Homes In Cairo Research Articles

The impact of sense of loneliness on geriatric depression: the mediating role of sense of mattering and psychological adjustment

BackgroundDepression is a highly prevalent mental disorder in older adults, and among its highest risk factors is loneliness. Although this relationship is commonly evident, the mechanisms underlying it, such as sense of mattering and psychological adjustment, lack exploration. The current research aims to examine the relationship between loneliness and geriatric depression and explore the mediating roles of sense of mattering and psychological adjustment.MethodsA sample of 200 older adults (63.5% females; mean age = 75.6; SD = 8.806) were recruited from 24 geriatric homes in Cairo, Egypt. Participants responded to the Arabic versions of the Mini-Mental State Examination for excluding the severely demented, Geriatric Depression Scale-15, University of California, Los Angeles Loneliness Scale-version 3, General Mattering Scale, and Brief Adjustment Scale-6. The mediation analysis was conducted using multiple linear regression with Hayes’ process macro on SPSS26 and structural equation modeling on JASP0.18.1.0.ResultsSense of mattering and psychological adjustment showed a significant total effect (β = .051, 95%CI [.045, .056], z = 18.436, p < .001) separated into a significant direct effect (β = .019, 95%CI [.009, .029], z = 3.784, p < .001) and a significant indirect effect (β = .031, 95%CI [.022, .041], z = 6.478, p < .001), indicating simultaneous partial mediation by the two variables. Additionally, sense of mattering accounts for 76% of the impact of loneliness on geriatric depression, and psychological adjustment accounts for 60.1%.ConclusionLoneliness significantly impacts geriatric depression through a sense of mattering and psychological adjustment. These findings implicate substantial insight for interventions that can be targeted at the reduction of geriatric depression through reducing loneliness feelings and enhancing sense of mattering and adjustment.

1985 Understanding the Perceptions of Caregivers of Older People in Residential Homes in Cairo

Abstract Introduction Institutional care for older people is a relatively new social phenomenon in Egypt that is associated with societal stigma. Traditionally dependent older people are looked after by family members at home. There are currently 145 care homes in Egypt, mostly based in Cairo serving 2% of the older population. The aim of this study was to understand the perspectives of paid caregivers on the strengths, weaknesses, opportunities, and threats (SWOT) associated with their professional roles. This knowledge is crucial to deliver a culturally sensitive training program for caregivers, and enhance their job satisfaction, ultimately leading to person-centred high-quality care. Method Two focus group meetings, 90 minutes each, were conducted with 39 caregivers in a private care home in Cairo. Each group was further divided into four working sub-groups using a SWOT approach to guide the discussion. Generic themes were identified, analysed, and agreed on by the group participants. Results Thirty-nine caregivers (31 % males), age range 18-50 years, were interviewed including undergraduate and qualified nurses and social workers. Five themes were identified: administration, team values, training, place and equipment, and residents and families. SWOT findings related to each theme are summarised below: Theme Strength Weakness Opportunities Threats Administration Support and flexibility Poor incentives Access to healthcare services Lack of rest facilities Team values Peer support Mixed qualities in different leaders Outdoor recreational activities Lone working Training Mentoring programme Unfulfilled training needs Regular updates on CGA No medical cover Place &amp; Equipment Resident accommodation Not always fit for purpose Health and safety compliance Cost of accommodation Residents and families Sharing knowledge Discriminatory attitudes toward staff Documentation of resident’s priorities Unfounded complaints Conclusion Reflecting on the views of paid caregivers provided valuable insight that could enhance the quality of institutional care for older people in Cairo.

Nutritional status and independence in instrumental activities of daily life in the elderly living in nursing homes and community dwellings: A comparative study

Background and objective: Dietary habits and patterns have been shown to have strong influence on the mental wellbeing of elderly. Aim of the study: to compare the current nutritional status and independence in instrumental activities of daily life (IADL) in the elderly living in nursing homes and community dwellings.Methods: The study was carried out in nursing homes and elderly clubs in Cairo using descriptive comparative design. It involved a group of 125 institutionalized elderly from six nursing homes in Cairo and a second group (community dwellers) of 250 elderly from social clubs or elderly daycare centers in Cairo. The data collection tools were an interview questionnaire including the Mini Nutritional Assessment (MNA), the IADL, and the 24-hour recall for dietary intake in addition to an inventory checklist for the nursing homes. The data collection lasted from October 2016 to December 2017.Results: The institutionalized elderly had significantly higher median age, more divorced /widows, from urban areas, with higher education, and more insufficient income; they were more obese (p = .02). In MNA 62.0% of those in community dwellings were normal compared to only 17.6% of institutionalized (p &lt; .001), but significantly more institutionalized elders had deficient caloric intake (80.0%) compared to 69.6% of those in community dwellings (p = .03). The IADL were significantly better among those in community dwellings. In multivariate analysis, having recreations was a positive predictor of MNA score, while smoking and institutionalization were negative predictors. As for the IADL score, the level of education was its positive predictor, whereas age and institutionalization were negative predictors. Body mass index (BMI) was positively predicted by female gender, educational level, and having recreations, and negatively predicted by age. For institutionalized elderly, income was a positive predictor of the MNA score, whereas the length of institutionalization was a negative predictor.Conclusion and recommendations: Malnutrition and dependency in IADL are more prevalent among elderly in nursing homes, and are related to the duration and characteristics of the institutionalization. The study recommends improving the dietary services in nursing homes, with training programs for their staff and regular monitoring of food services.

Fear of falls among nursing homes residents and community dwelling elderly

Background: fear of falling is common among elderly faller and it has been associated with impaired mobility and decreased functional status. As a result, older adults who have fallen are at greater risk of becoming institutionalized regardless of whether they have experienced an injurious fall. Objectives: the aim of the study is to assess the prevalence of fear of falls in elderly in geriatric home and in community dwelling elderly. Subjects and Methods: Design: A comparative study. Participants: 100 resident in nursing homes in Cairo and another 100 in community. Measurements: comprehensive geriatric assessment (CGA) including Minimental status examination (MMSE-30), Geriatric Depression scale (GDS-15), Mininutritional assessment (MNA), time up and go test (TUGT), activity of daily living (ADL), instrumental activity of daily living (IADl), Single item question “are you afraid of falling?” Results: the study showed that the prevalence of fear of falls in elderly living in nursing homes in Cairo is higher than others living in community, also showed that a higher percentage of environmental factors of falling among elderly in nursing homes compared to community, higher percentage of elderly with risk of fall living in nursing homes. Conclusion: prevalence of fear of falls is higher in elderly living in nursing homes in Cairo than others living in community.

Fear of falls among nursing homes residents and community dwelling elderly

Background: fear of falling is common among elderly faller and it has been associated with impaired mobility and decreased functional status. As a result, older adults who have fallen are at greater risk of becoming institutionalized regardless of whether they have experienced an injurious fall. Objectives: the aim of the study is to assess the prevalence of fear of falls in elderly in geriatric home and in community dwelling elderly. Subjects and Methods: Design: A comparative study. Participants: 100 resident in nursing homes in Cairo and another 100 in community. Measurements: comprehensive geriatric assessment (CGA) including Minimental status examination (MMSE-30), Geriatric Depression scale (GDS-15), Mininutritional assessment (MNA), time up and go test (TUGT), activity of daily living (ADL), instrumental activity of daily living (IADl), Single item question “are you afraid of falling?” Results: the study showed that the prevalence of fear of falls in elderly living in nursing homes in Cairo is higher than others living in community, also showed that a higher percentage of environmental factors of falling among elderly in nursing homes compared to community, higher percentage of elderly with risk of fall living in nursing homes. Conclusion: prevalence of fear of falls is higher in elderly living in nursing homes in Cairo than others living in community.

Risk of falls and Effect of a Health Education Program in Prevention of Falls among Elderly in Geriatric Homes in Cairo, Egypt

AbstractBackground: Geriatric Falls are considered as one of the serious public health problems, as they are common causes of morbidity mortality and poor quality of life. Health education intervention programs for fall prevention improves knowledge and number of falls among elderly.Aim: To assess risk of falling and home safety against falls among a group of elderly residents in Geriatric homes in Cairo, Egypt. Also, to explore the extent of falls` knowledge and evaluate the effectiveness of an intervention education program delivered to the elderly participants.Methods: A quasi-experimental interventional study was conducted upon 120 elderly participants in 7 geriatric homes in different districts in Cairo. The interview questionnaire included sociodemographic, general geriatric health, falls` risk assessment, geriatric home safety, falls` knowledge and falls` history sections. Educational Intervention was provided as a series of lectures to the elderly in the selected geriatric homes about falls related topics. Participants were interviewed for 3 times, before the intervention (pretest), after the intervention (posttest), and 6 months later (follow up posttest)Results: There was statistical significant improvement in the knowledge scores of geriatric participants regards different falls` topics in the posttest and follow up (6 months posttest) after implementation of the education intervention in comparison with the pretest scores (P=0.00). Elderly participants who experienced falling decreased from (35.8%) in the pre-test to (27.4 %) in the 6 months post-test after the education intervention.Conclusions: The health education intervention proved to be effective in increasing knowledge and reducing number of falls among geriatric participants.

Association between Potentially Inappropriate Prescription (PIP) and Health Outcome Among Geriatric Home Residents

Background: Appropriate prescribing of medications in elderly especially with advancing age is a major clinical and economic issue. Therefore, health care and appropriate use of medications with advancing age is one of the major challenges facing health care systems. Potentially inappropriate prescriptions (PIP) are defined by the presence of a risk of prescribed drugs that overweighs their benefit. Especially, when there are safer alternatives and include misuse of medications, prescription of drugs with significant drug–drug or drug– disease interactions and the negligence of beneficial medications. Aim of the Study: To assess the association between potentially inappropriate prescription and health outcome among a sample of Egyptian elderly patients in geriatric homes in Cairo. Methods: A cross-sectional study. A random sample of 120 geriatric home residents in Cairo. Demographic data were collected and comprehensive geriatric assessment was done for each participant including history taking, clinical examination, psychological, mental, functional, risk of falls and nutritional assessment. Assessment of potentially inappropriate prescription using STOPP criteria. Results: The present study showed that among the 120 participants; the prevalence of PIP using STOPP criteria was 27(22.5%) of them were taking one or more PIP, 24 (20%) were taking one PIP and 3 (2.5%) were taking 2 PIP, 12 (44.4%) of the studied participants having visual impairment were using PIP regarding STOPP criteria; 7 (25.9%) of the studied participants having hearing impairment were using PIP as detected by STOPP criteria, so there was significant relation between PIP and patients who had visual and hearing impairments, there was a significant relation between PIP among the studied group using STOPP criteria regarding functional assessment (Instrumental activity of daily living (IADL) with p-value equal (0.031), and there was no significant relation with cognitive, psychological, risk of falls and nutritional assessment and there was no significant relation with other health outcome. Conclusion: Potentially inappropriate prescription using STOPP criteria was found to be statistically significant with hearing, visual impairment and regarding functional assessment (IADL) only. No significant association with other health outcome.

Frailty and Cognitive Impairment

Background: frailty is defined as a multifactorial syndrome leading to difficulties in maintaining homeostasis, and vulnerability to stressors. Depression shares many manifestations, risk factors and consequences with frailty. Some studies included cognitive assessment as a component to evaluate frailty. Aim of the work: this study aimed to assess depression and cognition in frail elderly and to assess if depression could be underlying link between cognitive function and frailty. Patients and methods: this case control study included 102 males and females elderly living in geriatric homes in Cairo and excluded those who were bedridden or had sensory impairment interfering with communication, stroke, Parkinsonism, severe osteoarthritis, or dyspnea on ordinary exertion. All patients were subjected to comprehensive geriatric assessment. Frailty was diagnosed using a modified version of Fried criteria. We used the physical activity metric that was constructed by Avila-Funes. Conclusion: this study showed that cognitive impairment and depression did not differ between frail and non-frail subjects.

Prevalence and predictors of depression and anxiety among the elderly population living in geriatric homes in Cairo, Egypt.

Anxiety and depression are common in the elderly and affect their quality of life. The rates of depression and anxiety are higher among those living in institutional settings and are usually undiagnosed. The aim of the study was to determine the prevalence and predictors of depression, anxiety and mixed form (i.e. depression and anxiety) in the elderly living at geriatric homes. A cross-sectional study was conducted on 240 elderly participants from four randomly selected geriatric homes in Cairo. A pretested interview questionnaire was used to collect data. A short version of the Geriatric Depression Scale (GDS-15), the Hamilton Anxiety Scale, the Katz scale for Activity of Daily living, the three-item loneliness scale and the Personal Wellbeing Index Scale were used. The prevalence of depression, anxiety and mixed disorder among the studied group were 37.5, 14.2 and 30%, respectively. Old age and the presence of comorbidities were predictors for depression and/or anxiety. Female sex, a lower social class, insufficient income, partial independence and loneliness feeling are significant predictors for depression. Being married and loneliness feeling are significant predictors for anxiety, whereas the functional status is a significant predictor for mixed depression and anxiety. Depression and/or anxiety were found in more than 80% of the studied group. An older age, female sex, insufficient income, a lower social class, a partially independent functional status, the presence of comorbidities, more frequent loneliness feeling and being married or divorced were found to be significant predictors for these problems. This study reflects the need for the screening of the elderly in geriatric homes for depression and/or anxiety, especially among high-risk groups, and developing interventions to prevent and control such problems.

Attitudes of Elderly Egyptian Nursing Homes Residents Towards Advance Directives. Lack of Knowledge but Positive Attitudes

This study aimed to examine the attitude of elderly Egyptians living in nursing homes in Cairo to advance directives (ADs). A cross-sectional study was conducted and included a sample of 137 participants (60 years and above) from four nursing homes. The majority of them had never heard about ADs before. One hundred and twelve (81.8 %) showed an interest in ADs. The positive attitude toward ADs was associated with higher level of education, advancing age, sensory impairment, polypharmacy, those with functional dependency, and a greater number of existing co-morbidities. Nineteen participants (13.9 %) wanted a proxy for medical decisions, 18 (13.1 %) for financial matters and 75 (54.7 %) for both medical and financial issues. Regarding preferences for life-sustaining treatments; 63 (56.3 %) stated that they would refuse cardiopulmonary resuscitation, and 57 (50.9 %) would refuse mechanical ventilation if they were in an irreversible or incurable persistent vegetative state. Only 32 (28.6 %) participants accepted the idea of organ donation after death. This positive attitude for ADs among this sector of population may encourage the introduction of appropriate policies to facilitate the implementation of ADs among the elderly in Egypt.

Predicting falls among Egyptian nursing home residents: A 1-year longitudinal study

Background/PurposeFalls and their related complications are serious health problems among the institutionalized older population. This study aimed to evaluate the incidence of falls and the risk factors among nursing home residents in Cairo, Egypt. MethodsA one-year prospective cohort study was done in three nursing homes in Cairo. Overall, 84 residents aged over 60 years participated in this study. Baseline demographic characteristics and results of comprehensive geriatric assessments, e.g. cognition, depression, functional and nutritional status, previous falls, fear of falling, assistive device use, and assessment by the timed up-and-go test (TUG) test were collected. All falling accidents were recorded by the nursing home staff during the study period. ResultsDuring the study period, 163 incident falls (1940 falls/ 1000 resident-years) were identified in 53 fallers (631 fallers/1000 resident-years) were recorded. On average, fallers may fall twice a year (mean±SD 2.0±2.1 episodes, range 1–6). Compared to nonfallers, fallers were older, more likely to have hadprevious falls, fear of falling, frailty, impaired instrumental activities of daily living, poor cognitive status, malnutrition or its risk, assistive device use, and slower TUG. The most sensitive (86.8%) and specific (90.3%) predictor for falls in this study was TUG >14 seconds. ConclusionSixty-three percent of Egyptian nursing home residents may fall during one year follow-up with the incidence of 1019 falls/1000 resident-years. The most important predictive factor for falls in this study was the TUG >14 seconds.

Insomnia in institutionalized older people in Cairo, Egypt: Prevalence and risk factors associated

Insomnia symptoms are highly prevalent among the elderly. Nearly half of the elderly population reported difficulty in initiation and maintaining sleep. The presence of insomnia affects the quality of life of elderly and increases the risk of falls. This study aims to measure the prevalence of insomnia among a group of elderly living in geriatric homes in Cairo and to assess the factors affecting it. A cross sectional study was conducted on 184 elderly living in two geriatric homes in Cairo. Athens insomnia scale was used to assess insomnia through an interview questionnaire. The prevalence of insomnia among the studied elderly in geriatric homes in Cairo was 36.4%. Higher prevalence of insomnia was found among males and married elderly. Also, insomnia was associated with longer stay in geriatric homes. Feeling sleepy during the day (59.2%) was the most prevalent symptom. Suffering pain (73.5%), nocturia (42.7%), and suffering from chronic diseases (40.4%) were significantly associated with insomnia. A significantly higher percentage of elderly with bad self-perception of owns health, suffered of insomnia (77.8%). This study reveals that changes in lifestyle, optimization of living environment and symptom control can reduce the burden of insomnia and improve quality of life of institutionalized elderly in Egypt.

Nutritional status in older adults with mild cognitive impairment living in elderly homes in Cairo, Egypt.

To delineate the difference in nutritional risk between older adults with normal cognitive function and mild cognitive impairment living in elderly homes. Cross-sectional study. Three elderly homes in Cairo, Egypt. One hundred twenty older adults; men and women aged 60 years and older. Comprehensive geriatric assessment was done for every participant to evaluate medical, functional, cognitive and affective aspects. Nutritional status was assessed by using the mini-nutritional assessment (MNA). Nutritional deficit was considered to be present if the individuals were classified as malnourished or at nutritional risk by means of the MNA. The cognitive function was assessed by using the Mini-Mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA). MCI was identified in 46 (38.3%) of the participants. According to the MNA classification, 58 (48.3%) of the sample study was assessed as well nourished, 49 (40.8%) at risk of malnutrition and 13 (10.8%) as malnourished. Older adults with MCI had significantly higher frequency of being at risk of malnutrition or malnourished than those with normal cognition. Multiple logistic regression analysis revealed that the associations between MCI and nutritional deficit remained significant after adjustment for age, illiteracy, female gender and depression. These results suggest that MCI may be associated with nutritional risk, which emphasizes the importance of early identification of nutritional status among individuals with MCI. It remains to be demonstrated whether improvement in nutritional status may improve the cognitive function or delay progression to dementia in these patients.

Attitudes of Egyptian nursing home residents towards staying in a nursing home: a qualitative study

Aim. The aim of this study was to identify the attitudes of Egyptian nursing home residents towards staying in a nursing home and to differentiate between various types of these attitudes. Background. The number of older persons in Egypt who require nursing care is increasing. In response, nursing homes in bigger cities like Cairo were founded, although family care seems to be the prevalent norm. Methods. Semi-structured guideline interviews were performed with 21 residents from four different nursing homes in Cairo. Interviews were analyzed using qualitative content analysis. Findings. One category of resident was those who were sent to the nursing home by persons closely related to them. Another category made their own decision to move to a nursing home. Relationships with social networks and self-help abilities are factors of importance in influencing decision-making. Conclusion. Nursing homes in Egypt fulfil different functions for different types of older persons. Charitable institutions are a last resort for those with no income and a disrupted social network. For better-off older persons, nursing homes may provide the benefits of socialising with peers and receiving medical treatment.