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Aging, disability, and frailty: implications for universal design.

https://arctichealth.org/en/permalink/ahliterature82456
Source
J Physiol Anthropol. 2006 Jan;25(1):113-8
Publication Type
Article
Date
Jan-2006
Author
Crews Douglas E
Zavotka Susan
Author Affiliation
Departments of Anthropology and Consumer Sciences, The Ohio State University, Columbus, OH 43201, USA. Crews.8@osu.edu
Source
J Physiol Anthropol. 2006 Jan;25(1):113-8
Date
Jan-2006
Language
English
Publication Type
Article
Keywords
Activities of Daily Living
Aged
Aged, 80 and over
Anthropology, Physical - methods
Disabled Persons - rehabilitation
Environment Design - trends
Forecasting
Frail Elderly
Humans
Needs Assessment
World Health
Abstract
Throughout the world all populations are seeing burgeoning numbers of "elders", defined as persons aged 65 year and older. In many countries, including Japan, the United States, Norway, Sweden and the United Kingdom, those aged over 65 are at or approaching 15% of the population. As their numbers have increased, so have their health care expenses, leading to extensive research on the health, well being, and life expectancy of these increasingly older elders. Today this group is further sub-divided: the young-old ages 65-74, the old-old ages 75-84, and the oldest-old ages 85+, for both health care and research purposes. However broad variation still characterizes even these groupings. Rates of frailty and disability increase with increasing age among these elders. For example, inabilities to complete at least one activity of daily living increased from about 5-7% at ages 65-69 years to about 28-36% at ages 85+ in 1987. Death rates continue to decline at all ages past 50 years and rates of disability seem to be doing the same. For the foreseeable future, we may expect increasing numbers of older, frail elders than in previous decades. Thus, people are not only living longer, they generally are healthier at advanced ages than were previous cohorts, thus "old age" disabilities of the 20th century will be put off to even older ages during the 21st century. As yet there is no clear way to assess senescent changes in humans, although activities of daily living, allostatic load, and frailty indices have all been suggested. One future need is greater development and use of universal and accessible design in all aspects of the built environment.
PubMed ID
16617216 View in PubMed
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Alcohol withdrawal at home. Pilot project for frail elderly people.

https://arctichealth.org/en/permalink/ahliterature212064
Source
Can Fam Physician. 1996 May;42:937-45
Publication Type
Article
Date
May-1996
Author
D J Evans
S D Street
D J Lynch
Author Affiliation
Victoria Innovative Seniors Treatment Agency (VISTA), BC.
Source
Can Fam Physician. 1996 May;42:937-45
Date
May-1996
Language
English
Publication Type
Article
Keywords
Activities of Daily Living
Aged
Alcoholism - prevention & control
British Columbia
Case Management - organization & administration
Female
Frail Elderly
Geriatric Assessment
Home Care Services - organization & administration
Humans
Male
Pilot Projects
Program Evaluation
Social Support
Substance Withdrawal Syndrome - prevention & control
Abstract
The need for safe, accessible, client-centred, alcohol withdrawal services for seniors was recognized by health service workers in Victoria. A partnership of health and support service organizations developed and implemented a pilot project for treating alcohol withdrawal in the home. The project provided service that integrated well with a substance-abuse treatment program for seniors.
Notes
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Cites: Br J Psychiatry. 1995 Feb;166(2):154-737728359
Cites: Int J Addict. 1982 Aug;17(6):1031-467141764
PubMed ID
8688696 View in PubMed
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An examination of the impact of gender and veteran status on falls among community-dwelling seniors: implications for targeting falls prevention activities.

https://arctichealth.org/en/permalink/ahliterature164363
Source
Fam Community Health. 2007 Apr-Jun;30(2):121-8
Publication Type
Article
Author
Lori E Weeks
Author Affiliation
Department of Family and Nutritional Sciences, University of Prince Edward Island, Prince Edward Island, Canada. lweeks@upei.ca
Source
Fam Community Health. 2007 Apr-Jun;30(2):121-8
Language
English
Publication Type
Article
Keywords
Accidental Falls - prevention & control - statistics & numerical data
Activities of Daily Living
Age Factors
Aged
Aged, 80 and over
Canada - epidemiology
Female
Frail Elderly
Geriatric Assessment
Health Services for the Aged - utilization
Health Surveys
Humans
Male
Psychometrics
Public Health Administration
Residence Characteristics
Risk assessment
Risk factors
Sex Factors
Social Work
Veterans - statistics & numerical data
Wounds and injuries - epidemiology - prevention & control
Abstract
The objective of this study was to broaden our understanding of the specific characteristics of community-dwelling seniors who are at increased risk of falling and becoming injured, by paying particular attention to gender and veteran status. The 137 respondents included 69 senior male veterans and 68 seniors in the general population. Results indicated that the veterans were at higher risk of falling than the general senior population, and were at higher risk of becoming injured after falling. Senior women were at less risk of falling and becoming injured than the veterans, but were at higher risk than the senior nonveteran men. It is imperative to target screening and falls prevention activities at these and other specific subgroups in the senior population that are at high risk of falling and becoming injured.
PubMed ID
19241648 View in PubMed
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Apathy: prevalence, associated factors, and prognostic value among frail, older inpatients.

https://arctichealth.org/en/permalink/ahliterature124530
Source
J Am Med Dir Assoc. 2012 Jul;13(6):541-5
Publication Type
Article
Date
Jul-2012
Author
Eeva H Hölttä
Marja-Liisa Laakkonen
Jouko V Laurila
Timo E Strandberg
Reijo S Tilvis
Kaisu H Pitkälä
Author Affiliation
Helsinki University Central Hospital, Unit of General Practice and City of Helsinki, Health Center, Helsinki, Finland. eeva.holtta@hel.fi
Source
J Am Med Dir Assoc. 2012 Jul;13(6):541-5
Date
Jul-2012
Language
English
Publication Type
Article
Keywords
Activities of Daily Living
Aged
Aged, 80 and over
Apathy
Delirium - mortality - psychology
Dementia - mortality - psychology
Female
Finland - epidemiology
Frail Elderly - psychology
Humans
Inpatients - psychology
Male
Prevalence
Prognosis
Proportional Hazards Models
Risk factors
Sex Factors
Statistics, nonparametric
Abstract
The association of apathy with Alzheimer disease and other dementias and caregiver burden has been examined in a number of studies; however, less is known about its relationship with delirium and mortality. We aimed to investigate the prevalence, relationship with delirium and dementia, and prognostic value of apathy in an elderly and frail inpatient population.
The cohort included 425 patients in acute geriatric wards and in 7 nursing homes in Helsinki (1999-2000). Demographic factors, physical functioning, diagnoses, and drugs were assessed with special reference for dementia, delirium, and apathy. Mortality was registered from central registers.
Of the patients, 98 (23.1%) suffered from apathy, and it was more frequent among men (32% versus 21% women, P = .037 ). There was no difference in mean age, number of comorbidities, or in the mean number of medications between those with and without apathy; however, those with apathy had lower mean MMSE points (9.2 versus 14.0 without apathy, P
PubMed ID
22572553 View in PubMed
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Are physicians meeting the needs of family caregivers of the frail elderly?

https://arctichealth.org/en/permalink/ahliterature218411
Source
Can Fam Physician. 1994 Apr;40:679-85
Publication Type
Article
Date
Apr-1994
Author
S L Brotman
M J Yaffe
Author Affiliation
McGill University School of Social Work Consortium for Ethnicity and Stategic Social Planning.
Source
Can Fam Physician. 1994 Apr;40:679-85
Date
Apr-1994
Language
English
Publication Type
Article
Keywords
Activities of Daily Living
Adult
Aged
Attitude to Health
Caregivers - psychology
Counseling
Family - psychology
Female
Frail Elderly
Geriatric Assessment
Health Services Accessibility
Health services needs and demand
Health Services Research
Home Care Services - utilization
Humans
Jews
Male
Middle Aged
Patient satisfaction
Physician's Role
Quebec
Questionnaires
Abstract
To explore expressed needs, both formal and informal, of family caregivers of frail elderly. To evaluate roles of physicians.
Questionnaire survey of members of the Montreal Jewish community providing care for frail elderly family members.
Jewish community of Montreal.
Volunteer caregivers who were caring for a family member or friend 60 years or older, who had greatest responsibility for providing physical or emotional support to an elderly person, who saw themselves as caregivers, and who could speak English or French were studied. Of 118 volunteers, 32 were excluded because they withdrew for personal reasons or because they did not meet study criteria.
Demographic variables, functional status of the care receiver, use of home care services, and needs assessment to identify additional services.
An average of 75.4% respondents did not use formal support services. Just under half of caregivers were dissatisfied with the attention they received from the health care system, and more than one third expressed feelings of stress, depression, guilt, and isolation.
Hypotheses for this discontent are presented. Physicians may be uninterested in helping caregivers; even if they were receptive to counseling caregivers, they could be poorly remunerated for the types of counseling sessions that are usual for caregivers; and being a professional caregiver to family caregivers is demanding in itself.
Notes
Cites: Br J Psychiatry. 1968 Mar;114(508):265-784295821
Cites: Gerontologist. 1993 Jun;33(3):315-238325518
Cites: J Gerontol. 1977 Jul;32(4):420-7864206
Cites: Health Soc Work. 1980 Nov;5(4):39-467203256
Cites: J Am Geriatr Soc. 1981 Dec;29(12):568-717310040
Cites: Gerontologist. 1983 Dec;23(6):597-6046662373
Cites: Psychosomatics. 1984 May;25(5):369-71, 374-56739692
Cites: Gerontologist. 1979 Apr;19(2):175-83162534
Cites: Soc Work Health Care. 1985 Spring;10(3):1-143158088
Cites: Annu Rev Gerontol Geriatr. 1985;5:249-823936516
Cites: Gerontologist. 1987 Apr;27(2):209-143583013
Cites: CMAJ. 1988 Feb 1;138(3):231-53337990
Cites: Nurs Res. 1988 Jul-Aug;37(4):217-223393428
Comment In: Can Fam Physician. 1994 Sep;40:15097920040
Erratum In: Can Fam Physician 1994 Jun;40:1093
PubMed ID
8199520 View in PubMed
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ASIM: a system for monitoring and evaluating the long-term care of the elderly and disabled.

https://arctichealth.org/en/permalink/ahliterature221356
Source
Health Serv Res. 1993 Apr;28(1):27-44
Publication Type
Article
Date
Apr-1993
Author
M. Lagergren
Author Affiliation
Ministry of Health and Social Affairs, Stockholm, Sweden.
Source
Health Serv Res. 1993 Apr;28(1):27-44
Date
Apr-1993
Language
English
Publication Type
Article
Keywords
Activities of Daily Living
Aged
Databases, Factual - standards
Disabled Persons
Frail Elderly
Geriatric Assessment
Health Services Needs and Demand - standards - statistics & numerical data
Health Services Research
Humans
Institutionalization - statistics & numerical data
Long-Term Care - classification - organization & administration - standards
Medical Record Linkage
Outcome and Process Assessment (Health Care)
Quality Assurance, Health Care
Registries
Regression Analysis
Reproducibility of Results
Social Environment
Sweden
Urban Population
Abstract
A system for monitoring and evaluating the long-term care of the elderly and disabled is presented, and its problems of completeness, reliability, and validity are discussed.
Half-yearly (before 1987) and yearly (after 1987) surveys were taken from 1984 to 1990 of all persons living in the city of Solna, Sweden, who at May 1 and November 1, or November 1, were receiving long-term care services from the municipality or county council, or both.
Completeness of observations was studied by linking survey and admission/discharge observations and checking for breaks in the chain of care. Reliability was estimated by comparing involuntary double registrations. Validity of the chosen measures of need was tested by comparing them with the actual provision of care services.
Registrations concerning actually provided services, assessed need, social environment, and disability were collected on a regular basis by the staff responsible for the care services.
Completeness was estimated to be more than 99 percent after a special procedure was carried out for filling in gaps in the "care chain." Reliability testing of the disability measures showed between .69 and .76 Kappa coefficient of agreement. Disability variables were shown to explain 56 percent of variance in the need measure "appropriate level of care."
Tests of completeness, reliability, and validity showed satisfactory results with regard to the purpose of the monitoring system and the limitations inherent in a system intended for routine application.
Notes
Cites: Health Serv Res. 1980 Fall;15(3):281-3066782043
Cites: Int J Nurs Stud. 1985;22(3):183-2003850075
Cites: Scand J Soc Med. 1977;5(2):67-72302983
Cites: J Chronic Dis. 1987;40(6):481-93597653
Cites: Soc Sci Med. 1991;32(4):455-642024161
Cites: Milbank Q. 1987;65(4):614-383452018
Cites: Health Serv Res. 1990 Jun;25(2):349-602113045
Cites: Scand J Soc Med. 1978;6(1):25-9635497
Cites: Med Care. 1982 May;20(5):468-886808257
Cites: Soc Sci Med. 1987;24(10):867-732956687
Cites: JAMA. 1963 Sep 21;185:914-914044222
PubMed ID
8463108 View in PubMed
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The association between specific nurse case management interventions and elder health.

https://arctichealth.org/en/permalink/ahliterature175372
Source
J Am Geriatr Soc. 2005 Apr;53(4):597-602
Publication Type
Article
Date
Apr-2005
Author
Constance Schein
Anita J Gagnon
Lisa Chan
Isabelle Morin
Justin Grondines
Author Affiliation
Saint Anne of Winona-Benedictine Health System, Winona, Minnesota, USA.
Source
J Am Geriatr Soc. 2005 Apr;53(4):597-602
Date
Apr-2005
Language
English
Publication Type
Article
Keywords
Activities of Daily Living
Adaptation, Psychological
Aged
Aged, 80 and over
Analysis of Variance
Canada
Case Management
Community Health Centers
Female
Frail Elderly
Geriatric Nursing - organization & administration
Hospitals, University
Humans
Linear Models
Longitudinal Studies
Male
Outcome Assessment (Health Care)
Quality of Life
Risk Management
Sickness Impact Profile
Abstract
To describe the association between specific nursing interventions performed in the context of nurse case management and older people's quality of life and functional ability.
Longitudinal.
Nurse case management through a university hospital and two community health centers.
One hundred seventy-five community-dwelling frail older persons (> or =70 and at risk for repeated hospitalizations).
Specific groups of nursing interventions provided in the context of nurse case management over a 10-month period--coping assistance, lifespan care, risk management, and physical comfort promotion--were focused on. These interventions were recorded using a standardized nursing language. Outcomes were measured using telephone and home interview and medical record review using the 36-item Short Form and the Older American Resources and Services Multidimensional Functional Assessment Questionnaire.
Older people receiving coping assistance interventions demonstrated an increase in instrumental activity of daily living functioning although they had lower general health, role-emotional, and mental health scores.
Coping assistance is one nursing intervention of several provided in the context of nurse case management that is independently associated with improving the functional status of frail older persons even in the presence of declining health normally associated with aging over several months. Examining the relationships between specific nursing activities and health outcomes of frail older persons may be useful in furthering understanding of the results of randomized trials of nurse case management in this population.
PubMed ID
15817004 View in PubMed
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Caring for demented elderly in rural primary health care.

https://arctichealth.org/en/permalink/ahliterature73235
Source
Scand J Caring Sci. 1994;8(1):29-37
Publication Type
Article
Date
1994
Author
B. Sjöbeck
A. Isacsson
Source
Scand J Caring Sci. 1994;8(1):29-37
Date
1994
Language
English
Publication Type
Article
Keywords
Activities of Daily Living
Aged
Aged, 80 and over
Caregivers
Dementia - diagnosis - nursing
Female
Frail Elderly
Geriatric Assessment
Health Services for the Aged - supply & distribution
Housing for the Elderly
Humans
Male
Primary Health Care
Research Support, Non-U.S. Gov't
Rural Population
Sweden
Abstract
In 1988, the demented in an elderly rural population (n = 851) were traced and assessed with the GBS geriatric rating scale. The aim of the study was to investigate the level of impairments of demented persons primary cared for and to relate their impairments to form of housing; to compare the distribution of care between not-demented and demented in an elderly population, and to establish the primary caregiver/patient ratio. The majority of the demented (44/50) were cared for in the studied primary health care area, despite the scarcity of staff. All received formal care. They consumed more formal care than the not-demented in the population. In relation to amount of elderly persons helped, the home-help personnel ratio was 0.30, in district care the ratio was 0.02, whereas the ratio of general practitioners was 0.002, estimated from the number of contacts and staff.
PubMed ID
8159887 View in PubMed
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A clinimetric evaluation of specialized geriatric care for rural dwelling, frail older people.

https://arctichealth.org/en/permalink/ahliterature197279
Source
J Am Geriatr Soc. 2000 Sep;48(9):1080-5
Publication Type
Article
Date
Sep-2000
Author
K. Rockwood
K. Stadnyk
D. Carver
K M MacPherson
H E Beanlands
C. Powell
P. Stolee
V S Thomas
R S Tonks
Author Affiliation
Division of Geriatric Medicine, Dalhousie University and Centre for Health Care of the Elderly, Halifax, Nova Scotia, Canada.
Source
J Am Geriatr Soc. 2000 Sep;48(9):1080-5
Date
Sep-2000
Language
English
Publication Type
Article
Keywords
Activities of Daily Living
Aged
Aged, 80 and over
Female
Follow-Up Studies
Frail Elderly
Geriatric Assessment
Goals
Health Services for the Aged - organization & administration
Humans
Male
Mental Status Schedule
Needs Assessment - organization & administration
Nova Scotia
Patient Care Team - organization & administration
Patient-Centered Care - organization & administration
Program Evaluation
Quality of Life
Reproducibility of Results
Rural health services - organization & administration
Single-Blind Method
Abstract
To test Comprehensive Geriatric Assessment (CGA) as an adjunct to usual care.
A randomized controlled trial with 3, 6, and 12 months follow-up.
Rural communities.
A total of 182 of 265 frail older patients (52 refused, 2 withdrawn, 27 ineligible, 2 deaths) referred by family practitioners with allocation to intervention (n = 95) or usual care (n = 87).
Three-month implementation of CGA recommendations by a Mobile Geriatric Assessment Team (MGAT) with follow-up assessments at 3, 6, and 12 months. Geriatric nurse assessors, blinded to group assignment, performed each assessment.
Goal Attainment Scaling (GAS).
Baseline characteristics were comparable between groups. At 3 months, the intervention group was more likely to attain their goals (GAS total: chi = 46.4 +/- 5.9; GAS outcome chi = 48.0 +/- 6.6) compared with controls (total: chi = 38.7 +/- 4.1; outcome chi = 40.8 +/- 5.6) (P
PubMed ID
10983907 View in PubMed
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103 records – page 1 of 11.