Dissertationen zum Thema „Education of elderly“

This study examined the difference among 3 patient education intervention strategies and compliance in the hypertensive elderly. The strategies were verbal instructions, written instructions and both verbal and written instructions. An ex post facto descriptive design was implemented based on a Cognitive Information Processing Theory of Learning. Forty subjects were recruited and interviewed. Data analysis revealed that compliance did not differ significantly with the type of educational strategy.

Global populations are aging and by the turn of the century elderly populations will have increased significantly. The United Nations predicts that by the year 2025 the elderly will constitute 25 percent of the global population (UN Chronicle, 1988). Specifically, the global population of people over 60 years of age was 380 million in 1980, is expected to rise to 610 million in the year 2000 and will reach an alarming billion plus by 2025 (UN chronicle, 1988). The UN Chronicle anticipates faster increases in the 80 plus age group with 34 million in 1980, 58 million in 2000 and 114 million in the year 2025. The Canadian population is not excluded in the United Nations predictions. Canadians are also growing older and grayer. The "graying of Canada" is a phrase frequently coined by the media, in the latter years of the past decade. It is predicted that by the year 2025 approximately one in five Canadians will be over the age of 65 (Cooper, 1989). Senior citizens, in Canada, are now being subcategorized into the "young-old", the "old-old", the "well-ederly" and the "frail-elderly" (Cooper, 1989, p.114). The new era of Canadian seniors boasts a philosophy of living longer and dying younger (at heart). The UN Chronicle suggest that the trend towards aging could significanlty affect a society's development potential, particularly if dependency rates among the elderly are high. Eight percent of older Canadians reside in long term care institutions compared with five percent of older Americans (Tamarkin, 1988). This may suggest that Canadian dependency rates among the elderly population is higher than the United States of America or it may reflect the availability of programs specific to the elderly in Canada. Provincial governments within Canada are attempting to decrease dependency rates among the elderly by intitiating health care programs which will promote individual independence. Present day long term care facilities encourage independence among the elderly, replacing the once predominant philosophy of promoting individual dependency. This theoretical framework attempts to decrease dependency rates within long term care institutions while promoting personal independence, decision making autonomy and lifestyle flexibility. The promotion of the above named concepts assumes that the institutionalized adult's quality of life is enhanced and maintained. The provincial government of Alberta, specifically the Department of Health or Alberta Health, has in the last decade researched and implemented program changes in long term care facilities. These initiatives have had a significant impact on the delivery of care, services and programs provided to the instiutionalized elderly of Alberta. Policy and program changes introduced at the nursing home level have greatly improved and enhanced the resources and quality of existing health care services provided to the institutionalized elderly. In 1985 the revised Nursing Home Act of Alberta was introduced. This document governs all nursing homes or long term care facilities within the province. Professional staff was increased in these facilities to better meet the demands of an aging instiutionalized elderly population. The previous Nursing Home Act had established minimum standards of care and services to be delivered to the elderly but the revised 1985 Nursing Home Act further developed these standards in an effort to increase or maintain the individual's quality of life within an institution and to further promote independence amont the institutionalized elderly. Alberta Health then introduced, in 1987, a classification system for all nursing homes. The ultimate goal of the classification system is to fund facilities in a more equitable manner taking into account individual facility care requirements. For example, a nursing home with heavy or intense care requirements will be funded at a higher rate compared with facilities which have light or minimal care requirements. The classification system determines staffing patterns for the nursing department within long term care facilities. For facilities with above average care requirements the non-professional nursing staff was increased. The professional nursing staff ratio was increased from 17 percent to 22 percent. Professional and non-professional nursing staff was not decreased in any facility. The provincial Department of Health has made a concerted effort to improve the quality of life for elderly individuals residing within Alberta institutions. Medicine Hat, a southeastern Alberta community, has a total population of 42,290 (Census Summary Part3, 1988). The Census Summary (1988) explains that 14 percent of Medicine Hat's total population consists of adults over the age of 65 years. This is much higher than the provincial percentage of 8.2 percent. The Medicine Hat News (1990) reported that in the early months of 1990, 6,000 of the city's residents were 65 years of age and older but that number will soar to 7,200 by the year 2000 with half of these individuals 75 years of age and older. As the past Director of Nursing in a nursing home in Medicine Hat, I am most concerned with meeting the needs of the institutionalized elderly. The revised Alberta Nursing Home Act of 1985 and classification systme of 1987 have created the resources within a nursing home to realistically meet the complex and varying health care needs of older individuals. According to Maslow's (1970) theory of human motivation a hierarchy of human needs exists. The beginning point or basis for motivation theory is the meeting of human physiological needs such as food, clothing and shelter. Maslow's hierarchy of needs then continues with the human need for safety, love and belonging, esteem and lastly, the need for self-actualization. Individual learning experiences promote and meet one's esteem needs. However, Maslow proposed that esteem needs cannot be met unless those needs below it on the hierarchy scale are initially met and maintained. Nursing homes do meet the basic survival or physiological needs of their residents. These individuals are fed, clother and sheltered. Safety needs of the instiutionalized elderly are met by the institution in terms of 'security, structure, order and protection" (Maslow, 1970, p. 39). The institutional setting may not adequately meet the individual's need for love and belonging. This can be attempted, collectively, on a group basis but individual loneliness may prevail. It is hoped that these needs can be met with the assistance of the individuals' family or friends. If love and belonging needs are adequately fulfilled then Maslow acknowledges that esteem needs may be attained. Esteem needs include the desire "for self-respect or self-esteem and for the esteem of others" (Maslow, 1970, p. 45). The long term care facility may attempt to meet an individuals' esteem needs by providing learning opportunities which will promote "individual recognition, achievement, mastery, competence, confidence, independence, status, importance, appreciation and dignity" (p. 45). The meeting of an individual's esteem needs may or may not lead one to strive for self-actualization which, according to Maslow is the epitome of being. The need for interdependence is perhaps a higher need than self-actualization. The need for interdependence suggest that each individual or groups of individuals must rely on the other for their co-existence. Interdependence is crucial within long term care settings as residents, their familiees and/or significant others and the institution strive for an environment of mutuality. Historically, the physical, social, spiritual and mental well being of the institutionalized elderly was a goal most long term care facilities strived for. This conceptual framework surmises that learning needs are a part of the individual's mental and social needs. Nursing homes contain several departments which address specific needs of the resident. For instance, the nursing, dietary, phsiotherapy and occupational therapy departments ensure that the physical needs of the institutionalized elderly are assessed and addressed by the recreational department within a long term care facility. In Medicine Hat, community senior citizen centers as well as the local college have provided learning opportunities for older adults who reside in a community setting. However, long term care facilities have not truly addressed the issue of providing learning sessions for the lucid institutionalized elderly. Perhaps this is due, to some extent, to certain attitudes espoused by society in general, towards aging and the institutionalized elderly. Nursing homes may be perceived by some members of society as the final resting place for the living. Inhabitants of nursing homes may be perceived as a collective group rather than individuals with uniquely varying personalities, preferences, desire and emotions. The institutionalized elderly are individuals who wish to live their lives as do otje members of society, with definition, purpose and the desire to be recognized. Society has in the past negatively stereotyped aging and has held an infatuation with youth which has contributed to the ideology that aging was not an important process to be studied (Groombridge, 1982). However, with the realization that the elderly population is increasing significantly researchers are becoming more interested in understanding aging as it constitutes a complex process which involves biological, psychological, social, political and economic factors. According to McDaniel (1986) aging is poorly understood at present but is receiving greater attention and an increasing amount of research has rectnely been intiated on the subject. In my opinion, research initiatives concerning the institutionalized elderly are long overdue. Long term care facilities are now placing greater emphasis on the goals of resident individuality, personal autonomy and institutional flexibility with regard to the reidents' lifestyles. Long term care professionals are now motivated to inquire and seek clarification from their clientele in an effort to achieve this new goal. An increasing elderly population has prompted researchers to consider new and unexplored areas of critical thinking concerning elderhood. The identification of learning needs among the lucid institutionalized elderly is an unexplored area of elderhood. Past research on learning needs among the elderly indicates that gaps do exist in the research. Further studies are required in order to understand and plan future learning programs for the lucid instiutionalized individual.
ii, 151 leaves : ill. ; 29 cm.

For many years, research and clinical practice in gerontology has been influenced strongly by cultural concepts that lead to an overall negative perception of the elderly. Recently, psychologists have examined wisdom in order to provide an alternative viewpoint to the negative conceptions of old age. This study investigated how the elderly perceived wisdom and how the psychosocial conflict of “Integrity versus Despair” was experienced by the elderly. The elderly were approached as primary sources of knowledge for their views on wisdom. Using grounded theory methodology, twenty-one volunteer participants, 70 years of age or older, from the Sierra Nevada foothills of California, were each interviewed twice for an hour in order to form an inductive, data-driven theory concerning wisdom. The elderly described wisdom as a multi-faceted construct with a wide range of components. The resulting theory displayed a process by which the foundations of wisdom were formed during a person's lifetime, what developmental processes lead to wisdom, and the ways in which wisdom was demonstrated in a person's life. Of interest to psychotherapists and developmental psychologists, the integration of Erik Erikson's identity conflict of “Integrity versus Despair” may be facilitated through positive thinking techniques used by the elderly to overcome depression and to maintain a positive mood state. Thus, wisdom, as seen from the perspective of the elderly, may provide our society with an alternative conceptualizations of aging and a way to overcome despair in late life. Wisdom may be the pinnacle of human achievement across a lifespan of development.

Using a pre- and post-test design with both experimental and control groups, the research was conducted to see if life review improved the independence, depression, and integrated functioning of the institutionalized elderly. The elderly on the long term care unit of an acute care hospital waiting to be placed in a long term care facility were studied using a pre- and post-test design. Patients who were not depressed and could communicate in English were included in the study. They were randomly assigned to the experimental and control groups when possible. Patients in the experimental groups attended eight life review sessions over a four week period while the control groups carried on with the usual activities on the unit. Three scales, the Geriatric Depression Scale, Activities of Daily Living Evaluation Form, and the Geriatric Rating Scale were administered before the four week period and after. Data was also collected during the sessions on group process using the Group Process Observational Checklist on the experimental groups. Demographic data was collected on all the patients in the study. It was found that the experimental group did become more independent, integrated and less depressed. This study indicated that life review is beneficial for the institutionalized elderly but, it could not show exactly what variables in the life review process contributed to these positive results. Replication studies are needed to validate these findings.
Education, Faculty of
Educational Studies (EDST), Department of
Graduate

Falls are one of the leading causes of accidental death and injury in older people. Similarly, a fear of falling is extremely common in the elderly, with prevalence estimates upward of 90%. A fear of falling is associated with unnecessary activity restriction, avoidance, distress, an increased risk of falling, and a reduced quality of life. For all of these reasons, efforts to treat fear of falling and promote fall prevention are needed. In the present study, I investigated the effects of viewing a 15 min educational video about fall prevention on fear of falling and fall self efficacy in the elderly. While the video was developed to educate older individuals about practical steps they could take to avoid falling, the effects of the video on fear of falling and fall self-efficacy had not been investigated up to this point. Participants in the study consisted of 74 men and women over the age of 70 years who were recruited from several senior citizen groups. Participants were randomly assigned to one of three groups: (a) exposure to the video followed by a brief discussion, (b) exposure to the video alone, and (c) a waitlist control group. Measurements were taken 1 week before viewing the video and immediately after viewing the video. The dependent variables were scores on two self-report measures: The Falls Efficacy Scale and the Survey of Activities and Fear of Falling in the Elderly. Data were analyzed using a 2X3 ANOVA. Results showed no significant interaction effects, however a significant effect for trials was found for the Falls Efficacy Scale. Possible reasons for these findings were discussed.

Thesis (M.Ed.)--University of Toledo, 2009.
Typescript. "Submitted as partial fulfillment of the requirements for The Master of Education in Educational Theory and Social Foundations." "A thesis entitled"--at head of title. Bibliography: leaves 97-104.

Low-income older adults are at high risk for developing diet-related chronic diseases. Nutrition education programs can improve dietary and lifestyle practices, thereby decreasing the incidence of diet-related diseases. Focus groups were conducted to gain insight into the needs and preferences of low-income older adults for nutrition education. Results were made available for use in the Smart Choices Nutrition Education Program at Virginia Tech to aid in the development of nutrition education programs.

Four focus groups were conducted with a total of 35 elderly (28 females; 7 males), ages 55-90+ years, recruited from Congregate Meal Program sites in four regions of Virginia. Seventeen were African American, and 18 were non-Hispanic white. Discussion questions addressed practices for purchasing and preparing foods, importance of food to health, and preferences for education methods. The Determine Your Nutritional Health Checklist of the Nutrition Screening Initiative was used to assess nutritional risk of the elderly adults. Focus group discussions were audio-taped and written transcripts were made for use in data analysis. Themes of the discussions were identified in that analysis and reported in the following broad areas: Factors that Influenced Dietary Practices of Focus Group Participants and Perceived Needs and Preferences of Focus Group Participants for Nutrition Education.

All elderly believed that food was important to their health and were interested in nutrition education. The predominant theme was the influence of a health condition on dietary practices. The elderly made food choices according to dietary restrictions imposed by their health condition. The most prevalent health conditions were chronic diseases, primarily hypertension, diabetes, and hiatal hernia. The majority (32) were at nutritional risk, with a larger number at high risk (20) than at moderate risk (12). Food preferences and sensory attributes of food also were important to them when making food choices. Some reported that convenience was important because they did not want to spend time and effort to purchase and prepare foods. Some also reported experiencing food insecurity, primarily from lack of money. The majority learned about food and cooking from family members, and only a few learned about nutrition and food choices from health professionals. Most wanted information about disease-specific food choices and preparation methods, and preferred to receive this information during group discussions because sharing ideas and opinions was an effective way to learn. Only a few were interested in television programs, while many were interested in written materials. Nutrition education programs for low-income elderly should teach these adults how to choose and prepare foods that are appealing and nutritious, as well as within dietary restrictions imposed by their health conditions. Educators should convey this information to them in group settings and distribute written materials, such as pamphlets and brochures, that outline "how-to" information.
Master of Science

Falls are a major public health concern and contribute significantly to mortality and morbidity in the older adult population. Each year, approximately 3 million older adults are treated in emergency departments for fall-related injuries and at least 300,000 older people are hospitalized for hip fractures. The purpose of this project was to improve the participants' knowledge and highlight interventions to reduce the incidence of falls and injuries as a result of falls. The project was developed using the Stop Accidents, Deaths and Injuries (STEADI) toolkit, the Iowa model of evidence-based practice to promote quality of care, and the Lewin's change theory. The practice-focused question related to whether fall prevention would improve following the implementation of a staff education project using the STEADI toolkit. Twenty-six nurses were assessed to determine their knowledge deficits. Pretest and posttest data were analyzed, and as a result of the staff education initiative, the nurses' knowledge increased by 99.25%. Prior to the session, the facility had not participated in a fall-prevention initiative. This project offered a practical solution to the educational gaps identified at the practice setting. Adopting the STEADI toolkit at the practice setting is expected to improve patient safety, reduce falls with injuries and prevent fall-related deaths.

The demography of the United States is in the midst of an unprecedented transition that will result in persons age 65 and over outnumbering children by the year 2030 (MacManus, 1995). This demographic shift has the potential to give elderly voters significant influence over public education funding (Poterba, 1997). The purpose of this study was to describe the phenomenon of elderly voter attitudes toward public education funding in a rural county. By engaging elderly voters in dialogue that captured the essence of their lived experiences in school and in the community, valuable information related to how those experiences had nurtured community loyalty or fostered rational self-interest was obtained. A phenomenological approach rooted in the tenets of narrative analysis was used as the framework for the research design in this study. The setting was a rural county in a mid-Atlantic state. Ten volunteers were solicited from among typical elderly voters in the county. Data were collected from personal interviews, field notes, interview notes and reflexive notes. Constant-comparative analysis was conducted in accordance with a three-iteration strategy to develop within and across-case analyses. Code-mapping was used to develop a visible audit trail. Personal narratives based on information obtained from the four data sources were written for each participant. The themes that resulted from an analysis of each narrative across all cases were applied to the economic theories of community loyalty and rational self-interest. The application of the emergent themes relative to each theory led to the conclusion that the lived experiences of the ten participants in school and in the community had impacted their attitudes toward public education funding. The identification of these experiences has implications for local education policy makers as they engage in strategic planning initiatives.
Ph. D.

The objective of this study was to support the claim that drama education is no "mere frill" in the curriculum but is, in fact, important to the formation of attitudes and values in young people. The study moved in two directions. The literature was explored to establish a position on what is intended by the terms "attitude" and "drama education" and to demonstrate a connection between these two terms. Following a review of the literature which demonstrated that there was reason to believe that children's attitudes to ageing and to old people are less than ideal, the two strategies of a practical investigation were begun. In examining the attitudes of Grade 5 children to the elderly and to the ageing, quantitative and qualitative investigations were undertaken. The quantitative investigation employed the Children's Attitude Towards the Elderly (CATE) (Jantz, Seefeldt, Serock, and Galper, 1976) instrument to examine attitudes in one control and two experimental groups. The qualitative investigation consisted of the analyses of: (a) interviews with the teacher, and children of both experimental groups during and after the three units of drama education, (b) pre- and post-drawings by children from these groups, (c) the reflections written in their journals by children of the experimental groups after the drama education units, and (d) field notes taken during participant/observation in the drama classroom. The experimental groups were taught drama employing two different methods. Group A pursued the topic "Young People/Old People" in the drama classroom in child-directed drama, while Group B explored the same topic in teacher-directed drama. The results of both strategies were compared and contrasted under the rubrics of the theoretical positions on "attitudes" and on "drama education" adopted for the study. The research results converged to support the claim that, for the children of both experimental groups, doing drama had asssisted them as they rebuilt their attitudes to old people and to ageing. No such improvement had occurred for the Control Group. Positive attitude change consisted in (a) greater knowledge of old people and ageing, (b) a diminution in the fear of ageing and old people, (c) positive feelings toward the elderly, and (d) identification with the interests, feelings, goals, and means of elderly people. In addition, the qualitative study revealed that some children recognized that drama caused them to re-value the people in their own lives.
Education, Faculty of
Graduate

Health literacy among the elderly Hispanics is a problem for 44% who read at the lowest level due to issues with recognition, cognition, or vision. The purpose of this study was to determine the extent that elderly Hispanics have problems with medication adherence due to health literacy. The social cognitive theory was the framework for this study. Inclusion criteria consisted of being 65-75 years of age, and speaking and/or reading English and/or Spanish. Questionnaires from 156 individuals were completed in Cobb County/Atlanta GA and analyzed using multiple regression to determine the relationship between health literacy and medication usage. Medication adherence was the dependent variable and independent variables were gender, age, Hispanic origin, education, income, income means, health insurance, health literacy, and medication usage. Statistical significance was noted in medication adherence, health literacy, and working full-time. Results were based on the correct answers from health literacy questions, which showed an association between medication adherence and health literacy and a reduction in medication adherence problems among elderly Hispanics who worked full-time. These findings showed a significant association between medication adherence and health literacy level among elderly Hispanics. No medication adherence problems were noted among participants who had good health literacy, unlike participants with poor health literacy. A larger ethnic group may show a variation of problems in future studies. Implications for social change could include recommendations for the use of Spanish language hotlines and reading materials to provide care, knowledge, and medication information assistance.

It is the purpose of this study to compose a bibliography of primary level books and/or stories that depict a positive image of the elderly. Various procedures were used to gather selections of reading material for primary level children which portray this image. The following were the methods used for this compilation. Numerous reference books which categorize children's books under related topics were examined. Approximately thirty-five letters were submitted to various organizations which deal with the elderly population asking for information or sources regarding this topic. Letters were also sent to thirty-five randomly selected publishing companies requesting suggested literature. Several teacher's magazines occasionally sighted books of interest. The results are a compilation of seventy-two primary children's books and nine short stories that depict a positive image of the elderly.

The present study examined a social marketing approach to a health promotion program in stress management education that combined various aspects of large scale mass-market campaigns and individually tailored interventions. The study was conducted in two major phases using two groups from the main population of retired university faculty members. The intervention was a series of stress management seminars which was presented in each phase. Program evaluation took place at several intervals throughout the study. The first phase of the study served to assess the retirees' needs and to develop the program content and delivery style by using the target population's administrative committee. This committee became the focus group. The presentation of the stress management seminars to the focus group was specifically tailored to the group through frequent interactions and participation by the group members. On evaluation, the program was shown to be effective on a number of dimensions, but it was also labor intensive. A second phase was conducted on a larger sample from the target population of retirees. The sample was found to be equivalent to the focus group on demographic variables, stress levels, and stress management practices. This phase utilized the same program content that was developed in the first phase, but further examined program delivery. Two styles of program delivery were compared. The first was a didactic, lecture-style frequently used in large scale educational campaigns; the second was an interactive, discussion style, used more frequently in individual interventions. Overall, the program participants from both phases improved in their abilities to identify their stress symptoms, stress management strategies that they felt they would use, and increased their levels of perceived control over their stress. Factor analysis was one method used to evaluate program effectiveness and to replicate the factor structure of coping strategies from another study. The utility of factor analysis as an assessment procedure was developed and supported. No major significant differences between delivery styles were found. Thus, indirect tailoring of the program for the target population through the representative focus group was as effective as directly tailoring the program with the target population. Both the interactive and didactic approaches can be integrated into a single educational program to obtain an optimal combination of cost-effectiveness and informativeness. Once the program content was developed through the intensive process of tailoring in the first phase, the more efficient didactic delivery style could be used equally successfully with a matched population. Clinically, the study served as a cost-effective prototype of a stress-management education program for the mass-market.
Ph. D.

The elderly population is increasing in Sweden and they have a higher risk of suffering of poorer dental health. Dental professionals must be aware of this situation and aware that this group of people needs daily special dental treatment to obtain better oral health.   The Purposes of this study is to investigate what elderly patients think about dental professional’s pedagogical abilities for treating elderly individuals in dental care.   The methodology of this study was a qualitative research approach with qualitative interviews to examine the older patients' perceptions about pedagogical knowledge of dental care providers. The analysis of the empirical data was performed based on five themes. The first theme is the understanding of elderly patients in dental care. The four remaining themes are: knowledge, competence and experience, communication and patient education.   Results: Dental knowledge is within health care and pedagogical education, therefore dentistry professionals must know and develop several disciplines in the interdisciplinary field of knowledge between oral care, education and organization. This study has shown that older people perceive the existence of pedagogic failure in the treatment of elderly patients in dental care. If older patient perceptions are right it would require more patient education in geriatric dentistry to in turn improve oral health in this group of patients. The study also shows that older patients’ desires to get a better patient education from dental professionals, but older patients also want to be understood individually at the learning and treatment process.
nej

There is an acknowledged need for continual intellectual growth in older adults. This study describes the characteristics of learning practiced by a particular. group of well-elderly adults over the age of 75. Data were gathered self-reported learning experiences.A semi-structured interview was developed by the researcher to elicit responses in three areas that characterize learning: (1) decision to start to learn, (2) awareness of individual learning process, and (3) evaluation of their own learning processes. Fifteen members (n=10 women and n=5 men) of the Trinity United Methodist Church in Huntington, IN were interviewed.The data showed depth and comprehension in the learning experiences. The learning experiences ranged from skill acquisition to the writing of scholarly papers. The data indicated the group was homogeneous allowing it to be used for future research comparisons. Data for the three learning characteristics revealed that building on experience as a basis, the group was continually ready to learn. They had established wide resource networks, used a variety of printed, visual, and audio material, and readily sought expert advice. From the bases the participants to organized the material, evaluated the information, related the information to their situations, and then used the information to make decisions. All of the participants this process.
Department of Educational Leadership

Social workers are trained during the course of their education to work with the elderly and to understand the various dynamics of aging. These professionals also receive education on substance abuse and how to assess clients as well as link them to appropriate supportive services. How can social workers be more inclined to effectively treat the elderly substance abuser? What are, if any, special considerations a social worker should be aware of when working with the geriatric population? What treatment modalities seem to be more effective with the elderly client? This study utilized a qualitative analysis consisting of interviews with eight clinicians who specialize in the area of addiction treatment amongst the aging population. The purpose of this study was to gain insight and knowledge that can be used to promote social worker awareness of elderly substance abuse as well as the identification of effective addiction treatment methods in the field of gerontological social work. The findings of this study will impact future social work practice, policy and research in the areas of education, treatment, and advocacy for the aging and substance abuse populations. Keywords: gerontology, substance abuse, aging, polypharmacy, interventions

Introduktion/Bakgrund: Enligt ett flertal vetenskapliga rapporter är misshandel och utnyttjande av äldre ett växande problem i Europa och övriga världen. Det kommer att ställas högre krav på vårdgivare både inom familjen och inom välfärden på grund av en åldrande europeisk befolkning. Det förutses att en tredjedel av den europeiska befolkningen kommer att vara 60 år eller äldre år 2050. Tillförlitliga data och forskning är dock en bristvara när det kommer till misshandel och utnyttjande av äldre. Syfte: Att granska den tillgängliga forskningen om vilken effekt olika socioekonomiska faktorer (utbildning, yrke och förmögenhet) har huruvida äldre människor (60 år eller äldre) riskerar att utsättas för fysisk och/eller psykisk misshandel. Metod: En litteraturstudie valdes som arbetsmetod. Vetenskapliga artiklar och relevant litteratur har granskats och valts ut via olika databaser. Resultat: Studien kom fram till att olika socioekonomiska faktorer (utbildning, yrke och förmögenhet) påverkar huruvida äldre människor riskerar att utsättas för fysisk och/eller psykisk misshandel. Av de studerade faktorerna var utbildning den socioekonomiska faktor som främst påverkade huruvida en äldre människa riskerade att bli utsatt för misshandel eller inte. De andra faktorerna, yrke och förmögenhet/inkomst, var inte representerade i samma utsträckning som utbildning i studiens resultat. En annan påverkande faktor som hänger ihop med socioekonomiska faktorer visade sig vara könstilhörighet. Majoriteten av den granskade litteraturen bekräftar att det finns ett mönster som innebär att äldre kvinnor löper en större risk än män att utsättas för psykisk och/eller fysisk misshandel. Det var svårt att identifiera likheter eller skillnader mellan olika europeiska regioner på grund av att studiemetod och studiedesign skiljde sig allt för mycket åt mellan de olika vetenskapliga artiklarna. Slutsats: Resultatet från litteraturgranskningen visade att utbildning har en större påverkan än yrke och förmögenhet huruvida en äldre människa riskerar att bli utsatt för psykisk och/eller fysisk misshandel eller inte. Studien fann även att könsskillnader var tydliga och innebär äldre kvinnor löper större risk än män att bli utsatta. Något som också måste tas i beaktning i framtida forskning. Bristen på forskning och litteratur inom ämnet vittnar om att det finns ett stort behov av mer forskning. En bättre förståelse för relationen mellan socioekonomisk position och misshandel av äldre är viktigt för framtiden.
Abstract Introduction: The issue of elder abuse is described as increasing in Europe and beyond according to several scientific reports. An ageing European population combined with longer life expectancy will increase demands on family caregivers and a well-functioning health and social care workforce. It is estimated that in year 2050 one third of the European population will be 60 years or older. However there is still a shortage of confident data across European countries regarding the extent, features, determinants and effects of elder abuse. Aim: To review existing knowledge of the impact of various measures of socioeconomic position (education, occupation and wealth) on physical and psychological abuse among elderly people (60 years of age and over) in Europe. Method: A literature study was chosen as working method. Scientific articles and relevant literature were examined using different databases. Results: The review found that socioeconomic position factors (education, occupation, wealth) have an impact on the likelihood of elderly individuals experiencing abuse. Of the assessed factors, education has shown to be the socioeconomic factor which has the most impact on the likelihood of elder abuse. Other factors such as occupation and wealth and income, were not represented in the results at the same extent as education. Another important factor related to elderly people’s socio-economic position was found to be gender. The majority of articles analysed in this thesis confirms that there is a pattern where elderly women are more likely to experience abuse than are men. Due to different study designs and measures in the analysed scientific articles and reports differences according to area context were hard to identify. Conclusion: Results of this thesis showed that education as measure of socioeconomic position had the biggest impact on elder abuse as compared to occupation and wealth. However, gender (a factor strictly linked to socioeconomic position) differentials were remarkable, a subject which needs to be taken into consideration in future research. Further, the lack of literature in the research subject points out to an urgent need for further studies. This is urgently needed, as both ageing and abuse are increasing across Europe. A better understanding of the relation between socioeconomic position and abuse among elderly will be of paramount importance for future interventions aimed to curb the ever growing trend.

Dementia is a serious public health concern in the United States, with a prevalence of 5.2 million. There is currently no effective way to prevent or cure dementia, and the precise etiology is unknown, but it appears there are multiple risk factors. Prediabetes (PD) has been identified as a risk factor although the scientific evidence is conflicting. This study is important to those at high risk for dementia and to healthcare professionals who lack substantiated dementia prevention strategies. The purpose of this case control study was to determine whether PD is associated with dementia in adults aged 65-95 years and whether the association varies according to demographic (age, gender, race, and socioeconomic status [SES]) and health (atherosclerosis, body weight, cerebrovascular disease, dyslipidemia, hypertension, and stroke) risk factors. The ecosocial theory was selected to bridge the study findings to life-course exposures and risk factors. Cases (n = 574) and controls (n = 2,157) were sampled from a large ambulatory care dataset, and multivariable logistic regression was used to test the research hypotheses. No unadjusted association between PD and dementia was found (OR 1.08, 95% CI = .854, 1.241, p = .604). The regression analysis revealed no association between PD and dementia; however, atherosclerosis, hypertension, low body weight, and low/average SES were found to be significantly and independently associated with dementia. A stratified analysis revealed that race and SES did not alter the effect of PD on dementia. The implications for positive social change include the potential reduction of incident dementia through initiatives targeted toward demographic and health risk factors including atherosclerosis, hypertension, low body weight, and low/average SES.

Assistive technology may delay cognitively impaired elders’ need for long-term institutionalization, and the promote independence. Its use is on the rise, yet the gap between the needs of the cognitive impaired elderly and what developers of the assistive technologies design, manufacture, and implement, remains to be filled. Using Inayatullah’s 6-pillar approach, as the guide to the future of assistive technology, the purpose of this qualitative study was to explore how assistive technologies may fulfill the daily functional needs of the cognitively impaired elderly with Alzheimer’s or other dementia by 2037. Data were collected from a focus group of 10 seniors at a senior center in a large mid-Atlantic city, as well as survey data from with 5 family members of the cognitively impaired elderly and 16 technology developers from an engineering society. These data were coded according to the thematic content analysis and causal layered analysis. The future triangle analysis served as a second layer of analysis. Findings indicated that the most desirable outcome for 2037 is that of the “happy retiree,” characterized by flourishing cultural and financial opportunities, and the least desirable is that of the “struggling pensioner” characterized by monetary gains of the social elite at the expense of the poor and working class. The most expected outcome, though, is the “caring robot” that is characterized by the use of technology and artificial intelligence to promote equitable social and health care benefits to aging citizens. Positive social change may be achieved through recommendations to state, local, and national policy makers that support the improvement in the elders' well-being, the delay of hospitalization, and greater support for the duties of family members, and greater caretaker independence.

Three generations of registered nurses make up the current nursing workforce: Baby boomers, Gen X, and Gen Y. Each generation brings its own values, behaviors, and beliefs to the workplace. The generational diversity among nurses needs to be assessed along with other factors, such as social values of the elderly, anxiety toward aging, and practice settings, to examine how each factor impacts registered nurses' attitudes toward caring for the elderly. An exploration of these factors is significant to nurse leaders, since nurses have been known to display negative attitudes toward the elderly. The theoretical foundation for this study was based upon Rosenberg's three-component view of attitudes. The bias scores from Palmore's Facts on Aging Quiz (FAQ I) was used to indirectly measure the dependent variable, registered nurses' attitudes toward caring for the elderly. The independent variables were anxiety toward aging, social values of the elderly, generations, and practice settings. Kafer's Aging Opinion Survey was used to measure anxiety toward aging, and social values of the elderly. Practice settings and generations were identified by a demographic profile. The survey data were collected from 265 registered nurses. An Analysis of Variance (ANOVA) was used to compare mean attitude scores between each generation and practice setting. Pearson's correlation coefficient examined the relationship between nurses' attitudes toward caring for the elderly, social value of the age, and anxiety toward aging. A multiple linear regression analyzed each independent variables prediction of nurses' attitude scores. Findings indicated a statistically significant association between the dependent and independent variables. Findings suggest the need to evaluate these variables prior to job placement to ensure quality healthcare provision to the elderly. Such action positively impact social change because nursing practices may be inspired to develop programs that encourage more favorable attitudes toward the elderly.

In elderly women, discharge after gynecologic surgery is often associated with increased morbidity. Little information exists about elderly women's discharge destination after gynecologic surgery and the outcome of early hospital readmission. The purpose of this study, conceptualized using the quality health outcomes model, was to examine whether post hysterectomy discharge destination is an independent predictor of 30-day hospital readmission in women age 65 and older. Examination of covariates included patient age, race, medical comorbidity and complications of care, as well as surgical anatomic approach and operative technique. This study involved use of a retrospective cohort design and data from 10,598 cases contained in the Healthcare Cost and Utilization Project 2010 and 2011 California State Inpatient Databases. Results of the bivariate analysis showed a statistically significant association between discharge destination after hysterectomy and 30-day hospital readmission. Additionally, the results of multivariate logistic regression revealed the odds of readmission after discharge with home care were 2.99, p < .001, 95% CI [2.29, 3.67] times greater when compared with discharge home for self-care and 5.99, p < .001, 95% CI [4.68, 7.43] times greater with discharge to continuing inpatient care versus home for self-care. This study may lead to positive social change for elderly women by informing health care providers about the odds of early hospital readmission associated with discharge destination after hysterectomy. Further, this information may stimulate development of interventions to improve health care practices for elderly women preparing for hospital discharge after hysterectomy.

Purpose: The purpose of the study was to determine the impact of the discharge education plan on the 30 day heart failure (HF) hospital readmission rates of elderly patients.

Research Question: What was the impact of the discharge education plan including medication adherence, dietary discretion, daily exercise tolerance, daily weight recording, recognition of any early symptoms of worsening HF and early follow-up plan with the physician in reducing the 30 day HF hospital readmission rates of the elderly patients?

Research Hypothesis: The discharge education plan including medication adherence, dietary discretion, daily activity tolerance, daily weight monitoring, recognition of any early symptoms of worsening heart failure, and early follow–up with the physician will reduce the 30 day heart failure hospital readmission rates of elderly patients.

Background: HF is one of the most common diagnoses and indications for hospitalization among adults over 65 years in United States (Pang, Komajda, and Gheorghiade, 2010). HF admission results in 6.5 million hospital days annually. In 2010, the total cost of care for patients with HF was 39.2 billion dollars (Gheorghiade, Vaduganathan, Fonarow, and Bonow, 2013). About two million Medicare beneficiaries are readmitted within 30 days of release from the hospital each year, costing Medicare 17.5 billion dollars in additional hospital bills. It is reported that elderly patients with HF are at increased risk for early readmission as a result of behavioral factors such as medication non–adherence, dietary indiscretion, exercise intolerance, drug and alcohol abuse, inadequate access to follow-up care, and poor transition of care (Gheorghiade, et al., 2013).

Design and Methods: A retrospective, non–experimental, and descriptive chart review was used in this study. The quantitative data, using convenience sampling, selected charts of patients with a diagnosis and readmission of HF within 30 days of discharge from the hospital between May 2012 and June 2013, was reviewed.

Findings: A chi square statistic was used to investigate whether distributions of categorical variables differ and also compare the tallies or counts of categorical responses between the six independent variables. The significant results of the Chi square test for goodness of fit was found only for daily weight monitoring (p=0.0372) and with activity intolerance (p=0.0123). The test compared theoretical (expected) values to experimental (observed) values to determine whether the differences between these values are due to chance (sampling error) alone. The components of the discharge education plan that could not be tested were early recognition of worsening symptoms, early follow–up with the physician and medication non-compliance because of the low frequency counts of <5, and thus we cannot assume that the data follows a rough normal distribution. Therefore, the hypothesis was not supported.

The incidence of venous and arterial thromboembolic events (VTEs/ATEs) varies greatly by cancer type and age, with increased risk in the elderly. Very little research has been reported specific to elderly kidney cancer patients. Retrospective cohort analyses of Medicare patients, 11,463 with and 11,463 without kidney cancer, between 2003 and 2010 were conducted to compare incidence rates of VTEs/ATEs in cancer patients with matched noncancer patients and to assess independent risk factors for VTEs in cancer patients. The advanced epidemiology triangle was the theoretical framework used to interpret the association between incident events and other factors. Using Cox proportional hazard regression, the first 2 research questions examined whether the incidence rates of VTEs/ATEs were higher in kidney cancer patients than noncancer patients; the third research question assessed which factors were associated with VTEs after kidney cancer diagnosis. In the year prior to index date, cancer patients had higher incidence rates of VTEs than noncancer patients; the incidence rate of myocardial infarction was higher in cancer patients than noncancer patients for patients with a history of cardiovascular disease. Elderly kidney cancer patients with transitional cell tumors had lower rates of pulmonary embolism and ischemic stroke compared to patients with clear cell tumors. Recent history of VTE and Charlson comorbidity score were strong predictors of VTE after cancer diagnosis. These results can lead to positive social change by helping healthcare providers to determine who may benefit from closer observation or prophylaxis to prevent or minimize morbidity from these thromboembolic events, thus improving health and quality of life for elderly kidney cancer patients.

Multiple research studies have demonstrated racial, socioeconomic status (SES), and neighborhood disparities in first-line treatment of colorectal cancer patients, including those with metastatic colorectal cancer. However, disparities in adjunct monoclonal antibody treatment disparities have not been explored. The purpose of this study was to assess racial, SES, and neighborhood disparities in adjunct monoclonal antibody treatment of elderly metastatic colorectal cancer patients. The research was rooted in 3 theories: the fundamental cause theory, the diffusion of innovations theory, and theory of health disparities and medical technology. Data from the SEER-Medicare database and logistic regression were used to assess the relationship between the variables of interest and adjunct monoclonal antibody therapy. In this study, race (p = 0.070), SES (p = 0.881), and neighborhood characteristics (p = 0.309) did not significantly predict who would receive monoclonal antibody therapy. The results demonstrated a potential improvement in historically documented colorectal cancer treatment disparities. Specifically, historical treatment disparities may not be relevant to newer therapies prescribed to patients with severe disease. The difference could be related to improved access to care or a change in treatment paradigm due to the severity of metastatic colorectal cancer. Future studies aimed at understanding the causes of this social change (i.e., reduced treatment disparities) are warranted. Understanding the root cause of the reduced treatment disparities observed in this study could be used to reduce treatment disparities in other cancer populations.

The purpose of the study was to examine nutrition knowledge of elderly congregate meal site participants with particular interest directed towards nutrition risk levels and the demographic characteristics of education, age, and gender. The population utilized in this study were 120 elderly, both male and female, over the age of 60 years who attended ten congregate meal sites in Allen County, Indiana and who volunteered to participate. The researcher administered a 25 question nutrition knowledge survey and the 10 question Determine Your Nutritional Health Checklist at the meal sites. The study was designed to determine if there was a significant difference in nutrition knowledge among elderly at congregate meal sites who exhibit varying nutrition risk, education, and age levels and between elderly men and women. The conclusion was that there was a significant difference between nutrition knowledge of men and women with women scoring more correct answers on the survey. Although not shown statistically other preliminary findings suggest the need for further research; a greater proportion of females than males were in the lowest nutrition risk level; the 60-74 years olds had a higher nutrition knowledge average score than did the two older groups. Further, those with 9-11 years of education and in the lowest nutrition risk level (all females) had the highest nutrition knowledge score; and males with less than eight years of education had the lowest nutrition knowledge score and a preponderance of those were in the moderate or high risk level. The researcher also concluded that more nutrition education is needed for these participants, but it must be geared to their learning level to be effective.
Department of Family and Consumer Sciences

This study concerned the impact lifestyles of the elderly have on purchases from different product categories. The main purpose was to determine, evaluate, and analyze the effects of lifestyles on elderly shoppers' choice of retail outlets.

A história mostra que a violência contra velhos não é um problema recente na sociedade. Em diversas culturas, por muitas gerações, os comportamentos violentos contra os velhos vêm se repetindo. Nos últimos anos, percebe-se movimentos da sociedade para fazer frente à esta problemática. Leis são elaboradas, manuais de enfrentamento são disponibilizados, mas ainda insuficientes para dar conta do sofrimento das famílias envolvidas nesse tipo de violência. Autores como Foucault, Elias e Scotson e Faleiros foram alguns dos consultados para dar suporte teórico ao trabalho de campo e, posterior análise. Ciente da complexidade desta questão, esta tese se propôs a ouvir os agressores, por entender que todos os lados devem ter a possibilidade de falar. Os estudos sobre violência até então têm pesquisado basicamente esta questão a partir das vítimas, ou de dados registrados em serviços públicos que servem de porta de entrada para que as denúncias ocorram. Assim, o objetivo principal desta pesquisa é analisar os fatores que conduziram à violência contra as pessoas idosas através da perspectiva dos agressores, a fim de elaborar uma discussão que subsidie intervenções educativas no campo da violência. Para tal, tem-se como objetivos específicos a) conhecer as histórias da vida dos agressores de idosos; b) identificar os possíveis gatilhos que desencadearam as agressões; c) compreender os aspectos estruturais que possam ter relações com a prática da violência e d) oferecer elementos para intervenções educativas no campo da violência. Partindo dos objetivos propostos, optou-se por uma pesquisa exploratória, de caráter qualitativo, onde, através de narrativas, teve-se maior aproximação com as histórias das pessoas envolvidas. A amostra foi constituída por conveniência, sendo 5 mulheres e 3 homens, todos filhos, exceto um que era marido. Os resultados analisados a partir da Análise de Conteúdo proposta por Moraes foram organizados em duas grandes categorias, a saber: Multidimensionalidade da violência, subdividida em "Construção das relações familiares", "Consumo de drogas ilícitas e álcool" e "Desemprego", e a segunda categoria, nomeada de "Mecanismos Sociais de Atenção à Violência". Através do estudo, constatou-se que a maioria dos agressores é familiar muito próximo dos idosos, geralmente filhos e netos que, em geral, carregam as lembranças de terem sido vítimas de violência em outras fases das suas vidas. Os gatilhos para que a violência aconteça estão relacionados à desestrutura familiar, ao desemprego e ao consumo abusivo de álcool e/ou outros drogas ilícitas.Também identificou-se uma atuação precária dos mecanismos sociais de proteção aos idosos, que não conseguem garantir a segurança dos velhos. Além disso, ficam lacunas na prestação de um serviço realmente efetivo em decorrência de inúmeros fatores, mesmo quando contando com técnicos que possuam desejo para tal. Os resultados encontrados apontam para a complexidade da violência contra velhos, caracterizando-se como um processo multidimensional, no qual não é possível identificar uma única causa como geradora do evento. Alguns caminhos são apontados para minimizar as ocorrências. Desbanalizar a violência psicológica pode ser um caminho, uma vez que ela foi identificada como uma prática de menor gravidade pelos agressores. A reestruturação da rede de atenção, reestabelecendo os canais de comunicação entre as instituições, afim de agilizar as ações, dar suporte aos técnicos e evitar que novas violências sejam cometidas contra os velhos pode estar no percurso da proteção. Também sugere-se a urgência de repensar os currículos escolares nos diferentes níveis da educação formal, desde a pré-escola até os níveis universitários, para desenvolver relações intergeracionais positivas, que, certamente, será uma importante contribuição no âmbito da prevenção. Sabe-se que a tese trouxe contribuições para compreender o complexo processo da violência, mas também sinaliza para a necessidade de novas pesquisas paralelas a ações efetivas que mostrem para a sociedade que efetivamente se tem buscado fazer a diferença.
History shows us that the violence against old people is not a recent problem in the society. In several cultures, for many generations, the violent behavior against elderly has been repeated. In the last few years, a shift of behavior in society have been noticed in response to this problem. New laws are created, coping guides are shared, but these movements are insufficient to face the suffering of the families involved in this kind of violence. Foucault, Elias and Scotson and Faleiros were some of the authors referred to give theoretical support to the field research and subsequent analysis. Aware of the complexity of this subject, this thesis allowed the aggressors to be heard, understanding that all sides of the violence should be able to speak. Up to now, the studies about violence basically researched this issue from the victim's view or based on data recorded in public services that work as gateways of complaints registration. Thus, the main objective of this research is to analyze the factors that led to the violence against elderly from the aggressor's view, in order to organize a discussion to feed educational operations on the field of violence. To this purpose, it has as specific objectives: a) get to know the history of life of the old people’s aggressors; b) identify the possible triggers that cause aggressions; c) understand the structural aspects that could be related to the practice of violence; d) provide some elements for educational interventions in the field of violence. Based on the proposed objectives, it's been opted for an exploratory research, of qualitative character, where through the narratives it was possible to become closer to the stories of the involved people. The sample has been created by convenience, constituted by 5 women and 3 men all of them sons and daughters excluding one that was husband. The results analyzed from the Analysis of Content proposed by Moraes were organized into two big categories, namely: Multidimensionality of violence, subdivided into "Construction of family relationships", "Consumption of illicit drugs and alcohol" and "unemployment", and the second category named "Social Mechanisms of Attention to Violence". Through the study it was evidenced that most of the aggressors were a very close relative of the elderly, usually children and grandchildren who generally carry the memories of having been victims of violence in other phases of their lives. The triggers to violence are related to family dysfunction, unemployment and abusive consumption of alcohol and / or other illicit drugs. Also it has been identified a precarious actuation of the social mechanisms of protection of the elderly, which aren’t able to guarantee the security of the old people. In addition it keeps some gaps in rendering effective services due to numerous factors, even when it counts on technicians who have the desire to do so. The found results lead to the complexity of the violence against elderly and it is characterized as a multidimensional process without a single cause as event generator. Some paths are pointed to minimize occurrences. Considering the psychological violence could be a way, since the aggressors identified it as a minor severity practice. Restructuring the network of care, restoring the communication channels between the institutions in order to make the actions more efficient, give support to the technicians and prevent further violence being committed against the elderly could be in the protection route. The urgency to rethink the school curricula at all levels of formal education is suggested, from the pre-school to university levels, to develop positive intergenerational relations, which certainly will be an important contribution for the range of prevention. It is known that the thesis brought contributions to understand the complex process of violence, but also points to the need of further researches and effective actions, that shows to the society that it has tried to effectively make the difference.

Dissertação(mestrado)- Universidade Federal do Rio Grande, Pós-Graduação em Educação Ambiental- Instituto de Educação, 2011.
Submitted by eloisa silva (eloisa1_silva@yahoo.com.br) on 2012-07-08T18:43:07Z No. of bitstreams: 1 dissertao anacirema.pdf: 1877396 bytes, checksum: c3fd20e769fe11da13ec08531af60132 (MD5)
Approved for entry into archive by Bruna Vieira(bruninha_vieira@ibest.com.br) on 2012-07-09T19:43:59Z (GMT) No. of bitstreams: 1 dissertao anacirema.pdf: 1877396 bytes, checksum: c3fd20e769fe11da13ec08531af60132 (MD5)
Made available in DSpace on 2012-07-09T19:43:59Z (GMT). No. of bitstreams: 1 dissertao anacirema.pdf: 1877396 bytes, checksum: c3fd20e769fe11da13ec08531af60132 (MD5) Previous issue date: 2011
A presente pesquisa propõe um estudo acerca das relações sócioafetivas dos idosos institucionalizados no Asilo de Pobres do Rio Grande, com enfoque na educação ambiental, convidando à reflexão sobre os problemas sócioambientais dessa população, na busca pela superação dos mesmos. O objetivo principal desta pesquisa é analisar se relações sociais e afetivas de idosos asilados permite um desenvolvimento qualitativo na velhice. A pesquisa é de cunho qualitativo, na linha de pesquisa da Educação Ambiental não formal. Teve como base a Inserção Ecológica, metodologia que requer a imersão do pesquisador no ambiente investigado e está referendada na teoria bioecológica de desenvolvimento humano. Os participantes foram escolhidos por conveniência para atender aos objetivos da pesquisa. Efetuou-se uma consistente revisão bibliográfica na busca de maiores conhecimentos sobre o tema, utilizando como instrumentos para coleta de dados, entrevistas semi-estruturadas, diário de campo, que levantou dados sobre os entrevistados. A metodologia utilizada foi a História de Vida que permitiu estabelecer uma relação mais próxima com a população pesquisada e assim responder aos objetivos propostos. Concluí que para a melhoria na qualidade de vida desses idosos, a criação de espaços educativos dentro da instituição permitiria recuperar a visão integral do ser humano, não só limitando-se aos cuidados básicos de saúde e higiene, mas também favorecer qualidade nas suas interações sociais e afetivas. O tema escolhido para esta pesquisa é considerado relevante cientificamente, devido ao aumento da expectativa de vida da população idosa e consequentemente, seus impactos ambientais. As relações sociais e afetivas que os idosos asilados vivenciam, apresentam-se nesta pesquisa como uma possibilidade de rever o olhar estigmatizado que a sociedade tem sobre o idoso institucionalizado e consequentemente reverter o olhar que esse mesmo idoso sente por si, tornando mais humanas essas relações.
The present research proposes a study concerning the socio-affective relations of the elderly institutionalized in the poor asylum of Rio Grande, focused in the environmental education, inviting to a reflection about social and environmental problems of this population, in search of their overcoming. The main goal of this study is to analyse if social and affective relationships of sheltered elderly people permit a qualitative development in the old age. This is a qualitative study, in the research line of non-formal Environmental Education. This study was based on the Ecological Insertion, methodology that requires the immersion of the researcher in the investigated environment and is proposed by the bioecological systems theory. The participants were chosen by convenience in order to reach the research goals. A consistent bibliographical review was done to pursuit better knowledge about the theme, using as instruments for data collection, semi-structured interviews, field diary, that gathered data about the interviewees. The methodology used was the life history which allowed to be established a closer relationship with the researched population in order to reach the proposed goals. It was concluded that to improve the quality of life of these elderly people, the creation of educative spaces inside the institution would permit to recover the holistic approach of the human being, not only confined to basic procedures of health and personal care, but also favor quality in their social and affective interactions. The chosen theme for this research is considered scientifically relevant, due to the increase in the elderly population life expectancy and consequently, its environmental impacts. The social and affective relationships that the elderly people live, are shown in this research as a possibility of review the stigmatized look that the society has about the institutionalized elderly and consequently revert the look that this elderly feels about himself, turning these relationships more human.

As the baby boomer generation continues growing older, the geriatric community, and their needs grow larger. Many of those needs will necessitate the assistance of social workers’ knowledgeable of geriatrics. Research suggests that many social workers have negative attitudes toward older adults and show little interest in working with the population. The research question of this study was, does social workers’ personal, educational, and professional experience in geriatrics influence their knowledge on aging, and attitudes toward older adults? The researcher hypothesized that social workers with more experience have more knowledge on aging and view older adults more positively. Quantitative and Qualitative data was collected through the administration of a survey created through the online platform Qualtrics. Study participants consisted of 33 social workers located in the state of California. The data was analyzed using univariate and bivariate tests such as frequency, percentage, Pearson r correlation coefficient, and One-Way ANOVA, through the JMP data analysis software program. Additionally, the researcher read over study participants written responses in order to identify themes that emerged. Significant findings were found that supported the hypothesis. A significant relationship was found between social workers’ professional experience (number of years of job experience caring for an older adult), and their knowledge on aging (Facts on Aging II score). Also, the effect of study participants reported education level on their attitudes toward older adults, and knowledge on aging were also significant. Finally, nearly half of study participants reported some degree of interest in working with older adults, while the other half were either impartial or uninterested. The themes identified by the researcher, identified in participants written explanation of their level of interest in working with older adults, suggests that social workers’ interest in working with older adults is influenced by the degree to which they perceive the work as important, enjoyable, and fulfilling their professional goals. The results and findings of this study could contribute to the body of research focused on identifying what influences social workers’ interest for working in geriatrics.

The purpose of this study was to investigate the effects of a structured group experience (focusing on cognitive reprogramming) on the life satisfaction and subsequent adjustment of functional elderly persons residing in a nursing home. The study was designed to change the negative attitudes of participants towards themselves as elderly and to facilitate their adjustment to institutionalization. We are living in an aging society where increasing numbers of elderly people will spend their final years in a nursing home. The results of this study should be of significance to personnel employed in nursing homes, i.e., social workers, counselors, nurses, geriatricians, and others, who must assist new residents in making a successful adjustment. The study population consisted of twenty persons institutionalized for one year or less, who were at least sixty-five years of age, and physically able/willing to participate. Participants were assigned randomly to the experimental or the control group. The degree of change between pre and post-testing was measured on the Salamon-Conte Life Satisfaction In the Elderly Scale. The groups were homogeneous. The experiment was conducted for 1.5 hours biweekly for four consecutive weeks. A statistically significant difference was found between the mean scores of the two groups only in the life satisfaction variable. This difference led to the conclusion that the structured group experience was effective in improving life satisfaction among members of the experimental group.

More people in the United States are approaching retirement age, a trend which has resulted in increased study on life satisfaction and psychological well-being of the elderly. Previous researchers have focused on the relationship between religious social support and life satisfaction; however, there remains a gap in the literature regarding how race and gender may influence this association. Knowledge of interactions between religiosity, gender, and race will enable counselors working with different groups of religiously inclined clients to develop and implement religious-based interventions specific to their clients. Guided by the social ecological model, the purpose of this study was to examine how gender and race influence religious social relationships and psychological well-being, optimism, and self-rated health among the elderly, using data from the Religion, Aging, and Health Survey. Pearson bivariate correlations and hierarchical linear regression were used to examine multicollinearity among variables and whether the association between the religious variables measured and the psychological well-being of the elderly varied by gender and/or race. All 3 religious constructs significantly predicted positive well-being outcomes. However, only gender and race interactions were significant for the religious-based relationships with others variable. Income and marital status were found to be significant covariats for this study. Also, both income and marital status were significantly associated with the relationship between religious variables and the psychological well-being of the elderly. Findings from this study can aid religious leaders and public health practitioners in developing programs and policies to improve perception of health and psychological wellbeing among the elderly.

Geriatric board-certified specialists (GCSs) address health care needs of the growing geriatric population. The study's purposes were to: examine career paths of GCSs, identify influencing factors, and explore implications for higher education. Twelve of 14 original 1992 GCSs participated. Data included document collection and interviews. Using a qualitative methodology, commonalities were sought among individuals and HyperRESEARCH software was used for data management. The participants were adventurous, valued education, and were enthusiastic about physical therapy (PT), geriatrics, and specialization. Their career path began with choosing PT as a career, professional education, and their first job. One GCS moved directly into geriatrics. Others went to different settings before geriatrics. As participants recognized they "fit" in geriatrics, they pursued postprofessional education to increase knowledge before choosing board certification. In choosing PT, volunteer experience and personal research were common influences. In choosing to work with elders, influences throughout life gradually built a social context supporting the decision. GCSs chose specialist certification to assist in professionalization of geriatric PT, because they were highly skilled, for career advancement, and for self professionalization. Specialist certification had few financial consequences. Participants gained friends and professional networks. They experienced improved patient care, increased educational opportunities, and/or increased professional service. GCSs' vision was for a better society and health care system. This vision included successful aging - that it is possible and would benefit society. To bring about global change, GCSs perceived they had to influence older individuals, legislators, PT students, peers, and other professionals. Implications for higher education are as follows. Professional schools should not base admission on expressed intentions to work with elders. Curricula and clinical experiences should be such that a nonageist generalist is produced. Higher education's role postprofessionally can be through continuing education, formal degrees, and geriatric residency programs. Gerontology programs also could meet educational needs. Higher education can play an important role in the professionalization of individuals and ultimately the profession itself.

This thesis examined the life time exposure of women's employment on cognitive functioning and cognitive decline in late life. From the Cache County Study on Memory, Health, & Aging data, a sample of 2,588 women, aged 65 and older gave retrospective occupational hi story and were screened using the Modified Mini-Mental Stale Exam at study entry and approximately 3 years later. Non-demented women were used. Ordinary least squares regression was used cross-sectionally and longitudinally to test the association between cognitive complexity level of the longest job and baseline cognitive status, and rate of cognitive decline over approximately 3 years. Cross-sectional analysis revealed never-employed homemakers to have cognitive status mid-range. Higher "dat a" complexity levels were significantly associated with higher cognitive status at base line net of education. The results suggest some benefit of cognitively stimulating occupation to late-life functioning for women. Fw1her analyses with additional longitudinal cognitive testing in this population may enhance these findings.

A presente tese versa sobre a Educação a Distância e o desenvolvimento de estratégias pedagógicas, técnicas e metodológicas no intuito de abranger as necessidades biopsicossociais e incluir os idosos em cursos virtuais. Deste modo, o objetivo da presente pesquisa foi construir uma arquitetura pedagógica para a Educação a Distância voltada para cyberseniors. Esta necessidade surgiu da perspectiva de uma vida longa para uma grande parte da população, representando novos desafios, onde a educação a distância pode se tornar uma forma de inclusão social por suas inúmeras possibilidades. Desta forma as arquiteturas pedagógicas, como estruturas organizacionais do planejamento, podem auxiliar na discussão e reflexão sobre o tema. Para atender ao objetivo proposto, o estudo foi realizado em uma abordagem quali-quantitativa, composta por sete etapas de desenvolvimento. No decorrer das etapas foram oferecidos cursos de extensão para pessoas com 60 anos ou mais. Após a construção dos dois primeiros mapeamentos da arquitetura pedagógica, foram oferecidas seis oficinas virtuais (Espanhol. Fisioterapia, Cores, Fotografia, Trilhas Sonoras e História e Memória) no intuito de mapear indicadores para a construção da arquitetura pedagógica final. A coleta de dados foi realizada a partir de observações participantes, entrevistas, questionários e produções tecnológicas dos participantes mais velhos em ambientes virtuais de aprendizagem. Estes indicadores possibilitaram a construção da arquitetura pedagógica final onde se percebe a necessidade de aspectos gerontoeducacionais, como a resiliência e a reminiscência com os idosos. Com o estudo foi possível perceber que os idosos possuem potencial para aprender através da EAD, o que irá implicar mudanças culturais através de novas aprendizagens.
This thesis focuses on the Distance Education and the development of teaching strategies, techniques and methodology in order to address the biopsychosocial needs and include the elderly in virtual courses. Thus, the objective of this research was to build a pedagogical architecture for Distance Education facing cyberseniors. This need arose from the prospect of a long life for a large part of the population, representing new challenges, where the distance can become a form of social inclusion for its numerous possibilities. Thus the pedagogical architectures, organizational structures and planning, can assist in the discussion and reflection on the topic. To meet the proposed objective, the study was conducted in a qualitative and quantitative approach, consisting of seven stages of development. During the steps were offered extension courses for people aged 60 or more. After construction of the first two mappings of pedagogical architecture, virtual workshops were offered six (Spanish Physiotherapy, Colors, Photography, Soundtracks and History and Memory) with the aim of mapping indicators for the construction of architecture pedagogical end. Data collection was conducted from participant observations, interviews, questionnaires and technological productions of older participants in virtual learning environments. These indicators allowed the construction of pedagogical end architecture where one realizes the need for gerontological and educational aspects as resilience and reminiscence with the elderly. In the study it was revealed that the elderly have the potential to learn through distance learning, which will involve cultural changes through new learning.

Music Therapy
Ph.D.
Advancements in medical care are helping people to live longer lives. However, this longevity brings other challenges and health issues. As baby boomers age, the needs of an increasing number of individuals are growing as a consequence. Dementia is an issue in this aging population, and is associated with cognitive and other types of losses. Persons with dementia need emotional support, and these needs increase as the dementia progresses. It is important that these individuals with dementia receive medical and therapeutic care to maintain their quality of life for as long as possible. Music therapy is one treatment option that has been shown to provide cognitive, physical, emotional, social and behavioral benefits for this population. However, music therapy-specific assessments are needed to document the clinical and research outcomes of music therapy interventions. The purpose of this study was to examine the reliability of the Music Therapy Assessment for People with Dementia (MTAPD), a researcher-developed measure designed to assess behaviors or responses of persons with dementia during singing or vocalization, instrumental improvisation and in non-musical domains. In order to develop assessment items, the researcher, using videotapes, extracted and identified essential elements of clients' behaviors and responses. Those items were categorized into three domains (i.e., behaviors or responses during singing or vocalization (n=7), behaviors/responses during instrumental improvisation (n=16), and non-musical response or behaviors (n=6). Scoring was based on a five-point scale for items. After developing the assessment tool, the researcher asked eight music therapists with expertise in dementia to review the assessment. Nordoff-Robbins (NR) music therapists (n=9) and non-NR music therapists (n=14) participated in the reliability testing of the assessment. Therapists rated the musical behaviors and responses of clients in these three domains while viewing 15 video excerpts of clients with dementia in music therapy sessions. Results showed that the MTAPD was a reliable instrument for assessing musical and non-musical behaviors of individuals with dementia. An inter-rater reliability analysis generated particularly strong findings with all intraclass correlation coefficients above r = 0.85 with the exception of the analysis of agreement among the NR trained music therapists with more than 10 years of clinical experience. With further reliability and validity testing, the MTAPD may serve a variety of purposes in music therapy clinical practice and research.
Temple University--Theses

The problem of this study was to compare and evaluate two methods of teaching medication compliance to an elderly population with a variety of medical problems, cultural backgrounds, and educational levels. Eighty patients over 65 years old who were attending clinic at a county health care facility participated in the study and were randomly placed into two groups. The Medication Knowledge and Compliance Scale was used to assess the patients' medication knowledge and self—reported compliance. Group I (control) received only verbal teaching. Group II (experimental) received verbal teaching as well as a Picture Schedule designed to tailor the patients' medication schedule to their daily activities. Each patient was re—evaluated two to three weeks later. Medications were also counted at each visit and prescription refill records were examined. Knowledge and compliance did increase significantly among all 80 participants. Patients in Group II demonstrated a significantly greater increase in compliance than Group I but did not show a greater increase in knowledge. Patients in Group II also improved compliance as evidenced by their prescription refill records. This study demonstrates that even though significant barriers to learning exist, knowledge and compliance can be significantly improved when proper teaching techniques are utilized.