Challenges experienced by Portuguese professionals in humanitude care for institutionalized elderly people during the pandemic

Objective: To understand the challenges experienced by Portuguese workers in humanitude care for institutionalized elderly people during the pandemic. Method: This is a qualitative study, supported by reflections on the Humanitude Care Methodology, carried out with workers from different areas in a nursing home for elderly people in Portugal. Data collection took place between September and October 2020, from individual and online interviews. The categorization proposed by Bardin was adopted as the analysis technique. Results: Three categories emerged: (1) self-protection and of the other with the subcategories fear of being contaminated and fear of contaminating the elderly; (2) maintenance of affective relationships, broken down into the subcategories absence of family members in the nursing home and personal protective equipment as a barrier to communication and approximation; and (3) confinement of the elderly who attended the Day Center, with the subcategories lack of family support/loneliness and change in the elderly’s routine. Conclusion: The main challenges experienced by Portuguese workers are related to the necessary changes in the performance of care practices due to the use of personal protection that was not used before, limitations in affective relationships, and restrictions in interaction spaces.

Burnout Among Formal Caregivers and Risk of Violence Against Institutionalized Elderly

Sociodemographic changes occurring in past decades are reflected as increased population aging, resulting in a higher need to institutionalize elderly. Violence against elderly is a relevant public health problem. The aims of the present cross-sectional exploratory and descriptive study with a quantitative approach were to analyze burnout among formal caregivers at institutions for elderly and to assess the risk of violence against institutionalized elderly. As a part of project ESACA—Envelhecer com Segurança no Alentejo (Prevenir as Quedas e a Violência sobre Idosos)—Compreender para Agir (Aging Safely in Alentejo [Preventing Falls and Violence against Elderly]), the present study analyzed 34 formal caregivers from three institutions that provide care to elderly in the Evora district, Portugal. No situations involving violence against institutionalized elderly were detected. Most participants (96.3%) did not exhibit burnout, although they did report feeling physically and emotionally tired.

Potential Anticarcinogenic Effects From Plasma of Elderly After Exercise Training: A Pilot Study

This study aimed to evaluate the impact of exercise training plasma on in vitro prostate cancer cell viability and proliferation. PC3 prostate cancer cells were incubated with plasma obtained from young women with high and low physical fitness (PF) and with the plasma collected from institutionalized elderly before and after multimodal exercise training. Plasma from High PF women induced the lowest cell viability and proliferation after incubation time. PC3 cells presented lower cell viability and diminished rates of cell proliferation after the incubation with post-training plasma samples of elderly. The incubation of PC3 cells with post-training plasma of elderly decreased the mitochondrial membrane polarization and increased mitochondrial reactive oxygen species (ROS) production without changes in cytosolic ROS. Post-training plasma did not change apoptosis or necrosis rates in the PC-3 cell line. Multimodal exercise training increased the plasma levels of IL-2, IL-10, IFN-α, and FGF-1, and decreased TNF-α concentrations in institutionalized elderly. In conclusion, we showed that systemic adaptations in plasma mediators of institutionalized elderly may alter cell viability and proliferation by targeting mitochondrial ROS in a prostate cancer cell line.

Institutionalized elderly are able to detect small viscosity variations in thickened water with gum-based thickeners: should texture classifications be reviewed?

Background The prevalence of dysphagia is very high in institutionalized elderly. Knowledge of the rheological and sensory characteristics of the various thickeners in elderly is limited, although it has been seen that there are differences between the rheological behaviors of gum-based thickeners with different composition. Moreover, we have not found sensory studies of viscosity in institutionalized elderly. Our hypothesis was that viscosity ranges established by the scientific societies, such as the National Dysphagia Diet Task Force (NDD), seem to be very wide and individuals might be able to detect small differences within the same texture range. The objectives of our study were 1) comparing the rheological characteristics of two commercial gum-based thickeners with different composition, dissolved in water under standard conditions, and 2) perform a sensory analysis (with both adults and institutionalized elderly) to detect different viscosities within the same texture (nectar and honey). Methods Two commercial thickeners based on gums (NC and RC) were studied analyzing their viscosity in water with different concentrations (shear rate: 50 s− 1; temperature: 22–25 °C). A sensory analysis involving 26 elderly and 29 adult controls was carried out to evaluate whether differences within nectar and honey textures among gum-based thickeners could be distinguished. Results As the shear rate increases, viscosity decreases (non-Newtonian and pseudoplastic behavior). At the same concentration, each thickener produces a different viscosity (p < 0.05). Institutionalized elderly detected viscosity differences in nectar range of 49.9 (2.5) mPa·s (p < 0.05) and 102.2 (4.7) mPa·s (p < 0.0001). They also detected viscosity differences in honey texture range of 134.6 (9.7) mPa·s (p < 0.05) y 199.3 (9.2) mPa·s (p < 0.0001). Their caregivers also detected viscosity differences in both viscosity ranges (p < 0.0001) and with greater intensity than the elderly in honey texture (p: 0.016). Conclusions Our results suggest that the accepted viscosity ranges by NDD for the different textures might be too wide because institutionalized elderly and their caregivers are able to discern small differences in viscosity in nectar and honey textures. Gum-based thickeners with different composition showed differences in viscosity capacity, so they are not interchangeable.

Physical and Cognitive Functioning of Institutionalized Elderly People in Rural Areas. Preventive Actions Using Physical Activity and Music Therapy

Background: Comprehensive geriatric evaluation should include a functional and cognitive assessment to guide the intervention of interdisciplinary teams. The aim of this study was to analyze the physical capacities of institutionalized elderly people and to describe the preventive actions of physical activity and music therapy as non-invasive preventive pharmacological treatments given their importance for the cognitive and functional performance of elderly people. An observational and descriptive cross-sectional study was carried out. The participants in the study were 109 elderly people institutionalized in three residential centers with a mean age of 83.41 years (SD = 8.72). Findings: Most of the residents had very impaired physical faculties. However, cognitive impairment was not very high. Most residents (55.04%) had some form of dementia and/or high blood pressure (54.12%) followed by pathologies such as diabetes (27.52%), heart failure (17.43%), Parkinson’s disease (9.17%) and chronic obstructive pulmonary disease (8.25%). There were no differences in cognitive or physical capacity among the residents according to sex, age, or education and only those who had worked in the service sector had less cognitive capacity than those who had worked in the agricultural sector or as housewives. Applications: Facilitate the creation and development of programs based on physical activity and music therapy in residential centers that can prevent and improve pathologies on the elderly.