Relationship Between Home Caregivers and Caregivers Employed at Selected Institutions Providing Assistance to Seniors with Their Care Recipients Suffering from Dementia

Introduction: There are many difficulties connected with caring for an elderly person sufferring dementia. Symptoms such as aggression or apathy, as well as the progressive nature of the disorder, affect the attitude of both home and institutional caregivers towards the people for whom they care. An important element related to the provision of care is the relationship between a senior with dementia and those who provide the care (home and institutional caregivers). The aim of the article is to characterise and compare these relations. Material and methods: The study comprised 124 participants, 57 professional caregivers and 67 home carers. Two standardised questionnaires were used: the Neuropsychiatric Inventory Questionnaire (NPI-Q) and the Quality of Carer-Patient Relationship - QCPR Questionnaire. Additionally, the respondents provided socio-demographic data. The study was conducted via electronic media in the first quarter of 2021. Results: It was found that there is a significant difference in the relationship between home and institutional caregivers, with their charges in the dimension of "warmth and attachment" (measured by QCPR). People providing professional care have significantly higher scores in this area. There was also a significant difference between scores in the 'no conflict and criticism' dimension (measured by QCPR) for home and professional caregivers. Institutional caregivers, in relation to their care recipients, have a higher level of this indicator than home caregivers. Conclusions: Relationships between seniors with dementia and institutional or home carers differ with regard to some issues. The differences in relationships with seniors suffering dementia may be due to the time spent caring for this person and the caregiver's response to symptoms of dementia.

Piezopulsometric analysis of autonomic regulation of the cardiovascular system in an elderly person under stress

Описаны результаты применения нового метода артериальной пьезопульсометрии для неинвазивной оценки функционального состояния и физиологических механизмов автономной регуляции сердечно-сосудистой системы (ССС) у пожилого человека при острой боли, связанной с неожиданной физической травмой. Такое воздействие в первый же день вызвало негативную стресс-реакцию в мышечных эффекторах (МЭ) ССС, провоцируя аномальное усиление и ускорение сократимости миокарда ЛЖ сердца. Анализ графиков волн пульсового АД крови (ПАДК) показал, что максимальная скорость прироста ПАДК - VmaxPP, отражающая сократительную способность миокарда, выросла с 625±74 перед травмой до 2 117±173 мм рт. ст./с после травмы, исказив контур нормального графика. Причиной этого роста могло быть быстрое суммарное воздействие трансмиттеров нейроэндокринной симпатико-адреналовой системы на адренорецепторы кардиомиоцитов. Результаты спектрального анализа вариабельности параметров волн ПАДК подтвердили такую возможность. Было показано, что при стрессе норадреналин из активированных симпатических эфферентов добавляется к характерному для пожилых людей уже повышенному содержанию гуморальных катехоламинов в межклеточной среде миокарда вблизи адренорецепторов кардиомиоцитов. При этом существенно возрастает активность парасимпатических эфферентов, выделяющих ацетилхолин, ингибирующий контрактильную реакцию миокарда и тем самым выполняющий сдерживающую кардиопротекторную функцию. При исследовании механизмов автономной регуляции МЭ ССС в условиях стрессорного воздействия использовали персонализированный подход. The article describes the results of using the method of arterial piezopulsometry for non-invasive assessment of the functional state and physiological mechanisms of autonomous regulation of the cardiovascular system (CVS) in an elderly person with acute pain associated with unexpected physical trauma. On the first day, such an effect caused a negative stress reaction in the muscle effectors (ME) of the CVS, provoking an abnormal increase and acceleration of the contractility of the left ventricular myocardium. Analysis of the arterial blood pressure (PP) pulse wave graphs showed that the maximum rate of PP growth - VmaxPP, which reflects myocardial contractility, increased from 625±74 before injury to 2 117±173 mm Hg/s after injury, distorting the contour of the normal PP waveform. The reason for this growth could be the rapid cumulative effect of transmitters of the neuroendocrine sympathoadrenal system on adrenergic receptors (AR) of cardiomyocytes (CM). The results of the spectral analysis of the variability of the parameters of the PP waves confirmed this possibility. It was shown that under stress, norepinephrine from activated sympathetic efferents is added to the already increased content of humoral catecholamines in the extracellular environment of the myocardium near the AR of the CM, which is characteristic of the elderly. At the same time, the activity of parasympathetic efferents, releasing acetylcholine, which inhibits the contractile reaction of the myocardium and, thereby, performs a restraining cardioprotective function, significantly increases. A personalized approach was used for piezopulsometric study of the mechanisms of autonomous regulation of ME CVS under specific conditions of stress.

Social interactions in long-term care

Современное общество становится все более сложным, меняются не только технологии, но и его социально-возрастная структура. Человечество впервые столкнулось с ситуацией, когда пожилых больше, чем молодежи, и оказалось к этому не готово. Возникает новая задача - согласование взаимодействий и интересов множества субъектов социального взаимодействия в интересах пожилых. Традиционных управленческих воздействий государства становится недостаточно, постепенно складываются механизмы самоорганизации общества и автономности граждан. Новой проблемой стало не только быстрое старение общества, но и увеличение числа пожилых, требующих постоянного ухода в последние годы жизни. Уже сложившиеся «закрытые институты» - дома престарелых - сегодня все менее популярны у населения. В статье предложен обзор российского законодательства о долговременном уходе за пожилыми, а также анализ успехов и барьеров взаимодействия в организации ухода государства, коммерческих и некоммерческих учреждений в Санкт-Петербурге - городе пожилого населения и развитого социального обслуживания пожилых. Поэтому мы вправе сделать вывод, что социальное обслуживание в Петербурге может рассматриваться как перспективная модель развития долговременного ухода за пожилыми. Цель статьи - анализ особенности взаимодействий различных субъектов складывающейся в Петербурге системы долговременного ухода за пожилыми. Нас интересуют ситуации, когда имеющихся правовых норм/регулирования/вмешательства во взаимодействия достаточно, чтобы задачи ухода решались, а участники не страдали, и наоборот - когда имеющихся регулятивов недостаточно и либо задачи не решаются, либо потерпевшей стороной оказывается пожилой человек или его семья. Modern society is becoming more and more complex, not only technologies are changing, but also its socio-age structure. For the first time, mankind found itself in a situation where there are more elderly people than young people, and it turned out to be not ready for this. A new task arises - the coordination of interactions and interests of many subjects of social interaction in the interests of the elderly. The traditional administrative influences of the state are becoming insufficient; mechanisms of self-organization of society and the autonomy of citizens are gradually taking shape. A new problem has become not only the rapid aging of society, but also an increase in the number of elderly people requiring constant care in the last years of their lives, since the already existing «closed institutions». Nursing homes are less popular today. The article provides an overview of Russian legislation on long-term care for the elderly, as well as an analysis of the successes and barriers to interaction in organizing care for the state, commercial and non-profit institutions in St. Petersburg. Petersburg is a city of the elderly population and developed social services for the elderly. Therefore, we have the right to conclude that social services in St. Petersburg can be viewed as a promising model for the development of long-term care for the elderly. The purpose of the article is to analyze the peculiarities of interactions between various subjects of the system of long-term care for the elderly that is emerging in St. Petersburg. We are interested in situations when the existing legal norms/regulation/interference in interactions are sufficient for the tasks of care to be solved, and the participants did not suffer. And vice versa, when the existing regulations are insufficient, and either the tasks are not being solved, or the injured party is an elderly person or his family.

Recognizing Physical Activity of hospitalized Older People from Wearable Sensors Data using IoT

The IoT is a new concept that provides a world where smart, connected, embedded systems operate, giving rise to the amount of data from different sources that are considered to have highly useful and valuable information. Data mining would play a critical role in creating smarter IoT. Traditional care of an elderly person is a difficult and complex task. The need to have a caregiver with the elderly person almost all the time drains the human and financial resources of the health care system. The emergence of Artificial intelligence has allowed the conception of technical assistance where it helps and reduces the time spent by the caregiver with the elderly person. This work aims to focus on analyzing techniques that are used for prediction purposes of falls in the elderly. We examine the applicability of three classification algorithms for IoT data. These algorithms are analyzed and a comparative study is undertaken to find the classifier that performs the best analysis on the dataset using a set of predefined performance metrics to compare the results of each classifier.

Qualidade da atenção à saúde do idoso atenção primária: uma revisão integrativa

Objective: To investigate, through an integrative literature review, the quality of health care for the elderly in primary care. Material and Methods: Integrative literature review conducted in MEDLINE/PubMed, SciELO, LILACS and BDENF databases between April and May 2020, which generated 780 references. After removal of the duplicates and use of inclusion and exclusion criteria, the final sample consisted of 15 articles. Results: The quality of health care for the elderly in primary care was associated with potential and weaknesses that involved the availability and training of human resources, adoption of evaluation protocols, monitoring and follow-up, supply of inputs and structural variables linked to infrastructure and intersectoral support network. The effectiveness of actions to the elderly in primary care was related to the implementation of the Family Health Strategy, combined with the active action of the community health agent in the territory and the participation of the elderly in the decisions. Conclusion: Strengthening the health care of the elderly in primary care involves short, medium and long-term efforts related to education, human and material resources management, networking, and the formation of ties with the territory and the elderly person. Objetivo: Investigar, a través de una revisión integradora de la literatura, la calidad de la atención en salud del adulto mayor en atención primaria.Materiales y Métodos: Revisión bibliográfica integradora realizada en las bases de datos MEDLINE / PubMed, SciELO, LILACS y BDENF entre abril y mayo de 2020, que generó 780 referencias. Después de eliminar los duplicados y utilizar los criterios de inclusión y exclusión, la muestra final fue de 15 artículos.Resultados: La calidad de la atención en salud del adulto mayor en atención primaria se asoció con fortalezas y debilidades que involucraron la disponibilidad y formación de recursos humanos, adopción de protocolos de evaluación, seguimiento y seguimiento, suministro de insumos y variables estructurales vinculadas a la infraestructura y red de apoyo intersectorial. La efectividad de las acciones para el adulto mayor en atención primaria estuvo relacionada con la implementación de la Estrategia Salud de la Familia, combinada con el desempeño activo del agente comunitario de salud en el territorio y la participación del adulto mayor en las decisiones.Conclusión: El fortalecimiento de la atención a la salud del anciano en la atención primaria implica esfuerzos a corto, mediano y largo plazo relacionados con la educación, la gestión de los recursos humanos y materiales, el trabajo en red y la formación de vínculos con el territorio y el anciano. Objetivo: Investigar, por meio de uma revisão integrativa da literatura, a qualidade da atenção à saúde do idoso na atenção primária. Materiais e Métodos: Revisão integrativa da literatura realizada nas bases de dados MEDLINE/PubMed, SciELO, LILACS e BDENF entre os meses de abril e maio de 2020, as quais geraram 780 referências. Após remoção das duplicatas e emprego dos critérios de inclusão e exclusão a amostra final foi composta por 15 artigos. Resultados: A qualidade da atenção à saúde do idoso na atenção primária esteve associada a potencialidades e fragilidades que envolveram a disponibilidade e treinamento dos recursos humanos, adoção de protocolos de avaliação, acompanhamento e monitoramento, oferta de insumos e variáveis estruturais ligadas à infraestrutura e à rede de apoio intersetorial. A efetividade das ações à pessoa idosa na atenção primária esteve relacionada à implantação da Estratégia Saúde da Família, conjugada com a atuação ativa do agente comunitário de saúde no território e a participação do idoso nas decisões. Conclusão: Fortalecer a atenção à saúde do idoso na atenção primária envolve esforços a curto, médio e longo prazo relacionados à educação, gestão de recursos humanos e materiais, atuação em rede e a formação de vínculo com o território e a pessoa idosa.

NURSING AND AUDIOLOGY:

Geriatrics help prevent and promote actions that help to minimize the impacts on the quality of life of the elderly. Being the nurse together with a multidisciplinary team, of vital importance in the development of these actions, The Nurse seeks to adapt the reality and the environment to which the elderly person is, thus enabling a better quality of life in this environment. The audiologist audiologist aims at a concern in hearing health, seeking to assist in the prevention and promotion of actions that help patients to have a more effective social interaction and avoid isolation in the face of difficulties that they may present. In short, the natural aging process causes damage to various functions of the human body, and one of them is auditory. The presence of hearing loss has several negative consequences for the quality of life of individuals, especially social isolation and in these cases hearing aids end up being strong allies to minimize the impacts that hearing loss causes on people's lives. Thus, this work aims to relate the issue of social isolation caused by hearing loss, increased risk of depression in the selection process and adaptation of hearing aids for the elderly and the role of the geriatric nurse aiming at improving the quality of life and preventing problems that may arise. In this study, a bibliographic search was made in the databases and an interface between two areas of health: Nursing and Speech Therapy, and its search to improve the quality of life of the elderly population as a social being.

Reinforcement Techniques in Overcoming Post-Power Syndrome Anxiety Disorders in The Elderly

Everyone lives with a variety of presumptions that are not always to their liking, this allows a person to experience tremendous pressure and will foster a prolonged new problem. Post-power syndrome is a phenomenon that occurs in an elderly person who is not ready for old age, motivated by job loss and decreased function of certain organs. Researchers used qualitative research methods through case studies and observations of primary subjects. In this study apply reinforcement work or reinforcement in helping sufferers towards healing, in the form of positive reinforcement on daily good behavior. The results of this study showed that this reinforcement technique has an effect on the healing of post-power syndrome, while involving the participation of the family and the surrounding environment to bring out the meaning in the subject.

Poverty, beliefs about HIV-AIDS transmission, and the gap in HIV-AIDS testing among women between rural and urban areas in Cameroon

The objective of this study is to examine the effects of income poverty and beliefs about HIV-AIDS transmission on the gap in HIV-AIDS testing among women between rural and urban areas in Cameroon. The analysis is based on a sample of 7,464 women from the Multiple Indicator Cluster Survey (MICS 5) of Cameroon (NIS, 2015). Based on the literature on the demand for preventive health care, econometric results obtained using a decomposing differencesmodel based on Yun method, reveal that the HIV-AIDS screening rate of women living in rural areas is lower than that of women living in urban areas. Improvements in the level of economic well-being, demonstrated knowledge about HIV-AIDS, and education levels of rural women are likely to reduce this gap. On the other hand, having a child, knowing where to get tested for HIV-AIDS, or being an elderly person does no help reduce this gap.