Sensory Loss and Communication Difficulties in the Elderly

1999 ◽  
Vol 18 (1) ◽  
pp. 4-9 ◽  
Author(s):  
Norman P. Erber ◽  
Samuel C. Scherer
Keyword(s):  
The Elderly ◽  
Sensory Loss ◽  
Communication Difficulties

Gamma Knife thalamotomy for tremor in the magnetic resonance imaging era

2013 ◽  
Vol 118 (4) ◽  
pp. 713-718 ◽  
Author(s):  
Ali Kooshkabadi ◽  
L. Dade Lunsford ◽  
Daniel Tonetti ◽  
John C. Flickinger ◽  
Douglas Kondziolka
Keyword(s):  
Deep Brain Stimulation ◽  
Gamma Knife ◽  
Brain Stimulation ◽  
Rating Scale ◽  
Target Selection ◽  
The Elderly ◽  
Sensory Loss ◽  
The Face ◽  
The Mean ◽  
Deep Brain

Object The surgical management of disabling tremor has gained renewed vigor with the availability of deep brain stimulation. However, in the face of an aging population of patients with increasing surgical comorbidities, noninvasive approaches for tremor management are needed. The authors' purpose was to study the technique and results of stereotactic radiosurgery performed in the era of MRI targeting. Methods The authors evaluated outcomes in 86 patients (mean age 71 years; number of procedures 88) who underwent a unilateral Gamma Knife thalamotomy (GKT) for tremor during a 15-year period that spanned the era of MRI-based target selection (1996–2011). Symptoms were related to essential tremor in 48 patients (19 age ≥ 80 years and 3 age ≥ 90 years), Parkinson disease in 27 patients (11 age ≥ 80 years [1 patient underwent bilateral procedures]), and multiple sclerosis in 11 patients (1 patient underwent bilateral procedures). A single 4-mm isocenter was used to deliver a maximum dose of 140 Gy to the posterior-inferior region of the nucleus ventralis intermedius. The Fahn-Tolosa-Marin clinical tremor rating scale was used to grade tremor, handwriting, and ability to drink. The median follow-up was 23 months. Results The mean tremor score was 3.28 ± 0.79 before and 1.81 ± 1.15 after (p < 0.0001) GKT; the mean handwriting score was 2.78 ± 0.82 and 1.62 ± 1.04, respectively (p < 0.0001); and the mean drinking score was 3.14 ± 0.78 and 1.80 ± 1.15, respectively (p < 0.0001). After GKT, 57 patients (66%) showed improvement in all 3 scores, 11 patients (13%) in 2 scores, and 2 patients (2%) in just 1 score. In 16 patients (19%) there was a failure to improve in any score. Two patients developed a temporary contralateral hemiparesis, 1 patient noted dysphagia, and 1 sustained facial sensory loss. Conclusions Gamma Knife thalamotomy in the MRI era was a safe and effective noninvasive surgical strategy for medically refractory tremor in the elderly or those with contraindications to deep brain stimulation or stereotactic radiofrequency (thermal) thalamotomy.

Patients with special needs

2010 ◽  
Author(s):  
Gillian M Hood ◽  
Suyin GM Tan
Keyword(s):  
Intellectual Disability ◽  
Special Needs ◽  
Hearing Impairment ◽  
Disease Process ◽  
The Elderly ◽  
Communication Problem ◽  
Communication Problems ◽  
Communication Difficulties ◽  
Patients With Special Needs ◽  
Hospital Inpatients

Most anaesthetists recognize that there are specific groups of patients with whom communication is especially difficult due to issues relating to language. These groups are patients in whom a disease process interferes with communication—for example intellectual disability or hearing impairment, those with whom we do not share a common tongue, and those patients whose cultural background differs from ours. Patients with communication difficulties are disproportionately represented in the hospital population for a variety of reasons. The elderly form the bulk of hospital inpatients and are much more likely to have problems such as dementia, confusion, sedation and dysphasia. It is important to be cognisant of the issues that may arise with patients who have communication problems and, in addition to being aware of these problems, it helps to have a structured way of approaching the issue. Reading the patients’ notes prior to consultation gives advance warning of issues such as dementia or hearing impairment and allows communication to be tailored to the patients’ needs. Sometimes the patients’ understanding of language may be difficult to assess on first meeting—anaesthetists have all encountered patients who answer questions with a smiling ‘yes’ or ‘no’, only to subsequently discover their comprehension has been minimal. Enquiring of relatives, friends and staff helps to give a picture of a patient’s ability to communicate in the chosen language. Similarly, enquiring of the patient how communication can be facilitated, is helpful. … ‘It says in your notes that you have trouble finding words since your strok —is there anything I can do to make it easier for you to speak?’… Once the communication problem has been delineated it makes it easier to move on to the next step. Having orientated oneself to the patient’s particular problems with communication, it is also important to orientate the staff with whom one is working. …‘Rob, we are going to see Mr Smith now. He’s had problems with alcohol withdrawal over the last few days and he is still a bit confused. It is probably best if just one of us does the talking — are you happy to do that? ’ Not: ‘I wish you wouldn’t contradict me when I’m talking to patients…’ …

The communication and psychosocial perceptions of older adults with sensory loss: a qualitative study

2004 ◽  
Vol 24 (1) ◽  
pp. 113-130 ◽  
Author(s):  
CHYRISSE HEINE ◽  
COLETTE J. BROWNING
Keyword(s):  
Quality Of Life ◽  
Older Adults ◽  
Qualitative Study ◽  
Social Adjustment ◽  
Well Being ◽  
Sensory Loss ◽  
Communication Breakdown ◽  
Communication Difficulties ◽  
Mental Well Being

Sensory loss (visual and/or hearing loss) is prevalent in older adults. Decreased vision and/or hearing acuity often result in poor communication and psychosocial functioning. This qualitative study explores the communication and psychosocial perceptions of a group of older adults with single or dual sensory loss. The aims were to identify the communication difficulties and conversational strategies used by the subjects, and to explore their perceptions of their social adjustment, quality of life and physical and mental well-being. The participants were all older adults with sensory loss who attended the Vision Australia Foundation. In-depth interviews revealed that the participants experienced frequent communication difficulties. They identified the personal, situational and environmental triggers responsible for communication breakdown, and they described the compensation and avoidance strategies that they used. The participants acknowledged that frequent communication breakdown resulted in decreased socialisation. The problems of adjusting to sensory loss, depression, anxiety, lethargy and social dissatisfaction were cited as factors that affected their physical and mental well-being, while being optimistic, coping with their sensory loss, and maintaining social contact contributed to an improved quality of life. All participants expressed interest in being involved in further communication intervention programmes.

scholarly journals STEREOTIP TENTANG DIFABEL: SEBUAH PERSPEKTIF KOMUNIKASI LINTAS BUDAYA

2021 ◽  
Vol 10 (1) ◽  
pp. 33-43
Author(s):  
Drajat Wicaksono ◽  
Nikmah Suryandari ◽  
Allyvia Camelia
Keyword(s):  
Individual Differences ◽  
Intercultural Communication ◽  
Ethnic Groups ◽  
People With Disabilities ◽  
The Elderly ◽  
Individual Characteristics ◽  
Racial Groups ◽  
Persons With Disabilities ◽  
Negative Perception ◽  
Communication Difficulties

This paper will describe the study of stereotypes in persons with disabilities, from the perspective of intercultural communication. During this time people with disabilities often get a bad stigma and are still underestimated as a party that needs to be pitied. For families, sometimes people with disabilities are considered a disgrace that needs to be covered up. The assumption that people with disabilities are different and even abnormal is shown as a form of negative perception that is nothing but part of the stereotype. Stereotype is not only from the labeling process of the community, but also the labeling process carried out by the diffable to himself who is aware of the disabilities that he has. Communication difficulties will arise from stereotyping, which generalizes people based on little information and shapes people's assumptions based on their membership in a group. In other words, stereotyping is the process of placing people into established categories, or judgments about people or objects based on appropriate categories, rather than on their individual characteristics. In the study of intercultural communication, stereotyping is the categorization of a group in general by ignoring individual differences. These groups include: racial groups, ethnic groups, the elderly, various professional occupations, or people with certain physical appearance. Stereotype does not view individuals in the group as unique people or individuals

Vision and Hearing Loss in Older Adults: “Double Trouble”

2004 ◽  
Vol 5 (1) ◽  
pp. 35-40 ◽  
Author(s):  
Paige Berry ◽  
John Mascia ◽  
Bernard A. Steinman
Keyword(s):  
Hearing Loss ◽  
Vision Loss ◽  
The Elderly ◽  
The United States ◽  
Sensory Loss ◽  
Older Individuals ◽  
The People ◽  
Common Causes ◽  
Functional Implications ◽  
Dual Sensory Loss

Recent studies indicate that by age seventy, 21% of the people living in the United States have both vision and hearing loss. Dual sensory loss in the elderly has a significant effect on an individual’s ability to socialize, communicate with others, and live independently. This article addresses the issues faced by older individuals who are hard of hearing and blind or visually impaired. Common causes and behavioral signs of hearing and vision loss are discussed. An emphasis is placed on the functional implications of the dual sensory impairment and possible accommodations and communication strategies are outlined.

scholarly journals SUCCESSFUL MANAGEMENT OF SACRAL POSTHERPETIC NEURALGIA WITH GANGLION IMPAR BLOCK - A CASE REPORT

2019 ◽  
pp. 15-16
Author(s):  
PARTHASARATHY S ◽  
ANWAR BATCHA S
Keyword(s):  
Postherpetic Neuralgia ◽  
The Elderly ◽  
Sensory Loss ◽  
Varicella Zoster ◽  
Adequate Pain Relief ◽  
The Right ◽  
Ganglion Impar Block ◽  
Ganglion Impar ◽  
Varicella Zoster Infection

Postherpetic neuralgia (PHN) is one of the most common and important complications of severe varicella-zoster infection, especially occurring in 20% of the elderly patients. A 59-year-old female presented with pain in the right sacral region for the past 3 months. The pain was preceded by herpes zoster. She was diagnosed as a case of Sacral PHN. We administered paramedian approach of ganglion impar block with 10 ml of 0.25% bupivacaine with 8 mg dexamethasone which resulted in immediate adequate pain relief. On follow-up after 8 weeks, the pain score continued to be less with 3/10. No complications were encountered. There was no sensory loss. We conclude that ganglion impar block with a combination of local anesthetic and steroid is a viable treatment option for sacral PHN.

Laughter, communication problems and dementia

2008 ◽  
Vol 5 (1) ◽  
pp. 3-14 ◽  
Author(s):  
Camilla Lindholm
Keyword(s):  
Cognitive Impairment ◽  
Elderly Patients ◽  
Language Production ◽  
The Elderly ◽  
Memory Work ◽  
Communication Problems ◽  
Conversational Skills ◽  
Communication Difficulties ◽  
Institutional Contexts ◽  
Definition Of

This article investigates how the elderly with dementia and their professional caregivers use laughter as a device to deal with problems related to language production and comprehension. The data consist of two game-playing situations, used to engage the elderly people in memory work. The article shows how the elderly patients recurrently laugh to acknowledge communication difficulties and to show awareness of their potential non-competency. The professional caregivers are shown to use slightly different strategies for responding to laughter segments initiated by the patients, either making the shortcomings part of the conversation or avoiding referring to the lapse explicitly. The laughter strategies used by the patients are compared to those reported in the CA-literature on laughter. It is well known that laughter is used in sequences of trouble and delicacy in both ordinary and institutional contexts, but my study shows that speakers with dementia laugh when they encounter problems related to language production and comprehension. This functional expansion in relation to premorbid occurrence is evidence that laughter fits the definition of compensatory behaviour utilized to overcome communication barriers. Certain conversational skills are preserved in individuals with dementia, but due to their cognitive impairment these resources are utilized in a slightly different way than by healthy speakers.

scholarly journals Augmentative and alternative communication with adults and elderly in the hospital environment: an integrative literature review

Revista CEFAC ◽  
2020 ◽  
Vol 22 (5) ◽  
Author(s):  
Diego Nascimento de Carvalho ◽  
Ítala da Piedade Queiroz ◽  
Brenda Carla Lima Araújo ◽  
Sindy Lamônie do Espírito Santo Barbosa ◽  
Vanessa Cibelle Barboza de Carvalho ◽  
...  
Keyword(s):  
Augmentative And Alternative Communication ◽  
Communication Strategies ◽  
The Elderly ◽  
Integrative Review ◽  
Hospital Environment ◽  
Cochrane Library ◽  
Clinical Settings ◽  
Alternative Communication ◽  
Communication Difficulties ◽  
The Disabled

ABSTRACT Objective: to carry out an integrative review about the augmentative and alternative communication strategies used with adults and the elderly in the hospital environment and their impact on communication. Methods: this research study used the integrative review methodology with descriptors in English and Portuguese: 'communication', 'hospitals', 'communication aids for the disabled', in the following databases: LILACS, PubMed, Cinahl, Cochrane Library, SciELO, Scopus, Web of Science. Several articles in English and Portuguese, from the last 14 years, which addressed alternative communication strategies used with hospitalized adults and the elderly, were included. Studies on children, as well as duplicates, reviews, and those that addressed other methods of communication were excluded. Results: 13 articles characterized the alternative communication strategies used with adults and the elderly. There was a prevalence of intubated or tracheostomized patients, and health professionals, nurses being the ones with the highest citation, and researches on a qualitative approach. Six studies have used high and low technologies; however, most have shown a greater use of low-tech tools. Conclusion: a variety of high and low-tech strategies were identified, a reduction in communication difficulties being noted, as well as improvements in the quality of life and communication with professionals. The most used tool was the communication board, due to its hospitals' availability and its simple use. The evaluation and the effectiveness of communication tools in distinct clinical settings and profiles should be studied.

Cell surface changes during aging of human bladder epithelium examined by lectin probes and SEM

1990 ◽  
Vol 48 (3) ◽  
pp. 966-967
Author(s):  
J. Jacob ◽  
M.F.M. Ismail
Keyword(s):  
The Elderly ◽  
Ultrastructural Changes ◽  
Pokeweed Mitogen ◽  
Asymmetric Structure ◽  
Luminal Surface ◽  
Bladder Epithelium ◽  
Aldehyde Groups ◽  
Cell Surface Changes ◽  
Phosphate Buffered Saline ◽  
Surface Changes

Ultrastructural changes have been shown to occur in the urinary bladder epithelium (urothelium) during the life span of humans. With increasing age, the luminal surface becomes more flexible and develops simple microvilli-like processes. Furthermore, the specialised asymmetric structure of the luminal plasma membrane is relatively more prominent in the young than in the elderly. The nature of the changes at the luminal surface is now explored by lectin-mediated adsorption visualised by scanning electron microscopy (SEM).Samples of young adult (21-31 y old) and elderly (58-82 y old) urothelia were fixed in buffered 2% glutaraldehyde for 10 m and washed with phosphate buffered saline (PBS) containing Ca++ and Mg++ at room temperature. They were incubated overnight at 4°C in 0.1 M ammonium chloride in PBS to block any remaining aldehyde groups. The samples were then allowed to stand in PBS at 37°C for 2 h before incubation at 37°C for 30 m with lectins. The lectins used were concanavalin A (Con A), wheat germ agglutinin (WGA), phytohaemagglutinin (PHA) and pokeweed mitogen (PWM) at a concentration of 500 mg/ml in PBS at pH 7.A.

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