Dependent Elderly People Research Articles

Poverty situation, income and population consumption under the sign of reduction to the essential: Minimum consumption basket

At the level of 2019, the poverty in Romania was still very deep. The National Strategy on Social Inclusion and Poverty Reduction (2014-2020) shows that one in five Romanians, poverty caused by insufficient income, and much of the poverty caused by low income is persistent. Three quarters of the poor are has been in this situation for at least three years. Also, a third of the population cannot afford to buy products or services considered desirable or even necessary to live a decent life. According to the same document, there are still children who have never been to school, and the percentage of young people without a proper education is high. Many people are inactive or formally unemployed, with little chance of gaining adequate access to the labor market, and that there are inequalities in coverage with basic health services. The largest categories include children in difficult situations, people with disabilities, single or dependent elderly people and the Roma, who number three million people, but the estimated population as poor or vulnerable is about five million people.

The provision of mobile dental services to dependent elderly people in Switzerland

This work aimed at describing mobile dental services provided by both the private sector and the universities in Switzerland to dependent elderly people. It also aimed at presenting the views of both sectors on the current status of these services. As people age and become more care-dependent, their oral health requirements increase, as access to dental care decreases. A survey was sent to practitioners who potentially provided a mobile dental service (n=253). Five interviews were conducted with six individuals who have a leading role in Geriatric dentistry in the four universities in Switzerland that provide dental training. The private sector provides a mobile dental service to the elderly mainly through the use of portable equipment, while university services are provided by different models. The interviewees discussed the reasons as to why these services were set up. They discussed the challenges associated with treating dependent elderly patients, which often makes work in this field hard and unattractive. Both sectors see the need for better collaboration with other professionals. The private sector in Switzerland provides a mobile dental service to elderly people mostly through the use of portable equipment, while university services are provided in a variable configuration of models. Better collaboration is required to improve dental care and service delivery to dependent elders. There is a potential for improvement of these services, in order to meet the demand of an ageing population, catering for both the institutionalised elders and those living at home.

Willingness-to-pay and willingness-to-accept of informal caregivers of dependent elderly people in Shanghai, China

BackgroundIn order to make optimal long-term care-related decisions, it is important to take a societal perspective. Shanghai is one of the pilot cities of social long-term care insurance in China. However, little knowledge exists about the economic value of the informal care provided to dependent elderly people in China. This paper aims to evaluate the economic value of informal caregiving in Shanghai using the contingent valuation method by their least-preferred care tasks, and identify the associated factors of willingness-to-pay (WTP) and willingness-to-accept (WTA) of the informal caregivers.MethodsThis study employed the contingent valuation method to elicit 371 informal caregivers’ WTP and WTA for 1 hour of reduction or increase of least-preferred caring tasks in Shanghai. Univariate and multivariate analyses were conducted to explore the associated factors with the WTP and WTA values.ResultsThe average WTP and WTA were 25.31 CNY and 38.66 CNY, respectively. The associated factors with WTP include caregiver’s income and caregiver’s relationship to the recipient. Care recipient’s age, income, least-preferred task by the caregiver, and subscales of Caregiver Reaction Assessment were found to be associated with WTA. The non-responsiveness rates were 26.1 and 33.2% for WTP and WTA questions, respectively.ConclusionsThe findings of the current study demonstrated that decision-makers and researchers should take the economic valuation results of informal care into account to make more informed and effective long-term care-related policies and analyses.

The heterogeneous effect of retirement on informal care behavior.

It is often argued that the increased labor market participation of seniors threatens family support provided to dependent elderly people. The purpose of this paper is to assess the causal effect of retirement on the frequency of care provided by individuals aged 55-69 years to their elderly parent. Using data from the Survey of Health, Aging and Retirement in Europe (SHARE), we estimate an endogenous switching model that allows the retirement effect to be heterogeneous with respect to observed and unobserved characteristics. To tackle the possible endogeneity of selection into retirement, we use the heterogeneity of retirement rules between and within European countries. On average, being retired does not significantly impact the probability of providing care but significantly increases the frequency of care conditional on being caregiver. The same pattern is observed regardless of the individual observed characteristics, even if the provision of informal care appears to be less sensitive to the retirement status when the child cannot rely on the other parent to provide care or when both parents are in poor health. These results suggest that pension system reforms should not affect the number of caregivers. Some adverse effects on the intensity of involvement among caregivers are nevertheless expected.

Lazer para idosos que residem em instituições de longa permanência

Introdução: O envelhecimento é um processo que envolve perda das atividades funcionais e propensão ao adoecimento. Entende-se que as vivências e práticas do cotidiano, estejam associadas à percepção de qualidade de vida, nas quais as atividades de lazer são frutos de escolhas assumindo a função de descanso, entretenimento pessoal e social. Objetivo: Identificar o tipo de atividade de lazer ofertada em uma instituição de longa permanência para idosos e a adesão de acordo com o nível de dependência. Métodos: Tratou-se de uma pesquisa quantitativa, transversal e descritiva. Resultados: Participaram da pesquisa 14 profissionais da equipe assistencial. Verificamos que 100% dos idosos independentes aderem aos exercícios físicos, frequência a igreja e bate papo como atividades de lazer; 92,86% dos idosos parcialmente dependentes optam pela prática de assistir televisão (TV) e bate papo; 100% idosos dependentes aderem à prática de assistir TV. Constatamos que 92,86% das atividades de lazer são ofertadas por meio de serviço voluntariado e por servidores da própria instituição. Conclusão: Houve diversidade de atividades de lazer ofertadas, ainda que idosos possuam determinado grau de dependência para desenvolvê-las, sendo sua prática considerada importante pela equipe, em que a adesão está estreitamente relacionada a aspectos como concepções individuais de lazer e circunstância de saúde.

Abordări privind îngrijirea de lungă durată a persoanelor vârstnice, în ţările Uniunii Europene

This paper presents an analysis of the characteristics of public policies for dependent elderly people in Germany, Austria, Italy, Hungary and Portugal. The countries were selected taking into account the expertise in this field and the specifics of the socio-cultural context, so as to highlight the different solutions applied in those countries to solve certain problems related to the care of the elderly. The analysis of policies for dependents takes into account, for each country, the following: coordination of social and long-term care services; the beneficiaries and the minimum level of dependency for which it is granted, the procedure and criteria for assessing the dependency; the benefits provided (in kind and in cash); types of long-term care services providers. The analysis of this paper is based on information available in the database of the European Union - Mutual Information System on Social Protection which contains detailed and updated data on social protection systems in European countries, supplemented with information from studies, research reports conducted in within some projects financed within the Framework Program 7 of the European Commission, such as ANCIEN, MOPACT, but also public data available on the websites of the public ministries responsible with the provision of social services, as well of long-term care services for the elderly. The paper is structered as follows: the first part presents the characteristics of the policies for dependent elderly people from the selected countries, followed in the second part by a comparative analysis of the main aspects identified.

Management of home care by family caregivers to elderly after hospital discharge.

To understand the management of home care by family caregivers of dependent elderly people after hospital discharge. Qualitative research guided by hermeneutics-dialectic, anchored in the theory of communicative action. Data collection took place using a semi-structured interview with 11 participants. Two categories were constructed: Management of the many types of care by the caregiver and the relationship between family caregiver and health care network. Care and management actions carried out routinely cause major changes in the family caregiver's life. He/she does not recognize planning, home care periodicity or support in required procedures. The management of home care for dependent elderly people after hospital discharge is complex, involving physical and emotional overloads, as well as difficulties in getting support from health services. The planning shared between the health team and the family since the discharge is required, and the better visibility of the role of primary care when the patient is assisted by a home care service.

Health effects of dependent older people caregiving by family members

Care required by dependent older people is mostly provided by close family members. Caregiving is a demanding task, negatively affecting the physical and mental health of the caregiver. To describe the sociodemographic characteristics of informal caregivers of dependent elderly people in Chile and to evaluate the effect of providing care on the health of caregivers. Data from the Economic Characterization Survey (CASEN) done in 2015 was used. Using as index cases older people who were receiving care from a family member, 4,313 informal caregivers were identified, whose characteristics were analyzed. Descriptive statistics and matching through propensity score were estimated, based on a logistic model, which included covariates such as sex, age, marital status, education, occupation, and income. Finally, the effect of being an informal caregiver versus not being a caregiver on the perception of health was calculated. Forty four percent of the caregivers were offspring and 33.6% couples. Sixty seven percent were women, with a mean age of 56.5 years. Half of them had a partner, 43% had basic education or less, and 61% were inactive. Being a caregiver had a significant effect of health perception. People belonging to certain more vulnerable groups are more likely to assume caregiving. Providing care to a dependent older person has a negative effect on health perception.

Anxiety and depression in informal caregivers of dependent elderly people: an analytical study.

To analyze the symptoms of anxiety and depression in informal caregivers of dependent elderly at home. Analytical, cross-sectional study conducted in the city of Teresina (PI), with informal caregivers of dependent elderly people. Data collection took place from November 2017 to February 2018, using a characterization form for the dependent elderly and their caregiver, Beck's Anxiety Inventory (BAI) and Beck's Depression Inventory (BDI). The forward linear regression model was used to identify the predictive variables of anxiety and depression. It was found that 18.4% of caregivers had symptoms of depression; and 14%, moderate to severe anxiety. There was a correlation between anxiety and depression (p = 0.000). The findings of this study make it possible to assess anxiety and depression in caregivers of dependent elderly people, making it possible, through these parameters, to view the profile and care demands of this population.

Health Domain Determing Quality of Life of Elderly People in Baglung

Introduction: Quality of life reflects physical and mental health, emotional well being and social functioning of an individual’s life. Elderly is the period accompanied by decline in person’s physical and cognitive domain that is associated with decreased quality of life. The purpose of this study is to assess the health domains determining quality of life among elderly people in Baglung.
 Methods: A cross-sectional descriptive study was conducted among conveniently selected 130 elderly people in Jaimini-10, Baglung and interviewed using the WHO QOL-BREF structured interview schedule. The data were analyzed by using Statistical Package for Social Science (SPSS) Version 20.
 Results: The finding revealed that nearly elderly people enjoyed the quality of life as excellent (60.8%) and good (39.2%). Regarding the domains of QOL in the WHOQOL-BREF, the highest mean score was for the environmental domain (Mean 30.04±2.04) and lowest for the social relation domain (Mean 7.42±0.75). The quality of life was more excellent among females (50.63%), currently married (79.74%) than in widowed (20.25%), living in nuclear family (56.96%) than in joint family (43.03%) and independent elderly (88.61%) than dependent elderly people (11.39%). There was significant association of quality of life to age (p = 0.004), marital status (p= 0.000), educational status (p=0.000), occupation (p=0.004), financial status(p = 0.002) and social status (p = 0.023).
 Conclusions: This study concluded that three-fifths of respondents had excellent QOL. There was significant association of quality of life to age (p= 0.004), marital status (p= 0.000), educational status (p= 0.000), occupation (p= 0.004), financial dependency (p= 0.002) and social status (p= 0.023).

Impact of animal-assisted interventions on the resident

Animal-assisted interventions are designed for personal well-being. The objective of this study was to evaluate the effectiveness of these interventions in the context of residential facilities for dependent elderly people. Animal-assisted therapy, which can be delivered by trained staff, could be a tool to helpinstitutionalised elderly people cope with loneliness.

Qualidade de vida de cuidadores de idosos dependentes vinculados a uma unidade de saúde de Porto Alegre/RS

OBJETIVO: Avaliar a qualidade de vida de cuidadores de idosos dependentes vinculados a uma unidade de saúde de Porto Alegre.MÉTODOS: Trata-se de um estudo quantitativo, analítico, observacional do tipo transversal. A amostra foi composta por 59 cuidadores. Os instrumentos de coleta de dados foram: questionário sociodemográfico, Índice de Independência nas Atividades da Vida Diária (Escala de Katz) e questionário WHOQOL-Bref. As análises foram realizadas através do programa SPSS. A investigação da associação entre os desfechos e o grau de dependência dos idosos nas atividades da vida diária foi realizada através da análise de correlação de Pearson, com nível de significância de 5%.RESULTADOS: Verificou-se predomínio de mulheres, de meia-idade e com algum problema de saúde autorreferido exercendo o cuidado informal. Os maiores escores de qualidade de vida dos cuidadores foram verificados no domínio físico e os menores no domínio meio ambiente.CONCLUSÕES: Não foi encontrada associação estatística significativa entre o grau de dependência dos idosos nas atividades da vida diária e os domínios de qualidade de vida.

Do caregivers of non-dependent elderly have specific characteristics? Study among 876 elderly-caregiver dyads

The increase in life expectancy and the aging of the population have a significant impact on the informal care provided by caregivers. Protecting caregivers against excessive burden has become a public health priority. The majority of studies target only those providing care for dependent elderly people. The aim of this study was to describe the characteristics of informal caregivers of non-dependent elderly persons, their difficulties and their level of burden. A cross-sectional study was conducted among 876 dyads: elderly people (over 70 years of age, non-dependent, living at home and having requested assistance from CARSAT South-East) and their caregivers. Two questionnaires were administered: one for the elderly (including the Frailty Group Iso-Resource Evaluation) and one for caregivers (including the Mini-Zarit Scale). A multi-component analysis and a logistic regression were performed. The elderly were mainly women (77.6%) with a mean age of 82.2±5.8 years and most were frail (94.7%). Most of the caregivers were women (64.5%) with a mean age of 62.7±13.7 years. The multi-component analysis showed three categories of caregivers: spouses, children and others. Among them, spouses performed the most tasks (4.8±2.6) and had the greatest burden. Caregivers in the "others" category were the least burdened and were the least impacted in their daily life. The children category caregivers were divided into two subgroups: those with characteristics similar to "others" caregivers and those with characteristics similar to "spouse" caregivers. Heavy burden was related to greater impact on daily life, poor relationships with the elderly and caregivers' difficulties in performing their role. This study confirms the heterogeneous nature of informal caregiver profiles. It also shows that the characteristic features and the burden of these caregivers are similar whether the elderly person is dependent or non-dependent but frail.

Professional stress and social support feelings, coping strategies, and burn-out of caregivers in care facilities for dependent elderly people.

Caregivers in dependent elderly people facilities may develop a burn-out, but few studies have been conducted on the subject. The aim of this study is to evaluate the feelings of professional stress and social support, coping strategies and caregivers' burn-out including nurses, caregivers and medical psychologists, to identify the different coping strategies according to the burn-out level, and to analyze the links between burn-out, perceived work stress and perceived social support. Seven facilities were contacted, but only three sent back valid response questionnaires. Twenty-one caregivers completed the questionnaires (socio-demographic data, MBI, Brief Cope, SSQ6, JSS). Results showed a low level of burn-out and perceived stress and a satisfactory perceived social support. Functional coping strategies were used, especially by caregivers with lower burn-out level (positive reinterpretation) unlike caregivers with moderate or high burn-out level that used more dysfunctional strategies (substance abuse). Significant links were found between perceived work stress and emotional exhaustion, and between personal accomplishment, perceived social support and emotional exhaustion, and between perceived work stress and perceived social support. These results show the relevance of creating working groups for caregivers in stress situations. The groups help to develop or maintain functional coping strategies and provide adequate social support for the healthcare team. Taking into account burn-out improves caregivers' job satisfaction and care quality for the residents.

Drivers of Old-Age Dependence and Long-Term Care Usage in Switzerland—A Structural Equation Model Approach

Long-term care (LTC) encompasses a set of services provided to impaired and dependent elderly people. To assess the level of the dependence several scales are used, including activities of daily living (ADL), instrumental ADL (IADL) and functional limitations. Once an elderly person fails to perform these activities independently, he or she requires special assistance. Help can be provided as informal care by relatives and as formal care by professionals. The aim of this research is to study individual characteristics that relate to the demand of LTC and to analyze the relation between formal and informal care. We base our study on data from the Swiss Health Survey focusing on respondents aged over 65 years. Using the structural equation modeling technique, we develop a statistical model that considers the dependence concept as a latent variable. This hidden dependence variable combines three indices linked to the limitations in ADL, in IADL and functional limitations. Accounting for causality links between covariates enables us to include the indirect effect of pathologies on the receipt of LTC mediated via dependence. In our model, we do not assume a causal relationship between formal and informal care. From our results, we observe a significant impact of pathologies as well as of the socio-demographic factors on the demand for LTC. The relationship between formal and informal care is found to be of both a complementary and substitutional nature.

Transcultural adaptation and psychometric study of the French version of the nursing home survey on patient safety culture questionnaire

BackgroundThe Nursing Home Survey on Patient Safety Culture (NHSOPS) questionnaire was developed by the Agency for Healthcare Research and Quality (AHRQ), particularly as an intervention to raise staff awareness about patient safety issues. The main objective of the present study was to provide a validated French-language measure of the safety culture (SC) in nursing homes. Thus the aim was i) to carry out a transcultural adaptation into French of the NHSOPS questionnaire, ii) to assess its psychometric properties in a sample of professionals working in French EHPAD facilities and iii) to develop our own tool.MethodsThe study was carried out on volunteering professionals from 61 nursing homes (from January to March 2016). Two phases were conducted: an initial phase involving the translation and cultural adaptation of the questionnaire, and a second phase in which the psychometric properties of the questionnaire were assessed. A Structural Equation Model (SEM) with a maximum likelihood estimation method was used to evaluate the construct validity of the questionnaire. As the fit of the structure was not sufficient, an exploratory factor analysis using a principal axis factoring with an oblique rotation was then performed. Internal consistency was evaluated and we examined test-retest reliability using Intra-class Correlation Coefficients (ICC).ResultsDuring the initial phase, all items were retained and minor adjustments were made. The participation rate by professionals was 58.4%. The exploratory analysis led to the identification of seven dimensions: Teamwork, Staffing, Compliance with procedures, Handoffs, Feedback and communication about incidents, Supervisor expectations and actions promoting resident safety, Overall perceptions of resident safety and Organizational learning. The SEM confirmed the existence of the seven latent dimensions (CFI = 0.946; TLI = 0.933; SRMR = 0.059; RMSEA = 0.061); internal consistency was acceptable. ICC per item ranged from 0.19 to 0.88.ConclusionsThe results from this study were robust on seven dimensions. This French version is the first on Patient SC to have been applied to the medical-social sector caring for dependent elderly people in France. The NHSOPS questionnaire provides the opportunity to broach this subject. A national evaluation campaign should provide the opportunity to confirm or improve this measure.Trial registrationNCT02908373 (September 21, 2016) «Retrospectively registered».

Measuring the Impact of Taking Care in the Context of an Innovative System for Keeping Dependent Elderly People in Their Homes

Measuring the Impact of Taking Care in the Context of an Innovative System for Keeping Dependent Elderly People in Their Homes

O18 Development of help and surveillance technologies for dependent elderly people at home

O18 Development of help and surveillance technologies for dependent elderly people at home

Produção científica da enfermagem sobre o cuidado familiar de idosos dependentes no domicílio

RESUMOEste estudo objetiva analisar as tendências das pesquisas na área da enfermagem que abordem a temática do cuidado familiar de idosos dependentes por doenças crônicas no domicílio. Trata-se de uma revisão narrativa da literatura, a partir da questão norteadora “Quais as tendências das produções da enfermagem brasileira acerca do cuidado familiar de idosos dependentes por doenças crônicas no domicílio?”. A busca foi realizada no mês de agosto de 2017 no Banco de Teses e Dissertações da Associação Brasileira de Enfermagem, acessando os catálogos anuais disponíveis, dos anos de 1998 a 2014. Utilizou-se como estratégias de busca os índices por assunto “cuidadores”, “assistência domiciliar” e “pacientes domiciliares”. O número total de estudos encontrados foi 233 resumos, que após aplicação dos critérios de inclusão e exclusão, restaram 22 que compuseram o “corpus” deste estudo. A exploração dos dados foi realizada qualitativamente pela análise de conteúdo proposta por Bardin. Destes, 14 são dissertações e oito teses, distribuídas em dez universidades brasileiras, com destaque para região Sudeste. A maioria dos estudos utilizou a abordagem qualitativa, tendo destaque no ano de 2010 com maior concentração de defesas. Conclui-se que o foco principal dos estudos foi o cuidador familiar, desvelando aspectos relacionados à sua caracterização, experiências, vivências, qualidade de vida, sobrecarga, sentido do ser cuidador e suporte social. A compreensão dos aspectos envolvidos no cuidado familiar ao idoso dependente contribui para subsidiar as ações das equipes de saúde, principalmente no preparo/acompanhamento da família que virá ser cuidadora, identificando suas principais dificuldades, necessidades e condições apresentadas.

Levels of Satisfaction, Workload Stress and Support Amongst Informal Caregivers of Patients Receiving or Not Receiving Long-Term Home Nursing Care in Poland: A Cross-Sectional Study.

The role of informal caregivers was included in the Assumptions of the Long-Term Senior Policy in Poland for 2014–2020. The document acknowledged the necessity of diagnosing the needs of informal caregivers of elderly people and to implement systemic solutions that would enable the provision of assistance for them. In response, this study aimed to describe the situation of caregivers of patients receiving versus patients not receiving Long-Term Home Nursing Care (LTHNC; i.e., a formal program including regular visits by a nurse specializing in home care) in terms of caregiver socio-demographic characteristics, health self-assessment, work overload, satisfaction derived from being a caregiver, and the quality of perceived support. A cross-sectional study was conducted using the Carers of Older People in Europe (COPE) Index in 2015 in the north-eastern part of Poland involving 170 caregivers of patients supported with LTHNC and 86 caregivers of patients staying at home and not receiving LTHNC. We found that caregivers for patients receiving LTHNC were significantly less overloaded with care work than caregivers for patients without LTHNC support (p < 0.001). LTHNC support was also related to the level of satisfaction with providing care: Caregivers for patients receiving LTHNC were significantly more satisfied with performing their role and felt greater support than caregivers for patients without LTHNC (p < 0.001). Our study provides evidence for a positive relationship between LTHNC and the situation of informal caregivers of dependent elderly people at home. A formal program of visits by a nurse specializing in long-term home care may facilitate the provision by caregivers of better informal care to patients staying at home.