Calidad de la asistencia social en ancianos solos con atención domiciliaria / Quality of the social care in old men living alone under home care

Introducción: La calidad de la atención geriátrica en Cuba constituye una realidad impostergable. Objetivo: Evaluar la calidad de la asistencia social de salud en ancianos solos con atención domiciliaria. Método: Se realizó una investigación cualitativa, que incluyó a 4 838 ancianos, controlados por los departamentos de Trabajo Social del municipio de Santiago de Cuba, desde enero hasta diciembre del 2015, para lo cual se efectuó un muestreo por conglomerados bietápico, constituido por 387 gerontes. Se utilizó la metodología de la Escuela Nacional de Salud Pública de Cuba para evaluar las dimensiones: estructura, proceso y resultados. Resultados: Se encontró inadecuado el indicador recursos humanos y materiales. En el proceso resultaron adecuados la confección de la historia social y los registros administrativos. Conclusiones: La calidad de la asistencia social en ancianos solos con atención domiciliaria resultó inadecuada en los componentes estructura, proceso y resultados.

Introduction: The quality of geriatric care in Cuba constitutes an inevitable reality. Objective: To evaluate the quality of health social care in geriatric patients living under home care. Method: A qualitative investigation that included 4 838 old men, controlled by the departments of Social Work of Santiago de Cuba municipality was carried out from January to December, 2015, for which a sample through two-stage conglomerate constituted by 387 aged persons was made. The Cuban National School of Public Health methodology was used to evaluate the dimensions: structure, procedure and results. Results: The indicator human resources and materials resulted inadequate. Making the social history and the administrative registrations were appropriate. Conclusions: The quality of the social care in elderly living alone under home care was inadequate in the components structure, procedure and results.

Clarification of psychosocial factors required for continuance of life of elderly men living alone in heavy snowfall and underpopulated areas / Journal of Rural Medicine

Purpose: The aim of this study was to clarify psychosocial factors supporting elderly men who were living alone in a heavy snowfall area where the population aging rate exceeded 40%.Methods: The authors conducted semi-structured interviews with six elderly men living alone. As the method of analysis, we conducted a hierarchical cluster analysis of the contents of the interviews via text mining.Results: As a result, we found the psychosocial factors supporting the elderly men living alone. We divided the factors into six categories: “well-planned roof snow removal”, “interaction with young people”, “realization of the meaning of life via driving”, “engagement in leisure and recreational activities”, “living a life aligned with personal preference” and “insistence on living alone”.Conclusion: Formal and informal networking that avoids debasing these psychosocial factors required for the continuance of living life alone is necessary.

The Median Effect of Social Support on the Loneliness of Resilience in the Healthy Elderly Living Alone

Relationship between living alone of retired employees and depression and anxiety and mediating role of social participation quality / 吉林大学学报(医学版)

Objective:To explore the related factors of depression and anxiety among the retired employees, and to examine the mediating role of social participation quality in the elderly between living alone and depression and anxiety.Methods:The retired employees who met the admission criteria in the First Hospital of Jilin University were selected as the subjects. The basic situation questionnaire was used in this study, and the social participation quality, depression and anxiety were assessed by social aspect of the Quality of Life Scale, Patient Health Questionnaire Depression Table and Anxiety Screening Questionnaire, respectively. A total of 642 valid questionnaires were obtained. Linear regression analysis was used to analyze the influencing factors, and the mediating effect test was conducted by stepwise regression analysis.Results:The influencing factors of depression in the retired employees were physical exercise (β=-0.948, P<0.01), entertainment (β=-1.423, P<0.01), whether to suffer from chronic diseases (β=2.579, P<0.01), family income (β=-0.557,P<0.05), whether to insist on work (β=-1.673, P<0.05), and whether to live alone (β=2.097, P<0.01).The influencing factors of anxiety were physical exercise (β=-0.711, P<0.05), entertainment (β=-1.380, P<0.01), whether to suffer from chronic diseases (β=1.204, P<0.05), and whether to live alone (β=1.639,P<0.05).In the elderly, living alone status and social participation quality were input in the linear regression as the independent variables,and the results showed that the effects of living alone status on depression and anxiety had no the significant differences (β=0.837,P=0.218; β=0.837,P=0.218), and social participation quality played a full mediating role between living alone status and depression and anxiety.Conclusion:Physical exercise, entertainment, whether to suffer from chronic diseases and whether to live alone are the influencing factors of depression and anxiety in the retired employees; social participation quality plays a full mediating effect between living alone status and depression and anxiety.

Frustrated Interpersonal Needs and Life Satisfaction in the Elderly Living Alone

OBJECTIVE: This study aims to investigate differences between the elderly living alone and those living with others in frustrated interpersonal needs and life satisfaction. Also, we explore the effects of frustrated interpersonal needs on life satisfaction in the elderly living alone. METHODS: The participants include 572 elderly people aged over 60 in Busan, Korea. Life satisfaction were evaluated by the Life Satisfaction Self-Rating Scale (LSRS) and frustrated interpersonal needs were measured by the Interpersonal Needs Questionnaire-Revised (INQ-R). RESULTS: The overall LSRS scores were significantly lower in the elderly living alone (106.2±20.1) than living with others (115.3±13.9, p<0.001). The total INQ-R score was significantly lower in the elderly living alone (73.8±12.1) than those living with others (76.9±12.0, p<0.05). As a result of multiple regression analysis, we came to know that frustrated interpersonal needs were factors affecting life satisfaction in living alone group. CONCLUSION: The results of present study suggest that the elderly living alone are more likely to have poor life satisfaction and frustrated interpersonal needs. Also, frustrated interpersonal needs are related to life satisfaction. Thus, it is necessary to establish the social support system such as social isolation prevention and interpersonal relationship development.

Comparison Analysis of Dietary Behavior and Nutrient Intakes of the Elderly according to Their Family Status: The Korea National Health and Nutrition Examination Survey 2013–2016 / 대한지역사회영양학회지

OBJECTIVES: This study was undertaken to compare dietary life of the elderly living alone and in a family, and to compare differences based on gender, for the 2013-2016 Korea National Health and Nutrition Examination Survey (KNHANES). METHODS: The subjects included 2,612 elderly people aged over 65 years who participated in the health survey, health examination and nutrition survey. Subjects on a diet therapy were excluded. This study analyzed the general characteristics, dietary habits, daily energy and nutrient intakes, CPF ratio, estimated average requirement (EAR), nutrient adequacy ratio (NAR) and mean adequacy ratio (MAR), index of nutrient quality (INQ), and food consumption of the elderly living alone and in a family. We also compared the differences based on gender. RESULTS: Daily intake of food, water, dietary fiber, potassium, retinol, and riboflavin were low in the male elderly subjects living alone. The elderly living with family revealed higher NAR and MAR as compared to the elderly living alone. Although all MAR values were <1, the elderly living alone had lower values. Considering the intake of food, the consumption of seaweed, fish and shellfish, and oils (animal) was higher in elderly men living with families, whereas women living with families consumed more vegetables, fruits, seaweeds and seafood, as compared to their counterparts living alone. Furthermore, analyzing the foods consumed by the elderly people living alone, female subjects consumed more seaweed, milk and animal oil as compared to male subjects. CONCLUSIONS: The results of this study indicate that the elderly living alone have poor nutrient intake as compared to the elderly living with families. Based on this research data, we recommend that it is necessary to improve the health and nutritional status of the elderly living alone.

A Study on Factors Affecting Suicidal Tendency of the Elderly Living Alone on Care Services

OBJECTIVES: The high suicide rate has risen as a main concern in South Korea. Given the complexity of the mechanism resulting in complete suicide, studies targeting various populations are needed for broader understanding of its risk factors. This study aims to analyze the factors affecting the suicidal tendency in the population of the elderly living alone in Seoul depending on basic elderly-care services. METHODS: A total number of 415 people participated in the study. Home-visit interviews were administered by trained interviewers. Suicidal tendency was measured by the Korean version of mini international neuropsychiatric interview (K-MINI). Health-related quality of life was measured by a brief version of the World Health Organization Quality-of-life Scale (WHOQOL-BREF). Alcohol problem was assessed by the Korean version of the alcohol use disorders identification test (AUDIT-K). Among total subjects of 415 interviewees, the actual responses of 408 people were used for the final analysis. RESULTS: The result showed that the suicide risk was high in persons isolated from social support [odds ratio (OR) = 4.49], having depression (OR = 14.85), and having low quality of life (OR = 4.39). CONCLUSIONS: We found that social support, depression and health-related quality of life are associated with suicidal tendency in the elderly living alone on basic services. Our evidence will contribute to suicide prevention policy for the elderly living alone on care services.

Factors Associated with the Use of Over-the-Counter Medications in the Elderly Living Alone / 정신신체의학

OBJECTIVES: This study aimed to describe the use of over-the-counter (OTC) drugs and to identify predictors for their use in the elderly living alone. METHODS: This is a cross-sectional study that enrolled 1,099 subjects. Data regarding socio-demographic status, medical condition, cognition, mood disorder and use of OTC drugs were collected using self-administered questionnaire and from a specific semi-structured interview by a trained nurse. Data regarding use of OTC drugs were analyzed using descriptive statistics. Logistic regression analysis was applied to examine factors associated with the use of OTC drugs. RESULTS: The use of OTC drugs were reported by 35.4% of the subjects. Analgesics (13.6%) was the most frequent drugs. Depression (OR=1.10, 95% CI=1.10–1.87) and comorbidities measured by cumulative illness rating scale (CIRS) (OR=1.08, 95% CI=1.03–1.12) were significantly associated with the use of OTC drugs in the elderly living alone. CONCLUSIONS: Depression and severity of underlying medical conditions could be a predictor of the use of OTC drugs in the elderly living alone. The clinicians should be vigilant regarding the potential use of nonprescription medications in the elderly.

Analysis of health-related quality of life of elderly people living alone in Shanghai / 第二军医大学学报

Objective To analyze the health-related quality of life of elderly people living alone in Shanghai according to the survey data. Methods The data were extracted from the fifth national health services survey of Shanghai, and the data of 11 103 elderly people from 17 districts were analyzed. The elderly people living alone and those not living alone were matched using propensity score matching method, and the health-related quality of life of elderly people was measured by the European quality of life 5-dimensions (EQ-5D). The health-related quality-of-life indicators between the elderly people living alone and not living alone, including selection of EQ-5D dimensions, EQ-5D scores and EQ-VAS scores, were compared by Chi-square test and Mann-Whitney U test. Results The baselines of the elderly people living alone and not living alone matched well by propensity score matching, and there were no significant differences in selection of each dimension of the health-related quality of life, EQ-5D index scores or EQ-VAS scores between the two groups. Conclusion There is no difference in health-related quality of life between elderly people living alone and not living alone in Shanghai.

Suicidal Ideation of Elderly Living Alone in Urban and Rural Areas, its Related Factors / 農村醫學 地域保健

OBJECTIVES: This study used data of urban and rural elderly living alone to compare the general characteristics of the elderly who have had suicidal ideation, and to investigate the suicidal ideation of urban-rural elderly with varying degrees of emotional support status, health status, and health behavior. METHODS AND MATERIALS: The research participants included 2,750 elderly aged 65 or above, of which 1,487 were from dong unit and 1,263 were from eup·myeon units according to the raw data of 2011 Survey on Elderly Status. All collected data were analyzed using cross tabulation of SPSSWIN(ver 21.0) program and multivariate logistic regression. RESULTS: The results were as follows. First, the factors that influenced the suicidal ideation of urban and rural elderly living alone included degree of depression, experience of abuse, and nutritional management status. Second, the suicidal ideation of urban elderly living alone was affected by the emotional support of their children who live apart and their grandchildren. Third, the suicidal ideation of rural elderly living alone was affected by the emotional support of their kin (including siblings).

Diet and Health Status of Elderly Women According to the Family Type / 대한지역사회영양학회지

OBJECTIVES: This study aimed to evaluate the diet and health status of elderly women according to the family type. METHODS: A total of 307 elderly women participated in this study were divided into one of three groups according to their family type: residing with spouse (RSP; n=88), residing with son or daughter (RSD; n=119), and residing alone (RAL; n=100). Chi-square test was used to assess dietary habits and health status of the subjects by the family types. RESULTS: Results demonstrated significant associations between eating regular meals, person preparing meals, coffee intake, and bone fracture experience and family type. Among the three groups, the RSP and RAL groups had a higher percentage for preparing meals by themselves (p<0.001) than the RSD group. The RAL group had a lower percentage for eating regular meals (p<0.01) but a higher percentage for bone fracture experience (p<0.05) than the other groups. There were no significant differences in monthly allowance, self-estimated health status, physical activity, exercise, drinking, and dietary habits such as frequency of consumption of dairy, beans, eggs, fish, meat, fruits, and vegetables among the three groups. CONCLUSIONS: The results showed that elderly women residing alone without a son, daughter, or spouse had more diet-related and health problems such as irregular meals and high bone fracture experience. These findings suggested that elderly women residing alone need more attention and support.

Survey of “Rural type solitary death” through Postmortem Examination / 日本プライマリ・ケア連合学会誌

<b>Purpose</b>: To analyze “solitary deaths” in Hitachiomiya city through postmortem examination results, and contribute to formulation of preventative measures.<br><b>Methods</b>: The author surveyed 149 cases of elderly individuals found deceased in their house during the period between January 2008 and December 2014. All had lived alone or almost alone in social isolated conditions.<br><b>Results</b>: There were more males than females. Men were in a wide range of ages, while women were predominantly in their 80's and 90's. Nearly all cases were found within 2 days following death and deaths occurred more frequently in the winter and spring. Cardinal causes of death, were acute cardiac disorders and cerebrovascular diseases. Malignancy and pneumonia were less frequent. More than 90% of the corpses were found by their family members or relatives, and others by nursing service providers or neighbors.<br><b>Conclusion</b>: This analysis of “solitary deaths” in Hitachiomiya city showed predominance of men and shorter intervals between death and being found than those of metropolis after death.

The Impacts of Living Alone in in-Hospital and One-Year Clinical Outcomes after Acute Myocardial Infarction in Korean Patients

OBJECTIVE: The aim of this study is to evaluate the impact of living alone for in-hospital and one-year clinical outcome after acute myocardial infarction (AMI) in Korean patients. METHODS: A total of 1,700 patients who admitted at the Chonnam National University Hospital were analyzed. We divided the patients into two groups by the existence of a spouse or family member that lived together with the patient at the first time of hospital visit due to AMI. The primary endpoint was composed of in-hospital death and cardiac death during one-year clinical follow-up. Secondary end point was other major adverse cardio-cerebral events (MACCE) including non-fatal MI, repeat revascularization, ischemic or hemorrhagic stroke during one-year clinical follow-up. RESULTS: Living alone patient group had higher proportion of Killip class II-IV (34.3% vs. 26.6%, p=0.006) and higher value of high sensitivity C-reactive protein (2.2+/-4.0 vs. 1.5+/-3.4 ng/mL, p=0.019) than not living alone group. In-hospital death (8.9 % vs. 5.1%, p=0.010) and one-year cardiac death (7.7% vs. 4.6%, p=0.031) developed more in living alone groups. However, living alone was not an independent prognostic factor for in-hospital death (HR 1.51, 95% CI 0.91-2.52, p=0.113) and one-year cardiac death (HR 1.18, 95% CI 0.59-2.34, p=0.64) after multivariate analysis. CONCLUSION: Living alone was not an independent prognostic factor for in-hospital and one-year clinical outcome after AMI.

The Influencing Factors on the Ego Integrity of Elderly Living Alone / 한국간호교육학회지

PURPOSE: This study was conducted in order to determine the extent of ego integrity and to confirm the association between the sense of ego integrity and integrated loneliness, social support, and social activities. METHODS: For this study, 146 elderly people participated. The data was analyzed with SPSS/WIN 21.0, using descriptive statistics, t-test, ANOVA, correlation analysis, and hierarchical regression analysis. RESULTS: In regards to differences between ego integrity according to general characteristics of subjects, there was a statistically significant difference in education (F=4.13, p=.007). In elderly living alone, ego integrity was significantly positive correlated with social support and social activities, but negative correlated with loneliness. These variables explained 43.2% of the sense of ego integrity. CONCLUSION: The study suggested that nursing programs and social activity programs designed to aid the elderly living alone must focus on reducing loneliness, as well as increasing social support and social activities, while taking education into consideration. Also, these programs should strive to build social support systems.

Depressive status and influencing factors of elderly living alone in a community of Shanghai: A survey / 第二军医大学学报

Objective To investigate the depression status among the elderly living alone in a community of Shanghai and to analyze the influencing factors.

Factors Associated with Suicidal Ideation in Korean Elderly Living Alone ; Sociodemographic and Clinical Characteristics

OBJECTIVE: The purpose of this study was to examine the relationship between suicidal ideation and the associated with sociodemographic and clinical factors in community dwelling, elderly living alone in Korea. METHODS: A total of the 329 community-dwelling elderly aged 65 years or older who lived alone were recruited and they underwent the questionnaire including their sociodemographic data, Activities of Daily Living/Instrumental Activities of Daily Living scale (ADL/IADL) and the Korean version of the Short Geriatric Depression Scale (SGDS-K). Suicidal ideation was evaluated by using the "suicidal thought" item of the Beck Depression Inventory (BDI). RESULTS: According to the result of our sample of elderly living alone, 22.8% of the subjects reported their suicidal ideation. ADL/IADL score (p<0.01), subjective economic status (p<0.05), and subjective health status (p<0.05) had a negative correlation with suicidal ideation. SGDS-K score (p<0.05) had positive correlations with suicidal ideation. Multiple regression analysis revealed that suicidal ideation correlates to ADL/IADL score (p=0.025). CONCLUSION: This study exhibit that ADL/IADL is significantly associated with suicidal ideation.

A arte de morar só e ser feliz na velhice / The art of living alone and be happy in the elderly

Este estudo visa a analisar os motivos que levam uma pessoa a viver sozinha na terceira idade e o que ela pensa a respeito da ILPI - Instituição de Longa Permanência para Idosos. Como uma das etapas da pesquisa, realizamos entrevistas com 15 pessoas idosas que vivem sozinhas, de ambos os sexos, com idades variando dos 60 aos 93 anos e diferentes graus de instrução, que vivem em São Paulo, Grande ABCD (SP) e em uma cidade de Santa Catarina. Nosso objetivo inicial foi tentar entender as razões pela opção solitária de moradia, uma vez que vem crescendo o número de pessoas idosas que vivem sozinhas, em parte devido à longevidade humana que ora se verifica. Trata-se de uma análise qualitativa efetuada a partir das respostas dos idosos entrevistados, obtidas no primeiro semestre de 2010. Verificou-se que morar só, no sentido de ter autonomia, independência, pode ser desejo de muitas pessoas como condição para ser feliz, embora se constate quase como uma impossibilidade para grande parte da população.

The study in question analyzes the reasons why a person lives alone in old age and what old people think about the Institution of Long Term Elderly. To help us in the research we carried out interviews with 15 elderly people living alone, of both genders, with ages ranging from 60 to 93 years and with different levels of education - from housewives to doctors, who live in Sao Paulo, Santa Catarina and the cities of ABCD. Our goal was to try to understand the reasons for their choice of housing because it has increased the number of elderly people living alone at present due to human longevity. This is a qualitative analysis based on responses from interviews with elderly people, which occurred in the first half of 2010.

Dietary Behaviors and Seasonal Diversity of Food Intakes of Elderly Women Living Alone as Compared to Those Living with Family in Gyeongbuk Rural Area / 대한지역사회영양학회지

The purpose of this study was to assess dietary habits and seasonal variation and diversity of food intakes of elderly women living alone as compared to those of elderly women living with family in a rural area. Forty nine elderly women living alone and forty one elderly women living with family who reside in Goryeong-gun, Gyeongbuk, were interviewed using questionnaires in summer 2005, and their food intakes were assessed secondly in winter and thirdly in spring 2006. The average ages were 74.7 years for elderly living alone and 72.8 years for elderly living with family. Tooth status and bone fracture experience were similar between the groups. The prevalence of musculoskeletal disease was 61.2% and that of circulatory disease was 32.7% of the subjects. Average of total score of mental depression of the subjects was 5.94 out of 12 points, and it was not significantly different between the two groups. Skipping meals was more frequent and mealtime was more irregular in the elderly women living alone as compared with the elderly women living with family. Consumption of dietary supplements was also less in the elderly women living alone. Food intakes by the elderly women living alone tended to be lower than those by the elderly women living with family. Dietary diversity score was significantly lower with the elderly women living alone as compared with the elderly women living with family only in summer (p < 0.01). Percentages of the subjects who have taken meat group and vegetable group were significantly lower in the elderly living alone compared with the elderly living with family during summer. Therefore, it is necessary to develop food assistance or supporting program suited for the season within a community for elderly women living alone.

Seasonal Nutrient Intakes of Elderly Women Living Alone as Compared to Those Living with Family in the Gyeongbuk Rural Area / 대한지역사회영양학회지

For the rapidly growing elderly population, the achievement and maintenance of good nutritional status is critical to health, functioning and quality of life. Elderly women living alone have been identified as a group associated with poor nutrition. The purpose of this study was to assess dietary intakes of elderly women living alone as compared to those of elderly women living with family in a rural area and to examine seasonal variation. The subjects are 49 elderly women living alone and 41 elderly women living with family who reside in Goryeong-gun, Gyeongbuk, and their food intakes were assessed once each time in summer 2005, winter 2005-2006, and spring 2006. The average ages were 74.7 years for living alone and 72.8 years for living with family. Education level was not different between the two groups. Height, weight, body mass index, systolic and diastolic blood pressures, and fasting blood glucose were not significantly different between the two groups. Average intakes of major nutrients, nutrient adequacy ratio, mean adequacy ratio and index of nutritional quality were lower in the elderly women living alone compared with the elderly women living with family in summer, but the differences in intakes of most nutrients became insignificant both in winter and in spring. High carbohydrate and low fat diet was prevalent and intakes of carbohydrate and fat in summer deviated from macronutrient acceptable distribution ranges. Percentages of the subjects who consumed energy less than 75% of the estimated energy requirement and nutrients less than the estimated average requirement were higher than those reported by the Third National Health and Nutrition Examination Survey. In summer, the percentage of the subjects who consumed energy less than both 75% of the estimated energy requirement and 4 nutrients less than estimated average requirements was 58.5% of the elderly women living alone, which was higher than 26.5% of the elderly women living with family and that of National Nutrition Survey. Therefore, nutrition policies including nutrition education and support are necessary to improve nutritional status of elderly, especially elderly women living alone and should reflect regional and seasonal characteristics.

Loneliness and Cognitive Function in the Elderly Living Alone: Cross-sectional Study

BACKGROUND: Many foreign researchs show that physical illness and loneliness are causes of cognitive decline in old men. Especially, living alone group feels more depressive mood and loneliness than married group. Neverthe- less, there is no domestic research whether loneliness is associated with cognitive decline. METHOD: We have interviewed 95 elderly, living alone, who are supported by an elderly wellfare office of Seoul city. Educated three interviewers investigated sociodemographic characteristics, loneliness scale, dementia scale, instru- mental activity of daily living, and depression scale. RESULTS: The subjects were almost women(90.5%), low educated(no schooling; 67.4%), low economic status(income < 600,000 won/month; 97%) and had moderate-high degree loneliness(UCLA lonliness scale 49.8), mild depression (GDSSF-K score; 7.8). In a multiple regression analysis, there was no correlation between the loneliness and cognitive function(p=.878), no association between social disengagement index and cognitive function(p=.817). However, age (p=0.005), education(p=0.000), smoking(p=0.045) had statistical correlation with cognitive function. CONCLUSION: In living alone elderly, the cognitive function is not associated with loneliness and social support, but associated with age, education, smoking.