Compensatory Strategies: Prevalence of Use and Relationship to Physical Function and Well-Being

We examine prevalence of four compensatory strategies (assistive devices, receiving help, changing frequency, or method of performance) and their immediate and long-term relationship to well-being. A total of 319 older adults (>70 years) with functional difficulties at home provided baseline data; 285 (89%) provided 12-month data. For 17 everyday activities, the most frequently used strategy was changing method of performance ( M = 10.27 activities), followed by changing frequency ( M = 6.17), assistive devices ( M = 5.38), and receiving help ( M = 3.37; p = .001). Using each strategy type was associated with functional difficulties at baseline ( ps < .0001), whereas each strategy type except changing method predicted functional decline 12 months later ( ps < .0001). Changing frequency of performing activities was associated with depressed mood ( p < .0001) and poor mastery ( p < .0001) at both baseline and 12 months ( ps < .02). Findings suggest that strategy type may be differentially associated with functional decline and well-being although reciprocal causality and the role of other factors in these outcomes cannot be determined from this study.

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The perceptions of workers in a long-term care institution for older adults regarding the family

Texto & Contexto - Enfermagem ◽

10.1590/0104-07072014003170013 ◽

2014 ◽

Vol 23 (4) ◽

pp. 971-978 ◽

Cited By ~ 1

Author(s):

Naiana Oliveira dos Santos ◽

Margrid Beuter ◽

Nara Marilene Oliveira Girardon-Perlini ◽

Lisiane Manganelli Girardi Paskulin ◽

Marinês Tambara Leite ◽

...

Keyword(s):

Older Adults ◽

Long Term Care ◽

Well Being ◽

The Elderly ◽

Structured Interviews ◽

Term Care ◽

Care Institution ◽

The Family

This study aimed to investigate the perception of the workers in a Long-Term Care Institution for the Elderly regarding the families of the older adults in the institution. It is qualitative research, undertaken with 16 workers of the multidisciplinary team. Data collection occurred in February-June 2012, through semi-structured interviews. The technique used for treatment of the data was thematic analysis. The results indicate that the family members visit the Long-Term Care Institution for the Elderly rarely, with commemorative dates being the main occasions in which they appear. The workers evidenced some situations of abandonment, in which the family does not visit the older adult even when called. They understand that nobody can substitute the role of the family, as it is the reference for the older adults. Therefore, spending time with the family can positively influence the well-being of the older adults in institutions.

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Considering a Potential Role of Linalool as a Mood Stabilizer for Bipolar Disorder

Current Pharmaceutical Design ◽

10.2174/1381612826666200724160742 ◽

2020 ◽

Vol 26 (40) ◽

pp. 5128-5133

Author(s):

Kate Levenberg ◽

Wade Edris ◽

Martha Levine ◽

Daniel R. George

Keyword(s):

Bipolar Disorder ◽

Treatment Options ◽

Mood Stabilizer ◽

Well Being ◽

Epidemiologic Studies ◽

Treatment Regimens ◽

Bipolar Spectrum Disorders ◽

Short And Long Term

Epidemiologic studies suggest that the lifetime prevalence of bipolar spectrum disorders ranges from 2.8 to 6.5 percent of the population. To decrease morbidity and mortality associated with disease progression, pharmacologic intervention is indicated for the majority of these patients. While a number of effective treatment regimens exist, many conventional medications have significant side effect profiles that adversely impact patients’ short and long-term well-being. It is thus important to continue advancing and improving therapeutic options available to patients. This paper reviews the limitations of current treatments and examines the chemical compound Linalool, an alcohol found in many plant species, that may serve as an effective mood stabilizer. While relatively little is known about Linalool and bipolar disorder, the compound has been shown to have antiepileptic, anti-inflammatory, anxiolytic, anti-depressive, and neurotrophic effects, with mechanisms that are comparable to current bipolar disorder treatment options.

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Frailty and hospitalization-associated disability after pneumonia: A prospective cohort study

BMC Geriatrics ◽

10.1186/s12877-021-02049-5 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Chan Mi Park ◽

Wonsock Kim ◽

Hye Chang Rhim ◽

Eun Sik Lee ◽

Jong Hun Kim ◽

...

Keyword(s):

Older Adults ◽

Primary Outcome ◽

Long Term Care ◽

Functional Decline ◽

Tube Feeding ◽

Term Care ◽

Pneumonia Severity ◽

Frailty Assessment ◽

Nasogastric Tube Feeding

Abstract Background Pneumonia is a major cause of morbidity and mortality in older adults. The role of frailty assessment in older adults with pneumonia is not well defined. Our purpose of the study was to investigate 30-day clinical course and functional outcomes of pneumonia in older adults with different levels of frailty. Methods A prospective cohort was conducted at a university hospital in Seoul, Korea with 176 patients who were 65 years or older and hospitalized with pneumonia. A 50-item deficit-accumulation frailty index (FI) (range: 0–1; robust < 0.15, pre-frail 0.15–0.24, mild-to-moderately frail 0.25–0.44, and severely frail ≥ 0.45) and the pneumonia severity CURB-65 score (range: 0–5) were measured. Primary outcome was death or functional decline, defined as worsening dependencies in 21 daily activities and physical tasks in 30 days. Secondary outcomes were intensive care unit admission, psychoactive drug use, nasogastric tube feeding, prolonged hospitalization (length of stay > 15 days), and discharge to a long-term care institution. Results The population had a median age 79 (interquartile range, 75–84) years, 68 (38.6 %) female, and 45 (25.5 %) robust, 36 (47.4 %) pre-frail, 37 (21.0 %) mild-to-moderately frail, and 58 (33.0 %) severely frail patients. After adjusting for age, sex, and CURB-65, the risk of primary outcome for increasing frailty categories was 46.7 %, 61.1 %, 83.8 %, and 86.2 %, respectively (p = 0.014). The risk was higher in patients with frailty (FI ≥ 0.25) than without (FI < 0.25) among those with CURB-65 0–2 points (75 % vs. 52 %; p = 0.022) and among those with CURB-65 3–5 points (93 % vs. 65 %; p = 0.007). In addition, patients with greater frailty were more likely to require nasogastric tube feeding (robust vs. severe frailty: 13.9 % vs. 60.3 %) and prolonged hospitalization (18.2 % vs. 50.9 %) and discharge to a long-term care institution (4.4 % vs. 59.3 %) (p < 0.05 for all). Rates of intensive care unit admission and psychoactive drug use were similar. Conclusions Older adults with frailty experience high rates of death or functional decline in 30 days of pneumonia hospitalization, regardless of the pneumonia severity. These results underscore the importance of frailty assessment in the acute care setting.

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The Moderating Impact of Attending Services on the Effect of Older Adults’ Discrimination Experiences on Loneliness

Innovation in Aging ◽

10.1093/geroni/igaa057.1035 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 323-323

Author(s):

Dahee Kim ◽

Kyuho Lee

Keyword(s):

Older Adults ◽

Perceived Discrimination ◽

Well Being ◽

Religious Community ◽

Religious Activities ◽

Positive Effects ◽

Religious Behaviors ◽

Religious Services ◽

The Impact

Abstract Research has shown that perceived discriminations impact physical and mental health in later life. Discrimination experiences could make older adults consider themselves as a social misfit and decrease their social interactions, which finally increases their loneliness. Religious behaviors has been reported as a key factor of a lower sense of isolation. Considering that religious behaviors provide opportunities to engage in more extensive social networks and have supportive social ties with community members, attending religious services might decrease the impact of older adults’ perceived discrimination on loneliness. The current research aims to examine the moderating role of religious services attendance in the association between older adults’ perceived discrimination and loneliness. We used data of 4,488 adults aged 50 to 80 (M=66.27, SD=10.15) from the Health and Retirement Study (HRS) collected in 2012 and 2014. Linear regression analysis was performed to investigate whether older adults’ religious service attendance might decrease the impact of their perceived discriminations in daily life on the level of loneliness. The results indicated that more perceived discriminations older adults face on a daily basis were significantly associated with higher levels of loneliness. However, participants who frequently attended religious services showed a lower impact of perceived discriminations on their loneliness. These findings highlight the positive effects of engaging in religious activities on discriminated older adults’ social well-being. These findings also emphasize the role of the religious community as a social resource for socially marginalized older adults.

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Strategies and cognitive reserve to preserve lexical production in aging

GeroScience ◽

10.1007/s11357-021-00367-5 ◽

2021 ◽

Author(s):

Monica Baciu ◽

Sonja Banjac ◽

Elise Roger ◽

Célise Haldin ◽

Marcela Perrone-Bertolotti ◽

...

Keyword(s):

Older Adults ◽

Cognitive Aging ◽

Individual Variability ◽

Future Research ◽

Aging Effects ◽

Main Hypothesis ◽

Compensatory Strategies ◽

Age Related ◽

Complementary Domain

AbstractIn the absence of any neuropsychiatric condition, older adults may show declining performance in several cognitive processes and among them, in retrieving and producing words, reflected in slower responses and even reduced accuracy compared to younger adults. To overcome this difficulty, healthy older adults implement compensatory strategies, which are the focus of this paper. We provide a review of mainstream findings on deficient mechanisms and possible neurocognitive strategies used by older adults to overcome the deleterious effects of age on lexical production. Moreover, we present findings on genetic and lifestyle factors that might either be protective or risk factors of cognitive impairment in advanced age. We propose that “aging-modulating factors” (AMF) can be modified, offering prevention opportunities against aging effects. Based on our review and this proposition, we introduce an integrative neurocognitive model of mechanisms and compensatory strategies for lexical production in older adults (entitled Lexical Access and Retrieval in Aging, LARA). The main hypothesis defended in LARA is that cognitive aging evolves heterogeneously and involves complementary domain-general and domain-specific mechanisms, with substantial inter-individual variability, reflected at behavioral, cognitive, and brain levels. Furthermore, we argue that the ability to compensate for the effect of cognitive aging depends on the amount of reserve specific to each individual which is, in turn, modulated by the AMF. Our conclusion is that a variety of mechanisms and compensatory strategies coexist in the same individual to oppose the effect of age. The role of reserve is pivotal for a successful coping with age-related changes and future research should continue to explore the modulating role of AMF.

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106 - Environmental Influences on the Cognitive and Psychological Well Being of Older Adults with Dementia

International Psychogeriatrics ◽

10.1017/s1041610220001842 ◽

2020 ◽

Vol 32 (S1) ◽

pp. 15-16

Author(s):

William E. Reichman ◽

L. Bradford Perkins ◽

Hilde Verbeek

Keyword(s):

Quality Of Life ◽

Older Adults ◽

Physical Environment ◽

Culture Change ◽

Long Term Care ◽

Small Scale ◽

Term Care

This symposium will review the latest data on the influence of environmental design and its attributes on the cognitive and psychological wellbeing of older adults living with dementia. The presenters will cover the myriad ways in which the physical environment of care can adapt to the changing demands of older adults with sensory, motor and cognitive deficits and foster optimal functioning and quality of life. The role of emerging technologies will also be reviewed as they complement the contribution of the design of the physical environment to the wellbeing of older adults with cognitive impairment. Information will be offered through a review of the existing research literature as well as case studies that illustrate the impact of environmental modification on fostering wellbeing and minimizing the emergence of the behavioral and psychological symptoms of dementia. The presenters will represent and integrate sensibilities that have emerged from the fields of architecture, cognitive neuroscience and psychology.How the Principles of the Culture Change Movement Inform Environmental Design and the Application of Technology in the Care of Older Adults Living with DementiaWilliam E. ReichmanThe culture change movement informs a number of principles that have been applied to more contemporary design concepts for the congregate care of older adults living with dementia. This talk will review the core tenets of the Culture Change Movement as exemplified by the Greenhouse, Dementia Village and other innovative models of congregate long-term care. Specific reference will be made to how these tenets have been operationalized around the world into the design of programming and the creation of residential care environments that foster a better quality of life for older adults and an enhanced work environment for care providers. This talk will also include the emerging role of technologies that complement innovative design of the environment and which foster optimized social and recreational functioning of older adults living with dementia.A Better Life Through a Better Nursing Home DesignL. Bradford PerkinsOver the last 20 years there has been extensive experimentation related to the role of the environment in the housing, care and treatment of persons with Alzheimer’s and other age related dementias. Prior to that time the typical housing and care environment was a locked unit in a skilled nursing or other restrictive senior living facility. In 1991 the Presbyterian Association on Aging in Western Pennsylvania opened Woodside Place on its Oakmont campus. This small 36 bed facility was designed to incorporate the latest research and care experience with persons suffering from these issues. This one small project, as well as the long post occupancy research led by Carnegie Mellon University, clearly demonstrated that individuals with Alzheimer’s and related forms of dementia could lead a healthier, happier, higher quality of life in a more residential, less restrictive environment. Not everything in this pioneering project worked, and five generations of living and care models have followed that have refined the ideas first demonstrated by Woodside Place. Bradford Perkins, whose firm designed Woodside Place and over 100 other related projects, will discuss what was learned from Woodside Place as well as the five generations of projects (and post occupancy research) that followed.Innovative dementia care environments as alternatives for traditional nursing homes: evidence and experiences from the NetherlandsHilde VerbeekKey goals of the dementia care environment focus on increasing autonomy, supporting independence and trying to enable one’s own lifestyle for as long as possible. To meet these goals, innovative, small-scale and homelike care environments have been developed that have radically changed the physical, social and organizational aspects of long-term care in the Netherlands. This presentation discusses various Dutch models that have implemented small-scale and homelike care environments, including green care farms, dementia village and citizen initiatives. The models reflect a common care concept, focusing on residents’ remaining strengths, providing opportunity for choice and aiming to sustain a sense of self and control. A small number of residents (usually 6 to 8) live together in a homelike environment and nursing staff are part of the household. Residents are encouraged to participate in daily household activities, emphasizing normalization of daily life with person-centred care. The physical environment resembles an archetypal home. This talk presents the scientific evidence on the impact and effects of these small-scale, homelike models on residents, their family caregivers and staff. Furthermore, the presentation will highlight working approaches and how these initiatives have positively influenced routine care across the long-term care spectrum.

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The Impact of Function Focused Care From Acute Care to Home Care and Nursing Homes

Innovation in Aging ◽

10.1093/geroni/igaa057.2148 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 629-629

Author(s):

Silke Metzelthin ◽

Sandra Zwakhalen ◽

Barbara Resnick

Keyword(s):

Older Adults ◽

The Netherlands ◽

Home Care ◽

Acute Care ◽

Long Term Care ◽

Functional Decline ◽

Term Care ◽

The Us ◽

The Impact

Abstract Functional decline in older adults often lead towards acute or long-term care. In practice, caregivers often focus on completion of care tasks and of prevention of injuries from falls. This task based, safety approach inadvertently results in fewer opportunities for older adults to be actively involved in activities. Further deconditioning and functional decline are common consequences of this inactivity. To prevent or postpone these consequences Function Focused Care (FFC) was developed meaning that caregivers adapt their level of assistance to the capabilities of older adults and stimulate them to do as much as possible by themselves. FFC was first implemented in institutionalized long-term care in the US, but has spread rapidly to other settings (e.g. acute care), target groups (e.g. people with dementia) and countries (e.g. the Netherlands). During this symposium, four presenters from the US and the Netherlands talk about the impact of FFC. The first presentation is about the results of a stepped wedge cluster trial showing a tendency to improve activities of daily living and mobility. The second presentation is about a FFC training program. FFC was feasible to implement in home care and professionals experienced positive changes in knowledge, attitude, skills and support. The next presenter reports about significant improvements regarding time spent in physical activity and a decrease in resistiveness to care in a cluster randomized controlled trial among nursing home residents with dementia. The fourth speaker presents the content and first results of a training program to implement FFC in nursing homes. Nursing Care of Older Adults Interest Group Sponsored Symposium

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