Centre for Health & Policy Studies, Dept. of Community Health Sciences, University of Calgary, 3330 Hospital Dr. NW, Calgary, AB T2N 4T1, Canada. moos@ucalgary.ca
This article discusses the study design and methods used to contextualize and assess the social capital of seniors living in congregate housing residences in Calgary, Alberta. The project is being funded as a pilot project under the Institute of Aging, Canadian Institutes for Health Research.
Working with seniors living in 5 congregate housing residencies in Calgary, the project uses a mixed method approach to develop grounded measures of the social capital of seniors. The project integrates both qualitative and quantitative methods in a 3-phase research design: 1) qualitative, 2) quantitative, and 3) qualitative. Phase 1 uses gender-specific focus groups; phase 2 involves the administration of individual surveys that include a social network module; and phase 3 uses anamolous-case interviews. Not only does the study design allow us to develop grounded measures of social capital but it also permits us to test how well the three methods work separately, and how well they fit together to achieve project goals. This article describes the selection of the study population, the multiple methods used in the research and a brief discussion of our conceptualization and measurement of social capital.
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Influenza causes high morbidity and hospitalization rates in residents of seniors lodges, I causing increased pressure on emergency departments and hospital beds every winter. This quasi-experimental study assessed the prevention of influenza outbreaks and their consequences in Calgary lodges. A multidisciplinary team worked to improve communication between health professionals, increase resident and staff immunization coverage, obtain weights and creatinines prior to influenza season, and facilitate amantadine prophylaxis during influenza A outbreaks. We had an increase in standing orders for amantadine and up to 56% of residents from one lodge had documented creatinine levels. Amantadine was administered to residents within two days of outbreak notification. Influenza morbidity in lodge outbreaks decreased from a rate of 37% to 9% over the three years and hospitalization rates decreased from 9% to 1%. We recommend that other regions consider a similar approach to decreasing influenza morbidity and hospitalization in lodge residents.
OBJECTIVE--To study housing conditions of elderly people in Uppsala, Sweden. DESIGN--The Albertina Project is an epidemiological study. A postal questionnaire was sent to a random sample. SETTING AND SUBJECTS--The general population 75 years or older in the community of Uppsala, 1985. MAIN OUTCOME MEASURES--Information on marital status, housing conditions, housing standard, problems with the apartment/house, desires for modifications to the apartment, wishes to stay or to move related to the possibility to prevent institutionalization because of bad housing standard. RESULTS--About half of those who participated in the study were single (never married, divorced or widowed). 85% lived in their own homes, 10% in so-called service apartments, and only 5% in institutions. More than 90% had a good housing standard. 45% reported some form of housing problem, but only 14% wanted modifications to their dwelling, and only 8% wanted to move from their present dwelling, in most cases due to problems with stairs or need for more help. CONCLUSION--Most people lived in their own home and wanted to stay there. The housing standard appeared to be satisfactory in the majority of cases but minor modifications might prevent "unnecessary" moves to institutions.
The housing conditions of the elderly in Denmark are undergoing rapid improvement. The main reason for this is that the first generations to benefit from the growth of prosperity that started in the 1950s are now joining the ranks of the elderly. Similarly, the oldest of the elderly population--many of whom live in some of the country's oldest, smallest and technically worst housing--are now dying off. Most of the new elderly generation own their own home, usually a detached house, and the vast majority of them must be expected to be extremely satisfied with their homes and to want to remain in them in their old age. However, this may present difficulties, partly because it requires a certain income and partly because the dwellings require quite a lot of maintenance, gardening, street-cleaning, etc. The general rule seems to be that the elderly mainly only move from a good, big home when they lose their husband or wife or reach a point at which they need more care. Danish policy on housing for the elderly attaches importance to supporting the elderly in their own homes, and the available resources are largely concentrated on this intention. Here at the beginning of the 1990s this policy has run into difficulties because it has led to the allocation of resources being slanted in favour of relatively well-situated elderly people, while the weakest and poorest old people with the biggest need for care are not served satisfactorily.(ABSTRACT TRUNCATED AT 250 WORDS)
The purpose of this study was to illuminate how the integration of lucid individuals and agitated cognitively impaired individuals affects aspects of perceived quality of care. A questionnaire was mailed to hospital wards, nursing home wards and residential homes in Sweden. Nursing staff replied to the questionnaire on behalf of each care unit. Integration of cognitively impaired and lucid patients/residents was identified as a problem, regardless of whether the care unit was a hospital ward, nursing home or residential home. Agitated behaviours in people who were cognitively impaired could result in lucid residents becoming anxious, afraid and irritated. This in turn could lead to an exacerbation of behaviour in residents who were already agitated. Sometimes a lucid patient/resident was required to share a room with an agitated individual. There is a need for staff training specific to the needs of people with dementia. Findings suggest that there is a shortage of units designed specifically for the care of agitated cognitively impaired patients/residents. The findings of this study support the need for healthcare providers in long-term care settings to maintain the rights and well being of all patients/residents.
The aim was to study objectively assessed walkability of the environment and participant perceived environmental facilitators for outdoor mobility as predictors of physical activity in older adults with and without physical limitations. 75-90-year-old adults living independently in Central Finland were interviewed (n = 839) and reassessed for self-reported physical activity one or two years later (n = 787). Lower-extremity physical limitations were defined as Short Physical Performance Battery score =9. Number of perceived environmental facilitators was calculated from a 16-item checklist. Walkability index (land use mix, street connectivity, population density) of the home environment was calculated from geographic information and categorized into tertiles. Accelerometer-based step counts were registered for one week (n = 174). Better walkability was associated with higher numbers of perceived environmental facilitators (p
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The recent proliferation of unlicensed homes for the aged in Quebec, coupled with the increased needs of the population they serve, has raised concerns about the quality of case these homes provide. The authors compared the quality of care in unlicensed homes with that in licensed long-term care facilities in a region of Quebec.
The study involved 301 impaired people aged 65 and over in 88 residential care facilities (52 unlicensed, 36 licensed) in the Eastern Townships of Quebec. Study participants were chosen according to a 2-stage sampling scheme: stratified sampling of the primary units (facilities) and random sampling of the secondary units (residents). Quality of care was measured using the QUALCARE scale, a multidimensional instrument that uses a 5-point scale to assess 6 dimensions of care: environmental, physical, medical management, psychosocial, human rights and financial. A mean score of more than 2 was considered indicative of inadequate care.
Overall, the quality of care was similar in the unlicensed and licensed facilities (mean global score 1.61 [standard error of the mean (SEM) 0.06] and 1.47 [SEM 0.09] respectively). Examination of dimension-specific quality-of-care scores revealed that the unlicensed homes performed worse than the licensed facilities in 2 areas of care: physical care (mean score 1.80 [SEM 0.08] v. 1.51 [SEM 0.09] respectively, p = 0.017) and medical management (1.37 [SEM 0.06] v. 1.14 [SEM 0.05], p = 0.004). The dimension-specific scores also revealed that both types of homes lacked appropriate attention to the psychosocial aspect of care. Overall, 25% of the facilities provided inadequate care to at least one resident. This situation was especially prevalent among homes with fewer than 40 residents, where up to 20% of the residents received inadequate care.
Most of the unlicensed homes for the aged that were studied delivered care of relatively good quality. However, some clearly provided inadequate care.
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