The potential of wash-and-dry toilets to improve the toileting experience for nursing home residents.

PURPOSE: We investigated the feasibility of using a "wash-and-dry" toilet in the nursing home. DESIGN AND METHODS: We used a controlled comparison baseline-versus-treatment design with 22 female nursing home residents aged 75 and older living in a 562-bed, not-for-profit nursing home facility in Maryland. The Luscence Luxury Lavage wash-and-dry toilet-bidet system was installed in the bathrooms of the experimental group. Measurements included staff and resident toilet experiences and toilet reaction questionnaires, utilization logs, Minimum Data Set information, Mini-Mental State Examination scores, and urine cultures. RESULTS: About half of the residents and staff members reported the toilet to have a positive effect on toileting. We saw a positive trend in resident affect for the experimental group that was not apparent for the comparison group. Nursing staff reported that the toilet functions did clean the residents, but that cleaning was not complete. Bacterial content of urine decreased in the experimental group and increased in the comparison group during the trial. Toilet installation was more complex than anticipated. IMPLICATIONS: These results show that a wash-and-dry toilet shows promise for improved resident comfort in toileting and cleanliness, although further research is needed to verify the findings. Improved toilet design, design of nursing homes, and design of care activities would all improve the utility of these toilets in the nursing home population.

Socio-environmental exercise preferences among older adults.

BACKGROUND: To examine preferences concerning social and environmental aspects of exercise in the elderly population. METHODS: Participants were 324 community-dwelling persons aged 74-85 years who completed a health questionnaire that included items on exercise preferences as well as questions on demographic variables, health, and exercise habits. Selected participants then completed a physical performance battery to measure lower body functioning. RESULTS: A physician's advice to exercise, monitoring by a health professional, an evaluation of the exercise program by a professional, and the quality of the instructor were all rated as important or very important by at least 70% of the participants. Several other factors such as easy access to exercise facilities, type of exercise performed, free or low cost of a program, and other participants being of the same age were rated as slightly important or important. Preferences were related to participants' health and demographic characteristics. For example, participants who were not married were more interested in the social aspects of exercise programs, and those with higher levels of education and more resources were less concerned with program costs. CONCLUSIONS: The findings suggest that exercise programs should be tailored to meet the needs and wishes of subgroups of this population. In order to motivate at-risk elderly persons to exercise, programs must take these varying preferences into account and explore their meaning for program design.

Long-term abstinent alcoholics have a blunted blood glucose response to 2-Deoxy-d-glucose.

AIMS: In this study we explored the relationship between alcohol and carbohydrate consumption in long-term abstinent alcoholics. METHODS: We employed an established laboratory paradigm which allowed us to stimulate and measure dietary intake. 2-Deoxy-d-glucose (2-DG) is a glucose analogue that causes an intracellular energy deprivation resulting in exaggerated food consumption and a compensatory metabolic response to raise blood glucose. Using a double-blind design, we gave an infusion of 25 mg/kg 2-DG or placebo to 20 long-term abstinent alcoholics and 19 healthy volunteers. RESULTS: There were no baseline differences in any dietary, behavioural or biochemical variables. As expected, 2-DG increased caloric consumption and blood glucose levels in a time-dependent fashion. There were no differences in food consumption between the alcoholics and the healthy volunteers following the 2-DG stimulus. However, the alcoholic group had a significantly blunted response in blood glucose. CONCLUSIONS: The origin of this atypical blood glucose response may antedate the onset of alcoholism, or it may be secondary to alcohol-related damage that persists beyond 6 months. Previous accounts of increased sweet consumption in alcoholics were not substantiated, although they may be present in the peri-withdrawal period.