Elderly Clients Research Articles

Application of ‘CDC- Public Security Bureau-NGO’ Joint Prevention and Control Mechanism Allied AIDS prevention and control in Guigang, Guangxi

BackgroundHIV/AIDS has emerged as a nationwide epidemic and has taken the forefront position as the primary infectious killer of adults in China. The control and prevention of the disease have been hampered by a weak link in the form of heterosexual transmission. However, conventional intervention measures have demonstrated suboptimal efficacy in reducing the incidence of new HIV infections. In light of the current epidemiological characteristics, we have developed and executed an innovative intervention model known as the Joint Prevention and Control Mechanism of the ‘CDC-Public Security Bureau-NGO’. The purpose of this research is to assess the impact of this model on the AIDS awareness, HIV infection rates, sexual behavior, and associated factors among female sex workers and elderly clients. Through the provision of robust evidence of the efficacy of this innovative model, we seek to advocate for its implementation in future interventions.MethodsThe research design of this study incorporates both a serial cross-sectional study and time-series analysis from 2014 to 2021, including a 4-year traditional intervention (2014–2017) and the 4-year ‘CDC-Public Security Bureau-NGO’ innovative intervention (2018–2021), was conducted to evaluate the effects of the new intervention. The GM(1, 1) model was performed to predict the proportion of HIV infection without implementing the innovative intervention in 2018–2021; P and C values were used to evaluate the performance of the model. Mann-Kendall test and descriptive methods were used to analyzed the trend of traditional and innovative interventions models on HIV positive detection rate in FSWs and elderly clients.ResultsThe condom usage rates during the last commercial sexual encounter for FSWs and elderly clients improved from 74.9% and 9.1%, respectively, to 96.9% and 28.1%. (P < 0.05), newly reported cases of HIV have decreased by 15.56% yearly and the HIV positive detection rate among middle-aged and elderly people has dropped by 14.47%. The innovative intervention model has significantly reduced the HIV infection rates.ConclusionsThe ‘CDC-Public Security Bureau-NGO’ innovative intervention has achieved beneficial effects on HIV/AIDS prevention and control and provides a good reference for Guangxi, China.

Selection of long acting reversible contraception methods by emergency contraception clients: A prospective observational study

ObjectivesTo describe long acting reversible contraception (LARC) initiation in emergency contraception (EC) visits. Study designEC clients age 18–35 years at four Utah family planning clinics between February 2021 and April 2023 chose between oral EC and three LARC options. ResultsOf 2106 EC clients approached, 306 (14.5%) requested LARC and 293 initiated a device: 160 (55%) an etonogestrel implant+ oral levonorgestrel (LNG), 72 (25%) a copper intrauterine device (IUD), and 61 (21%) a 52 mg levonorgestrel IUD (p < 0.001). ConclusionsIn this observational study, one in seven EC clients initiated a LARC method and more frequently selected the etonogestrel implant with oral levonorgestrel over an IUD. Clinical Trial RegistrationClinicaltrials.gov NCT04678817; registered 12/16/20.

The Double Burden: The Digital Exclusion and Identity Crisis of Elderly Patients in Rural China

The rapid digitalization of China’s healthcare system, a phenomenon that accelerated during the Covid-19 pandemic, had two negative consequences for a significant portion of elderly persons in China. The first is an unfortunate practical outcome: their exclusion from many health services such as online medical appointment platforms, e-prescription requests, obtaining e-referrals, and sharing electronic medical records. The second is an emotionally debilitating identity crisis as elderly persons’ former status as knowledgeable senior mentors was replaced with social perceptions of them as helpless and ignorant souls reliant on more youthful persons for guidance and assistance. This article adopts a grounded theory to explore the phenomenon from the perception of excluded elderly persons using participatory observation and in-depth interviews of 44 elderly clients of a rural hospital in the Shandong province in eastern China. The study shows that the current focus on direct practical aspects of digital exclusion may fail to capture the impact and ancillary consequences such as a painful loss of self-esteem by the digitally excluded. As the study illustrates, the practical aspects can all be overcome through intervention by those who aid the digitally excluded but this help may exacerbate the rarely considered ancillary harms of digital exclusion. Studies of digital exclusion will make more significant contributions to our understanding of the phenomenon if they look beyond the obvious direct consequences of digital exclusion to consider possible ancillary and flow-on effects.

Perception of the Family Caregiver in Care for Chronic Older Adults after Discharge

Introduction:The global trend of population longevity has highlighted the need for studies with advanced age groups. With the significant increase in the number of older adults, it is logical to reason that there will be an increase in demand for health care. Objective:The study aims to describe, through Bardin's phenomenological analysis, the family's perception of the continuity of care for chronic older adults after discharge. Method: This study is a descriptive and exploratory field study with a cross-sectional character and a qualitative approach. The study was conducted in a West Zone of São Paulo -Brazil hospital. The study subjects were family members of elderly clients expected to be discharged from the hospital. The data was collected through interviews and analyzed using Bardin's phenomenological analysis, which involves a systematic and rigorous process of categorizing and interpreting the data.

Influence of service quality and customer perceived value on customer loyalty with customer satisfaction as a moderating factor: A study based on private elderly care services in China

Amidst China’s escalating aging population challenge, the efficacy and quality of private elderly care services are garnering increasing scrutiny. This research focuses on evaluating how service quality and customer perceived value influence the loyalty of elderly clients, with customer satisfaction acting as a mediating factor. Grounded in established service quality frameworks and loyalty theories, the study utilizes a quantitative methodology, administering surveys across eight private elderly care institutions in H city, China. A total of 600 surveys were collected, providing a comprehensive data set that encompasses five dimensions of service quality—tangibility, assurance, responsiveness, reliability, and empathy—as well as customer perceived value, satisfaction, and loyalty. Structural Equation Modeling (SEM) was employed to validate the hypothesized relationships. Findings reveal that service quality significantly boosts customer perceived value and satisfaction, which in turn markedly enhance customer loyalty. Notably, customer satisfaction emerged as a crucial mediator between service quality and loyalty, as well as between perceived value and loyalty. This study not only advances theoretical understanding of service quality impacts but also offers actionable insights for enhancing service delivery and customer loyalty in the context of private elderly care.

Practices of Physiotherapists on the Risk of Falls and Prevention in Clients Aged 65 and Older: Online Survey Results

Purpose: Physiotherapists frequently interact with older adults. We aimed to determine the physiotherapists’ practices for fall risk and prevention in clients at 65 years and older. &#x0D; Material and Methods: 72 physiotherapists responded to online survey including questions about demographic and professional characteristics, the awareness and practices of physiotherapists on falling and preventing falls. &#x0D; Results: 91.7% of physiotherapists reported that fall risk should be determined in all clients at 65 years and older. 30.6% of them stated that they evaluated the risk of falling in case of necessity, 83.3% stated that they did not use a standard assessment-treatment flow chart for risk of falling. In elderly clients with low or no risk of falling, 8.1% of physiotherapists; In elderly clients with high risk of falling 83.3% of physiotherapist applied a preventive physiotherapy approach to prevent falls. 67.9% of physiotherapists provide training and advice on fall prevention to elderly clients with low or no fall risk; 73.5% prefer assistive device reclamation in elderly clients with a high risk of falling.&#x0D; Conclusion: Interventions should be planned to improve fall risk awareness and practices among physiotherapists by following a standard assessment-treatment flow chart for their clients 65 years and older.

“I’ll fill in the gaps”: perspectives of HHAs on promoting aging in place for older adults with low incomes

ABSTRACT Older adults with low incomes experience disproportionate rates of cognitive and functional impairment and an elevated risk of nursing home admission. Home health aides (HHAs) may have insight into how to optimize aging in place for this population, yet little is known about HHAs’ perspectives on this topic. We conducted 6 focus groups with 21 English-speaking and 10 Spanish-speaking HHAs in Pennsylvania and New Jersey. Transcripts were analyzed using qualitative thematic analysis, and three themes emerged. First, HHAs described the uniqueness of their role within multidisciplinary care teams. Second, HHAs shared concrete interventions they employ to help their clients improve their function at home. Third, HHAs discussed barriers they face when helping clients age in place. Our findings suggest that HHAs have important insights into improving aging in place for older adults with low incomes and that their perspectives should be incorporated into care planning and intervention delivery.

Improved outcomes for depressed elder abuse victims with video-delivered psychotherapy during COVID-19

Objective: There is a lack of evidence-based scalable therapies for elder abuse victims, with no current remotely delivered tailored psychotherapy. The purpose of this manuscript is to (a) examine the effectiveness of a brief therapy for depression for elder abuse victims, and (b) to compare remote intervention delivery via phone or video to the traditional in-person delivery. Method: PROTECT, Providing Options to Elderly Clients Together, is a brief therapy developed in collaboration with partners at the Department for the Aging (DFTA) of New York City. During the COVID-19 outbreak, PROTECT delivery shifted from in-person to phone or video delivery. Depression severity was tracked using the Patient Health Questionaire-9 (PHQ-9). Reduction in depression severity was evaluated using a linear mixed effects model with non-inferiority test to compare the effectiveness of video vs in-person delivery of PROTECT. Results: PROTECT reduced depression (average 5.15 PHQ-9 points). Video and phone delivery were non-inferior to in-person delivery. The video group completed therapy more quickly than the in-person group and had a more rapid improvement in depression symptoms. Conclusions: PROTECT therapy delivered remotely reduces depression among diverse elder abuse victims. Video delivery of PROTECT could increase reach and scalability to serve more vulnerable older depressed victims.

Dietary intake at stake: Clients’ adjusted diagnostic explanations during dietary treatment of malnutrition (risk)

In this article, we show how elderly clients in Dutch dietary consultations adjust dietitians’ history taking questions that suggest a cause for weight loss. Using conversation analysis and discursive psychology, we analyzed the history taking phase of recorded primary care conversations of 7 dietitians with 17 clients with malnutrition (risk). In response to the dietitian's history taking question, clients repeatedly present: 1) a problem in which weight loss is presented as unexpected and a conscious reduction in dietary intake is (therefore) not an issue, 2) a problem for which they cannot be held responsible, but which at the same time acts as a reason for reduced dietary intake, 3) a problem in which higher dietary intakes have been recommended by a third party that have proved impracticable. In these adjusted diagnostic explanations, clients emphasize the multidimensionality of their weight loss, which concurrently provides an explanation as to why they cannot be (solely) held responsible for their reduced dietary intake. Clients’ adjusted diagnostic explanations make relevant an evaluation by the dietitian. Dietitians’ subsequent lack of uptake leads to clients recycling diagnostic explanations to still get a response from the dietitian. Our findings offer insight into improving client-centered counseling by paying attention to clients’ adjusted diagnostic explanations.

Pilot Study on Effect of Warm Compress Application using Optic Care Wear Vs Conventional Method on Level of Symptom Complex among Elderly Clients with Dry Eye Syndrome at Selected Old Age Home, Puducherry

Pilot Study on Effect of Warm Compress Application using Optic Care Wear Vs Conventional Method on Level of Symptom Complex among Elderly Clients with Dry Eye Syndrome at Selected Old Age Home, Puducherry

Climate Change As a Significant Factor to the Aggravation of Coronary Artery Disease Among Elderly: A Basis for Emphasizing Community-based Self-care Measures

Background: This research study explored the lived experience of the elderly with coronary artery disease (CAD) relevant to the effects of climate change as a basis for enhanced and strengthened community-based self-care measures.&#x0D; Methods: A descriptive phenomenological design was employed in the study. Consented face-to-face interview sessions with audio recordings were conducted to gather rich information. The data collected from 28 participants were analyzed using the modified Stevick-Colaizzi-Keen method.&#x0D; Results: Three themes emerged upon a thorough analysis of the results: (1) elucidating the elderly’s perception of climate change; (2) unveiling the effects of climate change on CAD; and (3) managing health-related behaviors in a changing environment. Evidence has revealed that climate change causes and aggravates this disease. CAD manifestations worsen when an elderly person is exposed to sudden changes in weather conditions, where various signs and symptoms are evident.&#x0D; Conclusion: In conclusion, elderly clients have an awareness of the concept of climate change and its physiologic effects on CAD; hence, employment of practical self-care measures and practices in managing manifestations, significantly helps them adapt and cope with the adverse effects climate change brings.

Inter-provincial variation in older home care clients and their pathways: a population-based retrospective cohort study in Canada

BackgroundIn Canada, publicly-funded home care programs enable older adults to remain and be cared for in their home for as long as possible but they often differ in types of services offered, and the way services are delivered. This paper examines whether these differing approaches to care shape the pathway that home care clients will take. Older adult client pathways refer to trajectories within, and out of, the home care system (e.g., improvement, long term care (LTC) placement, death).MethodsA retrospective analysis of home care assessment data (RAI-HC was linked with health administrative data, long-term care admissions and vital statistics in Nova Scotia Health (NSH) and Winnipeg Regional Health Authority (WRHA). The study cohort consists of clients age 60 + years, admitted to home care between January 1, 2011 to December 31, 2013 and up to four years from baseline. Differences in home care service use, client characteristics and their pathways were tested across the two jurisdictions overall, and among the four discharge streams within jurisdictions using t-tests and chi-square tests of significance.ResultsNS and WHRA clients were similar in age, sex, and marital status. NS clients had higher levels of need (ADL, cognitive impairment, CHESS) at base line and were more likely discharged to LTC (43% compared to 38% in WRHA). Caregiver distress was a factor correlated with being discharged to LTC. While a third remained as home care clients after 4 years; more than half were no longer in the community – either discharged to LTC placement or death. Such discharges occurred on average at around two years, a relatively short time period.ConclusionsBy following older clients over 4 years, we provide enhanced evidence of client pathways, the characteristics that influence these paths, as well as the length of time to the outcomes. This evidence is central to identification of clients at risk in the community and aids in planning for future home care servicing needs that will allow more older adults to remain living in the community.

Frailty prevalence and its associations with socioeconomic factors, health status, and healthcare utilization among elderly home care clients

Frailty prevalence and its associations with socioeconomic factors, health status, and healthcare utilization among elderly home care clients

The Effect of Knowledge of the Elderly and Family Caregivers on the Incidence of Readmission in the Elderly with Heart Failure: Systematic Review

Heart Failure (HF) is a progressive disease that occurs in 0.13% of Indonesia's population and is dominated by the elderly. This disease requires high costs due to high rehospitalization rates. In meeting their daily needs, the elderly with HF needs caregivers to pay attention to their health, prevent risk factors, and identify resources owned by the family to support the needs of the elderly with HF. The aim of this systematic review was to identify the effect of knowledge of elderly clients and caregivers on the incidence of re-hospitalization in the elderly with HF. The data collection method uses an electronic database from journals that have been published through ScienceDirect, EBSCOHost, ProQuest, ClinicalKey, and Scopus. The data was analyzed using PRISMA diagram. The results of the systematic review of related journals show that the knowledge of clients and caregivers can reduce the incidence of re-hospitalization, and worsening of conditions, and reduce the risk of mortality in heart failure patients, therefore good understanding and literacy is needed for caregivers and elderly clients with HF.

Getting Ready for Foot Care Certification: Implementing Off-loading Interventions to Prevent or Manage Injury.

Getting Ready for Foot Care Certification: Implementing Off-loading Interventions to Prevent or Manage Injury.

REDUCING BLOOD PRESSURE IN ELDERLY WITH STAGE 2 PRIMARY HYPERTENSION USING SLOW DEEP BREATHING EXERCISE INTERVENTION

Background: Elderly with hypertension is a phenomenon that is currently widely encountered in society. Uncontrolled hypertension in the elderly can cause various conditions that will affect the productivity and quality of life of the elderly. Objective: The purpose of this scientific work is so that students are able to carry out gerontic nursing care, namely assessment, diagnosis, intervention, implementation and evaluation in the elderly with hypertension. Methods: The method used is a case study of nursing care for the elderly with hypertension. This research was conducted by providing slow deep breathing exercise interventions to the elderly with hypertension as an effort to reduce blood pressure. There is non-pharmacological nursing care to maintain normal blood pressure so that the elderly can maintain their condition. Slow deep breathing exercise is a relaxation technique to lower blood pressure. Result: After being given the slow deep breathing exercise intervention to the client for 11 days and carried out 2 times a day there was a decrease in blood pressure in the client with the average decrease in systolic blood pressure in the client was 16.7 mmHg and the average decrease in diastolic blood pressure in the client was 6 ,7 mm Hg. Conclusion: It is recommended for nurses to provide slow deep breathing exercise therapy to elderly clients with hypertension as a companion to hypertension treatment to reduce blood pressure.

Social Service Strategy in Improving Elderly Welfare: Evidence from Indonesia

The aims of this study were to find out the social service programs at the Pangudi Luhur Integrated Center in achieving elderly welfare, to find out the supporting and inhibiting factors of the social service strategy of the Pangudi Luhur Bekasi Integrated Center in achieving elderly welfare, and to find out the results achieved from these programs. the Pangudi Luhur Bekasi Integrated Center social service program for the elderly. This study uses a descriptive research method with a qualitative approach. The results of this study are that the condition of elderly clients has changed after receiving social services at the Pangudi Luhur Bekasi Integrated Center. Elderly clients have their needs fulfilled and grow independent so that they can carry out their social functions and can develop so that they can continue their old age productively. However, on the one hand, there has been a dysfunction in the social service strategy at the Pangudi Luhur Bekasi Integrated Center, namely based on the ADL assessment sample data above, there are elderly clients who experience mild to severe dependence. This is due to declining health conditions and declining physical function.

Qualitative Research on the Development of the Humanities Therapy Program for the Older Adults Living Alone

The purpose of this study is to develop a draft of the humanities therapy program for the psychological and emotional support of older adults living alone. To achieve that, Focus Group Interview (FGI), as a sort of Qualitative research, was conducted with experts in humanities and art therapy. The selected research participants were six experts who had over five years of clinical career. They are specialists in life history, humanities therapy, arts therapy, reminiscence therapy, multicultural counseling, and drama therapy. As a result, three themes, seven categories, and fourteen details were drawn. First, regarding counselors’ attitude and viewpoint for elderly clients, their patience and wait, intently listening and empathy, and the attitude of stopping judgment were emphasized. Second, it was necessary to design the program in consideration of the physical, cognitive, and emotional characteristics of older adults living alone. In addition, in the social-context dimension, it was necessary to develop the program in consideration of residential characteristics such as urban, agricultural, or fishing areas. Lastly, it was necessary to modify the humanities therapy program in consideration of the purpose of the program, the theory of integration, session operation plan, and the appropriateness of media use. This study was aimed at developing a humanities therapy program for older adults living alone. It is expected to be used as the basic data to develop psychology and emotion programs for older adults living alone in the preventive dimension.

Beers criteria and potentially inappropriate medications in elderly: awareness, practice, knowledge and barriers among community pharmacists in Nigeria

BackgroundPotential inappropriate medications (PIMs) used in the elderly are an avoidable source of disease and death. Beers Criteria is among the commonly used measures that document PIMs. Community pharmacists’ knowledge on PIMs and existing criteria are essential to moderate the use of PIMs which would enhance overall health outcomes and costs. This study investigates awareness, knowledge, practice, and barriers of PIMs among community pharmacists in Ibadan, Nigeria.MethodsA cross-sectional study was carried out on 109 community pharmacists with the use of a self-administered questionnaire. Nine clinical vignettes based on the 2019 Beers Criteria were used to evaluate PIMs knowledge. Practice behavior regarding elderly clients was evaluated using a 5-point Likert scale with six items. Data were summarized by descriptive and inferential statistics.ResultsRespondents who knew guidelines that listed specific PIMs were (49; 47.1%), and of these, (21; 42.9%) were aware of Beers Criteria. From all the respondents, only 45 (41.3%) demonstrated good knowledge of Beers Criteria, while 82 (75.2%) narrated good practice when dealing with elderly clients in terms of asking suitable questions and contemplating their ages while dispensing medications. Major barrier identified was lack of knowledge of Beers Criteria (80; 73.4%). Pharmacists who were aware of Beers Criteria statistically had better knowledge than others (p = 0.003).ConclusionBeers Criteria awareness among community pharmacists is sub-optimal in Ibadan, Nigeria. Although practice when dealing with elderly customers was satisfactory, the knowledge was unsatisfactory. This underscores the need to intensify the awareness and use of guidelines that document specific PIMs such as Beers Criteria among community pharmacists.

ATTITUDES TOWARD AGING AMONG COLLEGE STUDENTS: RESULTS FROM THE INTERGENERATIONAL CONNECTIONS PROJECT

Abstract To improve college students’ attitudes toward aging, an intergenerational intervention was implemented to connect them with community-dwelling older adults with cognitive impairment. College students were trained to make weekly phone calls to Meals on Wheels clients (age 65+). This study was an investigation of changes in college students’ attitudes toward aging over the course of study participation.College students aged 18 to 30 from a large public university in North Texas were recruited. Participants (n = 41) completed surveys through QuestionPro at baseline, midway, and at the end of the study. The Fraboni Scale of Ageism was used to measure attitudes toward aging. Friedman tests and one-way repeated measures ANOVAs were computed. Results indicated that college students’ total ageism scores significantly improved over time (F(2, 76)=4.491, p=.014), as well as their antilocution ageism scores (F(2, 76)=5.075, p=.007), and their avoidance ageism scores (F(2, 76)=3.844, p=.026). In addition, scores on six specific items significantly improved after participating in the study: “Many old people are stingy and hoard their money and possessions”, “Many old people are not interested in making new friends‚”, “Many old people just live in the past”, “I personally would not want to spend much time with an old person”, “Most old people should not be trusted to take care of infants”, and “Most old people would be considered to have poor personal hygiene”. Results suggest that weekly engagement with older adults offers promise for improving attitudes towards aging among college students. Implications for research and practice are discussed.