Quality of life of elderly in a long-stay care facility in the city of Teresina-PI

The purposeof this research was to evaluate the quality of life of elderly people in a Long-Stay Care Facility for the Elderly (ILPI) in the city of Teresina. This is a descriptive and exploratory study with a quantitative methodology. Data collection was carried out between March and April 2019, through the application of the Pentacle of Well-being questionnaire for the elderly at a Long-stay Care Facility in the city of Teresina-PI. Data analysis was performed using the Tabwin 4.1.4 program. Twenty elderly people were interviewed and as to the profile found, 45% (n = 9) were between 80 and 89 years old and 50% (n = 10) were female and male. Regarding the questionnaire, the components nutrition, preventive behavior, social relationship and stress control showed satisfactory results, except for the component 'physical activity', in which 65% (n = 13) of the elderly rarely perform any physical activity. The lifestyle of the elderly is considered satisfactory, however, the Physical Activity component showed an unsatisfactory result.

A low phase angle determined by bioelectrical impedance analysis is associated with oropharyngeal dysphagia among institutionalized older adults

SUMMARY OBJECTIVE The aim was to evaluate the prevalence of oropharyngeal dysphagia (OD) and its association with body composition by bioelectrical impedance analysis (BIA) and functionality among institutionalized older adults. METHODS A cross-sectional study was conducted. The swallowing function and diagnosis of OD were evaluated with a volume-viscosity swallow test. Activities of daily living were evaluated by the Barthel Index. Body composition was evaluated by BIA, and phase angle (PhA) was determined. RESULTS Eighty institutionalized older adults were evaluated. The mean age of the study population was 82±9.5 years, and 65% were females. The OD prevalence was 30%, dependence was 30%, and sarcopenia was 16%. In the multivariate analysis, a low PhA (<3.5°) was independently associated with the presence of OD adjusted by sex and age (OR: 2.60, 95%CI 2.41-2.90, p=0.01). CONCLUSIONS A higher prevalence of OD was found. Significant and independent associations were found between low PhA, dependence, and sarcopenia with the presence of OD among institutionalized older persons.

Constituição do discurso da autonomia de idosas no cotidiano de uma Instituição de Longa Permanência para Idosos / Constitution of autonomy discourse of older person in the daily life of a Long-Term Care Facility for the older person

Resumo: Objetivo analisar a constituição do discurso da autonomia da pessoa idosa em uma Instituição de Longa Permanência, na perspectiva de profissionais e de idosas institucionalizadas. Método pesquisa qualitativa, desenvolvida na perspectiva do referencial pós-estruturalista, realizada em uma instituição filantrópica da cidade de Belo Horizonte, Minas Gerais, Brasil. Os dados foram coletados no período de janeiro a março de 2018, por meio de entrevista semiestruturada, com 13 profissionais e sete idosas, análise documental e observação e foram submetidos à análise de discurso. Resultados os efeitos da institucionalização na constituição da autonomia das idosas pode ser observado nos discursos das idosas e dos profissionais. A Instituição se constitui num local de disciplina, com rotinas bem estabelecidas, com pouco espaço para a tomada de decisão das idosas. Sua autonomia fica esquecida, pois as rotinas, de certa forma, encobrem seus desejos, suas escolhas e sua própria liberdade. Conclusão para um funcionamento adequado da estrutura, limites e regras fazem-se necessários. Entretanto, é importante considerar que as normas não são utilizadas, unicamente, como instrumento de controle e cerceamento do exercício de tomada de decisão das idosas. A transição epidemiológica exige das instituições mudanças em suas práticas cotidianas, advindas de políticas públicas específicas para as instituições, com a definição clara de seu papel e diretrizes para uma prática qualificada.

Abstract : Objective to analyze the constitution of autonomy discourse of the older person in a Long-Term Institution, from the perspective of professionals and institutionalized older person women. Method qualitative research, developed from the perspective of the post-structuralist framework, fulfilled in a philanthropic institution in the city of Belo Horizonte, Minas Gerais, Brazil. Data were collected, from January to March 2018, through semi-structured interviews with 13 professionals and seven older person women, document analysis and observation and were submitted to discourse analysis. Results the effects of institutionalization on the constitution of the older person's autonomy can be observed in the speeches of the older person and professionals. The Institution is a place of discipline, with well-established routines, with little space for older person women to make decisions. Their autonomy is forgotten, because routines, in a way, cover up their desires, their choices and their own freedom. Conclusion for a proper functioning of the structure, limits and rules are necessary. However, it is important to consider that the standards are not used solely as an instrument for controlling and restricting the older person women's decision-making exercise. The epidemiological transition requires from institutions changes in their daily practices, arising from specific public policies for institutions, with a clear definition of their role and guidelines for a qualified practice.

Atenção ao idoso frente à pandemia por Covid-19 / An alert regarding the elderly who face the Covid-19 pandemic

A doença Covid-19 atinge com gravidade pessoas acima dos 60 anos, em especial aquelas com comorbidades. A rapidez com que o vírus é transmitido exige conduta rápida na prevenção e adequado manejo, levando em consideração as fragilidades dessa população. Este relato de experiência tem por objeto descrever atividades desenvolvidas pela Divisão de Saúde do Idoso da Secretaria de Estado da Saúde do Paraná, de janeiro a julho de 2020, com vis-tas a contribuir nas tomadas de decisões de gestores e profissionais de saúde, com enfoque na saúde de idosos institucionalizados. São apresentadas duas Normas Orientativas: Atendimento dos Idosos Frente à Pandemia Covid-19 e Medidas de Prevenção, Controle e Testagem para Covid-19 em Instituição de Longa Permanência para Idosos. Descreve-se a organização e execução de videoconferência e do ciclo de web ­ Idosos e a Covid-19. A pandemia exige ação e inovação com vistas à proteção do idoso neste momento de risco. (AU)

The coronavirus hits more acutely the age group of those over 60 years old, especially those with chronic diseases. The speed at which the virus is transmitted demands a quick response in its prevention and adequate management, keeping in mind the frailties of this age group. This report describes from personal experience the development of the actions taken by the Senior Citizen Health Division of the Health Secretary of the Brazilian state of Paraná from March to July 2020. The objective is to contribute to the decisions of health officials and managers, with the focus on institutionalized senior ci-tizens. The following guidelines are presented: Treatment of seniors facing the Coving-19 pandemic and methods of prevention and Instituting long-term control and testing for Covid-19 for the elderly. Described in this report also is the series of videoconferences regarding seniors and Covid-19. This pandemic demands swift action and innovation to protect the elderly in this time of high risk. (AU)

Practices and behaviors of professionals after falls in institutionalized elderly with and without cognitive decline / Práticas e comportamentos dos profissionais após a queda nos idosos institucionalizados com e sem declínio cognitivo

ABSTRACT Falls are a major problem in nursing homes due to their high prevalence and impact on the functioning of elderly. Objective: This study aims to: a) construct and validate a scale for assessing the practices and behaviors of professionals from nursing homes after falls in elderly; b) describe practices and behaviors after falls; and c) associate practices and behaviors with professionals' length of experience, training and age. Methods: This is a correlational study, conducted in a sample of 152 professionals from six nursing homes. The study adhered to all of the Declaration of Helsinki principles. Results: The scale constructed has a Cronbach's alpha of 0.938. The 12 items of the scale are grouped into two factors. The most expressive indicators are the communication of fall episodes that result in severe injuries (4.64 ± 0.812) and the communication of falls that result in injuries and need intervention from health technicians (4.61 ± 0.832). We found no significant statistical difference between length of professional experience, training and age when associated with professional practices and behaviors after falls in elderly (p > 0.05). Conclusion: Future studies should investigate the association of post-fall professional practices and behaviors with fear of another fall, fall recurrence, and changes in functioning of the elderly following a fall.

RESUMO As quedas são um problema grave nas instituições de longa permanência para idosos nos lares devido à elevada prevalência e consequências na funcionalidade dos residentes. Objetivo: Este estudo tem como objetivos: a) Construir e validar uma escala para avaliar práticas e comportamentos de profissionais das instituições de longa permanência para idosos após a queda; b) Descrever as práticas e comportamentos dos profissionais após a queda e c) Associar as práticas e comportamentos ao tempo de exercício profissional, formação e idade do profissional. Métodos: Estudo correlacional, realizado com uma amostra de 152 profissionais de seis instituições. Durante este estudo, cumprimos todos os princípios da declaração de Helsínquia. Resultados: A escala construída possui um alfa de Cronbach de 0,938. Os 12 itens são distribuídos em dois fatores. Os indicadores com maior expressão são a comunicação de episódios de queda, resultando em lesões graves (4,64 ± 0,812) e a comunicação de queda, resultando em lesões e necessitando de intervenção dos técnicos de saúde (4,61 ± 0,832). Não encontramos diferença estatística significativa entre o tempo de experiência profissional, formação e idade, quando associados às práticas e comportamentos profissionais após queda de idosos (p > 0,05). Conclusão: Estudos futuros devem associar práticas e comportamentos profissionais após uma queda ao medo de uma nova queda, à recorrência e à evolução da funcionalidade do idoso após a queda.

Interobserver analysis of safety practices and behaviors adopted by elderly people to prevent falls / Análise Interobservadores das práticas e comportamentos de segurança adotados pelos idosos institucionalizados para prevenir quedas / Análisis interobservadores de prácticas y comportamientos de seguridad adoptadas por ancianos institucionalizados para prevenir caídas

Objective: determine the psychometric properties of the safety practices and behaviors dimension of the Scale of Practices and Behaviors of Institutionalized Elderly People to Prevent Falls in a sample of elderly people with cognitive decline. Method: methodological study, with a quantitative approach, to assess the psychometric properties of the mentioned scale in a sample with 102 elderly people with cognitive decline who lived in two long-term care institutions for the public in this age group. Internal consistency evaluation was carried out by calculating the Cronbach's alpha coefficient; interobserver reliability was expressed by Cohen's kappa coefficient; and temporal stability, by obtaining Spearman correlation. Compliance with all ethical procedures was observed. Results: the dimension of safety practices and behaviors showed α = 0.895 for its 11 items. Seven out of the 11 items reached good to excellent agreement among the experts for interobserver reliability. Kappa index values indicated that the instrument is valid and reliable. Safety practices and behaviors were influenced by institutionalization time, being at least 85 years old, and gait skills. Conclusion: the results pointed out that the instrument has good reproducibility and is valid and reliable, which allows its use in clinical practice in elderly people with cognitive decline as well as in research.

Objetivo: determinar as propriedades psicométricas da dimensão das práticas e dos comportamentos de segurança da Escala de Práticas e Comportamentos dos Idosos Institucionalizados para Prevenir Quedas numa amostra de idosos com declínio cognitivo. Método: estudo metodológico, com abordagem quantitativa, para a avaliação das propriedades psicométricas da escala numa amostra de 102 idosos com declínio cognitivo, residentes em duas Instituições de Longa Permanência para Idosos. A avaliação da consistência interna foi efetuada pelo α de Cronbach, a confiabilidade interobservadores, calculada pelo coeficiente de concordância Kappa de Cohen e a estabilidade temporal, pela correlação de Spearman. Todos os procedimentos éticos foram contemplados no estudo. Resultados: a dimensão das práticas e dos comportamentos de segurança da escala apresentou um α=0,895 para os seus 11 itens. Na confiabilidade interobservador, 7 dos 11 itens obtiveram de boa a excelente concordância entre os juízes. Os valores do Índice Kappa evidenciam que o instrumento é válido e fidedigno. As práticas e os comportamentos de segurança são influenciados pelo tempo de institucionalização, idade superior a 85 anos e capacidade de marcha. Conclusão: os resultados indicam uma boa reprodutibilidade, o instrumento é válido e fidedigno, permitindo a utilização do instrumento na clínica em idosos com declínio cognitivo e na investigação.

Objetivo: determinar las propiedades psicométricas de la dimensión de prácticas y conductas de seguridad de la Escala de prácticas y comportamientos de los ancianos institucionalizados para prevenir las caídas, sobre una muestra de ancianos con deterioro cognitivo. Método: estudio metodológico de abordaje cuantitativo para evaluar las propiedades psicométricas de la escala sobre muestra de 102 ancianos con deterioro cognitivo, residentes en dos hogares para ancianos. Evaluación de consistencia interna verificada por α de Cronbach, confiabilidad interobservadores calculada por coeficiente de concordancia Kappa de Cohen, estabilidad temporal comprobada por correlación de Spearman. Fueron contemplados todos los procedimientos éticos. Resultados: la dimensión de prácticas y comportamientos de seguridad de la escala expresa α=0,895 para sus 11 ítems. En confiabilidad interobservadores, 7 de los 11 ítems obtienen buena o excelente concordancia entre los evaluadores. Los valores del índice Kappa evidencian que el instrumento es válido y fidedigno. Las prácticas de comportamiento de seguridad están influidas por el tiempo de institucionalización, edad superior a 85 años y capacidad de marcha. Conclusión: los resultados demuestran buena reproductividad, el instrumento es válido y confiable, pudiéndoselo utilizar en la clínica con ancianos con deterioro cognitivo y en la investigación.

Valores proteicos en adultos mayores institucionalizados en el municipio de Santa Clara / Proteic values in elderly institutionalized in the municipality of Santa Clara

Introducción: La población cubana enfrenta hoy el fenómeno del envejecimiento. Objetivo: Caracterizar valores proteicos en adultos mayores institucionalizados. Métodos: Se efectuó un estudio descriptivo y transversal de adultos mayores con 60 años y más, quienes vivían en los hogares de ancianos de Santa Clara, provincia de Villa Clara, desde enero del 2016 hasta diciembre del 2017. El universo estuvo constituido por 366, de los cuales se seleccionó una muestra no probabilística de 182. Se determinaron valores séricos de proteínas totales, albúmina, globulinas e inmunoglobulinas (A, G, M), así como complemento C3 y C4. Resultados: Predominó el sexo femenino (53,3 %), el color de la piel blanco (78,6 %), las edades de 60-74 años, el estado nutricional sobrepeso y los antecedentes de osteoartrosis, hipertensión arterial e hiperlipidemia. Las proteínas totales presentaron valores de 74,00 ± 5,461 y las inmunoglobulinas: IgA 2,57 ± 0,944; IgG 11,06 ± 2,094 e IgM 1,13 ± 0,612. Conclusiones: Se produjo una disminución progresiva de proteínas totales, albúmina, globulinas e inmunoglobulinas (G, A y M), estas se mantuvieron en el rango de normalidad pero sus valores medios estuvieron cercanos al límite inferior de dicho rango. Con el avance de la edad este fenómeno aumentó y se produjo una mayor disminución. El complemento C3 y C4 no presentó variaciones en relación con el valor normal.

Introduction: The Cuban population faces today the phenomenon of aging. Objective: To characterize proteic values in institutionalized elderly. Methods: A descriptive and cross-sectional study of elderly with 60 years and more who lived in the home for the aged of Santa Clara, Villa Clara, was carried out from January, 2016 to December, 2017. The universe was constituted by 366, of which a non probabilistic sample of 182 was selected. Seric values of total proteins were determined, albumin, globulins and immunoglobulins (A, G, M), as well as C3 and C4 supplement. Results: There was a prevalence of female sex (53.3%), white skin color (78.6%), 60-74 ages, overweight as nutritional state and history of osteoarthrosis, hypertension and hyperlipemia. Total proteins presented values of 74.00 ± 5.461 and immunoglobulins: IgA 2.57 ± 0.944; IgG 11.06 ± 2.094 and IgM 1.13 ± 0.612. Conclusions: a progressive decrease of total proteins, albumin, globulins and immunoglobulins (G, A and M) took place, they stayed in the range of normality but their means values were near the inferior limit of such range. With the advance of age this phenomenon increased and a higher decrease took place. The C3 and C4 complement didn't present variations related to the normal value.

Dimensions assigned to Long Term Care Facilities by managers and health professionals: interfaces and contradictions / Dimensões atribuídas por gestores e profissionais às Instituições de Longa Permanência: Interface e contradições

Abstract Objective: to analyze the dimensions assigned to long term care facilities for the elderly (LTCFs) by managers and health professionals. Method: a descriptive-exploratory study with a qualitative approach was conducted in the metropolitan area of Belo Horizonte, through ten focus groups with 51 managers and health professionals. Analysis was based on the content of the interviews. Results: considering the most common themes, three empirical categories emerged that explained the consensuses and contradictions present in the empirical material: a) the LTCF and the perpetuation of the asylum space; b) the LTCF as a space for health treatment c) a home: convergences and contradictions in the LTCF. Initially, findings relating to the political definition of the LTCF directly linked to social organs are evidenced. In the second category, LTCFs are described negatively, perpetuating the stigma of the term "asylum" which still reverberates in their daily lives. As a treatment space, LTCFs are considered health facilities due to the services offered and the presence of health professionals on a daily basis. In the third analysis, they are recognized as a home, based on current legislation that describes the LTCF as a collective, residential area. Conclusion: it is important to discuss the different attributes given to the LTCF to create resolutive actions in the care of the institutionalized elderly. The importance of thinking about the rights to health of the elderly and the need to understand how they inhabit this space is also emphasized. AU

Resumo Objetivo: analisar as dimensões atribuídas por gestores e profissionais às Instituições de Longa Permanência para Idosos (ILPI). Método: pesquisa descritivo-exploratória, de abordagem qualitativa, realizada na Região Metropolitana de Belo Horizonte, Minas Gerais, Brasil, por meio de entrevistas e 10 grupos focais com 51 gestores municipais e 62 profissionais atuantes. A análise deu-se pelo conteúdo das entrevistas. Resultados: A partir do agrupamento dos temas recorrentes emergiram três diferentes dimensões que explicitaram os consensos e contradições presentes no material empírico: a) ILPI e a perpetuação do espaço asilar, b) ILPI como espaço de tratamento e c) Um domicílio: convergências e divergências na ILPI. Inicialmente, são evidenciados achados referentes à definição política sobre as ILPI vinculadas diretamente aos órgãos sociais. Na segunda categoria, as ILPI são conotadas negativamente perpetuando-se o estigma da denominação de "asilo" que ainda repercute no seu cotidiano. Como espaço de tratamento, as ILPI são tidas como estabelecimentos de saúde em decorrência dos serviços ofertados e da presença de profissionais de saúde na rotina na instituição. Numa terceira análise, são reconhecidas como um domicílio, fundamentada na legislação vigente que aponta a ILPI como espaço coletivo de caráter residencial. Conclusão: faz-se necessária a discussão de diferentes atributos dados às ILPI com o intuito de efetivação de ações resolutivas no cuidado ao idoso institucionalizado. Ressalta-se a importância de se pensar no direito à saúde desses idosos e a necessidade de compreensão do modo como os idosos habitam esse espaço. AU

Atenção à saúde bucal do idoso institucionalizado por meio e ações de extensão universitária / Oral health care of institutionalized elderly by means of university extension actions

Introdução: o aumento da expectativa de vida da população brasileira demanda atendimento odontogeriátrico integrado às outras áreas da saúde, com vistas a fornecer melhor qualidade de vida aos idosos, especialmente aos mais vulneráveis. Objetivo: verificar as necessidades em relação à saúde bucal de idosos institucionalizados, e realizar a reabilitação oral e prevenção das doenças bucais, por meio de ações de extensão comunitária. Método: participaram deste estudo 46 idosos, 28 mulheres e 18 homens (média de idade de 76 anos), procedentes de Instituição de Longa Permanência para Idosos (ILPI) localizada na cidade de Passo Fundo - RS. O processo metodológico envolveu exame clínico (anamnese, exame físico extra e intrabucal), diagnóstico/planejamento e tratamento odontológico. Resultados: observou-se que a maior parte dos idosos necessitava confecção de dentaduras superiores e/ou inferiores (50%), exodontias (30,43%), confecção de próteses parciais (15,21%), tratamento periodontal (10,86%) e dentística (6,52%). Discussão e Conclusão: mediante estes resultados as ações de extensão comunitária focalizaram procedimentos odontológicos específicos que associados às orientações de higiene oral e prevenção melhoraram significativamente a mastigação, estética e nutrição dos pacientes, contribuindo também para incrementar a qualidade de vida e a autoestima dos idosos. (AU)

Introduction: increased life expectancy of the population demand integrated odontogeriatric service to other areas of health, in order to provide a better quality of life for older people, especially the most vulnerable. Objective: the aim of this study was to assess the needs in relation to oral health of institutionalized elderly, and perform oral rehabilitation and prevention of oral diseases, through community outreach activities. Method: the study included 46 elderly, 28 women and 18 men, average age 76 years, coming from long-stay institutions for the elderly (LTCF), located in the city of Passo Fundo-RS. The methodological process involved clinical examination (anamnesis, physical examination and intraoral extra), diagnostic/planning and dental treatment. Results: it was observed that most elderly needed making dentures upper and/or lower (50%), tooth extraction (30.43%), making partial dentures (15.21%), periodontal treatment (10.86%) and dentistry (6.52%). Discussion and Conclusion: with these results the community outreach activities focused on specific dental procedures associated with the guidelines of oral hygiene and prevention significantly improved mastication, esthetics and nutrition of patients contributing also to increase the quality of life and self-esteem of the elderly. (AU)

Estado nutricional de idosos em uma instituição de longa permanência / Nutritional status of elderly in a long-term institution

Objetivo - Identificar o estado nutricional e fatores associados em idosos de uma instituição de longa permanência no Município de São Paulo. Métodos - Estudo transversal com 42 idosos independentes, de 60 anos ou mais de idade. Foi realizada avaliação nutricional por meio de Índice de Massa Corporal (IMC) e estudo das variáveis: idade, gênero, tempo de residência na instituição, número de doenças e de medicamentos, e tipos de próteses dentárias utilizadas. Resultados - Entre as mulheres 41,7% apresentaram excesso de peso e 20,8% baixo peso, 55,5% dos homens apresentaram peso normal, 22,2% baixo peso e 22,3% excesso de peso. As doenças mais prevalentes nestes moradores que fazem uso, em média, de 5,8 medicamentos ao dia, são hipertensão, dislipidemia, depressão e incontinência urinária. O uso de próteses dentárias é presente em 92,9%. Conclusões - Há um maior desequilíbrio no estado nutricional entre as mulheres, apresentando, principalmente excesso de peso, e a maioria dos homens classificados com peso normal. A totalidade dos idosos possui doenças, sobretudo as crônicas não transmissíveis, e a maioria faz uso de fármacos e de próteses dentárias.

Objective - To identify the nutritional status and associated factors in an elderly long-stay institution in São Paulo. Methods - Cross-sectional study, with 42 independent seniors, 60 years or older. Nutritional assessment was performed using Body Mass Index (BMI) and to study variables: age, gender, residence time in the institution, number of illnesses and medications, and types of dental prostheses used. Results - Among women 41.7% were overweight and 20.8% underweight, and 55.5% of men had normal weight, underweight 22.2% and 22.3% overweight. The most prevalent of these residents who use an average of 5.8 medications per day, are hypertension, dyslipidemia, depression and urinary incontinence. The use of dental prostheses is present in 92.9%. Conclusions - There is a greater imbalance in the nutritional status of women, presenting, especially overweight, and most men classified as having normal weight. All the elderly have diseases, especially chronic diseases, and most uses of drugs and dental prostheses.

Avaliação do equilíbrio postural e dos fatores ambientais relacionados às quedas em idosos de instituições de longa permanência / Assessing postural balance and the environmental factors related to falls among the elderly living in homes for the aged

O presente artigo busca caracterizar o perfil sócio-econômico de 21 idosos acima de 60 anos de duas instituições de longa permanência da cidade de Franca-SP, avaliar o equilíbrio postural através da escala de equilíbrio de Berg e detectar os possíveis fatores associados às quedas no ambiente físico das instituições. Os resultados apontaram para 61,9% de idosos do sexo feminino, com idades entre 60 e 85 anos ou mais, e maior percentual na faixa etária entre 60 e 70 anos, solteiros, escolaridade funda mental, tempo de instituição entre 10 e 26 anos, com doenças de base relacionadas aos sistemas cardiorrespiratório, músculo-esquelético, somato-sensório e tegumentar, que recebiam proventos da aposentadoria e destinavam cerca de 70% da renda para a instituição. As pontuações obtidas da aplicação da escala possibilitaram a identificação de que quanto mais a tarefa exigia do idoso, menor era a pontuação obtida pelo mesmo. Em três idosos, o número máximo de pontos atingidos predizia um equilíbrio debilitado, com 100% de risco de quedas. As duas instituições possuíam características físicas, ambientais e de pessoal similares e apresentavam alguns atores associados à possibilidade de quedas, como a inexistência de barras de apoio em sanitários e a presença de uma escada de livre acesso aos idosos, além de uma preocupação em relação ao uso adequado de roupas e sapatos pelos idosos. Embora o estudo tenha gerado resultados de caráter mais descritivo do que conclusivo, o con junto de dados possibilitou algumas reflexões acerca da situação dos idosos das instituições, direcionando para a impor tância de realização de pesquisas multidisciplinares que contribuam para um (re)pensar a situação de vida dos mesmos nas instituições de longa permanência.

The purpose of this descriptive study was to characterize the socioeconomic profile of 21 elderly individuals aged over 60 years living in homes of the aged in the city of Franca, in the state of São Paulo, assess their postural balance through the Berg's Scale of Balance, and find the possible factors associated to falls at the institutions. The results presented that 61.9% of the elderly subjects were women, with ages from 60 to 85 years or more, with most in the age group between 60 and 70 years, single, with primary education level, living in the institution for a period of 10 to 26 years, with underlying diseases related to the cardiopulmonary, muscle-skeletal, somatosensorial and tegumentary systems, and who received retirement pension and spent about 70% of their income with the institution. The scores obtained on the scal allowed for identifying that the more the task demanded from the elderly, the lower the score they obtained. In three individuals, the highest score they achieved predicted impaired balance, with 100% of risk for falls. The institutions had similar physical, environmental, and personal characteristics and presented some factors associated to the possibility of falls, such as the lack of support grab bars in the bathrooms and stairs with easy access for the aged individuals, besides a concern about the using clothes and shoes appropriately. Although the study yielded more descriptive than conclusive results, the data allowed for reflecting on the situation of the elderly individuals from the studied institutions, showing there is a need for performing multidisciplinary research that contribute to (re)thinking about their situation at these homes.

A importância do levantamento de queixas de idosos institucionalizados durante a entrevista para o planejamento da reabilitação fonoaudiológica / La importancia de coleccionar quejas de envejecidos institucionalizados durante la entrevista de planeamiento de rehabilitación fonoaudiológica / The importance of collecting complaints of institutionalized old people during the interview for planning phonoaudiological rehabilitation

O objetivo do presente estudo foi caracterizar as queixas relatadas por idosos institucionalizados durante entrevista fonoaudiológica, ressaltando a sua importância para o processo de reabilitação. Foram avaliados 28 idosos residentes em uma Instituição de Longa Permanência Para Idosos (ILPIs), filantrópica, localizada no Município de Santo André-SP, sendo 18 (64,3%) do sexo masculino e 10 (35,7%) do sexo feminino; com idade média de 66,86 (+/- 0.95) anos. A obtenção de dados foi realizada pelo levantamento de queixas fonoaudiológicas, feita por meio de entrevista, auxiliada por um questionário que contemplou informações sobre dados pessoais, queixas referentes à saúde geral, audição, voz, fala, alimentação, linguagem e cognição. Foram encontradas queixas fonoaudiológicas referentes à cognição (96,4%), linguagem (78,6%), motricidade oral / alimentação (53,6%), audição (46,4%), voz (35,7%) e fala (3,6%), podendo estar vinculadas ao envelhecimento ou a patologias. Para diferenciá-las, o fonoaudiólogo proporcionará apoio em diagnóstico, tratamento e reabilitação. As entrevistas revelaram um alto índice de queixas fonoaudiológicas de idosos institucionalizados, havendo necessidade do profissional configurá-la como um espaço de escuta e acolhimento ao paciente, possibilitando, durante toda a reabilitação, confiança e credibilidade no profissional que agora, após escutar, irá direcionar o foco terapêutico, construindo um planejamento individualizado ao quadro clínico e moldado pelos interesses e necessidades do paciente.

The aim of the present study was characterizing complaints reported for institutionalized old people during the phonoaudiological interview, emphasizing its importance for the rehabilitation process. 28 resident old people were evaluated at a philanthropic Long-Permanence Institution for Old People (ILPIs), located in Santo André-SP, being 18 (64.3%) male and 10 (35.7%) female; mean age of 66.86 (+/-0.95) years. Data collecting was carried out by receiving phonoaudiological complaints, done through interviews helped by a questionnaire that contemplated information on personal data, complaints referring to general health, hearing, voice, speech, food, language and cognition. Phonoaudilogical complaints were found referring to cognition (96.4%), language (78.6%), oral motor function / food (53.6%), hearing (46.4%), voice (35.7%) and speech (3.6%) that may be linked to aging or to pathologies. To differentiate them, the phonoaudiologist will provide support in diagnosis, treatment and rehabilitation. The interviews revealed a high rate of phonoaudiological complaints of institutionalized old people, and there is aneed for the professional to shape it like a space of listening and human support to the patient, making possible, during the entire rehabilitation process, confidence and credibility in the professional, which, after listening, will direct the therapeutic focus, building an individualized plan according to the clinical condition and molded by the interests and necessities of the patient.

El presente estudio intenciona caracterizar quejas hechas por envejecidos institucionalizados durante la entrevista fonoaudiológica, enfatizando su importancia para el proceso de rehabilitación. 28 envejecidos residentes fueron evaluados en una Institución de Permanencia Larga para Viejos (ILPIs), de naturaleza filantrópica, localizada en Santo André-SP, siendo 18 varones (64.3%) y 10 mujeres (35.7%); edad media de 66.86 (+/-0.95) años. El recogimiento de datos fue realizado recibiendo quejas fonoaudiológicas hechas en entrevistas ayudadas por un cuestionario que contempló informaciones sobre datos personales, quejas que se refieren a salud general, audición, voz, habla, comida, lenguaje y cognición. Quejas fonoaudiológicas fueron encontradas con referencia a la cognición (96.4%), el lenguaje (78.6 %), las funciones motoras-orales / comida (53.6%), audición (46.4%), voz (35.7%) y habla (3.6 %) que pueden se deber al envejecimiento o a patologías. Para diferenciarlos, el fonoaudiólogo proporcionará el apoyo en diagnóstico, tratamiento y rehabilitación. Las entrevistas revelaron una alta taja de quejas fonoaudiológicas de envejecidos institucionalizados, y hay la necesidad del profesional formarlas como un espacio de escucha y apoyo humano al paciente, haciendo posible, durante el proceso de rehabilitación entero, la creación de confianza y credibilidad en el profesional, que, después de la escucha, dirigirá el foco terapéutico, construyendo un plan individualizado según la condición clínica y moldeado por los intereses y las necesidades del paciente.

Health Status for the Elderly Living in a Home for the Aged

BACKGROUND: The number of the elderly living in a home for the aged is increasing as the socio-culture changes, but health management for the institutionalized elderly has been discontinuos, centered on the single treatment of the disease. The aim of this study is to collect baseline data which is for development of the health maintenance program for the elderly living in a house for the aged. METHODS: We reviewed the journals related to the health maintenance program for the elderly. We selected the contents about health management program for the elderly. 3 domain of the contens were done. The 3 domain were physical health (interview for health habit, physical exam, clinical test), mental health (Korean version of geriatric depression scale, Korean version of mini mental status examination), assessment of functional status (katz activities of daily living, lawtons instrumental activities of living).. 158 elderly people living in a home for the aged in Seoul have been researched since August 1996. RESULT: Total subjects were 158 (men 73, women 85). The average age was 78.1(+/-7.2). The rate of smoking, alcohol drinking, exercise were 32%, 20.4%, 34.4%, each. The rate of assitive device use was 28.3%. The prevalence of sleep distur-bance, urinary incontinence were 69.7%, 17.3%. The prevalence of gait disturbance was 38.4%. The occurrence rate of falling for last 1 year was 29.6%. The prevalence of fear of falling was 57.2%. The positive rate of VDRL was 12.3%, the prevalence of anemia was 48.7%. The prevalence of degenerative arthritis, hypertension were 44.2%, 31.3%, each. The prevalence of depression, dementia were 71.3%, 56.7%, each. The rate of elderly person dependent on one and more ADL was 8.1%. CONCLUSION: We found the health status of the elderly living in a home for the aged. On the basis of the results of the study, it is needed that continuous application of the program for management of the elderly in a home for the aged, keeping searching proper contents of examination and methods of measurement.

Comparison of the depression and anxiety between the elderly in the home for the aged and those in the community / 영남의대학술지

This survey was conducted from January 1991 to May 1991. Two hundred and eight residents in 4 government supported homes for the aged and hundred and eleven living in the community in Taegu, Korea, were examined to evaluate the depression and the anxiety of the aged with combined anxiety and depression scale (CADS) and somatization symptom check list (SCL). There are no significant differences between residents in the home for the aged and those living in the community on the total scores of CADS and SCL. However, in the case of the total score of CADS of the female subjects in the home for the aged were significantly higher than those of the community residents. The elderly in the home for the aged tended to have pure depression, while community residents were likely to have anxiety and depression. Fifty-two subjects of home for the aged and sixty-nine of the community scored over 50 points of CADS, which indicates considerable depression or anxiety. In psychosocial factors, the subjects who in the following situations had statistically significant higher scores than others. The results were as follow. Poor health, unhappiness, unsatisfaction to the past occupation, pessimistic thought in future view for both group and unsatisfaction of the relationship with familiar people for the elderly in the community. The SCL scores of two groups subgrouped by under 49 and 50 on CADS showed significant differences between each subgroup on all of the SCL items. It could be suggested that somatic symptoms for the aged is a sign of depression.

A Study of Depression Observed Among The Eledrly Residing in Home For The Aged In Korea / 영남의대학술지

Using Zung's self-rating depression scale, the authors studied depression in 310 elderlies residing in the 9 home for the aged (HFA) in Kyungbuk area, and 234 elderlies living in Taegu city and 107 elderlies attending a Life-long education program in Taegu, which serve as a control group, Community resident elderlies (CRE). The research had been administered during the period from June to August, 1986. The results were as follows: 1. The mean scores of male, female, and the total of the elderlies in HFA were 38.95±11.55, 44.18±14.15, and 42.8±13.7 respectively while CRE marked 40.8±11.3 for male, 45.2±12.0 for female, and 43.4±11.9 for the total. Therefore there were significant differences between male and female in both groups (<0.01, p<0.001), though no significant difference between the two groups. However, the depression score of elderlies in HFA might be much higher than that of CRE if 81 elderlies (14.2%) in HFA who had been left out of the statistical evaluation due to their having severe depression, organic brain syndrome, or pseudoementia, etc had been included. 2. The score distribution by items for the elderlies in HFA were from highest scores hopelessness, worthlessness, emptiness, decreased appetite, confusion, while for CRE, hopelessness, decreased appetite, psychomotor retardation, indecisiveness, and worthlessness, Elderlies in HFA showed significantly high scores in depressed mood, weight loss, suicidal rumination (ideation) and psychomotor excitement, while CRE showed significantly high scores in decreased appetite, psychomotor retardation, indecisiveness, and dissatisfaction. 3. Elderlies who scored over 50 numbered 10 males (16%), 57 females (34%), and total of 67 (29%) in HFA and 28 male (21%), 77 females (37%), and total of 105 (31%) in CRE: female showed higher seores in both groups. 4. Psychococial factors such as getting older (respectively p<0.01, p<0.01), being Buddhist (respectively p<0.01, p<0.01), and monthly pocket money less than ₩30,000 (respectively p<0.001, p<0.001) were found to have a noticeable impact on the depression level of the elderlies in both groups. Factors such as illiteracy (p<0.001), monthly pocket money less than ₩10,000 (p<0.05), and having no family (p<0.01) recorded significantly higher scores among CRE than the elderlies in HFA.