scholarly journals Elderly care in the emergency department: an integrative review

2018 ◽  
Vol 21 (2) ◽  
pp. 243-253 ◽  
Author(s):  
Luciana Aparecida Soares de Andrade ◽  
Sulamita de Paula Santos ◽  
Roselene Campos Corpolato ◽  
Mariluci Hautsch Willig ◽  
Maria de Fátima Mantovani ◽  
...  

Abstract Objective: To identify the care practices of nurses for the elderly in emergency departments. Method: An integrative review was carried out in the CAPES database, selecting publications in English, Portuguese and Spanish published between January 2011 and October 2016. The descriptors used were: "Emergency nursing"; "Geriatric nursing"; "Health services for the elderly"; "Elderly person"; "Nursing care". Results: Sixteen articles were analyzed in English, the majority of which had a qualitative approach (56.2%). Australia had the largest number of publications (31.2%). After reading the studies in full, the common themes were organized and classified into three categories: Challenges/difficulties in the care of the elderly in the emergency department, Positive experiences of elderly care in the emergency department and The emergency department as a space of death and dying. Conclusion: The care practices of nurses are focused on identifying the main problems regarding elderly care, adaptation and the planning of their work routine. Another strategy is the implementation of instruments of evaluation specific to elderly patients and the involvement of the family in all stages of care.

2018 ◽  
Vol 28 (2) ◽  
pp. 571-574
Author(s):  
Ivanka Stambolova ◽  
Stefan Stambolov

In outpatient care the home care, including hospices, is recognized as a model for providing quality, cost-effective and charitable care. The focus is mainly on the care that helps everyday lifeof the patient as well as the relatives, rather than on treatment, and in most cases it takes place in the patients' home. In Europe, in recent years there has been a real "boom" in home care due to demographic processes linked to increased needs for elderly care and chronically ill under the conditions of limited financial resources.In outpatient medical care in our country by means of a national framework contract there are regulated visits to the patient's home by a doctor, as well as visits by medical staff employed by him - nurse, midwife, medical assistant / paramedic / for manipulation, counseling and monitoring. At the same time there is no regulated legal activity in the Republic of Bulgaria, which is essentially the subject of home care.Since 1994 „Caritas“ has carried out the "Home Care" service, which provides a complex - health and social care for over 360 sick adults in a place where the elderly person feels the most comfortable - in their own home. „Caritas Home Care“ is provided by mobile teams of nurses and social assistants who visit the elderly at home and provide them with the necessary care according to their health and social needs.With the establishment of the first „Home Care Center“ in Lozenets region, Sofia, with the support of the PHARE ACCESS program in 2003, the Bulgarian Red Cross introduces in Bulgaria an integrated model for provision of health care and social services in the home of adults, chronically ill and people with permanent disabilities. To date, there are a number of problems in home care related to the realization of home care for patients in need in out-of-hospital settings: lack of legal regulation for home care, lack of qualified staff in outpatient care; lack of organization and structures for care; unsettled funding and the inability of the part of the population that is most in need of care to pay for it, there is no regulation to control the activity. Although home care began over 20 years ago, our country is yet to make its way to the European program called „Home care in Europe“.


Author(s):  
Marijo Hébert ◽  
Kareen Nour ◽  
Patrick Durivage ◽  
Isabelle Wallach ◽  
Véronique Billette ◽  
...  

ABSTRACTThe understanding of palliative care practices at home (PCH) is limited by the lack of available scientific knowledge. This is explained by the fact that its practices are relatively recent and they question our relationship with death and dying individuals. This study aims to contribute to the advancement of knowledge about PCH with the elderly. More specifically, with a perspective of social exclusion, it aims to understand how practices either do or do not produce social exclusion with seniors receiving palliative care. Nineteen participants from two local community services centers were interviewed and six multidisciplinary meetings were attended for observation. This study suggests that positive representations concerning the elderly in palliative care and recognition of their autonomy can avoid social exclusion, including its symbolic and identificatory dimensions. However, standardization of practices seems to contribute to institutional exclusion and foster nonrecognition.


2017 ◽  
Vol 29 (2) ◽  
pp. 338-345 ◽  
Author(s):  
Masaru Kawakami ◽  
◽  
Shogo Toba ◽  
Kohei Fukuda ◽  
Shinya Hori ◽  
...  

[abstFig src='/00290002/07.jpg' width='210' text='The motion detection system' ] Fall accident prevention is one of the most important issues in elderly care settings. To prevent an accident, it is necessary to notify caregivers if the elderly person is getting out of bed. We have previously developed a posture discrimination system based on body motions. Herein, we propose a discrimination method by using machine learning to improve the performance of the system. A purpose of this study is to evaluate the proposed method. Elderly people in a nursing home were chosen as subjects in this study. We analyzed the body motion data during bed rest and bed exit of the subjects using the proposed method. These results suggest that it is effective.


2020 ◽  
Vol 73 (suppl 3) ◽  
Author(s):  
Josiane Steil Siewert ◽  
Angela Maria Alvarez ◽  
Silvia Maria Azevedo dos Santos ◽  
Fabiana Almeida Brito ◽  
Karina Silveira de Almeida Hammerschmidt

ABSTRACT Objective: To ascertain the characteristics of the nursing care provided to institutionalized elderly people with dementia. Methods: Integrative review of studies published between 2013 and 2017, in English, Spanish, and Portuguese, from the databases BDENF, LILACS, CINAHL, PubMed, SciELO, TRIP, and National Guideline Clearing House. Thematic data analysis was used. Results: From the data collected in the 41 included studies, three themes emerged: Care with a focus on the needs of elderly people in LTCIEs; Care based on the work process of the nursing team; and Shared care. Final considerations: Elderly care can take place from different perspectives: that of the elderly; the nursing team; and it can be shared among the different parties involved. The importance of communication must be stressed, as do the development of skills and attitudes of the team, as well as proper training and support, good environment in the care process, and an approach centered on the institutionalized elderly.


Author(s):  
Maria João Soares ◽  
Rogério Ferrinho Ferreira ◽  
João Vítor Vieira

The objective of this chapter is to identify the gains associated with rehabilitation nursing care implemented in the elderly person with mobility deficit of the fractured femur. An integrative literature review with a qualitative synthesis retrospectively by 2014 was used. Older femur fractures undergo physical changes that affect their motor function and cause dependence in their activities of daily living (ADLs). From the specialized intervention in rehabilitation nursing, sensitive gains in mobility, functional independence in ADLs, hospital admission and rehabilitation time, quality of life and mortality rate, and health expenditures emerge were found. Fracture of the femur is usually associated with a fall from a height and occurs mainly in independent females in ADLs. In this population, gains that are sensitive to rehabilitative nursing care are recognized in the scientific evidence. The rehabilitation nurse thus has a relevant role in the qualification and quality of life of the person, with evident implications in the elderly care, in an institutional and community context.


2011 ◽  
Vol 6 (1) ◽  
pp. 104
Author(s):  
Patrícia Peres Oliveira ◽  
Priscilla Sete de Carvalho Onofre ◽  
Paula Bertone Norberto

ABSTRACT Objective: to know the feelings of elderly people living in a long term care institution (ILP) with regard to the death of friends and relatives. Methodology: this is a descriptive and exploratory research with a qualitative approach, using the oral history method through two guiding questions: “Have you ever experienced the death of a friend, relative, or even some close colleague living in this institution? “and” How you face this situation?”. The data collection was carried out by means of recorded interviews, with the signing of Free and Informed Consent Term, help between January and March 2010, with twenty elderly people, from both sexes, aged between 72 and 89 years, living in an institution for elderly care in Sao Paulo city, as approved by the Research Ethics Committee of Universidade Paulista under CAAE 5380.0.000.251/09, obtaining a favorable opinion, under the Protocol 715/09. Results: from analyzing the interviews, four thematic focuses emerged: loss due to withdrawal from family relationships, new friendships, the existence after the death of friends and relatives, reflections on the possibility of one’s own death. Conclusions: it was possible to understand that the death of beloved people brings the elderly person closer to her/his own mortality, turning the grieving process more difficult, but separation is much more difficult to be interpreted because it is the loss of living persons. Therefore, it is essential that the health professionals and caregivers give support to the elderly people in their process of facing the suffering experienced. Descriptors: geriatric nursing; death; qualitative research. RESUMO Objetivo: conhecer os sentimentos dos idosos residentes em uma instituição de longa permanência (ILP) em relação à morte de amigos e familiares. Metodologia: trata-se de pesquisa descritiva e exploratória com abordagem qualitativa, utilizando o método da história oral a partir de duas questões norteadoras: “O senhor já vivenciou a morte de algum amigo, parente ou mesmo algum colega mais próximo residente nesta instituição? “e” “Como foi para o senhor enfrentar essa situação?” A coleta de dados foi realizada por meio de entrevistas gravadas, com assinatura de Termo de Consentimento Livre e Esclarecido, realizadas entre janeiro e março de 2010, com vinte idosos, de ambos os sexos, com idade entre 72 anos e 89 anos, residentes em uma instituição para idosos da cidade de São Paulo, conforme aprovação do Comitê de Ética em Pesquisa da Universidade Paulista sob o CAAE n. 5380.0.000.251/09, tendo obtido parecer favorável, sob o Protocolo nº 715/09. Resultados: a partir das análises das entrevistas emergiram quatro focos temáticos: a perda pela separação do convívio familiar, novas amizades, a existência após a morte dos amigos e familiares, reflexões sobre a possibilidade da própria morte. Conclusões: foi possível compreender que a morte de pessoas queridas aproxima o idoso de sua própria mortalidade, dificultando o processo de luto, mas a separação é muito mais difícil de ser interpretada por ser a perda de pessoas vivas. Portanto é fundamental que os profissionais de saúde e cuidadores deem suporte aos idosos em seu processo de enfrentamento do sofrimento vivenciado. Descritores: enfermagem geriátrica; morte; pesquisa qualitativa. RESUMEN Objetivo: conocer los sentimientos de los ancianos residentes en una institución de larga permanencia (ILP) en relación a la muerte de amigos y familiares. Metodología: esta es una investigación descriptiva y exploratoria con abordaje cualitativo, utilizando el método de la  historia oral, desde das preguntas orientadoras: “¿Usted ya vivenció la muerte de algún amigo, pariente o mismo algún colega más cercano residente en esta institución? “e” ¿Cómo fue para usted hacer frente a esa situación?”. La recogida de datos se realizó por medio de entrevistas grabadas, con firma de Término de Consentimiento Libre Y Esclarecido, realizadas entre enero y marzo de 2010, con veinte ancianos, de ambos sexos, con edades entre 72 y 89 años, residentes en una institución para ancianos en la ciudad de São Paulo, conforme aprobación del Comité de Ética en Investigación de la Universidade Paulista bajo el CAAE 5380.0.000.251/09, teniendo obtenido opinión favorable, bajo el Protocolo 715/09. Resultados: desde los análisis de las entrevistas surgieron cuatro focos temáticos: la pérdida por separación del convivio familiar, nuevas amistades, la existencia después de la muerte de amigos y familiares, reflexiones acerca de la posibilidad de la propia muerte. Conclusiones: fue posible comprender que la muerte de personas queridas aproxima el anciano de su propia mortalidad, dificultando el proceso de luto, pero la separación es mucho más difícil de ser interpretada por ser la pérdida de personas vivas. Por lo tanto, es fundamental que los profesionales de la salud y los cuidadores den soporte a los ancianos en su proceso de enfrentamiento del sufrimiento vivenciado. Descriptores: enfermería geriátrica; muerte; investigación cualitativa.


2011 ◽  
Vol 2 ◽  
Author(s):  
Birgit Pfau-Effinger ◽  
Ralf Och ◽  
Per H. Jensen

The focus of this article is on the effects of the strengthening of economic principles in the field of care that have taken place in many European welfare states since the 1990s, which are connected with new emphases on ‘choice', on the role of the market in the provision of elderly care, and on efficiency as a new main welfare value. As a central part of this development, the figure of the elderly person in need of care, who was interpreted before these changes as the client or patient, has been replaced by the figure of a ‘consumer' who makes ‘free choices'. In most countries the frail elderly can choose between offers by different providers of home care who compete on the care market and care performed by family members. The focus of this article is on the legal construction of the working conditions of the family care giver. It aims to give an answer to two different research questions: How do different welfare states legally construct the working conditions of caring family members and their relationship with the elderly ‘care consumers'? And to what degree does this cause tensions between the desire to care or not to care and actual care conditions and opportunities? In order to answer these questions, we compared the legal construction of the work situation of family care givers in Germany and Denmark, as well as the resulting effects on their relationship with the older relatives who receive care. The findings show that the degree to which ‘consumerism' in long-term care causes tensions in the situation of the caring family member and in the care relationship depends on the ways in which it is embedded in a family-care regime. In this regard, the tensions are clearly greater in the semi-formal family-care regime of Germany compared to the formal family-care regime in Denmark.       


2008 ◽  
Vol 14 (7) ◽  
pp. 363-367 ◽  
Author(s):  
Doan Hoang ◽  
Elaine Lawrence

We propose a technique in which elderly people can be monitored non-intrusively. The information is kept in an ‘active’ health record which becomes alive when attention or action is necessary concerning the condition of the elderly person. The proposed system consists of three main components: a sensor/actor loop, sensor records and associated active services, and a Grid middleware platform. Information is captured in realtime within a collaborative health-care Grid. The Grid connects elderly people, caregivers and medical service providers in ways that reduce unnecessary calls on expensive medical services through an intermediate local service centre (which can be virtual) assisted with Internet communications and monitoring technologies. The proposal should support preventive health-care programmes for reducing the cost of caring for the elderly.


2021 ◽  
Vol 8 ◽  
Author(s):  
Miran Lee ◽  
Dinh Tuan Tran ◽  
Joo-Ho Lee

As the elderly population increases, the importance of the caregiver’s role in the quality of life of the elderly has increased. To achieve effective feedback in terms of care and nursing education, it is important to design a robot that can express emotions or feel pain like an actual human through visual-based feedback. This study proposes a care training assistant robot (CaTARo) system with 3D facial pain expression that simulates an elderly person for improving the skills of workers in elderly care. First, in order to develop an accurate and efficient system for elderly care training, this study introduces a fuzzy logic–based care training evaluation method that can calculate the pain level of a robot for giving the feedback. Elderly caregivers and trainees performed the range of motion exercise using the proposed CaTARo. We obtained quantitative data from CaTARo, and the pain level was calculated by combining four key parameters using the fuzzy logic method. Second, we developed a 3D facial avatar for use in CaTARo that is capable of expressing pain based on the UNBC-McMaster Pain Shoulder Archive, and we then generated four pain groups with respect to the pain level. To mimic the conditions for care training with actual humans, we designed the system to provide pain feedback based on the opinions of experts. The pain feedback was expressed in real time by using a projector and a 3D facial mask during care training. The results of the study confirmed the feasibility of utilizing a care training robot with pain expression for elderly care training, and it is concluded that the proposed approach may be used to improve caregiving and nursing skills upon further research.


2017 ◽  
Vol 20 (3) ◽  
pp. 409-420 ◽  
Author(s):  
Allan Gustavo Brigola ◽  
Bruna Moretti Luchesi ◽  
Estefani Serafim Rossetti ◽  
Eneida Mioshi ◽  
Keika Inouye ◽  
...  

Abstract Objective: to analyze the profile of a population of caregivers from a city in a rural area of the state of São Paulo, Brazil, and identify their health complaints and the characteristics of care provided. Method: a prospective cross-sectional study was performed based on a domicile survey of 99 caregivers and their elderly care recipients. Information about the profile, context of care and health complaints of the caregivers was collected. The caregivers responded to the Zarit Burden Inventory and the Geriatric Depression Scale-15 and the elderly underwent a cognition and functionality assessment. The chi-squared test with odds ratio (OR) was performed to test associations. Result: the majority of the caregivers were women (n=76), elderly (n=83), with a median age 65.8 (±10.4) years and 4.9 (±4.2) years of formal schooling. The most frequent health complaints were pain, systemic hypertension, insomnia, back problems and vision problems. The elderly care recipients were men (n=75), with an average age of 72.0 (±8.2) years. Analysis of associations revealed that caregivers who received emotional support had a lower chance of being highly overburdened (OR=0.37; CI95% 0.15-0.90). Caring for over five years was associated with arthritis (OR=2.50; CI95% 1.0-6.56). Caring of an elderly person with cognitive impairment was strongly associated with peripheral vascular diseases (OR=2.70; CI95% 1.11-6.85) and other diseases (OR=6.94; CI95% 1.43-33.63). Conclusion: A better understanding of the reality of care in rural and remote areas and the identification of factors related to the health care of caregivers provides better care management for the elderly and caregivers, who themselves are aging.


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