication management in older people on complex medication regimes residing in the community, work. This realist synthesis uses secondary data and primary data from interviews to develop the programme theory. A realist logic of analysis will synthesise data both within and across the two data sources to inform the design of a complex intervention(s) to help improve medication management in older people. 1. Literature review The review (using realist synthesis) contains five stages to develop an initial programme theory to understand why processes are more or less successful and under which situations: focussing of the research question; developing the initial programme theory; developing the search strategy; selection and appraisal based on relevance and rigour; and data analysis/synthesis to develop and refine the programme theory and context, intervention and mechanism configurations. 2. Realist interviews Realist interviews will explore and refine our understanding of the programme theory developed from the realist synthesis. Up to 30 older people and their informal carers (15 older people with multi-morbidity, 10 informal carers and 5 older people with dementia), and 20 care staff will be interviewed. 3. Developing framework for the intervention(s) Data from the realist synthesis and interviews will be used to refine the programme theory for the intervention(s) to identify: the mechanisms that need to be 'triggered', and the contexts related to these

Using comprehensive geriatric assessment for quality improvements in healthcare of older people in UK care homes: protocol for realist review within Proactive Healthcare of Older People in Care Homes (PEACH) study.

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Zubair, Maria; Chadborn, Neil H; Gladman, John R F; Dening, Tom; Gordon, Adam L; Goodman, Claire

2017-10-10

Care home residents are relatively high users of healthcare resources and may have complex needs. Comprehensive geriatric assessment (CGA) may benefit care home residents and improve efficiency of care delivery. This is an approach to care in which there is a thorough multidisciplinary assessment (physical and mental health, functioning and physical and social environments) and a care plan based on this assessment, usually delivered by a multidisciplinary team. The CGA process is known to improve outcomes for community-dwelling older people and those in receipt of hospital care, but less is known about its efficacy in care home residents. Realist review was selected as the most appropriate method to explore the complex nature of the care home setting and multidisciplinary delivery of care. The aim of the realist review is to identify and characterise a programme theory that underpins the CGA intervention. The realist review will extract data from research articles which describe the causal mechanisms through which the practice of CGA generates outcomes. The focus of the intervention is care homes, and the outcomes of interest are health-related quality of life and satisfaction with services; for both residents and staff. Further outcomes may include appropriate use of National Health Service services and resources of older care home residents. The review will proceed through three stages: (1) identifying the candidate programme theories that underpin CGA through interviews with key stakeholders, systematic search of the peer-reviewed and non-peer-reviewed evidence, (2) identifying the evidence relevant to CGA in UK care homes and refining the programme theories through refining and iterating the systematic search, lateral searches and seeking further information from study authors and (3) analysis and synthesis of evidence, involving the testing of the programme theories. The PEACH project was identified as service development following submission to the UK Health

[Care preferences and spatial mobility : Factors influencing care-related willingness to move of elderly people in partnerships in a rural area].

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Rudel, Miriam; Abraham, Martin; Görtler, Edmund

2017-04-01

The availability of local support and care infrastructures at the place of residence is an important issue for the elderly living in rural areas. Spatial mobility can be seen as a strategy to cope with a lack of local care facilities. This study analyzes the preferences of older people living in long-term relationships concerning support and care arrangements. Furthermore, it is analyzed how far and under which circumstances older couples are willing to relocate their place of residence in response to regional care infrastructures. Using a quasi-experimental survey design, inhabitants of a small rural community aged over 50 years were interviewed and confronted with descriptions of fictitious situations with randomized options for moving residence. A Tobit model estimation method is applied to examine the determinants of older couples' care-related willingness to move their residence.The results show that most people prefer either the support of their own partner or outpatient care. Residential care is especially preferred by people aged 75 years and above, whereas new forms of support, such as senior cooperatives, are evaluated as attractive especially by younger age groups. Thus, information and advisory campaigns should address the target group in question even at an early stage in older peoples' life course. Care-related willingness to move home of couples aged 50 years and more is significantly determined by local provision of support and care infrastructures. The expansion of any care infrastructure at older peoples' place of residence can significantly reduce their willingness to move. In particular an increased availability of outpatient care is associated with a comparatively large reduction in couples' likelihood to move. In this way local commitment to rural areas can be sustained and rural depopulation can be prevented. At an alternative place of residence assisted living and residential care in particular can significantly enhance the willingness to

Older people's views on what they need to successfully adjust to life with a hearing aid

OpenAIRE

Kelly, Timothy B; Tolson, Debbie; Day, Tracy; McColgan, Gillian; Kroll, Thilo; Maclaren, William

2013-01-01

This article reports a study exploring what older people believe would enable them to adjust to and gain maximum benefit from wearing a hearing aid. A mixed methods approach was employed during 2006 involving interviews with key stakeholders, a survey across three Scottish health board areas and focus groups. Nine key stakeholders from six national and local organisations were interviewed about the needs of older people being fitted with hearing aids. In total, 240 older people belonging to t...

Identifying motivators and barriers to older community-dwelling people participating in resistance training: A cross-sectional study.

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Burton, Elissa; Lewin, Gill; Pettigrew, Simone; Hill, Anne-Marie; Bainbridge, Liz; Farrier, Kaela; Langdon, Trish; Airey, Phil; Hill, Keith D

2017-08-01

Participation rates of older people in resistance training (RT) are low despite increasing research showing many health benefits. To increase the number of older people participating in RT it is important to know what would motivate people to become involved, what motivates those who participate to continue, and the factors preventing many older people from commencing participation. To investigate these issues, a questionnaire was mailed to three groups of older people: (1) those receiving home care services, (2) members of a peak non-government seniors' organisation and (3) those participating in a specific gym-based RT programme. In total, 1327 questionnaires were returned (response rate = 42.5%). To feel good physically and mentally were the main reasons motivating participation among all three groups, and falls prevention was identified as an important motivator for the home care respondents. Pain, injury and illness were the main barriers to participating, or continuing to participate. However, medical advice was a factor influencing participation commencement. The results suggest organisations providing RT programmes for older people should tailor the promotion and delivery of programmes to address key motivators and barriers specific to each group to increase the proportion of older people initiating and continuing to engage in RT.

Older people's perception of and coping with falling, and their motivation for fall-prevention programmes

DEFF Research Database (Denmark)

Høst, Dorte; Hendriksen, Carsten; Borup, Ina

2011-01-01

This study aims to investigate older people's perceptions of and coping with falls, and what motivates them to join such programmes.......This study aims to investigate older people's perceptions of and coping with falls, and what motivates them to join such programmes....

Treasures from from nature in the Netherlands - Accessible and motivating horticultural activities for older people

NARCIS (Netherlands)

Dr. Hans Schuman

2009-01-01

Stichting Natuurlijk Genieten is a Dutch foundation, founded by Jeannette Bolck, and dedicated to stimulating the development of a more natural living environment for older people living permanently in residential care centres. Many older people, in particular with Alzheimer's, are dependent on

Barriers to Care for Depressed Older People: Perceptions of Aged Care among Medical Professionals

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McCabe, Marita P.; Davison, Tanya; Mellor, David; George, Kuruvilla

2009-01-01

The current study evaluated barriers to detection of depression among older people. Focus groups were conducted with 21 professional carers, 4 nurses, 10 general practitioners, and 7 aged care managers. The results demonstrated that care for older people is primarily focused on physical care. Further, staff resources, a lack of continuity of care,…

Bus use and older people: a literature review applying the Person-Environment-Occupation model in macro practice.

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Broome, Kieran; McKenna, Kryss; Fleming, Jennifer; Worrall, Linda

2009-03-01

The same reasons that prompt older people to give up driving can also result in difficulties with accessing public transport. Difficulties using public transport can limit older people's participation in society, thereby impacting negatively on their health. Focusing on public buses, this review explicates the link between bus usability and the health of older people and frames existing evidence on bus usability issues. The Person-Environment-Occupation (PEO) model offers a framework by which bus usability can be assessed. A combination of person-centred, environmental, and occupation-related factors, including bus design, service provision and performance, information, and the attitudes of staff and the community, impact on older people's ability to catch buses. More systematic research needs to take place in order to develop a comprehensive understanding of bus usability. Occupational therapy has a key role to play in conceptualizing, implementing, and evaluating improvements in bus usability for older people.

A comparison of the factors influencing life satisfaction between Korean older people living with family and living alone.

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Shin, S H; Sok, S R

2012-06-01

As the global population of older people continuously increases, many countries are beginning to experience health problems associated with older age. These countries may be interested in knowing and understanding the health problems experienced by the older Korean population, which is projected to age the most rapidly. This study aimed to compare and examine the factors that influence the life satisfaction between older people living with their family and those living alone. A cross-sectional survey was conducted. The participants comprised a total 300 older Koreans (150 living with their family, 150 living alone) aged 65 years or over who met the eligibility criteria. All measures were self-administered. Data were analysed using the SAS statistical software program version 6.12 (SAS Institute Inc., Cary, NC). The older people living with their family were better than the older people living alone in perceived health status, self-esteem, depression and life satisfaction. Perceived health status, self-esteem, depression, age and monthly allowance were found to be the factors related to the life satisfaction of older people living with their family and those living alone. The factors that were found to have the greatest influence on the life satisfaction of older people living with their family and those living alone were depression and perceived health, respectively. This study may help healthcare providers to understand the factors that can influence the life satisfaction among older people living with their family and living alone in Korea. © 2011 The Authors. International Nursing Review © 2011 International Council of Nurses.

Obesity, sarcopenia, sarcopenic obesity and reduced mobility in Brazilian older people aged 80 years and over.

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Santos, Vanessa Ribeiro Dos; Gomes, Igor Conterato; Bueno, Denise Rodrigues; Christofaro, Diego Giulliano Destro; Freitas, Ismael Forte; Gobbo, Luis Alberto

2017-01-01

To analyze which abnormalities in body composition (obesity, sarcopenia or sarcopenic obesity) are related to reduced mobility in older people aged 80 years and older. The sample included 116 subjects aged 80 years and older. The body composition was measured using dual-energy X-ray absorptiometry (DXA) and mobility was assessed by motor tests. The χ2 test was used to analyze the proportion of older people with sarcopenia, obesity and sarcopenic obesity based on sex as well as to indicate an association between obesity, sarcopenia, sarcopenic obesity and mobility. Binary logistic regression, adjusted for the variables (sex and osteoarticular diseases), was used to express the magnitude of these associations. One-way analysis of variance was used to compare the mobility of four groups (Normal, Obesity, Sarcopenia and Sarcopenic Obesity). The Sarcopenia Group had lower performance in the lower limbs strength test and in sum of two tests compared with Obesity and Normal Groups. Older people with sarcopenia had higher chance of reduced mobility (OR: 3.44; 95%CI: 1.12-10.52). Older people aged 80 years and older with sarcopenia have more chance for reduction in mobility.

Mini-mental state examination as a predictor of mortality among older people referred to secondary mental healthcare.

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Su, Yu-Ping; Chang, Chin-Kuo; Hayes, Richard D; Perera, Gayan; Broadbent, Matthew; To, David; Hotopf, Matthew; Stewart, Robert

2014-01-01

Lower levels of cognitive function have been found to be associated with higher mortality in older people, particularly in dementia, but the association in people with other mental disorders is still inconclusive. Data were analysed from a large mental health case register serving a geographic catchment of 1.23 million residents, and associations were investigated between cognitive function measured by the Mini-Mental State Examination (MMSE) and survival in patients aged 65 years old and over. Cox regressions were carried out, adjusting for age, gender, psychiatric diagnosis, ethnicity, marital status, and area-level socioeconomic index. A total of 6,704 subjects were involved, including 3,368 of them having a dementia diagnosis and 3,336 of them with depression or other diagnoses. Descriptive outcomes by Kaplan-Meier curves showed significant differences between those with normal and impaired cognitive function (MMSE scoremental health services regardless of a dementia diagnosis. Causal pathways between this exposure and outcome (for example, suboptimal healthcare) need further investigation.

Associations of Various Health-Ratings with Geriatric Giants, Mortality and Life Satisfaction in Older People

NARCIS (Netherlands)

Puvill, Thomas; Lindenberg, Jolanda; Gussekloo, Jacobijn; de Craen, Anton J. M.; Slaets, Joris P. J.; Westendorp, Rudi J.

2016-01-01

Self-rated health is routinely used in research and practise among general populations. Older people, however, seem to change their health perceptions. To accurately understand these changed perceptions we therefore need to study the correlates of older people's self-ratings. We examined self-rated,

Clinical Pharmacology of Chemotherapy Agents in Older People with Cancer

Directory of Open Access Journals (Sweden)

Xiaoye He

2011-01-01

Full Text Available Populations around the world are aging, and the associated increase in cancer incidence has led to the recognition of the importance of geriatric oncology. Chronological age is a poor determinant of pharmacological response to cancer chemotherapy agents. Age-associated changes in physiology and organ function have a significant impact on the clinical pharmacology of cancer chemotherapy agents used in cancer treatment. Altered response to medicines in older people is a consequence of changes in body composition, organ function, concomitant pathophysiology, multiple medications, genetic determinants of drug response, and patient's clinical status. These issues highlight the need to individualize the management of cancer in the older people with consideration of age-related changes in the clinical pharmacology of cancer drugs, analgesics, and adjunctive therapies.

Few older people in New Zealand who commit suicide receive specialist psychogeriatric services.

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Cheung, Gary; Casey, Jane

2014-08-01

Suicide in older people is a growing public health concern in many parts of the world. The literature on this issue is lacking in New Zealand. The aim of this study is to ascertain whether this group is accessing specialist psychogeriatric services. A retrospective case series study of completed suicides in older people (≥65 years) during a three-year period from January 2010 to December 2012 was performed. An online survey detailing demographic and clinical information was completed by psychiatrists in 15 of the 20 District Health Boards in New Zealand. Only about 15% of older people who committed suicide were accessing specialist psychogeriatric services and the group with the highest suicide rate (men≥85 years) did not feature in specialist services. Depression (61%) was the most common diagnosis and nearly half (35%) had had contact with specialist services within three days prior to the suicide. Over half (52%) had a history of past suicide attempt(s). Older people who complete suicide are infrequently accessing specialist services. In those that do, there are questions to be answered regarding suicide prediction and prevention for this high-risk group of vulnerable individuals. More research is required targeting those not accessing specialist services, in particular the high risk group of older men. The role of general practitioner, community care, the assessment and management of depression and whether there is any access issue to specialist psychogeriatric services require elucidation. © The Royal Australian and New Zealand College of Psychiatrists 2014.

Prevalence and correlates of depression among HIV-infected and -affected older people in rural South Africa.

Science.gov (United States)

Nyirenda, M; Chatterji, S; Rochat, T; Mutevedzi, P; Newell, M-L

2013-10-01

Little is known about depression in older people in sub-Saharan Africa, the associated impact of HIV, and the influence on health perceptions. Examine the prevalence and correlates of depression; explore the relationship between depression and health perceptions in HIV-infected and -affected older people. In 2010, 422 HIV-infected and -affected participants aged 50+ were recruited into a cross-sectional study. Nurse professionals interviewed participants and a diagnosis of depressive episode was derived from the Composite International Diagnostic Interview (Depression module) using the International Classification of Diseases diagnostic criteria and categorised as major (MDE) or brief (BDE). Overall, 42.4% (n=179) had a depressive episode (MDE: 22.7%, n=96; BDE: 19.7%, n=83). Prevalence of MDE was significantly higher in HIV-affected (30.1%, 95% CI 24.0-36.2%) than HIV-infected (14.8%, 95% CI 9.9-19.7%) participants; BDE was higher in HIV-infected (24.6%, 95% CI 18.7-30.6%) than in HIV-affected (15.1%, 95% CI 10.3-19.8%) participants. Being female (aOR 3.04, 95% CI 1.73-5.36), receiving a government grant (aOR 0.34, 95% CI 0.15-0.75), urban residency (aOR 1.86, 95% CI 1.16-2.96) and adult care-giving (aOR 2.37, 95% CI 1.37-4.12) were significantly associated with any depressive episode. Participants with a depressive episode were 2-3 times more likely to report poor health perceptions. Study limitations include the cross-sectional design, limited sample size and possible selection biases. Prevalence of depressive episodes was high. Major depressive episodes were higher in HIV-affected than HIV-infected participants. Psycho-social support similar to that of HIV treatment programmes around HIV-affected older people may be useful in reducing their vulnerability to depression. © 2013 The Authors. Published by Elsevier B.V. All rights reserved.

Prevalence and correlates of depression among HIV-infected and -affected older people in rural South Africa☆

Science.gov (United States)

Nyirenda, M.; Chatterji, S.; Rochat, T.; Mutevedzi, P.; Newell, M.-L.

2013-01-01

Background Little is known about depression in older people in sub-Saharan Africa, the associated impact of HIV, and the influence on health perceptions. Objectives Examine the prevalence and correlates of depression; explore the relationship between depression and health perceptions in HIV-infected and -affected older people. Methods In 2010, 422 HIV-infected and -affected participants aged 50+ were recruited into a cross-sectional study. Nurse professionals interviewed participants and a diagnosis of depressive episode was derived from the Composite International Diagnostic Interview (Depression module) using the International Classification of Diseases diagnostic criteria and categorised as major (MDE) or brief (BDE). Results Overall, 42.4% (n=179) had a depressive episode (MDE: 22.7%, n=96; BDE: 19.7%, n=83). Prevalence of MDE was significantly higher in HIV-affected (30.1%, 95% CI 24.0–36.2%) than HIV-infected (14.8%, 95% CI 9.9–19.7%) participants; BDE was higher in HIV-infected (24.6%, 95% CI 18.7–30.6%) than in HIV-affected (15.1%, 95% CI 10.3–19.8%) participants. Being female (aOR 3.04, 95% CI 1.73–5.36), receiving a government grant (aOR 0.34, 95% CI 0.15–0.75), urban residency (aOR 1.86, 95% CI 1.16–2.96) and adult care-giving (aOR 2.37, 95% CI 1.37–4.12) were significantly associated with any depressive episode. Participants with a depressive episode were 2–3 times more likely to report poor health perceptions. Limitations Study limitations include the cross-sectional design, limited sample size and possible selection biases. Conclusions Prevalence of depressive episodes was high. Major depressive episodes were higher in HIV-affected than HIV-infected participants. Psycho-social support similar to that of HIV treatment programmes around HIV-affected older people may be useful in reducing their vulnerability to depression. PMID:23726780

Motivational determinants of exergame participation for older people in assisted living facilities : Mixed-methods study

NARCIS (Netherlands)

Meekes, W.M.A.; Stanmore, E.K.

2017-01-01

Exergames (exercise-based videogames) for delivering strength and balance exercise for older people are growing in popularity with the emergence of new Kinect-based technologies; however, little is known about the factors affecting their uptake and usage by older people.The aim of this study was to

Assessing health and well-being among older people in rural South Africa

Directory of Open Access Journals (Sweden)

F. Xavier Gómez-Olivé

2010-09-01

Full Text Available Background: The population in developing countries is ageing, which is likely to increase the burden of non-communicable diseases and disability. Objective: To describe factors associated with self-reported health, disability and quality of life (QoL of older people in the rural northeast of South Africa. Design: Cross-sectional survey of 6,206 individuals aged 50 and over. We used multivariate analysis to examine relationships between demographic variables and measures of self-reported health (Health Status, functional ability (WHODASi and quality of life (WHOQoL. Results: About 4,085 of 6,206 people eligible (65.8% completed the interview. Women (Odds Ratio (OR=1.30, 95% CI 1.09, 1.55, older age (OR=2.59, 95% CI 1.97, 3.40, lower education (OR=1.62, 95% CI 1.31, 2.00, single status (OR=1.18, 95% CI 1.01, 1.37 and not working at present (OR=1.29, 95% CI 1.06, 1.59 were associated with a low health status. Women were also more likely to report a higher level of disability (OR=1.38, 95% CI 1.14, 1.66, as were older people (OR=2.92, 95% CI 2.25, 3.78, those with no education (OR=1.57, 95% CI 1.26, 1.97, with single status (OR=1.25, 95% CI 1.06, 1.46 and not working at present (OR=1.33, 95% CI 1.06, 1.66. Older age (OR=1.35, 95% CI 1.06, 1.74, no education (OR=1.39, 95% CI 1.11, 1.73, single status (OR=1.28, 95% CI 1.10, 1.49, a low household asset score (OR=1.52, 95% CI 1.19, 1.94 and not working at present (OR=1.32; 95% CI 1.07, 1.64 were all associated with lower quality of life. Conclusions: This study presents the first population-based data from South Africa on health status, functional ability and quality of life among older people. Health and social services will need to be restructured to provide effective care for older people living in rural South Africa with impaired functionality and other health problems.

Self-reported health and functional limitations among older people in the Kassena-Nankana District, Ghana

Directory of Open Access Journals (Sweden)

Cornelius Debpuur

2010-09-01

Full Text Available Background: Ghana is experiencing significant increases in its ageing population, yet research on the health and quality of life of older people is limited. Lack of data on the health and well-being of older people in the country makes it difficult to monitor trends in the health status of adults and the impact of social policies on their health and welfare. Research on ageing is urgently required to provide essential data for policy formulation and programme implementation. Objective: To describe the health status and identify factors associated with self-rated health (SRH among older adults in a rural community in northern Ghana. Methods: The data come from a survey on Adult Health and Ageing in the Kassena-Nankana District involving 4,584 people aged 50 and over. Survey participants answered questions pertaining to their health status, including self-rated overall health, perceptions of well-being and quality of life, and self-reported assessment of functioning on a range of different health domains. Socio-demographic information such as age, sex, marital status and education were obtained from a demographic surveillance database. Results: The majority of older people rated their health status as good, with the oldest old reporting poorer health. Multivariate regression analysis showed that functional ability and sex are significant factors in SRH status. Adults with higher levels of functional limitations were much more likely to rate their health as being poorer compared with those having lower disabilities. Household wealth was significantly associated with SRH, with wealthier adults more likely to rate their health as good. Conclusion: The depreciation in health and daily functioning with increasing age is likely to increase people's demand for health care and other services as they grow older. There is a need for regular monitoring of the health status of older people to provide public health agencies with the data they need to assess

Self-reported health and functional limitations among older people in the Kassena-Nankana District, Ghana.

Science.gov (United States)

Debpuur, Cornelius; Welaga, Paul; Wak, George; Hodgson, Abraham

2010-09-27

Ghana is experiencing significant increases in its ageing population, yet research on the health and quality of life of older people is limited. Lack of data on the health and well-being of older people in the country makes it difficult to monitor trends in the health status of adults and the impact of social policies on their health and welfare. Research on ageing is urgently required to provide essential data for policy formulation and programme implementation. To describe the health status and identify factors associated with self-rated health (SRH) among older adults in a rural community in northern Ghana. The data come from a survey on Adult Health and Ageing in the Kassena-Nankana District involving 4,584 people aged 50 and over. Survey participants answered questions pertaining to their health status, including self-rated overall health, perceptions of well-being and quality of life, and self-reported assessment of functioning on a range of different health domains. Socio-demographic information such as age, sex, marital status and education were obtained from a demographic surveillance database. The majority of older people rated their health status as good, with the oldest old reporting poorer health. Multivariate regression analysis showed that functional ability and sex are significant factors in SRH status. Adults with higher levels of functional limitations were much more likely to rate their health as being poorer compared with those having lower disabilities. Household wealth was significantly associated with SRH, with wealthier adults more likely to rate their health as good. The depreciation in health and daily functioning with increasing age is likely to increase people's demand for health care and other services as they grow older. There is a need for regular monitoring of the health status of older people to provide public health agencies with the data they need to assess, protect and promote the health and well-being of older people.

Improvement in the physiological function and standing stability based on kinect multimedia for older people

OpenAIRE

Chen, Chih-Chen

2016-01-01

[Purpose] The increase in the Taiwanese older population is associated with age-related inconveniences. Finding adequate and simple physical activities to help the older people maintaining their physiological function and preventing them from falls has become an urgent social issue. [Subjects and Methods] This study aimed to design a virtual exercise training game suitable for Taiwanese older people. This system will allow for the maintenance of the physiological function and standing stabili...

Exergames to Improve Postural Balance in Older People with Dementia

OpenAIRE

Majed, Lina; Hansen, Clint

2016-01-01

The focus of the study concerns the well-documented increased risk of falling in older adults that can lead sometimes to fatal consequences. Improving posture and motor skills is central to preventing falls. Further investigations targeting specific older people such as those suffering from cognitive impairment or dementia are still needed for fall prevention (Shaw, 2003). New technology-based methods, such as digital motion-sensitive games or exergames, appear promising for improving bala...

Older people who are 'weary of life': their expectations for the future and perceived hopelessness

NARCIS (Netherlands)

Rurup, M.L.; Pasman, H.R.W.; Kerkhof, A.J.F.M.; Deeg, D.J.H.; Onwuteaka-Philipsen, B.D.

2011-01-01

Older people who are 'weary of life': their expectations for the future and perceived hopelessness There has been a debate for over a decade in the Netherlands about whether physicians should be allowed to provide assistance with suicide to older people who are 'weary of life'. Actual knowledge

Gait, mobility, and falls in older people

OpenAIRE

Gschwind, Yves Josef

2012-01-01

My doctoral thesis contributes to the understanding of gait, mobility, and falls in older people. All presented projects investigated the most prominent and sensitive markers for fall-related gait changes, that is gait velocity and gait variability. Based on the measurement of these spatio-temporal gait parameters, particularly when using a change-sensitive dual task paradigm, it is possible to make conclusions regarding walking, balance, activities of daily living, and falls in o...

Promoting Oral Health and Quality of Life of Older People - The Need for Public Health Action.

Science.gov (United States)

Petersen, Poul Erik; Ogawa, Hiroshi

2018-01-01

This report intends to review the global burden of oral disease among older people and to examine their oral health needs. The evidence on the inter-relationships between poor oral health conditions of older people, general health and quality of life is highlighted. Finally, WHO strategies to improve oral health of older people are reviewed. The information relevant to this review was extracted from the WHO Global Oral Health Data Bank, the PubMed database, and the Cochrane Library. Surveys were carried out according to the criteria recommended by the WHO epidemiological manual Oral Health Surveys - Basic Methods. In addition, global data were sought on coverage of oral health care among older people. Finally, WHO policy documents on health care for aged people were gathered through the WHO website. Across the globe, many older people suffer from oral pain or discomfort. Poor oral health during old age is mostly manifest in high caries experience, high prevalence rates of advanced periodontal disease, severe tooth loss, dry mouth, and oral pre-cancer/cancer. In both developing and developed countries, the burden of disease is particularly high among underprivileged and disadvantaged older people. In numerous countries, high proportions of the aged population are not covered by primary oral health care; this is mainly the case in low and middle income countries due to a critical shortage of dentists. In 2015, the WHO published the World Report on Ageing and Health, which outlines a framework for action to foster healthy ageing. The policies are highly relevant to the improvement of oral health. Transformation of oral health systems away from a disease-based curative model and towards disease prevention, as well as the provision of older-person-centred integrated care are required. Moreover, wide-ranging public health action on ageing is urgently needed.

Psychosocial Issues in Engaging Older People with Physical Activity Interventions for the Prevention of Falls

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Nyman, Samuel R.

2011-01-01

This article presents an overview of the psychosocial factors that influence older people's participation in physical activity interventions to prevent falls. The importance of psychosocial factors is stressed inasmuch as interventions will be rendered useless if they do not successfully gain the active participation of older people. The theory of…

Self-reported skin concerns: An epidemiological study of community-dwelling older people.

Science.gov (United States)

Cowdell, Fiona; Dyson, Judith; Long, Judith; Macleod, Una

2018-03-25

To identify the frequency and impact of self-reported skin concerns in community-dwelling older people. Globally, the population is getting older and it is essential to develop effective interventions to promote healthy ageing. Skin change with age is inevitable and renders this often neglected organ more vulnerable to damage and breakdown; this can be costly to individuals and society. Maintenance of skin health in older people presents a health challenge that has yet to be fully understood or addressed. Cross-sectional, self-reported questionnaire survey in England. Patients registered with participating general practices (n = 3), aged ≥70 years, living in their own homes and able to give informed consent (n = 3,359) were sent a letter of invitation to a free health and care assessment, and 1116 responded. When asked "do you have any concerns about your skin?", 16.5% (n = 183) said yes. Of this group, the most common concerns were dry skin 80.7% (n = 146), itching 56.9% (n = 103) and aged appearance 61% (n = 113). Itch, dry skin and inflammation were rated as most bothersome. There was a significant association between the dry skin and itch χ 2 (1) = 6.9, p < .05. Many community-dwelling older people suffer from skin concerns predominantly dry skin and itching that is often bothersome. Skin health assessment is often absent in routine consultations with community-dwelling older people. Dry, itchy skin is prevalent and can be simply managed with low-cost interventions. This has the potential to reduce suffering and maintain or improve skin barrier function. Nurses and other health professionals should therefore routinely assess and advise on skin health care for this population. © 2018 John Wiley & Sons Ltd.

Smart technologies to enhance social connectedness in older people who live at home.

Science.gov (United States)

Morris, Meg E; Adair, Brooke; Ozanne, Elizabeth; Kurowski, William; Miller, Kimberly J; Pearce, Alan J; Santamaria, Nick; Long, Maureen; Ventura, Cameron; Said, Catherine M

2014-09-01

To examine the effectiveness of smart technologies in improving or maintaining the social connectedness of older people living at home. We conducted a systematic review and critical evaluation of research articles published between 2000 and 2013. Article screening, data extraction and quality assessment (using the Downs and Black checklist) were conducted by two independent researchers. Eighteen publications were identified that evaluated the effect of smart technologies on dimensions of social connectedness. Fourteen studies reported positive outcomes in aspects such as social support, isolation and loneliness. There was emerging evidence that some technologies augmented the beneficial effects of more traditional aged-care services. Smart technologies, such as tailored internet programs, may help older people better manage and understand various health conditions, resulting in subsequent improvements in aspects of social connectedness. Further research is required regarding how technological innovations could be promoted, marketed and implemented to benefit older people. © 2014 ACOTA.

The power(s) of observation: Theoretical perspectives on surveillance technologies and older people.

Science.gov (United States)

Mortenson, W Ben; Sixsmith, Andrew; Woolrych, Ryan

2015-03-01

There is a long history of surveillance of older adults in institutional settings and it is becoming an increasingly common feature of modern society. New surveillance technologies that include activity monitoring, and ubiquitous computing, which are described as ambient assisted living (AAL) are being developed to provide unobtrusive monitoring and support of activities of daily living and to extend the quality and length of time older people can live in their homes. However, concerns have been raised with how these kinds of technologies may affect user's privacy and autonomy. The objectives of this paper are 1) to describe the development of home-based surveillance technologies; 2) to examine how surveillance is being restructured with the use of this technology; and 3) to explore the potential outcomes associated with the adoption of AAL as a means of surveillance by drawing upon the theoretical work of Foucault and Goffman. The discussion suggests that future research needs to consider two key areas beyond the current discourse on technology and ageing, specifically: 1) how the new technology will encroach upon the private lived space of the individual, and 2) how it will affect formal and informal caring relationships. This is critical to ensure that the introduction of AAL does not contribute to the disempowerment of residents who receive this technology.

The power(s) of observation: Theoretical perspectives on surveillance technologies and older people

Science.gov (United States)

Mortenson, W. Ben; Sixsmith, Andrew; Woolrych, Ryan

2017-01-01

There is a long history of surveillance of older adults in institutional settings and it is becoming an increasingly common feature of modern society. New surveillance technologies that include activity monitoring, and ubiquitous computing, which are described as ambient assisted living (AAL) are being developed to provide unobtrusive monitoring and support of activities of daily living and to extend the quality and length of time older people can live in their homes. However, concerns have been raised with how these kinds of technologies may affect user’s privacy and autonomy. The objectives of this paper are 1) to describe the development of home-based surveillance technologies; 2) to examine how surveillance is being restructured with the use of this technology; and 3) to explore the potential outcomes associated with the adoption of AAL as a means of surveillance by drawing upon the theoretical work of Foucault and Goffman. The discussion suggests that future research needs to consider two key areas beyond the current discourse on technology and ageing, specifically: 1) how the new technology will encroach upon the private lived space of the individual, and 2) how it will affect formal and informal caring relationships. This is critical to ensure that the introduction of AAL does not contribute to the disempowerment of residents who receive this technology. PMID:29307944

Psychiatrists' and Psychiatry Residents' Attitudes Toward Transgender People.

Science.gov (United States)

Ali, Nareesa; Fleisher, William; Erickson, Julie

2016-04-01

Gender minority groups, such as transgender individuals, frequently encounter stigma, discrimination, and negative mental health outcomes, which can result in contact with mental health professionals. Recent studies suggest that negative attitudes toward transgender individuals are prevalent and measurable within the general population. The Genderism and Transphobia scale (GTS) measures anti-transgender feelings, thoughts, and behaviors. The purpose of this study was to use the GTS to conduct an investigation of psychiatrists' attitudes toward transgender individuals. A cross-sectional survey of n = 142 faculty members and residents from the Department of Psychiatry at the University of Manitoba was conducted. Respondents completed an online survey consisting of demographic questions and the GTS. Responses were analyzed descriptively and compared to previously published data on the GTS. There was a trend for psychiatrists and psychiatry residents within this sample to endorse less negative attitudes toward transgender people compared to other published data using a sample of undergraduate students. Descriptive analyses suggest that psychiatrists' and psychiatry residents' GTS scores may be related to gender identity, political ideology, religiosity, and levels of both professional and personal contact. These data evoke optimism regarding psychiatrists' and psychiatry residents' attitudes toward transgender individuals. Additional larger-scale studies comparing this medical specialty group with other specialty groups will further elucidate factors that modify physician attitudes toward this patient population. These findings may contribute to the development of educational strategies to ensure that the transgender population receives medical treatment without stigma or attitudinal compromise.

Mobility assessment in older people : new possibilities and challenges

NARCIS (Netherlands)

Zijlstra, Wiebren; Aminian, Kamiar

A major challenge for researchers and clinicians who address health issues in the ageing population is to monitor functioning, and to timely initiate interventions that aim to prevent loss of functional abilities and to improve the quality of life of older people. With the progress of technologies

Dietary Behaviors of Elderly People Residing in Central Iran: A Preliminary Report of Yazd Health Study (YAHS

Directory of Open Access Journals (Sweden)

Davood Bahrami

2016-06-01

Full Text Available Introduction: Food habits play important roles in maintaining physical and mental health and preventing chronic illnesses in the elderly. The aim of the present study was to investigate dietary behaviors of elderly people residing in Yazd city which is located in central Iran. Methods: The present analysis was conducted on 1684 participants entered to Yazd Health Study (YAHS aged over 60 years during 2014-2015. Demographic characteristics, health status, physical activity, economic status, education and dietary behaviors were collected by using a validated questionnaire. Results: Our analysis revealed that only 1.2% of the elderly consumed more than two servings of dairy per day. Furthermore only 3 and 9.8 percent of elders consumed more than three servings/day of vegetables and fruits, respectively. The study also showed that 22.9% ate more than five servings of sugar per day, 22.5% took more than four units of legumes weekly, 56.1% ate two to three servings of poultry per week, 77% reported eating fast foods for at least once a week, 47.8% consumed canned foods less than once a week of and 86.3% reported taking breakfast for at least five times a week. For cooking 18.9% of elderly still use hydrogenated vegetable oils, 52.8% of the elderly did not separate visible fats from red meat before cooking, 65.8% chose high-fat dairy and  24% of older people reported using frying and grilling as their primary cooking method. Our findings also suggest that dietary behavior is different between elder men and women. Conclusion: Unhealthy dietary habits, including low vegetables, fruits and dairy products intake, are highly prevalent among elderly people residing in Yazd. Community based interventions targeting this age group, in order to improve their dietary intake, are highly recommended.

Cholesterol Drugs for People 75 and Older: When You Need Them and When You Don't

Science.gov (United States)

® Cholesterol drugs for people 75 and older When you need them—and when you don’t Y our body makes a waxy substance ... statins to prevent heart disease. But for older people, there is no clear evidence that high cholesterol ...

A Pilot Physical Activity Initiative to Improve Mental Health Status amongst Iranian Institutionalized Older People

Directory of Open Access Journals (Sweden)

Hossein Matlabi

2014-07-01

Full Text Available Background: Sufficient level of physical activity may promote overall and mental health of old people. This study was carried out to investigate the practicability of a physical activity promotion initiative amongst institutionalized older people in Tabriz, Iran. Methods: Purposive sampling method was used in this semi-experimental study to recruit 31 older people living in a selected residential care in Tabriz. Moderate-intensity aerobic and muscle-strengthening activity was planned for those who had not severe baseline cognitive impairment or were not too frail to undertake the survey. The General Health Questionnaire (GHQ-28 was used to measure mental health status before and after intervention through a face-to-face interview. Descriptive statistics, Wilkcoxon rank-sum, Mann–Whitney U and Chi-Square tests were employed to analyses the data. Results: The applied intervention was significantly improved status of physical health, anxiety and insomnia, social dysfunction and severe depression. Conclusion: Incorporation of physical activity promotion programs into routines of older people residential care homes in Iran is feasible but may need training of physical activity specialists to work with older people based on their physical endurance and limitations.

Knowledge and attitudes of doctors toward the sexuality of older people in Turkey.

Science.gov (United States)

Dogan, Sultan; Demir, Basaran; Eker, Engin; Karim, Salman

2008-10-01

Few studies have looked at healthcare professionals' knowledge of and attitudes to later life sexuality in both Western and Eastern cultures. Here we examine the attitudes and knowledge of Turkish medical doctors toward sexuality in older people. Eighty-seven doctors, from various specialties, who were directly involved in the care of older people, were contacted by post and asked to complete the Turkish version of the Aging Sexual Knowledge and Attitudes Scale (ASKAS). A majority of physicians indicated that they had limited information and knowledge regarding sexual health issues in older people (69%). Although a small percentage (14.5%) reported that they "always" discuss sexuality and sexual problems with older patients, the majority (69%) indicated that they "sometimes" raise questions about sexuality with these patients. A high percentage (81%) stated that they would be helpful and receptive should an elderly patient initiate a discussion about sexual issues. Most participants (77%) thought that the patient's gender was of no importance when taking a sexual history. Overall, the responses to ASKAS showed that physicians had limited knowledge but their attitude was positive toward sexuality in the elderly. Female physicians had less knowledge than males and had more negative attitudes toward sexuality in this age group. Total and knowledge subscale scores of ASKAS showed that older physicians had more knowledge than younger physicians but similar attitudes. A comparison of the knowledge and attitude scores of psychiatrists, surgeons and non-surgeons showed no significant difference among the three groups. This study identified a low level of awareness of later life sexuality among Turkish medical doctors. These findings identify a need to improve the education and training of doctors at both undergraduate and postgraduate levels to enable them to provide better sexual health care to older people.

Social marketing strategies for reaching older people with disabilities: findings from a survey of centers for independent living participants.

Science.gov (United States)

Moone, Rajean Paul; Lightfoot, Elizabeth

2009-01-01

Centers for independent living (CILs) provide critical supports, services, and advocacy for assisting people with disabilities in living independently. As there is a rapidly increasing population of older people with disabilities, many CILs are now considering how to actively engage older adults in their organizations. This study utilized a survey of older people with disabilities to help identify social marketing techniques that community organizations like CILs can use to effectively reach older people with disabilities. Utilizing the components of the social marketing mix in designing outreach efforts, including a critical examination of product, place, price, participants, and partnering, CILs and other community agencies can better reach older adults with disabilities.

Early signs of mobility decline and physical activity counseling as a preventive intervention in older people

DEFF Research Database (Denmark)

Mänty, Minna Regina

indicate that self-reported preclinical mobility limitation and fall history should be considered as important early indicators of functional decline among community-dwelling older adults. In addition, the results suggest that physical activity counseling for older adults may provide an effective means......The purpose of this study was to examine the early signs of mobility decline and falls in older people. In addition, the effects of physical activity counseling on the development of mobility limitation in an older community-dwelling population were studied. Data from two larger studies were used......: Screening and Counseling for Physical activity and Mobility among Older People, SCAMOB, a 2-year single-blinded randomized controlled trial (n=632) with a 1.5-year post-intervention follow-up, focused on 75 to 81-year-old community-dwelling people and the FITSA study, a 3-year prospective observational...

Understanding the experiences of racialized older people through an intersectional life course perspective.

Science.gov (United States)

Ferrer, Ilyan; Grenier, Amanda; Brotman, Shari; Koehn, Sharon

2017-04-01

This article proposes the development of an intersectional life course perspective that is capable of exploring the links between structural inequalities and the lived experience of aging among racialized older people. Merging key concepts from intersectionality and life course perspectives, the authors suggest an analytic approach to better account for the connections between individual narratives and systems of domination that impinge upon the everyday lives of racialized older people. Our proposed intersectional life course perspective includes four dimensions: 1) identifying key events and their timing, 2) examining locally and globally linked lives, 3) exploring categories of difference and how they shape identities, 4) and assessing how processes of differentiation, and systems of domination shape the lives, agency and resistance among older people. Although applicable to various forms of marginalization, we examine the interplay of racialization, immigration, labour and care in later life to highlight relationships between systems, events, trajectories, and linked lives. The illustrative case example used in this paper emerged from a larger critical ethnographic study of aging in the Filipino community in Montreal, Canada. We suggest that an intersectional life course perspective has the potential to facilitate a deeper understanding of the nexus of structural, personal and relational processes that are experienced by diverse groups of older people across the life course and into late life. Copyright © 2017 Elsevier Inc. All rights reserved.

Loneliness and social support of older people in China: a systematic literature review.

Science.gov (United States)

Chen, Yu; Hicks, Allan; While, Alison E

2014-03-01

Loneliness is a serious problem for older people, which can be alleviated by social support. The dramatic population ageing together with social and economic change in China increases the likelihood of loneliness and the availability of different sources of social support of older people. The aim of this review was to identify the prevalence of loneliness and its related factors and sources of social support of older people in China. Electronic literature searches were conducted in September 2011 using Web of Science, PsycINFO, MEDLINE, PubMed, CINAHL, China Academic Journal and VIP Database for Chinese Technical Periodicals. Twenty-six papers were identified and reviewed. The prevalence of loneliness varied across the studies, reflecting the different measurements and samples. Marital status, gender, age, educational level, economic level, living arrangements, health status and social support were significant factors related to loneliness. The family was the most important source of social support followed by friends. The receipt of family support improved subjective well-being and mental health, but the effects of support from friends were inconsistent. Chinese older people received relatively little support from neighbours, governmental or other social organisations. Further well-designed studies are needed to identify additional factors related to loneliness and to understand the support from friends, neighbours, formal organisations and other sources. © 2013 John Wiley & Sons Ltd.

Stress and Depression among Older Residents in Religious Monasteries: Do Friends and God Matter?

Science.gov (United States)

Bishop, Bishop J.

2008-01-01

The purpose of this investigation was to explore how friendship and attachment to God provide protective benefits against stress and depression. Participants included 235 men and women, age 64 and older, residing in religious monasteries affiliated with the Order of St. Benedict. Hierarchical multiple regression analyses were completed to assess…

How nurses restore and maintain mobility in hospitalised older people: An integrative literature review.

Science.gov (United States)

Constantin, Stephanie; Dahlke, Sherry

2018-05-17

The aim of this integrative review of the literature was to evaluate and summarise current research about how nurses maintain and improve hospitalised older peoples' mobility levels. Older persons make up the majority of healthcare recipients, and they are at risk to experience significant decline in their mobility once hospitalised. This can result in longer hospitalisations or nursing home admissions. Currently, it is not well understood how nurses maintain and restore mobility of hospitalised older persons. An integrative literature review using key concepts related to hospitalised older people, mobility and nursing care was conducted. Whittemore and Khalf's five-stage methodological framework for integrative reviews was utilised. Two reviewers screened 1640 resources from four computerised databases published in English during 2000-2017. Reviewers used the Mixed Methods Appraisal Tool (MMAT) and CASP quality appraisal tools to assess the thirteen included articles. The findings of this review reveal that little is known about how frequently nurses are mobilising, that many nurses perceive mobilising older patients to be physiotherapy's responsibility and that education about mobilisation can improve nurses' willingness to mobilise people. By investing in education and training programmes targeted for nurses, nurses can feel empowered in their ability to mobilise patients and are encouraged to take ownership of their patient's functional needs. In order to facilitate mobility, adequate staffing levels are necessary for transferring and ambulation, mobility assistive devices such as walkers and canes and environments with adequate space to mobilise. More research is needed to better understand and overcome barriers that nurses face in mobilised older people in acute care. The nursing team can work together to prioritise mobilisation to assist in restoring and maintaining the function of hospitalised older people. Educators could review their mobility programmes

Associations between multidimensional frailty and quality of life among Dutch older people.

Science.gov (United States)

Gobbens, Robbert J J; van Assen, Marcel A L M

2017-11-01

To examine the associations between components of physical, psychological and social frailty with quality of life among older people. This cross-sectional study was carried out in a sample of Dutch citizens. A total of 671 people aged 70 years or older completed a web-based questionnaire ('the Senioren Barometer'). This questionnaire contained the Tilburg Frailty Indicator (TFI) for measuring physical, psychological and social frailty, and the WHOQOL-OLD for measuring six quality of life facets (sensory abilities, autonomy, past, present and future activities, social participation, death and dying, intimacy) and quality of life total. Nine of fifteen individual frailty components had an effect on at least one facet of quality of life and quality of life total, after controlling for socio-demographic factors, multimorbidity and the other frailty components. Of these nine components five, two and two refer to physical, psychological and social frailty, respectively. Feeling down was the only frailty component associated with all quality of life facets and quality of life total. Both physical inactivity and lack of social relations were associated with four quality of life facets and quality of life total. This study showed that quality of life in older people is associated with physical, psychological and social frailty components, emphasizing the importance of a multidimensional assessment of frailty. Health care and welfare professionals should in particular pay attention to feeling down, physical inactivity and lack of social relations among older people, because their relation with quality of life seems to be the strongest. Copyright © 2017 Elsevier B.V. All rights reserved.

The care of and communication with older people from the perspective of student nurses. A mixed method study.

Science.gov (United States)

Hammar, Lena Marmstål; Holmström, Inger K; Skoglund, Karin; Meranius, Martina Summer; Sundler, Annelie J

2017-05-01

Undergraduate nurse education needs to prepare student nurses to meet the demands and to have the necessary communication skills for caring for an increasing older population. The challenges involve how best to support and empower student nurses to learn the communication skills needed to care for older people. The aim of this study was to investigate student nurses' views on the care of and communication with older people. A descriptive study with a mixed-method approach was conducted. Quantitative and qualitative data were collected from a questionnaire completed by third-year Swedish student nurses in 2015. The student nurses reported positive attitudes to the care of and communication with older people. The findings focus on the central aspects related to relationship building, techniques for communication and external prerequisites. Despite positive attitudes, student nurses had a limited view of communication with older people. Educators need to increase student nurses' capacity to communicate effectively with older people. Educational interventions to improve and evaluate the communication competency of nurses and student nurses are needed. Copyright © 2017 Elsevier Ltd. All rights reserved.

What determines the preference for future living arrangements of middle-aged and older people in urban China?

Science.gov (United States)

Meng, Dijuan; Xu, Guihua; He, Ling; Zhang, Min; Lin, Dan

2017-01-01

Living arrangements are important to the elderly. However, it is common for elderly parents in urban China to not have a living situation that they consider ideal. An understanding of their preferences assists us in responding to the needs of the elderly as well as in anticipating future long-term care demands. The aim of this study is to provide a clear understanding of preferences for future living arrangements and their associated factors among middle-aged and older people in urban China. Data were extracted from the CHARLS 2011-2012 national baseline survey of middle-aged and elderly people. In the 2011 wave of the CHARLS, a total of 17,708 individual participants (10,069 main respondents and 7,638 spouses) were interviewed; 2509 of the main respondents lived in urban areas. In this group, 41 people who were younger than 45 years old and 162 who had missing data in the variable "living arrangement preference" were excluded. Additionally, 42 people were excluded because they chose "other" for the variable "living arrangement preference" (which was a choice with no specific answer). Finally, a total of 2264 participants were included in our study. The most popular preference for future living arrangements was living close to their children in the same community/neighborhoods, followed by living with adult children. The degree of community handicapped access, number of surviving children, age, marital status, access to community-based elderly care centers and number of years lived in the same community were significantly associated with the preferences for future living arrangements among the respondents. There is a trend towards preference for living near adult children in urban China. Additionally, age has a positive effect on preference for living close to their children. Considerations should be made in housing design and urban community development plans to fulfill older adults' expectations. In addition, increasing the accessibility of public facilities in

How do we incorporate patient views into the design of healthcare services for older people: a discussion paper.

Science.gov (United States)

Brocklehurst, Paul R; McKenna, Gerald; Schimmel, Martin; Kossioni, Anastassia; Jerković-Ćosić, Katarina; Hayes, Martina; da Mata, Cristiane; Müller, Frauke

2018-04-06

Across the European Union costs for the treatment of oral disease is expected to rise to €93 Billion by 2020 and be higher than those for stroke and dementia combined. A significant proportion of these costs will relate to the provision of care for older people. Dental caries severity and experience is now a major public health issue in older people and periodontal disease disproportionately affects older adults. Poor oral health impacts on older people's quality of life, their self-esteem, general health and diet. Oral health care service provision for older people is often unavailable or poor, as is the standard of knowledge amongst formal and informal carers. The aim of this discussion paper is to explore some of the approaches that could be taken to improve the level of co-production in the design of healthcare services for older people. People's emotional and practical response to challenges in health and well-being and the responsiveness of systems to their needs is crucial to improve the quality of service provision. This is a particularly important aspect of care for older people as felt, expressed and normative needs may be fundamentally different and vary as they become increasingly dependent. Co-production shifts the design process away from the traditional 'top-down' medical model, where needs assessments are undertaken by someone external to a community and strategies are devised that encourage these communities to become passive recipients of services. Instead, an inductive paradigm of partnership working and shared leadership is actively encouraged to set priorities and ultimately helps improve the translational gap between research, health policy and health-service provision. The four methodological approaches discussed in this paper (Priority Setting Partnerships, Discrete Choice Experiments, Core Outcome Sets and Experience Based Co-Design) represent an approach that seeks to better engage with older people and ensure an inductive, co

Is the Australian 75+ Health Assessment person-centred? A qualitative descriptive study of older people's perceptions.

Science.gov (United States)

Price, Kay; Grimmer, Karen; Foot, Jan

2017-12-01

Objective The aim of the present study was to explore the perspectives of older people following their recent participation in a 75+ Health Assessment (75+HA) and interrogate these perspectives using a person-centred lens. Methods A qualitative descriptive study design was used within a larger study funded by the Australian Primary Health Care Research Institute. Nineteen participants from four different general practices in one Australian state described their perceptions of the 75+HA in a face-to-face interview. Data were then analysed using a qualitative content analysis approach. Results The purpose of the 75+HA was not well understood by participants. Participant responses reveal that where, when, who and how a primary health professional conducted the 75+HA affected what older people talked about, the guidance they sought to deal with issues and, in turn, the actioning of issues that were discussed during the 75+HA. Conclusion To enable older people to make informed decisions about and successfully manage their own health and well being, and to choose when to invite others to act on their behalf, primary health professionals need to ask questions in the 75+HA within a person-centred mindset. The 75+HA is an opportunity to ensure older people know why they need support, which ones, and agree to, supports and services they require. What is known about the topic? The Australian Medicare Benefits Schedule includes the 75+HA, developed as a proactive primary care opportunity for general practitioners and practice nurses to identify issues affecting community-dwelling older people's health and well being. The aim of the 75+HA is to consider a broad range of factors that could affect physical, psychological and social functioning, which, in turn, affects overall health, and the capacity of older people to live independently in the community. Underlying the 75+HA is the importance of detecting early functional decline to enable healthy aging. What does this paper add

Effect of the conditional cash transfer program Oportunidades on vaccination coverage in older Mexican people

Science.gov (United States)

2013-01-01

Background Immunization is one of the most effective ways of preventing illness, disability and death from infectious diseases for older people. However, worldwide immunization rates are still low, particularly for the most vulnerable groups within the elderly population. The objective of this study was to estimate the effect of the Oportunidades -an incentive-based poverty alleviation program- on vaccination coverage for poor and rural older people in Mexico. Methods Cross-sectional study, based on 2007 Oportunidades Evaluation Survey, conducted in low-income households from 741 rural communities (localities with <2,500 inhabitants) of 13 Mexican states. Vaccination coverage was defined according to three individual vaccines: tetanus, influenza and pneumococcal, and for complete vaccination schedule. Propensity score matching and linear probability model were used in order to estimate the Oportunidades effect. Results 12,146 older people were interviewed, and 7% presented cognitive impairment. Among remaining, 4,628 were matched. Low coverage rates were observed for the vaccines analyzed. For Oportunidades and non-Oportunidades populations were 46% and 41% for influenza, 52% and 45% for pneumococcal disease, and 79% and 71% for tetanus, respectively. Oportunidades effect was significant in increasing the proportion of older people vaccinated: for complete schedule 5.5% (CI95% 2.8-8.3), for influenza 6.9% (CI95% 3.8-9.6), for pneumococcal 7.2% (CI95% 4.3-10.2), and for tetanus 6.6% (CI95% 4.1-9.2). Conclusions The results of this study extend the evidence on the effect that conditional transfer programs exert on health indicators. In particular, Oportunidades increased vaccination rates in the population of older people. There is a need to continue raising vaccination rates, however, particularly for the most vulnerable older people. PMID:23835202

Demographic and psychosocial correlates of sexual activity in older Chinese people.

Science.gov (United States)

Yang, Shuyan; Yan, Elsie

2016-03-01

This study examines sexual activity and associated psychosocial factors in older Chinese people. Sexuality continues to play a pivotal role in our lives even as we grow old. There is, however, very limited research on the topic in older populations. Cross-sectional survey. A representative sample of 688 older Chinese people (>60 years old) were individually interviewed on their demographic characteristics; their interest in, knowledge of and perceived control over sexual activities; and their engagement in sexual activity. The results show that 51·32% of men and 41·26% of women reported engaging in some form of sexual activity. Sexual intercourse and caressing were commonly reported. A multiple regression analysis also showed that a higher level of sexual activity was associated with being younger, living with a spouse, having a strong interest in sex, having sufficient knowledge of elder sexuality and a high perceived control over sex. Distinct predictive factors in each gender were observed. A high level of perceived control was associated with a higher level of sexual activity in males but not females. A series of binary logistic regression analyses were conducted to determine the demographic and psychosocial correlates of sexual activity. With the exception of the use of objects (sex toys), sexual activities were consistently associated with being younger; living with a spouse; and having high levels of interest, knowledge and perceived control. A sizable amount of older Chinese people engage in varying degrees of sexual activity, and most are still interested in sex. Frontline health professionals need to be aware of the growing needs for sex education in older persons, particular attention should be paid to discuss the limitations brought about by various chronic conditions associated with ageing and their relevance to elder sexuality. © 2015 John Wiley & Sons Ltd.

The impact of the economic recession on well-being and quality of life of older people.

Science.gov (United States)

Fenge, Lee-Ann; Hean, Sarah; Worswick, Louise; Wilkinson, Charlie; Fearnley, Stella; Ersser, Steve

2012-11-01

The importance of economic well-being is recognised in the recent UK Government policy. Older people may be particularly vulnerable to economic fluctuations as they are reliant on fixed incomes and assets, which are reducing in value. Within the literature, little is understood about the impact of the current economic downturn on people's general quality of life and well-being and, in particular, there is little research on the financial experiences and capability of the older age group, a concern in light of the ageing UK population. This article reports a qualitative research study into the nature of older peoples' vulnerability by exploring their perceptions of the impact of the economic recession on their well-being and quality of life. It explores specifically a group of older people who are not the poorest within the ageing population, but who may be described as the 'asset rich-income poor' group. Key themes relate to the impact of the recession on the costs of essential and non-essential items and dimensions of mental, physical and social well-being. Implications for health and social care practice in meeting the needs of older people during times of economic recession are then explored. The paper adds to the debate by demonstrating that the recession is having adverse consequences for older people's quality of life in terms of economic, mental and social well-being, although there is also evidence that some of them are equipped with certain resilience factors due to their money management and budgeting skills. © 2012 Blackwell Publishing Ltd.

Prevalence and Clinical Correlates of Sarcopenia in Community-Dwelling Older People: Application of the EWGSOP Definition and Diagnostic Algorithm

Science.gov (United States)

2014-01-01

Background. Muscle impairment is a common condition in older people and a powerful risk factor for disability and mortality. The aim of this study was to apply the European Working Group on Sarcopenia in Older People criteria to estimate the prevalence and investigate the clinical correlates of sarcopenia, in a sample of Italian community-dwelling older people. Methods. Cross-sectional analysis of 730 participants (74% aged 65 years and older) enrolled in the InCHIANTI study. Sarcopenia was defined according to the European Working Group on Sarcopenia in Older People criteria using bioimpedance analysis for muscle mass assessment. Logistic regression analysis was used to identify the factors independently associated with sarcopenia. Results. Sarcopenia defined by the European Working Group on Sarcopenia in Older People criteria increased steeply with age (p Nutritional intake, physical activity, and level of comorbidity were not associated with sarcopenia. Conclusions. Sarcopenia identified by the European Working Group on Sarcopenia in Older People criteria is a relatively common condition in Italian octogenarians, and its prevalence increases with aging. Correlates of sarcopenia identified in this study might suggest new approaches for prevention and treatment of sarcopenia. PMID:24085400

Infection control strategies for preventing the transmission of meticillin-resistant Staphylococcus aureus (MRSA) in nursing homes for older people.

Science.gov (United States)

Hughes, Carmel; Smith, Michael; Tunney, Michael; Bradley, Marie C

2011-12-07

Nursing homes for older people provide an environment likely to promote the acquisition and spread of meticillin-resistant Staphylococcus aureus (MRSA), putting residents at increased risk of colonisation and infection. It is recognised that infection prevention and control strategies are important in preventing and controlling MRSA transmission. To determine the effects of infection prevention and control strategies for preventing the transmission of MRSA in nursing homes for older people. We searched the Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library 2011, Issue 2), the Cochrane Wounds Group Specialised Register (searched May 27th, 2011). We also searched Ovid MEDLINE (from 1950 to April Week 2 2011), OVID MEDLINE (In-process and Other Non-Indexed Citations, April 26th 2011) Ovid EMBASE (1980 to 2011 Week 16), EBSCO CINAHL (1982 to April 21st 2011), DARE (1992 to 2011, week 16), Web of Science (1981 to May 2011), and the Health Technology Assessment (HTA) website (1988 to May 2011). Research in progress was sought through Current Clinical Trials (www.controlled-trials.com), Medical Research Council Research portfolio, and HSRPRoj (current USA projects). All randomised and controlled clinical trials, controlled before and after studies and interrupted time series studies of infection prevention and control interventions in nursing homes for older people were eligible for inclusion. Two review authors independently reviewed the results of the searches. Another review author appraised identified papers and undertook data extraction which was checked by a second review author. For this second update only one study was identified, therefore it was not possible to undertake a meta-analysis. A cluster randomised controlled trial in 32 nursing homes evaluated the effect of an infection control education and training programme on MRSA prevalence. The primary outcome was MRSA prevalence in residents and staff, and a change in infection

Influences on emergency department length of stay for older people.

Science.gov (United States)

Street, Maryann; Mohebbi, Mohammadreza; Berry, Debra; Cross, Anthony; Considine, Julie

2018-02-14

The aim of this study was to examine the influences on emergency department (ED) length of stay (LOS) for older people and develop a predictive model for an ED LOS more than 4 h. This retrospective cohort study used organizational data linkage at the patient level from a major Australian health service. The study population was aged 65 years or older, attending an ED during the 2013/2014 financial year. We developed and internally validated a clinical prediction rule. Discriminatory performance of the model was evaluated by receiver operating characteristic (ROC) curve analysis. An integer-based risk score was developed using multivariate logistic regression. The risk score was evaluated using ROC analysis. There were 33 926 ED attendances: 57.5% (n=19 517) had an ED LOS more than 4 h. The area under ROC for age, usual accommodation, triage category, arrival by ambulance, arrival overnight, imaging, laboratory investigations, overcrowding, time to be seen by doctor, ED visits with admission and access block relating to ED LOS more than 4 h was 0.796, indicating good performance. In the validation set, area under ROC was 0.80, P-value was 0.36 and prediction mean square error was 0.18, indicating good calibration. The risk score value attributed to each risk factor ranged from 2 to 68 points. The clinical prediction rule stratified patients into five levels of risk on the basis of the total risk score. Objective identification of older people at intermediate and high risk of an ED LOS more than 4 h early in ED care enables targeted approaches to streamline the patient journey, decrease ED LOS and optimize emergency care for older people.

Losing connections and receiving support to reconnect: experiences of frail older people within care programmes implemented in primary care settings.

Science.gov (United States)

Bindels, Jill; Cox, Karen; De La Haye, Jean; Mevissen, Ger; Heijing, Servé; van Schayck, Onno C P; Widdershoven, Guy; Abma, Tineke A

2015-09-01

The objective of this study was to evaluate whether care provided in the care programmes matched the needs of older people. Care programmes were implemented in primary-care settings in the Netherlands to identify frail older people and to prevent further deterioration of health. In total, 23 older people participated in in-depth interviews. Within this study, three older people participated as co-researchers; they gathered and analysed the data together with the academic researchers. Content analysis was used to analyse the data. Two categories emerged from the data: 'Losing connections' and 'Receiving support to reconnect.' 'Losing connections' reflects the needs of older people and 'Receiving support to reconnect' reflects their experience and the appreciated aspects of the provided care. A relationship of trust with the practice nurse (PN) appeared to be an important aspect of care, as it fostered the sharing of feelings and issues other than physical or medical problems that could not be shared with the general practitioner. The PNs are experienced as connectors, who help to restore feelings of connectedness and older peoples' access to resources in the community. The relationship with the PN was experienced as valuable because of the feelings of 'connectedness' it created. Through this connectedness, older people could discuss feelings of loneliness, depression and frustration in receiving and acquiring the appropriate resources and services with the PNs. Furthermore, the relationship with the PN helped the older people to gain access to other health professionals and services. The results imply that care for frail older people should include an awareness of the importance of the trusting relationship. Nurses can play a vital role in creating a trusting relationship and are able to bridge the gap between older people and other professionals and services. © 2014 John Wiley & Sons Ltd.

Economic evaluation of a multifactorial, interdisciplinary intervention versus usual care to reduce frailty in frail older people.

Science.gov (United States)

Fairhall, Nicola; Sherrington, Catherine; Kurrle, Susan E; Lord, Stephen R; Lockwood, Keri; Howard, Kirsten; Hayes, Alison; Monaghan, Noeline; Langron, Colleen; Aggar, Christina; Cameron, Ian D

2015-01-01

To compare the costs and cost-effectiveness of a multifactorial interdisciplinary intervention versus usual care for older people who are frail. Cost-effectiveness study embedded within a randomized controlled trial. Community-based intervention in Sydney, Australia. A total of 241 community-dwelling people 70 years or older who met the Cardiovascular Health Study criteria for frailty. A 12-month multifactorial, interdisciplinary intervention targeting identified frailty characteristics versus usual care. Health and social service use, frailty, and health-related quality of life (EQ-5D) were measured over the 12-month intervention period. The difference between the mean cost per person for 12 months in the intervention and control groups (incremental cost) and the ratio between incremental cost and effectiveness were calculated. A total of 216 participants (90%) completed the study. The prevalence of frailty was 14.7% lower in the intervention group compared with the control group at 12 months (95% CI 2.4%-27.0%; P = .02). There was no significant between-group difference in EQ-5D utility scores. The cost for 1 extra person to transition out of frailty was $A15,955 (at 2011 prices). In the "very frail" subgroup (participants met >3 Cardiovascular Health Study frailty criteria), the intervention was both more effective and less costly than the control. A cost-effectiveness acceptability curve shows that the intervention would be cost-effective with 80% certainty if decision makers were willing to pay $A50,000 per extra person transitioning from frailty. In the very frail subpopulation, this reduced to $25,000. For frail older people residing in the community, a 12-month multifactorial intervention provided better value for money than usual care, particularly for the very frail, in whom it has a high probability of being cost saving, as well as effective. Trial registration: ACTRN12608000250336. Copyright © 2015 AMDA – The Society for Post-Acute and Long-Term Care

Urinary incontinence in older people living in the community: examining help-seeking behaviour.

NARCIS (Netherlands)

Teunissen, T.A.M.; Weel, C. van; Lagro-Janssen, A.L.M.

2005-01-01

BACKGROUND: Only a small proportion of older people with urinary incontinence seek help, despite the availability of adequate treatment. AIM: To ascertain the patient- and disease-specific factors that determine whether medical care for urinary incontinence is sought by independently living older

Understanding factors influencing vulnerable older people keeping warm and well in winter: a qualitative study using social marketing techniques.

Science.gov (United States)

Tod, Angela Mary; Lusambili, Adelaide; Homer, Catherine; Abbott, Joanne; Cooke, Joanne Mary; Stocks, Amanda Jayne; McDaid, Kathleen Anne

2012-01-01

To understand the influences and decisions of vulnerable older people in relation to keeping warm in winter. A qualitative study incorporating in-depth, semi-structured individual and group interviews, framework analysis and social marketing segmentation techniques. Rotherham, South Yorkshire, UK. 50 older people (>55) and 25 health and social care staff underwent individual interview. The older people also had household temperature measurements. 24 older people and 19 health and social care staff participated in one of the six group interviews. Multiple complex factors emerged to explain whether vulnerable older people were able to keep warm. These influences combined in various ways that meant older people were not able to or preferred not to access help or change home heating behaviour. Factors influencing behaviours and decisions relating to use of heating, spending money, accessing cheaper tariffs, accessing benefits or asking for help fell into three main categories. These were situational and contextual factors, attitudes and values, and barriers. Barriers included poor knowledge and awareness, technology, disjointed systems and the invisibility of fuel and fuel payment. Findings formed the basis of a social marketing segmentation model used to develop six pen portraits that illustrated how factors that conspire against older people being able to keep warm. The findings illustrate how and why vulnerable older people may be at risk of a cold home. The pen portraits provide an accessible vehicle and reflective tool to raise the capacity of the NHS in responding to their needs in line with the Cold Weather Plan.

How older people with incurable cancer experience daily living: A qualitative study from Norway.

Science.gov (United States)

Haug, Sigrid Helene Kjørven; Danbolt, Lars J; Kvigne, Kari; Demarinis, Valerie

2015-08-01

An increasing number of older people are living with incurable cancer as a chronic disease, requiring palliative care from specialized healthcare for shorter or longer periods of time. The aim of our study was to describe how they experience daily living while receiving palliative care in specialized healthcare contexts. We conducted a qualitative research study with a phenomenological approach called "systematic text condensation." A total of 21 participants, 12 men and 9 women, aged 70-88, took part in semistructured interviews. They were recruited from two somatic hospitals in southeastern Norway. The participants experienced a strong link to life in terms of four subthemes: to acknowledge the need for close relationships; to maintain activities of normal daily life; to provide space for existential meaning-making and to name and handle decline and loss. In addition, they reported that specialized healthcare contexts strengthened the link to life by prioritizing and providing person-centered palliative care. Older people with incurable cancer are still strongly connected to life in their daily living. The knowledge that the potential for resilience remains despite aging and serious decline in health is considered a source of comfort for older people living with this disease. Insights into the processes of existential meaning-making and resilience are seen as useful in order to increase our understanding of how older people adapt to adversity, and how their responses may help to protect them from some of the difficulties inherent to aging. Healthcare professionals can make use of this information in treatment planning and for identification of psychosocial and sociocultural resources to support older people and to strengthen patients' life resources.

Coffee, Cake & Culture: Evaluation of an art for health programme for older people in the community.

Science.gov (United States)

Roe, Brenda; McCormick, Sheila; Lucas, Terri; Gallagher, Wendy; Winn, Andrea; Elkin, Sophie

2016-07-01

Arts for health initiatives and networks are being developed in a number of countries and an international literature is emerging on the evidence of their benefits to people's health, wellbeing and quality of life. Engagement in cultural and creative arts by older people can increase their morale and self-confidence and provides opportunities for social connection. Museums and galleries are increasingly required to justify their expenditure, reach and impact and some are working in partnership with local councils, hospitals, schools and communities to improve access to their collections. There is a body of literature emerging that describes such initiatives but empirical evidence of their benefits is less developed. This article reports an evaluation of an art for health initiative - Coffee, Cake & Culture organised and delivered by Whitworth Art Gallery and Manchester Museum in 2012 for older people living in a care home and a supported living facility. The study has identified the benefits and impacts of the arts for health programme and its feasibility for older people, with or without diagnosed memory loss - dementia, living in a care home or supported living facility and their care staff. The findings demonstrate there were benefits to the older people and their care staff in terms of wellbeing, social engagement, learning, social inclusion and creativity. These benefits were immediate and continued in the short term on their return home. The majority of older people and care staff had not previously been to the art gallery or museum and the programme encouraged creative arts and cultural appreciation which promoted social inclusion, wellbeing and quality of life. The programme is feasible and important lessons were identified for future planning. Further research involving partnerships of researchers, arts for health curators, artists, care staff, older people and their families is warranted. © The Author(s) 2014.