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Physical barriers and risks in basic activities of daily living performance evaluation in state housing for older people in Chile
- Authors:
- PIZZI Marcela, et al
- Journal article citation:
- Housing Care and Support, 16(1), 2013, pp.23-31.
- Publisher:
- Emerald
The design of housing can have a significant impact on older people’s independence when performing basic activities of daily living (BADLs). This study observed the BADL performance of older people living independently in housing for older people provided by the State of Chile in the city of Santiago. The overall purpose of the research is to generate an objective assessment instrument to serve as a basis for housing adaptations and improvement or for the use in new designs appropriate to the changing functional capacities of this age group. A total of 40 older people were visited in their homes by at least 2 researchers to observe their capacity to carry out 40 tasks associated with BADLs. The findings show that State housing design is significant in BADLs performance, limiting functionality in one third of the observed tasks. These mainly concerned demanding reaching requirements associated with height, but also extended to other inadequacies in design which act as barriers or bring potential risks. The paper prompts a reassessment by State housing providers of the design of housing types for older people as well as the adaptation of existing units to extend independence in time rather than undermine it.
Neuropsychological correlates of performance based functional status in elder adult protective services referrals for capacity assessments
- Authors:
- SCHILLERSTROM Jason E., et al
- Journal article citation:
- Journal of Elder Abuse and Neglect, 25(4), 2013, pp.294-304.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
High rates of executive function impairment had been previously identified in clients referred by Texas Adult Protective Services (APS) to geriatric psychiatry for decision-making capacity assessments. This study aims to determine the independent relationship between neuropsychological screening instruments, particularly instruments sensitive to executive function, and performance-based functional tasks in elder referrals. The retrospective medical review (n = 75/157 referrals completed all neuropsychological and functional assessments) revealed that only the Executive Interview (EXIT25) contributed independent variance to money management performance, telephone use ability, and summed performance. The study concludes that executive instruments may specifically inform decision-making capacity assessments. (Edited publisher abstract)
Nutritional status of community-dwelling older people with dementia: associations with individual and family caregivers' characteristics
- Authors:
- RULLIER Laetitia, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 28(6), 2013, pp.580-588.
- Publisher:
- Wiley
The object of this study was to explore the associations of individual characteristics of both older people with dementia and family caregivers with the nutritional status of older people with dementia. The cross-sectional study comprising community-dwelling older persons with dementia and 56 family caregivers was conducted at home by a psychogerontologist working for a community gerontological center. Older people with dementia were assessed with Mini mental state examination, Instrumental Activities of Daily Living, Activities of Daily Living (ADL), and NeuroPsychiatric Inventory (NPI) and family caregivers with the Burden Interview (Zarit scale), the State-Trait Anxiety Inventory, the Center for Epidemiologic Studies Depression Scale, and the emotional impact measure of NPI. For both, nutritional status was evaluated using the Mini Nutritional Assessment (MNA). Among older people with dementia, 58.9% were at risk of malnutrition and 23.2% presented a poor nutritional status, and among the family caregivers, 32.1% and 5.4%, respectively. The MNA score of older people with dementia was strongly and inversely associated with the ADL score and was strongly and positively associated with the MNA score of family caregiver. These two factors significantly explained 32% of variation of MNA score of older people with dementia. These findings confirm the value of investigating nutritional deficiencies in dementia within the caregiving dyad and suggest that the functional status of older people with dementia and the nutritional status of family caregivers should be carefully assessed. (Publisher abstract)
The effect of physical rehabilitation on activities of daily living in older residents of long-term care facilities: systematic review with meta-analysis
- Authors:
- CROCKER Tom, et al
- Journal article citation:
- Age and Ageing, 42(6), 2013, pp.682-688.
- Publisher:
- Oxford University Press
Background: The worldwide population is ageing. One expected consequence of this is an increase in morbidity and an associated increased demand for long-term care. Physical rehabilitation is beneficial in older people, but relatively little is known about effects in residents of long-term care facilities. Objective: to examine the effects of physical rehabilitation on activities of daily living (ADL) in elderly residents of long-term care facilities. Methods: Systematic review with meta-analysis of randomised controlled trials. The authors included studies that compared the effect of a physical rehabilitation intervention on independence in ADL with either no intervention or an alternative intervention in older people (over 60 years) living in long-term care facilities. We searched 19 databases including the Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, CINAHL, AMED, Web of Knowledge and Google Scholar. Two researchers independently screened papers and extracted data. Outcomes of included studies were combined in a standardised mean difference random-effects meta-analysis. Results: Thirteen of 14 studies identified were included in the meta-analysis. Independence in ADL was improved by 0.24 standard units (95% CI: 0.11–0.38; P = 0.0005). This is equivalent to 1.3 points on the Barthel Index (0–20 scale). No significant differences in effect were found based on participant or intervention characteristics. Larger sample size and low attrition were associated with smaller estimates of effect. All studies were assessed to be at risk of bias. Conclusions: Physical rehabilitation may improve independence for elderly long-term care facility residents, but mean effects are small. It is unclear which interventions are most appropriate. (Publisher abstract)
Exercise programs for people with dementia: review
- Authors:
- FORBES D., et al
- Publisher:
- John Wiley and Sons; Cochrane Collaboration
- Publication year:
- 2013
- Pagination:
- 73
- Place of publication:
- Chichester
In an update of a previous 2008 review, this systematic review review evaluated the results of 16 trials (search date August 2012), including 937 participants, that tested whether exercise programs could improve cognition, activities of daily living, challenging behaviour, depression, and mortality in older people with dementia or benefit their family caregivers. The review found promising evidence that exercise programs can significantly improve the cognitive functioning of people with dementia and their ability to perform daily activities, but there was a lot of variation between trial results that we were not able to explain. The studies showed no significant effect of exercise on mood, with little or no evidence regarding behaviour, mortality in older people with dementia, benefit to family caregivers, or use of health care services. The review calls for further well-designed research to examine these outcomes and to determine the best type of exercise program for people with different types and severity of dementia. (Edited publisher abstract)
“Make Every Moment Count” in care for older people
- Author:
- MACINTOSH Edith A.
- Journal article citation:
- Working with Older People, 17(3), 2013, pp.125-129.
- Publisher:
- Emerald
Purpose – The purpose of this paper is to highlight the importance of Make Every Moment Count (MEMC) and explain the development of it. Design/methodology/approach – A working group of representatives from key organisations in Scotland developed the resource MEMC. It was tested out in a variety of care settings and issued to all care homes for older people and care at home services in Scotland. Findings – The paper highlights the importance of participating in day-to-day life on health and well-being and provides feedback from care staff on using the resource. Practical implications – The resource is for all those supporting someone to engage in day-to-day life. A lot of good care is given however sometimes the small, everyday interactions are taken for granted and people need reminded about the big difference this can make to someone's life. Social implications – MEMC has the potential to begin to change culture – to rethink “activity” which is often thought of as planned organised events to everyday activities and interactions. Originality/value – This paper describes an initiative which sets out to remind us all of the importance of basic human rights – dignity, respect and choice. (Publisher abstract)
A projection method for public health and long-term care expenditures
- Authors:
- DE LA MAISONNEUVE Christine, MARTINS Joaquim Oliveira
- Publisher:
- Organisation for Economic Co-operation and Development
- Publication year:
- 2013
- Pagination:
- 75
- Place of publication:
- Paris
This paper proposes a new set of public health and long-term care (LTC) expenditure projections until 2060. It disentangles health from long-term care expenditure, as well as the demographic from the non-demographic drivers, and refines the previous methodology, in particular by extending the country coverage. Regarding health care, non-demographic drivers are identified, with an attempt to better understand the residual expenditure growth, by determining which share can be explained by the evolution of health prices and technology effects. Concerning LTC, an estimation of the determinants of the number of dependants (people needing help in their daily life activities) is provided. Cost-containment and a cost-pressure scenarios are provided, together with sensitivity analysis. On average, across OECD countries, total health and long-term care expenditure is projected to increase by 3.3 and 7.7 percentage points of GDP (gross domestic product) between 2010 and 2060 in the cost-containment and the cost-pressure scenarios respectively. For the BRIICS countries (Brazil. Russia, India, Indonesia, China and South Africa), it is projected to increase by 2.8 and 7.3 percentage points of GDP over the same period in the cost-containment and the cost-pressure scenarios respectively. (Edited publisher abstract)
Factors associated with depression and anxiety in older adults with intellectual disabilities: results of the healthy ageing and intellectual disabilities study
- Authors:
- HERMANS Heidi, EVENHUIS Heleen M.
- Journal article citation:
- International Journal of Geriatric Psychiatry, 28(7), 2013, pp.691-699.
- Publisher:
- Wiley
The objective of this article is to study which factors are associated with depression and anxiety in older adults with intellectual disabilities (ID). Depressive and anxiety symptoms were studied in 990 participants with borderline to profound ID, aged ≥ 50 years, using self-report and informant-report screening questionnaires. Participants were drawn from three large Intellectual Disability services in the Netherlands. In 290 participants, major depression and anxiety disorders were assessed with a standardised psychiatric interview. Associations with personal, medical and psychosocial factors, which were collected through questionnaires and participants' medical and psychological records, were studied using multiple logistic regression analysis. Increased depressive symptoms were positively associated with increased anxiety symptoms, number of life events during the past year and chronic diseases (heart failure, stroke, chronic obstructive pulmonary disease, coronary artery disease, diabetes mellitus and malignity in the previous 5 years) and negatively with instrumental activities of daily living (IADL) abilities. Major depression was positively associated with chronic diseases and negatively with IADL abilities. Increased anxiety symptoms were positively associated with borderline or mild ID and increased depressive symptoms and negatively associated with Down syndrome, epilepsy and social contacts. Anxiety disorders showed no significant associations. To develop effective prevention and treatment policies, factors associated with depression and anxiety in older adults with ID should be further examined in longitudinal research. (Publisher abstract)