ABSTRACT
BACKGROUND: We aimed to gain more insight into autonomy of older people with intellectual disabilities in a residential care facility in making choices. METHODS: We performed a descriptive ethnographic study in a residential facility in the Netherlands for 22 persons, aged 54-89 years, with mild to moderate intellectual disabilities (IQ <70) and low social-emotional development levels. We combined participant observations and qualitative interviews. RESULTS: Based on the observations, the main themes for the interviews were established. Residents indicated to be free to make independent choices, and experienced less autonomy with regard to health issues and finances. Support staff stated that residents' level of autonomy depends on residents' characteristics, needs, preferences, the attitude of support staff and the rules of the care institution. CONCLUSION: Residents had a clear view on their autonomy in making independent choices. Support staff is mindful of preserving residents' autonomy, which in practice is limited.
Subject(s)
Intellectual Disability , Aged , Humans , Frail Elderly , Anthropology, Cultural , Residential Facilities , Attitude of Health PersonnelABSTRACT
Social workers (SW) and community health workers (CHW) have emerged as key workforce personnel in efforts to care for elders in the U.S. However, little is known about the presence and roles of SW and CHW in primary care practices. This paper presents findings from a nationally representative survey of geriatrics and primary care practices. Physician and nurse practitioner clinicians were randomly selected within practices, stratifying by practice staffing and presence/absence of geriatric clinicians; our final sample for this analysis included 341 practices. Key findings include: reported challenges in meeting the social service needs of elders, underutilization of SW, and fuller utilization of social work competencies in practices in which both SW and CHW were present. These findings offer a unique perspective of SW on interprofessional teams and have implications for the future of the profession.
Subject(s)
Community Health Workers/organization & administration , Frail Elderly , Nurse Practitioners/psychology , Physicians/psychology , Social Work/organization & administration , Adult , Aged , Aged, 80 and over , Attitude of Health Personnel , Cross-Sectional Studies , Female , Geriatric Assessment/methods , Humans , Male , Middle Aged , Professional CompetenceABSTRACT
RESUMO Objetivo: analisar a associação dos marcadores e da condição de fragilidade física à incontinência urinária em assistência ambulatorial de geriatria e gerontologia. Método: estudo transversal, desenvolvido na atenção secundária à saúde de ambulatório do Paraná, com 384 idosos. Coletaram-se dados entre setembro de 2016 a março de 2017 mediante fenótipo de fragilidade e questionário International Consultation on Incontinence Questionnaire - Short Form. Resultados: dos idosos 118 (30,7%) foram considerados não frágeis, 212 (55,2%) pré-frágeis, 54 (14,1%) frágeis, 106 (27,6%) com incontinência urinária, 50 (47,2%) com impacto muito grave na rotina diária, 18 (17,0%) grave, 16 (15,0%) moderado, 11 (10,4%) leve a nenhum impacto. Associaram-se à incontinência urinária a condição de fragilidade (p=0,011), os marcadores força de preensão manual diminuída (p=0,027), fadiga e exaustão (p=0,002) e velocidade da marcha reduzida (p=0,000). Conclusão: os resultados contribuem com o desenvolvimento crítico da enfermagem no momento de avaliar as necessidades de cuidado gerontológico.
RESUMEN Objetivo: analizar la asociación de los marcadores y la condición de fragilidad física a la incontinencia urinaria en la atención ambulatoria en geriatría y gerontología. Método: estudio transversal, desarrollado en atención secundaria ambulatoria de salud del estado de Paraná (Brasil), con 384 ancianos. La recolección de datos se realizó entre septiembre de 2016 y marzo de 2017, mediante fenotipo de fragilidad y cuestionario International Consultation on Incontinence Questionnaire - Short Form. Resultados: 118 (30,7%) ancianos se consideraron no débiles, 212 (55,2%) pre débiles, 54 (14,1%) débiles, 106 (27,6%) con incontinencia urinaria, 50 (47,2%) con impacto muy grave en la rutina diaria, 18 (17,0%) con impacto grave, 16 (15,0%) con impacto moderado, 11 (10,4%) con leve o ningún impacto. Se asociaron a la incontinencia la condición de fragilidad (p=0,011), los marcadores fuerza de sujeción manual disminuida (p=0,027), fatiga y agotamiento (p=0,002) y velocidad da marcha reducida (p=0,000). Conclusión: los resultados contribuyen al desarrollo crítico de la enfermería al momento de evaluar las necesidades de cuidado gerontológico.
ABSTRACT Objective: To analyze the association of markers and physical frailty condition with urinary incontinence in outpatient geriatric and gerontological care. Method: A cross-sectional study, developed in the secondary health care of an outpatient clinic of Paraná, with 384 elderly. Data were collected between September 2016 and March 2017 through frailty phenotype and the questionnaire International Consultation on Incontinence Questionnaire - Short Form. Results: of the elderly 118 (30.7%) were considered non-frail, 212 (55.2%) pre-frail, 54 (14.1%) frail, 106 (27.6%) with urinary incontinence, 50 (47.2 %) with very severe impact on daily routine, 18 (17.0%) severe, 16 (15.0%) moderate, 11 (10.4%) mild to no impact. Urinary incontinence was associated with the condition of frailty (p=0.011), the markers for decreased handgrip strength (p=0.027), fatigue and exhaustion (p=0.002) and reduced gait speed (p=0.000). Conclusion: The results contribute to the critical development of nursing when assessing the needs of gerontological care.
Subject(s)
Humans , Aged , Aged, 80 and over , Urinary Incontinence , Frail Elderly , Geriatric Nursing , Aged , FrailtyABSTRACT
PURPOSE: The purpose of this study was to identify the effect of subjective xerostomia and salivary pH in salivary glands stimulated by laughter therapy in frail elderly women. METHODS: The research used a one-group pretest-posttest design. Data were collected from July 2, 2015 to September 30, 2015. A sample of 41 frail female elderly patients was recruited at A Nursing Home in K City, Korea. We measured xerostomia and salivary pH using a questionnaire and BCP test paper (pH 5.6~7.2). Laughter therapy was given once a week for four weeks (3 items). Data were analyzed through descriptive statistics, independent t-test, ANOVA, paired t-test and Cronbach's using the SPSS 18.0 program. RESULTS: There were significant differences in salivary pH according to oral health (t=-2.06, p<.05). There were significant differences in xerostomia (t=4.41, p<.001) and salivary pH (t=-7.94, p<.001) after salivary glands stimulated by laughter therapy. CONCLUSION: Salivary glands stimulated by laughter therapy improved xerostomia and salivary pH of the frail elderly. Therefore, salivary glands stimulated by laughter therapy may be useful in promoting and maintaining oral health among the frail elderly in the rapidly increasing population of old people.
Subject(s)
Aged , Female , Humans , Frail Elderly , Hydrogen-Ion Concentration , Korea , Laughter Therapy , Laughter , Nursing Homes , Oral Health , Salivary Glands , XerostomiaABSTRACT
AIM: To describe the programme and research protocol of our updated preventive home visit programme for ambulatory frail older adults in the Japanese Long-Term Care Insurance system. BACKGROUND: Our previous trials have shown that the nature of recommendations during preventive home visits is a key issue. The present programme has updated our previous one by including a unique structured assessment with treatment recommendations tied to an ongoing programme for quality assurance. DESIGN: A randomized, controlled trial. METHODS: Eligible participants (n = 360) will be randomly assigned to home visit (n = 179) and control (n = 181) groups in three suburban municipalities. Nurses provide recommendations based on structured assessments to participants in visit group every 3 months from September 2011-October 2013. The primary outcomes are parameters related to quality of life, including activities of daily living, instrumental activities of daily living, depression, cognitive capacity, daily-life satisfaction and self-efficacy for health promotion; these are collected by mail at baseline, 12 and 24 months. The secondary outcome is long-term care use over the study period. To evaluate the visit process, we are qualitatively analysing documentation data from the assessment sheet and chart. CONCLUSION: This study is collecting and analysing evidence regarding the process and outcomes of preventive home visits based on structured care-need assessments. TRIAL REGISTRATION: The study protocol was registered for the UMIN clinical registry approved by ICMJE (No. UMIN000006463, October 04, 2011).
Subject(s)
Frail Elderly , House Calls , Preventive Health Services/standards , Aged , Case-Control Studies , Humans , Japan , Single-Blind MethodABSTRACT
Objetivo. Determinar la prevalencia del síndrome de fragilidad y los factores asociados a este, en adultos mayores no institucionalizados de Emiliano Zapata, Tabasco, México,en el año 2008. Material y métodos. Estudio de diseño transversal, con universo de 2.375 adultos mayores. La muestra fue probabilística (p=0,9, q=0,1, Z=1,96, d=0,05), de 94 adultosmayores. El muestreo fue aleatorio simple. Los criterios de inclusión fueron cualquier sexo y sin enfermedades cognitivas de diagnóstico conocido. Se consideraron las variables sociodemográficas, enfermedades, estado nutricional, funcionalidad para actividades básicas de la vida diaria y síndrome de fragilidad. Como instrumentos seusaron cuestionario de nutrición (Nutritional Screening Initiative), escala de Katz y escala de Barber. Para el análisis se usaron estadística descriptiva, prueba exacta deFisher con 95% de confianza (p≤0,05) y el software Epi Info® versión 3,3,2.Resultados. Se incluyeron 94 adultos mayores, 63% femeninos y 37% masculinos. La edad media fue 69,4±7,1 años. La morbilidad estuvo presente en 85%. Hubo riesgonutricional elevado en 86,2%. La dependencia básica para la vida diaria fue de 9,6%. La prevalencia del síndrome de fragilidad fue 98%. Como factor asociado se encontróel riesgo nutricional (p=0,02). Conclusiones. La prevalencia del síndrome de fragilidad observada en esta serie fue mayor ala reportada por otros autores. El estado nutricional se encuentra asociado a este síndromegeriátrico...
Objective: To determine the frailty syndrome prevalence and the associated factors to it, in noinstitutionalized older adults from Emiliano Zapata, Tabasco, Mexico, in 2008. Material and methods: Design: cross-sectional. Universe: 2.375 older adults. Sample: randomized(p=0,9, q=0,1, Z=1,96, d=0,05) 94 olderadults. Sampling: randomized simple. Inclusion criterions: any sex, without cognitive diseases of known diagnosis. Variables: socio-demographics,diseases, nutritional status, functionality for basic activities of daily life, frailty syndrome.Instruments: nutrition questionnaire (Nutritional Screening Initiative), Katz scale, Barber scale. Analysis: descriptive statistic, Fisher Exact Testwith 95% of confidence (p≤0.05). Software: Epi Info® version 3.3,2.Results: 94 older adults, 63% females, 37% males; mean age, 69,4±7,1 years-old; present morbility, 85%; high nutritional risk,86,2%; basicdependence for daily life, 9,6%; frailty syndrome prevalence, 98%; associated factors: nutritionalrisk (p=0,02). Conclusions: The frailty syndrome prevalenceobserved in this series was major to report for other authors. The nutritional status its associatedto this geriatric syndrome....
