scholarly journals Application of Artificial Sunlight for the Elderly as a Possible Environmental Nursing Practice

2018 ◽  
Vol 2 (1) ◽  
pp. 1-5 ◽  
Author(s):  
Shigeru Goto ◽  
Toshiaki Nakano ◽  
Chao-Long Chen ◽  
King-Wah Chiu ◽  
Li-Wen Hsu ◽  
...  
Keyword(s):  
Intensive Care ◽  
Nursing Practice ◽  
The Elderly ◽  
Medical Expenditure ◽  
Clinical Settings ◽  
Term Care ◽  
Aged People ◽  
Beneficial Effects ◽  
Healthy Longevity ◽  
Aged Person

Aging and aged societies have arrived in many countries where significant development of medicine and the economy has been achieved. Japan is a highly aged society with a shortage of carers both at home and in long-term care settings. In fact, more persons of advanced age who do not need intensive care in hospitals strongly desire health care to be delivered in their own home with their family. Environmental nursing practice, which means that nurses improve the environment of patients or the elderly properly in accordance with healthcare considerations, is currently playing a more important role, not only to prevent the elderly from contracting various diseases, but also to provide a facility for supporting an aged person to live a fulfilling life, preferably one that includes independence. This approach will lead to a reduction in medical expenditure by increasing the number of aged people with healthy longevity without the need for hospitalization or intensive care. This short communication focuses on healthy lighting for the elderly based on our research and experience regarding the beneficial effects of artificial sunlight on nonalcoholic steatohepatitis (NASH), asthma and food allergy, and ulcerative colitis in experimental animal models and clinical settings. Then, we review other studies and discuss how artificial sunlight would be useful for the elderly as one of the environmental nursing practices. Keywords: Artificial Sunlight, Phototherapy, Elderly People, Environmental Nursing, Vitamin D

Functional disability with systematic trends and uncertainty: a comparison between China and the US

2021 ◽  
pp. 1-30
Author(s):  
Yu Fu ◽  
Michael Sherris ◽  
Mengyi Xu
Keyword(s):  
Systematic Uncertainty ◽  
Functional Disability ◽  
Long Term Care ◽  
The Elderly ◽  
Aged Care ◽  
Term Care ◽  
Healthy Longevity ◽  
The Us ◽  
Long Term Care Insurance

Abstract China and the US are two contrasting countries in terms of functional disability and long-term care. China is experiencing declining family support for long-term care and developing private long-term care insurance. The US has a more developed public aged care system and private long-term care insurance market than China. Changes in the demand for long-term care are driven by the levels, trends and uncertainty in mortality and functional disability. To understand the future potential demand for long-term care, we compare mortality and functional disability experiences in China and the US, using a multi-state latent factor intensity model with time trends and systematic uncertainty in transition rates. We estimate the model with the Chinese Longitudinal Healthy Longevity Survey (CLHLS) and the US Health and Retirement Study (HRS) data. The estimation results show that if trends continue, both countries will experience longevity improvement with morbidity compression and a declining proportion of the older population with functional disability. Although the elderly Chinese have a shorter estimated life expectancy, they are expected to spend a smaller proportion of their future lifetime functionally disabled than the elderly Americans. Systematic uncertainty is shown to be significant in future trends in disability rates and our model estimates higher uncertainty in trends for the Chinese elderly, especially for urban residents.

scholarly journals Translation, adaptation and pilot testing of the Pictorial Fit-Frail Scale (PFFS) for use in Malaysia – The PFFS-Malay version (PFFS-M)

2021 ◽  
Vol 16 (2) ◽  
pp. 27-36
Author(s):  
Sally Suriani Ahip ◽  
Sazlina Shariff-Ghazali ◽  
Sabrina Lukas ◽  
Azah Abdul Samad ◽  
Ummu Kalsum Mustapha ◽  
...  
Keyword(s):  
The Elderly ◽  
Face Validity ◽  
Clinical Settings ◽  
Term Care ◽  
Targeted Interventions ◽  
Adverse Health Outcomes ◽  
Health Domains ◽  
Important Health ◽  
The Face ◽  
Important Health Issue

Background: Frailty is an important health issue in an aging population; it is a state of vulnerability that renders the elderly susceptible to adverse health outcomes, including disability, hospitalization, long-term care admission and death. Early frailty stages are recognizable through screening and are reversible with targeted interventions. To date, however, there is no screening tool for use in Malaysia. The English Pictorial Fit-Frail Scale (PFFS) is a visual tool that assesses a person’s fitness-frailty level in 14 health domains, with higher scores indicating higher frailty. Objective: The aim was to translate and adapt the English PFFS for use in Malaysian clinical settings. Methods: The original English PFFS underwent forward and backward-translation by two bilingual translators to and from the Malay language. A finalized version, the PFFS-Malay (PFFS-M), was formed after expert reviewers’ consensus and was pilot tested with 20 patients, 20 caregivers, 16 healthcare assistants, 17 nurses and 22 doctors. Score agreement between patients and their caregivers and among healthcare professionals were assessed. All participants rated their understanding of the scale using the feasibility survey forms. Results: A total of 95 participants were included. There were high percentages of scoring agreements among all participants on the scale (66.7% to 98.9%). Overall feedback from all respondents were positive and supported the face validity of the PFFS-M. Conclusion: The PFFS-M reflects an accurate translation for the Malaysian population. The scale is usable and feasible and has face validity. Reliability and predictive validity assessments of the PFFS-M are currently underway.

scholarly journals Decoupling of Elderly Healthcare Demand and Expenditure in China

Healthcare ◽  
2021 ◽  
Vol 9 (10) ◽  
pp. 1346
Author(s):  
Shangguang Yang ◽  
Danyang Wang ◽  
Wenhui Li ◽  
Chunlan Wang ◽  
Xi Yang ◽  
...  
Keyword(s):  
Health Insurance ◽  
Elderly Population ◽  
The Elderly ◽  
Health Condition ◽  
Medical Expenditure ◽  
Linear Regression Models ◽  
Healthy Longevity ◽  
The Government ◽  
Elderly Healthcare ◽  
Significant Factors

This study examined the changing trajectory and factors that influenced the health and medical expenditure of the Chinese elderly population over the past two decades. Based on the Chinese Longitudinal Healthy Longevity Survey (CLHLS) from 1998 to 2018, inferential and multiple linear regression models were constructed. The key finding is that China has experienced a decoupling of healthcare demand (HCD) and healthcare expenditure (HCE) since around 2014, when HCE began to decline despite the fact that HCD continued to rise. This is a promising sign, suggesting that the government’s health insurance policy is working. Furthermore, participating in health insurance schemes can significantly reduce the elderly’s HCD and HCE, demonstrating that health insurance can effectively affect the elderly’s decision to seek medical treatment and improve their health condition. We also found that age, region, basic old-age insurance, and care by the government and institutions were significant factors that influenced the healthcare demand and expenditure of the elderly population.

scholarly journals Forecasting the Health Transition and Medical Expenditure of the Future Elderly in China: A Longitudinal Study Based on Markov Chain and Two Part Model

2022 ◽  
Vol 9 ◽  
Author(s):  
Yuan Gao ◽  
Jingbo Li ◽  
Xin Yuan
Keyword(s):  
Transition Probability ◽  
Rapid Development ◽  
The Elderly ◽  
Medical Expenditure ◽  
Gender Mainstreaming ◽  
Health State ◽  
Health Transition ◽  
Term Care ◽  
The Future ◽  
Part Model

Set in the rapid development of population aging, this study focuses on the relationship between health and medical expenditure of the elderly population. Taking the health and medical expenditure of the elderly as the research object, this study analyzes the characteristics and the intrinsic relationship between them. Based on the future elderly model, this study calculates the transition probability of the elderly's self-assessment health state using the Health Transition Model and estimates the medical expenditure of the elderly by the Two-Part Model. Based on the above, this study predicts the trend of the population size and medical expenditure of the elderly in the next 15 years (2020–2035). Based on the results, the policy suggestions are put forward. To begin with, strengthening health management and health services for the elderly in the construction of healthy China. Next, building a comprehensive system of health care for the elderly in government, society, family, and individual. Then, establishing a long-term care service system as soon as possible. In addition, it is better to establish lifelong health consciousness and cultivate healthy accomplishment behavior. Finally, it is necessary to promote gender mainstreaming in the health field.

scholarly journals Generalized Zero-Adjusted Models to Predict Medical Expenditures

2021 ◽  
Vol 2021 ◽  
pp. 1-18
Author(s):  
Xin Xu ◽  
Tao Ye ◽  
Dongxiao Chu
Keyword(s):  
The Elderly ◽  
Healthcare Research ◽  
Medical Expenditure ◽  
Inverse Gaussian ◽  
Healthy Longevity ◽  
Link Functions ◽  
Special Cases ◽  
The Right ◽  
Adjusted Model ◽  
Generalized Zero

In healthcare research, medical expenditure data for the elderly are typically semicontinuous and right-skewed, which involve a point mass at zero and may exhibit heteroscedasticity. The problem of a substantial proportion of zero values prevents traditional regression techniques based on the Gaussian, gamma, or inverse Gaussian distribution, which may lead to understanding the standard errors of the parameters and overestimating their significance. A common way to counter the problem is using zero-adjusted models. However, due to the right-skewness in the nonzeros’ response, conventional zero-adjusted models such as zero-adjusted gamma, zero-adjusted Inverse Gaussian, and classic Tobit may not perform well. Here, we firstly generalize those three types of the conventional zero-adjusted model to solve the problem of right-skewness in health care. The generalized zero-adjusted models are very flexible and include the zero-adjusted Weibull, zero-adjusted gamma, zero-adjusted inverse Gaussian, and classic Tobit models as their special cases. Using the Chinese Longitudinal Healthy Longevity Survey, we find that, according to the AIC, SBC, and deviance criteria, the zero-adjusted generalized gamma model is the best one of these generalized models to predict the odds of zero cost accurately. In order to depict the predictors affecting the amount expenditure, we further discuss the situations where the mean, dispersion of a nonzero amount expenditure and model the probability of a zero amount of ZAGG in terms of predictor variables using suitable link functions, respectively. Our analysis shows that age, health, chronic diseases, household income, and residence are the main factors influencing the medical expenditure for the elderly, but the insurance is not significant. To the best of our knowledge, little study focused on these situations, and this is the first time.

Pharmacology Issues Related to Dementia Syndrome of Depression in Elderly Residents of Long-Term Care Settings

2015 ◽  
Vol 25 (2) ◽  
pp. 61-69
Author(s):  
Angel L. Ball ◽  
Adina S. Gray
Keyword(s):  
Depressive Symptoms ◽  
The Elderly ◽  
Environmental Communication ◽  
Pharmacological Intervention ◽  
Team Approach ◽  
Discussion Paper ◽  
Term Care ◽  
Anticholinergic Medications ◽  
Inappropriate Treatment ◽  
Dementia Syndrome

Pharmacological intervention for depressive symptoms in institutionalized elderly is higher than the population average. Among the patients on such medications are those with a puzzling mix of symptoms, diagnosed as “dementia syndrome of depression,” formerly termed “pseudodementia”. Cognitive-communicative changes, potentially due to medications, complicate the diagnosis even further. This discussion paper reviews the history of the terminology of “pseudodementia,” and examines the pharmacology given as treatment for depressive symptoms in the elderly population that can affect cognition and communication. Clinicians can reduce the risk of misdiagnosis or inappropriate treatment by having an awareness of potential side effects, including decreased attention, memory, and reasoning capacities, particularly due to some anticholinergic medications. A team approach to care should include a cohesive effort directed at caution against over-medication, informed management of polypharmacology, enhancement of environmental/communication supports and quality of life, and recognizing the typical nature of some depressive signs in elderly institutionalized individuals.

The Unusual Cruelty of Nursing Homes Behind Bars

2020 ◽  
Vol 32 (5) ◽  
pp. 264-271
Author(s):  
Rachel E. López
Keyword(s):  
Nursing Homes ◽  
Human Dignity ◽  
Prison Population ◽  
Financial Burden ◽  
The Elderly ◽  
The United States ◽  
Term Care ◽  
Trained Staff ◽  
State Prisons ◽  
The Cost

The elderly prison population continues to rise along with higher rates of dementia behind bars. To maintain the detention of this elderly population, federal and state prisons are creating long-term care units, which in turn carry a heavy financial burden. Prisons are thus gearing up to become nursing homes, but without the proper trained staff and adequate financial support. The costs both to taxpayers and to human dignity are only now becoming clear. This article squarely addresses the second dimension of this carceral practice, that is the cost to human dignity. Namely, it sets out why indefinitely incarcerating someone with dementia or other neurocognitive disorders violates the Eighth Amendment of the United States Constitution’s prohibition on cruel and unusual punishment. This conclusion derives from the confluence of two lines of U.S. Supreme Court precedent. First, in Madison v. Alabama, the Court recently held that executing someone (in Madison’s case someone with dementia) who cannot rationally understand their sentence amounts to cruel and unusual punishment. Second, in line with Miller v. Alabama, which puts life without parole (LWOP) sentences in the same class as death sentences due to their irrevocability, this holding should be extended to LWOP sentences. Put another way, this article explains why being condemned to life is equivalent to death for someone whose neurodegenerative disease is so severe that they cannot rationally understand their punishment.

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