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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
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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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Attention, frailty, and falls: the effect of a manual task on basic mobility.

https://arctichealth.org/en/permalink/ahliterature46336
Source
J Am Geriatr Soc. 1998 Jun;46(6):758-61
Publication Type
Article
Date
Jun-1998
Author
L. Lundin-Olsson
L. Nyberg
Y. Gustafson
Author Affiliation
Department of Geriatric Medicine, Umeå University, Sweden.
Source
J Am Geriatr Soc. 1998 Jun;46(6):758-61
Date
Jun-1998
Language
English
Publication Type
Article
Keywords
Accidental Falls - prevention & control
Activities of Daily Living - classification
Aged
Aged, 80 and over
Attention
Cross-Sectional Studies
Disability Evaluation
Female
Frail Elderly
Geriatric Assessment
Humans
Male
Mental Status Schedule
Motor Skills
Prospective Studies
Research Support, Non-U.S. Gov't
Risk factors
Sweden
Abstract
OBJECTIVE: To investigate the effect of a second task on balance and gait maneuvers used in everyday life. Our hypothesis was that those who were more distracted by a familiar manual task performed concurrently with functional maneuvers were more frail and more prone to falls. DESIGN: A cross-sectional design with prospective follow-up for falls. SETTING: Sheltered accommodation in Umeå, Sweden. PARTICIPANTS: Forty-two residents (30 women, 12 men; mean age +/- SD = 79.7 +/- 6.1 years), ambulant with or without a walking aid, able to follow simple instructions and able to carry a tumbler. MEASUREMENTS: Timed Up & Go (TUG), i.e., the time taken to rise from an armchair, walk 3 meters, turn round, and sit down again. TUG was repeated with an added manual task (TUGmanual), which was to carry a glass of water while walking. The Montgomery-Asberg Depression Rating Scale, Barthel Index, Functional Reach, Mini-Mental State Examination, and Line Bisection test were used to assess for frailty. The subjects were followed-up prospectively regarding falls indoors for a period of 6-months. RESULTS: Subjects with a time difference (diffTUG) between TUGmanual and TUG of > or = 4.5 seconds were considered to be distracted by the second task. Ten subjects had a difference in time of > or = 4.5 seconds. These subjects were more frail, and seven of them fell indoors during the follow-up period (odds ratio 4.7, 95%Confidence Interval (CI) 1.5-14.2). CONCLUSION: The time difference between the TUGmanual and the TUG appears to be a valid marker of frailty and a useful tool for identifying older persons prone to falling.
PubMed ID
9625194 View in PubMed
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Being in a Bubble: the experience of loneliness among frail older people.

https://arctichealth.org/en/permalink/ahliterature277468
Source
J Adv Nurs. 2016 Mar;72(3):631-40
Publication Type
Article
Date
Mar-2016
Author
Elin Taube
Ulf Jakobsson
Patrik Midlöv
Jimmie Kristensson
Source
J Adv Nurs. 2016 Mar;72(3):631-40
Date
Mar-2016
Language
English
Publication Type
Article
Keywords
Activities of Daily Living - psychology
Aged
Aged, 80 and over
Female
Frail Elderly - psychology
Humans
Loneliness - psychology
Male
Social Isolation - psychology
Social Participation - psychology
Sweden
Abstract
The aim of this study was to explore the experience of loneliness among frail older people living at home.
Loneliness is a threat to the physical and psychological well-being with serious consequences if left unattended. There are associations between frailty and poor psychological well-being, implying that frail older people who experience loneliness are vulnerable.
Qualitative content analysis, focusing on both latent and manifest content.
Frail older people (65+ years), living at home and who have experienced various levels in intensity of loneliness, were purposively selected from a larger interventional study (N = 12). For this study, 'frail' means being dependent in activities of daily life and having repeated contacts with healthcare services. Data were collected between December 2009-August 2011. Semi-structured interviews were performed, audio recorded and transcribed verbatim.
The analysis resulted in the overall theme 'Being in a Bubble', which illustrates an experience of living in an ongoing world, but excluded because of the participants' social surroundings and the impossibility to regain losses. The theme 'Barriers' was interpreted as facing physical, psychological and social barriers for overcoming loneliness. The theme 'Hopelessness' reveals the experience when not succeeding in overcoming these barriers, including seeing loneliness as a constant state. A positive co-existing dimension of loneliness, offering independence, was reflected in the theme 'Freedom'.
The findings suggest that future strategies for intervening should target the frail older persons' individual barriers and promoting the positive co-existing dimension of loneliness. When caring, a person centred approach, encompassing knowledge regarding physical and psychological aspects, including loneliness, is recommended.
PubMed ID
26568280 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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Caring for undernourished patients in an orthopaedic setting.

https://arctichealth.org/en/permalink/ahliterature90668
Source
Nurs Ethics. 2009 Jan;16(1):5-18
Publication Type
Article
Date
Jan-2009
Author
Khalaf Atika
Berggren Vanja
Westergren Albert
Author Affiliation
University Hospital, Malmö, Sweden.
Source
Nurs Ethics. 2009 Jan;16(1):5-18
Date
Jan-2009
Language
English
Publication Type
Article
Keywords
Adult
Aged
Attitude of Health Personnel
Female
Fractures, Bone - nursing
Frail Elderly
Humans
Male
Malnutrition - nursing
Nurse-Patient Relations
Nurses - psychology
Nursing Staff, Hospital
Sweden
Thinness - nursing
Abstract
This study elucidates the nursing of undernourished patients as experienced by eight registered clinical nurses and five nursing assistants by using content analysis. The participants' narratives describe the inner perspective of caring for undernourished patients, known in Sweden as 'the thin ones'. Categories identified were: frustration in nursing, joy in nursing and that undernourishment is taboo. The taboo was narrated as feelings of guilt and shame. Frustration in nursing could be seen as feeling stressed, exposed, lonely, powerless, helpless, and being torn between demands and needs. Joy in nursing was experienced when creating a trusting relationship, promoting pleasure in the meal situation and working with respect for each individual's life-style and context of life. Understanding staff members' views is important when implementing guidelines as well as in the teaching situation in order to identify where staff stand with regard to knowledge and attitudes.
PubMed ID
19103687 View in PubMed
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Case managers for frail older people: a randomised controlled pilot study.

https://arctichealth.org/en/permalink/ahliterature144071
Source
Scand J Caring Sci. 2010 Dec;24(4):755-63
Publication Type
Article
Date
Dec-2010
Author
Jimmie Kristensson
Anna K Ekwall
Ulf Jakobsson
Patrik Midlöv
Ingalill R Hallberg
Author Affiliation
Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden. Jimmie.Kristensson@med.lu.se
Source
Scand J Caring Sci. 2010 Dec;24(4):755-63
Date
Dec-2010
Language
English
Publication Type
Article
Keywords
Aged
Case Management
Frail Elderly
Humans
Pilot Projects
Sweden
Abstract
The aim was to test sampling and explore sample characteristics in a pilot study using a case management intervention for older people with functional dependency and repeated contact with the healthcare services as well as to investigate the effects of the intervention on perceived health and depressed mood after 3 months. The aim was also to explore internal consistency in the life satisfaction index Z, activities of daily living-staircase and Geriatric Depression Scale-20.
This pilot study was carried out in a randomised controlled design with repeated follow-ups. In all, 46 people were consecutively and randomly assigned to either an intervention (n = 23) or a control (n = 23) group. Two nurses worked as case managers and carried out the intervention, which consisted of four parts.
No differences were found between the groups at baseline. The results showed the participants had low life satisfaction (median 14 vs. 12), several health complaints (median 11) and a high score on the Geriatric Depression Scale (median 6) at baseline, indicating the risk of depression. No significant effects were observed regarding depressed mood or perceived health between or within groups at follow-up after 3 months. Cronbach's alpha showed satisfactory internal consistency for group comparisons.
The sampling procedure led to similar groups. The life satisfaction, functional dependency and symptoms of depression measures were reliable to use. No changes in perceived health and symptoms of depression were found after 3 months, indicating that it may be too early to expect effects. The low depression score is noteworthy and requires further research.
PubMed ID
20409057 View in PubMed
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Cross-sectional assessment and subgroup comparison of functional disability in patients with rheumatoid arthritis in a Swedish health-care district.

https://arctichealth.org/en/permalink/ahliterature14345
Source
Disabil Rehabil. 1995 Feb-Mar;17(2):94-9
Publication Type
Article
Author
P. Bendtsen
P. Bjurulf
E. Trell
F. Lindström
J E Larsson
Author Affiliation
Department of Community Medicine, Faculty of Health Sciences, Linköping University, Sweden.
Source
Disabil Rehabil. 1995 Feb-Mar;17(2):94-9
Language
English
Publication Type
Article
Keywords
Activities of Daily Living
Adult
Age Factors
Aged
Aged, 80 and over
Arthritis, Rheumatoid - classification - physiopathology - psychology
Comparative Study
Cross-Sectional Studies
Disability Evaluation
Female
Frail Elderly
Humans
Male
Middle Aged
Pain Measurement
Questionnaires
Research Support, Non-U.S. Gov't
Sex Factors
Socioeconomic Factors
Sweden
Abstract
A cross-sectional study was undertaken on 222 patients with rheumatoid arthritis (RA) within a Swedish health-care district. An exploratory analysis of functional status, according to a Swedish version of the Health Assessment Questionnaire (HAQ), was carried out in order to explore the extent and pattern of functional disability in an unselected group of individuals with RA. The mean score of functional disability according to HAQ increased with more clinical manifest disease. There were no significant differences between the mean score in men and women. Most functional disability was related to hand-grip function and the ability to take care of personal hygiene. Increased functional disability was significantly associated with increasing age and disease duration. There was no significant relation between functional status and housing condition and educational level. A strong correlation was found between pain and functional disability. Multiple regression analysis was performed and predictive functional scores were tabulated based upon sex, age at onset and duration of RA disease.
PubMed ID
7795266 View in PubMed
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Daily life after moving into a care home--experiences from older people, relatives and contact persons.

https://arctichealth.org/en/permalink/ahliterature84582
Source
J Clin Nurs. 2007 Sep;16(9):1712-8
Publication Type
Article
Date
Sep-2007
Author
Andersson Ingegerd
Pettersson Elisabet
Sidenvall Birgitta
Author Affiliation
Department of Public Health and Caring Sciences, Caring Sciences, Uppsala University, Uppsala, Sweden.
Source
J Clin Nurs. 2007 Sep;16(9):1712-8
Date
Sep-2007
Language
English
Publication Type
Article
Keywords
Activities of Daily Living - psychology
Aged
Aged, 80 and over
Attitude of Health Personnel
Boredom
Decision Making
Family - psychology
Female
Frail Elderly - psychology
Humans
Interior Design and Furnishings
Interpersonal Relations
Loneliness - psychology
Male
Nursing Homes - organization & administration
Nursing Methodology Research
Patient Admission
Patient Participation - psychology
Patients' Rooms
Personal Autonomy
Privacy - psychology
Qualitative Research
Quality of Life - psychology
Questionnaires
Sweden
Abstract
AIMS AND OBJECTIVES: To describe older people's experiences of daily life at the care home after admittance with respect to their perceptions of participation in the decision to move. Furthermore, the aim was to study the experiences of their relatives and contact persons with respect to the daily life of the same residents. BACKGROUND: When older persons move into a care home, the whole family often play an important part. Thus, it is interesting to study how newly admitted older people, their relatives and staff members experience daily life in a modern care home. METHODS: Qualitative design. The participants comprised a purposive sample of 13 residents, recently admitted to a care home, 69-90 years old, both single living and married, both moving from their own homes and from different institutions. Interviews were carried out with the older people (n = 13), their relatives (n = 10) and contact persons (n = 11). RESULTS: The majority of the residents reported satisfaction with care home living. The relatives were also satisfied, secure and appreciated the privacy and homely atmosphere of the flat. The disadvantage of one-room flats was that the residents might have felt lonely. The relatives felt that the residents were bored, but few residents desired more activities, even if some of them longed for people to socialize with. For many older people, perhaps talking is the most important 'activity' at care homes. Concerning self-determination, some residents did not find it satisfactory. RELEVANCE TO CLINICAL PRACTICE: Staff members must pay attention to residents' need to talk with people. For many older people, talking is perhaps the most important 'activity' at care homes. Nurses must safeguard residents' self-determination. When residents are in control of their lives, they may become satisfied with time.
PubMed ID
17727589 View in PubMed
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A day to be lived. Elderly peoples' possessions for everyday life in assisted living.

https://arctichealth.org/en/permalink/ahliterature114950
Source
J Aging Stud. 2013 Apr;27(2):135-42
Publication Type
Article
Date
Apr-2013
Author
Catharina Nord
Author Affiliation
Department of Social and Welfare Studies, National Institute for the Study of Ageing and Later Life, Linköping University, Norrköping, Sweden. catharina.nord@liu.se
Source
J Aging Stud. 2013 Apr;27(2):135-42
Date
Apr-2013
Language
English
Publication Type
Article
Keywords
Activities of Daily Living
Adaptation, Psychological
Aged - psychology
Aged, 80 and over - psychology
Assisted Living Facilities
Female
Frail Elderly - psychology
Household Articles
Humans
Male
Middle Aged - psychology
Qualitative Research
Sweden
Abstract
This study is a qualitative interview study about the household possessions that elderly women and men brought with them when moving into assisted living. The move implied a substantial reduction of their possessions since, in all cases, they had left a larger dwelling than the one they moved to. The study gives a glimpse into the everyday life of the oldest old in assisted living. The things the elderly participants brought were of three types; cherished objects, representations of who they were, and mundane objects. The most important objects indicated by the elderly often belonged to the third type, and were preferred for the significance they had for the everyday life of the individual. These objects revealed a circumscribed but dignified life in their private bed-sitting room, often in solitude, where the elderly individuals pursued various interests and small-scale activities. However, this life was organized and preferred by the individuals themselves, in accordance with the principles of resident autonomy and individual choice that are promoted in assisted living. The author suggests that these self-engaged pursuits can contribute to bridging the gap between disengagement and activity theories. The study results also contribute to making visible the private life of the oldest old in assisted living.
PubMed ID
23561278 View in PubMed
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77 records – page 1 of 8.