Aged Facilities Research Articles

베하스(BeHaS)운동프로그램이 집단시설 거주 노인의 근력과 유연성에 미치는 효과

Purpose: The purpose of this study was to identify the effects of the BeHaS exercise program, developed by Jong Im Kim (2006), consisting of exercise, education and cognitive support on muscle strength and flexibility in elders who live in elderly facilities. Method: This study was designed using one group pretest-posttest experimental design, 19 elders, the subjects of the group participated in the BeHaS exercise program. The BeHaS exercise program was provided for 60-80 minutes per session once a week for 8 weeks. Data was collected by research assistants using structured interview and measurement tool, from January, 2011 to March, 2011. Data were analyzed using the SPSS Win 17.0, general characteristics were analyzed with real number and percentage, muscle strength and flexibility were analyzed with Mean and SDs. Results: There were significant increase pre and post test for the left shoulder flexibility (p=.000) and waist flexibility (p=.030). Conclusion: In conclusion, this study confirms that BeHaS exercise program played a useful role in partial improving flexibility in the Institutionalized Elders.

Factors related to early case detection of tuberculosis in health service facilities for the elderly

The proportion of newly notified tuberculosis cases aged over 65 years has been rising and reached 49.2% in 2001. For this reason, the Ministry of Health, Labor and Welfare recommended in 1999 to give preventive therapy for tuberculosis to elderly persons with fibrous lesions on chest X-ray. However, our research pointed out many problems in the matter and low public health benefits of preventive therapy. At present, early case detection and treatment are considered to be the most effective tuberculosis control measures for the elderly in Japan. For the purpose of developing the most effective case finding method for the elderly, we investigated various aspects of tuberculosis in health service facilities for the elderly. Health service facilities for the elderly were established since 1988 to provide nursing care and rehabilitation services to enable elderly persons who no longer need hospitalized care to return home. Questionnaires were mailed to 358 health service facilities for the elderly in a metropolitan city and 4 prefectures. One hundred and sixty-nine facilities (47.2%) responded. Among them, 61 (36.1%) are attached to hospitals, 21 (12.4%) are attached to clinics, and 87 (51.5%) are not attached to any medical facilities. The median duration from the opening of the facility was 3.5 years, and 113 (66.9%) facilities were founded within 5 years. The mean age was 83.2 years for facility-care users and 79.6 years for day-care users. The mean duration of care was 7 months for facility-care users and 13 months for day-care users. Pre-admission chest X-ray was conducted for facility-care users in 72 (42.6%) facilities, and for day-care users in 40 (23.7%) facilities. Comparing with 84.3% (Shishido, 2002) in special nursing homes for the elderly, the rate was significantly lower in health service facilities for the elderly. Periodic TB screening during care utilization was also less frequently carried out in health service facilities for the elderly (45.6% for facility-care users and 15.4% day-care users). A possible reason is that special nursing homes for the elderly are mandated to conduct periodic TB screening as provided by the TB Control Law, while health service facilities for the elderly are not under such provision. Periodic TB screening for employees was carried out in 160 (94.7%) facilities. Respiratory symptoms were less frequently checked compared with anorexia or lassitude. Thirty-two facilities (18.9%) checked the facility-care user everyday for respiratory symptoms using a check-list, while 114 facilities (67.5%) checked only for anorexia or lassitude (p < 0.01). When persistent respiratory symptoms were observed in facility-care users, 157 (93.5%) facilities referred them to hospitals with letters explaining their symptoms and 108 (63.9%) facilities requested chest X-ray and sputum tests. However, for day-care users, most facilities only advised them to visit medical institution without any letter of referral. Within 5 years, 52 (30.8%) facilities reported 65 TB cases among facility users and 5 (3.0%) facilities reported 5 TB cases among employees. Based on person-year, case rate was calculated to be 104.6 per 100,000 among elderly facility users. This rate was compared with that of people aged 75 years over in the community. Rate ratio was 1.04 (95% CI: 0.82-1.34). The risk of developing tuberculosis was slightly higher in the elderly facility users, but the risk was not statistically significant. This result may be influenced by the low response rate from facilities with tuberculosis cases. We conclude that it is very important to detect TB cases at the early stage of disease not only to protect the elderly from tuberculosis death but also to prevent outbreak of tuberculosis infection in health service facilities for the elderly. Effective and feasible tuberculosis control for the elderly should be provided under the TB control Law and be implemented with the cooperation from related medical institutions and public health centers.

Foodservice Management and Food Safety Knowledge and Practices of Employees in Elderly Welfare Facilities

This study examined the current status of foodservice management in elderly welfare facilities and evaluated food service workers' food safety practices and knowledge. For this, the directors of 20 elderly welfare facili- ties (each with fewer than 50 residents) located in Seoul were interviewed and a survey of 40 foodservice workers was conducted to determine their food safety knowledge and practices. The facilities accommodated an average of 28 residents. All the facilities were self-operated and approximately 62% were dependent on payments by residents. Only 15% had a dietitian in charge of menu planning, food purchasing, and food safe- ty management. Approximately 50% had their facility managers take responsibilities for menu planning and food safety management. Most of the facilities provided food safety training within their own facility and sa- nitized their utensils, cutting boards, and dishcloths on a daily basis. A limited number of foodservice work- ers, insufficient training programs, and budget constraints were some of the major barriers to food safety management. Their average score on food safety practices was 1.62, and that on food safety knowledge was 17.6 out of 19 points. These results indicate that the foodservice workers had good food safety knowledge and appropriate food safety practices. There was a significant correlation only between food safety practices related to receiving and storing food products and knowledge of personal hygiene.

Catheter associated urinary tract infection within care of the elderly facilities: results from a Scottish pilot study

Following a review of the current methodology for catheter associated urinary tract infection (CAUTI) surveillance in Scotland a protocol was developed by Health Protection Scotland incorporating infection definitions based on clinical signs and symptoms rather than microbiology criteria. These definitions are recommended by the European Centre for Disease Prevention and Control for use in care of the elderly facilities as they hope to reduce the overestimation of urinary tract infections by excluding asymptomatic bacteriuria. In 2009, a pilot study of the protocol was carried out in volunteer care of the elderly facilities across Scotland. A total of 659 patients admitted to the care of the elderly facilities participated in CAUTI surveillance in six pilot hospitals and a total of 122 catheters were inserted. During the study period a total of 19 urinary tract infections were identified of which 15 met the criteria for CAUTI. The CAUTI surveillance protocol and data definitions appeared to be robust. The study was therefore able to provide valuable data about catheter use and CAUTI incidence rates. The surveillance protocol and collection tool can be easily adapted for use in care home settings thus providing a valuable surveillance tool for these resident populations.

The effects of robot therapy in the elderly facilities

Interaction with animals has been known to be emotionally beneficial to people, and applied to medical treatment. However, many hospitals and nursing homes, especially in Japan, do not accept animals because of negative effects, such as allergy, infection, bites, and scratches. We developed a seal-type mental commitment robot, named Paro. The purpose of designing Paro is not only as substitute of pets but also for robot therapy. We have conducted one year experiment and a long-term experiment in elderly institutions to investigate the effects of robot therapy. In the one year experiment at a care house, there were 12 subjects, aged 67-89 years. Their mental cognitive states were assessed by the Mini Mental Status Examination, and scores ranged from 15 to 29. We observed subjects' social interaction with each other and with Paro by recording the activities of the subjects spent in the public areas. In addition, we measured the hormones 17-OHCS and 17-KS-S in the urine of the subjects as a means of measuring stress. In the long-term experiment (five years case study) at a health service facility, there were 14 subjects, aged from 77 to 98. Their dementia levels were as follows: non-dementia: 1 person, slightly degree: 4 people, middle degree: 5 people and a little high degree: 3 people. We observed interaction between the subjects and Paro, and conducted face scales which was used to evaluate subjects' mood. In the one year experiment, the results showed that Paro encouraged subjects to communicate with each other and strengthen their individual social ties. Furthermore, the results of urinary tests obtained from 9 subjects showed the improvement of reactions of their vital organs to stress. In the long-term experiment, the results showed that feelings of the elderly people were improved by interaction with Paro, and the effects showed up over the five years. From our research, we found the improvement of elderly people's communication and social ties, stress, and long term effect of mood improvement. We expect mental commitment robot “Paro” will be widely used in elderly institutions, and improve their quality of life.

Measurements of Major-Indoor Air Quality and Application of Humidify and Sterilization System in the Facility for Elderly

Measurements of Major-Indoor Air Quality and Application of Humidify and Sterilization System in the Facility for Elderly

The Hypertension–Dementia Connection: A Chance to Make a Difference?

Two recent studies address the effect of hypertension treatment on Alzheimer neuropathology and dementia risk. In one study, researchers examined the brains of 291 deceased elders (average age at death, 83) who had been recruited from nursing homes or elder facilities. The researchers compared the amounts of Alzheimer neuropathology (neuritic plaques and neurofibrillary tangles) in patients with histories of treated hypertension, untreated hypertension, or normotension. Only brains with no significant pathology other than Alzheimer changes were included. Subjects with treated hypertension had the least AD neuropathology, and those with …

CHANGES OF COMMON SPACES OF HIGH-RISE, HIGH-DENSITY HOUSINGS IN URBAN AREA IN THE PAST DECADES OF THE DECLINING BIRTH RATE SOCIETY

High-rise and high-density complexes in urban areas have abundant outdoor spaces, many regional facilities and rooms for common use. We found that these common spaces have been changed their uses in the past three or four decades in order to meet the needs. Especially, a lot of common spaces have been turned into facilities for children and elderly. We easily understand that the elderly facilities have increased because aging is a marked progression of the high-rise and high-density complexes. While, it is remarkable that in spite of the decreasing children in the complexes the children facilities have never been disused, in fact, they have increased. The children's facility in the complexes have been attracting children and their parents in their neighbor areas.

Current State of Re-admission of the Patients who Belong to Elderly Facility in Case of Emergency Medical Treatment

Current State of Re-admission of the Patients who Belong to Elderly Facility in Case of Emergency Medical Treatment

노인주거시설의 외부공간 유형에 관한 연구

The purpose of this study is to provide suitable outdoor spaces for Korean elderly, examining characteristics and types of existing outdoor spaces and presenting design guideline of outdoor space for elderly. To do this, this study examined previous research papers and scholastic writings, related to elderly housing, and analyzed twelve cases of elderly housing complex. Additionally evaluation of usage pattern and physical trace carried out on twelve cases. As a result, first, the study showed that outdoor spaces for elderly were classified 5 types; entrance area of housing complex, building entrance area, outdoor living area, in & outdoor neutral area, and parking lots. Outdoor living area is subdivided into residents' public space, green space, health & sports space and landscape space. Characteristics of outdoor space are deeply related to safety, amenity, recognition and efficiency. Second, types of outdoor space in elderly facilities are very limited in verity, just facilitating with rest space, sport space, and garden space. Third, from a standpoint of barrier-free-design, twelve cases are not carefully concerning about outdoor space for elderly.

Assessment of Bioaerosols in the Public Buildings of Korea

The concentration of airborne bacteria and fungi in public buildings is regulated by law in Korea. Levels are investigated during the moderate seasons, spring (March—May) and autumn (September—November), using a six-stage cascade impactor. Total concentrations of airborne bacteria and fungi range from 290 to 940 cfu · m-3 and 330 to 540 cfu · m -3, respectively. The levels of airborne bacteria and fungi are significantly highest in a kindergarten building and lowest in an elderly welfare facility ( p&lt;0.05). The ratio of respirable to total concentration range from 30 to 40% for airborne bacteria and from 55 to 70% for airborne fungi but there is no significant difference among the public buildings examined ( p&gt;0.05). The mean ratios of indoor and outdoor concentrations of airborne bacteria and fungi are below 1.0 regardless of the fraction of particle size and building type. The indoor concentration of airborne bacteria and fungi do not correlate significantly with indoor temperature and relative humidity ( p&gt;0.05). However, this does have a significant positive correlation with CO2 and the number of people per area of the sampling site ( p&lt;0.05), which implies that the activity of residents has considerable effect on the levels of both airborne bacteria and fungi.

The use of an existing house as an elderly facility

The use of an existing house as an elderly facility

高齢者居住施設における個室・ユニット化の意義および問題点 : 個室・ユニット型養護老人ホームへの建替え事例を通して

高齢者居住施設における個室・ユニット化の意義および問題点 : 個室・ユニット型養護老人ホームへの建替え事例を通して

Are the facilities for the elderly annoying

Are the facilities for the elderly annoying

高齢者居住施設における生活単位の一括・分散と共用空間の滞在行為に関する研究 : 日・韓,高齢者施設6施設の異なる空間構成における入居者の生活と空間の使われ方

高齢者居住施設における生活単位の一括・分散と共用空間の滞在行為に関する研究 : 日・韓,高齢者施設6施設の異なる空間構成における入居者の生活と空間の使われ方

The Interpretation and Nursing Care for the Behavior of Elderly with Dementia in Health Service Facilities for Elderly

The Interpretation and Nursing Care for the Behavior of Elderly with Dementia in Health Service Facilities for Elderly

Dehydroepiandrosterone sulphate and dementia

Animal and human studies suggest that the adrenal androgen dehydroepiandrosterone sulphate (DHEAS) may be related to cognitive function. Aim of this study was to explore the relationships between circulating serum levels of DHEAS and cognitive function in a sample of over 90-year-olds. Thirty-four subjects (7 males, 27 females) aged 91–104 years were recruited in long-stay elderly facilities or at home in Bologna. Each subject received a semi-structured interview assessing medical history in order to exclude as much as possible the influence of medical conditions, pharmacological treatments and nutritional status on DHEAS levels. The diagnosis of dementia was made for 18 subjects according to the guidelines of the American Psychiatric Association. No differences were found between DHEAS concentrations of demented and non-demented subjects (sex and age-adjusted ANOVA F = 2.003, p = 0.168). No significant correlations were found between DHEAS and a number or cognitive testing scores, when adjusting for sex and age. In conclusion, our data do not suggest a causal role of DHEAS in senile dementia. The low DHEAS levels observed by some authors in patients with organic brain syndromes could be an artifact deriving from infectious or debilitating conditions.

Feeding difficulty in elderly patients with dementia: Confirmatory factor analysis

The latent structure of feeding difficulty in elderly patients with dementia was investigated using multivariate statistical techniques including exploratory and confirmatory factor analysis. A survey design of 345 elderly patients with the diagnosis of dementia using a questionnaire completed by key workers and primary nurses, was used in local psychogeriatric and continuing care of the elderly facilities. Feeding difficulty and nursing intervention were estimated followed by fitting of latent variable models of feeding difficulty to the data using structural equation modelling. Three models of feeding difficulty in elderly patients with dementia, with 2, 3 and 4 factor structures respectively were compared. All three models showed a good fit to the data as assessed by several standard criteria. The 3 and 4 factor models, however, showed significantly better fit than the 2 factor model. The 4 factor model introduced a latent variable of “oral difficulty” with feeding which merits further investigation. This study demonstrates the possibility of developing reliable and validated scales for the assessment of feeding difficulty in elderly patients with dementia.

Assessing the impact of delayed discharge on acute care.

This study examined the incidence of delayed discharge in three acute treatment wards. Of 118 admissions during the eight-week study period, 13.5 per cent (n = 16) were categorised as 'inappropriately located' by the study tool. The staff cited lack of rehabilitative facilities or care of the elderly facilities as reasons for patients' inappropriate stay in the acute ward. The authors recommend that healthcare professionals and social services departments liaise more closely to reduce the incidence of delayed discharge and allow these patients to return to the community whenever feasible.

特集 社会医学としての聴覚医学的諸問題 老人施設における難聴の実態

老人施設における65-100歳の高齢者219名について簡易聴力検査と質問法によって難聴の実態を調査した。 この結果, 約半数は主に痴呆のために検査不能であった。 難聴の程度は, 軽度63名, 中等度33名, 重度と正常各5名であった。 聴力型は主に高音漸傾型で, 加齢による難聴と考えられる。 また, 難聴の自覚は低く, 介護者の認識はさらに低かった。 域値上昇と明瞭度低下の自覚があったが, 補聴器の装用は2名のみであった。