Elderly Care Home Residents Research Articles

How do advanced nurse practitioners enhance healthcare outcomes in frail older patients living in care homes?

Background: As the UK healthcare service strains to meet the demand from its ageing population for 24-hour care, there is an increased need to develop an effective way to provide quality care to frail residents living in care homes. The role of the advanced nurse practitioner (ANP) has evolved over the last 20 years, developing in part to meet the shortfall of GPs and geriatric specialist doctors. Despite research having been previously conducted in the US and Canada into how the ANP role can function within care homes, there has been limited exploration into how the role can enhance UK healthcare outcomes in relation to the 2019 NHS Long-Term Plan, which aimed to provide care closer to home for ageing patients. Aims: This paper was designed to critically review published primary research papers and evaluate the impact of the ANP role on healthcare outcomes for frail elderly care home residents. Its objective was to help guide future healthcare delivery policy within the UK. Methods: A saturated systematic search of primary research literature was conducted. An inclusion/exclusion criterion was also utilised. Key papers identified were subject to critical synthesis, using ratified critical appraisal tools from the Joanna Briggs Institute and mixed-method appraisal tool by Hong et al (2018) . A thematic/narrative approach was employed to evaluate the findings of the mixed-method heterogenic-style research. Results: A total of 14 primary research papers met the criteria, which included mixed methods of study from across four English language-speaking countries. Five outcome themes were recurrent throughout the synthesis of the results, including, in order of prevalence: improved/equivalent quality of care; successful collaborative role; reduced hospitalisations; timely access to primary/secondary care; colleague/patient/family satisfaction. Discussion: Following the review of the highlighted themes, there was a consensus that ANPs positively influence the care quality of elderly patients living within care homes. Although no superiority over a physician approach was found, there was indication of supplementary benefits when including ANPs in the care home setting. These include instilling positive role models into the healthcare environment, increasing the general knowledge and education capacity of care staff, and streamlining communication—especially within advanced care planning and coordination of care. These qualities clearly encompass the current NHS priorities of the 2019 Long-Term Plan and the Enhanced Health in Care Homes Framework, which are set to be fully achieved by 2024.

The prognostic value of the NECPAL instrument, Palliative Prognostic Index, and PROFUND index in elderly residents of nursing homes with advanced chronic condition

BackgroundIt is essential to assess the need for palliative care and the life prognosis of elderly nursing home residents with an advanced chronic condition, and the NECPAL ICO-CCOMS©4.0 prognostic instrument may be adequate for both purposes. The objective of this study was to examine the predictive capacity of NECPAL, the Palliative Prognosis Index, and the PROFUND index in elderly residents with advanced chronic condition with and without dementia, comparing their results at different time points.MethodsThis prospective observational study was undertaken in eight nursing homes, following the survival of 146 residents with advanced chronic condition (46.6% with dementia) at 3, 6, 12, and 24 months. The capacity of the three instruments to predict mortality was evaluated by calculating the area under the receiver operating characteristic curve (AUC), with 95% confidence interval, for the global population and separately for residents with and without dementia.ResultsThe mean age of residents was 84.63 years (± 8.989 yrs); 67.8% were female. The highest predictive capacity was found for PROFUND at 3 months (95%CI: 0.526–0.756; p = 0.016), for PROFUND and NECPAL at 12 months (non-significant; AUC > 0.5), and NECPAL at 24 months (close-to-significant (AUC = 0.624; 95% CI: 0.499–0.750; p = 0.053). The highest capacity at 12 months was obtained using PROFUND in residents with dementia (AUC = 0.698; 95%CI: 0.566–0.829; p = 0.003) and NECPAL in residents without dementia (non-significant; AUC = 0.649; 95%CI: 0.432–0.867; p = 0.178). Significant differences in AUC values were observed between PROFUND at 12 (p = 0.017) and 24 (p = 0.028) months.ConclusionsPROFUND offers the most accurate prediction of survival in elderly care home residents with advanced chronic condition overall and in those with dementia, especially over the short term, whereas NECPAL ICO-CCOMS©4.0 appears to be the most useful to predict the long-term survival of residents without dementia. These results support early evaluation of the need for palliative care in elderly care home residents with advanced chronic condition.

Impact of a COVID-19 Outbreak in an Elderly Care Home after Primary Vaccination.

Elderly care home residents are particularly vulnerable to COVID-19 due to immune-senescence, pre-existing medical conditions, and the risk of transmission from staff and visitors. This study aimed to describe the outcomes of a COVID-19 outbreak in a long-term care facility for elderly persons following the initial vaccination. A single-center, retrospective, observational design was used to analyze the variables associated with hospitalization and death rate by logistic regression. Adjusted odds ratios (aOR) and their 95% confidence intervals (CI) were calculated. Sixty-eight residents received the first dose of the COVID-19 vaccine. Despite being negative six days after vaccination, the performance of a second test 4 days later revealed 51 positives (75.0%) among residents and 18 among workers (56.3%). A total of 65 of the 68 residents (95.58%) had positive results with symptoms, whereas 34.9% required hospitalization, and 25.8% died. The best-fitting model to explain the distribution of cases reflects three points at the time of infection.. The time from vaccination to symptom onset explains the hospitalization and mortality rates since a day elapsed halves the risk of hospitalization (aOR = 0.57; CI = 0.38-0.75) and the risk of death by a quarter (aOR = 0.74; CI = 0.63-0.88). Nursing homes present an elevated risk of transmission and severity of SARS-CoV-2 infection. Although vaccination reduces the risk of hospitalization and death, extreme prevention and control measures are essential in these institutions despite the high vaccination coverage.

The association of SARC-F score with atherosclerosis in elderly residents of care homes

The association of SARC-F score with atherosclerosis in elderly residents of care homes

Covid-19 Vaccines As a Condition of Employment: Impact on Uptake, Staffing, and Mortality in Elderly Care Homes

Laws mandating vaccination against Covid-19 as a condition of employment in health and care sectors were commonplace during the pandemic. Using weekly data at the local authority level, we examine the impact of the vaccine mandate for elderly care homes in England on vaccine take-up, staffing levels, and mortality. Our identification strategy involves (1) comparing take-up and staffing in English elderly care homes relative to other social care settings unaffected by the mandate; (2) comparing take-up and staffing in English elderly care homes relative to those in Wales where the mandate also did not apply; and (3) comparing Covid-19 mortality among English elderly care home residents relative to mortality in domestic homes in England and to care homes in Wales. Our results suggest that the mandate substantially decreased the proportion of care home workers who remained unvaccinated (equivalent to between 28,000 and 41,000 fewer unvaccinated staff), but this came at the cost of a reduction in staffing levels of between 3% and 4% (equivalent to 14,000 to 18,000 staff). We observe this effect most strongly in areas of low unemployment. Our results do not provide evidence that the vaccine mandate was successful in its primary aim of reducing care home deaths. Relatively wide confidence intervals mean inferences regarding mortality are more uncertain than for vaccination uptake and staffing. This paper was accepted by Carri W. Chan, healthcare management. Supplemental Material: The data and e-companion are available at https://doi.org/10.1287/mnsc.2023.4832 .

SARS-CoV-2-specific memory B cells can persist in the elderly who have lost detectable neutralizing antibodies.

Memory B cells (MBCs) can provide a recall response able to supplement waning antibodies (Abs) with an affinity-matured response better able to neutralize variant viruses. We studied a cohort of elderly care home residents and younger staff (median age of 87 years and 56 years, respectively), who had survived COVID-19 outbreaks with only mild or asymptomatic infection. The cohort was selected because of its high proportion of individuals who had lost neutralizing antibodies (nAbs), thus allowing us to specifically investigate the reserve immunity from SARS-CoV-2–specific MBCs in this setting. Class-switched spike and receptor-binding domain (RBD) tetramer–binding MBCs persisted 5 months after mild or asymptomatic SARS-CoV-2 infection, irrespective of age. The majority of spike- and RBD-specific MBCs had a classical phenotype, but we found that activated MBCs, indicating possible ongoing antigenic stimulation or inflammation, were expanded in the elderly group. Spike- and RBD-specific MBCs remained detectable in the majority of individuals who had lost nAbs, although at lower frequencies and with a reduced IgG/IgA isotype ratio. Functional spike-, S1 subunit of the spike protein– (S1-), and RBD-specific recall was also detectable by enzyme-linked immune absorbent spot (ELISPOT) assay in some individuals who had lost nAbs, but was significantly impaired in the elderly. Our findings demonstrate that a reserve of SARS-CoV-2–specific MBCs persists beyond the loss of nAbs but highlight the need for careful monitoring of functional defects in spike- and RBD-specific B cell immunity in the elderly.

Responsibility for vitamin D supplementation of elderly care home residents in England: falling through the gap between medicine and food

IntroductionDaily vitamin D supplements are recommended for elderly care home residents; however, they are rarely given and vitamin D deficiency in care homes is widespread. This study aimed to understand...

Ethnographic research method for psychological and medical studies in light of COVID ‐19 pandemic outbreak: Theoretical approach

Ethnographic research is perhaps the most common applicable type of qualitative research method in psychology and medicine. In ethnography studies, the researcher immerses himself in the environment of participants to understand the cultures, challenges, motivations, and topics that arise between them by investigating the environment directly. This type of research method can last for a few days to a few years because it involves in-depth monitoring and data collection based on these foundations. For this reason, the findings of the current study stimuli the researchers in psychology and medicine to conduct studies by applying ethnographic research method to investigate the common cultural patterns: language, thinking, beliefs, and behavior for groups of addicts, the bullies and their bullies, hospitalized psychiatric patients, psychiatric nursing groups, psychologists, counselors and psychotherapists, elderly residents of care homes, abused persons, orphans, persons with special needs, groups of gifted students in gifted schools and centers, and family with special needs children. The ethnographic approach is a very important method in medicine to investigate the health case of the patients with chronic diseases, such as heart diseases, cancer, diabetes, blood pressure, and others. And examine the effectiveness of the treatment plan and take a decision to continue this plan, or change it, in the treatment of a particular disease group. As well as detection of the side effects of drugs and treatment plan for certain groups of patients, and learning about the common culture of pregnant women about the process of pregnancy and childbirth.

Nutritional status of elderly residents of long-term care homes in Klang Valley, Malaysia: a cross-sectional study

Nutritional status of elderly residents of long-term care homes in Klang Valley, Malaysia: a cross-sectional study

Suspected cluster of Neisseria meningitidis W invasive disease in an elderly care home: do new laboratory methods aid public health action? United Kingdom, 2015.

In 2015, a suspected cluster of two invasive meningococcal disease (IMD) cases of serogroup W Neisseria meningitidis (MenW) occurred in elderly care home residents in England over 7 months; case investigations followed United Kingdom guidance. An incident control team reviewed epidemiological information. Phenotyping of case specimens informed public health action, including vaccination and throat swabs to assess carriage. Whole genome sequencing (WGS) was conducted on case and carrier isolates. Conventional phenotyping did not exclude a microbiological link between cases (case 1 W:2a:P1.5,2 and case 2 W:2a:NT). After the second case, 33/40 residents and 13/32 staff were vaccinated and 19/40 residents and 13/32 staff submitted throat swabs. Two MenW carriers and two MenC carriers were detected. WGS showed that MenW case and carrier isolates were closely related and possibly constituted a locally circulating strain. Meningococcal carriage, transmission dynamics and influence of care settings on IMD in older adults are poorly understood. WGS analyses performed following public health action helped to confirm the close relatedness of the case and circulating isolates despite phenotypic differences and supported actions taken. WGS was not sufficiently timely to guide public health practice.

Relationships between orthostatic hypotension, frailty, falling and mortality in elderly care home residents

BackgroundOrthostatic hypotension (OH; profound falls in blood pressure when upright) is a common deficit that increases in incidence with age, and may be associated with falling risk. Deficit accumulation results in frailty, regarded as enhanced vulnerability to adverse outcomes. We aimed to evaluate the relationships between OH, frailty, falling and mortality in elderly care home residents.MethodsFrom the Minimum Data Set (MDS) document, a frailty index (FI-MDS) was generated from a list of 58 deficits, ranging from 0 (no deficits) to 1.0 (58 deficits). OH was evaluated from beat-to-beat blood pressure and heart rate (finger plethysmography) collected during a 15-min supine-seated orthostatic stress test. Retrospective and prospective falling rates (falls/year) were extracted from facility falls incident reports. All-cause 3-year mortality was determined. Data are reported as mean ± standard error.ResultsData were obtained from 116 older adults (aged 84.2 ± 0.9 years; 44% males) living in two long term care facilities. The mean FI-MDS was 0.36 ± 0.01; FI-MDS was correlated with age (r = 0.277; p = 0.003). Those who were frail (FI ≥ 0.27) had larger Initial (− 17.8 ± 4.2 vs − 6.1 ± 3.3 mmHg, p = 0.03) and Consensus (− 22.7 ± 4.3 vs − 11.5 ± 3.3 mmHg, p = 0.04) orthostatic reductions in systolic arterial pressure. Frail individuals had higher prospective and retrospective falling rates and higher 3-year mortality. Receiver operating characteristic curves evaluated the ability of FI-MDS alone to predict prospective falls (sensitivity 72%, specificity 36%), Consensus OH (sensitivity 68%, specificity 60%) and 3-year mortality (sensitivity 77%, specificity 49%). Kaplan Meier survival analyses showed significantly higher 3-year mortality in those who were frail compared to the non-frail (p = 0.005).ConclusionsFrailty can be captured using a frailty index based on MDS data in elderly individuals living in long term care, and is related to susceptibility to orthostatic hypotension, falling risk and 3-year mortality. Use of the MDS to generate a frailty index may represent a simple and convenient risk assessment tool for older adults living in long term care. Older adults who are both frail and have impaired orthostatic blood pressure control have a particularly high risk of falling and should receive tailored management to mitigate this risk.

Scabies outbreaks in ten care homes for elderly people: a prospective study of clinical features, epidemiology, and treatment outcomes

SummaryBackgroundScabies outbreaks in residential and nursing care homes for elderly people are common, subject to diagnostic delay, and hard to control. We studied clinical features, epidemiology, and outcomes of outbreaks in the UK between 2014 and 2015.MethodsWe did a prospective observational study in residential care homes for elderly people in southeast England that reported scabies outbreaks to Public Health England health protection teams. An outbreak was defined as two or more cases of scabies (in either residents or staff) at a single care home. All patients who provided informed consent were included; patients with dementia were included if a personal or nominated consultee (ie, a family member or nominated staff member) endorsed participation. Dermatology-trained physicians examined residents at initial clinical visits, which were followed by two mass treatments with topical scabicide as per local health protection team guidance. Follow-up clinical visits were held 6 weeks after initial visits. Scabies was diagnosed through pre-defined case definitions as definite, probable, or possible with dermatoscopy and microscopy as appropriate.Findings230 residents were examined in ten outbreaks between Jan 23, 2014, and April 13, 2015. Median age was 86·9 years (IQR 81·5–92·3), 174 (76%) were female, and 157 (68%) had dementia. 61 (27%) residents were diagnosed with definite, probable, or possible scabies, of whom three had crusted scabies. Physical signs differed substantially from classic presentations. 31 (51%) of the 61 people diagnosed with scabies were asymptomatic, and only 25 (41%) had burrows. Mites were visualised with dermatoscopy in seven (11%) patients, and further confirmed by microscopy in three (5%). 35 (57%) cases had signs of scabies only on areas of the body that would normally be covered. Dementia was the only risk factor for a scabies diagnosis that we identified (odds ratio 2·37 [95% CI 1·38–4·07]). At clinical follow-up, 50 people who were initially diagnosed with scabies were examined. No new cases of scabies were detected, but infestation persisted in ten people.InterpretationClinical presentation of scabies in elderly residents of care homes differs from classic descriptions familiar to clinicians. This difference probably contributes to delayed recognition and suboptimal management in this vulnerable group. Dermatoscopy and microscopy were of little value. Health-care workers should be aware of the different presentation of scabies in elderly people, and should do thorough examinations, particularly in people with dementia.FundingPublic Health England and British Skin Foundation.

Diagnosis, treatment, and control of scabies: can we do better?

In 2017, the Department of Control of Neglected Tropical Diseases of WHO recommended that scabies be added to the neglected tropical disease portfolio and called for action to improve control efforts. Scabies affects around 200 million people at any one time, 1 Karimkhani C Colombara DV Drucker AM et al. The global burden of scabies: a cross-sectional analysis from the Global Burden of Disease Study 2015. Lancet Infect Dis. 2017; 17: 1247-1254 Summary Full Text Full Text PDF PubMed Scopus (130) Google Scholar causes an intensely itchy rash, and leads to bacterial infection and autoimmune disease. 2 Engelman D Kiang K Chosidow O et al. Toward the global control of human scabies: introducing the International Alliance for the Control of Scabies. PLoS Negl Trop Dis. 2013; 7: e2167 Crossref PubMed Scopus (123) Google Scholar Although the greatest burden is in disadvantaged populations in resource-limited and tropical settings, scabies also causes a substantial health-care burden via institutional outbreaks in high-income and temperate settings. Scabies outbreaks in ten care homes for elderly people: a prospective study of clinical features, epidemiology, and treatment outcomesClinical presentation of scabies in elderly residents of care homes differs from classic descriptions familiar to clinicians. This difference probably contributes to delayed recognition and suboptimal management in this vulnerable group. Dermatoscopy and microscopy were of little value. Health-care workers should be aware of the different presentation of scabies in elderly people, and should do thorough examinations, particularly in people with dementia. Full-Text PDF Open Access

Effect of facilities management components on the quality of life of Chinese elderly in care and attention homes

PurposeQuality of life (QoL) for elderly residents of care and attention (C&A) homes has become an important consideration, given the increasingly aging population. Due to the number of hours such residents spend indoors, the quality of the facilities can contribute to their day-to-day QoL. This study aims to investigate the effect of facilities management (FM) on the QoL of Chinese elderly people living in C&A homes.Design/methodology/approachA survey of perceived satisfaction with the components of FM and QoL was carried out with a sample of residents. A total of 18 FM components and five QoL domains, including physical health, independence, psychological health, social relationships and living environment, as well as overall QoL, were identified.FindingsThe findings show that physical health is influenced by accessibility, doors and windows and signage; independence can be improved by enhancing accessibility, water supply, lighting and ventilation; accessibility, water supply, distance and doors and windows all predict psychological health; social relationships are improved by lighting and ventilation; distance impacts positively on the living environment; and overall QoL is predicted by lighting, ventilation, accessibility, doors and windows, handrails, recreation and signage.Originality/valueThe study recommends that designers and facilities managers review the micro-climate settings to harness available natural lighting and ventilation, introduce bimetallic strips to the heating systems to maintain a suitable water temperature and install large, easy-to-understand and graphic signage for straightforward wayfinding in C&A homes.

Longitudinal survey of Clostridium difficile presence and gut microbiota composition in a Belgian nursing home.

BackgroundIncreasing age, several co-morbidities, environmental contamination, antibiotic exposure and other intestinal perturbations appear to be the greatest risk factors for C. difficile infection (CDI). Therefore, elderly care home residents are considered particularly vulnerable to the infection. The main objective of this study was to evaluate and follow the prevalence of C. difficile in 23 elderly care home residents weekly during a 4-month period. A C. difficile microbiological detection scheme was performed along with an overall microbial biodiversity study of the faeces content by 16S rRNA gene analysis.ResultsSeven out of 23 (30.4 %) residents were (at least one week) positive for C. difficile. C. difficile was detected in 14 out of 30 diarrhoeal samples (43.7 %). The most common PCR-ribotype identified was 027. MLVA showed that there was a clonal dissemination of C. difficile strains within the nursing home residents. 16S-profiling analyses revealed that each resident has his own bacterial imprint, which was stable during the entire study. Significant changes were observed in C. difficile positive individuals in the relative abundance of a few bacterial populations, including Lachnospiraceae and Verrucomicrobiaceae. A decrease of Akkermansia in positive subjects to the bacterium was repeatedly found.ConclusionsA high C. difficile colonisation in nursing home residents was found, with a predominance of the hypervirulent PCR-ribotype 027. Positive C. difficile status is not associated with microbiota richness or biodiversity reduction in this study. The link between Akkermansia, gut inflammation and C. difficile colonisation merits further investigations.Electronic supplementary materialThe online version of this article (doi:10.1186/s12866-016-0848-7) contains supplementary material, which is available to authorized users.

Awareness of Elderly Care Home Residents' Families with Regard to Expansion of Nurses' Medical Roles

Awareness of Elderly Care Home Residents' Families with Regard to Expansion of Nurses' Medical Roles

The experience of dissolving polypharmacy by reducing the prescription of anti-ulcer drugs in residents of a special geriatric nursing home.

As part of a broader study on polypharmacy among elderly nursing home residents, we examined the impact of reducing or discontinuing the prescription of proton pump inhibitors and other anti-ulcer drugs. We employed a strategy of reducing and discontinuing the prescription of drugs to 160 elderly residents of the Hiroshima Atomic Bomb survivors nursing home, Kandayama Yasuragien. The residents had entered the home between April 2012 and November 2015. As part of this study into anti-ulcer drugs, we also measured the concentrations of Helicobacter pylori antigen in stool specimens, and the serum concentrations of H pylori antibodies and pepsinogen I and II. The proportions of residents who were taking more than six drugs on April 2012, August 2014 and November 2015 were 55.2%, 49.0% and 43.0%, respectively. At the same times, the proportions of residents who were taking anti-ulcer drugs were 50.0%, 49.0% and 6.0%, respectively. The presence of H pylori antigen and antibodies, and serum pepsinogen concentrations, did not influence the decisions to continue or discontinue anti-ulcer drugs. We have already reported that reduction of diuretics reduces the incidence of falls and fall-related fractures in our residents, and have demonstrated the benefits of discontinuing folic acid and drugs that are given to control hyperkalemia. In the present study, we found that many anti-ulcer drugs were also of low necessity to elderly care home residents. It is essential to examine the clinical benefits of addressing polypharmacy in elderly individuals. In the future, we intend to focus on reducing hypnotics, laxatives and other drugs.

Periodontal status and oral health-related quality of life in elderly residents of aged care homes in Delhi.

The aim of the present study was to explore the associations between clinical periodontal findings and oral health-related quality of life in elderly people residing in the aged care homes of Delhi, India. A cross-sectional study was carried out among 500 residents of aged care homes across Delhi. Data were collected by carrying out clinical oral examinations and by filling a self-administered questionnaire. Oral health-related quality of life was assessed by a pretested Hindi version of the Geriatric Oral Health Assessment Index (GOHAI-Hi). Periodontal status was assessed using the Community Periodontal Index - CPI, and loss of attachment and tooth mobility was assessed using a modified Miller's index. Of a total of 500 participants, 221 (44.20%) were men and 279 (55.80%) were women The mean additive score GOHAI score was 41.57 ± 6.07 and the mean number of negative impacts or mean simple count GOHAI score was 6.27 ± 1.54. Mean GOHAI scores were significantly higher among men than women, and were found to be decreasing continuously with the increasing age categories. Tooth mobility and loss of attachment scores were found to be significantly associated with oral health-related quality of life, whereas Community Periodontal Index scores showed a negative correlation with it. The geriatric population, especially those in aged care homes, is a special need group because of their inability to access dental care rather than some particular feature of their oral or general health The findings of the present study point to a need to improve access to oral healthcare for this elderly population.

Assessment of a Self-Reported Drinks Diary for the Estimation of Drinks Intake by Care Home Residents: Fluid Intake Study in the Elderly (FISE).

We evaluated the accuracy of a newly developed self-completed Drinks Diary in care home residents and compared it with direct observation and fluid intake charts. Observational study. Residential care homes in Norfolk, UK. 22 elderly people (18 women, mean age 86.6 years SD 8.6, 12 with MMSE scores <27). Participants recorded their own drinks intake over 24 hours using the Drinks Diary while care staff used the homes' usual fluid intake chart to record drinks intake. These records were compared with drinks intake assessed by researcher direct observation (reference method), during waking hours (6am to 10pm), while drinks taken from 10pm to 6am were self-reported and checked with staff. Drinks intake assessed by the Drinks Diary was highly correlated with researcher direct observation (Pearson correlation coefficient r=0.93, p<0.001, mean difference -163ml/day) while few staff-completed fluid charts were returned and correlation was low (r=0.122, p=0.818, mean difference 702ml/day). The Drinks Diary classified 19 of 22 participants correctly as drinking enough or not using both the European Food Safety Authority and US recommendations. The Drinks Diary estimate of drinks intake was comparable with direct observation and more accurate (and reliably completed) than staff records. The Drinks Diary can provide a reliable estimate of drinks intake in elderly care home residents physically and cognitively able to complete it. It may be useful for researchers, care staff and practitioners needing to monitor drinks intake of elderly people, to help them avoid dehydration.

Influence of a Relaxation Program, Cognitive Training and a Combination of Both Intervention Forms On Neuropsychological and Affective Parameters in Elderly Care Home Residents

Introduction Evaluation of non-medical interventions on cognitive and emotional competence in old age is among the goals of research in clinical gerontopsychology. Aims The goals of our study were to assess the impact of and analyze the differences between a cognitive training program, relaxation training according to Jacobson and a combination of both forms of intervention on cognitive performance, well-being and pain in older people. Methods 26 care home residents (group 1) underwent the Jacobson relaxation training first, followed by a combination of relaxation and cognitive training. 24 participants (group 2) underwent a cognitive training program in the first instance followed by the combined intervention. Various psychological tests were implemented at three time points of measurement. Results - Significant improvement in dementia screening, in visual short-term memory and working memory both after the relaxation training only as also after combination training - Relevant improved performance in ultra short-term memory after combination training - Significant reduction in depression scores in both study groups - Relevant improvement in state of well-being after all training variants Conclusion Jacobson relaxation has a markedly stronger positive effect in optimizing the cognitive and emotional status of elderly persons compared to the more frequently propagandized and implemented cognitive training.