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1.
J Nutr Gerontol Geriatr ; 34(2): 90-109, 2015.
Article in English | MEDLINE | ID: mdl-26106983

ABSTRACT

Nutrition interventions are important as the older population, most of whom live in the community, increases in size and diversity. They are key to leading a healthy, functional life and mitigating chronic health conditions. The Older Americans Act Nutrition Program served 86.3 million congregate and 137.4 million home-delivered meals to 1.6 million and 850,000 older adults, respectively (2012). Congregate and home-delivered participants were older, poorer, sicker, more functionally impaired, and at a greater risk of institutionalization than the general U.S. older population. The Nutrition Program is publically and privately funded. About 44% of congregate and 30% of home-delivered expenditures are from federal sources, which dropped from $25 per older adult in 1990 to $12 in 2013. Despite multiple funding sources, funding is insufficient for the expanding older population. Health, nutrition, and social service professionals need to coordinate their community-based services to truly help older adults remain in their homes.


Subject(s)
Community Health Services/legislation & jurisprudence , Food Services/legislation & jurisprudence , Health Services for the Aged/legislation & jurisprudence , Homebound Persons/legislation & jurisprudence , Aged , Aged, 80 and over , Community Health Services/economics , Community Health Services/statistics & numerical data , Consumer Behavior , Financing, Government , Food Quality , Food Services/economics , Food Services/statistics & numerical data , Food Supply , Health Status , Humans , Malnutrition/prevention & control , Nutritional Physiological Phenomena , Nutritional Requirements , Poverty , United States
2.
Rev. esp. med. legal ; 41(2): 58-64, abr.-jun. 2015. tab
Article in Spanish | IBECS | ID: ibc-135538

ABSTRACT

El envejecimiento poblacional progresivo produce un incremento en las tasas de dependencia y en la presencia de determinadas comorbilidades cuya atención supone una importante carga económica y sociosanitaria. La fragilidad, como síndrome clínicamente detectable, permite identificar a los pacientes con mayor riesgo de deterioro físico, y que van a precisar un mayor nivel de atención médica y social. La detección de la condición de fragilidad en el anciano se relaciona con problemas médico-legales como los relacionados con la capacidad de decidir, el acceso a los recursos sanitarios, la supervisión del paciente y el final de la vida. El texto pretende describir los problemas médico-legales asociados a la condición de fragilidad y evaluar el diagnóstico precoz de la misma como medio para mejorar la calidad del cuidado al anciano, así como su planificación y la toma de decisiones (AU)


Population aging produces a gradual increase in the rates of dependency and the presence of certain comorbidities whose attention is an important economic and social load. Frailty, as a clinically detectable syndrome, can identify patients at increased risk of physical damage that will require a higher level of health and social care. The detection of the condition of frailty in the elderly is related to medical and legal problems, such as those related to the ability to decide, access to health services, patient's supervision and end of life decisions. The text tries to describe the medical and legal problems related to frailty and evaluate early diagnosis of this entity as a way to improve the quality of care provided as well as the planning of the elder's care and decision making in advance (AU)


Subject(s)
Humans , Male , Female , Aged , Aged, 80 and over , Frail Elderly/statistics & numerical data , Homebound Persons/legislation & jurisprudence , Patient Care Planning/organization & administration , Hospice Care/organization & administration , Health Services for the Aged/legislation & jurisprudence , Health of Institutionalized Elderly , Decision Making , Social Planning , Population Dynamics
4.
Sanid. mil ; 70(3): 204-212, jul.-sept. 2014. tab
Article in Spanish | IBECS | ID: ibc-128441

ABSTRACT

Dado el progresivo envejecimiento poblacional y el consiguiente aumento de la prevalencia de personas con diagnóstico de demencia y la preocupación de los familiares de que se pueda abusar de ellos, desde este artículo se exponen las normativas legales sobre la incapacitación y se hace una revisión de sentencias del Tribunal Supremo entre los años 2005 y 2012 en la que están implicadas personas con el diagnóstico de demencia. Se concluye que la incapacitación de una persona con demencia y el correspondiente nombramiento de un tutor que la represente y cuide de ella y de sus bienes, es un recurso legal recomendable que se hace necesario en multitud de ocasiones, como puede verse en las diferentes sentencias analizadas


In view of the progressive population aging and the consequent increase of the persons' prevalence with diagnosis of dementia and the concern of the relatives of which it could abuse them, from this article the legal regulations are exposed on the incapacitation and there is done a review of judgments of the Supreme Court between the year 2005 and 2012 in which persons are involved by the diagnosis of dementia. The conclusion is that the incapacitation of a person with dementia and the corresponding appointment of a tutor who represents and takes care of his of her and of his goods, is a legal advisable resource that becomes necessary in multitude of occasions, since it can turn in the different analyzed judgments


Subject(s)
Humans , Dementia/classification , Homebound Persons/legislation & jurisprudence , Persons with Mental Disabilities/legislation & jurisprudence , Disability Evaluation , Legal Guardians , Supreme Court Decisions
6.
Rev. esp. geriatr. gerontol. (Ed. impr.) ; 48(6): 285-289, nov.-dic. 2013.
Article in Spanish | IBECS | ID: ibc-116826

ABSTRACT

Diversos estudios epidemiológicos han evaluado la relación entre el estado de fragilidad con episodios adversos geriátricos en salud como la mortalidad, la discapacidad, la pérdida de movilidad, la institucionalización o las caídas, demostrando una clara asociación. Sin embargo, estos episodios han sido valorados de forma heterogénea, tanto en su número, criterios empleados y tiempo de seguimiento. Esta asociación implica que el objetivo de la atención geriátrica no debe ser solo la prevención, el diagnóstico y el tratamiento de los procesos de la enfermedad mediante el trabajo multidisciplinar y el uso de niveles asistenciales adaptados a la funcionalidad del anciano, sino la detección del estado de fragilidad entendido como un síndrome previo a la discapacidad sobre el que implementar tratamientos específicos que retarden su aparición, y las consecuencias derivadas del deterioro funcional. Otro objetivo es el apoyo a otras especialidades médicas para estadificar el nivel de riesgo en circunstancias específicas como los tratamientos del cáncer, la realización de pruebas diagnósticas o las intervenciones quirúrgicas (AU)


Several epidemiological studies have analyzed the association between frailty status and adverse geriatric health outcomes, with there being a clear relationship being demonstrated in mortality, disability, mobility loss, institutionalization and falls. However, different studies have evaluated different number of these adverse events, with different criteria, and with different follow-up periods. As a result of this relationship, the objective of geriatric medicine must not only be the prevention, diagnosis and treatment of diseases based on multidisciplinary team work and use of geriatric units according to functional status of patients, but the detection, prevention and treatment of frailty. Frailty must be considered as a pre-disability state that can be prevented and treated to delay its progression towards disability, institutionalization, and death. The characterization of frailty status can also help other medical specialties to stratify the risk of adverse health outcomes in oncology treatments, surgical interventions, or diagnostic procedures (AU)


Subject(s)
Humans , Male , Female , Aged , Aged, 80 and over , Osteogenesis Imperfecta/epidemiology , Frail Elderly/psychology , Frail Elderly/statistics & numerical data , Homebound Persons/psychology , Homebound Persons/statistics & numerical data , Evaluation of Results of Therapeutic Interventions/methods , Fractures, Bone/epidemiology , Fractures, Bone/prevention & control , Homebound Persons/education , Homebound Persons/legislation & jurisprudence , Homebound Persons/rehabilitation , Outcome and Process Assessment, Health Care/standards , Outcome and Process Assessment, Health Care , Evaluation of Results of Preventive Actions/methods , Prospective Studies
7.
Fed Regist ; 78(136): 42455-6, 2013 Jul 16.
Article in English | MEDLINE | ID: mdl-23858565

ABSTRACT

The Department of Veterans Affairs (VA) is amending its regulation concerning filling prescriptions written by non-VA providers for veterans of a period of war who are receiving increased pension because they are permanently housebound or in need of aid and attendance. This rulemaking revises the regulation to reflect the current statutory periods of war to ensure that eligible veterans engaged in current and future conflicts receive medications prescribed by non-VA physicians when appropriate for their care.


Subject(s)
Eligibility Determination/legislation & jurisprudence , Health Services Accessibility/legislation & jurisprudence , Homebound Persons/legislation & jurisprudence , Prescription Drugs , United States Department of Veterans Affairs/legislation & jurisprudence , Veterans Health/legislation & jurisprudence , Veterans/legislation & jurisprudence , Drug Prescriptions , Humans , Pensions , United States , Warfare
8.
Rev. esp. salud pública ; 86(4): 381-392, jul.-ago. 2012. tab
Article in Spanish | IBECS | ID: ibc-103658

ABSTRACT

Fundamento: La Ley de Dependencia reconoce formalmente el papel del cuidador informal, incorporando una prestación económica para el mismo. El objetivo del trabajo es analizar el efecto de la instauración de la ley sobre la existencia del cuidado informal y evaluar el impacto económico de dicho cuidado en la ley dependiendo del financiador. Métodos: Se realizó un estudio transversal a partir de una muestra representativa de la población dependiente baremada de la provincia de Cuenca en febrero de 2009, obteniéndose información de personas con grados II y III de dependencia. Se cuantificó el impacto económico de la existencia del cuidado informal para Cuenca (muestra), Castilla-La Mancha y España mediante una simulación de prestaciones basada en el supuesto de no existencia de cuidado informal. Resultados: El 81,74% de las prestaciones de dependencia correspondió a la prestación diseñada para el cuidado informal. El coste total de las prestaciones de dependencia se redujo entre un 36,51% y un 80,53% debido a la existencia de cuidado informal, desagregado en un ahorro del 122,97-251,04% para el usuario y del 23,30-54,47% para el erario público. El copago medio estimado para el usuario fue de un 13,25% para la muestra, ascendiendo al 21,65-25,77% bajo el supuesto de extinción del cuidado informal. Conclusiones: El cuidado informal implica un importante ahorro de recursos familiares y públicos: los primeros al asumir un menor copago del teórico, trasladando dicha carga a las Comunidades Autónomas; los segundos, por el menor coste que suponen las prestaciones económicas respecto a las prestaciones de servicios(AU)


Background: The Law of Dependence keeps the informal caregiver’s role, incorporating a specific economic benefit. The aims of this work are 1) to analyze the effect of the Law on informal care existence, and 2) to value the economic impact in the Law, disaggregated by financier. Methods: A cross-section study has been conducted from a representative sample of the dependent population in Cuenca (Spain) in February, 2009. We have obtained information for people with level II and III of dependence. A care service delivery simulation is used to quantify the economic impact of informal care to Cuenca (sample), Castilla- La Mancha and Spain. Results: Informal care delivery is assigned in 81,74% of dependency benefits. Total costs of care service delivery is reduced between 36,51% and 80,53% if informal care exits, disaggregated into savings of 122,97-251,04% for user and 23,30-54,47% for public administration. Average estimated copayment for user is 13,25% for real sample, and it rises to 25,77% when it is supposed informal care extinguishes. Conclusions: Informal care is widespread in the Law, and it implies an important household and public resources saving: for household due to the assumption a smaller copayment that theoretical established, which is assumed by Autonomous Communities; in turn, for public administration, because of the fact economic deliveries require fewer resources(AU)


Subject(s)
Humans , Male , Female , Personal Autonomy , Homebound Persons/education , Homebound Persons/legislation & jurisprudence , Homebound Persons/statistics & numerical data , Costs and Cost Analysis/legislation & jurisprudence , Costs and Cost Analysis/methods , Social Support , 16672/trends , 50230 , /methods , Psychosocial Impact , Cross-Sectional Studies/methods , Cross-Sectional Studies/trends , 16672/legislation & jurisprudence
10.
Rev. clín. med. fam ; 5(1): 3-8, feb.2012. ilus
Article in Spanish | IBECS | ID: ibc-99794

ABSTRACT

Objetivos. Evaluar el impacto de la incorporación a un programa de atención domiciliaria a crónicos sobre personas mayores dependientes y su satisfacción con el mismo. Diseño. Estudio de intervención sin asignación aleatoria tipo "antes-después". Emplazamiento. Atención Primaria. Urbano. Participantes. Personas mayores dependientes al incorporarse éstos a un programa de atención domiciliaria a crónicos (n=156, con un 7,8% de perdidas en el año de seguimiento). Intervenciones. Incorporación a un programa de atención domiciliaria a crónicos de personas mayores dependientes y evaluación en el momento de incorporación al programa y al año de la misma. Las variables evaluadas fueron: salud percibida (escala Likert), calidad de vida (cuestionario de Nottingham), frecuentación (visitas/año y frecuentadores) y satisfacción con la atención recibida (escala Likert y puntos positivos y negativos del programa). Resultados. No modificación significativa de la salud percibida ni de la calidad de vida en la valoración global, pero sí en mejoría (p<0,05) en las esferas emocionales y de relación social de dicha calidad de vida. Disminución de la frecuentación (14,2 vs 9,0; p<0,01) y del porcentaje de hiperfrecuentadores (34,0% vs 17,1%; p<0,01). El 85,4% de los pacientes consideran que la asistencia mejoró al final del año de intervención, con mejora significativa de la satisfacción de la asistencia recibida global (p<0,05), médica (p<0,05) y de enfermería (p<0,01): (7,8 vs 8,5; 8,0 vs 8,7 y 7,3 vs 8,4 respectivamente). Conclusiones. La incorporación a un programa de atención domiciliaria de personas dependientes repercute positivamente en los pacientes al mejorar su percepción sobre la asistencia recibida, reducir su utilización de los servicios sanitarios y mejorar algunas esferas de su calidad de vida(AU)


Objectives. To assess the impact of enrolling in a home care program for chronically dependent elderly people and satisfaction with care. Design. Non-randomized, before-and-after study. Setting. Primary Care. Urban. Participants. Chronically dependent elderly people enrolling in a home care program (n=156, with a 7.8% drop-out rate during the one-year trial). Measures. Chronically dependent elderly patients enrolling in a home care program with assessment at time of entry and one year later. Variables were: perceived health (Likert scale), quality of life (Nottingham Questionnaire), visits received (visitors and number of visits/year) and satisfaction with care received (Likert scale and positive and negative aspects of the program). Results. No significant change in perceived health or overall quality of life; however, there was improvement (p<0.05) specially in emotional quality of life and in social relationships. Number of visits decreased (14.2 vs 9.0; p<0.01), as well as percentage of frequent visitors (34.0% vs 17.1%; p<0.01). 85.4% of patients felt that care improved towards end of study, with significant improvement in satisfaction with overall care received (p<0.05), and with medical (p<0.05) and nursing care (p<0.01): (7.8 vs 8.5, 8.0 vs 8.7 and 7.3 vs 8.4, respectively). Conclusions. Enrolling in a home care program for dependent elderly people has a positive effect on patients by improving perception of care received, reducing use of health care services and improving certain aspects of quality of life(AU)


Subject(s)
Humans , Male , Female , Aged , Aged, 80 and over , Frail Elderly/statistics & numerical data , Homebound Persons/legislation & jurisprudence , Home Care Services/legislation & jurisprudence , Home Care Services/organization & administration , Home Care Services/standards , Home Care Services , Assisted Living Facilities/legislation & jurisprudence , Assisted Living Facilities/methods , Family Practice/methods , Family Practice/trends , Health Services for the Aged/legislation & jurisprudence , Health Services for the Aged/organization & administration , Health Services for the Aged/standards
11.
Rev. esp. salud pública ; 85(6): 541-553, nov.-dic. 2011. tab
Article in Spanish | IBECS | ID: ibc-93732

ABSTRACT

Fundamento: A pesar de su importancia para el diseño de políticas públicas, son escasos los estudios sobre el grado en que el cuidado que reciben las personas mayores satisface sus necesidades. Los objetivos de este trabajo son: conocer la prevalencia de personas de 60 y más años que reciben atención y que tienen necesidades de cuidado no satisfechas; y establecer qué proveedor de cuidado (familiar, privado –empleadas de hogar- o público –servicios sociales-) tiene más probabilidades de satisfacer dichas necesidades. Métodos: Se utilizó una muestra de 3.718 personas de 60 y más años no institucionalizadas de la Encuesta de Discapacidad, Autonomía personal y situaciones de Dependencia 2008. Se realizaron tablas de contingencia para conocer la distribución de las necesidades de cuidado no satisfechas y se construyó un modelo de regresión logística binaria para identificar los factores asociados con las necesidades no satisfechas. Resultados: De las personas de 60 y más años que recibían atención, no satisficieron sus necesidades de cuidado 1039 (29%). Respecto a quienes recibieron únicamente cuidado familiar, quienes recibieron sólo cuidado de servicios sociales tuvieron menos probabilidades de tener satisfechas sus necesidades (OR=1,932 sig.=0,001) y quienes recibieron únicamente cuidado privado tuvieron más probabilidades (OR=0,673 sig.=0,015). Conclusiones: Quienes recibieron exclusivamente cuidado privado mostraron más probabilidades de tener satisfechas sus necesidades que quienes recibieron cualquier otra combinación de cuidado. Recibir únicamente atención de servicios sociales se relaciona con una mayor probabilidad de tener necesidades de cuidado insatisfechas, en relación con quienes reciben cuidado familiar o cuidado privado(AU)


Background: In spite of its importance for policy making, there have been few studies examining the satisfaction of care needs by the different care providers. The aims of this paper are: (1) to estimate the prevalence of dissatisfaction of care needs among people older than 59 years receiving care; and (2) to identify what care provider (family care, private care –paid care- or public care) has a higher probability of satisfying the needs of this population. Methods: This study is based on a sample of 3718 non-institutionalized people older than 59 years from the Survey on Disability, Personal Autonomy and Dependency Situations 2008. The distribution of unmet care needs among different groups of elderly people was cross-tabulated, and a regression logistic model was used to identify factors related to dissatisfaction of care needs. Results: 1,039 (29%) people older than 59 years had dissatisfied care needs. Compared to those receiving only family care, people receiving only public care were more likely to have dissatisfied needs (OR=1.932 sig.=0,001), and people receiving only paid care were less likely to have dissatisfied needs (OR=0.673 sig.=0.015). Conclusions: People receiving only paid care had a higher probability of having their needs satisfied than any other care combination. Those receiving only public care had a lower probability of having their needs satisfied than people receiving family care or paid care(AU)


Subject(s)
Humans , Male , Female , Middle Aged , Aged , Aged, 80 and over , Patient Satisfaction/legislation & jurisprudence , Frail Elderly/statistics & numerical data , Homebound Persons/legislation & jurisprudence , Homebound Persons/statistics & numerical data , Home Care Services/organization & administration , Home Care Services/trends , Needs Assessment/organization & administration , Needs Assessment/standards , Patient Acceptance of Health Care , Logistic Models , Homebound Persons/rehabilitation , Home Care Services/standards , Home Care Services , Health Services Needs and Demand/organization & administration , Health Services Needs and Demand , Disabled Persons/rehabilitation , Needs Assessment/trends , Needs Assessment
12.
Physis (Rio J.) ; 21(1): 147-157, 2011. tab
Article in Portuguese | LILACS | ID: lil-586052

ABSTRACT

Internação domiciliar é uma modalidade de atendimento à saúde que está se transformando em uma alternativa importante para minimizar alguns dos principais problemas inerentes aos sistemas de saúde vigentes, especialmente os da rede pública. O objetivo do estudo foi descrever o perfil sociodemográfico e clínico da população assistida pelo Programa de Internação Domiciliar (PID) HU em Casa do Hospital Universitário Clemente de Faria da Universidade Estadual de Montes Claros. O estudo foi descritivo e retrospectivo por meio da análise de prontuários, realizada de maio de 2005 a maio de 2008. Foram analisados 137 pacientes, sendo 75 do gênero feminino (54,7 por cento) e 62 do masculino (45,3 por cento). O grupo de 61 a 80 anos foi mais prevalente (37,2 por cento) e 73 por cento dos pacientes residiam em bairros periféricos do município de Montes Claros-MG. Dos agravos mais comuns na primeira internação, a pneumonia foi prevalente, 22 casos (16,1 por cento). A maioria dos pacientes foi encaminhada ao PID pela clinica médica (84,7 por cento), com intervalo de maior prevalência de duas a três internações (42,4 por cento). Do total de pacientes, 120 (87,6 por cento) permaneceram internados por 16 a 30 dias e 51,8 por cento não necessitaram passar novamente pelo PID para uma segunda internação. Com relação à resolutividade clínica, 130 (94,9 por cento) tiveram alta clínica, no PID, na primeira internação. O PID mostrou-se ser um programa de alta resolutividade, atendendo mais ao público idoso feminino, de baixa renda e com períodos de internação relativamente curtos.


The home care is a modality of health care which is becoming an important alternative to minimize some of mainly relevant problems of world health, especially the public health network. This paper aimed to describe the socio-demographic and clinical population assisted by the Home Care Program HU em Casa, of the University Hospital Clemente de Faria, Universidade Estadual de Montes Claros. It is a descriptive and retrospective study analyzing medical records from May 2005 to May 2008. Of the 137 analyzed patients, 75 were females (54.7 percent) and 62 males (45.3 percent). Concerning age, the 61-80 year group was the most prevalent (37.2 percent) and 73 percent lived and was attended in the peripheral districts of Montes Claros city. Among the most important diseases in the first admission, the most prevalent was pneumonia (22 cases, 16.1 percent). Most patients were referred to the HU em Casa Home Care Program for the medical clinic (84.7 percent) with a range of higher prevalence of 2 to 3 admissions (42.4 percent). Of the total patients, 120 (87.6 percent) stayed in hospital for 16 to 30 days. Referring to resolutivity, 130 (94.9 percent) patients were discharged to the program on the first admission. The PID proved to be a high-solving program, attended mainly elderly women with low income and with periods of relatively short hospitalization.


Subject(s)
Humans , Male , Female , Aged , Demography , Delivery of Health Care , Health of Specific Groups , Home Care Services/ethics , Home Care Services , Home Care Services , Age Factors , Ambulatory Care/ethics , Ambulatory Care/organization & administration , Ambulatory Care , Epidemiologic Factors , Health Services Research , Health Centers , Hospital Care , Homebound Persons/legislation & jurisprudence , Homebound Persons/psychology
13.
Rev. Soc. Esp. Enferm. Nefrol ; 13(4): 252-257, oct.-dic. 2010. tab
Article in Spanish | IBECS | ID: ibc-83043

ABSTRACT

La valoración del grado de dependencia de los pacientes en diálisis ha sido objeto de interés como indicador clínico y organizativo. El objetivo del estudio es conocer el grado de dependencia que presentan las personas sometidas a tratamiento con diálisis en Catalunya, según los criterios de la Ley sobre Promoción de la Autonomía Personal y Atención a las personas en situación de dependencia. Se ha realizado un estudio descriptivo transversal en 42 centros de Cataluña sobre el grado de dependencia de los pacientes en hemodiálisis. La recogida de datos se hizo mediante una encuesta basada en el baremo de la Ley más datos sociodemográfico y características del tratamiento. De los pacientes que componían la población renal de Cataluña fueron considerados por los profesionales sanitarios con algún grado de dependencia 806, de ellos 425 eran hombres y 381 mujeres; un 61% tienen edades superiores a 70 años. El 53% viven en pareja y el 80,1% tenían uno o más hijos. El 77,4 % de los pacientes habían sido trabajadores no cualificados, y el 65,4% dijeron no tener estudios. Se consideraron no dependientes 137 pacientes, con dependencia moderada 350, con dependencia importante 237 y con gran dependencia 82. Fue significativa (p<0,005) la relación de la dependencia con la edad, la movilidad y en los grandes dependientes la incapacidad para tomar decisiones. No tuvo significación estadística el tiempo de permanencia en hemodiálisis. Aunque el baremo de la Ley rebaja la valoración de dependencia realizada por los profesionales, los centros de hemodiálisis están atendiendo a un 19% de pacientes dependientes (AU)


The evaluation of the degree of dependency of patients on haemodialysis is a clinical and organizational indicator. The aim of the study is to determine the degree of dependency of people undergoing haemodialysis in Catalonia, according to the criteria established by the Act for the Promotion of Personal autonomy and Attention to Persons in a Situation of Dependency. A transversal descriptive study was carried out in 42 centres in Catalonia on the degree of dependency of patients on haemodialysis. The data were collected through a survey based on the scale established by the Act plus sociodemographic data and treatment characteristics. Of the patients who made up the renal population of Catalonia (3868), 806 were considered by the healthcare professionals to have a high degree of dependency, of whom 425 were men and 381 were women; 61% were older than 70. 53% live with a partner and 80.1% had one or more children. 77.4% of the patients had been unskilled workers, and 65.4% stated that they had no educational qualifications. 137 patients were considered not dependent, 350 were considered to have moderate dependency, 237 with significant dependency and 82 with a high dependency. There was a significant (p<0.005) relationship between dependency and age, mobility and, in those with high dependency, with the inability to make decisions. The time they had been on haemodialysis was not statistically signifi cant. Although the scale established by the Act reduces the evaluation of dependency carried out by the professionals, 19% of the patients being treated by the haemodialysis centres have a clear lack of personal autonomy (AU)


Subject(s)
Humans , Male , Female , Middle Aged , Aged , Aged, 80 and over , Renal Dialysis/nursing , Renal Dialysis , Homebound Persons/legislation & jurisprudence , Homebound Persons/rehabilitation , Personal Autonomy , Delivery of Health Care/legislation & jurisprudence , Delivery of Health Care , Frail Elderly , Cross-Sectional Studies , Data Collection , Confidence Intervals , Continuity of Patient Care/legislation & jurisprudence , Continuity of Patient Care/standards
15.
Metas enferm ; 13(5): 62-67, jun. 2010. graf
Article in Spanish | IBECS | ID: ibc-85726

ABSTRACT

Objetivos: detectar la sobrecarga de trabajo que sobre los profesionales deEnfermería ha podido producir la puesta en marcha de la Ley 39/2006, identificarproblemas relacionados con la implantación del Baremo de Valoraciónde Dependencia (BVD) y conocer las necesidades específicas de formaciónen los profesionales enfermeros como valoradores de la dependenciaen los pacientes inmovilizados.Material y métodos: se realiza un estudio trasversal descriptivo duranteabril de 2009 de la opinión de los profesionales de Enfermería de los Equiposde Atención Primaria (EAP) del área de Palencia. Se realiza a través deencuestas personales y anónimas, mediante un cuestionario de elaboraciónpropia, que recogía datos demográficos, laborales, aspectos relativos a la cumplimentacióndel BVD, trámites administrativos y necesidades formativas.Resultados: población diana son 151 enfermeros, de los cuales contestan un64,23% (97). El tiempo medio de realización del BVD es de 77,55 minutos;un 40,4% (38) cree que es complicado de completar, 8,5% (8) fácil yun 51,1% depende de los casos; el 69,1% (65) demanda más formación yun 58,5% (55) opina que se deberían crear equipos de valoración enfermerosindependientes. Un 63,8% (60) piensan que no han sido cubiertas las necesidadesde los pacientes, el 23,4% (22) que sus pacientes fallecen antesde recibirlas y un 12,8% (12) que las ayudas han sido eficaces.Conclusiones: la cumplimentación del baremo de valoración de dependenciaha supuesto una sobrecarga de trabajo enfermero. El BVD es difícilde rellenar, denso y en algunas ocasiones no recoge la situación real del paciente.La creación de grupos de profesionales enfermeros entrenados e independientesdel EAP hubiera salvado obstáculos como la valoración subjetivay presiones por parte de las familias (AU)


Objectives: to detect the work overload that the coming into effect of Law39/2006 might have had on nursing professionals, to identify problems relatingto the implantation of the Dependency Law Assessment Rating Scale andto determine the specific training needs of nursing professionals as evaluatorsof the dependency level of immobilised patients.Material and methods: a cross-sectional descriptive study was conducted inApril 2009 on the opinion of the nursing professionals that comprise primarycare teams in the area of Palencia. Anonymous personal polls were carriedout using a self-elaborated questionnaire which gathered information on demographicdata, work-related data, aspects relating to the completion of thedependency law assessment rating scale, administrative- red tape proceduresand training needs.Results: the target population was composed of 151 nurses, of which 64,23%(97) responded. Mean time for the completion of the assessment rating scalewas 77,55 minutes; 40,4% (38) thought it was hard to complete, 8,5%(8) easy to complete and 51,1% said complexity was case-dependent;69,1%(65) requested more information and 58,5% (55) were of the opinionthat independent assessment nursing teams should be created. 63,8% (60)thought that patient needs had not been covered, 23,4% (22) stated thattheir patients died before they could be assessed and 12,8% (12) that the aidshad been effective.Conclusions: the completion of the dependency assessment rating scale hasrepresented an increase in the work load of nurses. The dependency assessmentrating scale is hard to fill in, it is long and in some instances does notreflect the real situation of the patients. The creation of trained groups of nursingprofessionals that work independently from the primary care centreswould have solved these obstacles such as subjective assessment and the pressureon the part of the families (AU)


Subject(s)
Humans , Homebound Persons/legislation & jurisprudence , Nursing Care/trends , Disability Evaluation , Law Enforcement , Workload/statistics & numerical data , Primary Health Care/trends , Forms and Records Control
17.
Dev Disabil Res Rev ; 15(2): 152-8, 2009.
Article in English | MEDLINE | ID: mdl-19489086

ABSTRACT

Onset of acquired central nervous system (CNS) injury during the normal developmental process of childhood can have impact on cognitive, behavioral, and motor function. This alteration of function often necessitates special education programming, modifications, and accommodations in the education setting for successful school reentry. Special education is not necessarily a special classroom, but an individualized set of educational needs, determined by a multidisciplinary school team, to promote educational success. The purpose of this article is to inform those pediatricians and pediatric allied health professionals treating children with CNS injury of the systems in place to support successful school reentry and their role in contributing to developing an appropriate educational plan.


Subject(s)
Brain Damage, Chronic/rehabilitation , Brain Injuries/rehabilitation , Child Behavior Disorders/rehabilitation , Continuity of Patient Care , Education, Special/methods , Learning Disabilities/rehabilitation , Spinal Cord Injuries/rehabilitation , Adolescent , Brain Damage, Chronic/diagnosis , Brain Damage, Chronic/etiology , Brain Injuries/diagnosis , Brain Injuries/etiology , Child , Child Behavior Disorders/diagnosis , Child Behavior Disorders/etiology , Child, Preschool , Continuity of Patient Care/legislation & jurisprudence , Cooperative Behavior , Disability Evaluation , Education, Special/legislation & jurisprudence , Eligibility Determination/legislation & jurisprudence , Homebound Persons/education , Homebound Persons/legislation & jurisprudence , Humans , Infant , Interdisciplinary Communication , Learning Disabilities/diagnosis , Learning Disabilities/etiology , Mainstreaming, Education/legislation & jurisprudence , Patient Care Team/legislation & jurisprudence , Spinal Cord Injuries/diagnosis , Spinal Cord Injuries/etiology , United States
18.
Todo hosp ; (256): 284-288, mayo 2009. tab, graf
Article in Spanish | IBECS | ID: ibc-85274

ABSTRACT

Durante los años 2003 y 2007 en Extremadura se trabajó en procesos de coordinación que proprocionaran a la acción de atenicón a las patologiasy de atención a la dependencia, un espacio compartido de acción que optimizara todas las oportunidades que el sistema en su conjunto brindado y que hasta el momento habían encontrado escasos espacios de coordinación (AU)


During 2003 and 2007, work was carried out in Extremadura oncoordination processes which willprovide, for the areas of attention to pathologies and attentionto dependency,a shared space of actionwhich will optimise all the opportunities which the system as a whole provided and which up to then had found few spaces of coordination (AU)


Subject(s)
Humans , Homebound Persons/legislation & jurisprudence , Dependent Ambulation/legislation & jurisprudence , Personal Autonomy , Law Enforcement , /legislation & jurisprudence
19.
Rev. Rol enferm ; 30(5): 328-330, mayo 2007.
Article in Spanish | IBECS | ID: ibc-79741

ABSTRACT

El 15 de diciembre del año pasado el Boletín Oficial del Estado (BOE) publicaba la LEY 39/2006 de Promoción de la Autonomía Personal y Atención a las personas en situación de dependencia, hoy en día ya conocida popularmente como «Ley de Dependencia». Se trata de una norma que pretende dar respuesta a una necesidad cada vez más acusada por la sociedad moderna: ordenar un modelo de asistencia a personas que sufran una dependencia en sus distintos grados. Se pretende garantizar unas cotas de calidad de vida para todas aquellas personas que sufren algún tipo de limitación para poder desarrollar su actividad diaria. El texto normativo contempla también importantes mejoras para los cuidadores informales, es decir, las personas que tienen la responsabilidad de cuidar de algún familiar que debe enfrentarse a la vida sufriendo una dependencia(AU)


On December 15, 2006, the Official Spanish State Register, the «Boletín Oficial del Estado BOE», published Law 39/2006 The Promotion of Personal Autonomy and Treatment for persons who live under conditions making them dependent on someone else; this law is popularly known as the «Dependency Law». At issue here is a law whose objective is to provide an answer to an ever growing necessity in modern society: to enact a treatment model for persons who suffer varying degrees of dependency on others. By means of this law, the authorities hope to guarantee some quality of living quotas for all those people who suffer some kind of limitation in their ability to carry out daily life activities. Included in the articles of this law are important improvements for informal caretakers, that is those persons who have the responsibility to care for a relative who must face life suffering from dependency on others(AU)


Subject(s)
Humans , Male , Female , Aged , Old Age Assistance/legislation & jurisprudence , Health Services for the Aged/legislation & jurisprudence , Homebound Persons/legislation & jurisprudence , Aged Rights , Frail Elderly , Homes for the Aged , Caregivers/legislation & jurisprudence
20.
Rev. Síndr. Down ; 23(88): 15-19, mar. 2006.
Article in Es | IBECS | ID: ibc-72069

ABSTRACT

El Consejo de Ministros español el aprobó un Anteproyecto de Ley de Promoción de la Autonomía personal y atención a las personas en situación de Dependencia el 30 de diciembre de 2005. Se trata de un texto muy esperado, muy anunciado y muy de nuestro tiempo, pero se percibe en el movimiento asociativo de la discapacidad cierta decepción. El anteproyecto de ley aparece poco concreto, vaciado de contenido. No se determina a quién se va a incluir, en qué servicios, con cuánta intensidad y cómo va ser el copago que se contempla. El anteproyecto no ha sido pactado ni con las Comunidades Autónomas ni con los representantes de los colectivos afectados. Está muy orientado hacia lo asistencial, y muy poco hacia la autonomía creativa y cualificada. Incrementa el número de baremos que se han de calcular. Excluye a los menores de tres años con consecuencias que pueden ser muy significativas. No incluye a las familias con niños pequeños y es altamente inconcreto a la hora de establecer ayudas económicas. Es de esperar que, en la fase en que el anteproyecto se encuentra, el Gobierno muestre voluntad real de diálogo para que la ley aborde de verdad el problema de la dependencia (AU)


No disponible


Subject(s)
Humans , Disabled Persons/legislation & jurisprudence , Homebound Persons/legislation & jurisprudence , Personal Autonomy , Dependency, Psychological , Jurisprudence
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