Search results for ‘Subject term:"very old people"’ Sort:
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Improving quality and value in healthcare for frail older people
- Authors:
- GEORGE James, et al
- Journal article citation:
- Quality in Ageing, 8(4), December 2007, pp.4-9.
- Publisher:
- Pier Professional
- Place of publication:
- Brighton
This article reports an important multi-centre practice-based review that identifies good practice and an ideal pathway for the healthcare of frail older people, which, if replicated nationally, could result in improved quality of care and better value for money for the NHS. Data on healthcare resource groups (HRGs) in England were examined as a marker for the management of elderly people though the healthcare system. Care pathways in several different NHS trusts were explored via staff interviews. A high variation in treatment outcomes across centres were found. Principles of best practice were identified and included: comprehensive geriatric assessment; the availability of specialist geriatric teams and wards; and shared assessment and co-ordination between care agencies.
Neurocognition of centenarians: neuropsychological study of elite centenarians
- Authors:
- LUCZYWEK E., et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 22(10), October 2007, pp.1004-1008.
- Publisher:
- Wiley
The aim of this study was to evaluate the cognitive state of highly selected Polish centenarians and analyze the mechanisms of their functioning. The selected centenarian group (10 persons) and a reference group (20 persons) who started aging (65 years) were examined with a sensitive set of neuropsychological tests and tasks in clinical-experimental assessment. As expected, the centenarians' cognitive functions were different from those of the subjects who started aging, however, not in all aspects. For instance, the former scored significantly lower in the area of linguistic functions but the ability to plan and controlled perform complex visuospatial task with use of simultaneous and sequential strategies was preserved despite unfavourable symptoms of natural aging such as permanence attention as well as prolonged action time. The results suggest that the studied centenarians show a dominant right-hemispheric pattern functioning not only in relation to perception, but also to planning and executing complex activities. The study and description of preserved neurocognition of centenarians was possible due to introducing a special procedure sensitive to the preserved functions.
Depression in the oldest old in urban and rural municipalities
- Authors:
- BERGDAHL E., et al
- Journal article citation:
- Aging and Mental Health, 11(5), September 2007, pp.570-578.
- Publisher:
- Taylor and Francis
The aim was to compare an urban and a rural old population regarding depression. A population-based, cross-sectional study in five depopulated areas and one expanding urban city in northern Sweden. Participants aged 85 and above were evaluated for depression. Data were collected from structured interviews and assessments and from relatives, caregivers and medical charts. Depression was screened for using the Geriatric Depression Scale-15 (GDS-15) and evaluated by the Montgomery-Åsberg Depression Rating Scale (MADRS). In total, 29% of the 363 participants were depressed (34% in the rural municipality and 27% in the urban municipality). Fifty-one percent versus 69% were receiving treatment with antidepressants. In the rural areas, those with depression were less frequently treated with selective serotonin reuptake inhibitor (SSRI) medications (36% versus 65%; p = 0.004), instead there were participants treated with Tri Cyclic Antidepressant's (TCA's) (10%, versus 0%; p = 0.0018). A larger proportion of the participants in the urban sample had responded to treatment (59% versus 27%; p = 0.175). It is concluded that depression in old age appears to be a common cause of emotional suffering among the oldest old. In the rural areas, depression was more often inadequately treated and it was also treated with inappropriate medications.
Who will care for the oldest people in our ageing society?
- Authors:
- ROBINE Jean-Marie, et al
- Journal article citation:
- British Medical Journal, 17.03.07, 2007, pp.570-571.
- Publisher:
- British Medical Association
The number of informal carers for frail elderly people is set to fall steeply. The authors propose a way to assess the trend that should help policy makers plan for the deficit, using an indicator to monitor potential informal care resources. American and Swiss data is used as examples.
How equitable is Sweden's changing care-mix? Linking individual and regional characteristics over time
- Authors:
- DAVEY Adam, et al
- Journal article citation:
- Ageing and Society, 27(4), July 2007, pp.511-532.
- Publisher:
- Cambridge University Press
Given its relative ethnic and socio-economic homogeneity, Sweden is an ideal nation for the study of variations in formal and informal care as a function of gender, disability and advanced age. This paper reports an analysis of the relationships between gender, disability and age and the formal care delivered to more than 1,200 people aged 75 or more years in Sweden in 1994 and 2000. In municipalities that provided above-average home-help hours per recipient, and that had high institutional placement rates, women were relatively less likely to have been receiving informal assistance alone, those with greater disability were more likely to have been receiving all forms of assistance, the oldest-old were less likely to have been receiving either informal or formal help alone, and rates of formal assistance and of no informal care were relatively low. In municipalities with high rates of institutional placement, the oldest-old were relatively more likely to have been receiving both formal and informal assistance. Sweden's system of old-age care appears broadly equitable although the quality of care could not be fully assessed. Although home and community-based service provision (HCBS) has recently decreased, variations in the volume and mix of delivered formal services reflect differences in need.
Physical, cognitive, and psychosocial variables from the disablement process model predict patterns of independence and the transition into disability for the oldest-old
- Authors:
- FAUTH Elizabeth Braungart, et al
- Journal article citation:
- Gerontologist, 47(5), October 2007, pp.613-624.
- Publisher:
- Oxford University Press
This study used the Disablement Process Model to predict whether a sample of the oldest-old maintained their disability or disability-free status over a 2- and 4-year follow-up, or whether they transitioned into a state of disability during this time. The study followed a sample of 149 Swedish adults who were 86 years of age or older over a period of 4 years. The sample were grouped by ability in activities of daily living as being functional survivors (nondisabled over time), increasingly disabled (initially nondisabled but later disabled), chronically disabled (disabled at all waves), or deceased. Variables from baseline were used to predict group membership into these four longitudinal outcome groups. Results indicated that demographic factors, physical impairments, physical and cognitive limitations, and psychosocial variables at baseline predicted membership into the functional survivor group after 2 years and most continued to distinguish between functional survivors and other groups after 4 years. These findings indicate key variables that may be useful in predicting shorter term longitudinal changes in disability. By understanding the physical, cognitive, and psychological variables that predict whether a person develops a disability within the next 2 or 4 years, we may be better able to plan for care or implement appropriate interventions.
Survival in the community of the very old depressed, discharged from medical inpatient care
- Authors:
- WILSON Kenneth, MOTTRAM Patricia, HUSSAIN Maryyum
- Journal article citation:
- International Journal of Geriatric Psychiatry, 22(10), October 2007, pp.974-979.
- Publisher:
- Wiley
The aim was to examine the prevalence and associated risk factors of depression in older patients discharged home from acute medical care and their influence on duration of survival in the community. A cross-sectional, prevalence study of depression in recently discharged patients and a prospective, case-controlled study of depressed and psychiatrically asymptomatic sub groups, exploring the relationship between depression, associated risk factors, and duration of survival in the community. A community study of patients aged 75 and older discharged from the Countess of Chester Hospital and Wirral Hospitals Trust serving Wirral and West Cheshire, England. Three hundred and eleven patients were entered into the prevalence study. One hundred and fifty-eight patients (54 depressed and 104 asymptomatic) were entered into the prospective case controlled study and followed up for up to two years. Depression was defined by GMS/AGECAT criteria. Demographic details, handicap, pain, forced expiratory volume and social network were measured as dependent variables in the prevalence study and included in the analysis of risk factors potentially associated with duration of survival in the community. A depression prevalence rate of 17.4% was found. Age, forced expiratory volume and handicap were associated with depression but depression was the only base-line variable associated with reduced survival in the community as defined by mortality and re-admission. Depression is common in older people discharged from acute medical care and is a major risk factor for reduced duration of community survival.
Relationships between objective and perceived housing in very old age
- Authors:
- NYGREN Carita, et al
- Journal article citation:
- Gerontologist, 47(1), February 2007, pp.85-95.
- Publisher:
- Oxford University Press
This study aimed to explore relationships between aspects of objective and perceived housing in five European samples of very old adults, as well as to investigate whether cross-national comparable patterns exist. The study utilized data from the first wave of the ENABLE–AGE Survey Study. The five national samples (from the countries Germany, the UK, Sweden, Hungary, Latvia) totalled 1,918 individuals aged 75 to 89 years. Objective assessments of the home environment covered the number of environmental barriers as well as the magnitude of accessibility problems (an aspect of person–environment fit). To assess perceptions of housing, instruments on usability, meaning of home, and housing satisfaction were used. Housing-related control was also assessed. Overall, the results revealed that the magnitude of accessibility problems, rather than the number of physical environmental barriers, was associated with perceptions of activity-oriented aspects of housing. That is, very old people living in more accessible housing perceived their homes as more useful and meaningful in relation to their routines and everyday activities, and they were less dependent on external control in relation to their housing. The patterns of such relationships were similar in the five national samples. It is concluded that objective and perceived aspects of housing have to be considered in order to understand the dynamics of aging in place, and the results can be used in practice contexts that target housing for senior citizens.
Importance of the home environment for healthy aging: conceptual and methodological background of the European ENABLE-AGE project
- Authors:
- IWARSSON Susanne, et al
- Journal article citation:
- Gerontologist, 47(1), February 2007, pp.78-84.
- Publisher:
- Oxford University Press
An increasing proportion of very old people remain living in their homes despite declines in physical and mental health. This poses challenges to societal planning and housing development. The authors provide an overview of the aims and research methods used in the European project "Enabling Autonomy, Participation, and Well-Being in Old Age: The Home Environment a Determinant for Healthy Aging" (ENABLE-AGE). Researchers gathered data in urban regions in five European countries: Germany, the UK, Sweden, Hungary and Latvia. The goal of the project was to deliver evidence-based guidelines for home assessment and home modifications among older people.
Housing and care for older people: life in an English purpose-built retirement village
- Authors:
- BERNARD Miriam, et al
- Journal article citation:
- Ageing and Society, 27(4), July 2007, pp.533-554.
- Publisher:
- Cambridge University Press
Retirement communities are a relatively new long-term accommodation and care option in the United Kingdom. Policy makers and providers endorse the proposition that they are suited for the accommodation of both ‘fit’ and ‘frail’ older people, although comparatively little is known about what it is actually like to live in such communities, about whether they cater adequately for older people with a wide spectrum of needs and abilities, or if they provide acceptable solutions to older people's housing or care needs. This paper addresses these questions by reporting the findings of an independently funded three-year study of a new retirement village, Berryhill, in the north Midlands of England. The paper examines the background to this and similar developments, details how the study was carried out, and then examines what it was like to live at Berryhill. It focuses on the housing and care aspects, and explores the residents' motivations for moving to the village; their views about the accommodation; and their use of and satisfaction with the social and leisure amenities. The health and care needs of residents and the formal and informal supports are also featured. The conclusion discusses whether the village can truly be a ‘home for life’ in the face of increasing frailty, and whether or not these new models of accommodation and care can indeed cater for both ‘fit’ and ‘frail’ older people.