scholarly journals In-home care and ‘supported independence’ for the frail elderly: A social work perspective

2016 ◽  
Vol 24 (1) ◽  
pp. 3-13
Author(s):  
Doug Matthews

The article focuses on role of social workers in providing in-home care and assistance with the activities of daily living (ADL) for older people in New Zealand. From the physician- and hospital-based medical care for older people, a shift back to home-based medical care was emphasized by the Ministry of Social Development in April 2001. The New Zealand Health of Older People Strategy was implemented with the aim of achieving positive aging, quality of life and independence.

2010 ◽  
Vol 34 (1) ◽  
pp. 11 ◽  
Author(s):  
Jenny Carryer ◽  
Chiquita O. Hansen ◽  
Judy A. Blakey

To examine issues related to the working life of registered nurses in residential care for older people in New Zealand, 48 registered nurses completed surveys (n = 28) or participated in discussions (n = 26) regarding their work roles, continuing education and interactions with specialist nurse services when providing care for older people living with chronic illnesses. This nursing workforce is characterised by ageing, relative isolation, reduced confidence and few opportunities for induction of new graduates. Registered nurses reported their struggle to deliver the appropriate quality of care to residents as acuity increases, general practitioner availability decreases and the opportunities for increasing their knowledge and competence remain limited. The provision of nursing services in residential care for older people is an area of growing concern to many Western countries. Nurse practitioners offer opportunities to improve the quality of residential care. What is known about the topic?The lack of registered nurses generally and the more critical shortage in residential care is well known. What does this paper add?This paper explains the impact on the current and future viability and the quality of registered nurse services in an area of service where acuity continues to rise and the demand for nursing services is increasing. What are the implications for practitioners?Nurses in older care settings often express a sense of isolation and note limited career development despite their passion for serving the frail older person. The establishment of nurse practitioner (gerontology) roles offers the potential for improved quality of clinical care for residents and clinical champions for development of nursing services.


2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 48-48
Author(s):  
Rui Zhou ◽  
Joyce Cheng ◽  
Shuangshuang Wang ◽  
Nengliang (Aaron) Yao

Abstract Home-based medical care (HBMC) is emerging in China, but research understanding the efficiency and effectiveness of this new care model is rare. In this study, researchers interviewed 17 Chinese homebound adults aged 45 and older (53% females, mean age=76) who have received HBMC, and collected detailed information regarding their experiences and attitudes toward HBMC. Participants were recruited from healthcare institutions in Shanghai, Jinan, and Zhangqiu of China. The evaluation of patients’ experiences with HBMC yielded both positive and negative aspects. Positive experiences included 1) the delivery method was convenient for homebound patients; 2) health problems could be detected timely because doctors visited patients regularly; 3) home care providers had better bedside manners and professional skills than hospital-based providers; 4) the medical insurance covered the cost of home care services. Negative experiences related to the supply and quality of care, including 1) the scope of current HBMC services was too limited to meet the needs of homebound patients; 2) the visit time was too short; 3) healthcare providers’ professional skills varied greatly. Findings from this study suggest that the HBMC model benefited Chinese older adults, primarily homebound adults, in terms of convenience and affordability. There are opportunities to expand the scope of home care services and improve the quality of care. Policymakers may consider providing more resources and incentives to enhance HBMC in China. Educational programs may be created to train more HBMC providers and improve their professional skills.


2020 ◽  
Vol 7 ◽  
Author(s):  
Lina Ma ◽  
Jagadish K. Chhetri ◽  
Yaxin Zhang ◽  
Pan Liu ◽  
Yumeng Chen ◽  
...  

Objectives: The World Health Organization (WHO) proposed the Integrated Care for Older People (ICOPE) screening tool to identify older people with priority conditions associated with declines in intrinsic capacity (IC). We aimed to determine the clinical utility of the WHO ICOPE screening tool in a Chinese population.Method: A total of 376 adults aged 68.65 ± 11.41 years participated in the study. IC was assessed with the WHO ICOPE screening tool, covering five domains: cognitive, locomotor, sensory, vision, and psychological capacity. We assessed the activities of daily living (ADL); instrumental activities of daily living (IADL); the Fried frailty phenotype; FRAIL scale; Strength, Assistance With Walking, Rising From chair, Climbing Stairs, and Falls (SARC-F) scale; Mini-mental State Examination (MMSE); Geriatric Depression Scale (GDS); social frailty; and quality of life.Results: There were 260 (69.1%) participants who showed declines in one or more IC dimensions. The percentages of decline in mobility, cognition, vitality, hearing, vision, and psychological capacity were 25.3, 46.8, 16.2, 15.4, 11.7, and 12.0%, respectively. IC decreased with increasing age. After adjusting for age, sex, and multimorbidity, participants with declines in IC were more likely to be older, frail, and disabled. They also had worse physical, mental, and overall health. There was a higher prevalence of declines in IC in participants with frailty. After adjusting for age, IC was positively correlated with walking speed, resilience score, and MMSE score and negatively correlated with frailty, SARC-F score, IADL score, GDS score, and physical and mental fatigue. The IC score was not associated with body composition variables such as fat-free mass, body fat percentage, or visceral fat area. Higher IC was associated with better quality of life. The area under the curve of the receiver operating characteristic (AUC-ROC) for the ICOPE screening tool vs. Fried phenotype, FRAIL, ADL disability, IADL disability, and SARC-F were 0.817, 0.843, 0.954, 0.912, and 0.909, respectively.Conclusion: Our research affirms that the ICOPE screening tool is useful to identify adults with poor physical and mental function in a Chinese sample. This tool may assist in identifying declines in IC in an integrative care model and help slow down function decline and onset of care dependence.


Author(s):  
Ranjeet S. Sawant ◽  
Bharat D. Zinjurke ◽  
Sandeep V. Binorkar

Abstract The ongoing coronavirus pandemic is caused by severe acute respiratory syndrome coronavirus 2 (SARS CoV 2) and unique in various facets. The earlier experience from the past severe acute respiratory syndrome (SARS) epidemics seem to be insufficient and there is need for better strategies in public health and medical care. Ayurved & Yog are well known for their preventive and therapeutic aspect, but not getting utilized properly for prevention of Covid 19 crisis which may also be helpful as supportive therapy along with current line of management. This paper is aimed at unrevealing the role of Ayurved and Yoga guidelines established by Department of AYUSH for prevention from SARS-CoV-2 by providing help to improving the quality of supportive/prophylactic therapy in relation with their immunity.


2021 ◽  
Vol 11 (2) ◽  
pp. 213
Author(s):  
Dulce Romero-Ayuso ◽  
Cristian Cuerda ◽  
Carmen Morales ◽  
Ricardo Tesoriero ◽  
José Matías Triviño-Juárez ◽  
...  

Cognitive dysfunction affects the performance of Activities of Daily Living (ADL) and the quality of life of people with these deficits and their caregivers. To the knowledge of the authors, to date, there are few studies that focus on knowing the relationship between personal autonomy and deductive reasoning and/or categorization skills, which are necessary for the performance of the ADL. The aim of this study was to explore the relationships between ADL and categorization skills in older people. The study included 51 participants: 31 patients with cognitive impairment and 20 without cognitive impairment. Two tests were administered to assess cognitive functions: (1) the Montreal Cognitive Assessment (MoCA); and (2) the digital version of Riska Object Classification test (ROC-d). In addition, the Routine Tasks Inventory-2 (RTI-2) was applied to determine the level of independence in activities of daily living. People with cognitive impairment performed poorly in categorization tasks with unstructured information (p = 0.006). Also, the results found a high correlation between cognitive functioning and the performance of ADLs (Physical ADL: r = 0.798; p < 0.001; Instrumental ADL: r = 0.740; p < 0.001), a moderate correlation between Physical ADLs and categorization skills (unstructured ROC-d: r = 0.547; p < 0.001; structured ROC-d: r = 0.586; p < 0.001) and Instrumental ADLs and categorization skills in older people (unstructured ROC-d: r = 0.510; p < 0.001; structured ROC-d: r = 0.463; p < 0.001). The ROC-d allows the assessment of categorization skills to be quick and easy, facilitating the assessment process by OT, as well as the accuracy of the data obtained.


Author(s):  
К. А. Галкин

Ситуация пандемии COVID-19 в очередной раз напомнила о необходимости использования онлайн-сообществ здоровья, особенно в тех районах, где не хватает мест в местных больницах или существуют проблемы с получением качественной медицинской помощи. Это, например, сельские районы, где медицина ориентирована на лечение экстренно возникающих заболеваний и у врачей существуют сложности с возможностью лечения новой коронавирусной инфекции. Онлайн-сообщества здоровья в таком случае предоставляют возможность узнать необходимую информацию, а также общаться со специалистами, которые знают особенности нового коронавируса и могут дать необходимые советы. В настоящей статье на примере глубинных интервью с пожилыми людьми из сёл Ленинградской обл. и Республики Карелия рассмотрена роль телемедицины для пожилых людей и общения в онлайн-сообществах здоровья в контексте преодоления одиночества и изолированности, которая существует в сельской местности. В статье проанализированы особенности и основные препятствия для использования пожилыми людьми телемедицины и общения в онлайнсообществах здоровья - это проблемы с инфраструктурой и отключением электричества, отсутствие у пожилых людей компьютерной грамотности для общения и взаимодействия в онлайн-сообществах здоровья. Роль последних рассмотрена с точки зрения развития самозаботы пожилых людей в сельской местности в периферийных поселениях из-за отсутствия необходимой медицинской помощи. The situation of the COVID-19 pandemic has once again reminded of the need to use telemedicine and online health communities, especially in areas where there are not enough places in local hospitals or there are problems with obtaining quality medical care, such as rural areas where rural medicine is focused on treatment of emergency diseases and doctors have difficulties with the possibility of treatment, as well as explaining about the new coronavirus infection to patients and how this disease can be treated. In this case, online health communities provide an opportunity to find out the necessary information, as well as communicate with specialists who know the features of the new coronavirus and can give the necessary advice. Using the example of in-depth interviews with older people from villages in the Leningrad Region and the Republic of Karelia, the article examines the role of telemedicine for older people and communication in online health communities in the context of overcoming loneliness and isolation that exist in rural areas. The article analyzes the features of the use of telemedicine and the key barriers to the use of telemedicine and communication of older people in online disease communities. In rural areas the main barriers to telemedicine use are infrastructure problems and power outages, as well as the lack of computer literacy for communication and elder people’s interaction in online health communities. In the article the role of online health communities is considered in the context of the self-care of older people and from the point of view of the development of self-care of older people in rural peripheral settlements due to the lack of necessary medical care.


Author(s):  
Hylton B. Menz

Foot problems affect one in four people aged over 65 years and have a major detrimental impact on mobility and quality of life. With advancing age, the foot undergoes several cutaneous, vascular, neurological, and musculoskeletal changes, all of which may impair this important weight bearing function and predispose the older person to the development of foot symptoms. This chapter provides an overview of the prevalence and impact of foot problems in older people, and briefly discusses the management of common foot problems in older people including skin and nail disorders, vascular disorders, and structural deformities. The important role of footwear in the management of foot problems is also highlighted.


2019 ◽  
Vol 25 (7) ◽  
pp. 326-332
Author(s):  
Kanyanat Supaporn ◽  
Sang-arun Isaramalai ◽  
Wandee Suttharangsee

Background: Older people in Thailand receive general medical and social care at the end of life, and many rarely access palliative services. In light of this, improving the quality of care for the ageing population relies on addressing the needs of family caregivers, who provide the majority of care in a home setting. Understanding caregivers' perspectives when caring for a friend or relative will help to improve the quality of care that they provide. Aim: To explore caregivers' perspectives on improving care for older people in Thailand in the palliative stage. Methods: A qualitative study using in-depth interviews and observation of 10 older people in the palliative stage and their caregivers was undertaken. Data were analysed using content analysis. Findings: Data analysis revealed three themes: caregivers cared to repay the older person's previous kindness, caregivers cared and changed their caregiving behaviour to minimise the older person's perception of being abandoned or being a burden, and to follow Thai ancestral traditions, so that the older person could die peacefully. Conclusion: This study provides specific instructions for those who provide care for older Thai people in the palliative stage. Finding ways to address caregivers' perspectives on improving care quality could enhance the experience of care recipients.


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