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Strategies of care: changing elderly care in Italy and the Netherlands
- Author:
- ROIT Barbara Da
- Publisher:
- Amsterdam University Press
- Publication year:
- 2010
- Pagination:
- 220p.
- Place of publication:
- Amsterdam
This book traces the changes in the elderly care systems of Italy and the Netherlands since the early 1990s, drawing attention to the advantages and disadvantages of these two very different models. It examines the formal care system of the Dutch, and reveals how this system, despite strong policy pressures, has remained relatively stable, while the Italian system has undergone major transitions despite minimal policy intervention. Based on a wealth of data and extensive interviews with both caregivers and patients, this book is designed for anyone interested in the future of European health care debates. Contents include: changing care systems - an introduction; the context and policy trajectories; the challenge of dependence; changing care packages; care packages in practice; the creation of care packages and the transformations of care systems; and conclusions.
Chronic endurance exercise training prevents aging-related cognitive decline in healthy older adults: a randomized controlled trial
- Authors:
- MUSCARI Antonio, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 25(10), October 2010, pp.1055-1064.
- Publisher:
- Wiley
This study investigated the effects of endurance exercise training (EET) on the cognitive status of healthy community-dwelling older people in Pianoro, northern Italy. One hundred and twenty healthy subjects, aged 65 to 74 years, were randomised into treatment and control groups. The treatment consisted of 12 months of supervised EET in a community gym. All participants were assessed both at baseline and after 12 months. Cognitive status was assessed by the Mini Mental State Examination (MMSE). Anthropometric indexes, routine laboratory measurements and C-reactive protein (CRP) were also assessed. The control group showed a significant decrease in MMSE score, which differed significantly from the treatment group scores. The odds ratio for the treated older adults to have a stable cognitive status after 1 year, as compared to the control group, was 2.74 after adjustment for age, gender, educational level and several other possible confounders. Blood pressure, body mass index, waist circumference and serum cholesterol did not differ significantly between the two groups, while CRP decreased only in the treatment group. The authors concluded that a 12-month EET intervention may reduce the onset of age-related cognitive decline.
Depressive symptoms are associated with hospitalization, but not with mortality in the elderly: a population-based study
- Authors:
- LAUDISIO Alice, et al
- Journal article citation:
- Aging and Mental Health, 14(8), November 2010, pp.955-961.
- Publisher:
- Taylor and Francis
This article examines whether older people with depression might request more healthcare services. The aim of the study was to evaluate the association of depressive symptoms with hospitalisation and mortality rates in an unselected community-dwelling older population. The study assessed the association of the 30-items Geriatric Depression Scale (GDS) score with 1-year hospitalisation and mortality in all 344 subjects aged 75 and over living in Tuscania, Italy. This population had been enrolled in a national study of the genetic determinants of health status. All participants were visited by the study researchers at baseline and after a 1-year follow-up. Analyses were conducted using continuous, as well as categorical GDS score levels. The results showed that, after adjusting for potential confounders, depressive symptoms were associated in Cox regression modelling with hospitalisation but not with mortality. Increasing GDS score levels were associated with increasing risk of hospitalisation. Up to 39% of hospitalisations might be attributed to depression. The article concludes that depressive symptoms are not associated with increased mortality rates in general older populations. However, depressive symptoms represent a potentially reversible determinant of increased hospitalisation rates in these subjects, independent of the presence and severity of other medical conditions.
Social vulnerability, mental health and correlates of frailty in older outpatients living alone in the community in Italy
- Authors:
- BILOTTA Claudio, et al
- Journal article citation:
- Aging and Mental Health, 14(8), November 2010, pp.1024-1036.
- Publisher:
- Taylor and Francis
This study aimed to determine the main social, functional and clinical characteristics of community-dwelling older outpatients living alone and to find correlates of frailty in this population. This cross-sectional survey considered 302 community-dwelling outpatients aged 65 and over consecutively referred to a geriatric medicine clinic in Italy from June to November 2009. The participants underwent a comprehensive geriatric assessment including frailty status evaluated by means of the study of osteoporotic fractures (SOF) criteria. Student's t-test and the chi-squared test were used to compare subjects 'living alone' and 'not living alone' as well as 'frail' and 'not frail' subjects among the participants living alone. Multiple logistic regression analyses were performed to find independent correlates of frailty among participants living alone. The results showed that 124 (41%) of participants were living alone. Compared to the subjects not living alone, they were older, received less assistance from informal and formal caregivers, had poorer living and financial conditions, a better cognitive status and functional self-sufficiency, but a worse emotional status. Forty-one of them were frail. Among the 116 frail elders, subjects living alone also showed a higher prevalence of unexpected new diagnoses of dementia than those not living alone. Independent correlates of frailty among participants living alone were: having experienced a severe acute disease in the past year, dependence in the bathing BADL ability, depression, and incontinence. The article concludes that in older outpatients living alone, including those who were frail, there is a lower availability of personal assistance, significantly more social and financial vulnerability and a higher risk of depression.
Ageing societies: challenges and opportunities: evidence from the BUPA health pulse 2010 international healthcare survey
- Authors:
- FERNANDEZ Jose-Luis, FORDER Julien
- Publisher:
- Bupa
- Publication year:
- 2010
- Pagination:
- 27p., bibliog.
- Place of publication:
- London
This report presents the findings of the Bupa Health Pulse 2010 international healthcare survey around the theme of 'ageing societies'. It summarises some of the most important evidence about the ageing process across the world, and discusses some of the key policy challenges that ageing presents, looking particularly at the capacity for societies to provide high quality support for their older people in the future. The study surveyed 12,262 people across 12 countries (Australia, Brazil, China, France, Germany, India, Italy, Mexico, Russia, Spain, UK, USA), but the patterns described are common to a much larger number of countries. The report is structured around 3 parts. The first examines the question of the ageing process in different societies and what it means in terms of: increases in the older population; changes in the balance between young and old; and increases in the number of people with health problems and in the level of demand for care services. The second part examines the support system required to look after older people in need of care including: the sharing of caring and funding responsibilities between the state and private individuals; the need to ensure that resources are in place to look after the growing number of older people; and the levels of support provided to older people in need. The last section summarises the key policy implications.
The burden of long-term care: how Italian family care-givers become employers
- Author:
- DEGIULI Francesca
- Journal article citation:
- Ageing and Society, 30(5), July 2010, pp.755-777.
- Publisher:
- Cambridge University Press
This qualitative research looks at the increasing demand for long-term care services for older people which has developed in Italy, due to an increasingly ageing population, rising female labour-market participation and the restructuring of the welfare state, how it has been met by mostly women immigrants, of many nationalities who are hired to provide individualised care in people’s own homes and other private settings, and why family care-givers choose this care-support option. Semi-structured interviews comprising over 30 questions, of between 60 and 100 minutes, were conducted with 26 family members who were caring for a disabled older person. Sections entitled, ‘how employing paid care-givers began’, ‘elders and residential facilities’, ‘family care-givers and public services: an unfriendly relationship’, and ‘how family care-givers became employers’ detail participants’ responses in their own words, and show most did not choose home care given by immigrants with economic reasoning alone, but to provide consistency in cultural, moral and traditional understandings of family responsibilities and care. Insights into Italian attitudes of the care-labour market and welfare state are seen, ranging from those with wealth’s preference for a free market to the majority view of a greater role for the welfare state in helping people cope with the increased burden of long-term care.
The effects of a physical activity programme on the psychological wellbeing of older people in a residential care facility: an experimental study
- Authors:
- CIAIRANO Silva, LIUBICICH Monica Emma, RABAGLIETTI Emanuela
- Journal article citation:
- Ageing and Society, 30(4), May 2010, pp.609-626.
- Publisher:
- Cambridge University Press
This study analyses the physical and psychological benefits associated with physical exercise sessions given by 6 specially trained instructors on older people living in a northern Italian residential care home. Previous research, mostly focusing on older people living independently suggests that physical exercise (formal or e.g. gardening or housekeeping) may minimise or reverse physical frailty and spontaneously boost basic activities such as unassisted dressing and washing, while formal physical exercise programmes in nursing home residents decreased depression and anxiety levels and increased cognitive functioning. The effects of such aerobic activity interventions on the residents’ general health perceptions, perceptions that health limits moderate to heavy physical exercise, and positive and negative self-perceptions were assessed. Twenty two, mixed gender, self-sufficient, older people (10 control, 12 test - given two 45 minute sessions for 13 weeks over 5 months) of average age 80.6 years, completed the Italian version of the 36-item Short Form Health Survey Questionnaire, pre and post-test. The findings showed that the perception that one’s health can limit moderate to heavy physical activity decreased post intervention in the test group while it increased in the control group, positive self-perception remained stable in the test group but it was reduced in the control group and that there was no interaction between group and time with respect to general health perceptions and negative self-perception.