scholarly journals Functional independence of the elderly in multiprofessional home care

2019 ◽  
Vol 41 (1) ◽  
pp. 43168
Author(s):  
Talita Ferreira Turatti do Carvalhal ◽  
Elenize Losso ◽  
Leon Martins Boava ◽  
Suzane Ketlyn Martello ◽  
Manoela De Paula Ferreira ◽  
...  

Functional evaluation is one of the pillars of elderly home care for planning of interventions targeting the autonomy of this population. To verify Functional Independence Measure (FIM) in senior patients on a home care program. Retrospective quantitative study with elderly patients assisted by a home care service in the city of Curitiba, from August 2012 to December 2016. The following information was collected: gender, age, clinical diagnosis, and mean FIM scores at admission and discharge. Inclusion and exclusion criteria were met, descriptive statistics was used and, for association of variables, Wilcoxon’s and Spearman’s tests were applied. 1,614 patients were included, with predominance of women (n = 953; 59.53%), mean age of 78.7 ± 9.2 years, clinical diagnoses of diseases mostly affecting the central nervous system (CNS), the respiratory system, the joint and musculoskeletal system, and the circulatory system. The initial mean FIM was 50.56 points, while the final one was 55.36 points, with significant difference – Z = -5.09, p = 0.0001. Most seniors presented maximum to moderate dependence; however, a significant improvement in FIM after the health care provided in their homes was observed in patients with minimum dependence or modified independence.

2017 ◽  
Vol 5 (1) ◽  
pp. 23 ◽  
Author(s):  
Daniela Fernandes Tonholi ◽  
Gisele Oltramari

Aims: To determine the prevalence, cognitive performance and functionality of elderly people with Alzheimer's disease in long-stay institutions for the elderlyin the city of Bento Gonçalves. Methods: Cross-sectional study including 24 elderly residents in long-stay institutions for the elderly, sociodemographic datawere obtained, and the elderly were subjected to functional evaluation by the Functional Independence Measure and evaluation of cognitive performancethrough the mental state the Mini (MMSE). Results: Most of the residents were female (83%), as 54.2% schooling had completed junior high school, mostof the elderly (70.8%) was admitted by the will of the family, 100% of the elderly showed cognitive performance bad, and the smaller the more dependentcognitive performance was the individual. Conclusion: institutionalized elderly with Alzheimer's disease had negative results on cognitive performance,as well as deficits in their ability to perform activities of daily living, thus altering their functionality.Keywords: aging; functionality; cognition; Alzheimer Disease; long-stay institutions.


2021 ◽  
Vol 74 (1-2) ◽  
pp. 20-24
Author(s):  
Natasa Radosavljevic ◽  
Dejan Nikolic ◽  
Sofija Radosavljevic ◽  
Mirko Grajic ◽  
Ksenija Boskovic

Introduction. The aim of the study was to evaluate the correlation between different levels of examined comorbidities using the Cumulative Illness Rating Scale for Geriatrics and motor Functional Independence Measure test in the elderly after hip fracture. Material and Methods. The study included 203 geriatric patients, 65 years of age and older, who were referred to a rehabilitation program at the Institute for Rehabilitation after hip fracture. The following comorbidities were analyzed: cardiac, vascular, and respiratory. The motor component of Functional Independence Measure was used to assess functional recovery. The Cumulative Illness Rating Scale for Geriatrics was used to calculate the comorbidity index. The patients were assessed on 4 different occasions: on admission, on discharge, 3 months after discharge, and 6 months after discharge. The short-term and long-term efficiency of rehabilitation treatment was measured. Results. There is a significant difference in motor Functional Independence Measure scores between different levels of vascular (p = 0.010) and respiratory (p = 0.047) comorbidities only on admission, while at other times of observation no significant difference (p > 0.05) was found. The highest level of correlation was found in level 3 comorbidity severity index for cardiac comorbidity (discharge/3 months) (Pearson?s correlation - R = 0.938) and vascular comorbidity (discharge/3 months) (R = 0.912), and level 2 comorbidity severity index for respiratory comorbidity (discharge/3 months) (R = 0.941). Conclusion. Rehabilitation treatment of the elderly after hip fracture plays a significant role both in short-term and long-term recovery, particularly in the functional domains even in persons with significant comorbidities. Early inclusion and an individually designed rehabilitation program with continuous monitoring of the elderly after hip fractures results in functional improvement and better quality of life.


2016 ◽  
Vol 144 (1-2) ◽  
pp. 31-37 ◽  
Author(s):  
Sladjana Arsic ◽  
Ljubica Konstantinovic ◽  
Fadilj Eminovic ◽  
Dragan Pavlovic

Introduction. It has been assumed that there is causality of the achieved level of functional independence with the degree of preservation of cognitive function in stroke patients. Demographic characteristics may be important for monitoring the achieved level of functional independence. Objective. The aim of this study was to examine the relationship of demographic characteristics and functional independence in regard to the level of cognitive impairment in stroke patients. Methods. The study included 50 stroke patients after rehabilitation, as well as age- and gender-matched 50 subjects selected randomly, according to the demographic characteristics of the studied sample, who in their medical history had no neurological disorders. For the assessment of functional independence, the Functional Independence Measure (FIM) test was used. The general cognition was estimated by the Mini-Mental State Examination (MMSE) test. The statistical analyses included the Mann-Whitney test, for two independent samples, measures of canonical correlation, and ?2 test. Results. There was a statistically significant difference between the groups in relation to risk factors, hypertension and diabetes mellitus type II (p<0.001); There was a statistically significant difference within the groups in relation to the cognitive impairment in all the examined demographic characteristics (p<0.001); the differences within the groups in relation to the cognitive impairment are present on all subscales of the FIM test (p<0.05); the differences within the groups in relation to handedness, hemiparesis, show that mild cognitive impairment is more common among left hemiparesis, while a more severe one is more common among right-sided hemiparesis (p<0.05); More severe cognitive impairment is common among women, the elderly and in persons with lower education (p<0.05). Conclusion. By prevention of risk factors, and prevention of possible cognitive impairment, consequences of stroke can be reduced, the recovery can be made more successful, and quality of life can be improved.


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“.


1996 ◽  
Vol 59 (6) ◽  
pp. 260-263 ◽  
Author(s):  
Susanna E Robinson ◽  
Anne G Fisher

In this study, the Assessment of Motor and Process Skills (AMPS), an observational assessment of functional ability, was compared with other tests of function and cognition, namely the Functional Independence Measure (RM), the CAMCOG (the cognitive component of the CAMDEX [Cambridge Examination for Mental Status in the Elderly]) and the Mini-Mental State Examination (MMSE). The subjects were people with diagnosed dementia or mild memory impairment. The results were as expected, revealing significant relationships between AMPS process ability and the CAMCOG, the MMSE and the FIM social/cognition scale, and between AMPS motor ability and the RM physical scale. This supported the validity of the AMPS as an evaluation of the interaction between cognitive impairments and disability in complex activities of daily living.


2021 ◽  
Vol 42 ◽  
Author(s):  
Cristiane da Silva Gabriel Capeletto ◽  
Rosimere Ferreira Santana ◽  
Lívia Maria da Silva Souza ◽  
Keila Mara Cassiano ◽  
Ana Carolina Siqueira de Carvalho ◽  
...  

ABSTRACT Objective To estimate the prevalence of mechanical restraint and factors associated with its practice in elderly in Home Care. Methods This was a cross-sectional study with 162 elderly randomly assigned to a home care program in Rio de Janeiro, from March 2018 to July 2018. Used as a technique for data collection and direct observation and structured interview of elderly clinical data. Data were analyzed descriptively and inferentially. Results There was a 13% prevalence of mechanical restraint in elderly in home care. The most frequent restraints were the use of bandage, tissues and sheets in the arms/legs and chests of the elderly, and the justification for their use were control of aggressive behavior (28.6%), prevention of falls (19%) and protection (19%). Of the total elderly participants, 42.9% remained contained for more than 24 hours, and in 85.7% of the cases, the individuals were confined to a room. Conclusion It is necessary to expand the training of formal and informal caregivers, recommending the rehabilitation of care practices that preserve the elderly's autonomy, giving them dignity, respecting gerontological and home care principles.


Author(s):  
Frank J. Elgar ◽  
Graham Worrall ◽  
John C. Knight

ABSTRACTAs the demand for home care services increases, health care agencies should be able to predict the intake capacity of community-based long-term care (CBLTC) programs. Two hundred and thirty-seven clients entering a CBLTC program were assessed for activities of daily living (ADL) and cognitive and affective functioning and were then followed to monitor attrition and reasons why clients left the program. Compromised ADL functioning at baseline increased likelihood of death and institutionalization by 2 per cent each year. Over a 10-year period, reduced cognitive functioning at baseline increased the risk of death by 9 per cent and decreased the likelihood of leaving the program due to improvement by 18 per cent. Reduced affective functioning at baseline increased the risk of institutionalization during the course of the study by 3 per cent. Routine functional assessments with the elderly may help in the management of similar home care programs.


1985 ◽  
Vol 71 (5) ◽  
pp. 449-454 ◽  
Author(s):  
Vittorio Ventafridda ◽  
Marcello Tamburini ◽  
Silvana Selmi ◽  
Luigi Valera ◽  
Franco De Conno

At the Pain Clinic of the National Cancer Institute of Milan, a special Home Care Program has been set up to assist advanced cancer patients with pain and their families during their remaining survival. The Home Care Unit comprises a team of physicians, nurse clinicians, psychologists and many volunteers who are active both in the hospital and at the patient's home. This entire operation provides a continuous relationship between the family, the patient and the Home Care Unit. This Home Care Program, which is one of a kind with other forms of treatment for advanced cancer patients (i.e. hospices), has produced interesting results. Out of a sample group of 50 patients, 33 were monitored at home by the Home Care Unit while 17 had their families to do the monitoring. Over a six-week period the following results were reported: a) Improvement of psycho-emotional factors such as anxiety, weakness and mood for both patients and their families who entered the Home Care Program. b) The Quality of Life Index remained unchanged for the sample group that entered the Home Care Program whereas it deteriorated for patients monitored by their families. c) A decrease in the Integrated Pain Score for both groups; however, results showed a statistically significant difference in favor of patients on the Home Care Program. d) The Performance Status decreased by very little over the study period, and there was little difference between the two groups. These results confirm the need for a Home Care Program which must go hand in hand with the Pain Clinic as an effective way to control Total Pain.


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