People In Aged Care Facilities Research Articles

People under 60living in aged care facilities in Victoria

To describe the characteristics of people under 60 years of age living in residential aged care in Victoria and to examine the occupational participation of younger residents in aged care facilities by measuring their social contact, participation in recreation and community access. A survey was sent to the Directors of Nursing at all 803 Commonwealth Department of Health and Aged Care registered aged care facilities in Victoria. The survey had a 78% response rate and information was provided about the characteristics of 330 people under 60 years with high clinical needs residing in aged care facilities. This sample was extremely isolated from peers, with 44% receiving a visit from a friend less often than once per year. Sixteen per cent of residents participated in a recreation activity less than once per month and 21% went outside less than once per month. Of the sample, 34% almost never participated in any community-based activities such as shopping, leisure or visiting friends and family. Over one third of younger people in aged care are effectively excluded from life in our community. Most younger residents are socially isolated and have limited opportunities for recreation. Placement of younger people in aged care facilities is inappropriate, and alternative care models and settings are required.

POOLE’S ALGORITHM: NURSING MANAGEMENT OF DISTURBED BEHAVIOUR IN OLDER PEOPLE - THE EVIDENCE

Disturbed behaviour in older people is a challenging and complex clinical problem. Accurate nursing assessment and management are key elements for good outcomes. The literature shows that nurses do not consistently understand this clinical syndrome and appropriate education is needed. In recognition of limited time frames and of theories of learning, an algorithm has been developed detailing, in order of priority, the management of aggression, delirium, depression or other mental disorders and dementia, plus an outline of supportive communication and care techniques. Three separate packages, each comprising a booklet of lecture notes and resources plus a matching poster are available. Each of these relates particularly to the needs of older people in aged care facilities, acute care or the community.

Previous creatinine levels safely predict amantadine dose for influenza A outbreak control.

Amantadine, an antiviral agent, is the only drug currently approved in Canada for prophylaxis of influenza A virus infection. To minimize side effects, the amantadine dose is adjusted for age and estimated creatinine clearance (CrCl) based on plasma creatinine (Cr) levels. As amantadine is used more frequently for influenza A outbreak control in care facilities for elderly people, physicians are increasingly called on to prescribe it for residents and to consider the necessity of requesting plasma Cr levels. To determine whether previous Cr levels are predictive in estimating current CrCl and safe amantadine dose determination. Residents' charts were reviewed in two facilities in Vancouver, British Columbia. CrCl estimated using previous or current Cr results, current weight and age, as well as recommended amantadine doses based on Canadian National Advisory Committee on Immunization guidelines, were studied. 165 charts with Cr results in March 1998 were included; 122 had results before March 1998, and 103 had Cr results after March 1998. Pearson's correlation coefficient for CrCl estimated from current and previous Cr values was 0.929 for results less than six months previously, 0.974 for six to 12 months previously and 0.952 for 12 to 18 months previously. The same or a more conservative dose of amantadine was predicted in 92% of cases when using a Cr result taken within the previous year and in 76% of cases when using a Cr result taken 12 to 18 months previously. In long term care facilities, Cr levels measured up to 12 months previously can usually safely be used to estimate CrCl. Using previous Cr results permits advance preparation of doctor's orders for amantadine prophylaxis and avoids repeating Cr testing on every resident when an outbreak occurs, reducing related staff time and cost.

Listening in the care environment—chaos or clarity for the hearing-impaired elderly person

The reported study evaluates listening circumstances within long-stay wards in an attempt to understand the nature of the environment and so develop and subsequently evaluate a programme of nursing intervention for hearing-impaired residents. Evidence is presented which indicates that improvement of the residents' listening environment, promotes adaptation to hearing aids and enhances residents' quality of life. It is recommended that attending to the listening environment becomes a concern of nurses working within continuing care facilities for elderly people.