Number Of Elderly Persons Research Articles

Octo- and nonagenarians\u2019 outlook on life and death when living with an implantable cardioverter defibrillator: a cross-sectional study

BackgroundElderly individuals are increasingly represented among patients with implantable cardioverter defibrillators (ICD), but data describing life with an ICD are scarse among octo- and nonagenarians. Moreover, few studies have reported those elderly patients’ perspective on timly discussions concerning what shock deactivation involves, preferences on battery replacement, and their attitudes about turning off the ICD nearing end-of-life. Consequently, the aim of the study was to describe outlooks on life and death in octo- and nonagenarian ICD-recipients.MethodsParticipants were identified via the Swedish Pacemaker- and ICD-registry, with 229 octo- and nonagenarians (82.0 ± 2.2 years, 12% female) completing the survey on one occasion. The survey involved questions on health and psychological measures, as well as on experiences, attitudes and knowledge of end-of-life issues in relation to the ICD.ResultsThe majority (53%) reported their existing health as being good/very good and rated their health status as 67 ± 18 on the EuroQol Visual Analog Scale. A total of 34% had experienced shock(s), 11% suffered from symptoms of depression, 15% had anxiety, and 26% reported concerns related to their ICD. About one third (34%) had discussed their illness trajectory with their physician, with those octo- and nonagenarians being more decisive about a future deactivation (67% vs. 43%, p < .01). A minority (13%) had discussed what turning off shocks would involve with their physician, and just 7% had told their family their wishes about a possible deactivation in the future. The majority desired battery replacement even if they had reached a very advanced age when one was needed (69%), or were seriously ill with a life-threatening disease (55%). When asked about deactivation in an anticipated terminal illness, about one third (34%) stated that they wanted to keep the shocks in the ICD during these circumstances. About one-fourth of the octo- and nonagenarians had insufficient knowledge regarding the ethical aspects, function of the ICD, and practical consequences of withdrawing the ICD treatment in the end-of-life.ConclusionsIncreasing numbers of elderly persons receive an ICD and geriatric care must involve assessments of life expectancy as well as the patient’s knowledge and attitudes in relation to generator changes and deactivation.

PSYCHOLOGICAL DISORDERS IN OLD AGE AND AYURVEDA

According to modern concept aging is a physical, physiological, psychological phenomenon which is result because of inherent evolutionary changes occurring in the mind and body system. Hypertension, Ischemic Heart Disease, Diabetes, Senile Dementia, Alzheimer's disease, Parkinsonism, Degenerative Arthritis, Osteoporosis, Opportunistic Infections, Prostatic enlargement, degenerative eye diseases like Cataract which causes major morbidity in old age. In old age most commonly Psychological disorders are observed like senile dementia, Alzheimer disease, depression. Ayurveda describe aging is Swabhava of human body i.e. ''Shirayate Tata Shariram''. Ayurveda Samhita described that after sixty age function of brain decrease so psychological disorders are occur in this age. Aim of this subject is to enlighten the basic concept of mental disorder both in Ayurveda and Modern books and discussion on different views. In recent era we see technology increases in health science but life span of people decreases from 100 years to 60- 70 years. Ayurveda is science of life and longevity. Ayurveda give basic knowledge about age related problems. Conclusion made by comparing between Ayurveda and modern concepts of Psychological disorders.&#x0D; Demographically India is the second largest country in the world with the largest number of aged persons (60+ years). Psychological disorders are big problem in old age, so for confirm diagnosis and treatment we need to enhance our knowledge.

Oral hygiene practice and oral health status of geriatric population in selected area of Rangpur, Bangladesh

Background: Throughout the world, a demographic revolution is underway. The proportion of older people is growing faster than any other group. A growth spurt in the number of elderly persons has resulted from improvements in both social living conditions and medical care. This poses tremendous challenges to health and social policy planners, particularly because disease patterns will shift concurrently.Objectives: The present study was planned and carried out with the aim of assessment of the oral hygiene practice and oral health status among geriatric population.Materials &amp; Methods: This cross sectional study was done among the geriatric population with a view to assess their oral hygiene practice and oral health status. Purposively selected 26 geriatric peoples were interviewed through a structured closed end questionnaire followed by a observational checklist.Results: In this study, it is found that most (84.6%) respondents brush their teeth regularly; more than half (57.7%) respondents brush their teeth twice; most (53.8%) of respondents brush their teeth after awake at morning, and 30.8% respondents brush 2-3 min; half of respondents use tooth brush and tooth paste. In this study, it is found that, respondents aged 70 years have Decayed Missed Filled Teeth (DMFT) (mean ± SD) 5.20 5.72, OHI (mean ± SD) 2.56 01.87. We also found that, respondents have Plaque Index (PI) (mean ± SD) 1.29 1.50, and GI (mean ± SD) 0.20 0.44.Conclusion: Oral health is one of the important components of aging; due to the presence of oral disease, it can affect general health and quality of life of elderly people.KYAMC Journal Vol. 9, No.-2, July 2018, Page 48-52

Depression and its associated risk factors among elderly in an urban area: A cross- sectional study

Introduction: The world's population is ageing rapidly. India too, is in a phase of demographic transition and there has been a sharp increase in the number of elderly persons. Getting older can bring many health challenges to the elderly including neuropsychiatric disorders. Among the neuropsychiatric disorders, depression is the commonest and poses a substantial public health problem contributing significantly to the global burden of the disease. This study was conducted with the objective to determine the prevalence of depression among the elderly and to find out the associated factors. Materials and Methods: A community based cross sectional study was conducted among the elderly residing in the Urban Field Practice Area of Community Medicine Department, RIMS, Imphal from October 2014 to September 2016. Data was collected by interview method. Mini Mental State Examination (MMSE) was used as a screening tool to rule out dementia. Geriatric Depression Scale-30 (GDS-30) which was translated into the local language was used to identify those individuals having depression. Descriptive statistics such as percentages, mean and standard deviation were used to summarize the data. Chi-square test was used for testing the association between depression and selected socio demographic variables. Results: The prevalence of depression was found to be 29.4% in this study. In Univariate analysis age, education, occupation, marital status, type of the family, financial dependency, health condition and limitation of daily activities were found to be significantly associated with depression. In multivariate analysis only age was found to be significantly associated with depression. Conclusion: Depression is common in this study area and more so among oldest old, illiterates and widowed elderly. These study findings can help program managers implement a more comprehensive strategy in this community for timely interventions to promote mental health and prevent geriatric depression.

Quality of life and depression in elderly persons engaged in physical activities

Backgroung/Aim. Since the number of elderly persons is gradually increasing worldwide, there is a need to identify the factors that affect the quality of healthy ageing. On the other hand, depression is the most common psychiatric disorder in the elderly and one of the most serious health problems that modern society is facing. Considering the importance of physical activity for healthy ageing, the question is whether there are differences in quality of life and depression in the elderly in relation to the certain characteristics of physical activities practicing. Methods. Differences in the quality of life and occurrence of depression in elderly were examined in relation to duration of a single training session and frequency of physical activities per week. This non-experimental, descriptive and comparative cross-sectional study involved a total of 188 persons aged 65?84 years, where 90 persons are engaged in a physical activity while 98 persons are not. The Older People?s Quality of Life Questionnaire and the Geriatric Depression Scale were used. Results. Statistically significant difference was found in the following domains of quality of life: health, social relationships and psychological and emotional well-being as well as in the total score of quality of life and in the occurrence of depression. The highest values of quality of life and the lowest level of depression manifestation were observed in the group of persons whose single training session lasted for 60 minutes, and in the group of persons engaged in a physical activity twice a week. Conclusion. The main finding indicates that the differences in the duration of a single training session and the frequency of physical activities per week reflect on the overall quality of life, individual domains of quality of life and the occurrence of depression in the elderly persons.

The Felt Need of Home-based Geriatric Care in Bangladesh

Aging is an emerging issue in Bangladesh, yet adequate infrastructures, policies, programs and services are not there to cater to the needs of the growing number of elderly persons in the country. Although aging is a personal concern in many ways, but coping with this demographic shift does not come down to individual effort only. Rather, it calls for a comprehensive approach– on the part of state, communities, institutions and organizations. As an institutional government welfare approach to geriatric nursing and care for this large population remains a costly proposition, and family is the first and foremost arena for addressing different issues of elderly persons, an education and training curriculumfacilitated community/family/home-based geriatric care system is recommended which may be more affordable, cost-saving, cost-effective, interactive, humane and inclusive. We have to prepare ourselves, to handle this emerging inevitable stage of the population, which we all, someday, will be a part of.

Self-Organizing Peer-To-Peer Middleware for Healthcare Monitoring in Real-Time.

As the number of elderly persons with chronic illnesses increases, a new public infrastructure for their care is becoming increasingly necessary. In particular, technologies that can monitoring bio-signals in real-time have been receiving significant attention. Currently, most healthcare monitoring services are implemented by wireless carrier through centralized servers. These services are vulnerable to data concentration because all data are sent to a remote server. To solve these problems, we propose self-organizing P2P middleware for healthcare monitoring that enables a real-time multi bio-signal streaming without any central server by connecting the caregiver and care recipient. To verify the performance of the proposed middleware, we evaluated the monitoring service matching time based on a monitoring request. We also confirmed that it is possible to provide an effective monitoring service by evaluating the connectivity between Peer-to-Peer and average jitter.

Design of a Compressive Sensing Based Fall detection System for Elderly Using WSN

Recent researches have pointed out that one third persons are aged 65 and above requires special health care. As the number of elderly person is increasing, home monitoring for healthcare applications is playing a vital role in our daily life. Falls are one of the unpredicted but hazardous events. A sudden fall has to be informed to the caretaker immediately and wireless sensor networks are capable of sensing these falls. In this framework, fall frames are identified from a monitored video and transmitted using wireless sensor nodes. Since the multimedia data requires high bandwidth, there is a need for efficient compression. In this paper, compressed sensing based fall detection system for elderly using WSN (CSFDS) is proposed. A quantization with entropy coding is incorporated in this new fall detection framework for achievement of the efficient video compression. Performance evaluation is done using parameters like peak signal to noise ratio, structural similarity index, transmission energy, delay and packet loss. Simulation results show the CSFDS framework outperforming the raw frame transmission by achieving 83.4% reduction in transmission energy and time. An average PSNR and SSIM value of 34.67 dB and 0.9706 respectively is achieved.

Cross-sectoral collaboration by telehealth for prevention of acute admissions in elderly

Introduction: High age is associated with an increased risk of hospital-demanding disease. In only 20 years, the number of 80+ in Denmark will double from approximately 238,000 in 2015 to 470,000 in 2035. Despite the increasing number of aged persons, the number of hospital beds in Denmark are being reduced as new ‘super-hospitals’ are built across the country. In response, health care delivery organisations and authorities have focused their efforts on avoiding acute short-term ( Description of care practice: Consequently, there is a demanding need for rethinking current practices and finding alternative ways by which it is possible to diagnose potentially acute patients quickly and initiate proper treatment. Building on the existing collaboration and practises in the Danish healthcare system between general practices, home care delivered by the municipalities and secondary care (hospitals) and the technological infrastructure available in Region of Southern Denmark, PAATH (Prevention of Acute Admissions by Telehealth) will facilitate new cross-sectoral procedures that strengthen the collaboration for the benefit of patients (70+). PAATH’s aim is to demonstrate if by utilising existing technological solutions, we can develop and demonstrate a complete process from home-monitoring of patient’s vital signs to remote specialist consultation that can ultimately prevent acute admissions to hospital. Acute team nurses in Svendborg Municipality are equipped with a “GERI-suitcase” containing a range of devices to measure vital signs, blood tests, bladder scan etc. The data from the devices are automatically transferred via a tablet (which also enables real-time video consultation) to a joint IT platform, where the GP, hospital, home care and the patient all have access and are able to see the data. The treating doctor will thus have immediate access to the data and a much clearer picture of the patient’s current situation and thereby a qualified foundation for deciding the treatment and next steps, i.e. if the patient can be treated at home, at the geriatric outpatient clinic or admissions is required. The GERI-suitcase concept is tested for an eight-month period between July 2016 and February 2017. Conclusion and discussion: With the intention of demonstrating the potential in new cross-sectoral work procedures and telehealth supported home-monitoring by acute team for the prevention of acute admissions of elderly medical patients, PAATH began in January 2016 and is in the process of testing the GERI-suitcase in real-life settings. The purpose of PAATH is to demonstrate if it is technically, medically, organisationally and culturally feasible. Effectiveness (reduction in acute admissions, contacts to GP and home care services) will be far more scientifically and rigorously evaluated in further studies that are planned to succeed PAATH.

Palliative Care for Institutionalized Elderly Persons: Experience of Caregivers

Abstract The number of elderly persons institutionalized in residential facilities that provide various types of care is increasing all the time. Care is provided by caregivers who, often unknowingly, are delivering palliative care, and in doing so, are accompanying the elderly persons to their death. The aim of the present study was to investigate how terminal illness and death are experienced by caregivers. A qualitative explorative-descriptive study was carried out, featuring a phenomenological approach, in accordance with Giorgi. The sample was comprised of nine individuals who worked in residential facilities, with data collected through a semi-structured interview. Following data analysis, eight categories were defined: relationship with the elderly person; positive experiences, positive feelings, negative experiences, negative feelings, strategies, consequences and training. These categories were then divided into subcategories. It can be concluded that the caregivers experienced great difficulty when dealing with suffering at the end of life. This did not prevent them from enjoying their work, and a number of positive aspects of their relationships with the elderly were mentioned. The need to provide more support for these professionals, whether through further training or the level of psychological support provided, is also fundamental in this area of palliative care, as only in this way will individuals feel more able and confident about performing their tasks, brining greater benefit for the elderly persons.

Diabetes type 2 diabetes in the elderly – solved and unsolved questions

The number of elderly persons with diabetes mellitus type 2 is expected to progressively increase. Management of this category of patients should be individualised and include the adequate correction of hyperglycaemia, prevention of long-term complications, prevention of hypoglycaemia, reduction of cardiovascular mortality and preservation of quality of life. This article summarises basic information on the pathophysiology of carbohydrate metabolism, peculiarities of the course of diabetes and use of antidiabetic drugs in the elderly. Special attention is paid to reviewing the goals of glycaemic control and proposed clinical guidelines.

Review of Pension Schemes in India

In an immensely populated country like India, as the years pass by the population is showing an increasing trend, and also the numbers of aged persons has been increasing at a faster pace. Therefore this backdrop leads to the prominence of the social security pension schemes, and the magnitude of the fund invested to reform the India’s pension system. Thus this paper tries to create a meta-analysis of the reasons and probable aspects behind the effectiveness of the pension schemes. The paper also provides an outline between the differences between organized and unorganized or informal sector as an important aspect to decipher the reason creating a backlog in the Indian pension system, this leads to the emergence of Life Insurance Corporation of India (LICI) as a sole proprietor to cover workers under the informal sector and private sector. Thus the core objective of the paper is to analyse the importance of LICI considering their pension schemes, and whether the effectiveness of the pension schemes (as operated by the central government) has a causal relation with the pension schemes run by LICI or not. Again, the a part of the paper provides a highlight on the active participation of government to create a structured pension scheme through Atal Pension Yojna, which was launched in the year 2015, during the budget planning of 2015-2016. The ideology of this paper starts with the existing features and details of Atal Pension Yojna. The motive of this scheme (as per the explanation provided by PFRDA) was to eradicate the old-age insecurity faced by individuals. The pension was designed in such a format that with an investment of only Rs 1000 (initial rate of premium, premium ranges from Rs 1000-Rs 5000) by individual within the age range of 18 years to 40 years, will lead to an accumulation of a lump-sum corpus that will be effective during old-age of the individuals. But there are few flaws that can be observed within the scheme, therefore, this paper also tries to create a meta-analysis about the structure of Atal Pension Yojna and also tries to provide a brief explanation on the probable flaws of the scheme.

Household arrangements of elderly persons in Brazil: analyses based on the national household survey sample (2009)

Introduction Increased longevity and, consequently, a rise in the number of elderly persons in Brazil, has an effect on different sectors, especially family living arrangements. Objective To analyze the socioeconomic profile of the family living arrangements of the elderly using PNAD micro-data (2009). Method A quantitative, descriptive, cross-sectional study using PNAD micro-data (2009) was performed. The elderly family living arrangements that constituted households in Brazil were analyzed. Results: The results indicated that the most representative arrangement was a couple who lived with their children and other relatives, followed by single parent units and couples with children. The head of household in most of the arrangements featuring a couple with children and other relatives was a man, while in one-person, single parent and mixed arrangements the head of household was more likely to be a woman. Conclusion Decisions regarding the type of family arrangement are attributed not only to the elderly individual and his or her family, but are the result of historical, sociocultural, political, economic and demographic factors, which may positive or negatively interfere with the quality of life of elderly persons.

Attitudes Towards the Elderly among Nursing Students in Poland–Initial Findings

Background: Similarly to many developed countries, the demographic tendency in Poland is that of a systematic increase in the number of elderly persons in the general population structure. In 2013 in Poland the percentage of people over 65 equalled 14.7%, where the average life expectancy for women was 81.1 and 73.1 for men. It is estimated that by 2020 the percentage of elderly citizens in the Polish society will have increased by 18.2%. The aim of the research was the assessment of the nursing students’ attitudes towards the elderly in Poland. Methods: The tool used for the assessment of the attitudes towards the elderly in Poland was the KAOP scale (Kogan’s Attitudes Toward Old People Scale) first used in 1961 by N. Kogan. Statistical analysis shows that there is a correlation between the attitude towards the elderly and the type of the programme of studies (the day-programme vs. extramural programme), sex of the subjects, age and education. However, the analysis does not indicate a link between the subjects’ attitude and their marital status, place of residence, family model and the frequency of contacts with the elderly. Results: According to the Kogan scale, among 360 subjects 133 (36.9%) of them presented a positive attitude towards the elderly, and 227 (63.1%) had a negative viewpoint. 44 students (34.6%) who were raised by their parents and did not have everyday contact with older members of their families presented a positive attitude, and 83 of them (65.4%) showed a negative one. Conclusions: Longitudinal research is necessary in order to evaluate the students’ attitude towards the elderly. In order to assess the attitudes towards the elderly, it is crucial to gather country-specific tools taking into account social, cultural and religious features.

Ethnobotanical studies on plants used in folk medicines in cure of Diabetes in Gondwana Region of Madhya Pradesh

Ethnobotany started off as an appendage to classical taxonomy and systematic biology essentially listing species collected from wild and used by ethnic communities. Many indigenous communities have accumulated lot of empirical knowledge on the basis of their experience while dealing with nature and natural resources. The present study has been conducted on Gond Tribes in Gondwana region in state of Madhya Pradesh. Diabetes mellitus is a metabolic disorder in the endocrine system. It is defined as a state in which homeostasis of carbohydrate and lipid metabolism is improperly regulated by insulin. Diabetes is regarded as a group of disorder associated with high blood sugar levels which leads to several complications as increase in blood pressure, complications in vision through eyes, heart, kidney. The symptoms are observed by various age group with loss in weight, increase in thirst, increase in frequency of urination and in excretion of sweet urine. The information was documented through rapid roving survey method for selection of Gond localities in Gondwana belts for recording floristic diversity and their ethno-medicinal uses. During the visits a rapport was made with a number of elderly person of tribal communities and traditional herbal healers who were contacted to collect the information and interviewed. The discussion revealed local name of species, plant part used, formulation and dosages of herbal drug used by traditional healers and tribal communities. The specimens were collected, processed and identified with help of flora. The results of the study as documented from traditional healers conducted in districts of Hoshangabad and Seoni district revealed that the traditional healers found out of 500 persons suffered from Diabetes who were tested and examined for infestation in tribal pockets of Madhya Pradesh state were administered different herbal plant formulation based on availability of medicinal plants in their habitat. About 29% of tribals patients were benefitted from diabetes by use by use of leaf extract of Gymnera sylvestris, 18% of tribals patients were benefitted from diabetes by use of leaf juice of Ocimum sanctum, 16% of tribals patients were benefitted from diabetes by use of bark gum resins of Petrocarus marsupium, whereas 15% of tribals patients were benefitted by use fruit/leaf juice of Aegle marmelo, 13% of tribals patients were benefitted from diabetes by use of whole plant of Convolvulus arvensis and 21% of tribals patients were benefitted from diabetes by use leaf juice of Azadirachta indica, whereas 4% of tribals could not be benefitted by any herbal medicine found in their localities. Similarly traditional healers in Gondwana region of Jabalpur district revealed formulations prepared as seed powder of Abrus precatorius Linn., leaf mesh Aegle marmelos (Linn.) Correa, bark powder of Ailanthus excelsa (Roxb), leaf powder of Andrographic lineate Wall Ex Nees Azadiracta indica A.Juss., leaf powder of Caesalpinia bonduc Linn, root powder of Coccina grandis (L.)Voight, tuber extract or decoction Caralluma adscendes (Roxb.) R.Br, leaf powder of Costus specious (Koen) Smith, leaf powder of Tinospora cordifolia (Willd) Hook. F. and Th., and stem bark of Pterocarpus marsupium Roxb. had been found effective in controlling blood sugar of patients suffering from Diabetes. The study concludes a number of promising plants with different plant parts and formulations are prevalent in cure of diabetes used by tribal communities in Gondwana region to cure patients from diabetes among Gond tribes of Madhya Pradesh

Functional disability and associated factors in two samples of elderly Nigerians

Background: The increasing number of elderly persons and their attendant functional disability have implication on public health programmes in developing countries. However, there is limited information on the profile of disability in the elderly residing outside major cities in Nigeria. Objectives: This was to estimates disability in a representative sample of persons aged 60 and older in an urban and a rural areas of Oyo State. Methods Design: A comparative cross-sectional survey. Setting: Iseyin and Ilua are urban and rural communities, respectively, in Oke-Ogun area of Oyo State, in South Western Nigeria. Materials and Methods: A structured interviewer administered questionnaire was used to obtain information on socio-demographic characteristics and instrumental activities of daily living. Participants: Consenting adults aged 60 years and above. Main Outcome Measures: These include the prevalence of disability in both communities major impairments or health problems with a significant difference in limiting the activities of the elderly, instrumental activities of daily living activities of daily living (IADL-ADL) disability by location and significant predictors of disability in both groups. Results: A total of 630 respondents: 316 in urban and 314 in rural locations were interviewed. The majority (61.4%) were females and 42.1% were aged 60–69 years. The prevalence of disability was 32.7% (30.1% and 35.4%) among urban and rural respondents, respectively. The main ADL-IADL disabilities reported were going to farm or some other places of work (19.2%), doing everyday household chores (18.1%) and getting around the house (15.7%). Significantly higher proportion of those in urban (73.7%) compared to rural (57.7%) had a severe disability (P = 0.016). IADL was also significantly higher (20.9%) among urban respondents (P = 0.010). Significant predictors for disability were increasing age, not working currently and having a health problem. Conclusions: Functional disability was prevalent in both communities, but more so in the urban area. Other social factors were predictors.

Demographic aging of population and the social protection system in the Republic of Macedonia

The process of demographic aging has been observed in many of the European countries as well as in the Republic of Macedonia. Based on the UN projections for participation of the elderly in the Republic of Macedonia, it is expected that the number of elderly persons at the age group older than 60 years will increase from 16.5% in 2009 to 33.0% in 2050 and for the elderly aged over 80 years from 2% in 2009 to 6.8% in 2050.This process affects almost all segments of society, but its impact is particularly evident on the system of pension insurance, healthcare as well as on social protection. Adopted international documents and harmonisation with national legislation lead to complete transformation of the system of social protection of the elderly. New scientific knowledge, changes of economic conditions and demographic realities lead to introduction of new social protection principles such as pluralism, decentralization, and inclusion.This paper analyzes both international and national legal framework of social protection of elderly through the segments of introduced innovations, with special emphasis on the rights and services as well as on the assessment of the development of social services in accordance to the needs of elderly people, their availability and efficiency in meeting of individual needs of elderly. Expansion of the programs and implementation of the new scheme of social protection in the area of elderly care represents a convergence to the concept of active aging and to the holistic approach in the process of planning and provision of social services.

Balancing struggles with desired results in everyday activities: strategies for elderly persons with physical disabilities.

The number of elderly persons with disabilities needing support with everyday activities increasing in Japan and around the world. Yet, engagement in everyday activities can support the quality of their daily life. Despite research focusing on reported meanings of people's actions, there is still limited knowledge on how engagement in everyday activity is enacted along with the meanings of persons' actions. The aim of the present study was to identify meanings of persons' actions within everyday activities of elderly Japanese with physical disabilities. Five elderly persons with physical disabilities living in the community participated in this study. Data were gathered by 10 participant observations of everyday activities supplemented with 13 unstructured interviews. Narrative analysis was used to identify meanings of persons' actions. The analysis identified an overall plot termed 'balancing struggles with desired results'. This plot illustrated that participants' and other involved individuals balanced problematic situations with finding situations that accommodated their needs. Meanings of these actions were further identified as three complementary strategies. Two of three strategies aimed to mitigate given problems, one by 'acting on a plan to achieve one's goals', the other by 'taking a step in a preferred direction by capitalising on emerging opportunities'. The third strategy focused on avoiding undesirable experiences by 'modifying problematic situations'. In conclusion, these findings call for care and rehabilitation providers' sensitivity to shifting foci of what matters in daily life's situations as well as aligning with persons' skills, resources and perspectives. Accordingly, the judicious and flexible use of these complementary strategies can enhance elderly persons' quality of daily living through everyday activities.

Caring time and types of care services provided to help elderly person to keep living at home -Comparison between informal and formal care-

Background: In many countries, including Japan, the number of elderly persons living with multiple chronic health problems increases. To tackle this issue and to allow elderly persons to keep living at home in a healthy, comfortable and safe manner, Japan has implemented a community-based integrated care system in 2006. The goal of this system is to ensure that each community is equipped to provide medical, long-term, and social care at home every time and only when it is necessary. Achieving this goal requires an access to care 24 hours a day, 365 days a year, as well as the delivery of both formal and informal care services. However, Japan is currently in a situation where high expectations towards informal care are difficult to fulfill. Purpose: This research investigates the quantity of various types of medical and long-term care provided to elderly persons that live at home and require care. It also contributes to understand the situation towards informal care, which currently lacks transparency in Japan. The final goal is to provide information that can be used to determine the quantity of formal care service that need to be provided at home. Methods: The quantity of care given by family members was evaluated through a work sampling method. An analysis was also conducted to reveal in which moment of the day this care was delivered and to determine the duration of each episode of care. The analysis took into consideration the type of care, the time frame and the duration of care for every elderly persons requiring care targeted in the survey. The day was divided in 24 one-hour time frames. Moreover, a comparison with the situation in residential care settings was made using data on formal care provided in long-term care facilities. Data: This research draws on two different data sets and analysis streams. The first data set is on family care and was collected through a self-reported questionnaire. It was distributed to 500 households with an elderly person that requires care (referred as “elderly persons with certified International Journal of Integrated Care – Volume 15, 27 May – URN:NBN:NL:UI:10-1-117031 – http://www.ijic.org/ 15th International Conference on Integrated Care, Edinburgh, UK, March 25-27, 2015 2 care needs” in the Long-term Care Insurance System of Japan). The duration of care was selfreported per unit of 10 minutes over a one-week period. The second data set was collected by investigators in two long-term care facilities. The duration of care was reported per unit of 1 minute over a one-day period. Data on the characteristics of the 115 persons admitted and on the 31 staff members was also collected. The content of care was categorized using the codes developed by Tsutsui in 1995 and currently used in research on the care need certification system of Japan. Results: 1. The type of care provided at home and in facilities did not significantly differ. In both settings, the most frequent types of care were “dressing”, “eating support”, “hygiene and grooming”, “toilet support”. Between 30% and 70% of persons also received care affiliated to the codes “communication”, “evaluation and monitoring”, “transfer”, “report and collect of information”, “medication”, “bed making”, and “laundry”. 2. In facilities, care could be categorized in 4 time frames: from 6 to 9, 10 to 17, 18 to 21 and 22 to 5 o’clock. 3. At home, 30% to 40% of families also gave some type of care in the 22 to 5 o’clock time frame. 4. In this time frame, the most frequent type of care in both settings was “toilet support”. 5. When the person suffers from dementia and requires medical care, the care occurrence rate increase in all time frames. Conclusions and discussion: To maintain the quality of care at home and reduce the burden of family caregivers, it seems necessary to deliver home visiting services in the 22 to 5 o’clock time frame. Regarding elderly persons with dementia or with medical care needs, the involvement of primary doctors and the existence of facilities equipped for short-term admissions are also required. Even though the community-based integrated care system was developed to coordinate such services, the role of coordinating all these services in an integrated manner was not clearly assigned to a specific institution. To achieve the goals mentioned above, a care plan that clarifies the type of care and the provider depending on the time frame needs to be implemented. Further research should be conducted to determine the methodology behind the creation of such a care plan.

Assessment of the Determinants of Healthy Ageing among the Rural Elderly of North-Eastern Nigeria

Healthy ageing is a lifelong process optimizing opportunities for improving and preserving health and physical, social and mental wellness, independence, quality of life and enhancing successful life-course transition. In Sub-Saharan Africa, it is estimated that the number of elderly persons will rise from about 37.1 million in 2005 to 155.4 million in 2050. The elderly population in Nigeria is estimated at 4 percent and is expected to triple by the year 2020. The increasing number of the older population will increase the burden on the health resources. The objective of this study was to evaluate the determinants of healthy ageing among rural elderly in northern Nigeria in order to promote those that have positive correlation with healthy aging. A cross sectional descriptive study was conducted among 1600 rural elderly aged ≥60 years using interviewer administered semi-structured questionnaire between June and July, 2011. Majority (53.8%) are 60 - 64 years, 24.6% >69 years, 72.4% are males while most are Muslims (85.6%) and 81. 4% are still married. Most are farmers (48.9%) while 73.6% have no formal education. 85.3% earn less than $100 monthly while 47.6% have no income. 93.5% do not take alcohol, 92.1% do not smoke and 89.8% are physically active. 83.1% have normal blood pressure (on examination), 88.3% normal blood glucose level (on examination). Diet, no smoking, high physical activity and adequate sleep are positively correlated with healthy aging (p < 0.05). Good health practices and family support should be sustained while special care for the aged should be established by the government.