Residents Of Long-term Care Institutions Research Articles

Condições de saúde, taxa de incidência e letalidade por Covid-19 em idosos institucionalizados após primeiro ano da pandemia em Maceió-AL

This study aimed to identify the sociodemographic, clinical, and nutritional profile, as well as to determine the incidence and lethality rate for COVID-19 in elderly residents in Long-Term Care Institutions for the Elderly in the municipality of Maceió – Alagoas, in the period 2020 and 2021. In the first year of the pandemic in Maceió, the reported incidence of COVID-19 was 31/100 residents in LTCFs, while the lethality rate was 6.56%, with elderly males representing the largest number of deaths (62.5%), the variables that presented as risk factors were sex, age, previous diagnosis of DM and low weight (p < 0.050) and the variable education (p = 0.081). The data from this research reinforce results presented by other researchers where the previous diagnosis of diabetes is associated with the outcome death and male gender, age, low education and BMI are associated with the occurrence of the disease.

The prevalence and risk factors of pressure ulcers among residents of long-term care institutions: a case study of Kazakhstan

Limited information is available regarding the prevalence of pressure ulcers (PUs) in residential homes in Central Asia. Therefore, the aim of this study was to identify the prevalence rates and risk factors associated with PUs among residents of long-term care medical institutions in the Republic of Kazakhstan. This cross-sectional study was conducted in four long-term care institutions in Kazakhstan. The study sample consisted of 640 patients who were assessed for the presence of PUs and associated risk factors. The evaluation was performed using the International Prevalence Measurement of Care Quality (Landelijke Prevalentiemeting Zorgkwaliteit, LPZ), the Braden scale, and the Care Dependency Score (CDS). The overall prevalence of PUs, classified as categories I–IV, was found to be 37%. When excluding category I PUs, the prevalence decreased to 35.6%. The odds ratios (ORs) for presenting with PUs were as follows: history of stroke (OR 5.22), diseases of the digestive system (OR 10.01), presence of spinal cord lesions/paraplegia (OR 20.50), recent reported confusion within the last 7 days (OR 184.00), and limited extent dependency according to the CDS (OR 4.44; 95%CI 1.31–16.1). It is imperative to establish specialized training programs aimed at equipping medical personnel, relatives, and patients themselves with the necessary skills to provide optimal care for individuals affected by PUs.

Abstract P249: Association Between Loneliness and Functionality in an Elderly Population

Background: Functionality plays a pivotal role in the well-being and autonomy of older individuals. Discovering new predictors of functional decline is a pressing concern, with loneliness emerging as an unconventional risk factor for chronic diseases. However, its role in functional limitations remains poorly understood. Hypothesis: Loneliness is an independent predictor of limitations in Activities of Daily Living (ADLs) and Instrumental ADLs (IADLs) among individuals aged 80 or older. Methods: A cross-sectional analysis was conducted using data from Wave 8 of the Survey of Health, Ageing, and Retirement in Europe (SHARE), spanning 28 European countries, for participants aged 80 and above, excluding residents in long-term care institutions. Loneliness was assessed using a reduced version of the R-UCLA Loneliness Scale, including measures of companionship, feeling left out, and isolation on a 3-point Likert scale ("often," "some of the time," "hardly ever or never"). Participants scoring 4 to 9 were categorized as lonely. The outcome was defined as the presence of limitations in one or more of the six ADLs and/or the nine IADLs. Logistic regression models were employed to control for potential confounding factors. Multivariate analysis included covariates with p<0.200 and no multicollinearity. Model quality was evaluated using the area under the ROC curve, and the significance level was set at 5%. The analysis was conducted using IBM SPSS, version 28.0. Results: The study included 7,434 individuals, with 58.2% (n=4,323) being female and a mean age of 84.4 (±3.8) for both genders. A majority of participants (52.5%, n=3,879) had low levels of education (ISCED-97 from 0 to 2). Comorbidities included cardiovascular disease (22%, n=1,634), stroke (7%, n=523), diabetes mellitus (17.2%, n=1,281), cancer (6.6%, n=494), and obesity (16.8%, n=1,180). In the univariate analysis, older adults classified as lonely exhibited an odds ratio (OR) of 2.213 (95% CI: 2.016 - 2.428) for presenting limitations in one or more ADLs/IADLs. The multiple model showed an OR of 1.472 (95% CI: 1.313 - 1.649) for having one or more ADLs/IADLs limitations in the presence of loneliness. This association remained significant even after adjusting for confounders (age, gender, education, chronic diseases, hip fracture, pain and European region). The AUC was 76,4%. Conclusions: Our study reveals an independent link between loneliness and limitations in ADLs and IADLs among individuals aged 80 or older from the SHARE dataset. These findings lend support to interventions aimed at preventing loneliness and preserving functionality in this age group.

Validating an Assessment Tool for Oral Health and Oral Care Procedures Performed by Healthcare Workers for Older Residents in Long-Term Care Institutions.

Poor oral health is a growing concern among older populations. It is often caused by a failure to maintain proper oral hygiene and inaccessible dental care. Poor oral health in older individuals in long-term care institutions (LTCIs) can be attributed to the fact that healthcare workers might be poorly trained in oral care assessment and practice. To address this issue, an assessment tool has been developed and validated to guide and evaluate healthcare workers' oral care practices, ensuring the delivery of adequate care and early detection of dental diseases in LTCIs. The tool includes an oral health assessment and an assessment of oral care procedures. It was developed following a robust literature review, two stages of expert reviews, content validity checks, and a pilot study. A total of twenty-three items were developed and validated, with seven items related to oral health assessment and sixteen related to oral care procedures. The items were assessed for content validity and relevance, with high values of 1 obtained for all Item-level Content Validity Index (I-CVI), Scale-level Content Validity Index (S-CVI), and S-CVI/Universal Agreement (UA) scores. This indicates a high level of agreement among the experts (n = 12) regarding the relevance and importance of the items. A pilot study involving 20 nursing students confirmed the tool's reliability, applicability, and feasibility, demonstrating its high appropriateness and applicability. The newly developed and validated assessment tool can effectively guide and evaluate healthcare workers' oral care practices, enhancing their competence and improving the oral health of older residents.

Educational Programme on Knowledge, Attitudes, and Practice of Oral Care/Hygiene Provision by Healthcare Providers to Older Residents in Long-Term Care Institutions: A Case-Control Study.

Much attention has been paid to advocate proper oral care/hygiene provision by healthcare providers in long-term care institutions (LTCIs). This study aimed to evaluate the effects of an oral health education (OHE) programme (intervention) on knowledge, attitudes, and practice (KAP) of healthcare providers in providing oral care/hygiene to older residents in LTCIs. A case control study was conducted at two LTCIs, with one assigned as the intervention group and the other as the control group. A KAP survey was administered before and after the intervention, and oral status was assessed by standardized clinical photographs taken before and after oral hygiene provision on three older residents. A total of 40 healthcare providers (20 in intervention and 20 in control groups) participated, with the attitudes and overall KAP significantly improved in the intervention group after the OHE programme. Interestingly, the knowledge of those in the control LTCI was significantly declined at re-evaluation (mean scores were from 17.25 to 14.30), indicating inadequate oral health and care training despite having more experience in taking care of older people. Significant differences in practice were observed between the two groups after the OHE programme (p = 0.006). The three older residents exhibited poor oral health and multiple oral problems. This study revealed that the OHE programme effectively improved attitudes of the healthcare providers and provided a sustaining effect on attitude towards oral health and oral care. However, there were still inadequacies in oral hygiene provision by some healthcare providers, possibly due to unattended oral diseases and hygiene needs, as well as personal and environmental barriers that merit further investigation. Regular evaluation and enforcement of oral care/hygiene provision in LTCIs are necessary to maintain oral health and prevent dental and gum diseases in older residents. Immediate referral for dental treatment is recommended for older people with signs of dental/oral disease(s).

Development and validation of predictive workable weight equations for Brazilian older adult residents in long-term care institutions.

Weight measurement is important in the nutritional anthropometric monitoring of older adults. When this measurement is not possible, estimates may be used. Developing and validating weight predictive equations for older adult residents in long-term care institutions in Brazil. The sample comprised 393 older adult residents in long-term care institutions. Data were collected in two stages, with 315 older adults in the first and 78 in the second. We have measured the arm, calf, and waist circumferences, as well as the triceps and subscapular skinfold and knee height. Multiple linear regression was used to develop the equations, which were evaluated through the coefficient of determination, standard error of estimation, Akaike information criterion, intraclass correlation coefficient (ICC), and Bland-Altmann plot. Five models with different anthropometric measurements were developed, (1) arm circumference as a discriminant variable (ICC: 0.842); (2) best statistical fit for men and women (ICC: 0.874) and its stratification by sex (3) (ICC: 0.876); (4) easy-to-perform measurement for men and women (ICC: 0.842) and its stratification by sex (5) (ICC: 0.828). Five models for estimating the weight of older adult residents in long-term care institutions were developed and validated. The choice to use the models should be based on the physical capacity of the older adults to be evaluated.

Factors Related to Meaning in Life Among Residents of Long-Term Care Institutions.

Meaning in life plays an important role in, and is associated with all dimensions of, well-being. Finding meaning in life has been shown to increase life satisfaction in residents of long-term care (LTC) institutions, whereas social support has been found to relate positively with meaning of life. Interactions with LTC staff are the main source of social support for LTC residents. The purpose of this study was to explore the factors related to meaning in life in LTC residents, especially those associated with interactions between nursing assistants and residents. A cross-sectional study design was applied to interview participants from October 2015 through July 2016. One hundred fifty-four residents from six LTC institutions participated in this study. The Staff-Patient Interaction Scale and Meaning-in-Life Scale were used to collect data. The statistical methods of t test, Pearson's correlation, and stepwise regression of forward selection analysis were used to explore the factors related to meaning in life in the study population. The participants were found to perceive a moderate level of meaning in their lives, with a Meaning-in-Life Scale average total score of 42.75 (range: 17-63, SD = 10.19). Staff-patient interaction (β = .50), financial support from government subsidies and social assistance (β = -.41), and number of medical diagnoses (β = -.18) were the three most important factors related to meaning in life, explaining 44.2% of the variance. Improving the quality of interactions between nurse assistants and residents and health promotion may increase meaning in life in LTC residents.

Consequences of the COVID-19 measures for wellbeing aspects of long-term care residents

To examine the impact of COVID-19 measures on residents of long-term care institutions, two surveys were conducted in the spring of 2020. Leontjevas et al. (study 1) inventoried practitioners' opinions, Van der Roest et al. (study 2) opinions of care workers, family, and residents without severe cognitive impairments. This article describes the combined results on social interaction and loneliness, challenging behaviour and mood, and lessons learned. In study 1, an online survey distributed to nursing home psychologists, they were asked to complete it anonymously and share the link with their fellow elderly care physicians and nurse specialists. 16 participants were then interviewed via video calling. In study 2, three hundred and fifty-seven care organizations were invited to recruit residents without severe cognitive impairments, family members and care workers for participating in a digital, anonymous survey (Study 2). The completed surveys of 323 practitioners (study 1) and 193 residents, 1609 family members and 811 employees (study 2) were included in the analyses. Social contacts of residents had changed in frequency and form compared to before the COVID-measures. Many residents experienced some loneliness during the visit ban, especially residents without cognitive impairments. There were both an increase and a decrease in challenging behaviour and affect. Several strategies used to reduce the effects of COVID-19 measures on well-being, were considered maintainable. Our studies confirmed a major impact of the COVID-19 measures on the wellbeing of long-term care residents, but also showed successful strategies of practitioners that can benefit future practice.

Integration and Promotion of a Care Model for Chewing and Swallowing Reconstruction Teams

Eating with the mouth is one of the basic joys of life. However, some 450,000 people currently live with nasogastric tubes in Taiwan. The causes of dysphagia disorders are complicated. Caring effectively for these cases requires interdisciplinary medical cooperation. Taiwan is expected to become a super-aged society in 2025. In Taiwan, people over 65 years old, residents of long-term care institutions, and stroke cases experience high rates of dysphagia. Every case of dysphagia has a potential risk of aspiration pneumonia, with pneumonia ranking as the third leading cause of death in people over 65 years old. Therefore, this issue demands the attention and assistance of medical care personnel. The integrated care model used at Kaohsiung Siaogang Hospital to promote the reconstruction of dysphagia functions is introduced in this article to help give medical teams interested in assisting cases a deeper understanding of this model. Integrating the resources and manpower of multiple disciplines helps cases improve dysphagia functions and reduces the need for indwelling nasogastric tubes and the incidence of aspiration pneumonia. Let us protect the everyday happiness of eating and improve quality of life.

Assessment of the Risk of Depression in Residents Staying at Long-Term Care Institutions in Poland During the COVID-19 Pandemic Depending on the Quality of Cognitive Functioning.

Background: The development of the COVID-19 pandemic has prompted the implementation of many procedures to safeguard against further increases in illness. Unfortunately, this has drastically reduced residents’ contact with their families, which has increased feelings of loneliness and isolation. This is particularly difficult in long-term care facilities, where the risk of developing depression is higher than in the general population.Objectives: The aim of the study was to assess the risk of depression among the residents of long-term care institutions in Poland during the COVID-19 pandemic and to determine the relationship between the risk of depression and the occurrence of cognitive impairment in the study group.Methods: The study included 273 residents from long-term care institutions in Poland. The risk of depression was determined based on an originally designed questionnaire. The cognitive state of the subjects was assessed using the screening test Mini-Mental State Examination (MMSE). Both the depression risk assessment and the MMSE test were conducted twice: in March and December 2020.Results: In March, severe dementia was present in 28.2% of the residents and normal MMSE scores were observed in 16.1% of the subjects; in December, the prevalence of severe dementia increased to 31.1% and that of normal scores decreased to 10.3%. In March, no participant was found to be at high risk of depression and moderate risk was observed in 14.3% of the subjects; in December, 2.6% of the residents had a high risk score and 45.4% had a moderate risk score. Statistical analysis revealed that higher MMSE scores correspond with a higher risk of depression.Conclusion: A higher risk of depression was observed with the development of the pandemic. Residents with cognitive impairment were characterised by a lower risk of depression compared to individuals with normal MMSE scores. During the study, progression of cognitive impairment was observed in the residents.

Factors Affecting Dietary Improvements in Elderly Residents of Long-Term Care Institutions Receiving Domiciliary Dental Care.

Background: Oral disabilities occur due to tooth loss. This study aimed to investigate oral and systemic factors related to diet in elderly residents receiving domiciliary dental care. Methods: The subjects were 74 consenting residents. Survey items included whether subjects could eat independently and diet type. Subjects were examined by the dentist for the number of teeth, occlusal support index, and wearing dentures. Contingency table analysis was performed to determine what levels of decline in general and oral functions led to difficulties eating a normal diet. Results: There was a significant difference in the mean number of activities of daily living (ADL) requiring assistance evident between subjects eating a normal diet and those eating fluid boiled rice (p < 0.01). A comparison of occlusal support and diet type showed that most subjects who ate a soft diet or gruel had no occlusal support. Almost all subjects who ate a normal diet wore dentures. However, only 38% of subjects eating a soft diet and 40% of those eating gruel did wear dentures; both group differences were significant (p < 0.01). Conclusions: Future studies need to further investigate oral factors related to the type of diet and their relationships to domiciliary dental care in older adults.

Randomized clinical trial of complete denture cleaning methods in residents of care institutions

Aim: To evaluate the efficacy of ultrasonic bath and traditional brushing in the hygiene of complete dentures of dependent residents in long-term care institutions (LTCIs). Methods: A randomized cross-over clinical study was conducted in 17 maxillary complete denture wearers living in LTCIs. Cleaning protocols were brushing or ultrasonic bath, both applied with neutral liquid soap. Biofilm biomass were estimated by MTT reduction assay and specific microbial load (CFU) of Streptococcus spp., Staphylococcus spp. and Candida spp. were quantified by selective and differential culture media. Results: Ultrasound method showed higher percentage reduction of biofilm biomass and specific microbial loads of Streptococcus spp. compared to brushing (p&lt;0.01). Reduction of microbial loads of the other microorganisms were not different between cleaning methods (p&gt;0.05). Conclusions: The ultrasonic bath proved to be a feasible alternative method for the mechanical cleaning of complete dentures in LTCIs.

Nutritional Care in Acute and Chronic Illness

Nutrition is essential for maintaining good health and preventing diseases, especially in patients suffering from acute or chronic diseases, infectious diseases, or critical illnesses because dietary intake involves both quantitative and qualitative changes and may disturb energy homeostasis (Richardson & Davidson, 2003). The metabolism of patients with critical illnesses is categorized as hypercatabolic, with significant loss of lean body tissue facilitated by the immune-neuroendocrine response of acute critical illness (Mechanick & Brett, 2005). Therefore, facing hunger during a period of physiological stress because of disease or treatment, results in an increased basal metabolic rate, accelerated protein breakdown, and increased energy and nutritional requirements in response to tissue damage, infection, and inflammation. This situation will develop rapidly into malnutrition or further exacerbate malnutrition because of inflammation and metabolic stress associated with diseases and injuries (Wortinger & Burns, 2015). The inflammatory response triggers the neurophysiology of patients and severely affects digestive behavior (Konsman & Dantzer, 2001), especially in terms of increasing demand for protein to provide amino acids for immunoglobulin and acute-phase protein production, both of which are fundamental to proper immune system functions. Under conditions of severe nutrient deficiency, the protein catabolism of the viscera and skeletal muscle for energy and protein generation will occur quickly in the acute phase. This catabolism has the potential to affect the cardiovascular, respiratory, immune, and all other body systems (Chan, 2015). Therefore, malnutrition during hospitalization may initiate immunosuppression and increase the risk of bacterial spread and sepsis, delayed wound healing, impaired organ function, prolonged hospitalization, and morbidity and mortality (Chan, 2015). As severe malnutrition is related to poor illness or treatment outcomes, which is associated with longer hospitalization and increased medical expenses, assessing patients' nutritional status and providing adequate nutritional care are critical. A nutritional assessment that includes body weight, physical condition and muscle condition, and calculation of resting energy requirements must be included as a standard part of the initial examination received by each patient. The results of this assessment should be considered together with the patient's illness status to formulate a nutritional care plan to provide the nutrition (energy, protein, essential fatty acids, and micronutrients) necessary to meet daily requirements, minimize metabolism, and break down proteins to support the immune system and wound healing (Chan, 2010). It is necessary to provide patients with full-spectrum nutrition and be aware that overeating may also cause metabolic and gastrointestinal complications, liver dysfunction, increased carbon dioxide production, and respiratory muscle weakness (Chan, 2010). Natural food should be provide the main source of nutrition as much as possible, and patients should be encouraged to eat a high-quality, complete diet. Although nutritionists may contribute to the assessment and design of nutritional plans for patients in clinical practice, their limited availability in hospitals disallows their providing the individualized attention required by each patient (Xu et al., 2017). Nurses have the most contact with patients and are most sensitive to their illness conditions. They are able to quickly assess the patient's nutritional needs according to changes in the situation, make referrals, and provide consultations on diet modifications. As the nutritional status of patients is involved in their treatment and physical recovery, nurses have always shouldered inter-professional responsibilities and played an essential role in the nutritional care of patients (Xu et al., 2017). For hospitalized patients and residents of long-term care institutions, nurses are able to pay attention to their nutritional related problems during the process of care, respond rapidly to nutrition-related treatment needs, and participate in the transdisciplinary professional team to prevent patient malnutrition.

Experience in long-term care organizing in Israel geriatric institutions during the COVID-19 pandemic

The main measures to prevent the spread of the COVID-19 virus in long-term institutions for elderly people should be based on the principle of social distancing and on limiting direct physical contact between older residents and their families. In this regard, the system of nursing care for the elderly residents of long-term care institutions is forced to reorganize in order to provide residents and their families with adequate quality care, while ensuring infection safety.

Prevalence of urinary incontinence and perception of impact on quality of life in institutionalized elderly

OBJECTIVE: Identify the prevalence of urinary incontinence (UI) and perception of impact on quality of life in institutionalized elderly. METODHS: Observational, descriptive study, with a qualitative approach carried out through data collection, with the application of a questionnaire composed of Subject Characterization and application of the International Consultation on Incontinence Questionnaire - Short Form (ICIQ-SF). Sample of 37 elderly people aged 60 or over, integrated mental and cognitive health and residents of Long-Term Care Institutions in the South Zone of the city of São Paulo. The data were submitted to descriptive analysis. RESULTS: The average age of the elderly was 80 years, 33 women and 4 men. Of these, UI complaints are present in 26 elderly people (22 women and 4 men), reinforcing that UI is present in both sexes. In the ICIQ_SF score, it is observed that urinary loss compromises the quality of life of most of those who report this symptom (n = 17). CONCLUSION: A high prevalence of Urinary Incontinence was found in institutionalized elderly people with severe impairment in the subjects' quality of life.

Effects of auricular acupressure on depression and anxiety in older adult residents of long-term care institutions: A randomized clinical trial

The current study was a single-blind clinical trial that evaluated the effect of auricular acupressure on older adults’ depression and anxiety. Forty-seven older adults in long-term care institutions were randomly divided into two groups using block randomization. In the experimental group, patches with magnetic beads were pasted onto the auricular Shenmen acupoints for 14 days. In the control group, blank patches were used. Among the older adults in the study institutions, 82.09% scored ≥5 points on the Geriatric Depression Scale (GDS). Significant differences in GDS scores were observed between the two groups after both 7 and 14 days of treatment (p < 0.05). There was no significant difference (p < 0.05) in anxiety scores between the two groups at 7 days, but there was a significant difference after 14 days of the intervention (p < 0.05). Our results suggest that acupressure can reduce depression and anxiety among older adults in long-term care institutions.

Chewing Screen and Interventions for Older Adults

Seeing older adults with nasogastric (NG) tubes in nursing homes is an unfortunately widespread phenomenon in Taiwan. NG tubes deprive the wearer of the tastes, smells, and joys of food and have been associated with malnutrition and increased susceptibility to aspiration pneumonia. In our studies, we found that 43% of nursing home residents in Taiwan are intubated with an NG tube and revealed a significant lower body mass index and hypoalbuminemia in these residents. In addition, the prevalence of dysphagia in residents of long-term care institutions was found to be greater than 60%. Older adults with dysphagia usually rely on liquid diets, which are frequently low in fiber, fruit, vegetable, and cereal contents. It is well known that diets low in fiber and vegetables increase the risks of constipation and cardiovascular events in older adults. A low intake of plant flavanols may also make older adults more susceptible to chronic inflammation. A high intake of red meats, eggs, or seafood may nurture gut microorganisms that catabolize carnitine and choline to trimethylamine-N oxide and which have been significantly linked to cardiovascular diseases and increased mortality. In contrast, eating plant vegetables and cereals is known to nurture better microbiota that produce short chain fatty acids, which, in turn, nurture enterocytes and improve immunity and brain health. Thus, the aims of this article are to demonstrate how to assess elders with chewing difficulty and dysphagia and to provide functional food scales for the classification, training, and care of active-aging nutrition. Through this article, we anticipate helping long-term care caregivers master key techniques for training and caring for elders with chewing difficulties and/or dysphagia. This article is also expected to 1) improve the nutrition of elders and satisfaction with feeding, 2) improve chewing and dysphagia care and training in long-term care institutions, and 3) avoid NG tube institution and aspiration pneumonia. The suggestions of this article may be used in the future to assist long-term care units across the interdisciplinary care providers teams to promote chewing instruction, swallowing care training, and active aging, appropriate nutrition, and health in older adult populations.

Fatores de risco que potencializam fragilidades em idosos institucionalizados

O artigo tem como objetivo analisar fatores de risco que potencializam fragilidades nos residentes em Instituições de Longa Permanência para Idosos. O estudo caracteriza-se como uma revisão integrativa da literatura que consistiu em seis etapas: definição do tema e formulação da questão norteadora; estabelecimento dos critérios de inclusão e exclusão; definição dos descritores; pré-seleção dos artigos; avaliação dos estudos selecionados; e apresentação da revisão. Foram revisados 16 estudos, entre os anos de 2016 a 2019 a partir da busca nas bases de dados Scientific Electronic Library Online (Scielo), LILACS e Pubmed utilizando-se como descritores Idosos, Instituição de Longa Permanência para Idosos, fragilidade, desnutrição, depressão, acidentes por quedas. De acordo com evidências desses estudos a depressão se destaca entre os fatores de risco que potencializam fragilidades em idosos institucionalizados, a qual pode estar associada ao tempo de institucionalização, autopercepção de saúde e qualidade do sono. Houve, ainda, prevalência de desnutrição nesse grupo de idosos, bem como o aumento do risco de quedas, o qual pode estar relacionado com a saúde psicológica e o estado nutricional debilitado do indivíduo. Tais fatores afetam consideravelmente a condição de saúde e a qualidade de vida dessa população. Depreende-se que conhecimento acerca dos principais fatores de risco que potencializam fragilidades em idosos institucionalizados é de suma importância para a aplicação de ações preventivas, visando a preservação da saúde dos mesmos.

Spirituality, satisfaction with life and health-related behavior of older residents of long-term care institutions—a pilot study

Spirituality and satisfaction with life are psychological factors related to health behavior. The aim of the study was to determine whether satisfaction with life acts as a mediator in the relationship between the spirituality of residents of long-term care institutions and their health-related behavior. A total of 102 people aged 60–99 were examined. It was found that satisfaction with life played a mediating role in the relationship between spirituality and health behavior. The study addresses the gap in knowledge regarding institutionalized older adults, exploring the role of spirituality and satisfaction with life on lifestyle in nursing home settings.

Falls in long-term care institutions for elderly people: protocol validation.

To validate the content of a fall management risk protocol in long-term institutions for elderly people. Methodological, quanti-qualitative study using the Delphi technique. The tool, based on the literature, was sent electronically to obtain consensus among the 14 experts that meet the defined inclusion criteria. The 27 indicators of the protocol are organized in three dimensions: prepare for the institutionalization (IRA=.88); manage the risk of falls throughout the institutionalization (IRA=.9); and lead the communication and formation (IRA=1), with a CVI=.91. Two rounds were performed to get a consensus superior to 80% in every item. The values obtained in the reliability test (>0.8) show that the protocol can be used to meet the intended goal. The next step is the clinic validation of the protocol with residents of long-term care institutions for elderly people.