Dissertationen zum Thema „Senior community centers“

Research surrounding older adults, social support, and emotional well-being are richly researched topics. However, literature is devoid of qualitative studies and research focusing specifically on community centers and older adultsâ social networks, which are integral for understanding the growing needs of older adults in todayâ s society. Guided by the theoretical frameworks of phenomenology, activity theory, and ecological theory, four in-in-depth interviews were conducted and then coded for themes. The central themes highlighted family connection, connection with others, resiliency, helping others, type of activity, restoring self, community connection, exploration, convenience, and life stages. Suggestions for future research and possible impacts for clinical practice are discussed.
Master of Science

Introduktion: Rekommendation av fysisk distansering på grund av Covid-19 har förutom begränsning av socialt umgänge med familj och vänner även inneburit att kommunala mötesplatser och träffpunkter har stoppat sina aktiviteter för seniorer. Denna förändring har för många äldre medfört en avsaknad av sociala sammanhang och ökad ensamhet. Att försöka uppmuntra äldre till en fortsatt social delaktighet med hjälp av informations-och kommunikationsteknik (IKT) ses därmed som en viktig del i det hälsofrämjande arbetet gentemot målgruppen äldre. Syfte: Studien syftade till att få en ökad förståelse för hur olika kommunala mötesplatser upplevde och arbetade med att främja social delaktighet digitalt bland målgruppen seniorerunder Corona Covid 19 pandemin. Metod: Studien genomfördes genom en kvalitativ intervjustudie med en semistrukturerad intervjuguide. Tio yrkesverksamma personer deltog vilka representerade 7 kommunala mötesplatser för seniorer i Skåne. Data analyserades med kvalitativ innehållsanalys. Resultat: Majoriteten av mötesplatserna hade förändrat sin verksamhet och erbjöd istället aktiviteter av olika slag genom IKT. De flesta av kommunerna erbjöd även IT-supportstöd under pandemin. De äldre upplevdes dock som svåra att nå och rekrytering till digital aktivitet ansågs som låg. Slutsats: Av studien framgick att mötesplatserna bör arbeta för att stärka de äldres digitala kompetens och motivation för främjande av social delaktighet digitalt. De yrkesverksamma behöver också stimuleras i det digitala utvecklingsarbetet och erhålla kontinuerlig kompetensutveckling. Verksamheterna bör införa en digital strategi för utvecklingens fortlevnad även efter att de fysiska mötesplatserna öppnat upp.
Introduction; Covid-19 has, in addition to restricting social contact with family and friends, also meant that municipal meeting places have stopped their activities for seniors. For many older people, this change has led to a lack of social context and increased loneliness. Trying to encourage the elderly to continue social participation with the help of information and communication technology (ICT) is thus seen as an important part of the health promotion work. Aim; The study aimed to gain an increased understanding of how different municipal meeting places experienced and worked to promote social participation digitally among the target group of seniors during the Corona Covid 19 pandemic. Methods; The study was conducted through a qualitative interview study with a semi-structured interview guide. Ten professionals participated, represented 7 municipal meeting places for seniors in Skåne. The data was analyzed with qualitative content analysis. Results; The majority of the meeting places had changed their operations and instead offered activities of various kinds through ICT. Most of the municipalities also offered IT support during the pandemic. However, the elderly were perceived as difficult to reach and recruitment to digital activity was considered low. Conclusions; The meeting places should work to strengthen the elderly's digital competence and motivation for promoting social participation digitally. The professionals also need to be stimulated in the digital development work and receive continuous competence development. The workplaces should introduce a digital strategy for the survival of development even after the physical meeting places have opened up.

Community-based care facilities have a positive effect in supporting older adults and people with dementia thus improving their well-beings. Despite authoring empirical studies focused on providing design interventions, researchers often remain unclear about whether and how exactly practitioners and architects should implement these interventions. This paper presents an on-going project of a senior center in a small municipality in Germany. It aims to explain how the municipality (the client) and the design team (the architect) cooperate to apply updated research-based interventions, and how trade-offs are made. It discusses several research-based interventions during the design process. They include: 1) the early engagement of architects into the planning process; 2) the use of small-scale care units as care concept; 3) offering easily accessible and visible communal areas within the building; 4) providing an area open to the neighborhood; and 5) taking into consideration of the local urban form and materials. The article enables the readers to gain an insider look of the design process of a care facility and become familiar with some of the common trade-offs in design practice. Sufficient access to research materials and efficient communication with the client from the beginning of a project are the key elements to successfully implement research-based design interventions.

The subject of this thesis is the conversion and extension of the former School of Industrial High School in Rousínov furniture and expansion of housing for the elderly. School buildings were built in the 70s of the 20th century and today are only partially and temporarily used, and are waiting for its rebirth. The aim of the project is to open the area to people and incorporate it into the daily life of citizens Rousínov. Cinema, restaurants, galleries, clubs and housing - it's all part of the new city center. Already incurred background builds housing for the elderly, which is its location in the heart of a quality place for the next stage of life. By activating these functions is an isolated island in the city center becomes a full-fledged part of the public space Rousínov. The first stage is the conversion of schools to the cultural and community center. Slogan conversion is cleansing. Clean up objects from unnecessary structures and layers of history. Show support structure and inject new energy into the buildings. The construction itself enables spatial play of vertical and horizontal surfaces. Space clubrooms and galleries are open to the second floor, housing units are designed as maisonettes. Everything is simple and functional. It remains only the pace of life, which objects to bring residents Rousínov. As a next stage will be created in the area of housing for seniors. Demand for housing for the elderly is still high and it's no different in Rousínov and surroundings. In the House of care service that is not on the edge and the capacity is insufficient. Therefore, the potential use of school premises in the town center is a suitable solution for senior housing. The proposal does not find one universal solution for all, but aims to promote the uniqueness and future residents based on their individual needs. Therefore, there is no one big complex retirement home, but three different objects according to the degree of autonomy of the population.

This study explores the influences of female under-representation in senior leadership positions in community secondary schools in rural Tanzania. Key issues include factors contributing to women under-representation in leadership, the perceptions of members of school communities of women leaders and the challenges facing current women leaders that deter other women teachers from taking leadership posts. The empirical study included interviews, focus group discussions and questionnaires and involved 259 participants at schools and district level in one district in rural Tanzania. Twenty schools were involved and included 20 heads of schools, teachers, members of school boards, parents and a District Educational Officer. The empirical study found that, at the individual level, familial responsibilities and rejecting the post due to poor social services in rural areas deterred women from taking leadership posts. At the organisational level, the lack of transparent procedures for recommending, recruiting and appointing heads also contributed to poorer access by women. At the societal level, negative perceptions and stereotypes of female leaders, conservative expectations of women in the private domain rather than in professional and public roles, and deep-seated beliefs in some rural areas pertaining to issues such as witchcraft, at times resulted in physical risk and exploitation of female leaders. These proved to be strong barriers to leadership succession and resulted in on-going, significant challenges for incumbent female leaders. Overall, the study concludes that female under-representation in school leadership in rural Tanzania is influenced by a number of interrelated factors at the individual, societal and organisational level (Fagenson, 1990a), with dominant social norms and values having a cross-cutting influence on the access, experience and perceptions of female school leaders. The study thus suggests a number of measures for improving female representation in community secondary school leadership in Tanzania at the professional and personal development level, recruitment level and policy level.

The subject of my diploma thesis is a proposal of a new community center for seniors near Brno in the village Pravlov. The building is designed for 12 people in 11 separate housing units. The building is divided into three floors. On the ground floor there are civic amenities (doctor's office, hairdresser) and technical facilities (utility room, cleaning room, facilities for employees). On the second and third floors there are separate apartments 1 + 1 and 1 + kk. Vertical walls are made of aerated concrete blocks, horizontal structures are made of reinforced concrete monolithic ceiling structures. The vertical connection between the individual floors is created by a prefabricated staircase. The community center for seniors is covered by a vegetation roof and part of the building is covered by a flat roof. On the south side of the building is located balcony.

Magister Educationis - MEd
Since the inception of the University in 1960 under the Apartheid regime and up until a few years ago Afrikaans had dominated both as educational and as communication medium. However, political change - at the University and in South Africa - has brought about a change in language patterns. According to the HSRC Work Committee on Languages and Language Instruction (1981), a high percentage (40%) of Afrikaans-speaking people classified as coloured and living in the Cape Peninsula choose English as the medium of instruction and also regard it as the most important language to be learnt at schools (also 40%). As a result of this, and the enrolment of a large percentage of Xhosa speaking students, who generally prefer English to Afrikaans as an educational medium, English has become the language most commonly used both inside and outside the classroom. The homogeneity of preference has, however, not been matched by mastery of the language. For approximately 70% of all first-year students English is a second or even a third language. Though University entry is based on at least ten years of the study of English, standards of proficiency differ quite considerably as a result of inequalities in education. Because students need to improve their level of English proficiency I investigated the effectiveness of using senior students as tutor assistants in an academic development programme, the English Special Project, at UWC. This study aims at revealing that the tutor assistantships in the English Special Project can alleviate problems that occur with annual increases in student numbers under certain conditions. These are that: 1 prospective tutor assistants undergo proper tutor assistant training; 2 tutor assistants are committed to the course of academic development; 3 tutor assistants have the time available that is necessary for the task. In Chapter 1 give an insight into what this study is about, the reasons for conducting it and what my personal involvement with the ESP has been. In Chapter 2 I review some of the overseas and local literature on TA systems. In Chapter 3 I describe a case-study to evaluate the success of the TA system in the ESP with reference to academic development. I emphasize the intensive, individual care of and attention to first-year students. In an attempt to address the problem, the effectiveness of senior students as tutor assistants to assist in tutorial sessions is described. In Chapter 4 I discuss the value of TA intervention in the ESP at personal and social levels. Chapter 5 contains the general conclusions and my recommendations to improve the ESP.

碩士
玄奘大學
社會福利學系碩士在職專班
100
Abstract Currently the related researches regarding Community Caring Centers, it’s rare to find the ones with senior citizens’ user experience of the community caring centers as well as the practicalities of the service provided. We live in the age of customer- service-orientated society; therefore users’ feedbacks are highly valued. The objectives of this research are, to reinterpret the implementation and the regulation of community caring centers through interviewing senior citizens who participated the activities provided from the center, analyzing their motivations for participating, their feedbacks, and the impacts on their personal lives; to improve the effectiveness of the future Community Caring Centers. This research is done with Qualitative Research Method, collecting the complete data through participation, observation and in-depth interviews. The objects of this research are selected by purposive sampling, there are 9 selected objects. The findings: •Most of senior citizens give positive affirmation regarding the services of the community caring center. •The user experiences of the services are influenced by unique individuality, the motives of participation, and the feedbacks. •Without the comprehensive guidance from the government, the senior citizens are not well informed with their entitled welfare services, rights, and welfare policies. •Ministry of the Interior doesn’t include Community Caring Centers as part of welfare services for senior citizens. •Using Andersen’s Behavioral Model as a comparison in the analysis, identifying the differences in organization nature, service provider, location and staff, I recognized this model is not suitable as a comparison. Suggestions according to the findings: •Government should integrate the guidance of welfare services to senior citizens; make them aware of their own benefits. •Provides the sufficient funds to handle the related service. •Improve the quality of the volunteers and social workers. •Make it more available and accessible; a more accurate evaluation of senior citizen’s demands and feedback; to pay much attention to senior citizen’s user experience.

碩士
東海大學
企業管理學系碩士班
103
In recent years, Taiwan government has being consistently implemented “community care centers for senior citizens” in most urban and rural communities under the concept of “Aging in place”. This study is aimed to explore how community care centers for senior citizens work and to analyze possible essential elements of successful community care centers for senior citizens. The research method adopted is the qualitative system dynamics approach. In this research, a community care center that has being continuously growing in the number of activities held and the number of participants is chosen to be the case under study. Several in-depth interviews have been conducted and a growth dynamics model is built to capture the growth dynamics of the community care center. Based on the system dynamics model, it is found that the most critical subsystems for “Community Care Centers for Senior Citizens” included: Fundraising, Volunteers management and operation of representative. The three subsystems are found to be interlocked with each other and the Volunteers management subsystem is of the essence of the success of “Community Care Centers for Senior Citizens”. It is suggested that one should carefully focus on volunteers management to achieve the success of Community Care Centers for Senior Citizens.

See Wing Yan, Natalie.
"Architecture Department, Chinese University of Hong Kong, Master of Architecture Programme 2008-2009, design report."
Includes bibliographical references (leaves 34-35).
Chapter Chapter 1 --- Thesis statement --- p.p.4
Chapter Chapter 2 --- Introduction of Environment and behavior Relationship --- p.p.5
Chapter Chapter 3 --- Life of the Elderly in Shum Shui Po --- p.p.6-p.7
Chapter Chapter 4 --- Their Needs --- p.p.8-p.9
Chapter Chapter 5 --- Possible Programs --- p.p.10-p.11
Learning class and Educational program --- p.p.10
Improve the local environment --- p.p.11
Develop Local Economy --- p.p.12
Provide Spaces for Exhibition and Carnivals --- p.p.13
Chapter Chapter 6 --- Possible Sites --- p.p.14
Chapter Chapter 7 --- Relationship between Environment and Human Behavior --- p.p.15-p.19
Encourage the participation of acivity --- p.p.15
Relationship between Environment and Hu-man Behavior in SSP
"Sectional Study-Sit, Scan, Read" --- p.p.16
Sectional Study-Wandering or Shopping --- p.p.17
"Sectional Study-Sit, Scan, Talk" --- p.p.18
Sectional Study-Special Event --- p.p.19
Chapter Chapter 8 --- Precedent Study --- p.p.20-22
Aria Matsubara --- p.p.20
Nursing Home for the Elderly Wienberg Campus Total Aging in Place Project --- p.p.21
Ten Kerselaere --- p.p.22
Chapter Chapter 9 --- Design Operation --- p.P.23
Chapter Chapter 10 --- Massing Exploration --- p.p.24-p.26
Regeneration of Street Life --- p.P.24
Regeneration of Street Life / Creating Anchor Point --- p.p.25
1:500 Site Model --- p.p 26
Chapter Chapter 11 --- Plans --- p.p.27
Chapter Chapter 12 --- Sectional Perspectives --- p.p.28
Chapter Chapter 13 --- Perspectives --- p.p.29-p.30
View1-Roof Garden --- p.p 29
View2-Frorn 2nd Floor Sport Centre --- p.p.30
View3-From Food Court --- p.p.31
View4-From 1F library atrium --- p.p.32
Chapter Chapter 14 --- 1:200 Final Model --- p.p 33
Chapter Chapter 15 --- Bibliography --- p.p 34.p 35

碩士
國立臺東大學
進修部環境經濟資管碩專(假日)
106
The purpose of this study is to, based on the two-factor theory, discuss the current status of senior volunteer participation in community volunteer service, explore the factors impacting the intention to continue service of senior volunteers who serve at community care centers as volunteers, and investigate the relationship between continued service and senior volunteers’ motives for participating in activities at different community care centers. The primary subjects of this study are elderly persons over 55 years of age with the ability to engage in volunteer work at community care centers. Surveys were conducted using questionnaires formulated based on the purposive sampling method; a total of 227 valid questionnaires were recovered. After completing the coding and error-checking procedures on empirical data obtained, the researcher utilized SPSS descriptive analysis and partial least squares (PLS) structural equation modeling to verify the reliability and validity of questionnaire data and authenticate the research hypothesis and conceptual model designed for this study. Results of the study show that senior volunteers of community care centers all exhibit high levels of intention to continue service; elderly persons with higher levels of participation exhibit stronger degrees of identification after engaging in service work; and stronger identification with the work undertaken leads to higher levels of intention to continue service. Through these finding it can be discovered that key dimensions related to the motivators factors (self realization) and hygiene factors (work environment) of the two-factor theory have significant levels of impact on attitudes, subjective norms, perceived behavioral control, and intention to continue service. It is hoped that the outcomes of this study can be utilized by institutions seeking to retain the service of their volunteers to enhance the intention to continue service of senior volunteers by satisfying their various needs and reducing their motivation toward gaining personal interest.

博士
東方設計大學
文化創意設計研究所
107
This research aims to examine the status、differences and causal relationship of senior citizen involvement in community care centers’ participation motive、degree of satisfaction、quality of life、sense of happiness and willingness of re-participation. The research was conducted by the self-made questionnaire「Structural analysis of Kaohsiung City’s senior citizen involvement in community care centers’ participation motive、degree of satisfaction、quality of life、sense of happiness and willingness of re-participation」and deployed purposive sampling method. Participants included 328 senior citizen surveyed from the seventeen community care centers within Kaohsiung City’s twelve administrative districts. Surveyed results were compared through descriptive statistical analysis, t-test, f-test and Scheffe’s method to examine the hypothesis made using the structural analysis, and the findings are as of the following: 1. Surveyor’s participation motivation rating and other factors、degree of satisfaction rating and other factors、quality of life rating and other factors、sense of happiness and other factors、all contribute to positive and prominent level in the willingness of re-participation. 2. No significant differences were identified due to gender difference of surveyor in the participation motive differences, all factors and overall differences. In the degree of satisfaction rating differences, ‘physical’ and ’mental’ difference was significant, male participants had higher rating than female participants. In the quality of life rating difference, ‘physical’、’mental’ and overall differences was significant, male participants had higher rating than female participants. Sense of happiness rating difference, ‘self-development’、 ‘physical and mental wellbeing’、 ‘emotional reaction’、 ‘ interpersonal relationship’ difference was observed, except for ‘emotional reaction’ factor, female participants had higher rating than male participants, all other factors, male participants had higher rating than female participants. No significant differences were identified for willingness of re-participation. 3. Significant differences were identified for ‘self-development’ and ‘other influence’ factors due to marital status differences. For ‘self-development’ factor, married participants had higher rating than non-married participants did. As for ‘other influence’ factor, non-married participants had higher rating than married participants did. In the degree of satisfaction rating differences, ‘mental’ difference was significant, married participants had higher rating than non-married participants did. In the quality of life rating differences, both ‘mental’ and ‘social’ difference were significant, married participants had higher rating than non-married participants did. In the sense of happiness rating differences, ‘life satisfaction’、 ‘self-development’、 ‘emotional reaction’ and overall difference were significant, married participants had higher rating than non-married participants did. No significant differences were identified for willingness of re-participation. 4. Significant differences were identified due to age differences, for participation motivation factors such as ‘self-development’、 ‘seek knowledge skill’ 、 ‘society contact’ and overall difference factors participants had higher rating for age group lower than 70 years old compared to those of age 71 and above, showed greater significance. Participants with age lower than 67 years old compared to those of age 71 and above showed greater significance with higher rating for ‘interpersonal relationship’ factor. Participants with age higher than 68 years old compared to those of age 67 and below, showed greater significance with higher rating for ‘personal interest’ factor. For degree of satisfaction, participants with age higher than 68 years old compared to those of age 67 and below showed greater significance with higher rating for ‘mental’ and ‘physical’ factors. Participants with age lower than 70 years old compared to those of age 71 and above showed greater significance with higher rating for ‘education level’ factor. For quality of life, participants with age higher than 68 years old compared to those of age 67 and below showed greater significance with higher rating for ‘mental’ and ‘physical’ factors. For sense of happiness, participants with age lower than 70 years old compared to those of age 71 and above showed greater significance with higher rating for ‘interpersonal relationship’ factor. Participants with age higher than 68 years old compared to those of age 67 and below showed greater significance with higher rating for ‘emotional reaction’ factor. No significant differences were identified for willingness of re-participation. 5. Significant differences were identified due to differences in education level, for participation motivation factors such as ‘self-development’、 ‘interpersonal relationship’、 ‘other influence’ 、 ‘society contact’ and overall difference factors, participants had higher rating for education level of high school and below compared to those of College/Bachelor and above education level. Participants with education level of primary school and below compared to those of College/Bachelor and above education level showed greater significance with higher rating for ‘seek knowledge skill’ factor. For degree of satisfaction, participants with education level of high school and above compared to those primary school and below, showed greater significance with higher rating for ‘social’ factor. Participants with education level of primary school and below compared to those College/Bachelor and above, showed greater significance with higher rating for ‘educational’ factor. For quality of life, participants with education level of high school and above compared to those primary school and below, showed greater significance with higher rating for ‘social’ factor. Participants with education level of College/Bachelor and above compared to those primary school and below, showed greater significance with higher rating for ‘environmental’ factor. For sense of happiness, participants with education level of high school and above compared to those primary school and below, showed greater significance with higher rating for ‘life satisfaction’、 ‘self-development’ 、 ‘emotional reaction’ and overall difference factors. No significant differences were identified for willingness of re-participation. 6. Significant differences were identified due to differences in economic status level, for participation motivation factors such as ‘self-development’、 ‘seek knowledge skill’、 ‘interpersonal relationship’、 ‘society contact’、 ‘personal interest’ and overall difference factors, participants had higher rating for those with child support plus superannuation/bank interest compared to those supported by society welfare assistance. For degree of satisfaction, participants with child support plus superannuation/bank interest compared to those supported by society welfare assistance, showed greater significance with higher rating for ‘physical’、 ‘mental’ and overall difference factors. For quality of life, participants with child support compared to those supported by society welfare assistance, showed greater significance with higher rating for ‘physical’、 ‘mental’、 ‘social’ and overall difference factors. For sense of happiness, participants with child support plus superannuation/bank interest compared to those supported by society welfare assistance, showed greater significance with higher rating for ‘life satisfaction’、 ‘self-development’、 ‘emotional reaction and overall difference factors. Participants with superannuation/bank interest compared to those supported by society welfare assistance, showed greater significance with higher rating for ‘interpersonal relationship’ factor. No significant differences were identified for willingness of re-participation. 7. Significant differences were identified due to differences in living habit, for participation motive factors, including ‘self-development’、 ‘seek knowledge skill’、 ‘other influence’ factors, participants living with families、couple living together had higher rating than those lived alone. Participants that lived alone compared to those living with families、couple living together, showed greater significance with higher rating for ‘interpersonal relationship’ factor. For degree of satisfaction, participants that are living with families、living alone compared to couple living together, showed greater significance with higher rating for ‘social’ factor. Participants that are living with families、 couple living together compared to those living alone, showed greater significance with higher rating for ‘physical’ and ‘mental’ factors. For quality of life, participants that are living with families、couple living together compared to those living alone, showed greater significance with higher rating for ‘physical’ 、 ‘mental’ and ‘social’ factors. For sense of happiness, participants that live alone compared to those living with families, showed greater significance with higher rating for ‘interpersonal relationship’ factor. Participants that are living with families、 couple living together compared to those living alone, showed greater significance with higher rating for ‘life satisfaction’ 、 ‘self-development’ and ‘emotional reaction’ factors. No significant differences were identified for willingness of re-participation. 8. Significant differences were identified due to participants’ year of engagement for participation motive differences, all factors and overall differences, 2 years and above participants had higher rating than one year or below participants did. For degree of satisfaction, all factors and overall differences, 2 years and above participants had higher rating than one year or below participants did. For quality of life, all factors and overall differences 2 years and above participants had higher rating than one year or below participants did. With regards to sense of happiness, all factors and overall differences, 2 years and above participants had higher rating than one year or below participants did. No significant differences were identified for willingness of re-participation. 9. Participation motivation have a direct and positive influence upon degree of satisfaction、quality of life、sense of happiness and willingness of re-participation, the correlation between quality of life towards willingness of re-participation is supported. Degree of satisfaction upon quality of life、sense of happiness and willingness of re-participation have a positive influence, the correlation between sense of happiness towards willingness of re-participation is supported. Degree of quality of life and sense of happiness、willingness of re-participation have a positive influence, a positive correlation between sense of happiness towards willingness of re-participation. 10. Participation motivation、degree of satisfaction upon quality of life、sense of happiness and willingness of re-participation influential model is a model of goodness fit and this theoretical model can be supported by data evidences.

O envelhecimento populacional tem vindo a revelar-se cada vez mais acentuado, associado a este está o aumento da prevalência de doenças não transmissíveis de evolução prolongada. O uso de medicamentos tem-se revelado essencial na resposta às múltiplas comorbilidades que as pessoas idosas desenvolvem. O envelhecimento da população desencadeou a criação de medidas políticas para dar resposta às necessidades desta população idosa e às suas famílias. Foram criadas respostas sociais, especificamente os centros de dia que visam acompanhar e apoiar as famílias em alturas de maior fragilidade. A responsabilidade de cuidar das pessoas idosas dependentes por norma cabe à família, que na impossibilidade de os assegurar, recorre a estes centros de dia e aos seus cuidadores formais. As pessoas idosas representam uma população vulnerável, tornando-se essencial identificar as necessidades dos seus cuidadores no processo de gestão da medicação, garantindo a adesão à terapêutica dos utentes que frequentam os centros de dia, bem como a manutenção da sua segurança. O projeto “Cumprir a medicação +” foi desenvolvido num centro de dia, na zona de abrangência da UCC onde decorreu o estágio. Teve como objetivo contribuir para a capacitação das ajudantes de ação direta relativamente ao processo de gestão da medicação das pessoas idosas. A fundamentação teórica baseou-se numa revisão bibliográfica e numa revisão da literatura do tipo Scoping Review. O projeto foi suportado pelo modelo teórico de Dorothea Orem e a metodologia do planeamento em saúde para avaliar necessidades, fixar objetivos, programar a intervenção comunitária, executá-la e avaliá-la. Foram desenvolvidas intervenções no âmbito da educação para a saúde. Destacam-se como principais resultados deste projeto, a participação das ajudantes de ação direta, quer na adesão às sessões de formação e satisfação com as mesmas, assim como os resultados satisfatórios sobre os conhecimentos adquiridos. Torna-se evidente que pela proximidade que o enfermeiro de enfermagem comunitária tem com a comunidade e pelos problemas de saúde que identifica, encontra-se num papel privilegiado para o apoio e acompanhamento das ajudantes de ação direta. As atividades executadas contribuíram para o desenvolvimento de competências específicas do enfermeiro especialista em enfermagem comunitária e de saúde pública.
We have an ever-increasing ageing of the population is tied to the increase of prolonged course noncontagious diseases and illnesses. The use of medication has become essential in addressing the comorbidity an elderly person develops. The population ageing phenomenon has pushed for policies capable of addressing the needs of the population in this age group and their families. To accomplish this, several social measures were taken, more specifically the creation of day care centres that seek to follow and support families in need. The responsibility of taking care of the elderly person is usually of their own family, but when the family is not able to provide adequate care they seek out these day care centres and professional caregivers for help. Elderly people are a vulnerable part of the population, and so it is essential to identify the needs of the caregivers in terms of managing, ensuring that the users of the day care centres follow their treatment properly and that they are safe. Project “Cumprir a medicação +” (Following the treatment plan +) was developed at a day care centre in the area where the internship took place. The project sought to contribute to training the direct action assistants for managing the medication of elderly people. The theoretical fundaments were based on a bibliographic and literature review of the Scoping Review. The project was supported by the Dorothea Orem’s theoretical model and the methodology for healthcare planning to according to assess needs, set goals, schedule community intervention, execute it and evaluate it. Interventions were done within the scope of healthcare education. The noteworthy main results of this project were the engagement of the direct action assistants, both in joining the training sessions and feeling satisfied with these, as well as the satisfactory results about the knowledge attained. It is clear that due to the proximity to the community and the health problems that they identify, community nurses are in a privileged role to provide support to direct action assistants. The activities done have contributed to the development of specific skills for the nurse specialised in communitarian nursing and healthcare.

The Chinese government has long assumed that families will bear the social and health care burden of the older population. However, this is becoming increasingly difficult and is hardly a model of care that can be sustained with the projected growth of the older demographic. Since the late 1970s, China has successfully controlled the population growth by applying the One-Child Policy. However, its byproduct, the “4-2-1 problem”, along with the unavoidable trends of globalization and migration, means that older generations must often rely on themselves, and not their children or grandchildren, for care and support. To prepare for this challenge – the weakening of traditional filial piety – this proposal of an active retirement community centre for calligraphy art reflects a desire for a new way of living during the second half of life. Instead of viewing old age as a residual period, this proposal sets the stage for older adults to continue their contributions as they age. Calligraphy performance as a traditional cultural activity offers older adults a great balance between activity and leisure, caring for the body and caring for the soul. Additionally, the artistic quality of calligraphy art is used to express and convey ideas for the design process.

碩士
國立臺東大學
身心整合與運動休閒產業學系
101
This main purpose of this research is to discuss the physical fitness of the elderly in Taitung. This participants were recruited from the Taitung County Community Care Center. In total, 226 questionnaires were administrated and all of them were qualified to be used in the research. Based on the collected data, descriptive statistics, T-test, One-Way ANOVA were used to analyze the raw scores. According to the analysis, I have concluded: 1. The elderly performed better in 2-Munite Leglift (cardio-respiratory) and worse in Behind Interlocking (flexibility) in general. 2. In Taitung City Community Center, the elderly performed better in One-Foot Standing (balancing) and worse in Behind Interlocking (flexibility). In Chengong Town Community Center, the elderly performed better in 2-Munite Leglift (cardio-respiratory) and worse in Behind Interlocking (flexibility). In Luye Township Community Center, the elderly performed better in 30-Second Sitting-Standing (muscle) , and worse in One-Foot Standing (balancing). In Dawu Township Community Center, the elderly performed better in 2.44-Meter Walking (agility), and worse in One-Foot Standing (balancing). 3. Different backgrounds make clear differences in the physical fitness. Among the elderly, females performed better than males, younger elderly performed older elderly, and high-educated elderly performed better than low-educated elderly. 4. The elderly who were confident about their health and fitness performed better than those who were not. Based on the above findings, the conclusions of this study presented to seniors Taitung current status of physical fitness, community care centers, and future research suggestions, hoping for Taitung seniors fitness gain some help. Key words:senior citizens, community care centers,functional fitness

碩士
國立成功大學
建築學系碩博士班
100
This is a research about people, their surrounded environment, the things they use daily, as well as, the role of designers. In particular, the research concerns the life of elderly people, that is, how a designer may help to improve the quality of their lives through redesigning their living environment. To actually examine how design may affect the life of the elderly, the research is conducted as an action research in a rural community located in southern Taiwan. Based on Bronfenbrenner’s Ecological Systems Theory, the research identifies community kitchen service (exosystem), group cooking (mesosystem), and cooking objects (microsystem) as key environments that support the main part of daily living for the elderly in the senior center of the target community. Research actions are planned according to the three environmental systems into three stages. Stage 1, initial investigation, the elderly participate in the research action to examine the content of community kitchen service, the physical environment that supports the service, and the people that involved in the service. Stage 2, design participation, the elderly, with the help of research, identify issues in the physical environment and the group cooking process, and discuss possible design solutions to address the issues. Stage 3, solution exploration, the researcher implement prototype solutions for the elderly to examine and try them out. The research takes, in total, 28 months, and has gone through numerous action-reflection cycles. Lessons learned from the research actions lead to a concept model of community kitchen in the context of senior care center, in which the physical environment of the community kitchen should: (1) provide adequate furniture for the elderly; (2) allow the elderly to work in groups while preparing meals; (2) be easily expandable. Furthermore, three design principles are formulated: reduce obstacles, provide assistance, and promote participation. The overall reflection of this research is that designers and the elderly should work as a team, while design is the medium of communication, to achieve better living environment for the elderly.

碩士
國立宜蘭大學
人文及管理學院高階經營管理碩士在職專班
105
This study provide suggestion about active aging learning, by exploring questions and straits where implement active aging learning at Yilan county. In the study, we explore experiences from those 9 managers by using In-Depth Interview method, and, applying Ground Theory to analysis those first data to construct our result. Result show that key success constructs about community active aging learning are Product and Resources; first of all, factors of product including Promoting, Admissions, Content of Courses and Teaching Method; second, factors of resources including Financial Resource and Teacher Resource. This study found out the applying method like , promoting methods are have words of mouth, exhibitions, app community and traditional marketing method; admissions method including phone calling admission and admissions guide; third, content of lesson courses including seasonal cooking course, life living course, health education course, physical course, handicraft making course and studying course; forth, there are three teaching course, accompanied teaching, interactive teaching and progressive teaching. In addition, financial problems comes from government like, the subsidy period too short and the budget for active aging learning isn’t enough; at last, teacher resource comes from external hire, internal hire and volunteers.

碩士
嘉南藥理大學
醫務管理系
106
With the progress of medical technology and the improvement of living standard, the life expectancy of our country continues to prolong, which makes the population aging speed accelerate, and the whole population composition, family structure, life style and social pattern also change. As the demand for care services for the elderly is increasing, the community care center has actively promoted to enhance community care and support, so that elderly people can live comfortably and confidently in their familiar places. Elastic band exercise programs are currently used in community health promotion activities to assist elderly people to enhance their muscle strength and muscle endurance, and to prevent and delay the disability and dementia. In order to investigate the effect of the elastic band exercise program and the improvement of the elderly physical fitness. The main purpose of this study was to explore effects of physical fitness functions, independent life ability, activity, nutrition, oral cavity, social withdraw, memory and depression of the elderly in a community caring concern center after the implementation of an elastic band program. 　　Subjects of this study were the elderly of a community care center in southern Taiwan. The elastic band exercise program cooperated with the government long-term Care ten-year Program 2.0 was implemented. The curriculum was a 3-month weekly course intervention, two hours each time. 25 cases collected before and after the program were analyze. After data collection, descriptive statistics was used to describe characteristics of subjects, Wilcoxon Signed Ranked Test was used to compare differences of body fitness functions before and after the program intervention. McNemar test was used to analyze and evaluate differences of independent life ability, activity, nutrition, oral cavity, social withdraw, memory and depression of the elderly. 　　Results showed that subjects were mostly female (76%), the average age was 79 years old, and mostly elementary school graduated (56%). After the intervention of the elastic band exercise program, lower limb softness of the elderly had a significant improvement (p=0.023), the other body fitness functions had no significant differences. After the intervention, there were no significant changes in independent life ability, activity, nutrition, oral cavity, social withdraw, memory and depression of the elderly. Although most data had no significant differences after the intervention, but through interviews, elders expressed that the body muscle strength and softness increased, memory retention increased, appetite was better, mood is more pleasant, and more like to participate in group activities. 　　We suggest that the program intervention time can be increased, and should be combined with diversified resources to encourage the interaction and participation of the elderly in order to delay the dementia and disability, and enhance the quality of the elderly life in the community.

碩士
國立高雄師範大學
成人教育研究所
107
Abstract The purpose of this study was to investigate the relationship between the acceptance of table games learning and participation behavior among the elderly in community care centers in Kaohsiung City. The researchers conducted a questionnaire survey using 600 elderly community care centers in Kaohsiung as research samples. The measured variables include personal background variables (gender, age, education, family type, health status), learning acceptance (environment and safety, administration and teaching, learning change, teacher quality and moving service) and participation behavior (friends) Accompanied, integrated into learning, experience sharing, and participation in emotional pleasure. After the questionnaire was collected, the data were analyzed by SPSS for descriptive statistics, t-test, single-factor variance analysis, Pearson product difference correlation and two-factor variance analysis. The important results are as follows: 1. The Kaohsiung City Community Care Centers with different background variables have significant differences in the acceptance of table games. 2. Kaohsiung City Community Care Center The elders in the table game "learning acceptance" are highly consistent. 3. People of different genders have significant differences in the perception of "administration and teaching". 4. Kaohsiung City Community Care Center The elders in the table game "participation behavior" are highly consistent. 5. Subjects of different ages have significant differences in the understanding of "environment and safety", "administration and teaching", "teacher quality and moving service" and "learning acceptance as a whole". 6. Subjects with different academic qualifications have significant differences in their understanding of “administration and teaching”. 7. There is a significant difference in the perceptions of "administration and teaching", "environment and safety", "learning change", "teacher quality and moving service" and "learning acceptance as a whole" in different family types. . Finally, based on the research results, the researchers made recommendations to the Kaohsiung City Social Affairs Bureau, community care bases or development associations, entrusted agencies or units and follow-up researchers. Keywords: community care base elders, table games, learning acceptance, participation behavior

博士
國立中正大學
成人及繼續教育研究所
104
This study discusses the beneficial effects of a positive psychology program on the mental health of senior citizens at community daycare centers. Employing qualitative research methodology, semi-structured interviews were conducted and supplemented by participant observation. Nine participants of the positive psychology program’s learning activities were selected as interview subjects to examine various aspects, such as lifestyle characteristics, educational history and the program’s mental health benefits. The information collected was analyzed to establish research findings. Moreover, a short version of the Geriatric Depression Scale (GDS-SF) was used on the participants both before and after their exposure to the aforementioned program. The results were then matched against the interview findings to determine the effects that the program intervention had on the subjects’ mental health. In view of the study objective, the following insights are concluded: A.The key factors affecting the physical and mental conditions of the seniors at daycare centers are the emotional impacts resulting from the impairment of body functions and the difficulty to adapt psychologically; both of which in turn cause mental health issues. B.Negative family relationship is an influential factor that triggers the emotions of seniors at daycare centers. C.The senior daycare participants experienced an initial curiosity toward the positive psychology program and showed a shift in their attitudes: from resistance to deepening engagement. D.Both fellowship and the leader’s support are the catalytic forces that engaged senior daycare participants in the positive psychology program. E.Physical limitations, cognitive functions and mental attitude are major limitations that hinder participation in the positive psychology program. F.The positive psychology program can substantially improve senior daycare participants’ mental health with positive psychological enhancement, increased capacity of cognitive functions, upgrading of the quality of life and generation of social support. G.Assessment results of the Geriatric Depression Scale show that the positive psychology program has beneficial effects on the mental health of senior daycare participants. Based on the results of this study, the following recommendations are made: A.For government authorities: 1.Enhance seniors’ psychological wellness by perfecting the geriatric mental health policies. 2.Pay particular attention to senior citizens’ mental and emotional issues, and intervene accordingly. 3.Reinvigorate old age through lifelong learning activities. B.For community day-care practices: 1.Trigger positive emotions in senior citizens to foster positive mental attributes. 2.Create a mentally beneficial, supportive environment where seniors enjoy freedom of choice and feel that they are in control. 3.Help the seniors to fulfill their health potential with needs met in a proactive, timely manner. 4.Planning of programs must take into consideration the educational needs of senior citizens, with particular emphasis placed on individual differences. 5.Psychology-related learning activities should be arranged for senior citizens to cultivate positive life experiences. C.For senior citizens: 1.Develop a positive mindset and face old age with a positive attitude. 2.Pursue intentional activities that trigger positive emotions. 3.Boost spiritual health and ponder the meaning of life. D.Recommendations for future research: 1.Expand the selection of subjects and the scope of study to investigate the mental health benefits of positive psychology programs. 2.Adopt different paradigms and viewpoints for more thorough comparisons and deeper inquiries. 3.From a holistic perspective, devise a positive emotions scale for seniors to further deepen and broaden the scope of study.

Contexte: Les centres de jour offrent des interventions de groupe à des personnes âgées qui présentent des incapacités, dans le but de favoriser leur maintien à domicile. Des études récentes tendent à démontrer qu’une utilisation régulière du service serait nécessaire pour induire des effets bénéfiques. Objectifs: Cette recherche visait à documenter l’utilisation des centres de jour par des personnes âgées qui présentent des incapacités. Elle comportait trois principaux objectifs: 1) Caractériser les utilisateurs de centre de jour et ce qui les distingue des non-utilisateurs et analyser les déterminants de l’utilisation du centre de jour. 2) Explorer l’adéquation entre les activités offertes par les centres de jour et les caractéristiques d’autonomie et de santé des utilisateurs. 3) Définir les facteurs associés à la régularité de la participation. Méthodes: Cette recherche s’appuie sur une analyse secondaire de données recueillies auprès de 723 personnes âgées qui ont participé au projet de démonstration SIPA (Services intégrés pour personnes âgées) implanté dans deux CLSC de la région de Montréal. L’utilisation du centre de jour a été documentée pendant une période de six mois, auprès des cinq centres de jour existant sur ce même territoire. Des informations sur le fonctionnement des centres de jour ont été obtenues par des entrevues et des rencontres de groupe auprès de coordonnateurs de ces centres. Les données ont été analysées à l’aide de statistiques descriptives, d’analyses en regroupement et d’analyses de régression logistique et multiple. Résultats: Les résultats sont présentés dans trois articles, soit un pour chacun des objectifs. Article 1: La proportion d’utilisateurs de centre de jour est de 18,8% (IC-0,95: 16,0 à 21,7%). Les facteurs suivants augmentent la probabilité d’utiliser le centre de jour: être plus jeune (RC: 1,12; IC-0,95: 1,06 à 1,19); ne pas avoir une éducation universitaire (RC: 1,92; IC-0,95: 1,04 à 3,57); recevoir l’aide du CLSC pour les activités de vie quotidienne plus d’une fois par semaine (RC: 1,73 et 2,48 pour aide de deux à cinq fois par semaine et aide de six à sept fois par semaine respectivement; IC-0,95: 1,06 à 2,80 et 1,22 à 5,06); faire partie du bassin de desserte d’un centre de jour dont les coûts sont moins élevés (RC: 1,054 ; IC-0,95: 1,001 à 1,108 pour chaque augmentation de 1$); et pour les hommes seulement, avoir déjà subi un accident vasculaire cérébral et présenter davantage d’incapacités fonctionnelles (interaction entre le sexe et la présence d’un AVC: RC: 0,298; IC-0,95: 0,108 à 0,825; interaction entre le sexe et les capacités fonctionnelles mesurées à l’OARS: RC: 1,096; IC-0,95: 1,019 à 1,178). De plus, on observe une plus grande probabilité d’utiliser le centre de jour chez les personnes qui cohabitent avec une personne de soutien. Toutefois, cette relation ne s’observe que chez les personnes nées au Canada (interaction entre la cohabitation avec la personne de soutien et le pays de naissance: RC: 0,417; IC-0,95: 0,185 à 0,938). Article 2: Des analyses en regroupement ont permis de distinguer quatre profils de participants ayant des caractéristiques similaires: 1) les personnes fragilisées par un âge avancé et un grand nombre de problèmes de santé; 2) les participants plus jeunes et plus autonomes que la moyenne, qui semblent des utilisateurs précoces; 3) les personnes qui présentent des incapacités d’origine cognitive; et 4) celles qui présentent des incapacités d’origine motrice. Les activités de groupe des centres de jour ont été regroupées en huit catégories: exercices physiques; groupe spécifique pour un diagnostic ou un problème fonctionnel commun; activités fonctionnelles; stimulation cognitive; activités musicales ou de réminiscence; sports et jeux physiques; intégration sociale; prévention et promotion de la santé. Les activités les plus fréquentes sont les exercices physiques et les activités d’intégration sociale auxquelles ont participé plus de 90% des utilisateurs de centre de jour, et ce en moyenne à respectivement 78% (±23%) et 72% (±24%) de leurs présences au centre de jour. Les autres catégories d’activités rejoignent de 45% à 77% des participants, et ce en moyenne à 35% (±15%) à 46% (±33%) de leurs présences. La participation aux diverses catégories d’activités a été étudiée pour chaque profil d’utilisateurs et comparée aux activités recommandées pour divers types de clientèle. On observe une concordance partielle entre les activités offertes et les besoins des utilisateurs. Cette concordance apparaît plus grande pour les participants qui présentent des problèmes de santé physique ou des incapacités d’origine motrice et plus faible pour ceux qui présentent des symptômes dépressifs ou des atteintes cognitives. Article 3: Les participants au centre de jour y sont inscrits en moyenne à raison de 1,56 (±0,74) jours par semaine mais sont réellement présents à 68,1% des jours attendus. Les facteurs suivants sont associés à une participation plus régulière au centre de jour en termes de taux de présences réelles / présences attendues: ne pas avoir travaillé dans le domaine de la santé (b: ,209; IC-0,95: ,037 à ,382); recevoir de l’aide du CLSC les jours de fréquentation du centre de jour (b: ,124; IC-0,95: ,019 à ,230); être inscrit pour la journée plutôt que la demi-journée (b: ,209: IC-0,95: ,018 à ,399); lors de ses présences au centre de jour, avoir une moins grande proportion d’activités de prévention et promotion de la santé (b: ,223; IC-0,95: ,044 à ,402); et enfin, avoir un aidant qui présente un fardeau moins élevé pour les personnes avec une atteinte cognitive et un fardeau plus élevé pour les personnes sans atteinte cognitive (interaction entre la présence d’atteinte cognitive et le fardeau de l’aidant: b: -,008; IC-0,95: -,014 à -,044). Conclusion: Conformément à leur mission, les centres de jour rejoignent une bonne proportion des personnes âgées qui présentent des incapacités. Cette étude fait ressortir les caractéristiques des personnes les plus susceptibles d’y participer. Elle suggère la nécessité de revoir la planification des activités pour assurer une offre de services qui tienne davantage compte des besoins des participants, en particulier de ceux qui présentent des atteintes cognitives et des symptômes de dépression. Elle démontre aussi que l’intensité d’exposition au service semble faible, ce qui soulève la question des seuils d’exposition nécessaires pour induire des effets favorables sur le maintien à domicile et sur la qualité de vie de la clientèle cible.
Background: Adult Day Centers (ADC) offer group-based interventions to older, community-dwelling individuals with functional limitations, with the aim of helping them remain in the community for as long as possible. Recent studies seem to indicate that regular use is needed for positive effects on participants and their caregivers. Objectives: The purpose of this study was to document the use of ADCs by seniors with functional limitations. There were three main objectives: 1) To identify the characteristics of ADC users versus non-users and to identify the determinants of use. 2) To explore how well ADC program activities matched the different needs of participants with various health and functional characteristics profile. 3) To examine the factors related to regularity of ADC attendance. Methods: This study was based on a secondary analysis of data collected from 723 seniors participating in the Services intégrés pour personnes âgées (SIPA) demonstration project implemented in two CLSCs in Montreal. ADC use data were obtained for a six month period, from the five ADCs serving the same catchment area. To better understand the ADC program characteristics, individual interviews and focus groups were carried out with ADC coordinators. Data were analysed with descriptive statistics, cluster analysis, and logistic and multiple regression analysis. Results: The results are presented in three articles, one for each main objective. Article 1: The proportion of ADC users was 18.8% (CI-0.95: 16.0 – 21.7%). The following factors increased the probability of ADC use: being younger (OR: 1.12; CI-0.95: 1.06 – 1.19); not having a university degree (OR: 1.92; CI-0.95: 1.04 – 3.57); receiving help from the CLSC for daily living activities more than once a week (OR: 1.73 and 2.48 for help two to five times per week and six to seven times per week respectively; CI-0.95: 1.06 - 2.80 and 1.22 - 5.06); being in the catchment population of an ADC with a lower daily fee (OR: 1.054; C-I0.95: 1.001 - 1.108 for each 1$ fee increase); and for men only, having had a stroke or presenting with more functional incapacities (interaction between gender and presence of a stroke: OR: 0.298; CI-0.95: 0.108 - 0.825; interaction between gender and functional capacity as measured by OARS: OR: 1.096; CI-0.95: 1.019 - 1.178). In addition, the probability of ADC use was higher among individuals who live with the person identified as their caregiver. However, this association was found only among persons born in Canada (interaction between whether they lived with caregiver and country of birth: OR: 0.417; CI-0.95: 0.185 - 0.938). Article 2: Four different participant profile groups were identified using cluster analysis: 1) frail seniors of advanced age who had a large number of health problems; 2) individuals who were younger and more independent than the average participants who appeared early users of ADC; 3) individuals with functional impairment related to cognitive problems; and 4) those with movement disorders which affected their independence. Classification of program activities by a panel of experts distinguished eight categories of activities: physical exercise; groups for those with common diagnoses or functional problems; functional activities; cognitive stimulation; music or reminiscence activities; sports and physical games; social skills and interaction; disease prevention and health promotion activities. The most frequent activities were physical exercise, and social skills and interaction activities in which more of 90% of ADC users participated, respectively at a mean of 78% (± 23%) and 72% (± 24%) of their attendances at the ADC program. Other categories of activities were provided to 45 to 77% of participants, and at a mean of 35% (± 15%) to 46% (± 33%) of their ADC attendances. Participation in these activities categories was examined for each profile group, and compared to the recommended activities for such client group. Partial correspondence was found between program activities and participants’ needs. Concordance seemed higher for individuals with physical health problems or mobility impairments and weaker for those presenting with depressive symptoms or cognitive impairments. Article 3: ADC participants were registered with their program for a mean of 1.56 (±0.74) days per week, but were actually present 68.1% of the scheduled days. More regular attendance (higher proportion of scheduled days attended) was associated with: a previous profession of ADC participant or spouse in a sector other than health care (b: .209; CI-0.95: .037 − .382); the individual receiving formal help for activities of daily living on days of expected ADC participation (b: .124; CI-0.95: .019 − .230); enrolment for the whole day rather than half a day (b: .209 : CI-0.95: .018 − .399); lower participation rates in prevention and health promotion activities (b: .223; CI-0.95: .044 − .402); and among participants with cognitive impairment, lower caregiver burden, and among persons without cognitive impairment, higher caregiver burden (interaction between cognitive impairment and caregiver burden: b: -.008; CI-0.95: -.014 − -.044). Conclusion: In keeping with their mission, adult day centres attract a large portion of seniors with disabilities. This study has identified the characteristics of the clientele who are most likely to participate in centre activities. Results also suggest a need to review the planning of activity program components to ensure that the services offered best respond to client needs, particularly clients presenting with depressive symptoms or cognitive impairments. It has also demonstrated that the intensity of exposure to this service tends to be low overall, which raises the question of the level of exposure needed to have a positive influence on the quality of life and ability to remain in the community among this population.