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1
Figueiredo, Sabrina. "Nordic Walking: a new training for frail elderly." Thesis, McGill University, 2010. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=86946.
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The elderly are the fastest growing proportion of the world population. Additional increase in longevity, brought about by improved medical technology, will impact significantly on the health care system as, with advancing age comes a variety of acute and chronic health conditions. No matter how fit, advancing age leads to reduction in mobility and physical function, and these changes, affect quality of gait and the capacity for functional and safe ambulation. With the frail elderly, gait impairments are often severe and impact on health and quality of life. Given that improving walking capacity among the elderly is a desired goal, a structured review was conducted - Manuscript 1 - to derive a global estimate for elderly people of the effectiveness of walking training in improving walking related outcomes. The review included publications on MEDLINE, Embase, CINAHL and the Cochrane Library published in English or Portuguese in peer-reviewed journals. Effect sizes of walking programs in these articles were estimated and forest plotted; there was no overall significant effect of walking training on walking distance or gait speed. Some individual studies showed large effect sizes but were underpowered; others showed small effect sizes. Heterogeneity in population and the nature, frequency and intensity of training indicates that this important question is not yet answered and further research is needed.<br>The second manuscript presents the results of a pilot study designed to provide supporting data for a future trial testing a novel walking training strategy - Nordic style pole walking. The purpose of the pilot study was to estimate, for frail elderly persons undergoing physical rehabilitation, the relative efficacy in improving functional walking capacity of two gait training interventions: Nordic Walking and Overground Walking. A randomized controlled trial of 30 participants from two rehabilitations centers of the Greater Montreal Area was carried out: 14 randomized to Nordic Walking and 16 randomized to Overground Walking. Effect sizes for Nordic Walking were moderate for 6MWT (ES = 0.5), large for gait speed (ES = 0.9), and small for fear of falling (E.S = 0.4). Overground Walking showed moderate effects sizes for 6MWT (ES = 0.5) and small ones for gait speed (E.S = 0.4) and fear of falling (E.S = 0.3). After calculating the effectiveness ratio of both interventions, Nordic Walking was 125% more effective in improving gait speed than regular Overground Walking among a frail elderly population. Future trials with large sample sizes are needed to corroborate these results.<br>Les personnes âgées forment la tranche de la population mondiale dont la croissance est la plus rapide. De plus, l'augmentation de l'espérance de vie grâce aux avancées technologiques en médecine va affecter de façon considérable le système de santé. En effet, le vieillissement de la population implique une diminution des fonctions physiques. Ces diminutions influence la marche et la capacité de se déplacer de façon fonctionnelle et sécuritaire. Une intervention, destinée à améliorer la marche pourrait améliorer la santé et la qualité de vie des personnes âgées fragiles. En premier lieu, une revue structurée de la littérature a été effectuée (Manuscrit 1) afin d'évaluer l'efficacité des programmes couramment utilisés afin d'améliorer la marche chez les personnes âgées. Les banques de données MEDLINE, Embase, CINAHL et Cochrane Library ont permis de trouver des articles anglais ou portugais publiés dans des journaux révisés par les pairs. La taille d'effet de ces programmes de marche ont étés estimés puis illustrés dans un graphique en arbre. Aucun programme de marche n'améliorait significativement l'endurance ou la vitesse de marche. Dans ces études, les programmes avec une taille d'effet importante avaient une puissance statistique faible et les autres programmes avaient une taille d'effet réduite. Afin d'identifier et d'estimer l'efficacité d'interventions destinées à améliorer la marche chez les personnes âgées, d'autres études sont nécessaires.<br>Le second manuscrit a évalué l'efficacité de deux interventions destinées à améliorer la capacité fonctionnelle de marche chez les personnes âgées fragiles. Un projet pilote de type essai clinique randomisé a comparé la marche nordique au programme « overground walking ». Trente participants en provenance de deux centres de réadaptation de la région de Montréal ont été aléatoirement placés dans la marche nordique (n=14) et dans le « overground walking » (n= 16). Pour la marche nordique, la taille d'effet pour le 6MWT était modérée (ES=0.5), celle de vitesse de marche était importante (ES=0.9), et celle pour la peur de chuter était petite (ES=0.4). Pour le « overground walking », la taille d'effet pour le 6MWT était modéré (ES= 0.5). La taille d'effet pour la vitesse de marche était petite (E.S. = 0.4) tout comme celle pour la peur de chuter (E.S = 0.3). Les ratios d'efficacité pour les deux interventions ont démontré qu'en comparaison avec le « overground walking » la marche nordique est 125% plus efficace pour améliorer la vitesse de marche chez les personnes âgées fragiles. D'autres études avec de plus large échantillons sont nécessaires pour corroborer ces résultats.
2
Ellmers, Susan E. "Drug handling in fit & frail elderly people." Thesis, University of Bath, 1991. https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.292811.
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Zochling, Jane Margaret. "The Epidemiology of Osteoporosis in the Frail Institutionalized Elderly." University of Sydney. Department of Rheumatology, 2004. http://hdl.handle.net/2123/637.
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As our population ages, the proportion of frail elderly people requiring assisted accommodation in aged care facilities is increasing. This population is at high risk of falls and fractures, which bring significant morbidity and mortality. The prevalence of osteoporosis also increases with age, but there have been few studies of bone density in residents of hostels and nursing homes. This thesis looked at the prevalence of osteoporosis and falls in elderly people in residential care, to define the size of the problem and identify risk factors for low bone density and falling, with particular reference to vitamin D levels. Two thousand and five men and women aged between 65 and 104 years were enrolled in the Falls and Fracture Risk in the Elderly Epidemiology (FREE) study between 1999 and 2003. The key findings from analysis of this population were firstly, that quantitative ultrasound (QUS) measures were higher in men than women independent of age, and that in men there was no significant decline in either BUA or VOS, but in women BUA declined by over 3% per decade and VOS by 1% per decade. Both ultrasound machines used in the study were shown to be reliable, with precision unaffected by advanced age. QUS was found to be sensitive to longitudinal change even in this frail elderly cohort. Vitamin D deficiency was found in the majority of elderly aged care facility residents but supplementation conferred higher serum 25-OH-vitamin D levels. Vitamin D levels were not shown to be related to BUA, VOS or the risk of falling in this population. Serum parathyroid hormone might be important in determining future falls risk. In summary, the results of this thesis give an important insight into the prevalence of osteoporosis and falls in the frail elderly, and how these might be predicted. Future study of prospective fracture rates in this group will then be able to assess relative risk factors for osteoporotic fracture, and identify those individuals who might benefit from directed fracture prevention strategies.
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Zochling, Jane Margaret. "The Epidemiology of Osteoporosis in the Frail Institutionalized Elderly." Thesis, The University of Sydney, 2003. http://hdl.handle.net/2123/637.
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As our population ages, the proportion of frail elderly people requiring assisted accommodation in aged care facilities is increasing. This population is at high risk of falls and fractures, which bring significant morbidity and mortality. The prevalence of osteoporosis also increases with age, but there have been few studies of bone density in residents of hostels and nursing homes. This thesis looked at the prevalence of osteoporosis and falls in elderly people in residential care, to define the size of the problem and identify risk factors for low bone density and falling, with particular reference to vitamin D levels. Two thousand and five men and women aged between 65 and 104 years were enrolled in the Falls and Fracture Risk in the Elderly Epidemiology (FREE) study between 1999 and 2003. The key findings from analysis of this population were firstly, that quantitative ultrasound (QUS) measures were higher in men than women independent of age, and that in men there was no significant decline in either BUA or VOS, but in women BUA declined by over 3% per decade and VOS by 1% per decade. Both ultrasound machines used in the study were shown to be reliable, with precision unaffected by advanced age. QUS was found to be sensitive to longitudinal change even in this frail elderly cohort. Vitamin D deficiency was found in the majority of elderly aged care facility residents but supplementation conferred higher serum 25-OH-vitamin D levels. Vitamin D levels were not shown to be related to BUA, VOS or the risk of falling in this population. Serum parathyroid hormone might be important in determining future falls risk. In summary, the results of this thesis give an important insight into the prevalence of osteoporosis and falls in the frail elderly, and how these might be predicted. Future study of prospective fracture rates in this group will then be able to assess relative risk factors for osteoporotic fracture, and identify those individuals who might benefit from directed fracture prevention strategies.
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Faxén, Irving Gerd. "Nutritional status and cognitive function in frail elderly subjects /." Stockholm, 2004. http://diss.kib.ki.se/2004/91-7140-004-4/.
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Barry, David C. "Preferences of frail elders regarding ideal living environments /." free to MU campus, to others for purchase, 2000. http://wwwlib.umi.com/cr/mo/fullcit?p9988647.
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McNamee, Paul. "The resource implications of care for frail older people." Thesis, University of Newcastle Upon Tyne, 2002. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.270586.
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Wang, Miranda, and 王慕恩. "Nutritional interventions among community-dwelling frail elderly : a systematic review." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2013. http://hdl.handle.net/10722/193851.
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Background: The worldwide ageing demographic trend has resulted in a growing number of frail elderly who are in the last stages of autonomous living. Oral nutritional interventions for the frail elderly address the body’s natural weight loss, sometimes reversing weight loss, though the literature is not of one accord. No review of nutritional interventions has been conducted for community-dwelling frail elderly, who are most likely to benefit from these interventions and delay adverse outcomes.
Objective: (i) This systematic review analyzes results from randomized controlled trials of oral nutrition interventions for the community-dwelling frail elderly to determine their efficacy in making gains in nutritional and functional status.
(ii) The secondary objective is to analyze the quality of the studies in this review and draw conclusions for further areas of development in the field of nutrition in elderly care.
Methods: Randomized controlled trials of oral nutritional supplements were searched in The Cochrane Library and PubMed, and hand searched in reference lists of systematic reviews. These interventions targeted protein-energy deficiency and included oral supplementation or supplementation paired with exercise compared to a placebo or usual practice. Community-dwelling frail elderly not institutionalized or hospitalized were eligible. Studies targeting disease-specific elderly were excluded.
Results: Out of 120 search results, six trials were included in this review. A small weight gain from oral nutritional interventions among frail community-dwelling elderly was reported in five out of six studies. Functional status did not improve significantly with the interventions. Studies used unstandardized definitions and different ways to measure outcomes, resulting in heterogeneity.
Conclusions: The few and poor quality of studies demonstrates the need for more studies of better quality and homogeneity assessing oral nutritional interventions for nutritional and functional gain in frail elderly who are not yet suffering from adverse outcomes.<br>published_or_final_version<br>Public Health<br>Master<br>Master of Public Health
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Lammes, Eva. "Nutrition, energy metabolism and body composition in the frail elderly /." Stockholm, 2007. http://diss.kib.ki.se/2006/91-7357-058-3/.
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張學泰 and Xuetai Zhang. "Community-based care for the frail elderly in urban China." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2002. http://hub.hku.hk/bib/B31243903.
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Zhang, Xuetai. "Community-based care for the frail elderly in urban China /." Hong Kong : University of Hong Kong, 2002. http://sunzi.lib.hku.hk/hkuto/record.jsp?B24873457.
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Splinter, Audrey Patricia. "An investigation into how elderly persons perceive elder Abuse." Thesis, University of the Western Cape, 2009. http://etd.uwc.ac.za/index.php?module=etd&action=viewtitle&id=gen8Srv25Nme4_6309_1276805303.
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<p>The international concern about human rights, gender equality, domestic violence and the increase in the aging populations has brought elder abuse into the public focus. Elder abuse is a complex, multi-faceted health, social, criminal justice, international public health and human rights issue. The widely divergent and varying definitions is a controversial problem to understanding elder abuse. The elderly have been excluded from national gender-based programs on domestic violence and the abuse of women and children. In South Africa victims of elder abuse are often physically and or cognitively unable to speak for themselves which necessitates that the public be empowered and trained to become advocates for the aged. Lachs &<br>Pillemer ( 2004 : 1265 ) states that &ldquo<br>the physical and psychological impairement of elder persons could be predisposing factors for elder abuse &ldquo<br>. Statistical evidence on the incidence and prevalence rates of elder abuse is lacking as elderly persons are reluctant to identify care givers for fear of abandonment, retaliation and being left destitute ( Lachs &<br>Pillemer, 2004 : 1265 ). Despite the Bill of Rights as set out in the South African Constitution and the Older Persons Act, No. 13 of 2006 which was developed to deal with the empowerment and protection of elder persons and promote and maintain their status, rights, safety, security and well being the abuse of elder person continues to occur ( Older Persons Act, No. 13 of 2006 ). This qualitative research study is allied with the phenomenological approach in an attempt to understand elder person&rsquo<br>s perception, viewpoints and perspectives from their lived experiences and personal lives. Three (3) focus group discussions and eighteen (18) one-on-one interviews were conducted with elder persons living in the suburbs of Cape Town. Data from participants were audio-taped, transcribed verbatim before an inductive analysis lead to the emergence of broad themes and patterns. The main findings of the research study concluded that elderly persons were informed but not empowered about financial, emotional and verbal abuse. The abuse of the elder person in old age homes also featured prominently. The findings of the research study can be used to provide education and empower elder persons and the general public on specific aspects related to elder abuse which are : Financial, Emotional, Verbal and the abuse by staff at old age homes. These findings could be utilized by health and social welfare advocates and organisations who offer community educational and development programs to advocate against elder abuse.</p>
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Cronin, Donna Leilani. "Effects of functional and resistive exercise training on physical function and perceived self-efficacy and well-being in frail elderly adults." Access restricted to users with UT Austin EID Full text (PDF) from UMI/Dissertation Abstracts International, 2001. http://wwwlib.umi.com/cr/utexas/fullcit?p3036587.
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Grenier, Amanda. "Diverse older women : narratives negotiating frailty." Thesis, McGill University, 2002. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=82884.
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This study explores women's narratives from within and outside of the frail/non-frail binary of public home care services. It focuses on the stories that are commonly told about older women's needs and bodies and the regulatory potential of these accounts. Considering power, language, diversity and change, this study focuses on the way that twelve diverse older women at various social locations (e.g., ability, age, culture, ethnicity, 'race', sexual orientation, and socio-economic status) understand, make meaning, and negotiate the concept of frailty in relation to their everyday lives. The sample includes six women considered 'frail' in relation to service (i.e., according to clinical judgement & home care eligibility guidelines), as well as women not considered 'frail' (i.e., non-service recipients).<br>The twelve older women's storied responses, illustrations and experiences challenge the various stories that are told about them. Their complex accounts both reflect and reject dominant notions, blur the boundary between the frail and non-frail classifications, expose frailty as contextual, temporal and relative, as well as illustrate the connections between medical and social needs. Their individual accounts highlight how they make meaning of their life events in relation to their diverse experiences and identities, as well as how these identities and interpretations are key to their negotiations of life and needs. The variations between the imposed stories about frailty and women's self-perceptions highlight the research, policy and practice relevance of a narrative approach focused on in-depth local accounts, raise questions about the current priorities within home care services, as well as the future of social work practice with older women considered frail.
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Rydwik, Elisabeth. "Effects of physical training on physical performance in frail elderly people /." Stockholm : Karolinska institutet, 2007. http://diss.kib.ki.se/2007/978-91-7357-310-8/.
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Romell, Eleanor, and Kevin Broxe. "The Impact of Nutrition on the Frail Elderly - A Literature Study." Thesis, Uppsala universitet, Institutionen för folkhälso- och vårdvetenskap, 2019. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-386058.
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ABSTRACT Background: The population of elderly people is an expanding group with an average life expectancy far exceeding that of only several decades ago. This increased number of older adults is a direct result of improved medical improvements, but it has also created a group vulnerable to the decline of bodily functions, diminished physical strength and poor quality of life. They are susceptible to poor nutrition and frailty that can lead to ill health and poor quality of life that ultimately imposes a strain on the health care system and its resources. It is key that effective intervention be established to reverse the negative impacts on the elderly and reduce the growing expenses related to frailty and malnutrition in these older individuals. Purpose: The purpose of this literature study was to demonstrate the value of nutrition for older adults with specific focus on preventing or reducing the incidence of frailty. Method: The method used to write this paper was a literature study based on quantitative original articles. Results: It is important that the elderly maintain good nutrition including; an appropriate amount of protein, an adequate amount of total caloric intake and a diet that will prevent the onset of malnutrition that could otherwise lead to frailty. Diets with an increased amount of protein can help reduce the incidence of frailty or prevent further decline in the state of existing frailty. The prevention of malnutrition through good nutrition including a sufficient amount of daily caloric intake it integral in preventing frailty. Conclusion: This research demonstrates that good nutrition is integral for mature adults over the age of 60 years of age. It is vital that this group of individuals have a sufficient amount of protein in their daily diet, that their overall caloric intake is at an appropriate level and that good nutrition is maintained in order to avoid malnutrition that could further decline to a state of frailty. It is important to prevent malnutrition that can lead to frailty and promote good nutrition that can lead to a good quality of life for older adults. Key Words: frailty, prevention, nutrition, protein, intervention, nutritional status<br>SAMMANFATTNING Bakgrund: Den äldre populationen är en expanderande grupp med en livslängd som överträffar den förväntade livslängden som man hade för bara ett par år sedan. Det ökade antalet äldre individer är ett direkt resultat av de medicinska framstegen men detta har också skapat en grupp som är sårbar för kroppsliga funktionsnedgångar, försämrad fysisk styrka och dålig livskvalité. Dessa individer är mottagliga för skörhet och malnutrition vilket kan leda till dålig hälsa och dålig livskvalité och blir slutligen en belastningen för hälso- och sjukvården och dess resurser. Det är viktigt att det utförs interventioner för att reversera de negativa effekterna på de äldre individerna och minska de ökande kostnaderna relaterat till skörhet och malnutrition hos dessa äldre individer. Syfte: Syftet med denna litteraturstudie var att demonstrera värdet av nutrition hos äldre med ett specifikt fokus på att förebygga eller reducera förekommandet av skörhet. Metod: Metoden för denna studie har varit litteraturstudie baserad på kvantitativa originalartiklar. Resultat: Det är av stor vikt att den äldre generationen uppehåller en god nutrition vilket innebär; en tillräcklig mängd protein, ett tillräckligt stort kaloriintag samt en diet som minskar risken för malnutrition som annars kan leda till skörhet. Dieter med en ökad mängd protein kan hjälpa att reducera prevalensen av skörhet eller minska vidare utveckling av redan existerande skörhet. Preventionen av malnutrition genom god nutrition med ett tillräckligt intag av kalorier är en väsentlig del för att kunna förebygga skörhet. Slutsats: Forskning visar att god nutrition är väsentligt för äldre vuxna över 60 år. Det är viktigt att denna grupp av individer har en tillräcklig mängd protein in deras diet, att deras totala kaloriintag är tillräckligt och att en god nutrition uppehålls för att kunna undvika malnutrition som senare kan leda till en fortsatt försämring av den redan existerande skörheten. Det är viktigt att förebygga malnutrition som kan leda till skörhet samt främja god nutrition som kan leda till en god livskvalité för äldre Nyckelord: Skörhet, prevention, nutrition, protein, intervention, nutritionsstatus
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Ödlund, Olin Ann. "Nutritional and functional effects of energy-dense food in the frail elderly /." Stockholm, 2004. http://diss.kib.ki.se/2004/91-7140-080-X/.
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Liu, Qiaoming. "Social support for the frail elderly at two kinds of retirement communities." PDXScholar, 1990. https://pdxscholar.library.pdx.edu/open_access_etds/4098.
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As few studies focus explicitly on social support for residents by residents in retirement communities which have staff, this thesis is designed to explore the nature of informal social support among residents at planned, non-subsidized retirement care facilities: the types, the amount, the impact, the limitation and the appropriateness of such support. Our focus is to explore whether different organization of a retirement community affects social support among residents, so we compare two retirement care facilities. One provides single-level care for its residents and the other provides multiple-level care. We chose our two sites from retirement care facilities in the City of Portland, Oregon. We generated our data by interviewing residents who live independently in the two retirement communities.
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Wong, Irene. "Difficulties & rewards for caregivers who take care of frail elders during the end-of-life period /." View the Table of Contents & Abstract, 2006. http://sunzi.lib.hku.hk/hkuto/record/B36783316.
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Mak, Suk-kwan Lorensa. "An exploratory study of the influence of Chinese values on the caregiving of Frail elderly /." Hong Kong : University of Hong Kong, 1994. http://sunzi.lib.hku.hk/hkuto/record.jsp?B1399167X.
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Sävenstedt, Stefan. "Telecare of frail elderly : reflections and experiences among health personnel and family members." Doctoral thesis, Umeå universitet, Institutionen för omvårdnad, 2004. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-339.
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Telecare has been an approach to care that, internationally, has experienced a generally rapid development during the last ten years. There are many examples of successful pilot projects where ICT applications have been used in the care of elderly: for improved remote consultation with health professionals, to improve the communication and support of the elderly person’s social network, and as intelligent sensors intended to improve the safety of the elderly person. Despite these successes, implementation has been slow. This research project was set up to provide additional knowledge on some of the important questions regarding quality and implementation aspects of the use of ICT application on the care of frail elderly persons. The overall aim of the research project is to illuminate reasoning and experiences of using applications of telecare for frail elderly persons. The research project comprised five studies that were conducted using qualitative research methods. Four of them were carried out within the framework of three telecare projects. Different qualitative research approaches such as content analysis, phenomenological hermeneutics and conversational and discourse analysis were used, in accordance with the research questions of each study. The experiences revealed in the findings of the studies indicate that it is possible to have communication of good quality via videoconferencing with frail elderly persons, even those that have mild or mid-level dementia, provided the conditions are right. Technical limitations of the videoconferencing media in transferring communication cues and the limitations on what the camera can expose place special demands on those communicating with the frail elderly and on the general setting. On the other hand, these limitations on the context of interaction in some situations also seem to be an advantage for demented elderly persons and contribute to increased attention. One example of meaningful remote communication with frail elderly persons was family members’ videophone conversations with their demented relatives when they were placed in nursing homes or homes for respite services. This communication gave new possibilities of being involved in caring for, and of maintaining a relationship with, their demented relative. An introduction of teleconsultations in the care of frail elderly persons will, according to the experiences recorded, affect the professional role and the practical spheres of involved health professionals. The perceptions and experiences of participating health personnel indicate that in order for ICT applications to become valuable assets in the care of frail elderly persons they have to be part of a care alternative that is viewed by all concerned as the best alternative, as a whole, for all affected parties. Further research is needed in order to confirm or refute the findings of this thesis and in order to further broaden our understanding of the use of ICT applications in the care of frail elderly persons. This could facilitate a development of ICT applications suitable for the care of frail elderly persons and their introduction into regular care activities, to the benefit of both the frail elderly persons and their carers.
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Dumughn, Ishbel. "Mental health, marital intimacy and support in elderly caregivers of physically frail partners." Thesis, University of Edinburgh, 1998. http://hdl.handle.net/1842/26467.
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The impact of caregiving and the role of psychosocial resources are examined in elderly spouses of the physically frail. Despite evidence from the literature, the strain of caring for older people with physical illnesses is less well recognised that that of caring for dementia sufferers. Similarly, although marriage is the prime location of care, the impact on the marital relationship is little studied. In this study elderly spouse caregivers were interviewed before and after their partner's attendance at a day hospital. Questionnaires were used to assess stressors, mood, general mental health and perceptions of strain, marital intimacy and social support. The relationship between these variables was therefore explored using a longitudinal design. It was predicted that mental health would be significantly improved at the second meeting, principally predicted by the caregiver's satisfaction with the formal service and their perceptions of informal support and intimacy. Gender differences were explored and qualitative data presented. The results are discussed with reference to the implications for formal service provision and methodological issues are highlighted.
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Sävenstedt, Stefan. "Telecare of frail elderly : reflections and experiences among health personnel and family members /." Umeå : Univ, 2004. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-339.
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Meyer, Rhonda D. (Rhonda Dawn). "Effects of Strength on Selected Psychomotor Performances of Healthy and Frail Elderly Females." Thesis, University of North Texas, 1993. https://digital.library.unt.edu/ark:/67531/metadc500976/.
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The purpose of this study was to compare muscle strength and psychomotor performance measures in healthy (n = 18) and frail (n = 21) groups of elderly women utilizing movements requiring various amounts of strength and ballistic action. Subjects were community-dwelling females ranging in age from 66-92 years. Evaluations of functional assessment of motor skills and grip strength occurred. Psychomotor performance was measured through production of aiming movements on a Digitizing Tablet. RT, MT, and movement kinematics (e.g., peak velocity, deceleration, movement adjustments) were evaluated. Differences between groups were apparent in quantity and quality of movement. Healthy subjects were stronger and faster than frail subjects, producing smoother movements with fewer adjustments. Strength appears to differentially affect healthy and frail samples and merits further exploration.
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Wissendorff, Ekdahl Anne. "Frail and Elderly Hospital Patients : The Challenge of Participation in Medical Decision Making." Doctoral thesis, Linköpings universitet, Hälsa, Aktivitet, Vård (HAV), 2012. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-81408.
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Background: In research, patient participation in medical decision-making has been shown to be associated with higher patient satisfaction and improvement of treatment outcomes. But when it comes to patient participation when being old and frail there are pitfalls and the research in this area is sparse. The aim of this thesis is to explore participation in medical decision making of the frail elderly patient in hospital from the perspectives of patients themselves and the health care staff. In this thesis frail, elderly patients is defined as individuals 75 years old or older, who during the past 12 months have received inpatient hospital care three or more times and who have three or more diagnoses in three or more diagnostic groups according to the classification system ICD-10. The participants were frail patients’ in hospital or newly discharged and it was health care personnel working with frail elderly patients. In three of the studies the method was mainly qualitative (Paper I, III, IV) and in one (Paper II) quantitative. The qualitative methods were one-to-one tape-recorded interviews of 25 patients (Paper I and IV), 18 personnel (III and IV), 5 focus group interviews of physicians (Paper III) and 26 days of observations in hospital wards (IV). Chosen methodologies of analysis were content analysis and Grounded Theory. The quantitative study (II) was a cross-sectional survey using telephone interviews with patients (n= 156). This material was descriptively analysed and examined using weighted kappa statistics. Results: The results reported in Paper II show that elderly patients generally want to participate more in medical decision making than they do, though preferences for degree of participation are highly individualized – both findings important to consider in clinical practice. According to the patients important key concepts of patient participation in medical decision making are to be listened to and to be informed (Paper I). The main reasons for not being able to participate included having many illnesses and generally, overall bad medical condition (Paper II). Also, cited as a problem was difficulty in understanding medical information, for example when given by a foreign-speaking physician (Paper I, II and IV). Frail, elderly patients complained that they were less informed than was their preference (Paper I, II and IV). Moderate agreement was obtained between patient’s preferred and actual roles in medical decision making. Patients often expressed gratitude and confidence in their health care (Paper I and IV), but also, sympathy for stressed health care personnel who had so much to do. The frail elderly patients do sometimes feel like a burden to the health care (Paper I and IV). The professionals gave expressions of trying to avoid taking care of frail elderly patients and at the same time expressions of frustration and bad conscience not being able to take good care of them due to lack of time and lack of beds (Paper III, IV). Especially the physicians felt they were trapped between the needs of the patients’ and the remunerations system rewarding time-constricted health care production (number of investigations, operations, easy accessibility) – not a time-consuming holistic view on all illnesses and medications including communication with the patients and all caregivers involved (Paper III). Both patients and the professionals perceive the hospital as some kind of “institution of power”, difficult to challenge, and the decisions of which one has to accept. Conclusion: In this thesis there are shown a number of challenges to participation in medical decision making by frail, elderly patients, which thus limits quality of care for this patient group. Health care is revealed as not well adapted to meet these patients’ complex needs. A model is presented that explains how the organisation of health care, and the reimbursement system, does not facilitate a holistic view. The health care professionals appear to adapt to the organisation and the remuneration system, which leads to practices, such as, rapid discharges and a tendency to examine the patient for only one or a few problems. Finally a suggestion for a model to improve care of frail elderly patients is presented. This model includes the need of more hospital wards being able to work with a holistic view, better skills in gerontology and geriatrics and a more adapted remuneration system for the frail, elderly patients.
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Troyer, Richard. "Attributions of Responsibility Among Caregivers of the Frail Elderly: Predicting Formal Service Use." TopSCHOLAR®, 1989. https://digitalcommons.wku.edu/theses/2920.
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A review of the research on family caregivers of the frail elderly indicates that although caregivers often experience high levels of burden, they make only minimal use of available professional, or formal, services. A theoretical model of helping and coping proposed by Brickman, Rabinowitz, Karuza, Coates, Cohn, and Kidder (1982) suggests that attributions of responsibility for causing and for solving problems define four distinct attributional styles, each determining how people will respond to outside help. The current study of 40 family caregivers attempted to validate an attribution instrument based on the Brickman et al. (1982) model, and to determine whether scores from the instrument were predictive of formal service use. Four models were hypothesized to be identified through factor analysis, each coinciding with one of Brickman's attributional styles. It was also hypothesized that score totals for each of the attributional style models would be predictive of formal service use. Neither hypothesis was supported. However, evidence which did not reach statistical significance suggests the existence of the models in this group. Also, regression analysis found several demographic variables to be predictive of formal service use. These include; care receiver age, caregiver education level, and whether or not the caregiver lives with the care-receiver. Caution must be taken in generalizing the findings from this study due to the questionable validity of the measurement instruments and to the small sample size. Suggested future research includes further validation work on the assessment instruments, and the recruitment of a larger sample group.
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Schindler, Doris. "Intergenerational Programming: A Confluence of Interests Between the Frail Elderly and Urban Youth." PDXScholar, 1992. https://pdxscholar.library.pdx.edu/open_access_etds/1387.
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Two groups of urban residents present ongoing problems, the frail elderly and disadvantaged youth who are approaching transition from school to the work force. Many of the disadvantaged youth are at risk because of family background, inadequate education, and lack of work experience. Many of the frail elderly are unable to care for themselves because of debility, chronic illness, or functional impairments (Eustis, 1974). The United States is experiencing an unprecedented increase in the numbers of persons over 65 years of age and it is expected that between 1980 and 2000 there will be a 67 percent increase in persons 80 and over. These demographic changes are significant especially for long-term care policy for the elderly. There is an urgent need to provide the kind of care that permits them to continue to live in their own homes. The frail elderly perceive their need for a dependable source of food as a primary requirement. If this is not met, institutional care becomes the only possible option. Urban youth face an increasing pressure to take a job in order to earn money, often at the expense of further education. Part-time work and school can be managed, and with planning, the classroom curriculum can be blended with the job. Intergenerational programs present a possible solution to some of the problems of the frail elderly and youth. They can be brought together through one of these programs for their mutual benefit. Intergenerational programming is the process of planned and purposeful interaction between generations. The programs encompass a range of ideas as they are guided by the needs of the community and its resources to meet these needs (Newman, 1983). Project MAIN was one of these projects. In 1983 under the auspices of Portland Youth Advocates, Project MAIN was created to meet the needs of the frail elderly and youth in an urban area. Many of the frail elderly were confined to their homes, unable to do ordinary tasks such as grocery shopping. Low-income teenagers needed access to an income-generating jobs program that would permit them to remain in school. Project MAIN was planned to help disadvantaged youth and simultaneously enrich the lives of the elderly (Ventura-Merkel, 1988). Project MAIN was conceived as a dynamic entity that could not be seen directly, but perceived as a process that had qualitative effects on those with whom it came in contact. It was planned as an active participatory learning experience for youth. Relevant classroom curricula blended with part-time jobs. The focus was on full participation by the youth in the process of providing a shopping service for the homebound elderly. Two important elements of the project were active youth participation and project-oriented learning. The youth planned and operated a shopping service for the frail elderly clients. The youth continued with their education and worked part-time. They began with minimum wage and increases came regularly, following satisfactory evaluation by peers and staff. As they became more competent, they assisted the staff with supervision and instruction. A case study explored the outcomes of Project MAIN. A weakness in the data from guided interviews of the clients resulted from memory loss and confusion encountered in a few of the elderly. A strength was the flexible interviews which gave the elderly time to explore new ideas as they emerged. The outcomes of Project MAIN were measured by the level of satisfaction for both the elderly clients and the participating youth. The levels of satisfaction were high in the pilot project, with its four weeks of intensive training and careful supervision. Adequate funding from private organizations made this possible. In the demonstration phase, funding became an acute problem. Training and supervision of the youthful shoppers was curtailed. Although the clients found the service better than they had before Project MAIN, complaints of broken appointments and declining dependability began to be heard. It became evident that the youth were in need of better preparation and more intensive supervision. Because of lack of funds, it was not possible to supply staff for these tasks. From the outcomes of the pilot project, it is evident that the concept of Project MAIN is a viable one for meeting the needs of the frail elderly and youth. However, from the demonstration phase, it was seen that without adequate funding, the quality of the shopping service declined. Decisions need to be made in the early planning of a program like Project MAIN. Elimination of staff needed for training and supervision in favor if increasing the number of youthful shoppers can threaten the viability of the program.
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Silva, Taís Regina da. "Síndrome da Fragilidade em idosos hospitalizados." Universidade Estadual Paulista (UNESP), 2018. http://hdl.handle.net/11449/152936.
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Previous issue date: 2018-02-08<br>Introdução: A Síndrome da Fragilidade (SF) descreve o estado clínico no qual o idoso apresenta diminuição das reservas fisiológicas e da função de diversos sistemas e órgãos, de tal modo que a capacidade para lidar com fatores estressores do dia a dia fica comprometida, resultando em vulnerabilidade clínica. A hospitalização é considerada um evento que traz consequências importantes para a funcionalidade do idoso e se tratando de idosos frágeis essa consequência pode ser ainda mais grave. Objetivo: Avaliar a prevalência da Síndrome da Fragilidade em idosos internados através de dois instrumentos: Critérios do Cardiovascular Health Study (CHS) e Índice do Study of Osteoporotic Fractures (SOF) e associar a SF com desfechos da internação. Métodos: Estudo observacional analítico e prospectivo. Foram avaliados 98 pacientes internados e identificados através da análise de prontuário os dados sociodemográficos e clínicos e aplicados, no início da internação, os instrumentos CHS e SOF, que classificaram os pacientes como frágeis, pré frágeis ou saudáveis. Após a saída do paciente, através de análise de prontuário, foi observado o desfecho da internação (tempo de internação, complicações na internação, reinternação e óbito na internação/reinternação). Foram feitas associações das variáveis clínicas e desfechos com a SF e análise de concordância entre os instrumentos. Resultados: A amostra foi composta por 98 pacientes com média de idade de 75,30±9,40 anos, sendo 50% do sexo feminino. A prevalência da SF na amostra pelos critérios CHS foi de 82,65% e pelo índice SOF foi de 71,42%. Foi identificada associação significativa (p<0,05) entre a idade, Índice de Massa Corpórea (IMC) e internações prévias com a SF. Em relação aos desfechos observou-se associação significativa (p<0,05) entre as complicações da internação, tempo de internação, óbito na internação, reinternação e óbito na reinternação com a SF. Os instrumentos CHS e SOF apresentaram concordância substancial (K=0,6316). Conclusão: A amostra apresentou alta prevalência da SF. Idosos considerados frágeis pelos instrumentos CHS e SOF se mostraram mais propensos a ter o desfecho de mortalidade e desenvolverem maior número de complicações e tempo de internação e também apresentaram mais reinternações do que pacientes considerados não frágeis.<br>Introduction: The Frailty Syndrome (FS) describes the clinical stage in which the elderly people present a reduction of the physiological reserves as well as of the functions of diverse systems and body organs, in a way that the ability to deal with daily stress factors is compromised, resulting in a clinical vulnerability. Hospitalization is considered an event that brings important consequences to the elderly functionality and when dealing with frail elderly people this consequence can be even more serious. Objective: To evaluate the prevalence of the Frailty Syndrome in hospitalized elderly people through two criteria: Cardiovascular Health Study index (CHS) and the Study of Osteoporotic Fractures index (SOF) and to relate the FS with the hospitalization outcome. Methods: Analytical and prospective observational study. Ninety-eight hospitalized patients were evaluated, and based on the medical records, the sociodemographic and clinical data were identified and applied in the beginning of the hospitalization, the CHS and SOF indexes that classified the patients as frail, pre-frail, or healthy. After the patient was discharged from the hospital, the outcome of the hospitalization was observed based on the medical records analysis (hospitalization period, complications and death during the hospitalization and rehospitalization). Clinical variables associations were carried out with the FS and between indexes. Results: The sample was composed by 98 patients, with an average age of 75,30±9,40, and 50% of them were female. The prevalence of the FS in the sample by the CHS index was 82.65% and 71.42% by the SOF index. A significant association was identified (p<0,05) between the age, the Body Mass Index (BMI) and previous hospitalizations with the FS. Regarding the outcomes, a significant association was observed (p<0,05) between the complications during the hospitalization, the hospitalization period, the death, the rehospitalization and the death during the rehospitalization with the FS. The CHS and SOF indexes presented a substantial agreement (K=0,6316). Conclusion: The sample presented a high prevalence of the FS. The elderly people considered frail were more inclined to present death outcome, greater number of complications during the hospitalization, longer hospitalization period and more rehospitalization than the patients considered non-frail.
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Lindelöf, Nina. "Effects and experiences of high-intensity functional exercise programmes among older people with physical or cognitive impairment /." Luleå : Luleå tekniska universitet/Hälsovetenskap/Sjukgymnastik, 2008. http://epubl.ltu.se/1402-1544/2008/01/.
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Hanusaik, Nancy Anna. "Association of measures of functional status with fat-free mass in frail elderly women." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1997. http://www.collectionscanada.ca/obj/s4/f2/dsk2/ftp01/MQ29708.pdf.
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Hanusaik, Nancy Anna. "Association of measures of functional status with fat-free mass in frail elderly women." Thesis, McGill University, 1996. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=27333.
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The association of functional status with fat-free mass (FFM) was examined cross-sectionally in a sample of 30 frail elderly women $(81.5 pm 7$ years) to evaluate potential outcome indicators for nutritional interventions. FFM, determined using multi-frequency bioelectrical impedance analysis, was lower in this frail group than in previous reports for "younger" elderly females. All measures of muscle strength (handgrip, biceps, quadriceps) were significantly correlated with FFM $ rm (r ge 0.45, p le 0.02),$ while the measures of global function (Timed "Up & Go" Test and walking speed) as well as self-perceived health were not. The measures of muscle strength and global function were found to have good reliability based on measurements taken on two occasions separated by one week $ rm (ICC ge 0.80).$
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He, Weijia, and 何維佳. "Use of proxy method for assessing swallowing-related quality of life in frail elderly." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2014. http://hdl.handle.net/10722/202377.
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Dysphagia, which refers to difficulties in swallowing, is a common clinical dysfunction with high morbidity in the ageing population. At least four validated questionnaires are available for assessing swallowing-related quality of life. These include the M. D. Anderson Dysphagia Inventory (MDADI), the Swallow Quality-of-Life Questionnaire (SWAL-QOL), the Sydney Swallowing Questionnaire (SSQ) and the Dysphagia Handicap Index (DHI). However, these questionnaires are either designed for some specific dysphagic populations or only focused on the impact of swallowing disorders at the impairment level. The Swallowing Activity and Participation Profile (SAPP) has been developed and validated as a self-reported tool for dysphagic population to assess the effects of swallowing problems on the physical, functional and social aspects of quality of life.
It is common to find the elderly population exhibiting cognitive impairment. Elderly people with cognitive impairment may have difficulties completing the questionnaire by themselves. In such cases, family members or caregivers are often asked to judge how the dysphagic individuals are affected by the swallowing dysfunction. There are, however, most of the previous studies failed to investigate the validity and reliability of such proxy method. Thus, the objective of this study was to verify the reliability of proxy method in assessing swallowing-related quality of life for frail elderly people who are not able to finish the self-reported questionnaire because of their cognitive impairment.
Forty-six elderly individuals (24 males and 22 females) and their respective caregivers (six males and 36 females) participated in this study. All the elderly received a clinical swallowing assessment to confirm the existence and the severity of dysphagia. They were assigned into the dysphagic group and the non-dysphagic group according to the results of swallowing assessment, and then asked to complete a quality of life questionnaire (SAPP) and a swallowing function scale, called Eating Assessment Tool (EAT-10). Their caregivers were invited to complete the same assessment tasks from the perspective of the elderly and to report how they perceived the elderly persons’ swallowing–related quality of life as the proxies.
The scores obtained from the questionnaires filled out by the elderly participants and their caregivers were compared. The findings showed that there was no statistically significant agreement between the elderly and the caregivers. The association between the responses of the elderly and the caregivers on quality of life was not as strong as what was hypothesized at the beginning of this study. However, the test-retest reliability of the instrument of this study was good, as shown by the intra-class correlation coefficient in the elderly group. The current study found that dysphagia had a negative impact on the dysphagic elderly’s emotional well-being, but was not clear if the proxy method could be used as a valid and reliable method for assessing the elderly’s swallowing-related quality of life. Further studies with a larger sample size and a wider range of dysphagia severity are needed.<br>published_or_final_version<br>Speech and Hearing Sciences<br>Master<br>Master of Philosophy
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Owens, Margaret N. "The lived experience of daughters who care for frail, elderly parents in the parents' home." Cincinnati, Ohio : University of Cincinnati, 2004. http://rave.ohiolink.edu/etdc/view?acc%5Fnum=ucin1084469332.
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Brink, F. J. "The development of a financial plan to partly cover the cost of frail care in a retirement village in George." Thesis, Port Elizabeth Technikon, 2002. http://hdl.handle.net/10948/84.
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The world population is ageing, and this is also relevant to South Africa. At the same time the potential support ratio (the number of persons aged 15 to 64 years per one older person aged 65 years or older) is falling, and the dependency burden on potential workers increases. To alleviate the financial burden on the aged, and their families, it has become necessary to develop a financial plan to cover the cost of frail care. The overall purpose of this research is to determine whether any financial plans exist which are relevant. If nothing existed, a plan had to be developed. The research methodology for this study comprised the following steps: Firstly, the demographics of the world and South Africa were researched. The concept of frail (long-term) care in the United States of America and New Zealand was investigated to determine what is available. The subsidisation concept of the South African Government towards caring for the elderly was also investigated. Secondly, a questionnaire was sent to the residents of five retirement complexes in George to determine their interest in such a plan. The records of the frail care unit that these residents utilise were analysed to determine the number of residents needing frail care. A comparative study of the cost of frail care in the Southern Cape was undertaken. Thirdly, two options to partly subsidise the cost of frail care were examined, where the first option covers the running cost, and the second option, subsidising one third of the frail care cost, builds up a sustainable fund after the first five year period. The funds of the second option can then be utilised in the subsequent years to increase the subsidisation portion of frail care cost. The final step of this study entailed the formulation of recommendations to implement the frail care nursing levy as soon as possible, with special attention given to the following: a) It must be compulsory for new residents to join the fund. b) A yearly capital amount of R100 000 or more is needed to sustain the fund. c) A contract must be drafted to set out all the rules and regulations to the residents. d) An attitude change amongst some residents is required. Individuals must realise that the success of this plan depends upon themselves and with the necessary support could make a significant contribution towards their own peace of mind if and when frail care is needed.
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JÃnior, Arnaldo Aires Peixoto. "AvaliaÃÃo de marcadores inflamatÃrios, da modulaÃÃo do sistema nervoso autonÃmico e de suas associaÃÃes na fragilidade de idosos." Universidade Federal do CearÃ, 2014. http://www.teses.ufc.br/tde_busca/arquivo.php?codArquivo=12065.
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nÃo hÃ<br>IntroduÃÃo: Sarcopenia, estado inflamaÃÃo crÃnica e diminuiÃÃo da modulaÃÃo autonÃmica cardÃaca sÃo frequentemente descritos em idosos frÃgeis. No entanto, o papel da inflamaÃÃo e diminuiÃÃo da modulaÃÃo autonÃmica em perda de massa muscular associada ao envelhecimento deve ser esclarecido. Objetivo: identificar, em idosos frÃgeis e robustos residentes na comunidade, correlaÃÃes entre alteraÃÃes autonÃmicas, nÃveis sÃricos de marcadores bioquÃmicos de inflamaÃÃo e diminuiÃÃo da forÃa e do desempenho muscular. Resultados: 98 voluntÃrios frÃgeis e robustos com idade de 60 anos ou mais foram submetidos à avaliaÃÃo clÃnica, exames laboratoriais e anÃlise da variabilidade da frequÃncia cardÃaca em decÃbito dorsal e em ortostase. O logaritmo natural do Ãndice de variabilidade da frequÃncia cardÃaca baixa frequÃncia (LF) foi inversamente relacionado com o marcador bioquÃmico da inflamaÃÃo fibrinogÃnio em idosos com fragilidade (p=0,046), mas nÃo em robustos. NÃo houve associaÃÃo entre Ãndices de variabilidade da frequÃncia cardÃaca e marcadores bioquÃmicos de inflamaÃÃo interleucina-6 e proteÃna C reativa ultrassensÃvel. Velocidade da marcha foi negativamente relacionada com o fibrinogÃnio em idosos frÃgeis (p=0,033), mas nÃo em idosos robustos. Em todos os idosos, velocidade da marcha foi negativamente relacionada com o fibrinogÃnio (p=0,017), interleucina-6 (p=0,038) e proteÃna C reativa ultrassensÃvel (p=0,010). ConclusÃo: nossos resultados sugerem que a sarcopenia relacionada inflamaÃÃo pode ser, pelo menos parcialmente, influenciada por diminuiÃÃo da modulaÃÃo autonÃmica em idosos.<br>Background: sarcopenia, chronic inflammation status and impairment of cardiac autonomic modulation are often described in frailty elderly. However, the role of inflammation and decreased autonomic modulation in loss of muscle mass associated with aging need to be enlightened. Aim: we aimed to identify, in community-dwelling frailty and robust elderly, correlations among autonomic changes, serum levels of biochemical markers of inflammation and decreased muscle strength and performance. Results: 98 volunteers aged 60 or older was assessed by clinical evaluation, laboratory tests and analysis of heart rate variability (HRV) in the supine and standing positions. The natural logarithm of the HRV index Low Frequency (LF) was inversely related with the biochemical marker of inflammation fibrinogen in frail elderly (p=0.049), but not in robust. There was no association between heart rate variability indices and biochemical markers of inflammation interleukin-6 and C-reactive protein high sensitivity. Gait speed was negatively correlated with fibrinogen in frail elderly (p=0.033), but not in elderly robust. In all elderly, gait speed correlated negatively with fibrinogen (p=0.017), IL-6 (p=0.038) and high-sensitivity CRP (p=0.010). Conclusion: our results suggest that inflammation-related sarcopenia can be at least partially influenced by decreased autonomic modulation in the elderly.
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Khursigara, Zareen. "Factors regulating resting energy expenditure and thermic effect of food in elderly women." Thesis, McGill University, 2005. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=84046.
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Hypothesis. We hypothesized that contrary to "normal aging," frail elderly women would have a heightened resting energy expenditure per kg fat free mass (REE/kg FFM) and thermic effect of food (TEF) response.<br>Methods. 13 healthy (H) [X +/- SEM: 81.4 +/- 1.1 yr] and 9 frail elderly women (F) [84.7 +/- 1.6 yr], free from acute conditions underwent REE and TEF measurements (liquid standard mixed meal: 720 kcal, 58% carbohydrate, 14% protein, 28% fat) using ventilated hood indirect calorimetry. Anthropometric and body composition measurements, thyroid hormones, cortisol, cytokines and catecholamine concentrations, and physical activity (PASE) and mobility ("time up and go" TUG) scores were related to the results obtained.<br>Results. H had a faster TUG: 10.2 +/- 1.6 vs. 21.0 +/- 9.3 s (p=0.001), greater PASE score: 179.2 +/- 116.1 vs. 47.1 +/- 26.2 (p=0.003), greater triiodothyronine [T3]: 5.1 +/- 0.6 vs. 4.3 +/- 0.4 rhomol/L (p=0.003) and lower cortisol concentrations: 351.1 +/- 19.9 vs. 474.5 +/- 43.6 nmol/L (p=0.011). In H vs. F: REE/kg FFM was 1044 +/- 20.4, 1021 +/- 23.7 kcal/day (NS) and TEF response as expressed as % of REE was 18.4 +/- 5.6, 19.5 +/- 4.2 (NS). The time course of glucose (p=0.043) and insulin from 90 minutes onwards (P=0.013) suggested insulin resistance in F. REE was positively correlated with FFM, percent body fat and [T3] (r>0.499, p<0.021).<br>Conclusion. REE/kg FFM and TEF response was not different between H and F and thus the greater prevalence of malnutrition in F, cannot be explained by these parameters.
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Fitzsimons, Claire Frances. "Oxygen uptake kinetics at the onset of exercise and cardiorespiratory fitness in frail elderly people." Thesis, University of Edinburgh, 2006. http://hdl.handle.net/1842/24572.
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Methods: VO<sub>2</sub> and walking speed were measured during 3 minutes of comfortable self-paced walking in young (Y) (N=17, median age 23 (20-29) years) and healthy elderly (HE) (N=15; median age 80 (76-87) years) volunteers and groups of patients recovering from a hip fracture (HF) (N=8; median age 81 (72-91) years) or stroke (ST) (N=66; median age 74 (49-87) years). Results: <i>Feasibility. </i>On 214/277 study visits individuals completed 3 walks of 3 minutes (77%). Participants maintained a constant walking speed of moderate intensity and achieved steady state VO<sub>2 </sub>conditions within 3 minutes on 127/214 visits. 114/127 visits (41% of 277) were adequately described using a monoexponential model (82% Y; 44% HE; 53% HF; 32% ST). <i>Validity</i>: A group comparison of MRT demonstrated content validity (Y 20s; HE 37s; HF 52s; ST 42s, mean values, visit 1). Criterion-related concurrent validity (MRT versus VO<sub>2</sub> max, in Y and HE) and predictive validity of MRT were not demonstrated. <i>Reproducibility: </i>The Standard Error of Measurement (SEM) of the MRT was 4.9s in the Y group, 4.4s in the HE group and 7.0s for the HF group. Limits of agreement of MRT for the HF group were -23 to 30s. <i>Training intervention:</i> Poor tolerance of the study methodology in the frailer stroke patients compromised evaluation of the training intervention. A before and after training comparison of MRT was possible in 4 stroke patients. A training related reduction in MRT (49s to 35s (mean values, N=4)) was evident. Conclusion: The inability of frailer study participants to achieve feasibility criteria and inconclusive validity questions the applicability of this measure to those for whom it is intended – very frail, older people.
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Ardenghi, Diego Macgadi. "Exploring the views of relatives of frail elderly patients about the UBC geriatric dentistry program." Thesis, University of British Columbia, 2014. http://hdl.handle.net/2429/48373.
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Elderly residents of long-term care facilities (LTC) have difficulty accessing dental services. Aiming to improve access for this population, the Geriatric Dental Program (GDP) was established by the UBC Faculty of Dentistry in 2002. Within the GDP, elderly LTC residents receive fee-for-service dental treatment. The objective of this research is to explore whether having access to the GDP services had an impact on the life of the patients’ relatives (family members). This research hopes to better understand how quality of health in relation to dental health extends to relatives who are responsible for the frail elderly patients who receive the dental care. Such understanding will contribute to our recognition of a more holistic and widespread impact of dental care access to all segments of our society.
Methods: Data was collected through semi-structured, face-to-face, audio-recorded interviews with family members of elderly patients from the UBC-GDP. A purposive criterion sampling method was used to select the family members to participate in this study. The final number of participants was determined according to saturation procedures. Interview transcription and data coding procedures were conducted following Saldaña1. All interviews were transcribed verbatim. In a second step, NVivo software was used to code and organize the transcripts into different categories to develop themes. The analysis of the data followed a qualitative, interpretive Thematic Analysis.
Results: Final analysis shows that family members are worried about their relatives’ oral health; they believe that it is difficult to find private dentists with geriatric expertise and to make appointments for their family members outside of UBC, and that the UBC program helped them in fulfilling this task. Moreover, the UBC-GDP made their life less stressful and relieved the burden of setting up appointments for their relatives making their life easier. Thus, the UBC GD program positively affected the life of relatives by improving access to dental care services for the growing geriatric segment of our Canadian society. Furthermore, this study shows that the UBC GD program not only improved the perceived oral health but also impacted the relatives’ life in a positive way.<br>Dentistry, Faculty of<br>Graduate
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Lemieux, Ann L. "The experience of adult sons and daughters of hospitalized frail elderly parents : a qualitative study." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1996. http://www.collectionscanada.ca/obj/s4/f2/dsk3/ftp05/mq23378.pdf.
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Mak, Suk-kwan Lorensa, and 麥淑筠. "An exploratory study of the influence of Chinese values on the caregiving of Frail elderly." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 1994. http://hub.hku.hk/bib/B31249899.
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Subki, Manal. "Assessment of the nutritional status of frail elderly persons participating in geriatric day hospital rehabilitation program." Thesis, McGill University, 2001. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=33847.
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We assessed the nutritional status and physical function of 121 women (79.4 +/- 6.6 y, 26.8 +/- 5.6 kg/m2) and 61 men (78.6 +/- 8.3 y, 26.6 +/- 4.7 kg/m2) participating in the Geriatric Day Hospital. According to a composite index of malnutrition, 19% of them were found malnourished whereas the Mini-Nutritional Assessment, a validated nutritional screening tool, found that 56% of the elderly were malnourished or at risk for malnutrition. Malnourished persons, as determined by the composite index, had a lower lean body mass (LBM) by bioelectrical impedance analysis compared with the well-nourished group (40.5 +/- 9.7 vs. 42.0 +/- 8.7 kg, p = 0.0001). LBM correlated significantly with handgrip strength (r = 0.34, p = 0.0001) but not with gait speed (r = 0.04, p = 0.27). There were no significant differences between nutritional states for any of the two tests of physical function. The score of the MNA, correlated with gait speed (r = 0.24, p = 0.02) but the performance at the physical tests was not different according to the nutritional status defined by this tool. We conclude that malnutrition is relatively prevalent among frail persons participating in the Geriatric Day Hospital and that malnutrition is one among many other factors that contribute to their low level of physical performance. As such, a nutritional intervention may be of benefit in improving the physical function of frail elderly persons who are malnourished.
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Chan, Lung-fai, and 陳龍輝. "Mental health of Chinese spousal caregivers of frail elderly: the role of the traditional Chinese familyvalues." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2007. http://hub.hku.hk/bib/B38482034.
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Fernandes, Alan Lins. "Efeitos da suplementação de proteína de soja versus proteína do soro do leite em idosos com pré-fragilidade e fragilidade submetidos a um programa de treinamento de força." Universidade de São Paulo, 2017. http://www.teses.usp.br/teses/disponiveis/39/39132/tde-30012018-110203/.
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A fragilidade cursa com importante alterações biológicas, dentre as quais destacam-se uma considerável perda de massa, força e função muscular. O consumo de proteínas aliado ao treinamento de força, parece atuar como uma estratégia promissora para atenuar alguns danos morfofuncionais decorrentes do envelhecimento. Portanto, a presente tese tem como objetivo central investigar os efeitos de diferentes fontes de suplementação de proteínas (Soja versus whey) combinadas ao treinamento de força sobre a massa e força muscular em idosos com pré-fragilidade e fragilidade. Esta tese faz parte de um grande ensaio clínico registrado na plataforma clinicaltrial.gov (NCT01890382), intitulado \"Protein Intake and Resistance Training in Aging: The Pro Elderly Study\", com desenho aleatorizado, duplo-cego, controlado por placebo e de grupos paralelos. Os voluntários foram randomicament alocados para compor os três grupos experimentais, placebo (PLA, n = 21), Whey (n = 22) e Soja (n = 22). Todas as análises seguiram o princípio de intenção de tratamento (ITT) através do Mixed Model (SAS) para análises de medidas repetidas e, quando pertinente, post hoc de Tukey para comparações múltiplas. Os resultados demonstraram que a média de ingestão protéica total; PC;; nos grupos whey e soja, respectivamente) não foi capaz de gerar diferenças entre as fontes ou superioridade ao placebo no tocante a massa, força e função muscular dos idosos com pré-fragilidade e fragilidade. Todos os grupos apresentaram aumento na massa magra (+ 0,4 kg), massa apendicular (+ 0,3 kg), ganhos de força muscular nos testes de 1RM no Leg-Press (+ 13 kg) e no supino (+ 5,0 kg), aumento do PT (+ 8,5 N.m) e da TDF geral (+ 60 N.m.;& sup1;), aumento na AST dos músculos reto femoral ( + 0,04 cm²) e vasto lateral (+1,3 cm²), melhora da resistência muscular de membos inferiores (+ 1,1 u.a) e melhora na qualidade de vida, sem ddistinção entre PLA, whey e soja. Portanto, não foram observadas diferenças entre as fontes protéicas em resposta ao TF sobre a massa, força ou função muscular de idosos pré-frágeis e frágeis<br>Frailty is a geriatric syndrome characterized by progressive biological decline and associated with decreased muscle mass, strength, and functional capacity. Protein consumption in ideal amounts and of high biological value, combined with resistance training, has been shown promising to attenuate age-related damages. Although, the present research aimed to investigate the chronic effects of different sources of protein supplementation (Soy versus whey) combined with resistance training in pre-frail and frail elderly. This thesis is part of a large clinical trial enrolled on the clinicaltrial.gov platform (NCT01890382) entitled Protein Intake and Resistance Training in Aging: \"The Pro Elderly Study\", in a randomized, doubleblind, placebo-controlled and parallel-group design. Experimental design were randomly composed of three groups, placebo (PLA, n = 21), Whey (n = 22) and Soy (n = 22. All analyzes were evaluated in intention to treat procedure throughout Mixed Model (SAS), was used for analysis of repeated measures and, when appropriate, post hoc Tukey for multiple comparisons. The mean total protein intake (1.2 and 1.3 & sup1; in the whey and soy groups, respectively) was not able to induce different responses between protein sources and superiority to placebo in muscle mass, strength and function in pre-frail and frail elderly. All groups increased lean mass (+ 0.4 kg), appendicular mass (+ 0.3 kg), muscle strength gains during 1-RM test in Leg-Press (+ 13 kg) and chest-press (+5,0 kg), increased peak torque (+ 8.5 Nm) and general PTO (+ 60 Nm & sup1;), CSA of rectus femoris (+ 0.04 cm²) and vastus lateralis (+1.3 cm²), timed-stands (+ 1.1 a.u) and improved quality of life for PLA, whey and soy. Therefore, no differences were observed between protein sources in response to ST on muscle mass, strength or function in pre-frail and frail elderly
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Stadnyk, Karen J. "Testing the measurement properties of the Short Form-36 Health Survey in a frail elderly patient population." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1997. http://www.collectionscanada.ca/obj/s4/f2/dsk2/ftp04/mq24924.pdf.
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Fossum, Tracy-Lynn A. "Reasons for choosing community versus institutional long-term care for frail elderly people living with their spouses." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 2000. http://www.collectionscanada.ca/obj/s4/f2/dsk2/ftp01/MQ52899.pdf.
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Chan, Lung-fai. "Mental health of Chinese spousal caregivers of frail elderly : the role of the traditional Chinese family values /." View the Table of Contents & Abstract, 2007. http://sunzi.lib.hku.hk/hkuto/record/B38165727.
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Hui, Yee-ki, and 許綺琪. "Gender differences in psychological wellbeing of spousal carers for frail elderly in Hong Kong: a secondary dataanalysis." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2009. http://hub.hku.hk/bib/B45167898.
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Silva, Vanessa Abreu da 1980. "Desfechos da síndrome da fragilidade : um estudo longitudinal com idosos em atendimento ambulatorial." [s.n.], 2014. http://repositorio.unicamp.br/jspui/handle/REPOSIP/283899.
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Orientador: Maria José D'Elboux<br>Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Enfermagem<br>Made available in DSpace on 2018-08-27T08:50:00Z (GMT). No. of bitstreams: 1
Silva_VanessaAbreuda_D.pdf: 2181192 bytes, checksum: f2b09456b1f7e48f3b035d252adb01da (MD5)
Previous issue date: 2014<br>Resumo: Este estudo teve como objetivo analisar os desfechos e fatores associados à síndrome da fragilidade de idosos atendidos em serviço de geriatria de um hospital escola. Trata-se de um estudo quantitativo, comparativo e com delineamento longitudinal, integrante da pesquisa maior intitulada "Qualidade de vida em idosos: indicadores de fragilidade e de bem-estar subjetivo", que compreende duas fases. Na Fase 1 (2005-2007), foram avaliados 150 idosos em acompanhamento no ambulatório de geriatria. Na Fase 2 (2013), os idosos foram novamente contatados, por telefone ou visita domiciliar, e submetidos, após o consentimento, a uma entrevista para a coleta de dados sociodemográficos, de saúde e funcionalidade. Foi adotado o fenótipo de fragilidade de Fried et al., 2001. Os desfechos estudados foram: queda, hospitalização, comorbidade e óbito. Na fase 2, dos 150 idosos participantes da primeira fase, 71 evoluíram a óbito e 25 foram excluídos. Assim, a amostra contou com 54 idosos respondentes, com predomínio do sexo feminino e idade igual ou superior a 80 anos. No que diz respeito à saúde e à funcionalidade, houve diferença estatisticamente significante entre todas as variáveis estudadas, com exceção do número de hospitalizações e do número de quedas. É notável o declínio da funcionalidade desses idosos, avaliada por meio dos instrumentos: SPPB, MIF e AIVD, cujas médias dos seus escores reduziram significativamente. O estado cognitivo também apresentou diferença estatística com redução da média do escore do MEEM na fase 2 (p<0,001). Quanto à fragilidade, houve aumento na média do número de critérios (3,83) quando comparados à fase 1 (2,43), e a maioria dos idosos pontuou para todos os critérios de fragilidade, com exceção para o critério "perda de peso não intencional". Houve aumento na proporção de idosos classificados como frágeis (50,0% fase 1 e 88,9% fase 2) e nenhum idoso foi considerado não frágil. O desfecho queda (fase 2) associou-se a hospitalização e com os critérios de fragilidade exaustão e perda de peso não-intencional na fase 1. O idoso que relatou hospitalização na fase 1 teve maior risco de hospitalização na fase 2. Do mesmo modo o desfecho comorbidade (Índice de Comorbidade de Charlson) foi associado a própria comorbidade na fase 1. Sobre o desfecho óbito verificou-se diferença significativa para a variável idade, níveis de fragilidade, comorbidade e o critério de fragilidade baixo nível de atividade física. Este estudo longitudinal proporcionou maior conhecimento sobre os eventos adversos da síndrome da fragilidade em idosos em acompanhamento ambulatorial<br>Abstract: This study aimed to analyze the outcomes and factors related to the frailty syndrome in a population of elderly patients treated in the outpatient geriatric service of a teaching hospital. This quantitative, comparative and longitudinal study is part of the larger research project "Quality of life in the elderly: frailty and subjective welfare indicators", conducted at the Geriatric Clinic of the Hospital of the State University of Campinas. This study used a convenience sample and had two phases (Phase 1 and 2). In Phase 1 (2005-2007),150 elderly patients followed up at the geriatric clinic were assessed. In Phase 2 (2013), the elderly were contacted again by phone or home visit and, after their consent, they were interviewed to collect sociodemographic and health data. Moreover, frailty was assessed according to the frailty criteria defined by Fried et al. (2001). The following events were considered as outcomes: fall, hospitalization, comorbidity and death. In Phase 2, of the 150 participants in Phase1, 71 died and 25 were excluded. Thus, Phase 2 sample had 54 respondents, predominantly women, and the rate of 80-year-old or older patients almost doubled (34% in Phase 1 and 64.4% in Phase 2). Concerning health and functionality, there was a statistically significant difference between all variables under study, except for number of hospitalizations and number of falls. The decline of functionalityis marked among these elderly and it was assessed using the tools SPPB, FIM and IADL, whose average scores decreased considerably. The cognitive state also showed a statistical difference, with a decrease in the average MMSE score in Phase 2 (p<0.001). As to frailty, the average number of criteria increased in Phase 2 (3.83) when compared to Phase 1 (2.43), and most of the elderly scored on all frailty criteria, except for "unintentional weight loss". The rate of the elderly classified as frail increased (50% in Phase1 and 88.9% in Phase 2) and none of the elderly was considered as non-frail. The outcome fall (Phase 2) was related to hospitalization and to the frailty criteria "exhaustion" and "unintentional weight loss" in Phase 1. Also was observed that the elderly who were hospitalized in Phase 1 were at a higher risk of hospitalization in Phase 2. As regards the outcome comorbidity (Charlson Comorbidity Index), the variable associated was comorbidity itself. Concerning the outcome death, we observed a significant difference in age, levels of frailty, comorbidity, and in the frailty criterion "low level of physical activity". This longitudinal study provided a more comprehensive knowledge of the adverse events of the frailty syndrome in the elderly followed up at an outpatient geriatric clinic. Therefore, we expect to contribute to more efficient public policies for the elderly population, considering the phenomenon of population aging and the magnitude of the frailty syndrome<br>Doutorado<br>Enfermagem e Trabalho<br>Doutora em Ciências da Saúde
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Gray, Roberta. "Constructions of frailty in a senior housing facility /." Thesis, Connect to this title online; UW restricted, 1998. http://hdl.handle.net/1773/8259.
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Vogler, Constance. "Reducing fall risk in older people discharged from hospital: a randomised controlled trial comparing (i) seated lower limb resistance training, (ii) functional weight-bearing exercises and (iii) social visits." Thesis, The University of Sydney, 2007. https://hdl.handle.net/2123/28062.
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Whilst exercise therapy has been found in trials to reduce fall rates in older
people, not all exercise interventions have been found to be equally effective in
preventing falls or reducing fall risk factors. Older people who have recently been
discharged from hospital are at an increased risk of falling, but they are a
population that has not been well studied in interventional trials.
This study aimed to investigate the effects of different types of exercise therapy
on fall risk factors in older people recently discharged from hospital, using a
randomised controlled trial. It also aimed to determine the extent to which gains in
physical performance and functional ability were maintained or lost following the
completion of the 12-week trial.
Firstly a reliability study of outcome factors for risk of falling was tested in the
home setting, using portable equipment, to determine intra-rater reliability.
Secondly, the main randomised controlled trial of subjects recently discharged
from two hospitals in Sydney’s northern suburbs was performed, comparing the
impact of seated resistance, fimctional weight-bearing exercises and social visits
on fall risk factors. After the interventions at 12 weeks, there were significant
improvements in composite fall risk (measured by the Physiological Profile
assessment), coordinated stability, maximal balance range, body sway and fingerpress
reaction time when comparing the functional weight-bearing exercises with
control. There was a significant improvement in composite fall risk for the seated
resistance group when compared with control. There was evidence of detraining
(complete or partial) for all of the above measures that had improved at 12 weeks.
Seated resistance exercises had the highest rate of musculoskeletal injury.
It can be concluded that in people recently discharged from hospital, functional
weight-bearing exercises had a greater impact on improving fall risk factors than
seated resistance exercises. Twelve weeks after the cessation of exercises,
detraining had occurred, highlighting the importance of longer-term exercises to
maintain improvements in this population.