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Sample records for at-risk older people

  1. Optimizing footwear for older people at risk of falls.

    PubMed

    Menant, Jasmine C; Steele, Julie R; Menz, Hylton B; Munro, Bridget J; Lord, Stephen R

    2008-01-01

    Footwear influences balance and the subsequent risk of slips, trips, and falls by altering somatosensory feedback to the foot and ankle and modifying frictional conditions at the shoe/floor interface. Walking indoors barefoot or in socks and walking indoors or outdoors in high-heel shoes have been shown to increase the risk of falls in older people. Other footwear characteristics such as heel collar height, sole hardness, and tread and heel geometry also influence measures of balance and gait. Because many older people wear suboptimal shoes, maximizing safe shoe use may offer an effective fall prevention strategy. Based on findings of a systematic literature review, older people should wear shoes with low heels and firm slip-resistant soles both inside and outside the home. Future research should investigate the potential benefits of tread sole shoes for preventing slips and whether shoes with high collars or flared soles can enhance balance when challenging tasks are undertaken. PMID:19235118

  2. Considering the benefits of egg consumption for older people at risk of sarcopenia.

    PubMed

    Smith, Alison; Gray, Juliet

    2016-06-01

    Sarcopenia is an important health issue for older people. It is closely linked with frailty and malnutrition and can significantly reduce both health and quality of life for those affected. Sarcopenic decline in muscle mass can start as early as the fourth and fifth decade of life, so the maintenance of muscle mass throughout adulthood, through regular physical activity and a balanced diet, should be an important consideration in reducing the risk of sarcopenia in older age. Maintaining regular exercise throughout older age remains key to the treatment of sarcopenia, as does an adequate intake of nutrients, including high-quality protein and vitamin D. A significant proportion of older people fail to meet the recommended requirements for protein; it has also been suggested that the requirements in existing recommendations could be higher. Evidence is emerging that an adequate intake of protein at each meal may be required to optimise muscle synthesis in older people. Eggs are an inexpensive, widely available and easily digestible source of high-quality protein and contain a significant proportion of leucine, an amino acid that is important for muscle synthesis, as well as many other nutrients of significance for older people, including vitamin D and omega-3 fatty acids. For many older people, eggs are a familiar and acceptable protein food at breakfast and other meals. Encouraging both those approaching older age and older people to include eggs more frequently, as part of a healthy, balanced diet and in addition to physical activity, could help them maintain their muscle strength and function, thereby preserving their functional capacity and reducing morbidity, mortality and healthcare costs associated with sarcopenia. PMID:27270199

  3. Napping in older people 'at risk' of dementia: relationships with depression, cognition, medical burden and sleep quality.

    PubMed

    Cross, Nathan; Terpening, Zoe; Rogers, Naomi L; Duffy, Shantel L; Hickie, Ian B; Lewis, Simon J G; Naismith, Sharon L

    2015-10-01

    Sleep disturbance is prevalent in older adults, particularly so in those at a greater risk of dementia. However, so far the clinical, medical and neuropsychological correlates of daytime sleep have not been examined. The aims of this study were to investigate the characteristics and effects of napping using actigraphy in older people, particularly in those 'at risk' of dementia. The study used actigraphy and sleep diaries to measure napping habits in 133 older adults 'at risk' of dementia (mean age = 65.5 years, SD = 8.4 years), who also underwent comprehensive medical, psychiatric and neuropsychological assessment. When defined by actigraphy, napping was present in 83.5% (111/133) of participants; however, duration and timing varied significantly among subjects. Nappers had significantly greater medical burden and body mass index, and higher rates of mild cognitive impairment. Longer and more frequent naps were associated with poorer cognitive functioning, as well as higher levels of depressive symptoms, while the timing of naps was associated with poorer nocturnal sleep quality (i.e. sleep latency and wake after sleep onset). This study highlights that in older adults 'at risk' of dementia, napping is associated with underlying neurobiological changes such as depression and cognition. Napping characteristics should be more routinely monitored in older individuals to elucidate their relationship with psychological and cognitive outcomes. PMID:26096839

  4. Older People and HIV

    MedlinePlus

    ... Many older people believe that HIV only affects younger people Most older people get little training in ... diseases among older people, as they do for younger people. Physicians may not diagnose HIV infection in ...

  5. Pilot study to investigate the feasibility of the Home Falls and Accidents Screening Tool (HOME FAST) to identify older Malaysian people at risk of falls

    PubMed Central

    Romli, Muhammad Hibatullah; Mackenzie, Lynette; Lovarini, Meryl; Tan, Maw Pin

    2016-01-01

    Objective The relationship between home hazards and falls in older Malaysian people is not yet fully understood. No tools to evaluate the Malaysian home environment currently exist. Therefore, this study aimed to pilot the Home Falls and Accidents Screening Tool (HOME FAST) to identify hazards in Malaysian homes, to evaluate the feasibility of using the HOME FAST in the Malaysian Elders Longitudinal Research (MELoR) study and to gather preliminary data about the experience of falls among a small sample of Malaysian older people. Design A cross-sectional pilot study was conducted. Setting An urban setting in Kuala Lumpur. Participants 26 older people aged 60 and over were recruited from the control group of a related research project in Malaysia, in addition to older people known to the researchers. Primary outcome measure The HOME FAST was applied with the baseline survey for the MELoR study via a face-to-face interview and observation of the home by research staff. Results The majority of the participants were female, of Malay or Chinese ethnicity and living with others in a double-storeyed house. Falls were reported in the previous year by 19% and 80% of falls occurred at home. Gender and fear of falling had the strongest associations with home hazards. Most hazards were detected in the bathroom area. A small number of errors were detected in the HOME FAST ratings by researchers. Conclusions The HOME FAST is feasible as a research and clinical tool for the Malaysian context and is appropriate for use in the MELoR study. Home hazards were prevalent in the homes of older people and further research with the larger MELoR sample is needed to confirm the validity of using the HOME FAST in Malaysia. Training in the use of the HOME FAST is needed to ensure accurate use by researchers. PMID:27531736

  6. Older People and HIV

    MedlinePlus

    ... common than they were before the use of anti-HIV drugs. It is difficult to know what is causing mental problems in older people with HIV. Is it normal aging, or is it HIV disease? Research studies have ...

  7. Older Women: A Population at Risk for Mental Health Problems.

    ERIC Educational Resources Information Center

    Wisniewski, Wendy; Cohen, Donna

    The expanding population of older women relative to older men or the "feminization of aging" is a significant demographic trend with important implications for the future. Older women are at risk for extended years of widowhood, living alone, institutionalization, poverty, and mental health problems. Although the dementias of late life appear to…

  8. Deprescribing in older people.

    PubMed

    Page, Amy Theresa; Potter, Kathleen; Clifford, Rhonda; Etherton-Beer, Christopher

    2016-09-01

    Older people with chronic disease have great potential to benefit from their medications but are also at high risk of harm from their medications. The use of medications is particularly important for symptom control and disease progression in older people. Under-treatment means older people can miss out on the potential benefits of useful medications, while over-treatment (polypharmacy) puts them at increased risk of harm. Deprescribing attempts to balance the potential for benefit and harm by systematically withdrawing inappropriate medications with the goal of managing polypharmacy and improving outcomes. The evidence base for deprescribing in older people is growing. Studies to reduce polypharmacy have used a range of methods. Most evidence for deprescribing relates to the withdrawal of specific medications, and evidence supports attempts to deprescribe potentially inappropriate medicines (such as long-term benzodiazepines). There is also evidence that polypharmacy can be reduced by withdrawing specific medications using individualised interventions. More work is needed to identify the sub-groups of older people who may most benefit from deprescribing and the best approaches to undertaking the deprescribing interventions. PMID:27451330

  9. Oral health for older people.

    PubMed

    2016-08-01

    Compared with previous generations, more older people have retained some or all of their teeth, but more than 40% of community-dwelling older people aged 75 and over have unmet oral health needs. However, the importance of oral health can be undervalued by healthcare professionals and older people. Three studies relating to oral health for older people are summarised. PMID:27573957

  10. Diabetes in older people.

    PubMed

    Bennett, Katie

    2015-10-01

    The management of diabetes in older people is often challenging and poorly researched. The prevalence of cognitive impairment, chronic kidney disease and other co-existing comorbidities increase with age and have a significant impact on glycaemic control targets and treatment options. This conference examined current clinical practice, highlighted differences in the management of diabetes in the older person and suggested potential areas of future research. PMID:26430187

  11. Learning Opportunities for Older People.

    ERIC Educational Resources Information Center

    MacKeracher, Dorothy

    1980-01-01

    The author summarizes a conference on learning opportunities for older people by discussing six issues: (1) perspectives of older people and service providers; (2) categorization of older learners; (3) learning needs of older people; (4) participation rates; (5) government policies; and (6) curriculum concerns. (SK)

  12. Gastrointestinal care for older people.

    PubMed

    Tremayne, Penny; Harrison, Penny

    2016-07-01

    This article discusses gastrointestinal (GI) healthcare in older people. It outlines the physiological changes that occur in the GI tract as a result of ageing, and discusses common GI disorders in older people. These GI disorders include dysphagia, gastrointestinal reflux disease, colorectal cancer, diverticular disease, constipation and anaemia. Healthcare professionals should be aware of the factors that may influence gastrointestinal health in older people, including nutrition, hydration and alcohol use, which are important considerations when delivering person-centred care. PMID:27380703

  13. Improving Medication Management among At-risk Older Adults

    PubMed Central

    Martin, Delinda; Kripalani, Sunil; DuPapau, V.J.

    2013-01-01

    Low health literacy is common among Medicare recipients and affects their understanding of complex medication regimens. Interventions are needed to improve medication use among older adults, while addressing low health literacy. Community-dwelling older adults in this study were enrolled in an inner-city adult day center. They completed a baseline measure of health literacy, medication self-efficacy, and medication adherence. They were provided with a personalized, illustrated daily medication schedule (PictureRx™). Six weeks later, their medication self-efficacy and adherence were assessed. Among the 20 participants in this pilot project, 70% had high likelihood of limited health literacy and took an average of 13.2 prescription medications. Both self-efficacy and medication adherence increased significantly after provision of the PictureRx cards (p<0.001 and p<0.05, respectively). Al participants rated the PictureRx cards as very helpful in terms of helping them remember the medication’s purpose and dosing. Illustrated daily medication schedules improve medication self-efficacy and adherence among at-risk, community-dwelling older adults. PMID:22587641

  14. Clinical Trials and Older People

    MedlinePlus

    ... have a much wider applicability. Researchers need the participation of older people in their clinical trials so ... contact with questions about the study or your participation. Control group —the group of participants who get ...

  15. Esperanto and Older People.

    ERIC Educational Resources Information Center

    Gal, Ilona

    1978-01-01

    Research has indicated that the elderly retain the ability to learn, and specifically to learn new languages. Furthermore, the increasingly greater proportion of old people in the population demands that their need for continued intellectual stimulation be met. In the absence of explicit motives for learning an ethnic language, Esperanto is a good…

  16. PTSD in older bereaved people.

    PubMed

    O'Connor, Maja

    2010-08-01

    Late life bereavement has been associated with psychological problems, mainly depression. A few studies indicated that posttraumatic stress disorder (PTSD) was an important issue in late life bereavement reactions. This study aimed to assess the prevalence of PTSD in recently bereaved older people compared with married controls and to investigate whether the loss of a spouse in old age, in contrast with earlier assumptions, could lead to PTSD. Two hundred and ninety-six Danish older bereaved people (mean age 73 years, 113 males) were chosen from national registers and assessed two months postbereavement. They were compared with a control group of 276 married older people. The prevalence of PTSD and depression were measured through a self-report questionnaire. Results showed that 16% of the bereaved and 4% of the control group had a PTSD diagnosis (ES = 0.35; Cohen's d = 0.74). Additionally, 37% of the bereaved and 22% of the control group had mild to severe depression (ES = 0.19; Cohen's d = 0.37). The results suggested that late life spousal bereavement result in PTSD with equal frequency to general samples of bereaved persons. Furthermore, the prevalence of PTSD in the first months after bereavement was more elevated than the level of depression. This makes PTSD an important factor when studying late life bereavement reactions. PMID:20686978

  17. Interface Design and Engagement with Older People

    ERIC Educational Resources Information Center

    Hawthorn, D.

    2007-01-01

    The current paper examines the design process that led to an unusually successful interactive tutorial for older people. The paper describes the issues that make designing for older people different. These include differences between the designer and the target population and the difficulty that older people have in interacting with low-fidelity…

  18. Lived experiences of self-care among older, home-dwelling individuals identified to be at risk of undernutrition

    PubMed Central

    Tomstad, Solveig T; Söderhamn, Ulrika; Espnes, Geir Arild; Söderhamn, Olle

    2012-01-01

    Introduction In a society where most older people live in their own homes, it may be expected of older individuals to exercise their potential to take care of themselves in daily life. Nutrition is a central aspect of self-care, and groups of older, home-dwelling people are at risk of undernutrition. Aim The aim of this study was to describe the lived experiences of self-care and features that influence health and self-care among older, home-dwelling individuals identified to be at risk of undernutrition. Methods Qualitative interviews were performed with eleven home-dwelling individuals who had been identified as being at risk of undernutrition. The interviews were recorded, transcribed verbatim, and analyzed with a descriptive phenomenological method. Findings Self-care as a lived experience among older, home-dwelling individuals identified to be at risk of undernutrition is about being aware of food choices and making decisions about taking healthy steps or not. In the presence of health problems, the appetite often decreases. Being able to take care of oneself in daily life is important, as is receiving help when needing it. Working at being physically and socially active and engaged may stimulate the appetite. Having company at meals is important and missed when living alone. Being present and taking each day by day, as well as considering oneself in the light of past time and previous experiences and looking ahead, is central, even when having fears for the future and the end of life. Conclusion Health care professionals should be aware of these findings in order to support self-care in older people, and they should pay attention to the social aspects at meals. PMID:23271914

  19. Advice on healthy eating for older people.

    PubMed

    Fisher, Karen

    As part of its Food and Health Action Plan, the Department of Health is working with the food industry, and with other stakeholders, to establish a coherent national plan to help people in England improve their diets. Maintaining a healthy diet is important for all age groups, but healthy older people have particular needs. Karen Fisher describes the specific nutritional issues affecting healthy older people and suggests advice that nurses can offer people during opportunistic consultations in primary care. PMID:16350521

  20. Youth "At Risk"? Young People, Sexual Health and Consent

    ERIC Educational Resources Information Center

    Powell, Anastasia

    2007-01-01

    In Australia, there is a growing expectation that sexuality education should reduce the risks associated with youth sex by providing young people with information on protecting their sexual health. However, this information may be insufficient to ensure that young people make choices that support their sexual safety and autonomy. This paper…

  1. Prevalence and Correlates of At-Risk Drinking Among Older Adults: The Project SHARE Study

    PubMed Central

    Moore, Alison A.; Xu, Haiyong; Ang, Alfonso; Tallen, Louise; Mirkin, Michelle; Ettner, Susan L.

    2010-01-01

    ABSTRACT BACKGROUND At-risk drinking, excessive or potentially harmful alcohol use in combination with select comorbidities or medication use, affects about 10% of elderly adults and is associated with higher mortality. Yet, our knowledge is incomplete regarding the prevalence of different categories of at-risk drinking and their associations with patient demographics. OBJECTIVE To examine the prevalence and correlates of different categories of at-risk drinking among older adults. DESIGN Cross-sectional analysis of survey data. SUBJECTS Current drinkers ages 60 and older accessing primary care clinics around Santa Barbara, California (n = 3,308). MEASUREMENTS At-risk drinkers were identified using the Comorbidity Alcohol Risk Evaluation Tool (CARET). At-risk alcohol use was categorized as alcohol use in the setting of 1) high-risk comorbidities or 2) high-risk medication use, and 3) excessive alcohol use alone. Adjusted associations of participant characteristics with at-risk drinking in each of the three at-risk categories and with at-risk drinking of any kind were estimated using logistic regression. RESULTS Over one-third of our sample (34.7%) was at risk. Among at-risk individuals, 61.9% had alcohol use in the context of high-risk comorbidities, 61.0% had high-risk medication use, and 64.3% had high-risk alcohol behaviors. The adjusted odds of at-risk drinking of any kind were decreased and significant for women (odds ratio, OR = 0.41; 95% confidence interval: 0.35-0.48; p-value < 0.001), adults over age 80 (OR = 0.55; CI: 0.43-0.72; p < 0.001 vs. ages 60-64), Asians (OR = 0.40; CI: 0.20-0.80; p = 0.01 vs. Caucasians) and individuals with higher education levels. Similar associations were observed in all three categories of at-risk drinking. CONCLUSIONS High-risk alcohol use was common among older adults in this large sample of primary care patients, and male Caucasians, those ages 60-64, and those with lower levels of education

  2. Suicide in older people: Revisioning new approaches.

    PubMed

    Deuter, Kate; Procter, Nicholas; Evans, David; Jaworski, Katrina

    2016-04-01

    This discussion paper identifies and examines several tensions inherent in traditional approaches to understanding older people's suicide. Predicted future increases in the absolute number of elderly suicides are subject to careful interpretation due to the underreporting of suicides in older age groups. Furthermore, a significant number of studies of older people's death by suicide examine risk factors or a combination of risk factors in retrospect only, while current approaches to suicide prevention in the elderly place disproportionate emphasis on the identification and treatment of depression. Taken together, such tensions give rise to a monologic view of research and practice, ultimately limiting our potential for understanding older people's experience of suicide and suicidal behaviour. New approaches are necessary if we are to move beyond the current narrow focus that prevails. Fresh thinking, which draws on older people's experience of attempting to die by suicide, might offer critical insight into socially-constructed meanings attributed to suicide and suicidal behaviour by older people. Specifically, identification through research into the protective mechanisms that are relevant and available to older people who have been suicidal is urgently needed to effectively guide mental health nurses and health-care professionals in therapeutic engagement and intervention. PMID:26762697

  3. A One-to-One Programme for At-Risk Readers Delivered by Older Adult Volunteers

    ERIC Educational Resources Information Center

    Fives, Allyn; Kearns, Noreen; Devaney, Carmel; Canavan, John; Russell, Dan; Lyons, Rena; Eaton, Patricia; O'Brien, Aoife

    2013-01-01

    This paper is based on a randomized controlled trial (RCT) evaluation of a reading programme delivered by older adult volunteers for at-risk early readers. Wizards of Words (WoW) was targeted at socially disadvantaged children in first and second grade experiencing delays in reading but who were not eligible for formal literacy supports. The…

  4. Improving nutrition in older people in acute care.

    PubMed

    Best, Carolyn; Hitchings, Helen

    2015-07-22

    Older people have an increased risk of becoming malnourished when they are ill. Admission to hospital may affect their nutritional intake and nutritional status. Nutrition screening and implementation of nutrition care plans can help minimise the risk of malnutrition in acute care settings, if used effectively. The nutritional care provided to older inpatients should be timely, co-ordinated, reviewed regularly and communicated effectively between healthcare professionals and across shifts. This article explores what malnutrition means, why older people in hospital might be at risk of malnutrition and the effect hospital admission might have on nutrition and fluid intake. It makes suggestions for addressing these issues, encourages nurses to look at the nutritional care provided in their clinical area, to reflect on what they do well and consider what can be done to improve patients' experiences. PMID:26198529

  5. Intergenerational Talk and Communication with Older People.

    ERIC Educational Resources Information Center

    Giles, Howard; And Others

    1992-01-01

    Overviews evolving program of interdisciplinary, multimethod research concerned with intergenerational communication. Concludes from studies that young people process and respond to speech of older people in stereotypical ways. Uses lifespan and intercultural perspectives to argue that communicative patterns observed in studies are sometimes…

  6. Brief Report: Young People at Risk for Eating Disorders in Southeast Brazil

    ERIC Educational Resources Information Center

    Moya, Tatiana; Fleitlich-Bilyk, Bacy; Goodman, Robert

    2006-01-01

    A representative sample of 7-14-year-old young people in southeast Brazil (N=1251) was assessed using standardized parent and youth interviews, thereby identifying an "at-risk" group of young people who met one or more DSM-IV criteria for anorexia and/or bulimia nervosa. These young people were compared with an age and gender matched comparison…

  7. How Many People Are Affected by or at Risk for Endometriosis?

    MedlinePlus

    ... people are affected by or at risk for endometriosis? Skip sharing on social media links Share this: ... menstruates. Factors that May Increase the Risk of Endometriosis Studies show that women are at higher risk ...

  8. How Many People Are Affected by or at Risk for Down Syndrome?

    MedlinePlus

    ... people are affected by or at risk for Down syndrome? Skip sharing on social media links Share this: ... ethnicity. 4 , 5 Maternal Age and Risk for Down Syndrome Because the likelihood that an egg will contain ...

  9. Chronic foot pain in older people.

    PubMed

    Menz, Hylton B

    2016-09-01

    Foot pain is a common accompaniment of advancing age, affecting at least one in four older people. However, management of foot pain is a largely undervalued aspect of geriatric health care, resulting in many older people needlessly enduring chronic foot pain and related disability. The aim of this review is to provide an overview of (i) the prevalence and risk factors for foot pain, (ii) the impact of foot pain on mobility and quality of life, and (iii) the conservative management of foot pain. The available evidence indicates that although foot pain is common and disabling in older people, conservative interventions such as routine foot care, footwear advice and foot orthoses are effective at reducing foot pain and may also assist in maintaining mobility and independence in this age group. PMID:27451329

  10. The Right to Health of Older People.

    PubMed

    Baer, Britta; Bhushan, Anjana; Taleb, Hala Abou; Vasquez, Javier; Thomas, Rebekah

    2016-04-01

    A focus on the right to the enjoyment of the highest attainable standard of health (hereinafter, "the right to health") draws attention to the health needs of older people, including the most marginalized among them. Many factors that influence vulnerability or impede the enjoyment of health and access to quality services result from an inability to freely exercise these human rights. A human rights approach can help to address the legal, social, and structural barriers to good health for older persons, clarifying the legal obligations of State and non-State actors to uphold and respect these rights. However, despite growing impetus for action, this area has historically received limited attention. Drawing on practice examples from different regions, this article unpacks the meaning of the right to health and other related human rights of older people in practice, covering both health care and underlying determinants of their health. Questions of availability, accessibility, acceptability, and quality are highlighted from the perspective of older people's health and well-being. The article brings together knowledge, principles, norms, and standards from the human rights law, health, and ageing arenas. By making links between these arenas, it is hoped that the article fills a gap in thinking on how to achieve the progressive realization of the right to health of older people and the effective promotion and protection of their other related human rights, which are crucial for the enjoyment of health. PMID:26994261

  11. Pressure ulcer prevention in frail older people.

    PubMed

    Barry, Maree; Nugent, Linda

    2015-12-16

    Pressure ulcers are painful and cause discomfort, have a negative effect on quality of life, and are costly to treat. The incidence and severity of preventable pressure ulcers is an important indicator of quality of care; it is essential that healthcare providers monitor prevalence and incidence rates to ensure that care strategies implemented are effective. Frail older people are at increased risk of developing pressure ulcers. This article discusses the complexities of preventing pressure ulcers in frail older people and emphasises the importance of structured educational programmes that incorporate effective clinical leadership and multidisciplinary teamwork. PMID:26669407

  12. Detecting dehydration in older people: useful tests.

    PubMed

    Hooper, Lee; Bunn, Diane

    Dehydration is common in older people, leading to longer hospital stays and increased disability and mortality. Health professionals can diagnose water-loss dehydration by taking a blood sample and measuring serum osmolality, but a less-invasive test would be useful. Evidence that tests, clinical signs or questions tested to date are useful when screening for dehydration in older people is limited. This article looks at known risk factors, signs and test for dehydration, and outlines evidence on how useful they have proven to be. Part 2 describes how a care home has used a multicomponent strategy to improve hydration. PMID:26455128

  13. Caring for Older People. Public transport.

    PubMed Central

    Roper, T. A.; Mulley, G. P.

    1996-01-01

    Most older people are mobile and able to use public transport without any problems. Those who are hard of hearing or have poor vision and those with mobility problems need not be deterred from using public transport. Though the design and provision of suitable buses, taxis, and trains is not always optimum, many now have imaginative features to help older passengers. Travel by air and sea needs extra planning for disabled elderly people, but helpful advice is available and much can be done to enable even the most disabled traveller to make long journeys confidently and in comfort. Images p415-a Fig 1 Fig 2 Fig 3 PMID:8761236

  14. Can we improve clinical prediction of at-risk older drivers?

    PubMed Central

    Bowers, Alex R.; Anastasio, R. Julius; Sheldon, Sarah S.; O’Connor, Margaret G.; Hollis, Ann M.; Howe, Piers D.; Horowitz, Todd S.

    2013-01-01

    Objectives To conduct a pilot study to evaluate the predictive value of the Montreal Cognitive Assessment test (MoCA) and a brief test of multiple object tracking (MOT) relative to other tests of cognition and attention in identifying at-risk older drivers, and to determine which combination of tests provided the best overall prediction. Methods Forty-seven currently-licensed drivers (58 to 95 years), primarily from a clinical driving evaluation program, participated. Their performance was measured on: (1) a screening test battery, comprising MoCA, MOT, MiniMental State Examination (MMSE), Trail-Making Test, visual acuity, contrast sensitivity, and Useful Field of View (UFOV); and (2) a standardized road test. Results Eighteen participants were rated at-risk on the road test. UFOV subtest 2 was the best single predictor with an area under the curve (AUC) of .84. Neither MoCA nor MOT was a better predictor of the at-risk outcome than either MMSE or UFOV, respectively. The best four-test combination (MMSE, UFOV subtest 2, visual acuity and contrast sensitivity) was able to identify at-risk drivers with 95% specificity and 80% sensitivity (.91 AUC). Conclusions Although the best four-test combination was much better than a single test in identifying at-risk drivers, there is still much work to do in this field to establish test batteries that have both high sensitivity and specificity. PMID:23954688

  15. Destination memory impairment in older people.

    PubMed

    Gopie, Nigel; Craik, Fergus I M; Hasher, Lynn

    2010-12-01

    Older adults are assumed to have poor destination memory-knowing to whom they tell particular information-and anecdotes about them repeating stories to the same people are cited as informal evidence for this claim. Experiment 1 assessed young and older adults' destination memory by having participants tell facts (e.g., "A dime has 118 ridges around its edge") to pictures of famous people (e.g., Oprah Winfrey). Surprise recognition memory tests, which also assessed confidence, revealed that older adults, compared to young adults, were disproportionately impaired on destination memory relative to spared memory for the individual components (i.e., facts, faces) of the episode. Older adults also were more confident that they had not told a fact to a particular person when they actually had (i.e., a miss); this presumably causes them to repeat information more often than young adults. When the direction of information transfer was reversed in Experiment 2, such that the famous people shared information with the participants (i.e., a source memory experiment), age-related memory differences disappeared. In contrast to the destination memory experiment, older adults in the source memory experiment were more confident than young adults that someone had shared a fact with them when a different person actually had shared the fact (i.e., a false alarm). Overall, accuracy and confidence jointly influence age-related changes to destination memory, a fundamental component of successful communication. PMID:20718537

  16. Destination Memory Impairment in Older People

    PubMed Central

    Gopie, Nigel; Craik, Fergus I. M.; Hasher, Lynn

    2012-01-01

    Older adults are assumed to have poor destination memory— knowing to whom they tell particular information—and anecdotes about them repeating stories to the same people are cited as informal evidence for this claim. Experiment 1 assessed young and older adults’ destination memory by having participants tell facts (e.g., “A dime has 118 ridges around its edge”) to pictures of famous people (e.g., Oprah Winfrey). Surprise recognition memory tests, which also assessed confidence, revealed that older adults, compared to young adults, were disproportionately impaired on destination memory relative to spared memory for the individual components (i.e., facts, faces) of the episode. Older adults also were more confident that they had not told a fact to a particular person when they actually had (i.e., a miss); this presumably causes them to repeat information more often than young adults. When the direction of information transfer was reversed in Experiment 2, such that the famous people shared information with the participants (i.e., a source memory experiment), age-related memory differences disappeared. In contrast to the destination memory experiment, older adults in the source memory experiment were more confident than young adults that someone had shared a fact with them when a different person actually had shared the fact (i.e., a false alarm). Overall, accuracy and confidence jointly influence age-related changes to destination memory, a fundamental component of successful communication. PMID:20718537

  17. Older People as Consumers of Education.

    ERIC Educational Resources Information Center

    Knox, Alan

    Socio-psychological variables that influence the extent to which older people (age: 50+) will be consumers of education are examined to arrive at criteria for programs appropriate to the developmental needs of this group. Research indicates that two primary influences are changes in learning abilities and interests. Secondary influences include…

  18. Frail Older People as Participants in Research

    ERIC Educational Resources Information Center

    Peel, Nancye M.; Wilson, Cecilia

    2008-01-01

    This article describes the experience of interviewing frail older people in a research project investigating hip fracture risk factors. Specific methodological strategies to maximize participation and data quality and to facilitate the interview process related to participant inclusion criteria, initial approach, questionnaire format, and…

  19. Prevention of Dehydration in Independently Living Elderly People at Risk: A Study Protocol of a Randomized Controlled Trial

    PubMed Central

    Konings, Francis J. C. M.; Mathijssen, Jolanda J. P.; Schellingerhout, Jasper M.; Kroesbergen, Ike H. T.; Goede de, Joyce; Goor de, Ien A. M.

    2015-01-01

    Background: Dehydration of elderly people living independently is a very important public health issue. This study compares two interventions to prevent dehydration in elderly people at risk: an educational intervention and an educational intervention in combination with a drink reminder device. Methods: This is an experimental two-armed parallel study. A Public Health Service develops the interventions and will be partnering with a general practice and a university to evaluate the effects. Two groups – all people aged 80 years and older, and people of 65 years and older who have cardiovascular disease – receive a letter from the general practice in which they are asked whether they want to participate in the study and if so to return the form. People who want to participate and whose daily fluid intake is insufficient are randomized to receive either the educational intervention or the educational intervention in combination with a drink reminder device. The participants are asked to fill in a questionnaire before the intervention, 6 weeks after the start of the intervention and 6 months after the start (or after the end) of the intervention. Changes between the two groups in fluid intake, knowledge, awareness of the risks of dehydration, and quality-of-life will be tested by Linear Mixed Model analyses. Conclusions: This study will improve the knowledge of the effectiveness of interventions designed to prevent dehydration in elderly people. PMID:26644904

  20. Dietary factors and depression in older people.

    PubMed

    Williamson, Claire

    2009-10-01

    Depression is one of the most prevalent mental health conditions and can affect people of all ages, but it is becoming more common among the older population with increasing life expectancy. Observational studies have found poor micronutrient status (particularly folate and vitamin B12) to be associated with an increased risk of depression in older people. Supplementation with folic acid has been shown to enhance anti-depressant drug treatment and there is preliminary evidence that supplementation with certain micronutrients may help improve depressive symptoms in older patients. There has also been a lot of interest in the role of long-chain omega-3 fatty acids in depression. However, the evidence from randomized controlled trials is limited and difficult to evaluate owing to considerable variability between studies. The research highlights the importance of a healthy diet and lifestyle to help maintain good mental health into old age and health professionals should try to support older people in trying to achieve this. PMID:19966681

  1. Helicobacter pylori infection in older people

    PubMed Central

    Pilotto, Alberto; Franceschi, Marilisa

    2014-01-01

    Since the discovery of Helicobacter pylori (H. pylori) infection as the major cause of gastroduodenal disorders three decades ago, H. pylori has been the focus of active research and debate in the scientific community. Its linkage to several diseases, such as peptic ulcer disease, gastritis and gastric malignancy is incontestable. In particular, it has been noticed that, as the aged population is increasing worldwide, older people are at increased risk of developing several gastroduodenal diseases and related complications. At the same time, gastric cancer is definitely more frequent in elderly than in adult and young people. In addition, it has been showed that peptic ulcer and related complications occur much more commonly in aged individuals than in young people, resulting in a significantly higher mortality. Although this infection plays a crucial role in gastrointestinal disorders affecting all age groups and in particular older people, only a few studies have been published regarding the latter. This article presents an overview of the epidemiology, diagnosis, clinical manifestations and therapy of H. pylori infection in elderly people. PMID:24914358

  2. Correlates of Physical Activity Among Middle-Aged and Older Korean Americans at Risk for Diabetes

    PubMed Central

    Han, Benjamin; Sadarangani, Tina; Wyatt, Laura C.; Zanowiak, Jennifer M.; Kwon, Simona C.; Trinh-Shevrin, Chau; Lee, Linda; Islam, Nadia S.

    2016-01-01

    Purpose To explore correlates of meeting recommended physical activity (PA) among middle-aged and older Korean Americans at risk for diabetes mellitus (DM). Design and Methods PA patterns and their correlates were assessed among 292 middle-aged and older Korean Americans at risk for DM living in New York City (NYC) using cross-sectional design of baseline information from a diabetes prevention intervention. PA was assessed by self-report of moderate and vigorous activity, results were stratified by age group (45-64 and 65-75), and bivariate analyses compared individuals performing less than sufficient PA and individuals performing sufficient PA. Logistic regression was used to calculate adjusted odds ratios predicting sufficient PA. Findings After adjusting for sex, age group, years lived in United States, marital status, health insurance and body mass index (BMI), sufficient PA was associated with male sex, older age, lower BMI, eating vegetables daily, and many PA-specific questions (lack of barriers, confidence, and engagement). When stratified by age group, male sex and eating vegetables daily was no longer significant among Koreans age 65 to 75 years of age, and BMI was not significant for either age group. Conclusions PA interventions targeting this population may be beneficial and should consider the roles of sex, age, physical and social environment, motivation, and self-efficacy. Clinical Relevance Clinical providers should understand the unique motivations for PA among Korean Americans and recognize the importance of culturally driven strategies to enable lifestyle changes and support successful aging for diverse populations. PMID:26641597

  3. Pathways between stigma and suicidal ideation among people at risk of psychosis.

    PubMed

    Xu, Ziyan; Müller, Mario; Heekeren, Karsten; Theodoridou, Anastasia; Metzler, Sibylle; Dvorsky, Diane; Oexle, Nathalie; Walitza, Susanne; Rössler, Wulf; Rüsch, Nicolas

    2016-04-01

    Mental illness stigma may contribute to suicidality and is associated with social isolation and low self-esteem among young people at risk of psychosis. However, it is unclear whether mental illness stigma contributes to suicidality in this population. We therefore examined the associations of self-labeling and stigma stress with suicidality among young people at risk. Self-labeling as "mentally ill", stigma stress, social isolation, self-esteem, symptoms and suicidal ideation were assessed in 172 individuals at risk of psychosis. Self-labeling and stigma stress were examined as predictors of suicidality by path analysis. Increased self-labeling as "mentally ill" was associated with suicidality, directly as well as indirectly mediated by social isolation. More stigma stress was related to social isolation which in turn was associated with low self-esteem, depression and suicidal ideation. Social isolation fully mediated the link between stigma stress and suicidal ideation. Interventions to reduce the public stigma associated with risk of psychosis as well as programs to facilitate non-stigmatizing awareness of at-risk mental state and to reduce stigma stress among young people at risk of psychosis might strengthen suicide prevention in this population. PMID:26843510

  4. Access to Vocational Guidance for People at Risk of Social Exclusion.

    ERIC Educational Resources Information Center

    Clayton, Pamela M., Ed.; Fojcik, Vavrinec; Greco, Silvana; Hulkko, Johanna; Kelly, Eimer; Kostka, Miroslav; McGill, Paul; Machackova, D.; Maiello, Marco; Makela, Eija; Sinorova, Lenka; Troska, Robert; Ward, Mary

    This document contains 7 papers that evolved from 44 case studies of access to vocational guidance for people at risk of social exclusion in 5 European countries. The following papers are included: "Introduction" (Pamela Clayton); "Access to Vocational Guidance in Italy" (Silvana Greco, Marco Maiello); "Access to Vocational Guidance in Ireland"…

  5. How Many People Are Affected by or at Risk for Cushing's Syndrome?

    MedlinePlus

    ... Small Business Programs Activities and opportunities geared toward small businesses Peer Review Review of the scientific & technical merit of grant applications Contacts for NICHD Funding Information ... at risk for Cushing’s syndrome? Skip sharing on social media links Share this: Page Content The risk of developing Cushing’s syndrome is small; only two to three people per million are ...

  6. Perceptions of older people on disaster response and preparedness.

    PubMed

    Duggan, Seana; Deeny, Pat; Spelman, Ruth; Vitale, Catherine T

    2010-03-01

    Most disasters occur in developing countries but in the last decade due to the increasing threat of floods, air disasters and terrorist threat, disaster response and preparedness is a growing global concern. Due to an ageing population across the world, older people now constitute a significant proportion of those at risk from disasters. This paper reports on a qualitative study carried out in Sri Lanka and in the United States where a group of older people were asked about aspects of disaster response and preparedness. The group from Sri Lanka (n=9) who had direct experience of the 2004 Indian Ocean Tsunami were asked how they perceived international aid relief and a group of white Caucasians from East Coast USA (n=8) were asked about disaster preparedness. Findings indicate that both groups had similar issues albeit that they were looking at different phases of the disaster cycle and from different cultural perspectives. Both groups identified issues related to, protecting the rights of the older person and preventing loss of independence in responding and preparing for a disaster, mistrust of government and access to resources and all expressed strong feelings of self-responsibility. PMID:20925760

  7. Stigma and suicidal ideation among young people at risk of psychosis after one year.

    PubMed

    Xu, Ziyan; Mayer, Benjamin; Müller, Mario; Heekeren, Karsten; Theodoridou, Anastasia; Dvorsky, Diane; Metzler, Sibylle; Oexle, Nathalie; Walitza, Susanne; Rössler, Wulf; Rüsch, Nicolas

    2016-09-30

    Suicidality is common among individuals at risk of psychosis. Emerging findings suggest that mental illness stigma contributes to suicidality. However, it is unclear whether stigma variables are associated with suicidality among young people at risk of psychosis. This longitudinal study assessed perceived public stigma and the cognitive appraisal of stigma as a stressor (stigma stress) as predictors of suicidal ideation among individuals at risk of psychosis over the period of one year. One hundred and seventy-two participants between 13 and 35 years of age were included who were at high or ultra-high risk of psychosis or at risk of bipolar disorder. At one-year follow-up, data were available from 73 completers. In multiple logistic regressions an increase of stigma stress (but not of perceived stigma) over one year was significantly associated with suicidal ideation at one-year follow-up, controlling for age, gender, symptoms, comorbid depression and suicidal ideation at baseline. Interventions to reduce public stigma and stigma stress could therefore improve suicide prevention among young people at risk of psychosis. PMID:27419651

  8. Self reported rates of criminal offending and victimization in young people at-risk for psychosis.

    PubMed

    Purcell, R; Harrigan, S; Glozier, N; Amminger, G P; Yung, A R

    2015-08-01

    A significant relationship exists between experiencing psychosis and both engaging in criminal offending and being a victim of crime. A substantial proportion of violence and offending occurs during the first episode of psychosis, but it is unclear whether such behaviour is also evident in the earlier pre-psychotic stage of illness. As part of a prospective study of young people who were seeking help for mental health problems, we enquired about participants' experiences of being charged and/or convicted of a criminal offence and being a victim of crime. This paper uses cross-sectional baseline data to compare the rates of these forensic outcomes in participants at-risk of psychosis (n=271) with those not at-risk (n=440). Univariate logistic regression showed that the at-risk for psychosis group was significantly more likely than the not at-risk participants to report having been charged by police (11.1% vs 5.9%; p=.015) and convicted by the courts (4.4% vs. 1.6%; p=0.028) with a non-violent offence, as well as to have been convicted of any criminal offence (6.3% vs. 3.0%; p=0.037). The at-risk were also more likely to report having been a victim of crime (23.7% vs 14.0%; p=.002), particularly violent victimization (16.5% vs 8.2%; p=.001). In multivariate logistic regression analyses, being at-risk for psychosis remained a significant predictor of three of the four outcome measures after controlling for other known covariates such as gender, age, substance misuse and unemployment. This is the first study to demonstrate that, relative to their non-psychotic help-seeking counterparts, young people at-risk for psychosis are at higher risk of forensic outcomes, particularly violent crime victimization. PMID:26036816

  9. Evidence-based review of interventions for medically at-risk older drivers.

    PubMed

    Classen, Sherrilene; Monahan, Miriam; Auten, Beth; Yarney, Abraham

    2014-01-01

    OBJECTIVE. To conduct an evidence-based review of intervention studies of older drivers with medical conditions. METHOD. We used the American Occupational Therapy Association's classification criteria (Levels I-V, I = highest level of evidence) to identify driving interventions. We classified studies using letters to represent the strength of recommendations: A = strongly recommend the intervention; B = recommend intervention is provided routinely; C = weak evidence that the intervention can improve outcomes; D = recommend not to provide the intervention; I = insufficient evidence to recommend for or against the intervention. RESULTS. For clients with stroke, we recommend a graded simulator intervention (A) and multimodal training in traffic theory knowledge and on-road interventions (B); we make no recommendation for or against Dynavision, Useful Field of View, or visual-perceptual interventions (I). For clients with visual deficits, we recommend educational intervention (A) and bioptic training (B); we make no recommendation for or against prism lenses (I). For clients with dementia, we recommend driving restriction interventions (C) and make no recommendation for or against use of compensatory driving strategies (I). CONCLUSION. Level I studies are needed to identify effective interventions for medically at-risk older drivers. PMID:25005514

  10. Evidence-Based Review of Interventions for Medically At-Risk Older Drivers

    PubMed Central

    Monahan, Miriam; Auten, Beth; Yarney, Abraham

    2014-01-01

    OBJECTIVE. To conduct an evidence-based review of intervention studies of older drivers with medical conditions. METHOD. We used the American Occupational Therapy Association’s classification criteria (Levels I–V, I = highest level of evidence) to identify driving interventions. We classified studies using letters to represent the strength of recommendations: A = strongly recommend the intervention; B = recommend intervention is provided routinely; C = weak evidence that the intervention can improve outcomes; D = recommend not to provide the intervention; I = insufficient evidence to recommend for or against the intervention. RESULTS. For clients with stroke, we recommend a graded simulator intervention (A) and multimodal training in traffic theory knowledge and on-road interventions (B); we make no recommendation for or against Dynavision, Useful Field of View, or visual–perceptual interventions (I). For clients with visual deficits, we recommend educational intervention (A) and bioptic training (B); we make no recommendation for or against prism lenses (I). For clients with dementia, we recommend driving restriction interventions (C) and make no recommendation for or against use of compensatory driving strategies (I). CONCLUSION. Level I studies are needed to identify effective interventions for medically at-risk older drivers. PMID:25005514

  11. Managing agitated behaviour in older people.

    PubMed

    King, Camille

    2012-09-01

    Older people diagnosed with dementia can have complex needs, especially when they exhibit agitated behaviour. Patients with agitated behaviour challenge the delivery of health care. Often the behaviour is a symptom of unmet needs in this population (Dewing 2010). It is important for nurses to understand the underlying causes and apply evidence-based interventions in their nursing practice to promote health, safety and the highest quality of life possible. This article defines and classifies agitated behaviours, discusses implications for their management and then presents evidence-based interventions nurses can use. The interventions are categorised according to each of the five senses. PMID:23008918

  12. Screening for Malnutrition in Older People.

    PubMed

    Guyonnet, Sophie; Rolland, Yves

    2015-08-01

    Malnutrition risk increases with age and level of care. Despite significant medical advances, malnutrition remains a significant and highly prevalent public health problem of developed countries. Earlier identification and appropriate nutrition support may help to reverse or halt the malnutrition trajectory and the negative outcomes associated with poor nutritional status. A nutrition screening process is recommended to help detect people with protein-energy malnutrition (PEM) or at malnutrition risk. Evidence supports that oral nutritional supplements and dietary counseling can increase dietary intake and improve quality of life in elderly with PEM or at malnutrition risk. This article examines nutritional screening and assessment tools designated for older adults. PMID:26195101

  13. The Market for Community Services for Older People.

    ERIC Educational Resources Information Center

    Hereford, Russell W.

    The Supportive Services Program for Older Persons is designed to demonstrate that a private market for home and community-based health related services can be developed in response to the demand expressed by older people and their families. The objective of the program is to expand the service options available to older people by letting market…

  14. Perceptions of disaster preparedness among older people in South Korea.

    PubMed

    Yoo, Myoungran; Lee, Mijung; Tullmann, Dorothy

    2016-03-01

    Older people are a major vulnerable population. During disasters, given their physical frailty, lower social status, loss of medications and medical care, the vulnerability of older people increases. The purpose of this study was to examine the perceptions of older people in Korea on various aspects of disaster preparedness to better understand their special needs and to facilitate appropriate disaster planning. The study was qualitative and used focus group interviews with 12 older people in one major city and one rural area of South Korea. Four themes were identified by the analysis of the interviews: defenceless state, reality of accepting limitations, strong will to live, importance of disaster preparedness governmental efforts for the older people. Findings indicated that preparation of shelters and transportation was critical to help older people survive in times of disasters and suggested that there should be active involvement of the government in terms of disaster planning, managing and preparing older people for disasters. In addition, healthy older people can be assets to disaster relief efforts by providing practical and emotional support for the most fragile older people. Older people can also provide knowledge of their special needs to the government to improve their disaster response policy. PMID:26179452

  15. An integrated practice approach to mobility care for older people.

    PubMed

    Taylor, Janice; Hill, Heather; Kay, Kate

    2016-03-16

    Mobility is important to older people in nursing homes and residential facilities since it contributes to their health and quality of life. Many residents in such facilities require some form of assistance to move and accomplish activities of daily living. Therefore, nurses and healthcare assistants should have the knowledge and skills to provide effective mobility care. This article discusses three important aspects of mobility care: safety, mobility optimisation and person-centred approaches to care. Safety is important as residents and staff are at risk of injury during mobility care. Mobility optimisation is essential to ensure residents maintain their independence. Person-centred approaches to care are central to providing an integrated approach to mobility care. PMID:26982868

  16. Attitudes and stereotypes: nurses' work with older people.

    PubMed

    Pursey, A; Luker, K

    1995-09-01

    The study reported here sought to describe the differences between nurses' attitudes towards work with older people in the collective sense and their attitudes towards the individuals with whom they work. A convenience sample of 136 community nurses was obtained. Data were collected by means of a questionnaire incorporating the report of two critical incidents--one of effective practice and one of ineffective practice with older people. In addition in-depth qualitative interviews were conducted with 22 respondents. The findings lead the authors to challenge the common assumption that an identified lack of desire in nurses to work with older people is due solely to negative attitudes which nurses hold towards older people themselves. The paper concludes that the high dependency levels of older people and structure of nursing work with older people in hospitals means that fewer nurses make this area a positive career choice. PMID:7499623

  17. Carotenoids and health in older people.

    PubMed

    Woodside, Jayne V; McGrath, Alanna J; Lyner, Natalie; McKinley, Michelle C

    2015-01-01

    As the proportion of older people increases, so will chronic disease incidence and the proportion of the population living with disability. Therefore, new approaches to maintain health for as long as possible in this age group are required. Carotenoids are a group of polyphenolic compounds found predominantly in fruit and vegetables that have been proposed to have anti-inflammatory and antioxidant effects. Such properties may impact on the risk diseases which predominate in older people, and also ageing-related physiological changes. Working out the effect of carotenoid intake versus fruit and vegetable intake is difficult, and the strong correlation between individual carotenoid intakes also complicates any attempt to examine individual carotenoid health effects. Similarly, research to determine whether carotenoids consumed as supplements have similar benefits to increased dietary intake through whole foods, is still required. However, reviewing the recent evidence suggests that carotenoid intake and status are relatively consistently associated with reduced CVD risk, although β-carotene supplementation does not reduce CVD risk and increases lung cancer risk. Increased lycopene intake may reduce prostate cancer progression, with a potential role for carotenoids at other cancer sites. Lutein and zeaxanthin have a plausible role in the maintenance of eye health, whilst an association between carotenoid intake and cognitive and physical health appears possible, although research is limited to date. Given this accruing evidence base to support a specific role for certain carotenoids and ageing, current dietary advice to consume a diet rich in fruit and vegetables would appear prudent, and efforts maintained to encourage increased intake. PMID:25466302

  18. Controlling joint pain in older people.

    PubMed

    Paisley, Peter; Serpell, Mick

    2016-01-01

    Jont pain in oldder people The prevalence of chronic pain in older people in the community ranges from 25 to 76% and for those in residential care, it is even higher at 83 to 93%. The most common sites affected are the back, hip, or knee, and other joints. There is increased reporting of pain in women (79%) compared with men (53%). Common conditions include osteoarthritis and, to a lesser extent, the inflammatory arthropathies such as rheumatoid arthritis. The differential diagnosis includes non-articular pain such as vascular limb pain and nocturnal cramp, some neuropathic pain conditions (such as compressive neuropathies and postherpetic neuralgia), soft tissue disorders such as fibromyalgia and myofascial pain syndromes. In addition to an assessment of pain intensity, a biopsychosocial model should be adopted to ascertain the effect of the pain on the patient's degree of background pain at rest. The disease is often localised to the large load-bearing joints, predominantly the hips and knees. In contrast to osteoarthritis, the inflammatory arthritides typically present with symmetrical swollen, stiff, and painful small joints of the hands and feet, usually worse in the morning. PMID:27180497

  19. Newer Drugs Helping Older People with Eye Disease

    MedlinePlus

    ... People With Eye Disease Treatments keeping those with macular degeneration reading and driving longer, study finds To use ... life for many older people with age-related macular degeneration (AMD), a new study indicates. The drugs Avastin ...

  20. Seniors-on-line: introducing older people to technology.

    PubMed

    Irizarry, C; Downing, A; Elford, C

    1997-03-01

    Retired Engineers are playing an important role in ensuring that older people are not excluded from the benefits of technological advances. Technology is playing an increasingly important role in the lives of older people as it is incorporated into assistive devices, home security, access to health care, banking, communication and many other areas. However, if older people are unfamiliar with new technologies and find them daunting, they may not benefit fully from these advances. In order to minimize difficulties arising from unfamiliarity with technology, an introductory computer course was offered to people aged 55 and over. Teaching methods appropriate to the needs of older people were used: small classes, students and instructors from same age cohort, slow pace of presentation and ample opportunity to ask questions. Retired Engineers make up the majority of instructors. Three hundred and sixty nine older people have participated in the course and most plan to continue using a computer. PMID:9141312

  1. Hand-Grip Strength Cut-Points to Screen Older Persons at Risk for Mobility Limitation

    PubMed Central

    Sallinen, Janne; Stenholm, Sari; Rantanen, Taina; Heliövaara, Markku; Sainio, Päivi; Koskinen, Seppo

    2010-01-01

    Objectives To determine optimal hand-grip strength cut-points for increased likelihood for mobility limitation among older people and to study whether these cut-points differ according to body mass index (BMI). Design and setting Cross-sectional analysis of data collected in the Finnish population-based Health 2000 Survey. Participants and measurements 1 084 men and 1 562 women aged 55 years and older with complete data on anthropometry, hand-grip strength and self-reported mobility. Mobility limitation was defined as difficulties in walking 0.5-km or climbing stairs. Receiver Operating Characteristics analysis was used to estimate hand-grip strength cut-points for increased likelihood for mobility limitation. Results The overall hand-grip strength cut-points for increased likelihood for mobility limitation were 37 kg (sensitivity 62% and specificity 76%) for men and 21 kg (67% and 73%) for women. Hand-grip strength by BMI interaction on mobility limitation was significant among men (p = 0.022), while no such interaction was observed among women (p = 0.156). Among men, most optimal cut-offs were 33 kg (73% and 79%) for normal-weight men, 39 kg (67% and 71%) for overweight men and 40 kg (57% and 68%) for obese men. Among women, BMI-specific hand-grip strength cut-off values did not markedly increase accuracy over the overall cut-off value. Conclusion Hand-grip strength test is a useful tool to identify persons with increased risk for mobility limitation. Among men, the hand-grip strength cut-points for mobility increased along with BMI, while among women only one hand-grip strength threshold was identified. PMID:20863331

  2. Impact of prescribed medications on patient safety in older people

    PubMed Central

    Anathhanam, Sujo; Powis, Rachel A.; Robson, Jeremy

    2012-01-01

    Appropriate prescribing for older adults presents unique challenges to the prescriber. An understanding of the scale of the problems and contributing factors is essential when designing interventions to improve patient safety. The altered pharmacology of ageing, the existence of multiple medical conditions and the exclusion of elderly patients from many trials render this subgroup of the population particularly vulnerable to underprescribing and overprescribing. Adverse drug events are common, causing significant morbidity and mortality as well as having economic implications. ‘High-risk’ medications such as opioids, anticoagulants and antipsychotics can have benefits in this group of patients but strategies to optimize their safety are required. Tools exist that help to identify those at risk of adverse drug reactions and to screen for inappropriate prescribing. Developments in information technology are ongoing, and it is hoped that these may enhance the process of medication reconciliation across healthcare transitions and alert the prescriber to potential adverse drug events. This review addresses commonly encountered issues when prescribing for older people, considers strategies to improve medication safety and offers a list of ‘top tips’ to aid the clinician. PMID:25083234

  3. Taking older people's rights seriously: the role of international law.

    PubMed

    Tang, Kwong-leung

    2008-01-01

    Older people face many difficult challenges that amount to a deplorable violation of their basic human rights (poverty, discrimination, denial of social services, etc.). However, the world has been slow to react. Factors that limit global responses to the challenges of aging include: limited political will, the prevalence of neo-liberalism, and NGOs' longstanding advocacy for other seemingly "more" disadvantaged groups. Such oppression of and discrimination against older people require a concerted world-wide response. We contend that the introduction of an international convention on the human rights of older people is most relevant. Reinforced by a potent international monitoring system, the convention should contain comprehensive and legally binding provisions that require participating states to promote older people's rights. It is argued that international law would be a powerful force in defending and protecting older persons, operating as a baseline for establishing underlying values for national aging policies and linking older persons' concerns with other segments of society. PMID:18198162

  4. Media portrayal of older people as illustrated in Finnish newspapers.

    PubMed

    Koskinen, Sanna; Salminen, Leena; Leino-Kilpi, Helena

    2014-01-01

    Media portrayals of older people, such as those in newspapers, both inform and reflect public attitudes. By becoming aware of culturally influenced attitudes about older people, and how these attitudes are reflected in the ways older people are viewed, treated, and cared for in society, the healthcare profession can better understand how to provide high-quality care. By applying an ethnographic approach in textual reality, this paper explores how newspaper articles focusing on health portray older people in society, using Finland as an example. The data consist of articles selected from three of the main Finnish daily newspapers during a 3-month period in the spring of 2012. The findings show that, overall, the society regards older people and their care as important. However, there were suggestions of paternalistic attitudes towards older people. Furthermore, the perceptions regarding different groups of older people could lead to the possibility of inequality. The media portrayals of older people worldwide seem to share similarities, although the findings of this study are particularly in accordance with the cultural attributes of the Nordic countries and societies. PMID:25261872

  5. Media portrayal of older people as illustrated in Finnish newspapers

    PubMed Central

    Koskinen, Sanna; Salminen, Leena; Leino-Kilpi, Helena

    2014-01-01

    Media portrayals of older people, such as those in newspapers, both inform and reflect public attitudes. By becoming aware of culturally influenced attitudes about older people, and how these attitudes are reflected in the ways older people are viewed, treated, and cared for in society, the healthcare profession can better understand how to provide high-quality care. By applying an ethnographic approach in textual reality, this paper explores how newspaper articles focusing on health portray older people in society, using Finland as an example. The data consist of articles selected from three of the main Finnish daily newspapers during a 3-month period in the spring of 2012. The findings show that, overall, the society regards older people and their care as important. However, there were suggestions of paternalistic attitudes towards older people. Furthermore, the perceptions regarding different groups of older people could lead to the possibility of inequality. The media portrayals of older people worldwide seem to share similarities, although the findings of this study are particularly in accordance with the cultural attributes of the Nordic countries and societies. PMID:25261872

  6. EXECUTIVE DYSFUNCTION IN HOMEBOUND OLDER PEOPLE WITH DIABETES MELLITUS

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The objective of this study was to describe patterns of cognitive deficits and activities of daily living (ADLs) in older people with diabetes mellitus. We conducted a cross-sectional, population-based study on two hundred ninety-one homebound people aged 60 and older, 40% with diabetes mellitus, in...

  7. Psychosocial barriers to sexual intimacy for older people.

    PubMed

    Garrett, Dawne

    A review of the literature relating to the psychosocial barriers to sexual intimacy in older people reveals wide-ranging influences on people aged 75-85 years. These influences include: a lack of positive social policy, a lack of research, partner availability, negative media portrayals, psychological factors, relationship factors, and difficulties in interactions with health professionals. Stereotypical attitudes about sexual intimacy and older people remain a cultural norm. A high value is placed on a gold standard of sexual performance, which can reinforce negative esteem and set unrealistic expectations and measures for older people. This article focuses on the majority of the older population who do not require residential care. It examines major influences emerging from a review of the literature from 1995 to 2013, which informs a working definition for sexual intimacy in people over the age of 75 years. The article concludes with key recommendations for nurses working with older adults. PMID:24690929

  8. Involving older people in improving general hospital care.

    PubMed

    Hayes, Nicky; Dearnley, Barbara

    2007-05-01

    User involvement is high on the NHS agenda. At King's College Hospital, London, older people helped to develop the Improving Hospital Care for Older People project by producing teaching and learning materials for staff using e-learning. The project was set up by holding focus groups with older people. Staff surveys were also conducted to explore views and identify issues to be addressed. Older people's representatives were selected and directly involved in developing learning materials. This article describes the process of working together and includes the personal reflections of some of the key players. It discusses barriers to effective user involvement work between staff and older people, and identifies some benefits and opportunities presented by this approach. PMID:17518196

  9. Intersectoral interagency partnerships to promote financial capability in older people.

    PubMed

    Hean, Sarah; Fenge, Lee Ann; Worswick, Louise; Wilkinson, Charlie; Fearnley, Stella

    2012-09-01

    From the second quarter of 2008, the UK economy entered a period of economic decline. Older people are particularly vulnerable during these times. To promote ways in which older people can be better supported to maintain their financial well-being, this study explored the sources older people utilize to keep themselves financially informed. Interviews with older people (n = 28) showed that older people access trusted sources of information (e.g. healthcare professionals) rather than specialist financial information providers (e.g. financial advisors) which highlighted the need for interagency working between financial services in the private, public and voluntary sectors. An example of how such interagency partnerships might be achieved in practice is presented with some recommendations on directions for future research into interagency working that spans public, private and voluntary sectors. PMID:22734939

  10. Mental health issues and discrimination among older LGBTI people.

    PubMed

    Tinney, Jean; Dow, Briony; Maude, Phillip; Purchase, Rachel; Whyte, Carolyn; Barrett, Catherine

    2015-09-01

    LGBT is an acronym used to describe people from diverse sexual orientation or gender identity, people that are gay, lesbian, bisexual, or transgender. LGBT people do not constitute a single group nor does each individual "group" constitute a homogeneous unity. However, as higher rates of depression and/or anxiety have been observed in older LGBT people, compared to their heterosexual counterparts (Guasp, 2011) there is a need to raise the profile of mental health issues amongst these groups. The additional letter I is also often included in the acronym LGBTI as intersex people are often included as another gender diverse group. However, there is very little research that includes intersex people and none on older intersex people's mental health so this editorial is restricted to consideration of older LGBT people. PMID:26223452

  11. Circadian temperature rhythms of older people

    NASA Technical Reports Server (NTRS)

    Monk, T. H.; Buysse, D. J.; Reynolds, C. F. 3rd; Kupfer, D. J.; Houck, P. R.

    1995-01-01

    This collection of studies had the aim of exploring whether older (77+ years) men and women have circadian body temperature rhythms different from those of younger adults. A total of 20 older men and 28 older women were compared with either 22 young men or 14 middle-aged men in four protocols; all but the first protocol using a subset of the sample. The four protocols were: 1) 24 h, and 2) 72 h data collections on a normal laboratory routine (sleeping at night); 3) between 36 h and 153 h of field data collection at home; and 4) 36 h of a constant conditions routine (wakeful bedrest under temporal isolation) in the laboratory. There was some evidence for an age-related phase advance in temperature rhythm, especially for the older men on a normal routine, though this was not present in the constant conditions protocol, where 5 of the older subjects showed major delays in the timing of the body temperature trough (10:00 or later). There was no statistically significant evidence from any of the protocols that older subjects generally had lower temperature rhythm amplitudes than younger adults. Only when older men were compared with younger men in 24-h rhythm amplitude by simple t-test did any comparison involving amplitude achieve statistical significance (p < 0.05).

  12. Intrinsic Brain Activity of Cognitively Normal Older Persons Resembles More That of Patients Both with and at Risk for Alzheimer's Disease Than That of Healthy Younger Persons

    PubMed Central

    Pasquini, Lorenzo; Tonch, Annika; Plant, Claudia; Zherdin, Andrew; Ortner, Marion; Kurz, Alexander; Förstl, Hans; Zimmer, Claus; Grimmer, Timo; Wohlschäger, Afra; Riedl, Valentin

    2014-01-01

    Abstract In Alzheimer's disease (AD), recent findings suggest that amyloid-β (Aβ)-pathology might start 20–30 years before first cognitive symptoms arise. To account for age as most relevant risk factor for sporadic AD, it has been hypothesized that lifespan intrinsic (i.e., ongoing) activity of hetero-modal brain areas with highest levels of functional connectivity triggers Aβ-pathology. This model induces the simple question whether in older persons without any cognitive symptoms intrinsic activity of hetero-modal areas is more similar to that of symptomatic patients with AD or to that of younger healthy persons. We hypothesize that due to advanced age and therefore potential impact of pre-clinical AD, intrinsic activity of older persons resembles more that of patients than that of younger controls. We tested this hypothesis in younger (ca. 25 years) and older healthy persons (ca. 70 years) and patients with mild cognitive impairment and AD-dementia (ca. 70 years) by the use of resting-state functional magnetic resonance imaging, distinct measures of intrinsic brain activity, and different hierarchical clustering approaches. Independently of applied methods and involved areas, healthy older persons' intrinsic brain activity was consistently more alike that of patients than that of younger controls. Our result provides evidence for larger similarity in intrinsic brain activity between healthy older persons and patients with or at-risk for AD than between older and younger ones, suggesting a significant proportion of pre-clinical AD cases in the group of cognitively normal older people. The observed link of aging and AD with intrinsic brain activity supports the view that lifespan intrinsic activity may contribute critically to the pathogenesis of AD. PMID:24689864

  13. [Dissertations 25 year after date 41. Older people's adaptability].

    PubMed

    de Baat, C; Gerritsen, A E; van der Putten, G J; van der Maarel-Wierink, C D

    2015-09-01

    In 1990, the thesis 'Removable complete dentures in older people, an issue dealing with adaptability?' was published. Among other things, this thesis aimed at finding a method of measuring older people's adaptability to removable complete dentures. Its conclusion was that a subscale of the "Beoordelingsschaal voor Oudere Patiënten" (Rating scale for older patients) had predictive value. Subsequently, only a few research projects on this topic have been carried out. They dealt with demonstrated adaptation achieved after treatment, the realised adaptation. The results were disappointing. Ever since the availability of endosseous oral implants, research into adaptability to conventional removable complete dentures seems less relevant. During the last decades, inquiries into a method of measuring treatment effectiveness has focused on older people's quality of life and general health condition. However, to assess with respect to oral health care an older person's general health condition and load-taking capacity adequately, some experience is indispensable. PMID:26397105

  14. Hymns and arias: musical hallucinations in older people in Wales.

    PubMed

    Warner, Nick; Aziz, Victor

    2005-07-01

    This is a phenomenological study of 30 consecutive referrals of older people with musical hallucinations concentrating on the names of the melodies heard. Hymns and Christmas carols were the most common experience with 'Abide with Me' particularly frequent. PMID:16021667

  15. Minimising barriers to dental care in older people.

    PubMed

    2016-08-01

    Uptake of dental care is low among older people, and declines with age and deprivation. In this UK-based study researchers aimed to identify barriers to dental service use and suggest strategies to minimise these barriers. PMID:27573954

  16. Older People as a Developing Market for Cultural Heritage Sites

    ERIC Educational Resources Information Center

    Hansen, Anna; Zipsane, Henrik

    2014-01-01

    Is it morally acceptable for the heritage sector to see the growing population of senior citizens as a developing market? Jamtli is an open air museum in the north of Sweden. The main target group is families with children, but an increasing number of activities for older adults are being offered. The growing population of older people is a…

  17. The Meaning of "Aging in Place" to Older People

    ERIC Educational Resources Information Center

    Wiles, Janine L.; Leibing, Annette; Guberman, Nancy; Reeve, Jeanne; Allen, Ruth E. S.

    2012-01-01

    Purpose: This study illuminates the concept of "aging in place" in terms of functional, symbolic, and emotional attachments and meanings of homes, neighbourhoods, and communities. It investigates how older people understand the meaning of "aging in place," a term widely used in aging policy and research but underexplored with older people…

  18. A Drama Project about Older People's Intimacy and Sexuality

    ERIC Educational Resources Information Center

    Hafford-Letchfield, Trish; Couchman, Wendy; Webster, Maxine; Avery, Peter

    2010-01-01

    This paper describes an intergenerational project developed in partnership between a social work degree program and an Older People's Theatre group. Bringing together a small group of students, older actors, and film makers, methods from drama and the arts were utilised to explore the topic of intimacy and sexuality in later life. The project…

  19. How to Plan a College Program for Older People.

    ERIC Educational Resources Information Center

    Scanlon, John

    Recommendations are offered in this manual for planning, organizing, and financing academic programs for older people, based on the experience of institutions already conducting programs for older students, on current thinking in gerontology, and on knowledge and experience of staff and consultants of the Academy for Educational Development. Three…

  20. Who Is at Risk for Arrhythmia?

    MedlinePlus

    ... on Twitter. Who Is at Risk for an Arrhythmia? Arrhythmias are very common in older adults. Atrial fibrillation (a common type of arrhythmia that can cause problems) affects millions of people, ...

  1. People with Intellectual Disabilities Living in Generic Residential Services for Older People in the UK

    ERIC Educational Resources Information Center

    Thompson, D. J.; Ryrie, I.; Wright, S.

    2004-01-01

    Background: As part of a UK programme of work focusing on older people with intellectual disabilities, the circumstance of those who reside in generic services for older people were investigated. Materials and methods: Questionnaires were sent to 2570 residential and nursing homes in 53 local authorities across the UK. Results: Five hundred and…

  2. ICT and Older People: Beyond Usability

    ERIC Educational Resources Information Center

    Hernandez-Encuentra, Eulalia; Pousada, Modesta; Gomez-Zuniga, Beni

    2009-01-01

    This study examined the use that older, regular users of computers make of information and computer technology in their daily lives. Opinions from such users were obtained regarding what they want these technologies to offer them in the future. By means of a discussion group and an online questionnaire, our critical case examined a group of mature…

  3. Finding professional fulfilment in caring for older people.

    PubMed

    Perry, Beth

    2007-03-01

    This paper describes the findings of a phenomenological study of professional fulfilment in nurses who care for older people. The author sought to uncover what brings career satisfaction to nurses who care for older people and subsequently what motivates these caregivers to continue to care. The findings have implications for clinical nurses who may see reflections of their own approaches to care in the narratives presented. The examples of care reported may inspire nurses who work with older adults by affirming their own nursing interventions. PMID:17402532

  4. Counseling Older Adults at Risk of Suicide: Recognizing Barriers, Reviewing Strategies, and Exploring Opportunities for Intervention

    ERIC Educational Resources Information Center

    Sawyer, Patricia; Williams, Beverly Rosa

    2012-01-01

    Age-related challenges to health and well-being among older adults give rise to a distinctive array of risk factors for suicide, calling for a unique approach to suicide interventions. Americans over the age of 65 are disproportionally overrepresented in the number of completed suicides. This paper examines the epidemiology of geriatric suicide,…

  5. Physical activity in older people: a systematic review

    PubMed Central

    2013-01-01

    Background Physical activity (PA) in older people is critically important in the prevention of disease, maintenance of independence and improvement of quality of life. Little is known about the physical activity of the older adults or their compliance with current physical activity guidelines. Methods A systematic literature search of the published literature was conducted. Included were published reports of original research that independently reported: the PA level of non-institutional older adults (aged 60 years and over); and the proportion of older adults in the different samples who met PA recommendations or guidelines. The review was restricted to studies published since 2000 to provide a current picture of older adults’ PA levels. Results Fifty three papers were included in the review. The percentage of older adults meeting recommended physical activity ranged from 2.4 – 83.0% across the studies. Definitions of “recommended” physical activity in older adults varied across the studies as did approaches to measurement which posed methodological challenges to data analysis. Older age groups were less likely than the reference group to be regularly active, and women were less likely than men to achieve regular physical activity, especially leisure time physical activity, when measured by both subjective and objective criteria. Conclusion The review highlights the need for studies which recruit representative random samples of community based older people and employ validated measurement methods consistently to enable comparison of PA levels over time and between countries. PMID:23648225

  6. Physical Activity among Older People and Related Factors

    ERIC Educational Resources Information Center

    Persson, Ann; While, Alison

    2012-01-01

    Objective: To investigate the duration, intensity and type of physical activity undertaken by people aged 60 years and over in relation to their reported levels of participation in social activities and their perceptions of their neighbourhood. Design: A cross-sectional questionnaire survey of older people attending two luncheon and eight social…

  7. Physical Activity among Older People Living Alone in Shanghai, China

    ERIC Educational Resources Information Center

    Chen, Yu; While, Alison E; Hicks, Allan

    2015-01-01

    Objective: To investigate physical activity among older people living alone in Shanghai, People's Republic of China, and key factors contributing to their physical activity. Methods: A cross-sectional questionnaire survey was administered in nine communities in Shanghai, using a stratified random cluster sample: 521 community-dwelling older…

  8. Developing Methods of Repurposing Electronic Health Record Data for Identification of Older Adults at Risk of Unintentional Falls

    PubMed Central

    Baus, Adam; Zullig, Keith; Long, Dustin; Mullett, Charles; Pollard, Cecil; Taylor, Henry; Coben, Jeffrey

    2016-01-01

    Nationally, nearly 40 percent of community-dwelling adults age 65 and older fall at least once a year, making unintentional falls the leading cause of both fatal and nonfatal injuries among this age group. Addressing this public health problem in primary care offers promise. However, challenges in incorporating fall risk screening into primary care result in a problem of missed opportunities for screening, counseling, intervention, and ultimately prevention. Given these barriers, this study examines the potential for the innovative use of routinely collected electronic health record data to provide enhanced clinical decision support in busy, often resource-thin primary care environments. Using de-identified data from a sample of West Virginia primary care centers, we find that it is both feasible and worthwhile to repurpose routinely collected data for the purpose of identification of older adults at risk of falls. Searching of both free-text and semistructured data was particularly valuable. PMID:27134607

  9. Communicating Science to Officials and People at Risk During a Slow-Motion Lava Flow Crisis

    NASA Astrophysics Data System (ADS)

    Neal, C. A.; Babb, J.; Brantley, S.; Kauahikaua, J. P.

    2015-12-01

    From June 2014 through March 2015, Kīlauea Volcano's Púu ´Ō´ō vent on the East Rift Zone produced a tube-fed pāhoehoe lava flow -the "June 27th flow" - that extended 20 km downslope. Within 2 months of onset, flow trajectory towards populated areas in the Puna District caused much concern. The USGS Hawaiian Volcano Observatory (HVO) issued a news release of increased hazard on August 22 and began participating in public meetings organized by Hawai`i County Mayor and Civil Defense two days later. On September 4, HVO upgraded the volcano alert level to WARNING based on an increased potential for lava to reach homes and infrastructure. Ultimately, direct impacts were modest: lava destroyed one unoccupied home and one utility pole, crossed a rural roadway, and partially inundated a waste transfer station, a cemetery, and agricultural land. Anticipation that lava could reach Pāhoa Village and cross the only major access highway, however, caused significant disruption. HVO scientists employed numerous methods to communicate science and hazard information to officials and the at-risk public: daily (or more frequent) written updates of the lava activity, flow front locations and advance rates; frequent updates of web-hosted maps and images; use of the 'lines of steepest descent' method to indicate likely lava flow paths; consistent participation in well-attended community meetings; bi-weekly briefings to County, State, and Federal officials; correspondence with the public via email and recorded phone messages; participation in press conferences and congressional briefings; and weekly newspaper articles (Volcano Watch). Communication lessons both learned and reinforced include: (1) direct, frequent interaction between scientists and officials and at-risk public builds critical trust and understanding; (2) images, maps, and presentations must be tailored to audience needs; (3) many people are unfamiliar with maps (oblique aerial photographs were more effective); (4

  10. Attitudes toward Older People and Coworkers' Intention to Work with Older Employees: A Taiwanese Study

    ERIC Educational Resources Information Center

    Lu, Luo

    2010-01-01

    The aim of this research was to examine attitudinal barriers to the employment of Taiwanese older workers (aged 60 and above). Face-to-face interviews were conducted to collect data using structured questionnaires from a sample of full-time employees (N = 258). We found that: (1) positive attitudes toward older people in general, perceived…

  11. Attitudes towards Older People and Managers' Intention to Hire Older Workers: A Taiwanese Study

    ERIC Educational Resources Information Center

    Lu, Luo; Kao, Shu-Fang; Hsieh, Ying-Hui

    2011-01-01

    The aim of this research was to examine attitudinal barriers to the managerial intention to hire older workers (aged 60 and above). Structured questionnaires were used to collect data from a sample of managers with hiring power (N = 305). We found that (a) positive attitudes towards older people in general, perceived subjective norm, personal…

  12. The disaster flood experience: Older people's poetic voices of resilience.

    PubMed

    Miller, Evonne; Brockie, Lauren

    2015-08-01

    This paper explores the experiences of older community-dwelling Australians evacuated from their homes during the 2011 and 2013 Queensland floods, applying the novel creative methodology of poetic inquiry as an analysis and interpretative tool. As well as exploring how older adults managed during a natural disaster, the paper documents the process and potential of poetic inquiry in gerontological research. The first and second poems highlight the different social resources older people have to draw on in their lives, especially during a crisis. Poem 1 ("Nobody came to help me") illustrates how one older resident felt all alone during the flood, whereas Poem 2 ("They came from everywhere"), Poem 3 ("The Girls") and Poem 5 ("Man in Blue Shirt") shows how supported--from both family and the wider community--other older residents felt. Poem 4 ("I can't swim") highlights one participant's fear as the water rises. To date, few studies have explicitly explored older adult's disaster experience, with this paper the first to utilise a poetic lens. We argue that poetic presentation enhances understanding of older residents' unique experiences during a disaster, and may better engage a wider audience of policy-makers, practitioners, the general community and older people themselves in discussion about, and reflection on, the impact and experience of disasters. PMID:26162730

  13. Protein Requirements and Recommendations for Older People: A Review

    PubMed Central

    Nowson, Caryl; O’Connell, Stella

    2015-01-01

    Declines in skeletal muscle mass and strength are major contributors to increased mortality, morbidity and reduced quality of life in older people. Recommended Dietary Allowances/Intakes have failed to adequately consider the protein requirements of the elderly with respect to function. The aim of this paper was to review definitions of optimal protein status and the evidence base for optimal dietary protein. Current recommended protein intakes for older people do not account for the compensatory loss of muscle mass that occurs on lower protein intakes. Older people have lower rates of protein synthesis and whole-body proteolysis in response to an anabolic stimulus (food or resistance exercise). Recommendations for the level of adequate dietary intake of protein for older people should be informed by evidence derived from functional outcomes. Randomized controlled trials report a clear benefit of increased dietary protein on lean mass gain and leg strength, particularly when combined with resistance exercise. There is good consistent evidence (level III-2 to IV) that consumption of 1.0 to 1.3 g/kg/day dietary protein combined with twice-weekly progressive resistance exercise reduces age-related muscle mass loss. Older people appear to require 1.0 to 1.3 g/kg/day dietary protein to optimize physical function, particularly whilst undertaking resistance exercise recommendations. PMID:26287239

  14. Transforming Practice with Older People through an Ethic of Care

    PubMed Central

    Ward, Lizzie; Barnes, Marian

    2016-01-01

    This article explores the relevance of deliberative practices framed by feminist care ethics to social work practice with older people. It draws on two connected projects which brought together older people: practitioners and academics. The first was a participatory research project in which the significance of care to well-being in old age emerged. The second was a knowledge exchange project which generated learning resources for social care practice based on the research findings of the first project. Here we analyse selected transcripts of recordings from meetings of both projects to consider the ways that discussions about lived experiences and everyday lives demonstrate care through this dialogue. Using this analysis, we propose that care ethics can be useful in transforming relationships between older people and those working with them through the creation of hybrid spaces in which ‘care-full deliberation’ can happen. We argue that such reflective spaces can enable transformative dialogue about care and its importance to older people and offer a counterbalance to the procedurally driven environments in which much social work practice takes place and can support practice more attuned to the circumstances and concerns of older people. PMID:27559205

  15. Protein Requirements and Recommendations for Older People: A Review.

    PubMed

    Nowson, Caryl; O'Connell, Stella

    2015-08-01

    Declines in skeletal muscle mass and strength are major contributors to increased mortality, morbidity and reduced quality of life in older people. Recommended Dietary Allowances/Intakes have failed to adequately consider the protein requirements of the elderly with respect to function. The aim of this paper was to review definitions of optimal protein status and the evidence base for optimal dietary protein. Current recommended protein intakes for older people do not account for the compensatory loss of muscle mass that occurs on lower protein intakes. Older people have lower rates of protein synthesis and whole-body proteolysis in response to an anabolic stimulus (food or resistance exercise). Recommendations for the level of adequate dietary intake of protein for older people should be informed by evidence derived from functional outcomes. Randomized controlled trials report a clear benefit of increased dietary protein on lean mass gain and leg strength, particularly when combined with resistance exercise. There is good consistent evidence (level III-2 to IV) that consumption of 1.0 to 1.3 g/kg/day dietary protein combined with twice-weekly progressive resistance exercise reduces age-related muscle mass loss. Older people appear to require 1.0 to 1.3 g/kg/day dietary protein to optimize physical function, particularly whilst undertaking resistance exercise recommendations. PMID:26287239

  16. Emergency care of older people who fall: a missed opportunity

    PubMed Central

    Snooks, Helen A; Halter, Mary; Close, Jacqueline C T; Cheung, Wai‐Yee; Moore, Fionna; Roberts, Stephen E

    2006-01-01

    Introduction A high number of emergency (999) calls are made for older people who fall, with many patients not subsequently conveyed to hospital. Ambulance crews do not generally have protocols or training to leave people at home, and systems for referral are rare. The quality and safety of current practice is explored in this study, in which for the first time, the short‐term outcomes of older people left at home by emergency ambulance crews after a fall are described. Results will inform the development of care for this population. Methods Emergency ambulance data in London were analysed for patterns of attendance and call outcomes in 2003–4. All older people who were attended by emergency ambulance staff after a fall in September and October 2003, within three London areas, were identified. Those who were not conveyed to hospital were followed up; healthcare contacts and deaths within the following 2 weeks were identified. Results During 2003–4, 8% of all 999 calls in London were for older people who had fallen (n = 60 064), with 40% not then conveyed to hospital. Of 2151 emergency calls attended in the study areas during September and October 2003, 534 were for people aged ⩾65 who had fallen. Of these, 194 (36.3%) were left at home. 86 (49%) people made healthcare contacts within the 2‐week follow‐up period, with 83 (47%) people calling 999 again at least once. There was an increased risk of death (standard mortality ratio 5.4) and of hospital admission (4.7) compared with the general population of the same age in London. Comment The rate of subsequent emergency healthcare contacts and increased risk of death and hospitalisation for older people who fall and who are left at home after a 999 call are alarming. Further research is needed to explore appropriate models for delivery of care for this vulnerable group. PMID:17142584

  17. Older People and Their Responsible Others.

    ERIC Educational Resources Information Center

    Kulys, Regina; Tobin, Sheldon S.

    1980-01-01

    Although the elderly in this country are often thought of as isolated and forgotten by family and friends, the study reported here found that this image differs significantly from reality in most cases. The authors discuss the various aspects of the support systems on which most elderly people rely. (Author)

  18. Alcohol use, socioeconomic deprivation and ethnicity in older people

    PubMed Central

    Rao, Rahul; Schofield, Peter; Ashworth, Mark

    2015-01-01

    Objectives This study explores the relationship between alcohol consumption, health, ethnicity and socioeconomic deprivation. Participants 27 991 people aged 65 and over from an inner-city population, using a primary care database. Primary and Secondary Outcome Measures Primary outcome measures were alcohol use and misuse (>21 units per week for men and >14 for units per week women). Results Older people of black and minority ethnic (BME) origin from four distinct ethnic groups comprised 29% of the sample. A total of 9248 older drinkers were identified, of whom 1980 (21.4%) drank above safe limits. Compared with older drinkers, older unsafe drinkers contained a higher proportion of males, white and Irish ethnic groups and a lower proportion of Caribbean, African and Asian groups. For older drinkers, the strongest independent predictors of higher alcohol consumption were younger age, male gender and Irish ethnicity. Independent predictors of lower alcohol consumption were Asian, black Caribbean and black African ethnicity. Socioeconomic deprivation and comorbidity were not significant predictors of alcohol consumption in older drinkers. For older unsafe drinkers, the strongest predictor variables were younger age, male gender and Irish ethnicity; comorbidity was not a significant predictor. Lower socioeconomic deprivation was a significant predictor of unsafe consumption whereas African, Caribbean and Asian ethnicity were not. Conclusions Although under-reporting in high-alcohol consumption groups and poor health in older people who have stopped or controlled their drinking may have limited the interpretation of our results, we suggest that closer attention is paid to ‘young older’ male drinkers, as well as to older drinkers born outside the UK and those with lower levels of socioeconomic deprivation who are drinking above safe limits. PMID:26303334

  19. Attitudes toward older people and coworkers' intention to work with older employees: a Taiwanese study.

    PubMed

    Lu, Luo

    2010-01-01

    The aim of this research was to examine attitudinal barriers to the employment of Taiwanese older workers (aged 60 and above). Face-to-face interviews were conducted to collect data using structured questionnaires from a sample of full-time employees (N= 258). We found that: (1) positive attitudes toward older people in general, perceived subjective norm, and traditional Chinese cultural values were all related to stronger intentions to work with older employees; (2) the model derived from the theory of reasoned action emerged the best model accounting for behavioral intention among competing structural models. The associations of positive attitudes and subjective norm with intention were found after controlling for demographics, cultural values, and personal contact experiences with older people. Our results highlight the importance and urgency of more concerted research to inform public and organizational policies to better promote and manage the careers of older employees in an aging, economically developing society. PMID:21261137

  20. Improving the knowledge base in older people's care.

    PubMed

    Lomas, Clare

    2016-02-01

    The UK has a rapidly ageing population, and the number of people aged over 75 is projected to double in the next 30 years. In November 2014, King's College London introduced the Older Person's Nurse Fellowship, a pioneering programme designed to give senior nurses the knowledge and skills to optimise quality of life for older people, and lead the way in transforming care and services. This article examines the fellowship programme, its aims and intended effect on practice. It also highlights a series of case study articles by four of the first cohort of fellows beginning in the March issue of Nursing Older People, which will show how the programme is helping senior nurses to improve care in a variety of settings. PMID:26938606

  1. The meaning of vulnerability to nurses caring for older people.

    PubMed

    Stenbock-Hult, Bettina; Sarvimäki, Anneli

    2011-01-01

    Research concerning work on caring for older people shows that care providers experience a variety of consuming emotions and stress. They can be said to be in a vulnerable position. It is not known, however, how the care providers themselves understand vulnerability. The aim of this study was to illuminate the meaning of vulnerability to care providers caring for older people. A qualitative interpretive approach was adopted. Data were collected through tape-recorded interviews with 16 female registered and practical nurses who were experienced in caring for older people. Qualitative analysis resulted in one core theme and six themes with subthemes. The core theme showed that, for the participating nurses, vulnerability essentially meant being human. The meanings of being human were illustrated by the six themes: having feelings; experiencing moral indignation; being harmed; having courage; protecting oneself; and maturing and developing. Analysis showed that vulnerability was a resource as well as a burden. PMID:21285195

  2. Longitudinal assessment of medical student attitudes toward older people.

    PubMed

    De Biasio, Justin C; Parkas, Valerie; Soriano, Rainier P

    2016-08-01

    Delivering adequate care to older people requires an increasing number of physicians competent in the treatment of this expanding subpopulation. Attitudes toward older adults are important as predictors of the quality of care of older people and of medical trainee likelihood to enter the geriatrics field. This study assessed the attitudes of 404 US medical students (MS) from the start of medical school to graduation using the University of California, Los Angeles (UCLA) Geriatrics Attitude Scale. It is the first study to utilize a longitudinal design to assess attitudes among students in a medical school with a longitudinal geriatrics clinical experience in the first two years and a required geriatrics clerkship in the third year. Participants' attitude scores toward older people were found to significantly decrease from 3.9 during the first two years to 3.7 during the final two. Significant differences existed between MS1 and MS3, MS1 and MS4, MS2 and MS3, and MS2 and MS4. Women and older students held significantly more positive attitudes than men and younger students. These results show that planned clinical exposures to older adults may not be sufficient to halt the decline in attitudes in medical school. A comprehensive empathy-building intervention embedded in the curriculum may better prevent this decline. PMID:26619339

  3. Predicting Ecstasy Use among Young People at Risk: A Prospective Study of Initially Ecstasy-Naive Subjects

    ERIC Educational Resources Information Center

    Vervaeke, Hylke K.E.; Benschop, Annemieke; Van Den Brink, Wim; Korf, Dirk J.

    2008-01-01

    Our aim is to identify predictors of first-time ecstasy use in a prospective study among young people at risk. As part of the multidisciplinary Netherlands XTC Toxicity Study (NeXT), we monitored 188 subjects aged up to 18 years who were ecstasy-naive at baseline but seemed likely to start taking ecstasy in the near future. After an 11- to…

  4. Students' ideals for nursing older people in practice.

    PubMed

    Alabaster, Erica S

    2006-06-01

    Aim.  Drawing on research exploring nursing students' experiences of working with older people, this paper aims to demonstrate how context and culture can impact on the realization of their ideals. Background.  The principles underpinning individualized and person-centred approaches to care resonate with those focal to gerontologic nursing. Restrictive contexts of care and pervasive workplace cultures render nurses unable to deliver care in accord with these. Design and method.  This interpretive study was informed by phenomenological-hermeneutic theory. A purposive sample (n = 10) was recruited from a single educational institution. Data were generated in two phases using loosely structured interviews and supplementary activity. Themes explicating their experiences were identified via systematized detailed analysis and issues pertaining to nursing students' orientation towards older people cut across these. Findings and discussion.  Students perceived that older people were prone to depersonalization and marginalization, so sought to show respect by coming to know individuals, form human connections with them and personalize care accordingly. Giving respect, promoting personhood, asserting reciprocal identity and maintaining dignity were prominent features of this but were often frustrated by practices and cultures encountered in mainstream settings. Conclusions.  Nursing students' approaches to older people are contextual and reflect elements of person-centred ideology. Their attempts upholding their ideals are liable to be subverted by workplace norms. Preparatory education should address these, assist students to learn how to attend to personhood in restrictive environments and offer targeted placements in age-specific and non-acute services. Relevance to clinical practice.  Demographic trends mean that working with older people has increased significance for nurses in most settings. Person-centredness is seen as beneficial for older people but

  5. How Many People Are Affected By or Are at Risk for Neural Tube Defects?

    MedlinePlus

    ... are affected by or are at risk for neural tube defects? Skip sharing on social media links Share this: ... with spina bifida. 1 The other types of neural tube defects are less common. About 340 infants are born ...

  6. Guide to providing mouth care for older people.

    PubMed

    Bissett, Susan; Preshaw, Philip

    2011-12-01

    The authors provide an overview of oral health, why it is important for older people and how poor oral health can affect nutritional status and quality of life. Practical advice is given on assessment of oral health; cleaning of natural teeth and dentures; and care of oral problems that commonly affect older people. An oral healthcare education session is recommended to provide hands-on advice to caregivers. The article is not intended as an exhaustive reference and the reader should always ask for professional dental advice and assistance if in doubt about any aspect of oral care. PMID:22256725

  7. Developing advanced nursing skills for frail older people.

    PubMed

    Goldberg, Sarah; Cooper, Jo; Russell, Catherine

    2014-05-01

    Improving hospital care for frail older people requires expertise, leadership and resources as these patients have multiple complex needs. One innovative solution to providing the skilled care necessary is to train experienced nurses to become advanced nurse practitioners (ANPs). Such roles encompass activity previously undertaken by medical staff, together with leadership, teaching, research and service development. Skills specific to caring for older people, such as comprehensive geriatric assessment, are also required. This article discusses the need for ANPs in this clinical area, a pilot that is under way in one acute trust to develop these roles, and the potential benefits and challenges that may accompany this development. PMID:24787943

  8. Resilience and vision impairment in older people.

    PubMed

    Thetford, Clare; Bennett, Kate M; Hodge, Suzanne; Knox, Paul C; Robinson, Jude

    2015-12-01

    Some people fare better than others when faced with adversity; they appear to be more 'resilient'. This article explores the concept of resilience in the context of vision impairment using two linked sets of narrative interview data from 2007 to 2010. Three case studies were analysed in detail using a framework approach based upon a social-ecological model of resilience and vision impairment. Within the model a range of assets and resources are identified which influence an individual's capacity for resilience. A set of criteria were used to establish the extent to which each individual appeared to be resilient at each point in time. Analysis revealed that it is not merely the presence or absence of individual, social, and community resources - but how these resources interact with each other - that influences resilience and can create a risk to wellbeing. To possess only some of these resources is not sufficient; there is a co-dependency between these resources which requires the presence of other resources for resilience to be achieved. Resilience is not a fixed state; individuals can become more or less resilient as their circumstances and resources change over time. We suggest that the concept of resilience has much to offer the field of vision impairment as it allows the identification of enablers as well as areas of barriers to improving people's health and wellbeing and suggests further opportunities for service providers to engage with clients, even those who appear to be supported, as people's social, economic and emotional landscapes continue to change over time, rather than identifying deficit. PMID:26568213

  9. Dementia in older people: an update.

    PubMed

    LoGiudice, D; Watson, R

    2014-11-01

    Dementia is a common condition of the elderly characterised by multiple cognitive deficits resulting in a decline from previous level of function. In the older person, multiple pathologies contribute, including changes commonly seen in Alzheimer disease, dementia with Lewy bodies in addition to vascular changes. Comorbid factors, such as depression, delirium and polypharmacy can contribute to cognitive decline. Novel biomarkers and neuroimaging techniques may assist in the near future to improve accuracy of diagnosis. To date, pharmacological therapies have been largely unsuccessful and provide symptomatic relief only. The timely diagnosis of dementia can facilitate important discussions regarding personal and financial planning and introduce education and supports to the person with dementia and their carers. The person with dementia commonly experiences behavioural and psychological symptoms of dementia that may cause much distress, including to families and carers. Clinical guidelines indicate non-pharmacological approaches as first line measures, including attention to pain, nutrition and the environment. Dementia is recognised as a National Health Priority in Australia, and efforts to target risk factors as preventative measures to delay onset of dementia require further urgent consideration. PMID:25367725

  10. Guidance on the management of pain in older people.

    PubMed

    Abdulla, Aza; Adams, Nicola; Bone, Margaret; Elliott, Alison M; Gaffin, Jean; Jones, Derek; Knaggs, Roger; Martin, Denis; Sampson, Liz; Schofield, Pat

    2013-03-01

    This guidance document reviews the epidemiology and management of pain in older people via a literature review of published research. The aim of this document is to inform health professionals in any care setting who work with older adults on best practice for the management of pain and to identify where there are gaps in the evidence that require further research. The assessment of pain in older people has not been covered within this guidance and can be found in a separate document (http://www.britishpainsociety.org/pub_professional.htm#assessmentpop). Substantial differences in the population, methods and definitions used in published research makes it difficult to compare across studies and impossible to determine the definitive prevalence of pain in older people. There are inconsistencies within the literature as to whether or not pain increases or decreases in this age group, and whether this is influenced by gender. There is, however, some evidence that the prevalence of pain is higher within residential care settings. The three most common sites of pain in older people are the back; leg/knee or hip and 'other' joints. In common with the working-age population, the attitudes and beliefs of older people influence all aspects of their pain experience. Stoicism is particularly evident within this cohort of people. Evidence from the literature search suggests that paracetamol should be considered as first-line treatment for the management of both acute and persistent pain, particularly that which is of musculoskeletal origin, due to its demonstrated efficacy and good safety profile. There are few absolute contraindications and relative cautions to prescribing paracetamol. It is, however, important that the maximum daily dose (4 g/24 h) is not exceeded. Non-selective non-steroidal anti-inflammatory drugs (NSAIDs) should be used with caution in older people after other safer treatments have not provided sufficient pain relief. The lowest dose should be provided

  11. Cortisol Awakening Response and Walking Speed in Older People

    PubMed Central

    Pulopulos, Matias M.; Puig-Perez, Sara; Hidalgo, Vanesa; Villada, Carolina; Salvador, Alicia

    2016-01-01

    In older people, less diurnal variability in cortisol levels has been consistently related to worse physical performance, especially to slower walking speed (WS). The cortisol awakening response (CAR) is a discrete component of the hypothalamic-pituitary-adrenal axis that has been related to several health problems, such as cardiovascular disease and/or worse performance on executive function and memory. The relationship between the CAR and physical performance in older people is poorly understood. In this study, in 86 older people (mean age = 64.42, SD = 3.93), we investigated the relationship between the CAR and WS, a commonly used measure of physical performance in the older population that has also been related to health problems, such as cardiovascular disease and executive function performance in older people. Additionally, we studied whether the relationship between the CAR and WS was independent from cortisol levels on awakening and several possible confounders. Results showed that a CAR of reduced magnitude (measured with 3 samples each day, for two consecutive days, and calculated as the area under the curve with respect to the increase), but not cortisol levels on awakening, was related to slower WS. In addition, this relationship was independent from cortisol levels on awakening. It is possible that a CAR of reduced magnitude would contribute to less diurnal cortisol variability, affecting physical performance. Additionally, it is possible that a CAR of reduced magnitude affects WS through a possible negative effect on executive function, or that the association between the CAR and WS is due to the fact that both are related to similar health problems and to changes in cognitive performance in older people. PMID:27191847

  12. Cortisol Awakening Response and Walking Speed in Older People.

    PubMed

    Pulopulos, Matias M; Puig-Perez, Sara; Hidalgo, Vanesa; Villada, Carolina; Salvador, Alicia

    2016-01-01

    In older people, less diurnal variability in cortisol levels has been consistently related to worse physical performance, especially to slower walking speed (WS). The cortisol awakening response (CAR) is a discrete component of the hypothalamic-pituitary-adrenal axis that has been related to several health problems, such as cardiovascular disease and/or worse performance on executive function and memory. The relationship between the CAR and physical performance in older people is poorly understood. In this study, in 86 older people (mean age = 64.42, SD = 3.93), we investigated the relationship between the CAR and WS, a commonly used measure of physical performance in the older population that has also been related to health problems, such as cardiovascular disease and executive function performance in older people. Additionally, we studied whether the relationship between the CAR and WS was independent from cortisol levels on awakening and several possible confounders. Results showed that a CAR of reduced magnitude (measured with 3 samples each day, for two consecutive days, and calculated as the area under the curve with respect to the increase), but not cortisol levels on awakening, was related to slower WS. In addition, this relationship was independent from cortisol levels on awakening. It is possible that a CAR of reduced magnitude would contribute to less diurnal cortisol variability, affecting physical performance. Additionally, it is possible that a CAR of reduced magnitude affects WS through a possible negative effect on executive function, or that the association between the CAR and WS is due to the fact that both are related to similar health problems and to changes in cognitive performance in older people. PMID:27191847

  13. Frail bodies, courageous voices: older people influencing community care.

    PubMed

    Barnes, Marian; Bennett, Gaynor

    1998-03-01

    Involving frail older users of health and social care services in decision making presents particular challenges for those committed to hearing the voices of service users. Age Concern Scotland initiated a project in Fife, the User Panels project, intended to enable older people who were unable to leave their homes without assistance to meet together to develop a collective voice expressing the needs and experiences of older service users. This paper reports on an evaluation of that project. It considers methodological questions posed by the evaluation of projects which aim to empower users, as well as discussing key findings from the evaluation. Older people were recruited through contacts in service agencies and other local organizations. The largest group was aged between 86 and 90 years and all were experiencing difficulties relating to poor health, physical frailty or disability. The project was based on a belief in the value of meeting together as a means through which people could develop the confidence to express their views. Those who became members of the panels valued this experience and reported intrinsic benefits related to the social contact, opportunities for learning and development of self-esteem. Evidence concerning enhanced capacity to exercise control over key aspects of their lives was less convincing. The work of the panels was generally well received by local social work and health agencies and had influenced local action in some areas. Responses to some issues raised by the panels generated a less positive response and the article considers reasons for this. The model is considered to demonstrate benefits both for the older people who become involved and for officials seeking to improve the sensitivity of services to the needs of older people. PMID:11560582

  14. Addressing the nutritional needs of older people in residential care homes.

    PubMed

    Merrell, Joy; Philpin, Susan; Warring, Joanne; Hobby, Debra; Gregory, Vic

    2012-03-01

    In the UK and Europe, malnutrition in older people is a significant and continuing problem. Malnutrition predisposes to disease, impedes recovery from illness, increases mortality and is costly to society. Despite the high number of older people potentially at risk, malnutrition in care homes has been under explored. There is concern that national guidelines regarding the nutritional care of older people in residential care homes are not always implemented. This qualitative study explored the factors that influence the nutritional care provided to residents in two different types of local authority residential care homes (providing personal care) in Wales. One home had communal dining rooms; the other had eight bedded units with their own kitchen and dining facilities. The sample of 45 participants, comprised 19 staff (managers, care and catering staff), 16 residents and 10 residents' relatives. Data were collected using semi-structured interviews, focus groups, observation and documentary review between August 2009 and January 2010. This paper focuses on how staff assessed and addressed residents' nutritional needs. In both care homes, staff strove to be responsive to residents' dietary preferences, provided person-centred care and worked in partnership with residents and their families to provide nutritious food in a homely environment. Neither home conducted nutritional screening to identify those at risk of malnutrition, contrary to national guidelines, but relied on ad hoc observation and monitoring. The staff's knowledge of special dietary needs was limited. A need for further training for care home staff regarding the importance of nutrition in maintaining health in older people, use of nutritional screening and special dietary needs was identified. Shared nutrition training between health and social care staff needs expansion and policy implications in terms of an enhanced regulatory focus on maintaining nutritional needs in care homes are proposed. PMID

  15. Sustainability Literacy of Older People in Retirement Villages

    PubMed Central

    Xia, Bo; Zuo, Jian; Skitmore, Martin; Buys, Laurie; Hu, Xin

    2014-01-01

    With many developed countries experiencing the aging of the population, older people play a large role in contributing to environmental problems but also to environmental solutions. The purpose of this research is to understand the awareness and behavior of current older people living in retirement villages towards sustainability development. To achieve this, a sustainability literacy survey was conducted with 65 older residents of a private retirement village located 10 Km outside the Brisbane, Australia's central business district (CBD). Most of residents recognized the importance of environment protection and would like to lead a more environmentally friendly lifestyle. In addition, the majority were willing to pay higher prices for a living environment with sustainable features. The importance of positive social communications was emphasized with most residents having established good relationships with others in the village. The findings provide an important insight into consumer perspectives regarding the sustainable features that should and can be incorporated into the village planning and development. PMID:25587448

  16. The Engagement of Older People in Civil Society Organizations

    ERIC Educational Resources Information Center

    Principi, Andrea; Chiatti, Carlos; Lamura, Giovanni; Frerichs, Frerich

    2012-01-01

    This article reviews recent international literature on the opportunities and restrictions experienced by older people to act as volunteers in civil society organizations. Our aim was to develop a conceptual framework applicable to the European ageing society. This aim was pursued through a computerized database search focused on studies analyzing…

  17. The Life-Course Origins of Mastery among Older People

    ERIC Educational Resources Information Center

    Pearlin, Leonard I.; Nguyen, Kim B.; Schieman, Scott; Milkie, Melissa A.

    2007-01-01

    In this article, we aim to identify the sources of mastery--the understanding that individuals hold about their ability to control the circumstances of their lives. The sample for our inquiry was drawn from the Medicare beneficiary files of people 65 and older living in Washington, DC, and two adjoining Maryland counties. We find that past…

  18. Social Exclusion and Older People: Exploring the Connections.

    ERIC Educational Resources Information Center

    Phillipson, Chris; Scharf, Thomas; Kingston, Paul; Smith, Allison E.

    2001-01-01

    The effect of social exclusion on older people has not been examined. Three issues regarding their participation in community life can be discerned: (1) participation and integration beyond the labor market; (2) spatial segregation, including geographic, economic, and social isolation; and (3) exclusion through withdrawal of institutions from…

  19. Measures for Assessing Student Attitudes toward Older People

    ERIC Educational Resources Information Center

    Lin, Xiaoping; Bryant, Christina; Boldero, Jennifer

    2011-01-01

    Measuring medical and allied health students' attitudes towards older people has been identified as an important research area. The present study compared the use of implicit and explicit attitude measures. Sixty-five undergraduates completed one explicit measure, the Fraboni Scale of Ageism (FSA), (Fraboni, Saltstone, & Hughes, 1990) and one…

  20. Newer Drugs Helping Older People with Eye Disease

    MedlinePlus

    ... 158961.html Newer Drugs Helping Older People With Eye Disease Treatments keeping those with macular degeneration reading and ... of long-term follow-up in studies evaluating disease treatments." Study ... U.S. National Eye Institute. The findings were published recently in the ...

  1. Children's Views of Older People

    ERIC Educational Resources Information Center

    Robinson, Sally; Howatson-Jones, Lioba

    2014-01-01

    Worldwide demographic change means that the responsibility for an aging population will fall to younger generations. This narrative literature review comprises an international examination of what has been published about children's views of older people between 1980 and 2011. Sixty-nine academic articles were inductively analyzed, and the…

  2. Older people's conceptualization of elder abuse and neglect.

    PubMed

    Taylor, Brian J; Killick, Campbell; O'Brien, Marita; Begley, Emer; Carter-Anand, Janet

    2014-01-01

    This qualitative study used data from eight focus groups involving 58 people aged over 65 years in both urban and rural settings across Northern Ireland and the Republic of Ireland. Following training, four older people assisted in facilitation and analysis as peer researchers. Increasing lack of respect within society was experienced as abusive. The vulnerability of older people to abuse was perceived as relating to the need for help and support, where standing up for themselves might have repercussions for the person's health or safety. Emotional abusiveness was viewed as underpinning all forms of abuse, and as influencing its experienced severity. Respondents' views as to whether an action was abusive required an understanding of intent: some actions that professionals might view as abusive were regarded as acceptable if they were in the older person's best interests. Preventing abuse requires a wide-ranging approach including rebuilding respect for older people within society. Procedures to prevent elder abuse need to take into account the emotional impact of family relationships and intent, not just a description of behaviors that have occurred. PMID:24779538

  3. Balance-Boosting Footwear Tips for Older People

    MedlinePlus

    ... Home » Learn About Feet » Tips for Healthy Feet Balance-Boosting Footwear Tips for Older People Balance in all aspects of life is a good ... mental equilibrium isn't the only kind of balance that's important in life. Good physical balance can ...

  4. Gateway to College: Lessons from Implementing a Rigorous Academic Program for At-Risk Young People

    ERIC Educational Resources Information Center

    Willard, Jacklyn Altuna; Bayes, Brian; Martinez, John

    2015-01-01

    This study reports on the implementation of Gateway to College, a program whose mission is to serve students who have dropped out of high school, or who are at risk of dropping out of high school, by allowing them to earn a high school diploma and credits toward a postsecondary degree. Gateway to College is uniquely ambitious in providing…

  5. Older people and digital disengagement: a fourth digital divide?

    PubMed

    Olphert, Wendy; Damodaran, Leela

    2013-01-01

    Digital technologies are becoming more pervasive in all areas of society. Enabling everyone to have access and capability to use the Internet and associated digital technologies, summed up in the term 'digital inclusion', is seen to have wide-ranging benefits to the individual, to the economy and to society. For older people, being digitally included can help them to maintain their independence, social connectedness and sense of worth in the face of declining health or limited capabilities, as well as also offering new opportunities to improve their quality of life. At present however, access to the technology and to the benefits is not equally distributed either between or within nations, and older people tend to be on the 'wrong' side of what is termed the 'digital divide'. Governments globally are developing strategies to promote digital inclusion and indeed Internet uptake is increasing steadily, including amongst older people. However, such strategies have focussed on getting people online, and there appears to be an assumption that once someone is online they will remain 'digitally engaged'. In fact statistics show that some users give up using the Internet, and there is emerging evidence that older people are more vulnerable to the factors which can lead to this outcome. The authors see this phenomenon as a potential but largely unrecognised 'fourth digital divide' which has serious implications for social inclusion. The objectives of this article are (a) to raise awareness of the phenomenon of digital disengagement by considering some of the emerging evidence, (b) to explore some of the potential implications of not recognising and therefore not addressing the needs of the digitally disengaged older population, and (c) to reveal the prevailing gap in knowledge which future research should address. PMID:23969758

  6. 10 Hz flicker improves recognition memory in older people

    PubMed Central

    Williams, Jonathan; Ramaswamy, Deepa; Oulhaj, Abderrahim

    2006-01-01

    Background 10 Hz electroencephalographic (EEG) alpha rhythms correlate with memory performance. Alpha and memory decline in older people. We wished to test if alpha-like EEG activity contributes to memory formation. Flicker can elicit alpha-like EEG activity. We tested if alpha-frequency flicker enhances memory in older people. Pariticpants aged 67–92 identified short words that followed 1 s of flicker at 9.0 Hz, 9.5 Hz, 10.0 Hz, 10.2 Hz, 10.5 Hz, 11.0 Hz, 11.5 Hz or 500 Hz. A few minutes later, we tested participants' recognition of the words (without flicker). Results Flicker frequencies close to 10 Hz (9.5–11.0 Hz) facilitated the identification of the test words in older participants. The same flicker frequencies increased recognition of the words more than other frequencies (9.0 Hz, 11.5 Hz and 500 Hz), irrespective of age. Conclusion The frequency-specificity of flicker's effects in our participants paralleled the power spectrum of EEG alpha in the general population. This indicates that alpha-like EEG activity may subserve memory processes. Flicker may be able to help memory problems in older people. PMID:16515710

  7. Older People and Social Connectedness: How Place and Activities Keep People Engaged

    PubMed Central

    Yen, Irene H.; Shim, Janet K.; Martinez, Airin D.; Barker, Judith C.

    2012-01-01

    To understand how older adults perceive and navigate their neighborhoods, we examined the implications of activity in their neighborhoods for their health. We interviewed 38 adults (ages 62–85) who lived in San Francisco or Oakland, California. Seven key themes emerged: (1) people express a wide range of expectations for neighborliness, from “we do not bother each other” to “we have keys to each other's houses”, (2) social distance between “other” people impede a sense of connection, (3) ethnic differences in living arrangements affect activities and activity locations, (4) people try to stay busy, (5) people able to leave their homes do many activities outside their immediate residential neighborhoods, (6) access to a car is a necessity for most, and (7) it is unusual to plan for the future when mobility might become limited. Multiple locations influence older adults' health, including residential neighborhoods. Older adults value mobility, active lives, and social connections. PMID:22272374

  8. Understanding factors influencing vulnerable older people keeping warm and well in winter: a qualitative study using social marketing techniques

    PubMed Central

    Lusambili, Adelaide; Homer, Catherine; Abbott, Joanne; Cooke, Joanne Mary; Stocks, Amanda Jayne; McDaid, Kathleen Anne

    2012-01-01

    Objectives To understand the influences and decisions of vulnerable older people in relation to keeping warm in winter. Design A qualitative study incorporating in-depth, semi-structured individual and group interviews, framework analysis and social marketing segmentation techniques. Setting Rotherham, South Yorkshire, UK. Participants 50 older people (>55) and 25 health and social care staff underwent individual interview. The older people also had household temperature measurements. 24 older people and 19 health and social care staff participated in one of the six group interviews. Results Multiple complex factors emerged to explain whether vulnerable older people were able to keep warm. These influences combined in various ways that meant older people were not able to or preferred not to access help or change home heating behaviour. Factors influencing behaviours and decisions relating to use of heating, spending money, accessing cheaper tariffs, accessing benefits or asking for help fell into three main categories. These were situational and contextual factors, attitudes and values, and barriers. Barriers included poor knowledge and awareness, technology, disjointed systems and the invisibility of fuel and fuel payment. Findings formed the basis of a social marketing segmentation model used to develop six pen portraits that illustrated how factors that conspire against older people being able to keep warm. Conclusions The findings illustrate how and why vulnerable older people may be at risk of a cold home. The pen portraits provide an accessible vehicle and reflective tool to raise the capacity of the NHS in responding to their needs in line with the Cold Weather Plan. PMID:22798252

  9. Well-being and prejudice toward obese people in women at risk to develop eating disorders.

    PubMed

    Magallares, Alejandro

    2012-11-01

    The literature has found that eating disorders (ED) patients usually have a depression and anxiety diagnosis. However, not many investigations have studied the relationship between ED and well-being. One of the main problems of patients with ED is their body image. These individuals usually see themselves too big but there are not many investigations that focus on how these patients see people with real weight problems. For this reason in this study it is analyzed how women in risk to develop ED see obese people. 456 female students were selected. It was found that women with high scores in the different subscales of the Eating Attitudes Test 26 (EAT-26; dieting, bulimia and oral control) had lower well-being (both subjective and psychological) and worse attitudes toward obese people (measured with Antifat Attitudes Test, AFA, Beliefs About Obese People Scale, BAOP, and Attitudes Toward Obese People Scale, ATOP) compared with women with low scores in the EAT-26. PMID:23156933

  10. The relationship between oral health and nutrition in older people.

    PubMed

    Walls, A W G; Steele, J G

    2004-12-01

    The oral health of older people is changing with reducing numbers of people relying on complete dentures for function, and retaining some natural teeth. Despite this there are substantial numbers of older people whose ability to chew foods is compromised by their oral health status, either because they have few or no natural teeth. This alteration results in individuals selecting a diet that they can chew in comfort. Such diets are low in fruits and vegetables intake with associated reduction in both non-starch polysaccharide and micronutrient intakes. There is also a trend for reduced dietary intake overall. Salivary flow and function may have an impact in relation to the ability to chew and swallow. Whilst there are few differences in salivary function in fit healthy unmedicated subjects, disease resulting in reduced salivary flow and particularly polypharmacy, with xerostomia as a side effect, are likely to have a role in older people. This paper explores the relationships between oral health status and food's choice and discusses the potential consequences for the individual of such dietary change. PMID:15563930

  11. Stigma as a stressor and transition to schizophrenia after one year among young people at risk of psychosis.

    PubMed

    Rüsch, Nicolas; Heekeren, Karsten; Theodoridou, Anastasia; Müller, Mario; Corrigan, Patrick W; Mayer, Benjamin; Metzler, Sibylle; Dvorsky, Diane; Walitza, Susanne; Rössler, Wulf

    2015-08-01

    According to stress-vulnerability models, social stressors contribute to the onset of schizophrenia. Stigma and discrimination associated with mental illness may be a stressor for young people at risk of psychosis even prior to illness onset, but quantitative longitudinal data on this issue are lacking. We examined the cognitive appraisal of stigma-related stress as predictor of transition to schizophrenia among young people at risk of psychosis. In Zürich, Switzerland, 172 participants between 13 and 35years old and with either high or ultra-high risk of psychosis or risk of bipolar disorder were included. With 71 dropouts, transition was assessed during 12months among 101 participants of whom 13 converted to schizophrenia. At baseline, the cognitive appraisal of stigma as a stressor was measured by self-report, based on the primary appraisal of stigma as harmful and the secondary appraisal of resources to cope with stigma. Positive and negative symptoms were examined using the Positive and Negative Syndrome Scale. Compared with participants who did not convert to schizophrenia, converters had significantly more positive (p<.001) and negative (p<.001) symptoms and reported higher levels of stigma-related harm (p=.003) and stress (p=.009) at baseline. More perceived harm due to stigma at baseline predicted transition to schizophrenia (odds ratio 2.34, 95%-CI 1.19-4.60) after adjusting for age, gender, symptoms and functioning. Stigma stress may increase the risk of transition to schizophrenia. Research is needed on interventions that reduce public negative attitudes towards young people at risk and that support individuals at risk to cope with stigma-related stress. PMID:26036814

  12. Interventions targeting social isolation in older people: a systematic review

    PubMed Central

    2011-01-01

    Background Targeting social isolation in older people is a growing public health concern. The proportion of older people in society has increased in recent decades, and it is estimated that approximately 25% of the population will be aged 60 or above within the next 20 to 40 years. Social isolation is prevalent amongst older people and evidence indicates the detrimental effect that it can have on health and wellbeing. The aim of this review was to assess the effectiveness of interventions designed to alleviate social isolation and loneliness in older people. Methods Relevant electronic databases (MEDLINE, EMBASE, ASSIA, IBSS, PsycINFO, PubMed, DARE, Social Care Online, the Cochrane Library and CINAHL) were systematically searched using an extensive search strategy, for randomised controlled trials and quasi-experimental studies published in English before May 2009. Additional articles were identified through citation tracking. Studies were included if they related to older people, if the intervention aimed to alleviate social isolation and loneliness, if intervention participants were compared against inactive controls and, if treatment effects were reported. Two independent reviewers extracted data using a standardised form. Narrative synthesis and vote-counting methods were used to summarise and interpret study data. Results Thirty two studies were included in the review. There was evidence of substantial heterogeneity in the interventions delivered and the overall quality of included studies indicated a medium to high risk of bias. Across the three domains of social, mental and physical health, 79% of group-based interventions and 55% of one-to-one interventions reported at least one improved participant outcome. Over 80% of participatory interventions produced beneficial effects across the same domains, compared with 44% of those categorised as non-participatory. Of interventions categorised as having a theoretical basis, 87% reported beneficial effects across

  13. Exploring nurses' use of language with older people.

    PubMed

    Draper, Peter; Wray, Jane; Burley, Sandra

    2013-11-01

    The authors discuss ways in which nurses speak to older people. Research shows that the words nurses use can have a powerful effect on the wellbeing of older people. An experimental project developed at the University of Hull is described in which creative writing techniques were used to increase nursing students' and staff's sensitivity to the importance of language in care. The project enabled participants to co-create a body of work that was subsequently displayed in the faculty reception, and it showed how trusting relationships could be developed between participants. The authors are working to extend the project by finding ways to embed creative writing in the undergraduate nursing curriculum. PMID:24171621

  14. Diagnosing and treating urinary tract infections in older people.

    PubMed

    Armstrong, Kirsty

    2015-05-01

    Even though diagnosing and treating urinary tract infections (UTIs) in older people can be difficult, it is essential to prevent reduction in the patients' wellbeing. Near-patient testing can be useful, but guidelines on this discuss the use of urine dipstick testing and laboratory culture in some detail. In addition, there are significant differences in the management of males and females, those with recurrent infections, and those with catheters. Community nurses are well placed to assess and manage this common condition, implementing correct treatment and resolution, owing to the close relationships they cultivate with service users. This article discusses the diagnosis and management of UTIs in older people, highlighting the differentials and red flags that need to be addressed urgently. PMID:25993370

  15. Can older people remember medication reminders presented using synthetic speech?

    PubMed Central

    Wolters, Maria K; Johnson, Christine; Campbell, Pauline E; DePlacido, Christine G; McKinstry, Brian

    2015-01-01

    Reminders are often part of interventions to help older people adhere to complicated medication regimes. Computer-generated (synthetic) speech is ideal for tailoring reminders to different medication regimes. Since synthetic speech may be less intelligible than human speech, in particular under difficult listening conditions, we assessed how well older people can recall synthetic speech reminders for medications. 44 participants aged 50–80 with no cognitive impairment recalled reminders for one or four medications after a short distraction. We varied background noise, speech quality, and message design. Reminders were presented using a human voice and two synthetic voices. Data were analyzed using generalized linear mixed models. Reminder recall was satisfactory if reminders were restricted to one familiar medication, regardless of the voice used. Repeating medication names supported recall of lists of medications. We conclude that spoken reminders should build on familiar information and be integrated with other adherence support measures. PMID:25080534

  16. Assessing the nutritional vulnerability of older people in developing countries.

    PubMed

    1997-12-01

    The nutrition of older people in developing countries, and the effect of their nutritional status on the quality of life, have not received sufficient attention. A 1997 symposium held at the London (England) School of Hygiene and Tropical Medicine addressed the assessment of nutritional vulnerability in older people in rural and urban settings. Reported were the results of a collaborative study conducted in the urban slums of Mumbai, India; a refugee camp for Rwandans in Karagwe, Tanzania; and rural communities in Malawi. Physical impairment was highest in India and increased with both age and deteriorating nutritional status in all three settings. Among the risk factors for nutritional vulnerability identified through the study to date are living alone, social isolation, reduced food intake, illiteracy, low socioeconomic status, and certain diseases. A field handbook to assess nutritional vulnerability has been prepared based on the research program and will be published in 1988. PMID:12293175

  17. Can older people remember medication reminders presented using synthetic speech?

    PubMed

    Wolters, Maria K; Johnson, Christine; Campbell, Pauline E; DePlacido, Christine G; McKinstry, Brian

    2015-01-01

    Reminders are often part of interventions to help older people adhere to complicated medication regimes. Computer-generated (synthetic) speech is ideal for tailoring reminders to different medication regimes. Since synthetic speech may be less intelligible than human speech, in particular under difficult listening conditions, we assessed how well older people can recall synthetic speech reminders for medications. 44 participants aged 50-80 with no cognitive impairment recalled reminders for one or four medications after a short distraction. We varied background noise, speech quality, and message design. Reminders were presented using a human voice and two synthetic voices. Data were analyzed using generalized linear mixed models. Reminder recall was satisfactory if reminders were restricted to one familiar medication, regardless of the voice used. Repeating medication names supported recall of lists of medications. We conclude that spoken reminders should build on familiar information and be integrated with other adherence support measures. PMID:25080534

  18. Nutrition, older people and the end of life.

    PubMed

    Donnelly, Geraldine; Wentworth, Lauren; Vernon, Martin J

    2013-12-01

    Older patients are at increased risk of malnutrition, resulting in higher mortality and morbidity. It is important to address nutritional need early in order to prevent or mitigate these adverse outcomes. Decisions about nutrition and hydration for older people presenting with acute illness or evolving multiple long-term conditions present great difficulty to all involved. Clinicians are more likely to encounter such situations as the population of older people with frailty syndromes expands. The clinical evidence base to guide such decisions is sparse and largely unhelpful. Clinicians must recognise their role in these difficult decisions. In addition to familiarity with the clinical evidence base, they must be fully informed of the legal, professional and moral context of the decisions with which they are faced. Responsible clinicians have a professional duty to elicit, understand and weigh the views of their patient, and where necessary their representatives. This can only be undertaken through a process of facilitated patient choice utilising the available legal and professional decision-making frameworks. Any decision relating to clinically assisted nutrition and/or hydration in a frail older person who is considered to be nearing the end of their life must also include explicit consideration of the needs of that individual for formalised palliative care. PMID:24298188

  19. Hair cortisol and cognitive performance in healthy older people.

    PubMed

    Pulopulos, Matias M; Hidalgo, Vanesa; Almela, Mercedes; Puig-Perez, Sara; Villada, Carolina; Salvador, Alicia

    2014-06-01

    Worse cognitive performance in older people has been associated with hypothalamic-pituitary-adrenal axis dysregulation (in particular, higher cortisol levels). Analysis of hair cortisol concentrations (HCC) is a novel method to measure long-term cortisol exposure, and its relationship with cognition in healthy older people has not yet been studied. We investigated whether HCC (measured in hair scalp) and diurnal salivary cortisol levels (awakening, 30min after awakening, and evening, across two days) were related to cognitive performance (assessed with the Trail-making Test A and B, Digit Span Forward and Backward, word list-RAVLT and Stories subtest of the Rivermead) in 57 healthy older people (mean age=64.75 years, SD=4.17). Results showed that lower HCC were consistently related to worse working memory, learning, short-term verbal memory (RAVLT first trial and immediate recall) and long-term verbal memory. In contrast, higher mean levels and higher diurnal area under the curve of diurnal salivary cortisol were related to worse attention and short-term verbal memory (immediate story recall), respectively. Interestingly, a higher ratio of mean levels of diurnal salivary cortisol over HCC were related to worse performance on working memory and short-term verbal memory, suggesting that those individuals with lower long-term cortisol exposure might be more vulnerable to the negative effect of HPA-axis dysregulation on these cognitive processes. Our findings suggest that both low long-term cortisol exposure and a possible dysregulation of the diurnal rhythm of the HPA-axis may account, at least in part, for the inter-individual variability in cognitive performance in healthy older people. PMID:24767624

  20. How Do Family Caregivers of Older People Give Up Caregiving?

    PubMed Central

    Mortazavi, Hamed; Peyrovi, Hamid; Joolaee, Soodabeh

    2015-01-01

    Background Population aging has social, economic and political consequences. Most family caregivers prefer to care for their family member older person with chronic disease at home. Despite traditional culture within Iranian families, in some cases, hospitalization of the elderly in nursing home is inevitable, and this affects the old person and his/her family. The aim of this study was to explain how Iranian family cargivers give up caring their older person with chronic condition at home. Methods A grounded theory approach was used to conduct the study. The study setting included four nursing homes under the auspices of Iran Welfare Organization. Fourteen participants were recruited through purposive sampling. Data were collected from December 2010 to March 2011 by Semi-structured interviews lasting about 17 to 95 minutes (average 52 minutes). Constant comparative analysis was used to analyze the data. Results Three main categories appeared at the end of the analysis: “going out of the road of usual life”, “challenge of meeting older person, family and caregivers care needs”, and “the appearance of inconstancy in the family”. They explained exclusively how family caregivers of old people give up caregiving. Conclusion Health care providers are recommended to become familiar with challenges of family caregivers in taking care of older person with chronic disease at home, and then organize their supportive and consulting actions according to family situations in order to improve the life quality of older person and family caregivers. PMID:26171407

  1. Older people with dysphagia: transitioning to texture-modified food.

    PubMed

    Ullrich, Sandra; Crichton, Jonathan

    Older people with dysphagia are at high risk of malnutrition. To maintain safe oral and nutritional intake, solid food may be texture-modified. Little is known about the transition experiences of older people who move from normal to texture-modified foods. The aim of this study was to describe residents' experiences as they transitioned from normal food to texture-modified food. The study used a qualitative descriptive design and individual interviews were conducted with a study group of 28 participants (residents, family members, nursing and care staff, and speech and language therapists). The interviews were thematically analysed. The findings suggest that transition creates the risk of distress, reducing eating to a matter of necessity and hunger, and that the process is perceived as abrupt, and characterised by lack of communication and awareness of the need for change. A key finding is that the language used during transition can be adversely affected by the management of risk. This language promotes a culture of care that emphasises the limitations of residents, reduces their motivation to eat and hinders the delivery of person-centred care. The findings suggest that care facilities for older people need to revisit their dysphagia management protocols to ensure that they support a person-centred approach for recipients of texture-modified food. PMID:26153808

  2. Barriers to physical activity in people at risk of coronary heart disease.

    PubMed

    Brown, J

    Scotland has a high risk of coronary heart disease (CHD) and a literature search identified the risk factors and the importance that physical activity plays in reducing the risk. The search also revealed that patients at risk of CHD find it difficult to increase their exercise levels. In an attempt to understand this, barriers to exercise were explored from a psychological perspective. The study uses the Multidimensional Health Locus of Control Scale (MHLCS) (Wallston and Wallston, 1978) in conjunction with a specifically designed exercise questionnaire. The results show that differences in exercise levels exist between different age groups and between males and females. Differences in MHLCS scores and in barriers to exercise are also shown between the different age groups and sexes, as well as between those working and those not working. The main barriers to exercises were time, ill health, preference to do other things, money, having nobody to go with and lack of confidence. PMID:10426012

  3. HIV among people who use drugs: a global perspective of populations at risk.

    PubMed

    Stockman, Jamila K; Strathdee, Steffanie A

    2010-12-01

    This article examines the epidemiology of HIV among selected subgroups of drug users around the world who are "most at risk"--men who have sex with men, female sex workers, prisoners, and mobile populations. The underlying determinants of HIV infection among these populations include stigma, physical and sexual violence, mental illness, social marginalization, and economic vulnerability. HIV interventions must reach beyond specific risk groups and individuals to address the micro-level and macro-level determinants that shape their risk environments. Public health interventions that focus on the physical, social, and health policy environments that influence HIV risk-taking in various settings are significantly more likely to impact the incidence of HIV and other blood-borne and sexually transmitted infections across larger population groups. PMID:21045594

  4. Positive Emotional Traits and Ambitious Goals among People at Risk for Mania: The Need for Specificity

    PubMed Central

    Gruber, June; Johnson, Sheri L.

    2010-01-01

    Recent psychosocial theories implicate disturbances in reward pursuit among individuals putatively at risk for mania. The present study examined associations of a measure of risk for mania (the Hypomanic Personality Scale; HPS) with both four trait positive emotions (joy, pride, compassion, and love) and ambitious life goals in five domains (fame, wealth, political influence, family, and friends) among 302 participants from two university settings. Findings indicated that higher HPS scores were related to reward (joy) and achievement-focused (pride) positive emotions, with weaker relations to prosocial (compassion, love) positive emotions. HPS scores were more robustly related to extrinsic (fame, politics) as compared to other-oriented (friends, family) ambitious life goals, with the exception of wealth. These effects were independent of current symptoms of mania and depression. Discussion focuses on the implications of elevated reward and achievement-related positive emotions and goals in understanding risk factors for mania. PMID:20360995

  5. Reviewing the Literature on "At-Risk" and Resilient Children and Young People

    ERIC Educational Resources Information Center

    Hanewald, Ria

    2011-01-01

    This review paper provides pre-service and in-service teachers, principals and other educational professionals with the information needed to understand the concept of resilience to affect positive development in children and young people in their care. It reviews and critiques the most influential literature on resiliency over the last four…

  6. Tackling anxiety and depression in older people in primary care.

    PubMed

    Bland, Phillip

    2012-01-01

    Epidemiological studies suggest that anxiety and depression are less common in older than younger adults. One in ten people aged > or = 65 fulfils the diagnostic criteria for at least one common mental disorder. Older depressed patients have an increased risk of both cardiac and all-cause mortality. Both anxiety and depression in older patients are often unrecognised and untreated, and have a poor prognosis. There is a progressive decline in the prevalence of common mental disorders above the age of 55. Anxiety and depression often occur together, and share many risk factors. However, anxiety tends to follow threats or traumatic events, whereas depression follows loss events. Chronic diseases, cognitive impairment, pain and functional disability are risk factors for the onset of depression, but not anxiety. Depression is between two and three times more common among those with a chronic physical health problem. Even patients with major depression often remain unrecognised and untreated. Generalised anxiety disorder (GAD) is by far the most common anxiety disorder in older people but most GAD patients are not recognised in primary care and only a third of them receive any form of treatment. Older patients often deny feeling anxious or depressed and are more likely to present with insomnia, irritability, agitation and multiple somatic complaints. GPs may erroneously believe that depression is a normal reaction to the losses of old age, and may be reluctant to initiate treatment. A good case can be made for replacing the PHQ-9 with the 15-item version of the Geriatric Depression Scale which almost entirely avoids somatic questions. This is a screening not a diagnostic tool and does not evaluate symptom severity. PMID:22720455

  7. Prefrontal hyperactivity in older people during motor planning.

    PubMed

    Berchicci, Marika; Lucci, Giuliana; Pesce, Caterina; Spinelli, Donatella; Di Russo, Francesco

    2012-09-01

    The aim of this study was to assess the influence of age-related changes in cortical activity related to the motor preparation involved in simple- and discriminative-reaction tasks. To distinguish between age effects on motor planning and stimulus processing, both movement- and stimulus-locked event related potentials (ERPs) were investigated in 14 younger, 14 middle-aged, and 14 older adults (mean ages 24.4, 49, and 70 years, respectively). The novel results of the present study are the prefrontal over-recruitment observed in older adults in movement-related cortical potentials (MRCPs) and the differential pattern of aging effects observed at behavioral and at electrophysiological level between middle-aged and older adults. Overall, the following results were observed: (i) behavioral results confirmed the well-known slowing of responses in aging people, which were associated with optimal accuracy; (ii) the age-related differences in cortical activity underlying the generation of voluntary movements in response to external stimuli were more pronounced for the motor planning than the stimulus processing stage; (iii) the source and the time-course analysis of the over-recruitment in the older adults indicated tonic involvement of prefrontal areas regardless of task complexity; and (iv) middle-aged adults showed a 'young adult-like' behavioral speed, but an 'older adult-like' overactivation of prefrontal areas. In summary, to reach the same accuracy, older subjects prepared the action with greater anticipation and higher cost, as indexed by the earlier latency onset and larger prefrontal cortical activation. PMID:22732557

  8. Assessment and management of nutrition in older people and its importance to health.

    PubMed

    Ahmed, Tanvir; Haboubi, Nadim

    2010-01-01

    Nutrition is an important element of health in the older population and affects the aging process. The prevalence of malnutrition is increasing in this population and is associated with a decline in: functional status, impaired muscle function, decreased bone mass, immune dysfunction, anemia, reduced cognitive function, poor wound healing, delayed recovery from surgery, higher hospital readmission rates, and mortality. Older people often have reduced appetite and energy expenditure, which, coupled with a decline in biological and physiological functions such as reduced lean body mass, changes in cytokine and hormonal level, and changes in fluid electrolyte regulation, delay gastric emptying and diminish senses of smell and taste. In addition pathologic changes of aging such as chronic diseases and psychological illness all play a role in the complex etiology of malnutrition in older people. Nutritional assessment is important to identify and treat patients at risk, the Malnutrition Universal Screening Tool being commonly used in clinical practice. Management requires a holistic approach, and underlying causes such as chronic illness, depression, medication and social isolation must be treated. Patients with physical or cognitive impairment require special care and attention. Oral supplements or enteral feeding should be considered in patients at high risk or in patients unable to meet daily requirements. PMID:20711440

  9. Assessment and management of nutrition in older people and its importance to health

    PubMed Central

    Ahmed, Tanvir; Haboubi, Nadim

    2010-01-01

    Nutrition is an important element of health in the older population and affects the aging process. The prevalence of malnutrition is increasing in this population and is associated with a decline in: functional status, impaired muscle function, decreased bone mass, immune dysfunction, anemia, reduced cognitive function, poor wound healing, delayed recovery from surgery, higher hospital readmission rates, and mortality. Older people often have reduced appetite and energy expenditure, which, coupled with a decline in biological and physiological functions such as reduced lean body mass, changes in cytokine and hormonal level, and changes in fluid electrolyte regulation, delay gastric emptying and diminish senses of smell and taste. In addition pathologic changes of aging such as chronic diseases and psychological illness all play a role in the complex etiology of malnutrition in older people. Nutritional assessment is important to identify and treat patients at risk, the Malnutrition Universal Screening Tool being commonly used in clinical practice. Management requires a holistic approach, and underlying causes such as chronic illness, depression, medication and social isolation must be treated. Patients with physical or cognitive impairment require special care and attention. Oral supplements or enteral feeding should be considered in patients at high risk or in patients unable to meet daily requirements. PMID:20711440

  10. The Teacher's Perspective in Older Education: The Experience of Teaching in a University for Older People in Spain

    ERIC Educational Resources Information Center

    Villar, Feliciano; Celdran, Montserrat; Pinazo, Sacramento; Triado, Carme

    2010-01-01

    The aim of this study was to explore university lecturers' descriptions of their teaching experience with older students. Twelve teachers of the Nau Gran (a university program for older people [UPOP] in Valencia, Spain) were interviewed. We analyzed their responses to questions about their experience of teaching older adults, the rewarding aspects…

  11. Magnitude of HIV infection among older people in Mufindi and Babati districts of the Tanzania mainland

    PubMed Central

    Nyigo, Vitus; Kilale, Andrew; Kilima, Stella; Shayo, Elizabeth H; Senkoro, Kesheni P; Mshana, Jonathan; Mushi, Adiel K; Matemba, Lucas; Massaga, Julius

    2014-01-01

    Introduction According to the 2011–2012 HIV and Malaria Indicator Survey, the prevalence of HIV infection in Tanzania is 5.1%, with limited information on its magnitude among older people, as the community believes that the elderly are not at risk. Consequently, little attention is given to the fight against HIV and AIDS in this group. The present study investigated the magnitude of HIV and AIDS infection among older people in rural and urban areas of the Tanzania mainland. Subjects and methods The study was conducted in Mufindi and Babati districts of Iringa and Manyara regions, respectively, through multistage sampling procedures. Dried blood spot cards were used to collect blood samples for HIV testing among consenting participants. HIV testing was done and retested using different enzyme-linked immunosorbent assay kits. Results A total of 720 individuals, 340 (47.2%) males and 380 (52.8%) females, were randomly selected, of whom 714 (99.2%) consented to HIV testing while six (0.8%) refused to donate blood. The age ranged from 50 to 98 years, with a mean age of 64.2 years. Overall, a total of 56 (7.8%) participants were HIV-positive. Females had a higher prevalence (8.3%) than males (7.4%), with Mufindi district recording the higher rate (11.3%) compared to the 3.7% of Babati district. The prevalence was higher in the rural population (9.4%) compared to 6.4% of their urban counterparts. Conclusion Although HIV/AIDS is considered a disease of individuals aged 15–49 years, the overall prevalence among the older people aged 50 years and above for Mufindi and Babati districts was higher than the national prevalence in the general population. These findings point to the need to consider strengthening interventions targeting older populations against HIV/AIDS in these districts while establishing evidence countrywide to inform policy decisions. PMID:24926202

  12. Draw a Young and an Older Person: Schoolchildren's Images of Older People

    ERIC Educational Resources Information Center

    Villar, Feliciano; Faba, Josep

    2012-01-01

    The goal of this study was to explore stereotypes of older people as expressed in drawings by a sample of primary school children. Sixty children from fourth to sixth grades (30 boys and 30 girls aged 9 to 12 years) were asked to draw a young man, a young woman, an old man, and an old woman. The drawings were content analyzed. Children in our…

  13. Food safety and older people: the Kitchen Life study.

    PubMed

    Dickinson, Angela; Wills, Wendy; Meah, Angela; Short, Frances

    2014-05-01

    Foodborne illness (FBI) is a major public health problem in the UK. Recent increases in cases of listeriosis in older people have focused attention on consumer food-related practices. Previous studies highlight poor relationships between what people know, what they say they do and what they actually do in the kitchen. The aim of the Kitchen Life study was to examine what actually happens in the domestic kitchen to assess whether and how this has the potential to influence food safety in the home. Drawing on a qualitative ethnographic approach, methods included a kitchen tour, photography, observation, video observation, informal interviews and diary methods. Ten households with older people (aged 60+) were recruited across the UK. It was found that trust in the food supply, use of food-labelling (including use-by dates), sensory logics (such as the feel or smell of food) and food waste were factors with the potential to influence risk of foodborne illness. Practices shifted with changing circumstances, including increased frailty, bereavement, living alone, receiving help with care and acquiring new knowledge, meaning that the risk of and vulnerability to foodborne illness is not straightforward. PMID:24784557

  14. Antimuscarinics in Older People: Dry Mouth and Beyond.

    PubMed

    Bostock, Clare; McDonald, Christopher

    2016-03-01

    Many common prescription and over-the-counter medications have antimuscarinic effects. Antimuscarinics are a well recognized cause of dry mouth, with potential to cause other physical and cognitive adverse effects. A comprehensive medication review in a patient presenting with dry mouth can lead to overall health improvements. Scoring systems can be helpful in identifying antimuscarinic drugs and their adverse effects. CPD/Clinical Relevance: Antimuscarinic drug use is prevalent and a common cause of dry mouth. Older people are particularly susceptible to antimuscarinic adverse effects. PMID:27188134

  15. An overview of appetite decline in older people.

    PubMed

    Pilgrim, Anna L; Robinson, Sian M; Sayer, Avan Aihie; Roberts, Helen C

    2015-06-01

    Poor appetite is a common problem in older people living at home and in care homes, as well as hospital inpatients. It can contribute to weight loss and nutritional deficiencies, and associated poor healthcare outcomes, including increased mortality. Understanding the causes of reduced appetite and knowing how to measure it will enable nurses and other clinical staff working in a range of community and hospital settings to identify patients with impaired appetite. A range of strategies can be used to promote better appetite and increase food intake. PMID:26018489

  16. Nonbelieved memories in middle-aged and older people.

    PubMed

    Brédart, Serge; Bouffier, Marion

    2016-05-01

    Previous studies have reported that young participants typically date events that they remember, but no longer believe they experienced, to the period of childhood. The present study investigated whether participants aged between 40 and 79years dated events related to relinquished memories to the period of childhood, as do younger people, or whether they dated such events to a period later in life. The study also compared believed and nonbelieved memories with respect to memory perspective (1st vs 3rd person perspective). Results indicated that the majority of middle-aged and older people dated nonbelieved memories to the period of childhood (median age=8years). No correlation was found between the participants' current age and their age at the time the nonbelieved event occurred. In addition, results showed that believed memories were more likely to be retrieved from a 1st person perspective than were nonbelieved memories. PMID:27136268

  17. "I Don't Want to Live like This Anymore": Disrupted Habitus in Young People "At Risk" of Diagnosis of Personality Disorder

    ERIC Educational Resources Information Center

    Gilbert, Tony; Farrand, Paul; Lankshear, Gloria

    2013-01-01

    This article reports on interview data gathered from 27 young people involved with a street-level service for young people considered "at risk" of diagnosis of personality disorder. Interviews with a self-selecting sample of young people explored the events that led to their initial contact with the service. Using Silverman's…

  18. Current Policy and Legislation in England Regarding Older People--What This Means for Older People with Learning Disabilities: A Discussion Paper

    ERIC Educational Resources Information Center

    Turner, Sue; Cooper Ueki, Madeline

    2015-01-01

    Background: This paper seeks to explore the opportunities and challenges generated by current policy, guidance and legislation in England relating to older people, in terms of the practical implications for older people with learning disabilities. Methods: Using the broad themes housing, employment, social inclusion and isolation, care and…

  19. Theorizing accommodation in supportive home care for older people.

    PubMed

    Ceci, Christine; Purkis, Mary Ellen; Björnsdóttir, Kristin

    2013-01-01

    This paper examines the issue of what thinking is necessary in order to advance a notion of accommodation in the organization and provision of supportive home care for older people. Accommodation in this context is understood as responsiveness to the singularity of older adults, and we consider how this idea might be used to support opportunities for (independent) living for elders as they age and become frailer. To elaborate the question we draw on examples from our empirical work - ethnographic studies of home care practice undertaken in Canada and Iceland - and consider these examples in light of critical philosophical and social theory, particularly Agamben's (1993) work, The Coming Community. This is a relevant frame through which to consider the potential for the accommodation of the unique needs of older adults in home care because it helps us to problematize the systems through which care is accomplished and the current, dominant terms of relations between individuals and collectives. We argue that giving substance to a notion of accommodation contributes an important dimension to aligned ideas, such as patient-centeredness in care, by working to shift the intentionality of these practices. That is, accommodation, as an orientation to care practices, contests the organizational impulse to carry on in the usual way. PMID:23273554

  20. Ginger Orally Disintegrating Tablets to Improve Swallowing in Older People.

    PubMed

    Hirata, Ayumu; Funato, Hiroki; Nakai, Megumi; Iizuka, Michiro; Abe, Noriaki; Yagi, Yusuke; Shiraishi, Hisashi; Jobu, Kohei; Yokota, Junko; Hirose, Kahori; Hyodo, Masamitsu; Miyamura, Mitsuhiko

    2016-01-01

    We previously prepared and pharmaceutically evaluated ginger orally disintegrating (OD) tablets, optimized the base formulation, and carried out a clinical trial in healthy adults in their 20 s and 50s to measure their effect on salivary substance P (SP) level and improved swallowing function. In this study, we conducted clinical trials using the ginger OD tablets in older people to clinically evaluate the improvements in swallowing function resulting from the functional components of the tablet. The ginger OD tablets were prepared by mixing the excipients with the same amount of mannitol and sucrose to a concentration of 1% ginger. Eighteen healthy older adult volunteers aged 63 to 90 were included in the swallowing function test. Saliva was collected before and 15 min after administration of the placebo and ginger OD tablets. Swallowing endoscopy was performed by an otolaryngologist before administration and 15 min after administration of the ginger OD tablets. A scoring method was used to evaluate the endoscopic swallowing. Fifteen minutes after taking the ginger OD tablets, the salivary SP amount was significantly higher than prior to ingestion or after taking the placebo (p<0.05). Among 10 subjects, one scored 1-3 using the four evaluation criteria. Overall, no aspiration occurred and a significant improvement in the swallowing function score was observed (p<0.05) after taking the ginger OD tablets. Our findings showed that the ginger OD tablets increased the salivary SP amount and improved swallowing function in older people with appreciably reduced swallowing function. PMID:27374286

  1. Refining the Measure and Dimensions of Social Values of Older People (SVOP)

    ERIC Educational Resources Information Center

    Yoon, Eunkyung; Kolomer, Stacey R.

    2007-01-01

    Older persons are living longer and healthier and, thus, are capable of being more productive and less dependent. Despite this trend, young people persistently hold the age-old negative stereotypes about older persons. The goals of this study were to develop a valid, reliable measure of social values of older people and to assess its utility as…

  2. The Housing and Support Needs of People with an Intellectual Disability into Older Age

    ERIC Educational Resources Information Center

    Shaw, K.; Cartwright, C.; Craig, J.

    2011-01-01

    Background: People with intellectual disabilities (IDs) are growing older as a population cohort. Many live at home with family members who are their carers but who are also becoming older and less able to provide care. The housing and support preferences of people with IDs and their carers into older age are poorly characterised in the…

  3. Ego Integrity of Older People with Physical Disability and Therapeutic Recreation

    ERIC Educational Resources Information Center

    de Guzman, Allan B.; Shim, Hye-Eun; Sia, Charmin Kathleen M.; Siazon, Wilbart Harvey S.; Sibal, Mary Joyce Ann P.; Siglos, Joanna Brigitte Lorraine C.; Simeon, Francis Marlo C.

    2011-01-01

    Ego integrity, the last developmental task in Erikson's psychological theory, develops naturally among older people. However, the presence of loss-like physical disability-can considerably affect the quality of life, interactions, and well being of older adults. Hence, older people with physical disabilities need more assistance in accomplishing…

  4. Behavioral surveillance among people at risk for HIV infection in the U.S.: the National HIV Behavioral Surveillance System.

    PubMed

    Gallagher, Kathleen M; Sullivan, Patrick S; Lansky, Amy; Onorato, Ida M

    2007-01-01

    The Centers for Disease Control and Prevention, in collaboration with 25 state and local health departments, began the National HIV Behavioral Surveillance System (NHBS) in 2003. The system focuses on people at risk for HIV infection and surveys the three populations at highest risk for HIV in the United States: men who have sex with men, injecting drug users, and high-risk heterosexuals. The project collects information from these three populations during rotating 12-month cycles. Methods for recruiting participants vary for each at-risk population, but NHBS uses a standardized protocol and core questionnaire for each cycle. Participating health departments tailor their questionnaire to collect information about specific prevention programs offered in their geographic area and to address local data needs. Data collected from NHBS will be used to describe trends in key behavioral risk indicators and evaluate current HIV prevention programs. This information in turn can be used to identify gaps in prevention services and target new prevention activities with the goal of reducing new HIV infections in the United States. PMID:17354525

  5. The Effect of an Educational Intervention on Alcohol Consumption, At-Risk Drinking, and Health Care Utilization in Older Adults: The Project SHARE Study

    PubMed Central

    Ettner, Susan L; Xu, Haiyong; Duru, O Kenrik; Tseng, Chi-Hong; Tallen, Louise; Barnes, Andrew; Mirkin, Michelle; Ransohoff, Kurt; Moore, Alison A

    2014-01-01

    Objective: The purpose of this study was to examine the effectiveness of a patient–provider educational intervention in reducing at-risk drinking among older adults. Method: This was a cluster-randomized controlled trial of 31 primary care providers and their patients ages 60 years and older at a community-based practice with seven clinics. Recruitment occurred from July 2005 to August 2007. Eligibility was determined by telephone and a baseline mailed survey. A total of 1,186 at-risk drinkers were identified by the Comorbidity Alcohol Risk Evaluation Tool. Follow-up patient surveys were administered at 3, 6, and 12 months after baseline. Study physicians and their patients were randomly assigned to usual care (n = 640 patients) versus the Project SHARE (Senior Health and Alcohol Risk Education) intervention (n = 546 patients), which included personalized reports, educational materials, drinking diaries, physician advice during office visits, and telephone counseling delivered by a health educator. Main outcomes were alcohol consumption, at-risk drinking (overall and by type), alcohol discussions with physicians, health care utilization, and screening and intervention costs. Results: At 12 months, the intervention was significantly associated with an increase in alcohol-related discussions with physicians (23% vs. 13%; p ≤ .01) and reductions in at-risk drinking (56% vs. 67%; p ≤ .01), alcohol consumption (-2.19 drinks per week; p ≤ .01), physician visits (-1.14 visits; p = .03), emergency department visits (16% vs. 25%; p ≤ .01), and nonprofessional caregiving visits (12% vs. 17%; p ≤ .01). Average variable costs per patient were $31 for screening and $79 for intervention. Conclusions: The intervention reduced alcohol consumption and at-risk drinking among older adults. Effects were sustained over a year and may have been associated with lower health care utilization, offsetting screening and intervention costs. PMID:24766757

  6. Older People's Views of Advice about Falls Prevention: A Qualitative Study

    ERIC Educational Resources Information Center

    Yardley, L.; Donovan-Hall, M.; Francis, K.; Todd, C.

    2006-01-01

    The aim of this study was to gain an understanding of older people's perceptions of falls prevention advice, and how best to design communications that will encourage older people to take action to prevent falls. Focus groups and interviews were carried out with 66 people aged 61-94 years recruited from a variety of settings, using falls…

  7. ICT, Education and Older People in Australia: A Socio-Technical Analysis

    ERIC Educational Resources Information Center

    Tatnall, Arthur

    2014-01-01

    People over 65 (or older people) are a growing proportion of the population in many developed countries including Australia. In the last 10 to 12 years interest from this group in the use of Information and Communication Technologies (ICT) and the Internet has also grown considerably. ICT has much to offer older people as a means of keeping in…

  8. Cognitive associations of subcortical white matter lesions in older people.

    PubMed

    O'Brien, John T; Wiseman, Rebecca; Burton, Emma J; Barber, Bob; Wesnes, Keith; Saxby, Brian; Ford, Gary A

    2002-11-01

    Hyperintense lesions (HL), as visualized on T2-weighted or FLAIR MRI, are a common finding in older people, but their clinical significance and influence on cognitive function remain to be clarified. We investigated the relationship between HL in deep white and gray matter structures and cognition in older subjects. We recruited 154 nondemented (Mini-Mental State Examination > 24) subjects (79 males) over the age of 70 from primary care (103 subjects with mild hypertension and 51 normotensive subjects). All subjects underwent FLAIR and proton density and T2-weighted axial 1.5-tesla MRI scans (slice thickness: 5 mm). The scans were rated for the presence and distribution of HL in the subcortical gray matter (caudate, putamen, globus pallidus, thalamus) and associated white matter tracts (internal/external capsule). Subjects (n = 149) underwent a comprehensive cognitive assessment involving tests of attention, processing speed, episodic memory, working memory, and executive function. Partial correlations (correcting for age, systolic blood pressure, and New Adult Reading Test [NART] score) were performed to investigate the relationship between cognition and white matter change. HL were found in 49% of subjects. HL in both the gray (thalamus and caudate) and white matter were significantly associated with impaired cognitive function in tasks involving processing speed and/or executive function, but showed no associations with episodic or working memory. HL in both subcortical gray matter structures and associated fiber tracts correlate with impairments in attention, executive function and processing, and memory retrieval speed in nondemented older community-dwelling subjects. Such lesions may be an important cause of age-related attentional and executive dysfunction in the elderly, as well as temporal lobe and hippocampal changes that have previously been reported to be associated with impairments to the ability to actually store and retrieve information from memory

  9. Autonomy for older people in residential care: a selective literature review.

    PubMed

    Welford, Claire; Murphy, Kathy; Rodgers, Vivien; Frauenlob, Theresia

    2012-03-01

    Autonomy is an important concept because it brings dignity to peoples' lives, regardless of physical circumstances. The United Nations (UN) Madrid International Plan of Action on Ageing emphasises the need to include older adults in autonomous decision-making processes. However, many older people living in residential care find that their autonomy is curtailed. This is largely because autonomy for older people is poorly understood, and hence, nurses working with older people need to become clear about what autonomy is and how it can be facilitated. In this, the first of three papers, the literature is reviewed specifically to establish the meaning of autonomy for older people in residential care as opposed to autonomy in a wider context. This important distinction may help nurses working with older people to begin to facilitate autonomy more effectively. PMID:22348264

  10. Predicting ecstasy use among young people at risk: a prospective study of initially ecstasy-naive subjects.

    PubMed

    Vervaeke, Hylke K E; Benschop, Annemieke; van den Brink, Wim; Korf, Dirk J

    2008-01-01

    Our aim is to identify predictors of first-time ecstasy use in a prospective study among young people at risk. As part of the multidisciplinary Netherlands XTC Toxicity Study (NeXT), we monitored 188 subjects aged > or = 18 who were ecstasy-naive at baseline but seemed likely to start taking ecstasy in the near future. After an 11- to 26-month follow-up period, 160 respondents remained (85.1%; mean age 21.0 years, 58.1% females): 65 who took ecstasy at least once (ecstasy users) and 95 non-users. At baseline and four times during follow-up, respondents completed self-report questionnaires. Cox regression analysis was used to examine the effects of baseline respondent characteristics on incident ecstasy use. Development of peer group ecstasy use was analyzed by logistic regression. Intention to use ecstasy, low education, and current weekly cannabis use independently increased the hazard rate for first ecstasy use. Although ecstasy use among peers at baseline was not a predictor, the proportion of ecstasy users with ecstasy-using peers increased markedly during the study. Our results suggest that targeted prevention activities should focus in particular on young people who have strong intentions to take ecstasy, especially if they are also regular smokers of cannabis. PMID:18724654

  11. Management of diabetes mellitus in older people with comorbidities.

    PubMed

    Huang, Elbert S

    2016-01-01

    Diabetes mellitus is a chronic disease of aging that affects more than 20% of people over 65. In older patients with diabetes, comorbidities are highly prevalent and their presence may alter the relative importance, effectiveness, and safety of treatments for diabetes. Randomized controlled trials have shown that intensive glucose control produces microvascular and cardiovascular benefits but typically after extended treatment periods (five to nine years) and with exposure to short term risks such as mortality (in one trial) and hypoglycemia. Decision analysis, health economics, and observational studies have helped to illustrate the importance of acknowledging life expectancy, hypoglycemia, and treatment burden when setting goals in diabetes. Guidelines recommend that physicians individualize the intensity of glucose control and treatments on the basis of the prognosis (for example, three tiers based on comorbidities and functional impairments) and preferences of individual patients. Very few studies have attempted to formally implement and study these concepts in clinical practice. To better meet the treatment needs of older patients with diabetes and comorbidities, more research is needed to determine the risks and benefits of intensifying, maintaining, or de-intensifying treatments in this population. This research effort should extend to the development and study of decision support tools as well as targeted care management. PMID:27307175

  12. Deprescribing in Frail Older People: A Randomised Controlled Trial

    PubMed Central

    Potter, Kathleen; Flicker, Leon; Page, Amy; Etherton-Beer, Christopher

    2016-01-01

    Objectives Deprescribing has been proposed as a way to reduce polypharmacy in frail older people. We aimed to reduce the number of medicines consumed by people living in residential aged care facilities (RACF). Secondary objectives were to explore the effect of deprescribing on survival, falls, fractures, hospital admissions, cognitive, physical, and bowel function, quality of life, and sleep. Methods Ninety-five people aged over 65 years living in four RACF in rural mid-west Western Australia were randomised in an open study. The intervention group (n = 47) received a deprescribing intervention, the planned cessation of non-beneficial medicines. The control group (n = 48) received usual care. Participants were monitored for twelve months from randomisation. Primary outcome was change in the mean number of unique regular medicines. All outcomes were assessed at baseline, six, and twelve months. Results Study participants had a mean age of 84.3±6.9 years and 52% were female. Intervention group participants consumed 9.6±5.0 and control group participants consumed 9.5±3.6 unique regular medicines at baseline. Of the 348 medicines targeted for deprescribing (7.4±3.8 per person, 78% of regular medicines), 207 medicines (4.4±3.4 per person, 59% of targeted medicines) were successfully discontinued. The mean change in number of regular medicines at 12 months was -1.9±4.1 in intervention group participants and +0.1±3.5 in control group participants (estimated difference 2.0±0.9, 95%CI 0.08, 3.8, p = 0.04). Twelve intervention participants and 19 control participants died within 12 months of randomisation (26% versus 40% mortality, p = 0.16, HR 0.60, 95%CI 0.30 to 1.22) There were no significant differences between groups in other secondary outcomes. The main limitations of this study were the open design and small participant numbers. Conclusions Deprescribing reduced the number of regular medicines consumed by frail older people living in residential care with no

  13. Radiographic correlates of hallux valgus severity in older people

    PubMed Central

    2010-01-01

    Background The severity of hallux valgus is easily appreciated by its clinical appearance, however x-ray measurements are also frequently used to evaluate the condition, particularly if surgery is being considered. There have been few large studies that have assessed the validity of these x-ray observations across a wide spectrum of the deformity. In addition, no studies have specifically focused on older people where the progression of the disorder has largely ceased. Therefore, this study aimed to explore relationships between relevant x-ray observations with respect to hallux valgus severity in older people. Methods This study utilised 402 x-rays of 201 participants (74 men and 127 women) aged 65 to 94 years. All participants were graded using the Manchester Scale - a simple, validated system to grade the severity of hallux valgus - prior to radiographic assessment. A total of 19 hallux valgus-related x-ray observations were performed on each set of x-rays. These measurements were then correlated with the Manchester Scale scores. Results Strong, positive correlations were identified between the severity of hallux valgus and the hallux abductus angle, the proximal articular set angle, the sesamoid position and congruency of the first metatarsophalangeal joint. As hallux valgus severity increased, so did the frequency of radiographic osteoarthritis of the first metatarsophalangeal joint and a round first metatarsal head. A strong linear relationship between increased relative length of the first metatarsal and increased severity of hallux valgus was also observed. Conclusions Strong associations are evident between the clinical appearance of hallux valgus and a number of hallux valgus-related x-ray observations indicative of structural deformity and joint degeneration. As it is unlikely that metatarsal length increases as a result of hallux valgus deformity, increased length of the first metatarsal relative to the second metatarsal may be a contributing factor to

  14. Belief in AIDS-Related Conspiracy Theories and Mistrust in the Government: Relationship With HIV Testing Among At-Risk Older Adults

    PubMed Central

    Ford, Chandra L.

    2013-01-01

    Purpose: One in 4 persons living with HIV/AIDS is an older adult (age 50 or older); unfortunately, older adults are disproportionately diagnosed in late stages of HIV disease. Psychological barriers, including belief in AIDS-related conspiracy theories (e.g., HIV was created to eliminate certain groups) and mistrust in the government, may influence whether adults undergo HIV testing. We examined relationships between these factors and recent HIV testing among at-risk, older adults. Design and Methods: This was a cross-sectional study among older adults enrolled in a large venue–based study. None had a previous diagnosis of HIV/AIDS; all were seeking care at venues with high HIV prevalence. We used multiple logistic regression to estimate the associations between self-reported belief in AIDS-related conspiracy theories, mistrust in the government, and HIV testing performed within the past 12 months. Results: Among the 226 participants, 30% reported belief in AIDS conspiracy theories, 72% reported government mistrust, and 45% reported not undergoing HIV testing within the past 12 months. Belief in conspiracy theories was positively associated with recent HIV testing (adjusted odds ratio [OR] = 1.94, 95% confidence interval [CI] = 1.05–3.60), whereas mistrust in the government was negatively associated with testing (OR = 0.43, 95% CI = 0.26–0.73). Implications: Psychological barriers are prevalent among at-risk older adults seeking services at venues with high HIV prevalences and may influence HIV testing. Identifying particular sources of misinformation and mistrust would appear useful for appropriate targeting of HIV testing strategies. PMID:23362210

  15. Functional Assessments Used by Occupational Therapists with Older Adults at Risk of Activity and Participation Limitations: A Systematic Review

    PubMed Central

    Wales, Kylie; Clemson, Lindy; Lannin, Natasha; Cameron, Ian

    2016-01-01

    Introduction The use of functional assessments to evaluate patient change is complicated by a lack of consensus as to which assessment is most suitable for use with older adults. Objective: To identify and appraise the properties of assessments used to evaluate functional abilities in older adults. Methods A systematic review of randomised controlled trials of occupational therapy interventions was conducted up to 2012 to identify assessments used to measure function. Two authors screened and extracted data independently. A second search then identified papers investigating measurement properties of each assessment. Studies from the second search were included if: i) published in English, ii) the assessment was not modified from its original published form, iii) study aim was to evaluate the quality of the tool, iv) and was original research. Translated versions of assessments were excluded. Measurement quality was rated using the COSMIN checklist and Terwee criteria. Results Twenty-eight assessments were identified from the systematic search of occupational therapy interventions provided to older adults. Assessments were of varied measurement quality and many had been adapted (although still evaluated as though the original tool had been administered) potentially altering the conclusions drawn about measurement quality. Synthesis of best evidence established 15 functional assessments have not been tested in an older adult population. Conclusions The Functional Autonomy Measurement System (SMAF) appears to be a promising assessment for use with older adults. Only two tools (the SMAF and the Assessment of Motor and Process Skills (AMPS)) were deemed to be responsive to change when applied to older adults. Health professionals should use functional assessments that have been validated with their population and in their setting. There are reliable and valid assessments to capture the functional performance of older adults in community and hospital settings, although

  16. Accident profile of older people in Antalya City Center, Turkey.

    PubMed

    Donmez, Levent; Gokkoca, Zuhal

    2003-01-01

    Accidents are major health problems leading to deaths and injuries among older people. The present study was performed to investigate the characteristics of the accidents experienced within the last 1 year in people aged 60 years and older living in Antalya City Center. The study was planned as a cross-sectional research. A total of 840 individuals selected from the study population with cluster-sampling method were used in questionnaires. A number of 163 (19.4%) individuals had at least one accident in the last year. A total of 178 accidents were reported within the last 1-year; 124 (69.7%) falls, 22 (12.4%) traffic accidents and 12 (6.7%) dropping of objects to head. The accidents occurred mostly at home (40.4%), at avenue-street etc. (31.5%), and in garden (8.4%). The result of logistic regression analysis revealed that accident frequency was positively related with female gender (odds=1.79, P<0.05), disability of lower extremities (odds=1.63, P<0.05) and hearing impairment (odds=2.01, P<0.05) whereas it was negatively related with living in detached house (odds=0.41, P<0.05). It was found that accidents caused health (82.0%) and financial (38.2%) problems in elderly and also the disabilities in daily activities (66.3%). Average numbers of days with disability in daily activities were 21.1 in 1 year per accident and 5.7 in 1 year per individual. Occurrence of health problems and disability in daily activities were more frequent among women compared to men (P<0.05). Methods like environmental measures or educational programs to prevent accidents and accident-related injuries must be focused on defined risk groups and places where the accidents occur more frequently. Future researches about the effectiveness of prevention in elderly on accident frequency, mortality and morbidity are needed to deal with this current problem. PMID:12888223

  17. An Exploration of Loneliness: Communication and the Social Networks of Older People with Cerebral Palsy

    ERIC Educational Resources Information Center

    Ballin, Liora; Balandin, Susan

    2007-01-01

    Background: There is a large body of research focusing on the experiences of loneliness of older adults, yet little is known about the loneliness experiences of older adults with lifelong disability. In this paper, the authors present some findings from a larger qualitative study on the loneliness experiences of older people with cerebral palsy.…

  18. Images of Older People in UK Magazine Advertising: Toward a Typology

    ERIC Educational Resources Information Center

    Williams, Angie; Wadleigh, Paul Mark; Ylanne, Virpi

    2010-01-01

    The use of images of older people in the British advertising media has been under-researched to date. Further, previous research in any country has tended to examine such images from an "a priori" framework of general impressions and stereotypes of older people. This study addresses these issues with British consumers' (n = 106) impressions, trait…

  19. Inquiry-Based Learning for Older People at a University in Spain

    ERIC Educational Resources Information Center

    Martorell, Ingrid; Medrano, Marc; Sole, Cristian; Vila, Neus; Cabeza, Luisa F.

    2009-01-01

    With the increasing number of older people in the world and their interest in education, universities play an important role in providing effective learning methodologies. This paper presents a new instructional methodology implementing inquiry-based learning (IBL) in two courses focused on alternative energies in the Program for Older People at…

  20. Communication between Older People and Their Health Care Agents: Results of an Intervention

    ERIC Educational Resources Information Center

    Gutheil, Irene A.; Heyman, Janna C.

    2005-01-01

    This study examined an intervention to help high-functioning community-dwelling older people communicate their wishes for care at the end of life with someone they would trust to make health care decisions for them if necessary. Groups consisted of dyads of older people and their potential or designated health care agents randomly assigned to the…

  1. Older People and Learning--Some Key Statistics. NIACE Briefing Sheet.

    ERIC Educational Resources Information Center

    National Inst. of Adult Continuing Education, Leicester (England).

    This briefing sheet provides a summary of statistics (primarily from United Kingdom and Dutch surveys) that relate to the participation of older people in learning. It provides evidence of current participation, recent trends, types of learning in which older people are involved, future intentions, and correlation between learning in later life…

  2. Psychosocial Issues in Engaging Older People with Physical Activity Interventions for the Prevention of Falls

    ERIC Educational Resources Information Center

    Nyman, Samuel R.

    2011-01-01

    This article presents an overview of the psychosocial factors that influence older people's participation in physical activity interventions to prevent falls. The importance of psychosocial factors is stressed inasmuch as interventions will be rendered useless if they do not successfully gain the active participation of older people. The theory of…

  3. Older People Becoming Successful ICT Learners over Time: Challenges and Strategies through an Ethnographical Lens

    ERIC Educational Resources Information Center

    Sayago, Sergio; Forbes, Paula; Blat, Josep

    2013-01-01

    A growing ageing population and an increasing reliance on information and communication technologies (ICT) to conduct activities associated with daily living means that addressing how older people learn to use ICT is timely and important. By drawing on a four-year ethnographical study with 420 older people in two different environments, this paper…

  4. Older People and Poverty in Rural Britain: Material Hardships, Cultural Denials and Social Inclusions

    ERIC Educational Resources Information Center

    Milbourne, Paul; Doheny, Shane

    2012-01-01

    This paper explores the relations between older people, poverty and place in rural Britain. It develops previous work on rural poverty that has pointed both to the significance of older people within the rural poor population and to their denials of poverty. The paper also connects with recent discussions on the complexity of relations between…

  5. Randomized Trial of Social Rehabilitation and Integrated Health Care for Older People with Severe Mental Illness

    ERIC Educational Resources Information Center

    Mueser, Kim T.; Pratt, Sarah I.; Bartels, Stephen J.; Swain, Karin; Forester, Brent; Cather, Corinne; Feldman, James

    2010-01-01

    Objective: The Helping Older People Experience Success (HOPES) program was developed to improve psychosocial functioning and reduce long-term medical burden in older people with severe mental illness (SMI) living in the community. HOPES includes 1 year of intensive skills training and health management, followed by a 1-year maintenance phase.…

  6. Theorising the Relationship between Older People and Their Immediate Social Living Environment

    ERIC Educational Resources Information Center

    Buffel, Tine; Verte, Dominique; De Donder, Liesbeth; De Witte, Nico; Dury, Sarah; Vanwing, Tom; Bolsenbroek, Anouk

    2012-01-01

    This article presents a theoretical framework for exploring the dynamics between older people and their immediate social living environment. After introducing a gerontological perspective that goes beyond "microfication," a literature review presents findings from studies that have explored the role of place and locality for older people. Next,…

  7. How Older People Position Their Late-Life Childlessness: A Qualitative Study

    ERIC Educational Resources Information Center

    Allen, Ruth E. S.; Wiles, Janine L.

    2013-01-01

    This research explored how older people describe their paths to late-life childlessness. In-depth accounts from 38 childless older people, age 63-93, highlight the complex journeys and diverse meanings of childlessness for male and female participants, single and partnered, including some who had outlived children. Positioning theory is used to…

  8. Not Quite Color Blind: Ethnic and Gender Differences in Attitudes toward Older People among College Students

    ERIC Educational Resources Information Center

    Laditka, Sarah B.; Laditka, James N.; Houck, Margaret M.; Olatosi, Bankole A.

    2011-01-01

    Attitudes toward older people can influence how they are treated and their cognitive and physical health. The populations of the United States and many other countries have become more ethnically diverse, and are aging. Yet little research examines how ethnic diversity affects attitudes toward older people. Our study addresses this research gap.…

  9. Mental Health and Wellbeing and Lifelong Learning for Older People. NIACE Briefing Sheet 92

    ERIC Educational Resources Information Center

    National Institute of Adult Continuing Education, 2009

    2009-01-01

    This briefing sheet is about lifelong learning for people aged 50+ years and how participation in learning can help maintain and improve mental health and wellbeing in later life. There is no commonly agreed definition of "older" people, and clearly people age at different rates. However, by the mid 50s, for most people retirement is beginning to…

  10. Mild cognitive impairment and its management in older people

    PubMed Central

    Eshkoor, Sima Ataollahi; Hamid, Tengku Aizan; Mun, Chan Yoke; Ng, Chee Kyun

    2015-01-01

    Mild cognitive impairment (MCI) is a common condition in the elderly. It is characterized by deterioration of memory, attention, and cognitive function that is beyond what is expected based on age and educational level. MCI does not interfere significantly with individuals’ daily activities. It can act as a transitional level of evolving dementia with a range of conversion of 10%–15% per year. Thus, it is crucial to protect older people against MCI and developing dementia. The preventive interventions and appropriate treatments should improve cognitive performance, and retard or prevent progressive deficits. The avoidance of toxins, reduction of stress, prevention of somatic diseases, implementation of mental and physical exercises, as well as the use of dietary compounds like antioxidants and supplements can be protective against MCI. The modification of risk factors such as stopping smoking, as well as the treatment of deficiency in vitamins and hormones by correcting behaviors and lifestyle, can prevent cognitive decline in the elderly. The progressive increase in the growth rate of the elderly population can enhance the rate of MCI all over the world. There is no exact cure for MCI and dementia; therefore, further studies are needed in the future to determine causes of MCI and risk factors of progression from MCI to dementia. This will help to find better ways for prevention and treatment of cognitive impairment worldwide. PMID:25914527

  11. Mild cognitive impairment and its management in older people.

    PubMed

    Eshkoor, Sima Ataollahi; Hamid, Tengku Aizan; Mun, Chan Yoke; Ng, Chee Kyun

    2015-01-01

    Mild cognitive impairment (MCI) is a common condition in the elderly. It is characterized by deterioration of memory, attention, and cognitive function that is beyond what is expected based on age and educational level. MCI does not interfere significantly with individuals' daily activities. It can act as a transitional level of evolving dementia with a range of conversion of 10%-15% per year. Thus, it is crucial to protect older people against MCI and developing dementia. The preventive interventions and appropriate treatments should improve cognitive performance, and retard or prevent progressive deficits. The avoidance of toxins, reduction of stress, prevention of somatic diseases, implementation of mental and physical exercises, as well as the use of dietary compounds like antioxidants and supplements can be protective against MCI. The modification of risk factors such as stopping smoking, as well as the treatment of deficiency in vitamins and hormones by correcting behaviors and lifestyle, can prevent cognitive decline in the elderly. The progressive increase in the growth rate of the elderly population can enhance the rate of MCI all over the world. There is no exact cure for MCI and dementia; therefore, further studies are needed in the future to determine causes of MCI and risk factors of progression from MCI to dementia. This will help to find better ways for prevention and treatment of cognitive impairment worldwide. PMID:25914527

  12. Unique factors that place older Hispanic women at risk for HIV: intimate partner violence, machismo, and marianismo.

    PubMed

    Cianelli, Rosina; Villegas, Natalia; Lawson, Sarah; Ferrer, Lilian; Kaelber, Lorena; Peragallo, Nilda; Yaya, Alexandra

    2013-01-01

    Hispanic women who are 50 years of age and older have been shown to be at increased risk of acquiring HIV infection due to age and culturally related issues. The purpose of our study was to investigate factors that increase HIV risk among older Hispanic women (OHW) as a basis for development or adaptation of an age and culturally tailored intervention designed to prevent HIV-related risk behaviors. We used a qualitative descriptive approach. Five focus groups were conducted in Miami, Florida, with 50 participants. Focus group discussions centered around eight major themes: intimate partner violence (IPV), perimenopausal-postmenopausal-related biological changes, cultural factors that interfere with HIV prevention, emotional and psychological changes, HIV knowledge, HIV risk perception, HIV risk behaviors, and HIV testing. Findings from our study stressed the importance of nurses' roles in educating OHW regarding IPV and HIV prevention. PMID:23790277

  13. Pain Assessment with Cognitively Impaired Older People in the Acute Hospital Setting

    PubMed Central

    2011-01-01

    Research reveals that older people continue to experience much suffering from acute and chronic pain conditions. People with cognitive impairment receive less analgesia than their cognitively intact peers. Postoperative pain assessment with older people in the acute hospital setting remains a challenge. Context and culture have a significant impact of pain assessment practices. Due to a paucity of research exploring how pain assessment and management practices with cognitively impaired older people may be realised in the acute hospital setting, there is a need for further research to be conducted. PMID:26524985

  14. The use of statins in people at risk of developing diabetes mellitus: evidence and guidance for clinical practice.

    PubMed

    Sattar, Naveed A; Ginsberg, Henry; Ray, Kausik; Chapman, M John; Arca, Marcello; Averna, Maurizio; Betteridge, D John; Bhatnagar, Deepak; Bilianou, Elena; Carmena, Rafael; Ceška, Richard; Corsini, Alberto; Erbel, Raimund; Flynn, Paul D; Garcia-Moll, Xavier; Gumprecht, Janusz; Ishibashi, Shun; Jambart, Selim; Kastelein, John J P; Maher, Vincent; da Silva, Pedro Marques; Masana, Luis; Odawara, Masato; Pedersen, Terje R; Rotella, Carlo Maria; Salti, Ibrahim; Teramoto, Tamio; Tokgozoglu, Lale; Toth, Peter P; Valensi, Paul; Vergès, Bruno

    2014-06-01

    Reducing low-density lipoprotein cholesterol (LDL-C) levels using statins is associated with significant reductions in cardiovascular (CV) events in a wide range of patient populations. Although statins are generally considered to be safe, recent studies suggest they are associated with an increased risk of developing Type 2 diabetes (T2D). This led the US Food and Drug Administration (FDA) to change their labelling requirements for statins to include a warning about the possibility of increased blood sugar and HbA1c levels and the European Medicines Agency (EMA) to issue guidance on a small increased risk of T2D with the statin class. This review examines the evidence leading to these claims and provides practical guidance for primary care physicians on the use of statins in people with or at risk of developing T2D. Overall, evidence suggests that the benefits of statins for the reduction of CV risk far outweigh the risk of developing T2D, especially in individuals with higher CV risk. To reduce the risk of developing T2D, physicians should assess all patients for T2D risk prior to starting statin therapy, educate patients about their risks, and encourage risk-reduction through lifestyle changes. Whether some statins are more diabetogenic than others requires further study. Statin-treated patients at high risk of developing T2D should regularly be monitored for changes in blood glucose or HbA1c levels, and the risk of conversion from pre-diabetes to T2D should be reduced by intensifying lifestyle changes. Should a patient develop T2D during statin treatment, physicians should continue with statin therapy and manage T2D in accordance with relevant national guidelines. PMID:24840509

  15. Reducing emergency bed-days for older people? Network governance lessons from the 'Improving the Future for Older People' programme.

    PubMed

    Sheaff, Rod; Windle, Karen; Wistow, Gerald; Ashby, Sue; Beech, Roger; Dickinson, Angela; Henderson, Catherine; Knapp, Martin

    2014-04-01

    In 2007, the UK government set performance targets and public service agreements to control the escalation of emergency bed-days. Some years earlier, nine English local authorities had each created local networks with their health and third sector partners to tackle this increase. These networks formed the 'Improving the Future for Older People' initiative (IFOP), one strand of the national 'Innovation Forum' programme, set up in 2003. The nine sites set themselves one headline target to be achieved jointly over three years; a 20 per cent reduction in the number of emergency bed-days used by people aged 75 and over. Three ancillary targets were also monitored: emergency admissions, delayed discharges and project sustainability. Collectively the sites exceeded their headline target. Using a realistic evaluation approach, we explored which aspects of network governance appeared to have contributed to these emergency bed-day reductions. We found no simple link between network governance type and outcomes. The governance features associated with an effective IFOP network appeared to suggest that the selection and implementation of a small number of evidence-based services was central to networks' effectiveness. Each service needed to be coordinated by a network-based strategic group and hierarchically implemented at operational level by the responsible network member. Having a network-based implementation group with a 'joined-at-the-top' governance structure also appeared to promote network effectiveness. External factors, including NHS incentives, health reorganisations and financial targets similarly contributed to differences in performance. Targets and financial incentives could focus action but undermine horizontal networking. Local networks should specify which interventions network structures are intended to deliver. Effective projects are those likely to be evidence based, unique to the network and difficult to implement through vertical structures alone. PMID

  16. Central Auditory Dysfunction in Older People with Memory Impairment or Alzheimer's Dementia

    PubMed Central

    Gates, George A.; Anderson, Melissa L.; Feeney, M. Patrick; McCurry, Susan M.; Larson, Eric B.

    2009-01-01

    Central auditory function is commonly compromised in people with a diagnosis of Alzheimer's disease (AD) and may precede the onset of clinical dementia by several years. Given that screening for AD in its earliest stages might someday be useful for emerging therapies aimed at limiting progression, we inquired whether central auditory testing might be suitable for identifying people at risk for dementia. To address this question, we performed a battery of behavioral central auditory tests in a cohort of 313 older people enrolled in a dementia surveillance research program. The cohort consisted of three groups: controls without memory loss (N=232), targets with mild memory impairment but without dementia (N=64), and targets with a dementia diagnosis (N=17). The auditory tests were the Synthetic Sentence Identification with Ipsilateral Competing Message (SSI), the Dichotic Sentence Identification test (DSI), the Dichotic Digits Test (DDT), and the Pitch Pattern Sequence (PPS) test. Additional control was provided by electrophysiologic testing to assess the integrity of the primary auditory pathways. The mean score on each central auditory test worsened significantly across the three memory groups even after adjusting for age and peripheral hearing status, being poorest in the pAD group and moderately reduced in the memory-impaired group compared to the mean scores in the control group. Heterogeneity of results was noted in all three groups. The electrophysiologic tests did not differ across the three groups. Central auditory function was affected by mild memory impairment. The Dichotic Sentence Identification in the free report mode appears to be the central auditory test most sensitive to the presence of memory impairment. Although central auditory testing requires specialized equipment and training, the objectivity of these tests is appealing. We recommend that comprehensive auditory testing be considered and further evaluated for its potential value as a baseline

  17. Social Peptides: Measuring Urinary Oxytocin and Vasopressin in a Home Field Study of Older Adults at Risk for Dehydration

    PubMed Central

    Galinsky, Adena M.; Hoffmann, Joscelyn N.; You, Hannah M.; Ziegler, Toni E.; McClintock, Martha K.

    2014-01-01

    Objectives. We present the novel urine collection method used during in-home interviews of a large population representative of older adults in the United States (aged 62–91, the National Social Life, Health and Aging Project). We also present a novel assay method for accurately measuring urinary peptides oxytocin (OT) and vasopressin (AVP), hormones that regulate social behaviors, stress, and kidney function. Method. Respondents in a randomized substudy (N = 1,882) used airtight containers to provide urine specimens that were aliquoted, stored under frozen refrigerant packs and mailed overnight for frozen storage (−80 °C). Assays for OT, AVP, and creatinine, including freeze-thaw cycles, were refined and validated. Weighted values estimated levels in the older U.S. population. Results. Older adults had lower OT, but higher AVP, without the marked gender differences seen in young adults. Mild dehydration, indicated by creatinine, specific gravity, acidity, and AVP, produced concentrated urine that interfered with the OT assay, yielding falsely high values (18% of OT). Creatinine levels (≥1.4mg/ml) identified such specimens that were diluted to solve the problem. In contrast, the standard AVP assay was unaffected (97% interpretable) and urine acidity predicted specimens with low OT concentrations. OT and AVP assays tolerated 2 freeze-thaw cycles, making this protocol useful in a variety of field conditions. Discussion. These novel protocols yielded interpretable urinary OT and AVP values, with sufficient variation for analyzing their social and physiological associations. The problem of mild dehydration is also likely common in animal field studies, which may also benefit from these collection and assay protocols. PMID:25360024

  18. Establishing the cause of memory loss in older people.

    PubMed

    Chouliaras, Leonidas; Topiwala, Anya; Cristescu, Tamara; Ebmeier, Klaus P

    2015-01-01

    Common causes of memory loss in older people are mild cognitive impairment, the various types of dementia, and psychiatric illness, mainly depression. Around 10% of patients with mild cognitive impairment progress to dementia each year. Alzheimer's disease accounts for 60-80% of cases. Other common types of dementia are vascular, fronto-temporal, Lewy body, Parkinson's, and mixed type dementia. There is evidence to suggest that dementia pathology is established before the onset of symptoms, and thus mild cognitive impairment can be considered as a predementia stage. NICE guidance suggests examination of: attention, concentration, short- and long-term memory, praxis, language and executive function. Particular attention should be paid to any signs of neglect, state of dress, agitation or poor attention. Dysphasia and difficulty in naming objects is often present. Mood symptoms (including suicidal ideation) may be primary or comorbid. Abnormal thoughts and perceptions should be probed for, as psychotic symptoms are common. Primary care options for cognitive testing include the General Practitioner Assessment of Cognition or the Abbreviated Mental Test Score. Physical examination should include observation of gait, inspection for tremor; examination for rigidity, bradykinesia, frontal release signs, upper motor neurone lesions, pulse and BP. Structural brain imaging can improve diagnostic accuracy, exclude other pathologies and act as a prognostic marker of dementia progression but the overlap in structural changes between the dementias makes imaging alone insufficient for diagnostic purposes. NICE guidelines recommend referral to a memory clinic for patients with mild cognitive impairment, those at high risk of dementia, such as patients with learning disabilities, Parkinson's disease, or patients who have had several strokes. PMID:25726616

  19. Iterative Evaluation in a Mobile Counseling and Testing Program to Reach People of Color at Risk for HIV--New Strategies Improve Program Acceptability, Effectiveness, and Evaluation Capabilities

    ERIC Educational Resources Information Center

    Spielberg, Freya; Kurth, Ann; Reidy, William; McKnight, Teka; Dikobe, Wame; Wilson, Charles

    2011-01-01

    This article highlights findings from an evaluation that explored the impact of mobile versus clinic-based testing, rapid versus central-lab based testing, incentives for testing, and the use of a computer counseling program to guide counseling and automate evaluation in a mobile program reaching people of color at risk for HIV. The program's…

  20. Higher Education and Older People: Some Theoretical Considerations, Part II.

    ERIC Educational Resources Information Center

    Covey, Herbert C.

    1983-01-01

    Describes disengagement, activity, lifespan, subcultural, and continuity theories of social gerontology in light of participation in higher education by older students. Argues that continuity theory holds the most promise in accounting for older students. Emphasizes the need to stress the positive roles of old age. (JAC)

  1. Evaluation of a Medicine Information Training Program for Older People.

    ERIC Educational Resources Information Center

    Quine, Susan

    1998-01-01

    Australian older adults were trained to act as advocates and role models to inform peers on effective use of medicines. Trainees reported difficulties experienced by older learners when training is too concentrated. Many noted increased self-esteem and personal growth as a result of their involvement. (SK)

  2. Older people's views on what they need to successfully adjust to life with a hearing aid

    PubMed Central

    Kelly, Timothy B; Tolson, Debbie; Day, Tracy; McColgan, Gillian; Kroll, Thilo; Maclaren, William

    2013-01-01

    This article reports a study exploring what older people believe would enable them to adjust to and gain maximum benefit from wearing a hearing aid. A mixed methods approach was employed during 2006 involving interviews with key stakeholders, a survey across three Scottish health board areas and focus groups. Nine key stakeholders from six national and local organisations were interviewed about the needs of older people being fitted with hearing aids. In total, 240 older people belonging to three different types of hearing impaired older people were surveyed: long-term users of hearing aids, new hearing aid users, and those on a waiting list from urban and rural areas (response rate = 24%). A series of eight follow-up focus groups with 31 audiology patients was held. Health professionals appeared to neglect appropriate provision of information and overly rely on technological interventions. Of 154 older people already fitted with hearing aids, only 52% of hearing aid users reported receiving enough practical help post fitting and only 41% reported receiving enough support. Approximately 40% reported not feeling confident in the use of their aids or their controls. Older people wanted more information than they received both before and after hearing aid fitting. Information provision and attention to the psychosocial aspects of care are key to enabling older people to adjust and optimise hearing aid benefit. PMID:23373520

  3. Partnership research with older people - moving towards making the rhetoric a reality.

    PubMed

    Reed, Jan; Weiner, Robert; Cook, Glenda

    2004-03-01

    As nursing develops closer partnerships with older people in delivering care, it also needs to develop partnerships in order to create the knowledge base for practice in a way that challenges professional hegemony and empowers older people. However, the process of developing partnerships in research takes place against a background of academic research traditions and norms, which can present obstacles to collaboration. This paper is a reflection on the issues that have arisen in three projects where older people were involved in research at different levels, from sources of data to independent researchers. It points to some of the areas that need further exploration and development. PMID:15028033

  4. Vision and falls in older people: risk factors and intervention strategies.

    PubMed

    Lord, Stephen R; Smith, Stuart T; Menant, Jasmine C

    2010-11-01

    Poor vision impairs balance and increases the risk of falls and fractures in older people. Multifocal glasses can add to this risk by impairing contrast sensitivity, depth perception, and ability to negotiate obstacles. Vision assessment and provision of new spectacles may not reduce, and may even increase, the risk of falls. Restriction of the use of multifocal glasses may reduce falls in active older people. Other effective fall prevention strategies include maximizing vision through cataract surgery and occupational therapy interventions in visually impaired older people. PMID:20934611

  5. Safer Wards: reducing violence on older people's mental health wards

    PubMed Central

    Brown, Juliette; Fawzi, Waleed; McCarthy, Cathy; Stevenson, Carmel; Kwesi, Solomon; Joyce, Maggie; Dusoye, Jenny; Mohamudbucus, Yasin; Shah, Amar

    2015-01-01

    Through the Safer Wards project we aimed to reduce the number of incidents of physical violence on older people's mental health wards. This was done using quality improvement methods and supported by the Trust's extensive programme of quality improvement, including training provided by the Institute for Healthcare Improvement. Violence can be an indicator of unmet needs in this patient population, with a negative effect on patient care and staff morale. Reducing harm to patients and staff is a strategic aim of our Trust. We established a multi-disciplinary group who led on the project on each ward and used a Pareto diagram to establish the focus of our work. We established a dashboard of measures based on our incident reporting system Datix, including number of incidents of violence, days between incidents, days of staff sickness, days between staff injury, use of restraint, and use of rapid tranquilisation (the last two being balancing measures in the reduction of violence). Each team identified factors driving physical violence on the wards, under headings of unmet patient needs, staff needs and staff awareness, which included lack of activity and a safe and therapeutic environment. Using driver diagrams, we identified change ideas that included hourly rounding (proactive checks on patient well-being), the addition of sensory rooms, flexible leave for patients, and a structured activity programme. We also introduced exercise to music, therapeutic groups led by patients, and focused on discharge planning and pet therapy, each of which starting sequentially over the course of a one year period from late 2013 and subject to a cycle of iterative learning using PDSA methods. The specific aim was a 20% decrease in violent incidents on three wards in City and Hackney, and Newham. Following our interventions, days between violent incidents increased from an average of three to an average of six. Days between staff injury due to physical violence rose from an average of

  6. Safer Wards: reducing violence on older people's mental health wards.

    PubMed

    Brown, Juliette; Fawzi, Waleed; McCarthy, Cathy; Stevenson, Carmel; Kwesi, Solomon; Joyce, Maggie; Dusoye, Jenny; Mohamudbucus, Yasin; Shah, Amar

    2015-01-01

    Through the Safer Wards project we aimed to reduce the number of incidents of physical violence on older people's mental health wards. This was done using quality improvement methods and supported by the Trust's extensive programme of quality improvement, including training provided by the Institute for Healthcare Improvement. Violence can be an indicator of unmet needs in this patient population, with a negative effect on patient care and staff morale. Reducing harm to patients and staff is a strategic aim of our Trust. We established a multi-disciplinary group who led on the project on each ward and used a Pareto diagram to establish the focus of our work. We established a dashboard of measures based on our incident reporting system Datix, including number of incidents of violence, days between incidents, days of staff sickness, days between staff injury, use of restraint, and use of rapid tranquilisation (the last two being balancing measures in the reduction of violence). Each team identified factors driving physical violence on the wards, under headings of unmet patient needs, staff needs and staff awareness, which included lack of activity and a safe and therapeutic environment. Using driver diagrams, we identified change ideas that included hourly rounding (proactive checks on patient well-being), the addition of sensory rooms, flexible leave for patients, and a structured activity programme. We also introduced exercise to music, therapeutic groups led by patients, and focused on discharge planning and pet therapy, each of which starting sequentially over the course of a one year period from late 2013 and subject to a cycle of iterative learning using PDSA methods. The specific aim was a 20% decrease in violent incidents on three wards in City and Hackney, and Newham. Following our interventions, days between violent incidents increased from an average of three to an average of six. Days between staff injury due to physical violence rose from an average of

  7. “More than I Expected”: Perceived Benefits of Yoga Practice among Older Adults at Risk for Cardiovascular Disease

    PubMed Central

    Alexander, Gina K.; Innes, Kim E.; Selfe, Terry K.; Brown, Cynthia J.

    2012-01-01

    Objective This study was conducted with participants from trials examining the effects of an Iyengar yoga program on cardiovascular disease risk. The objective of the current study was to evaluate the perceived benefits of yoga in a population of older, predominantly overweight adults participating in a gentle 8-week yoga program. Design This study used a constructivist-interpretive approach to naturalistic inquiry. Setting A total of 42 participants completed the intervention and met the inclusion criteria for the current qualitative study. Intervention The 8-week Iyengar yoga program included two 90-minute yoga classes and five 30-minute home sessions per week. Participants completed weekly logs and an exit questionnaire at the end of the study. Main Outcome Measures Qualitative data from weekly logs and exit questionnaires were compiled and conventional content analysis performed with the use of ATLAS.ti to facilitate the process. Results Four broad themes emerged from content analysis: Practicing yoga improved overall physical function and capacity (for 83% of participants); practicing yoga reduced stress/anxiety and enhanced calmness (83% of participants); practicing yoga enriched the quality of sleep (21% of participants); and practicing yoga supported efforts toward dietary improvements (14% of participants). Conclusions These results suggest that yoga may have ancillary benefits in terms of improved physical function, enhanced mental/emotional state, enriched sleep quality, and improved lifestyle choices, and may be useful as a health promotion strategy in the prevention and management of chronic disease. PMID:23374201

  8. Confidence and Expectations about Caring for Older People with Dementia: A Cross-Sectional Survey of Student Nurses

    ERIC Educational Resources Information Center

    Baillie, Lesley; Merritt, Jane; Cox, Janet; Crichton, Nicola

    2015-01-01

    Older people who are living with dementia often need healthcare, including hospital admissions, due to additional health conditions. Caring for older people who are living with dementia is, therefore, a core nursing role. This study investigated student nurses' expectations of, and confidence about, caring for older people with dementia and the…

  9. Working...with Foreign Languages, with Older People, or Outdoors.

    ERIC Educational Resources Information Center

    Bluford, Verada; Dillon, Conley Hall, Jr.

    1995-01-01

    Describes employment outlook, working conditions, and training requirements for three types of jobs: language related (teachers, interpreters, finance), working with older adults (social and health services), and working outdoors (agriculture, construction, engineering, fishing, forestry, mining, recreation). (SK)

  10. Diabetes in Older People - A Disease You Can Manage

    MedlinePlus

    ... Aging Diabetes In Older People—A Disease You Can Manage What Is Diabetes? Types Of Diabetes Pre- ... your diabetes in case of an emergency. Medicare Can Help Medicare will pay to help you learn ...

  11. On the threshold: older people's concerns about needs after discharge from hospital.

    PubMed

    Gabrielsson-Järhult, Felicia; Nilsen, Per

    2016-03-01

    Discharge from hospital is often strenuous for older people and requires adjustments from living an independent life to being in need of care and support. This study aims to explore older people's concerns about their needs after discharge. Twenty-seven observations recorded at hospital discharge planning meetings were analysed with content analysis. An overarching theme emerged: being in a life transition, which reflected the older person's vulnerable and ambiguous situation in the discharge process. The theme was developed from three categories: obtaining a secure life situation, need of continuous care and support, and influencing and regaining independence. The findings highlight that older patients want to influence their care after discharge. They strive to regain independence and express their concerns about how to obtain a secure life situation through care organised to fit their individual needs. Knowledge about older people's concerns is important for healthcare providers and social workers involved in planning and individualised care and services. PMID:25919854

  12. Emergency service use by older people in Samsun, Turkey.

    PubMed

    Dundar, Cihad; Sunter, A Tevfik; Canbaz, Sevgi; Cetinoglu, Erhan

    2006-01-01

    During the first 50 years of the 21st century, the world population aged 65 and older is expected to triple. Proper care of the older patient is one of the major priorities of many health care systems. In this descriptive study, patients treated and transported by 112 Emergency Help and Rescue Service in Samsun Province during the year 2004 were surveyed through review of command center records. All patients who were 65 years of age and older were included in the study. Collected data included patient sex and age, number of patients accessing emergency medical service (EMS) per hours of the day and per season, clinical diagnosis, and patient outcomes. In all, 2210 patients aged 65 years and older were identified; this group accounted for 24.5% of all records reviewed (n=9015). The rate of EMS use was highest in those older than 65 years of age (26 of 1000/y). Similar associations of ambulance transportation with older age and off-hour presentation were noted, as was increased usage during colder months of the year. Cardiovascular, neurologic, and respiratory problems were the 3 most frequent reasons for use of EMS. In almost three fourths of cases, outcome was recorded as transport to the hospital. Data presented here highlight the need for continued monitoring of EMS usage patterns so that planners will be prepared to accommodate the needs of the increasingly aging population. PMID:16644606

  13. Cultural and gender differences in coping strategies between Caucasian American and Korean American older people.

    PubMed

    Lee, HeeSoon; Mason, Derek

    2014-12-01

    Coping strategies have significant effects on older people's health. This study examined whether gender and ethnic differences influence the coping strategies chosen by older adults when they encounter daily life stressors. Data were collected from 444 community-dwelling people over the age of 65, including 238 Caucasian Americans and 206 Korean Americans. Results showed significant differences between the two groups. Korean Americans had higher scores on problem and emotion-focused coping strategies as well as avoidant coping strategies than Caucasian Americans. Caucasian older women employed more active coping, planning, and positive reframing skills; relied more on religion; and sought emotional support more than Caucasian men. For Korean Americans, older women utilized religion and denial; whereas older men employed instrumental support and substance abuse. The results suggest that practitioners should develop ethnic, gender-specific programs to help older adults cope more effectively with their daily life stressors. PMID:25260229

  14. In Hospital We Trust: Experiences of older peoples' decision to seek hospital care.

    PubMed

    Hallgren, Jenny; Ernsth Bravell, Marie; Dahl Aslan, Anna K; Josephson, Iréne

    2015-01-01

    The purpose of this study was to explore how older people experience and perceive decisions to seek hospital care while receiving home health care. Twenty-two Swedish older persons were interviewed about their experiences of decision to seek hospital while receiving home health care. The interviews were analyzed using qualitative content analysis. The findings consist of one interpretative theme describing an overall confidence in hospital staff to deliver both medical and psychosocial health care, In Hospital We Trust, with three underlying categories: Superior Health Care, People's Worries, and Biomedical Needs. Findings indicate a need for establishing confidence and ensuring sufficient qualifications, both medical and psychological, in home health care staff to meet the needs of older people. Understanding older peoples' arguments for seeking hospital care may have implications for how home care staff address individuals' perceived needs. Fulfillment of perceived health needs may reduce avoidable hospitalizations and consequently improve quality of life. PMID:25971421

  15. Imagery and Imaginary of Islander Identity: Older People and Migration in Irish Small-Island Communities

    ERIC Educational Resources Information Center

    Burholt, Vanessa; Scharf, Thomas; Walsh, Kieran

    2013-01-01

    This article examines the imagery and imaginaries of islander identity and makes an original contribution to the fields of gerontology and nissology. Drawing on data collected through in-depth interviews with 19 older residents of two small-island communities located off the island of Ireland, we address the central roles played by older people in…

  16. The Effects of an Education Program on Home Renovation for Fall Prevention of Korean Older People

    ERIC Educational Resources Information Center

    Jang, Miseon; Lee, Yeunsook

    2015-01-01

    This study aims to verify the effects of an education program on home renovation for fall prevention among older people, more specifically fall efficacy and home renovation intentions. A quasiexperimental study with nonequivalent control and comparative groups was conducted to demonstrate the effects of the education. A total of 51 older people…

  17. Considerations of prescription opioid abuse and misuse among older adults in West Virginia--An Under-Recognized Population at Risk.

    PubMed

    Grey, Carl; Hall, P Bradley

    2016-01-01

    Opioid abuse, misuse and overdose is now a public health epidemic receiving political, medical, and media attention at all levels. Despite the fact that many people know someone suffering from addiction, there is very little research focusing on this issue in older adults. Chronic pain, a highly prevalent affliction for the aging population, has been accompanied by a significant increase in opioid use. This, along with some unique aspects of older adults (increased susceptibility to illness, higher likelihood of altered presentation of illness, and impaired recovery), means that great care needs to be taken when considering opioids for treatment. Prudent prescribing is possible, but universal precautions should be taken to reduce the risk of opioid abuse, misuse, and addiction. This review provides education, summarizes current literature, and gives guidance in universal precautions for prescribing opioids. PMID:27301154

  18. Powerlessness of older people in Hong Kong: a political economy analysis.

    PubMed

    Kam, Ping-kwong

    2003-01-01

    Gerontologists agree that old age can be associated with an increase in powerlessness both in the personal domain and in the social and political fields. This paper is an attempt to understand the concept of powerlessness in old age within a political economy theoretical framework. The paper argues that the powerlessness of older people is not biologically determined. Rather, it is socially constructed. It has its roots in the social, economic, and political structure of society. For this reason, the paper argues that (a) the capitalist economic system discriminates against and marginalizes older people in the labor market. The current unfavorable economic climate will make the economic situation of older people worse. (b) The residual welfare system does not counteract the unfavorable impact of the economic system. Rather, it deprives older people of the necessary financial resources and social service supports that would enable them to lead independent and dignified lives. (c) The authoritarian political system creates adverse conditions that make it very difficult for older people to participate in the decision-making process on issues that affect their lives, as well as on broader political issues that affect the whole of society. It is the interplay among these economic, social, and political forces in Hong Kong that creates the political economy of powerlessness in old age and prevents older people from using their powers to master and control their lives. PMID:14733445

  19. Dimensions of Housing Deprivation for Older People in Ireland

    ERIC Educational Resources Information Center

    Nolan, Brian; Winston, Nessa

    2011-01-01

    Housing is an important aspect of living standards and quality of life for older persons, but the housing-related problems they may face encompass rather different circumstances, relating to the condition of the dwelling, how well equipped it is, whether housing costs represent a serious burden, and whether the neighbourhood environment is…

  20. Family, Close Relatives, Friends: Life Satisfaction among Older People

    ERIC Educational Resources Information Center

    Sener, Arzu; Oztop, Hulya; Dogan, Nuri; Guven, Seval

    2008-01-01

    This study examined the influence of socioeconomic (age, education, marital status, income, and health) and demographic variables and the quantity and quality of relationships with adult children, grandchildren, siblings and friends on life satisfaction of the elderly. Participants were 200 persons older than 60 years of age. Hierarchical…

  1. Adventure as Therapy: Using Adventure as Part of Therapeutic Programmes with Young People in Trouble and at Risk.

    ERIC Educational Resources Information Center

    McNutt, Brendan

    This paper defines "adventure-based intervention,""young people," and "trouble and risk" in light of the therapeutic work done at Bryn Melyn Community (Bala, Wales), a therapeutic treatment center. Bryn Melyn provides intensive individualized therapy to young people, aged 15-18, who are in the care of social services departments. Each teenager has…

  2. The “Younger-Sibling-at-Risk Design”: a Pilot Study of Adolescents with ADHD and an Older Sibling with Substance Use Disorder

    PubMed Central

    Donovan, Stephen J.; Levin, Frances R.

    2011-01-01

    Introduction This article introduces a “younger at-risk sibling” design to study progression from other psychopathologies to their substance use disorder (SUD) complications. The design selects not-yet-SUD adolescents with high-risk-for-SUD psychopathology only if an older sibling has SUD. This “proof of concept” pilot study examines the design’s feasibility if the younger sibling has attention deficit hyperactivity disorder (ADHD). Method Subjects were recruited from families at substance abuse treatment centers that had a non-SUD younger child with ADHD, from families at behavior disorder clinics that had a younger child with ADHD and SUD older child, and through general advertisements. Subjects were seen weekly for at least 3 months and monthly thereafter for 3 months. All were treated with open-label lisdexamfetamine dimesylate 30–70 mg per day. Outcomes explored were recruitment, compliance, diversion, ADHD improvement, and substance use interest. Results 25 families were screened, 13 evaluated, and 8 began medication. ADHD Rating Scale-IV scores obtained by parent adolescent consensus improved as expected with a stimulant. Rating forms could quantify substance use interest in subjects with some drug culture exposure but encountered a floor effect in those without. The design’s complexity and implicit commentary on family dynamics complicated recruitment but may have facilitated retention. Conclusion Sibling pairs in which the older sibling has substance use and the younger sibling has ADHD exist. Such younger siblings can be recruited into a treatment study. The design may shed light on the pathogenesis and prevention of SUD complications from ADHD and theoretically other SUD comorbidities. PMID:21517711

  3. Advertising Representations of Older People in the United Kingdom and Taiwan: A Comparative Analysis.

    PubMed

    Chen, Chin-Hui

    2015-01-01

    Cross-cultural studies of advertising representations of older people are relatively scarce. This article aims to fill in this gap via a comparison between Taiwan and the United Kingdom, employing a combination of quantitative content analysis and the qualitative grounded theory method. The content-analysis phase reveals underrepresentation of older people in both countries' advertising contexts, as well as representational differences between Taiwan and the United Kingdom in terms of older characters' role salience, the products, physical settings, and social networks they are associated with. The grounded-theory phase yields nine prototypes of older people along with subcategories to conceptualize the qualities of older people as they appear in TV ads in these countries. The findings are discussed in relation to the stereotyping of older people and transformed into hypothetical statements to be modified in future research. In conclusion, the Confucian tradition of filial piety is still found to be important in explaining the observed cross-cultural differences, but the emergence of new norms about aging in Taiwanese advertising also suggests that this tradition may be in decline. PMID:26243326

  4. Methodology for developing quality indicators for the care of older people in the Emergency Department

    PubMed Central

    2013-01-01

    Background Compared with younger people, older people have a higher risk of adverse health outcomes when presenting to emergency departments. As the population ages, older people will make up an increasing proportion of the emergency department population. Therefore it is timely that consideration be given to the quality of care received by older persons in emergency departments, and to consideration of those older people with special needs. Particular attention will be focused on important groups of older people, such as patients with cognitive impairment, residents of long term care and patients with palliative care needs. This project will develop a suite of quality indicators focused on the care of older persons in the emergency department. Methods/design Following input from an expert panel, an initial set of structural, process, and outcome indicators will be developed based on thorough systematic search in the scientific literature. All initial indicators will be tested in eight emergency departments for their validity and feasibility. Results of the data from the field studies will be presented to the expert panel at a second meeting. A suite of Quality Indicators for the older emergency department population will be finalised following a formal voting process. Discussion The predicted burgeoning in the number of older persons presenting to emergency departments combined with the recognised quality deficiencies in emergency department care delivery to this population, highlight the need for a quality framework for the care of older persons in emergency departments. Additionally, high quality of care is associated with improved survival & health outcomes of elderly patients. The development of well-selected, validated and economical quality indicators will allow appropriate targeting of resources (financial, education or quality management) to improve quality in areas with maximum potential for improvement. PMID:24314126

  5. Primary care professionals' perceptions of depression in older people: a qualitative study.

    PubMed

    Murray, Joanna; Banerjee, Sube; Byng, Richard; Tylee, Andre; Bhugra, Dinesh; Macdonald, Alastair

    2006-09-01

    An understanding of patients' perspectives is crucial to improving engagement with health care services. For older people who may not wish to bother medical professionals with problems of living such as depression, such exploration becomes critical. General practitioners (GPs), nurses and counsellors working in 18 South London primary care teams were interviewed about their perceptions of depression in older people. All three professional groups shared a predominantly psychosocial model of the causes of depression. While presentation of somatic symptoms was seen as common in all age groups, identification of depression in older patients was complicated by co-existent physical illnesses. GPs reported that older patients rarely mentioned psychological difficulties, but practice nurses felt that older people were less inhibited in talking to them about "non-medical" problems. Many older people were perceived to regard symptoms of depression as a normal consequence of ageing and not to think it appropriate to mention non-physical problems in a medical consultation. Men were thought to be particularly reluctant to disclose emotional distress and were more vulnerable to severe depression and suicide. Some GPs had mixed feelings about offering medication to address what they believed to be the consequences of loneliness and social isolation. Participants thought that many older people regard depression as a "sign of weakness" and the perceived stigma of mental illness was widely recognised as a barrier to seeking help. Cultural variations in illness beliefs, especially the attribution of symptoms, were thought to profoundly influence the help-seeking behaviour of elders from minority ethnic groups. Families were identified as the main source of both support and distress; and as such their influence could be crucial to the identification and treatment of depression in older people. PMID:16698157

  6. The Role of Housing Space in Determining Freedom and Flourishing in Older People

    ERIC Educational Resources Information Center

    Gilroy, Rose

    2005-01-01

    This paper takes as its central thesis Martha Nussbaum's normative proposition that social arrangements should be evaluated primarily according to the extent of freedom people have to promote or achieve functionings they value. Using this as a lens the paper explores the housing circumstances of older people in the UK. The paper makes three…

  7. Relating to Older People Evaluation (ROPE): A Measure of Self-Reported Ageism

    ERIC Educational Resources Information Center

    Cherry, Katie E.; Palmore, Erdman

    2008-01-01

    The Relating to Older People Evaluation (ROPE) is a 20-item questionnaire that measures positive and negative ageist behaviors that people may engage in during everyday life. In this article, we report the first findings from several administrations of the ROPE along with initial psychometric information on the instrument. Respondents were college…

  8. Patient safety and hydration in the care of older people.

    PubMed

    Burns, Julie

    2016-05-01

    Ensuring patients are adequately hydrated is a fundamental part of nursing care, however, it is clear from the literature that dehydration remains a significant problem in the NHS with implications for patient safety. The development of dehydration is often multifactorial and older age is an independent risk factor for the condition. However, the media often blame nursing staff for simply not giving patients enough to drink. This article discusses the scale of the problem in acute care settings and aims to raise awareness of the importance of hydration management and accurate documentation in nursing practice. It suggests that intentional hourly rounding may provide an opportunity for nurses to ensure older patients are prompted or assisted to take a drink. PMID:27125939

  9. Functional Balance and Its Determinants in Older People with Diabetes

    PubMed Central

    Tsai, Yi-Ju; Yang, Yi-Ching; Lu, Feng-Hwa; Lee, Pei-Yun; Lee, I-Ting; Lin, Sang-I

    2016-01-01

    Objective To determine functional balance abilities of older adults with diabetes, and identify determinants of these abilities. Methods Eighty diabetic and 67 healthy non-diabetic community-dwelling older adults completed the Mini Mental Status Examination (MMSE) and questionnaires about their medical and fall histories. Participants were also assessed for vision, plantar sensitivity, muscle strength, and functional balance, including Functional Reach (FR), Five Times Sit-to-Stand (FTSTS), and 180° turn (TURN). In addition to between-group comparisons, hierarchical regression analysis was conducted to identify the independent determinants for each of the individual balance tasks for the diabetes and control group separately. Results The diabetes group had significantly greater body mass index, higher rate of cardiac disease, and poorer plantar sensitivity, mental status, grip and lower limb strength. The diabetes group performed significantly poorer in FTSTS and TURN (both p<0.001), but not FR (p = 0.108). The significant determinants for the balance tasks varied substantially between tasks and groups. For the diabetes group, they included visual and plantar sensitivity and MMSE for FR (R2 = 0.39), ankle dorsiflexion strength for FTSTS (R2 = 0.377), and plantar sensitivity, knee extension strength and MMSE for TURN (R2 = 0.391). For the control group, knee extension strength emerged as the common and only significant determinant and only explained approximately 10% of the variance for FR and TURN. Conclusions Impairments in functional balance abilities were evident for older adults with diabetes. Their underpinning functional limitations were different for different tasks and were also different from those of the control group. Screening of functional balance and mental status, lower limb strength and sensory function, and interventions to address these impairments may be important to maintain function, independence and safety for older clients with diabetes

  10. Nuances in the Management of Older People With Multiple Myeloma.

    PubMed

    Pawlyn, Charlotte; Gay, Francesca; Larocca, Alessandra; Roy, Vivek; Ailawadhi, Sikander

    2016-06-01

    Multiple myeloma is a disease of the elderly, with about a third of patients at diagnosis older than 75 years of age. Yet, the population of elderly patients is heterogeneous: older patients are more likely to have comorbidities and frailties complicating both their initial diagnosis and subsequent management, but these are not consistent across the group. Furthermore, patients with comorbidities and frailty are generally underrepresented in clinical trials. Despite the survival of myeloma patients increasing following the introduction of novel agents, older patients continue to have worse outcomes with increased treatment-related toxicity. Treatment tolerability is not defined by age alone, rather a combination of age, physical function, cognitive function, and comorbidities. These factors all influence patients' tolerability of treatment and therefore treatment efficacy and should also be considered when reviewing the results of clinical trials. It is the nuances of determining how these factors interact that should influence initial treatment and ongoing management decisions and these will be discussed here. PMID:27038805

  11. Social connection, relationships and older lesbian and gay people1

    PubMed Central

    Barrett, Catherine; Whyte, Carolyn; Comfort, Jude; Lyons, Anthony; Crameri, Pauline

    2015-01-01

    This paper presents data from a small study exploring the impacts of homophobia on the lives of older lesbian and gay Australians. Eleven in-depth interviews were conducted with older lesbians (6) and gay men (5) ranging in age from 65 to 79 years. The study found that participants’ sense of self was shaped by the dominant medical, legal and religious institutions of their youth that defined them as sick, immoral or criminal. Participants described enforced “cure” therapies, being imprisoned, having employment terminated and being disowned and disinherited by family. In this context, intimate relationships and social networks provided refuge where trust was rebuilt and sexuality affirmed. Many created safe spaces for themselves. This equilibrium was threatened with increasing age, disability and the reliance on health and social services. Participants feared a return to institutional control and a need to “straighten up” or hide their sexuality. In response, partners stepped into the role of caregiver, at times beyond their capacity and at a cost to their relationship. The study describes the importance of understanding social connections in the lives of older lesbians and gay men. It highlights the need for inclusive services to ensure that social networks are supported and that health and well-being are promoted. PMID:25544830

  12. Concern about HIV and AIDS among older people in the slums of Nairobi, Kenya.

    PubMed

    Chepngeno-Langat, Gloria; Falkingham, Jane C; Madise, Nyovani J; Evandrou, Maria

    2012-09-01

    The article explores the way that social networks and personal experiences affect perceived HIV-related concerns among people aged 50 years or older living in a low resource neighborhood with high HIV prevalence in Nairobi, Kenya. Multiple logistic regression is used to model the association between the reporting of an HIV-related concern and individual-level characteristics, personal experiences, and social interaction. The main concerns regarding HIV reported by older people in the study included caring for orphaned children (65%), caring for people with AIDS (48%), and losing material and social support from adult children (36%). Interestingly, 38% of respondents voiced concerns about HIV infection among older people. Respondents who had been individually affected by HIV and AIDS, who were part of a wide social network, or who participated in community activities were frequently more likely to report a concern. The findings highlight the significance of the role of social interaction and social networks in the diffusion of information and knowledge. These findings have implications for HIV and AIDS policy and programs, highlighting the potential for social networks and community-level interventions to educate and increase awareness about HIV and AIDS among older people. Community leaders can make good peer educators and communication agents for HIV/AIDS campaigns. Additionally, the recognized high level of personal vulnerability to HIV infection among older people suggests the need for targeted sexual behavior change programs among this often neglected group. PMID:22324649

  13. The burden of disease in older people and implications for health policy and practice.

    PubMed

    Prince, Martin J; Wu, Fan; Guo, Yanfei; Gutierrez Robledo, Luis M; O'Donnell, Martin; Sullivan, Richard; Yusuf, Salim

    2015-02-01

    23% of the total global burden of disease is attributable to disorders in people aged 60 years and older. Although the proportion of the burden arising from older people (≥60 years) is highest in high-income regions, disability-adjusted life years (DALYs) per head are 40% higher in low-income and middle-income regions, accounted for by the increased burden per head of population arising from cardiovascular diseases, and sensory, respiratory, and infectious disorders. The leading contributors to disease burden in older people are cardiovascular diseases (30·3% of the total burden in people aged 60 years and older), malignant neoplasms (15·1%), chronic respiratory diseases (9·5%), musculoskeletal diseases (7·5%), and neurological and mental disorders (6·6%). A substantial and increased proportion of morbidity and mortality due to chronic disease occurs in older people. Primary prevention in adults aged younger than 60 years will improve health in successive cohorts of older people, but much of the potential to reduce disease burden will come from more effective primary, secondary, and tertiary prevention targeting older people. Obstacles include misplaced global health priorities, ageism, the poor preparedness of health systems to deliver age-appropriate care for chronic diseases, and the complexity of integrating care for complex multimorbidities. Although population ageing is driving the worldwide epidemic of chronic diseases, substantial untapped potential exists to modify the relation between chronological age and health. This objective is especially important for the most age-dependent disorders (ie, dementia, stroke, chronic obstructive pulmonary disease, and vision impairment), for which the burden of disease arises more from disability than from mortality, and for which long-term care costs outweigh health expenditure. The societal cost of these disorders is enormous. PMID:25468153

  14. Social marketing strategies for reaching older people with disabilities: findings from a survey of centers for independent living participants.

    PubMed

    Moone, Rajean Paul; Lightfoot, Elizabeth

    2009-01-01

    Centers for independent living (CILs) provide critical supports, services, and advocacy for assisting people with disabilities in living independently. As there is a rapidly increasing population of older people with disabilities, many CILs are now considering how to actively engage older adults in their organizations. This study utilized a survey of older people with disabilities to help identify social marketing techniques that community organizations like CILs can use to effectively reach older people with disabilities. Utilizing the components of the social marketing mix in designing outreach efforts, including a critical examination of product, place, price, participants, and partnering, CILs and other community agencies can better reach older adults with disabilities. PMID:19459127

  15. Differences in false recollection according to the cognitive reserve of healthy older people.

    PubMed

    Pitarque, Alfonso; Meléndez, Juan; Sales, Alicia; Mayordomo, Teresa; Escudero, Joaquín; Algarabel, Salvador

    2016-09-01

    We present an associative recognition experiment comparing three samples of healthy people (young people, older people with high cognitive reserve [HCR], and older people with low cognitive reserve [LCR], with each sample consisting of 40 people), manipulating stimuli repetition during the study phase. The results show significant differences among the three samples in their overall performance. However, these differences are not due to a different use of familiarity, but rather due to a different way of using recollection: although there are no differences in the hit rates between the HRC and LRC samples, the LCR group makes significantly more recollective false alarms than the HCR group. Moreover, repetition provokes an increase in the recollective false alarms in the LCR group, but this does not occur in the group of young people or in the HCR group. These findings are explained in terms of recollection-based monitoring errors and seem to provide support for the cognitive reserve hypothesis. PMID:26982550

  16. Olfactory processing in schizophrenia, non-ill first-degree family members, and young people at-risk for psychosis

    PubMed Central

    Kamath, Vidyulata; Turetsky, Bruce I.; Calkins, Monica E.; Kohler, Christian G.; Conroy, Catherine G.; Borgmann-Winter, Karin; Gatto, Dana E.; Gur, Raquel E.; Moberg, Paul J.

    2014-01-01

    Objectives While deficits in odor identification and discrimination have been reported in schizophrenia, few studies have examined the relative specificity of these deficits in patients and at-risk youth. Method Sniffin’ Sticks odor identification and discrimination were assessed in schizophrenia outpatients and non-ill first-degree relatives (Study One), as well as youth at clinical (CR) or genetic (GR) risk for schizophrenia (Study Two). Scores were z-transformed, using the performance of a demographically-matched adult or adolescent comparison group. Results Patients and relatives were impaired on odor identification, but odor discrimination impairment was limited to the patient group. A similar pattern of impairment emerged in at-risk youth. GR youth were impaired on odor identification but not discrimination, while CR youth were impaired on both tasks. In patients, olfactory impairment was correlated with negative symptomatology. Conclusions To our knowledge, this is the first study to show that CR youth are impaired on both olfactory tasks, as observed in adult schizophrenia patients. GR youth were impaired only on odor identification like their adult counterparts. These data suggest that odor identification impairment, in isolation, may represent a genetic marker of vulnerability for schizophrenia, while odor discrimination deficits may be a biomarker associated with the development of psychosis. PMID:22070564

  17. [The role of information as a preventive measure to the drug use among young people at risk].

    PubMed

    Sanchez, Zila van der Meer; Oliveira, Lúcio Garcia de; Ribeiro, Luciana Abeid; Nappo, Solange Aparecida

    2010-05-01

    Illicit drug consumption among youngsters is a public health concern that requires attention. However, little research has highlighted the importance of "drug information availability" among protection factors. The aim of this article is to identify, from the point of view of youngsters at risk, what factors could prevent them to try illicit drugs, focusing on the importance of "drug information availability". An intentional sample was selected, composed by 62 youngsters divided into two groups: (NU) non illicit users N=32 and (U) users N=30. The sample was recruited through key-informants and "snowball" and each participant was submitted to an in-depth semi-structured interview. According to NU "drug information availability" was reported as the main protector factor. Family-based information was the main source of knowledge followed by observation of the drug negative consequences on lives of friends who have already consumed illicit drugs in a regular-basis. Among users, it was reported a lack of drug knowledge or availability of partial information. We can conclude that among youngsters at risk, drug information availability is the main protection factor against experimental and regular drug consumption. Family based information was reported as its main source. PMID:20464182

  18. Care planning at home: a way to increase the influence of older people?

    PubMed Central

    Berglund, Helene; Dunér, Anna; Blomberg, Staffan; Kjellgren, Karin

    2012-01-01

    Introduction: Care-planning meetings represent a common method of needs assessment and decision-making practices in elderly care. Older people’s influence is an important and required aspect of these practices. This study’s objective was to describe and analyse older people’s influence on care-planning meetings at home and in hospital. Methods: Ten care-planning meetings were audio-recorded in the older people’s homes and nine were recorded in hospital. The study is part of a project including a comprehensive continuum-of-care model. A qualitative content analysis was performed. Results: Care-planning meetings at home appeared to enable older people’s involvement in the discussions. Fewer people participated in the meetings at home and there was less parallel talking. Unrelated to the place of the care-planning meeting, the older people were able to influence concerns relating to the amount of care/service and the choice of provider. However, they were not able to influence the way the help should be provided or organised. Conclusion: Planning care at home indicated an increase in involvement on the part of the older people, but this does not appear to be enough to obtain any real influence. Our findings call for attention to be paid to older people’s opportunities to receive care and services according to their individual needs and their potential for influencing their day-to-day provision of care and service. PMID:23593048

  19. An overview of foot ulceration in older people with diabetes.

    PubMed

    Moakes, Helen

    2012-09-01

    A patient's whole body is affected by diabetes but in particular this chronic disease can cause foot complications. Damage to the nerve and blood supply to the feet as a result of diabetes causes lack of sensation and ischaemia. These problems can lead to diabetic foot ulceration, which, if left untreated, can result in amputation or even death. An essential part of nurses' role in caring for older patients with diabetes in community, acute and residential settings is learning to recognise the signs of a high-risk diabetic foot, and when and where to get help for its treatment. PMID:23008915

  20. Cortisol awakening response and cognitive performance in hypertensive and normotensive older people.

    PubMed

    Pulopulos, Matias M; Hidalgo, Vanesa; Puig-Perez, Sara; Salvador, Alicia

    2016-07-01

    Healthy older people with a cortisol awakening response (CAR) of decreased magnitude show worse frontal cortex-related cognitive performance. Systemic hypertension has been related to a CAR of decreased magnitude. Additionally, worse executive function and processing speed have been observed in older people with systemic hypertension. This is the first study to examine the relationship between the CAR (measured with six saliva samples at home on two consecutive weekdays) and cognitive performance, in both hypertensive (n=26) and normotensive (n=28) older people (from 56 to 78years old). Hypertensive participants showed lower morning cortisol secretion, and they also woke up earlier. No differences in CAR were observed. A CAR of decreased magnitude was related to worse executive function in both hypertensive and normotensive participants, but to slower processing speed only in normotensive participants. Being treated with antihypertensive for a longer period of time was related to a CAR of increased magnitude and better performance on executive function. Our findings suggest that earlier awakening time in hypertensive older people might underlie the lower overall morning cortisol secretion observed in previous studies. Additionally, this study confirms that a dysregulation of the CAR is related to worse executive function, and it extends this association to hypertensive older people. Finally, it is worth noting that hypertension may moderate the relationship between CAR and processing speed. PMID:27208824

  1. TRialing individualized interventions to prevent functional decline in at-risk older adults (TRIIFL): study protocol for a randomized controlled trial nested in a longitudinal observational study

    PubMed Central

    2013-01-01

    Background Functional decline (FD) is a largely preventable feature of aging, characterized as gradual erosion of functional autonomy. This reduces an older person’s capacity for safe, independent community living. The healthcare needs of an unprecedented aging population places pressure on health systems to develop innovative approaches to ensuring older people live healthy and independent lives for as long as possible. TRIIFL aims to demonstrate that: 1. Incipient FD in older people can be identified using a simple telephone-screening process within four weeks of discharge from an emergency department presentation for a minor health event; and 2. Early engagement into a person-centered individualized intervention arrests or reduces the rate of FD over the next 12 months. Methods/Design A randomized controlled trial (RCT) nested within a 13-month longitudinal cohort study. The RCT (conducted over 12 months) tests the effectiveness of a novel, early, home-based, personalized program (compared with no intervention) in arresting or slowing FD. TRIIFL focuses on older adults living independently in the community, who have not yet had a serious health event, yet are potentially on the cusp of FD. Participants in the longitudinal cohort study will be recruited as they present to one large tertiary hospital Emergency Department, providing they are not subsequently admitted to a ward. Sample size calculations indicate that 570 participants need to be recruited into the longitudinal study, with 100 participants randomized into the trial arms. Measures from all subjects will be taken face-to-face at baseline (recruitment), then subsequently by telephone at one, four, seven and thirteen months later. Measures include functional abilities, quality of life, recent falls, mobility dependence, community supports and health service usage. Specific to the nested RCT, the quality of life tool (SF12) applied at one month, will identify individuals with low mental component quality

  2. Overweight and Obesity in Older People with Intellectual Disability

    ERIC Educational Resources Information Center

    de Winter, C. F.; Bastiaanse, L. P.; Hilgenkamp, T. I. M.; Evenhuis, H. M.; Echteld, M. A.

    2012-01-01

    Overweight and obesity are major health problems associated with increased cardiovascular disease risk, which is not sufficiently studied in people with intellectual disability yet. The present study was part of the Healthy Ageing in Intellectual Disability (HA-ID) study. The aim of this study was to establish (1) the prevalence of overweight,…

  3. A health visitor for older people in an accident and emergency department.

    PubMed

    Bridges, J; Meyer, J; McMahon, K; Bentley, J; Winter, J

    2000-02-01

    Published studies indicate that older people have special needs on discharge from accident and emergency (A&E) departments that are not always fully met. The literature reflects that although a significant proportion of older people have a decrease in functional independence and an increased need for services following discharge from A&E, social and functional assessment by A&E staff can be inadequate, as can the arrangement of follow-up community services. As part of a wider study into the organization of care for older people in A&E, a health visitor for older people was funded to work part-time in the A&E department of a large NHS Trust. The health visitor identified potential clients through reviewing the A&E documentation of patients aged 75 years or over discharged directly from A&E. Telephone calls or home visits were used to follow up those individuals deemed to be vulnerable by the health visitor. Interventions included health education, referral to other agencies and patient or family counselling. None of the clients followed up by the health visitor (n = 212) had been referred by A&E to a specialist in gerontology, which suggests that these clients would otherwise not have received the potential benefit of specialist intervention. The pilot study described here highlights a number of practical issues in relation to the health visitor post for older people in A&E, including the importance of dedicated office space and access to a telephone. Data collected during the study, plus the positive evaluation of the role by a small group of A&E staff confirm the claims made in other studies (e.g. Runciman et al, 1996) that health visitors for older people may be of value in meeting the post-discharge needs of these people. PMID:11125456

  4. Coffee, Cake & Culture: Evaluation of an art for health programme for older people in the community.

    PubMed

    Roe, Brenda; McCormick, Sheila; Lucas, Terri; Gallagher, Wendy; Winn, Andrea; Elkin, Sophie

    2016-07-01

    Arts for health initiatives and networks are being developed in a number of countries and an international literature is emerging on the evidence of their benefits to people's health, wellbeing and quality of life. Engagement in cultural and creative arts by older people can increase their morale and self-confidence and provides opportunities for social connection. Museums and galleries are increasingly required to justify their expenditure, reach and impact and some are working in partnership with local councils, hospitals, schools and communities to improve access to their collections. There is a body of literature emerging that describes such initiatives but empirical evidence of their benefits is less developed. This article reports an evaluation of an art for health initiative - Coffee, Cake & Culture organised and delivered by Whitworth Art Gallery and Manchester Museum in 2012 for older people living in a care home and a supported living facility. The study has identified the benefits and impacts of the arts for health programme and its feasibility for older people, with or without diagnosed memory loss - dementia, living in a care home or supported living facility and their care staff. The findings demonstrate there were benefits to the older people and their care staff in terms of wellbeing, social engagement, learning, social inclusion and creativity. These benefits were immediate and continued in the short term on their return home. The majority of older people and care staff had not previously been to the art gallery or museum and the programme encouraged creative arts and cultural appreciation which promoted social inclusion, wellbeing and quality of life. The programme is feasible and important lessons were identified for future planning. Further research involving partnerships of researchers, arts for health curators, artists, care staff, older people and their families is warranted. PMID:24686287

  5. Prevalence of Vestibular Disorder in Older People Who Experience Dizziness

    PubMed Central

    Chau, Allan T.; Menant, Jasmine C.; Hübner, Patrick P.; Lord, Stephen R.; Migliaccio, Americo A.

    2015-01-01

    Dizziness and imbalance are clinically poorly defined terms, which affect ~30% of people over 65 years of age. In these people, it is often difficult to define the primary cause of dizziness, as it can stem from cardiovascular, vestibular, psychological, and neuromuscular causes. However, identification of the primary cause is vital in determining the most effective treatment strategy for a patient. Our aim is to accurately identify the prevalence of benign paroxysmal positional vertigo (BPPV), peripheral, and central vestibular hypofunction in people aged over 50 years who had experienced dizziness within the past year. Seventy-six participants aged 51–92 (mean ± SD = 69 ± 9.5 years) were tested using the head thrust dynamic visual acuity (htDVA) test, dizziness handicap inventory (DHI), as well as sinusoidal and unidirectional rotational chair testing, in order to obtain data for htDVA score, DHI score, sinusoidal (whole-body, 0.1–2 Hz with peak velocity at 30°/s) vestibulo-ocular reflex (VOR) gain and phase, transient (whole-body, acceleration at 150°/s2 to a constant velocity rotation of 50°/s) VOR gain and time constant (TC), optokinetic nystagmus (OKN) gain, and TC (whole-body, constant velocity rotation at 50°/s). We found that BPPV, peripheral and central vestibular hypofunction were present in 38 and 1% of participants, respectively, suggesting a likely vestibular cause of dizziness in these people. Of those with a likely vestibular cause, 63% had BPPV; a figure higher than previously reported in dizziness clinics of ~25%. Our results indicate that htDVA, sinusoidal (particularly 0.5–1 Hz), and transient VOR testing were the most effective at detecting people with BPPV or vestibular hypofunction, whereas DHI and OKN were effective at only detecting non-BPPV vestibular hypofunction. PMID:26733940

  6. Prevalence of Vestibular Disorder in Older People Who Experience Dizziness.

    PubMed

    Chau, Allan T; Menant, Jasmine C; Hübner, Patrick P; Lord, Stephen R; Migliaccio, Americo A

    2015-01-01

    Dizziness and imbalance are clinically poorly defined terms, which affect ~30% of people over 65 years of age. In these people, it is often difficult to define the primary cause of dizziness, as it can stem from cardiovascular, vestibular, psychological, and neuromuscular causes. However, identification of the primary cause is vital in determining the most effective treatment strategy for a patient. Our aim is to accurately identify the prevalence of benign paroxysmal positional vertigo (BPPV), peripheral, and central vestibular hypofunction in people aged over 50 years who had experienced dizziness within the past year. Seventy-six participants aged 51-92 (mean ± SD = 69 ± 9.5 years) were tested using the head thrust dynamic visual acuity (htDVA) test, dizziness handicap inventory (DHI), as well as sinusoidal and unidirectional rotational chair testing, in order to obtain data for htDVA score, DHI score, sinusoidal (whole-body, 0.1-2 Hz with peak velocity at 30°/s) vestibulo-ocular reflex (VOR) gain and phase, transient (whole-body, acceleration at 150°/s(2) to a constant velocity rotation of 50°/s) VOR gain and time constant (TC), optokinetic nystagmus (OKN) gain, and TC (whole-body, constant velocity rotation at 50°/s). We found that BPPV, peripheral and central vestibular hypofunction were present in 38 and 1% of participants, respectively, suggesting a likely vestibular cause of dizziness in these people. Of those with a likely vestibular cause, 63% had BPPV; a figure higher than previously reported in dizziness clinics of ~25%. Our results indicate that htDVA, sinusoidal (particularly 0.5-1 Hz), and transient VOR testing were the most effective at detecting people with BPPV or vestibular hypofunction, whereas DHI and OKN were effective at only detecting non-BPPV vestibular hypofunction. PMID:26733940

  7. Population based study of hospitalised fall related injuries in older people

    PubMed Central

    Peel, N; Kassulke, D; McClure, R

    2002-01-01

    Objective: This study aimed to identify the distribution of fall related injury in older people hospitalised for acute treatment of injury, in order to direct priorities for prevention. Setting: A follow up study was conducted in the Brisbane Metropolitan Region of Australia during 1998. Methods: Medical records of patients aged 65 years and over hospitalised with a fall related injury were reviewed. Demographic and injury data were analysed and injury rates calculated using census data as the denominator for the population at risk. Results: From age 65, hospitalised fall related injury rates increased exponentially for both males and females, with age adjusted incidence rates twice as high in women than men. Fractures accounted for 89% of admissions, with over half being to the hip. Males were significantly more likely than females to have fractured their skull, face, or ribs (p<0.01). While females were significantly more likely than males to have fractured their upper or lower limbs (p<0.01), the difference between proportions of males and females fracturing their hip was not significant. Males were more likely than females (p<0.01) to have fall related head injuries (13% of admissions). Compared with hip fractures, head injuries contributed significantly to the burden of injury in terms of severity, need for intensive care, and excess mortality. Conclusions: The frequency and impact of hip fractures warrants continued emphasis in falls program interventions for both males and females to prevent this injury. However, interventions that go beyond measures to slow and protect against bone loss are also needed to prevent fall related head injuries. PMID:12460962

  8. Subcutaneous fluid administration and the hydration of older people.

    PubMed

    Gabriel, Janice

    Hypodermoclysis, or the subcutaneous administration of fluids, is a method of rehydration that is not routinely used in the UK. Yet it is a simple and effective method of fluid administration for individuals with mild-to-moderate dehydration, especially for the frail and elderly (Sasson and Shvartzman, 2001). Subcutaneous infusion is an alternative route of parenteral administration. It provides a number of advantages over the intravenous route for those individuals unable to tolerate enteral fluids, as it is associated with fewer complications, as well as a wider range of infusion sites. This makes it particularly advantageous for frail and/or older patients requiring low-volume hydration in the community setting. This article discusses indications and contraindications for subcutaneous infusions, as well as patient assessment, placement, securement and potential complications. PMID:25158361

  9. Subcutaneous fluid administration and the hydration of older people.

    PubMed

    Gabriel, Janice

    2014-07-01

    Hypodermoclysis, or the subcutaneous administration of fluids, is a method of rehydration that is not routinely used in the UK. Yet it is a simple and effective method of fluid administration for individuals with mild-to-moderate dehydration, especially for the frail and elderly ( Sasson and Shvartzman, 2001 ). Subcutaneous infusion is an alternative route of parenteral administration. It provides a number of advantages over the intravenous route for those individuals unable to tolerate enteral fluids, as it is associated with fewer complications, as well as a wider range of infusion sites. This makes it particularly advantageous for frail and/or older patients requiring low-volume hydration in the community setting. This article discusses indications and contraindications for subcutaneous infusions, as well as patient assessment, placement, securement and potential complications. PMID:25062366

  10. Experiences of predictive testing in young people at risk of Huntington's disease, familial cardiomyopathy or hereditary breast and ovarian cancer

    PubMed Central

    MacLeod, Rhona; Beach, Anna; Henriques, Sasha; Knopp, Jasmin; Nelson, Katie; Kerzin-Storrar, Lauren

    2014-01-01

    While debate has focused on whether testing of minors for late onset genetic disorders should be carried out if there is no medical benefit, less is known about the impact on young people (<25 years) who have had predictive testing often many years before the likely onset of symptoms. We looked at the experiences of young people who had had predictive testing for a range of conditions with variable ages at onset and options for screening and treatment. A consecutive series of 61 young people who had a predictive test aged 15–25 years at the Clinical Genetic Service, Manchester, for HD, HBOC (BrCa 1 or 2) or FCM (Hypertrophic Cardiomyopathy or Dilated Cardiomyopathy), were invited to participate. Thirty-six (36/61; 59%) agreed to participate (10 HD, 16 HBOC and 10 FCM) and telephone interviews were audiotaped, transcribed and analysed using Interpretative Phenomenological Analysis. None of the participants expressed regret at having the test at a young age. Participants saw the value of pretest counselling not in facilitating a decision, but rather as a source of information and support. Differences emerged among the three groups in parent/family involvement in the decision to be tested. Parents in FCM families were a strong influence in favour of testing, in HBOC the decision was autonomous but usually congruent with the views of parents, whereas in HD the decision was autonomous and sometimes went against the opinions of parents/grandparents. Participants from all three groups proposed more tailoring of predictive test counselling to the needs of young people. PMID:23860040