Dissertations / Theses on the topic 'Older people and people with disability and carers'
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Magnusson, Lennart. "Designing a responsive support service for family carers of frail older people using information and communication technology /." Göteborg : Acta Universitatis Gothoburgensis, 2005. http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&doc_number=013142543&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA.
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Fleming, Alfred Andrew. "Older Men Working it Out A strong face of ageing and disability." University of Sydney. Behavioural and Community Health Sciences, 2001. http://hdl.handle.net/2123/852.
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This hermeneutical study interprets and describes the phenomena of ageing and living with disability. The lived experiences of 14 older men and the horizon of this researcher developed an understanding of what it is like for men to grow old and, for some, to live with the effects of a major disability. The study is grounded in the philosophical hermeneutics of Gadamer and framed in the context of embodiment, masculinity, and narrative. I conducted multiple in-depth interviews with older men aged from 67 to 83 years of age. Seven of the participants had experienced a stroke and I was able to explore the phenomenon of disability with them. Through thematic and narrative analyses of the textual data interpretations were developed that identified common meanings and understandings of the phenomena of ageing and disability. These themes and narratives reveal that the men�s understandings are at odds with conventional negative views of ageing and disability. These older men are �alive and kicking�, they voice counternarratives to the dominant construction of ageing as decline and weakness, and have succeeded in remaking the lifeworld after stroke. Overall I have come to understand an overarching meaning of older men �working it out� as illustrative of a strong face of ageing and disability. Older men seek out opportunities to participate actively in community life and, despite the challenges of ageing and disability, lead significant and meaningful lives. These findings challenge and extend our limited understandings of men�s experiences of ageing and living with disability. This interpretation offers gendered directions for policy development, clinical practice, and future research.
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Rose, John Laurence. "Stress amongst staff working with people who have a learning disability." Thesis, University of Hertfordshire, 1996. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.309715.
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McIntyre, Anne Elizabeth. "The experience of falling of older people with dementia and their carers." Thesis, Brunel University, 2012. http://bura.brunel.ac.uk/handle/2438/7247.
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Falling by older people is of significant global concern as the population ages, because of subsequent injury, disability, admission to long-term care and mortality. Older people experiencing dementia are twice as likely to fall with more severe consequences. Unsurprisingly, carer-burden increases when a care-recipient falls. Older people are rarely asked about their falls experiences and those with dementia less so. The studies presented in this thesis explore the experiences of falling of older people with dementia and memory problems, and their carers. The studies were informed by contextualism and the primary study used interpretative phenomenological analysis to explore the experiences of nine older people with dementia and their 10 carers, using one-to-one and joint interviews, and three focus groups with nine older people experiencing memory problems and 12 carers from a branch of the Alzheimer’s society. Analysis of the data considered the falls experience itself and the perceived consequences of falls within two higher level themes: ‘Falling as a malevolent force’ as two themes - ‘Going back to the experience’, ‘Reactions, responses and coming to terms with events’, and ‘Falling as the manifestation of dementia’ as two themes - ‘Self, identity and falling’, ‘The caring relationship’. The secondary study elaborated upon primary study data using an inductive interpretative approach unaligned to any tradition. Older people recently diagnosed with dementia and carers from another Alzheimer’s Society branch participated in two focus groups. Participants discussed stimulus cards with quotations from primary study participants. Thematic analysis suggested four major themes: Making sense of falls, The personal and social significance of falling, Falling, self and identity and Struggling to care. The findings demonstrate how falling and dementia are enmeshed and embodied experiences for participants. Spouse-carers’ discussion of their own falls emphasise the need for joint assessment and intervention to reduce carerburden and preserve couplehood.
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Williams, Tanagh. "Caring for older people : insights from trainee clinical psychologists and family carers." Thesis, University of Warwick, 2014. http://wrap.warwick.ac.uk/65049/.
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This thesis focuses on the care of older people, both those with and without dementia, by family caregivers and one group of health professionals (trainee clinical psychologists). This thesis considers and explores a number of factors which are important to those providing care. These factors have been defined specifically as Religion / Spirituality in the literature review, which focuses on family caregivers of people with dementia. However, in the empirical paper those factors important to providing care were not pre-defined by the research team but emerged from the data. It is hoped that, in conjunction, these papers will contribute to understanding the perspectives of those caring for older people. Chapter 1 is a systematic literature review investigating the association between religion/spirituality and the psychological wellbeing/role adjustment among Black and Minority Ethnic (BME) family (informal) dementia caregivers. It focuses on one specific factor ‘religion/spirituality’ in order to understand one aspect of the dementia caregiving experience. Chapter 2 is an empirical study exploring trainee clinical psychologists’ experiences of working with older people, including people with and without dementia. Interpretative phenomenological analysis (IPA) was used to analyse the transcript data from eight interviews with participants. Three superordinate themes and nine subordinate themes emerged following the data analysis. The themes are explored, including implications for research, clinical practice and clinical psychology doctoral training. Chapter 3 is a reflective account, which includes the experience of carrying out the research and the insights it provided. Adopting the theme of ‘story’ allowed a connection to be made between hearing the stories of older people, and hearing the stories of participants in IPA research. The theme of ‘story’ then also allowed further exploration of this topic in books, research and media articles.
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Andersson, Stefan. "Information and Communication Technology - mediated support for working carers of older people." Doctoral thesis, Linnéuniversitetet, Institutionen för hälso- och vårdvetenskap (HV), 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:lnu:diva-65220.
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Despite a growing awareness of the importance of support for carers who combine paid work with care of an older relative, so called ‘working carers’, there remains a lack of empirical knowledge about more innovative ways to support this largest group of carers of older people. Information and Communication Technologies (ICTs) are becoming more readily available. As a result, ICTs have made it feasible to offer working carers more targeted forms of support. This thesis aimed to gain an understanding about support for working carers of older people via the use of ICT. An integrative literature review was conducted to explore and evaluate the current evidence base concerning the use of ICT-mediated support for working carers (I). Content analysis of qualitative data was used to describe nursing and support staff’s experiences of using web-based ICTs for information, e-learning and support of working carers (II). Content analysis was also used to describe working carers’ experiences of having access to a web-based family care support network provided by the municipality (III). Descriptive statistical methods were used to analyse survey data which focused on the types of support received and how they were valued by working carers, with a focus on ICT support (IV). Findings highlighted that ICT mediated support provided working carers with the means to manage their caring situation, via the provision of information, e-learning and education, in addition to practical assistance and emotional and/or physical respite from caregiving. In this way, working carers felt empowered in their caring situation by feeling more competent and prepared in their caring role and by strengthening their self-efficacy and positive self-appraisal of their situation. Carers were provided channels to share their frustrations and burdens via forums for emotional and social support between working carers, caring professionals, and other peer carers. This led to working carers feeling less burdened by their caregiving role and it helped promote their wellbeing. Further, carers were helped in some instances to balance work and care. As a result caregiving activities conflicting with work obligations were then lessened. In contrast, when ICT mediated support was neither provided in a timely fashion or in accordance with individual carers’ needs and preferences, then it was perceived by them to be unimportant. Cross-sectional data revealed that take-up of support services was low suggesting that unmet support needs may be inflated by work-care conflicts. For carers with lower digital skills, the additional time needed to learn to use ICTs was a further barrier. Overall, ICT mediated support acted as a complementary form of support for working carers. Measures to overcome dis-empowering aspects of this innovative from of support are needed to avoid working carers’ deprioritizing their own support needs and also to avoid possible digital exclusion from the current information society.
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Abbott, Angela. "Orientations and lifeworlds of carers of older people in Tyne and Wear, UK." Thesis, University of Newcastle Upon Tyne, 2012. http://hdl.handle.net/10443/1766.
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This thesis focuses on the subjectivities and everyday routines of people who provide home-based care to older people at a political juncture which is reorienting social care towards self-directed support. Promoting the uptake of personal cash budgets and encouraging more person-centred provision, personalisation agendas loosely knit with the recognition politics of the disability movement, and connect to the emerging ‘Big Society’ discourse by encouraging more support from family, friends and volunteers. Their discursive combination strengthen and legitimate choice and control agendas that are potentially progressive in many ways, but have less obvious benefit from a carer perspective. This qualitative research draws upon semi-structured interviews and solicited diaries to explore the everyday practices, spaces and emotional investments of paid and unpaid home-based carers in Tyne and Wear, UK. Using feminist and poststructuralist understandings of diverse care economies, and phenomenological concepts of orientation and life-world, I argue that in negotiating the right thing to do, carer orientations in ‘being for others’ traverse competing social expectations, and disrupt and constitute caring spaces, practices and identities. Individualised notions of choice and control may fray and unravel when directed towards carers who de-limit possibilities in their everyday lives in a desire for coherence, predictability and legitimacy. Findings suggest that ‘good enough’ care imaginaries are often co-produced in a context of significant constraint. Yet, in augmenting imagined notions of home and family in everyday caring routines, carer respondents often insist on the necessity of practices which extend beyond utility, reflecting on the life-course to sustain meaningful stories and coherent identities for older people and for themselves.
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Lee, Hyunsook. "Comparative study of carers of older people with dementia in Scotland and Korea." Thesis, University of Edinburgh, 2011. http://hdl.handle.net/1842/9796.
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This study aims to explore Scottish and Korean carers‘ attitudes towards the diagnosis of dementia in their relative, family care, community care and to residential care in Scotland and Korea respectively, also under examination was the origin of different carers‘ attitudes between Scotland and Korea. The dominant argument between previous Western and Eastern comparative studies on attitudes, has been that culture made the difference. In other words, the cultural factor was recognised as a main determinant of attitudes towards a diagnosis of dementia, towards social services at home and residential care in Asian societies, including Korea. This thesis starts with the question: Does culture really explain the phenomenon of Asian people‘s attitudes towards dementia? Indeed the tradition of filial piety has been changing and now seems to be rather weak in modern Asian society. In particular, contemporary Korea is modernised and westernised, as a result, many older people live apart from their adult children and their nuclear families. This study asserts that Confucianism is a much less significant factor than differences in social policy. In other words, this thesis focuses not on Confucianism, but on the impact of institutions on carers‘ attitudes towards dementia. Finally, this thesis explores this argument through the following research question: What are the origins of different carers‘ attitudes between Scotland and Korea? In order to develop this argument, this thesis has carried out interviews with 14 Scottish carers and 28 Korean carers; and adopted a qualitative approach that would yield a rich exploration and deeper understanding of the different attitudes between carers in Scotland and Korea. Based on this data, this thesis examines carers‘ attitudes towards the diagnosis of dementia (chapter 3), family care (chapter 4), community care (chapter 5), and residential care (chapter 6). Each chapter analyses similarities and differences in attitudes in Scotland and Korea from the point of view of culture or the social welfare system. To conclude, these findings explain that the origin of carers‘ attitudes in this study is based on social policy rather than culture. In other words, the Korean carers‘ attitudes and behaviours towards diagnosis and long-term care services are rooted in the residual welfare system rather than Confucianism. Likewise, this study found that Confucianism has a less significant influence than social policy on carers‘ attitudes towards the utilisation of health care, community care and residential care. Unlike previous studies on East Asia, that argue for a cultural explanation, this study of Korean carers demonstrates that the residual welfare system is more persuasive than the cultural approach derived from Confucianism . This study contributes to the comparative study of Scotland and Korea as well as being a qualitative study in Korea. In addition, it will provide a new perspective on attitudes towards studies on East Asia. Moreover, the study will suggest political implications through the exploration of the carers‘ attitudes towards dementia diagnosis, social services at home and residential care. It also can provide lessons on dementia and dementia care from different experiences in Scotland and Korea.
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Sahar, Junaiti. "Supporting family carers in caring for older people in the community in Indonesia." Thesis, Queensland University of Technology, 2002. https://eprints.qut.edu.au/36786/1/36786_Digitised%20Thesis.pdf.
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The purpose of the study:
The purpose of this research study was to improve the health status of older people living in the community through implementing a family carers' training program.
Background of the study:
Many previous studies have reported the improvement of family carers' knowledge in providing better care for older people as well as reducing their burden, anxiety and depression. However, those studies have not addressed clearly the impact of the programs on the health status of older people living in the community.
Design of the study:
An experimental design with pre and post-tests of intervention and control groups was used in the study.
The intervention of the study:
The intervention group attended the training program and received a training package consisting of 8 health education booklets and trainees'guide at the beginning of the study. They were also provided with guidance practice and follow-up support following the training program. The control group received usual care and support during the study. However, at the end of the study they were provided with the training package.
Population and sample:
All older people (60 years and above) living with their family carers in the district of Beiji, Depok Indonesia formed the population for this study. Two villages were randomly selected from the six villages in this district. One village was randomised to become the intervention group and the other became the control group. A sample of 120 older people and their primary carers (120) were selected from of the two villages. Therefore, the total sample consisted of 480 participants made up of 240 family carers and 240 older people.
Data collection and instruments:
The data were collected within three time points (baseline, 3 and 6 months) by using several tested and widely used instruments. Some additional questions relating to the family carers' training program were also added. All instruments were tested for reliability in Indonesia before being used for the present study.
Data analysis:
T-test and Chi-square analyses were used to identify baseline differences between the intervention and control groups. ANOVA was used to examine the differences between selected internal or external factors of older people and the health status of older people. Two-way repeated measures ANCOV A was chosen to evaluate the differences within the three time points and between groups and controlled for baseline differences or some potential confounders. Friedman's test was used to test the variances which were not equal and for categorical data. For the dichotomous variables, the Cochran's test was chosen.
Results:
Overall, the findings over the six-month period for the intervention group showed a significant increase for the knowledge, skills, attitudes, global social support and life satisfaction perceived by family carers when compared to those of the control group. The objective burden was significantly lower in the intervention group than that of the control group. The subjective burden was not significantly different between the groups. However, further analysis using independent pairwise comparisons (Bonferroni) showed the intervention group significantly lower than the control group. Similarly the health status of older people in the intervention group, including physical, mental, global social support, life satisfaction, and blood pressure was significantly increased when compared to those of the control group. In contrast to these findings, the activities of daily living of older people were not significantly different between groups.
Conclusions:
In conclusion, the Family Carers' Training Program made a positive impact on the health status of older people through increasing the family carers' ability in caring for older people. This program was found to be acceptable by the population and feasible to implement within the Indonesian population.
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Ng, Ka-man Carmen. "An exploration of experiential learning with carers participating in a multi-skills training course on care of the elderly." Hong Kong : University of Hong Kong, 2000. http://sunzi.lib.hku.hk/hkuto/record.jsp?B22331463.
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Henry-Nweye, Roseline Awhoma. "Older people and their carers' perspectives of causes and risk factors to hospital readmissions." Thesis, University of Liverpool, 2011. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.569577.
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Emergency readmission to hospital is one of the greatest pressures on the National Health Service and research shows that 40% are avoidable (Department of Health 2000; Nikolaus et al 1992, ONS 2002;). Hospital read missions have generally been researched form a quantitative approach and perceived as unavoidable or avoidable. For example, evidence suggests that unavoidable read missions are caused by relapse of chronic disease, the changes in family life and the effect of limitation of primary care services!-..(11ound et al 2002; Dobrzanska & Newell, 2006) while the avoidable read missions 'are due to non- involvement in carers, unresolved health problems on discharge, lack of support in the homes, and poor communication across sectors of health care (Buell 2008, Gravelle et al 2007,). However, there is a lack of research on older people and their carers perceived reasons for readmissions. Aim; The overall purpose of this study was to explore individual older person and their carers' perceptions of hospital read missions, with the goal of providing evidence for the development of safe and effective intervention strategies to decrease costly hospital read missions for older patients in the United Kingdom. Methodology; Qualitative method, with a descriptive phenomenological approach was used as the research design. The setting for the study was in the community where in-depth interviews with older people and their main carers were conducted and used as to access and explore their experiences regarding health and social care services at home after initial hospital discharge. Analysis; The purposive sample consisted of 30 in-depth interviews with nineteen older people who had been discharged from hospital and eleven of their carers. The older people are 65years and over, all lived within Liverpool, Halton and St Helen's Primary Care Trusts in the North West of England in the United Kingdom. Interviews were audio-recorded and transcribed, and were analysed thematically. Results; Participants reported a preference for care to be delivered to them in their homes. The problems identified are lack of empowerment and involvement in care suggesting a need for additional individualised support at home. Additionally, inadequacy of care provision, overburden and lack of supports to informal carers' is also highlighted. The resultant effect is that older people were making hurried, life- changing decisions to move into sheltered accommodation, residential or nursing homes. Discussion; In order to control hospital read missions, the author recommends that those in charge of policy-making for continuing care of older people in the community should direct health practitioners to provide individualised support to older people after discharge from hospital. Some recommended services could include health risk assessment, routine health screening which includes nutrition screening and counselling, health promotion programs, home injury control services, depression and mental health screening and medication management and counselling. The study revealed that care at home is possible with support from 10 I family members/friends, with the implication that those without families should be considered for care elsewhere. Key words: old people, elder people, older people, seniors, geriatric, Hospital readmission, unplanned readmission, readmissions, systematic literature review, home care, hospital discharge to community, community rehabilitation, hospital to home. 11
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Statham, Joyce. "A day at a time : a study of unsupported family carers of older people." Thesis, University of Glasgow, 2003. http://theses.gla.ac.uk/3484/.
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Informal carers provide the majority of care for older people living in the community. The provision of care can be very stressful and is said to have an adverse affect on caregivers’ health. Policy has recognised the need to support carers and a key objective has been to improve service provision for them. Research has shown that service intervention can prevent the breakdown of care and admission to long term care. However, relatively few carers and older people use formal services. While the low uptake of support services is documented, it is not fully understood. The aim of this study was to explore the experiences of informal carers of older people who received no support services. It focused particularly on the question: why when caregiving is portrayed as being stressful, do carers continue without support from formal service providers? Purposive sampling was used to obtain a sample of unsupported carers of older people, who were interviewed three times over a period of two years. For this longitudinal study a predominantly qualitative approach underpinned by the principles of grounded theory was chosen with a quantitative component included in the second stage. The study used a range of methods including focus groups, interviews and self-completion questionnaires. The main source of data was individual in-depth interviews, while self-completion questionnaires and literature provided secondary and tertiary sources of data. Data were analysed according to the principles of grounded theory. The study found that carers were motivated by a strong sense of duty and a desire to maintain their independence and control over their lives and the caregiving situation. They regarded formal services as authoritarian and intrusive. Acceptance of support was associated with feelings of failure and a potential loss of control.
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Logan, Caroline. "Caregiving to older people who have a dementia : an investigation of stress and coping in carers." Thesis, University of Oxford, 1995. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.306888.
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Corner, Lynne. "Developing approaches to person-centred outcome measures for older people in rehabilitation settings." Thesis, University of Newcastle Upon Tyne, 1999. http://hdl.handle.net/10443/629.
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The rationale for this study was the need to bring a social science perspective to developing approaches for person-centred outcome measures in rehabilitation settings for older people. To date this field has largely been dominated by clinicians and the biomedical model of impairment, disability and handicap. Qualitative methods (findings from focus group discussions informed later focus interviews with individuals) were used to establish and explore the views of older people about a range of issues linked to conceptualising outcome, including participating in decisions regarding their health, to examine how older people made judgements, what they valued and prioritised, what their expectations were, how care was experienced and how changes are sustained over time. Symbolic interactionism and grounded theory provided the overall theoretical approach to the methods used. A distinction is made between older people's 'public' and 'private views'. This analytical distindon provides the framework within which the accounts are explored and presented in the thesis. The public accounts focus on the social and moral obligations associated with the experience of being an older citizen. The thesis explores the role of reciprocity, justice and conscience in these accounts. The private accounts reveal the wide range and diversity of opinion and experiences that exist. Three groups of people were identified: empowered, reluctant collaborators; and dominated. It is argued that future best practice for outcome evaluation in health and social care professionals will need to explore the private views of older people in greater depth. Institutionalised ageism and structured dependency are major barriers to empowering older people to participate in identifying outcomes. Until these issues are recognised and resolved, more meaningful participation in the identification and method of assessment of outcomes is unlikely. The findings should be of relevance to researchers, to users of health services and to clinicians working in rehabilitation settings for older people.
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Hovda, Theodore James. "Lower extremity strength and its association with physical function and disability." Electronic thesis, 2002. http://dspace.zsr.wfu.edu/jspui/handle/10339/208.
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Fowler, Susan. "Older people and hospital discharge : how service users’, carers’ and professionals’ experiences can inform social work practice." Thesis, Northumbria University, 2009. http://nrl.northumbria.ac.uk/7257/.
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Lane, Paula. "An exploration of the health and social care needs and experiences of family carers of older people." Thesis, University of Ulster, 2002. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.393483.
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Pleschberger, Sabine, Elisabeth Reitinger, Birgit Trukeschitz, and Paulina Wosko. "Older people living alone (OPLA) - non-kin-carers' support towards the end of life: qualitative longitudinal study protocol." Springer Nature, 2019. http://dx.doi.org/10.1186/s12877-019-1243-7.
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Background: A growing number of older people, mainly women, live in single households. They represent avulnerable group as staying at home may turn out challenging when care needs increase, particularly at the end oflife. Non-kin-carers can play an essential role in supporting individuals' preferences to stay at home. In research Little attention has been paid to non-kin-carers, such as friends and neighbors, yet. Thus, the Older People Living Alone (OPLA) study will evaluate whether non-kin support is robust enough to enable care dependent people to stay athome even at the end of life. This paper aims to introduce the research protocol.
Methods: We plan to apply a qualitative longitudinal study to better understand how older people living aloneand their non-kin-carers manage to face the challenges with increased care needs towards the end-of-life. We willconduct serial interviews with the older persons living alone and their non-kin-carers. A total of 20-25 completedata sets and up to 200 personal interviews were planned. These will be complemented by regular telephonecontacts. All interviews will be analysed following the grounded theory approach and strategies for reconstructingcase trajectories, supported by MAXQDA software. In the course of the study, inter- and transdisciplinary workshopsshall assure quality and support knowledge transfer.
Discussion: This study protocol aims to guide research in a field that is difficult to approach, with regard to itstopic, methodology and the interdisciplinary approach. As this study introduces longitudinal qualitative Research methodology in the field of home care in Austria, a deeper understanding of (end-of-life-) care trajectories will beenhanced, which is of major relevance for future care planning. With investment in additional reflexivity andcommunication procedures innovative results and robust knowledge are expected outcomes.
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Smyth, Catherine M. "Carers' intentions to encourage healthy diet in people with a learning disability : the application of Theory of Planned Behaviour." Thesis, University of Edinburgh, 2009. http://hdl.handle.net/1842/25209.
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People with learning disabilities are increasingly living in community settings with support from care staff who have a large influence on their lives, including diet. The Theory of Planned Behaviour (TPB) is a model that has been used to examine many health behaviours with reference to underlying beliefs. This model has only recently been applied to proxy populations, i.e. with one group about the health behaviours of another. The purpose of the current project was to determine if the TPB was a useful predictor of care staff’s intentions to encourage a healthy diet in their clients with a learning disability. Method: 112 care staff from five voluntary or charitable organisations that provide support to people with learning disabilities were involved in the study and care staff from each completed a TPB questionnaire regarding their intention to encourage healthy eating over the next year for their clients. Results: The results indicate that the Theory of Planned Behaviour is indeed applicable to this population. The variables which make up the original model of Theory of Planned Behaviour: attitudes, subjective norm and perceived behavioural control, were found to be statistically significant predictors of carers’ intentions to encourage healthy diet in their client. Additional variables (self-efficacy and self identity) were not found to improve the model. Subjective norm was found to be the most predictive variable within the model. The results are discussed with a view to how Theory of Planned Behaviour could be a useful model in guiding healthy eating interventions within this population.
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Matson, Neil. "Coping with caring : a study of the influence of coping on the stress experienced by carers of stroke victims and carers of confused older people." Thesis, University of Exeter, 1991. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.304904.
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McGhee, Adrienne L. "The knowledge of doing: Exploring the knowledge of support to older people with an intellectual disability." Thesis, Queensland University of Technology, 2014. https://eprints.qut.edu.au/74855/1/Adrienne%20McGhee%20Thesis.pdf.
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This ethnography presents a contextualised understanding of frontline knowledge used in the support to people ageing with an intellectual disability who live in accommodation and support services in south-east Queensland. The study identified that disability support workers accessed a range of knowledges which they synthesised into a dynamic and responsive locale knowledge, and subsequently translated into everyday acts of support within contexts of multi-faceted complexity. Findings from the study have numerous implications for the knowledge development activities of formal service and educational systems within Australia's newly implemented National Disability Insurance Scheme.
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Darby, Janet. "The Acute Medical Unit : narratives of older people and their informal carers about the hospital stay and resettlement experience." Thesis, University of Salford, 2015. http://usir.salford.ac.uk/33991/.
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Introduction: Many older people presenting to Acute Medical Units (AMUs) are discharged home after only a short length of stay, yet research has found that many re-present to hospital within a year. This constructivist study explored patient and informal carer views of care and treatment received on an AMU whilst participating in a trial of a specialist geriatric intervention. Method: Eighteen older patients and six of their informal carers were purposefully selected from the above trial. These participants were interviewed in their homes up to six weeks following discharge. An interview guide was used to encourage participants to provide both narratives and their opinions and views around the AMU stay, and the resettlement period back home. The data were analysed using two analytic approaches: thematic and narrative analysis. Results: The analysis revealed five major themes. These revolved around participants making positive comments about the AMU staff, whilst also revealing an underlying subtle message that things could be better. The participants were similarly positive about the geriatricians, but were unable to articulate what had been done for them. On discharge, the patients had both outstanding health and daily living needs, which were not resolved by the admission. These needs impacted on their informal carers, who supported them with their daily living activities. Overall these participants were stoical and had low expectations of hospital care. Conclusion: The study has provided an in-depth understanding of the older patient and informal carer experience of an AMU stay. The recommendations made revolve around meeting patient’s basic physiological needs, improving staff communication with both patients and their informal carers, and improving the on-going care management of these patients post discharge, including further medical review and rehabilitation.
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Elliott, Sheryl DeJoy. "The Historical, Political, Social, and Individual Factors That Have Influenced the Development of Aging and Disability Resource Centers and Options Counseling." PDXScholar, 2013. https://pdxscholar.library.pdx.edu/open_access_etds/1072.
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This thesis reports on the perspectives and experiences of policymakers, advocates, agency supervisors, and experts in the field of gerontology, about the development of Aging and Disability Resource Centers (ADRC) programs and Options Counseling (OC). By examining the foundations upon which ADRCs and OC are built, this study sought to inform future research about the effectiveness of existing practice, increase understanding of best practices, and clarify whether these emerging services are accomplishing original goals.
ADRCs and OC intend to address long-term care issues and healthcare needs by providing a single entry point to the social service system. ADRCs offer information, assistance, and OC to people of all ages, incomes, and disabilities, and promote long-term care options that honor independence and respect for the needs and preferences of individuals, their families, and caregivers. They are the latest iteration of policymakers' efforts to provide affordable home-and community-based care for older persons and their caregivers.
A total of fifteen qualitative interviews were conducted and analyzed using grounded theory methods. Key persons interviewed included experts in the area of aging, aging policy, and aging. Participants were recruited through referrals suggested by Portland State University's (PSU) Institute on Aging (IOA) staff. In addition, several key experts known to the researcher through affiliation with PSU's IOA agreed to be interviewed. Snowball sampling was then used to locate additional key experts.
Interview participants were classified as advocates, state decision makers, policy makers, or academicians. Advocates included national and state directors of agencies that promote the development and management of effective services to aging adults. State decision makers included state directors, ADRC directors and supervisors, and program analysts. Policy makers interviewed were national program directors responsible for shaping the future of developing programs to assist older adults. Academicians who participated in the study have been instrumental in developing and researching practices that promote well-being for the aging and the aged. These key experts were selected based on their knowledge and ability to inform the strengths, weakness, and development of ADRCs and Options Counseling. Many have been instrumental in health and aging policy and service development and research, and possess insider knowledge not available to the general public regarding attitudes and interests motivating the actors.
Findings indicate that ADRCs and OC are designed to manage within existing social service systems. They can benefit some individuals by providing more options and support in accessing public and private services. It remains to be seen whether they have the capacity to ameliorate some existing system-level problems. Findings highlight program strengths and weaknesses, sustainability issues, and policymakers, state decision makers', and providers' commitment to sustaining ADRCs and OC.
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Tipsuk, Parnnachat. "Caring for Older Adults with Disability: Lived Experience of Family Caregivers in Rural Thailand." Miami University / OhioLINK, 2016. http://rave.ohiolink.edu/etdc/view?acc_num=miami1472591969.
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Webber, Sarah Helen. "The lost elements of care? : an ethic of care and social care assessment for older people and carers in England." Thesis, University of Bristol, 2015. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.684643.
Full textAbstract:
Adult social care is undergoing a period of 'radical reform', shaped by concern over changing demographics (the 'ageing population'), diminishing resources, increasing demands for independence and a focus on individual and community responsibility. Within this context, access to local authority social care funding and support is limited to those who, after assessment, are deemed to have 'eligible needs' . This research examines social care assessment for older people and family carers, utilising an ethic of care perspective to challenge the contemporary policy focus on ' independence' and 'individual or community responsibility'. Through original, qualitative interviews with older people, family carers, charity workers, care providers and those working for the local authority, this research investigates how assessment is conducted and experienced in two local authorities, updating and increasing understanding of assessment practice. By utilising an ethic of care perspective, the research highlights that the views of older people, family carers and social workers on 'the person', the role of the state and the purpose and conduct of assessment call into question many of the assumptions which underlie current and future adult social care policy and legislation. The research focuses on how ethic of care perspectives challenge the current assessment process but also highlights where Tronto's (1993) elements of care are already present in assessment practice. It argues that changes in line with an ethic of care, building on the elements in practice, would improve the experiences of those going through the process as well as those who conduct assessments. This analysis emphasises areas which are missing from the wider debate on adult social care, highlighting the value of an ethic of care as an evaluative framework but also, as an ethic of care perspective reflects the views of those involved in the system, as a foundation for a future assessment process.
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Bromley, Leslie Andrew. "How do carers of people with an intellectual disability with dementia experience their role and the support they receive through services?" Thesis, University of Exeter, 2014. http://hdl.handle.net/10871/16367.
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Background: People with an intellectual disability often require carers to provide assistance in their basic living needs and to help them achieve the best quality of life possible. The increased prevalence of dementia in people with an intellectual disability over recent years has prioritised the importance of research into the impact this has had on people with an intellectual disability with dementia, their carers, and their support services. There has been a lack of qualitative studies investigating the experiences of carers for people with an intellectual disability and dementia and their perceptions of services that support them to carry out their role. These carers fulfil an important need within the community and this study explored family and paid carers’ experiences of caring for people who have an intellectual disability with dementia. Method: This paper describes a qualitative study that used semistructured interviews to investigate both paid and family carer’s experiences of caring for people with an intellectual disability with dementia. Face-to-face interviews were conducted with 12 carers and the resulting data were analysed using thematic analysis. Results: The analysis generated 9 meta-themes including a carer’s identity, transitions in the carer experience, self-care, difficulties in caring, changes to services, recommendations for change, barriers to accessing carer support, sources of support and resources, and sharing carers’ best practice. Conclusions: The implications of the results are discussed and recommendations for future research are provided.
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Robertson, Jane M. "Making sense and finding meaning : comparing narratives of older people with dementia and carers about the quality of an ordinary life." Thesis, University of Stirling, 2010. http://hdl.handle.net/1893/2530.
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This research examines narratives about the quality of everyday life with dementia. The aim of the study is to compare and contrast differing perspectives about the impact of ageing and dementia upon the lives of older people with dementia. A total of 50 interviews with six older people with dementia and ten family and paid carers were conducted over a two-year period. Narrative analysis was used to examine the content and structure of their accounts to understand their perspectives on what matters most to people living with dementia. This in-depth analysis enabled an exploration of different social concepts and narrative constructions that people draw upon in making sense of their experiences of caring and living with dementia. The analysis demonstrated that older people incorporate ageing and dementia into a continuing sense of self. Positive constructions of living with dementia involve the ability to lead a meaningful life that supports pre-existing social roles and relationships and active engagement within the family and community. The emphasis is on living an ordinary life while responding to the challenges associated with cognitive impairment and social stigma. For family and paid carers, perceptions of a meaningful life depend on how the identity of the older person with dementia is positioned relative to past social roles and relationships. Positive constructions assume continuity as opposed to focusing on disruption in the person’s identity and life. Carer perspectives are also influenced by how the person is perceived to conform to social standards of normality. The narratives of older people with dementia reflect their active struggle to find meaning in terms of realising their sense of self within a social world that largely defines them as different and out of the ordinary. The narratives of carers resonate with emotional difficulty, reflecting their struggle to make sense of a life that is not represented as essentially normal. These findings show that, for all, finding meaning in everyday life depends upon making sense of that life as normal and ordinary.
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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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Blackwell, Rebecca. "Improving the experiences of palliative care for older people, their carers and staff in the Emergency Department using experience-based co-design." Thesis, King's College London (University of London), 2015. https://kclpure.kcl.ac.uk/portal/en/theses/improving-the-experiences-of-palliative-care-for-older-people-their-carers-and-staff-in-the-emergency-department-using-experiencebased-codesign(9de694f8-899e-4387-9680-02a7f0da8b8c).html.
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Background: The Emergency Department (ED) is often viewed as an inappropriate environment for terminally ill older patients; however, palliative admissions to the ED continue to occur. Despite an increased focus on end of life and palliative care services, the role of the ED has generally been neglected in the UK. Aim and Methodology: This study used the participatory action research methodology, Experience-based Co-design to identify concerns and solutions to improve experiences of palliative care provision in the ED for older patients (65+), their carers and staff at Guy’s and St Thomas’ Hospital NHS Foundation Trust ED. Methods: Experiential narrative data were gathered using audio and filmed interviews, and analysed using a thematic framework to identify the main challenges. Findings were validated by the staff and patient/carer groups, who selected four improvements priorities (IP) each (eight in total). Findings, in the format of a patient/carer film and a staff presentation were shared at a co-design event which enabled participants to collaboratively select shared IPs and began to redesign applicable elements of the service. The study was enhanced by findings from a data collection field trip to a geriatric-only ED at Mount Sinai Hospital in New York. Using interviews and observation additional background contextual data on palliative care coding and ED impact on the patient journey were identified. Findings: The four staff IPs were: ‘helping them [patients and carers] find their way’, ‘being informed and informing them [patients and carers]’, ‘seeing the person in the patient’, and ‘expectations of the care we can give’. Patient and carer IPs were similar: ‘finding our way’, ‘knowing what’s happening’, ‘seeing the person in the patient’, and ‘expectations of care’. The co-design event explored these issues and the group began to develop plans to improve them. Immediate strategies aimed to: improve self-management and ownership, develop ED-based palliative care pathways and staff training, create dedicated palliative care space in the ED, improve IT and databases, improve patient experience, and share the learning of the study. Impact: Early study impact includes palliative care referral improvements, introducing routine ED visits by the palliative care team, development on palliative care pathway processes in the ED, development of mandatory palliative care training in the ED which includes the patient/carer film. Based on feedback from the co-design event, the film was expanded to include the staff experience as well.
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Worthen, Laura T. "Caregiving in Later Life: A Contextual Approach to the Provision of Care." Thesis, University of North Texas, 2003. https://digital.library.unt.edu/ark:/67531/metadc4246/.
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Guided by the life course perspective, this study examined the frequency of caregiving provided by older adults to kin and non-kin. A telephone survey produced a random sample of adults 60 years of age and older, which was predominantly White, with higher income and education levels (n = 278). Bivariate and multivariate analyses tested the impact of demographic characteristics and other variables, conceptualized as physical, human, and social capital, on the frequency of caregiving. Gender, age, health, limitations, education, income, household composition, social contact, and reciprocity were analyzed in multinomial logistic regressions. Caregiving was defined as care provided to sick or disabled persons, with frequency of providing care classified as often, sometimes, and never. The majority of older adults provided at least some care to others over a one-year period, with almost one-third doing so often and only one-quarter never doing so. Most provided care to more than one person, with over one-quarter providing care to multiple friends only. Age failed to predict caregiving involvement when physical and social capital variables were considered. The odds of often providing care are higher for women, although gender did not predict those who never provided care. Having at least some college only significantly predicted women who often provided care. Living with a disabled person increased the frequency of caregiving, although that care was not always for the disabled person. Similarly, living with a spouse, as compared to living alone, increased caregiving involvement but often the spouse was not the care recipient. These findings highlight a need for policy changes that will support and recognize the contributions of older caregivers of both family and friends. The definition of caregiving is another policy issue that should be addressed. These findings also challenge policymakers and community leaders to promote informal caregiving by providing educational programs to enhance and better utilize the talents, abilities, and altruistic concerns of older caregivers.
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Erlandsson, Sara. "Hjälp för att bevara eller förändra? : Åldersrelaterade diskurser om omsorg, stöd och service." Doctoral thesis, Stockholms universitet, Institutionen för socialt arbete - Socialhögskolan, 2014. http://urn.kb.se/resolve?urn=urn:nbn:se:su:diva-102584.
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This thesis analyses the categorisation of adult persons who need help to cope in everyday life as either older persons or persons with a disability. Despite the development of social services in the Scandinavian countries being guided by the principles of universalism and equality, adults in need of care have different rights to support depending on their current age and at which age disability occurs. This thesis aims to explore how age-based differences in access to care, support and service are legitimised. In the thesis, the concept of help is used to refer to care, support and service. Using a discourse analytic approach, Swedish elderly and disability policies and websites through which providers of help market their services were examined. The analysis, inspired by the theoretical framework of governmentality, draws attention to how users of help and helpers are constituted in two age-related discourses on help. The first discourse, help to maintain, is used mainly in relation to older persons. In this discourse older persons are constituted as subjects in need of safety, comfort and company while the helpers are represented as caring and knowing. The second discourse, help to change, constitutes younger persons with a disability as citizens in becoming. Help aims to improve the situation for younger help users in varying ways: the opportunity to fully determine the tasks performed by helpers is essential to users of personal assistance whereas personal development as regards both practical and social skills is the key to change for persons with an intellectual or mental disability. While help for younger persons is represented as a means to enhance the individual’s self-determination and ability to participate in society, help for older persons is represented as aiming to maintain past patterns of life, not aspiring towards change or improvement. It is argued that these representations support a lower ambition for eldercare than for disability services.
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Edelbrock, Dorothy Marcia. "Disease, disability, service use and social support amongst community-dwelling people aged 75 years and over: the Sydney older persons study." Thesis, Queensland University of Technology, 2004. https://eprints.qut.edu.au/15961/1/Dorothy_Edelbrock_Thesis.pdf.
Full textAbstract:
This study investigates the characteristics of and the interrelationships between disease, disability, service use and social support in a random sample of 647 community dwellers aged 75 years and over. The two broad objectives of the study are: to examine the physical aspects and manifestations of health by investigating disease and disability and the interrelationships between these two factors, and; to examine the social aspects of health by investigating service use and social support and the interrelationships between these two factors.
Given the dramatic population ageing in Australia, particularly in the very old age groups, the health, well-being and quality of life of older Australians are of paramount importance and will be well into the future. The proportion of the population with diseases and disabilities increases significantly with age. As the physical aspects of health are manifested with increasing age the social aspects of health also become increasingly important. Older adults, particularly those in advanced old age, are disproportionately high users of health and community services. Despite the high use of services in this age group, far more older adults living in the community rely on their families, friends and neighbours for social support and many older adults use a combination of formal services and informal social support. Little is known about people aged 75 years and over living in the community in Australia. In particular, significant knowledge gaps exist with regard to the relationship between disease and disability and that between service use and social support. The characteristics of social support in this group of older adults are also largely unknown.
The papers presented in this thesis are based on data collected in The Sydney Older Persons Study (SOPS). This is a large longitudinal multidisciplinary project which began in 1991 in order to investigate the health and service use patterns of people aged 75 years and over living in the community in the Central Sydney Health Area. The initial sample consisted of two groups: first, the Australian Bureau of Statistics (ABS) selected census districts with probability proportional to size and 9271 households were door-knocked to obtain a random sub-sample of the general community (n=320, response rate 73%); second, community-living veterans and war widows residing in the Central Sydney Health Area were selected at random from a list provided by the Department of Veterans Affairs to obtain a veteran/war widow sub-sample (n=327, response rate 82%). Respondents participated in both an interview conducted by a social scientist and a medical assessment performed by a medical practitioner with experience in geriatric medicine. An informant was sought for each respondent and this informant participated in a phone interview conducted by a social scientist.
The first paper in this thesis investigates the characteristics of diseases (neurodegenerative, systemic and psychiatric) including their prevalence and association with age. The second paper extends the first by examining the nature of the relationship between disease and disability and in particular which individual diseases and groups of diseases have the greatest impact on disability. The third paper expands the analysis in the second paper by focusing in greater detail on the relationship between disease and disability. The contribution of clinically-diagnosed individual diseases and groups of diseases to three different measures of disability (clinician-rated, informant-rated or proxy and self-report) is investigated here. The fourth paper examines the possibility of disease and disability being the major predictors of service use and social support. It focuses on the determinants of service use and social support using Andersen's behavioral model. The fifth paper investigates the characteristics of social support, in particular gender differences and the socio-demographic variables associated with social support. This is an important research area because lower levels of social support have been found to predict mortality, disease and lower levels of well-being. Finally, the sixth paper links the major themes of the fourth and fifth papers by investigating the relationship between service use and social support. This paper tests Cantor's 'hierarchical-compensatory' mechanism, which predicts a negative association between service use and social support, and the 'bridging' mechanism which predicts a positive association between these two factors. Thus it assesses the extent to which demands for service use and for social support are made together or in a compensatory fashion for respondents of equal disease and disability.
The presented work demonstrates that neurodegenerative diseases [dementia, cognitive impairment, parkinsonism, instability (gait ataxia), immobility (gait slowing) and motivation loss/behaviour change] have the largest and most significant increases with age of all disease groups. Therefore the hypothesis made in paper one that neurodegenerative diseases will come to dominate the health care needs of older adults, particularly when combined with population ageing, is supported. Further, results of papers two and three indicate that neurodegenerative diseases result in greater levels of disability, lending credence to the finding that it is these neurodegenerative diseases that are of central importance to the future of the health care needs of older adults of advanced age. While systemic diseases play an important role in disability, the neurodegenerative diseases are under-recognised by self-report and yet are most strongly associated with severe disability. A major recommendation of this study is that assessments and diagnosis of neurodegenerative diseases be included in disability assessments.
With regard to the social aspects of health, the fourth paper finds that disease and disability are the main predictors of service use and social support. The fifth paper highlights important gender differences in social support and also finds that lower levels of social support are associated with increased age, male gender, single marital status and lower socioeconomic status. Because it is widely accepted that social support is protective against adverse health outcomes and low levels of wellbeing, these groups of older adults are at risk of poorer health and wellbeing. Finally the sixth paper fills some knowledge gaps with regard to the relationship between service use and social support. It shows that with regard to IADL (instrumental activities of daily living) services and IADL social support, Cantor's 'hierarchical-compensatory' mechanism (negative correlation) applies but with regard to medical services and both ADL (activities of daily living) and IADL social support the 'bridging' mechanism (positive correlation) is supported.
These complex interrelationships between disease, disability, service use and social support are summarised schematically in a model. In light of significant population ageing, substantial resources in the form of medical and community services and social support from carers, family, friends and neighbours will need to be devoted to older adults with diseases, in particular neurodegenerative diseases, and to those with disabilities. Given the increasing importance of disease, disability, service use and social support in very old age, it is crucial that knowledge and understanding of these factors and their interrelationships be advanced in order to better allocate and sustain resources and to ultimately improve the health, well-being and quality of life of very old adults.
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Edelbrock, Dorothy Marcia. "Disease, disability, service use and social support amongst community-dwelling people aged 75 years and over: the Sydney older persons study." Queensland University of Technology, 2004. http://eprints.qut.edu.au/15961/.
Full textAbstract:
This study investigates the characteristics of and the interrelationships between disease, disability, service use and social support in a random sample of 647 community dwellers aged 75 years and over. The two broad objectives of the study are: to examine the physical aspects and manifestations of health by investigating disease and disability and the interrelationships between these two factors, and; to examine the social aspects of health by investigating service use and social support and the interrelationships between these two factors. Given the dramatic population ageing in Australia, particularly in the very old age groups, the health, well-being and quality of life of older Australians are of paramount importance and will be well into the future. The proportion of the population with diseases and disabilities increases significantly with age. As the physical aspects of health are manifested with increasing age the social aspects of health also become increasingly important. Older adults, particularly those in advanced old age, are disproportionately high users of health and community services. Despite the high use of services in this age group, far more older adults living in the community rely on their families, friends and neighbours for social support and many older adults use a combination of formal services and informal social support. Little is known about people aged 75 years and over living in the community in Australia. In particular, significant knowledge gaps exist with regard to the relationship between disease and disability and that between service use and social support. The characteristics of social support in this group of older adults are also largely unknown. The papers presented in this thesis are based on data collected in The Sydney Older Persons Study (SOPS). This is a large longitudinal multidisciplinary project which began in 1991 in order to investigate the health and service use patterns of people aged 75 years and over living in the community in the Central Sydney Health Area. The initial sample consisted of two groups: first, the Australian Bureau of Statistics (ABS) selected census districts with probability proportional to size and 9271 households were door-knocked to obtain a random sub-sample of the general community (n=320, response rate 73%); second, community-living veterans and war widows residing in the Central Sydney Health Area were selected at random from a list provided by the Department of Veterans Affairs to obtain a veteran/war widow sub-sample (n=327, response rate 82%). Respondents participated in both an interview conducted by a social scientist and a medical assessment performed by a medical practitioner with experience in geriatric medicine. An informant was sought for each respondent and this informant participated in a phone interview conducted by a social scientist. The first paper in this thesis investigates the characteristics of diseases (neurodegenerative, systemic and psychiatric) including their prevalence and association with age. The second paper extends the first by examining the nature of the relationship between disease and disability and in particular which individual diseases and groups of diseases have the greatest impact on disability. The third paper expands the analysis in the second paper by focusing in greater detail on the relationship between disease and disability. The contribution of clinically-diagnosed individual diseases and groups of diseases to three different measures of disability (clinician-rated, informant-rated or proxy and self-report) is investigated here. The fourth paper examines the possibility of disease and disability being the major predictors of service use and social support. It focuses on the determinants of service use and social support using Andersen's behavioral model. The fifth paper investigates the characteristics of social support, in particular gender differences and the socio-demographic variables associated with social support. This is an important research area because lower levels of social support have been found to predict mortality, disease and lower levels of well-being. Finally, the sixth paper links the major themes of the fourth and fifth papers by investigating the relationship between service use and social support. This paper tests Cantor's 'hierarchical-compensatory' mechanism, which predicts a negative association between service use and social support, and the 'bridging' mechanism which predicts a positive association between these two factors. Thus it assesses the extent to which demands for service use and for social support are made together or in a compensatory fashion for respondents of equal disease and disability. The presented work demonstrates that neurodegenerative diseases [dementia, cognitive impairment, parkinsonism, instability (gait ataxia), immobility (gait slowing) and motivation loss/behaviour change] have the largest and most significant increases with age of all disease groups. Therefore the hypothesis made in paper one that neurodegenerative diseases will come to dominate the health care needs of older adults, particularly when combined with population ageing, is supported. Further, results of papers two and three indicate that neurodegenerative diseases result in greater levels of disability, lending credence to the finding that it is these neurodegenerative diseases that are of central importance to the future of the health care needs of older adults of advanced age. While systemic diseases play an important role in disability, the neurodegenerative diseases are under-recognised by self-report and yet are most strongly associated with severe disability. A major recommendation of this study is that assessments and diagnosis of neurodegenerative diseases be included in disability assessments. With regard to the social aspects of health, the fourth paper finds that disease and disability are the main predictors of service use and social support. The fifth paper highlights important gender differences in social support and also finds that lower levels of social support are associated with increased age, male gender, single marital status and lower socioeconomic status. Because it is widely accepted that social support is protective against adverse health outcomes and low levels of wellbeing, these groups of older adults are at risk of poorer health and wellbeing. Finally the sixth paper fills some knowledge gaps with regard to the relationship between service use and social support. It shows that with regard to IADL (instrumental activities of daily living) services and IADL social support, Cantor's 'hierarchical-compensatory' mechanism (negative correlation) applies but with regard to medical services and both ADL (activities of daily living) and IADL social support the 'bridging' mechanism (positive correlation) is supported. These complex interrelationships between disease, disability, service use and social support are summarised schematically in a model. In light of significant population ageing, substantial resources in the form of medical and community services and social support from carers, family, friends and neighbours will need to be devoted to older adults with diseases, in particular neurodegenerative diseases, and to those with disabilities. Given the increasing importance of disease, disability, service use and social support in very old age, it is crucial that knowledge and understanding of these factors and their interrelationships be advanced in order to better allocate and sustain resources and to ultimately improve the health, well-being and quality of life of very old adults.
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Garabedian, Claire Elizabeth. "'I'd rather have music!' : the effects of live and recorded music for people with dementia living in care homes, and their carers." Thesis, University of Stirling, 2014. http://hdl.handle.net/1893/21757.
Full textAbstract:
The objectives of this thesis were to explore the effects of receptive individualised live and recorded-music on interactions within participating dyads consisting of a person with dementia who was in their final phase of life (resident), and a person with whom he or she shared a close connection (carer), as well as on each individual participant. A 'Receptive' music intervention is one where participants are not required to do anything but listen. METHODS The conceptual frameworks of realist evaluation, ethnography, symbolic interactionism, and dramaturgical actionism influenced the design of this study. There were two phases: during phase-1, fifteen semi-structured interviews were conducted with 'key-consultants', who were specialists in topics related to this thesis, to inform the design of 'phase-2'. During 'phase-2', musical interventions were conducted at five non-NHS care homes in Scotland over a period of nine-months. Each intervention consisted of either individualised live-music (3 sessions) or the same or similar music pre-recorded (three sessions); all music was played by the researcher on the solo cello. Interventions took place in residents' private bedrooms, and lasted between fifteen and seventy-minutes. The order of live and recorded-music interventions was switched for approximately half the dyads. Each intervention was video-recorded for later observation. Semi-structured interviews and Visual Analogue Scales (VAS) were administered with each participating carer before and after the conclusion of their series of interventions, to compare their expectations with their actual experiences and to better understand their experience. Whenever possible, key-staff and managers were also interviewed to learn what their perceptions of this study had been: its effects on them and on participants. ANALYSIS required repeated visits to the raw data: beginning with thickly-describing all video-footage; then thematically coding all thick-descriptions and transcribed audio-interviews; and lastly revisiting all video-footage via a self-modified version of an evaluative observation instrument; 'Person Interaction Environment Care Experience in Dementia' (PIECE-dem). FINDINGS support prior research regarding the beneficial effects of individualised receptive music on listeners who have dementia. This study suggests that both live and recorded-music promote wellbeing, and enhance dyad interaction in the moment of listening. These findings demonstrate the potential for receptive music to create an embodied sense of 'haven' for people with dementia who are nearing the end of life and for those sharing the experience with them: by capturing and holding their attention, and transporting them either back in time, or entirely out of time into a state of 'flow', or into an 'intense musical experience'.
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Hickman, Louise D. "Patients, carers and nurses collaborators in development of a new model of nursing care for older persons in the acute care setting /." View thesis, 2007. http://handle.uws.edu.au:8081/1959.7/37238.
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Thesis (Ph.D.)--University of Western Sydney, 2007.A thesis presented to the University of Western Sydney, College of Health and Science, School of Nursing, in fulfilment of the requirements for the degree of Doctor of Philosophy. Includes bibliographies.
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Ng, Ka-man Carmen, and 吳家雯. "An exploration of experiential learning with carers participating in amulti-skills training course on care of the elderly." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2000. http://hub.hku.hk/bib/B31979026.
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Chu, Eva Pui Yi. "Women in the middle : economic restrictions and informal care : an exploratory study on the economic disadvantages of female informal carers of the Chinese old people in Hong Kong." HKBU Institutional Repository, 1995. http://repository.hkbu.edu.hk/etd_ra/45.
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Easterling, Calvin Henry. "The Developmentally Disabled Elderly in Canada: Access to Health Care and Social Services." Thesis, University of North Texas, 1992. https://digital.library.unt.edu/ark:/67531/metadc332746/.
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The accessibility, predictors, and use of health care and social services among developmentally disabled elderly adults in Canada were examined using a nationally representative social survey. The first research hypothesis is that the independent variables will contribute significantly to the prediction of the dependent variables. A second hypothesis is that the slope of any given independent variable will not equal zero. The results of this research show that the illness (need) variables are the most predictive correlate of the utilization of health care and social services. The predisposing variables have secondary explanatory power, with the enabling variables accounting for the least amount of variance. The hypotheses were tested by step-wise multiple regression analysis using SPSS-X.
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Thieman, Lauren Pauline. "Clients' perspectives of the home modification process and products." Oxford, Ohio : Miami University, 2008. http://rave.ohiolink.edu/etdc/view?acc%5Fnum=miami1215984301.
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Johansson, Carina, and Helena Vårhall. "ACTION ett IKT-baserat stöd i vård och omsorg : Personalens erfarenheter av att stödja äldre och deras anhöriga via ACTION-tjänsten." Thesis, Högskolan i Borås, Institutionen för Vårdvetenskap, 2011. http://urn.kb.se/resolve?urn=urn:nbn:se:hb:diva-20274.
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Eftersom andelen äldre som är i behov av vård- och omsorg ökar i samhället kommer även anhörigvårdare att öka och i många fall kan det innebära en tung börda, isolering och ensamhet. ACTION-tjänsten är en form av IKT-baserat anhörigstöd som kan vara ett komplement till andra former av stöd till anhöriga. Med IKT menas Informations och Kommunikations Teknologi. Tidigare forskning om vård- och omsorgspersonalens upplevelser och erfarenheter av att arbeta med ACTION-tjänsten är knapphändig. Syftet med studien var att beskriva vård- och omsorgspersonalens erfarenheter av att stödja äldre och anhöriga som vårdar sina äldre närstående i hemmet, via ACTION-tjänsten. Tio kvalitativa intervjuer genomfördes med vård- och omsorgspersonal som arbetar med ACTION-tjänsten. Intervjuerna analyserades utifrån kvalitativ innehållsanalys. Studien visar att ACTION-personalen upplever det positivt att stödja anhörigvårdare och deras närstående via ACTION-tjänsten. ACTION-personalen tycker att ACTION-programmen är ett bra hjälpmedel för att ge de anhöriga kunskaper och självförtroende och på så vis kunna stärkas i sin roll som anhörigvårdare. Genom kontakt via bildtelefoni skapas en djupare relation mellan personal och anhörigvårdare eftersom att de har möjlighet att pratas vid oftare och de ser varandra vid samtalet. Genom detta upplever personalen att de på ett bra sätt kan ge den individuella vård och stöd som anhörigvårdarna är i behov av. Personalen upplever det också positivt att kunna hjälpa anhörigvårdare att bryta sin isolering genom att skapa sociala kontaktnät mellan ACTION-användarna. I studien framkommer det också att flera av personalen saknar stöd och handledning från kommunledningen. I diskussionen diskuteras resultatens huvudfynd med stöd av tidigare forskning.Program: Specialistsjuksköterskeutbildning med inriktning mot distriktssköterska
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Okonkwo, Ozioma C. "Awareness of functional difficulties in mild cognitive impairment relation to cognitive variables and mood /." Birmingham, Ala. : University of Alabama at Birmingham, 2008. https://www.mhsl.uab.edu/dt/2009r/okonkwo.pdf.
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Thesis (Ph. D.)--University of Alabama at Birmingham, 2008.Title from PDF title page (viewed Sept. 23, 2009). Additional advisors: Karlene K. Ball, H. Randall Griffith, Daniel C. Marson, Sylvie Mrug, David E. Vance. Includes bibliographical references (p. 59-80).
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Arnadottir, Solveig. "Physical activity, participation and self-rated health among older community-dwelling Icelanders : a population-based study." Doctoral thesis, Umeå universitet, Sjukgymnastik, 2010. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-35823.
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Background: The main objective of this study was to investigate older people’s physical activity, their participation in various life situations, and their perceptions of their own health. This included an exploration of potential influences of urban versus rural residency on these outcomes, an evaluation of the measurement properties of a balance confidence scale, and an examination of the proposed usefulness of the International Classification of Functioning, Disability and Health (ICF) as a conceptual framework to facilitate analysis and understanding of selected outcomes. Methods: The study design was cross-sectional, population-based, with random selection from the national register of one urban and two rural municipalities in Northern Iceland. There were 186 participants, all community-dwelling, aged 65 to 88 years (mean = 73.8), and 48% of the group were women. The participation rate was 79%. Data was collected in 2004, in face-to-face interviews and through various standardized assessments. The main outcomes were total physical activity; leisure-time, household, and work-related physical activity; participation frequency and perceived participation restrictions; and self-rated health. Other assessments represented aspects of the ICF body functions, activities, environmental factors and personal factors. Moreover, Rasch analysis methods were applied to examine and modify the Activities-specific Balance Confidence (ABC) scale and the ICF used as a conceptual framework throughout the study. Results: The total physical activity score was the same for urban and rural people and the largest proportion of the total physical activity behavior was derived from the household domain. Rural females received the highest scores of all in household physical activity and rural males were more physically active than the others in the work-related domain. However, leisure-time physical activity was more common in urban than rural communities. A physically active lifestyle, urban living, a higher level of cognition, younger age, and fewer depressive symptoms were all associated with more frequent participation. Rural living and depressive symptoms were associated with perceived participation restrictions. Moreover, perceived participation restrictions were associated with not being employed and limitations in advanced lower extremity capacity. Both fewer depressive symptoms and advanced lower extremity capacity also increased the likelihood of better self-rated health, as did capacity in upper extremities, older age, and household physical activity. Rasch rating scale analysis indicated a need to modify the ABC to improve its psychometric properties. The modified ABC was then used to measure balance confidence which, however, was found not to play a major role in explaining participation or self-rated health. Finally, the ICF was useful as a conceptual framework for mapping various components of functioning and health and to facilitate analyses of their relationships. Conclusions: The results highlighted the commonalities and differences in factors associated with participation frequency, perceived participation restrictions, and self-rated health in old age. Some of these factors, such as advanced lower extremity capacity, depressive symptoms, and physical activity pattern should be of particular interest for geriatric physical therapy due to their potential for interventions. While the associations between depressive symptoms, participation, and self-rated health are well known, research is needed on the effects of advanced lower extremity capacity on participation and self-rated health in old age. The environment (urban versus rural) also presented itself as an important contextual variable to be aware of when working with older people’s participation and physically active life-style. Greater emphasis should be placed on using Rasch measurement methods for improving the availability of quality scientific measures to evaluate various aspects of functioning and health among older adults. Finally, a coordinated implementation of a conceptual framework such as ICF may further advance interdisciplinary and international studies on aging, functioning, and health.
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Cowdell, Fiona. ""That's how we do it ... we treat them all the same" : an exploration of the experiences of patients, lay carers and health and social care staff of the care received by older people with dementia in acute hospital settings." Thesis, Bournemouth University, 2008. http://eprints.bournemouth.ac.uk/10449/.
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'... we treat them all the same'. This study aimed to explore the experiences of patients, lay carers and health and social care staff of care received by older people with dementia in the acute hospital setting. In view of the ageing population, an increasing prevalence of dementia and the emerging dignity agenda this is a particularly topical subject. Four elements are included in this thesis: a literature review, a research study, a practice development project and an integrative review. A literature review sets person-focused research in the context of dementia research as a whole. It also identifies ways in which studies have been conducted in an ethical and meaningful manner. An ethnographic approach was used in the research study to collect data through observation, conversations and interviews. Findings portray a bleak picture of the care of this vulnerable group. Patients demonstrated, through words and actions, how difficult they found the experience. Lack of communication was an issue as was the obvious distress caused by delivery of personal care. Lay carers were relatively uncritical although this may have been due, in part, to the recruitment process. Staff generally appeared to have good intention. Most stated that they had received little or no preparation or education in dementia care. Many staff functioned almost entirely within thebed and body'framework. They frequently avoided communication with patients. Staff worked in a deeply embedded habitus, in which they appeared not to really think about what they were doing. They demonstrated a lack of empathy with patients. The concept that staff were working in a 'switched off mode and lacked empathy called for a practice development project that engaged them on both cognitive and emotional levels. A practice development project based on the philosophies of confluent education and situated learning was implemented. Initial evaluation has demonstrated some tangible changes in practice. An integrative review draws these elements together into a coherent whole. Potential contributions to the body of knowledge are acknowledged, as are limitations of the work. This study has shown that people with dementia, even those at an advanced stage and with superimposed physical illness, can be engaged in research that is both ethical and meaningful. It has shown that improvements in practice are possible. They need to be underpinned by a belief in the personhood of staff as well as patients. Areas for further research and practice development in this vital subject have been identified.
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Ferrer, Michele Lacerda Pereira. "O impacto dos fatores ambientais na incapacidade funcional de idosos: a importância de políticas públicas que valorizem o Aging in place." Universidade de São Paulo, 2018. http://www.teses.usp.br/teses/disponiveis/6/6132/tde-23032018-094707/.
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Introdução: A incapacidade no idoso é multidimensional, envolvendo aspectos de saúde física, emocional, cognitiva, ambiental e social. Os fatores ambientais têm um impacto importante como facilitadores ou barreiras nas atividades e participação social do idoso, especialmente relacionado ao ambiente de moradia e a capacidade de continuar vivendo no próprio domicilio apesar do envelhecimento (Aging in place). Políticas públicas devem ser pensadas levando a questão do Aging in place em consideração. Objetivos: investigar o impacto dos fatores ambientais na incapacidade de idosos que residem em conjuntos habitacionais verticais de interesse social que não contam com quesitos de acessibilidade como o elevador, sob a perspectiva da Classificação Internacional de Funcionalidade, Incapacidade e Saúde (CIF). Método: Para alcance dos objetivos propostos foi necessário a realização da validação de construto e identificação das propriedades psicométricas e de normatização do WHODAS 2.0- 12 itens para avaliação da incapacidade em idosos brasileiros. Após esta etapa, foi realizada a análise dos fatores ambientais sugeridos pela CIF e reconhecidos por moradores dos conjuntos habitacionais e sua associação com a incapacidade funcional. Os estudos transversais aqui apresentados foram realizados com duas amostras distintas: Amostra 1 para o processo de validação de construto e normatização do WHODAS 2.0 contou com 350 idosos assistidos pelo Centro de referência do Idoso na cidade de São Paulo. Com dados desta amostra foi realizada uma análise fatorial exploratória, confirmatória e teoria de resposta ao item e análise de variância para validação de construto e observação da distribuição dos escores na amostra. Amostra 2 contando com 96 idosos residentes em um conjunto habitacional com 26 edifícios verticais com até 4 andares em Bragança Paulista (SP) para análise do impacto dos fatores ambientais na incapacidade dos idosos. Com os dados desta amostra foi realizada análise de regressão linear multivariada para identificação dos fatores ambientais mais associados ao aumento do escore de incapacidade. Resultados: O WHODAS 2.0, 12 itens apresentou boa adequação das cargas fatorais em um modelo unidimensional somente com 10 itens dos 12 avaliados. A retirada do item 6 (concentrar-se) e 10 (lidar com pessoas estranhas) na análise fatorial exploratória melhorou o desempenho do teste com variância explicada de 70 por cento (x2/df = 2,45; p < 0,001, NNFI = 0,98, CFI = 0,99, GFI = 0,99, RMSEA = 0,06; Alpha de Cronbach = 0,95 e Mc Donald = 0,92). Na análise da associação entre barreiras ambientais e incapacidade observou-se que fatores ambientais como escadas, acesso ao transporte público, ruídos, clima e preconceito reconhecidos como barreira foram associados a um aumento no escore do WHODAS 2.0-BO. Conclusão: A presença de barreiras ambientais como dificuldade de acesso ao transporte público, presença de escadas na entrada da casa, ruídos, condições climáticas adversas e preconceito foram associadas a um aumento no escore de incapacidade, o que pode impedir idosos de continuar vivendo no próprio domicílio na presença de tais barreiras. Políticas públicas deveriam considerar o envelhecimento e as barreiras ambientais identificadas neste estudo para a garantia do Aging in place.Introduction: Disability in older people is multidimensional with physical, emotional, cognitive, environmental and social aspects. The environmental factors could have an important impact as facilitators or barriers in their activities and social participation, specially related to the habitation and the aging in place. Public housing policies should be made based on aging in place. Objectives: to investigate the impact of environmental factors in disability of older people living in a multi-storey apartment complex building for low-income families with no elevator, by International Classification of Functioning, Disability and Health (ICF) perspective. Method: As a first step to this study purpose, analyses of the psychometric properties and normative data of the WHODAS 2.0- 12 item were necessary to validate this instrument and assess disability in Brazilian older people. After that, the analysis of the environmental factors (as suggested by ICF) recognized by older people living in apartment complex building and their association with disability was done. The cross-sectional studies here presented were done with two different samples: Sample 1 was used to identify the construct validation and normative data of the WHODAS 2.0 12 item. This sample had 350 individuals attending a community based reference center for older people in São Paulo. The construct validity was tested with Exploratory and Confirmatory Factor Analysis, Parallel Analysis, Item Response Theory. Sample 2 was used to analyse the perceived environmental factors and the disability. It had 96 older people living in a multi-storey apartment complex for low income families in Bragança Paulista. The regression linear analysis was done to identify the environmental barriers associated to disability in the older people. Results: The WHODAS 2.0, 12-item version, is a unidimensional scale, and goodness of fit occurs only with 10 items evaluating disability in older people. Withdrawn items 6 (concentration) and 10 (leading with strangers) established an appropriate adjustment, with high and excellent values for all indicators. The explained variance was 70 per cent and confirmatory analysis showed X2/df = 2,45; p < 0,001, NNFI = 0,98, CFI = 0,99, GFI = 0,99, and RMSEA = 0,06; reliability indexes Cronbachs ( = 0.95) and McDonalds ( = 0,92) were adequate. This new version was named WHODAS 2.0-BO (Brazilian version for older people). At the environmental barriers and disability association study was observed the association between perceived barriers as public transportation, stairs, noise, climate and prejudice and disability with the increased WHODAS 2.0-BO score. Conclusion: older people who recognize environmental barriers such as access to public transportation, stairs, noise, adverse climate and prejudice have an increase in disability score, which can prevent them from aging in place. The public policies should consider the aging and the environmental barriers identified by this study in order to assure aging in place.
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Summers, Michael. "Great expectations : a policy case study of four case management programs in one organisation /." Connect to thesis, 2007. http://repository.unimelb.edu.au/10187/2182.
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Four different case management programs delivered by UnitingCare Community Options (UCCO) in the eastern suburbs of Melbourne were examined against the expectations of case management as a policy solution to a range of perceived policy problems at the micro-, meso- and macro-levels. The micro-level expectations were related to client and family experiences of the service system and outcomes. At the meso-level expectations were focused on perceived service delivery problems such as poor matching of services to the needs of ‘complex’ clients including a lack of integration, flexibility and responsiveness to clients’ needs and preferences. Perceived macro-level policy problems were concerned with a variety of issues including increasing rates of institutionalisation, increasing costs to governments, lack of economic efficiency and the desire to create market or quasi-market conditions in the community care service delivery sector. (For complete abstract open document)
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King, Rosie. "'What is going to happen to me now?’: systemic uncertainty and complexity between hospital and home for older people, people with disability, carers and service providers." Thesis, 2010. http://hdl.handle.net/2440/64112.
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The focus of this thesis is on the impact that a hospital admission can have on the continuing ability of Home and Community Care¹ (HACC) clients (older people and people with disability) to remain living in their home. Of concern to HACC service providers were their clients' readmissions to hospital and/or unnecessary institutionalisation after hospitalisation. Both events were considered poor outcomes by HACC service providers. The desire to improve these poor outcomes and to alleviate discontinuous care led the HACC program to fund a project in Adelaide, which I undertook as action research.
In this thesis I investigated how poor outcomes could be avoided and continuity of care improved in the South Australian hospital and HACC systems. A literature review revealed that population ageing, the demand and resource pressures on acute hospitals and community services and the paucity of discharge planning were factors leading to discontinuity of care of older people and people with disability, as well as impacting on their carers. Theoretical perspectives first look at the divisions between the biomedical and social models of health, as well as the critiques of medical care and the role of bureaucracy put forward by iatrogenesis and medicalisation. Next, the theoretical lens turns to the lives of people, where the centrality of 'care' and interdependence are considered, along with the need to improve our understanding of the nature of vulnerability and the importance of resilience to moving beyond the dominant 'problem-based' discourse of ageing and disability.
Processes in the action research included two cyclical phases of making plans, embarking on actions and observing the results of the actions. Methods for collecting data included surveys (n=16 older patients and 10 carers), an evaluation (n=28), face-to-face interviews (n=52), one focus group (n=8), three Reference Groups (n=46), a workshop (n=14) and a nominal group (n=14). The interviews and surveys provided the opportunity to analyse the admission, hospitalisation and discharge issues for HACC clients and their carers from the perspectives of hospital nurses (n=19) and 33 community care providers. The latter participants were clinicians and case managers from domiciliary care² (n=23) and community nurses³ (n=10). These interviews were analysed thematically.
Results from the action research project yielded valuable research insights and successful actions which were reflexively planned, implemented and evaluated. The actions increased local linkages between the hospital and community service providers, collaboration, communication and access to information about the HACC program. Despite this, the action research project appeared to have little or no direct effect on avoiding poor outcomes or improving discontinuity of care. Such effects were more complex and beyond the scope of a project of this size. Achieving the necessary systems and structural changes to address these problems would have required more time, resources, capacity and leadership to be committed by government departments and the agencies.
The descriptive statistics of surveys with patients and carers and the key issues identified by the Reference Group supported triangulation of the interviews with domiciliary, community nursing and hospital participants. Findings from the interviews with domiciliary, community nursing and hospital participants point to uncertainty and complexity before, during and after hospitalisation of older people, people with disability, their carer/family, and also for service providers. Before admission to hospital there are four 'dimensions of uncertainty', and during hospitalisation, there were four categories which contributed to 'complexity in discharge planning'. When leaving hospital, 'adjustment and adaptation' highlights individual patients' and carer/families' adjustments. In addition, it points to the need/potential for service adaptation to support people's ability to return home. Putting these dimensions together, the main themes to emerge in this context are ‘systemic uncertainty and complexity'. In building upon these themes, I have developed a model of systemic uncertainty and complexity before, during and after hospital. Given this new knowledge about the context of uncertainty and complexity on the one hand, and adjustment and adaptation on the other, I conclude by considering the implications of these understandings for theory, policy and practice.
¹ The HACC program, funded jointly by the Australian, State and Territory governments, targets community-dwelling frail aged people, people with disability, and their carers, who in the absence of basic maintenance and support services are at risk of premature or inappropriate long-term residential care.
² Domiciliary care services are provided to older people (aged 65 years and over) and younger people with disability whose ability to care for themselves is reduced. Domiciliary care assists them to stay living in their own homes, by providing physical assistance, rehabilitation and personal care, as well as respite and support for carers. By promoting independence and improving quality of life for clients, domiciliary care services aim to prevent unnecessary admission into hospital or residential care.
³ Community nursing services provide community based health and care services, including rehabilitation, therapy and nursing care.Thesis (Ph.D.) -- University of Adelaide, School of Population Health and Clinical Practice, 2010
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Ang, Seng Giap Marcus. "Identifying carers’ concern for older people at risk of falling at home." Thesis, 2020. http://hdl.handle.net/1959.13/1410828.
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Research Doctorate - Doctor of Philosophy (PhD)Background: Informal carers such as family members and friends are crucial in providing assistance to older people (care recipients) and preventing them from falling at home. Many carers experience increased psychological distress and caregiving burden when looking after their care recipients who have fallen previously. However, there were no previous studies found about carers’ concern for their care recipients at risk of falling, and there was no validated instrument for measuring this concern. Aims: This thesis aims to: 1) explore the factors influencing carers’ fall concern, 2) develop an instrument for measuring this concern, and 3) evaluate the psychometric properties of the Carers’ Fall Concern Instrument (CFC-I). Methods: The study was conducted over three phrases which include: 1) interviewing 22 carers about their fall concern, 2) exploring the content validity and reliability of the initial CFC-I on 32 carers, and 3) testing the construct validity and reliability of CFC-I on 143 carers. All participating carers were providing support for an older person aged 60 years and over and living at home. Results: During Phase One, four themes were identified as influencing carers’ fall concern. These included: 1) carers’ perception of fall and fall risk, 2) care recipients’ behaviour and attitude towards fall risk, 3) care recipient’s health and function, and 4) care recipients’ living environment. During Phase Two, a 46-item CFC-I was developed and tested with a resultant average content validity of 0.82. In Phase Three, the final 16-item CFC-I reported a Cronbach alpha of 0.93 and can discriminate carers looking after care recipients with or without falls. Conclusion: The CFC-I is the first multi-item instrument designed for measuring carers’ fall concern. Healthcare professionals are encouraged to use the CFC-I in future fall prevention programmes to determine the impact of fall risk on carers and to develop targeted interventions for managing their fall concern.
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Giebel, C., Kathryn Lord, C. Cooper, J. Shenton, J. Cannon, D. Pulford, L. Shaw, et al. "A UK survey of COVID-19 related social support closures and their effects on older people, people with dementia, and carers." 2020. http://hdl.handle.net/10454/18158.
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YesObjectives: The aim of this national survey was to explore the impact of COVID-19 public health measures on access to social support services and the effects of closures of services on the mental well-being of older people and those affected by dementia. Methods: A UK-wide online and telephone survey was conducted with older adults, people with dementia, and carers between April and May 2020. The survey captured demographic and postcode data, social support service usage before and after COVID-19 public health measures, current quality of life, depression, and anxiety. Multiple linear regression analysis was used to explore the relationship between social support service variations and anxiety and well-being. Results: Five hundred and sixty-nine participants completed the survey (61 people with dementia, 285 unpaid carers, and 223 older adults). Paired samples t-tests and X2 -tests showed that the mean hour of weekly social support service usage and the number of people having accessed various services was significantly reduced post COVID-19. Multiple regression analyses showed that higher variations in social support service hours significantly predicted increased levels of anxiety in people with dementia and older adults, and lower levels of mental well-being in unpaid carers and older adults. Conclusions: Being unable to access social support services due to COVID contributed to worse quality of life and anxiety in those affected by dementia and older adults across the UK. Social support services need to be enabled to continue providing support in adapted formats, especially in light of continued public health restrictions for the foreseeable future.
National Institute for Health Research. Grant Number: ARC NWC. University of Liverpool. Grant Number: COVID‐19 Strategic Research Fund
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Fordyce, Janice L. Abood Doris A. "The relationship between nutritional risk factors, nutritional risk indicators, and the severity of physical disability within older adult home delivered meal program participants." Diss., 2005. http://etd.lib.fsu.edu/theses/available/etd-11102005-153928.
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Thesis (M.S.)--Florida State University, 2005.Advisor: Doris A. Abood, Florida State University, College of Human Sciences, Dept. of Nutrition, Food and Exercise Sciences. Title and description from dissertation home page (viewed Jan. 27, 2006). Document formatted into pages; contains x, 73 pages. Includes bibliographical references.
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Reese, Theresa Catherine Burkhead E. Jane. "The relationship between spirituality and adaptation to disability in older adults." 2004. http://etd.lib.fsu.edu/theses/available/etd-02062004-233614.
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Thesis (Ph. D.)--Florida State University, 2004.Advisor: Dr. E. Jane Burkhead, Florida State University, College of Education, Dept. of Special Education and Rehabilitation Counseling Services. Title and description from dissertation home page (viewed June 15, 2004). Includes bibliographical references.