Caring for the elderly in Chile. Exploring the experiences of men who care for dependent people

Recognizing that research on care has tended to focus on the experiences of female caregivers, this study, based on the experience of men caregivers of dependent elderly people in Chile, has sought, among others, to answer what meanings give them the men caregivers in the care given to dependent elderly people, and what consequences the need to care for others has had for them. Through a qualitative study based on interviews with ten men caregivers of dependent people, it has been possible to determine that, among others, caregivers mean care as an expression of love, but also as a responsibility. On the other hand, caring for others has had negative consequences both for their mental health and for their income generation. The study concludes by recognizing, among other aspects, that interventions and policies of care that are conceived from a rights perspective, must address in a robust way the needs of both people involved in the arrangements, care receivers, and the caregiver. In doing so, the State has a crucial role, as the first guarantor of rights.

The Interactome in the Evolution From Frailty to Sarcopenic Dependence

Biomarkers are essential tools for accurate diagnosis and effective prevention, but their validation is a pending challenge that limits their usefulness, even more so with constructs as complex as frailty. Sarcopenia shares multiple mechanisms with frailty which makes it a strong candidate to provide robust frailty biomarkers. Based on this premise, we studied the temporal evolution of cellular interactome in frailty, from independent patients to dependent ones. Overweight is a recognized cause of frailty in aging, so we studied the altered mechanisms in overweight independent elderly and evaluated their aggravation in dependent elderly. This evidence of the evolution of previously altered mechanisms would significantly support their role as real biomarkers of frailty. The results showed a preponderant role of autophagy in interactome control at both different functional points, modulating other essential mechanisms in the cell, such as mitochondrial capacity or oxidative stress. Thus, the overweight provoked in the muscle of the elderly an overload of autophagy that kept cell survival in apparently healthy individuals. This excessive and permanent autophagic effort did not seem to be able to be maintained over time. Indeed, in dependent elderly, the muscle showed a total autophagic inactivity, with devastating effects on the survival of the cell, which showed clear signs of apoptosis, and reduced functional capacity. The frail elderly are in a situation of weakness that is a precursor of dependence that can still be prevented if detection is early. Hence biomarkers are essential in this context.

Quality of life of dependent elderly people in Romania. University Publishing House, Bucharest, 2020. Mihaela Ghența, Aniela Matei, Luise Mladen-Macovei, Elen-Silvana Bobârnat

The book Quality of Life of Old Dependent People in Romania presents a part of the research results obtained during 2018-2020 in the research project with the same name. In the context of a pronounced process of population ageing and raising needs of social services for old people, the publication of this volume becomes very important. The book contains a comprehensive review of the literature regarding quality of life in old age, the results obtained during the research on old dependent people in Romania and measures of social policy developed in the process of consultation of experts in the field using the Policy Delphi method.

Experience of General Practice Residents Caring for Dependent Elderly during the First COVID-19 Lockdown—A Qualitative Study

Background: Understanding the experiences of general practice (GP) residents caring for dependent elderly people during the first lockdown as part of the countries COVID-19 pandemic strategy. The aim was to explore themes that could explain the gap between the missions and values at the heart of GP practice during this period of strict isolation. Method: Qualitative study using an iterative approach. Semi-structured interviews were conducted with 13 GP residents using a pre-established interview guide. Audio recordings were transcribed verbatim. Data were analyzed according to a coding grid, developed using Nvivo software (NVivo Qualitative Data Analysis Software; QSR International Pty Ltd. Version Release 1.5.1 (940) 2021), to identify emerging themes. Results: Three themes emerged from this qualitative research: cognitive dissonance, psychosocial risks, and fear. General practice residents have lived in the paradox between care and deprivation of liberty of dependent elderly people. Conclusion: The results suggest that the GP residents experienced a form of work-related suffering in this situation of deprivation of liberty of dependent elderly people. The present research serves as a pilot study to explore how GP residents experienced their care of locked-up dependent elderly people.

From Words to “Making Up People”

The words we use both reflect and shape societal attitudes and inflect the interactions of physicians and patients. Words construct concepts of causality and assign responsibility for illness, often attributing blame to patients. This chapter describes how patients are considered “poor historians” who arrive with “chief complaints” and are “non-compliant” with prescribed medications. It emphasizes the need for physicians to be aware of how their words and demeanors affect their patients and how infantilizing language is detrimental to the well-being of the dependent elderly. It explores the impact of apparently innocent word choices, how medical students learn that talking with patients is considered unimportant, and how words shape our thoughts and how we see the world. The chapter examines how labeling and classifying people may lead to “making up people,” creating ways of being made possible by the new taxonomy and explores this “looping effect” in the instance of “cancer survivors.”

Family Responsibilities and Silence of Rural Migrant Workers in China: The Role of Town-Fellow Organizations

Employee voice in China remains an under-researched topic from an industrial relations perspective. We investigated the relationship between family dependents (children and elderly) and migrant worker silence, with town-fellow organizations as a moderator, based on the data of the 2014 Guangdong Migrant Workers Survey. The findings reveal that migrant workers with dependent children are more likely to keep silent when their labour rights and interests are violated at the workplace, while family responsibilities for dependent elderly family members do not have significant impacts on migrant workers’ silence. In addition, town-fellow organizations weaken the association between family responsibilities for elderly dependents and silence. Our study contributes to the existing literature on employee voice and provides evidence on the role of town-fellow organizations in China as an informal, emerging institutional actor that regulates labour relations through their involvement in dispute resolution.

Factors related to lower functional capacity of institutionalized older adults

The aim of this study was to assess the functional capacity of institutionalized older people and to verify which sociodemographic, health factors and oral health were related to the worse ability to perform daily activities. It was a cross-sectional study conducted with 512 institutionalized elderly people. Sociodemographic profile; general health and oral health conditions were evaluated. Functional capacity was assessed by Barthel Index. A high prevalence of functional dependent elderly was found (47.1%). A lower functional capacity was associated with female (p=0.006); higher education (p=0.009); older elderly (p<0.045); decision to institutionalize by others (p=0.011); affected cognitive state (p<0.001); reduced mobility (p<0.001), less autonomy for self-care in oral health and worse oral health. Institutionalized elderly has low functional capacity that is related to several aspects of their lives.

Memória de pessoas idosas que cuidam: vivências e desafios do cuidar

Este artigo apresenta os resultados de uma pesquisa qualitativa, analítico-descritivo, cujo objetivo foi analisar a memória de pessoas idosas que estão na condição de cuidadoras de idosos dependentes em domicílio. Participaram da pesquisa trinta pessoas idosas cuidadoras assistidas pelo PAMDIL. As memórias foram analisadas por meio do Discurso do Sujeito Coletivo (DSC). O DSC revelou que o ato de cuidar provocou a reorganização da vida familiar. Todas as pessoas idosas que cuidam referiram mudanças em suas vidas quando passaram para a condição de cuidadoras. As alterações mencionadas estão relacionadas à falta de tempo para o exercício de atividades sociais, problemas econômicos devido ao aumento de gastos e sobrecarga física. Concluiu-se a partir das memórias, foi possível conhecer a realidade, as vivências e desafios das pessoas idosas, a partir do momento que passaram a estar na condição de cuidadoras.Descritores: Memória, Cuidador, Idoso. Memory of elderly that care: experiences and challenges of caringAbstract: This paper presents the results of a qualitative, analytical and descriptive research, whose objective was to analyze the memory of elderly people who are caregivers of dependent elderly at home. Thirty elderly caregivers assisted by PAMDIL participated in the research. Memories were analyzed using Collective Subject Discourse (CSD). The DSC revealed that caring led to the reorganization of family life. All the elderly caregivers reported changes in their lives as caregivers. The changes mentioned are related to lack of time for social activities, economic problems due to increased spending and physical overload. It was concluded from the memories, it was possible to know the reality, the experiences and challenges of the elderly, from the moment they were in the condition of caregivers.Descriptors: Memory, Caregiver, Elderly. Memoria de las personas mayores quien cuidan: experiencias y desafíos del lo cuidarResumen: Este artículo presenta los resultados de una investigación cualitativa, analítica y descriptiva, cuyo objetivo fue analizar la memoria de las personas mayores que son cuidadores de ancianos dependientes en el hogar. Treinta cuidadores ancianos asistidos por PAMDIL participaron en la investigación. Los recuerdos fueron analizados utilizando el Discurso del Sujeto Colectivo (CSD). El DSC reveló que el cuidado llevó a la reorganización de la vida familiar. Todos los cuidadores ancianos informaron cambios en sus vidas como cuidadores. Los cambios mencionados están relacionados con la falta de tiempo para actividades sociales, problemas económicos debido al aumento del gasto y la sobrecarga física. Se concluyó a partir de los recuerdos, fue posible conocer la realidad, las experiencias y los desafíos de los ancianos, desde el momento en que se encontraban en la condición de cuidadores.Descriptores: Memoria, Cuidador, Ancianos.

Five Commercial Immunoassays for SARS-CoV-2 Antibody Determination and Their Comparison and Correlation with the Virus Neutralization Test

There is an ongoing debate as to whether SARS-CoV-2 antibodies can be found in patients who have recovered from COVID-19 disease. Currently, there is no consensus on whether the antibodies, if present, are protective. Our regular measurements of SARS-CoV-2 antibodies, starting in July 2020, have provided us with the opportunity of becoming acquainted with the five different immunoassays. A total of 149 patients were enrolled in our study. We measured the samples using each immunoassay, then performing a virus neutralization test and comparing the results of SARS-CoV-2 antibodies with this test. We observed that the production of neutralizing antibodies is age-dependent. Elderly patients have a higher proportion of high neutralizing titers than young patients. Based on our results, and in combination with the literature findings, we can conclude that the serological SARS-CoV-2 antibody measurement is a helpful tool in the fight against COVID-19. The assays can provide information about the patient’s previous contact with the virus. Anti-spike protein assays correlate well with the virus neutralization test and can be used in the screening of potential convalescent plasma donors.