Rest Homes Research Articles

Treating melancholia at home: theoretical wisdom and grim reality in the career of E.C. Seguin.

E.C. Seguin was one of the early, influential 19th-century neurologists who participated in the development of neurology as a specialty in the United States. Born in France, but raised from early childhood in the United States, Seguin published widely, developed a high-profile New York City practice, and was named Clinical Professor of Diseases of the Mind and Nervous System at the College of Physicians and Surgeons (New York) in 1874. Typical of the era, he studied neurologic disorders, but also several conditions that today would be considered in the realm of psychiatry. One of his seminal papers was titled "The treatment of mild cases of melancholia at home" (1876). Contrary to the widespread practice of isolating patients in either rest homes or asylums, Seguin introduced and formalized treatment of depression within the household. Against this academic backdrop, Seguin returned home on October 31, 1882, to discover that his own wife, afflicted with long-standing depression and treated at home, had committed suicide after murdering their 3 children. The grim dichotomy between the confidently written paper and the reality of the treatment failure is a neurologic lesson in humility regarding diseases and their unpredictable outcomes.

The Psychosocial Effects of a Companion Robot: A Randomized Controlled Trial

To investigate the psychosocial effects of the companion robot, Paro, in a rest home/hospital setting in comparison to a control group. Randomized controlled trial. Residents were randomized to the robot intervention group or a control group that attended normal activities instead of Paro sessions. Sessions took place twice a week for an hour over 12 weeks. Over the trial period, observations were conducted of residents' social behavior when interacting as a group with the robot. As a comparison, observations were also conducted of all the residents during general activities when the resident dog was or was not present. A residential care facility in Auckland, New Zealand. Forty residents in hospital and rest home care. Residents completed a baseline measure assessing cognitive status, loneliness, depression, and quality of life. At follow-up, residents completed a questionnaire assessing loneliness, depression, and quality of life. During observations, behavior was noted and collated for instances of talking and stroking the dog/robot. In comparison with the control group, residents who interacted with the robot had significant decreases in loneliness over the period of the trial. Both the resident dog and the seal robot made an impact on the social environment in comparison to when neither was present. Residents talked to and touched the robot significantly more than the resident dog. A greater number of residents were involved in discussion about the robot in comparison with the resident dog and conversation about the robot occurred more. Paro is a positive addition to this environment and has benefits for older people in nursing home care. Paro may be able to address some of the unmet needs of older people that a resident animal may not, particularly relating to loneliness.

Factors Affecting Cognitive Function in Older Adults: A Turkish Sample

Summary Background The purpose of this study was to determine the influential factors of cognitive function in older adults. Methods In this study, 377 older adults (mean age: 74.71 ± 6.15 years) were examined. The Hodkinson Abbreviated Mental Test (HAMT) was used to describe cognitive function of the individuals. The Centers for Disease Control (CDC) Health-Related Quality of Life (HRQOL-4) survey tool was used to measure the quality of life. Possible influential factors of cognitive function were also detected. The following independent variables were included in the logistic regression analysis: age, gender, education level, residency, smoking habit, musculoskeletal pain, medication use, number of unhealthy mental days, number of unhealthy physical days, and activity limitation days. Results The results indicated that the elderly with cognitive impairment showed low scores in terms of the three parameters of the CDC HRQOL-4. The findings also indicate that the following variables were found to significantly affect cognitive function: (1) age, (2) residency (rest home), (3) smoking (yes or quit), and (4) number of unhealthy mental days. Conclusion Older adults should be assessed in terms of factors related to cognition, such as age, residency, smoking, and mood in order to plan the most suitable geriatric care.

Hearts of Pine: Songs in the Lives of Three Korean Survivors of the Japanese “Comfort Women.” by Joshua D. Pilzer (review)

Reviewed by: Hearts of Pine: Songs in the Lives of Three Korean Survivors of the Japanese “Comfort Women.” by Joshua D. Pilzer Jessica Payette (bio) Hearts of Pine: Songs in the Lives of Three Korean Survivors of the Japanese “Comfort Women.” By Joshua D. Pilzer. New York: Oxford University Press, 2012. 168pp. Presented in conjunction with a companion website, http://www.oup.com/us/companion.websites/9780199759576. From Angry Anthems to Tragic Teuroteu: Listening to the Recalibration of Selfhood in Songs of Korean Sexual Trauma Survivors On December 14, 2011, activists for the Korean Council for the Women Drafted for Sexual Slavery by Japan (henceforth abbreviated as the Korean Council), in Seoul, and the Washington Coalition for Comfort Women Issues, as well as an assortment of other human rights advocacy organizations, gathered in front of Japanese embassies around the globe to hold their 1,000th Wednesday demonstration protesting the refusal of the Japanese government to offer a public apology and legal reparations to the survivors of the military sexual slavery system that was implemented during the Asia-Pacific War (1930–45). During this period an estimated 50,000 to 200,000 women were falsely promised education or stable employment by the Japanese military; they were abducted or voluntarily left their homes with no inkling of the horrors that they would face as “comfort women” (ianfu in Japanese). Imprisoned in “comfort stations,” they were forced to have sex with soldiers and affiliated civilians or face brutal [End Page 81] beatings if they refused.1 While some women were the private sexual slaves of high-ranking officers, others were confined to tiny rooms where they had no choice but to submit to the demands of many soldiers per day. Many of these women died or committed suicide after being liberated in 1945, and the ones who lived faced societal pressure to remain silent about their experiences. For over four decades, former “comfort women” who suddenly found themselves deposited back into mainstream society in Korea and elsewhere did not openly acknowledge their past or receive therapy; they existed as an anonymous conglomerate whose nondescript story was guarded as a national secret. The terrible memories that vividly haunted survivors in their dreams could only be verbally expressed through metaphor, which is why many of them were drawn to the expressive medium of song. In 1991, encouraged by a spirit of growing nationalism and critical reevaluation of Japanese colonization that propelled the gradual democratization of South Korea, survivor Kim Haksun delivered the first public testimony, in which she spoke about being maltreated and witnessing the deaths of other women. This prompted the organization of the first Wednesday demonstration, for the 1992 Korean visit of Japan’s prime minister, Miyazawa, and the filing of a petition to the United Nations Commission on Human Rights, which brought global attention to the issue. In addition to serving as a constant reminder that Japan has not yet complied with international mandates, the Wednesday demonstrations also continue to provide a forum for survivors to interact with each other and the public as they strive to educate younger generations whose history books fail to expose them to the thousands of women who continue to be deprived of basic human rights upon being taken captive by sexual slavery systems. In 2001 ethnomusicologist Joshua Pilzer nervously attended a Wednesday demonstration in Seoul, hoping to establish a connection with survivors despite feeling that he was “tailor-made to the worst possible subject position from which to take on the project, radically separated from these elderly Korean women survivors of sexual violence and war by gender, generation, culture, class, and experience” (ix). His knowledge of the Korean language and traditional folk songs helped him to gradually form bonds with some of the Korean survivors, who welcomed him to the House of Sharing—a rest home and museum for survivors founded by monks and followers of the Jogye Order of Korean Buddhism—and granted him the opportunity to listen to and record cherished songs that were sung in public and private settings. When the House of Sharing moved from Seoul to a more spacious suburban site in 1995, it was designed [End Page 82] to be...

Colourful shades of grey

The process of ageing has severe consequences for many European (mainline) churches, including diaconal work with, by and for senior citizens. In this article the author describes how diaconal agents within the Protestant Church in the Netherlands are responding to challenges of ageing in current local and national diaconal policy. Historically, the diaconate in the Netherlands was involved with senior citizens due to its function of poor relief and the establishment of senior rest homes. This societal function of the diaconate ended with the establishment of the twentieth century welfare state. Ageing intensifies the need to reflect on the role(s) of the diaconate regarding senior citizens, not least because of the severe ageing of churches themselves. An analysis of diaconal policy examples at local and national levels indicates a growing awareness of the need to reinvent the diaconal function of the church regarding senior citizens. In order to clarify this development theologically, the author underscores the importance of the concept of the 'diaconal vocation of the congregation', as it derives from the church order of the Protestant Church.

Does the Presence of Anterior Mandibular Teeth Increase the Incidence of Denture Stomatitis?

To compare the frequency of denture stomatitis (DS) under maxillary complete dentures (CDs) in patients with opposing mandibular distal extension removable partial dentures (RPDs) and CDs. Participants included 365 maxillary CD wearers (241 women, mean age 70.5 ± 13.2 years; 124 men, mean age 71.5 ± 10.4 years) from 7 rest homes in Istanbul. A total of 268 had mandibular CDs; 97 had mandibular distal extension RPDs. Two independent, calibrated examiners performed oral examinations. Presence of maxillary denture-related stomatitis and the effect of risk factors on DS were evaluated and recorded. The frequency of palatal DS (Newton I-III) was 45.1% (n = 121) in the mandibular CD group and 49.5% (n = 48) in the mandibular distal extension RPD group, a statistically insignificant difference (p= 0.4). Factors significantly associated with palatal DS were maxillary denture age (p= 0.02), reduced occlusal vertical dimension (p= 0.04), and nocturnal denture wear (p= 0.03). In this study, DS beneath maxillary CDs did not differ between mandibular distal extension RPD and CD wearers. The presence of mandibular anterior teeth did not influence the occurrence of palatal DS.

The slow death of autopsies: a retrospective analysis of the autopsy prevalence rate in Austria from 1990 to 2009

Autopsies are still the gold standard by which treatmentmethods, clinical decision-making procedures and diag-nostic tools can be measured. They not only help toestablish the true cause of death, they also provide aninsight into how patients’ deaths can be prevented infuture.In Austria, where autopsy enjoyed its apotheosis in the1800s, the law permits non-forensic autopsies to be donewithout the consent of next of kin in cases in which there isa clear medical or scientific interest. Autopsy rate reportingmay vary between institutions, depending on whetherforensic, other outpatient cases, stillbirth cases, and casesreferred from outside the hospital are included; many of therates are reported from individual hospitals and appear inpublished studies.This study is unique in the literature due to the fact thatit is based on a huge data set containing individual infor-mation for every single person deceased in Austria between1990 and 2009. Our data provided by ‘‘Statistics Austria’’[1] include: status and kind of autopsies (medicolegal,clinico-pathological, others), sex, religion, family status,province, nationality, institution/place and date of death,age of deceased in years. The effect of the interestingvariables as well as their interaction terms on the autopsywas estimated by a logistic regression model. 95 % confi-dence intervals are given in brackets.The autopsy preva-lence rate for the 1.565.151 cases with no missing values inthe explanatory variables during the observation perioddecreased from 34.2 % (33.8, 34.5) in 1990 to 17.5 % in2009 (17.3, 17.8).Between 2004 and 2009 the frequency of clinico-path-ological autopsies decreased from 18.2 % (18.0, 18.5) to14.4 % (14.2, 14.6) of all deaths. The medicolegal autopsyprevalence rate remained stable on a low level at about1.5 %.All variables in the regression model turned out to besignificant (p\0.01). Table 1 presents odds ratios (OR)for all variables that do not include an interaction term with‘‘year of death’’.The probability of autopsy is highest among personswith unknown religious affiliation with an OR of 1.21compared to the reference group Roman Catholic. Incontrast Jews demonstrate the lowest autopsy prevalencerate with an OR of 0.28.Foreigners have a slightly higher probability of postmortem examinations with an OR of 1.04 compared toAustrians.The probability of autopsy is higher among singles,widowed and divorced people compared to married cou-ples. Divorced people display the highest OR with a valueof 1.42.Persons dying in a rest home are subject to a much lowerprobability for an autopsy with an OR of 0.03 compared topersons dying in a hospital. Moreover, all other locations(living address, transport, and other institutions/places ofdeath) express a lower probability than the location hospital.Persons dying between February and December have alower probability of autopsy than in the reference monthJanuary. The largest difference demonstrates Decemberwith an OR of 0.91.The weekday of death shows a quite small influence onthe autopsy probability. The largest difference to the

Over the Hill: A rest home for performance studies scholars

Over the Hill: A rest home for performance studies scholars

Acknowledging small acts of kindness

As regular readers will know, a number of recent editorials in Nursing Ethics have focused on unethical health-care practice. It is necessary to strive to understand this and to work in our different areas of practice to eradicate it. It is also important to draw attention to, celebrate and reward ethical practice. Therefore, I would like to share a practice example that highlights, I believe, the very best of nursing practice. It was just after 9 am on a Monday morning when an email with the subject ‘Fab student’ was forwarded to me by a colleague. The email was from a staff nurse in the emergency department of a local hospital. She described a practice situation where one of our student nurses had, in her view, gone beyond the call of duty in delivering end-of-life care to a patient. I contacted both the student and the staff nurse and asked them to describe the situation in detail. Each wanted to give credit to the other for the actions that undoubtedly enhanced the final hours of an elderly patient. The staff nurse, Sarah, emailed me her version of events. She described her busy practice area and the admission of a patient she called ‘Lily’ (not her real name). Lily was a 78-year-old woman who was admitted from a residential home. ‘She had been an independent woman who only gave up work a couple of years before which she worked as a carer in a rest home herself’. Lily had no family and had arrived at the hospital, around lunchtime, after collapsing and having a period of unconsciousness. A variety of diagnoses were initially suggested. She was found to have significant abdominal pain and was referred to the surgical team who thought she may have a perforated bowel secondary to an obstruction. Sarah said:

The fatigue and self-care agency levels of the elderly people staying in rest homes and the relation between these two conditions

This study was carried out to determine the fatigue and self-care levels of the elderly and the relation between these two conditions. One hundred forty-two individuals at the age of 65 or over were included in the descriptive-analytic study. Data were collected using Personal Information Forms to determine socio-demographic features and social relationships, and the Visual Analog Scale for Fatigue (VAS-F) to determine the fatigue status and Exercise of Self-Care Agency Scale (ESCA) to measure the self-care agency. The mean age of the elders who participated in the survey was 76.15±8.61 and their fatigue and energy level scores from VAS-F were 5.08±2.20 and 3.70±1.51 respectively. The value obtained from ESCA was 82.68±16.39. There is, statistically, a weak negative correlation (r=−0.459; p=0.00) between fatigue and energy levels, a weak positive correlation (r=0.284; p=0.01) between self-care agency and energy levels, a weak negative correlation (r=−0.258; p=0.02) between self-care agency and fatigue levels. According to the survey findings, it can be hypothesized that as elders living in rest homes, their energy level falls down, they experience moderate fatigue and have self-care agency a little more than moderate level, and the lack of energy and fatigue they experience affect their self-care agency.

Multi-Modal Sensing M2M Healthcare Service in WSN

A multi-modal sensing M2M healthcare monitoring system for the continuous monitoring of patients under their natural physiological states or elderly persons with chronic diseases is summarized. The system is designed for homecare or the monitoring of the elderly who live in country side or small rest home without enough support from caregivers or doctors, instead of patient monitoring in big hospital environment. Further insights into the natural cause and progression of diseases are afforded by context-aware sensing, which includes the use of accelerometers to monitor patient activities, or by location-aware indoor tracking based on ultrasonic and RF sensing. Moreover, indoor location tracking provides information about the location of patients in their physical environment and helps the caregiver in the provision of appropriate support.

Traitement de l’hallux valgus modéré par chevron percutané : résultats préliminaires d’une série de 56 pieds à 1 an de recul moyen

This research, conducted at two rest homes in Manisa, Turkey, was undertaken to examine the effect of castor oil pack (COP) administrations on constipation in the elderly. Study participants were monitored for 7 days before, 3 days during, and 4 days after COP administration utilizing the Recall Bias and Visual Scale Analog (RB-VSAQ) as well as the Standard Diary developed by Pamuk et al. Wilcoxon Signed Ranks, Repeated Measures, Bonferroni, and Mann-Whitney U tests were used for data analysis. Eighty percent of study subjects had been constipated for 10 years or longer. COP administration did not have an effect on the number of bowel movements or amount of feces, but decreased the feces consistency score, straining during defecation and feeling of complete evacuation after a bowel movement, thus decreasing symptoms of constipation. We conclude that COP may be used for controlling symptoms of constipation.

노인봉사활동이 여중생의 진로발달에 미치는 영향 -진로태도성숙도, 진로결정수준을 중심으로-

본 연구는 여중생들에게 봉사체험활동의 일환으로 정기적으로 실시한 노인봉사활동이 그들의 진로발달에 어떠한 영향을 미쳤는지에 대해 분석하였다. 연구대상은 경기도에 소재한 Y여자중학교에서 인근 노인복지시설에 정기적으로 봉사활동을 실시한 2학년생 30명이다. 연구도구 및 내용은 진로태도성숙도검사지(CAMI)와 진로결정검사지 (CDS)를 사용하여, 구체적으로 진로태도성숙도의 5가지의 하위요인(결정성, 준비성, 독립성, 목적성, 확신성)과 진로결정 수준의 변화에 대해 살펴보았다. 연구결과는 첫째, 노인봉사활동이 여중생의 진로태도성숙도의 향상에 부분적인 도움을 주는 것으로 나타났다. 둘째, 노인봉사활동이 여중생의 진로결정수준을 향상시키는데 도움을 주는 것으로 나타났다. 셋째, 가족단위로 함께 참여했을 경우가 진로태도성숙도와 진로결정수준을 높이는데 보다 효과적인 것으로 나타났다. 본 연구결과로 볼 때, 노인봉사활동을 가족단위로 참여하는 것은 여중생의 진로발달에 도움을 주므로 진로 교육 프로그램을 계획할 때, 관련내용을 포함시키는 것이 효과적일 것으로 사료된다. This study was conducted to analyze the influences of older volunteer activity. In detail, Administered on girl's maddle school students with the program's purpose on encouragement of positive career development. The study sample was taken from 30 students attending Y girl's middle school in Gyeonggi province, all of whom were regular volunteers at a near by rest home. The contents of the study and apparatus alike incorporated the use of a CAMI and CDS employed as a means of observing the changes before and after older volunteer activity experience in relation to five sub factors and career decision level. The data were analyzed by t-test using the SPSS Program. The results were as follows: First, it appears that older volunteer activity, in general, partial effect of improving a girl's middle school students' career attitude maturity. Second, it appears that older volunteer activity, improving effect a girl's middle school students' career decision level. Third, a girl's middle school students' career attitude maturity and career decision level had positive to advance more in particular in cases where the students' family also participated in older volunteer activity. As observed by the above results, a older volunteer activity experience should be an integral to a girl's middle school students' career education program plan as an effective means of enhancing their career attitude maturity and career decision level.

Here Comes Curly Claus

Here Comes Curly Claus Fred Chappell (bio) “What are them things poking out of your head?” Jerry tried to read the name on the cardboard tag pinned to Connie Morgan’s gray knit sweater. Or maybe she was Megan. The red crayoned letters on the green background were squeezed together and the light in this “day room” was uncertain. The dark ceiling made all the space shadowy. Red Candles were set upon the upright piano and upon the long sideboard against the north wall, and the flames danced, flickering. “These are my antlers,” Jerry said. He made a guess. “I am one of Santa’s reindeer, Miz Morgan.” “I ain’t no Morgan.” She glowered at him, leaning back in her wheelchair. “My name is Megan. You know what I’d do if I was a Morgan? I’d jump down in a well and drown myself; that’s what I’d do.” The woman seated next to her in one of the folding chairs took her left hand and patted it gently. “Now, Connie, you’d never do any such thing.” She was neatly dressed in a dark blue neck-high dress, and her tone when she spoke to Jerry suggested that she was accustomed to calming her friend and muting her declarations. “I’m Cordelia Scott. Connie and I have been here a long time now.” “I didn’t mean to upset her,” he said. “I read her name tag wrong.” “Actually,” Cordelia said, “Connie is a Morgan. She was married to Hank Morgan for forty-seven ears before he passed on. She has four children and six grandchildren.” Still staring aggressively into Jerry’s face, Connie replied. “I was born a Megan, and I’m a Megan now, and if you a-been married to Hank Morgan, you might just jump down in a well yourself.” “I would try not to,” Cordelia said, “and you shouldn’t be talking that way to this nice young man. It is good of him to come to see us at Christmas here at the rest home, and we should be grateful.” She let go Connie’s hand. “What is your name?” she asked, “Jerry Dennison,” he said. “But today I’m one of Santa’s helpers.” “Your antlers would make you out to be a reindeer.” “I’m a magic reindeer who can be an elf at the same time.” “Two for one.” [End Page 83] “That’s the idea,” Jerry said, “but it may not be clear to everybody.” “It ain’t to me,” Connie said. “Them horns sticking out of your head look mighty quair.” “I’m a special helper for Santa.” She shook her head. “It don’t make a speck of sense. Mamie Medford told us you would be an elf. That’s what Santy Claus uses for helpers.” “I couldn’t find an elf costume. I thought I’d better dress up for the occasion, but I don’t have anything but my regular clothes. Last time I was in Glosson’s Barbershop, I saw these antlers tacked up to hang coats on, and I asked. I thought I could come as a reindeer to be Christmas-like and help Santa at the same time. I borrowed some of these little bells and attached them.” He gave his head a vigorous shake, and the bells sounded, though not entirely merrily. “It’s the best I could do. I was hoping it would be okay.” “It’s very inventive,” Cordelia said. “Don’t you think so, Connie?” “I never heard of a reindeer being his helper. The reindeers pulls his sleigh, flying up in the air.” “But I’m special,” Jerry said. “Wait a second.” He dug into the pocket of his green plaid shirt and withdrew a red plastic ball with an elastic band. He fumbled it over his head and perched the ball on the tip of his nose. “See? Rudolf the Red-Nosed Reindeer, that’s who I am. You know about Rudolf, don’t you?” She glared. “Now you look more quair than before. Are you some kind of crazy person?” “Now, Connie,” Cordelia said. “Santa will be here soon. I’ll...

Well-being and belief in a just world among rest home residents

Several theorists have contended that belief in a just world may be one way elderly rest home residents cope with anxiety, fear, and depression and thus maintain their well-being. In this study we explored belief in a just world and length of time elderly have been residing in rest homes in Lebanon in relation to their levels of self-rated quality of life. A sample of 354 cognitively able elderly people were selected from 36 nursing homes. Interview questionnaires including a translated and validated Self-beliefs in a Just World Scale (BJW-S; Lipkus, Dalbert, & Siegler, 1996) and the EuroQol Visual Analogue Scale (EQ-VAS; Brooks, 1996) that measures respondents' quality of life on a 20cm visual analogue scale. The relationship between Arabic BJW-S scores and length of stay measured on the EQ-VAS was examined using analysis of variance. The findings showed significant main effects for belief in a just world on levels of EQ-VAS, but no significant effects of length of time in rest home on levels of EQ-VAS. Residents who had strong beliefs in a just world seem to have better abilities to cope with negative life events and better self-rated feelings of well-being than did residents who did not believe the world was just and who rated their own well-being lower.

The effect of mandibular anterior teeth on the hypermobile tissue in the anterior part of the maxilla

The absence of posterior occlusal contacts may result in increased anterior occlusal contacts and forces between natural mandibular dentition and artificial maxillary dentition. The impact of natural mandibular anterior teeth on the development of hypermobile tissues in the anterior part of the edentulous maxillary alveolar ridge was investigated in this study. The study group consisted of 410 patients with maxillary complete dentures and various mandibular dentitions from seven rest homes in Istanbul. The data; including hypermobile tissue in the anterior part of the maxilla, occlusal relationship, nocturnal wear, denture age, and duration of the maxillary full edentulism period were recorded. A chi-square test was performed to analyze the effects of following data: Existence of mandibular anterior teeth, poor adaptation of the dentures, nocturnal wear, types of occlusal contacts, and gender, on the resorption of the anterior part of the maxilla. To examine the effects of the presence of anterior mandibular teeth and early maxillary edentulism on bone resorption in the anterior part of the maxilla, a logistic regression analysis was performed. The results reveal that patients with edentulous maxilla and natural mandibular anterior teeth are approximately twice more likely to show risk of hypermobile tissue in the anterior part of the maxilla than are full edentulous patients. Further, edentulous periods exceeding 30 years in maxilla seem to increase this risk approximately 4 times.

Residential aged care in Auckland, New Zealand 1988-2008: do real trends over time match predictions?

in Auckland, New Zealand in 1988, 7.7% of those aged over 65 years lived in licenced residential aged care. Age-specific rates approximately doubled for each 5-year age group after the age of 65 years. Even with changes in policies and market forces since 1988, population increases are forecast to drive large growth in demand. This study shows previously unrecognised 20-year trends in rates of care in a geographically defined population. four cross-sectional surveys of all facilities (rest homes and hospitals) licenced for long-term care of older people were conducted in Auckland, New Zealand in 1988, 1993, 1998 and 2008. Facility staff completed survey forms for each resident. Numbers of licenced and occupied beds and trends in age-specific and age-standardised rates in residential aged care are reported. over the 20-year period, Auckland's population aged over 65 years increased by 43% (from 91,000 to 130,000) but actual numbers in care reduced slightly. Among those aged over 65 years, the proportion living in care facilities reduced from 1 in 13 to 1 in 18. Age-standardised rates in rest-home level care reduced from 65 to 33 per thousand, and in hospital level care, from 29 to 23 per thousand. Had rates remained stable, over 13,200 people, 74% more than observed, would have been in care in 2008. growth predicted in the residential aged care sector is not yet evident. The introduction of standardised needs assessments before entry, increased availability of home-based services, and growth in retirement villages may have led to reduced utilisation.

Eating environment in the aged‐care residential setting in New Zealand: Promoters and barriers to achieving optimum nutrition. Observations of the foodservice, menu and meals

AbstractAim: To investigate the foodservice, menu and meals in the aged‐care residential setting to identify promoters and barriers to achieving optimum nutrition.Method: An observational study conducted by the University of Otago Dietetic Training Programme. Rest home dietitians around New Zealand identified a final convenience sample of 50 facilities. Ten final‐year student dietitians each spent two days in their designated rest homes, administering a 19‐item questionnaire to ascertain practices relating to staffing, dining environment, menu, meals, snacks, feeding assistance, fluids, special diets, nutrition care, medications, nutrition policy and access to sunlight. Observations describing foodservice and meal‐related activities only are reported in this paper.Results: Most rest homes had the ability to provide for the needs of residents. Ninety per cent of facilities offered menu cycles of at least four weeks long. Potential barriers to meeting needs were inadequate amounts of protein‐rich food for numbers served and lack of perceived choice in menus and meal service. Lack of foodservice staff training and poor uptake of training opportunities contributed to these barriers.Conclusions: This is the first such study conducted in New Zealand. Results should be of interest to the Ministry of Health and district health boards that are charged with the responsibility to ensure that meals in long‐term care facilities meet the nutritional needs of this potentially vulnerable population. Shortcomings identified in the present study require a multidisciplinary approach that should include district health boards, auditing agencies, aged‐care organisations, training providers and dietitians.

Fatigue and Physical Activity Levels of 65 and Over Older People Living in Rest Home

The purpose of this study was to investigate fatigue and habitual physical activity in older people aged 65 and over living in rest home and to examine the relationship between these two variables. As a data-collecting device, the CHAMPS questionnaire (physical activity assessment questionnaire) was modified, and the Fatigue Severity Scale was used. An additional questionnaire was administered to obtain demographic data. One hundred and twenty-four individuals completed the study (mean age 74.98 ± 7.05 years, 37.1% female). Of these individuals, 50 (40.3%) reported fatigue symptoms. Weekly caloric expenditure in all activities was 3,896 ± 5,297 kcal. Individuals’ average weekly energy consumption calculated in terms of CHAMPS was 2,158 ± 3,781 kcal for the fatigue group. Higher fatigue was associated with lower physical activity levels ( p < 0.00, r = −0.263). According to binary logistic regression analysis, it was found that CHAMPS decreased as the value of fatigue increased ( p < 0.00). Fatigue is a symptom often found among older people. The results suggest that higher fatigue was associated with lower physical activity levels in older people.

The Food Problem in Hanoi during the Subsidy Period: How Workers Coped

This article shows mainly how the administrators and workers in the Thang Long cigarette factory in Hanoi coped with a deepening food shortage from the 1970s to the mid-1980s. When the government could not provide a stable supply of food or prevent rising food prices on the open market, the factory administrators organized food-related programmes for their workers, such as eating halls, rest homes and schools for workers' young children. But these programmes could not meet the workers' needs during the crisis years, so they relied on themselves. They pursued a variety of activities, including increasing their working hours, seeking other jobs outside and pursuing illicit activities to earn extra money. The evidence in this article further indicates that the Vietnamese government modified its policies as it tolerated deviations from its socialist vision of a centralized economy.