The Rural Elderly: Program Planning Guidelines.

ERIC Educational Resources Information Center

Coward, Raymond T.; Kerckhoff, Richard K.

Designed for the rural practitioner, this manual offers a description of the major developmental tasks faced by individuals during the latter part of the life span and a summary of the major implications that research holds for building community programs for the rural elderly. Section II discusses two major assumptions: (1) because human beings…

Improving activities of daily living for nursing home elder persons in Taiwan.

PubMed

Chang, Su-Hsien; Wung, Shu-Fen; Crogan, Neva L

2008-01-01

Excess disability among nursing home elder persons can be prevented or remediated. Because of self-selected disuse and caregiver support of dependency, nursing home residents are likely to develop excess disability. No study was found to test a theory-based program aimed at improving elder persons' self-care abilities for Taiwanese nursing home elder persons who are at risk for developing excess disability. The purpose of this study was to test the effectiveness of a theory-based intervention program on self-care, specifically on activities of daily living (ADLs) performance among nursing home elder persons in Taiwan. A secondary aim was to determine the correlation between ADLs performance and three bliss concepts: life satisfaction, self-esteem, and motivation in health behavior. This study used a quasi-experimental, two-group, pretest-posttest design. Forty-two qualified participants were recruited from two nursing homes located in southern Taiwan and assigned to either the experimental group (n = 21) or the comparison group (n = 21). Participants in the experimental group received the Self-Care Self-Efficacy Enhancement Program (SCSEEP), and those in the comparison group received biweekly social visits for 6 weeks. Levels of ADLs performance were measured by Tappen's Refined ADL Assessment Scale. Life satisfaction was measured by Adams' Life Satisfaction Index A. Self-esteem was measured by Rosenberg's Self-Esteem Scale. Motivation in health behavior was measured by Cox's Health Self-Determinism Index. Elder persons receiving the SCSEEP had significant improvement in feeding, dressing, grooming, and washing activities. Self-esteem (p = .011) and life satisfaction (p = .033) but not motivation in health behavior (p = .282) were positively correlated with levels of ADLs performance. The SCSEEP provides a theory-based intervention model for Taiwanese nursing home elder persons aimed at improving ADLs performance. Further research with a larger sample size is needed to determine the long-term maintenance and effectiveness of this theory-driven SCSEEP in specific culture groups.

PubMed Central

Roberge, Roger

1992-01-01

The elderly face a decrease in physical capacity and an increase in chronic health problems. Exercise increases cardiovascular fitness, muscle strength and bone mass. Training programs are feasible and beneficial for the elderly. Regular exercice can lead to longer and healthier life. PMID:21221405

When worlds collide: elder caregiving poses new challenges for balancing work and life.

PubMed

Rachor, M M

1998-09-01

Nearly one in four U.S. households (an estimated 22.4 million) are caring for elderly family members or friends; as the nation's population ages, more and more workers will take on elder caregiving responsibilities. As this trend continues, employers will face increasing concerns about lost productivity and many employees will struggle to balance the demands of work and caregiving responsibilities. To help resolve the situation, many employers may look to a comprehensive work/life program, which incorporates an intensive focus on elder-care issues, to help boost morale, improve employee productivity and job performance, and reduce stress and absenteeism associated with caregiving.

Montessori-based dementia care.

PubMed

Cline, Janet

2006-10-01

Montessori-based Dementia Care is an approach used in Alzheimer's care that does not involve chemical or physical restraints. This program works by giving the elder with Alzheimer/Dementia a purpose by getting them involved. When staff/families care for a confused Alzheimer/Dementia patient, who is having behaviors, the Montessori program teaches them to look at what is causing the behavior. When assessing the elder to determine what is causing the behavior, the goal is to find the answer, but the answer cannot be dementia. The goal of the program is to bring meaning to the life of an Alzheimer/Dementia elder.

Effect of the long-term care prevention project on the motor functions and daily life activities of the elderly.

PubMed

Wada, Yoshihiro; Sakuraba, Keisyoku; Kubota, Atsushi

2015-01-01

[Purpose] The purpose of this study was to verify the effects of the long-term care prevention project and develop an effective program. [Subjects] A total of 81 elderly people (age, 79 ± 5.1 years; height, 149.2 ± 9.2 cm; weight, 54.2 ± 11.4 kg). [Methods] Grip, knee extension muscular strength, 10 m walking speed, and Timed Up and Go time were measured for evaluation of motor functions, and the "Locomo 25", a 25-question risk assessment questionnaire, was used as the judgment criterion for evaluation of daily life activities, with measurements being taken at the beginning of the project and after three months. [Results] In the motor functions evaluation, significant differences were observed in 10 m walking speed, Timed Up and Go time, and knee extension strength. In the daily life activities evaluation, scores for pain, rising movement, standing movement, indoor walking, outdoor walking, and fear of falling were significantly reduced. In addition, a significant correlation was also observed between motor functions and daily life activities. [Conclusion] The result of this study indicated that the long-term care prevention project is effective in maintaining or improving muscular strength and mitigating pain in the elderly and that it is an effective program for maintaining daily life activities. We were also able to show that it would be effective to develop programs with a low exercise intensity that can be performed on a continuing by the elderly.

Health-Related Quality of Life Measures for Physically Active Elderly in Community Exercise Programs in Catalonia: Comparative Analysis with Sedentary People

PubMed Central

Fortuño-Godes, Jesús; Guerra-Balic, Myriam; Cabedo-Sanromà, Josep

2013-01-01

Objective. To evaluate Health-Related Quality of Life (HRQoL), medication used, and Stock of Health Capital (SHC) in physically active elderly participants in Community Exercise Programs (CEPs) compared to a sedentary group. Methods. EuroQol standardized instrument was completed by physically active elderly (n = 2,185) who participated in CEPs. Common items were compared to HRQoL data of 1,874 sedentary elderly people, taken from the Catalan Health Survey 2006 (CHS'06). Visual Analogue Scale (VAS) outcomes and medication used were assessed through parametric statistics. Dimensions of health conditions were compared, between sedentary people and physically active elderly participants in CEPs. SHC results were obtained combining the EuroQol scores and Life Expectancy (LE) values. An economic value of €34,858.70 was assigned to these years of LE. Results. Physically active subjects had better HRQoL values (75.36 in males and 70.71 in females) than CHS'06 sedentary subjects (58.35 in males and 50.59 in females). Medication used was different between physically active subjects (1.89 in males and 2.87 in females) and CHS'06 sedentary subjects (4.34 in males and 4.21 in females). SHC data for physically active elderly (€465,988.31/QALY in males and €522,550.31/QALY in females) were higher than for CHS'06 sedentary subjects (€363,689.33/QALY in males and €346,615.91/QALY in females). PMID:24454357

Voluntary Associations, Life Satisfaction, and Other Correlates of Participation in Programs for the Elderly. A Preliminary Analysis.

ERIC Educational Resources Information Center

Grote, N. P.; Baumhover, L. A.

The relationship between life satisfaction and voluntary association membership is passing through its descriptive phases and is now being examined in depth. As part of a three-year longitudinal study to evaluate a Title VII program, this data reports on an analysis of life satisfaction, voluntary association membership, health status, and SES…

Perceived Health, Life Satisfaction, and Activity in Urban Elderly: A Controlled Study of the Impact of Part-Time Work.

ERIC Educational Resources Information Center

Soumerai, Stephen B.; Avorn, Jerry

1983-01-01

Assessed whether part-time employment affects the perceived health, life satisfaction, and activity of urban retirees (N=55). Program participants were hired to perform park maintenance. Interviews after the 6-month program revealed significant, positive effects of paid employment on measures of perceived health and life satisfaction. (Author/JAC)

[Design, implementation and evaluation of a health education program for the elderly].

PubMed

Pino, Margarita; Ricoy, Maria Carmen; Portela, Julio

2010-09-01

The objective was to design, implement and evaluate a health education program, using the analysis of the habits that harm the health of people over 65 years old. An evaluative research was carried out from a multiple case study in the North-West area of Spain, combining both the quantitative and the qualitative approach. A questionnaire and interview were used as tools for data collection. The elderly take a lot of medicines and also treat themselves. A small group smoke and drink alcohol. Over 25% have sedentary habits and their average body mass rate was 30.55. The implementation of the programme has significantly influenced their quality of life. Elderly people have deep rooted unhealthy habits. The achievement of educational contents improved their quality of life. However, they are reluctant to assume new habits, even though they are healthy.

Social workers' roles in addressing the complex end-of-life care needs of elders with advanced chronic disease.

PubMed

Kramer, Betty J

2013-01-01

This study examined social workers' roles in caring for low-income elders with advanced chronic disease in an innovative, community-based managed care program, from the perspective of elders, family, team members, and social workers. The results are drawn from a larger longitudinal, multimethod case study. Sources of data include survey reports of needs addressed by social workers for 120 deceased elders, five focus groups with interdisciplinary team members, and in-depth interviews with 14 elders and 10 of their family caregivers. A thematic conceptual matrix was developed to detail 32 distinctive social work roles that address divergent needs of elders, family, and team members. Distinctive perceptions of social workers' roles were identified for the different stakeholder groups (i.e., elders, family caregivers, team members, and social workers). Findings from this study may inform supervisors and educators regarding training needs of those preparing to enter the rapidly growing workforce of gerontological social workers who may be called upon to care for elders at the end of life. Training is particularly warranted to help social workers gain the skills needed to more successfully treat symptom management, depression, anxiety, agitation, grief, funeral planning, and spiritual needs that are common to the end of life.

Integrating Oral and General Health Screening at Senior Centers for Minority Elders

PubMed Central

Cheng, Bin; Northridge, Mary E.; Kunzel, Carol; Huang, Catherine; Lamster, Ira B.

2013-01-01

Racial/ethnic and socioeconomic disparities regarding untreated oral disease exist for older adults, and poor oral health diminishes quality of life. The ElderSmile program integrated screening for diabetes and hypertension into its community-based oral health activities at senior centers in northern Manhattan. The program found a willingness among minority seniors (aged ≥ 50 years) to be screened for primary care sensitive conditions by dental professionals and a high level of unrecognized disease (7.8% and 24.6% of ElderSmile participants had positive screening results for previously undiagnosed diabetes and hypertension, respectively). Dental professionals may screen for primary care–sensitive conditions and refer patients to health care providers for definitive diagnosis and treatment. The ElderSmile program is a replicable model for community-based oral and general health screening. PMID:23597378

The Continuum of Life: Health Concerns of the Indian Elderly. Final Report on the National Indian Conference on Aging (2nd, Billings, Montana, August 15-18, 1978).

ERIC Educational Resources Information Center

National Indian Council on Aging, Albuquerque, NM.

Focusing on the physical well-being and personal environment of the Indian elderly, the conference attracted 3,000 persons from 209 Indian tribes. Its program was organized into: (1) description of existing resources serving elderly Indians; (2) determination of the additional or remedial action required; and (3) identification of methodology for…

"Community ambassadors" for South Asian elder immigrants: late-life acculturation and the roles of community health workers.

PubMed

Blair, Thomas R W

2012-11-01

Elder immigrants face multiple barriers to accessing health care and other basic services. The Community Ambassador Program for Seniors (CAPS), based in Fremont, California, trains volunteer "ambassadors" from several ethnic and faith communities to perform information and referral services for elders, particularly immigrants. The purpose of this study is to examine the roles of ambassadors in ecologic context as community health workers (CHWs) for clients undergoing late-life acculturation. Ambassadors from three different communities, all of South Asian heritage, were interviewed using a semi-structured guide. 20 out of 23 ambassadors from these communities participated, from December 2008 to December 2009. Data collection and analysis followed grounded theory methodology. Results are presented as an integrated explanatory model, with three major components: (1) acculturative stress, particularly within elders' families; (2) polygonal relationships, a construct that includes elders, their caregivers, CHWs, and service providers, and builds on the notion of a "geriatric triad" (Adelman, Greene, & Charon, 1987); and (3) role hybridity, a novel explanation for CHWs' social niche. Ambassadors mediated elder clients' acculturation both inside and outside elders' families. As such, ambassadors worked in polygonal relationships with elder clients and elders' children, rather than simply working in dyads with elder clients themselves. In the CAPS context, this polygonal framework integrates intra-familial and extra-familial acculturative dynamics into a single relational model. Within these relationships, CHWs exhibited hybridity of social roles, integrating familial and professional attributes, but fully achieving neither familial nor professional status. Practical implications, including importance of outreach to elders' children, accessibility of social programs, and the consequences of role hybridity as a property of CHW identity and function, are discussed. Copyright © 2012 Elsevier Ltd. All rights reserved.

Cost-effectiveness of an influenza vaccination program offering intramuscular and intradermal vaccines versus intramuscular vaccine alone for elderly.

PubMed

Leung, Man-Kit; You, Joyce H S

2016-05-11

Intradermal (ID) injection is an alternative route for influenza vaccine administration in elderly with potential improvement of vaccine coverage. This study aimed to investigate the cost-effectiveness of an influenza vaccination program offering ID vaccine to elderly who had declined intramuscular (IM) vaccine from the perspective of Hong Kong public healthcare provider. A decision analytic model was used to simulate outcomes of two programs: IM vaccine alone (IM program), and IM or ID vaccine (IM/ID program) in a hypothetic cohort of elderly aged 65 years. Outcome measures included influenza-related direct medical cost, infection rate, mortality rate, quality-adjusted life years (QALYs) loss, and incremental cost per QALY saved (ICER). Model inputs were derived from literature. Sensitivity analyses evaluated the impact of uncertainty of model variables. In base-case analysis, the IM/ID program was more costly (USD52.82 versus USD47.59 per individual to whom vaccine was offered) with lower influenza infection rate (8.71% versus 9.65%), mortality rate (0.021% versus 0.024%) and QALYs loss (0.00336 versus 0.00372) than the IM program. ICER of IM/ID program was USD14,528 per QALY saved. One-way sensitivity analysis found ICER of IM/ID program to exceed willingness-to-pay threshold (USD39,933) when probability of influenza infection in unvaccinated elderly decreased from 10.6% to 5.4%. In 10,000 Monte Carlo simulations of elderly populations of Hong Kong, the IM/ID program was the preferred option in 94.7% of time. An influenza vaccination program offering ID vaccine to elderly who had declined IM vaccine appears to be a highly cost-effective option. Copyright © 2016 Elsevier Ltd. All rights reserved.

Lifestyle intervention using Internet of Things (IoT) for the elderly: A study protocol for a randomized control trial (the BEST-LIFE study).

PubMed

Kato, Sawako; Ando, Masahiko; Kondo, Takaaki; Yoshida, Yasuko; Honda, Hiroyuki; Maruyama, Shoichi

2018-05-01

Modification of lifestyle habits, including diet and physical activity, is essential for the prevention and control of type 2 diabetes mellitus (T2DM) in elderly patients. However, individualized treatment is more critical for the elderly than for general patients. This study aimed to determine lifestyle interventions that resulted in lowering hemoglobin A 1c (HbA 1c ) in Japanese pre- and early diabetic elderly subjects. The BEST-LIFE trial is an ongoing, open-label, 6-month, randomized (1:1) parallel group trial. Subjects with HbA 1c of ≥5.6%-randomly assigned to the intervention or control group -use wearable monitoring devices loaded with Internet of things (IoT) systems that aids them with self-management and obtaining monthly remote health guidance from a public health nurse. The primary outcome is changes in HbA 1c after a 6-month intervention relative to the baseline values. The secondary outcome is the change of behavior modification stages. The background, rationale, and study design of this trial are also presented. One hundred forty-five subjects have already been enrolled in this lifestyle intervention program, which will end in 2019. The BEST-LIFE trial will provide new evidence regarding the effectiveness and safety of our program on lowering HbA 1c in elderly subjects with T2DM. It will also investigate whether information communication technology tools and monitoring devices loaded with IoT can support health care in elderly subjects. The trial registration number is UMIN-CTR: UMIN 000023356.

[Measurement of functional capacity and health related quality of life in an elderly group following a walking program: pilot study].

PubMed

Fortuño Godes, Jesús; Romea Viñets, Jordi; Guerra Balic, Myriam; Sainz Pardo, Gregorio; Queralt Zueras, Josep

2011-01-01

This pre-experimental study analyses the Functional Capacity (FC), Body Mass Index (BMI), Health Related Quality of Life (HRQoL) and Health Capital Stock (HCS) of elderly people participating in a Walking program in Granollers (Barcelona). One hundred and seventy-three participants were invited to participate. One hundred and one of them were users of the Municipal Program for Elderly People, and 72 received information by the communication media. One hundred and thirty-one (76.3%) of the participants completed the Program. The intervention consisted of a 6-month program, supervised by a specialist instructor once a week and controlled daily by a pedometer. The 6-minute walk test (6MWT) was analysed for the FC, and the EuroQoL for the HRQoL. The preferences derived from the EuroQoL scores and the Life Expectancy were used to calculate the FC. The monetary data were obtained using a fixed value. An increase in the average number of steps was observed after the program, especially in men. The results also showed a decrease in the BMI. The participants showed a improvement in overall health perception at the end of the program. The HCS scores confirmed the improvement in the HRQoL in men. The Program was positive for increasing the number of steps and improving physical condition and health. The usefulness of the pedometer as a motivational tool of physical exercise is discussed. Copyright © 2010 SEGG. Published by Elsevier Espana. All rights reserved.

Health Related Quality of Life in Iranian Elderly Citizens: A Systematic Review and Meta-Analysis

PubMed Central

Farajzadeh, Mohammad; Ghanei Gheshlagh, Reza; Sayehmiri, Kourosh

2017-01-01

ABSTRACT Background: The ever-growing elderly population of Iran and their physical and mental consequences put emphasis on the necessity of determining the quality of life (QoL) in this social group. This systematic review and meta-analysis aimed to estimate the mean score of QoL in Iranian elderly citizens. Methods: Twenty-one articles that were indexed in Iranian (MagIran and Iran Medex) and international (Scientific Information Database, Google Scholars, Science Direct, PubMed, ProQuest, Scopus) databases were selected. The articles have used the Short Form Health Survey (SF-36) to measure QoL in Iranian elderly. The collected data were analyzed using a random effects model, while heterogeneity of the studies was measured by I2 index. The data analysis was performed by STATA. Results: The sample size of the 21 articles was 5318 and the mean score of QoL in the healthy and sick elderly citizens was 53.8 (CI 95%: 49.4-58.2) and 50.6 (CI 95%: 38.4-62.9) respectively. In addition, there was no significant relationship between the score of QoL and the year of publication of the articles. (P=0.748) Conclusion: Given that QoL of the studied elderly was almost at an average level, there is a need to codify and implement comprehensive programs through effective training programs toward improving QoL of the elderly. PMID:28409164

[Effect of family cohesion, subjective happiness and other factors on death anxiety in Korean elders].

PubMed

Jo, Kae Hwa; Song, Byung Sook

2012-10-01

The purposes of this study were to explore the effects of family cohesion and subjective happiness on death anxiety of Korean elders and to identify other factors contributing to death anxiety. The participants were 280 elders who lived in P metropolitan city. Data were collected between November 5, 2011 and January 12, 2012 using the Short Portable Mental Status Questionnaire (SPMSQ), Family Cohesion Evaluation Scale, Subjective Happiness Scale, and Fear of Death Scale (FODS). Data were analyzed using the SPSS/WIN 19.0 program. Family cohesion, marital status, religious activity, perceived health status, and subjective happiness were included in the factors affecting death anxiety of Korean elders. These variables explained 50.1% of death anxiety. The results of the study indicate that these variables should be considered in developing nursing intervention programs to decrease death anxiety and increase family cohesion and subjective happiness for life integration in Korean elders.

The Isfahan Comprehensive Elderly Study: Objectives, research design, methodology, and preliminary results.

PubMed

Heidari, Zahra; Feizi, Awat

2017-01-01

This paper presents the objectives, research design, methodology, and primary findings of the Isfahan Comprehensive Elderly Study (ICES). In this cross-sectional study, 603 elderly persons (aged 60 and over) were selected by multistage cluster sampling method from Isfahan, Iran, in 2016 comprehensive questionnaires along with a detailed interview were used to collect information on personal, family, socioeconomic, health and social services characteristics, life styles, physical illnesses and chronic diseases, mental, emotional and cognition disorders, quality of life, disabilities, sleep quality, social supports, life satisfaction, self-efficacy, and of participants. The mean ± standard deviation (SD) age of participants was 69.66 ± 6.31 years, consisting of 50.75% females. About 23% of elderly persons were at the risk of malnutrition and 4.5% were current smoker. Severe and mild depression were documented in 9.3% and 30.2% among included study subjects, respectively. About half of the participants had hypertension, and 26.8% suffered from cardiovascular disease. The mean ± SD of total score of Geriatric Depression Scale, Perceived Stress Scale, Older People's Quality of Life, Physical Activity Scale for the Elderly and Pittsburg Sleep Quality Index was 8.84 ± 6.79, 14.76 ± 5.92, 133.99 ± 10.55, 142.04 ± 120.53, and 6.17 ± 3.44, respectively. Elderly males had significantly higher life satisfaction and self-efficacy and better cognitive function than females ( P < 0.01). The findings of current study provided a comprehensive overview of the current health status and lifestyle of older adults in Isfahan city. The ICES could help policy makers to design appropriate prevention and interventional programs and policies to cover the specific needs of the elderly population.

The Isfahan Comprehensive Elderly Study: Objectives, research design, methodology, and preliminary results

PubMed Central

Heidari, Zahra; Feizi, Awat

2017-01-01

Background: This paper presents the objectives, research design, methodology, and primary findings of the Isfahan Comprehensive Elderly Study (ICES). Materials and Methods: In this cross-sectional study, 603 elderly persons (aged 60 and over) were selected by multistage cluster sampling method from Isfahan, Iran, in 2016 comprehensive questionnaires along with a detailed interview were used to collect information on personal, family, socioeconomic, health and social services characteristics, life styles, physical illnesses and chronic diseases, mental, emotional and cognition disorders, quality of life, disabilities, sleep quality, social supports, life satisfaction, self-efficacy, and of participants. Results: The mean ± standard deviation (SD) age of participants was 69.66 ± 6.31 years, consisting of 50.75% females. About 23% of elderly persons were at the risk of malnutrition and 4.5% were current smoker. Severe and mild depression were documented in 9.3% and 30.2% among included study subjects, respectively. About half of the participants had hypertension, and 26.8% suffered from cardiovascular disease. The mean ± SD of total score of Geriatric Depression Scale, Perceived Stress Scale, Older People's Quality of Life, Physical Activity Scale for the Elderly and Pittsburg Sleep Quality Index was 8.84 ± 6.79, 14.76 ± 5.92, 133.99 ± 10.55, 142.04 ± 120.53, and 6.17 ± 3.44, respectively. Elderly males had significantly higher life satisfaction and self-efficacy and better cognitive function than females (P < 0.01). Conclusion: The findings of current study provided a comprehensive overview of the current health status and lifestyle of older adults in Isfahan city. The ICES could help policy makers to design appropriate prevention and interventional programs and policies to cover the specific needs of the elderly population. PMID:28919912

Are the Elderly Retired from Active Life? A Cross-Cultural Comparison.

ERIC Educational Resources Information Center

Shenk, Dena; Vora, Erika

A problem with gerontology theory is that it focuses on a social view of the aged, ignoring individual and cultural variables. A person is judged to have aged successfully if he has adjusted to society's definition of an "elderly person." Similarly, most studies of programs and options for the aged reflect the view of the service…

Effects of a 12-Week Exercise Training Program on Physical Function in Institutionalized Frail Elderly

PubMed Central

Ferreira, Cristiane Batisti; Teixeira, Pâmela dos Santos; Alves dos Santos, Geiane; Dantas Maya, Athila Teles; Americano do Brasil, Paula; Souza, Vinícius Carolino; Córdova, Cláudio; Lima, Ricardo Moreno; Nóbrega, Otávio de Toledo

2018-01-01

With the increase in life expectancy, the Brazilian elderly population has risen considerably. However, longevity is usually accompanied by problems such as the loss of functional capacity, cognitive decline, frailty syndrome, and deterioration in anthropometric parameters, particularly among those living in long-term care facilities. This randomized controlled trial aimed to verify the effects of exercise training on biochemical, inflammatory, and anthropometric indices and functional performance in institutionalized frail elderly. The sample consisted of 37 elderly people of both genders, aged 76.1 ± 7.7 years, who were randomly allocated into 2 groups: 13 individuals in the exercise group (EG) and 24 in the control group (CG). Anthropometrics, clinical history, functional tests, and biochemical evaluation were measured before and after the completion of a physical exercise program, which lasted for 12 weeks. The 12-week exercise program for frail elderly residents in a long-term care facility was efficient in improving muscle strength, speed, agility, and biochemical variables, with reversal of the frailty condition in a considerable number. However, no effects in anthropometric and inflammatory parameters were noted. PMID:29593907

Self-transcendence, spiritual perspective, and sense of purpose in family caregiving relationships: a mediated model of depression symptoms in Korean older adults.

PubMed

Kim, Suk-Sun; Hayward, R David; Reed, Pamela G

2014-09-01

This study used structural equation modeling to test the mediated model of late-life depression to understand the mechanisms that account for the direct and indirect effects of spiritual variables and purpose in life on depression within the context of Korean family caregiving relationships. A secondary analysis study design used data from a study that tested a theory of family interdependence of 157 Korean elder-family caregiver dyads in Seoul, Korea. Both caregivers' and elders' self-transcendence was positively related to their own sense of purpose in life. However, only elders' spiritual perspective was related to purpose in life. Also, elders' purpose in life was positively associated with caregivers' purpose in life. Furthermore, there was a strong negative relationship between elders' purpose in life and their depressive symptoms, but there was not a significant negative relationship between caregivers' purpose in life and elders' depressive symptoms. Last, elders' purpose in life mediated the negative effects of elders' self-transcendence and spiritual perspective and of caregivers' self-transcendence and purpose in life on elders' depression. The findings suggest that purpose in life for both the caregiver and elder played an important role in elders' depression. Self-transcendence also was related to decreased depression in elders. It is suggested that more attention be given to caregiver and elder purpose in life in developing interventions to reduce or avoid elder depression in Korean elders.

Social Work Practice with LGBT Elders at End of Life: Developing Practice Evaluation and Clinical Skills Through a Cultural Perspective.

PubMed

Arthur, Darren P

2015-01-01

This article focuses on culturally sensitive clinical issues related to best practices with lesbian, gay, bisexual, transgender (LGBT) elder patients at end-of-life (EOL) at key points in the therapeutic relationship. Vital concepts, including practice evaluation and clinical skills, are presented through a cultural and oncology lens. There is a paucity of LGBT research and literature as well as a shortfall of MSW graduate school education specific to social work palliative and end-of-life care (PELC) practice with LGBT elders. The content of this article is designed to be adapted and used as an educational tool for institutions, agencies, graduate programs, medical professions, social work, and students. Learning the unique elements of LGBT cultural history and their implications on EOL care can improve social work practice. This article provides an examination from assessment and engagement basics to advance care planning incorporating specific LGBT EOL issues.

Strategic and Sustainable Communications in Support of Elder Care Benefits (Part 2 of a Working Caregivers Feature)

ERIC Educational Resources Information Center

Federico, Richard

2004-01-01

Many employers today have work/life programs and benefits in place to assist their employees in maintaining a healthy balance between their job duties and the responsibilities they bear in their daily lives. One such responsibility with which aging baby boomers are increasingly being charged is caring for an elderly loved one. Although many…

Memory Recall and Participation Levels in the Elderly: A Study of Golden Age Radio.

ERIC Educational Resources Information Center

Durham, Pamela R.; Whittemore, Margaret P.

1993-01-01

Twelve women (mean age 90) in a nursing home listened to Golden Age radio programs and answered trivia questions. Reactions to musical programs showed they encouraged reminiscence; trivia stimulated recall of historical and life events. In contrast, comedy programs evoked little response. (SK)

Sustainability and scalability of the hospital elder life program at a community hospital.

PubMed

Rubin, Fred H; Neal, Kelly; Fenlon, Kerry; Hassan, Shuja; Inouye, Sharon K

2011-02-01

The Hospital Elder Life Program (HELP), an effective intervention to prevent delirium in older hospitalized adults, has been successfully replicated in a community teaching hospital as a quality improvement project. This article reports on successfully sustaining the program over 7 years and expanding its scale from one to six inpatient units at the same hospital. The program currently serves more than 7,000 older patients annually and is accepted as the standard of care throughout the hospital. Innovations that enhanced scalability and widespread implementation included ensuring dedicated staffing for the program, local adaptations to streamline protocols, continuous recruitment of volunteers, and more-efficient data collection. Outcomes include a lower rate of incident delirium; shorter length of stay (LOS); greater satisfaction of patients, families, and nursing staff; and significantly lower costs for the hospital. The financial return of the program, estimated at more than $7.3 million per year during 2008, comprises cost savings from delirium prevention and revenue generated from freeing up hospital beds (shorter LOS of HELP patients with and without delirium). Delirium poses a major challenge for hospital quality of care, patient safety, Medicare no-pay conditions, and costs of hospital care for older persons. Faced with rising numbers of elderly patients, hospitals can use HELP to improve the quality and cost-effectiveness of care. © 2011, Copyright the Authors. Journal compilation © 2011, The American Geriatrics Society.

Effects of compound music program on cognitive function and QOL in community-dwelling elderly

PubMed Central

Fujita, Takaaki; Ito, Akemi; Kikuchi, Nana; Kakinuma, Tomohiro; Sato, Yoshihisa

2016-01-01

[Purpose] Interventions using music, physical exercise, and reminiscence therapy are widely used both for rehabilitation and care of the elderly. This study aimed to investigate the effect of structured interventions comprising music, physical exercise, and reminiscence therapy on cognitive function and quality of life of the community-dwelling elderly. [Subjects and Methods] The study included 15 community-dwelling elderly people who used a day-care center. Participants underwent sessions comprising the following three factors: 1) singing songs familiar to the elderly; 2) physical exercise to music; and 3) observation of historical pictures. Sessions were conducted once or twice per week, 30 to 40 min per day, for 10 weeks. Pre and post interventions of the Mini Mental State Examination, the Behavioral Rating Scale for the Elderly, and the SF-8 were compared. [Results] No significant difference was observed between pre- and post-intervention scores on the Mini Mental State Examination and the Behavioral Rating Scale for the Elderly. However, the post intervention physical component summary of SF-8 was significantly higher than the pre intervention summary. [Conclusion] This study suggests that interventions comprising music, physical exercise, and reminiscence therapy may contribute toward the improvement of elderly individuals’ health-related quality of life, especially physical health. PMID:27942151

Activities of daily living (ADL) of single elderly individuals using social assistive programs in a rural community.

PubMed

Yokokawa, Yoshiharu; Miyoshi, Kei; Kai, Ichiro

2017-01-01

Objectives　The proportion of elderly individuals living alone is increasing in Japan. Matsumoto city office provides social assistive programs such as home help, lunch delivery, life advice, and safety check telephone calls. The purpose of this study was to compare the level of ADL between the elderly using social assistive programs (the use group) and those who did not (the non-use group).Methods　We conducted a cross-sectional study at Shiga district of Matsumoto city in September 2014. A total of 128 elderly individuals participated in this study. Health volunteers asked these subjects to complete a questionnaire without assistance. Measurement items included lifestyle variables and social support networks. With respect to the frequency of use, we used questions that inquired about the use of the social assistive program. We included a set of instruments commonly used in the health assessment of elderly populations: functional capacity (Instrumental ADL, Intellectual Activity, Social Role), social support, nutrition (Mini Nutrition Assessment [MNA]) and depressive symptoms (Geriatric Depression Scale [GDS]).Results　The use group consisted of 24 elderly individuals participating in the social support program. The non-use group consisted of 89 elderly individuals living alone without programs. The mean age of those who completed the survey was 83.9±4.2 years for the use group and 82.3±4.3 years for the non-use group. Comparisons between the two groups did not show significant difference in terms of their intellectual activity, social role, emotional social support, and MNA or GDS scores. The use group was more likely to use the public transfer service and receive instrumental social support from children and relatives.Conclusions　By means of utilizing the public transfer service, and receiving family support, the elderly living alone who used social assistive programs could live independently. These findings suggest a need for improvement in the public transfer service and social network.

The Influence of Skill Development Training Program for Spiritual Care of Elderly Individual on Elderly Care Technician Students' Perception of Spiritual Support.

PubMed

Bulduk, Serap; Usta, Esra; Dinçer, Yeliz

2017-06-01

Spiritual care means helping an individual protect, maintain and gain all the dimensions of his/her existence. Elderly care technicians face numerous cases or crisis situations in which elderly individuals from different backgrounds question the meaning and value of life. Elderly care technicians must acknowledge that the spirituality is an important element in the way an elderly individual receives healthcare and they must be equipped for this matter. This study was conducted in order to examine the influence of "Skill Development Training Program for Spiritual Care of Elderly Individual," which was carried out with students from elderly care program, on the perception of spirituality support in a pretest-posttest quasi-experimental study design with control group. As the data collection form, "Spiritual Support Perception" (SSP) scale was used. The mean scores of the intervention group after the training and after one month are 50.39 ± 5.34 and 51.13 ± 4.98, respectively, and those of the control group are 43.16 ± 4.83 and 42.72 ± 4.48. A statistically significant difference was found between the mean scores of the intervention group from the pretest and the posttests immediately after the training and one month after the training (f = 94.247, p = 0.001). In the control group, however, there was no significant change in the SSP mean scores (f = 0.269, p = 0.77). As a result, this study pointed out the necessity of such training programs for healthcare professionals to make a distinction between their professional duties and their own personalities in order to offer spiritual care to the elderly individual.

[Effects on salivation, xerostomia and halitosis in elders after oral function improvement exercises].

PubMed

Kim, Young Jin; Park, Kyung Min

2012-12-01

The purpose of this study was to investigate effects of Oral Function Improvement Exercises on salivation, xerostomia and halitosis in elderly people. The participants in the study were 48 female community-dwelling elders in D city. The Oral Function Improvement Exercises were given 3 times a week, for a total of 24 times from August to October 2011. Spitting method, Visual Analogue Scale, and halimeter (mBA-21) were used to evaluate the effects of Oral Function Improvement Exercises on salivation, xerostomia, and halitosis. The data were analyzed using χ²-test and t-test with the SPSS program. The experimental group had significantly better salivation, and less xerostomia and halitosis than the control group. The results indicate that Oral Function Improvement Exercises were effective for salivation, xerostomia and halitosis in the elders. Therefore, it was suggested that Oral Function Improvement Exercise are applicable in a community nursing intervention program to improve the quality of life for elders.

The Impact Of Dispositional Variables Of Elders, Relatives, And Paid Caregivers On Elders' Empowerment And Life Satisfaction.

PubMed

Tomai, Manuela; Pezzuti, Lina; Mebane, Minou; Benedetti, Maura; Moro, Annalisa

2017-01-01

Background/Study Context: The impact of dispositional characteristic of elders' closest network members on elders' life satisfaction and empowerment has remained largely unexplored. This innovative study aimed to assess the impact of dispositional variables of elders, relatives, and paid caregivers on life satisfaction and empowerment of elders. One hundred forty-three triads (one elder, one paid caregiver, and one relative) completed six scales measuring modifiable personality characteristics (loneliness, optimism, regulation of positive and negative emotions), life satisfaction, and sense of empowerment. Two dispositional variables of relatives (positivity and ability to set goals) and one dispositional variable of care workers (self-satisfaction) were significantly related to life satisfaction of elders. Positivity of elders and the capacity to set objectives of the family members affected empowerment of elders. Future interventions aiming to improve life satisfaction and empowerment of elders should focus on these modifiable dispositional variables.

Impact of continuous in-home rehabilitation on quality of life and activities of daily living in elderly clients over 1 year.

PubMed

Imanishi, Miyuki; Tomohisa, Hisao; Higaki, Kazuo

2017-11-01

To verify the effect of in-home rehabilitation on quality of life and activities of daily living in elderly clients. In this non-randomized controlled intervention trial, elderly participants were separated into a rehabilitation or a non-rehabilitation group (n = 100 each). The non-rehabilitation group received basic in-home nursing care, including assistance with cooking, cleaning, toileting, meals and medication. The rehabilitation group received a physical treatment program provided by a licensed professional once a week and basic nursing care in the home. For each group, quality of life and activities of daily living were assessed approximately every 3 months over a 1-year period. Quality of life was evaluated using the Philadelphia Geriatric Center Morale Scale, and activities of daily living were evaluated based on the Functional Independence Measure. The rehabilitation group showed statistically significant improvements in both quality of life and activities of daily living. In contrast, the non-rehabilitation group, although showing slight improvement in quality of life at 9 months, showed almost no effects at the other time-points and no significant changes in activities of daily living over the course of the study. The results of the present study suggest that long-term continuous in-home rehabilitation might improve quality of life and activities of daily living in elderly clients. Geriatr Gerontol Int 2017; 17: 1866-1872. © 2017 Japan Geriatrics Society.

How trained volunteers can improve the quality of hospital care for older patients. A qualitative evaluation within the Hospital Elder Life Program (HELP).

PubMed

Steunenberg, Bas; van der Mast, Roos; Strijbos, Marije J; Inouye, Sharon K; Schuurmans, Marieke J

The aim of this study was to investigate, using a mixed-methods design, the added value of a trained Hospital Elder Life Program (HELP) volunteer to the quality of hospital care in the Netherlands. The trained volunteers daily stimulate older patients, at risk of a delirium, to eat, to drink, and to exercise, and they provide walking assistance and cognitive stimulation. This study showed that each group appreciated the extra attention and service from the volunteers. The positive effect on feelings of loneliness during the hospital stay was an unexpected outcome. The volunteers themselves appreciated their work. In conclusion, a HELP volunteer should be provided to every older hospital patient. Copyright © 2016 Elsevier Inc. All rights reserved.

The effects of strength training on cognitive performance in elderly women.

PubMed

Smolarek, André de Camargo; Ferreira, Luis Henrique Boiko; Mascarenhas, Luis Paulo Gomes; McAnulty, Steven R; Varela, Karla Daniele; Dangui, Mônica C; de Barros, Marcelo Paes; Utter, Alan C; Souza-Junior, Tácito P

2016-01-01

Aging is a degenerative process marked by recognized functional, physiological, and metabolic impairments, such as dynapenia and diminished cognitive capacity. Therefore, the search for innovative strategies to prevent/delay these physiological and cognitive disorders is essential to guarantee the independence and life quality of an elderly population. The aim of this work is to verify the effect of a 12-week resistance exercise program on the general physical aptitude and cognitive capacities of elderly and sedentary women. Twenty-nine women (65.87±5.69 years) were divided into two groups. The control group was composed of eight elderly women who met the same inclusion criteria of the study and the strength training group was composed of 29 elderly women who were subjected to a resistance exercise program defined by 12 upper and lower limb exercises combined in 3×10 repetitions with 1-minute interval between repetitions and two resting minutes between exercises (three times/week). Weight loads were fixed between 60% and 75% of the apparent 1 repetition maximum, which was estimated by the test of 10 maximum repetitions. The direct curl was performed for upper body strength evaluation with 2.3 kg dumbbells for 30 seconds, whereas the chair test was used for lower body evaluation (total sit-stand movements in 30 seconds). The cognitive capacities of subjects were evaluated by "The Montreal Cognitive Assessment" questionnaire. After 12 weeks, the elderly group showed significant increases in the average upper body strength (58%), lower body strength (68%), and cognitive capacity (19%). The present study demonstrated that regular resistance exercises could provide significant gains on the upper and lower body strength concomitant to positive improvements on cognitive capacities of elderly women, bringing enhanced life quality.

Cost-effectiveness of programs to eliminate disparities in elderly vaccination rates in the United States

PubMed Central

2014-01-01

Background There are disparities in influenza and pneumococcal vaccination rates among elderly minority groups and little guidance as to which intervention or combination of interventions to eliminate these disparities is likely to be most cost-effective. Here, we evaluate the cost-effectiveness of four hypothetical vaccination programs designed to eliminate disparities in elderly vaccination rates and differing in the number of interventions. Methods We developed a Markov model in which we assumed a healthcare system perspective, 10-year vaccination program and lifetime time horizon. The cohort was the combined African-American and Hispanic 65 year-old birth cohort in the United States in 2009. We evaluated five different vaccination strategies: no vaccination program and four vaccination programs that varied from “low intensity” to “very high intensity” based on the number of interventions deployed in each program, their cumulative cost and their cumulative impact on elderly minority influenza and pneumococcal vaccination rates. Results The very high intensity vaccination program ($24,479/quality-adjusted life year; QALY) was preferred at willingness-to-pay-thresholds of $50,000 and $100,000/QALY and prevented 37,178 influenza cases, 342 influenza deaths, 1,158 invasive pneumococcal disease (IPD) cases and 174 IPD deaths over the birth cohort’s lifetime. In one-way sensitivity analyses, the very high intensity program only became cost-prohibitive (>$100,000/QALY) at less likely values for the influenza vaccination rates achieved in year 10 of the high intensity (>73.5%) or very high intensity (<76.8%) vaccination programs. Conclusions A practice-based vaccination program designed to eliminate disparities in elderly minority vaccination rates and including four interventions would be cost-effective. PMID:25023889

Cost-effectiveness of programs to eliminate disparities in elderly vaccination rates in the United States.

PubMed

Michaelidis, Constantinos I; Zimmerman, Richard K; Nowalk, Mary Patricia; Smith, Kenneth J

2014-07-15

There are disparities in influenza and pneumococcal vaccination rates among elderly minority groups and little guidance as to which intervention or combination of interventions to eliminate these disparities is likely to be most cost-effective. Here, we evaluate the cost-effectiveness of four hypothetical vaccination programs designed to eliminate disparities in elderly vaccination rates and differing in the number of interventions. We developed a Markov model in which we assumed a healthcare system perspective, 10-year vaccination program and lifetime time horizon. The cohort was the combined African-American and Hispanic 65 year-old birth cohort in the United States in 2009. We evaluated five different vaccination strategies: no vaccination program and four vaccination programs that varied from "low intensity" to "very high intensity" based on the number of interventions deployed in each program, their cumulative cost and their cumulative impact on elderly minority influenza and pneumococcal vaccination rates. The very high intensity vaccination program ($24,479/quality-adjusted life year; QALY) was preferred at willingness-to-pay-thresholds of $50,000 and $100,000/QALY and prevented 37,178 influenza cases, 342 influenza deaths, 1,158 invasive pneumococcal disease (IPD) cases and 174 IPD deaths over the birth cohort's lifetime. In one-way sensitivity analyses, the very high intensity program only became cost-prohibitive (>$100,000/QALY) at less likely values for the influenza vaccination rates achieved in year 10 of the high intensity (>73.5%) or very high intensity (<76.8%) vaccination programs. A practice-based vaccination program designed to eliminate disparities in elderly minority vaccination rates and including four interventions would be cost-effective.

Looking Forward: Texas and Its Elderly. Highlights of the Robert Lee Sutherland Seminar (4th, Austin, Texas, May 12, 1984).

ERIC Educational Resources Information Center

Coleman, Marion Tolbert, Ed.; And Others

This document presents the program agenda and highlights from the one-day Robert Lee Sutherland Seminar held to examine the current status and the future of the elderly population of Texas. Included is the speech, "The Longevity Revolution" by Robert N. Butler, in which is discussed the gain in life expectancy, the feminization of aging,…

The Beneficial Effects of Cognitive Training With Simple Calculation and Reading Aloud (SCRA) in the Elderly Postoperative Population: A Pilot Randomized Controlled Trial.

PubMed

Kulason, Kay; Nouchi, Rui; Hoshikawa, Yasushi; Noda, Masafumi; Okada, Yoshinori; Kawashima, Ryuta

2018-01-01

Background: There has been little research conducted regarding cognitive treatments for the elderly postsurgical population. Patients aged ≥60 years have an increased risk of postoperative cognitive decline, a condition in which cognitive functions are negatively affected. This cognitive decline can lead to a decline in quality of life. In order to maintain a high quality of life, the elderly postsurgical population may benefit from treatment to maintain and/or improve their cognitive functions. This pilot study investigates the effect of simple calculation and reading aloud (SCRA) cognitive training in elderly Japanese postsurgical patients. Methods: Elderly patients undergoing non-cardiovascular thoracic surgery under general anesthesia were recruited ( n = 12). Subjects were randomly divided into two groups-one that receives 12 weeks of SCRA intervention, and a waitlisted control group. Before and after the intervention, we measured cognitive function [Mini-Mental Status Exam-Japanese (MMSE-J), Frontal Assessment Battery (FAB), computerized Cogstate Brief Battery (CBB)] and emotional state [General Health Questionnaire-12 (GHQ-12), Geriatric Depression Scale (GDS), Quality of Life Scale-5 (QOL-5)]. Results: Group difference analyses using ANCOVA with permutation test showed that the intervention SCRA group had a significant improvement in FAB motor programming sub-score, GDS, and QOL-5 compared to the control group. Within-group analyses using Wilcoxon signed-rank test to compare baseline and follow-up showed that the SCRA intervention group total FAB scores, FAB motor programming sub-scores, and QOL-5 scores were significantly improved. Discussion: This pilot study showed that there are important implications for the beneficial effects of SCRA intervention on cognitive function and emotional state in the postoperative elderly population; however, further investigations are necessary to reach any conclusions. Trial registration: This study was registered with the University Hospital Medical Information Network (UMIN) Clinical Trial Registry (UMIN000019832).

The Beneficial Effects of Cognitive Training With Simple Calculation and Reading Aloud (SCRA) in the Elderly Postoperative Population: A Pilot Randomized Controlled Trial

PubMed Central

Kulason, Kay; Nouchi, Rui; Hoshikawa, Yasushi; Noda, Masafumi; Okada, Yoshinori; Kawashima, Ryuta

2018-01-01

Background: There has been little research conducted regarding cognitive treatments for the elderly postsurgical population. Patients aged ≥60 years have an increased risk of postoperative cognitive decline, a condition in which cognitive functions are negatively affected. This cognitive decline can lead to a decline in quality of life. In order to maintain a high quality of life, the elderly postsurgical population may benefit from treatment to maintain and/or improve their cognitive functions. This pilot study investigates the effect of simple calculation and reading aloud (SCRA) cognitive training in elderly Japanese postsurgical patients. Methods: Elderly patients undergoing non-cardiovascular thoracic surgery under general anesthesia were recruited (n = 12). Subjects were randomly divided into two groups—one that receives 12 weeks of SCRA intervention, and a waitlisted control group. Before and after the intervention, we measured cognitive function [Mini-Mental Status Exam-Japanese (MMSE-J), Frontal Assessment Battery (FAB), computerized Cogstate Brief Battery (CBB)] and emotional state [General Health Questionnaire-12 (GHQ-12), Geriatric Depression Scale (GDS), Quality of Life Scale-5 (QOL-5)]. Results: Group difference analyses using ANCOVA with permutation test showed that the intervention SCRA group had a significant improvement in FAB motor programming sub-score, GDS, and QOL-5 compared to the control group. Within-group analyses using Wilcoxon signed-rank test to compare baseline and follow-up showed that the SCRA intervention group total FAB scores, FAB motor programming sub-scores, and QOL-5 scores were significantly improved. Discussion: This pilot study showed that there are important implications for the beneficial effects of SCRA intervention on cognitive function and emotional state in the postoperative elderly population; however, further investigations are necessary to reach any conclusions. Trial registration: This study was registered with the University Hospital Medical Information Network (UMIN) Clinical Trial Registry (UMIN000019832). PMID:29643802

Beyond Work-Family Programs: Confronting and Resolving the Underlying Causes of Work-Personal Life Conflict.

ERIC Educational Resources Information Center

Kofodimos, Joan R.

Work-Family Programs (WFPs) are among the most popular and publicized workplace innovations of the 1990s. These programs are intended to alleviate employees' work-personal conflicts by addressing issues such as child care assistance, parental leave, elder care, flexible working arrangements, wellness and fitness, and stress management. The problem…

An adapted mindfulness-based stress reduction program for elders in a continuing care retirement community: quantitative and qualitative results from a pilot randomized controlled trial.

PubMed

Moss, Aleezé S; Reibel, Diane K; Greeson, Jeffrey M; Thapar, Anjali; Bubb, Rebecca; Salmon, Jacqueline; Newberg, Andrew B

2015-06-01

The purpose of this study was to test the feasibility and effectiveness of an adapted 8-week Mindfulness-Based Stress Reduction (MBSR) program for elders in a continuing care community. This mixed-methods study used both quantitative and qualitative measures. A randomized waitlist control design was used for the quantitative aspect of the study. Thirty-nine elderly were randomized to MBSR (n = 20) or a waitlist control group (n = 19), mean age was 82 years. Both groups completed pre-post measures of health-related quality of life, acceptance and psychological flexibility, facets of mindfulness, self-compassion, and psychological distress. A subset of MBSR participants completed qualitative interviews. MBSR participants showed significantly greater improvement in acceptance and psychological flexibility and in role limitations due to physical health. In the qualitative interviews, MBSR participants reported increased awareness, less judgment, and greater self-compassion. Study results demonstrate the feasibility and potential effectiveness of an adapted MBSR program in promoting mind-body health for elders. © The Author(s) 2014.

A nursing response to the needs of the elderly.

PubMed

Koff, S Z; Koff, H V

1997-01-01

The aging phenomenon, a mark of contemporary society, has underscored the need to maintain and improve the health status of the elderly as well as their quality of life and to prevent their institutionalization. In a response to this need, the Foundation of the New York State Nurses Association has designed a unique and comprehensive health promotion program based on the cooperative efforts of volunteer nurses and consumers which is addressed to the well and frail elderly living in the community. This article discusses the various facets of the initial establishment of the process. More specifically, it focuses on the needs of the target population, the structure of the program, its curriculum, an evaluation comparing this effort with others, and the advantages accruing to the nursing profession.

Need for geriatric dentistry training programs in Iran.

PubMed

Mir, Arash Poorsattar Bejeh

2013-01-01

A shifting pattern from communicable diseases to the chronic noncommunicable diseases and increased life expectancy are being sensed throughout the world. Aged populations with multiple chronic diseases come up with their unique needs and require specific attention to be challenged by the health systems. Neglected orodental facts among the elders and the dearth of specific designated undergraduate and postgraduate courses of geriatric dentistry in Iran inevitably adversely affect the delivery of appropriate dental care service to elders by untrained dentists. In this article, a proposal for academic geriatric dentistry courses in Iran is introduced and highlighted with regards to elders' special needs.

The Role of Meaning in Life for the Quality of Life of Community-Dwelling Chinese Elders With Low Socioeconomic Status

PubMed Central

2018-01-01

Objectives: There is limited research on the meaning in life among Chinese elders. This study aims to examine the association among functional disabilities, meaning in life, social network, and quality of life in community-dwelling Chinese elders with low socioeconomic status. Methods: A cross-sectional survey was used to collect data from 339 poor community-dwelling Chinese elders aged 60 and above. Results: The results showed that meaning in life and social network were significantly related to quality of life. Moreover, social network was a mediator to the relationship between functional disability and quality of life, and meaning in life was a partial mediator to the relationship between social network and quality of life. Conclusion: Workshops should be organized by the elderly service providers for Chinese elders facing deterioration in health and activity levels to learn to live intentionally and purposefully. A social network among elders should also be fostered in the community. PMID:29780856

Technologies for participatory medicine and health promotion in the elderly population

PubMed Central

Nieto-Riveiro, Laura; Groba, Betania; Miranda, M. Carmen; Concheiro, Patricia; Pazos, Alejandro; Pousada, Thais; Pereira, Javier

2018-01-01

Abstract Introduction: The progressive aging of the population is a socio-demographic phenomenon experienced by most countries in the world in recent decades, especially in Japan and in many European Union countries. During this process, so-called “geriatric syndromes” frequently occur. The focus of this study is the quality of life of the elderly in relation to these 3 factors: risk of falls, urinary incontinence, and insomnia. Objective: The main purpose is to determine the impact of a multifactorial intervention program implemented with institutionalized elderly people. The program is focused on the treatment of the aforementioned factors. Methods and Analysis: The study will be carried out with elderly people living in three residences for the elderly in A Coruña Province (Galicia, Spain).It is a prospective and longitudinal study, with a temporary series design of a “quasi-experimental” type that evaluates the effect of an intervention in 1 given population by doing assessments pre- and post-intervention, but there is no comparison with a control group. The intervention will be based on a multifactorial program, including the following phases: the use of wearable devices (wearable fitness trackers to register physical activity and sleep), the use of an App on a Tablet to record the participants’ occupations and activities, counseling about performance in activities of daily living, the implementation of a physical activity program, and the treatment of the pelvic floor (according to each research line). The Quality of Life (QoL) will be assessed before and after the intervention, with the use of the questionnaire EuroQol-5D-5L. Data analysis will be applied with all registered variables through a quantitative perspective. Ethics and Dissemination: The protocol has been approved by the host institution's ethics committee (Research Ethics Committee of Galicia) under the number 2017/106. Results will be disseminated via peer-reviewed journal articles and conferences. This clinical trial is registered at ClinicalTrials.gov identifier: NCT03504813. PMID:29768372

Technologies for participatory medicine and health promotion in the elderly population.

PubMed

Nieto-Riveiro, Laura; Groba, Betania; Miranda, M Carmen; Concheiro, Patricia; Pazos, Alejandro; Pousada, Thais; Pereira, Javier

2018-05-01

The progressive aging of the population is a socio-demographic phenomenon experienced by most countries in the world in recent decades, especially in Japan and in many European Union countries. During this process, so-called "geriatric syndromes" frequently occur. The focus of this study is the quality of life of the elderly in relation to these 3 factors: risk of falls, urinary incontinence, and insomnia. The main purpose is to determine the impact of a multifactorial intervention program implemented with institutionalized elderly people. The program is focused on the treatment of the aforementioned factors. The study will be carried out with elderly people living in three residences for the elderly in A Coruña Province (Galicia, Spain).It is a prospective and longitudinal study, with a temporary series design of a "quasi-experimental" type that evaluates the effect of an intervention in 1 given population by doing assessments pre- and post-intervention, but there is no comparison with a control group.The intervention will be based on a multifactorial program, including the following phases: the use of wearable devices (wearable fitness trackers to register physical activity and sleep), the use of an App on a Tablet to record the participants' occupations and activities, counseling about performance in activities of daily living, the implementation of a physical activity program, and the treatment of the pelvic floor (according to each research line). The Quality of Life (QoL) will be assessed before and after the intervention, with the use of the questionnaire EuroQol-5D-5L. Data analysis will be applied with all registered variables through a quantitative perspective. The protocol has been approved by the host institution's ethics committee (Research Ethics Committee of Galicia) under the number 2017/106. Results will be disseminated via peer-reviewed journal articles and conferences. This clinical trial is registered at ClinicalTrials.gov identifier: NCT03504813.

Sexuality and elderly with chronic diseases: A review of the existing literature.

PubMed

Merghati-Khoei, Effat; Pirak, Arezoo; Yazdkhasti, Mansoureh; Rezasoltani, Parvaneh

2016-01-01

Increased life expectancy and the growing phenomenon of aging can lead to increased burden of chronic diseases (CDs) which adversely affects the overall health of elderly, their sexuality in particular. Sexual life of an aged population is overlooked in many of the societies. In the present narrative review, we aim to assess the impact of CDs on sexual function of elderly people. We used internet databases including PubMed, EMBASE, ISI Web of Science, Google Scholar, SID, Iran Medex, Magiran, IPPF, and UNFPA without time limit. Ninety-eight out of 174 relevant articles were selected which met the inclusion criteria: those articles were research-based in English or Persian (original or review articles) and textbooks; specified one or more CDs and sexual function of the cases; elderly people over the age of sixty, men and women; and coordination between articles and research goals. We excluded qualitative and case studies. We reported the most related CDs with sexual function in literature review and used the biological and psychological impact of the CDs on sexual function of elderly population based on the conceptual model of Verschuren et al . (2010). The results of the studies were classified into the themes including physical, psychological, and cultural and social. Diabetes, cardiovascular, cancerous, and chronic respiratory diseases and also some medications can reduce sexual capacity and desire in particular resulting in negative impact on the quality of elderly sexual life. CDs may influence sexual expressions and responses which adversely affect one's mood and energy so that can cause depression and grief, as well as loss of self-confidence, self-esteem, and self-concept in elderly adults. The factors affecting sexuality of an elderly with CDs include cultural and mythical beliefs about age and illnesses, fear, and embarrass of changed physical appearance. The research conducted among elderly population examining the adverse influence of CDs on aged people's sexual life in general, sexual function and performance, and intimate interaction. It is considered that programs on sexual health needs of aged population for the health-care workers can prove beneficial in improving sexual health.

Sexuality and elderly with chronic diseases: A review of the existing literature

PubMed Central

Merghati-Khoei, Effat; Pirak, Arezoo; Yazdkhasti, Mansoureh; Rezasoltani, Parvaneh

2016-01-01

Background: Increased life expectancy and the growing phenomenon of aging can lead to increased burden of chronic diseases (CDs) which adversely affects the overall health of elderly, their sexuality in particular. Sexual life of an aged population is overlooked in many of the societies. In the present narrative review, we aim to assess the impact of CDs on sexual function of elderly people. Materials and Methods: We used internet databases including PubMed, EMBASE, ISI Web of Science, Google Scholar, SID, Iran Medex, Magiran, IPPF, and UNFPA without time limit. Ninety-eight out of 174 relevant articles were selected which met the inclusion criteria: those articles were research-based in English or Persian (original or review articles) and textbooks; specified one or more CDs and sexual function of the cases; elderly people over the age of sixty, men and women; and coordination between articles and research goals. We excluded qualitative and case studies. We reported the most related CDs with sexual function in literature review and used the biological and psychological impact of the CDs on sexual function of elderly population based on the conceptual model of Verschuren et al. (2010). Results: The results of the studies were classified into the themes including physical, psychological, and cultural and social. Diabetes, cardiovascular, cancerous, and chronic respiratory diseases and also some medications can reduce sexual capacity and desire in particular resulting in negative impact on the quality of elderly sexual life. CDs may influence sexual expressions and responses which adversely affect one's mood and energy so that can cause depression and grief, as well as loss of self-confidence, self-esteem, and self-concept in elderly adults. The factors affecting sexuality of an elderly with CDs include cultural and mythical beliefs about age and illnesses, fear, and embarrass of changed physical appearance. The research conducted among elderly population examining the adverse influence of CDs on aged people's sexual life in general, sexual function and performance, and intimate interaction. Conclusion: It is considered that programs on sexual health needs of aged population for the health-care workers can prove beneficial in improving sexual health. PMID:28331522

Cost-effectiveness of a multicomponent primary care program targeting frail elderly people.

PubMed

Ruikes, Franca G H; Adang, Eddy M; Assendelft, Willem J J; Schers, Henk J; Koopmans, Raymond T C M; Zuidema, Sytse U

2018-05-16

Over the last 20 years, integrated care programs for frail elderly people aimed to prevent functional dependence and reduce hospitalization and institutionalization. However, results have been inconsistent and merely modest. To date, evidence on the cost-effectiveness of these programs is scarce. We evaluated the cost-effectiveness of the CareWell program, a multicomponent integrated care program for frail elderly people. Economic evaluation from a healthcare perspective embedded in a cluster controlled trial of 12 months in 12 general practices in (the region of) Nijmegen. Two hundred and four frail elderly from 6 general practices in the intervention group received care according to the CareWell program, consisting of multidisciplinary team meetings, proactive care planning, case management, and medication reviews; 165 frail elderly from 6 general practices in the control group received usual care. In cost-effectiveness analyses, we related costs to daily functioning (Katz-15 change score i.e. follow up score minus baseline score) and quality adjusted life years (EQ-5D-3 L). Adjusted mean costs directly related to the intervention were €456 per person. Adjusted mean total costs, i.e. intervention costs plus healthcare utilization costs, were €1583 (95% CI -4647 to 1481) higher in the intervention group than in the control group. Incremental Net Monetary Benefits did not show significant differences between groups, but on average tended to favour usual care. The CareWell primary program was not cost-effective after 12 months. From a cost-effectiveness perspective, widespread implementation of the program in its current form cannot be recommended. The study was registered in the ClinicalTrials.govProtocol Registration System: ( NCT01499797 ; December 26, 2011). Retrospectively registered.

Dispositional characteristics, relational well-being and perceived life satisfaction and empowerment of elders.

PubMed

Francescato, Donata; Pezzuti, Lina; Mebane, Minou; Tomai, Manuela; Benedetti, Maura; Moro, Annalisa

2017-10-01

The broad purpose of this research is to identify the key modifiable variables most related to elders' life satisfaction and empowerment in order to improve the efficacy of interventions projects. Our study aims to integrate the theoretical perspectives of personality and community psychology focusing both on dispositional characteristics and relational well-being of elders, investigating triads, composed by an elder, a paid caregiver and the most involved relative. This study explores the impact of (1) some socio-demographic characteristics of elders, (2) some modifiable dispositional variables of elders and (3) elders' relational well-being on elders' empowerment and life satisfaction. The study involved 429 people in 143 triads. Semi-structured interviews with elders, paid caregiver and close relatives were used to construct a new pilot measure of elders' relational well-being. Life Satisfaction, Empowerment, Loneliness, Positivity, Humor and Emotions self-efficacy scales were also administered. Hierarchical multiple regressions were performed. Elders' positivity, relational well-being of elders and living alone were significantly related to empowerment. Elders' relational well-being and positivity significantly contributed to life satisfaction. Interventions to increase empowerment and life satisfaction should focus primarily on augmenting positivity and relational well-being integrating the theoretical premises of both personality and community psychology.

Effect of Oral Health Care Program on Oral Health Status of Elderly People Living in Nursing Homes: a Quasi-experimental Study.

PubMed

Ildarabadi, Es-Hagh; Armat, Mohammad Reza; Motamedosanaye, Vahideh; Ghanei, Farzaneh

2017-12-01

Oral health of elderly people plays a major role in their overall health and quality of life, and is an integral part of personal care. The aim of this study was to evaluate the effect of implementing the oral health care program (OHCP) on oral health status of elderly people resident in nursing homes. This quasi-experimental study was carried out using a pretest-posttest design on 101 elderly people (46 in the intervention group and 55 in the control group) resident in two randomly selected nursing homes in Mashhad, Iran. In the intervention group, the OHCP was carried out by caregivers for 8 weeks. The control group received routine care. Using the oral health assessment tool, the oral health status of elderly people was assessed in both groups at three times; onset of the study, 4th, and 8th week after the start of the study. The oral health status of the elderly people in both groups was not statistically significantly different at baseline, but it changed significantly at the 4 th , and 8 th weeks (p<.001). The implementation of the OHCP for elderly people resident in nursing homes may improve their oral health status after 4 weeks. It is recommended that OHCP be included in care plans of all nursing homes to improve the elderly people's oral health status.

Development of Elderly Quality of Life Index – Eqoli: Item Reduction and Distribution into Dimensions

PubMed Central

Paschoal, Sérgio Márcio Pacheco; Filho, Wilson Jacob; Litvoc, Júlio

2008-01-01

OBJECTIVE To describe item reduction and its distribution into dimensions in the construction process of a quality of life evaluation instrument for the elderly. METHODS The sampling method was chosen by convenience through quotas, with selection of elderly subjects from four programs to achieve heterogeneity in the “health status”, “functional capacity”, “gender”, and “age” variables. The Clinical Impact Method was used, consisting of the spontaneous and elicited selection by the respondents of relevant items to the construct Quality of Life in Old Age from a previously elaborated item pool. The respondents rated each item’s importance using a 5-point Likert scale. The product of the proportion of elderly selecting the item as relevant (frequency) and the mean importance score they attributed to it (importance) represented the overall impact of that item in their quality of life (impact). The items were ordered according to their impact scores and the top 46 scoring items were grouped in dimensions by three experts. A review of the negative items was performed. RESULTS One hundred and ninety three people (122 women and 71 men) were interviewed. Experts distributed the 46 items into eight dimensions. Closely related items were grouped and dimensions not reaching the minimum expected number of items received additional items resulting in eight dimensions and 43 items. DISCUSSION The sample was heterogeneous and similar to what was expected. The dimensions and items demonstrated the multidimensionality of the construct. The Clinical Impact Method was appropriate to construct the instrument, which was named Elderly Quality of Life Index - EQoLI. An accuracy process will be examined in the future. PMID:18438571

The relationships among Muslim Uyghur and Kazakh disabled elders' life satisfaction, activity of daily living, and informal family caregiver's burden, depression, and life satisfaction in far western China: A structural equation model.

PubMed

Wang, Wen Ting; He, Bin; Wang, Yu Huan; Wang, Mei Yan; Chen, Xue Feng; Wu, Fu Chen; Yang, Xue

2017-04-01

1 Hypothesis Disabled elders' activities of daily living, caregiver burden, caregiver depression, and caregivers' life satisfaction are significantly related to the life satisfaction of elderly people with disability. 2 Hypothesis There are direct and indirect effects between the life satisfaction of elders, disabled elders' activities of daily living, and family caregivers' factors. This study explored the interrelationships of disabled elders' life satisfaction and activities of daily living, caregivers' factors (burden, depression, and life satisfaction) through a structural equation model. In total, 621 dyads of disabled elders and informal family caregivers completed questionnaires during face-to-face interviews in Xinjiang Uyghur Autonomous Region from September 2013 to January 2014. Activity of daily living exerted a direct effect on life satisfaction of disabled elders and 30.4% indirect effect through caregivers' factors. Caregiver burden had a 60.0% direct effect on life satisfaction of disabled elders and a 40.0% indirect effect through the caregiver depression. Caregiver depression showed 76% direct effect on life satisfaction of disabled elders and 24% indirect effect through caregivers' life satisfaction. Direct relationships between activity of daily living and caregiver burden, caregiver burden and caregiver depression, and caregiver depression and caregivers' life satisfaction were observed. Activity of daily living had a 91.3% indirect effect on caregiver depression mediated by caregiver burden; caregiver burden had a 40.0% indirect effect on caregivers' life satisfaction mediated by caregiver depression. Results provide useful information for nurses and policymakers and shed light on the need to consider caregivers' factors in improving care recipients' life satisfaction. © 2017 John Wiley & Sons Australia, Ltd.

Integration Experiences Casebook: Program Ideas in Aging and Developmental Disabilities.

ERIC Educational Resources Information Center

Janicki, Matthew P.; Keefe, Robert M.

An assortment of 38 case studies illustrates efforts to integrate elderly individuals with developmental disabilities into generic aging services and into community life. The case studies include models and practice experiences that aided seniors to retire, participate in programs and services, and become part of their community's aging network.…

Multicomponent Program to Reduce Functional Decline in Frail Elderly People: A Cluster Controlled Trial.

PubMed

Ruikes, Franca G H; Zuidema, Sytse U; Akkermans, Reinier P; Assendelft, Willem J J; Schers, Henk J; Koopmans, Raymond T C M

2016-01-01

The increasing number of community-dwelling frail elderly people poses a challenge to general practice. We evaluated the effectiveness of a general practitioner-led extensive, multicomponent program integrating cure, care, and welfare for the prevention of functional decline. We performed a cluster controlled trial in 12 general practices in Nijmegen, the Netherlands. Community-dwelling frail elderly people aged ≥70 years were identified with the EASY-Care two-step older persons screening instrument. In 6 general practices, 287 frail elderly received care according to the CareWell primary care program. This consisted of proactive care planning, case management, medication reviews, and multidisciplinary team meetings with a general practitioner, practice and/or community nurse, elderly care physician, and social worker. In another 6 general practices, 249 participants received care as usual. The primary outcome was independence in functioning during (instrumental) activities of daily living (Katz-15 index). Secondary outcomes were quality of life [EuroQol (EQ5D+C) instrument], mental health and health-related social functioning (36-item RAND Short Form survey instrument), institutionalization, hospitalization, and mortality. Outcomes were assessed at baseline and at 12 months, and were analyzed with linear mixed-model analyses. A total of 204 participants (71.1%) in the intervention group and 165 participants (66.3%) in the control group completed the study. No differences between groups regarding independence in functioning and secondary outcomes were found. We found no evidence for the effectiveness of a multifaceted integrated care program in the prevention of adverse outcomes in community-dwelling frail elderly people. Large-scale implementation of this program is not advocated. © Copyright 2016 by the American Board of Family Medicine.

Abuse, Neglect, and Violence Against Elderly Women in Ghana: Implications for Social Justice and Human Rights.

PubMed

Sossou, Marie-Antoinette; Yogtiba, Joseph A

2015-01-01

This article discusses abuse and neglect of elderly women in Ghana and the traditional practices that adversely affect their human rights. Their situation is characterized by pervasive poverty, illiteracy, widowhood, predominantly rural dwelling, and subjection to insidious cultural practices and superstitious beliefs. Increase in life expectancy and population trends point to significant increases in the numbers of the elderly women. Breakdown of the extended family support system and the waning of filial obligations are factors affecting their welfare. Accurate data on these abuses is lacking due to cultural inhibitions and non-reporting. Legislations and NGO programs are addressed to combat abuses.

Cottage Crafts Final Report. ESL Cottage Industry Education and Employment Program. July 1, 1982 - June 30, 1983. A 310 Adult Education Project.

ERIC Educational Resources Information Center

Henry, Jean; And Others

The ESL (English as a second language) Cottage Industry Education and Employment Program was developed to provide ESL and life skills instruction to homebound and elderly refugees while, at the same time, fostering the continuation of native crafts and folklife. The program was the cooperative effort of local adult education staff, leaders and…

Listening to the Voices of Native Hawaiian Elders and ‘Ohana Caregivers: Discussions on Aging, Health, and Care Preferences

PubMed Central

Mokuau, Noreen; Ka’opua, Lana S.; Kim, Bum Jung; Higuchi, Paula; Braun, Kathryn L.

2015-01-01

Native Hawaiians, the indigenous people of Hawai’i, are affected by varying social and health disparities that result in high prevalence of chronic disease, early onset of disability, and shorter life expectancy compared to other ethnic groups in Hawai’i. Six listening meetings were conducted, involving 41 community-dwelling kūpuna (Native Hawaiian elders) and ‘ohana (family) caregivers to investigate health and care preferences that offer the potential for improving well-being in later life for Native Hawaiian elders. As background, we provide three explanatory perspectives and theories—life course perspective, minority stress theory, and historical trauma—that guided the design of this study and provided the study’s context. A number of overarching themes and subthemes were identified, some of which point to universal concerns with age and caregiving (such as challenges and costs associated with growing old and caregiving) and others that are culturally specific (such as influence of culture and social stressors, including discrimination, on health needs and care preferences). Results give further support to the urgency of affordable, accessible, and acceptable programs and policies that can respond to the growing health and care needs of native elders and family caregivers. PMID:24659060

Geriatric health policy in India: The need for scaling-up implementation

PubMed Central

Paul, N. Sherin Susan; Asirvatham, Mathew

2016-01-01

In an anticipation of the rising geriatric population in India, the Central government constituted the National Policy for Older Persons in 1999 to promote the health and welfare of senior citizens in India. A major strategy of this policy is to encourage families to take care of their older family members. The policy also encourages voluntary organizations to supplement the care provided by the family and provide care and protection to vulnerable elderly people. The implementation of this policy, particularly in the rural areas, has been negligible and calls for a scaling-up of programs to address the physical, psychological, and social needs of the poor. Due to breakdown of the joint family system and the migration of the younger generation to the towns and cities, the elderly parents in the villages are left to fend for themselves. Too old to work and with little or no source of income, the elders are struggling even to satisfy their basic needs. This article primarily focuses on the various facets of elderly care in India. As a fledgling nation in elderly care, we should take cues from other nations who have pioneered in this field and should constantly evolve to identify and face the various challenges that come up, especially from rural India. The Rural Unit for Health and Social Affairs Department of a well-known Medical College in South India has developed a “senior recreation day care” model which proves to be a useful replicable model to improve the quality of life and nutritional status of the elderly in the lower rungs of society. More than a decade since its inception, it is now the right time to assess the implementation of our geriatric health policy and scale-up programs so that the elderly in our country, irrespective of urban and rural, will have a dignified and good quality life. PMID:27843821

Attitudes of elderly Korean patients toward death and dying: an application of Q-methodology.

PubMed

Yeun, Eunja

2005-11-01

The aim of this study was to identify the attitudes of elderly Korean patients toward death and dying using Q-methodology to aid in the development of basic strategies for nursing care of elderly Koreans. Thirty participants at a university hospital sorted 40 selected Q-statements on a nine-point scale. Data analysis identified three types of attitudes toward death and dying in elderly patients in Korea: religion-dependent, science-adherent, and sardonic. Religion-dependent elders are highly dependent upon religion as evidenced by their reply that they would like to rely on God and a minister the most. Science-adherent elders have great affection for life and believe in modern medical advancements. The sardonic elders regard death as the dispensation of nature so there is no need to be afraid of death and dying. This study will contribute to the understanding that nurses and other health professionals have of the perceptions of elderly Koreans about death and dying. Also, the findings may provide the basis for the development of more appropriate strategies to improve death and dying education programs of health professionals.

[Influenza vaccination in the elderly population in Mexico: economic considerations].

PubMed

Gutiérrez, Juan Pablo; Bertozzi, Stefano M

2005-01-01

To estimate costs and health outcomes that could be attained by an influenza vaccination program in adults 65 years of age and older in Mexico. Between June and October 2004, a model was constructed to estimate the number of life years lost due to influenza and the fraction that could be prevented by vaccination among adults 65 years of age and older. The model also allowed the estimation of the net cost of a vaccination program, including both the cost of delivering the vaccine and savings from prevented infections and their treatment costs. Using two scenarios of vaccine effectiveness, between 7 454 and 11 169 life years could saved by the vaccine if given to all adults 65 years and older in Mexico, with a net cost per life year saved between 13 301 and 21 037 Mexican pesos (about dollar 1 210 and dollar 1 910 US dollars). Influenza vaccination among the elderly in Mexico would result in savings per life year saved well below the Mexican gross domestic product (GDP) per capita, suggesting, even without examining alternative uses for these resources, that this is a cost effective intervention in Mexico and probably also in other middle-income developing countries.

The use of the functional independence measure in elderly.

PubMed

Ribeiro, Dâmarys Kohlbeck de Melo Neu; Lenardt, Maria Helena; Lourenço, Tânia Maria; Betiolli, Susanne Elero; Seima, Marcia Daniele; Guimarães, Carlos Alberto

2018-06-07

To analyze in scientific publications how the Functional Independence Measure (FIM) has been employed to evaluate the elderly. Integrative review of periodical publications between 2011 and 2015, available online in full-text in Portuguese, English and Spanish. 129 articles were found; after the application of the criteria, they resulted in 21. The studies were categorized into two groups: A) follow or compare scores in FIM (cohort studies, case-control, clinical trials), focusing on rehabilitation, evaluation of programs and changes in the functional level after procedures/interventions; and B) measure/associate the functionality of the elderly (cross-sectional studies), focused on evaluation protocols in elderly health and associations to the caregiver burden, hospital stay, balance, satisfaction with life, cognition and clinical/socio-demographic aspects. The FIM was used in several scenarios of healthcare for the elderly, particularly in rehabilitation and outpatient clinics or health centers.

Sarcopenia and decreased muscle strength in the elderly woman: resistance training as a safe and effective intervention.

PubMed

Foster-Burns, S B

1999-01-01

A principle component of age-related weakness and frailty in women is sarcopenia. This decrease in skeletal muscle mass is a progressive syndrome that will affect the quality of life for elderly women by decreasing the ability to perform many activities of daily living. Strength training is known to be an effective means of increasing muscular strength and size in many populations, and can be utilized successfully to significantly improve muscle strength, muscle mass and functional mobility in elderly women up to the age of 96 years. Such exercise can minimize the syndrome of physical frailty due to decreased muscle mass and strength. Any rehabilitation or exercise program for the elderly woman would benefit from the inclusion of such a training regime.

The effects of self-directed home exercise with serial telephone contacts on physical functions and quality of life in elderly people at high risk of locomotor dysfunction.

PubMed

Aoki, Kana; Sakuma, Mayumi; Ogisho, Noriyuki; Nakamura, Kozo; Chosa, Etsuo; Endo, Naoto

2015-01-01

Exercise is essential for maintaining quality of life (QOL) in elderly individuals. However, adherence to exercise programs is low. Here, we assessed the effectiveness of a self-directed home exercise program with serial telephone contacts to encourage exercise adherence among elderly individuals at high risk of locomotor dysfunction. We recruited community-dwelling adults (ｧ65 years) in Niigata, Japan, who were targets of the long-term care prevention project for locomotor dysfunction but did not participate in the government-sponsored prevention programs. The study was conducted from November 2011 to October 2012. Participants received exercise instruction and performed exercises independently for 3 months with serial telephone contacts. The single-leg stance and five-times sit-to-stand tests were used to assess physical function. The SF-8 was used to measure health-related QOL. Ninety-seven participants were enrolled in the study, representing 2.5% of eligible people;87 completed the intervention. Scores from physical function tests were significantly improved by the intervention, as were 7 of eight SF-8 subscales. Adherence was 85.4% for the single-leg standing exercise and 82.1% for squatting. Thus, self-directed home exercise with serial telephone contacts improved physical function and health-related QOL, representing a promising model for preventing the need for long-term care due to locomotor dysfunction.

Correlation of physical aptitude; functional capacity, corporal balance and quality of life (QoL) among elderly women submitted to a post-menopausal physical activities program.

PubMed

de Souza Santos, César Augusto; Dantas, Estélio Enrique Martin; Moreira, Maria Helena Rodrigues

2011-01-01

The objective of this study was to evaluate the effect of physical activity from the "Menopause in Form" program on physical aptitude, functional capacity, corporal balance and QoL among elderly women. In addition, correlations among these variables were examined. The present work was a longitudinal study that was quasi-experimental and correlational. A total of 323 elderly women (age: 69.0±5.53 years) participated in this study. Subjects were non-institutionalized, post-menopausal individuals residing at the Elderly Care Center in Belém Municipality (Pará, Brazil) and practiced one activity (i.e., dancing or walking) over a 10-month period. The assessment protocols used were the following: the Fullerton functional fitness test battery (physical aptitude); the activities of daily living (ADL) indices (functional capacity); the Tinetti-scale (corporal balance); and the WHOQOL-OLD questionnaire (QoL). The adopted significance level was p<0.05. Results from the Wilcoxon test demonstrated significant differences for the post-test assessment of functional capacity (Δ%=5.63%; p=0.0001) and general QoL (Δ%=9.19%; p=0.001). These results suggest that the physical activities employed during the "Menopause in Form" program resulted in significant improvements in the functional capacity and QoL of post-menopausal elderly women. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Perceived health, life satisfaction, and cardiovascular risk factors among elderly Korean immigrants and elderly Koreans.

PubMed

Sin, Mo-Kyung; Chae, Young-Ran; Choe, Myoung-Ae; Murphy, Patrick; Kim, Jeungim; Jeon, Mi-Yang

2011-03-01

Acknowledging that changes in sociocultural environment influence health status, the purpose of this study was to compare perceived health, life satisfaction, and cardiovascular health in elderly Korean immigrants and elderly Koreans. In this cross-sectional study, a convenience sample of 88 elderly Korean immigrants and 295 elderly Koreans 65 and older were recruited from Korean communities in the United States and Korea. Respondents' perceived health was measured by self-assessment; life satisfaction was self-assessed using a dichotomous scale of general satisfaction with life; and cardiovascular health status was surveyed by self-report of major diagnosed cardiovascular risk factors (i.e., hypertension, hyperlipidemia, diabetes mellitus) and body mass index measurement for obesity. Despite having better perceived health and life satisfaction, elderly Korean immigrants also had higher prevalence of cardiovascular risk factors. The findings provide health care providers with useful information for effective health assessment of minority immigrants. Copyright 2011, SLACK Incorporated.

Quality of life in elders living alone in Taiwan.

PubMed

Lin, Pao-Chen; Yen, Miaofen; Fetzer, Susan Jane

2008-06-01

The aim of this study was to identify and describe predictors of QOL of elders who live alone in Taiwan. Despite a growing population of elders who live alone, research on their quality of life, important for policy decisions and health care provider interventions is virtually absent. A descriptive correlational design surveyed 192 Taiwanese elders living alone, selected at random from urban and rural areas. During home visits elders completed the WHO-QOL-BREF, Social Support Scale and Center for Epidemiological Studies Depression Scale (CES-D) in addition to providing demographic data. Multiple linear regressions showed that six variables predicted physical health and the psychological wellbeing QOL domains, accounting for 74.5 and 60.1% of the variance, respectively. Four variables predicted 46.7 and 34.3% of the environmental and the social relationship QOL domains, respectively. Elders who live alone in rural areas and suffer from depression are at high risk for a low quality of life. However, elders living alone reported a better quality of life than their institutionalized counterparts. Interventional research and policy decisions focused on treatment for depression and providing social support networks, as these elders age, will be particularly important. By understanding variables associated with elders' quality of life, nurses can coordinate interventions to improve their quality of life. Poorly educated rural women who live alone are particularly vulnerable. Nursing assessment of quality of life indicators and implementation of strategies for increased social support are needed for high-risk elders.

Family structure and quality of life of elders in rural China: the role of the new rural social pension.

PubMed

Liu, Huijun; Han, Xiuhua; Xiao, Qunying; Li, Shuzhuo; Feldman, M W

2015-01-01

Using data from a survey in Ankang district of Shaanxi province of China in 2011, this article examines the protective effect of the New Rural Social Pension (NRSP) on quality of life of rural elders, as well the moderating effect on association between family structure and quality of life. An instrumental variable approach is used. NRSP is shown to significantly improve the quality of life of rural elders, and a robustness check shows that this effect is consistent across different sets of subgroups. Compared with the elders who have at least one son, the quality of life of those who are childless or have only one child is significantly lower. The NRSP is more likely to significantly improve the quality of life of one-child elders. In addition, the associations between the NRSP and the different facets of quality of life of the elders are significant except for the facet of sensory abilities.

Family Structure and Quality of Life of Elderly in Rural China: The Role of the New Rural Social Pension

PubMed Central

Liu, Huijun; Han, Xiuhua; Li, Shuzhuo; Feldman, Marcus W.

2017-01-01

Using data from a survey in Ankang district of Shaanxi province of China in 2011, this paper examines the protective effect of the NRSP on quality of life of the rural elderly, as well the moderating effect on association between family structure and quality of life. An instrumental variable approach is used. NRSP is shown to significantly improve the quality of life of rural elderly, and a robustness check shows that this effect is consistent across different sets of subgroups. Compared with the elderly who have at least one son, the quality of life of those who are childless or have only one child is significantly lower. The NRSP is more likely to significantly improve the quality of life of the one-child elderly. In addition, the associations between the NRSP and the different facets of quality of life of the elderly are significant except for the facet of sensory abilities. PMID:25356822

A cross-sectional study on quality of life among the elderly in non-governmental organizations' elderly homes in Kuala Lumpur.

PubMed

Onunkwor, Obinna Francis; Al-Dubai, Sami Abdo Radman; George, Philip Parikial; Arokiasamy, John; Yadav, Hemetram; Barua, Ankur; Shuaibu, Hassana Ojonuba

2016-01-12

There is a rapid increase in the population of the elderly globally, and Malaysia is anticipated to become an ageing nation in 2030. Maintaining health, social participation, reducing institutionalization, and improving quality of life of the elderly are public health challenges of the 21(st) century. Quality of life among elderly in Elderly Homes in Malaysia is under researched. This study aims to determine the quality of life and its associated factors among the Elderly in Elderly Homes in Kuala Lumpur. This was a cross-sectional study among 203 residents aged 60 years or more in eight randomly selected Elderly Homes in Kuala Lumpur in September 2014. Stratified simple random sampling was used to select participants. Study instruments included World Health Organization Quality of Life Questionnaire-Brief Version (WHOQOL-BREF), Multidimensional Scale for Perceived Social Support, and a questionnaire for Socio-demographic variables. Data collection was by face to face interview. Univariate and Multivariate analysis were used to determine associations, and P-value <0.05 was considered statistically significant. The mean (Standard deviation) for the physical domain was 14.3 (±2.7), 13.7 (±2.5) for the psychological domain, 10.8 (±3.4) for the social domain, and 13.0 (±2.5) for the environment domain. Factors significantly associated with quality of life included age, gender, level of education, economic status, outdoor leisure activity, physical activity, duration of residence, type of accommodation, co-morbidities, and social support. This study confirms that multiple factors are associated with quality of life among elderly in elderly homes. Social support, chronic co-morbidities, gender and outdoor leisure activity were significantly associated with all the domains of quality of life. Among the four domains of quality of life, the physical domain had the highest score while the social domain had the lowest score. This emphasizes the need for more social support-related interventions in these homes.

Predicting life satisfaction of the Angolan elderly: a structural model.

PubMed

Gutiérrez, M; Tomás, J M; Galiana, L; Sancho, P; Cebrià, M A

2013-01-01

Satisfaction with life is of particular interest in the study of old age well-being because it has arisen as an important component of old age. A considerable amount of research has been done to explain life satisfaction in the elderly, and there is growing empirical evidence on best predictors of life satisfaction. This research evaluates the predictive power of some aging process variables, on Angolan elderly people's life satisfaction, while including perceived health into the model. Data for this research come from a cross-sectional survey of elderly people living in the capital of Angola, Luanda. A total of 1003 Angolan elderly were surveyed on socio-demographic information, perceived health, active engagement, generativity, and life satisfaction. A Multiple Indicators Multiple Causes model was built to test variables' predictive power on life satisfaction. The estimated theoretical model fitted the data well. The main predictors were those related to active engagement with others. Perceived health also had a significant and positive effect on life satisfaction. Several processes together may predict life satisfaction in the elderly population of Angola, and the variance accounted for it is large enough to be considered relevant. The key factor associated to life satisfaction seems to be active engagement with others.

Cost-effectiveness of a herpes zoster vaccination program among the French elderly people.

PubMed

Belchior, Emmanuel; Lévy-Bruhl, Daniel; Le Strat, Yann; Herida, Magid

2016-09-01

A vaccine against herpes zoster (HZ) and its complications has already proven safe and effective against infection and pain and against the related deterioration of quality of life in the elderly. In order to inform the vaccination decision-making process regarding inclusion of this vaccine in the French immunization schedule, we assessed the cost-effectiveness of several vaccination scenarios, compared to no vaccination. We chose to use a previously published Markov model. Starting vaccination in elderly individuals aged 65, 70 and 75 y old appears more cost-effective than vaccination for those aged 60 y old, with a cost-effectiveness ratio between 30,000 and 35,000 euros per quality-adjusted-life year (QALY) gained for the first 3 age groups versus 54,500 €; for the latter group. These results largely contributed to the recommendation to include the HZ vaccination in the French immunization schedule for people aged between 65 and 74 y old in France.

[Health status, health perception, and health promotion behaviors of low-income community dwelling elderly].

PubMed

Lee, Tae-Wha; Ko, Il-Sun; Lee, Kyung-Ja; Kang, Kyeong-Hwa

2005-04-01

The purpose of the study was to investigate the health status(present illness, ADL and IADL), health perception, and health promotion behaviors of low-income elderly who are receiving the visiting nurse service in the community. The sample of the study was 735 elderly over 65 years old with basic livelihood security, who were conveniently selected from 245 public health centers nation-wide. Data collection was done using a structured questionnaire through interviews by visiting nurses. The average number of present illnesses in the study subjects was 4.18. The average scores of ADL and IADL were 15.903.39 and 9.772.97 respectively, which indicates a relatively independent everyday life. However, 64.2% of the subjects perceived their health status as 'not healthy'. In terms of health promotion behaviors, 77.8% of the subjects had ceased smoking, 83.9% stopped drinking, 56.4% had a regular diet, 45.8% received regular physical check-ups during the past two years, and 66% received flu shots. Approximately 50% of the subjects were practicing 3-4 health promotion behaviors. Significant factors associated with health promotion behaviors were ADL, IADL and self-efficacy. Health promotion programs which focus on regular diet, exercise, and regular physical check-ups should be developed to improve independence of everyday life and quality of life among low-income elderly.

The effects of self-efficacy enhancing program on foot self-care behaviour of older adults with diabetes: A randomised controlled trial in elderly care facility, Peninsular Malaysia.

PubMed

Ahmad Sharoni, Siti Khuzaimah; Abdul Rahman, Hejar; Minhat, Halimatus Sakdiah; Shariff-Ghazali, Sazlina; Azman Ong, Mohd Hanafi

2018-01-01

Self-care behaviour is essential in preventing diabetes foot problems. This study aimed to evaluate the effectiveness of health education programs based on the self-efficacy theory on foot self-care behaviour for older adults with diabetes. A randomised controlled trial was conducted for 12 weeks among older adults with diabetes in elderly care facility in Peninsular Malaysia. Six elderly care facility were randomly allocated by an independent person into two groups (intervention and control). The intervention group (three elderly care facility) received a health education program on foot self-care behaviour while the control group (three elderly care facility) received standard care. Participants were assessed at baseline, and at week-4 and week-12 follow-ups. The primary outcome was foot-self-care behaviour. Foot care self-efficacy (efficacy expectation), foot care outcome expectation, knowledge of foot care and quality of life were the secondary outcomes. Data were analysed with Mixed Design Analysis of Variance using the Statistical Package for the Social Sciences version 22.0. 184 respondents were recruited but only 76 met the selection criteria and were included in the analysis. Foot self-care behaviour, foot care self-efficacy (efficacy expectation), foot care outcome expectation and knowledge of foot care improved in the intervention group compared to the control group (p < 0.05). However, some of these improvements did not significantly differ compared to the control group for QoL physical symptoms and QoL psychosocial functioning (p > 0.05). The self-efficacy enhancing program improved foot self-care behaviour with respect to the delivered program. It is expected that in the future, the self-efficacy theory can be incorporated into diabetes education to enhance foot self-care behaviour for elderly with diabetes living in other institutional care facilities. Australian New Zealand Clinical Trial Registry ACTRN12616000210471.

The effects of self-efficacy enhancing program on foot self-care behaviour of older adults with diabetes: A randomised controlled trial in elderly care facility, Peninsular Malaysia

PubMed Central

Abdul Rahman, Hejar; Minhat, Halimatus Sakdiah; Shariff-Ghazali, Sazlina; Azman Ong, Mohd Hanafi

2018-01-01

Background Self-care behaviour is essential in preventing diabetes foot problems. This study aimed to evaluate the effectiveness of health education programs based on the self-efficacy theory on foot self-care behaviour for older adults with diabetes. Methods A randomised controlled trial was conducted for 12 weeks among older adults with diabetes in elderly care facility in Peninsular Malaysia. Six elderly care facility were randomly allocated by an independent person into two groups (intervention and control). The intervention group (three elderly care facility) received a health education program on foot self-care behaviour while the control group (three elderly care facility) received standard care. Participants were assessed at baseline, and at week-4 and week-12 follow-ups. The primary outcome was foot-self-care behaviour. Foot care self-efficacy (efficacy expectation), foot care outcome expectation, knowledge of foot care and quality of life were the secondary outcomes. Data were analysed with Mixed Design Analysis of Variance using the Statistical Package for the Social Sciences version 22.0. Results 184 respondents were recruited but only 76 met the selection criteria and were included in the analysis. Foot self-care behaviour, foot care self-efficacy (efficacy expectation), foot care outcome expectation and knowledge of foot care improved in the intervention group compared to the control group (p < 0.05). However, some of these improvements did not significantly differ compared to the control group for QoL physical symptoms and QoL psychosocial functioning (p > 0.05). Conclusion The self-efficacy enhancing program improved foot self-care behaviour with respect to the delivered program. It is expected that in the future, the self-efficacy theory can be incorporated into diabetes education to enhance foot self-care behaviour for elderly with diabetes living in other institutional care facilities. Trial registration Australian New Zealand Clinical Trial Registry ACTRN12616000210471 PMID:29534070

A randomized controlled trial of Turkish folklore dance on the physical performance, balance, depression and quality of life in older women.

PubMed

Eyigor, Sibel; Karapolat, Hale; Durmaz, Berrin; Ibisoglu, Ugur; Cakir, Serap

2009-01-01

The present study has been carried out to investigate the effects of group-based Turkish folkloric dances on physical performance, balance, depression and quality of life (QoL) in 40 healthy adult elderly females over the age of 65 years. Subjects were randomly allocated into Group 1 (folkloric dance-based exercise) and Group 2 (control). A 8-week dance-based exercise program was performed. Outcome measures included a 20-m walk test, a 6-min walk test, stair climbing and chair rise time, Berg balance scale (BBS), the Medical Outcomes Study (MOS) 36-item short form health survey (SF-36), and geriatric depression scale (GDS) questionnaires. In Group 1 statistically significant improvements were found in most of the physical performance tests, BBS and some SF-36 subscales after the exercise (p<0.05). In the Group 2 there was no clinically significant change in the variables. Comparing the groups, significant improvements in favor of Group 1 have emerged in most of the functional performance tests, in some of the SF-36 subscales and BBS score (p<0.05). We achieved improvements in physical performance, balance and QoL in elderly females. Application of folkloric dance specific to countries as an exercise program for elderly people may be helpful.

Suicidal ideation and attempted suicide in elderly people - subjective experiences.

PubMed

Gutierrez, Denise Machado Duran; Sousa, Amandia Braga Lima; Grubits, Sonia

2015-06-01

We discuss the subjective experiences of elderly people who show suicidal ideation and/or attempts at suicide, based on their own reports. We understand the concept of 'subjective' as referring to intra-psychic experience resulting from social, economic, relationship or biographical conditions. Although the subject is sparsely covered in the literature, it is important, because it is in the field of subjectivity that ideations of, and attempts at, suicide develop and occur until they become a concrete act. Empirical data were collected through semi-structured interviews focusing on: social characterization, portrayal and mode of life, previous mental state, atmosphere of the attempt, effects on the health of the elderly person and family. Based on the analysis of the meanings that emerge, five empirical categories were generated: (1) subject's feeling of being in a non-place; (2) absence of acceptance of losses; (3) suffering due to ingratitude of family members; (4) feeling of uselessness of, and in, life; (5) re-signification of the situations that generate suicide-related conduct. The results point to a fundamental need to incorporate knowledge about the subjective processes into programs for prevention of suicide among the elderly who have ideation of, or attempts at, suicide.

Work-related change in residential elderly care: Trust, space and connectedness

PubMed Central

van der Borg, Wieke E; Verdonk, Petra; Dauwerse, Linda; Abma, Tineke A

2017-01-01

Increasing care needs and a declining workforce put pressure on the quality and continuity of long-term elderly care. The need to attract and retain a solid workforce is increasingly acknowledged. This study reports about a change initiative that aimed to improve the quality of care and working life in residential elderly care. The research focus is on understanding the process of workforce change and development, by retrospectively exploring the experiences of care professionals. A responsive evaluation was conducted at a nursing home department in the Netherlands one year after participating in the change program. Data were gathered by participant observations, interviews and a focus and dialogue group. A thematic analysis was conducted. Care professionals reported changes in workplace climate and interpersonal interactions. We identified trust, space and connectedness as important concepts to understand perceived change. Findings suggest that the interplay between trust and space fostered interpersonal connectedness. Connectedness improved the quality of relationships, contributing to the well-being of the workforce. We consider the nature and contradictions within the process of change, and discuss how gained insights help to improve quality of working life in residential elderly care and how this may reflect in the quality of care provision. PMID:28626242

Prevalence of Types of Cancers in the Elderly Covered by Insurance of the Islamic Republic of Iran Broadcasting Company in 2015 - Comparison with Younger Groups.

PubMed

Roshani, Zahra; Akbari Kamrani, Ahmad Ali; Shati, Mohsen; Sahaf, Robab

2016-01-01

Presently, the world population of the elderly is growing. By improving health hygiene and welfare indicators, mortality and birth rates decrease and life expectancy increases, making the present century the century of elderly. Aging is one of the main risk factors for development of cancer, which itself is the second cause of death in old people. This study was conducted to assess the prevalence of cancer in the elderly covered by the Islamic Republic of Iran Broadcasting (IRIB) insurance program and to obtain suitable programs for cancer screening and early detection, increase patient survival, improve elderly care and to reclaim the cost of treatment in comparison to the national and international statistics. This is a cross-sectional study conducted on all elderly patients diagnosed with malignancy based on their pathology reports. In this study, of the total 75,500 patients covered by IRIB insurance, 17.2% belonged to the elderly group, males accounting for 53.3%. The most common cancers in old men were prostatic cancer (61.3%), colon cancer (10.3%) cancer of the hematologic system, bladder cancer (9.6%), lung cancer (9.1%), thyroid cancer (3.9%) and brain tumors (1.3%). In the elderly women, the most common cancers were breast cancer (80.1%), colon cancer (5.1%), thyroid cancers (4.4%), bladder and hematologic system malignancies (3.6), lung cancer (2.9%) and brain tumors (0.7%). In addition, the prevalence of cancer was almost the same as national and international statistics. With the exception of non-melanoma skin cancer no difference was shown in prevalence of cancer between IRIB elderly patients and the other groups of cancer patients in Iran.

Profile of psychiatric disorders and life events in medically ill elderly: experiences from geriatric clinic in Northern India.

PubMed

Prakash, Om; Gupta, L N; Singh, V B; Singhal, A K; Verma, K K

2007-11-01

Morbidity among elderly people has an important influence on their psychological well-being. Evaluation of the morbidity profile and its determinants, which have implications for management of medical problems of elderly people, are scarce in developing countries. Even the physicians' detection rate of mental distress in elderly populations is low in medical outpatient clinics. This could be due to the large caseloads and also, importantly, underestimation of psychological concerns of the elderly. The objective of this study was to study the psychiatric co-morbidity and life events among elderly medical outpatients. One hundred medically ill elderly (>60 years) patients attending the Geriatric Clinic at Bikaner (North India) constituted the study population. The physical diagnosis was made by a physician based on reported illness, clinical examination and medical records. Psychiatric diagnosis was made by detailed clinical psychiatric interview using ICD-10 guidelines. Life events were assessed by the Indian adaptation of Presumptive Stressful Life Events Scale. Hypertension was the most commonly reported physical diagnosis (50%), other specific medical illnesses were osteoarthritis (15%), diabetes (13%) and constipation (8%). The study found 18% subjects had depression and 11% had other mental disorders. Patients with mental disorders had suffered more recent stressful life events. Among life events, conflicts in family (16%); unemployment of self or children (9%) was reported by elderly psychiatric patients. Other reported life events in psychiatric diagnosed elderly were conflict in family (7%), illness of self (6%) or family members (5%) and death of family members (5%) or close relatives (4%). Mental disorders are common among medically ill elderly patients, but they are poorly recognized and treated. Assessment of the psychiatric morbidity will help in strengthening psycho-geriatric services and thus, improve the quality of life of the elderly. Copyright 2007 John Wiley & Sons, Ltd.

[A phenomenological study of suicide attempts in elders].

PubMed

Im, Mi Young; Kim, Yun Jeong

2011-02-01

The purpose of this study was to examine the meaning and essence of suicide for elderly people who had previously attempted suicide as an older person. Giorgi's descriptive phenomenology was used for analysis. The researchers carried out in-depth interviews, recordings and memos individually with four elders. The elders were individuals who had attempted suicide sometime in the past 5 yr. They were interviewed from 5 to 10 times using open-ended questions and a semi-structural format. Demographic data were also collected. The meaning of suicide before a suicide attempt in older people had four core components: conflict with family, powerlessness and despair in their life with a drop in self-esteem, using internal and external resources to resolve their troubles and awareness of imminent crisis. These results of this study will increase understanding of suicide in older people by defining their subjective experience of suicide attempts and applying grounded data in the development of programs that provide concrete intervention strategies to prevent suicide in elderly people.

The Digital Life History Project: Intergenerational Collaborative Research

ERIC Educational Resources Information Center

Loe, Meika

2013-01-01

This article describes the Digital Life History Project, a 10-week "lab" linked to a course on aging, in which students and community-dwelling elders work together to create a short digital story honoring the elder's life. After two interview sessions, the pair works together to produce a 3- to 5-minute digital life story narrated by the elder.…

A Comparative Study of Health Status and Quality of Life of Elderly People Living in Old Age Homes and within Family Setup in Raigad District, Maharashtra.

PubMed

Amonkar, Priyanka; Mankar, Madhavi Jogesh; Thatkar, Pandurang; Sawardekar, Pradeep; Goel, Rajesh; Anjenaya, Seema

2018-01-01

The traditional concept of family in India to provide support to the elderly is changing soon with disintegration of joint families. In this scenario the concept of old age homes (OAHs) is gaining momentum and the number of people seeking OAH care is rapidly increasing. However, not much is known about the quality of life (QOL) of Indian elderly staying in the OAH setup. To assess and compare the Health status, Quality of Life and Depression in elderly people living in OAHs & within family using WHOQOL -OLD questionnaire & Geriatric Depression Scale. A cross sectional study was conducted in elderly aged above 60 years of age. After taking a written consent and matching for age and sex & socioeconomic status, 60 elderly from OAHs & 120 elderly living within family setup were selected randomly. The WHOQOL-OLD standard questionnaire & GDS were used to assess quality of life & depression in elderly. The QOL of elderly in domains of autonomy, past present & future activities, social participation and intimacy was better in family setup (60.62, 70.62, 66.14 and 58.43) as compared to OAHs (51.35, 62.91, 59.47and 41.16) (p<0.05). There was statistically significant difference in mean geriatric depression scores of both the group (3.96 within family setup and 5.76 in OAH's). Quality of life of elderly within family setup was better as compared to elderly in OAHs.

Minority Elderly Adaptation to Life-Threatening Events: An Overview with Methodological Consideration.

ERIC Educational Resources Information Center

Trimble, Joseph E.; And Others

A review of pertinent research on the adaptation of ethnic minority elderly to life-threatening events (personal, man-made, or natural) exposes voids in the research, presents methodological considerations, and indicates that ethnic minority elderly are disproportionately victimized by life-threatening events. Unusually high numbers of…

Effects of Medical Insurance on the Health Status and Life Satisfaction of the Elderly

PubMed Central

GU, Liubao; FENG, Huihui; JIN, Jian

2017-01-01

Background: Population aging has become increasingly serious in China. The demand for medical insurance of the elderly is increasing, and their health status and life satisfaction are becoming significant issues. This study investigates the effects of medical insurance on the health status and life satisfaction of the elderly. Methods: The national baseline survey data of the China Health and Retirement Longitudinal Survey in 2013 were adopted. The Ordered Probit Model was established. The effects of the medical insurance for urban employees, medical insurance for urban residents, and new rural cooperative medical insurance on the health status and life satisfaction of the elderly were investigated. Results: Medical insurance could facilitate the improvement of the health status and life satisfaction of the elderly. Accordingly, the health status and life satisfaction of the elderly who have medical insurance for urban residents improved significantly. The regression coefficients were 0.348 and 0.307. The corresponding regression coefficients of the medical insurance for urban employees were 0.189 and 0.236. The regression coefficients of the new rural cooperative medical insurance were 0.170 and 0.188. Conclusion: Medical insurance can significantly improve the health status and life satisfaction of the elderly. This development is of immense significance for the formulation of equal medical security. PMID:29026784

Civic Engagement of Older Adults in Mainland China.

PubMed

Chen, Haiping; Adamek, Margaret

2017-07-01

Due to great challenges resulting from China's rapid population aging, Chinese elders are mobilized to address problems caused by this demographic trend through civic engagement. Based on an integrative review of policy, research, and practice, this article reveals that today's Chinese elders have a higher level and wider scope of civic engagement than previous cohorts. A set of factors contributing to such improvement are further identified, including the reform of the national economy, transformation of governmental functions, and the use of effective strategies applied to concrete programs. However, several constraints limiting Chinese elders' equal, active engagement in civic life remain, including the social stratification of older adults, preferential selection of participants due to the nation's socioeconomic development strategy, and family care work competing with other types of civic activities. Finally, future directions for policy, research, and practice are proposed in order to increase Chinese elders' civic engagement.

Mental health is the most important factor influencing quality of life in elderly left behind when families migrate out of rural China.

PubMed

Xie, Jian-fei; Ding, Si-qing; Zhong, Zhu-qing; Yi, Qi-feng; Zeng, Sai-nan; Hu, Jun-hua; Zhou, Jian-da

2014-01-01

to investigate the quality of life and the associated factors on left behind elderly in rural China. the research was conducted cluster sampling to select 456 elderly left behind when family members migrated out of rural China to participate in a cross-sectional study by completing a general data questionnaire and Quality of Life questionnaire. 91.5% of the elderly requested psychological counseling and education. For the elderly, scores for mental health (39.56±13.73) were significantly lower compared with Chinese standard data (61.6±13.7) (P<0.001). Age, chronic disease type, gender, residence pattern and economic support from children were the main psychological factors influencing this population. mental health is the most important factor influencing quality of life of elderly left behind when family members migrated out of rural China. Our study suggested a need to widely establish a general practitioner team for psychological intervention for improving rural elderly people's Quality of Life level, especially in the psychological domain.

Internet-based remote counseling to support stress management: preventing interruptions to regular exercise in elderly people

NASA Astrophysics Data System (ADS)

Hashimoto, Sayuri; Munakata, Tsunestugu; Hashimoto, Nobuyuki; Okunaka, Jyunzo; Koga, Tatsuzo

2006-01-01

Our research showed that a high degree of life-stress has a negative mental health effect that may interrupt regular exercise. We used an internet based, remotely conducted, face to face, preventive counseling program using video monitors to reduce the source of life-stresses that interrupts regular exercise and evaluated the preventative effects of the program in elderly people. NTSC Video signals were converted to the IP protocol and facial images were transmitted to a PC display using the exclusive optical network lines of JGN2. Participants were 22 elderly people in Hokkaido, Japan, who regularly played table tennis. A survey was conducted before the intervention in August 2003. IT remote counseling was conducted on two occasions for one hour on each occasion. A post intervention survey was conducted in February 2004 and a follow-up survey was conducted in March 2005. Network quality was satisfactory with little data loss and high display quality. Results indicated that self-esteem increased significantly, trait anxiety decreased significantly, cognition of emotional support by people other than family members had a tendency to increase, and source of stress had a tendency to decrease after the intervention. Follow-up results indicated that cognition of emotional support by family increased significantly, and interpersonal dependency decreased significantly compared to before the intervention. These results suggest that face to face IT remote counseling using video monitors is useful to keep elderly people from feeling anxious and to make them confident to continue exercising regularly. Moreover, it has a stress management effect.

Can an active aging index (AAI) provide insight into reducing elder abuse? A case study in Rajshahi District, Bangladesh.

PubMed

Tareque, Md Ismail; Ahmed, Md Munsur; Tiedt, Andrew D; Hoque, Nazrul

2014-01-01

We use data from respondents aged 60 years and above, collected during April 2009 in the Rajshahi district of Bangladesh, to examine whether high activeness, as captured by an AAI or in sub-domains, can help reduce the risk of elder abuse. The findings suggest that more than half of rural elderly and 14 percent of urban elderly were at some point abused. High activeness in health and security dimensions lowers the risk of being abused while those who are low active in community participation have the lowest risk of being abused in both rural and urban areas. Being literate (elderly with primary/secondary education) is revealed to be a significant factor that lowers the risk of abuse in both rural and urban areas. These results imply a need for educational programs that bolster positive and proper community interaction, in turn promoting a secure later life for elders, and reducing burden for families and society. High activeness in health and security dimensions should also be promoted to keep the elderly healthy and protect from abusive behavior. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Do 12-week yoga program influence respiratory function of elderly women?

PubMed

Bezerra, Lídia Aguiar; de Melo, Helton Fabrício; Garay, Ana Paula; Reis, Victor Machado; Aidar, Felipe José; Bodas, Ana Rita; Garrido, Nuno Domingos; de Oliveira, Ricardo Jacó

2014-09-29

Aging produces several respiratory limitations and reduces tolerance to physical efforts, sometimes leading to pulmonary diseases in the elderly. The literature draws attention to the possible benefits of Yoga practice among the elderly, presenting evidence for significant improvements in quality of life. It was hypothesized that yoga practice can improve respiratory function in the elderly. The effects of a yoga program on pulmonary volumes and respiratory muscle strength were verified in 36 elderly women divided into a yoga group [YG] (63.1 ± 13.3 years of age) and a control group (61.0 ± 6.9 years of age). Maximal inspiratory and expiratory pressure (MIP and MEP) were assessed by a manovacuometer and tidal volume (VT), vital capacity (VC) and minute ventilation (VE) were measured by a ventilometer. The program comprised 65 min sessions, 3 times/week during 12 weeks. The heart rate and respiratory rate decreased significantly in the YG (76-39 ± 8-03 vs. 74-61±10.26 bpm and 18.61 ± 3.15 vs. 16.72 ± 3.12 resp/min, respectively). In the YG, VT and VE increased significantly (0.55 ± 0.22 vs. 0.64 ± 0.2 ml and 9.19 ± 2.39 vs. 10.05 ± 2.11 ml, respectively), as well as VC (1.48 ± 0.45 vs. 2.03 ± 0.72 ml). Improvements were also found in MIP and MEP in the YG (62.17 ± 14.77 vs. 73.06 ± 20.16 cmH2O and 80.56 ± 23.94 vs. 86.39 ± 20.16 cmH2O, respectively). It was concluded that a 12-week yoga program significantly improves pulmonary function of aged women.

The experience of daily life of acutely admitted frail elderly patients one week after discharge from the hospital

PubMed Central

Andreasen, Jane; Lund, Hans; Aadahl, Mette; Sørensen, Erik E.

2015-01-01

Introduction Frail elderly are at higher risk of negative outcomes such as disability, low quality of life, and hospital admissions. Furthermore, a peak in readmission of acutely admitted elderly patients is seen shortly after discharge. An investigation into the daily life experiences of the frail elderly shortly after discharge seems important to address these issues. The aim of this study was to explore how frail elderly patients experience daily life 1 week after discharge from an acute admission. Methods The qualitative methodological approach was interpretive description. Data were gathered using individual interviews. The participants were frail elderly patients over 65 years of age, who were interviewed at their home 1 week after discharge from an acute admission to a medical ward. Results Four main categories were identified: “The system,” “Keeping a social life,” “Being in everyday life,” and “Handling everyday life.” These categories affected the way the frail elderly experienced daily life and these elements resulted in a general feeling of well-being or non-well-being. The transition to home was experienced as unsafe and troublesome especially for the more frail participants, whereas the less frail experienced this less. Conclusion and discussion Several elements and stressors were affecting the well-being of the participants in daily life 1 week after discharge. In particular, contact with the health care system created frustrations and worries, but also physical disability, loneliness, and inactivity were issues of concern. These elements should be addressed by health professionals in relation to the transition phase. Future interventions should incorporate a multidimensional and bio-psycho-social perspective when acutely admitted frail elderly are discharged. Stakeholders should evaluate present practice to seek to improve care across health care sectors. PMID:26037333

Families and elder care in the twenty-first century.

PubMed

Bookman, Ann; Kimbrel, Delia

2011-01-01

Although most Americans know that the U.S. population is aging, they are far less informed about the reality of providing elders with personal care, health care, and social support. Families-particularly women-have always been critical in providing elder care, but the entry of so many women into the paid labor force has made elder care increasingly difficult. Ann Bookman and Delia Kimbrel show how changes in both work and family life are complicating families' efforts to care for elderly relatives. Because almost 60 percent of elder caregivers today are employed, many forms of caregiving must now be "outsourced" to nonfamily members. And because elders are widely diverse by race and socioeconomic status, their families attach differing cultural meanings to care and have widely different resources with which to accomplish their care goals. Although the poorest elders have access to some subsidized services, and the wealthiest can pay for services, many middle-class families cannot afford services that allow elders to age in their homes and avoid even more costly institutional care. Six key groups--health care providers, nongovernmental community-based service providers, employers, government, families, and elders themselves--are engaged in elder care, but their efforts are often fragmented and uncoordinated. All six groups must be able to work in concert and to receive the resources they need. Both employer and government policies must be improved. Although large businesses have taken up the elder care challenge, most small and mid-sized firms still do not offer flexible work arrangements. Social Security and Medicare have provided critical support to families caring for elders, yet both face significant financial shortfalls. The Older American Act and the National Family Caregiver Support Program have broadened access to elder services, but need updating to address the needs of today's employed caregivers and elders who want to "age in place." And just over half of the nation's workforce is eligible for the unpaid leave benefits provided by the Family and Medical Leave Act. The authors close by reflecting on the need for a coordinated, cross-sector movement to create an "aging-friendly" society in the United States-a society that values well-being across the life span and supports citizens from diverse cultures and income levels as they age.

The effect of community health nurse home visit on self-care self-efficacy of the elderly living in selected Falavarjan villages in Iran in 2010.

PubMed

Hosseini, Habibollah; Torkani, Sara; Tavakol, Khosrow

2013-01-01

Perceived self-efficacy is a strong predictor for behavior. Considering the importance of health-promoting self-care behaviors in increasing quality of life in the elderly, this study was aimed at defining the effect of nurse home visits on self-care self-efficacy of the elderly in rural areas. This is a pre and post quasi-experimental study conducted on 33 older adults randomly selected from five villages in Falavarjan province in Iran. Intervention program was in the direction of self-care self-efficacy in four domains including nutrition, health practice, physical activity, and well-being in the form of five home visit programs and one group session by a nurse during 6 weeks, and included two different sections of education and nursing interventions administered based on needs assessment and determination of the tasks for the clients and their families. Theoretical framework of this study was supported by Bandura's self-efficacy, Orem's self-care theory, and Pender's revised health promotion model. The data were collected by self-care self-efficacy and demographic information questionnaire before and after the intervention. Data were analyzed by descriptive statistics and paired t-test. The mean elderly score in the four aforementioned domains increased after the home visit program. A significant difference was seen in the mean total scores of self-care self-efficacy and its subscales by paired t-test before and after intervention (P < 0.001). It was observed that home visit program, integrated with the theories, had a positive influence on improving self-care self-efficacy of the elderly, and was supported by Bandura's theory of self-efficacy suggesting four sources of performance accomplishment, vicarious experience, verbal persuasion, and emotional arousal. With regard to the importance of self-care behavior in health promotion of the elderly, multifaceted low-cost interventions with the highest effect seem essential.

The effect of community health nurse home visit on self-care self-efficacy of the elderly living in selected Falavarjan villages in Iran in 2010

PubMed Central

Hosseini, Habibollah; Torkani, Sara; Tavakol, Khosrow

2013-01-01

Background: Perceived self-efficacy is a strong predictor for behavior. Considering the importance of health-promoting self-care behaviors in increasing quality of life in the elderly, this study was aimed at defining the effect of nurse home visits on self-care self-efficacy of the elderly in rural areas. Materials and Methods: This is a pre and post quasi-experimental study conducted on 33 older adults randomly selected from five villages in Falavarjan province in Iran. Intervention program was in the direction of self-care self-efficacy in four domains including nutrition, health practice, physical activity, and well-being in the form of five home visit programs and one group session by a nurse during 6 weeks, and included two different sections of education and nursing interventions administered based on needs assessment and determination of the tasks for the clients and their families. Theoretical framework of this study was supported by Bandura's self-efficacy, Orem's self-care theory, and Pender's revised health promotion model. The data were collected by self-care self-efficacy and demographic information questionnaire before and after the intervention. Data were analyzed by descriptive statistics and paired t-test. Results: The mean elderly score in the four aforementioned domains increased after the home visit program. A significant difference was seen in the mean total scores of self-care self-efficacy and its subscales by paired t-test before and after intervention (P < 0.001). Conclusions: It was observed that home visit program, integrated with the theories, had a positive influence on improving self-care self-efficacy of the elderly, and was supported by Bandura's theory of self-efficacy suggesting four sources of performance accomplishment, vicarious experience, verbal persuasion, and emotional arousal. With regard to the importance of self-care behavior in health promotion of the elderly, multifaceted low-cost interventions with the highest effect seem essential. PMID:23983728

Age-related differences in the quality of life in end-stage renal disease in patients enrolled in hemodialysis or continuous peritoneal dialysis.

PubMed

Laudański, Krzysztof; Nowak, Zbigniew; Niemczyk, Stanisław

2013-05-20

The aim of the present study was to compare the experience elderly and younger patients in terms of emotional status, disease perception, methods of coping with the end-stage renal disease (ESRD) stress, and health-related quality of life in 2 different settings of renal replacement therapy: hemodialysis (HD) and continuous ambulatory peritoneal dialysis programs (CAPD). Specifically, we hypothesized that younger people will more frequently use goal-oriented strategies to cope with illness-related stress and elderly patients will use more strategies related to the control of emotion. A total of 69 HD patients, 40 CAPD patients, and 89 healthy volunteers were analyzed. The Situation and Trait Anxiety Inventory, the Profile of Mood States, the Cognitive Stress Appraisal Questionnaire, and the Nottingham Health Profile were used to assess anxiety, long-term emotional status, coping mechanisms, and health-related quality of life. Data were collected on several biochemical and demographic variables. Our study revealed that younger and elderly people on dialysis faced quite different problems. Younger people in both RRT groups had statistically higher assessment of ESRD as loss or challenge and they more frequently used distractive and emotional preoccupation coping strategies. Depression, confusion, and bewilderment dominate the emotional status of both patient populations, especially in the younger cohort. Both HD(young) and CAPD(young) patients complained more about lack of energy, mobility limitations, and sleep disturbances as compared to their elderly HD and CAPD counterparts. There are different needs and problems in younger and elderly patients on renal replacement therapy. Younger people required more ESRD-oriented support to relieve their health-related complaints to the level observed in their peers and needed extensive psychological assistance in order to cope with negative emotions related to their disease.

End-of-life care for advanced dementia patients in residential care home-a Hong Kong perspective.

PubMed

Luk, James K H; Chan, Felix H W

2017-08-28

Dementia will become more common as the population ages. Advanced dementia should be considered as a terminal illnesses and end-of-life (EOL) care is very much needed for this disease group. Currently, the EOL services provided to this vulnerable group in Hong Kong, especially those living in residential care homes, is limited. The usual practice of residential care homes is to send older residents with advanced dementia to acute hospitals when they are sick, irrespective of their wish, premorbid status, diagnoses and prognosis. This may not accord with what the patients perceive to be a "good death". There are many barriers for older people to die in place, both at home and at the residential care home. In the community, to enhance EOL care to residential care home for the elderly (RCHE) residents, pilot EOL program had been carried out by some Community Geriatric Assessment Teams. Since 2015, the Hospital Authority funded program "Enhance Community Geriatric Assessment Team Support to End-of-life Patients in Residential Care Homes for the Elderly" has been started. In the program, advance care planning (ACP), Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) (non-hospitalized) order will be established and the program will be expected to cover all clusters in Hong Kong by 2018/2019. In hospital setting, EOL clinical plan and EOL ward in geriatric step-down hospitals may be able to improve the quality of death of older patients. In Sep 2015, the Hospital Authority Guidelines on Life-Sustaining Treatment in the Terminally Ill was updated. Amongst other key EOL issues, careful (comfort) hand feeding was mentioned in the guideline. Other new developments include the possible establishment of enduring power of attorney for health care decision and enhancement of careful hand feeding amongst advanced dementia patients in RCHEs.

Classification of Support Needs for Elderly Outpatients with Diabetes Who Live Alone.

PubMed

Miyawaki, Yoshiko; Shimizu, Yasuko; Seto, Natsuko

2016-02-01

To investigate the support needs of elderly patients with diabetes and to classify elderly patients with diabetes living alone on the basis of support needs. Support needs were derived from a literature review of relevant journals and interviews of outpatients as well as expert nurses in the field of diabetes to prepare a 45-item questionnaire. Each item was analyzed on a 4-point Likert scale. The study included 634 elderly patients with diabetes who were recruited from 3 hospitals in Japan. Exploratory factor analysis was performed to determine the underlying structure of support needs, followed by hierarchical cluster analysis to clarify the characteristics of patients living alone (n=104) who had common support needs. Exploratory factor analysis suggested a 5-factor solution with 23 items: (1) hope for class and gatherings, (2) hope for personal advice including emergency response, (3) supportlessness and hopelessness, (4) barriers to food preparation, (5) hope of safe medical therapy. The hierarchical cluster analysis of subjects yielded 7 clusters, including a no special-support needs group, a collective support group, a self-care support group, a personal-support focus group, a life-support group, a food-preparation support group and a healthcare-environment support group. The support needs of elderly patients with diabetes who live alone can be divided into 2 categories: life and self-care support. Implementation of these categories in outpatient-management programs in which contact time with patients is limited is important in the overall management of elderly patients with diabetes who are living alone. Copyright © 2015 Canadian Diabetes Association. Published by Elsevier Inc. All rights reserved.

Effects of tai chi qigong on psychosocial well-being among hidden elderly, using elderly neighborhood volunteer approach: a pilot randomized controlled trial.

PubMed

Chan, Aileen Wk; Yu, Doris Sf; Choi, K C

2017-01-01

To test the feasibility and preliminary effectiveness of a tai chi qigong program with the assistance of elderly neighborhood volunteers in strengthening social networks and enhancing the psychosocial well-being of hidden elderly. "Hidden elderly" is a term used to describe older adults who are socially isolated and refuse social participation. This pilot randomized controlled trial recruited 48 older adults aged 60 or above who did not engage in any social activity. They were randomized into tai chi qigong (n=24) and standard care control (n=24) groups. The former group underwent a three-month program of two 60-minute sessions each week, with the socially active volunteers paired up with them during practice. Standard care included regular home visits by social workers. Primary outcomes were assessed by means of the Lubben social network and De Jong Gieveld loneliness scales, and by a revised social support questionnaire. Secondary outcomes were covered by a mental health inventory and the Rosenberg self-esteem scale, and quality of life by using the 12-Item Short Form Health Survey. Data was collected at baseline, and at three and six months thereafter. The generalized estimating equations model revealed general improvement in outcomes among participants on the tai chi qigong program. In particular, participants reported a significantly greater improvement on the loneliness scale ( B =-1.32, 95% confidence interval [CI] -2.54 to -0.11, P =0.033) and the satisfaction component of the social support questionnaire ( B =3.43, 95% CI 0.10-6.76, P =0.044) than the control group. The pilot study confirmed that tai chi qigong with elderly neighborhood volunteers is a safe and feasible social intervention for hidden elderly. Its potential benefits in improving social and psychological health suggest the need for a full-scale randomized controlled trial to reveal its empirical effects.

Intervention for the maintenance and improvement of physical function and quality of life among elderly disaster victims of the Great East Japan Earthquake and Tsunami.

PubMed

Greiner, Chieko; Ono, Kana; Otoguro, Chizuru; Chiba, Kyoko; Ota, Noriko

2016-08-01

The purpose of this study was to examine the effectiveness of an exercise class implemented in an area affected by the Great East Japan Earthquake and Tsunami for maintaining and improving physical function and quality of life (QOL) among elderly victims. Participants were 45 elderly disaster victims. To measure the effectiveness of the exercise classes, results on the Functional Reach Test (FRT), Timed Up and Go Test (TUG), One-leg Standing Balance (OSB), and Chair Stand Test (CST) were measured at the beginning of the exercise classes, and after 3 and 6months. In order to assess health-related QOL, the 8-item Short-Form Health Survey (SF-8) was carried out at the beginning of the exercise classes, and after 1, 3, and 6months. Of the 45 people who consented to participate, 27 continued the program for 6months and were used for analysis. Analysis of the results for FRT, OSB, and CST showed significant improvements (respectively, p=.000, .007, and .000). SF-8 showed significant increases for the subscales of bodily pain (p=.004), general health perception (p=.001), and mental health (p=.035). By continuing an exercise program for 6months, improvements were seen in lower limb muscle strength and balance functions. Effectiveness for HRQOL was also observed. Copyright © 2016 Elsevier Inc. All rights reserved.

Productive activity and life satisfaction in Korean elderly women.

PubMed

Kim, Ju-Hyun

2013-01-01

The purpose of this study is to explain the effect of participation in productive activities on life satisfaction and its implications for social evaluation of productive aging. This study uses data collected from 1,250 elderly women living in urban areas. The regression model was used to examine the influence of elderly women's participation in productive activities on their life satisfaction. Elderly women who participate in volunteer work, learning, and social group activities commonly recognized their activities as meaningful, feeling like worthwhile members of society, and evaluated such activities as very positive. In contrast, elderly women who participated in household chores and family care activities expressed a negative life satisfaction. The difference in life satisfaction regarding productive activities stems not only from the physical and environmental differences but also from the gap between the official social value underpinned by the recognition of surrounding people, their support, and the value of productive activities.

Aging and quality of life of elderly people in rural areas.

PubMed

Garbaccio, Juliana Ladeira; Tonaco, Luís Antônio Batista; Estêvão, Wilson Goulart; Barcelos, Bárbara Jacome

2018-01-01

To evaluate the quality of life and health of elderly in rural areas of Minas Gerais State's center-west. Cross-sectional study, in four municipalities of Minas Gerais State, by interviewing elderly people. Associations between socio-demographic and quality of life variables were tested, separated into "satisfactory"/"unsatisfactory" with values from the median of positive answers. It was used the chi-square test, Fisher's test and regression. 182 elderly answered the questions and showed a relation with the "satisfactory" quality of life - bivariate (p < 0.05): age by 69 years (61.6%), married (61.7%), living by 54 years in rural areas (68%), with no financial support (59.5%), living with someone else (61%), non-smoker (60%), presenting good health (76.7%), satisfied with life (69.6%); regression: not having financial support, living with someone else and not smoking. Elderly people in rural areas present good quality of life/health in the cognitive aspect, access to services, goods, habits, but awareness must be constant due to their weakness.

[Social representations of elders' quality of life].

PubMed

Silva, Luípa Michele; Silva, Antonia Oliveira; Tura, Luiz Fernando Rangel; Moreira, Maria Adelaide Silva Paredes; Rodrigues, Rosalina Aparecida Partezani; Marques, Maria do Céu

2012-03-01

This study aimed to identify elders' social representations of quality of life. This is an exploratory study with a sample of 240 elders, of both sexes. For data collection we used a Free Association Test with Words, using the inductive stimulus 'quality of life" and sociodemographic variables. The interviews were analyzed with the software Alceste. Of the 240 studied eslders, 167 were women, with the dominant age from 60 to 69 years, income between two and three minimum wages, most of the married and with catholicism as the predominant religion. The results from Alceste pointed towards seven hierarchical classes: accessibility, work, activity, support affection, care and interactions. Social representations of quality of life by elders can support professionals in understanding the adhesion to preventive practices for the elderly and in strengthening policies directed to this population.

Religiosity, social support, and life satisfaction among elderly Korean immigrants.

PubMed

Park, Jisung; Roh, Soonhee; Yeo, Younsook

2012-10-01

The present study tested Smith's (2003. Theorizing religious effects among American adolescents. Journal for the Scientific Study of Religion, 42, 17-30. doi:10.1111/1468-5906.t01-1-00158) theory of religious effects to explore the relationship of religiosity, social support, and life satisfaction among elderly Korean immigrants. The study investigated the mediating role of social support to the relationship between religiosity and life satisfaction. We hypothesized that religiosity would be positively associated with life satisfaction and that the relationship between religiosity and life satisfaction would be mediated by social support. Structural equation modeling was used to test the proposed hypotheses with a sample of 200 Korean immigrant older adults in New York City (mean age = 72.5, range = 65-89). We found that greater religiosity was related to greater life satisfaction and that social support partially explained the positive relationship between religiosity and life satisfaction. Results indicated that religious engagement and social support could be significant factors to improve the quality of life among elderly Korean immigrants. Social services that facilitate religiosity and social support may be beneficial for Korean elders' life satisfaction. Future studies are invited to replicate this study for diverse ethnic groups of elderly immigrants.

Jumping combined exercise programs reduce fall risk and improve balance and life quality of elderly people who live in a long-term care facility.

PubMed

Cakar, E; Dincer, U; Kiralp, M Z; Cakar, D B; Durmus, O; Kilac, H; Soydan, F C; Sevinc, S; Alper, C

2010-03-01

The objective of this study was to determine whether regular combined exercise program, which consists strength, stretching and aerobic exercises and additional jumping training, improve balance, fall risk, quality of life and depression status of older people living in a residential care. A total of 168 residents who live in a long term care facility were screened. The trial began with 78 eligible participants and they were randomly grouped as combined exercises program (COM) group that includes stretching, strength and aerobic exercises, and COM plus jumping (COMpJ) group. 66 of the participants finished the trial. The groups were convened three times a week for six weeks. Each group had a warm-up, effective training and a cooling down periods. The total exercising time was no longer than 45 minutes in each group. Berg balance test and Biodex Balance System for the assessment of the dynamic balance and fall risk, short form 36 (SF 36) for the health related quality of life and Geriatric Depression Scale (GDS) for evaluation of the depression status were used. The balance improvement and fall risk reduction were observed in both of the groups at the end of the trial; however, the improvements were statistically better in jumping combined group. Also health related quality of life improved in both groups. Regular group exercise in a long term care facility have several beneficial effects on the elderly residents in regard to balance improvement, fall risk reduction and quality of life. The addition of jumping to strength, stretching and aerobic exercises provides important contributions to balance improvement and fall risk reduction.

Healthy Eating Exploratory Program for the Elderly: Low Salt Intake in Congregate Meal Service.

PubMed

Seo, S; Kim, O Y; Ahn, J

2016-03-01

This study reported on an exploratory program to help the low income elderly improve healthy eating behavior, specifically by reducing salt intake. We conducted an exploratory program for 4 weeks for this study. The exploratory program involved offering menus with reduced salt and providing education on healthy eating. After the exploratory program, a survey of the elderly and in-depth interviews allowed us to evaluate the program for foodservice providers (dietitian, social workers, and volunteer workers). This study included both foodservice workers and elderly who actually used the foodservice in a congregate meal service system. This is a unique approach. A congregate meal service center in Seoul, Korea. Seventy four elderly in a congregate meal service center. Demographics were collected, and the healthy eating program and healthy eating education for elderly respondents were evaluated. The elderly showed high satisfaction with the exploratory program for healthy eating. We found no significant differences in satisfaction with the program between the elderly who attended education sessions and those who did not, but more of the elderly from the education sessions showed positive behavioral change intentions. The exploratory program influenced to reduce the salt intake of the elderly in congregate meal service. This study suggests cooperation of foodservice providers and the support of administrators is critical to the success of such programs.

Experiential Learning: A Definitive Edge in the Job Market

ERIC Educational Resources Information Center

Clark, James; White, Gayle Webb

2010-01-01

The value of experiential learning is explored as it has now become a given among educators and corporate leaders that a university must provide experiential learning programs such as internships; real-life cases in marketing research, advertising, etc.; and voluntary student participation in income tax preparation for the needy and elderly; and…

Prime-Time Television Portrayals of Older Adults in the Context of Family Life.

ERIC Educational Resources Information Center

Dail, Paula W.

1988-01-01

Content analyzed portrayal of older adults in 12 family-oriented, prime-time television programs to determine cognitive, physical, and health status; social interaction; and emotional behavior. Among 193 characters portraying elderly adults, 3,468 verbalizations and behaviors were examined. Results suggest that persons over age 55 are more…

The Phenomenology of Late Life Depression.

ERIC Educational Resources Information Center

Blazer, Dan; And Others

The paper reports results of one project from the National Institute of Mental Health Epidemiologic Catchment Area (ECA) Program: the Duke ECA study (also known as the Piedmont Health Survey). To determine if depressive symptoms are different in the depressed elderly, 46 community subjects, over 60 years of age with a current diagnosis of…

Effectiveness of Life Review Therapy on Quality of Life in the Late Life at Day Care Centers of Shiraz, Iran: A Randomized Controlled Trial.

PubMed

Sharif, Farkhondeh; Jahanbin, Iran; Amirsadat, Afsar; Hosseini Moghadam, Mahboobeh

2018-04-01

Life review therapy, used as part of a comprehensive therapy plan for increasing the quality of life of the elderly, helps them to resolve their past conflicts, reconstruct their life stories, and accept their present conditions. The present study aimed to explore the effectiveness of life review therapy on the quality of life of the elderly. The present study was a randomized controlled trial with a pre-posttest design during April to Aug 2014. The study was conducted on 35 members of the elderly day care centers in Shiraz, Iran, that were randomly assigned to two groups (experimental and control). The subjects in the experimental group attended 8 two-hour sessions of life review therapy. The quality of life of the elderly participants was evaluated before, immediately, one month, and three months after the intervention using the quality of life questionnaire (WHOQOL_BREF). Data analysis was conducted through SPSS version 22, using statistical tests including Chi-square, repeated measures test and T-test, with the significance level of 0.05. The results of the study showed that life review therapy interventions significantly improved the quality of life of the elderly (P<0.05). Moreover, group interaction with passage of time was also significant, which indicates that the pattern of changes has been different between the two groups. The findings of the study confirm the research hypotheses, showing that the application of life review is effective and viable. It is recommended that all nursing homes and even the families of the elderly should employ this convenient, inexpensive, quick, and practical method. Trial Registration Number: IRCT2015021621106N1.

[The association between health-related quality of life and voice as evaluated by an acoustic analysis in elderly Japanese nursing home residents].

PubMed

Hara, Shuichi; Miura, Hiroko; Yamasaki, Kiyoko; Morisaki, Naoko; Sumi, Yasunori

2015-01-01

We carried out a cross-sectional study investigating the association between health-related quality of life (HRQOL) and voice, as evaluated by an acoustic analysis, in elderly residents of a nursing home. The HRQOL of 61 elderly nursing home residents (mean age: 82.1±8.3 years) was assessed via the SF-8 Health Survey questionnaire, Japanese version (SF-8). The subjects' voices were recorded and analyzed by a voice assessment software program, which calculated the pitch period perturbation quotient (PPQ), amplitude perturbation quotient (APQ), and noise-to-harmonic ratio (NHR). Subjects who scored under the 25th percentile on general health (GH), vitality (VT), or physical summary (PCS) in the SF-8 showed significantly higher PPQ, APQ, and NHR scores in comparison to their counterparts (p<0.05). After adjustment for age, lower GH scores were found to be associated with higher PPQ, APQ, and NHR scores; lower VT scores were associated with higher APQ and NHR scores; and lower PCS scores were associated with higher APQ and NHR scores (p<0.05). The results of the acoustic analysis indicated that voice was associated with HRQOL in the elderly nursing home residents of the present study. Among the acoustic parameters that were analyzed, PPQ, APQ, and NHR may be an influential factor that can be used to assess HRQOL, independently of the effects of age, in elderly individuals.

Clinical and economic impact of herpes zoster vaccination in elderly in Italy.

PubMed

Boccalini, Sara; Alicino, Cristiano; Martinelli, Domenico; Bechini, Angela; Tiscione, Emilia; Pellizzari, Barbara; Prato, Rosa; Icardi, Giancarlo; Iannazzo, Stefania; Bonanni, Paolo

2017-02-01

Herpes zoster (HZ) is a very relevant pathology among elderly people (≥ 60 years of age), with a considerable disease burden and loss of quality of life. In the last years a new vaccine against HZ became available in Italy. Therefore, the Italian decision makers are now confronted with the decision whether that vaccination should be implemented. Pharmaco-economic analyses represent useful tools to value the feasibility of new immunization programs and their sustainability. To this aim, an ad hoc population model was developed in order to value the clinical and economic impact of HZ vaccination program for the elderly in Italy. Particularly, different immunization scenarios were modeled: vaccination of 60 years-old subjects (single cohort strategy), simultaneous vaccination of people aged 60 and 65 years (double cohort strategy) and, lastly, immunization of people aged 60, 65 and 70 years (triple cohort strategy), thus leading to the vaccination of 5, 10 and 15 cohorts during the first 5 years of the program. The mathematical model valued the clinical impact of vaccination on the number of HZ, post-herpetic neuralgia (PHN) and ophthalmic HZ. The results of the analysis show that, in Italy, a cohort-based HZ vaccination program in elderly could have a relevant impact on the reduction of clinical cases and a favorable economic profile for the National Health Service (NHS), as already foreseen in other countries. In addition, further benefits could be obtained when extending the study period beyond the 5-year horizon of our analysis.

The Lifestyle Interventions and Independence for Elders Study: design and methods.

PubMed

Fielding, Roger A; Rejeski, W Jack; Blair, Steven; Church, Tim; Espeland, Mark A; Gill, Thomas M; Guralnik, Jack M; Hsu, Fang-Chi; Katula, Jeffrey; King, Abby C; Kritchevsky, Stephen B; McDermott, Mary M; Miller, Michael E; Nayfield, Susan; Newman, Anne B; Williamson, Jeff D; Bonds, Denise; Romashkan, Sergei; Hadley, Evan; Pahor, Marco

2011-11-01

As the number of older adults in the United States rises, maintaining functional independence among older Americans has emerged as a major clinical and public health priority. Older people who lose mobility are less likely to remain in the community; demonstrate higher rates of morbidity, mortality, and hospitalizations; and experience a poorer quality of life. Several studies have shown that regular physical activity improves functional limitations and intermediate functional outcomes, but definitive evidence showing that major mobility disability can be prevented is lacking. A Phase 3 randomized controlled trial is needed to fill this evidence gap. The Lifestyle Interventions and Independence for Elders (LIFE) Study is a Phase 3 multicenter randomized controlled trial designed to compare a supervised moderate-intensity physical activity program with a successful aging health education program in 1,600 sedentary older persons followed for an average of 2.7 years. LIFE's primary outcome is major mobility disability, defined as the inability to walk 400 m. Secondary outcomes include cognitive function, serious fall injuries, persistent mobility disability, the combined outcome of major mobility disability or death, disability in activities of daily living, and cost-effectiveness. Results of this study are expected to have important public health implications for the large and growing population of older sedentary men and women.

Implications of measures of quality of life for policy development.

PubMed

Mosteller, F

1987-01-01

Quality of life measurements can lead to legislative programs for health, new policies for the health care system, and possibly new attitudes in the courts. Clinical decisions, public health evaluations, and advice for legislatures and courts require diverse measures. We illustrate potential use of such measures with reimbursement problems, programs like Head Start, mainstreaming the handicapped, day care and prenatal care, terminal care for the elderly, monitoring programs, and chronic disabilities. The many treatment policies discussed at the Portugal Conference show the need for quality of life measures in clinical trials. The courts, although considering quality of life, do not seem to consider quality of life measures. If scientists and medical experts wish to establish or change the positions of the courts, consensus conferences appear more effective than regulation or new legislation. To contribute more than they now do to policy, workers measuring quality of life need to develop a variety of measures and methods. They, then, must apply them to medical and health problems, build up a substantial literature, and set priorities for the research needs of the field.

Ethnographic Exploration of Empowerment to Improve Elderly Residents' Quality of Life.

PubMed

Tabatabaei, Seyed Zia; Ebrahimi, Fatemeh; Hamzah, Azimi Bin Hj; Rezaeian, Mohsen; Kamrani, Mahnaz Akbari

2017-01-01

Evidence underscores that empowerment is central to improve the elderly residents' quality of life. In truth, empowerment is a process through which individuals gain better control over their life. The aim of this study was to explore how perceived empowerment influence on the quality of life among elderly Malay residents. A focus ethnographic approach was employed in a Malaysian residential home between May 2011 and January 2012. Data were gathered from participant observations, field notes, in-depth interviews, and exploring related documents. The analysis of the data gathered in the current study resulted in the development of three themes - social life and its requirements, caregivers' skills empowerment, and listening and supporting. Findings of the study provide new insights that are useful in charting new guideline for care providers and policy makers to improve the elderly residents' quality of life.

An exploration of antecedents of positive affect among the elderly: a cross-sectional study.

PubMed

Lee, Sunwoo

2016-02-01

Positive affect contributes to the healthy life style, which, in turn, explains life satisfaction and psychological well-being among the elderly. Existent literature has reinforced that physical activity participation influences development of positive affect for the elderly. Because of the increased life constraints and physical problems, however, maintenance of positive affect might be challenging for elderly people. Data were drawn from a sample of the Survey of Health, Ageing and Retirement in Europe. A total sample of 3845 males and 3912 females aged between 65 and 103 years from 16 European countries was analyzed. Perception of life constraints, health problems, physical activity engagement and positive affect were measured by a structured questionnaire. Confirmatory factor analysis and a technique of structural equation modelling were employed using Amos 18 to examine the hypothesized relationships between study variables. Perceived life constraints and physical problems significantly affected the acquisition of positive affect among the elderly. Physical activity was found to have a significant path coefficient towards the measure of positive attitude and emotion. Physical activity was also a significant mediator between physical problems and positive affect. This study extended our understanding of how the perception of life constraints and health problems influence the elderly's daily experience. Study finding reinforced the goodness of physical activity participation to enhance positive affect among the elderly. We should administer sustainable and evidence-based physical activity including interventions and infrastructure to improve positive affect and psychological well-bing among the elderly. © The Author 2015. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

[Frailty, disability and multi-morbidity: the relationship with quality of life and healthcare costs in elderly people].

PubMed

Lutomski, Jennifer E; Baars, Maria A E; Boter, Han; Buurman, Bianca M; den Elzen, Wendy P J; Jansen, Aaltje P D; Kempen, Gertrudis I J M; Steunenberg, Bas; Steyerberg, Ewout W; Olde Rikkert, Marcel G M; Melis, René J F

2014-01-01

To assess the independent and combined impact of frailty, multi-morbidity, and activities of daily living (ADL) limitations on self-reported quality of life and healthcare costs in elderly people. Cross-sectional, descriptive study. Data came from The Older Persons and Informal Caregivers Minimum DataSet (TOPICS-MDS), a pooled dataset with information from 41 projects across the Netherlands from the Dutch national care for the Elderly programme. Frailty, multi-morbidity and ADL limitations, and the interactions between these domains, were used as predictors in regression analyses with quality of life and healthcare costs as outcome measures. Analyses were stratified by living situation (independent or care home). Directionality and magnitude of associations were assessed using linear mixed models. A total of 11,093 elderly people were interviewed. A substantial proportion of elderly people living independently reported frailty, multi-morbidity, and/or ADL limitations (56.4%, 88.3% and 41.4%, respectively), as did elderly people living in a care home (88.7%, 89.2% and 77,3%, respectively). One-third of elderly people living at home (31.9%) reported all three conditions compared with two-thirds of elderly people living in a care home (68.3%). In the multivariable analysis, frailty had a strong impact on outcomes independently of multi-morbidity and ADL limitations. Elderly people experiencing problems across all three domains reported the poorest quality-of-life scores and the highest healthcare costs, irrespective of their living situation. Frailty, multi-morbidity and ADL limitations are complementary measurements, which together provide a more holistic understanding of health status in elderly people. A multi-dimensional approach is important in mapping the complex relationships between these measurements on the one hand and the quality of life and healthcare costs on the other.

Measuring the quality of life of the elderly in health promotion intervention clinical trials.

PubMed Central

Kutner, N G; Ory, M G; Baker, D I; Schechtman, K B; Hornbrook, M C; Mulrow, C D

1992-01-01

The Multicenter Trials of Frailty and Injuries: Cooperative Studies of Intervention Techniques (FICSIT) is a series of clinical trials of biomedical, behavioral, and environmental interventions to reduce the risks of frailty and injury among the elderly. Reliable assessment of the quality of life reported by the subjects is a central issue in evaluating the interventions. An intervention may have a significant impact on an elderly person's sense of well-being, even though significant improvement is not observed in selected physical outcome measures. Elderly persons' compliance with particular intervention regimens may be influenced by the quality of life effects that they perceive in relation to the intervention. The researchers review the definition and measurement of quality of life in the trials, with particular attention to issues in determining common measures used at all study locations. Practical considerations in the selection and use of quality of life measures in both community and institutional populations are addressed. Topics discussed include the interrelation of aging, functional capacities, and quality of life; the multi-dimensionality of quality of life in relation to differential intervention effects; and age-related issues in the collection of quality of life data. Preliminary observations are reviewed, and potential contributions of FICSIT to intervention-sensitive quality of life assessments among the elderly are noted. PMID:1410233

Swallowing frequency in elderly people during daily life.

PubMed

Tanaka, N; Nohara, K; Kotani, Y; Matsumura, M; Sakai, T

2013-10-01

Disuse atrophy of swallowing-related organs due to an excessive decrease in swallowing frequency is suspected to occur in patients with poor oral intake, especially elderly people. However, swallowing frequency in daily life has not previously been examined in the elderly. This study examined swallowing frequency in elderly people and compared these findings to those in a younger population and differences in the degree of activity in daily life. (i) We compared swallowing frequency in 20 elderly people (82·0 ± 8·3 year) and 15 healthy young people (26·5 ± 3·5 year). (ii) 20 elderly people were divided into two groups according to the degree of activity in daily life: a semi-bedridden group and bedridden group; the swallowing frequency was compared between these groups. (i) The swallowing frequency in the elderly people was 2-19 times per hour and the mean was 9·4 ± 4·9, and that in the healthy young people was 16-76 times per hour and the mean was 40·7 ± 19·5. Swallowing frequency in elderly people was significantly lower than that in young healthy people (P < 0·0001). (ii) The swallowing frequency in bedridden group was 2-11 times per hour and the mean was 6·8 ± 3·3, and that in semi-bedridden group was 3-19 times per hour and the mean was 11·9 ± 5·1. Swallowing frequency in bedridden group was significantly lower than that in semi-bedridden group (P < 0·05). These results indicate that in daily life, elderly people tend to swallow less frequently than young people. In addition, swallowing frequency was lower in elderly subjects with a low degree of activity in daily life. © 2013 John Wiley & Sons Ltd.

Medicare and Medicaid programs; fire safety requirements for certain health care facilities. Final rule.

PubMed

2003-01-10

This final rule amends the fire safety standards for hospitals, long-term care facilities, intermediate care facilities for the mentally retarded, ambulatory surgery centers, hospices that provide inpatient services, religious nonmedical health care institutions, critical access hospitals, and Programs of All-Inclusive Care for the Elderly facilities. Further, this final rule adopts the 2000 edition of the Life Safety Code and eliminates references in our regulations to all earlier editions.

Sustaining Clinical Programs During Difficult Economic Times: A Case Series from the Hospital Elder Life Program

PubMed Central

SteelFisher, Gillian K.; Martin, Lauren A.; Dowal, Sarah L.; Inouye, Sharon K.

2013-01-01

OBJECTIVES To explore strategies used by clinical programs to justify operations to decision-makers using the example of the Hospital Elder Life Program (HELP), an evidence-based, cost-effective program to improve care for hospitalized older adults. DESIGN Qualitative study design utilizing 62 in-depth, semi-structured interviews conducted with HELP staff members and hospital administrators between September 2008 and August 2009. SETTING 19 HELP sites in hospitals across the U.S. and Canada that had been recruiting patients for at least 6 months. PARTICIPANTS and MEASUREMENTS HELP staff and hospital administrator experiences sustaining the program in the face of actual or perceived financial threats, with a focus on factors they believe are effective in justifying the program to decision-makers in the hospital or health system. RESULTS Using the constant comparative method, a standard qualitative analysis technique, three major themes were identified across interviews. Each focuses on a strategy for successfully justifying the program and securing funds for continued operations: 1) interact meaningfully with decision-makers, including formal presentations that showcase operational successes, and also informal means that highlight the benefits of HELP to the hospital or health system; 2) document day-to-day, operational successes in metrics that resonate with decision-maker priorities; and 3) garner support from influential hospital staff that feed into administrative decision-making, particularly nurses and physicians. CONCLUSION As clinical programs face financially challenging times, it is important to find effective ways to justify their operations to decision-makers. Strategies described here may help clinically-effective and cost-effective programs sustain themselves, and thus may help improve care in their institutions. PMID:22091501

Intergenerational support, satisfaction with parent-child relationship and elderly parents' life satisfaction in Hong Kong.

PubMed

Peng, Chenhong; Kwok, Chi Leung; Law, Yik Wa; Yip, Paul S F; Cheng, Qijin

2018-01-22

This study examines in what exchange patterns that three types of intergenerational support are associated with elderly parents' life satisfaction, and whether elderly parents' evaluation on parent-child relationship plays a mediation role on those associations. Data were drawn from Hong Kong Panel Survey for Poverty Alleviation. Respondents aged 65 and over were included ( N=504). Three types of support, namely, daily-living, financial, and emotional support were examined in four patterns-the over-benefited , under-benefited , reciprocal and no flow of exchange. A multivariable linear regression was applied to investigate the association between pattern of intergenerational exchange and life satisfaction, and mediation analysis was employed to examine the mediating role of satisfaction with parent-child relationship on their associations. Elderly parents were less satisfied with their lives when they had no flow of exchange in daily-living support, and more satisfied when they were under-benefited in financial support, and over-benefited or reciprocal in emotional support. Elderly parents' satisfaction with parent-child relationship mediated the association between exchange of emotional support and life satisfaction; but not the association between daily-living or financial support and life satisfaction. Different types of intergenerational support are associated with elderly parents' life satisfaction in different patterns.

Physical activity intervention for elderly patients with reduced physical performance after acute coronary syndrome (HULK study): rationale and design of a randomized clinical trial.

PubMed

Tonet, Elisabetta; Maietti, Elisa; Chiaranda, Giorgio; Vitali, Francesco; Serenelli, Matteo; Bugani, Giulia; Mazzoni, Gianni; Ruggiero, Rossella; Myers, Jonathan; Villani, Giovanni Quinto; Corvi, Ursula; Pasanisi, Giovanni; Biscaglia, Simone; Pavasini, Rita; Lucchi, Giulia Ricci; Sella, Gianluigi; Ferrari, Roberto; Volpato, Stefano; Campo, Gianluca; Grazzi, Giovanni

2018-05-21

Reduced physical performance and impaired mobility are common in elderly patients after acute coronary syndrome (ACS) and they represent independent risk factors for disability, morbidity, hospital readmission and mortality. Regular physical exercise represents a means for improving functional capacity. Nevertheless, its clinical benefit has been less investigated in elderly patients in the early phase after ACS. The HULK trial aims to investigate the clinical benefit of an early, tailored low-cost physical activity intervention in comparison to standard of care in elderly ACS patients with reduced physical performance. HULK is an investigator-initiated, prospective multicenter randomized controlled trial (NCT03021044). After successful management of the ACS acute phase and uneventful first 1 month, elderly (≥70 years) patients showing reduced physical performance are randomized (1:1 ratio) to either standard of care or physical activity intervention. Reduced physical performance is defined as a short physical performance battery (SPPB) score of 4-9. The early, tailored, low-cost physical intervention includes 4 sessions of physical activity with a supervisor and an home-based program of physical exercise. The chosen primary endpoint is the 6-month SPPB value. Secondary endpoints briefly include quality of life, on-treatment platelet reactivity, some laboratory data and clinical adverse events. To demonstrate an increase of at least one SPPB point in the experimental arm, a sample size of 226 patients is needed. The HULK study will test the hypothesis that an early, tailored low-cost physical activity intervention improves physical performance, quality of life, frailty status and outcome in elderly ACS patients with reduced physical performance. Clinicaltrials.gov, identifier NCT03021044 , first posted January, 13th 2017.

Socio-Demographic Variables and Successful Aging of the Angolan Elderly

PubMed Central

Galiana, Laura; Gutiérrez, Melchor; Sancho, Patricia; Francisco, Elizabeth-Hama; Tomás, José M.

2016-01-01

The proportion of elderly people is growing faster than any other age group. Amongst them, the group of oldest old is indeed the segment of the elderly population with the fastest growth rate. The increase in the proportion of elderly in the Angolan population makes research on this area badly needed. Within the theoretical framework of successful aging, the study aims to test for sociodemographic group differences in perceived health, life satisfaction, and social relations in Angolan elderly. The dependent variables are three of the components of what has been called successful aging. Data came from a cross-sectional survey of elderly people living in Luanda. 1003 Angolan elderly were surveyed on sociodemographic information, perceived health, life satisfaction, and social support. MANOVAs were calculated to test for mean differences in the dependent variables. Results permit to conclude that the factors associated with the largest differences on the Angolan elderly's quality of life and social relations were age (becoming oldest old) and institutionalization. The interactions of several factors with age pointed out that the oldest old were clearly a group in which the decreased quality of life due to becoming oldest old could not be compensated by other factors, as it was the case in the group of young old. PMID:27088039

[Who told you to grow old and live on the streets?].

PubMed

Brêtas, Ana Cristina Passarella; Marcolan, João Fernando; Rosa, Anderson da Silva; Fernandes, Flávia Saraiva Leão; Raizer, Milena Veiga

2010-06-01

This qualitative case study is part of another study: Aging, health and work. The objective of this excerpt was to identify the meaning of aging on the streets for the elderly living on the street. The subjects' statements were analyzed under the light of the following themes: history of aging and history of life on the streets. It was understood that the streets are usually a hostile environment for the elderly. It does not guarantee the basic life conditions, affecting the mental health of people who are forced to live on the streets, particularly the elderly. The street does not offer any way out and, together with to the life conditions of the elderly living on the streets leads to the gradual loss of self-esteem, significantly affecting self-care. In addition to these issues, we found that compromised functional capacity puts the life/survival of the elderly living on the streets at risk.

The reluctance to burden others as a value in end-of-life decision making: a source of inaccuracy in substituted judgment.

PubMed

Winter, Laraine; Parks, Susan M

2012-03-01

Most patients are decisionally incapacitated at the end of life, leaving final treatment decisions to proxies, whose substituted judgment is often inaccurate. We investigated the reluctance to burden others (RBO), a commonly cited patient value, as a possible source of proxy inaccuracy. In a sample of 202 elders and their proxies, elders responded to three burden-related questions and the Life-prolonging Treatment Preferences Questionnaire. Proxies used substituted judgment to respond to the same questions. Although RBO predicted treatment preferences for both elders and proxies, elders rated RBO significantly more important than did proxies. In addition, larger elder-proxy differences in RBO were associated with more inaccurate substituted judgment.

[Health-related quality of life evaluation of elderly aged 65 years and over living at home].

PubMed

Jalenques, I; Auclair, C; Rondepierre, F; Gerbaud, L; Tourtauchaux, R

2015-06-01

To assess health-related quality of life in French adults aged 65 years and over, living at home, with a specific self-administered questionnaire, the LEIPAD, cross-culturally adapted in French. Elderly completed socio-demographic and medical questionnaires, a questionnaire about negative life events during the last 12 months and the LEIPAD. Data of 195 subjects (mean age: 72.6 years, men: 56.5%) were analyzed. The response rates to the LEIPAD scales were superior to 90%. Elderly reported on the whole a good health-related quality of life. Age had a negative effect on quality on life, which deteriorates over years. Age was correlated to the scales "Physical function", "Self-care", "Cognitive functioning" and "Sexual functioning". Elderly hospitalized in the last year had worse quality of life with a significant difference for "Physical function" scale. The number of health problems was positively correlated to "Physical function" scale. Elderly declaring at least one health problem had worse quality of life for this scale. Problems in couple, materials and financial problems had also negative effects on health-related quality of life. Our study highlights a good health-related quality of life for the majority of these adults aged 65 years and over, as well as the negative effect of age, health, couple, materials and financial problems on their quality of life. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

[Law and the phase of life old age].

PubMed

Klie, Thomas

2017-06-01

In spite of the greatly increased role, which the law attributes to the design of individual life styles and living of elderly people, there is no special legal area known in the German legal system, such as "rights of the elderly", which is the case in the field of the youth law. Special legal regulations covering the concerns/issues of elderly people were always considered to be in danger, as they may have the potential to discrimination, either in a positive or negative way. Due to this fact, the rights of the elderly can be described as synthetic and are subject to constant changes, as can be observed within the pension act. The legal areas and legal regulations, which are of particular importance for the life style and living situations of elderly people are presented. The legal need for action regarding the special protection of vulnerable elderly people is discussed and in the further course utilized for a conception of "rights of the elderly".

Psychosocial stressors in inter-human relationships and health at each life stage: A review.

PubMed

Kagamimori, Sadanobu; Nasermoaddeli, Ali; Wang, Hongbing

2004-05-01

Currently, psychosocial stressors' impacts on health are increasing. Among these stressors, this review focused on inter-human relationships. Since social supports could be protective against ill health, consequences contributing to psychosocial stressors are discussed here in relation to social supports for each stage of childhood, adulthood and elderly status.For childhood, parental divorce/isolation, and child abuse/neglect appeared to be determinants of healthy development at either the initial or later stages. According to prospective studies, such stressors, especially those occurring until around 3 years of age, were associated with later adverse life quality in adulthood. Therefore, nationwide preventive strategies were developed in each country to monitor protective social programs.For adulthood, job strain was focused on Karasek's job strain model, effort-reward imbalance, employment grade and working hours. These psychosocial stressors were shown to affect not only the physical health but also the mental health of working people. These days, since Karoshi and even suicide related to excessive workloads are taking a toll on workplace organization, stress-coping abilities such as a sense of coherence were introduced from the individual-social interaction aspect.For elderly status, retirement, caring for the elderly, and spouse bereavement were discussed as psychosocial stressors. Some evidence indicates that these stressors could be determiants of health. Finally, social supports have been demonstrated to promote health and protect the elderly against diseases and death.

Family factors in end-of-life decision-making: family conflict and proxy relationship.

PubMed

Parks, Susan Mockus; Winter, Laraine; Santana, Abbie J; Parker, Barbara; Diamond, James J; Rose, Molly; Myers, Ronald E

2011-02-01

Few studies have examined proxy decision-making regarding end-of-life treatment decisions. Proxy accuracy is defined as whether proxy treatment choices are consistent with the expressed wishes of their index elder. The purpose of this study was to examine proxy accuracy in relation to two family factors that may influence proxy accuracy: perceived family conflict and type of elder-proxy relationship. Telephone interviews with 202 community-dwelling elders and their proxy decision makers were conducted including the Life-Support Preferences Questionnaire (LSPQ), and a measure of family conflict, and sociodemographic characteristics, including type of relationship. Elder-proxy accuracy was associated with the type of elder-proxy relationship. Adult children demonstrated the lowest elder-proxy accuracy and spousal proxies the highest elder-proxy accuracy. Elder-proxy accuracy was associated with family conflict. Proxies reporting higher family conflict had lower elder-proxy accuracy. No interaction between family conflict and relationship type was revealed. Spousal proxies were more accurate in their substituted judgment than adult children, and proxies who perceive higher degree of family conflict tended to be less accurate than those with lower family conflict. Health care providers should be aware of these family factors when discussing advance care planning.

Prevalence of elder abuse and neglect in seniors with psychiatric morbidity - example from central moravia, czech republic.

PubMed

Luzny, Jan; Jurickova, Lubica

2012-01-01

Elder abuse and neglect (EAN) comprises emotional, financial, physical, and sexual abuse, neglect by other individuals, and self-neglect. Elder abuse and neglect in seniors with psychiatric morbidity was not monitored in the Czech Republic at all, despite the literature shows mental morbidity as one of the important risk factor for developing elder abuse and neglect. We designed comparative cross sectional study comprising 305 seniors hospitalized in Mental Hospital Kromeriz in June 2011 - group of 202 seniors hospitalized due to mental disorder in psychogeriatric ward and group of 103 seniors hospitalized due to somatic disorder in internal ward. Content analysis of medical records was done in both groups of seniors, with regards to symptoms of elder abuse. Then, we discussed the topic of elder abuse with 30 nurses of psychogeriatric ward in focus group interview. Between two compared groups of seniors we detected statistically higher prevalence of elder abuse in seniors with psychiatric morbidity (48 cases, 23.8% prevalence of EAN), compared to somatically ill seniors (3 cases, 2.9%). As for nursing staff, 5 from 30 nurses (16.7%) have never heard about symptoms of elder abuse and neglect, 10 from 30 nurses (33.3%) had just a partial knowledge about elder abuse and neglect and its symptoms, the rest of nurses (15 from 30 nurses, 50.0%) had good knowledge about elder abuse and neglect and its symptoms. Elder abuse and neglect seems to be a relevant problem in senior population with mental disorders. Development of educational programs for nursing and medical staff about Elder abuse and neglect (symptoms of EAN, early detection of EAN, knowledge how to report cases of EAN) could improve the situation and help mentally ill seniors to better quality of life.

Developmental and Contextual Correlates of Elders' Anticipated End-of-Life Treatment Decisions

ERIC Educational Resources Information Center

Decker, Ilene M.; Reed, Pamela G.

2005-01-01

The purpose of this study was to gain insight into developmental and contextual correlates of the aggressiveness in treatment that community-based elders anticipate they will desire at the end of life. Elders completed questionnaires to measure 4 developmental factors (integrated moral reasoning, self-transcendence, past experience with…

Perceived reasons for, opinions about, and suggestions for elders considering suicide: elderly outpatients' perspectives.

PubMed

Chen, Ying-Jen; Tsai, Yun-Fang; Ku, Yan-Chiou; Lee, Shwu-Hua; Lee, Hsiu-Lan

2014-07-01

The purposes of this study were to explore elderly outpatients' perceived reasons for, opinions of, and suggestions for elderly people considering suicide in Taiwan. Elderly outpatients (N = 83) were recruited in 2011-2012 by convenience sampling from three randomly selected medical centers in Taiwan. Data were collected in individual interviews using a semi-structured guide and analyzed by content analysis. Findings revealed that most participants had heard of elderly suicide, with television news as the main source for their information. Their opinions about elderly suicide reflected judgmental attitudes, negative emotional reactions, expectations of social welfare, and could happen after losing one's meaning in life. Their suggestions for elderly people considering suicide fell into four major themes: give up suicidal ideas, seek help, enhance social welfare, and attend religious activities. Since television news was the main source for participants' information about elderly suicide, this mass medium should be used in suicide prevention to disseminate suicide knowledge, increase access to help, and strengthen suicide-protective factors among the elderly. Furthermore, no participants mentioned depression as a reason for attempted or completed suicide among older people despite depression being a well-known suicide-risk factor. Future suicide-prevention programs should emphasize the role of depression in suicide among older people. Participants also did not suggest that older people considering suicide seek help from the health system. Thus, older people should be educated about the role of the health system in suicide prevention and trained as gatekeepers to recognize signs of suicide ideation and respond appropriately.

24 CFR 100.302 - State and Federal elderly housing programs.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 24 Housing and Urban Development 1 2011-04-01 2011-04-01 false State and Federal elderly housing... State and Federal elderly housing programs. The provisions regarding familial status in this part shall... specifically designed and operated to assist elderly persons, as defined in the State or Federal program. ...

24 CFR 100.302 - State and Federal elderly housing programs.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 24 Housing and Urban Development 1 2010-04-01 2010-04-01 false State and Federal elderly housing... State and Federal elderly housing programs. The provisions regarding familial status in this part shall... specifically designed and operated to assist elderly persons, as defined in the State or Federal program. ...

42 CFR 460.6 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-10-01

... ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) Basis... enrolled in a PACE program. PACE stands for programs of all-inclusive care for the elderly. PACE center is... care for the elderly that is operated by an approved PACE organization and that provides comprehensive...

42 CFR 460.6 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-10-01

... ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) Basis... enrolled in a PACE program. PACE stands for programs of all-inclusive care for the elderly. PACE center is... care for the elderly that is operated by an approved PACE organization and that provides comprehensive...

Elder Specialists: Psychosocial Aspects of Medical Education in Geriatric Care

ERIC Educational Resources Information Center

McCann-Stone, Nancy; Robinson, Sherry B.; Rull, Gary; Rosher, Richard B.

2009-01-01

This paper describes an Elder Specialist Program developed by one school of medicine to sensitize medical students to geriatric psychosocial issues. Elder Specialists participate in panel discussions as part of each geriatric session. As an alternative to traditional senior mentoring programs, the Elder Specialist Program provides all students a…

Gender differences in positive life orientation among the nursing home elders in China: A cross-sectional study.

PubMed

Jin, Cheng; Zheng, Zhibo; Xian, Wei; Bai, Ming; Jin, Liying; Li, Yuting; Yang, Xiufei; Sheng, Yang; Ai, Wensi; Liu, Hongbo

2017-09-01

Life orientation among the nursing home elders would differ from those of community-dwelling elders due to the different living environment, but may have greater differences in gender. This study was designed to investigate the positive life orientation and explore the potential risk factors including gender disparities among nursing home elders in China. This cross-sectional study was conducted in Northeast China. Two steps cluster sampling procedure were chosen. Basic activities of daily living (BADL) and instrumental activities of daily living (IADL) systems were used to estimate the functional status. Positive life orientation was measured using the six-question life orientation scale (LOS). 2512 nursing home elders were enrolled in the study. The mean age of the participants was 73.14±6.746years. Of the 1308 men and 1204 women, 14.9% had a positive life orientation in women and 16.1% in men. Higher level of education, independent in BADL and IADL were related to positive life orientation both in men and women. Age and BMI were also found to be significantly associated with positive life orientation in men (OR=0.587, 1.132, respectively). For women, the influence of income and vision on positive life orientation was also significant (OR=1.967, 1.926, respectively). The positive life orientation was higher in men than women. The gender-specific differences contribute to take more effective measures to improve the positive life orientation. Copyright © 2017 Elsevier B.V. All rights reserved.

Subjective and psychological well-being of students of a University of the Third Age: Benefits of continuing education for psychological adjustment in the elderly

PubMed Central

Ordonez, Tiago Nascimento; Lima-Silva, Thaís Bento; Cachioni, Meire

2011-01-01

Objectives The present study sought to characterize the degree of general satisfaction with life and degree of satisfaction on four domains: health, physical capacity, mental capacity and social involvement, and to determine the characteristics of self-reports of individuals enrolled on the program in relation to their psychological well-being focusing on the dimensions: autonomy, personal growth, control, positive relationships with others, purpose, personal acceptance and generativity, and to analyse the effect of time studying on level of well-being. Method A total of 140 elderly students of a University for the Third Age took part in the study. The Global Satisfaction With Life Scale and the Self Development Scale (with six psychological well-being subscales) were applied. Continuous variables for the two groups were compared using the Mann-Whitney test. Spearman’s correlation coefficient was used to analyze the relationship among numeric variables. Internal consistency of the instrument scales was analysed by calculating Cronbach’s alpha coefficient. Results Results showed that students who had attended the University of the Third Age for six months or longer had a higher level of satisfaction with life and greater psychological adjustment compared with new entrants to the same institution. Conclusion The study results confirmed the positive effects of continuing education on the well-being of elderly and its contribution to successful aging. PMID:29213747

Medicare and Medicaid Programs; Fire Safety Requirements for Certain Health Care Facilities. Final rule.

PubMed

2016-05-04

This final rule will amend the fire safety standards for Medicare and Medicaid participating hospitals, critical access hospitals (CAHs), long-term care facilities, intermediate care facilities for individuals with intellectual disabilities (ICF-IID), ambulatory surgery centers (ASCs), hospices which provide inpatient services, religious non-medical health care institutions (RNHCIs), and programs of all-inclusive care for the elderly (PACE) facilities. Further, this final rule will adopt the 2012 edition of the Life Safety Code (LSC) and eliminate references in our regulations to all earlier editions of the Life Safety Code. It will also adopt the 2012 edition of the Health Care Facilities Code, with some exceptions.

The Role of Nutrition and Literacy on the Cognitive Functioning of Elderly Poor Individuals.

PubMed

Leist, Anja K; Novella, Rafael; Olivera, Javier

2018-06-08

Maintaining cognitive function is a prerequisite of living independently, which is a highly valued component in older individuals' wellbeing. In this paper we assess the role of early-life and later-life nutritional status, education and literacy on the cognitive functioning of older adults living in poverty in Peru. We exploit the baseline sample of the Peruvian non-contributory pension program Pension 65 and find that current nutritional status and literacy are strongly associated with cognitive functioning for poor older adults. In a context of rising popularity of non-contributory pension programs around the world, our study intends to contribute to the discussion of designing accompanying measures to the pension transfer, such as adult literacy programs and monitoring of adequate nutrition of older adults.

Knowledge of advance directive and perceptions of end-of-life care in Chinese-American elders: The role of acculturation.

PubMed

Gao, Xiang; Sun, Fei; Ko, Eunjeong; Kwak, Jung; Shen, Huei-Wern

2015-12-01

This study aimed to describe knowledge of an advance directive (AD) and preferences regarding end-of-life (EoL) care communication, decision making, and designation of surrogates in Chinese-American elders and to examine the role of acculturation variables in AD awareness. Survey data were collected through face-to-face interviews on a sample of 385 Chinese-American elders aged 55 or above living in the Phoenix metropolitan area. The choice of language (Mandarin, Cantonese, or English) and place of interview (senior apartments, Chinese senior centers, or homes) was at the respondent's preference. Hierarchical logistic regression analysis was employed to examine the influence of acculturation variables on AD awareness. Some 21% of participants had heard about ADs, and only 10% had completed one. Elders with higher acculturation levels (OR = 1.04, p < 0.10) and those residing more than 20 years in the United States (OR = 6.87, p < 0.01) were more likely to be aware of ADs after controlling for the effects of demographics, health, and experiences of EoL care. The majority preferred physicians to initiate AD discussions (84.9%) and identified burdens on families as the most important factor in making EoL decisions (89.3%). About 55.1 % considered daughters as the preferred healthcare surrogate. Acculturation levels influence awareness of an AD, and family values are crucial in EoL care decision making. Cultural factors should be considered in designing and delivering appropriate programs to promote knowledge of EoL care among Chinese-American elders and their families.

Teaching, learning, and assessment in geriatric dentistry: researching models of practice.

PubMed

Shah, Naseem

2010-01-01

Changing demography due to the increasing population of elderly persons the world over has raised new challenges in every sphere of life. The greatest challenge is to provide affordable, accessible, and equitable health care to this population. Oral health is an integral part of general health and affects physical and mental well-being and quality of life of elderly persons. To provide quality oral health care to the elderly, it is important to focus on education in geriatric dentistry, since it is known that education is closely linked to health care provision. It has been found that education in geriatric dentistry has wide variations in different parts of the world. Also, it is being taught at different levels: the predoctoral curriculum, postdoctoral certificate/diploma courses of varying duration by direct or distance mode using computer-assisted learning, degree courses of three years' duration, or continuing education programs. This article attempts to study geriatric dentistry education in global perspective. It is discussed in three sections: 1) varying concepts and methods of teaching, learning, and assessment in dental education; 2) status of geriatric dental education in developed and developing countries with emphasis on the Indian scenario; and 3) challenges and opportunities in developing geriatric dental education.

Designing an Elderly Assistance Program Based-on Home Care

NASA Astrophysics Data System (ADS)

Umusya'adah, L.; Juwaedah, A.; Jubaedah, Y.; Ratnasusanti, H.; Puspita, R. H.

2018-02-01

PKH (Program Keluarga Harapan) is a program of Indonesia’s Government through the ministry of social directorate to accelerate the poverty reduction and the achievement of Millennium Development Goals (MDGs) target as well as the policies development in social protection and social welfare domain or commonly referred to as Indonesian Conditional Cash Transfer (CCT) Program. This research is motivated that existing participants of the family expectation program (PKH) that already exist in Sumedang, Indoensia, especially in the South Sumedang on the social welfare components is only limited to the health checking, while for assisting the elderly based Home Care program there has been no structured and systematic, where as the elderly still need assistance, especially from the family and community environment. This study uses a method of Research and Development with Model Addie which include analysis, design, development, implementation and evaluation. Participants in this study using purposive sampling, where selected families of PKH who provide active assistance to the elderly with 82 participants. The program is designed consists of program components: objectives, goals, forms of assistance, organizing institutions and implementing the program, besides, program modules include assisting the elderly. Form of assistance the elderly cover physical, social, mental and spiritual. Recommended for families and companions PKH, the program can be implemented to meet the various needs of the elderly. For the elderly should introspect, especially in the health and follow the advice recommended by related parties

Calibrating and adjusting expectations in life: A grounded theory on how elderly persons with somatic health problems maintain control and balance in life and optimize well-being

PubMed Central

Helvik, Anne-Sofie; Iversen, Valentina Cabral; Steiring, Randi; Hallberg, Lillemor R-M

2011-01-01

Aim This study aims at exploring the main concern for elderly individuals with somatic health problems and what they do to manage this. Method In total, 14 individuals (mean=74.2 years; range=68–86 years) of both gender including hospitalized and outpatient persons participated in the study. Open interviews were conducted and analyzed according to grounded theory, an inductive theory-generating method. Results The main concern for the elderly individuals with somatic health problems was identified as their striving to maintain control and balance in life. The analysis ended up in a substantive theory explaining how elderly individuals with somatic disease were calibrating and adjusting their expectations in life in order to adapt to their reduced energy level, health problems, and aging. By adjusting the expectations to their actual abilities, the elderly can maintain a sense of that they still have the control over their lives and create stability. The ongoing adjustment process is facilitated by different strategies and result despite lower expectations in subjective well-being. The facilitating strategies are utilizing the network of important others, enjoying cultural heritage, being occupied with interests, having a mission to fulfill, improving the situation by limiting boundaries and, finally, creating meaning in everyday life. Conclusion The main concern of the elderly with somatic health problems was to maintain control and balance in life. The emerging theory explains how elderly people with somatic health problems calibrate their expectations of life in order to adjust to reduced energy, health problems, and aging. This process is facilitated by different strategies and result despite lower expectation in subjective well-being. PMID:21468299

"Nobody ever asked me before": understanding life experiences of African American elders.

PubMed

Shellman, Juliette

2004-10-01

With the unprecedented growth in the African American elderly population, there exists an urgent need to prepare nurses to deliver culturally competent care. The purpose of this study was to increase the knowledge available about the cultural heritage, worldviews, and life experiences of African American elders. Reminiscence interviews were conducted with African American elders living in a medium-sized northeast urban community. Data were analyzed using Spiegelberg's phenomenological Method. The following themes emerged: (a) nobody ever asked me before, (b) stories of discrimination, (c) coping with discrimination, (d) the hurt of discrimination, and (e) self-discoveries. Nurses, through the use of reminiscence, can gain insight into the cultural heritage, worldviews, and life experiences of African American elders and improve their ability to deliver culturally competent care to this population.

[Satisfaction with life, dental experience and self-perception of oral health among the elderly].

PubMed

Rigo, Lilian; Basso, Kenny; Pauli, Jandir; Cericato, Graziela Oro; Paranhos, Luiz Renato; Garbin, Raissa Rigo

2015-12-01

The scope of this article is to analyze the relationship between satisfaction with quality of life, self-perception of oral health and experience with dental surgeons. The study is cross-sectional epidemiological in structure with a sample of 326 elderly individuals over 60 years of age living in a city in the north of the State of Rio Grande do Sul, Brazil. The instrument for data collection was a self-administered questionnaire with queries relating to self-perception in oral health (OHIP - Oral Health Impact Profile), Quality of Life Satisfaction scale and sociodemographic issues. The findings showed that the elderly with higher levels of quality of life satisfaction manifested an enhanced perception of their own oral health as well as a better perceived image of dental surgeons and less anxiety about their experiences with the dentist. It was proven that both the self-perception that the elderly have about oral health as well as their experience with dentists is associated with the quality of life satisfaction of the elderly. The results have important implications for decision-makers and formulators of public policy.

An exploration of antecedents of positive affect among the elderly: a cross-sectional study

PubMed Central

2016-01-01

Abstract Background: Positive affect contributes to the healthy life style, which, in turn, explains life satisfaction and psychological well-being among the elderly. Existent literature has reinforced that physical activity participation influences development of positive affect for the elderly. Because of the increased life constraints and physical problems, however, maintenance of positive affect might be challenging for elderly people. Methods : Data were drawn from a sample of the Survey of Health, Ageing and Retirement in Europe. A total sample of 3845 males and 3912 females aged between 65 and 103 years from 16 European countries was analyzed. Perception of life constraints, health problems, physical activity engagement and positive affect were measured by a structured questionnaire. Confirmatory factor analysis and a technique of structural equation modelling were employed using Amos 18 to examine the hypothesized relationships between study variables. Results: Perceived life constraints and physical problems significantly affected the acquisition of positive affect among the elderly. Physical activity was found to have a significant path coefficient towards the measure of positive attitude and emotion. Physical activity was also a significant mediator between physical problems and positive affect. Conclusions: This study extended our understanding of how the perception of life constraints and health problems influence the elderly’s daily experience. Study finding reinforced the goodness of physical activity participation to enhance positive affect among the elderly. We should administer sustainable and evidence-based physical activity including interventions and infrastructure to improve positive affect and psychological well-bing among the elderly. PMID:25829500

The use of focus groups in evaluating quality of life components among elderly Chinese people.

PubMed

Leung, Kai-Kuen; Wu, En-Chang; Lue, Bee-Horng; Tang, Li-Yu

2004-02-01

In Taiwan, to measure the quality of life (QOL) of elderly Chinese, one must rely on instruments developed in other Chinese or Western populations and not specifically for the elderly. The purpose of this study is to understand the components of QOL for elderly Chinese from Taiwan living in residential homes or in their communities. Forty-four elderly men and women divided into six focus groups were interviewed on video tape and the resultant recording was analyzed qualitatively by six independent researchers. The study yielded 15 QOL domains grouped into six dimensions: physical health (physical well-being, impact of illness, medical care), psychological health (mood states, life attitude and retrospection, philosophy of living, self-efficacy), social function (connectedness, exercise and leisure activities, social activities and services), living environment (living environment and arrangements, institutional factors), economic status, and religion and death (religion, death). For elderly Chinese in Taiwan, positive and negative life domains are equally important in the perception of life quality; person-environment interaction is a major consideration in the evaluation of QOL; family ties are an important component of QOL; traditional Chinese beliefs exert a positive influence on perceived QOL; and social functioning and vitality have a different meaning in Chinese compared to Western cultures.

Effect of a 16-week Pilates exercise program on the ego resiliency and depression in elderly women

PubMed Central

Roh, Su Yeon

2016-01-01

This study aims to examine the effect of a 16-week Pilates exercise program on the ego resiliency and depression in elderly women. Before participating in Pilates exercise programs, researcher explained the purpose and the intention of the research to elderly women who were willing to participate in this research. A total of 148 elderly women agreed to participate in the program and they filled in ego resiliency and depression questionnaires. Then, the elderly participated in the 16-week Pilates exercise program and completed the same questionnaires afterwards. Collected data was analyzed by the SPSS ver. 20.0 program and results of paired t-test were as follows; there were statistically significant differences in all subvariables of the ego resiliency such as self-confidence (t=7.770, P<0.001), communication efficiency (t=2.690, P<0.01), optimistic trait (t=1.996, P<0.05), and anger management (t=4.525, P<0.001) after elderly women participated in the 16-week Pilates exercise program, there was a statistically significant difference in depression of elderly women who participated in the 16-week Pilates exercise program (t=−6.506, P<0.001) which was statistically lower than before their participation in the program. Consequently, participating in the Pilates exercise program can help improve the ego-resiliency and alleviate depression of the elderly women. PMID:27807531

Effect of a 16-week Pilates exercise program on the ego resiliency and depression in elderly women.

PubMed

Roh, Su Yeon

2016-10-01

This study aims to examine the effect of a 16-week Pilates exercise program on the ego resiliency and depression in elderly women. Before participating in Pilates exercise programs, researcher explained the purpose and the intention of the research to elderly women who were willing to participate in this research. A total of 148 elderly women agreed to participate in the program and they filled in ego resiliency and depression questionnaires. Then, the elderly participated in the 16-week Pilates exercise program and completed the same questionnaires afterwards. Collected data was analyzed by the SPSS ver. 20.0 program and results of paired t -test were as follows; there were statistically significant differences in all subvariables of the ego resiliency such as self-confidence ( t =7.770, P <0.001), communication efficiency ( t =2.690, P <0.01), optimistic trait ( t =1.996, P <0.05), and anger management ( t =4.525, P <0.001) after elderly women participated in the 16-week Pilates exercise program, there was a statistically significant difference in depression of elderly women who participated in the 16-week Pilates exercise program ( t =-6.506, P <0.001) which was statistically lower than before their participation in the program. Consequently, participating in the Pilates exercise program can help improve the ego-resiliency and alleviate depression of the elderly women.

On the Life Aesthetics of Aging People--Slowness Makes Life Beautiful

ERIC Educational Resources Information Center

Chang, Kuei-Chiu; Chou, Mei-Ju

2015-01-01

Taiwan has a rapid increase of elder population, which is supposed to double within the next 25 years. However, lifelong aesthetics learning for the elderly has not yet been fully developed. In the environment emphasizing on lifelong learning with increasing elder people, it is a crucial mission to design appropriate environment, curriculum,…

Health status among elderly Hungarians and Americans.

PubMed

Buss, T F; Beres, C; Hofstetter, C R; Pomidor, A

1994-07-01

Selected health status data for elderly populations from similar industrial cities-Youngstown, Ohio, USA, and Debrecen, Hungary-were compared. Because of their impoverished health care system, unregulated heavily industrialized society, and unhealthful life-styles Hungarians were hypothesized to have poorer health status than Americans, even after taking into account demographic mediating factors. The study provides a health status baseline for elderly Hungarians shortly after communism's fall in 1989-1990 and shows how great a gap exists between Hungarian health status and that in the West. Hungarians were in much poorer health as measured by functional status, symptomatology, medical condition, depression, and subjective health status. Distinctions persisted when controlling for gender, age, and education. Poverty-level (and income) did not explain health status differences. The paper concludes that Hungary should pay more attention to health promotion, prevention, and primary care, as well as to reforming patient management in hospitals, nursing homes, and home care programs.

24 CFR 886.329a - Preferences for occupancy by elderly families.

Code of Federal Regulations, 2011 CFR

2011-04-01

... elderly families. 886.329a Section 886.329a Housing and Urban Development REGULATIONS RELATING TO HOUSING... DIRECT LOAN PROGRAM, SECTION 202 SUPPORTIVE HOUSING FOR THE ELDERLY PROGRAM AND SECTION 811 SUPPORTIVE... Preferences for occupancy by elderly families. (a) Election of preference for occupancy by elderly families—(1...

Life-sustaining treatments: what doctors do, what they want for themselves and what elderly persons want.

PubMed

Carmel, S

1999-11-01

In view of the current social dilemmas regarding the use of life-sustaining treatments (LST) at the end of life, the purpose of the study was to reveal sources of interpersonal and intrapersonal conflict among the most involved parties, in a society where open doctor-patient communication about end-of-life treatment is rare. Two comparative analyses were conducted: (a) between physicians' practice and elderly persons' preferences regarding the use of different life-sustaining treatments in different illness conditions, and (b) between physicians' hypothetical practice for an elderly person in a metastatic cancer condition, elderly persons' preferences and physicians' preferences for themselves, should they be in the same illness condition. Data were collected in Israel from 339 physicians working in two medical centers, and from a random sample of 987 elderly persons. Attitudes and practice regarding artificial tube feeding, mechanical ventilation and cardiopulmonary resuscitation (CPR) in three different illness conditions were evaluated by close-ended questions. The findings indicate disagreements between the elderly and the physicians on a number of issues: in general, physicians report that they would use more LST than what the elderly report that they would want. Physicians differentiate among different illness conditions and different LST more than elderly persons do. Physicians are more likely to use artificial feeding than CPR, while elderly persons prefer the use of CPR more than artificial feeding. The comparison of physicians' hypothetical practice, the wishes of the elderly, and physicians' wishes for themselves regarding the use of LST in a metastatic cancer condition, shows that physicians would use LST differently from what the elderly want, and that they want less LST for themselves than they would order for elderly patients. The discrepancies found between the physicians' practice and the elderly persons preferences reflect differences in perceptions of artificial feeding and a lack of public knowledge regarding the effectiveness of CPR. They also reflect differences in attitudes regarding the prolongation of life in various illness conditions. The discrepancy between physicians' practice and their preferences for themselves underscores the personal and professional dilemmas related to these issues, which are faced daily by many physicians, and impede their compassionate behavior toward patients. Increasing the awareness of physicians of such discrepancies, and providing them with appropriate behavioral tools, including communication skills, is a timely need which should be addressed by the medical profession, medical services and medical schools.

[The Technology Acceptance Model and Its Application in a Telehealth Program for the Elderly With Chronic Illnesses].

PubMed

Chang, Chi-Ping

2015-06-01

Many technology developments hold the potential to improve the quality of life of people and make life easier and more comfortable. New technologies have been well accepted by most people. Information sharing in particular is a major catalyst of change in our current technology-based society. Technology has widely innovated life and drastically changed lifestyles. The Technology Acceptance Model (TAM), a model developed to address the rapid advances in computer technology, is used to explain and predict user acceptance of new information technology. In the past, businesses have used the TAM as an assessment tool to predict user acceptance when introducing new technology products. They have also used external factors in the model to influence user perceptions and beliefs and to ensure the successful spread of new technologies. Informatization plays a critical role in healthcare services. Due to the rapid aging of populations and upward trends in the incidence of chronic illness, requirements for long-term care have increased in both quality and quantity. Therefore, there has been an increased emphasis on integrating healthcare and information technology. However, most elderly are significantly less adept at technology use than the general population. Therefore, we reexamined the effect that the essential concepts in a TAM exerted on technology acceptance. In the present study, the technology acceptance experience with regard to telehealth of the elderly was used as an example to explain how the revised technology acceptance model (TAM 2) may be effectively applied to enhance the understanding of technology care among nurses. The results may serve as a reference for future research on healthcare-technology use in long-term care or in elderly populations.

Assessing the Psychoeducational Approach to Transcendence and Health Program: An Intervention to Foster Self-Transcendence and Well-Being in Community-Dwelling Older Adults.

PubMed

McCarthy, Valerie Lander; Bowland, Sharon; Hall, Lynne A; Connelly, Jennifer

2015-12-01

The late-life developmental process of self-transcendence shapes elders' perspectives on self, others, the nature of this world, and of a dimension beyond the here and now. This qualitative pilot study evaluated the Psychoeducational Approach to Transcendence and Health (PATH) Program, a psychoeducational intervention to promote self-transcendence and well-being in community-dwelling women at a senior center. The intervention involved eight weekly group sessions using group processes, mindfulness practices, creative experiences, and independent at-home practice. The findings supported the underlying theory-based structure and content of the intervention and indicated the intervention may empower elders to attend to self-care, develop acceptance, and learn new skills associated with health and well-being, thus merits further study. Based on insights gained from facilitators' and participants' experiences and perceptions, the intervention will be revised and strengthened. © The Author(s) 2015.

Improving Attitudes toward Elderly People: Evaluation of an Intervention Program for Adolescents.

ERIC Educational Resources Information Center

Dooley, Stephen; Frankel, B. Gail

1990-01-01

In an experimental evaluation of a "friendly visitor" type of program in which adolescents visited senior citizens, it was found that general attitudes toward elderly people improved following weekly contact with specific elderly persons. Two outcomes of these programs were found: the provision of service to the elderly and the change of negative…

Residential independence of elderly immigrants in Canada.

PubMed

Lee, Sharon M; Edmonston, Barry

2014-12-01

This article addresses three questions: Are elderly immigrants less likely than Canadian-born elderly people to reside independently? What are the effects of economic, cultural, and life course factors on residential independence among elderly immigrants? What are the effects of immigrant-specific characteristics such as duration of residence and cultural background? Descriptive results show that elderly immigrants are less likely to reside independently, but the large gap of over 15 per cent is reduced to 5 per cent once economic, cultural, life course, and other factors are considered in the multivariate analysis. Effects of economic, cultural, and life course factors are mostly as expected, as are those of immigrant-specific characteristics such as duration of residence. Although aging immigrants have more-varied living arrangements than their Canadian-born peers, these are likely to increasingly include residential independence.

Evaluation of the late life disability instrument in the Lifestyle Interventions and Independence for Elders Pilot (LIFE-P) study

USDA-ARS?s Scientific Manuscript database

The late life disability instrument (LLDI) was developed to assess limitations in instrumental and management roles using a small and restricted sample. In this paper we examine the measurement properties of the LLDI using data from the Lifestyle Interventions and Independence for Elders Pilot (LIFE...

Imagining the Alternatives to Life Prolonging Treatments: Elders' Beliefs about the Dying Experience

ERIC Educational Resources Information Center

Winter, Laraine; Parker, Barbara; Schneider, Melissa

2007-01-01

Deciding for or against a life-prolonging treatment represents a choice between prolonged life and death. When the death alternative is not described, individuals must supply their own assumptions. How do people imagine the experience of dying? The authors asked 40 elderly people open-ended questions about dying without 4 common life-prolonging…

[The prevalence and influencing factors of abuse and negligence against elderly in rural areas of Anhui province].

PubMed

Su, Pu-yu; Hao, Jia-hu; Xiong, Li-ming; Yu, Dan-dan; Cao, Yue-ting; Fang, Yun; Jiang, Xiu-ling; Qian, Qiao-xia; Tao, Fang-biao

2011-02-01

To investigate the prevalence and influencing factors related to abuse and negligence against the elderly in the rural areas. 975 elderly over 60 years from 41 counties in Anhui province were included. All participants completed an anonymous questionnaire including items as: educational background, marital condition, income, child-discipline, rude action to parents, daily activities, physical functions, having chronic illness, abuse and negligence against the elderly, etc. In the last year, rates of common physical abuse, serious physical abuse, emotional abuse, financial exploitation, negligence, overall abuse and negligence against the elderly were 4.5%, 1.5%, 26.9%, 4.9%, 7.2%, 29.9% respectively. Among the 281 victims, 80.4% reported that they were suffered more than 3 times of abuse and neglect episodes, and 34.9% reported that they were suffered more than 2 forms of abuse and negligence. The primary sadism was carried out by the daughter-in-law or son-in-law (43.2%) of the elderly. Low activity on daily life and having chronic illness were the risk factors causing common physical abuse while better education was the protective factor to it. Low ability in managing daily activity of living was the risk factor causing serious physical abuse. Less active on daily life and having rude action to parents were the risk factors to emotional abuse, but being strict with their children was the protective factor to emotional abuse. Less active on daily life, often beating their children and having rude action to parents were the risk factors related to financial exploitation. Less active on daily life, having rude action to parents and having bad physical functions were the risk factors causing negligence. Less active on daily life and having rude manner to parents were the risk factors of overall elderly abuse and negligence, but being strict with their children was protective factor to the abuse and negligence against the elderly. High prevalence on abuse and negligence against the elderly was seen in the rural areas of China. Different forms on elderly abuse and negligence were affected by different factors that called for more attention to be paid to those elderly with lower ability in managing their daily life.

24 CFR 884.223a - Preference for occupancy by elderly families.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 24 Housing and Urban Development 4 2011-04-01 2011-04-01 false Preference for occupancy by elderly... PROGRAM, SECTION 202 SUPPORTIVE HOUSING FOR THE ELDERLY PROGRAM AND SECTION 811 SUPPORTIVE HOUSING FOR... Preference for occupancy by elderly families. (a) Election of preference for occupancy by elderly families—(1...

Heroes of Their Own Stories: Expressions of Aging in International Cinema

ERIC Educational Resources Information Center

Yahnke, Robert E.

2005-01-01

This study of 14 international feature-length films (1988-2003) is aimed at providing gerontologists with models of successful aging that portray elders as being valued within the context of community. Elders serve as role models and mentors for the young, and they resolve mid-life crises for the middle-aged. Elders complete their life's work in…

A Review on Internet Use and Quality of Life of the Elderly

ERIC Educational Resources Information Center

Boz, Hayat; Karatas, Sibel Esra

2015-01-01

As the world population rapidly ages, improving the quality of life (QOL) of the elderly and enabling them to age actively is increasingly becoming a global policy concern. In this context, emphasis is also given to information and communication technologies (ICTs) that may play a significant part in enhancing the QOL of the elderly. This review…

75 FR 45694 - Agency Information Collection Activity Under OMB Review

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-03

... approved information collection: 49 U.S.C. Sections 5310 and 5311--Capital Assistance Program for Elderly... Assistance Program for Elderly Persons and Persons with Disabilities and Nonurbanized Area Formula Program (OMB Number 2132-0500) Abstract: The Capital Assistance Program for Elderly Persons and Persons with...

Invisible Voices: An Intersectional Exploration of Quality of Life for Elderly South Asian Immigrant Women in a Canadian Sample.

PubMed

Alvi, Shahid; Zaidi, Arshia U

2017-06-01

Despite the emerging presence of South Asian elderly population in Canada, there continues to be a paucity of research concerning the immigration and acculturation experiences of these marginalized elderly populations and their quality of life. This research builds knowledge of the quality of life experiences faced by South Asian elderly immigrant women residing in Canada using an intersectional analytical framework. While there is a gradually developing body of research regarding elder persons globally, the present research is unique in that explores challenges, stresses and strains, and builds an understanding of the treatment of older ethnic minorities and immigrant families. Furthermore, this research has implications for policies and practices governing these growing aging populations. Finally, this research gives voice to a "silenced" and invisible group of elders whose stories may help to make improvements in the quality of living and well-being for the aging South Asian immigrant population in Canada.

Gender differences of social interactions and their effects on subjective well-being among Japanese elders.

PubMed

Okabayashi, Hideki; Hougham, Gavin W

2014-01-01

Gender differences of social interactions and their effects on subjective well-being among Japanese elders over three years were examined. Repeated measurements of 498 elders over a three-year survey interval were obtained from a baseline mail survey and two- and three-year follow-up surveys. Outcomes were analyzed using Hierarchical Linear Modeling. Male elders were more likely to have a spouse and work at paid jobs, while female elders were likely to have more frequent contacts with their child/children and more interactions with friends. As the elders aged over three years, life satisfaction decreased, while depression did not show any significant overall trend. There were no beneficial effects of social interactions on change in well-being, although social participation, interaction with friends, and conversation with spouse were beneficially related to baseline levels of both depressive tendency and life satisfaction. Among female elders only, the number of children had beneficial effects on life satisfaction. There are modest gender differences of the impact of social interactions on the well-being of Japanese elders, and the number of children seems to be more important as potential sources of support for female rather than male elders. Spousal conversation and non-obligatory social interaction such as unpaid social activities and friendship seem to be important for both male and female elders in Japan. These findings suggest that social relations among Japanese elders may be moving away from more gender dependent patterns seen in the past.

Gender differences of social interactions and their effects on subjective well-being among Japanese elders

PubMed Central

2013-01-01

Objectives Gender differences of social interactions and their effects on subjective well-being among Japanese elders over three years were examined. Methods Repeated measurements of 498 elders over a three-year survey interval were obtained from a baseline mail survey and two- and three-year follow-up surveys. Outcomes were analyzed using Hierarchical Linear Modeling. Results Male elders were more likely to have a spouse and work at paid jobs, while female elders were likely to have more frequent contacts with their child/children and more interactions with friends. As the elders aged over three years, life satisfaction decreased, while depression did not show any significant overall trend. There were no beneficial effects of social interactions on change in well-being, although social participation, interaction with friends, and conversation with spouse were beneficially related to baseline levels of both depressive tendency and life satisfaction. Among female elders only, the number of children had beneficial effects on life satisfaction. Conclusions There are modest gender differences of the impact of social interactions on the well-being of Japanese elders, and the number of children seems to be more important as potential sources of support for female rather than male elders. Spousal conversation and non-obligatory social interaction such as unpaid social activities and friendship seem to be important for both male and female elders in Japan. These findings suggest that social relations among Japanese elders may be moving away from more gender dependent patterns seen in the past. PMID:23614456

"Improving Native American elder access to and use of health care through effective health system navigation".

PubMed

Willging, Cathleen E; Sommerfeld, David H; Jaramillo, Elise Trott; Lujan, Erik; Bly, Roxane Spruce; Debenport, Erin K; Verney, Steven P; Lujan, Ron

2018-06-18

Public insurance reforms of the past two decades have failed to substantively address the healthcare needs of American Indians in general, let alone the particular needs of American Indian elders, ages 55 years and older. Historically, this population is more likely to be uninsured and to suffer from greater morbidities, poorer health outcomes and quality of life, and lower life expectancies compared to all other United States aging populations, representing a neglected group within the healthcare system. Despite the pervasive belief that the Indian Health Service will address all their health-related needs, American Indian elders are negatively affected by gaps in insurance and lack of access to health care. While the 2010 Patient Protection and Affordable Care Act included provisions to ameliorate disparities for American Indians, its future is uncertain. In this context, American Indian elders with variable health literacy must navigate a complex and unstable healthcare system, regardless of where they seek care. This community-driven study features a mixed-method, participatory design to examine help-seeking behavior and healthcare experiences of American Indian elders in New Mexico, in order to develop and evaluate a tailored intervention to enhance knowledge of, access to, and use of insurance and available services to reduce healthcare disparities. This study includes qualitative and quantitative interviews combined with concept mapping and focus groups with American Indian elders and other key stakeholders. The information gathered will generate new practical knowledge, grounded in actual perspectives of American Indian elders and other relevant stakeholders, to improve healthcare practices and policies for a population that has been largely excluded from national and state discussions of healthcare reform. Study data will inform development and evaluation of culturally tailored programming to enhance understanding and facilitate negotiation of the changing landscape of health care by American Indian elders. This work will fill a gap in research on public insurance initiatives, which do not typically focus on this population, and will offer a replicable model for enhancing the effects of such initiatives on other underserved groups affected by healthcare inequities. This protocol does not include the collection of health outcome data. Clinicaltrials.gov, NCT03550404 . Registered June 6, 2018.

Cognitive Inference Device for Activity Supervision in the Elderly

PubMed Central

2014-01-01

Human activity, life span, and quality of life are enhanced by innovations in science and technology. Aging individual needs to take advantage of these developments to lead a self-regulated life. However, maintaining a self-regulated life at old age involves a high degree of risk, and the elderly often fail at this goal. Thus, the objective of our study is to investigate the feasibility of implementing a cognitive inference device (CI-device) for effective activity supervision in the elderly. To frame the CI-device, we propose a device design framework along with an inference algorithm and implement the designs through an artificial neural model with different configurations, mapping the CI-device's functions to minimise the device's prediction error. An analysis and discussion are then provided to validate the feasibility of CI-device implementation for activity supervision in the elderly. PMID:25405211

75 FR 28673 - Notice of Request for Extension of a Currently Approved Information Collection

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-21

... approved information collection: 49 U.S.C. Sections 5310 and 5311--Capital Assistance Program for Elderly... Assistance Program for Elderly Persons and Persons with Disabilities and Nonurbanized Area Formula Program (OMB Number: 2132-0561) Background: The Capital Assistance Program for Elderly Persons and Persons with...

26 CFR 601.803 - Program operations and requirements.

Code of Federal Regulations, 2013 CFR

2013-04-01

... REVENUE PRACTICE STATEMENT OF PROCEDURAL RULES Tax Counseling for the Elderly § 601.803 Program operations and requirements. (a) Objective. The objective of the Tax Counseling for the Elderly program is to... assistance provided under Tax Counseling for the Elderly programs must be provided free of charge to...

26 CFR 601.803 - Program operations and requirements.

Code of Federal Regulations, 2011 CFR

2011-04-01

... REVENUE PRACTICE STATEMENT OF PROCEDURAL RULES Tax Counseling for the Elderly § 601.803 Program operations and requirements. (a) Objective. The objective of the Tax Counseling for the Elderly program is to... assistance provided under Tax Counseling for the Elderly programs must be provided free of charge to...

26 CFR 601.803 - Program operations and requirements.

Code of Federal Regulations, 2014 CFR

2014-04-01

... REVENUE PRACTICE STATEMENT OF PROCEDURAL RULES Tax Counseling for the Elderly § 601.803 Program operations and requirements. (a) Objective. The objective of the Tax Counseling for the Elderly program is to... assistance provided under Tax Counseling for the Elderly programs must be provided free of charge to...

26 CFR 601.803 - Program operations and requirements.

Code of Federal Regulations, 2012 CFR

2012-04-01

... REVENUE PRACTICE STATEMENT OF PROCEDURAL RULES Tax Counseling for the Elderly § 601.803 Program operations and requirements. (a) Objective. The objective of the Tax Counseling for the Elderly program is to... assistance provided under Tax Counseling for the Elderly programs must be provided free of charge to...

Mid-Life Proteinuria and Late-Life Cognitive Function and Dementia in Elderly Men: The Honolulu-Asia Aging Study

PubMed Central

Higuchi, Masaya; Chen, Randi; Abbott, Robert D.; Bell, Christina; Launer, Lenore; Ross, G. Webster; Petrovitch, Helen; Masaki, Kamal

2015-01-01

Background Impaired renal function has been linked to cognitive impairment. We assessed mid-life proteinuria and late-life cognitive function in elderly Asian males. Methods The Honolulu Heart Program is a prospective study that began in 1965 with 8,006 Japanese-American men ages 45–68 years. Mid-life proteinuria was detected by urine dipstick in 1971–74. The Honolulu-Asia Aging Study began 20 years later, with cognitive assessment by the Cognitive Abilities Screening Instrument (CASI) in 3,734 men. Standard criteria were used to classify 8-year incident dementia and subtypes. RESULTS The age-adjusted incidence of dementia increased significantly from 13.8, to 22.8, to 39.7 per 1,000 person years follow-up, among those with no, trace and positive mid-life proteinuria, p=0.004. Using linear regression adjusting for age, education, APOEε4, stroke, hypertension, systolic blood pressure, diabetes, fasting blood glucose, physical activity and baseline CASI, those with positive proteinuria had significantly higher annual change in CASI over 8 years follow-up (−1.24, p=0.02), reference=no proteinuria. Multivariate Cox regression found positive proteinuria had a significant association with incident all-cause dementia (RR=2.66, 95%CI=1.09–6.53, p=0.03), but no significant associations with incident Alzheimer’s disease or vascular dementia. CONCLUSION Mid-life proteinuria was an independent predictor for late-life incident all-cause dementia and cognitive decline over 8 years. PMID:25626635

PERCEIVED FEASIBILITY OF ESTABLISHING DEDICATED ELDER ABUSE PROGRAMS OF CARE AT HOSPITAL-BASED SEXUAL ASSAULT/DOMESTIC VIOLENCE TREATMENT CENTETR.

PubMed

Du Mont, Janice; Mirzaei, Aftab; Macdonald, Sheila; White, Meghan; Kosa, Daisy; Reimer, Linda

2014-12-01

Elder abuse is an increasingly important issue that must be addressed in a systematic and coordinated way. Our objective was to evaluate the perceived feasibility of establishing an elder abuse care program at hospital-based sexual assault and domestic violence treatment centers in Ontario, Canada. In July 2012, a questionnaire focused on elder abuse care was distributed to all of Ontario's Sexual Assault/Domestic Violence Treatment Centre (SA/DVTC) Program Coordinators/Managers. We found that the majority of Program Coordinators/ Managers favored expansion of their program mandates to include an elder abuse care program. However, these respondents viewed collaboration with a large network of well trained professionals and available services in the community that address elder abuse as integral to responding in a coordinated manner. The expansion of health services to address the needs of abused older adults in a comprehensive and integrated manner should be considered as an important next step for hospital-based violence care programs worldwide.

[Association between sleep quality and life function among elderly community residents].

PubMed

Tanaka, Mika; Kusaga, Mari; Tagaya, Hirokuni; Miyoko, I; Oshima, Asami; Watanabe, Chiho

2012-01-01

To investigate the association between sleep quality and life function in an elderly Japanese population. A total of 563 residents of a village in Kumamoto Prefecture aged ≥65 years were asked to fill out a self-administered questionnaire survey from June to July 2010. Sleep quality and life function were respectively evaluated using the Pittsburgh Sleep Quality Index (PSQI) and Basics Check List, which is used to screen elderly individuals at high risk of needing long-term care in the future. As adjustment factors, age, sex, economic situation, residency status, medical history, depression status, and cognitive function were assessed. We examined the relationship between sleep quality and life function using multiple logistic regression analysis, with life function as a dependent variable. Subjects already receiving care or with psychiatric disorders or severe cognitive disturbance were excluded from analysis. Among the subjects (n=395), a significant relationship was found between poor sleep quality and impaired life function in all models. The odds ratio was 1.82 (95% confidence interval: 1.03-3.23) in the final model controlling for all adjustment factors. Our findings here suggest a significant relationship between poor sleep quality and impaired life function among elderly community residents. Given these findings, intervention to improve sleep may help delay or prevent the need for long-term care among elderly individuals.

The community case management program: for 12 years, caring at its best.

PubMed

Luzinski, Cyndy Hunt; Stockbridge, Eleanor; Craighead, Janet; Bayliss, Deborah; Schmidt, Marie; Seideman, Janice

2008-01-01

One of the most complex issues currently under debate in this country is how best to provide health care for our society. Since 1995, Poudre Valley Hospital in Fort Collins, Colorado, has been effectively addressing one facet of this national crisis by providing services to a population of primarily elderly, chronically ill individuals perpetually caught in the gaps between acute and end-of-life services. Community case managers link program participants with appropriate health care services and providers that enhance physiological and functional status, identify resources that enrich quality of life, and encourage relationships and skills which foster self-efficacy. By emphasizing timely access to health-maximizing services, this program documented an impressive 81% reduction in financial losses to the organization during 2006 for emergency and inpatient services provided to a specific sample from this population.

Assessment of elder mistreatment in two American Indian samples: psychometric characteristics of the HS-EAST and the Native Elder Life-Financial Exploitation and -Neglect measures.

PubMed

Jervis, Lori L; Fickenscher, Alexandra; Beals, Janette

2014-04-01

Although elder mistreatment among ethnic minorities is increasingly gaining attention, our empirical knowledge of this phenomenon among American Indians remains quite limited, especially with respect to measurement. The Shielding American Indian Elders (SAIE) Project used a collaborative approach to explore culturally informed measurement of elder mistreatment in two American Indian elder samples (a Northern Plains reservation and a South Central metropolitan area). The project sought to investigate the performance characteristics of the commonly used Hwalek-Sengstock Elder Abuse Screening Test (HS-EAST), as well as to examine the psychometric properties of a new measure developed to capture culturally salient aspects of mistreatment in American Indian contexts--the Native Elder Life Scale (NELS). Using methods and samples comparable to those in the literature, the HS-EAST performed adequately in these Native samples. The NELS also shows promise for use with this population and assesses different aspects of elder mistreatment than does the HS-EAST.

Quality of life and wellbeing of the elderly in Lebanese nursing homes.

PubMed

Doumit, Jacqueline; Nasser, Ramzi

2010-01-01

The purpose of this paper is to assess quality of life in relation to wellbeing among Lebanese nursing home elderly residents. The study attempts to understand the impact of structures, processes and skills on elderly health status. In this paper, 220 normally functioning elderly respondents from 33 nursing homes were studied. A quasi-experimental approach measured psychological and health-related factors using the Geriatric Depression Scale, Activity of Daily Living, EuroQol EQ-5D and the Mini-Nutritional Assessment (MNA) instruments. A relatively high level of mild depression among elderly residents and a lack of mobility were found. Generally, normally functioning elderly residents were well nourished and had moderate daily activity levels. The study is original in the sense that it assesses elderly residents' psychological and physical health status in relation to institutional structures, processes, and skills.

Analysis of the effects of removable dentures on the psychological status, quality of life, and masticatory function of the elderly

NASA Astrophysics Data System (ADS)

Dyas, R.; Nathanael, M.; Indrasari, M.; Masulili, C.; Rahardjo, T. B.; Agustin, D.; Hogervorst, E.; Kusdhany, L.

2017-08-01

Older age is a major risk factor for diseases of the teeth and mouth and dementia. Diseases of the teeth and mouth can lead to tooth loss. The use of removable dentures can help the elderly to replace lost teeth; therefore, dentures are expected to improve the masticatory function, quality of life, and psychological status of the elderly. The aim of this study was to analyze the effects of removable denture usage on the improvement of the psychological status, quality of life, and masticatory function of elderly people. The data was obtained from 30 respondents. The patients answered questionnaires before they used the dentures, 2 weeks after they began using dentures, and 2 months after they started wearing dentures. Four different questionnaires were used: EuroQol Five Dimensions questionnaire (EQ-5D) and Geriatric Depression Scale (GDS), to measure psychological status; a mastication questionnaire to measure masticatory function; and a validated quality of life questionnaire. Based on the results of this study, it is clear that after 2 months of denture usage, removable dentures in the elderly can significantly improve their quality of life, masticatory function, and psychological status(p<0.05).

Quality of life in Chinese family caregivers for elderly people with chronic diseases.

PubMed

Xie, Hui; Cheng, Cheng; Tao, Yisheng; Zhang, Jie; Robert, Delprino; Jia, Jihui; Su, Yonggang

2016-07-06

Inadequate studies have been conducted in China to examine quality of life in family caregivers. Quality of life in family caregivers for elderly people with chronic diseases was evaluated, and the demographic and characteristic factors of both elderly people and their caregivers were explored. The 36-Item Short Form Health Survey (SF-36) was used to assess health-related quality of life in 407 family caregivers caring for elderly people with chronic diseases in six communities on the Mainland China. The explanatory variables included family caregivers' demographic and other caregiving variables related to eldercare. Descriptive statistics and multiple linear regression analysis were used in the data analysis, performed via SPSS 17.0. Mean SF-36 and physical and mental component scores were 66.14 ± 17.50, 70.06 ± 16.49, and 62.22 ± 18.51, respectively. The scores of caregivers' physical function and bodily pain were significantly higher, while the scores of caregivers' role limitations due to physical problems, general health, vitality, social function, mental health and role limitations due to emotional problems were significantly lower. Caregivers' ages, comorbidity, the perceived effects of caregiving on caregivers' social lives and elderly individuals' ages, marital status and Activities of Daily Living scores were significantly associated with the physical component score. In addition, caregivers' age, the affordability of the elderly person's healthcare expenses, the perceived effects of caregiving on caregivers' social lives, and elderly people's marital status and ADL scores were significantly associated with the mental component score. Family caregivers for elderly people with chronic diseases showed poorer mental and better physical well-being. Factors of both elderly people and their caregivers impact the caregivers' quality of life. These findings highlight the importance of addressing mental health of family caregivers, and of providing economical support and psychological care for them.

Jog Your Mind: methodology and challenges of conducting evaluative research in partnership with community organizations.

PubMed

Bier, Nathalie; Lorthios-Guilledroit, Agathe; Nour, Kareen; Parisien, Manon; Ellemberg, Dave; Laforest, Sophie

2015-01-01

Jog Your Mind is a community-based program aiming at empowering elderly people to maintain their cognitive abilities using a multi-strategic approach including cognitively stimulating activities, mnemonic strategies, and strategies to promote healthy behaviors. It is offered to elderly individuals without known or diagnosed cognitive impairment by volunteers or community practitioners over ten weekly sessions. This paper describes the protocol of a quasi-experimental study designed to evaluate Jog Your Mind. Community responsible to recruit participants were either assigned to the experimental group (participating in the Jog Your Mind program) or to the control group (one-year waiting list). All participants were interviewed at baseline (T1), after the program (T2), and 12 months after the baseline (T3). Primary outcomes were the use of everyday memory strategies and aids and subjective memory functioning in daily life. Secondary outcomes included attitudes, knowledge, and behaviors related to cognitive vitality and cognitive abilities (memory and executive functions). Program delivery, organizational and environmental variables were recorded to document the implementation process. Twenty-three community organizations recruited 294 community-dwelling elderly individuals in total at T1. Between T1 and T3, an attrition rate of 15.2% was obtained. Jog Your Mind is one of the only programs targeting cognition among older adults being offered in community settings by community practitioners. The protocol described was designed with a focus on maximizing broad generalizations of the results while achieving scientific rigor. It can serve as an example to guide future research aiming to evaluate health interventions under natural conditions.

[Cost- effectiveness analysis of pneumococcal vaccination in Iceland].

PubMed

Björnsdóttir, Margrét

2010-09-01

Pneumococcus is a common cause of disease among children and the elderly. With the emergence of resistant serotypes, antibiotic treatment is getting limited. Many countries have therefore introduced a vaccination program among children against the most common serotypes. The aim of this study was to analyse cost-effectiveness of adding a vaccination program against pneumococcus in Iceland. A cost-effectiveness analysis was carried out from a societal perspective where the cost-effectiveness ratio ICER was estimated from the cost of each additional life and life year saved. The analyse was based on the year 2008 and all cost were calculated accordingly. The rate of 3% was used for net present-value calculation. Annual societal cost due to pneumococcus in Iceland was estimated to be 718.146.252 ISK if children would be vaccinated but 565.026.552 ISK if they would not be vaccinated. The additional cost due to the vaccination program was therefore 153.119.700 ISK . The vaccination program could save 0,669 lives among children aged 0-4 years old and 21.11 life years. The cost was 228.878.476 ISK for each additional life saved and 7.253.420 ISK for each additional life year saved. Given initial assumptions the results indicate that a vaccination programme against pneumococcal disease in Iceland would be cost effective.

The empowerment of elderly patients with chronic obstructive pulmonary disease: Managing life with the disease

PubMed Central

Fallahi-Khoshknab, Masoud; Pourhabib, Ali

2017-01-01

Chronic obstructive pulmonary disease (COPD) is a serious health problem that has significant effects on the life status of elderly persons. Use of the empowerment approach is necessary for health promotion in older people with COPD, but little attention has so far been paid to all the dimensions of empowerment in the management of COPD, which would provide useful knowledge regarding elders with COPD. This article reports on a study exploring people’s experiences of the empowerment of older people with COPD. This study adopted an exploratory qualitative design and was carried out using grounded theory methodology. Grounded theory was considered appropriate for this study because of its focus on how people respond to and act on the problems that they encounter. We collected data by conducting in-depth semi-structured interviews and taking field notes. Twenty-four participants were selected through purposive sampling. The results showed that in encountering the complexity of disease and in response to difficulties induced by COPD, three strategies were applied. Elderly persons with COPD, their family caregivers, and professional team members engaged in “managing life with COPD,” “striving to keep abreast of life,” “preparing for battle with disease,” and “helping to stabilize the elder’s life.” The outcome of these strategies was “co-existence with disease.” The potential of “managing life with COPD” was influenced by the following factors: “co-existence with ageing,” “personal potential,” “a challenged health system,” and “weak social support.” “Managing life with COPD” enables the elder to feel in control and live optimally. This is a fragile balance, however, and the unpredictability of COPD can tip the elder into “self-efficacy.” Understanding the experiences of the empowerment process of older people with COPD can help health professionals provide more focused elderly care. PMID:28369069

24 CFR 891.740 - Responsibilities of Borrower.

Code of Federal Regulations, 2010 CFR

2010-04-01

... PROGRAM, SECTION 202 SUPPORTIVE HOUSING FOR THE ELDERLY PROGRAM AND SECTION 811 SUPPORTIVE HOUSING FOR PERSONS WITH DISABILITIES PROGRAM) SUPPORTIVE HOUSING FOR THE ELDERLY AND PERSONS WITH DISABILITIES Loans for Housing for the Elderly and Persons with Disabilities Section 202 Projects for the Nonelderly...

Combining Employment and Caregiving: An Intricate Juggling Act.

ERIC Educational Resources Information Center

Guberman, Nancy; Maheu, Pierre

1999-01-01

The process that allows family caregivers to combine employment and elder care was examined in interviews with 25 caregivers. The effects of elder care on employment are the result of the degree to which caregivers manage to maintain balance between different life spheres: personal and social life, family life, caregiving, and employment. (53…

Exercise interventions in polypathological aging patients that coexist with diabetes mellitus: improving functional status and quality of life.

PubMed

Cadore, Eduardo Lusa; Izquierdo, Mikel

2015-06-01

In elderly populations, diabetes is associated with reduced muscle strength, poor muscle quality, and accelerated loss of muscle mass. In addition, diabetes mellitus increases risk for accelerated aging and for the development of frailty syndrome. This disease is also associated with a polypathological condition, and its complications progressively affect quality of life and survival. Exercise interventions, including resistance training, represent the cornerstones of diabetes management, especially in patients at severe functional decline. This review manuscript aimed to describe the beneficial effects of different exercise interventions on the functional capacity of elderly diabetics, including those at polypathological condition. The SciELO, Science Citation Index, MEDLINE, Scopus, SPORTDiscus, and ScienceDirect databases were searched from 1980 to 2015 for articles published from original scientific investigations. In addition to the beneficial effects of exercise interventions on glycemic control, and on the cardiovascular risk factors associated with diabetes, physical exercise is an effective intervention to improve muscle strength, power output, and aerobic power and functional capacity in elderly diabetic patients. Thus, a combination of resistance and endurance training is the most effective exercise intervention to promote overall physical fitness in these patients. In addition, in diabetic patients with frailty and severe functional decline, a multicomponent exercise program including strength and power training, balance exercises, and gait retraining may be an effective intervention to reduce falls and improve functional capacity and quality of life in these patients.

Attitudes of the Life Threatened Hospitalized Elderly

ERIC Educational Resources Information Center

Moore, Robert J.; Newton, James H.

1977-01-01

This article deals with a survey of 29 elderly patients' attitudes toward death, dying, aging, life's meaning, security, pain, and interpersonal relationships. This paper was presented at the annual Canadian Psychological Association meeting, Toronto, Ontario, June 1976. (Author)

The linkage of life course, migration, health, and aging: health in adults and elderly Mexican migrants.

PubMed

de Oca, Verónica Montes; García, Telésforo Ramírez; Sáenz, Rogelio; Guillén, Jennifer

2011-10-01

Migration is a phenomenon that impacts individuals throughout the life course. Particularly, Mexican elderly migrants show evidence of lifetime accumulations of the effects of migration on health conditions. Examine how the relationship between historical time and individual time explains different factors impacting the health of Mexican adult and elderly migrants in Mexico and the United States. Data from in-depth interviews with Mexican migrants living in selected locations in Mexico and the United States were used to illustrate the links between life course conditions, aging, migration, and health outcomes. According to this theoretical perspective and the data, historical time, age at migration, and the conditions under which the migration trajectory developed, show different impacts on the health and quality of life of the elderly, as revealed through analysis of labor experience, disease and accidents, medical service, health treatment, transnational networks, and family formation.

"Stay Tuned": The Role of ICTs in Elderly Life.

PubMed

Colombo, Fausto; Aroldi, Piermarco; Carlo, Simone

2014-01-01

Ageing in western society has become a key issue in political and academic debate: politicians, sociologists, doctors, demographers, psychologists, economists are trying to understand how ageing will impact our future society. In this frame, media and communication technologies seem to be more and more relevant for the elderly, thanks to those services and devices helping people to grow old actively. Technologies, the Internet and ICTs could help the elderly to improve their quality of life, to be healthy and independent and to get better assistance. Our ongoing research investigates the relationship between the elderly and use of technologies, and explores the role played by media and ICTs in building a friendly and positive environment for the elderly, and in constructing and maintaining social relations and promoting healthy ageing. Specifically, the research will investigate the use of ICTs by the elderly by taking into account two different perspectives: a) Exchanges between generations: lengthening of life corresponds to a longer period of cohabitation between at least three generations (grandparents, children, grandchildren), and also of co-use of digital media. The research wants to investigate relations between two age groups (grandparents and grandchildren; young people and older people) to understand the dynamics of intergenerational mutuality in the use of technologies and ICTs. b) Media, ICTs, Health: the Western world is increasingly populated by elderly population. Technologies and ICTs can help elderly people to improve their quality of life, to be healthy and independent and to get better assistance. ICTs should encourage active ageing and, in the case of health technologies, new models of care. The project, lasting 1 year, is based on (1) a survey on young elderly (65-74 yrs) population in Italy, and (2) a field-work which consists of family interviews and ethnographical sections in natural contexts.

Implications of an ageing population in the Asian context.

PubMed

Suyono, H

1999-12-01

Population aging is the increasing number and proportion of old persons aged 60 years and above in the developing countries and 65 years and above in the developed countries that exceeds 10% of the total population. In Asia, the last decade of the 20th century is marked by significant changes in the age structure due to the process of population aging. The implications of this aging population on the life of Asian countries has to be addressed since demographically the current situation is changing rapidly and there lie the future challenges that have to be answered. Due to the growing size of the elderly population, Asia will need better plans to prevent these elderly groups from turning into the socioeconomically vulnerable group of society. However, many governments are not prepared with effective policies, programs, and services that are particularly designed to care for the elderly. The provision of infrastructure and services, including education, employment, health and housing are necessary steps that need to be taken. Some of the suggested measures include: the Social Safety Net Programs; the implementation of the Association of Southeast Asian Nations Plan of Action on Rural Development and Poverty Eradication; and strengthen volunteerism and the role of private sector in human development. The role of the media in transmitting information concerning policies and programs intended to increase the welfare of the older persons is also very important.

Developing effective animal-assisted intervention programs involving visiting dogs for institutionalized geriatric patients: a pilot study.

PubMed

Berry, Alessandra; Borgi, Marta; Terranova, Livia; Chiarotti, Flavia; Alleva, Enrico; Cirulli, Francesca

2012-09-01

An ever increasing interest in the therapeutic aspects of the human-animal bond has led to a proliferation of animal-assisted interventions (AAI) involving dogs. However, most of these programs lack a solid methodological structure, and basic evaluative research is needed. The purpose of this study was to test the value of dog-assisted interventions as an innovative tool to increase quality of life in the geriatric population. Nineteen patients (men and women) with a mean age of 85 years participated in the study. Interactions between patients and visiting dogs occurred either in a social situation (socialization sessions) or in a therapeutic context (physical therapy sessions). We derived and characterized a specific ethogram of elderly-dog interactions aimed at evaluating the effectiveness of visiting dogs in improving mood, catalyzing social interactions and reducing their everyday apathetic state. Cortisol levels were also measured in the saliva, and depressive state was evaluated. Overall, results show a time-dependent increase in social behaviour and spontaneous interactions with the dogs. Dog-mediated interactions affected the daily increase in cortisol levels, thus having an 'activational effect', in contrast to the apathetic state of institutionalized elderly. Dog-mediated intervention programs appear to be promising tools to improve the social skills and enrich the daily activities of the institutionalized elderly. © 2012 The Authors. Psychogeriatrics © 2012 Japanese Psychogeriatric Society.

Well-being dialogue: Elderly women's subjective sense of well-being from their course of life perspective

PubMed Central

Svensson, Ann-Marie; Mårtensson, Lena B.

2012-01-01

In this article, we are concerned with narratives of elderly women's well-being from their perspectives of the latter parts of their life, living at special housing accommodation (SHA) in the context of Swedish elderly care. In focusing on narratives about well-being, we have a two-fold focus: (1) how the elderly women create their own identity and meaning-making based on lifetime experience; and (2) how narratives of well-being are reflected through the filter of life in situ at the SHA. Based on empirical data consisting of well-being narratives, a dialogical performance analysis was undertaken. The results show how relationships with important persons during various stages of life, and being together and enjoying fellowship with other people as well as enjoying freedom and self-determination, are central aspects of well-being. The conclusions drawn are that the characteristic phenomena of well-being (the what) in the narratives are continuity, identity, and sociality for the elderly person, and this is manifested (the how) as a question of contrasting the state of self-management and self-decline. PMID:23237627

Re-experiencing Violence across the Life Course: Histories of Childhood Maltreatment and Elder Abuse Victimization.

PubMed

Kong, Jooyoung; Easton, Scott D

2018-03-26

This study primarily examines the associations between histories of childhood maltreatment (i.e., neglect, emotional, physical, and sexual abuse) and elder abuse victimization and explores whether gender moderates the associations. We conducted a secondary data analysis of 5,968 older adults (mean age = 71 years) based on data from the Wisconsin Longitudinal Study (2010-2011). Using retrospective self-reports of childhood and current (past 12 months) victimization experiences, logistic regression analyses were conducted to estimate the effects of early-life adversities on the likelihood of elder abuse victimization. Results indicate that childhood emotional abuse and childhood sexual abuse were associated with greater risk of being abused as older adults, after controlling for childhood and adult background factors. We also found that the effect of childhood sexual abuse on elder abuse victimization was weaker for women than men. Findings suggest that the phenomenon of revictimization may occur not only in early and middle adulthood, but also in late life. To advance our understanding of victimization across the life course, future research on root causes of elder abuse should include histories of child abuse.

Conflict resolution with end of life decisions in critical care settings.

PubMed

Murphy, C; Sweeney, M A

1995-01-01

This demonstration will present the key modules from an innovative videodisc-based program that was designed as an educational tool for health care professionals. It provides a resource for learning to deal with patients and families regarding the increasing problematic area of end-of-life-decisions. Tough Choices: Ethics, the Elderly, and Life-Sustaining Technologies is an interactive program that combines abstract ethical approaches with the realistic drama of a critical care setting. The format integrates scientific facts about the patient with value questions regarding the utilization of life-sustaining technologies. The unique program provides health care personnel with strategies on how to guide family decision-making as well as examples of the various interventions. This interactive multimedia program opens up an opportunity for health care providers to participate in a clinical case in which life and death decisions are made. Learners can explore various perspectives and treatment options within the framework of the dramatic case presentation without the usual time constraints or worries about causing harm to patients. The program involves learners in a variety of ethical and legal dilemmas that centers around a patient, her family, and a variety of health care professionals. Dramatic advances in the development of life-sustaining medical technologies have given hope to many people whose conditions would have meant certain death only a few years ago. As access to the technologies has expanded, concern for their appropriate utilization has become an issue worthy of increasing attention. Questions about the benefits of life-sustaining treatments are being raised in many quarters, particularly when the technology is viewed as a modern means of postponing death and prolonging suffering. Tough Choices brings to life the story of Irene Sullivan, an elderly widow who has an unexpected heart attack. Suddenly, her very existence depends on the life-support provided by mechanical ventilation and cardiopulmonary resuscitation (CPR). This is a growing area of concern since more than half of the patients who receive CPR and tube feedings and one third of the people receiving mechanical ventilation are 65 or over. Mrs. Sullivan's health care team is forced to deal with the opposing viewpoints of several close family members regarding the utilization of advanced medical technology. The interactive program invites viewers to explore the complex ethical and legal dilemmas involved in making life-and-death decisions about her care. It also permits immediate access to supportive resources in three areas: the clinical chart, abstracts of relevant research studies on life-sustaining technologies, and information from the professional literature on advance directives. The program incorporates practical steps involved in implementing the Patient Self-Determination Act as it follows the patient from the time of hospitalization through a series of life-threatening crises. Two very different aspects of the role of the health care professionals were explored: a crisis mode which covers the steps in managing a full-blown crisis situation, and a prevention mode which analyzes steps that could have been followed to keep an ethical crisis from occurring. The strong role models for practice display many of the characteristics that the helping professions need to foster in an atmosphere of healthcare reform.

Balance Training Enhances Vestibular Function and Reduces Overactive Proprioceptive Feedback in Elderly

PubMed Central

Wiesmeier, Isabella K.; Dalin, Daniela; Wehrle, Anja; Granacher, Urs; Muehlbauer, Thomas; Dietterle, Joerg; Weiller, Cornelius; Gollhofer, Albert; Maurer, Christoph

2017-01-01

Objectives: Postural control in elderly people is impaired by degradations of sensory, motor, and higher-level adaptive mechanisms. Here, we characterize the effects of a progressive balance training program on these postural control impairments using a brain network model based on system identification techniques. Methods and Material: We analyzed postural control of 35 healthy elderly subjects and compared findings to data from 35 healthy young volunteers. Eighteen elderly subjects performed a 10 week balance training conducted twice per week. Balance training was carried out in static and dynamic movement states, on support surfaces with different elastic compliances, under different visual conditions and motor tasks. Postural control was characterized by spontaneous sway and postural reactions to pseudorandom anterior-posterior tilts of the support surface. Data were interpreted using a parameter identification procedure based on a brain network model. Results: With balance training, the elderly subjects significantly reduced their overly large postural reactions and approximated those of younger subjects. Less significant differences between elderly and young subjects' postural control, namely larger spontaneous sway amplitudes, velocities, and frequencies, larger overall time delays and a weaker motor feedback compared to young subjects were not significantly affected by the balance training. Conclusion: Balance training reduced overactive proprioceptive feedback and restored vestibular orientation in elderly. Based on the assumption of a linear deterioration of postural control across the life span, the training effect can be extrapolated as a juvenescence of 10 years. This study points to a considerable benefit of a continuous balance training in elderly, even without any sensorimotor deficits. PMID:28848430

Building electronic forms for elderly program: integrated care model for high risk elders in Hong Kong.

PubMed

Yiu, Rex; Fung, Vicky; Szeto, Karen; Hung, Veronica; Siu, Ricky; Lam, Johnny; Lai, Daniel; Maw, Christina; Cheung, Adah; Shea, Raman; Choy, Anna

2013-01-01

In Hong Kong, elderly patients discharged from hospital are at high risk of unplanned readmission. The Integrated Care Model (ICM) program is introduced to provide continuous and coordinated care for high risk elders from hospital to community to prevent unplanned readmission. A multidisciplinary working group was set up to address the requirements on developing the electronic forms for ICM program. Six (6) forms were developed. These forms can support ICM service delivery for the high risk elders, clinical documentation, statistical analysis and information sharing.

The evaluation of oral health-related factors on the quality of life of the elderly in Babol.

PubMed

Motallebnejad, Mina; Mehdizadeh, Shervin; Najafi, Nazanin; Sayyadi, Fatemeh

2015-01-01

Considering an increase in elderly population in recent years, it has become necessary to pay attention to this group so that they can have a higher quality of life (QoL). Oral health is one of the factors affecting the QoL of the elderly. The purpose of this study is to evaluate the effect of oral health on the QoL of the elderly population in Babol, Iran. In this study, we used the multi-stage cluster sampling technique to select 300 elderly subjects, over 65 years of age, living in Babol. Oral health-related QoL was evaluated by the Persian version of oral health impact profile (OHIP-14) questionnaire. Data were collected on gender, age, occupation, education, the date of the last dental visit, use of prosthetic appliances, and dental treatment needs, including the periodontal, prosthetic, and surgical needs, by interview and examination. Data were analyzed with SPSS software program using Mann-Whitney and Kruskal-Wallis tests. The mean age of the subjects was 71.4 ± 5.6 years, with 183 males (61%) and 117 females (39%). The mean score of OHIP-14 questionnaire was 22.4 ± 8.2, with a range of 5‒50. The highest score was achieved on the psychological discomfort domain. There was no significant difference in OHIP-14 scores according to gender, with significantly lower scores in subjects with academic education. The subjects wearing prosthetic appliances had lower OHIP-14 scores compared to those who did not wear prosthetic appliances. OHIP-14 scores were lower in the dentate individuals compared to the edentulous individuals. There was no correlation between the age and the OHIP-14 score. In general, the results of the present study showed a moderate oral health-related QoL in the elderly living in Babol, who have orodental problems.

Older persons' experiences of a home-based exercise program with behavioral change support.

PubMed

Arkkukangas, Marina; Sundler, Annelie J; Söderlund, Anne; Eriksson, Staffan; Johansson, Ann-Christin

2017-12-01

It is a challenge to promote exercise among older persons. Knowledge is needed regarding the maintenance of exercise aiming at preventing falls and promoting health and well-being in older persons. This descriptive study used a qualitative inductive approach to describe older persons' experiences of a fall-preventive, home-based exercise program with support for behavioral change. Semi-structured interviews were conducted with 12 elderly persons aged 75 years or older, and a qualitative content analysis was performed. Four categories emerged: facilitators of performing exercise in everyday life, the importance of support, perceived gains from exercise, and the existential aspects of exercise. With support from physiotherapists (PTs), home-based exercise can be adapted to individual circumstances in a meaningful way. Including exercises in everyday life and daily routines could support the experience of being stronger, result in better physical functioning, and give hope for an extended active life in old age.

Prevalence of Elder Abuse and Neglect in Seniors with Psychiatric Morbidity - Example from Central Moravia, Czech Republic

PubMed Central

Luzny, Jan; Jurickova, Lubica

2012-01-01

Background: Elder abuse and neglect (EAN) comprises emotional, financial, physical, and sexual abuse, neglect by other individuals, and self-neglect. Elder abuse and neglect in seniors with psychiatric morbidity was not monitored in the Czech Republic at all, despite the literature shows mental morbidity as one of the important risk factor for developing elder abuse and neglect. Methods: We designed comparative cross sectional study comprising 305 seniors hospitalized in Mental Hospital Kromeriz in June 2011 – group of 202 seniors hospitalized due to mental disorder in psychogeriatric ward and group of 103 seniors hospitalized due to somatic disorder in internal ward. Content analysis of medical records was done in both groups of seniors, with regards to symptoms of elder abuse. Then, we discussed the topic of elder abuse with 30 nurses of psychogeriatric ward in focus group interview. Results: Between two compared groups of seniors we detected statistically higher prevalence of elder abuse in seniors with psychiatric morbidity (48 cases, 23.8% prevalence of EAN), compared to somatically ill seniors (3 cases, 2.9%). As for nursing staff, 5 from 30 nurses (16.7%) have never heard about symptoms of elder abuse and neglect, 10 from 30 nurses (33.3%) had just a partial knowledge about elder abuse and neglect and its symptoms, the rest of nurses (15 from 30 nurses, 50.0%) had good knowledge about elder abuse and neglect and its symptoms. Conclusion: Elder abuse and neglect seems to be a relevant problem in senior population with mental disorders. Development of educational programs for nursing and medical staff about Elder abuse and neglect (symptoms of EAN, early detection of EAN, knowledge how to report cases of EAN) could improve the situation and help mentally ill seniors to better quality of life. PMID:23113221

Using a Geriatric Mentoring Narrative Program to Improve Medical Student Attitudes towards the Elderly

ERIC Educational Resources Information Center

Duke, Pamela; Cohen, Diane; Novack, Dennis

2009-01-01

This study examined first-year medical student attitudes concerning the elderly before and after instituting a geriatric mentoring program. The program began and ended with a survey designed to assess students' attitudes toward the elderly. During the mentoring program, students visited the same senior for four visits throughout the academic year.…

Total and central obesity in elderly associated with a marker of undernutrition in early life - sitting height-to-stature ratio: A nutritional paradox.

PubMed

Silveira, Erika Aparecida; Ferreira, Carla Cristina da Conceição; Pagotto, Valéria; Santos, Annelisa Silva E Alves de Carvalho; Velasquez-Melendez, Gustavo

2017-05-06

The purpose of this study was to investigate whether sitting height-to-stature ratio (SHSR) is associated with total and central obesity in the elderly. This was a cross-sectional study with 133 noninstitutionalized elderly. High SHSR (≥ 1SD above the mean) was used as a marker of undernutrition (MU) in early life. Poisson's multiple regression was used to determine the association between variables. The prevalence of high SHSR was 21.0%, total obesity 43.6% and central obesity 50.4%. Elderly with high SHSR presented a statistically significant association with total obesity (PR 1.50; 95% CI 1.04-2.18) and central obesity (PR 1.42; 95% CI 1.03-1.95) after adjustment for sex, age, educational level and income in the multivariate analysis. The occurrence of total and central obesity in the elderly was associated with a MU in early life. This result indicates that nutritional deficiencies in childhood may increase the risk of obesity in the elderly, a nutritional paradox. © 2017 Wiley Periodicals, Inc.

Website design: technical, social and medical issues for self-reporting by elderly patients.

PubMed

Taylor, Mark J; Stables, Rod; Matata, Bashir; Lisboa, Paulo J G; Laws, Andy; Almond, Peter

2014-06-01

There is growing interest in the use of the Internet for interacting with patients, both in terms of healthcare information provision and information gathering. In this article, we examine the issues in designing healthcare websites for elderly users. In particular, this article uses a year-long case study of the development of a web-based system for self-reporting of symptoms and quality of life with a view to examine the issues relating to website design for elderly users. The issues identified included the technical, social and medical aspects of website design for elderly users. The web-based system developed was based on the European Quality of Life 5-Dimensions health-status questionnaire, a commonly used tool for patient self-reporting of quality of life, and the more specific coronary revascularisation outcome questionnaire. Currently, self-reporting is generally administered in the form of paper-based questionnaires to be completed in the outpatient clinic or at home. There are a variety of issues relating to elderly users, which imply that websites for elderly patients may involve different design considerations to other types of websites.

Participation of the elderly after vision loss.

PubMed

Alma, Manna A; van der Mei, Sijrike F; Melis-Dankers, Bart J M; van Tilburg, Theo G; Groothoff, Johan W; Suurmeijer, Theo P B M

2011-01-01

To assess the degree of participation of the visually impaired elderly and to make a comparison with population-based reference data. This cross-sectional study included visually impaired elderly persons (≥55 years; n = 173) who were referred to a low-vision rehabilitation centre. Based on the International Classification of Functioning, Disability and Health (ICF) participation in: (1) domestic life, (2) interpersonal interactions and relationships, (3) major life areas, and (4) community, social and civic life was assessed by means of telephone interviews. In addition, we assessed perceived participation restrictions. Comparison with reference data of the elderly showed that visually impaired elderly persons participated less in heavy household activities, recreational activities and sports activities. No differences were found for the interpersonal interactions and relationships domain. Participants experienced restrictions in household activities (84%), socializing (53%), paid or voluntary work (92%), and leisure activities (88%). Visually impaired elderly persons participate in society, but they participate less than their peers. They experience restrictions as a result of vision loss. These findings are relevant, since participation is an indicator for successful aging and has a positive influence on health and subjective well-being.

A Community Health Worker-Based Program for Elderly People With Hypertension in Indonesia: A Qualitative Study, 2013.

PubMed

Rahmawati, Riana; Bajorek, Beata

2015-10-15

Hypertension is prevalent in the elderly, but treatment is often inadequate, particularly in developing countries. The objective of this study was to explore the role of a community-based program in supporting patients with hypertension in an Indonesian rural community. A qualitative study comprising observation and in-depth interviews was conducted in an Integrated Health Service Post for the Elderly (IHSP-Elderly) program in Bantul district (Yogyakarta province). Eleven members of IHSP-Elderly program (ie, hypertensive patients), 3 community health workers (CHWs), and 1 district health staff member were interviewed to obtain their views about the role of the IHSP-Elderly program in hypertension management. Data were analyzed using thematic analysis. CHWs played a prominent role as the gatekeepers of health care in the rural community. In supporting hypertension management, CHWs served members of the IHSP-Elderly program by facilitating blood pressure checks and physical exercise and providing health education. Members reported various benefits, such as a healthier feeling overall, peer support, and access to affordable health care. Members felt that IHSP-Elderly program could do more to provide routine blood pressure screening and improve the process of referral to other health care services. CHWs have the potential to liaise between rural communities and the wider health care system. Their role needs to be strengthened through targeted organizational support that aims to improve delivery of, and referral to, care. Further study is needed to identify the key factors for effective CHW-based programs in rural communities and the incorporation of these programs into the health care system.

A depth video sensor-based life-logging human activity recognition system for elderly care in smart indoor environments.

PubMed

Jalal, Ahmad; Kamal, Shaharyar; Kim, Daijin

2014-07-02

Recent advancements in depth video sensors technologies have made human activity recognition (HAR) realizable for elderly monitoring applications. Although conventional HAR utilizes RGB video sensors, HAR could be greatly improved with depth video sensors which produce depth or distance information. In this paper, a depth-based life logging HAR system is designed to recognize the daily activities of elderly people and turn these environments into an intelligent living space. Initially, a depth imaging sensor is used to capture depth silhouettes. Based on these silhouettes, human skeletons with joint information are produced which are further used for activity recognition and generating their life logs. The life-logging system is divided into two processes. Firstly, the training system includes data collection using a depth camera, feature extraction and training for each activity via Hidden Markov Models. Secondly, after training, the recognition engine starts to recognize the learned activities and produces life logs. The system was evaluated using life logging features against principal component and independent component features and achieved satisfactory recognition rates against the conventional approaches. Experiments conducted on the smart indoor activity datasets and the MSRDailyActivity3D dataset show promising results. The proposed system is directly applicable to any elderly monitoring system, such as monitoring healthcare problems for elderly people, or examining the indoor activities of people at home, office or hospital.

A Depth Video Sensor-Based Life-Logging Human Activity Recognition System for Elderly Care in Smart Indoor Environments

PubMed Central

Jalal, Ahmad; Kamal, Shaharyar; Kim, Daijin

2014-01-01

Recent advancements in depth video sensors technologies have made human activity recognition (HAR) realizable for elderly monitoring applications. Although conventional HAR utilizes RGB video sensors, HAR could be greatly improved with depth video sensors which produce depth or distance information. In this paper, a depth-based life logging HAR system is designed to recognize the daily activities of elderly people and turn these environments into an intelligent living space. Initially, a depth imaging sensor is used to capture depth silhouettes. Based on these silhouettes, human skeletons with joint information are produced which are further used for activity recognition and generating their life logs. The life-logging system is divided into two processes. Firstly, the training system includes data collection using a depth camera, feature extraction and training for each activity via Hidden Markov Models. Secondly, after training, the recognition engine starts to recognize the learned activities and produces life logs. The system was evaluated using life logging features against principal component and independent component features and achieved satisfactory recognition rates against the conventional approaches. Experiments conducted on the smart indoor activity datasets and the MSRDailyActivity3D dataset show promising results. The proposed system is directly applicable to any elderly monitoring system, such as monitoring healthcare problems for elderly people, or examining the indoor activities of people at home, office or hospital. PMID:24991942

Relationship among health-related quality of life, depression and awareness of home care services in elderly patients.

PubMed

Polat, Ülkü; Bayrak Kahraman, Burcu; Kaynak, İlknur; Görgülü, Ümit

2016-11-01

The present descriptive study was carried out to determine the relationship between health-related quality of life, depression and awareness of home care services among elderly patients. Patients aged 65 years or older staying at the surgery and internal medicine clinics were included in the study. The "Patient Introduction Form," "Short Form-36 Quality of Life Questionnaire" and "Geriatric Depression Scale" were utilized in the collection of data. In the present study, it was determined that only approximately half of elderly patients (54.9%) knew the concept of home care, most of them had not previously received home care and requested home care related to medical care. The mean scores were lower in some areas of the quality of life questionnaire in some factors that could influence home care awareness. These factors were determined as: female sex, history of falling, chronic illness, functionally, moderately or severely dependent, no previous receipt of home care and wishing to receive home care. The home care requirement of elderly patients can be influenced by many physiological, psychological and social factors that can affect their quality of life. Thus, it is of utmost importance that medical professionals evaluate the quality of life of elderly individuals and its influencing factors. Geriatr Gerontol Int 2016; 16: 1211-1219. © 2015 Japan Geriatrics Society.

Quality of Life, Values, and Teamwork in Geriatric Care: Do We Communicate What We Mean?

ERIC Educational Resources Information Center

Clark, Philip G.

1995-01-01

Outlines a framework for organizing discussions of quality of life for elderly persons with disabilities, reviews relevant empirical research, and develops a framework for understanding the different interpretations of quality of life as it is used in communication among health care providers, elderly patients, and their families. New models of…

Coping strategies and quality of life in caregivers of dependent elderly relatives.

PubMed

Rodríguez-Pérez, Margarita; Abreu-Sánchez, Ana; Rojas-Ocaña, María Jesús; Del-Pino-Casado, Rafael

2017-04-14

Despite the importance of coping in caregiving, there are few studies on the relationship between coping and quality of life in caregivers of the frail dependent elderly. Thus, this study aims to analyze the relationship between coping strategies and quality of life dimensions in primary caregivers of dependent elderly relatives. A cross-sectional study was conducted from 86 caregivers. Predictive variables were coping strategies (problem-focused, emotion-focused, socially-supported, and dysfunctional); dependent variables were quality of life dimensions (psychological, physical, relational, and environmental); and potential confounding variables were age, gender, perceived health and burden of caregiver, and functional capacity of care receiver. Correlation coefficients were calculated and multiple linear regression analysis was performed. After controlling for potential confounders, dysfunctional coping was related to worse quality of life in the psychological dimension, while emotion-focused and socially-supported coping were related to superior psychological and environmental dimensions of quality of life. The physical and relational dimensions of quality of life were not related to coping strategies. 1) it is important to consider coping strategies in the assessment of primary caregivers of dependent elderly relatives; 2) the quality of life of caregivers is related to their coping strategies, 3) their quality of life can be worsened by avoidance-type coping, and 4) their quality of life can be improved by active emotion-focused coping and socially-supported coping.

78 FR 8690 - Notice of Request for Revision of Information Collections

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-06

.... 5310--Capital Assistance Program for Elderly Persons and Persons with Disabilities and Section 5311... [email protected] . 49 U.S.C. 5310--Capital Assistance Program for Elderly Persons and Persons with... U.S.C. 5310--Capital Assistance Program for Elderly Persons and Persons with Disabilities and...

24 CFR 891.545 - Completion of project, cost certification, and HUD approvals.

Code of Federal Regulations, 2011 CFR

2011-04-01

... DIRECT LOAN PROGRAM, SECTION 202 SUPPORTIVE HOUSING FOR THE ELDERLY PROGRAM AND SECTION 811 SUPPORTIVE HOUSING FOR PERSONS WITH DISABILITIES PROGRAM) SUPPORTIVE HOUSING FOR THE ELDERLY AND PERSONS WITH DISABILITIES Loans for Housing for the Elderly and Persons with Disabilities Section 202 Projects for the...

Interrupted Time Series Analysis: A Research Technique for Evaluating Social Programs for the Elderly

ERIC Educational Resources Information Center

Calsyn, Robert J.; And Others

1977-01-01

After arguing that treatment programs for the elderly need to be evaluated with better research designs, the authors illustrate how interrupted time series analysis can be used to evaluate programs for the elderly when random assignment to experimental and control groups is not possible. (Author)

Effects of Third Age Learning Programs on the Life Satisfaction, Self-Esteem, and Depression Level among a Select Group of Community Dwelling Filipino Elderly

ERIC Educational Resources Information Center

Escolar Chua, Rowena L.; de Guzman, Allan B.

2014-01-01

With the growing number of older adults becoming a global concern, many countries have focused on education as a means of promoting successful aging. Although third age learning is gaining substantial ground in other countries, it is not well-established in the Philippines. The overall intent of this experimental study was to assess the…

24 CFR 880.612a - Preference for occupancy by elderly families.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 24 Housing and Urban Development 4 2011-04-01 2011-04-01 false Preference for occupancy by elderly... PROGRAM, SECTION 202 SUPPORTIVE HOUSING FOR THE ELDERLY PROGRAM AND SECTION 811 SUPPORTIVE HOUSING FOR... Management § 880.612a Preference for occupancy by elderly families. (a) Election of preference for occupancy...

24 CFR 891.863 - Maintenance as supportive housing units for elderly persons and persons with disabilities.

Code of Federal Regulations, 2011 CFR

2011-04-01

... units for elderly persons and persons with disabilities. 891.863 Section 891.863 Housing and Urban... ELDERLY PROGRAM AND SECTION 811 SUPPORTIVE HOUSING FOR PERSONS WITH DISABILITIES PROGRAM) SUPPORTIVE HOUSING FOR THE ELDERLY AND PERSONS WITH DISABILITIES For-Profit Limited Partnerships and Mixed-Finance...

24 CFR 891.863 - Maintenance as supportive housing units for elderly persons and persons with disabilities.

Code of Federal Regulations, 2010 CFR

2010-04-01

... units for elderly persons and persons with disabilities. 891.863 Section 891.863 Housing and Urban... ELDERLY PROGRAM AND SECTION 811 SUPPORTIVE HOUSING FOR PERSONS WITH DISABILITIES PROGRAM) SUPPORTIVE HOUSING FOR THE ELDERLY AND PERSONS WITH DISABILITIES For-Profit Limited Partnerships and Mixed-Finance...

The salience network in the apathy of late-life depression.

PubMed

Yuen, Genevieve S; Gunning-Dixon, Faith M; Hoptman, Matthew J; AbdelMalak, Bassem; McGovern, Amanda R; Seirup, Joanna K; Alexopoulos, George S

2014-11-01

Apathy is prevalent in late-life depression and predicts poor response to antidepressants, chronicity of depression, disability, and greater burden to caregivers. However, little is known about its neurobiology. Salience processing provides motivational context to stimuli. The aim of this study was to examine the salience network (SN) resting-state functional connectivity (rsFC) pattern in elderly depressed subjects with and without apathy. Resting-state functional MRI data were collected from 16 non-demented, non-MCI, elderly depressed subjects and 10 normal elderly subjects who were psychotropic-free for at least 2 weeks. The depressed group included 7 elderly, depressed subjects with high comorbid apathy and 9 with low apathy. We analyzed the rsFC patterns of the right anterior insular cortex (rAI), a primary node of the SN. Relative to non-apathetic depressed elderly, depressed elderly subjects with high apathy had decreased rsFC of the rAI to dorsal anterior cingulate and to subcortical/limbic components of the SN. Depressed elderly subjects with high apathy also exhibited increased rsFC of the rAI to right dorsolateral prefrontal cortex and right posterior cingulate cortex when compared to non-apathetic depressed elderly. Elderly depressed subjects with high apathy display decreased intrinsic rsFC of the SN and an altered pattern of SN rsFC to the right DLPFC node of the central executive network when compared to elderly non-apathetic depressed and normal, elderly subjects. These results suggest a unique biological signature of the apathy of late-life depression and may implicate a role for the rAI and SN in motivated behavior. Copyright © 2014 John Wiley & Sons, Ltd.

Quality of Life in Elderly Cancer Patients Undergoing Chemotherapy.

PubMed

Lavdaniti, Maria; Zyga, Sofia; Vlachou, Eugenia; Sapountzi-Krepia, Despina

2017-01-01

As life expectancy increases, it is expected that 60% of all cases of cancer will be detected in elderly patients in the next two decades. Cancer treatment for older persons is complicated by a number of factors, thus negatively affecting patients' quality of life. The purpose of this study is to investigate quality of life in elderly cancer patients undergoing chemotherapy. This study was descriptive and non-experimental. It was conducted in one large hospital in a major city of Northern Greece. The sample was convenience comprising 53 elderly cancer patients undergoing cycle 3 chemotherapy. The data was collected using the Functional Assessment of Cancer Therapy scale and included questions related to demographic and clinical characteristics. The majority of participants were men (n = 27, 50.9%) who were married (n = 32, 79.5%). Their mean age was 70.07 ± 3.60. Almost half of the sample (n = 30, 56.6%) had colon cancer. There was a statistical significant difference between men and women pertaining to physical wellbeing (p = 0.004) and overall quality of life (p < 0.001). When comparing each subscale with the patients' marital status it was found that there was a statistical difference with respect to social/family wellbeing (p = 0.029), functional wellbeing (p = 0.09) and overall quality of life (p < 0.001). Moreover, the type of cancer affected overall quality of life (p < 0.001) and social/family wellbeing (p = 0.029). These findings call attention to quality of life and its related factors in elderly cancer patients. It is highly recommended to envisage measures for improving quality of life in this group of cancer patients.

Cough in the Elderly Population: Relationships with Multiple Comorbidity

PubMed Central

Song, Woo-Jung; Morice, Alyn H.; Kim, Min-Hye; Lee, Seung-Eun; Jo, Eun-Jung; Lee, Sang-Min; Han, Ji-Won; Kim, Tae Hui; Kim, Sae-Hoon; Jang, Hak-Chul; Kim, Ki Woong; Cho, Sang-Heon; Min, Kyung-Up; Chang, Yoon-Seok

2013-01-01

Background The epidemiology of cough in the elderly population has not been studied comprehensively. The present study aimed to investigate the epidemiology of cough in a community elderly population, particularly in relation with their comorbidity. Methods A cross-sectional analysis was performed using a baseline dataset from the Korean Longitudinal Study on Health and Aging, a community-based elderly population cohort study. Three types of cough (frequent cough, chronic persistent cough, and nocturnal cough) were defined using questionnaires. Comorbidity was examined using a structured questionnaire. Health-related quality of life was assessed using the Short Form 36 questionnaire. Results The prevalence was 9.3% for frequent cough, 4.6% for chronic persistent cough, and 7.3% for nocturnal cough. In multivariate logistic regression analyses, smoking, asthma and allergic rhinitis were found to be risk factors for cough in the elderly. Interestingly, among comorbidities, constipation and uncontrolled diabetes mellitus (HbA1c ≥ 8%) were also found to have positive associations with elderly cough. In the Short Form 36 scores, chronic persistent cough was independently related to impairment of quality of life, predominantly in the mental component. Conclusions Cough has a high prevalence and is detrimental to quality of life in the elderly. Associations with smoking, asthma and rhinitis confirmed previous findings in younger populations. Previously unrecognised relationships with constipation and uncontrolled diabetes mellitus suggested the multi-faceted nature of cough in the elderly. PMID:24205100

Aerobic training modulates T cell activation in elderly women with knee osteoarthritis

PubMed Central

Gomes, W.F.; Lacerda, A.C.R.; Brito-Melo, G.E.A.; Fonseca, S.F.; Rocha-Vieira, E.; Leopoldino, A.A.O.; Amorim, M.R.; Mendonça, V.A.

2016-01-01

Osteoarthritis of the knee (kOA) is a disease that mainly affects the elderly and can lead to major physical and functional limitations. However, the specific effects of walking, particularly on the immune system, are unknown. Therefore, this study aimed to analyze the effect of 12 weeks of walking (3×/week) on the leukocyte profile and quality of life (QL) of elderly women with kOA. Sixteen women (age: 67±4 years, body mass index: 28.07±4.16 kg/m2) participated in a walking program. The variables were assessed before and after 12 weeks of training with a progressively longer duration (30–55 min) and higher intensity (72–82% of HRmax determined using a graded incremental treadmill test). The QL was assessed using the Medical Outcomes Study 36-Item Short Form Health Survey (SF-36), and blood samples were collected for analysis with a cell counter and the San Fac flow cytometer. Walking training resulted in a 47% enhancement of the self-reported QL (P<0.05) and a 21% increase in the VO2max (P<0.0001) in elderly women with kOA. Furthermore, there was a reduction in CD4+ cells (pre=46.59±7%, post=44.58±9%, P=0.0189) and a higher fluorescence intensity for CD18+CD4+ (pre=45.30±10, post=64.27±33, P=0.0256) and CD18+CD8+ (pre=64.2±27, post=85.02±35, P=0.0130). In conclusion, the walking program stimulated leukocyte production, which may be related to the immunomodulatory effect of exercise. Walking also led to improvements in the QL and physical performance in elderly women with kOA. PMID:27828665

42 CFR 460.30 - Program agreement requirement.

Code of Federal Regulations, 2010 CFR

2010-10-01

... (CONTINUED) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PACE Program Agreement § 460.30 Program agreement requirement. (a) A PACE organization must...

42 CFR 460.30 - Program agreement requirement.

Code of Federal Regulations, 2011 CFR

2011-10-01

... (CONTINUED) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PACE Program Agreement § 460.30 Program agreement requirement. (a) A PACE organization must...

[The life of elderly women living alone].

PubMed

Kim, Chunmi; Ko, Moon Hee; Kim, Moon Jeong; Kim, Joohyun; Kim, Hee Ja; Moon, Jin Ha; Baek, Kyoung Seon; Son, Haeng-Mi; Oh, SangEun; Lee, YoungAe; Choi, Jung-Sook

2008-10-01

This study aimed to uncover the fundamental nature of living alone in female elderly. The phenomenological research approach developed by van Manen was adopted. The theme was 'taking a firm stand alone on the edges of life'. The composition elements of living alone experienced by elderly women were as follows: 1) Corporeality: participants perceived their bodies by their health status. Unhealthy participants were suffering with diseases and dependant on other persons, while healthy participants were free from family responsibility and kept on moving. 2) Spatiality: participants felt both freedom and loneliness while they stayed home. 3) Relationality: participants felt pity and yearning for their bereaved husband and sometimes talked to his picture. According to their children's filial piety, participants were pleased or displeased. However, they incessantly devoted themselves to their children. 4) Temporality: participants considered the rest of their life as extra-time which was proceeding to death, and tried to keep themselves busy before they died. A nurse should understand the multifarious aspects of elderly women's life, and then intervene to consolidate their strengths for self-supporting the final years of life.

Association between religiosity/spirituality and quality of life or depression among living-alone elderly in a South Korean city.

PubMed

Moon, Yoo Sun; Kim, Do Hoon

2013-12-01

This study investigated the effects of religiosity and spirituality on quality of life and depression among older people. Two hundred and seventy-four solitary elderly people aged over 65 years living in Chuncheon city, South Korea were selected. Symptoms of depression were evaluated using the Short Geriatric Depression Scale-Korean version (SGDS-K) and quality of life was measured using Geriatric Quality of Life-Dementia (GQOL-D). We used the Duke Religion Index (DUREL) to assess religiosity and spirituality. There was a significant correlation between scales of depression (SGDS-K), quality of life (GQOL-D), and scale of religiosity/spirituality (DUREL) in older people. Depressed people had a lower score GQOL-D than non-depressed people. Among the depressed, those believing in a religion had a higher GQOL-D score than the non-religious. Multiple regression analysis revealed that religiosity and spirituality had significant effects on depression and quality of life among the elderly. Interestingly, religiosity and spirituality were not related to depression and quality of life amongst Buddhists, but were related amongst Protestants and Catholics. Religiosity and spirituality had significant effects on depression and on quality of life among the Korean elderly. However, there are different relationships between depression and religiosity, quality of life, and religiosity based on different religions. More research is needed to elucidate these findings. Copyright © 2013 Wiley Publishing Asia Pty Ltd.

Dynamic profile of health investment and the evolution of elderly health.

PubMed

Lo, Te-Fen; Hsieh, Chee-Ruey

2013-01-01

A considerable number of studies have sought to examine the determinants of elderly health. Nevertheless, few of them incorporate a life-course perspective to analyze the dynamics of transition for both health conditions and their predictors. We utilize a nationally representative longitudinal data set of 4007 Taiwanese aged 60 or over and employ discrete-time duration models to investigate the association between annual mortality and its potential risk factors over a nearly twenty-year period (1989-2007). We place particular emphasis on the inherently dynamic character of Grossman's model, and specifically on how public and private health investment shape the personal health outcome over time. Our results support the hypothesis that depreciation rates depend on personal characteristics. In addition, we find that the dynamic profiles of both public and private health investment significantly influence the elderly mortality. An important implication of our study is that implementing universal health insurance and tobacco control programs are effective channels through which the government improves personal health. Copyright © 2012 Elsevier Ltd. All rights reserved.

75 FR 25319 - Tax Counseling for the Elderly (TCE) Program Availability of Application Packages; Correction

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-07

... DEPARTMENT OF THE TREASURY Internal Revenue Service Tax Counseling for the Elderly (TCE) Program...: Correction to a notice. SUMMARY: This document contains a correction to a notice of the Tax Counseling for... application packages for the 2011 Tax Counseling for the Elderly (TCE) Program. FOR FURTHER INFORMATION...

78 FR 17777 - Tax Counseling for the Elderly (TCE) Program Availability of Application Packages

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-22

... DEPARTMENT OF THE TREASURY Internal Revenue Service Tax Counseling for the Elderly (TCE) Program...: This document provides notice of the availability of Application Packages for the 2014 Tax Counseling... for submitting an application package to the IRS for the Tax Counseling for the Elderly (TCE) Program...

Research on Physical Activity in the Elderly: Practical Implications for Program Planning.

ERIC Educational Resources Information Center

Myers, Anita M.; Gonda, Gail

1986-01-01

The authors critically examine the research on physical activity in the elderly to assess the elderly's capacity for exercise and the benefits accruing from exercise. Lower-intensity exercise programs attract a more representative group of senior participants and overcome many barriers. Implications for program planning and efforts are discussed.…

Church-Based Programs for Caregivers of Non-Institutionalized Elders.

ERIC Educational Resources Information Center

Haber, David

Church-based programs for caregivers of black elders have emerged from both demographic and cultural factors. To investigate the effectiveness of a training program for caregivers of noninstitutionalized elders, 95 Washington, D.C. adults (99% black, 87% female), who were providing caregiving assistance to an older adult, completed a 12-hour…

Life Events, Public Policy and the Economic Vulnerability of Children and the Elderly.

ERIC Educational Resources Information Center

Burkhauser, Richard V.; Duncan, Greg J.

This report uses longitudinal data to provide a dynamic picture of the family income experiences of children and the elderly. In contrast to the image of fairly stable incomes during most life-cycle stages, findings show substantial income volatility at all points in the life span, placing substantial numbers of the population at risk of suffering…

A Community Health Worker–Based Program for Elderly People With Hypertension in Indonesia: A Qualitative Study, 2013

PubMed Central

Bajorek, Beata

2015-01-01

Introduction Hypertension is prevalent in the elderly, but treatment is often inadequate, particularly in developing countries. The objective of this study was to explore the role of a community-based program in supporting patients with hypertension in an Indonesian rural community. Methods A qualitative study comprising observation and in-depth interviews was conducted in an Integrated Health Service Post for the Elderly (IHSP-Elderly) program in Bantul district (Yogyakarta province). Eleven members of IHSP-Elderly program (ie, hypertensive patients), 3 community health workers (CHWs), and 1 district health staff member were interviewed to obtain their views about the role of the IHSP-Elderly program in hypertension management. Data were analyzed using thematic analysis. Results CHWs played a prominent role as the gatekeepers of health care in the rural community. In supporting hypertension management, CHWs served members of the IHSP-Elderly program by facilitating blood pressure checks and physical exercise and providing health education. Members reported various benefits, such as a healthier feeling overall, peer support, and access to affordable health care. Members felt that IHSP-Elderly program could do more to provide routine blood pressure screening and improve the process of referral to other health care services. Conclusion CHWs have the potential to liaise between rural communities and the wider health care system. Their role needs to be strengthened through targeted organizational support that aims to improve delivery of, and referral to, care. Further study is needed to identify the key factors for effective CHW-based programs in rural communities and the incorporation of these programs into the health care system. PMID:26469948

42 CFR 460.34 - Duration of PACE program agreement.

Code of Federal Regulations, 2011 CFR

2011-10-01

... (CONTINUED) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PACE Program Agreement § 460.34 Duration of PACE program agreement. An agreement is...

42 CFR 460.34 - Duration of PACE program agreement.

Code of Federal Regulations, 2010 CFR

2010-10-01

... (CONTINUED) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PACE Program Agreement § 460.34 Duration of PACE program agreement. An agreement is...

Quality of Life, Integrative Community Therapy, Family Support, and Satisfaction with Health Services Among Elderly Adults with and without Symptoms of Depression.

PubMed

de Lima Silva, Vanessa; de Medeiros, Caroline Addison Carvalho Xavier; Guerra, Gerlane Coelho Bernardo; Ferreira, Priscila Helena Antunes; de Araújo Júnior, Raimundo Fernandes; de Araújo Barbosa, Stphannie Jamyla; de Araújo, Aurigena Antunes

2017-06-01

The aim of this cross-sectional study was to analyse quality of life, socio-demographic characteristics, family support, satisfaction with health services, and effect of integrative community therapy among non-institutionalised elderly adults with and without symptoms of depression in the state of Rio Grande do Norte, Brazil. Data from elderly adults with (n = 59) and without (n = 61) depressive symptoms were compared. The instruments used were the Mini-Mental State Examination, the short version of the Geriatric Depression Scale, a clinical socio-demographic questionnaire, the abbreviated version of the World Health Organisation Quality of Life questionnaire, the Family Assessment Device, and the Patient Satisfaction with Mental Health Services Rating Scale. Elderly adults with depressive symptoms had lower quality of life in the social relations domain than did those without depressive symptoms (p = 0.003). In addition, compared with those without depression, fewer elderly adults with depressive symptoms attended integrative community therapy (p = 0.04); they also reported a low degree of family involvement in problem solving (p = 0.04) and showed apathy regarding their satisfaction with health services (p = 0.007). These results have important implications in the decision-making process with regard to strategies for improving the health status of elderly adults with depressive symptoms.

Finding a Sense of Home across the Pacific in Old Age- Chinese American Senior's Report of Life Satisfaction in a Foreign Land.

PubMed

Zhan, Heying Jenny; Wang, Qi; Fawcett, Zoe; Li, Xiaoqing; Fan, Xiying

2017-03-01

Finding a sense of home for international migrants is challenging. It is even more so for older adults who migrate to a foreign country later in life to follow their adult children. This study examines Chinese immigrant elders' report of their sense of home and life-satisfaction. Based on 21 intensive interviews and107 surveys with elderly immigrants of Chinese descent, this research finds that a comfortable living condition in a natural and built environment contribute to Chinese elders' narrative of a sense of home. The lack of English language, however, makes immigrant Chinese elders feel very unsettled. Being together with children and having good social benefits are major pull factors that contribute to immigrant elders' decision to settle down in a foreign country. Those who report a stronger sense of home tend to report a higher level of life satisfaction. In conclusion, the authors argue that immigrant elders are defining their sense of home with a greater sense of independence from their adult children. Favorable social policies toward older adults, such as Medicare, Medicaid, low income housing, and social services, are important factors that make older immigrants feel a sense of home in a foreign land, although the inability to communicate is a barrier to a complete sense of home for transnational migrants in old age.

Life concerns of elderly people living at home determined as by Community General Support Center staff: implications for organizing a more effective integrated community care system. The Kurihara Project.

PubMed

Takada, Junko; Meguro, Kenichi; Sato, Yuko; Chiba, Yumiko

2014-09-01

In Japan, the integrated community care system aims to enable people to continue to live in their homes. Based on the concept, one of the activities of a Community General Support Center (CGSC) is to provide preventive intervention based on a Community Support Program. Currently, a Basic Checklist (BC) is sent to elderly people to identify persons appropriate for a Secondary Prevention Program. To find people who had not responded to the BC, CGSC staff evaluated the files of 592 subjects who had participated in the Kurihara Project to identify activities they cannot do that they did in the past, decreased activity levels at home, loss of interaction with people other than their family, and the need for medical interventions. This information was classified, when applicable, into the following categories: (A) 'no life concerns'; (B) 'undecided'; and (C) 'life concerns'. The relationships between these classifications and clinical information, certified need for long-term care, and items on the BC were examined. The numbers of subjects in categories A, B, and C were 291, 42, and 186, respectively. Life concerns were related to scores on the Clinical Dementia Rating, global cognitive function, depressive state, and apathy. Most items on the BC were not associated with classification into category C, but ≥25% of the subjects had life concerns related to these items. Assessment of life concerns by the CGSC staff has clinical validity. The results suggest that there are people who do not respond to the checklist or apply for Long-Term Care Insurance, meaning that they 'hide' in the community, probably due to apathy or depressive state. To organize a more effective integrated community care system, the CGSC staff should focus mainly on preventive care. © 2014 The Authors. Psychogeriatrics © 2014 Japanese Psychogeriatric Society.

Pilates and Proprioceptive Neuromuscular Facilitation Methods Induce Similar Strength Gains but Different Neuromuscular Adaptations in Elderly Women.

PubMed

Teixeira de Carvalho, Fabiana; de Andrade Mesquita, Laiana Sepúlveda; Pereira, Rafael; Neto, Osmar Pinto; Amaro Zangaro, Renato

2017-01-01

Background/Study Context: The aging process is associated with a decline in muscle mass, strength, and conditioning. Two training methods that may be useful to improve muscle function are Pilates and proprioceptive neuromuscular facilitation (PNF). Thus, the present study aimed to compare the influence of training programs using Pilates and PNF methods with elderly women. Sixty healthy elderly women were randomly divided into three groups: Pilates group, PNF group, and control group. Pilates and PNF groups underwent 1-month training programs with Pilates and PNF methods, respectively. The control group received no intervention during the 1 month. The maximal isometric force levels from knee extension and flexion, as well as the electromyography (EMG) signals from quadriceps and biceps femoris, were recorded before and after the 1-month intervention period. A two-way analysis of variance revealed that the Pilates and PNF methods induced similar strength gains from knee flexors and extensors, but Pilates exhibited greater low-gamma drive (i.e., oscillations in 30-60 Hz) in the EMG power spectrum after the training period. These results support use of both Pilates and PNF methods to enhance lower limb muscle strength in older groups, which is very important for gait, postural stability, and performance of daily life activities.

Relationships between social support and depression, and quality of life of the elderly in a rural community in Malaysia.

PubMed

Ibrahim, Norhayati; Din, Normah Che; Ahmad, Mahadir; Ghazali, Shazli Ezzat; Said, Zaini; Shahar, Suzana; Ghazali, Ahmad Rohi; Razali, Rosdinom

2013-04-01

This study aimed to examine the role of social support and depression in predicting the quality of life among the elderly living in a rural Federal Land Development Authority (FELDA) community in Malaysia. A total of 162 elderly settlers of FELDA Sungai Tengi, aged 60 years and above, were selected by universal sampling method in this cross-sectional study. Three standardized instruments - the 12-item Short Form (SF-12), 15-item Geriatric Depression Scale (GDS-15) and Medical Outcome Study Social Support (MOS-Social Support) - were used to assess for quality of life, depression and social support. Quality of life of the elderly people in this community was high, especially in terms of physical components as compared to mental components. The mean scores for emotional role in the SF-12 was relatively the highest (90.74 ± 21.59) with social functioning being the lowest (30.35 ± 22.29). The results also showed that the mean value was higher for physical component summary (74.40) as compared to mental component summary (51.51). Approximately 23.5% suffered mild depression and only 2.5% had severe depression. This study showed that the elderly FELDA settlers have a high quality of life, mainly on the physical components of life and low rate of severe depression, a positive indicator of their psychological well-being. Social support in the form of emotional/informational support, and depression were significant factors related to their good quality of life. Copyright © 2013 Wiley Publishing Asia Pty Ltd.

Protective factors against suicide among young-old Chinese outpatients

PubMed Central

2014-01-01

Background Suicide is common among the elderly worldwide. However, no literature could be found on the beliefs/expectations that protect young-old people from attempting suicide. The purpose of this study was to explore young-old outpatients’ reasons for not killing themselves in Taiwan. Method Data for this qualitative descriptive study were extracted from a large research series. From the 83 elderly outpatients in the original sample, 31 were chosen for this study because they were young-old (65–74 years old) and from two randomly selected medical centers in northern Taiwan. Data on participants’ reasons for not killing themselves in unhappy situations were collected in individual interviews using a semi-structured guide and analyzed by content analysis. Results Analysis of interview data identified six major themes: satisfied with one’s life, suicide cannot resolve problems, fear of humiliating one’s children, religious beliefs, never thought about suicide, and living in harmony with nature. Conclusion These identified protective factors (reasons for living) could be added to suicide-prevention programs for the elderly. Our findings may also serve as a reference for geriatric researchers in western countries with increasing numbers of elderly ethnic minority immigrants. PMID:24739419

[The details of clinical examination of elders].

PubMed

Proshchaev, K I; Il'nitskiĭ, A N; Krivetskiĭ, V V; Varavina, L Iu; Kolpina, L V; Gorelik, S G; Fesenko, V V; Krivtsunov, A N

2013-01-01

At present, the ever-increasing number of persons of elderly and senile age does not receive from health and social care agencies sufficient volume of health services and social care they require. This article reveals the essence of such a concept as the phenomenon of senile asthenia. It also describes the characteristic of the algorithm of the specialized geriatric examination of elderly patients, which includes not only traditional but also very important for an elderly person special part, in particular, balance and gait assessment, identification of nutritional status to objectify the syndrome of malnutrition, assessment of mental function, activity level of an elderly person, the state of movement, a detailed identification of the social features of life of an elderly person, the quality of his life. The application of this algorithm will significantly improve the quality of geriatric care provided through the objectification of the pathology in the elderly person and assessment of the volume of medical and social care he needs.

42 CFR 460.32 - Content and terms of PACE program agreement.

Code of Federal Regulations, 2011 CFR

2011-10-01

... SERVICES (CONTINUED) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PACE Program Agreement § 460.32 Content and terms of PACE program agreement. (a...

Elderly persons' experiences of striving to receive care on their own terms in nursing homes.

PubMed

Anderberg, Patrice; Berglund, Anna-Lena

2010-02-01

Elderly persons' participation in and decisions about their own care need more attention. The aim of this study was to gain a deeper understanding of elderly persons' experiences of care and help, and how their lives change in nursing homes. Fifteen elderly persons living in four nursing homes were interviewed about their experiences of needing care and help in their daily life. The interviews were analysed using van Manen's phenomenological approach. Elderly persons' experiences of care and help were described as: a balance between sorrow and relief, a struggle to maintain control and connectedness, managing to live in the present and yet worrying about the future, and an attempt to hide one's vulnerability in order to be accepted and create an inner calm in an exposed situation. In conclusion, important issues were raised concerning elderly persons' perspectives on care and help in daily life in nursing homes.

Transcending old age: creativity, development and psychoanalysis in the life of a centenarian.

PubMed

Settlage, C F

1996-06-01

The author of this paper presents therapeutic work with an elderly patient during the tenth and eleventh decades of her life. The author's focus is on the interplay of the creative, developmental and therapeutic processes in the revision of psychic structure. The paper depicts the experience of very old age, particularly the confrontation with mortality. It notes transference and countertransference reactions to the elderly patient. Poems the patient wrote during the last ten years of her life convey her experience of the described processes. The paper gives further confirmation to the recently acquired appreciation of the suitability of elderly individuals for psychoanalytic treatment.

The elderly traveller.

PubMed

Ramos-Sesma, V; Górgolas-Hernández Mora, M; Ramos-Rincón, J M

2018-04-20

Improved living conditions and advances in medicine have extended life expectancy and quality of life, resulting in an increasing number of elderly travellers. Pathophysiological changes and treatments can reduce the efficacy of vaccines and facilitate drug interactions. Elderly travellers have various characteristics that should be considered when offering pre-trip counselling, which should include proper management of chronic diseases that are susceptible to worsening during the trip, as well as an appropriate study and follow-up after the trip. We performed a narrative review of the main problems of elderly travellers. Copyright © 2018 Elsevier España, S.L.U. and Sociedad Española de Medicina Interna (SEMI). All rights reserved.

Studies of the Future Aged. An International Symposium.

ERIC Educational Resources Information Center

Friis, Henning; Sheppard, Harold L., Ed.

These six papers report on future-oriented studies of the situation of the elderly. "Changing Elderly in a Changing Society: Danish Elderly in the Next Century" (Henning Friis) reports on research dealing with preferences of the future elderly for their life when they grow older. "Aging Effectively: Meeting the Challenge of an Aging…

The Geographic Accessibility and Inequality of Community-Based Elderly Learning Resources: A Remodeling Assessment, 2009-2017

ERIC Educational Resources Information Center

Tseng, Ming-Hseng; Wu, Hui-Ching

2018-01-01

Continuous elderly learning activities not only empower elderly populations' knowledge about health but also enhance these populations' social connections and social abilities, which can enhance their overall quality of life. Geographic accessibility is a determinant factor for elderly participation in social activities. In this study, we proposed…

Study of Spirituality in Elderly With Subjective Memory Complaints.

PubMed

Trivedi, Surbhi C; Subramanyam, Alka A; Kamath, Ravindra M; Pinto, Charles

2016-01-01

Subjective memory complaints are very common among elderly. They can be due to depression, cognitive decline, or be a part of normal aging process. Spirituality is another important dimension in elderly, and it is believed to help them cope with various adversities. This study was done to find out whether any relation exists between these 2 variables in elderly. A total of 120 elderly individuals, presenting with subjective memory complaints, were divided into 3 groups - controls, elderly with depression, and elderly with mild cognitive impairment (MCI). Spirituality in them was studied by dividing it into the subdomains of self-transcendence, presence of meaning in life, search for meaning in life, and locus of control. Spirituality was the highest in controls, followed by MCI group, and then depression group. Spirituality had a direct negative relationship with severity of depression, while relationship of spirituality with severity of cognitive decline was more complex. Relationship of spirituality with mental health status in elderly patients seemed bidirectional, that is, cause as well as effect relationship. © The Author(s) 2015.

Promoting physical activity for elders with compromised function: the lifestyle Interventions and Independence for elders (LIFE) study physical activity intervention

PubMed Central

Rejeski, W Jack; Axtell, Robert; Fielding, Roger; Katula, Jeffrey; King, Abby C; Manini, Todd M; Marsh, Anthony P; Pahor, Marco; Rego, Alvito; Tudor-Locke, Catrine; Newman, Mark; Walkup, Michael P; Miller, Michael E

2013-01-01

The Lifestyle Interventions and Independence for Elders (LIFE) Study is a Phase III randomized controlled clinical trial (Clinicaltrials.gov identifier: NCT01072500) that will provide definitive evidence regarding the effect of physical activity (PA) on major mobility disability in older adults (70–89 years old) who have compromised physical function. This paper describes the methods employed in the delivery of the LIFE Study PA intervention, providing insight into how we promoted adherence and monitored the fidelity of treatment. Data are presented on participants’ motives and self-perceptions at the onset of the trial along with accelerometry data on patterns of PA during exercise training. Prior to the onset of training, 31.4% of participants noted slight conflict with being able to meet the demands of the program and 6.4% indicated that the degree of conflict would be moderate. Accelerometry data collected during PA training revealed that the average intensity – 1,555 counts/minute for men and 1,237 counts/minute for women – was well below the cutoff point used to classify exercise as being of moderate intensity or higher for adults. Also, a sizable subgroup required one or more rest stops. These data illustrate that it is not feasible to have a single exercise prescription for older adults with compromised function. Moreover, the concept of what constitutes “moderate” exercise or an appropriate volume of work is dictated by the physical capacities of each individual and the level of comfort/stability in actually executing a specific prescription. PMID:24049442

The Relationship between Activities of Daily Living and Life Satisfaction in the Elderly: Active Engagement as Compared to Passive Participation.

ERIC Educational Resources Information Center

Iannuzzelli, Jena; England, Eileen M.

Daily activities and social contact were studied as influences on the life satisfaction of elderly people. It was considered that all activities might not be equal and that individuals who participate in more active activities and who have more active social contacts would score higher in life satisfaction than those who engage in inactive…

Effects of Social Networks on the Quality of Life in an Elder and Middle-Aged Deaf Community Sample

ERIC Educational Resources Information Center

Gerich, Joachim; Fellinger, Johannes

2012-01-01

This article endeavors to investigate the role of social networks in contributing to the quality of life of an elder and middle-aged Deaf population. In particular, it poses the question of whether a certain network composition (deaf and hearing network persons) provides positive resources to improve quality of life and attempts to identify…

Quality of Life in Ageing Societies: Italy, Portugal, and Turkey

ERIC Educational Resources Information Center

Arun, Ozgur; Cevik, Aylin Cakiroglu

2011-01-01

The aim of this study was to compare and analyze the quality of life of the elderly in three aging countries: Italy, Portugal, and Turkey. This was done by using data provided by the European Quality of Life Survey completed in 2004. By doing so, we could then operationalize the conditions of the elderly in Turkey who have a rapid aging process…

Factors Associated With Health-Related Quality of Life Among an Older Population in a Largely Rural Western Region

ERIC Educational Resources Information Center

Borders, Tyrone F.; Aday, Lu Ann; Xu, Ke Tom

2004-01-01

As elderly people become a larger proportion of the rural population, it is important to identify those at risk for poor health. Predictors of health-related quality of life can be useful in designing interventions. Purpose: One objective of the present study was to profile the health-related quality of life of community-dwelling, elderly people…

Subjective Values of Quality of Life Dimensions in Elderly People. A SEM Preference Model Approach

ERIC Educational Resources Information Center

Elosua, Paula

2011-01-01

This article proposes a Thurstonian model in the framework of Structural Equation Modelling (SEM) to assess preferences among quality of life dimensions for the elderly. Data were gathered by a paired comparison design in a sample comprised of 323 people aged from 65 to 94 years old. Five dimensions of quality of life were evaluated: Health,…

Magnitude and Correlates of Anemia in Elderly Women of a Resettlement Colony of Delhi.

PubMed

Singh, Tulika; Nagesh, S; Ray, T K

2018-01-01

Anemia of any degree contributes significantly to morbidity and mortality and has a significant effect on the quality of life of elderly women. Despite its clinical importance, anemia in the elderly women is underrecognized. The objective of this study was to assess the magnitude and correlates of anemia in elderly women of a resettlement colony of Delhi. A community-based, cross-sectional study for the duration of 1 year was conducted among 512 geriatric women (≥60 years). Demographic characteristics, dietary assessment, and behavioral risk factors were determined by interview, and the participants underwent physical examination followed by hemoglobin estimation by HemoCue. Anemia was defined using the WHO criteria of hemoglobin <12 g/dl. Chi-square test was employed to study the association between sociodemographic factors and anemia followed by multivariate regression analysis. The prevalence of anemia was 79.9% according to the WHO criteria of hemoglobin <12 g/dl in females. Age, education, marital status, financial dependence, diagnosed chronic disease, diet, calorie intake, history of worm infestation, and body mass index (BMI) were significantly associated with anemia on univariate analysis. In multivariate analysis, age, marital status, financial dependence, diagnosed chronic disease, diet, calorie intake, and BMI were significant explanatory variables for anemia. Our study points out high prevalence of and some of the major factors associated with anemia in elderly women. The need of the hour is to include our elderly women under the gamut of National Anemia Prophylaxis Program.

Exploring Musical Activities and Their Relationship to Emotional Well-Being in Elderly People across Europe: A Study Protocol.

PubMed

Grau-Sánchez, Jennifer; Foley, Meabh; Hlavová, Renata; Muukkonen, Ilkka; Ojinaga-Alfageme, Olatz; Radukic, Andrijana; Spindler, Melanie; Hundevad, Bodil

2017-01-01

Music is a powerful, pleasurable stimulus that can induce positive feelings and can therefore be used for emotional self-regulation. Musical activities such as listening to music, playing an instrument, singing or dancing are also an important source for social contact, promoting interaction and the sense of belonging with others. Recent evidence has suggested that after retirement, other functions of music, such as self-conceptual processing related to autobiographical memories, become more salient. However, few studies have addressed the meaningfulness of music in the elderly. This study aims to investigate elderly people's habits and preferences related to music, study the role music plays in their everyday life, and explore the relationship between musical activities and emotional well-being across different countries of Europe. A survey will be administered to elderly people over the age of 65 from five different European countries (Bosnia and Herzegovina, Czechia, Germany, Ireland, and UK) and to a control group. Participants in both groups will be asked about basic sociodemographic information, habits and preferences in their participation in musical activities and emotional well-being. Overall, the aim of this study is to gain a deeper understanding of the role of music in the elderly from a psychological perspective. This advanced knowledge could help to develop therapeutic applications, such as musical recreational programs for healthy older people or elderly in residential care, which are better able to meet their emotional and social needs.

Quality of life and self-esteem among the elderly in the community.

PubMed

Tavares, Darlene Mara Dos Santos; Matias, Thaís Gabriela Cruz; Ferreira, Pollyana Cristina Dos Santos; Pegorari, Maycon Sousa; Nascimento, Janaina Santos; Paiva, Mariana Mapelli de

2016-11-01

This study sought to investigate the association between the scores for quality of life (QoL) and self-esteem among the elderly in an urban community. A cross-sectional, quantitative and analytical household survey was conducted with 1,691 elderly persons resident in an urban area in a county in Minas Gerais state. The World Health Organization Quality of Life BREF (WHOQOL-BREF), the World Health Organization Quality of Life OLD (WHOQOL-OLD) questionnaires and the Rosenberg Self-Esteem Scale were used in this study. A descriptive statistical analysis and a linear regression model (p < 0.05) were conducted. The results revealed that the social relationships domain (71.19) and the topic of death and dying (74.30) had the highest mean scores among the elderly; while the lowest mean scores were the environment domain (60.39) and the topic of social participation (63.06). The self-esteem scores showed an average of 9.36 ± 4.09. Associations were evident for the lower scores of quality of life in all the WHOQOL-BREF domains and WHOQOL-OLD aspects (except death and dying) with lower levels of self-esteem (p <0.001). The results provide data that contribute to a better understanding of the aspects that influence the QoL of the elderly due to reduced self-esteem, thus providing information for the development of health strategies.

Whey protein, amino acids, and vitamin D supplementation with physical activity increases fat-free mass and strength, functionality, and quality of life and decreases inflammation in sarcopenic elderly.

PubMed

Rondanelli, Mariangela; Klersy, Catherine; Terracol, Gilles; Talluri, Jacopo; Maugeri, Roberto; Guido, Davide; Faliva, Milena A; Solerte, Bruno S; Fioravanti, Marisa; Lukaski, Henry; Perna, Simone

2016-03-01

Interventions to attenuate the adverse effects of age-related loss of skeletal muscle and function include increased physical activity and nutritional supplementation. This study tested the hypothesis that nutritional supplementation with whey protein (22 g), essential amino acids (10.9 g, including 4 g leucine), and vitamin D [2.5 μg (100 IU)] concurrent with regular, controlled physical activity would increase fat-free mass, strength, physical function, and quality of life, and reduce the risk of malnutrition in sarcopenic elderly persons. A total of 130 sarcopenic elderly people (53 men and 77 women; mean age: 80.3 y) participated in a 12-wk randomized, double-blind, placebo-controlled supplementation trial. All participants concurrently took part in a controlled physical activity program. We examined body composition with dual-energy X-ray absorptiometry, muscle strength with a handgrip dynamometer, and blood biochemical indexes of nutritional and health status, and evaluated global nutritional status, physical function, and quality of life before and after the 12 wk of intervention. Compared with physical activity and placebo, supplementation plus physical activity increased fat-free mass (1.7-kg gain, P < 0.001), relative skeletal muscle mass (P = 0.009), android distribution of fat (P = 0.021), handgrip strength (P = 0.001), standardized summary scores for physical components (P = 0.030), activities of daily living (P = 0.001), mini nutritional assessment (P = 0.003), and insulin-like growth factor I (P = 0.002), and lowered C-reactive protein (P = 0.038). Supplementation with whey protein, essential amino acids, and vitamin D, in conjunction with age-appropriate exercise, not only boosts fat-free mass and strength but also enhances other aspects that contribute to well-being in sarcopenic elderly. This trial was registered at clinicaltrials.gov as NCT02402608. © 2016 American Society for Nutrition.

Uncertainty, the Overbearing Lived Experience of the Elderly People Undergoing Hemodialysis: A Qualitative Study.

PubMed

Sahaf, Robab; Sadat Ilali, Ehteram; Peyrovi, Hamid; Akbari Kamrani, Ahmad Ali; Spahbodi, Fatemeh

2017-01-01

The chronic kidney disease is a major health concern. The number of the elderly people with chronic renal failure has increased across the world. Dialysis is an appropriate therapy for the elderly, but it involves certain challenges. The present paper reports uncertainty as part of the elderly experiences of living with hemodialysis. This qualitative study applied Max van Manen interpretative phenomenological analysis to explain and explore experiences of the elderly with hemodialysis. Given the study inclusion criteria, data were collected using in-depth unstructured interviews with nine elderly undergoing hemodialysis, and then analyzed according to Van Manen 6-stage methodological approach. One of the most important findings emerging in the main study was "uncertainty", which can be important and noteworthy, given other aspects of the elderly life (loneliness, despair, comorbidity of diseases, disability, and mental and psychosocial problems). Uncertainty about the future is the most psychological concerns of people undergoing hemodialysis. The results obtained are indicative of the importance of paying attention to a major aspect in the life of the elderly undergoing hemodialysis, uncertainty. A positive outlook can be created in the elderly through education and increased knowledge about the disease, treatment and complications.

Intensive exercise reduces the fear of additional falls in elderly people: findings from the Korea falls prevention study.

PubMed

Oh, Dong Hyun; Park, Ji Eun; Lee, Eon Sook; Oh, Sang Woo; Cho, Sung Il; Jang, Soong Nang; Baik, Hyun Wook

2012-12-01

Falls among older people are a major public health problem and may result in fracture, medical complications that require hospitalization, and fear of additional falls. Given the prevalence and impact of the fear of falling again, reducing the incidence of falls is important to prevent additional falls. This study analyzed whether exercise programs decrease the fear of future falls in elderly patients who have fallen previously. A randomized controlled study was performed that included 65 elderly community-dwelling subjects who had fallen in the previous year. Subjects were randomized into two groups: an exercise group (EG, n = 36) and a control group (CG, n = 29). The EG participated in three exercise sessions per week for 12 weeks. Muscle strength, balance, agility, flexibility, and muscular endurance were measured at baseline and after 12 weeks. After the 12-week exercise program, the subjects in the EG demonstrated remarkable improvement in their walking speed, balance (p = 0.003), back strength (p = 0.08), lower extremity strength (p = 0.004), and flexibility (p < 0.001). When asked whether they were afraid of falling, more participants in the EG than in the CG responded "not at all" or "a little." The 12-week exercise program described here reduced the fear of falling (p = 0.02). It also improved the balance, flexibility, and muscle strength of the participants and was associated with improved quality of life.

"People don't understand what goes on in here": A consensual qualitative research analysis of inmate-caregiver perspectives on prison-based end-of-life care.

PubMed

Depner, Rachel M; Grant, Pei C; Byrwa, David J; Breier, Jennifer M; Lodi-Smith, Jennifer; Luczkiewicz, Debra L; Kerr, Christopher W

2018-05-01

The age demographic of the incarcerated is quickly shifting from young to old. Correctional facilities are responsible for navigating inmate access to healthcare; currently, there is no standardization for access to end-of-life care. There is growing research support for prison-based end-of-life care programs that incorporate inmate peer caregivers as a way to meet the needs of the elderly and dying who are incarcerated. This project aims to (a) describe a prison-based end-of-life program utilizing inmate peer caregivers, (b) identify inmate-caregiver motivations for participation, and (c) analyze the role of building trust and meaningful relationships within the correctional end-of-life care setting. A total of 22 semi-structured interviews were conducted with inmate-caregivers. Data were analyzed using Consensual Qualitative Research methodology. All inmate-caregivers currently participating in the end-of-life peer care program at Briarcliff Correctional Facility were given the opportunity to participate. All participants were male, over the age of 18, and also incarcerated at Briarcliff Correctional Facility, a maximum security, state-level correctional facility. In total, five over-arching and distinct domains emerged; this manuscript focuses on the following three: (a) program description, (b) motivation, and (c) connections with others. Findings suggest that inmate-caregivers believe they provide a unique and necessary adaptation to prison-based end-of-life care resulting in multilevel benefits. These additional perceived benefits go beyond a marginalized group gaining access to patient-centered end-of-life care and include potential inmate-caregiver rehabilitation, correctional medical staff feeling supported, and correctional facilities meeting end-of-life care mandates. Additional research is imperative to work toward greater standardization of and access to end-of-life care for the incarcerated.

Effectiveness of a community-based program for suicide prevention among elders with early-stage dementia: A controlled observational study.

PubMed

Kim, Jong-Pill; Yang, Jinhyang

The purpose of this study was to develop a small-group-focused suicide prevention program for elders with early-stage dementia and to assess its effects. This was a quasi-experimental study with a control group pretest-posttest design. A total of 62 elders diagnosed with early-stage dementia who were receiving care services at nine daycare centers in J City Korea participated in this study. The experimental group participated in the suicide prevention program twice a week for 5 weeks with a pretest and two posttests The developed suicide prevention program had a significant effect on the perceived health status, social support, depression, and suicidal ideation of elders with early-stage dementia. Nurses should integrate risk factors such as depression and protective factors such as health status and social support into a suicide prevention program. This community-based program in geriatric nursing practice can be effective in preventing suicide among elders with early-stage dementia. Copyright © 2016 Elsevier Inc. All rights reserved.

State tax incentives for person giving informal care of the elderly.

PubMed

Hendrickson, M C

1988-12-01

Programs for informal caregivers of frail elderly can be adopted by States to address some of the problems associated with an expanding and costly long-term care system. In this article, highlights are given from a 3-year study of Idaho and Arizona tax incentive programs. Characteristics of informal caregivers and elderly participants are described, and elderly participants are compared with elderly nonparticipants and with the general elderly population. Tax incentives were positively related to the level of service and financial support provided by informal caregivers. Data were inadequate to determine whether the induced informal help substituted for public expenditures.

Meals for the Elderly

NASA Technical Reports Server (NTRS)

1977-01-01

NASA is drawing upon its food-preparation expertise to assist in solving a problem affecting a large segment of the American population. In preparation for manned space flight programs, NASA became experienced in providing astronauts simple, easily-prepared, nutritious meals. That experience now is being transferred to the public sector in a cooperative project managed by Johnson Space Center. Called Meal System for the Elderly, the project seeks to fill a gap by supplying nutritionally balanced meal packages to those who are unable to participate in existing meal programs. Many such programs are conducted by federal, state and private organizations, including congregate hot meal services and home-delivered "meals on wheels." But more than 3.5 million elderly Americans are unable to take advantage of these benefits. In some cases, they live in rural areas away from available services; in others, they are handicapped, temporarily ill, or homebound for other reasons. Meal System for the Elderly, a cooperative program in which the food-preparation expertise NASA acquired in manned space projects is being utilized to improve the nutritional status of elderly people. The program seeks to fill a gap by supplying nutritionally-balanced food packages to the elderly who are unable to participate b existing meal service programs.

Elders' Life Stories: Impact on the Next Generation of Health Professionals

PubMed Central

2013-01-01

The purpose of this study was to pilot an enhanced version of the “Share your Life Story” life review writing workshop. The enhanced version included the addition of an intergenerational exchange, based on the content of seniors' writings, with students planning careers in the health sciences. The researcher employed a mixed methods design. Preliminary results using descriptive analysis revealed an increase in positive images of aging and a decrease in negative images of aging among the five student participants. Qualitative results revealed six themes that illuminate the hows and whys of the quantitative results as well as additional program benefits. Feedback from students and seniors helped to refine the intergenerational protocol for a larger scale study. PMID:24027579

Pathogenesis and treatment of falls in elderly

PubMed Central

Pasquetti, Pietro; Apicella, Lorenzo; Mangone, Giuseppe

2014-01-01

Summary Falls in the elderly are a public health problem. Consequences of falls are increased risk of hospitalization, which results in an increase in health care costs. It is estimated that 33% of individuals older than 65 years undergoes falls. Causes of falls can be distinguished in intrinsic and extrinsic predisposing conditions. The intrinsic causes can be divided into age-related physiological changes and pathological predisposing conditions. The age-related physiological changes are sight disorders, hearing disorders, alterations in the Central Nervous System, balance deficits, musculoskeletal alterations. The pathological conditions can be Neurological, Cardiovascular, Endocrine, Psychiatric, Iatrogenic. Extrinsic causes of falling are environmental factors such as obstacles, inadequate footwear. The treatment of falls must be multidimensional and multidisciplinary. The best instrument in evaluating elderly at risk is Comprehensive Geriatric Assessment (CGA). CGA allows better management resulting in reduced costs. The treatment should be primarily preventive acting on extrinsic causes; then treatment of chronic and acute diseases. Rehabilitation is fundamental, in order to improve residual capacity, motor skills, postural control, recovery of strength. There are two main types of exercises: aerobic and muscular strength training. Education of patient is a key-point, in particular through the Back School. In conclusion falls in the elderly are presented as a “geriatric syndrome”; through a multidimensional assessment, an integrated treatment and a rehabilitation program is possible to improve quality of life in elderly. PMID:25568657

[Xerostomia and its impact on oral health-related quality of life].

PubMed

Herrmann, Gianna; Müller, Karolina; Behr, Michael; Hahnel, Sebastian

2017-02-01

Dry mouth is a frequently occurrence in elderly people and causes numerous clinical and social problems. To investigate the quality of life in geriatric patients living in nursing homes depending on the subjective sensation of dry mouth and associated oral parameters. A total of 62 male and female elderly patients living in 7 cooperating nursing homes were interviewed employing questionnaires with regard to their oral health-related quality of life (GOHAI) and their subjective perception of dry mouth (sXI-D). Dental status, drinking habits and current medication were documented. The mean GOHAI score was 53.6 and the mean sXI-D score was 7.9. Oral health-related quality of life was significantly influenced by the subjective sensation of dry mouth (p < 0.001), whereas no significant impact of the number of residual teeth or implants or the character of prosthetic restorations could be identified. Xerostomia was significantly influenced by the number of medications consumed (p = 0.039). Xerostomia has a significant impact on the oral health-related quality of life of elderly people living in nursing homes. Thus, dental treatment should focus on the alleviation of xerostomia to improve the oral health-related quality of life in the elderly population.

26 CFR 601.806 - Solicitation of applications.

Code of Federal Regulations, 2010 CFR

2010-04-01

... REVENUE PRACTICE STATEMENT OF PROCEDURAL RULES Tax Counseling for the Elderly § 601.806 Solicitation of... Internal Revenue Service Tax Counseling for the Elderly program should request an application from the: Program Manager, Tax Counseling for the Elderly, Taxpayer Service Division TX:T:I, Internal Revenue...

26 CFR 601.806 - Solicitation of applications.

Code of Federal Regulations, 2012 CFR

2012-04-01

... REVENUE PRACTICE STATEMENT OF PROCEDURAL RULES Tax Counseling for the Elderly § 601.806 Solicitation of... Internal Revenue Service Tax Counseling for the Elderly program should request an application from the: Program Manager, Tax Counseling for the Elderly, Taxpayer Service Division TX:T:I, Internal Revenue...

26 CFR 601.806 - Solicitation of applications.

Code of Federal Regulations, 2014 CFR

2014-04-01

... REVENUE PRACTICE STATEMENT OF PROCEDURAL RULES Tax Counseling for the Elderly § 601.806 Solicitation of... Internal Revenue Service Tax Counseling for the Elderly program should request an application from the: Program Manager, Tax Counseling for the Elderly, Taxpayer Service Division TX:T:I, Internal Revenue...

26 CFR 601.806 - Solicitation of applications.

Code of Federal Regulations, 2011 CFR

2011-04-01

... REVENUE PRACTICE STATEMENT OF PROCEDURAL RULES Tax Counseling for the Elderly § 601.806 Solicitation of... Internal Revenue Service Tax Counseling for the Elderly program should request an application from the: Program Manager, Tax Counseling for the Elderly, Taxpayer Service Division TX:T:I, Internal Revenue...

26 CFR 601.806 - Solicitation of applications.

Code of Federal Regulations, 2013 CFR

2013-04-01

... REVENUE PRACTICE STATEMENT OF PROCEDURAL RULES Tax Counseling for the Elderly § 601.806 Solicitation of... Internal Revenue Service Tax Counseling for the Elderly program should request an application from the: Program Manager, Tax Counseling for the Elderly, Taxpayer Service Division TX:T:I, Internal Revenue...

26 CFR 601.802 - Cooperative agreements.

Code of Federal Regulations, 2014 CFR

2014-04-01

... STATEMENT OF PROCEDURAL RULES Tax Counseling for the Elderly § 601.802 Cooperative agreements. (a) General. Tax Counseling for the Elderly programs will be administered by sponsor organizations under... agreements. If appropriations to implement the Tax Counseling for the Elderly program are received at a time...

26 CFR 601.802 - Cooperative agreements.

Code of Federal Regulations, 2013 CFR

2013-04-01

... STATEMENT OF PROCEDURAL RULES Tax Counseling for the Elderly § 601.802 Cooperative agreements. (a) General. Tax Counseling for the Elderly programs will be administered by sponsor organizations under... agreements. If appropriations to implement the Tax Counseling for the Elderly program are received at a time...

26 CFR 601.802 - Cooperative agreements.

Code of Federal Regulations, 2012 CFR

2012-04-01

... STATEMENT OF PROCEDURAL RULES Tax Counseling for the Elderly § 601.802 Cooperative agreements. (a) General. Tax Counseling for the Elderly programs will be administered by sponsor organizations under... agreements. If appropriations to implement the Tax Counseling for the Elderly program are received at a time...

26 CFR 601.802 - Cooperative agreements.

Code of Federal Regulations, 2010 CFR

2010-04-01

... STATEMENT OF PROCEDURAL RULES Tax Counseling for the Elderly § 601.802 Cooperative agreements. (a) General. Tax Counseling for the Elderly programs will be administered by sponsor organizations under... agreements. If appropriations to implement the Tax Counseling for the Elderly program are received at a time...

[Quality of life in institutionalized elderly people of Medellín].

PubMed

Estrada, Alejandro; Cardona, Doris; Segura, Angela María; Chavarriaga, Lina Marcela; Ordóñez, Jaime; Osorio, Jorge Julián

2011-01-01

Many factors contribute to the deteriorating quality of life of elderly people living in care institutions. Some of these problems are a consequence of few contacts with relatives and friends, and being alone with a feeling of isolation. The conditions of quality of life are explored for elderly people living in care institutions. In a cross sectional study, 276 subjects were selected from 39 long term institutions located in the city of Medellín, Colombia. The sex ratio was female: male 60:40% with a mean age of 79.2 ± 8.0. Elderly subjects with cognitive problems or not living in the institution were excluded. The World Health Organization Quality of Life of Older Adults (WHOQOL-OLD) questionnaire was applied; in additional, capacity and cognitive functional scales of Pfeffer, the anxiety scale of Goldberg, and the Geriatric Depression Scale of Yesavage were administered. Mininutritional assessment scales and complementary questionnaires about demographics, health perception, social support system were also included. The information was analyzed using the Mann Whitney U test, Kruskal Wallis test, Pearson correlation and multiple linear regression method. Most (71%) considered themselves autonomous for undertaking daily, habitual activities. Other statistics included the following: 45.7% with depression, 33.0% with anxiety, 28.3% with functional problems, and 54.3% at risk of malnutrition. A negative quality-of-life assessment was associated with the following factors: female, diabetes, depression, anxiety and high functional capacity. A positive quality-of-life assessment was associated with individuals who voluntarily came to the institution. Quality of life for elderly people living in care institutions can become deteriorated when they are not capable to do the usual activities necessary for daily living. Exacerbating factors included sex, symptoms of depression, anxiety, or perceived mistreatment by their families.

The Study of Smartphone Usage Competency Assessment and Training for the Elderly.

PubMed

Lu, Sheng-Chieh; Wen, Tzu-Ning; Chang, Po-Lun

2017-01-01

This study aimed at developing an assessment of smartphone usage competence and constructing a training program for the elderly. A list of smartphone usage competencies with 34 items was defined through expert survey and panel. Based on the competence and previous literature, a training program and learning aids were designed in this study. There were 41 participants in our program. The results of self-administrated smartphone usage ability questionnaire indicated that all competencies were significantly improved after training. However, the results also demonstrated that some items were still difficult for the elderly to comprehend. Overall, this study provided a first exploration of defining smartphone usage competency and built a training program for the elderly. With strong suggestion, future mobile health (mHealth) services can follow this study to insure the smartphone usage ability of the elderly.

Heroes of their own stories: expressions of aging in international cinema.

PubMed

Yahnke, Robert E

2005-01-01

This study of 14 international feature-length films (1988- 2003) is aimed at providing gerontologists with models of successful aging that portray elders as being valued within the context of community. Elders serve as role models and mentors for the young, and they resolve mid-life crises for the middle-aged. Elders complete their life's work in the context of community (aging in place), where they struggle to maintain abiding values and draws others to the community. The study concludes with examples of key visual metaphors utilized at the endings of selected films that affirm the role of elders as catalysts for change for the young, the middle-aged, and even their communities.

Organizational capacities for 'residential care homes for the elderly' to provide culturally appropriate end-of-life care for Chinese elders and their families.

PubMed

Kong, Sui-Ting; Fang, Christine Meng-Sang; Lou, Vivian Weiqun

2017-01-01

Developing culturally appropriate end-of-life care for Chinese elderly and families is not an endemic challenge for Hong Kong, but that of the Western countries with a noticeable trend of rising Chinese population. The particular development of Hong Kong healthcare system, which is currently the major provider of end-of-life care, makes Hong Kong a fruitful case for understanding the confluence of the West and the East cultures in end-of-life care practices. This study therefore aims at building our best practice to enhance the capacity of residential care homes in providing culturally appropriate end-of-life care. We conducted two phases of research, a questionnaire survey and a qualitative study, which respectively aims at (1) understanding the EoL care service demand and provision in RCHEs, including death facts and perceived barriers and challenges in providing quality end-of-life care in care homes, and (2) identifying the necessary organizational capacities for the 'relational personhood' to be sustained in the process of ageing and dying in residential care homes. Findings shed light on how to empower residential care homes with necessary environmental, structural and cultural-resource-related capacity for providing quality end-of-life care for Chinese elders and their families. Copyright © 2016 Elsevier Inc. All rights reserved.

Recommendations for Infant Feeding Policy and Programs in Dzimauli Region, South Africa: Results From the MAL-ED Birth Cohort.

PubMed

Mushaphi, Lindelani Fhumudzani; Mahopo, Tjale Cloupas; Nesamvuni, Cebisa Noxolo; Baloyi, Brenda; Mashau, Ellen; Richardson, Jeniata; Dillingham, Rebecca; Guerrant, Richard; Ambikapathi, Ramya; Bessong, Pascal

2017-09-01

There is strong evidence that exclusive breastfeeding (EBF) in the first 6 months of life reduces the risk of diseases in infancy and in later life. To understand the maternal reasoning that influences optimum infant feeding practices of caregivers in semirural communities of Limpopo province. Nested qualitative study among mothers in an ongoing birth cohort study was conducted; structured and semi-structured interviews were used to collect data. Data from 234 infants after 6 months of follow-up was included for quantitative analysis. Four focus discussion groups comprising 7 to 10 caregivers were used to obtain perception of mothers on breastfeeding. A semi-structured interview guide was used to stimulate discussions. Thematic content analyses were conducted to identify the main themes that influence breastfeeding practices of caregivers. Over 90% of the caregivers initiated breastfeeding after delivery. However, less than 1% of mothers practiced EBF by 3 months, and none of the children were exclusively breastfed for up to 6 months. All caregivers introduced non-breast milk liquids and solids by the second month of child's life. Common reasons for introducing non-breast milk foods included insufficiency of breast milk production, going back to work or school, and influence by elderly women (mothers/mothers-in-law) and church members. Exclusive breastfeeding was not practiced in this community due to cultural and religious beliefs and misinformation. The involvement of elderly women and church members in infant feeding education and promotion programs and the dissemination of breastfeeding information through mobile phones to younger mothers are recommended.

Team Performance and Risk-Adjusted Health Outcomes in the Program of All-Inclusive Care for the Elderly (PACE)

ERIC Educational Resources Information Center

Mukamel, Dana B.; Temkin-Greener, Helena; Delavan, Rachel; Peterson, Derick R.; Gross, Diane; Kunitz, Stephen; Williams, T. Franklin

2006-01-01

Purpose: The Program of All-Inclusive Care for the Elderly (PACE) is a community-based program providing primary, acute, and long-term care to frail elderly individuals. A central component of the PACE model is the interdisciplinary care team, which includes both professionals and non-professionals. The purpose of this study was to examine the…

The spiritual well-being of elderly people: a study of a French sample.

PubMed

Velasco-Gonzalez, Lucy; Rioux, Liliane

2014-08-01

The aim of our research was to identify predictors of the spiritual well-being of elderly people. More specifically, we postulated that subjective well-being and its components would be predictors of spiritual well-being, and more so than age and health status. We invited 133 people aged 60-95 to complete a questionnaire that included the French adaptation (Velasco and Rioux in Revue Canadienne des Sciences du Comportement 41(2):102-128, 2009) of Paloutzian and Ellison's (Loneliness: A sourcebook of current theory, research and therapy, Wiley-Interscience, New York, 1982) Spiritual Well-Being Scale, Ryff and Essex's (Psychol Aging 7:507-517, 1992) Psychological Well-Being Scale (translated by Lapierre and Desrochers 1997), Salamon and Conte's (Meas Eval Guid 15(3):194-200, 1982) Life Satisfaction in the Elderly Scale (validated by Rousseau and Dubé in 1993), and the French version (Blais et al. in Can J Behav Sci 21:210-223, 1989) of Diener et al. (J Pers Assess 49:71-75, 1985) Satisfaction with Life Scale. The results only partially confirm our hypothesis, because only satisfaction with life as a whole and two items in "Life Satisfaction in the Elderly Scale" make it possible to predict the spiritual well-being of elderly people. Moreover, neither health status nor age was found to be a significant predictor of spiritual well-being. This research helps understand better the links between the concept of spiritual well-being and that of subjective well-being of elderly people and could contribute to the development of a tool that could take into account the spiritual well-being of elderly people, whether they be believers, agnostic, or atheist.

End-of-Life Caregiver’s Perspectives on their Role: Generative Caregiving

PubMed Central

Phillips, Linda R.; Reed, Pamela G.

2010-01-01

Purpose: To describe caregivers’ constructions of their caregiving role in providing care to elders they knew were dying from life-limiting illnesses. Design and Methods: Study involved in-depth interviews with 27 family caregivers. Data were analyzed using constant comparative analysis. Results: Four categories were identified: centering life on the elder, maintaining a sense of normalcy, minimizing suffering, and gift giving. Generative caregiving was the term adopted to describe the end-of-life (EOL) caregiving role. Generative caregiving is situated in the present with a goal to enhance the elder’s present quality of life, but also draws from the past and projects into the future with a goal to create a legacy that honors the elder and the elder–caregiver relationship. Implications: Results contribute to our knowledge about EOL caregiving by providing an explanatory framework and setting the caregiving experience in the context of life-span development. PMID:19651667

[Correlation between quality of life and morbidity of the caregivers of elderly stroke patients].

PubMed

Santos, Nilce Maria de Freitas; Tavares, Darlene Mara Dos Santos

2012-08-01

The objective of this study was to describe the sociodemographic characteristics and the quality of life of the caregivers of elderly individuals with a stroke history, and correlate morbidity with the caregivers' quality of life scores. This is a cross-sectional household survey that interviewed the caregivers of elderly individuals using the following tools: a semi-structured instrument; the World Health Organization Quality of life-BREF; and the Brazilian Multidimensional Functional Assessment Questionnaire. Descriptive analysis and Pearson's correlation (p<0.05) were performed. Most participants were female (93.5%), with a mean age of 55.4±14.17 years, married or living with a partner (58.7%), with four to eight years of education (28.3%), and an income equivalent to one minimum wage salary (34.8%). The highest quality of life score was in the social relations domain (67.57) and the lowest was in the environmental domain (54.82). The highest number of caregiver morbidities correlated with the lowest scores in all quality of life domains.

"I am active": effects of a program to promote active aging.

PubMed

Mendoza-Ruvalcaba, Neyda Ma; Arias-Merino, Elva Dolores

2015-01-01

Active aging involves a general lifestyle strategy that allows preservation of both physical and mental health during the aging process. "I am Active" is a program designed to promote active aging by increased physical activity, healthy nutritional habits, and cognitive functioning. The purpose of this study was to assess the effectiveness of this program. Sixty-four healthy adults aged 60 years or older were recruited from senior centers and randomly allocated to an experimental group (n=31) or a control group (n=33). Baseline, post-test, and 6-month follow-up assessments were performed after the theoretical-practical intervention. Effect sizes were calculated. At the conclusion of the program, the experimental group showed significant improvement compared with the control group in the following domains: physical activity (falls risk, balance, flexibility, self-efficacy), nutrition (self-efficacy and nutritional status), cognitive performance (processing speed and self-efficacy), and quality of life (general, health and functionality, social and economic status). Although some declines were reported, improvements at follow-up remained in self-efficacy for physical activity, self-efficacy for nutrition, and processing speed, and participants had better nutritional status and quality of life overall. Our findings show that this program promotes improvements in domains of active aging, mainly in self-efficacy beliefs as well as in quality of life in healthy elders.

24 CFR 880.205 - Limitation on distributions.

Code of Federal Regulations, 2011 CFR

2011-04-01

... PROGRAM, SECTION 202 SUPPORTIVE HOUSING FOR THE ELDERLY PROGRAM AND SECTION 811 SUPPORTIVE HOUSING FOR... returns: (1) For projects for elderly families, the first year's distribution will be limited to 6 percent... in the Federal Register. (2) For projects for non-elderly families, the first year's distribution...

24 CFR 881.205 - Limitation on distributions.

Code of Federal Regulations, 2010 CFR

2010-04-01

... PROGRAM, SECTION 202 SUPPORTIVE HOUSING FOR THE ELDERLY PROGRAM AND SECTION 811 SUPPORTIVE HOUSING FOR... following maximum returns: (1) For projects for elderly families, the first year's distribution will be... be made by Notice in the Federal Register. (2) For projects for non-elderly families, the first year...

24 CFR 881.205 - Limitation on distributions.

Code of Federal Regulations, 2011 CFR

2011-04-01

... PROGRAM, SECTION 202 SUPPORTIVE HOUSING FOR THE ELDERLY PROGRAM AND SECTION 811 SUPPORTIVE HOUSING FOR... following maximum returns: (1) For projects for elderly families, the first year's distribution will be... be made by Notice in the Federal Register. (2) For projects for non-elderly families, the first year...

24 CFR 880.205 - Limitation on distributions.

Code of Federal Regulations, 2010 CFR

2010-04-01

... PROGRAM, SECTION 202 SUPPORTIVE HOUSING FOR THE ELDERLY PROGRAM AND SECTION 811 SUPPORTIVE HOUSING FOR... returns: (1) For projects for elderly families, the first year's distribution will be limited to 6 percent... in the Federal Register. (2) For projects for non-elderly families, the first year's distribution...

24 CFR 883.306 - Limitation on distributions.

Code of Federal Regulations, 2011 CFR

2011-04-01

... PROGRAM, SECTION 202 SUPPORTIVE HOUSING FOR THE ELDERLY PROGRAM AND SECTION 811 SUPPORTIVE HOUSING FOR... projects for elderly families, the first year's distribution will be limited to 6 percent on equity. The... increase in subsequent years' distributions. (2) For projects for non-elderly families the first year's...

24 CFR 883.306 - Limitation on distributions.

Code of Federal Regulations, 2010 CFR

2010-04-01

... PROGRAM, SECTION 202 SUPPORTIVE HOUSING FOR THE ELDERLY PROGRAM AND SECTION 811 SUPPORTIVE HOUSING FOR... projects for elderly families, the first year's distribution will be limited to 6 percent on equity. The... increase in subsequent years' distributions. (2) For projects for non-elderly families the first year's...

Religiosity, Social Support, and Life Satisfaction among Elderly Korean Immigrants

ERIC Educational Resources Information Center

Park, Jisung; Roh, Soonhee; Yeo, Younsook

2012-01-01

Purpose: The present study tested Smith's (2003. Theorizing religious effects among American adolescents. "Journal for the Scientific Study of Religion, 42", 17-30. doi:10.1111/1468-5906.t01-1-00158) theory of religious effects to explore the relationship of religiosity, social support, and life satisfaction among elderly Korean…

Older Latinos' Attitudes toward and Comfort with End-of-Life Planning

ERIC Educational Resources Information Center

Heyman, Janna C.; Gutheil, Irene A.

2010-01-01

The purpose of this study was to determine which of two educational interventions delivered in Spanish would influence Latino elders' attitudes toward and comfort with end-of-life planning in comparison with a control group receiving only standard information routinely provided. Using a posttest-only control group design, elders receiving home…

The Subjective Well-Being of Immigrants Aged 50 and Older in Israel

ERIC Educational Resources Information Center

Amit, Karin; Litwin, Howard

2010-01-01

The present study evaluated the integration of elderly people who migrated to Israel during their lifetimes. Subjective well-being, as measured by the immigrants' perception of quality of life, satisfaction with life and emotional state, served as a general indicator of integration. The integration of elderly immigrants has not received adequate…

Independent Living Functions for the Elderly (IN-LIFE): Supporting Communication in Dementia.

PubMed

Smith, Sarah K; Astell, Arlene J

2017-01-01

Independent Living Functions for the Elderly (IN-LIFE) is a 3 year multidisciplinary, multisite European project that aims to prolong and support independent living for people with cognitive impairments, through (ICT) services. Sheffield is one of six research sites and is focused on enhancing communication and conversations using touch screen computers.

Educating the Isolated Ageing: Improving the Quality of Life of the Housebound Elderly through Educational Teleconferencing.

ERIC Educational Resources Information Center

Swindell, Richard; Mayhew, Claire

1996-01-01

Eighteen homebound frail elderly took part in an eight-week teleconference that provided practical information (nutrition, health, social services) as well as stimulated thinking. Quality of life improvements and further interest in education resulted. Teleconferencing proved a cost-effective method of reaching homebound persons. (SK)

Yoga respiratory training improves respiratory function and cardiac sympathovagal balance in elderly subjects: a randomised controlled trial

PubMed Central

Santaella, Danilo F; Devesa, Cesar R S; Rojo, Marcos R; Amato, Marcelo B P; Drager, Luciano F; Casali, Karina R; Montano, Nicola

2011-01-01

Objectives Since ageing is associated with a decline in pulmonary function, heart rate variability and spontaneous baroreflex, and recent studies suggest that yoga respiratory exercises may improve respiratory and cardiovascular function, we hypothesised that yoga respiratory training may improve respiratory function and cardiac autonomic modulation in healthy elderly subjects. Design 76 healthy elderly subjects were enrolled in a randomised control trial in Brazil and 29 completed the study (age 68±6 years, 34% males, body mass index 25±3 kg/m2). Subjects were randomised into a 4-month training program (2 classes/week plus home exercises) of either stretching (control, n=14) or respiratory exercises (yoga, n=15). Yoga respiratory exercises (Bhastrika) consisted of rapid forced expirations followed by inspiration through the right nostril, inspiratory apnoea with generation of intrathoracic negative pressure, and expiration through the left nostril. Pulmonary function, maximum expiratory and inspiratory pressures (PEmax and PImax, respectively), heart rate variability and blood pressure variability for spontaneous baroreflex determination were determined at baseline and after 4 months. Results Subjects in both groups had similar demographic parameters. Physiological variables did not change after 4 months in the control group. However, in the yoga group, there were significant increases in PEmax (34%, p<0.0001) and PImax (26%, p<0.0001) and a significant decrease in the low frequency component (a marker of cardiac sympathetic modulation) and low frequency/high frequency ratio (marker of sympathovagal balance) of heart rate variability (40%, p<0.001). Spontaneous baroreflex did not change, and quality of life only marginally increased in the yoga group. Conclusion Respiratory yoga training may be beneficial for the elderly healthy population by improving respiratory function and sympathovagal balance. Trial Registration CinicalTrials.gov identifier: NCT00969345; trial registry name: Effects of respiratory yoga training (Bhastrika) on heart rate variability and baroreflex, and quality of life of healthy elderly subjects. PMID:22021757

Body mass index, life-style, and healthy status in free living elderly people in Menorca Island.

PubMed

Ferra, A; Bibiloni, M Del Mar; Zapata, M E; Pich, J; Pons, A; Tur, J A

2012-04-01

To assess the BMI, life-style, and healthy status, and explore relationships between these parameters, among Menorca's free living elderly people. A cross-sectional survey carried out in Menorca Island in 2009. A random sample (n=450) of the elderly population (≥65 years) was interviewed. Anthropometric measurements and a general questionnaire incorporating questions related to socio-demographic and life-style factors and health status were used. Approximately five per cent of elders were underweight and 60% overweight or obese. Underweight were positively and overweight and obesity negatively affected by age. The prevalence of central obesity, according to the WC cut-off points, was 66.8% in men and 85.1% in women. Low education, socioeconomic status and physical activity were risk factors for malnutrition and overweight/obesity. A possible cognitive impairment was found among elderly persons with BMI<22 kg/m2. A J-shaped association between BMI and hypertension, hypercholesterolemia, heart failure and other CV diseases, a U-shaped relation between BMI and diabetes mellitus, arthritis, and chronic bronchitis, and an inverted J-shape between BMI and gastric ulcer, osteoporosis and bone fractures, cancer, and prostatitis (in men) were found. Both low and high BMI are associated with a wide range of prevalent conditions and diseases in Menorca elderly men and women.

Discussion of Late-Life Suicide: How Social Workers Perceive and Intervene in Elderly Suicide

ERIC Educational Resources Information Center

Kim, Yujin

2013-01-01

As the prevalence of suicide among the elderly has developed in recent years into one of the more serious social problems in South Korea, preventing these elderly suicides has emerged as a national priority. Korean social workers play a major role in the recent elderly suicide prevention efforts that were implemented starting in 2007. The purpose…

Influence of social support on cognitive function in the elderly.

PubMed

Yeh, Shu-Chuan Jennifer; Liu, Yea-Ying

2003-05-30

Social support is important in daily activities of the elderly. This study tests the hypothesis that there is an association between social support and cognitive function among the elderly in a community setting. Face-to-face interviews were conducted in a cross-sectional stratified random sample of 4,993 elderly (> or =65 years) city residents. Using multiple regression analysis, we investigated the influence of social support on cognitive function. 12% were over 80 years old. 53.28% were men. 67.14% were married. Higher Short Portable Mental Status Questionnaire (SPMSQ) scores (higher score means better cognitive function) were associated with strong social support, as measured by marital status and perceived positive support from friends. Lower cognitive function was associated with older and with female respondents. Only instrumental activities of daily living (IADL) were statistically and negatively related to SPMSQ. Lower functional status was associated with lower cognitive function. Elders with grade school educations had lower SPMSQ scores than did elders with high school educations. In Taiwan, higher cognitive function in community-living elderly was associated with increased social support. Life-style management should provide social activities for the elderly to promote a better quality of life.

Food For Elderly -Space Benefits

NASA Image and Video Library

2009-10-08

View of men packaging special food for the elderly, a spinoff program from the space program under auspices of Technology Utilization Program. Men and food are in the Bldg.37, where food has been stowed.

Food For Elderly -Space Benefits

NASA Image and Video Library

2009-10-08

View of men packaging special food for the elderly, a spinoff program from the space program under auspices of Technology Utilization Program. Men and food are in the Bldg.37, where food has been stowed

42 CFR 460.168 - Reinstatement in other Medicare and Medicaid programs.

Code of Federal Regulations, 2011 CFR

2011-10-01

... HEALTH AND HUMAN SERVICES (CONTINUED) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) Participant Enrollment and Disenrollment § 460.168...

42 CFR 460.50 - Termination of PACE program agreement.

Code of Federal Regulations, 2011 CFR

2011-10-01

... SERVICES (CONTINUED) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) Sanctions, Enforcement Actions, and Termination § 460.50 Termination of PACE...

42 CFR 460.168 - Reinstatement in other Medicare and Medicaid programs.

Code of Federal Regulations, 2010 CFR

2010-10-01

... HEALTH AND HUMAN SERVICES (CONTINUED) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) Participant Enrollment and Disenrollment § 460.168...

42 CFR 460.50 - Termination of PACE program agreement.

Code of Federal Regulations, 2010 CFR

2010-10-01

... SERVICES (CONTINUED) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) Sanctions, Enforcement Actions, and Termination § 460.50 Termination of PACE...

State tax incentives for persons giving informal care to the elderly

PubMed Central

Hendrickson, Michael C.

1988-01-01

Programs for informal caregivers of frail elderly can be adopted by States to address some of the problems associated with an expanding and costly long-term care system. In this article, highlights are given from a 3-year study of Idaho and Arizona tax incentive programs. Characteristics of informal caregivers and elderly participants are described, and elderly participants are compared with elderly nonparticipants and with the general elderly population. Tax incentives were positively related to the level of service and financial support provided by informal caregivers. Data were inadequate to determine whether the induced informal help substituted for public expenditures. PMID:10312965

Uncertainty, the Overbearing Lived Experience of the Elderly People Undergoing Hemodialysis: A Qualitative Study

PubMed Central

Sahaf, Robab; Sadat Ilali, Ehteram; Peyrovi, Hamid; Akbari Kamrani, Ahmad Ali; Spahbodi, Fatemeh

2017-01-01

ABSTRACT Background: The chronic kidney disease is a major health concern. The number of the elderly people with chronic renal failure has increased across the world. Dialysis is an appropriate therapy for the elderly, but it involves certain challenges. The present paper reports uncertainty as part of the elderly experiences of living with hemodialysis. Methods: This qualitative study applied Max van Manen interpretative phenomenological analysis to explain and explore experiences of the elderly with hemodialysis. Given the study inclusion criteria, data were collected using in-depth unstructured interviews with nine elderly undergoing hemodialysis, and then analyzed according to Van Manen 6-stage methodological approach. Results: One of the most important findings emerging in the main study was “uncertainty”, which can be important and noteworthy, given other aspects of the elderly life (loneliness, despair, comorbidity of diseases, disability, and mental and psychosocial problems). Uncertainty about the future is the most psychological concerns of people undergoing hemodialysis. Conclusion: The results obtained are indicative of the importance of paying attention to a major aspect in the life of the elderly undergoing hemodialysis, uncertainty. A positive outlook can be created in the elderly through education and increased knowledge about the disease, treatment and complications. PMID:28097174

Elderly Individuals with Diabetes: Adding Cognitive Training to Psychoeducational Intervention

ERIC Educational Resources Information Center

Vianna Paulo, Debora Lee; Sanches Yassuda, Monica

2012-01-01

The present research examined the effects of a cognitive training program combined with psychoeducational intervention for diabetic elderly patients. Specifically, it aimed at assessing the effects of an eight-session cognitive training and educational program in diabetic elderly individuals and investigating changes in their awareness about…

42 CFR 460.64 - Personnel qualifications for staff with direct participant contact.

Code of Federal Regulations, 2010 CFR

2010-10-01

... OF HEALTH AND HUMAN SERVICES (CONTINUED) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PACE Administrative Requirements § 460.64 Personnel... frail or elderly population; (4) Meet a standardized set of competencies for the specific position...

42 CFR 460.64 - Personnel qualifications for staff with direct participant contact.

Code of Federal Regulations, 2011 CFR

2011-10-01

... OF HEALTH AND HUMAN SERVICES (CONTINUED) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PACE Administrative Requirements § 460.64 Personnel... frail or elderly population; (4) Meet a standardized set of competencies for the specific position...

75 FR 24963 - Notice of Proposed Information Collection for Public Comment: 202 Demonstration Planning Grant...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-06

... subcontractor, VIVA Consulting LLC, a study of the Section 202 Supportive Housing for the Elderly Demonstration Planning Grant Program. The Section 202 Supportive Housing for the Elderly program provides capital advances and operating funds to nonprofit organizations (``sponsors'') to develop affordable elderly...

Service Learning for Medical Students: Program Development and Students' Reflections

ERIC Educational Resources Information Center

Yang, Shu-Huei; Shih, Chun-Kuang; Liu, Chu-Hsiu; Peng, Hsiang-Ting; Chan, Wing P.

2014-01-01

We designed a cross-disciplinary interdepartmental volunteer program, which involved student participation in "community care teams for the elderly living alone." Our aim was to enhance communication between students and the elderly. Students were expected to meet and learn to get along with the elderly, to develop listening and…

Are elder siblings helpers or competitors? Antagonistic fitness effects of sibling interactions in humans

PubMed Central

Nitsch, Aïda; Faurie, Charlotte; Lummaa, Virpi

2013-01-01

Determining the fitness consequences of sibling interactions is pivotal for understanding the evolution of family living, but studies investigating them across lifetime are lacking. We used a large demographic dataset on preindustrial humans from Finland to study the effect of elder siblings on key life-history traits. The presence of elder siblings improved the chances of younger siblings surviving to sexual maturity, suggesting that despite a competition for parental resources, they may help rearing their younger siblings. After reaching sexual maturity however, same-sex elder siblings' presence was associated with reduced reproductive success in the focal individual, indicating the existence of competition among same-sex siblings. Overall, lifetime fitness was reduced by same-sex elder siblings' presence and increased by opposite-sex elder siblings' presence. Our study shows opposite effects of sibling interactions depending on the life-history stage, and highlights the need for using long-term fitness measures to understand the selection pressures acting on sibling interactions. PMID:23173210

Oral health and quality of life in the municipal senior citizen´s social clubs for people over 65 of Valencia, Spain

PubMed Central

Haya-Fernández, María-Celia; Sanz-García, María-Teresa

2016-01-01

Background The world population is aging considerably. The state of elderly´s dentition is poor. Many authors agree that the oral health status influence the elderly´s quality of life.The objective of our study was to analyze the relation between the oral health status and the general health status through the quality of life of elderly people aged 65 years or more in Valencia, Spain. Material and Methods A cross-sectional oral health survey and an oral examination have been designed to study an elderly population. Subjects: 202 adults (103 men and 99 women). Age: 65 years of age and over. Setting: Randomly selected senior citizen´s social clubs. The Oral Health Impact Profile (OHIP-14) has been used to obtain the oral health survey. Moreover, the EuroQol-5d and a Visual Analogue Scale (VAS) have been the tools to obtain the general health status. Finally, sociodemographic and oral health questions have been needed. Results Descriptive and inferential results have been done and the main results are the following, the mean additive score of the OHIP-14 was 8.88, the mean value of the EuroQol-5d was 0.58 and of the VAS, 72.90. The OHIP-14 was consistently and significantly correlated with the index EuroQol-5d and with variables such as number of teeth, missing teeth, DMFT, dental status (being or not edentulous) and occupation. The EuroQol-5d was related to dental habits, sex, income, systemic pathologies and filled teeth. Conclusions The oral health has a high impact on quality of life. The oral health and the general health are closely related. The oral hygiene and getting toothless influence negatively on the quality of life of elderly people. Key words:Elderly, geriatric dentistry, oral health, oral hygiene, quality of life. PMID:27694787

[Prevalence of obstructive sleep apnea-hypopnea syndrome in adults aged over 60 yeaes in dongying city].

PubMed

Su, Yi; Xu, Weiwei; Wang, Xiangyun; Zhang, Zhili; Cao, Yingchun; Yu, Qiuhong; Li, Jiandong

2016-02-01

To survey the prevalence of obstructive sleep apnea-hypopnea syndrome(OSAHS) in adults aged over 60 years in Dongying city,and analyze the risk factors and the extent of damage to the quality of life for the elderly to provide the basis for prevention and treatment of OSAHS people. One thousand subjects were derived from a random cluster sampling in seven districts of Dongying city:they were asked to answer the questions from questionnaires. According to the questionnaire scoring, 100 subjects in high-risk group were selected randomly to make polysomnography monitoring for a whole night,so that the prevalence of the disease was calculated and the related risk factors were analyzed; elderly patients diagnosed with OSAHS were asked to assess the quality of life assessment questionnaire by face to face to understand the quality of life dimensions injury. The actual number of completed surveys was 934, and the efficiency was 93.4%. The estimated prevalence of OSARS in elder people defined by apnea-hypopnea index (AHI ≥ 5) was 32.5%; Multivariate analysis revealed that age smoking, family snoring,neck circumference, waist circumference, and abnormality of the upper airway were respectively independent risk factors of OSAHS,and the abnormalities of the upper airway had the most obvious impact on AHI. The damage caused by OSAHS to the quality of life for elderly people followed their daily work life, social relationships, symptoms, alertness, emotional, general health, symptoms. The estimated prevalences of OSAHS in elder people were high. Actively promoting good habits to older people, weight loss, early detection and correct upper airway abnormalities may reduce the estimated prevalence of OSAHS. In the treatment process, the patient's physician should pay attention to their emotional and groom their psychological problems to improve the quality of life in elder people.

Cumulative Advantage, Cumulative Disadvantage, and Evolving Patterns of Late-Life Inequality.

PubMed

Crystal, Stephen; Shea, Dennis G; Reyes, Adriana M

2017-10-01

Earlier studies have identified a pattern of cumulative advantage leading to increased within-cohort economic inequality over the life course, but there is a need to better understand how levels of inequality by age have changed in the evolving economic environment of recent decades. We utilized Survey of Income and Program Participation (SIPP) data to compare economic inequality across age groups for 2010 versus 1983-1984. We examined changing age profiles of inequality using a summary measure of economic resources taking into account income, annuitized value of wealth, and household size. We adjusted for survey underreporting of some income and asset types, based on National Income Accounts and other independent estimates of national aggregates. We examined inequality by age with Gini coefficients. Late-life (65+) inequality increased between the 2 periods, with Gini coefficients remaining higher than during the working years, but with a less steep age difference in inequality in 2010 than in 1983-1984. Inequality increased sharply within each cohort, particularly steeply in Depression-era, war-baby, and leading-edge baby boom cohorts. The top quintile of elderly received increasing shares of most income sources. Increasing inequality among older people, and especially in cohorts approaching late life, presages upcoming financial challenges for elderly persons in the lower part of the income distribution. Implications of this increasingly high-inequality late-life environment need to be carefully evaluated as changes are considered in Social Security and other safety-net institutions, which moderate impacts of economic forces that drive increasingly disparate late-life economic outcomes. Published by Oxford University Press on behalf of the Gerontological Society of America 2016.

Effectiveness of Vocal Therapy for the Elderly When Applying Conventional and Intensive Approaches: A Randomized Clinical Trial.

PubMed

Godoy, Juliana; Silverio, Kelly; Brasolotto, Alcione

2018-05-21

The aim of this study was to verify the effects of the method Vocal Therapy for the Elderly and the differences in treatment efficacy when it was administered intensively or in the conventional way. Twenty-seven elderly individuals were randomized into two groups and referred for 16 sessions of vocal therapy. The Intensive Group (IG) had therapy four times a week, whereas the Conventional Group had it twice a week. The effects of the therapy were assessed by auditory-perceptual analysis, the Voice-Related Quality of Life protocol, and visual-perceptive analysis of laryngoscopy examinations. The first stage consisted of evaluating the vocal quality and self-assessment of 15 subjects before and after a time period equal to that which they would undergo in vocal therapy. The second stage consisted of comparing the assessments of all participants in the week preceding the beginning of treatment, in the week following the end of treatment, and 1 month after that. There was no difference between perceptual voice parameters and self-assessment when the subjects were not undergoing therapy. When comparing the periods immediately before and after therapy, there was improvement in vocal quality and Voice-Related Quality of Life. One month later, the benefits that had been revealed through the self-assessment protocol, and some of the improvements in vocal parameters were maintained. There was no difference between the IG and Conventional Group with the exception of vocal fold bowing, which decreased in the IG group. The Vocal Therapy for the Elderly program is effective for treating voice presbyphonia. An intensive approach may be superior with regard to vocal fold bowing. Copyright © 2018 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Proportion and factors associated with depressive symptoms among elderly in an urban slum in Bangalore.

PubMed

Thirthahalli, Chethana; Suryanarayana, S P; Sukumar, Gautham Melur; Bharath, Srikala; Rao, Girish N; Murthy, Nandagudi Srinivasa

2014-12-01

Depression among elderly is emerging as an important public health issue in developing countries like India. Published evidence regarding the magnitude and determinants of depression among elderly hailing from urban slum is currently limited. Hence, the current study was conducted to assess magnitude of the problem and identify factors associated with depression among the elderly in an urban slum. A cross-sectional study was done to cover total of 473 elderly persons from an urban slum in Bangalore, India. They were assessed for depression using Center for Epidemiologic Studies Depression scale. The overall prevalence of depression was found to be 37.8 (95% CI = 33.43-42.16). Multivariate analysis revealed that unemployment (self or children) (odds ratio (OR) 2.6; 95% confidence interval (CI) 1.41-4.72), illness of self (OR 2.2; 95% CI 1.45-3.21), female gender (OR 1.9; 95% CI 1.19-2.89), conflicts in family (OR 1.6; 95% CI 1.03-2.43), and marriage of children or grandchildren (OR 1.6; 95% CI 1.02-2.68) as independent risk factors. Depression among elderly is an important health issue of this area. Psychological intervention need to be provided for all elderly persons especially at the time of being diagnosed with any kind of illness. Strategies should be targeted to the females. The stressful life events need to be identified and remedial actions taken. This facility should be made available to them at the primary level of health care. There is a need to include screening of depression in our national health programs.

Strategies to facilitate implementation and sustainability of large system transformations: a case study of a national program for improving quality of care for elderly people.

PubMed

Nyström, Monica Elisabeth; Strehlenert, Helena; Hansson, Johan; Hasson, Henna

2014-09-18

Large-scale change initiatives stimulating change in several organizational systems in the health and social care sector are challenging both to lead and evaluate. There is a lack of systematic research that can enrich our understanding of strategies to facilitate large system transformations in this sector. The purpose of this study was to examine the characteristics of core activities and strategies to facilitate implementation and change of a national program aimed at improving life for the most ill elderly people in Sweden. The program outcomes were also addressed to assess the impact of these strategies. A longitudinal case study design with multiple data collection methods was applied. Archival data (n = 795), interviews with key stakeholders (n = 11) and non-participant observations (n = 23) were analysed using content analysis. Outcome data was obtained from national quality registries. This study presents an approach for implementing a large national change program that is characterized by initial flexibility and dynamism regarding content and facilitation strategies and a growing complexity over time requiring more structure and coordination. The description of activities and strategies show that the program management team engaged a variety of stakeholders and actor groups and accordingly used a palate of different strategies. The main strategies used to influence change in the target organisations were to use regional improvement coaches, regional strategic management teams, national quality registries, financial incentives and annually revised agreements. Interactive learning sessions, intense communication, monitor and measurements, and active involvement of different experts and stakeholders, including elderly people, complemented these strategies. Program outcomes showed steady progress in most of the five target areas, less so for the target of achieving coordinated care. There is no blue-print on how to approach the challenging task of leading large scale change programs in complex contexts, but our conclusion is that more attention has to be given to the multidimensional strategies that program management need to consider. This multidimensionality comprises different strategies depending on types of actors, system levels, contextual factors, program progress over time, program content, types of learning and change processes, and the conditions for sustainability.

Marketing and design of residential energy conservation programs for the elderly

DOE Office of Scientific and Technical Information (OSTI.GOV)

Berry, L.; Schweitzer, M.; Freeman, E.

1988-02-01

This report describes barriers to energy conservation by the elderly. Because of these barriers, they have a greater need for programs that assist with the installation of energy-efficiency improvements. In response to this need, a number of specialized programs are operated for the elderly. This report contains descriptions of 39 energy conservation programs for the elderly. Telephone interviews were conducted with the managers of these programs to identify marketing techniques and organizational structures. Interagency networking, presentations and referrals are the most common methods of recruiting clients. Other marketing techniques in order of the frequency of use are: direct mail, billmore » inserts, television, radio, printed materials, and telemarketing. Many managers consider word-of-mouth advertising from satisfied clients the most effective form of marketing. Interagency networking and support (financial, structural and in-kind) can offer real advantages in the operation of conservation programs for the elderly. The use of specific marketing techniques is probably less important to success in recruiting clients than the degree of trust potential clients have in the sponsoring organization(s). 4 figs., 10 tabs.« less

24 CFR 888.315 - Restrictions on retroactive payments.

Code of Federal Regulations, 2010 CFR

2010-04-01

... PROGRAM, SECTION 202 SUPPORTIVE HOUSING FOR THE ELDERLY PROGRAM AND SECTION 811 SUPPORTIVE HOUSING FOR PERSONS WITH DISABILITIES PROGRAM) SECTION 8 HOUSING ASSISTANCE PAYMENTS PROGRAM-FAIR MARKET RENTS AND... Elderly or Handicapped, and Special Allocations Projects § 888.315 Restrictions on retroactive payments...

42 CFR 460.150 - Eligibility to enroll in a PACE program.

Code of Federal Regulations, 2011 CFR

2011-10-01

... SERVICES (CONTINUED) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) Participant Enrollment and Disenrollment § 460.150 Eligibility to enroll in a...

42 CFR 460.150 - Eligibility to enroll in a PACE program.

Code of Federal Regulations, 2010 CFR

2010-10-01

... SERVICES (CONTINUED) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) Participant Enrollment and Disenrollment § 460.150 Eligibility to enroll in a...

The value of public transportation for improving the quality of life for the rural elderly.

DOT National Transportation Integrated Search

2012-07-01

Transportation for the rural elderly is an increasing concern as baby boomers age and young people continue to exit rural communities. As the elderly are no longer able to drive themselves, they rely on alternate forms of transportation, including pu...

Tackling the Challenge of the Aging Society: Detecting and Preventing Cognitive and Physical Decline through Games and Consumer Technologies

PubMed Central

An, Ji-Young; Heshmati, Almas

2017-01-01

Objectives This study seeks to review some of the approaches employed to address health and well-being issues in the elderly population. Methods This article reviews and analyses a range of projects and approaches designed for the elderly population and aimed at preserving and/or enhancing physical and cognitive capabilities in later life. Results Various intervention measures have been developed across the globe to preserve and/or enhance physical and cognitive capabilities of the elderly population. A selection of these measures is described in this article. Conclusions Approaches which combine games psychology and mechanics with enabling technologies designed to engage, influence and motivate elderly people can encourage healthy active aging lifestyles. Healthy active aging helps to realise a double dividend of reduced healthcare costs and an improved quality of life for the elder citizen. PMID:28523206

Who Says There Is No Life after Abandonment? A Grounded Theory on the Coping of Abandoned Filipino Elderly in Nursing Homes

ERIC Educational Resources Information Center

de Guzman, Allan B.; Lacorte, Jeremy C.; Lacsamana, Andrea Keith G.; Lagac, Mark Lawrence M.; Laguador, Jobel M.; Lapid, Jazminn Jessica R.; Lee, Lyndcie Miriele C.

2012-01-01

Cases of abandoned elderly are increasing worldwide. By and large, this group struggles with the sudden change in living arrangement as well as abandonment by their families. Consequently, many elderly are forced into living in nursing homes for the remainder of their lives. Abandonment among these elderly negatively affects how they view…

Evaluation of Walkers for Elderly People

DTIC Science & Technology

2001-10-25

speed, acceleration, electromyogram I. INTRODUCTION Walking is a basic everyday activity. In an aging society, elderly people need to walk to promote...their health and independence. By retaining ambulatory independence, elderly people increase their quality of life and reduce the costs of both...II. METHODOLOGY Six elderly people aged between 70 and 91 years (average 82±7.9 years) participated in the study. Before the experiment, written

[Motivational orientation and depressive symptoms in the elderly].

PubMed

Altintas, E; Guerrien, A

2009-04-01

This article is focused on motivation and depression in later life. For about 20 years, research on the motivation of elders has underlined the importance of the cognitive evaluation of life contexts, notably in terms of self-determination. This cognitive evaluation determines the motivational orientation for daily activities (notably the levels of intrinsic and extrinsic motivation). The purpose of this research was specifically to study the relationships between the existence of four types of motivation (intrinsic, self-determined extrinsic, nonself-determined extrinsic and amotivation) and the consequences for adaptation and well-being. The study, therefore, focused on the possible links between motivation and geriatric-depression level and explored the nature of this link. Forty persons aged 60 or over (31 women: 80.48+/-9.24; nine men: 80.56+/-9.48) who live in nursing homes (20 elderly) or in their own homes (20 elderly) were enrolled. Elderly persons were assessed with specific and standardized tools: the Elderly Motivation Scale (EMS, in the French version: EMPA) and the Geriatric Depression Scale (GDS). For the statistical analyses of the results, correlations and Mann-Whitney test were used. We found that in elderly people, the motivational styles (the four types of motivation) can be reliably measured and are related to geriatric depression. First, significant positive links were noticed between intrinsic motivation and depression scores and between self-determined extrinsic motivation and depression scores. Conversely, significant negative links were noticed between nonself-determined extrinsic motivation and depression scores and between amotivation and depression scores. The most self-determined elders presented low-depression levels, whereas the more nonself-determined elders showed high-depression levels. Moreover, motivational styles significantly differed in the two groups (depressive or not depressive). The most depressive elders showed significantly lower-intrinsic and self-determined motivation levels. Our results support the hypothesis that motivational styles are related to important aspects (adaptation, well-being and depression) of the life of elderly people. Self-determination theory appears of high interest in research on aging and especially on the determinants of well-being in the elders.

Trajectory of Life Satisfaction and Its Relationship with Subjective Economic Status and Successful Aging

ERIC Educational Resources Information Center

Hsu, Hui-Chuan

2010-01-01

The aim of the study was to explore the relationship between subjective economic status and indicators of successful aging to life satisfaction trajectories among the elderly in Taiwan. Data were from the four waves of "Survey of Health and Living Status of the Elderly in Taiwan". Hierarchical linear modeling was conducted. Subjective…

Similarities and Contrasts in Quality of Child and Sibling Relationships with Elderly.

ERIC Educational Resources Information Center

Cicirelli, Victor G.

Relationships with family members have been shown to be important in old age, both with adult children and with elderly siblings. Through shared memories such relationships may help with the life review (a process in which there is a detailed reconsideration and evaluation of personal experiences throughout life). To compare the differences in…

24 CFR 888.320 - One-time Contract Rent determination.

Code of Federal Regulations, 2010 CFR

2010-04-01

... PROGRAM, SECTION 202 SUPPORTIVE HOUSING FOR THE ELDERLY PROGRAM AND SECTION 811 SUPPORTIVE HOUSING FOR PERSONS WITH DISABILITIES PROGRAM) SECTION 8 HOUSING ASSISTANCE PAYMENTS PROGRAM-FAIR MARKET RENTS AND... Elderly or Handicapped, and Special Allocations Projects § 888.320 One-time Contract Rent determination...

42 CFR 460.24 - Limit on number of PACE program agreements.

Code of Federal Regulations, 2011 CFR

2011-10-01

... SERVICES (CONTINUED) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PACE Organization Application and Waiver Process § 460.24 Limit on number of...

42 CFR 460.24 - Limit on number of PACE program agreements.

Code of Federal Regulations, 2010 CFR

2010-10-01

... SERVICES (CONTINUED) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PACE Organization Application and Waiver Process § 460.24 Limit on number of...

77 FR 20695 - Tax Counseling for the Elderly (TCE) Program Availability of Application Packages

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-05

... DEPARTMENT OF THE TREASURY Internal Revenue Service Tax Counseling for the Elderly (TCE) Program...: This document provides notice of the availability of Application Packages for the 2013 Tax Counseling... . The deadline for submitting an application package to the IRS for the Tax Counseling for the Elderly...

Testing reliability and validity of oral impacts on daily performances for Chinese-speaking elderly Singaporeans.

PubMed

Nair, Rahul; Tsakos, Georgios; Yee Ting Fai, Robert

2016-12-01

To cross-culturally adapt the oral impacts on daily performance (OIDP) and assess its reliability and validity on Chinese-speaking community dwelling elderly Singaporeans. There are no previous reports of valid oral health-related quality of life instruments for elderly Singaporeans or perceived conditions associated with impacts reported in OIDP among the Singaporean elders. The OIDP was translated from English to Chinese and then back translated. The OIDP questionnaire along with questions related to overall quality of life and self-rated dental health was administered to 202 Chinese-speaking elderly Singaporeans by trained interviewers, and it was repeated after 1 month. Test-retest reliability was assessed using intraclass correlation coefficient; internal consistency was established using Cronbach's alpha, and construct validity using correlation coefficients with self-reported oral health-related and global quality of life measures. In addition, Kruskal-Wallis tests assessed differences in the OIDP score between different subjective health and global quality of life groups. The median age of participants was 75 years. About 19% reported oral impacts and difficulty eating was the most prevalent oral impact. Internal consistency was good with a Cronbach's alpha of 0.75, and the intraclass correlation coefficient was 0.75 (0.67-0.81). OIDP was significantly correlated with all measures of self-reported oral health and global ratings of quality of life, with correlation coefficients ranging between 0.15 and 0.52. Groups with worse perceptions about their health and quality of life had significantly higher OIDP scores. The OIDP showed successful reliability and validity for its use among Chinese-speaking older Singaporeans. © 2015 John Wiley & Sons A/S and The Gerodontology Association. Published by John Wiley & Sons Ltd.

Who Am I to Decide Whether This Person Is to Die Today? Physicians' Life-or-Death Decisions for Elderly Critically Ill Patients at the Emergency Department-ICU Interface: A Qualitative Study.

PubMed

Fassier, Thomas; Valour, Elizabeth; Colin, Cyrille; Danet, François

2016-07-01

We explored physicians' perceptions of and attitudes toward triage and end-of-life decisions for elderly critically ill patients at the emergency department (ED)-ICU interface. This was a qualitative study with thematic analysis of data collected through semistructured interviews (15 emergency physicians and 9 ICU physicians) and nonparticipant observations (324 hours, 8 units, in 2 hospitals in France). Six themes emerged: (1) Physicians revealed a representation of elderly patients that comprised both negative and positive stereotypes, and expressed the concept of physiologic age. (2) These age-related factors influenced physicians' decisionmaking in resuscitate/not resuscitate situations. (3) Three main communication patterns framed the decisions: interdisciplinary decisions, decisions by 2 physicians on their own, and unilateral decisions by 1 physician; however, some physicians avoided decisions, facing uncertainty and conflicts. (4) Conflicts and communication gaps occurred at the ED-ICU interface and upstream of the ED-ICU interface. (5) End-of-life decisions were perceived as more complex in the ED, in the absence of family or of information about elderly patients' end-of-life preferences, and when there was conflict with relatives, time pressure, and a lack of training in end-of-life decisionmaking. (6) During decisionmaking, patients' safety and quality of care were potentially compromised by delayed or denied intensive care and lack of palliative care. These qualitative findings highlight the cognitive heuristics and biases, interphysician conflicts, and communication gaps influencing physicians' triage and end-of-life decisions for elderly critically ill patients at the ED-ICU interface and suggest strategies to improve these decisions. Copyright © 2015 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

Orofacial pain conditions and impact on quality of life in community-dwelling elderly people in Hong Kong.

PubMed

Luo, Yan; McMillan, Anne S; Wong, May C M; Zheng, Jun; Lam, Cindy L K

2007-01-01

To determine orofacial pain (OFP) characteristics, associated disability, and effect on quality of life in elderly community-dwelling Chinese people. A cross-sectional survey involving elderly people registered with the Family Medicine Unit of the University of Hong Kong served as the sampling frame. Elderly people with recent OFP symptoms and a comparison control group without OFP participated. Standard questions were asked about OFP conditions in the previous month and the Oral Health Impact Profile (OHIP-14), General Health Questionnaire (GHQ-12), and pain-related disability questions were administered prior to a standard clinical examination. Ninety-five people with OFP and 100 people without OFP participated. The median number of pain symptoms per subject was 2.0. Toothache was the most common symptom (58.9%); shooting pain across the face and muscle tenderness were the least common (6.3%). More than half of the pain participants described moderate to severe OFP. The prevalences of patients with neurological/vascular (NV), musculoligamentous/soft tissue (MST), or dentoalveolar (DA) OFP were 35.8%, 33.7%, and 30.5%, respectively. Chronic OFP was common (80%). The mean OHIP-14 summary score was significantly higher in OFP subjects than controls (P < .001) and significantly higher in the MST and DA subgroups than in the NV subgroup (P < .001). GHQ scores of > or = 4, indicating greater psychological distress, were more common in OFP subjects than controls (P < .01). Twenty percent of OFP subjects indicated that their conditions interfered with daily life activities, and in 9.9% it affected ability to work. OFP had a substantial detrimental impact on daily life activities, psychological distress level, and quality of life in Chinese elders. MST and DA conditions had the greatest adverse impact on quality of life.

Shelf stable meals for public sector uses

NASA Technical Reports Server (NTRS)

Schmandt, J. (Editor)

1977-01-01

The NASA Meal System was developed with three simple concepts in mind: (1) nutritious, conventional foods are packaged in single-serving units and assembled into complete meals; (2) the meals have an extended shelf-life and can be transported and stored without need for refrigeration or freezing; (3) preparation of the meal by the consumer is an easy task which is accomplished in ten minutes or less. The meal system was tested in 1975 and 1976 by different groups of elderly individuals. NASA and the LBJ School of Public Affairs sponsored a national conference to report on the demonstration of the meal system for the elderly and to explore potential uses of the system for social services, institutional feeding programs, disaster relief, and international aid. The proceedings of the conference and how different groups assessed the potential of the meal system are reported.

Elders as Teachers of Youth in American Indian Children's Literature.

ERIC Educational Resources Information Center

Charles, Jim

2000-01-01

Two books by and about American Indians demonstrate the positive impact of warm and caring relationships between elders and youth. Elders in these stories convey to children important lessons about life, death, traditions, heritage, and family; positively affect the identity development and emotional maturity of the adolescent protagonists; and…

Voltaire's Portrayal of Old Age.

ERIC Educational Resources Information Center

Berman, Lorna; Nelson, Judy

1987-01-01

Surveyed Voltaire's 50 plays to examine traits and roles assigned to elderly, influence of genre and author's age on portrayals, and factors to which elder's traits were attributed. Found elderly portrayed more favorably in tragedy than in comedy; no effect of period of life on portrayals. Wisdom was only trait consistently and specifically…

Real-Life/Real-Time Elderly Fall Detection with a Triaxial Accelerometer

PubMed Central

2018-01-01

The consequences of a fall on an elderly person can be reduced if the accident is attended by medical personnel within the first hour. Independent elderly people often stay alone for long periods of time, being in more risk if they suffer a fall. The literature offers several approaches for detecting falls with embedded devices or smartphones using a triaxial accelerometer. Most of these approaches have not been tested with the target population or cannot be feasibly implemented in real-life conditions. In this work, we propose a fall detection methodology based on a non-linear classification feature and a Kalman filter with a periodicity detector to reduce the false positive rate. This methodology requires a sampling rate of only 25 Hz; it does not require large computations or memory and it is robust among devices. We tested our approach with the SisFall dataset achieving 99.4% of accuracy. We then validated it with a new round of simulated activities with young adults and an elderly person. Finally, we give the devices to three elderly persons for full-day validations. They continued with their normal life and the devices behaved as expected. PMID:29621156

Real-Life/Real-Time Elderly Fall Detection with a Triaxial Accelerometer.

PubMed

Sucerquia, Angela; López, José David; Vargas-Bonilla, Jesús Francisco

2018-04-05

The consequences of a fall on an elderly person can be reduced if the accident is attended by medical personnel within the first hour. Independent elderly people often stay alone for long periods of time, being in more risk if they suffer a fall. The literature offers several approaches for detecting falls with embedded devices or smartphones using a triaxial accelerometer. Most of these approaches have not been tested with the target population or cannot be feasibly implemented in real-life conditions. In this work, we propose a fall detection methodology based on a non-linear classification feature and a Kalman filter with a periodicity detector to reduce the false positive rate. This methodology requires a sampling rate of only 25 Hz; it does not require large computations or memory and it is robust among devices. We tested our approach with the SisFall dataset achieving 99.4% of accuracy. We then validated it with a new round of simulated activities with young adults and an elderly person. Finally, we give the devices to three elderly persons for full-day validations. They continued with their normal life and the devices behaved as expected.

Storytelling: a care technology in continuing education for active ageing.

PubMed

Costa, Nadia Pinheiro da; Polaro, Sandra Helena Isse; Vahl, Eloá Aparecida Caliari; Gonçalves, Lucia Hisako Takase

2016-01-01

assessing relevance and effectiveness of care/educational technology in the form of "storytelling" as a strategy in the cultivation of active ageing (AA) for elderly users of a Basic Health Unit (BHU), from the Amazon region. convergent care research (CCR) held in a BHU in Belém, state of Pará, with eight elderly ladies for testing this technology. An active ageing assessment questionnaire and WHOQOL-BREF - quality of life assessment were applied. After training with a view to continuing education, elderly ladies told stories for an audience that addressed the question: "What did you learn from it for your life?" tThe popular stories elicited reactions from which the following categories emerged: solidarity; respect for the other; imagination, dreams, hopes and culture of the Amazonian. This practice had a positive result, producing changes in the quality of life of the elderly, particularly in the psychological domain. "storytelling" proved to be an innovative technology, a relevant and effective resource in health education, especially for active ageing.

[Development and reliability evaluation of an instrument to measure health-related quality of life in independent elderly].

PubMed

Lima, Maria José Barbosa de; Portela, Margareth Crisóstomo

2010-08-01

This study presents an instrument, the health-related quality of life (HRQOL) profile for independent elderly, to measure the health-related quality of life of the functionally independent elderly assisted in the outpatient setting, based on the adaptation of four validated scales: Short-Form Health Survey (SF-36), Duke-UNC Health Profile (DUHP), Sickness Impact Profile (SIP), and Nottingham Health Profile (NHP). The study also evaluates the instrument's reliability based on its use by two different observers with a 15-day interval. The instrument includes five dimensions (health perception, symptoms, physical function, psychological function, and social function) and 45 items. Reliability evaluation of the QUASI instrument was based on interviews with 142 elderly outpatients in the city of Rio de Janeiro, Brazil. Prevalence-adjusted kappa statistic was used to assess all 45 items. Correlation was also calculated between overall scores and scores on individual dimensions. In the reliability evaluation, 39 of the 45 items showed prevalence-adjusted kappa greater than 0.60.

A current perspective on geriatric lower urinary tract dysfunction.

PubMed

Jung, Ha Bum; Kim, Hyung Jee; Cho, Sung Tae

2015-04-01

Lower urinary tract dysfunction-such as urinary incontinence (UI), detrusor overactivity, and benign prostatic hyperplasia-is prevalent in elderly persons. These conditions can interfere with daily life and normal functioning and lead to negative effects on health-related quality of life. UI is one of the most common urologic conditions but is poorly understood elderly persons. The overall prevalence of UI increases with age in both men and women. Elderly persons often neglect UI or dismiss it as part of the normal aging process. However, UI can have significant negative effects on self-esteem and has been associated with increased rates of depression. UI also affects quality of life and activities of daily living. Although UI is more common in elderly than in younger persons, it should not be considered a normal part of aging. UI is abnormal at any age. The goal of this review is to provide an overview of the cause, classification, evaluation, and management of geriatric lower urinary tract dysfunction.

A current perspective on geriatric lower urinary tract dysfunction

PubMed Central

Jung, Ha Bum; Kim, Hyung Jee

2015-01-01

Lower urinary tract dysfunction-such as urinary incontinence (UI), detrusor overactivity, and benign prostatic hyperplasia-is prevalent in elderly persons. These conditions can interfere with daily life and normal functioning and lead to negative effects on health-related quality of life. UI is one of the most common urologic conditions but is poorly understood elderly persons. The overall prevalence of UI increases with age in both men and women. Elderly persons often neglect UI or dismiss it as part of the normal aging process. However, UI can have significant negative effects on self-esteem and has been associated with increased rates of depression. UI also affects quality of life and activities of daily living. Although UI is more common in elderly than in younger persons, it should not be considered a normal part of aging. UI is abnormal at any age. The goal of this review is to provide an overview of the cause, classification, evaluation, and management of geriatric lower urinary tract dysfunction. PMID:25874039

The Most Prevalent Causes of Deaths, DALYs, and Geriatric Syndromes in Iranian Elderly People Between 1990 and 2010: findings from the Global Burden of Disease study 2010.

PubMed

Namazi Shabestari, Alireza; Saeedi Moghaddam, Sahar; Sharifi, Farshad; Fadayevatan, Reza; Nabavizadeh, Fatemeh; Delavari, Alireza; Jamshidi, Hamid Reza; Naderimagham, Shohreh

2015-08-01

The substantial increase in life expectancy during recent decades has left all countries with a high number of elderly people that have particular health needs. Health policy-makers must be aware of the most prevalent causes of deaths and DALYs in this age group, as well as geriatric syndromes, in order to provide appropriate care and allocate resources in an equitable manner. The Global Burden of Disease study 2010 (GBD 2010), conducted by the institute for Health Metrics and Evaluation team, estimated the worldwide burden of diseases from 1990 to 2010. Its estimations were conducted on the basis of the proportion of deaths, the duration of symptoms and disability weights for sequelae, years lived with disability (YLDs), years of life lost (YLLs), and disability adjusted life years (DALYs) attributable to different diseases. In the present study, we extracted the data regarding the top five most prevalent causes of deaths, DALYs, and geriatric syndromes in the elderly based on the aforementioned GBD 2010, discussed the results using some tables and figures, reviewed the results, described the limitations of GBD 2010, and finally provided some recommendations as potential solutions. According to GBD 2010, the total number of deaths in Iran in 1990 was 321,627, of which 116,100 were in elderly people (those aged 60 years and above), meaning that 36.10% of all deaths occurred in the elderly. Among all diseases in this year, the first to third ranked causes of death were ischemic heart disease (IHD; 29.44%), neoplasms (13.52%), and stroke (7.24%). In comparison, the total number of deaths in Iran increased to 351,814 in 2010, with 213,116 of these occurring in the elderly (60.58% of deaths), but the most prevalent causes of death remained the same as in 1990. The highest 1990 DALYs rates were the result of IHD (21.56%), neoplasms (10.70%), and stroke (4.85%). IHD (22.77%), neoplasms (9.48%), and low back pain (LBP; 5.72%) were the most prevalent causes of DALYs in older Iranian adults in 2010. The fourth and fifth ranked causes of deaths and DALYs in both 1990 and 2010, both in Iran and globally, were different diseases and geriatric syndromes in the elderly Iranian population. The aged population of Iran is growing steadily, and there is a need for health policy-makers to create appropriate programs to meet the health needs of elderly people. Although GBD 2010 results are useful in providing burden estimations at regional and national levels, each individual country should estimate its burden of diseases, injuries, and risk factors at a sub-national level to obtain further details regarding the health status of its people. As no comprehensive study regarding elderly people in Iran has previously been conducted, our study will be a major source for identifying the important causes of deaths, DALYs, and geriatric syndromes among this population.

The influence of institutionalization on the perception of autonomy and quality of life in old people.

PubMed

Cobo, Carmen María Sarabia

2014-12-01

To evaluate the influence exercised by institutionalization on the autonomy and perception of quality of life among the institutionalized elderly. The study is quasi-experimental (interrupted time series) and longitudinal. The sample is composed for 104 elderly people who went into a three nursing home in Santander, Spain. To assess the quality of life and dependence two scales were used: the Barthel Index and Lawton Index. There was an important relationship between autonomy and independence and their deterioration due to their institutionalisation, such as the physical and social aspects. It´s important to point out that the dependence of the elderly is a complex phenomenon, which admits many types of intervention, including the customary ones referring to more classic welfare actions which tend to supplant the absence of autonomy in everyday life by facilitating services and attention to make up for this need, without having to resort to institutionalization.

Age rationing, the virtues, and wanting more life.

PubMed

Purviance, Susan M

1993-01-01

The goal of this paper is to show that Callahan's reasons for withholding life extending care cannot be made out exclusively in terms of contemporary notions of distributive justice and fair allocation. I argue that by relying on a notion of justice which links the merit of the individual with the fairness of a social pattern of shares, Callahan imputes vice to the elderly as he denies them eligibility for life-prolonging care. Aristotle's doctrine of the mean is a useful tool for character evaluation. One can speak meaningfully of a proper disposition of a person of a certain type (an elderly person) with respect to the good of continued life. I claim that the mean of one's disposition with respect to the good of continued life would be relative to one's age group, and would be determined by that principle by which an elderly person of practical wisdom would determine it. This leads to very different conclusions than those drawn by Callahan.

The effects of 16-week group exercise program on physical function and mental health of elderly Korean women in long-term assisted living facility.

PubMed

Sung, Kiwol

2009-01-01

The purpose of this study was to compare the effects of 16-week group exercise program on the physical function (ie, strength, flexibility, and balance) and mental health (ie, self-esteem and depression) of older elderlyl women (>or=75 years old) compared with younger elderly women (<75 years old). Exercise is crucial in maintaining older women's health and well-being. However, because most elders have at least one chronic disease, their physical function declines, so their dependence on others for instrumental daily living activities often increases. Older women typically have multiple barriers to participation in physical activities including higher disability rates. Of the total of 40 older women (older than 65 years) enrolled, 21 were older elders and 16 were younger elders. Lower body strength (using 30-second chair test), flexibility (sit-and-reach test), and static balance (ability to balance on one leg with open and closed eyes) were assessed. Self-esteem (using Rosenberg's Self-esteem Questionnaire) and depressive symptoms (using Yesavage's Geriatric Depression Scale) were assessed. Two-way analysis of variance was used to examine the differences between the 2 age groups. The intervention program was effective in improving body strength, flexibility, static balance, and self-esteem, regardless of age. Furthermore, older elders receiving the intervention program demonstrated greater improvement in self-esteem than younger elders did, although there were intervention effects in both age groups. Elderly women can realize benefits from a group exercise program that can improve their functional ability and self-esteem, both important to cardiovascular health.

Perceived success in addressing end-of-life care needs of low-income elders and their families: what has family conflict got to do with it?

PubMed

Kramer, Betty J; Yonker, James A

2011-01-01

The purpose of this study was to examine the predictors of perceived success in addressing the end-of-life care needs of low-income older adults and their family members. Perceived success is defined as the clinician's subjective assessment of the extent to which end-of-life care needs of the patient and family have been met by the interdisciplinary team. The results are drawn from a larger longitudinal multimethod case study designed to understand how end-of-life care is provided to a diverse group of frail elders in an innovative, fully "integrated," managed care program. Data were generated from 120 social work surveys detailing care experiences and outcomes particular to 120 elder deaths. Significant predictors of perceived success for addressing patient needs included patient care needs (β=0.17, P≤0.05), race (β=0.19, P≤0.05), patient preferences elicited (β=0.29, P≤0.01) and honored (β=0.20, P≤0.05), and family conflict (β=-0.24, P≤0.01). Significant predictors of perceived success for addressing family needs included family care needs (β=0.30, P≤0.001), team and administrative resources (β=0.19, P≤0.01), patient preferences honored (β=0.16, P≤0.05), quality of relationship with patient (β=0.27, P≤0.001) and family (β=0.23, P≤0.01), and family conflict (β=-0.31, P≤0.001). This study provides preliminary evidence of differential correlates and predictors of perceived success for addressing patient and family needs, highlighting the detrimental influence of family conflict. Future research is needed to better understand the kinds of assessment and intervention protocols that might prevent or ameliorate conflict and enhance structures and process-of-care variables to facilitate more successful outcomes. Copyright © 2011 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.

The effect of telehealth, telephone support or usual care on quality of life, mortality and healthcare utilization in elderly high-risk patients with multiple chronic conditions. A prospective study.

PubMed

Valdivieso, Bernardo; García-Sempere, Anibal; Sanfélix-Gimeno, Gabriel; Faubel, Raquel; Librero, Julian; Soriano, Elisa; Peiró, Salvador

2018-04-25

To assess the effect of home based telehealth or structured telephone support interventions with respect to usual care on quality of life, mortality and healthcare utilization in elderly high-risk multiple chronic condition patients. 472 elderly high-risk patients with plurimorbidity in the region of Valencia (Spain) were recruited between June 2012 and May 2013, and followed for 12 months from recruitment. Patients were allocated to either: (a) a structured telephone intervention, a nurse-led case management program with telephone follow up every 15 days; (b) telehealth, which adds technology for remote self-management and the exchange of clinical data; or (c) usual care. Main outcome measures was quality of life measured by the EuroQol (EQ-5D) instrument, cognitive impairment, functional status, mortality and healthcare resource use. Inadequate randomization process led us to used propensity scores for adjusted analyses to control for imbalances between groups at baseline. EQ-5D score was significantly higher in the telehealth group compared to usual care (diff: 0.19, 0.08-0.30), but was not different to telephone support (diff: 0.04, -0.05 to 0.14). In adjusted analyses, inclusion in the telehealth group was associated with an additional 0.18 points in the EQ-5D score compared to usual care at 12 months (p<0.001), and with a gain of 0.13 points for the telephone support group (p<0.001). No differences in mortality or utilization were found, except for a borderline significant increase in General Practitioner visits. Telehealth was associated with better quality of life. Important limitations of the study and similarity of effects to telephone intervention call for careful endorsement of telemedicine. Clinicaltrials.gov (identifier: NCT02447562). Copyright © 2018 Elsevier España, S.L.U. All rights reserved.

[Assessment and training of strength and balance for fall prevention in the elderly: recommendations of an interdisciplinary expert panel].

PubMed

Granacher, U; Muehlbauer, T; Gschwind, Y J; Pfenninger, B; Kressig, R W

2014-08-01

The proportion of elderly people in societies of western industrialized countries is continuously rising. Biologic aging induces deficits in balance and muscle strength/power in old age, which is responsible for an increased prevalence of falls. Therefore, nationwide and easy-to-administer fall prevention programs have to be developed in order to contribute to the autonomy and quality of life in old age and to help reduce the financial burden on the public health care system due to the treatment of fall-related injuries. This narrative (qualitative) literature review deals with a) the reasons for an increased prevalence of falls in old age, b) important clinical tests for fall-risk assessment, and c) evidence-based intervention/training programs for fall prevention in old age. The findings of this literature review are based on a cost-free practice guide that is available to the public (via the internet) and that was created by an expert panel (i.e., geriatricians, exercise scientists, physiotherapists, geriatric therapists). The present review provides the scientific foundation of the practice guide.

The association between death anxiety with spiritual experiences and life satisfaction in elderly people

PubMed Central

Taghiabadi, Mina; Kavosi, Ali; Mirhafez, Seyed Reza; Keshvari, Mahrokh; Mehrabi, Tayebe

2017-01-01

Introduction Death anxiety is a concept with greater importance among the elderly as they approach inevitability of death. Identifying the correlates of death anxiety among old people is important in order to reduce the burden of this problem. Therefore, the present study was performed with the aim to examine the association between spiritual experiences and life satisfaction with death anxiety in this stage of life. Method This cross-sectional study with descriptive-analytical design included 190 elderly people visiting the health and medical centers of Neyshabur city, Iran, during fall and winter, 2016. Participants were asked to complete three questionnaires including a 16-item spiritual experiences scale, life satisfaction index proposed by Wood and Shifor with 13 items, and a 27-item death anxiety scale developed by Aminpour. Analytical statistics (Spearman’s correlation coefficient, Pearson’s correlation coefficient) were conducted using SPSS software version 22. Results Fifty-eight percent of participants were in younger elderly age group with mean age of 68.18±7.13 years and the number of men and women was the same (95). A significant positive association between spiritual experiences and life satisfaction (r=0.2, p<0.05), a significant negative association between spiritual experiences and death anxiety (r=−0.184, p< 0.05) and a significant negative relationship between life satisfaction and death anxiety (r=−0.2, p<0.05) was found. Conclusion Based on results, it seems that reducing stressors in this stage of life including reduction of death anxiety, is possible through use of spiritual experiences and increasing life satisfaction. PMID:28461873

Cardiopulmonary Rehabilitation, Exercise Training, and Preventive Cardiology: An Overview of a Decade of Research at the Ochsner Heart and Vascular Institute: Presented in part at Grand Rounds, Research Series, Ochsner Medical Institutions, May 17, 1999

PubMed Central

Lavie, Carl J.; Milani, Richard V.; Cassidy, Mark M.; Gilliland, Yvonne E.; Bernal, J. Alberto

1999-01-01

A decade of research from the Ochsner Heart and Vascular Institute's cardiopulmonary rehabilitation and exercise training programs demonstrates the benefits of this therapy on coronary risk factors, exercise capacity, cardiopulmonary parameters, behavioral characteristics, and quality of life in various subgroups of patients, including the elderly, women, obese patients, and groups with dyslipidemia and psychological distress, as well as in patients with congestive heart failure or severe lung disease. Substantial data from our program support the idea that cardiopulmonary rehabilitation and exercise training programs are underemphasized and underutilized for the secondary prevention of coronary artery disease. PMID:21845136

Construct validity of the Groningen Frailty Indicator established in a large sample of home-dwelling elderly persons: Evidence of stability across age and gender.

PubMed

Peters, L L; Boter, H; Burgerhof, J G M; Slaets, J P J; Buskens, E

2015-09-01

The primary objective of the present study was to evaluate the validity of the Groningen Frailty Indicator (GFI) in a sample of Dutch elderly persons participating in LifeLines, a large population-based cohort study. Additional aims were to assess differences between frail and non-frail elderly and examine which individual characteristics were associated with frailty. By December 2012, 5712 elderly persons were enrolled in LifeLines and complied with the inclusion criteria of the present study. Mann-Whitney U or Kruskal-Wallis tests were used to assess the variability of GFI-scores among elderly subgroups that differed in demographic characteristics, morbidity, obesity, and healthcare utilization. Within subgroups Kruskal-Wallis tests were also used to examine differences in GFI-scores across age groups. Multivariate logistic regression analyses were performed to assess associations between individual characteristics and frailty. The GFI discriminated between subgroups: statistically significantly higher GFI-median scores (interquartile range) were found in e.g. males (1 [0-2]), the oldest old (2 [1-3]), in elderly who were single (1 [0-2]), with lower socio economic status (1 [0-3]), with increasing co-morbidity (2 [1-3]), who were obese (2 [1-3]), and used more healthcare (2 [1-4]). Overall age had an independent and statistically significant association with GFI scores. Compared with the non-frail, frail elderly persons experienced statistically significantly more chronic stress and more social/psychological related problems. In the multivariate logistic regression model, psychological morbidity had the strongest association with frailty. The present study supports the construct validity of the GFI and provides an insight in the characteristics of (non)frail community-dwelling elderly persons participating in LifeLines. Copyright © 2015 Elsevier Inc. All rights reserved.

Inpatient care expenditure of the elderly with chronic diseases who use public health insurance: Disparity in their last year of life.

PubMed

Chandoevwit, Worawan; Phatchana, Phasith

2018-06-01

The Thai elderly are eligible for the Civil Servant Medical Benefit Scheme (CS) or Universal Coverage Scheme (UCS) depending on their pre-retirement or their children work status. This study aimed to investigate the disparity in inpatient care expenditures in the last year of life among Thai elderly individuals who used the two public health insurance schemes. Using death registration and inpatient administrative data from 2007 to 2011, our subpopulation group included the elderly with four chronic disease groups: diabetes mellitus, hypertension and cardiovascular disease, heart disease, and cancer. Among 1,242,150 elderly decedents, about 40% of them had at least one of the four chronic disease conditions and were hospitalized in their last year of life. The results showed that the means of inpatient care expenditures in the last year of life paid by CS and UCS per decedent were 99,672 Thai Baht and 52,472 Thai Baht, respectively. On average, UCS used higher healthcare resources by diagnosis-related group relative weight measure per decedent compared with CS. In all cases, the rates of payment for inpatient treatment per diagnosis-related group adjusted relative weight were higher for CS than UCS. This study found that the disparities in inpatient care expenditures in the last year of life stemmed mainly from the difference in payment rates. To mitigate this disparity, unified payment rates for various types of treatment that reflect costs of hospital care across insurance schemes were recommended. Copyright © 2018 Elsevier Ltd. All rights reserved.

WOMAC and SF-36: instruments for evaluating the health-related quality of life of elderly people with total hip arthroplasty. A descriptive study.

PubMed

Rampazo-Lacativa, Mariana Kátia; Santos, Ariene Angelini dos; Coimbra, Arlete Maria Valente; D'Elboux, Maria José

2015-01-01

Quality-of-life results have increasingly been evaluated among patients undergoing joint replacements. The objective of this study was to compare two assessment instruments for health-related quality of life (one generic and the other specific), among elderly patients undergoing total hip arthroplasty. Cross-sectional descriptive study in a reference hospital in the region of Campinas. The subjects were 88 elderly outpatients aged 60 years or over who underwent primary total hip arthroplasty. Two instruments for assessing health-related quality of life were applied: the generic Medical Study 36-item Short-Form Health Survey (SF-36) and the specific Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Cronbach's alpha and the ceiling and floor effects of the instruments were evaluated. The scores from both instruments showed that issues of a physical nature affected these elderly people's quality of life most. The pain and stiffness dimensions of WOMAC showed ceiling effects and only the functional capacity and pain dimensions of the SF-36 did not show the ceiling effect. The SF-36 presented floor effects in the dimensions of physical and emotional aspects. Cronbach's alpha was considered satisfactory in both instruments (α > 0.70). The floor and ceiling effects that were observed suggest that these instruments may present some limitations in detecting changes to the majority of the SF-36 dimensions, except for functional capacity and pain, and to the pain and stiffness dimensions of WOMAC, when applied to elderly people with total hip arthroplasty.

Predictors of high healthcare costs in elderly patients with liver cancer in end-of-life: a longitudinal population-based study.

PubMed

Chiang, Jui-Kun; Kao, Yee-Hsin

2017-08-24

Studies have indicated a pervasive pattern of decreasing healthcare costs during elderly patients' last year of life. The aim of this study was to explore the predictors of high healthcare costs (HC) in elderly liver cancer patients in Taiwan during their last month of life (LML). Costs of hospitalization, outpatient visits, aggressiveness of care, and associated costs for elderly (age ≥ 65 y) patients with liver cancer in the LML were analyzed using a national insurance database. An HC was defined as being greater than the 90th percentile (US $5093) in the LML, amounting to 38.95% of total healthcare costs. We enrolled 2121 subjects who died during 1997-2011. Mean healthcare costs per person in their LML were US $8042 ± 3477 in the HC group and US $1407 ± 1464 in the non-HC group (p < 0.001). For patients receiving aggressive end-of-life (EOL) cancer care (e.g. intensive care, cardiopulmonary resuscitation, anticancer treatment, and a high number of admission days), comorbidities of chronic kidney disease, esophageal bleeding, and receiving opioids in the LML, were significantly independent positive predictors of HCs; but admission times, comorbidities of ascites, and hypertension were negative predictors. These findings could inform healthcare providers by avoiding aggressive treatments during EOL for elderly patients with liver cancer and to save on healthcare costs. Shorter admission days and more admission times in the last month of life could decrease healthcare costs.

Moving Towards the Age-friendly Hospital: A Paradigm Shift for the Hospital-based Care of the Elderly.

PubMed

Huang, Allen R; Larente, Nadine; Morais, Jose A

2011-12-01

Care of the older adult in the acute care hospital is becoming more challenging. Patients 65 years and older account for 35% of hospital discharges and 45% of hospital days. Up to one-third of the hospitalized frail elderly loses independent functioning in one or more activities of daily living as a result of the 'hostile environment' that is present in the acute hospitals. A critical deficit of health care workers with expertise and experience in the care of the elderly also jeopardizes successful care delivery in the acute hospital setting. We propose a paradigm shift in the culture and practice of event-driven acute hospital-based care of the elderly which we call the Age-friendly Hospital concept. Guiding principles include: a favourable physical environment; zero tolerance for ageism throughout the organization; an integrated process to develop comprehensive services using the geriatric approach; assistance with appropriateness decision-making and fostering links between the hospital and the community. Our current proposed strategy is to focus on delirium management as a hospital-wide condition that both requires and highlights the Geriatric Medicine specialist as an expert of content, for program development and of evaluation. The Age-friendly Hospital concept we propose may lead the way to enable hospitals in the fast-moving health care system to deliver high-quality care without jeopardizing risk-benefit, function, and quality of life balances for the frail elderly. Recruitment and retention of skilled health care professionals would benefit from this positive 'branding' of an institution. Convincing hospital management and managing change are significant challenges, especially with competing priorities in a fiscal environment with limited funding. The implementation of a hospital-wide delirium management program is an example of an intervention that embodies many of the principles in the Age-friendly Hospital concept. It is important to change the way hospital care is delivered to older adults in time to meet our needs when we need hospital services ourselves.

Living with elder wisdom.

PubMed

Bianchi, Eugene

2005-01-01

This study is based on interview research with over a hundred creative elders. Their spirituality is explored through their life experiences as re-interpreted in later years. Spirituality is often expressed in non-religious language. They speak of inner empowerments: cultivating self-esteem, harvesting memories, transformative turning points, life-long learning, themes of humor and gratitude, and encountering mortality. They also explore outward empowerments: developing new purposes, welcoming possibilities, fostering more freedom, cultivating family and friends, forming intentional communities, and taking on larger social causes re peace, justice and ecology. This elder spirituality manifests important changes in their earlier views of religion.

Developing a Peer Educator Program to Raise Awareness about Elder Abuse

ERIC Educational Resources Information Center

Weeks, Lori E.; Bryanton, Olive; McInnis-Perry, Gloria; Chaulk, Paul

2015-01-01

There continues to be lack of public awareness about elder abuse. To help address this issue, we developed and piloted an elder abuse peer educator training program from an educational gerontology and health empowerment perspective. We describe the process employed to train older adults as peer educators. We present evaluation results from data…

Confronting the Material Convoy in Later Life

PubMed Central

Smith, Gabriella V.; Ekerdt, David J.

2011-01-01

We adapt a metaphor from life course studies to designate the whole of one’s possessions, across time, as a convoy of material support. This dynamic collection of things supports daily life and the self, but it can also present difficulty in later life. To alleviate the purported burdens of the material convoy, a discourse has arisen that urges elders and their family members to reduce the volume of possessions. An analysis of 11 such possession management texts shows authors addressing two distinct audiences about elders’ need to downsize: family members and elders themselves. Authors who speak to family members do so with an urgent, unsentimental tone that echoes mainstream clutter-control advice about disorderly, overfull households. In texts for elders, the standard critique about consumption and unruly lives is gentler, more sensitive to the meaning of things, and underplays the emotions of divestment. There is stress on the responsibility to spare the next generation and control one’s legacy. These latter texts seem to respect that downsizing in later life symbolizes a narrowing of the life world. PMID:21822336

The study of a space configuration using space syntax analysis Case study: an elderly housing

NASA Astrophysics Data System (ADS)

Mariana, Yosica; Triwardhani, Arindra J.; Isnaeni Djimantoro, Michael

2017-12-01

The improvement in various aspect leads to prolong the life span of human life, which increasing the number of elderly in the urban areas in return. But the increasing population is not supported by the provision of adequate housing facilities for them. Most of the elderly house in Jakarta, is designed just like for common people without relizing thatthey had physical and mentally degradation following the age. Therefore, the elderly house need to design with special attention to their daily activity mobility which applied in effective room configuration. The connectivity between the activities is most important element to order the room configuration. This research conduct to search the room configuration in elderly house which can improve their productivity and live quality by using the space syntax theory. The research methods by using the syntactic plug-in in Grasshooper software and analyse the integration, choice, control value and entrophy in the activity configuration. The result show that the effective and efficient for elderly house is cluster centralized pattern. The lobby and reception take the important role as the integration aspect and the spatial awareness according to elderly activity.

Research on Indigenous Elders: From Positivistic to Decolonizing Methodologies

PubMed Central

Braun, Kathryn L.

2014-01-01

Although indigenous peoples have lower life expectancies than the social majority populations in their countries, increasing numbers of indigenous people are living into old age. Research on indigenous elders is informed by a number of research traditions. Researchers have mined existing data sets to compare characteristics of indigenous populations with non-indigenous groups, and these findings have revealed significant disparities experienced by indigenous elders. Some investigators have attempted to validate standardized research tools for use in indigenous populations. Findings from these studies have furthered our knowledge about indigenous elders and have highlighted the ways in which tools may need to be adapted to better fit indigenous views of the constructs being measured. Qualitative approaches are popular, as they allow indigenous elders to tell their stories and challenge non-indigenous investigators to acknowledge values and worldviews different from their own. Recently, efforts have extended to participatory and decolonizing research methods, which aim to empower indigenous elders as researchers. Research approaches are discussed in light of the negative experiences many indigenous peoples have had with Eurocentric research. Acknowledgment of historical trauma, life-course perspectives, phenomenology, and critical gerontology should frame future research with, rather than on, indigenous elders. PMID:23841952

Research on indigenous elders: from positivistic to decolonizing methodologies.

PubMed

Braun, Kathryn L; Browne, Colette V; Ka'opua, Lana Sue; Kim, Bum Jung; Mokuau, Noreen

2014-02-01

Although indigenous peoples have lower life expectancies than the social majority populations in their countries, increasing numbers of indigenous people are living into old age. Research on indigenous elders is informed by a number of research traditions. Researchers have mined existing data sets to compare characteristics of indigenous populations with non-indigenous groups, and these findings have revealed significant disparities experienced by indigenous elders. Some investigators have attempted to validate standardized research tools for use in indigenous populations. Findings from these studies have furthered our knowledge about indigenous elders and have highlighted the ways in which tools may need to be adapted to better fit indigenous views of the constructs being measured. Qualitative approaches are popular, as they allow indigenous elders to tell their stories and challenge non-indigenous investigators to acknowledge values and worldviews different from their own. Recently, efforts have extended to participatory and decolonizing research methods, which aim to empower indigenous elders as researchers. Research approaches are discussed in light of the negative experiences many indigenous peoples have had with Eurocentric research. Acknowledgment of historical trauma, life-course perspectives, phenomenology, and critical gerontology should frame future research with, rather than on, indigenous elders.

Health Care Service Needs and Correlates of Quality of Life: A Case Study of Elderly Chinese Immigrants in Canada

ERIC Educational Resources Information Center

Chow, Henry P. H.

2012-01-01

This study explored the health care service needs and the major correlates of quality of life among 127 community-dwelling elderly Chinese immigrants in a western Canadian city. Participants were interviewed in their homes by trained, bilingual interviewers employing a structured questionnaire that covered a wide range of topics including health…

Elder Abuse by Adult Children: An Applied Ecological Framework for Understanding Contextual Risk Factors and the Intergenerational Character of Quality of Life.

ERIC Educational Resources Information Center

Schiamberg, Lawrence B.; Gans, Daphna

2000-01-01

Using an applied ecological model, this study focuses on contextual risk factors of elder abuse. Five levels of environment were used to interpret existing research on risk factors. Configuration of risk factors provides a framework for understanding the intergenerational character of quality of life for older adults, developing recommendations…

[Association between physical and psychosocial impacts of oral disorders and quality of life among the elderly].

PubMed

Martins, Andréa Maria Eleutério de Barros Lima; Jones, Kimberly Marie; Souza, João Gabriel Silva; Pordeus, Isabela Almeida

2014-08-01

This study sought to evaluate the association between the impact of oral disorders in terms of physical/psychosocial dimensions and quality of life among the elderly. It involved a cross-sectional study conducted among the elderly (65-74 years) in 2008/2009. The social impact was assessed using the Oral Health Impact Profile (OHIP 14) and the quality of life using the SF 12 Short-Form Health Survey. Descriptive, univariate and multivariate (logistic regression) analysis was conducted with correction for the design effect, using SPSS(r)18.0 software. Of the 800 individuals approached, 736 elderly individuals participated (TR = 92%), with a mean age of 67.77 years, the majority of whom showed no impact based on the measurement of the prevalence of OHIP. The functional limitation dimension of the OHIP was associated with the physical domain of the SF12, irrespective of the other variables investigated. However, the seriousness of OHIP and its psychological discomfort and disability dimensions was associated with the mental domain of the SF12. The conclusion reached is that some impacts of oral disorders were associated with unsatisfactory quality of life in the physical and mental domains.

Nutritional status and functional ability of the elderly aged 60 to 90 years in the Mpigi district of central Uganda.

PubMed

Kikafunda, Joyce K; Lukwago, Fred B

2005-01-01

This study assessed the nutritional status of the elderly and their functional ability because poor nutritional status in the elderly is associated with poor functional ability. Anthropometric measurements, demographic and socioeconomic data, dietary assessment by a food frequency list, and activities of daily life data were collected cross sectionally in 2002. Participants (n = 100) were randomly selected and the response rate was 95.2%. The overall prevalences of undernutrition were 33.3% based on body mass index (<18.5 kg/m(2)) and 52% based on mid-upper arm circumference (<24 cm). There was a large, significant difference between prevalences of malnutrition by sex: 68% of women were undernourished (body mass index < 18.5 kg/m(2)) compared with 32.4% of men. Dietary assessment showed that intake of fish, cereals, vegetables, tubers, and legumes was moderate (three to six times/wk). Evaluation of the ability of elderly people to perform basic activities of daily living showed that 33% of subjects were independent in all activities of daily living, except for mobility and feeding. The relation between body mass index and variables associated with functional ability were significant with regard to mobility, continence, and feeding (P < 0.05). This study found that a large percentage of older men and women are malnourished. This influenced their daily activities, especially mobility and feeding. The elderly need to be incorporated into health programs and policy.

Elderly self-management: a qualitative study

PubMed Central

Ravanipour, Maryam; Salehi, Shayesteh; Taleghani, Fariba; Abedi, Heidar Ali

2010-01-01

BACKGROUND: The population of elderly in Iran and in the world is increasing. It is predicted that the population of elderly reaches to 10 millions in Iran by the year 2019. Elders more than other age groups are at risk of chronic diseases and health problems; and elderly affects their self-management and makes them feel disabled. Since the knowledge of self-management for Iranian elderly is not well developed, this paper aimed to determine the concept of self-management for Iranian elders. METHODS: This was a qualitative study with grounded theory approach on Iranian elderly self-management. Data were collected through deep interviews with 26 participants in a period of one year and were analyzed using a Strauss Corbin analysis method. RESULTS: Self-management in the context of power means using different managing methods in dealing with daily life needs, especially in interactions with others in a way that accelerates affairs with efficiency and satisfaction. The main categories emerged from this qualitative study included: managing plans, managing life goals and policies, persuading the desired goals, managing self-care, directing others, coordinating and consulting with others. CONCLUSIONS: The findings of this study provided a deep understanding of elderly perceptions of self-management in their lives. These findings can be a baseline for future researches on developing effective health interventions such as developing a nursing model for increasing the elderly self-management abilities in Iran. Such a model can provide a strong basis for nursing care. PMID:21589781

[Effects of community-based comprehensive fall prevention program on muscle strength, postural balance and fall efficacy in elderly people].

PubMed

Bae, Jeongyee; Cho, Seong Il

2014-12-01

The purposes of this study was to develop a comprehensive community-based fall prevention program and to test the effects of the program on the muscle strength, postural balance and fall efficacy for elderly people. The design of this study was a nonequivalent control group pretest-posttest design. There were 28 participants in the experimental group and 29 in the control group. The program consisted of balance exercises, elastic resistance exercises and prevention education. The program was provided five times a week for 8 weeks and each session lasted 90 minutes. Data were analyzed using χ²-test, independent t-test and paired t-test using the SPSS program. Muscle strength of the lower extremities, postural balance and fall efficacy scores significantly improved in the experimental group compared to the control group. These results suggest that this program can improve lower extremity muscle strength, postural balance and fall efficacy in elders. Therefore, this program is recommended for use in fall prevention programs for elders living in the community.

Care and Respect for Elders in Emergencies program: a preliminary report of a volunteer approach to enhance care in the emergency department.

PubMed

Sanon, Martine; Baumlin, Kevin M; Kaplan, Shari Sirkin; Grudzen, Corita R

2014-02-01

Older adults who present to an emergency department (ED) generally have more-complex medical conditions with complicated care needs and are at high risk for preventable adverse outcomes during their ED visit. The Care and Respect for Elders with Emergencies (CARE) volunteer initiative is a geriatric-focused volunteer program developed to help prevent avoidable complications such as falls, delirium and use of restraints, and functional decline in vulnerable elders in the ED. The CARE program consists of bedside volunteer interventions ranging from conversation to various short activities designed to engage and reorient high-risk, older, unaccompanied individuals in the ED. This article describes the development and characteristics of the CARE program, the services provided, the experiences of the elderly patients and their volunteers, and the growth of the program over time. CARE volunteers provide elders with the additional attention needed in an often chaotic, unfamiliar environment by enhancing their care, improving satisfaction, and preventing potential decline. © 2014, Copyright the Authors Journal compilation © 2014, The American Geriatrics Society.

[Evaluation of a medication self-management education program for elders with hypertension living in the community].

PubMed

Lee, Jong Kyung

2013-04-01

The purpose of this study was to examine the effect of a medication self-management education program on medication awareness, communication with health care provider, medication misuse behavior, and blood pressure in elders with hypertension. The research design for this study was a non-equivalent control group quasi-experimental design. Participants were 23 elders for the control group, and 26 elders for the experimental group. The experimental group participated in the medication self-management education program which included the following, verbal education, 1:1 consultation, practice in medication self-management, and discussion over 5 sessions. Data were analyzed using the SPSS 18.0 program. There were statistically significant differences between the experimental and control group for medication awareness, medication misuse behavior, and communication with health care providers. However, no significant difference was found between the two groups for blood pressure. The results indicate that the education program is effective in improving medication awareness and communication with health care providers and in decreasing medication misuse behavior. Therefore, it is recommended that this education program be used as an effective intervention for improving medication self-management for elders with hypertension.

Cost-benefit estimates of an elderly exercise program on Kaua'i.

PubMed

Sugihara, Naomi; Watanabe, Marisa; Tomioka, Michiyo; Braun, Kathryn L; Pang, Lorrin

2011-06-01

The elderly consume a disproportionate amount of health care resources, and the recent trend in obesity will only escalate costs. EnhanceFitness® (EF) is an exercise program designed to increase the strength, flexibility, and balance of older adults. A comprehensive controlled study in Washington state of an elderly population has shown that participants who attend at least one EF class per week reduce healthcare costs by 20% per year. The present study reports the costs and potential benefits of replicating EF on Kaua'i. For Kaua'i the annual cost of an EF pilot program for 132 clients would be $204,735. Attendance records of the Kaua'i program showed that 96 (73%) of those enrolled attended at least weekly. Based on national reports of healthcare costs for the elderly, averting 20% of the costs for these 96 elderly would save $344,256 per year. The expected investment to return ratio, I-R ratio, for EF on Kaua'i is about 1-1.8. On economic grounds, a case can be made to support and expand these types of programs. In these times of budget cuts, cost-benefit analysis provides a common economic "language" to prioritize among different programs.

Does informal care reduce public care expenditure on elderly care? Estimates based on Finland’s Age Study

PubMed Central

2013-01-01

Background To formulate sustainable long-term care policies, it is critical first to understand the relationship between informal care and formal care expenditure. The aim of this paper is to examine to what extent informal care reduces public expenditure on elderly care. Methods Data from a geriatric rehabilitation program conducted in Finland (Age Study, n = 732) were used to estimate the annual public care expenditure on elderly care. We first constructed hierarchical multilevel regression models to determine the factors associated with elderly care expenditure. Second, we calculated the adjusted mean costs of care in four care patterns: 1) informal care only for elderly living alone; 2) informal care only from a co-resident family member; 3) a combination of formal and informal care; and 4) formal care only. We included functional independence and health-related quality of life (15D score) measures into our models. This method standardizes the care needs of a heterogeneous subject group and enabled us to compare expenditure among various care categories even when differences were observed in the subjects’ physical health. Results Elder care that consisted of formal care only had the highest expenditure at 25,300 Euros annually. The combination of formal and informal care had an annual expenditure of 22,300 Euros. If a person received mainly informal care from a co-resident family member, then the annual expenditure was only 4,900 Euros and just 6,000 Euros for a person living alone and receiving informal care. Conclusions Our analysis of a frail elderly Finnish population shows that the availability of informal care considerably reduces public care expenditure. Therefore, informal care should be taken into account when formulating policies for long-term care. The process whereby families choose to provide care for their elderly relatives has a significant impact on long-term care expenditure. PMID:23947622

42 CFR 460.164 - Involuntary disenrollment.

Code of Federal Regulations, 2011 CFR

2011-10-01

... (CONTINUED) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) Participant Enrollment and Disenrollment § 460.164 Involuntary disenrollment. (a) Reasons...

42 CFR 460.162 - Voluntary disenrollment.

Code of Federal Regulations, 2010 CFR

2010-10-01

... (CONTINUED) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) Participant Enrollment and Disenrollment § 460.162 Voluntary disenrollment. A PACE...

42 CFR 460.164 - Involuntary disenrollment.

Code of Federal Regulations, 2010 CFR

2010-10-01

... (CONTINUED) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) Participant Enrollment and Disenrollment § 460.164 Involuntary disenrollment. (a) Reasons...

42 CFR 460.162 - Voluntary disenrollment.

Code of Federal Regulations, 2011 CFR

2011-10-01

... (CONTINUED) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) Participant Enrollment and Disenrollment § 460.162 Voluntary disenrollment. A PACE...

Elderly Parents and Adult Children as Caregivers. Highlights: An ERIC/CAPS Digest.

ERIC Educational Resources Information Center

Libert, Anne Blanford

This digest presents a contemporary description of the American elderly and adult children's caregiving to their parents. It includes a profile of the American elderly; a description of caregiving tasks performed by their adult children; and the impact of longer life expectancy, divorce rates, and employed daughters on caregiving. Caregiver strain…

Korean Elderly in America: Acculturation and Changes in Life Style.

ERIC Educational Resources Information Center

Koh, Yang K.; Bell, William G.

As the numbers of Korean immigrants, particularly Korean elders continues to increase, their adjustment problems and service needs are beginning to receive attention in communities with a large influx of Asian immigrants. To examine Korean elders' use of filial and formal support systems in dealing with their problems, 151 older Koreans living in…

The Elderly of Appalachia. Appalachian Data Bank Report #3.

ERIC Educational Resources Information Center

Rowles, Graham D.; And Others

Analysis of 1980 census data reveals that elderly people (age 65 and over) living in Central and Southern Appalachia suffer more inferior life circumstances than the elderly population in the nation as a whole, falling well below national averages in terms of income, access to transportation, availability of telephones, and presence of resources…

Cognitive-Behavioral Treatment of Late-Life Anxiety Disorders.

ERIC Educational Resources Information Center

Gorenstein, Ethan E.; Papp, Lazlo A.

In the absence of data, pharmacotherapy with benzodiazepines has become the mainstay of anxiety management in the elderly population. However, the use of benzodiazepines in the elderly has many problems. Elderly persons are more sensitive to anti-anxiety medications and are subject to a variety of increased risks, including cognitive impairment,…

Wisdomkeepers: Meetings with Native American Spiritual Elders.

ERIC Educational Resources Information Center

Arden, Harvey; Wall, Steve

This book documents meetings with Native American elders who shared their tribal stories of origin, sacred traditions, social life and customs, and traditional wisdom. The idea for the book began when a Cherokee medicine man requested that his tribal knowledge be documented for future generations. For the past 10 years, the spiritual elders of…

[Social inequality and participation in aging urban societies].

PubMed

Rüssler, H; Köster, D; Heite, E; Stiel, J

2013-06-01

The social and political participation of elderly people is characterized by social inequality. Participation processes normally consolidate and intensify the exclusion of senior citizens having low incomes and low educational qualifications. In the research and development project "Quality of Life of Elderly People in Living Quarters" being conducted by Dortmund University of Applied Sciences and Arts, one of the questions being examined is whether and to what extent socially disadvantaged elderly people in a social space typical of the Ruhr region (reference area Gelsenkirchen-Schalke) can be included in the shaping of their quarter. This paper is based on the results of a quantitative, written survey (cross-section) on the subjects of quality of life and participation, and on a trend analysis measuring the effects of participation processes initiated on the elderly persons involved. The results of the study show that it is possible to involve socially disadvantaged elderly people in participation processes geared to the specific social space. They also indicate that elderly people from different income groups increase their social capital in the context of enabling structures.

Health-Related Quality of Life and Preferred Health-Seeking Institutions among Rural Elderly Individuals with and without Chronic Conditions: A Population-Based Study in Guangdong Province, China

PubMed Central

Zhou, Zhiheng; Wang, Caixia; Yang, Huajie; Wang, Xiang; Zheng, Chanjiao; Wang, Jiaji

2014-01-01

The aim of this study was to examine health-related quality of life (HRQL) as measured by SF-36 and to identify these factors and the preferred health-seeking institutions of 12,800 persons aged 60 and older with and without chronic conditions in rural areas of Guangdong Province by multistage stratified cluster sampling method. HRQL among rural elderly subjects with chronic conditions was lower than that of elderly subjects with no chronic conditions. Multiple linear regression showed that marital status, living with children, cardiovascular disease, osteoporosis, cataract disease, and mental disease were the main affecting factors of HRQL. The main preferred health-seeking institutions selected by the rural elderly were community/town health service institutions, district hospitals, or secondary hospitals. Our findings indicate that the elderly in rural areas of Guangdong Province have a poor HRQL and incorrect health-seeking pathway. The healthcare policymakers should emphasize the need of developing effective and targeted community services strategies to improve the elderly individuals' HRQL in rural areas of China. PMID:24949425

A family involvement and patient-tailored health management program in elderly Korean stroke patients' day care centers.

PubMed

Chang, Ae Kyung; Park, Yeon-Hwan; Fritschi, Cynthia; Kim, Mi Ja

2015-01-01

This study aimed to examine the effects of a family involvement and functional rehabilitation program in an adult day care center on elderly Korean stroke patients' perceived health, activities of daily living, instrumental activities of daily living, and cost of health services, and on family caregivers' satisfaction. Using one-group pre- and posttest design, dyads consisting of 19 elderly stroke patients and family caregivers participated in 12-week intervention, including involvement of family caregivers in day care services and patient-tailored health management. Outcomes of patients and caregivers were significantly improved (all p < .001). However, the cost of health services did not decrease significantly. This program improved functional levels and health perception of elderly stroke patients and caregivers' satisfaction. However, results must be interpreted with caution, because this was only a small, single-group pilot study. This program may be effective for elderly stroke patients and their caregivers. © 2013 Association of Rehabilitation Nurses.

[The benefits of doing excercise in the elderly].

PubMed

Avila-Funes, José Alberto; García-Mayo, Emilio José

2004-01-01

Advanced age is associated with changes in body composition such as muscular mass loss, which is defined as sarcopenia. The former term plays a key role in the frailty model, although its source is unknown. Myriad strategies have been used to improve and increase muscular mass and function in older persons. The muscle is a versatile system that owes its great capacity to adaption to regular exercise programs. Aerobic exercise and resistance training improve muscular function and can minimize and even reverse sarcopenia in the elderly (healthy, very elderly or frail). The main difference in prescribing exercise for healthy adults and elderly individuals is that intensity of training program is lower for the latter. This review is aimed toward the physiopathologic aspects and clinical implications regarding muscular mass loss and to programs directed toward increasing strength and/or endurance in the elderly.

The association between observed mobility and quality of life in the near elderly

PubMed Central

Sullivan, Jeff; Goldman, Dana P.; Gill, Thomas M.

2017-01-01

Introduction Chronic diseases associated with aging, such as arthritis, frequently cause reduced mobility, pain and diminished quality of life. To date, research on the association between mobility and quality of life has primarily focused in the elderly; hence, much less is known about this association in the near elderly. This cross-sectional study aimed to assess the association between mobility and quality of life measures in the near elderly. Methods A prospective observational study of persons aged 50–69 years was conducted. The primary endpoint was quality of life measured by EQ-5D-5L, and the primary explanatory variable was observed mobility assessed using the 6-minute walk distance (6MWD). We applied regression models controlling for demographic, health status and other factors to evaluate the association between 6MWD and EQ-5D-5L. Results Of the 183 participants analyzed in the study, 37% were male and the average age was 59.8 years. After adjusting for differences in demographic characteristics and health status, EQ-5D-5L-based utility values were 0.046 points (p<0.001), or 5.2% (95% CI: 2.7% to 7.8%), higher on average for individuals with 100 meters longer 6MWD. Holding constant the mobility-specific component of EQ-5D-5L, we still found that walking an additional 100 meters was associated with an EQ-5D-5L utility value that was 0.029 points (p<0.001), or 3.5% (95% CI: 1.7% to 5.5%), higher than the average participant. Among persons with arthritis, the association between 6MWD and EQ-5D-5L was slightly stronger. Conclusions Near elderly persons with better mobility had higher quality of life. Diseases that decrease mobility, such as arthritis, are likely to have a significant impact on quality of life. PMID:28827806

Needs and Problems of Posbindu Program: Community Health Volunteers Perspective

NASA Astrophysics Data System (ADS)

Putri, S. T.; Andriyani, S.

2018-01-01

Posbindu is a form of public participation to conduct early detection and monitoring of risk factors for non-communicable diseases(NCD), and where it was carried out in as an integrated manner, routine and periodic event. This paper aims to investigates the needs and problems on Posbindu Program based on community health volunteers(CHVs) perspective. This study used descriptive qualitative method by open ended questions. Content analysis using to explicating the result. There are 3 theme finding about elderly needs in Posbindu; medical care, support group community, and health education. We found four theme problems which in Posbindu program: low motivation from elderly, Inadequate of facilities, physical disability, failed communication. To be effective in Posbindu program, all the stakeholders have reached consensus on the Posbindu program as elderly need. CHVs need given wide knowledge about early detection, daily care, control disease continuously so that the elderly keep feeling the advantages of coming to the Posbindu.

Recommendations for Infant Feeding Policy and Programs in Dzimauli Region, South Africa: Results From the MAL-ED Birth Cohort

PubMed Central

Mushaphi, Lindelani Fhumudzani; Mahopo, Tjale Cloupas; Nesamvuni, Cebisa Noxolo; Baloyi, Brenda; Mashau, Ellen; Richardson, Jeniata; Dillingham, Rebecca; Guerrant, Richard; Ambikapathi, Ramya; Bessong, Pascal

2018-01-01

Background There is strong evidence that exclusive breastfeeding (EBF) in the first 6 months of life reduces the risk of diseases in infancy and in later life. Objective To understand the maternal reasoning that influences optimum infant feeding practices of caregivers in semirural communities of Limpopo province. Methods Nested qualitative study among mothers in an ongoing birth cohort study was conducted; structured and semi-structured interviews were used to collect data. Data from 234 infants after 6 months of follow-up was included for quantitative analysis. Four focus discussion groups comprising 7 to 10 caregivers were used to obtain perception of mothers on breastfeeding. A semi-structured interview guide was used to stimulate discussions. Thematic content analyses were conducted to identify the main themes that influence breastfeeding practices of caregivers. Results Over 90% of the caregivers initiated breastfeeding after delivery. However, less than 1% of mothers practiced EBF by 3 months, and none of the children were exclusively breastfed for up to 6 months. All caregivers introduced non–breast milk liquids and solids by the second month of child’s life. Common reasons for introducing non–breast milk foods included insufficiency of breast milk production, going back to work or school, and influence by elderly women (mothers/mothers-in-law) and church members. Conclusion Exclusive breastfeeding was not practiced in this community due to cultural and religious beliefs and misinformation. The involvement of elderly women and church members in infant feeding education and promotion programs and the dissemination of breastfeeding information through mobile phones to younger mothers are recommended. PMID:28958169

25 CFR 20.400 - Who should receive Services to Children, Elderly, and Families?

Code of Federal Regulations, 2010 CFR

2010-04-01

... 25 Indians 1 2010-04-01 2010-04-01 false Who should receive Services to Children, Elderly, and... FINANCIAL ASSISTANCE AND SOCIAL SERVICES PROGRAMS Services to Children, Elderly, and Families § 20.400 Who should receive Services to Children, Elderly, and Families? Services to Children, Elderly, and Families...

25 CFR 20.400 - Who should receive Services to Children, Elderly, and Families?

Code of Federal Regulations, 2011 CFR

2011-04-01

... 25 Indians 1 2011-04-01 2011-04-01 false Who should receive Services to Children, Elderly, and... FINANCIAL ASSISTANCE AND SOCIAL SERVICES PROGRAMS Services to Children, Elderly, and Families § 20.400 Who should receive Services to Children, Elderly, and Families? Services to Children, Elderly, and Families...

A poetry program for the very elderly—Narrative perspective on one therapeutic model

PubMed Central

Wexler, Marvin

2014-01-01

The focus of this report is a poetry program that the author has been conducting at a nursing home/short-stay rehabilitation facility for the past three and a half years. The program involves reading poetry to groups of very elderly residents who have significant mental and/or physical disabilities. This article includes a description of the program and the author's observations of its beneficial effects. Poetry readings were also given to individual seniors who have significant dementia. The therapeutic value of the program to the elders and to the person reading the poetry to the elders is discussed. PMID:24899783

42 CFR 460.12 - Application requirements.

Code of Federal Regulations, 2010 CFR

2010-10-01

... (CONTINUED) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PACE Organization Application and Waiver Process § 460.12 Application requirements. (a...

42 CFR 460.54 - Termination procedures.

Code of Federal Regulations, 2010 CFR

2010-10-01

... (CONTINUED) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) Sanctions, Enforcement Actions, and Termination § 460.54 Termination procedures. (a) Except...

42 CFR 460.104 - Participant assessment.

Code of Federal Regulations, 2011 CFR

2011-10-01

... (CONTINUED) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PACE Services § 460.104 Participant assessment. (a) Initial comprehensive assessment—(1...

42 CFR 460.54 - Termination procedures.

Code of Federal Regulations, 2011 CFR

2011-10-01

... (CONTINUED) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) Sanctions, Enforcement Actions, and Termination § 460.54 Termination procedures. (a) Except...

42 CFR 460.12 - Application requirements.

Code of Federal Regulations, 2011 CFR

2011-10-01

... (CONTINUED) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PACE Organization Application and Waiver Process § 460.12 Application requirements. (a...

42 CFR 460.210 - Medical records.

Code of Federal Regulations, 2010 CFR

2010-10-01

...) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE... record must contain the following: (1) Appropriate identifying information. (2) Documentation of all...

42 CFR 460.210 - Medical records.

Code of Federal Regulations, 2011 CFR

2011-10-01

...) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE... record must contain the following: (1) Appropriate identifying information. (2) Documentation of all...

The effect of a VR exercise program on falls and depression in the elderly with mild depression in the local community.

PubMed

Yang, Jong-Eun; Lee, Tac-Young; Kim, Jin-Kyung

2017-12-01

[Purpose] The purpose of this study is to explore the effect of a VR exercise program on falls and depression in the elderly with mild depression who reside in the local community. [Subjects and Methods] This study was performed by targeting 15 elderly subjects with mild depression who resided in the local community. The targeted subjects voluntarily selected 3 VR exercise programs (each lasting 10 minutes) among 4 activities, and a resting time of 5 minutes was given for an interval after each activity. The VR exercise program was performed for total 12 weeks (36 times), 3 times a week, 45 minutes per session. [Results] After exercise, scores of static balance test (anteroposterior), Falls Efficacy Scale, and the Activities-specific Balance Confidence Scale in the test subjects were improved and depression and internal stress scores were significantly decreased after the intervention. [Conclusion] It can be concluded that the VR exercise program exerts a positive effect not only on the physical factor but also on the mental factor of the elderly subjects with mild depression who reside in the local community. It is expected that based on the VR exercise program, diversified home programs for the elderly should be developed in the future.

Oral Health-Related Quality of Life in the Elderly in Israel--Results from the National Health and Nutrition Survey of the Elderly 2005-2006.

PubMed

Zusman, Shlomo Paul; Kushnir, Daniel; Natapov, Lena; Goldsmith, Rebecca; Dichtiar, Rita

2016-01-01

To assess the oral health-related quality of life of the Israeli elderly. Data were collected from a subsample of those interviewed for the cross-sectional Mabat Zahav National Health and Nutrition Survey of the Elderly, carried out in 2005 and 2006 by the Ministry of Health in Israel. In-person interviews were conducted in the interviewees' homes using a structured questionnaire which included 7 questions on subjective dental health status and the 14 questions of the Oral Health Impact Profile 14 (OHIP-14). Statistical significance of continuous variables was assessed with the Student t-test; categorical variables with normal distribution were analysed using the chi-square test and those with non-normal distribution with the Wilcoxon Mann-Whitney two-sample test. 828 Jews and 159 Arabs from the total survey population of 1852 elderly (1536 Jews and 316 Arabs) completed the OHIP-14 questionnaire. An impact of oral health on the quality of life was reported by 16.6% of the respondents, 19.2% of females and 13.9% of males (p<0.05). There were statistically significant differences in impact prevalence by gender, place of birth and economic status. No such differences were found by age group, population group or education. Significant statistical correlation was found between subjective assessment of general and dental health and OHIP impact prevalence, with poorer assessment correlated with increased prevalence of impact. The quality of life of 17% of Israeli elderly is affected by oral health. The OHIP-14 findings emphasise the importance of including basic dental treatment (treatment of dental pain and infections) in the range of services covered by the National Health Insurance Law.

Cost-effectiveness of vaccination against pneumococcal bacteremia among elderly people.

PubMed

Sisk, J E; Moskowitz, A J; Whang, W; Lin, J D; Fedson, D S; McBean, A M; Plouffe, J F; Cetron, M S; Butler, J C

Clinical, epidemiologic, and policy considerations support updating the cost-effectiveness of pneumococcal vaccination for elderly people and targeting the evaluation only to prevention of pneumococcal bacteremia. To assess the implications for medical costs and health effects of vaccination against pneumococcal bacteremia in elderly people. Cost-effectiveness analysis of pneumococcal vaccination compared with no vaccination, from a societal perspective. The elderly population aged 65 years and older in the United States in 3 geographic areas: metropolitan Atlanta, Ga; Franklin County, Ohio; and Monroe County, New York. Incremental medical costs and health effects, expressed in quality-adjusted life-years per person vaccinated. Vaccination was cost saving, ie, it both reduced medical expenses and improved health, for all age groups and geographic areas analyzed in the base case. For people aged 65 years and older, vaccination saved $8.27 and gained 1.21 quality-adjusted days of life per person vaccinated. Vaccination of the 23 million elderly people unvaccinated in 1993 would have gained about 78000 years of healthy life and saved $194 million. In univariate sensitivity analysis, the results remained cost saving except for doubling vaccination costs, including future medical costs of survivors, and lowering vaccination effectiveness. With assumptions most unfavorable to vaccination, cost per quality-adjusted life-year ranged from $35 822 for ages 65 to 74 years to $598 487 for ages 85 years and older. In probabilistic sensitivity analysis, probability intervals were more narrow, with less than 5% probability that the ratio for ages 85 years and older would exceed $100000. Pneumococcal vaccination saves costs in the prevention of bacteremia alone and is greatly underused among the elderly population, on both health and economic grounds. These results support recent recommendations of the Advisory Committee on Immunization Practices and public and private efforts under way to improve vaccination rates.

Early 4-week cardiac rehabilitation exercise training in elderly patients after heart surgery.

PubMed

Eder, Barbara; Hofmann, Peter; von Duvillard, Serge P; Brandt, Dieter; Schmid, Jean-Paul; Pokan, Rochus; Wonisch, Manfred

2010-01-01

The aim of this study was to assess the effects on exercise performance of supplementing a standard cardiac rehabilitation program with additional exercise programming compared to the standard cardiac rehabilitation program alone in elderly patients after heart surgery. In this prospective, randomized controlled trial, 60 patients (32 men and 28 women, mean age 73.1 +/- 4.7 years) completed cardiac rehabilitation (initiated 12.2 +/- 4.9 days postsurgery). Subjects were assigned to either a control group (CG, standard cardiac rehabilitation program [n = 19]), or an intervention group (IG, additional walking [n = 19], or cycle ergometry training [n = 22]). A symptom limited cardiopulmonary exercise test and 6-minute walk test (6MWT) were performed before and after 4 weeks of cardiac rehabilitation. The MacNew questionnaire was used to assess quality of life (QOL). At baseline, no significant differences for peak oxygen uptake ((.)VO2), maximal power output, or the 6MWT were detected between IG and CG. Global QOL was significantly higher in IG. After 4 weeks of cardiac rehabilitation, patients significantly improved in absolute values of the cardiopulmonary exercise test, 6MWT, and QOL scores. Significant differences between groups were found for peak (.)VO2 (IG: 18.2 +/- 3.1 mL x kg x min vs. CG: 16.5 +/- 2.2 mL x kg x min, P < .05); maximal power output (IG: 72.2 +/- 16 W vs. CG: 60.7 +/- 15 W, P < .05); 6MWT (IG: 454.8 +/- 76.3 m vs. CG: 400.5 +/- 75.5 m, P < .05); and QOL global (IG: 6.5 +/- 0.5 vs. CG: 6.3 +/- 0.6, P < .05). The supplementation of additional walking or cycle exercise training to standard cardiac rehabilitation programming compared to standard cardiac rehabilitation alone in elderly patients after heart surgery leads to significantly better exercise tolerance.

Health and human services in an age of maturity.

PubMed

Aldridge, M G

1986-12-01

Catholic health care organizations are experiencing a tension between evangelical mission and expanding competition in medical markets. For the voluntary, not-for-profit health and human services system to survive and grow, hospital communities must find new revenue sources that do not create dependence on state and federal monies. The United States entered the Age of Maturity in 1985 as the "baby boomers" born between 1945 and 1957 became 40 years old, requiring health care providers to begin to plan for their care in old age. This large aging population, combined with a longer life span for Americans, will put increased burdens on health care organizations, particularly for chronic care, up to the year 2020 or beyond. Changes in family structure and social networks will be necessary as more people care for older relatives. The ratio of nonworkers to workers will increase, further burdening national and state tax bases, Social Security, and other worker-contributor programs. Investment banks are one option to finance the older population's increased needs for health and human services. Investment banks are funded by donations from the private sector (local and national businesses), the public sector (state, national, and local agencies), and new for-profit ventures for older persons. The contributions themselves remain in a central fund, with only the interest generated being used to fund local organizations committed to financial self-sufficiency and to helping the elderly. Older persons will carry increased economic and political clout in the Age of Maturity and will constitute a large percentage of hospitals' business. Therefore hospitals will have to develop a strong market position among the elderly. They must consider integrating a new service mix of both health and human services. Candidates for new hospital services for the elderly include housing programs, long-term care and continuum of care programs, employment programs, retirement planning, estate planning, day care, education and leisure programs, and family counseling.

[The prevalence of heartburn in the elderly patients in urban outpatient clinics in Russia].

PubMed

Morozov, S V; Stavraki, E S; Isakov, V A

2010-01-01

Heartburn is the most common symptom of GERD. It's prevalence among different age groups of Russian population has not been studied yet. To study the prevalence of heartburn and its influence on the quality of life patterns in Russian urban primary care patients. The data presented in the article is a part of ARIADNE study on epidemiology of heartburn in Russian urban population. A cross-sectional survey, using a reliable and validated self-filled questionnaire was performed on randomly selected 18706 primary care patients in the 11 largest cities of Russia. The data of 14,521 respondents were available to the final analysis. Among the respondents 8,643 (59.5%) reported heartburn, among them elderly (> or = 60 y. o.) 2,017. Heartburn was more prevalent in elderly (61.87%) compared to younger people (59.29%), p = 0.028. Frequent (> or = 2 times a week) heartburn was found in 3,295 respondents. The prevalence of frequent symptom was also higher in elderly then in people less than 60 y. o.: 30.59% compared to 21.42%, p < 0.001. The deeper influence of heartburn on the quality of life of the elderly respondents was found compared to younger patients, especially in regard to necessity to avoid favorite dishes and beverages (40.95% vs 37.52% in younger, p = 0.021), sleep disturbance (29.41% vs 19.22% respectively, p = 0.00001), need to limit physical activity (16.99% vs 13.61%, p = 0.0015). CONCLUSIONS; Heartburn is the prevalent symptom among Russian urban primary care patients. The prevalence of heartburn in patients 60 y. o. and older is higher than in younger people. Frequent heartburn is more prevalent in elderly people compared to younger. The quality of life is significantly decreased in patients experiencing heartburn. The impact of heartburn on the quality of life changes is stronger in elderly people.

South Winnipeg Integrated Geriatric Program (SWING): A Rapid Community-Response Program for the Frail Elderly

ERIC Educational Resources Information Center

Montgomery, Patrick R.; Fallis, Wendy M.

2003-01-01

The objective of this study was to compare enhanced access to geriatric assessment and case management to usual home care service provision for the frail elderly. This was a demonstration project, with randomized allocation to control or intervention groups of frail elderly persons who had been referred to the Home Care service in Winnipeg. Of the…

A Statewide Faculty Development Program for Undergraduate Social Work Educators in Eldercare. Final Report.

ERIC Educational Resources Information Center

Texas Consortium of Geriatric Education Centers, Houston.

The goal of the faculty development program that formed the basis of this project was to provide more social workers trained in working effectively with the elderly. Demographics indicate that the number of elderly, including frail elderly, will increase, and the need for social workers in this area already exceeds the available supply. Objectives…

Effect of Systematic Intensive Care Unit Triage on Long-term Mortality Among Critically Ill Elderly Patients in France: A Randomized Clinical Trial.

PubMed

Guidet, Bertrand; Leblanc, Guillaume; Simon, Tabassome; Woimant, Maguy; Quenot, Jean-Pierre; Ganansia, Olivier; Maignan, Maxime; Yordanov, Youri; Delerme, Samuel; Doumenc, Benoit; Fartoukh, Muriel; Charestan, Pierre; Trognon, Pauline; Galichon, Bertrand; Javaud, Nicolas; Patzak, Anabela; Garrouste-Orgeas, Maïté; Thomas, Caroline; Azerad, Sylvie; Pateron, Dominique; Boumendil, Ariane

2017-10-17

The high mortality rate in critically ill elderly patients has led to questioning of the beneficial effect of intensive care unit (ICU) admission and to a variable ICU use among this population. To determine whether a recommendation for systematic ICU admission in critically ill elderly patients reduces 6-month mortality compared with usual practice. Multicenter, cluster-randomized clinical trial of 3037 critically ill patients aged 75 years or older, free of cancer, with preserved functional status (Index of Independence in Activities of Daily Living ≥4) and nutritional status (absence of cachexia) who arrived at the emergency department of one of 24 hospitals in France between January 2012 and April 2015 and were followed up until November 2015. Centers were randomly assigned either to use a program to promote systematic ICU admission of patients (n=1519 participants) or to follow standard practice (n=1518 participants). The primary outcome was death at 6 months. Secondary outcomes included ICU admission rate, in-hospital death, functional status, and quality of life (12-Item Short Form Health Survey, ranging from 0 to 100, with higher score representing better self-reported health) at 6 months. One patient withdrew consent, leaving 3036 patients included in the trial (median age, 85 [interquartile range, 81-89] years; 1361 [45%] men). Patients in the systematic strategy group had an increased risk of death at 6 months (45% vs 39%; relative risk [RR], 1.16; 95% CI, 1.07-1.26) despite an increased ICU admission rate (61% vs 34%; RR, 1.80; 95% CI, 1.66-1.95). After adjustments for baseline characteristics, patients in the systematic strategy group were more likely to be admitted to an ICU (RR, 1.68; 95% CI, 1.54-1.82) and had a higher risk of in-hospital death (RR, 1.18; 95% CI, 1.03-1.33) but had no significant increase in risk of death at 6 months (RR, 1.05; 95% CI, 0.96-1.14). Functional status and physical quality of life at 6 months were not significantly different between groups. Among critically ill elderly patients in France, a program to promote systematic ICU admission increased ICU use but did not reduce 6-month mortality. Additional research is needed to understand the decision to admit elderly patients to the ICU. clinicaltrials.gov Identifier: NCT01508819.

Generational Differences In U.S. Public Spending, 1980–2000

PubMed Central

Pati, Susmita; Keren, Ron; Alessandrini, Evaline A.; Schwarz, Donald F.

2013-01-01

The balance between spending on children and spending on the elderly is important in evaluating the allocation of public welfare spending. We examine trends in public spending on social welfare programs for children and the elderly during 1980–2000. For both groups, social welfare spending as a percentage of gross domestic product changed little, even during the economic expansions of the 1990s. In constant dollars, the gap in per capita social welfare spending between children and the elderly grew 20 percent. Unlike spending for programs for the elderly, spending for children’s programs suffered during recessions. Public discussion about the current imbalance in public spending is needed. PMID:15371377

42 CFR 460.160 - Continuation of enrollment.

Code of Federal Regulations, 2010 CFR

2010-10-01

... (CONTINUED) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) Participant Enrollment and Disenrollment § 460.160 Continuation of enrollment. (a) Duration...

42 CFR 460.172 - Documentation of disenrollment.

Code of Federal Regulations, 2011 CFR

2011-10-01

... (CONTINUED) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) Participant Enrollment and Disenrollment § 460.172 Documentation of disenrollment. A PACE...

42 CFR 460.52 - Transitional care during termination.

Code of Federal Regulations, 2010 CFR

2010-10-01

... SERVICES (CONTINUED) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) Sanctions, Enforcement Actions, and Termination § 460.52 Transitional care...

42 CFR 460.140 - Additional quality assessment activities.

Code of Federal Regulations, 2011 CFR

2011-10-01

... SERVICES (CONTINUED) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) Quality Assessment and Performance Improvement § 460.140 Additional quality...

42 CFR 460.166 - Effective date of disenrollment.

Code of Federal Regulations, 2010 CFR

2010-10-01

... SERVICES (CONTINUED) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) Participant Enrollment and Disenrollment § 460.166 Effective date of...

42 CFR 460.160 - Continuation of enrollment.

Code of Federal Regulations, 2011 CFR

2011-10-01

... (CONTINUED) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) Participant Enrollment and Disenrollment § 460.160 Continuation of enrollment. (a) Duration...

42 CFR 460.52 - Transitional care during termination.

Code of Federal Regulations, 2011 CFR

2011-10-01

... SERVICES (CONTINUED) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) Sanctions, Enforcement Actions, and Termination § 460.52 Transitional care...

42 CFR 460.166 - Effective date of disenrollment.

Code of Federal Regulations, 2011 CFR

2011-10-01

... SERVICES (CONTINUED) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) Participant Enrollment and Disenrollment § 460.166 Effective date of...

Mental health first aid for the elderly: A pilot study of a training program adapted for helping elderly people.

PubMed

Svensson, Bengt; Hansson, Lars

2017-06-01

Epidemiological studies have shown a high prevalence of mental illness among the elderly. Clinical data however indicate both insufficient detection and treatment of illnesses. Suggested barriers to treatment include conceptions that mental health symptoms belong to normal aging and lack of competence among staff in elderly care in detecting mental illness. A Mental Health First Aid (MHFA) training program for the elderly was developed and provided to staff in elderly care. The aim of this study was to investigate changes in knowledge in mental illness, confidence in helping a person, readiness to give help and attitudes towards persons with mental illness. Single group pre-test-post-test design. The study group included staff in elderly care from different places in Sweden (n = 139). Significant improvements in knowledge, confidence in helping an elderly person with mental illness and attitudes towards persons with mental illness are shown. Skills acquired during the course have been practiced during the follow-up. The adaption of MHFA training for staff working in elderly care gives promising results. Improvements in self-reported confidence in giving help, attitudes towards persons with mental illness and actual help given to persons with mental illness are shown. However, the study design allows no firm conclusions and a randomized controlled trail is needed to investigate the effectiveness of the program. Outcomes should include if the detection and treatment of mental illness among the elderly actually improved.

A health recreation program for u-healthcare clients: effects on mental health.

PubMed

Lee, Jisan; Kim, Jeongeun; Jeong, Suyong; Choi, Hanna; Jin, Meiling; Kim, Sukwha

2014-10-01

In this study, a health recreation program was implemented with elderly patients (60 years of age or older) who were receiving ubiquitous healthcare (u-healthcare) services. Furthermore, we examined the effects of health recreation on perceived stress, anxiety, and depression, by comparing survey results before and after the recreation program was conducted. Thus, the aim of this study was to develop an offline service with the ability to promote the impact of the u-healthcare service on mental healthcare. A health recreation program, consisting of a variety of weekly games, songs, and minilectures about mental health over a 10-week period, was offered at a senior citizens center in K-Gu, Seoul, Korea. This program targeted 18 elderly people currently receiving u-healthcare services. Data on the impact of the program on the mental health of the elderly were collected through surveys administered before and after the recreation program, and the results were compared with those of a control group. The control group consisted of 18 elderly people who were receiving u-healthcare services from the same district. The perceived stress and anxiety of the experimental group decreased significantly compared with those of the control group. However, the program did not result in a significant reduction in depression. This offline health recreation program offered to elderly u-healthcare service clients contributed to the promotion of their mental health. Further studies will be required to better incorporate the offline mental healthcare program into their daily lives within the u-healthcare service.

The Role of Life-Space, Social Activity, and Depression on the Subjective Memory Complaints of Community-Dwelling Filipino Elderly: A Structural Equation Model

ERIC Educational Resources Information Center

de Guzman, Allan B.; Lagdaan, Lovely France M.; Lagoy, Marie Lauren V.

2015-01-01

Subjective memory complaints are one of the major concerns of the elderly and remain a challenging area in gerontology. There are previous studies that identify different factors affecting subjective memory complaints. However, an extended model that correlates life-space on subjective memory complaints remains a blank spot. The objective of this…

Pitfalls in communication that lead to nonbeneficial emergency surgery in elderly patients with serious illness: description of the problem and elements of a solution.

PubMed

Cooper, Zara; Courtwright, Andrew; Karlage, Ami; Gawande, Atul; Block, Susan

2014-12-01

To provide a description of communication breakdowns and to identify interventions to improve surgical decision making for elderly patients with serious illness and acute, life-threatening surgical conditions. Communication between surgeons, patients, and surrogates about goals of treatment plays an important and understudied role in determining the surgical interventions elderly patients with serious illness receive. Communication breakdowns may lead to nonbeneficial procedures in acute events near the end of life. We review the available literature on factors that lead to communication challenges and nonbeneficial surgery at the end of life. We use this review to identify solutions for navigating surgical decision making for seriously ill elderly patients with acute surgical conditions. Surgeon, patient, surrogate, and systemic factors-including time constraints, inadequate provider communication skills and training, uncertainty about prognosis, patient and surrogate anxiety and fear of inaction, and limitations in advance care planning-contribute to communication challenges and nonbeneficial surgery at the end of life. Surgeons could accomplish more effective communication with seriously ill elderly patients if they had a structured, standardized approach to exploring patients' preferences and to integrating those preferences into surgical decisions in the acute setting. Improved communication among surgeons, patients, and surrogates is necessary to ensure that patients receive the care that they want and to avoid nonbeneficial treatment. Further research is needed to learn how to best structure these conversations in the emergency surgical setting.

Oral health-related quality of life and nutritional status of institutionalized elderly population aged 60 years and above in Mysore City, India.

PubMed

Kshetrimayum, Nandita; Reddy, Chavva Venkata Konda; Siddhana, Sunitha; Manjunath, Maurya; Rudraswamy, Sushma; Sulavai, Sibyl

2013-06-01

To assess whether oral health-related quality of life (OHRQoL) is associated with nutritional status in the institutionalised elderly population of Mysore. Malnutrition in the elderly has an evident impact on their general health and quality of life. Analysis of data of the Geriatric Oral Health Assessment Index (GOHAI) and their association with the Mini Nutritional Assessment (MNA) results improves our understanding of the complex relationship between oral health and malnutrition. The study was conducted among the institutionalised elderly population in Mysore city, Karnataka. Data on socio-demographic, oral health status were gathered. OHRQoL was evaluated using GOHAI, and malnutrition risk using MNA. Out of 141 elderly, 41.1% were men and 58.9% were women with mean age of 72.2 ±7.5 years. Mean GOHAI score was 47.03 ± 9.2, with 69.5% had low perception of oral health. Mean MNA score was 9.91 ± 2.4, 15.6% were malnourished, 52.5% were at risk of malnutrition and 31.9% were adequately nourished. A strong association was found between the mean GOHAI and MNA scores.  Oral health-related quality of life was associated with nutritional deficit, and it requires a greater integration between dentistry and nutrition in the health promotion of older adults. © 2012 John Wiley & Sons A/S and The Gerodontology Society. Published by John Wiley & Sons Ltd.

Smoking status and its relationship with exercise capacity, physical activity in daily life and quality of life in physically independent, elderly individuals.

PubMed

Mesquita, R; Gonçalves, C G; Hayashi, D; Costa, V de S P; Teixeira, D de C; de Freitas, E R F S; Felcar, J M; Pitta, F; Molari, M; Probst, V S

2015-03-01

To investigate the relationship between smoking status and exercise capacity, physical activity in daily life and health-related quality of life in physically independent, elderly (≥60 years) individuals. Cross-sectional, observational study. Community-dwelling, elderly individuals. One hundred and fifty-four elderly individuals were categorised into four groups according to their smoking status: never smokers (n=57), passive smokers (n=30), ex-smokers (n=45) and current smokers (n=22). Exercise capacity [6-minute walk test (6MWT)], physical activity in daily life (step counting) and health-related quality of life [36-Item Short Form Health Survey (SF-36) questionnaire] were assessed. Current and ex-smokers had lower mean exercise capacity compared with never smokers: 90 [standard deviation (SD) 10] % predicted, 91 (SD 12) % predicted and 100 (SD 13) % predicted distance on 6MWT, respectively [mean differences -9.8%, 95% confidence intervals (CI) -17.8 to -1.8 and -9.1%, 95% CI -15.4 to -2.7, respectively; P<0.05 for both]. The level of physical activity did not differ between the groups, but was found to correlate negatively with the level of nicotine dependence in current smokers (r=-0.47, P=0.03). The median score for the mental health dimension of SF-36 was worse in passive {72 [interquartile range (IQR) 56 to 96] points} and current [76 (IQR 55 to 80) points] smokers compared with ex-smokers [88 (IQR 70 to 100) points] (median differences -16 points, 95% CI -22.2 to -3.0 and -12 points, 95% CI -22.8 to -2.4, respectively; P<0.05 for both). Among elderly individuals, current smokers had lower exercise capacity than never smokers. Although the level of physical activity did not differ between the groups, an association was found with smoking. Tobacco exposure was associated with worse scores for the mental health dimension of SF-36 in physically independent, elderly individuals. Copyright © 2014 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

42 CFR 460.122 - PACE organization's appeals process.

Code of Federal Regulations, 2011 CFR

2011-10-01

... SERVICES (CONTINUED) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) Participant Rights § 460.122 PACE organization's appeals process. For purposes...

42 CFR 460.158 - Effective date of enrollment.

Code of Federal Regulations, 2010 CFR

2010-10-01

... (CONTINUED) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) Participant Enrollment and Disenrollment § 460.158 Effective date of enrollment. A...

42 CFR 460.122 - PACE organization's appeals process.

Code of Federal Regulations, 2010 CFR

2010-10-01

... SERVICES (CONTINUED) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) Participant Rights § 460.122 PACE organization's appeals process. For purposes...

42 CFR 460.170 - Reinstatement in PACE.

Code of Federal Regulations, 2011 CFR

2011-10-01

... (CONTINUED) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) Participant Enrollment and Disenrollment § 460.170 Reinstatement in PACE. (a) A previously...

42 CFR 460.116 - Explanation of rights.

Code of Federal Regulations, 2010 CFR

2010-10-01

... (CONTINUED) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) Participant Rights § 460.116 Explanation of rights. (a) Written policies. A PACE...

42 CFR 460.156 - Other enrollment procedures.

Code of Federal Regulations, 2011 CFR

2011-10-01

... (CONTINUED) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) Participant Enrollment and Disenrollment § 460.156 Other enrollment procedures. (a) Items a...

42 CFR 460.158 - Effective date of enrollment.

Code of Federal Regulations, 2011 CFR

2011-10-01

... (CONTINUED) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) Participant Enrollment and Disenrollment § 460.158 Effective date of enrollment. A...

42 CFR 460.116 - Explanation of rights.

Code of Federal Regulations, 2011 CFR

2011-10-01

... (CONTINUED) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) Participant Rights § 460.116 Explanation of rights. (a) Written policies. A PACE...

42 CFR 460.156 - Other enrollment procedures.

Code of Federal Regulations, 2010 CFR

2010-10-01

... (CONTINUED) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) Participant Enrollment and Disenrollment § 460.156 Other enrollment procedures. (a) Items a...

42 CFR 460.170 - Reinstatement in PACE.

Code of Federal Regulations, 2010 CFR

2010-10-01

... (CONTINUED) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) Participant Enrollment and Disenrollment § 460.170 Reinstatement in PACE. (a) A previously...

Read Aloud Programs for the Elderly Project. Instructional Manual.

ERIC Educational Resources Information Center

Leonard, Gloria; And Others

This manual was developed by the staff of the Read Aloud Programs for the Elderly of the Seattle Public Library. It is based on a year's experience of conducting read-aloud programs in nursing homes and is meant to be a guide for setting up similar programs in other library systems. The first half of the manual, addressed to program managers,…

[Results of a physical therapy program in nursing home residents: A randomized clinical trial].

PubMed

Casilda-López, Jesús; Torres-Sánchez, Irene; Garzón-Moreno, Victor Manuel; Cabrera-Martos, Irene; Valenza, Marie Carmen

2015-01-01

The maintenance of the physical functionality is a key factor in the care of the elderly. Inactive people have a higher risk of death due to diseases associated with inactivity. In addition, the maintenance of optimal levels of physical and mental activity has been suggested as a protective factor against the development and progression of chronic illnesses and disability. The objective of this study is to assess the effectiveness of an 8-week exercise program with elastic bands, on exercise capacity, walking and balance in nursing home residents. A nursing home sample was divided into two groups, intervention group (n=26) and control group (n=25). The intervention group was included in an 8-week physical activity program using elastic bands, twice a week, while the control group was took part in a walking programme. Outcome measurements were descriptive variables (anthropometric characteristics, quality of life, fatigue, fear of movement) and fundamental variables (exercise capacity, walking and balance). A significant improvement in balance and walking speed was observed after the programme. Additionally, exercise capacity improved significantly (P≤.001), and the patients showed an improvement in perceived dyspnea after the physical activity programme in the intervention group. The exercise program was safe and effective in improving dyspnea, exercise capacity, walking, and balance in elderly. Copyright © 2014 SEGG. Published by Elsevier Espana. All rights reserved.

Harvest health: translation of the chronic disease self-management program for older African Americans in a senior setting.

PubMed

Gitlin, Laura N; Chernett, Nancy L; Harris, Lynn Fields; Palmer, Delores; Hopkins, Paul; Dennis, Marie P

2008-10-01

We describe the translation of K. R. Lorig and colleagues' Chronic Disease Self-Management Program (CDSMP) for delivery in a senior center and evaluate pre-post benefits for African American participants. Modifications to the CDSMP included a name change; an additional introductory session; and course augmentations involving culturally relevant foods, stress reduction techniques, and communicating with racially/ethnically diverse physicians. We recruited participants from senior center members, area churches, and word of mouth. We conducted baseline and 4-month post-interviews. A total of 569 African American elders attended an introductory session, with 519 (91%) enrolling in the 6-session program. Of the 519, 444 (86%) completed >/=4 sessions and 414 (79%) completed pre-post interviews. We found small but statistically significant improvements for exercise (p =.001), use of cognitive management strategies (p =.001), energy/fatigue (p =.001), self-efficacy (p =.001), health distress (p =.001), and illness intrusiveness in different life domains (probabilities from.001-.021). We found no changes for health utilization. Outcomes did not differ by gender, number of sessions attended, number and type of chronic conditions, facilitator, leader, or recruitment site. The CDSMP can be translated for delivery by trained senior center personnel to African American elders. Participant benefits compare favorably to original trial outcomes. The translated program is replicable and may help to address health disparities.

Quality of Life of the Elderly Receiving Old Age Pension in Lesotho.

PubMed

Mugomeri, Eltony; Chatanga, Peter; Khetheng, Ts'ele; Dhemba, Jotham

2017-01-01

The southern African country of Lesotho introduced an old age pension scheme in 2004 with the aim of enhancing the quality of life (QoL) of the nation's elderly population. This study is the first to assess the physical, psychological, social, and environmental aspects of the health-related QoL of the elderly in Lesotho since the pension scheme was adopted. Data for this study were gathered using the World Health Organization QoL-BREF questionnaire. Mean QoL scores were compared across demographic, socioeconomic, and clinical variables using analysis of variance, t test, and regression analysis. Findings indicate that respondents were least satisfied with the environmental and physical domains of QoL. They also indicate that the overall QoL of the elderly in Lesotho was mainly affected by marital status, level of education, type of housing, source of income, and level of satisfaction with income. These factors should thus be taken into account when developing interventions aimed at improving the QoL of the elderly in Lesotho.

Effectiveness of exercise and protein supplementation intervention on body composition, functional fitness, and oxidative stress among elderly Malays with sarcopenia.

PubMed

Shahar, Suzana; Kamaruddin, Norshafarina Shari; Badrasawi, Manal; Sakian, Noor Ibrahim Mohamed; Abd Manaf, Zahara; Yassin, Zaitun; Joseph, Leonard

2013-01-01

Sarcopenia, characterized as muscle loss that occurs with aging, is a major health problem in an aging population, due to its implications on mobility, quality of life, and fall risk. Protein supplementation could improve the physical fitness by increasing protein anabolism, and exercise has a documented evidence of positive effect on functional status among the elderly. However, the combined effect of both protein supplementation and exercise has not been investigated among sarcopenic elderly in the Asian population. Thus, this study aimed to determine the effectiveness of exercise intervention and protein supplementation either alone or in combination for 12 weeks, on body composition, functional fitness, and oxidative stress among elderly Malays with sarcopenia. Sixty five sarcopenic elderly Malays aged 60-74 years were assigned to the control group, exercise group (ExG), protein supplementation group (PrG), or the combination of exercise and protein supplementation group. A significant interaction effect between body weight and body mass index (BMI) was observed, with the PrG (-2.1% body weight, -1.8% BMI) showing the highest reductions. Further, there was a decrease in % body fat (-4.5%) and an increase in fat-free mass (kg) (+5.7%) in the ExG after 12 weeks (P < 0.05). The highest increments in lower and upper body strength were observed in the PrG (73.2%) and ExG (47.6%), respectively. In addition, the ExG showed a reduction in superoxide dismutase (SOD) levels, and both interventions did not alter either lipid or protein oxidation. In conclusion, the exercise program was found to improve muscle strength and body composition, while protein supplementation reduced body weight and increased upper body strength, among sarcopenic elderly in Malaysia.

Effectiveness of exercise and protein supplementation intervention on body composition, functional fitness, and oxidative stress among elderly Malays with sarcopenia

PubMed Central

Shahar, Suzana; Kamaruddin, Norshafarina Shari; Badrasawi, Manal; Sakian, Noor Ibrahim Mohamed; Manaf, Zahara Abd; Yassin, Zaitun; Joseph, Leonard

2013-01-01

Sarcopenia, characterized as muscle loss that occurs with aging, is a major health problem in an aging population, due to its implications on mobility, quality of life, and fall risk. Protein supplementation could improve the physical fitness by increasing protein anabolism, and exercise has a documented evidence of positive effect on functional status among the elderly. However, the combined effect of both protein supplementation and exercise has not been investigated among sarcopenic elderly in the Asian population. Thus, this study aimed to determine the effectiveness of exercise intervention and protein supplementation either alone or in combination for 12 weeks, on body composition, functional fitness, and oxidative stress among elderly Malays with sarcopenia. Sixty five sarcopenic elderly Malays aged 60–74 years were assigned to the control group, exercise group (ExG), protein supplementation group (PrG), or the combination of exercise and protein supplementation group. A significant interaction effect between body weight and body mass index (BMI) was observed, with the PrG (−2.1% body weight, −1.8% BMI) showing the highest reductions. Further, there was a decrease in % body fat (−4.5%) and an increase in fat-free mass (kg) (+5.7%) in the ExG after 12 weeks (P < 0.05). The highest increments in lower and upper body strength were observed in the PrG (73.2%) and ExG (47.6%), respectively. In addition, the ExG showed a reduction in superoxide dismutase (SOD) levels, and both interventions did not alter either lipid or protein oxidation. In conclusion, the exercise program was found to improve muscle strength and body composition, while protein supplementation reduced body weight and increased upper body strength, among sarcopenic elderly in Malaysia. PMID:24143082

Geriatric dentistry and prevention: research and public policy.

PubMed

Gershen, J A

1991-12-01

Changing demographics, including the increase in life expectancy and the growing numbers of elderly, has focused attention on the need for dental research activities to be expanded for geriatric dentistry. The elderly are at greater risk for oral disease, since gains in longevity result in more medically compromising conditions or systemic disease with oral manifestations. Also, as edentulism decreases and as more teeth are retained by the elderly, the pattern of oral diseases and the treatment of dental conditions will be altered. Barriers to self-care and professional care must be removed, and prevention and early intervention strategies must be formulated to reduce the risk of oral disease. Risk factors for oral diseases in the elderly can be reduced by personal home-care regimens, professionally provided preventive, diagnostic, and therapeutic care, changes in high-risk behavior, and a supportive environment. Generating new information about the prevention of oral diseases and conditions that have an impact on the elderly requires a substantial research effort. A research agenda for the elderly should include: epidemiologic studies of relevant oral diseases and related risk factors; investigations of patient and provider attitudes and behavior related to oral health; studies of the relationship between general health and oral health; development and testing of preventive and treatment strategies for conditions such as xerostomia, root caries, secondary caries, and gingival recession; and studies for the evaluation of the impact of the aging population on the dental delivery system. Public policy options to support geriatric oral health care and research are limited by the Government's pre-occupation with cost containment and the lack of visibility for dental programs.(ABSTRACT TRUNCATED AT 250 WORDS)

Elder abuse and dementia: a review of the research and health policy.

PubMed

Dong, XinQi; Chen, Ruijia; Simon, Melissa A

2014-04-01

Older adults with dementia may be at high risk for abuse, but the topic has not been well studied. We conducted a literature review to examine the relationships between elder abuse and dementia. We found that psychological abuse was the most common form of abuse among older adults, with estimates of its prevalence ranging from 27.9 percent to 62.3 percent. Physical abuse was estimated to affect 3.5-23.1 percent of older adults with dementia. We also found that many older adults experienced multiple forms of abuse simultaneously, and the risk of mortality from abuse and self-neglect may be higher in older adults with greater levels of cognitive impairment. We summarize programs and policies related to the abuse of older adults with dementia, including adult protective services, mandatory elder abuse reporting, and the Long-Term Care Ombudsman Program. We also summarize aspects of the National Alzheimer's Project Act, the Older Americans Act, and the Elder Justice Act. In spite of a recent increase in research and policy developments on elder abuse, challenges such as insufficient funding, limited knowledge about elder abuse, a lack of funding for the implementation of federal and state programs relevant to elder abuse and dementia, and a lack of dementia-specific training for front-line health care staff persist. Stronger programs targeting the well-being of older adults with dementia are needed.

42 CFR 460.132 - Quality assessment and performance improvement plan.

Code of Federal Regulations, 2011 CFR

2011-10-01

... AND HUMAN SERVICES (CONTINUED) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) Quality Assessment and Performance Improvement § 460.132 Quality...

42 CFR 460.18 - CMS evaluation of applications.

Code of Federal Regulations, 2010 CFR

2010-10-01

... (CONTINUED) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PACE Organization Application and Waiver Process § 460.18 CMS evaluation of applications...

42 CFR 460.22 - Service area designation.

Code of Federal Regulations, 2011 CFR

2011-10-01

... (CONTINUED) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PACE Organization Application and Waiver Process § 460.22 Service area designation. (a) An...

42 CFR 460.40 - Violations for which CMS may impose sanctions.

Code of Federal Regulations, 2011 CFR

2011-10-01

... HUMAN SERVICES (CONTINUED) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) Sanctions, Enforcement Actions, and Termination § 460.40 Violations...

42 CFR 460.20 - Notice of CMS determination.

Code of Federal Regulations, 2010 CFR

2010-10-01

... (CONTINUED) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PACE Organization Application and Waiver Process § 460.20 Notice of CMS determination. (a...

42 CFR 460.71 - Oversight of direct participant care.

Code of Federal Regulations, 2011 CFR

2011-10-01

... SERVICES (CONTINUED) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PACE Administrative Requirements § 460.71 Oversight of direct participant care...

42 CFR 460.94 - Required services for Medicare participants.

Code of Federal Regulations, 2010 CFR

2010-10-01

... SERVICES (CONTINUED) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PACE Services § 460.94 Required services for Medicare participants. (a) Except...

42 CFR 460.18 - CMS evaluation of applications.

Code of Federal Regulations, 2011 CFR

2011-10-01

... (CONTINUED) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PACE Organization Application and Waiver Process § 460.18 CMS evaluation of applications...

42 CFR 460.192 - Ongoing monitoring after trial period.

Code of Federal Regulations, 2011 CFR

2011-10-01

... SERVICES (CONTINUED) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) Federal/State Monitoring § 460.192 Ongoing monitoring after trial period. (a...

42 CFR 460.42 - Suspension of enrollment or payment by CMS.

Code of Federal Regulations, 2011 CFR

2011-10-01

... SERVICES (CONTINUED) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) Sanctions, Enforcement Actions, and Termination § 460.42 Suspension of...

42 CFR 460.40 - Violations for which CMS may impose sanctions.

Code of Federal Regulations, 2010 CFR

2010-10-01

... HUMAN SERVICES (CONTINUED) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) Sanctions, Enforcement Actions, and Termination § 460.40 Violations...

42 CFR 460.200 - Maintenance of records and reporting of data.

Code of Federal Regulations, 2011 CFR

2011-10-01

... HUMAN SERVICES (CONTINUED) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) Data Collection, Record Maintenance, and Reporting § 460.200...

42 CFR 460.22 - Service area designation.

Code of Federal Regulations, 2010 CFR

2010-10-01

... (CONTINUED) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PACE Organization Application and Waiver Process § 460.22 Service area designation. (a) An...

42 CFR 460.132 - Quality assessment and performance improvement plan.

Code of Federal Regulations, 2010 CFR

2010-10-01

... AND HUMAN SERVICES (CONTINUED) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) Quality Assessment and Performance Improvement § 460.132 Quality...

42 CFR 460.42 - Suspension of enrollment or payment by CMS.

Code of Federal Regulations, 2010 CFR

2010-10-01

... SERVICES (CONTINUED) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) Sanctions, Enforcement Actions, and Termination § 460.42 Suspension of...

42 CFR 460.94 - Required services for Medicare participants.

Code of Federal Regulations, 2011 CFR

2011-10-01

... SERVICES (CONTINUED) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PACE Services § 460.94 Required services for Medicare participants. (a) Except...

42 CFR 460.20 - Notice of CMS determination.

Code of Federal Regulations, 2011 CFR

2011-10-01

... (CONTINUED) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PACE Organization Application and Waiver Process § 460.20 Notice of CMS determination. (a...

42 CFR 460.190 - Monitoring during trial period.

Code of Federal Regulations, 2011 CFR

2011-10-01

... (CONTINUED) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) Federal/State Monitoring § 460.190 Monitoring during trial period. (a) Trial period review...

42 CFR 460.180 - Medicare payment to PACE organizations.

Code of Federal Regulations, 2011 CFR

2011-10-01

... SERVICES (CONTINUED) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) Payment § 460.180 Medicare payment to PACE organizations. (a) Principle of...

An e-Health Platform for the Elderly Population: The Butler System

ERIC Educational Resources Information Center

Etchemendy, E.; Banos, R. M.; Botella, C.; Castilla, D.; Alcaniz, M.; Rasal, P.; Farfallini, L.

2011-01-01

The Butler system is an e-health platform designed to improve the elderly population's quality of life. The Butler system has three applications diagnostic, therapeutic and playful. The objective of this work is to present the influence of the use of the platform on elderly users' mood states and the degree of acceptance. These measures were…

The Social Determinants of Depression in Elderly Korean Immigrants in Canada: Does Acculturation Matter?

ERIC Educational Resources Information Center

Kim, Wooksoo; Chen, Ya-Ling

2011-01-01

Depression in old age significantly decreases the quality of life and may lead to serious consequences, such as suicide. Existing literature indicates that elderly Korean immigrants may experience higher levels of depression than other racial ethnic group elders. The purpose of this exploratory study was to investigate factors that influence…

The Co-Residence of Elderly People with Their Children and Grandchildren

ERIC Educational Resources Information Center

Latorre Postigo, Jose Miguel; Lopez Honrubia, Rigoberto

2010-01-01

As a result of the increase in life expectancy in Western societies, the need for elderly people to live with their families (coresidence) is on the rise. The main objectives of this study were to determine the social perception of the advantages and drawbacks of coresidence with elderly people and establish the differences in this perception…

Filipino Elderly's Sense of Reminiscence, Living Disposition, and End-of-Life Views

ERIC Educational Resources Information Center

de Guzman, Allan B.; Chua, Vincent A., III; Claudio, Claudine Patricia F.; Consignado, Carlo E.; Consolacion, Dianne Karen C.; Cordero, Trisha Gabrielle L.

2009-01-01

The societal view that regards geriatrics as a period of decline may not be congruent to the views of elderly people themselves. This gives rise to the need for further understanding of how elderly individuals evaluate their lives. A phenomenological design was employed for purposes of discovering and characterizing the essence behind the life…

Elderly adults and skin disorders: common problems for nondermatologists.

PubMed

Na, Chang R; Wang, Steven; Kirsner, Robert S; Federman, Daniel G

2012-11-01

Diseases of elderly adults are becoming increasingly important as life expectancy gradually rises worldwide. To promote healthy aging, it is important to understand the skin changes associated with aging. This review focuses on the special considerations for some of the more common dermatological disorders in elderly adults and examines presentation, contributing factors, and association with systemic diseases.

[Analysis of the characteristics of the older adults with depression using data mining decision tree analysis].

PubMed

Park, Myonghwa; Choi, Sora; Shin, A Mi; Koo, Chul Hoi

2013-02-01

The purpose of this study was to develop a prediction model for the characteristics of older adults with depression using the decision tree method. A large dataset from the 2008 Korean Elderly Survey was used and data of 14,970 elderly people were analyzed. Target variable was depression and 53 input variables were general characteristics, family & social relationship, economic status, health status, health behavior, functional status, leisure & social activity, quality of life, and living environment. Data were analyzed by decision tree analysis, a data mining technique using SPSS Window 19.0 and Clementine 12.0 programs. The decision trees were classified into five different rules to define the characteristics of older adults with depression. Classification & Regression Tree (C&RT) showed the best prediction with an accuracy of 80.81% among data mining models. Factors in the rules were life satisfaction, nutritional status, daily activity difficulty due to pain, functional limitation for basic or instrumental daily activities, number of chronic diseases and daily activity difficulty due to disease. The different rules classified by the decision tree model in this study should contribute as baseline data for discovering informative knowledge and developing interventions tailored to these individual characteristics.

Domestic helpers as frontline workers in China's home-based elder care: A systematic review.

PubMed

Wang, Jing; Wu, Bei

2017-01-01

We conducted a systematic review of the existing empirical studies focusing on Chinese domestic helpers in mainland China and foreign domestic helpers in Hong Kong who provide care for community-dwelling older adults. There are very limited studies specifically focusing on this population. The findings synthesized domestic helpers' characteristics, acknowledged their contributions to elder care in China, and showed multiple challenges facing them, such as issues related to their physical health and emotional well-being, lack of legal rights protection, difficulties of adapting life in the host city, lack of training, and risk of abuse and sexual harassment. Our findings support the need for developing training and educational programs about legal rights protection and cultural competency for domestic helpers and the need to promote domestic helpers' access to health care and social welfare and opportunities for career advancement, and provide respectful working conditions.

Turf, team, and town: a geriatric interprofessional education program.

PubMed

Macrae, Nancy

2012-01-01

This program provides an interprofessional course to students, allowing them to learn together with each other and their elder teachers. include refining their professional parameters (turf), learning how to successfully collaborate with other professionals (team), and determining how to effectively design intervention plans for elders within their own communities (town). Various methods of evaluation, such as journals, participation in rounds, and OSCEs, used to assess students' status are described. Both students and faculty gained clearer perceptions of other professions through their work with each other and the ability to more effectively communicate with other profession. Both also learned, through their relationships with their elder teachers, more about how their specific professions' contributions can affect elders and how elders perceive and contribute to their own communities. This program has been a successful venture. The challenge is now to devise a way to provide similar experiences to a larger group of students.

Elder Self-Neglect in a Community-Dwelling U.S. Chinese Population: Findings from the Population Study of Chinese Elderly in Chicago (PINE) Study

PubMed Central

Dong, XinQi

2014-01-01

Objectives To examine the prevalence of self-neglect and its specific behaviors in a community-dwelling U.S. Chinese aging population. Design Population-based cohort study. Setting Community-dwelling population of Chinese older adults. Participants 3,159 Chinese older adults in the greater Chicago area interviewed from 2011-2013. Measurements Participant’s personal and home environment was rated based on prevalence of hoarding behavior, personal hygiene, repairs needed on the home, sanitary condition of the home, and adequacy of utilities. Prevalence estimates were presented across self-reported quality-of-life. Results Prevalence of self-neglect was 18.2% for mild self-neglect and 10.9% for moderate/severe self-neglect among Chinese older adults. In terms of specific phenotypes, unsanitary conditions (17.0%) was the most prevalent, followed by need of home repair (16.3%), hoarding behavior (14.9%), poor personal hygiene (11.3%), and inadequate utilities (4.2%). The prevalence of elder self-neglect of all severities and its phenotypes was higher among older adults with fair or poor quality-of-life as compared to that of older adults with good or very good quality-of-life. Lower quality-of-life was significantly associated with and increased risk for self-neglect of all severities (mild self-neglect: OR 1.93, 95% CI 1.26-2.96, p<0.001; moderate/severe self-neglect: OR 3.58, 95% CI 1.79-7.13, p<0.001) and specific personal and environmental hazards. Conclusion Elder self-neglect is prevalent, especially among those with lower levels of quality-of-life. Future research is needed to examine risk/protective factors associated with elder self-neglect. PMID:25439674

Admission of the very elderly to the intensive care unit: family members' perspectives on clinical decision-making from a multicenter cohort study.

PubMed

Heyland, Daren K; Dodek, Peter; Mehta, Sangeeta; Cook, Deborah; Garland, Allan; Stelfox, Henry T; Bagshaw, Sean M; Kutsogiannis, Demetrios J; Burns, Karen; Muscedere, John; Turgeon, Alexis F; Fowler, Rob; Jiang, Xuran; Day, Andrew G

2015-04-01

Little is known about the perspectives and experiences of family members of very elderly patients who are admitted to the intensive care unit. To describe family members' perspectives about care provided to very elderly critically ill patients. Multicenter, prospective, cohort study. In total, 535 family members of patients aged 80 years or older admitted to 22 intensive care units for more than 24 h. Family members reported that the "patient be comfortable and suffer as little as possible" was their most important value and "the belief that life should be preserved at all costs" was their least important value considered in making treatment decisions. Most family members (57.9%) preferred that life support be used for their family member, whereas 24.1% preferred comfort measures only, and 14.4% were unsure of their treatment preferences. Only 57.3% reported that a doctor had talked to them about treatment options for the patient. Overall, 29.7% of patients received life-sustaining treatments for more than 7 days and 50.3% of these died in hospital. Families were most satisfied with the skill and competency of nurses and least satisfied with being included and supported in the decision-making process and with their sense of control over the patient's care. There is incongruity between family values and preferences for end-of-life care and actual care received for very elderly patients who are admitted to the intensive care unit. Deficiencies in communication and decision-making may be associated with prolonged use of life-sustaining treatments in very elderly critically ill patients, many of whom ultimately die. © The Author(s) 2015.