Care For The Elderly Research Articles

Research on Mental Health Care Services for the Elderly in Yunnan

Yunnan; The elderly; Mental health; Services

Factors associated with frailty syndrome in elderly people with Parkinson's disease.

to analyze the sociodemographic and clinical factors associated with frailty in the elderly with Parkinson's disease in the context of a Specialized Health Care Service for the Elderly. documentary, analytical, correlational, cross-sectional study carried out with 230 elderly people with Parkinson's. The medical records of the patients were evaluated with a focus on two instruments: Clinical-Functional Vulnerability Index - 20; and the Multidimensional Assessment Care Plan. predominance of elderly people between 80 and 89 years old; women; with low education; classified as fragile. There was a correlation between frailty and the variables: sex; age; age group; schooling; motor manifestations; non-motor manifestations; Hoehn and Yahr staging and time to diagnosis. high simultaneity of frailty conditions and Parkinson's disease was observed. It is believed that the results will be able to help the structuring of protocols for nursing performance in a systematic way in the promotion of self-care of these individuals.

A Systematic Review of the Management of Preventive Health Care for the Elderly in the World

Objectives: The global shift from infectious diseases to chronic diseases is a global problem that will reduce the quality of life and increase the need for services such as rehabilitation services and services related to disability. An important issue in relation to aging is preventive care and how it is managed in the world. This systematic review has conducted a comparative study on the management of preventive healthcare for the elderly in the world. Methods & Materials: This is a review study that was done comparatively in 2020. This study was conducted to model the existing policies and programs for the care of the elderly in the countries. To collect data, Persian and international databases as well as Google Scholar scientific search engine were used using appropriate keywords, and finally 200 suitable articles were identified. The studies were categorized and their management system was evaluated and differences and similarities were determined while comparing. Results: In the present study, it was found that 50% of the surveyed countries had insurance coverage for the elderly. 64% of the countries, management and organization of health prevention services at the national level, 7.5% local, 21.4% state-federal and 7.1% national. It was local. How to finance the provision of services for the elderly in 50% of the countries surveyed through taxes, 14.2% premiums, 7.1% national health system, 7.1 individual reserve funds and the rest of the countries through the payment of the federal government, health insurance and etc. In 50% of the surveyed countries, the providers of first level services were the public sector, 28.5% of the private sector and the rest of the countries were municipalities, government, etc. Conclusion: The systems of elderly support and primary healthcare are intertwined in the main health system and function similar to the primary healthcare system of the country.

Adding health to years: A review of the National Programme for Health Care of the Elderly (NPHCE) in India.

The global share of elderly persons (60 years and above) is expected to rise from 13.4% in 2020 to 21.3% by 2050. In India, the elderly population accounts for 8.6% of the total population. A large share of responsibility on ensuring the health and well-being befalls on the government. Driven by the vision of healthy ageing, the National Programme for the Health Care of Elderly (NPHCE) was launched in 2011 by the Ministry of Health and Family Welfare. Yet, its effective implementation is challenged by the changing landscapes and epidemiological transitions. This review article explores the progress of elderly care with NPHCE, with a special focus on its implementation status, service delivery, and human resources to provide future directions for the program. It primarily uses the Common Review Mission Reports (2007-2019), archival sources from government websites, and relevant literature from PubMed, MEDLINE, and Google Scholar to provide an informed perspective of elderly care in India. We conclude that NPHCE requires strengthening through collaborative action between the relevant stakeholders. Strong implementation of appropriate policies and programs to address health care challenges of the ageing population is of crucial importance for India to achieve the health care needs of its elderly. As the elderly population is set to grow dramatically in the next few decades, this review article reveals areas needing urgent attention to strengthen elderly care through NPHCE in India.

Methods and Challenges in Preventive Dental Care of the Elderly

As individuals age, physiologic alterations take place in the oral cavity, and are thought to be a regular component of the ageing process. However, pathological developments that are not harmless, and that need professional care, are frequently encountered. The line between physiological ageing and actual pathological changes is not clear in all cases. The wellbeing of the oral cavity can be compromised with the initiation of tooth loss, soft tissue lesions such as oral carcinoma, neglected grossly carious teeth, neglected severe periodontitis, and orofacial neuralgia. For adequate oral health to be retained in older ages, oral diseases must be prevented and/or treated with emphasis in younger ages. Proper self-management measures—like brushing of teeth with a fluoridated toothpaste, dental flossing, and consuming nutrient-dense and balanced meals which have less refined carbohydrate are crucial preventive practices to be incorporated in daily life by people of all ages which includes the elderly. Dental care professionals can play a major role in prevention of dental problems and avoidance of more damage of oral tissues in older people. Professional activities comprise head, neck, and intraoral assessment of teeth and surrounding tissues for presence of oral manifestations of systemic illnesses, oral neoplasms, carious teeth, periodontitis, and impaired function and esthetics. Other measures for prevention comprise prophylaxis, dental care guidance, fluoride varnish provision, and proper therapy via restorations and reconstructions. Since the effects of dental conditions accrue as time passes, the necessity for sooner establishment of a preventive routine in life is vital for healthy ageing intraorally. Further, dental care for the geriatric population initiates in the younger ages through a stress on management of oral health issues early on, and from that point through an elaborate preventive plan moving ahead.

Effects of a Drums Alive® Intervention versus Hand-Foot Coordination Training on Motor, Cognitive and Motivational Parameters in Seniors

This study was conducted to compare the effects of two different interventions on the physiological, cognitive, and motivational parameters in seniors; and, how they would be accepted as alternative forms of exercise in the senior population. The facilitators recruited 26 randomly selected participants from two senior care facilities in Chemnitz, Germany who were required to complete two 45-minute exercise periods a week for 30 days. The first group completed the Drums Alive intervention which included a multi-dimensional approach using music, movement, drumming choreographies, games, and activities. The second intervention group completed a series of Hand-Foot Coordination exercises that used beat-keeping patterns on various parts of the body. Each intervention group had three divisions of participants, i.e. “healthy” to define those with no diagnosed malady, “dementia” for those with varying degrees of diagnosed dementia, and, “wheelchair” and those requiring a wheelchair for movement. The pre- and post-testing measurements consisted of age, heart rate, blood pressure, rate of perceived exertion (RPE), bar-drop test, chair-raise test, 6-minute walk test, memory, concentration, balance, reaction, coordination, and cognitive flexibility. In addition, to measure the level of motivation, i.e. fun, the participants used a tool that was developed by the Psychology Department of the Chemnitz University. The results demonstrated that both interventions were suitable alternates for senior-focused conventional sports offerings, however, the Drums Alive intervention outperformed the Hand-Foot Coordination intervention in a majority of the measured domains by an overall average of 9.45 percent. Of note, the data, vis a vis motivation, demonstrated a 38.4 percent increase for Drums Alive vice a 13.3 percent increase for Hand-Foot Coordination, suggesting the Drums Alive intervention offered more effective protocols that could inspire seniors to make this a part of an overall health and wellness plan to improve their quality of life.

Information and Assistance Needs and Expectations of Senior Residents in a Nursing Home in Singapore: Semi-structured Interviews With Senior Residents and Staff

Singapore, a young multi-racial and multi-religious city-state in Southeast Asia, is facing a demographic challenge—that of a rapidly falling birth rate and an increasingly aging population. By 2030, Singapore is expected to be a “super-aged” society, where more than 21% of its population will be 65 years of age or older, as defined by the Organization for Economic Cooperation and Development (OECD). Hence, the urban landscape in Singapore is also set to evolve. We expect to see more acute care hospitals, community hospitals, nursing homes, senior care centers, and senior activity spaces. As infrastructure and spaces for older persons, or seniors, become an increasingly more significant part of the built environment in Singapore, there is a need to explore how the design of the physical environment can improve the well-being of seniors and that staff, caregivers, family members as well as the larger community. In this paper, a brief look into nursing homes in Singapore is done, followed by the data and findings of a small-scale study involving semi-structured interviews that were carried out to explore the needs and expectations of senior residents in a nursing home in Singapore. In essence, this study found significant outcomes concerning the needs and expectations of nursing home residents, such as the desire for sustained social interaction, the preference for human-based assistance (rather than technology-based aid), and the penchant for independence (such as for food choices or having a variety of preferred daily activities) by seniors in their everyday lives. These inputs can be insightful and instrumental for the effective and user-centered design of new nursing homes in this rapidly aging city-state or other locales with similar demographics and settings.

Key Insights Into Schizophrenia Misdiagnosis and the Use of Antipsychotics

Key Insights Into Schizophrenia Misdiagnosis and the Use of Antipsychotics

Artificial intelligence healthcare service resources adoption by medical institutions based on TOE framework.

ObjectivesThis study used the Technology-Organization-Environment (TOE) framework to identify the factors involved in the decisions made by integrated medical and healthcare organizations to adopt artificial intelligence (AI) elderly care service resources.MethodThis study identified the Decision-making Trial and Evaluation Laboratory-Interpretive Structural Modeling (DEMATEL-ISM) method was used to construct a multilayer recursive structural model and to analyze the interrelationships between the levels. A MICMAC quadrant diagram was used for a cluster analysis.ResultsThe ISM recursive structural model was divided into a total of seven layers. The bottom layer contained the four factors of High risk of data leakage (T1), Lack of awareness of the value and benefits of AI healthcare technology (T5), Lack of management leadership support (O1), and Government policies (E1). Having a low dependency but high driving force, these factors are the root causes of adoption by healthcare organizations. The topmost layer contained the most direct factors, which had a high dependency but the low driving force, influencing adoption: Competitive pressures (E2), Lack of patient trust (E5), and Lack of excellent partnerships (E7). Healthcare organizations are more concerned with technology and their environments when deciding to adopt intelligent healthcare resources.ConclusionThe combination of the three methods of DEMATEL-ISM-MICMAC construction models provides new ideas for smart healthcare services for hospitals. The DEMATEL method favors the construction dimension of the micro-model, while the ISM method favors the construction dimension of the macro-model. Combining these two methods may reduce the loss of information within the system, simplify the matrix calculation workload, and improve the efficiency of operations while decomposing the complex problems into several sub-problems in a more comprehensive and detailed way. Conducting cluster analysis of the adoption determinants utilizing MICMAC quadrant diagrams may provide strong methodological guidance and decision-making recommendations for government departments, senior decision-makers in healthcare organizations, and policy-makers in associations in the senior care industry.

Muhammadiyah Senior Care : Innovations and Strategies For Social Services The Elderly In Yogyakarta

This study discusses Muhammadiyah Senior Care as an idea and innovation in social services. This model is part of the new characteristics in social service activities for the elderly. This in-depth study was carried out using a qualitative research approach with a descriptive type. Observations, interviews, and documentation that have been carried out are processed and analyzed by reducing data, displaying, and drawing conclusions. The results of this study indicate that Muhammadiyah Senior Care presents 3 steps of social services in the form of religious services, health services, and economic empowerment services. These three services are innovations as well as advocacy for the community to encourage increased social welfare.Keywords: Social Service, Elderly, Muhammadiyah, Empowerment, social advocacy

Probing into the Dilemma of Hospice Care for the Elderly in China

With the aging of the population gradually become a worldwide trend, China has entered into the aging society in 2000, the phenomenon of “getting old before getting rich” has caused a severe challenge. As a part of the pension system, hospice should be paid attention and promoted. However, due to the influence of China’s traditional view of death and the fact that hospice is not included in the medical insurance system, the idea of hospice has not been widely publicized. Based on Maslow’s hierarchy of needs theory, this paper analyzes the current situation of hospice care for the elderly in China and explores the specific difficulties encountered in its development, then we hope people re-understand the saying “a good death is better than a lazy life” and choose hospice care services rationally.

Role-Play versus Standardised Patient Simulation for Teaching Interprofessional Communication in Care of the Elderly for Nursing Students.

This study aims to describe and compare the effects of standardised patient simulation and role-play in the acquisition and retention of interprofessional communication in elderly care competence amongst nursing students. In this controlled clustered randomised trial, 121 nursing students attended a workshop on interprofessional communication in elderly care using role-play or standardised patient simulation. The study was conducted between September 2017 and February 2018. Participants’ knowledge, self-efficacy and communication skills were assessed using a simulated scenario at pre-test, post-test and 6-week follow-up points. Between-subject and within-subject differences were measured using counts and proportions of participants who achieved competence. Regardless of the strategy applied, a significant improvement in knowledge, skills, self-efficacy and overall interprofessional communication competence was found between pre-test and post-test. Moreover, there were significant differences between pre-test and follow-up for all the studied variables, but no differences were found between post-test and follow-up. Lastly, when comparing the success rates of both strategies, no significant differences were observed (p > 0.05). In conclusion, standardised patient simulation and role-play have been shown to promote an improvement on knowledge, self-efficacy and interprofessional communication skills in nursing students, although it is not possible to state which strategy is the most adequate for teaching this competency.

Problems Regarding Polypharmacy in Elderly in Indian Population

Among the general population, various international studies have shown that poly pharmacy is common in the older adults but those adults who were residing in nursing homes took the maximum number of drugs. It has also be shown that nearly half of the older adult population take one or more medications that are not medically necessary as per their conditions. According to various research, it has been clearly established that there is a strong association between multiple drug use and negative clinical consequences. In addition to that, conducting well-designed inter-professional intervention studies, which often include clinical pharmacists, that focus on enrolling high-risk older patients taking multiple medications with mixed results on distal health outcomes can improve the effectiveness of enhancing the overall quality of prescribing medications. It is critical to do research on poly pharmacy in a nation like India or other low to medium income countries. Poly pharmacy is induced by a multitude of variables at the levels of health-seeking, prescription, distribution, and usage. Society-based issues such as a lack of education and access to adequate healthcare in both rural and urban regions, as well as a general lack of health knowledge and passion, further aggravate the situation. Poly pharmacy is a key challenge in senior care. The senior population frequently has several medical diseases and may possibly suffer from cancer, which necessitates the use of multiple drugs for therapy. Multiple drugs used by an aged person can increase the likelihood of drug-drug interactions, noncompliance with the prescription, adverse drug responses, and reduced patient compliance.

Utilizing Peer Cohort Networks to Disseminate Information and to Prevent and Mitigate COVID-19 in Nursing Homes

The COVID-19 pandemic disproportionately impacted residents, families, and staff of nursing homes and senior care communities. Even with federally mandated emergency planning, the pandemic highlighted the lack of preparation to meet the daily challenges faced in senior care. In response, the federal CARES Act including funding for a nationwide network of nursing home cohorts led by academic health centers to disseminate clinical guidance in infection control and pandemic mitigation strategies. We present a case study of a successful diffusion model as implemented in Minnesota with seven cohorts comprised of 242 nursing homes and 544 employees. Experts in geriatric care, long term care regulatory management, and public health led ninety-minute sessions held over the span of sixteen weeks. The session format included foundational evidence-based practices in pandemic management (including infection control, social isolation, leadership, and other topics), individual case studies, peer to peer knowledge diffusion, and expert guidance.

Examining Physical and Social Environments of Korean American Family Caregivers of Persons Living with Dementia

IntroductionGrowing research supports the use of older volunteers to provide respite and community-based assistance to persons with ADRD and their caregivers. This study explores the impact of COVID-19 on a face-to-face, peer-led psychoeducational intervention for African American ADRD family caregivers, the Senior Companion Program Plus (SCP-Plus), and its subsequent need to ‘pivot’ during the pandemic. Method: The SCP-Plus was a randomized control trial across three states that assessed program impact on ADRD family caregiver stress/burden, coping, and social support. In spring 2020, the SCP-Plus intervention was halted because of the potential risk to participants due to COVID-19 (n = 20 enrolled dyads). In an effort to maintain rapport and trust, critical to retention in research studies, team members began weekly (March-April) and then bi-weekly calls (May-December) for the purpose of providing a social check-in and to provide updates on the status of the intervention.ResultsA total of 396 calls lasting approximately 10 minutes each were completed. Participants shared concerns around safety, access to food/supplies/masks/testing, feelings of stress and loss, concern for others, and the importance of technology as a means of social connection. Although the intervention aspect of the SCP-Plus ultimately ended due to COVID-19, information gleaned from these check-ins were used to pivot the study. The study moved forward by using a descriptive phenomenological approach to capture dyads’ lived experiences during COVID-19.DiscussionOverall, purposeful participant engagement through weekly/bi-weekly phone calls suggests that this is a promising strategy for participant retention as well as for pivoting research.

Large Scale Survey Research with Older Adults/Persons with Disabilities in a Public Health Crisis

Best practice for measuring quality improvement and consumer satisfaction of health and human services for older adults and people with disabilities relies on in-person survey administration. This poster highlights adaptation strategies undertaken across three large-scale evaluation studies of program/service delivery conducted during the COVID-19 pandemic, necessitating a departure from in-person techniques: 1) Integrated Satisfaction Measurement for the Program of All-Inclusive Care for the Elderly (I-SAT-PACE), 2) National Core Indicators- Aging and Disabilities/Intellectual and Developmental Disabilities (NCI-AD/IDD), and 3) Assisted Living Resident Quality of Life (AL-QOL). Data collection for these projects occurred from September 2020 to August 2021, providing an opportunity to showcase project adaptation over the course of the pandemic. Using project implementation examples across 15 states and approximately 10,100 participants, we discuss implications for successful survey coordination, interviewer training, data collection, and participant/stakeholder engagement during a public health emergency. Strategies included pivoting to phone, Zoom, and paper-based data collection and increasing technical assistance for field staff and participants. Project teams were able to increase access to participation by implementing multimodal survey delivery, mitigate coronavirus exposure, continue collecting older adults and people with disabilities’ experiences, and compare results based on method of delivery. Technology barriers, field staff dropout, need for larger sample sizes, and inclusion of participants with dementia, hearing, and speech impairments present important tradeoffs to consider. These examples indicate it is possible to administer hybrid data collection methods across populations with varying cognitive and physical abilities without compromising data quality.

Mobilizing Elders: An Interprofessional Effort

Older adults often experience functional decline during hospitalization as a result of immobility. Such decline has associated adverse outcomes, including gait instability, falls, pressure injuries, delirium, and new nursing home admissions. Our objective was to create an effective and sustainable in-hospital mobility program through enhanced interdisciplinary cooperation in an Acute Care of the Elderly (ACE) unit. An interdisciplinary team at UNC’s 25-bed ACE unit planned and delivered enhanced patient mobility beginning in July 2020. We used an input-process-output model to design and analyze an intervention based on enhanced collaboration. Inputs included a mobility taskforce which was comprised of physicians, nurses, physical and occupational therapists, and quality improvement specialists. Through regular meetings, each taskforce member contributed to the study design and were empowered to identify barriers to implementation. Outputs included stakeholder engagement and mobility rates. Early results show a doubling in mobility rates over a 6-month period with consistent and enthusiastic stakeholder engagement. Observations of such benefits include: a) stakeholder inclusion from each discipline ensured implementation that was pragmatic and easily incorporated into the daily workflow; b) mobility champions regularly disseminated information to their respective disciplines, leading to changes using a quality improvement process; and c) barriers to implementation were rapidly identified, and mobility champions were motivated to find solutions, allowing cohesive incorporation of a broad spectrum of priorities. An interprofessional team model is effective to mobilize hospitalized older adults, potentially reducing adverse hospital outcomes. Successful implementation of such programs is dependent on interprofessional collaboration.

Effects of Caregiver Interventions for Informal Caregivers of Older Adults With Cognitive Decline

Objectives: To identify baseline factors and process factors, which indicate changes that are associated with caregiving confidence improvement attributed to caregiver support. Methods: An intervention study using 35 informal caregivers (ICG) of older adults (≥65 years old) with cognitive decline. Recipients of ICGs belonged to the Programs of All Inclusive Care for the Elderly (PACE). Interventions were occupational therapy (OT) support or education about illness and effective caregiving methods, which took place in ICGs’ homes. OT interventions included training to reduce physical strain, and improve time and task organizations, and providing assistive devices). Caregiver confidence was measured using a Visual Analog Scale. Data were divided into two groups: improved confidence and decreased/no-change confidence. Eleven baseline data of care recipients (CRs) and ICGs as well as five process data were analyzed using logistic regression. Results: Baseline factors that differentiated the two groups were ICG’s age, caregiving confidence level, and CR’s cognitive status, of which classification accuracy was 94.3%. Only Zarit Buren Interview (ZBI) score was associated with caregiving confidence change, of which classification accuracy was 74.3%. Younger ICGs, lower cognition, and lower caregiving confidence among baseline factors, and improved ZBI among the process factors were associated with improved confidence. Discussion: Although our interventions prevented 65.7% of caregivers form declining their caregiving confidence, improving caregiving confidence was difficult while CRs’ cognition continued to decline. However, this positive change was possible even CRs had moderate dementia, on average. Personal interventions may be necessary to improve caregiving confidence and reduce ICG’s burden.

Leadership among Directors of Social Work in Long Term Care Facilities

Long term care facilities (LTC) provide ongoing care for seniors and chronically ill. To maximize the quality of the care, LTC staff must be properly trained to respond to patient care crises and communicate across departments. Although researchers have studied the leadership styles, strategies and interactions of facility administrators and nursing directors there is a substantial gap in the literature on the leadership styles and strategies employed by Directors of Social Work (DSW). The aim of this phenomenological study was to address this gap in research by exploring how DSW influenced leadership policies, prepared subordinates for crisis intervention and management, perceived that social workers influence decision making in patient care, and believed that communication amongst LTC staff about patient care could be improved.

Factors Related to the Care Management Practice for Old Public Assistance Recipients in Osaka City of Japan

The research was conducted between January 22 and February 25, 2021. The data was collected by self-administered questionnaires mailed to the participants at 800 care management centers and comprehensive community support centers in Osaka City. The centers were randomly selected. The response rate was 19.1%. The independent variables were: obtaining the qualification of a Senior Care Manager (SCM), who was a qualified person that acquired advanced knowledge and skills in care management by advanced training; experience years in Social Work (SW); experience years in care management; experiences in training programs for team approach; and experiences in training programs for supporting Old Public Assistance Recipients (OPAR). The dependent variables were the categorized contents in the Care Management Practice for old public assistance recipients. They were: Care planning and Implementation (CI); Assessment; Financial Support and Evaluation (FSE); Contract and Explanations in care management; Coordinating Informal support and Formal services in Care planning; and Arrangements in Financial supports for Formal service costs. The Structural Equation Modeling was performed for the examinations of the relationships. As a result, the goodness of the fit indices was acceptable, and we retained the models. In correlational analyses, CI and Assessment were significantly correlated with SCM (p<.05). FSE was significantly correlated with SW (p<.001) and OPAR (p<.05). In conclusion, the results implied that advanced qualification of a Senior Care Manager and a specified training program for supporting old public assistance recipients were effective in providing appropriate care management services.