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Elderly people who committed suicide – their contact with the health service. What did they expect, and what did they get?
- Authors:
- KJOLSETH Ildri, EKEBERG Oivind, STEIHAUG Sissel
- Journal article citation:
- Aging and Mental Health, 14(8), November 2010, pp.938-946.
- Publisher:
- Taylor and Francis
Contact between elderly patients and healthcare professionals may be crucial for suicide prevention. This study investigated how elderly suicide cases had perceived the health service and what characterised their contact with it. The article describes a psychological autopsy study based on qualitative interviews. A psychological autopsy reconstructs the suicide through interviews with informants who knew the deceased well. The aim was to have two or three informants for each of 23 suicide cases aged over 65. The 63 informants were relatives, general practitioners, and home-based care workers. The systematic text condensation method was applied to analyse the interviews. The results indicated that many of the elderly expressed distrust of health service once their functional decline began. They feared losing their autonomy if they became dependent on help, and many therefore refused health service provisions. Communication between them and helpers failed. As they gradually became more dependent on medical care, many experienced that they were not given the desired help, which confirmed their distrust. The article concludes that contact between these people and the health service must inspire confidence for it to prevent suicide. Elderly people at risk of suicide are vulnerable and feel degraded if their autonomy is threatened by health personnel. The structure and organisation of the health service, and each worker's contact with the elderly, must preserve their dignity.
The relationship between coping, self-esteem and health on outdoor walking ability among older adults in Norway
- Authors:
- BERGLAND Astrid, THORSEN Kirsten, LOLAND Nina Waaler
- Journal article citation:
- Ageing and Society, 30(6), August 2010, pp.949-963.
- Publisher:
- Cambridge University Press
Walking is an essential component of outdoor mobility, and recognised as one of the best forms of physical activity for older adults. The purpose of this study was to examine the relationships between socio-demographic factors, coping resources, self-esteem and health status with the outdoor walking ability of people aged 55–79 years living in the community. The hypothesis was that there is a positive association between outdoor walking ability and coping, self-esteem and health status. A nationally-representative sample of women and men were initially contacted by telephone and then mailed questionnaires to ask questions regarding socio-demographic attributes, coping resources, self-esteem, health status and outdoor walking ability. This paper concentrates on the 3,069 respondents aged 55-79 years who completed both the telephone interview and the questionnaire. Around one-half of the participants were women, and around one-half were aged 65 or more years. Regarding outdoor walking ability, only 0.7 per cent of the respondents were not able to walk at all, and 80.8 per cent could walk at least one kilometre without a pause. Binary logistic multivariate regression analyses showed that those who had good outdoor walking ability (one kilometre or more) were significantly younger than those who did not, and that they were predominantly men, partnered or married, not in paid work, experienced significantly little pain, had better self-reported health and higher perceived coping.
How do middle-aged employees combine work with caring for elderly parents?
- Authors:
- GAUTUN Heidi, HAGEN Kare
- Journal article citation:
- Community Work and Family, 13(4), November 2010, pp.393-409.
- Publisher:
- Taylor and Francis
This study focused on which labour policies can support employees who both work and care for older parents. It investigated how common it was for elderly employees to experience a squeeze between work and care obligations for their parents, and to what extent did this affect their behaviour in working life? The study presents findings from a representative survey conducted in Norway in 2007. Participants included 944 Norwegians, aged 45 to 65 years, with one or both parents still living. Findings revealed that 70% of respondents were both employed and caring for their elderly parents. Fifty-seven percent had experienced difficult situations in coping with both. The most preferable arrangement was flexible working hours. In conclusion, the study suggested that the best policies, which employees preferred, would enable the possibility to reduce or stagger working hours, or the option to work from home if necessary.
Older people with and without dementia participating in the development of an individual plan with digital calendar and message board
- Authors:
- HOLTHE Torhild, WALDERHAUG Stale
- Journal article citation:
- Journal of Assistive Technologies, 4(2), June 2010, pp.15-26.
- Publisher:
- Emerald
The EU-funded project Middleware Platform for eMPOWERing older people and people with cognitive impairments (MPOWER) aims to develop a technical middleware platform that enables rapid development of flexible, domain-specific applications that can be personalised for individual use. This paper presents the findings from a proof of concept application of this platform. Seven older people and their family carers from Trondheim participated in the pilot trial (February 2008-April 2009), which aimed to evaluate the services provided through an individual internet-based digital plan displayed as a calendar page. Both family carers and staff from domiciliary services could, from their home computer, add appointments and messages on the user's digital calendar. The respondents were 5 women and 2 men, aged between 65 and 92, and only 3 of them had used a computer before. The data collection regarding use, usability, utility and acceptance took place on a regular basis after a preset schedule. The results are presented as case histories, and analysis of the causes of the observed effects are divided into personal, technical and structural issues. The main conclusion is that the digital calendar with a message board demonstrated the potential to support older people at home, particularly older people with memory problems who need support in structuring the day and keeping an overview of their daily activities and appointments.
Activity of daily living problems in older cancer survivors: a population-based controlled study
- Authors:
- GROV Ellen Karine, FOSSÅ Sophie D., DAHL Alv A.
- Journal article citation:
- Health and Social Care in the Community, 18(4), July 2010, pp.396-406.
- Publisher:
- Wiley
For an older person, the ability to carry out activities of daily living (ADL) is essential for independent living. This cross-sectional study examined ADL problems in older cancer survivors compared to a cancer-free control group. Of the 11,899 participants, 911 individuals over 70 years had invasive cancer. Personal and Instrumental ADL (P-ADL and I-ADL) problems were self-rated (P-ADL problems addressed activities such as personal hygiene, dressing and eating, while I-ADL problems concerned household activities, managing finances, shopping and administration of medication). Associations among independent variables and P-ADL and I-ADL problems were examined. P-ADL problems were present in 10% of the cancer survivors and 8% of the controls. Correspondingly, 38% of the cancer survivors had I-ADL problems versus 32% of the controls. Older cancer survivors with co-morbidity showed higher rates of P-ADL and I-ADL problems compared with controls with co-morbidity (14% versus 9%, and 47% versus 39%). Cancer survivors with co-morbidity had more P-ADL and I-ADL problems than survivors without co-morbidity (14% versus 8%, and 47% versus 32%). Results revealed higher incidence of ADL problems among a population of older cancer survivors compared with cancer-free controls, and somatic co-morbidity further increased the prevalence of both P-ADL and I-ADL problems in the cancer survivors. In conclusion, the authors suggest that primary health care providers should pay attention to and assess ADL problems in older cancer survivors.
Cultural diversity between hospital and community nurses: implications for continuity of care
- Authors:
- HELLESO Ragnhild, FAGERMOEN Solveig
- Journal article citation:
- International Journal of Integrated Care, 10(1), 2010, Online only
- Publisher:
- International Foundation for Integrated Care
Nurses have a pivotal role in discharge planning for frail patients as increasing number of people need post-hospital nursing care in their homes. Despite considerable effort and focus on how to undertake hospital discharge successfully, the problem of ensuring continuity of care remains. The authors highlight and discuss three challenges that seem to be insufficiently articulated when hospital and community nurses interact during discharge planning: how local practices circumvent formal structures, how nurses' different perspectives influence their assessment of patients' need for post-hospital care, and how nurses have different understanding of what it means to be ‘ready to be discharged’. They propose that nurses need to discuss these challenges and their implications for nursing care so as to be ready to face changing demands for health care in future.
Rights, risks and restraint-free care of older people: person-centred approaches in health and social care
- Editors:
- HUGHES Rhidian, (ed.)
- Publisher:
- Jessica Kingsley
- Publication year:
- 2010
- Pagination:
- 224p., bibliog.
- Place of publication:
- London
This book provides health and social care professionals with an authoritative reading resource on the ethics and use of restraint. It provides an overview of the different forms of restraint, the conditions under which they are used and their implications for the health and wellbeing of older people. Practical approaches to minimising restraint are then explored, underlining the importance of person-centred care. Innovative programmes and approaches to reducing the use of restraint are described and assessed, and case studies are drawn upon to highlight practice challenges and their effective resolutions. The perspectives of older people and their carers and families, as well as of professionals, commissioners and regulators of health and social care, are also taken into account. The contributors are drawn from an international range of health and social care settings, as well as from the academic world.