Relatos de experiências: (com) vivência com idosos que apresentam alzheimer / Experiences reports: living with elderly people who present alzheimer

Este artigo trata do relato de um projeto de extensão que apresentacomo objetivo oferecer aos idosos com Alzheimer atividadesfísicas, fisioterápicas e arteterapia. Oportunizam-se aos cuidadoresatividades de apoio psicossocial. O projeto acontece há um ano eos resultados mostram o quanto é importante para os idosos, emboraa maioria desses já esteja na segunda fase da doença, poisas atividades oferecidas colaboram para a sua socialização, paramanutenção da sua capacidade funcional e percepções de sentimentos,afetos e lembranças. Aos cuidadores serve como apoiopara o enfrentamento desse momento difícil e pesaroso das suasvidas. Neste trabalho relatam-se resultados da experiência somentecom os idosos que apresentam diagnóstico possível e provável deAlzheimer.

This article treats about the report of an extention Project that showsas a purpose to give to the elderly people physical, physiotherapyand art-therapy activities. It has been given pychosocial support tothe people who are responsible for taking care of them. The projecthas been happening for one year and the results show how much itis important to the elderly people, although most of them are alreadyin the second level of the illness, because the activities offered helpfor their socialization, for the maintenance of their functional capacitiesand feeling perceptions, affection and memories. To the peoplewho are taking care of the elderly, the project serves as a supportto face this difficult and hard moment of their lives. In this paper arereported the results and experiences only with the old people whoshow possible and probable Alzheimer diagnosis.

Comparative study on P300 of patients with non-demented Parkinson's disease and mismatch negativity / 中国基层医药

0.05).P300 and amplitudes of the mismatch negativity(MMN) of group A were lower than that of group B.PL of MMN was obviously prolonged.By comparing PL of group A with thar of group B,there was obvious difference(P

The Reality of Services for Families with Demented Elderly People

OBJECTIVES: The purpose of this study was to look into caregivers who took care of their demented elderly family members in an effort to find out what types of services they actually called for and how to make a diagnosis of demented elderly people, provide treatment to them and make an intervention for their families at the same time. METHODS: The subjects in this study were 61 psychiatrists, neurologists and rehabilitation doctors who were in charge of demented elderly people, and they were members of the Korean Geriatrics Society and Korean Association for Geriatric Psychiatry. RESULTS: As for interest in helping caregivers for demented elderly people get rid of their stress, 45.9 percent (28 doctors) of the medical personnels investigated answered they tended to have lots of interest in that. To get them to dispel their stress, they conducted education (13 doctors), offered supportive treatment and encouragement (24 doctors) or provide mental treatment and encouragement (24 doctors) or provide mental treatment or medication if necessary (8 doctors). CONCLUSION: Medical intervention should be carried out to alleviate the behavioral and psychological symptoms of the elderly with dementia to help their caregivers not to be under pressure. Their stress should be managed in a systematic manner according to the dementia grade of patients they look after. A sort of one-stop service network should be built to lend assistance to main caregivers, and the government should set up a family support policy for them.

The Reality of Services for Families with Demented Elderly People

OBJECTIVES: The purpose of this study was to look into caregivers who took care of their demented elderly family members in an effort to find out what types of services they actually called for and how to make a diagnosis of demented elderly people, provide treatment to them and make an intervention for their families at the same time. METHODS: The subjects in this study were 61 psychiatrists, neurologists and rehabilitation doctors who were in charge of demented elderly people, and they were members of the Korean Geriatrics Society and Korean Association for Geriatric Psychiatry. RESULTS: As for interest in helping caregivers for demented elderly people get rid of their stress, 45.9 percent (28 doctors) of the medical personnels investigated answered they tended to have lots of interest in that. To get them to dispel their stress, they conducted education (13 doctors), offered supportive treatment and encouragement (24 doctors) or provide mental treatment and encouragement (24 doctors) or provide mental treatment or medication if necessary (8 doctors). CONCLUSION: Medical intervention should be carried out to alleviate the behavioral and psychological symptoms of the elderly with dementia to help their caregivers not to be under pressure. Their stress should be managed in a systematic manner according to the dementia grade of patients they look after. A sort of one-stop service network should be built to lend assistance to main caregivers, and the government should set up a family support policy for them.

The Coping Process of Family Caregivers for Demented Elderly

PURPOSE: The purpose of this study was to understand the coping process that family caregivers experience during the process of care, to grasp coping behaviors used to solve problems and, finally, to develop a substantive theory by analyzing the coping process. METHOD: The methodology of collecting and analyzing data used in this study followed the ground theory of Strauss and Corbin(1998). Data were collected through in-depth interviews with open-ended and descriptive questions about the subjects' coping experiences, which were audio-taped and transcribed. The survey was conducted between February 2000 and February 2001. The subjects of this study were 17 women. RESULT: The result of the study is as follows. The coping process of family caregivers while taking care of the demented elderly was found to have six stages: problem recognition: undertaking care: struggling: mental control: burden mediation; and acceptance. These stages proceed with reciprocal action and in cycle. CONCLUSION: The result of this study is helpful for developing effective and individual nursing strategies suitable for each coping stage. It is necessary to develop an assessment tool that can judge caregivers' coping stage based on the result of this study. Moreover, we need continuous study to practice nursing mediation and to analyze the change about nursing effect and family members' adaptation.

A Study on the Care Burden and Service Demand of the Poverty Families Caring for the Demented Elderly

The poverty families, who take care of the demented elderly, can suffer from the deficiency of social services for dementia and the condition and nature the families have. Therefore, This study examines the burden of the poverty caring for the demented elderly. This study focused on the three points : the level of care burden of the families, who take care of the demented elderly ; the needs of welfare services ; the differences of care burden and service demand on trait of the families and the demented elderly. In order to achieve them, the 250 families, who take care of the demented elderly at home, were sampled and the primary caregivers of family member interviewed. Then, the statistics of the 226 people were analyzed by SPSSWIN. The major findings of the study were as follows : First, the level of the care burden the families of the demented elderly have, participated in this research, is higher than 'a little yes'. In a type of the care burden, the social & personal restriction is higher than the other types, including physical restriction, economical restriction, and reciprocal restriction. Second, some families had used service and had a low satisfaction, because of no various and adequate services. It shows that the services for the demented elderly and their families is not enough to use, that the services is not various for the families having many problem related the demented elderly. Third, there are many services needed by the families caring for the demented elderly : residential care facilities for the demented elderly ; day care service center ; short-term care services ; family counseling service ; services at home ; nursing services at home ; night care services ; family meeting. Fourth, the most difficult thing of caring is the economic burden of the families. The families are willing to take care of the demented elderly at home, if the government supports economically them and serves proper services to them. Finally, the lower income of the families is, the more time of caring the demented elderly in a day is, the lower vital functions of the demented elderly are, and the lower level of academic achievement, the higher level of care burden of the families is. According to the result, the level of the care burden can be affected by the family's economic capacity, the vital function of the demented elderly, and the existence of service for the demented elderly. For the elderly welfare especially, the demented elderly and their poverty families, three opinions may be suggested. First, the service programs based on community should be developed to reduce the burdens-economic, psychological, medical burden, etc. - of the poverty families caring for the demented elderly. These programs may include preventive service, education programs of dementia, diagnosis services, family counseling, and medical service. Second, the national government and the local government must try to make policies to solve the temporary problems of the family having the demented elderly.

The Development and Effect of a CD ROM Based Caring Program for the Family Caregivers Amomg the Korean Demented Elderly / 대한의료정보학회지

In Korea, the number of older persons has been increasing annually. The proportion of older person aged 65 and over in Korea was 6.6% in 1998 and will reach 12% in 2020. Also, the older persons who are at greates risk for chronic illness with functional dependency is growing the fastest. One of the main diseases of elderly is dementia. Caring for the elderly, in particular elderly mentally ill patients has become one of the biggest social concerns in Korean society today. The caregiver who looks after a disabled or demented elderly person is usually a woman who is either a spouse of daughter in law in Korea. Caregivef s stress leads to dysphoria and in vulnerable individuals, to depression. Hence, family caregivers of people with dementia frequently experience significant emotional, physical and financial stress. So, there is a need to develop, for the Korean family caregiver, home-based nursing interventions using computer-assisted instructions made available either on CD ROM or over the internet. The purpose of this study was to develop and to examine the effect of a caring program for the family caregivers among the Korean demented elderly. The family caregiver nursing intervention program was developed using a team approach involving nursing professors and computer professionals. The application is available on CD ROM as well as on the World Wide Web. The CD ROM program is made up of five sections: 1) definition and symptoms of dementia to support basic medical and nursing knowledge including psychological problems of the demented elderly, 2) methods for coping with the demented elderly including video techniques, 3) physical care and ADL management for the demented elderly including vido techniques, 4) stress management methods for the family caregiver including music therapy, exercise therapy, oriental acupucture technique on the hand, foot massage and paper handicraft, 5) social referral information service. To examine the effect of a CD ROM based caring program, the study was implemented by nonequivalent control group pretest-posttest design. The subjects of this study were 52 family caregivers who were composed of 22 caregivers for the experimental group and of 30 caregivers for the control group. In this study, the measuring instruments were family caregivers nursing care need assessment tool, fatigue tool for family caregiver' s physical health state, OARS for family caregiver' s psychiatric heath state and family burden scale for family caregiver' s psychological health state. The results of the analysis were as follows: 1. There was no significant difference between experimental group and control group on pretest. So two group had homogeneity. 2. There was significant difference between experimental group and control group on posttest measuring nursing care need state(t=8.55, p<0.01)and family caregivef s psychological health state(t=2.58, p<0.05). Therefore, this CD ROM based caring program was revealed the positive effect for family caregivers among the Korean demented elderly. For further research, with distributing the CD ROM, it suggests that the effective caring program to decrease family caregivef s fatigue and psychological health state as like anxiety, stress, strain will be developed.

A Study on the Levels of Dementia-related Knowledge, Attitude, and Practice among Nursing assistants Caring for Institutionalized elders with dementia / 성인간호학회지

This study has been conducted for the purpose of identifying the levels of knowledge and attitude about dementia, and exploring the degrees of practice and the relationship among these variables in nursing assistants caring institutionalized demented elders. The subjects were 87 formal caregivers from 3 dementia-specialized nursing facilities, 2 dementia-specialized hospitals, 1 general psychiatric hospitals, and 3 general nursing homes. The data were gathered from July 10th to August 5th, 1998 through interviews by questionnaires. The measuring instruments of this study were developed by the researcher and proven for their reliability and validity. The collected data were analyzed using SAS program. 1) The lowest score among 6 sub-areas about practice showed on this subarea of maintenance of remained ADL function, offering stimuli and activities to demented elders was the second. 2) The third hypothesis of "the higher the attitude score they have, the higher the practice score they do" was supported (r=.370, p=.025). 3) The influencing factors significantly on knowledge were educational status, learning experience about taking care of patients, learning experience about dementia during last a year. 4) A factor of the period of taking care demented elders have significantly influenced on the attitude about dementia. 5) The influencing factors significantly on practice were age, marital status, learning experience about taking care of patients, learning experience about dementia during the last a year. 6) The most difficult situation the subjects perceived in taking care of demented elders was managing the aggressive and resistive behaviors of demented elders.

The Relationships between the Caring Burdens of Caregivers and the Psychopathology of In-home Demented Elderlies, and the Needs of Caregivers for the Social Services / 신경정신의학

OBJECTIVES: This study was attempted to offer the foundation data to develop a specific and practical social service of caregiver-centered. For this purpose we assessed the cognitive functions of a group aged 65 or more using the Korean version of Mini Mental State Examination(MMSE-K) in a Dong area of urban community. And then we reassessed the relationships between the caring burdens of caregivers and the psychopathology of in-home demented elderlies, and the needs of caregivers for the social services. METHODS: Subjects in this study were over the age of 65 and resided in a Dong area of urban community. At first, their cognitive functions were screened by MMSE-K. Subjects, whose total score of MMSE-K were below 24 and met the diagnostic criteria of DSM-IV for dementia, were enrolled in this study and defined to be the patients with dementia. Their psychiatric symptoms were assessed by Brief Psychiatric Rating Scale(BPRS), Hamilton's Rating Scale for Depression(HDRS) and Hamilton's Rating Scale for Anxiety(HARS). At the same time, the caring burdens of caregivers and their needs for social services were assessed by caregiver`s burden inventory(CBI). Total 23 subjects completed all of the assessments and their data were analysed statistically by ANOVA, chi2-test, and Duncan's multiple range test using SAS program. RESULTS: 1) The mean total score of BPRS tended to be correlated positively with the mean score of social activity restriction subscale of caring burden dimensions. 2) Some of religions of the caregivers could affect differently and significantly on the negative changes of relationships between the demented elderlies and their caregivers(p<.05). Especially, the Christians experienced less negative changes of relationships between them than the others did. 3) When the demented elderlies were males, total burdens of caregivers and negative changes of relationships between the demented elderlies and their caregivers, and between the caregivers and their relatives were significantly higher than the other burden dimensions were(p<.05). 4) When the demented elderlies were more educated, the psychological burdens of their caregivers were more severe(p<.05). 5) The more were the total burdens of the caregivers, they wanted more social services for them(p<.05). 6) The more were the psychological and financial burdens of the caregivers, their needs for the education and counselling services were more than the needs for the other social services(p<.05). CONCLUSION: Caregivers living with male demented elderlies, who had more severe psychopathology, had more burdens of caregiving and restricted the social activities of the in-home demented elderlies more severely. As a result, the relationships between them became more worse. Our results suggested that free-home helper services for the severely demented elderlies and education counselling services including information-referral service for their caregivers were in needs. Consequently, we should develop more specific services for in-home demented elderlies and their caregivers according to the needs in their family environments.