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Dissertations / Theses on the topic 'Older people with disabilities Care'

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Published: 10 December 2022

Last updated: 28 January 2023

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1

Lee, Jae Chul. "Health disparities in access to health care for older people with disabilities." Diss., Connect to online resource - MSU authorized users, 2008.

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Thesis (Ph.D.)--Michigan State University. Rehabilitation Counselor Education , 2008.
Title from PDF t.p. (viewed on July 2, 2009) Includes bibliographical references (p. 128-144). Also issued in print.

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Zhu, Bing Yu. "A feasibility study of the application of European long-term-care model to Macau LTC system." Thesis, University of Macau, 2012. http://umaclib3.umac.mo/record=b2595816.

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3

Marquis, Ruth. "The meaning of quality in living service environments: An analysis of the experiences of people with disabilities, elderly people and service workers." Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 1998. https://ro.ecu.edu.au/theses/976.

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The purpose of the study was to examine the experiences of both people with disabilities and elderly people and to identify their perceptions of quality as it relates to living in a service or being supported by a service to live in the community. The study was naturalistic in design and used a phenomenological approach and inductive analysis. It involved immersion in living services for a two year period, in-depth interviews with people living and working in services and participant observation. Fifty service users between the ages of twenty-one and ninety-six, and twenty-six service workers between the ages of twenty-six and fifty-four were informants in the study. The study comprised of three phases, the first phase involved repeated in-depth interviews with service users in two disability and two aged care living services to examine the experiences of people living in services and their perceptions of quality. As a result of the consistency with which relationships with key staff members emerged in the context of quality experiences, selected service workers who were named by service users were also interviewed. The findings in this phase indicated that relationships experienced by service users in their encounters with service workers were more significant in service users' evaluation of quality than tangible acts of physical and environmental care. Relational experiences of people living in services were variable. Some informants experienced consistent validation and socio-emotional support, whilst others experienced role distancing and negative communication experiences. Service workers who were interviewed as a result of being identified by service users in the context of quality, attached importance to the relational domain in the acts and behaviours of providing a service. They also attached personal meaning to their roles as service workers and shared the view that their role as service worker was underpinned by an ethos of communality. The second phase of the study involved accessing another five disability and five aged care services to collect further data to support or refute the findings from phase one. As a result a large data bank was established to confirm the consistency with which relational experiences in living services were linked to perceptions of quality by both service users and service providers. Acts and behaviours which were consistently present in the context of quality were also identified and the need for emotional support in the living context was further confirmed. The third phase of the study involved an in-depth analysis and identification of commonly experienced categories of relationships between service users and workers. Relationships were categorised into ethical and technical living service experiences and exemplars used to illustrate findings. Data analysis indicated that service experiences lie on a continuum, with mutually supportive relationships between service users and workers at one end, and physical and psychological abuse at the other. Experiences were variable in singular service contexts. This highlighted the individual nature of service relationships between service users and workers and the need to articulate human service as relationship. It also highlighted the inadequacies of using standard measures to evaluate quality in living services.

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4

Wardell, F. A. "An examination of the voluntary provision of care for adults with learning disabilities, mental health problems, physical disabilities and older people : Grampian, Highland and Edinburgh." Thesis, University of Aberdeen, 2007. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.590998.

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Recent government social policies, including those promoting community care and active citizenship, and specific volunteering policy (such as Millenium Volunteers and Project Scotland) have outlined an extended role for volunteers and voluntary organisations in the planning, design and delivery of services. In broad terms, these initiatives assume an untapped pool of volunteers ready and willing to be actively and meaningfully engaged. This research comprises two naturalistic studies which examine the assumptions underlying government policies including engagement, placement, organisation, management and retention of volunteers. Evidence was gathered by direct consultation with active volunteers (n=117) and their managers (n=72). Participants were recruited from organisations working with adults with learning disabilities, mental health problems, physical disabilities and older people across Scotland. This research found that volunteers become involved for many reasons: some young people consider their voluntary work as a ‘stepping-stone’ to employment, others, who feel themselves socially isolated for a number of reasons, report that volunteering is a useful way to gain social support. Volunteers require different levels of training, support and supervision. Tensions may inevitably arise between volunteering as a freely chosen activity by an individual and volunteering as part of contracted service provision by an increasingly professional voluntary organisation. For agencies to meet the demands of contracted service provision clearly defined procedures for selection, induction, training and supervision may be required. Given the inevitable resource implications this has for volunteer-engaging organisations is it unlikely that such an expansion in roles for volunteers would be cost-free. Organisations face a challenge to adapt effectively to the requirements of social policy while maintaining the enthusiasm and commitment of a diverse pool of volunteers.

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Boxenbaum, Eva. "The partnership metaphor in Quebec health care policy : the decision-making process with cognitively impaired elderly clients in home care." Thesis, McGill University, 2001. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=33063.

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This research evaluates Quebec's health care policy by analyzing how the partnership metaphor is implemented in policy and practice. The partnership construction is identified in 4 interpretive communities within long-term community services to the elderly population. This analysis focuses on the placement decision for cognitively impaired clients in home care. Interpretive policy analysis is employed to examine 3 policy documents and 3 client files, while grounded theory serves to analyze 13 semi-structured interviews with 2 administrators and 3 open triads of client, caregiver, and case manager. The findings show partnership to be an egalitarian, collaborative ideal widely adopted but with little consensus on the pertinent objects and actors. Important differences emerge in how partnership is applied to the placement decision, indicating a too flexible application. Specific restrictions are recommended on the application of the partnership metaphor in order to improve community services and organizational structures in health care.

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6

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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7

Dietz, Tracy L. "Predictors of Health Care and Social Service Utilization and Perceived Need Among the Disabled Elderly in Canada." Thesis, University of North Texas, 1992. https://digital.library.unt.edu/ark:/67531/metadc500776/.

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The world has experienced a tremendous growth in its elderly population. With the aging of the population, policy makers are concerned about the health of these elderly as well as their utilization of health care and social services and perceived need for additional services. The Canadian elderly population is similar to other elderly populations in that a few tend to be the heaviest users of the available services. The predictors of this utilization behavior and perceived need primarily include need variables, such as the number of limitations of daily living -- both ADLs and IADLs, and functional limitations. In addition, enabling variables, such as income, work activity and geographic region of residence were also found to be significant.

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Cermak, Tracy. "Developmentally Disabled Older Adults in Georgia: Rural, Metropolitan, and Urban Long Term Housing Availability." Atlanta, Ga. : Georgia State University, 2009. http://digitalarchive.gsu.edu/gerontology_theses/15/.

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Thesis (M.A.)--Georgia State University, 2009.
Title from title page (Digital Archive@GSU, viewed July 29, 2010) Ann Pearman, committee chair; Erin Ruel, Dennis Thompson, committee members. Includes bibliographical references (p. 73-81).

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Smith, Jan Elizabeth. "Needs, characteristics and experiences from minority ethnic adults with learning disabilities and minority ethnic older people living in care homes across England : an exploratory mixed methods study." Thesis, University of Kent, 2013. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.595300.

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10

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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11

Kiraly, Zoltan. "Pastoral care of older adults." Theological Research Exchange Network (TREN), 2002. http://www.tren.com.

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12

Zhang, Xuetai. "Community-based care for the frail elderly in urban China /." Hong Kong : University of Hong Kong, 2002. http://sunzi.lib.hku.hk/hkuto/record.jsp?B24873457.

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Sang, Lam Heung. "Family care for older people in China." Thesis, University of Sheffield, 2002. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.275073.

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Leung, Chun-sing Anthony. "Old People's community : care home /." Hong Kong : University of Hong Kong, 2001. http://sunzi.lib.hku.hk/hkuto/record.jsp?B25950368.

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15

Hope, Suzanne Victoria. "Hypoglycaemia in older people with diabetes." Thesis, University of Exeter, 2016. http://hdl.handle.net/10871/21935.

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Diabetes prevalence is increasing in our ageing and increasingly obese society. Diabetes is a heterogeneous condition, and challenges remain in all aspects of its management - from diagnosis through to optimising treatment, to managing complications. Increasing age brings altered physiological responses to disease, treatments and complications - and there may be more wide-ranging considerations such as dietary, mobility, dependency or cognition, to name just a few. Hypoglycaemia is one of the most important potential side-effects of insulin-therapy, and elderly adults are at particular risk from its consequences. Insulin-treated patients may have long-standing Type 1 diabetes, or have Type 2 diabetes which has progressed to requiring insulin treatment, due to progressive beta cell deficiency. Even within this group of patients, there is heterogeneity, and assessment of risks can be challenging. Endogenous insulin levels can be assessed by measuring C-peptide. Recent advances in this has meant this is much more practical, enabling assessment of endogenous levels in large numbers of patients more feasible, and hence allowing important questions to be addressed. In the context of older patients, particularly interesting questions are whether patients with long-standing Type 2 diabetes can develop severe insulin deficiency, and whether absolute/severe endogenous insulin levels have an impact on treatment or complications of diabetes within insulin-treated cohorts – such as hypoglycaemia. This may thence raise the question of whether C-peptide measurement could potentially be used as an extra clinical tool for risk assessment in a patient population which can be tricky to manage at times. The aim of this thesis is thus to explore some of the issues around management of diabetes in the elderly: in particular hypoglycaemia, and use of C-peptide to more fully assess patients and consider a possible role for it in routine clinical care of some patients. Chapter 1 puts the thesis in context, firstly reviewing hypoglycaemia in the elderly in general, and then considering aspects of endogenous insulin levels and C-peptide measurement. Chapter 2 addresses the problem of recognition of hypoglycaemia in an elderly population, using primary care records and documented symptoms at consultations. Are we missing hypoglycaemia in this population? Accurate diagnosis of diabetes is crucial for getting people on the right treatment guidelines, and can be challenging. Chapter 3 uses a spot urine measure of C-peptide to test for the first time the accuracy of the UK Practical Classification Guidelines (published by the Royal College of General Practitioners and NHS Diabetes). Progressive insulin deficiency in Type 2 diabetes is the main reason people with long-standing Type 2 diabetes may eventually require insulin treatment. Chapter 4 uses the spot urine measure of C-peptide as a screening tool to assess if insulin-treated people with a clinical diagnosis of Type 2 diabetes may develop absolute insulin deficiency. Even more practical than a spot urine test to measure C-peptide, could be a random non-fasting blood measure of C-peptide, which could thus be measured when patients have their routine blood tests done in the community or outpatient appointments. Chapter 5 looks at how such a measure correlates with the gold-standard mixed meal tolerance test C-peptide measure. Severe insulin deficiency in Type 1 diabetes has been correlated with increased complications including hypoglycaemia, but the impact of endogenous insulin levels has not been assessed greatly in Type 2 diabetes. Chapter 6 reports a study looking into this possible relationship, using hypoglycaemia questionnaire responses from a large number of community-dwelling insulin-treated adults (of both diagnoses), in the context of their clinical diabetes diagnosis and their random non-fasted blood C-peptide levels. Chapter 7 assesses in more detail the rates of hypoglycaemia in a small group of insulin-treated patients with a clinical diagnosis of Type 2 diabetes, selected on the basis of their endogenous C-peptide levels. As well as subjective assessment of their hypoglycaemia experience using questionnaires, continuous glucose monitoring was used to objectively assess their rates of hypoglycaemia and glucose variability. Chapter 8 pulls all the above chapters together, summarising them in the context of other research, discussing their limitations and possible areas for future research, and their implications for now for clinical practice.

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Chui, Shuk-wah Janet. "A study of the public policy on elderly care in Hong Kong." Click to view the E-thesis via HKUTO, 2004. http://sunzi.lib.hku.hk/hkuto/record/B31967498.

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17

Leung, Man-fuk Edward. "An analysis of policy on residential nursing care for the elderly in Hong Kong." [Hong Kong : University of Hong Kong], 1992. http://sunzi.lib.hku.hk/hkuto/record.jsp?B13236222.

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18

Moran, Shane. "China's aged care crisis : problems, resources, solutions /." View thesis, 2000. http://library.uws.edu.au/adt-NUWS/public/adt-NUWS20030829.165655/index.html.

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Thesis (Ph.D.)--University of Western Sydney, Hawkesbury, 2000.
"A thesis submitted in fulfilment of the requirements for the degree of Doctor of Philosophy, Faculty of Health, University of Western Sydney."

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19

King, Michelle Annette. "Medication care : databases, drug use and outcomes /." [St. Lucia, Qld.], 2003. http://www.library.uq.edu.au/pdfserve.php?image=thesisabs/absthe17995.pdf.

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20

King, Anna Irene Ivy. "Creating sustainable home care services for older people." Thesis, University of Auckland, 2010. http://hdl.handle.net/2292/5765.

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Background: The population is ageing and recent years have revealed substantial increases in expenditure and demand for home care services. However, provision of home care is fraught with quality issues such as high staff turnover rates, inadequate staff training, a lack of coordinator support and reduced continuity of care. Consequently, ensuring the sustainability of home care services remains a critical area of concern. Objective: To evaluate the impact of a restorative home care service, for older people with varying levels of need, in relation to improving quality and sustainability. Design: Randomised controlled trial with cluster randomisation. Older people and their support workers were identified via a home care agency and cluster randomised to receive either the restorative home care service (intervention=93) or usual home care (control=93). Intervention: The restorative home care service involved goal facilitation, repetitive activity of daily living exercises, and an in-depth initial assessment for older people; experiential training for support workers; care management role and enhanced skill and competency level for the coordinator. Participants: Older people (65+ years), living in their own homes, who received assistance from a home care agency in South Auckland, New Zealand. Methods: Face-to-face interviews were conducted with older people at baseline, four and seven months. The primary outcome was change in health related quality of life measured by the Short Form 36 Health Survey. Other scale measurements were utilised to assess physical, mental and social wellbeing. Informal carer stress was assessed with the Carer Reaction Assessment. Focus groups were held with support workers at baseline and 14 months to ascertain their opinions. Coordinator perceptions were established via one-on-one interviews at 14 months. A basic comparison of costs for the two groups was undertaken. Results: Compared with usual care, restorative home care demonstrated a statistically significant improvement in health related quality of life over time for older people (P=0.05). There were no changes in other scale measurements for older people in both groups over time. Support worker turnover was 42.5 and 17.9 percent for the control and intervention group, respectively, and job satisfaction improved within the intervention group in comparison to the control group. Value adding costs increased, while, non-value adding costs were reduced. Key aspects of the intervention contributing to these findings included goal facilitation and development of personalised support plans, the coordinators enhanced input and support and the improved training for support workers. Conclusions: This study demonstrated a restorative home care service can enhance the quality of service provision to benefit both older people and support worker staff. Further amendments are addressed, such as improving support worker employment conditions and raising the eligibility criteria for home care, to ensure future sustainability.

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21

Harding, J. A. "Medicines management for older people in primary care." Thesis, Queen's University Belfast, 2006. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.431600.

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22

Nie, Yajie. "Modelling long-term care for older people China." Thesis, University of Southampton, 2017. https://eprints.soton.ac.uk/408221/.

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This report outlines an Operational Research (OR) model to plan long-term care (LTC) provision for older people in urban and rural China. Many countries in both the developing and the developed world have been experiencing a marked demographic shift towards an ageing population. An ageing society can present challenges, such as addressing the high demand for health and social care amongst older people, particularly in the latter part of the life course. Planning, delivering and financing such LTC provision for older people can be a challenge for local and national governments. This research is part of the EPSRC Care Life Cycle (CLC) research project at the University of Southampton, which aims to build and use a suite of simulation models to assist UK policy makers at the national and local levels in planning health and social care provision more effectively for future cohorts of older people, both in the UK and globally. The model outlined in this report is a contribution to this body of work. This research involves the development and use of a discrete event simulation (DES) model (which is named as ‘SIMCARE-CHINA’ model) to display the different pathways for using alternative LTC services among older people in China: informal, institutional, community-based, private, and voluntary services. The number of people who do not need care or who have unmet needs is also included in the model. This model is applied to different areas/levels – urban areas and rural areas –to consider the different LTC demand projections. The main dataset used to make the projection is composed of the Chinese Health and Retirement Longitudinal Study (CHARLS) and the Chinese Longitudinal Healthy Longevity Survey (CLHLS). Data from other sources and previous studies are also used. SIMCARE-CHINA model can be used to test alternative scenarios and policy reforms and to evaluate their performance in terms of the LTC needs met amongst older people in urban and rural China, from the perspective of both the government and individuals. Thus, such modelling can offer researchers and policy makers an opportunity to understand the LTC system better and explore the outcomes and effects of different policies and reforms through simulation, with the aim of making recommendations for future improvements.

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23

Pang, Po-ling. "The construction of a model of community care for elderly people in Hong Kong." Hong Kong : University of Hong Kong, 2001. http://sunzi.lib.hku.hk/hkuto/record.jsp?B23234313.

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24

Alizadeh-Khoei, Mahtab. "Assessing factors in utilisation of health services and community aged care services by the Iranian elderly living in the Sydney metropolitan area acculturation aged care /." Connect to full text, 2008. http://hdl.handle.net/2123/3986.

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Thesis (Ph. D.)--University of Sydney, 2008.
Title from title screen (viewed Jan. 19, 2009) Includes tables and questionnaires in English and Farsi. Submitted in fulfilment of the requirements for the degree of Doctor of Philosophy to the School of Behavioural and Community Health Sciences, Faculty of Health Sciences. Includes bibliography. Also available in print form.

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Kiss, Vincent. "Facilitating access for older adults in residential care to computers and the internet." Australasian Digital Theses Program, 2008. http://hdl.handle.net/1959.3/39614.

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Thesis (PhD) - Swinburne University of Technology, 2008.
Submitted for the degree of Doctor of Philosophy, Swinburne University of Technology - 2008. Typescript. Includes bibliographical references (p. 194-228).

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Honeyfield, Georgia. "From wilderness to community a project to include crucial faith traditions in the pastoral care of long term care residents /." Theological Research Exchange Network (TREN), 1995. http://www.tren.com.

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27

Jörgensen, Diane Mary. "Factors influencing entry to residential care among older people." Thesis, University of Auckland, 2006. http://hdl.handle.net/2292/1762.

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With the population increasing, and the occupancy and dependency levels of older people in residential care rising, it is essential to examine the factors surrounding admission. The reasons for an older person choosing to move to residential care in New Zealand are not well documented, and little evidence surrounds the process. Clearly there is interplay of many factors, such as risk mitigation by health professionals, co-morbid disease, and concerns of the family. Objective: To seek out the significant factors and influences which persuade an older person to enter residential care, and the subsequent satisfaction. Design: Longitudinal mixed methods design (N = 31), using interviews with older people who were referred by the Needs Assessment Services Co-ordination (NASC). Also interviewed were caregivers, NASC managers, and the Multidisciplinary team. This research, called Older People Entering Residential Accommodation (OPERA) was a sub-study of the Assessment of Services Promoting Independence and Recovery in Elders (ASPIRE) trial (N=569). The data from ASPIRE was also available for use in the analysis. Face-to-face or telephone interviews were held with older people in three cities who needed substantial levels of support. Findings: The most significant factors for increasing the likelihood of residential care entry were: to have the potential care-giving child living far away, and needing a lot of support with the higher level daily living tasks. Also significant was the older person being home alone for long periods. It was clearly shown that while the doctor had the most influence over the person’s entry into residential care, the older person had the most influence with the decision to stay at home. The vast majority of the older people staying at home were happy with their decision to stay there, but unfortunately the vast majority of older people who entered residential care were unhappy with their decision to move there. Conclusions: This study demonstrated who was at risk of residential care entry, who had the controlling influence, and the subsequent older person satisfaction. Also highlighted was the need for improved communication to the older person, with improved community support and more customer-focused residential care.

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Stephen, Audrey I. "Exploration and development of bereavement care for older people." Thesis, Robert Gordon University, 2011. http://hdl.handle.net/10059/658.

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The rising population of older people in the UK (Office for National Statistics 2010) and pressure on healthcare services to reduce costs indicate the necessity of developing strategies that enable coping and independence. Loss through death of close family members, partners and friends is a key factor that inhibits physical, emotional and social well being of older people. The research carried out for this thesis explored bereavement in healthcare settings where contacts with bereaved older people commonly occur, and used data collected to develop guidelines for practice. The guidelines provide research informed enhancement to bereavement care and develop opportunities for meaningful interactions. They complement current policy development work on bereavement in healthcare settings (The Scottish Government 2011). A qualitative design drawing on phenomenological methodology was used to explore healthcare staffs’ experiences of caring for bereaved older people, and older people’s experiences of being bereaved and bereavement care. Theoretical sampling took place to recruit staff from a range of roles in general practice and community nursing, hospital wards and care homes, as well as a small sample of bereaved older people. Thirty nine participants took part in in-depth interviews that yielded four key themes: bereavement care depends on a relationship between healthcare staff and relatives; preparation for a relative’s death may not equate to preparedness for bereavement; the ‘Open Door’ to bereavement care is only slightly ajar, and bereavement care supports progression of the ‘Rolling Ball’ of life. The themes informed development of the guidelines in terms of structure and content. Recommendation statements consider bereavement care before the death; at the time of the death; and follow up in the weeks and months afterwards. Criteria in the recommendations provide suggestions for enhancements to practice that facilitate appropriate response to bereavement in older people. Consultation on the guidelines provided positive feedback that identified the potential to promote consistent interactions with bereaved older people, respond to needs and support coping.

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McNamee, Paul. "The resource implications of care for frail older people." Thesis, University of Newcastle Upon Tyne, 2002. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.270586.

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Millar, Anna. "Medicines management of older people in intermediate care facilities." Thesis, Queen's University Belfast, 2016. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.709548.

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Intermediate care (IC) describes services which are targeted at older adults and aim to prevent unnecessary hospital admission, promote faster recovery from illness, support timely discharge and maximise independent living. The aim of the research presented in this thesis was to explore various aspects of medicines management relating to IC facilities, including how medicines are managed by staff and patients, communication between IC facilities and other healthcare settings, pharmacy involvement with IC, and the appropriateness of prescribing amongst the population that IC services cater for. Both qualitative and quantitative methodology was used throughout the five studies contained in this thesis. Various challenges relating to how medicines are prescribed, supplied and reviewed within IC were described. Despite an evident need, there was a distinct lack of pharmacy input within IC. Community pharmacists had limited awareness of and involvement with their local IC services and viewed communication relating to patients’ medications as inconsistent when patients moved across the various healthcare interfaces. Furthermore, cases of potentially inappropriate prescribing (PIP) were found in significant proportions of older patients at both admission to and discharge from IC. Similarly, PIP was found to be highly prevalent amongst older adults at discharge from secondary care, where deficits in the communication across the healthcare interface were also noted. The work contained in this thesis has highlighted various deficits in how medicines are managed in this patient population, both in the IC setting and beyond. Whilst there appears to be a mismatch between the concept of IC and the reality of services provided, appropriate management of medicines is a fundamental component of care for the patient population targeted by such services and requires further attention. Defining and evaluating how pharmacists can effectively integrate with IC services should form the focus of future work in this area.

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Chesterman, John Francis. "Community care experiments for frail older people : two care management programmes evaluated." Thesis, University of Kent, 2003. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.396377.

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32

Wang, Shuang. "Fuzzified scoring of the functional assessment instrument." Diss., Columbia, Mo. : University of Missouri-Columbia, 2007. http://hdl.handle.net/10355/4984.

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Thesis (M.S.)--University of Missouri-Columbia, 2007.
The entire dissertation/thesis text is included in the research.pdf file; the official abstract appears in the short.pdf file (which also appears in the research.pdf); a non-technical general description, or public abstract, appears in the public.pdf file. Title from title screen of research.pdf file (viewed on November 6, 2007) Includes bibliographical references.

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Miller, Elizabeth Jill. "Burden of care: Ageing in urban Japan and China, the family and the State." Thesis, Australian Catholic University, 2002. https://acuresearchbank.acu.edu.au/download/62b59aa5e8cc5cfbda5bc47194b8aad083654c58ee1e900e2d64b1fdf4f0fbc6/1097376/65001_downloaded_stream_226.pdf.

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This thesis examines how rapid demographic, social and economic changes are impacting on traditional care for the urban aged in China and Japan as both experience world record rates of ageing caused by greater longevity and lower birth rates. The challenge for their governments is to foster active contribution by the healthy aged to society and protection for the frail aged. China lags behind Japan in special treatment for senior citizens. The manner in which these two countries handle the ageing of their populations could provide valuable lessons for Australia in the future.

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Byrd, Edwina Haith. "An analysis of functional status and utilization behavior in long-term care for the elderly /." The Ohio State University, 1985. http://rave.ohiolink.edu/etdc/view?acc_num=osu1487259125218917.

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Whiteley, Anna. "Understanding and experiencing ageing : the perspectives of older people with intellectual disabilities." Thesis, University of Edinburgh, 2016. http://hdl.handle.net/1842/25491.

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Background: This thesis contains two elements: the first is a systematic review examining some of the determinants of quality of life for people with intellectual disability. Understanding these determinants can drive improvement at both individual and societal level. Yet there are a number of quality of life measures which might confound findings between studies. This systematic review sought to identify factors that influence quality of life using self-report on one measure developed for use with people with intellectual disability, the ‘Quality of Life Questionnaire’ (Schalock & Keith 1993). The second element is an empirical study that aims to explore the lived experience of aging for older adults with intellectual disability. There are noted differences between people with and without disability as they grow older, for example in terms of health and social opportunity. Previous studies have not consistently sought the experience of the people with intellectual disability themselves, or have used participants not traditionally considered older adults. This study aims to address gaps and further our knowledge in the lived experience of getting older for older adults with intellectual disability. Method: Within the systematic review a systematic search of relevant studies to 20th January 2015 was completed using a specified inclusion criteria, yielding 13 peerreviewed journal articles. These were scored on 11-point purpose-designed quality criteria. For the empirical study semi-structured interviews were completed with ten participants with intellectual disability (age range 60 – 74 years, five female) regarding their understanding of getting older and their experience of ageing. Nine transcribed interviews were analysed using interpretative phenomenological analysis. Results: The systematic review found that living in a semi-independent environment or an urban setting, being employed, being involved in domestic and community activities, receiving social support and possessing social skills and self-determination were factors that improved quality of life for people with intellectual disability. Three major themes emerged from the empirical study data when participants discussed getting older: ‘Not changed by ageing’, ‘Thinking about the ageing process’ and ‘What happens when getting older’. Participants tended to feel that they were still the same due to continuation of the same activities and social support. They demonstrated confusion in the ageing process, considering the process ‘inevitable’ but insignificant, although also recognising some changes associated with the process. They discussed their views about what they considered happens when people get older, which tended to be stereotypical and often negative. However they also reflected on their own experiences and how they had changed. Discussion: The methodological quality of the studies reviewed was found to be generally low due to a range of factors including study design, measurement of intellectual disability and reporting of sample demographics and results and therefore conclusions should be treated with caution. This highlights a need for further research with people with intellectual disability of a higher methodological quality. The empirical study is discussed in reference to previous research and gerontological theories of ageing. The study highlighted that staff or family did not broadly discuss ageing with participants and their views often changed over the course of the interviews from more physical and negative aspects to how ageing impacted them. This research demonstrated older adults with intellectual disability do have opinions on ageing. Further exploration with people with intellectual disability on this topic is to be encouraged in the future to develop a more balanced view.

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Ruggiano, Nicole. "Intergenerational human service delivery in the formal care industry / a case study." Access to citation, abstract and download form provided by ProQuest Information and Learning Company; downloadable PDF file, 310 p, 2009. http://proquest.umi.com/pqdweb?did=1654499651&sid=2&Fmt=2&clientId=8331&RQT=309&VName=PQD.

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Oftedahl, Linda. "Hopelessness and hours of services received by elderly and disabled clients." Online version, 2001. http://www.uwstout.edu/lib/thesis/2001/2001oftedahll.pdf.

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McCann, M. D. "Risk factor for admission to care homes for older people." Thesis, Queen's University Belfast, 2010. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.528017.

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Wilson, Marie C. "Investigation of factors affecting dental care for dentate older people." Thesis, University of Manchester, 1991. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.549675.

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Irvine, Lindesay. "Understanding the experience of older people in acute health care." Thesis, Queen Margaret University, 2008. https://eresearch.qmu.ac.uk/handle/20.500.12289/7397.

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An interest in older people’s experiences of acute care and how they make sense of that experience was the starting point for this thesis. Using the epistemological base of social constructionism the thesis examines the experiences of care older people have within acute health care settings and explores the qualified nurse’s experiences of care in relation to older people in the context of acute care. Thirteen patients and fourteen nurses from one hospital participated, through semi-structured interviews, in the study. Field notes were used to further illuminate the context of the research. Data was coded using an inductive coding approach, followed by a refining of categories through the use of concept mapping. Data analysis was undertaken manually and cross checking undertaken to establish clear findings. Patient’s understandings and explanations of their care were identified, along with the nurse’s views and accounts of care within an organisational context. Many factors were found to be influential in the older person’s experience of care. Media coverage of care experiences, along with comparison of personal experiences affected the older person’s view of their care experience. The impact of the organisational approach to acute care was seen as a major factor in the care experience from the patient and nurse perspective. Lack of a shared philosophy of care within the nurse population led to a lack of continuity and consistency of care for patients. Similarly differing perspectives on the nature of the patient – nurse relationship led to tensions within the care environment causing stress and de-motivation in the nurse population that ultimately affected the patient experience. A conceptual framework was developed that illustrated the complicity between patients and nurses to maintain the illusion of a caring nurse.

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Sullivan, Jacqueline Patricia Clay Tubbs. "Pastoral care to younger adults in long-term care." Theological Research Exchange Network (TREN), 1997. http://www.tren.com.

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Kung, Francis Tat-yan. "Chronic pain in older people." Connect to thesis Connect to thesis, 2001. http://adt1.lib.unimelb.edu.au/adt-root/public/adt-VU2001.0028/index.html.

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Castree, Barbara J. "A study of community care for people with physical disabilities." Thesis, University of Newcastle Upon Tyne, 1993. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.308761.

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Franks, Jeannette Searle. "Residents in long-term care : a case-controlled study of individuals in nursing homes and assisted living in Washington State /." Thesis, Connect to this title online; UW restricted, 1996. http://hdl.handle.net/1773/11194.

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Neville, Christine C. "The impact of residential respite care on the behaviour of older people /." [St. Lucia, Qld.], 2004. http://www.library.uq.edu.au/pdfserve.php?image=thesisabs/absthe18245.pdf.

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Liu, Hong. "Development of residential care for older persons in China : a case study of Tianjin /." View the Table of Contents & Abstract, 2006. http://sunzi.lib.hku.hk/hkuto/record/B3640455X.

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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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Meyer, Tania. "A social work perspective on the socio-emotional experience of older persons with visual impairments." Thesis, Link to the online version, 2006. http://hdl.handle.net/10019/1112.

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Littbrand, Håkan. "Physical exercise for older people : focusing on people living in residential care facilities and people with dementia." Doctoral thesis, Umeå universitet, Geriatrik, 2011. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-39784.

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The main purposes of this thesis were to evaluate a high-intensity functional weight-bearing exercise programme, regarding its applicability (attendance, achieved intensity, adverse events) as well as its effect on physical functions and activities of daily living (ADL) among older people living in residential care facilities, with a special focus on people with dementia. Furthermore, a main purpose was to systematically review the applicability and effects of physical exercise on physical functions, cognitive functions, and ADL among people with dementia. A high-intensity functional weight-bearing exercise programme that includes lower-limb strength and balance exercises in standing and walking, was evaluated in a randomised controlled trial among 191 older people, dependent in ADL, living in residential care facilities, and with a Mini-Mental State Examination (MMSE) score of ten or more. One hundred (52.4%) of the participants had dementia. Participants were randomised to an exercise programme or a control activity, consisting of 29 supervised sessions over 3 months, as well as to an intake of a protein-enriched energy supplement or a placebo drink immediately after each session. The effect on physical functions was evaluated using the Berg Balance Scale, usual and maximum gait speed, and one-repetition maximum in a leg press machine measuring lower-limb strength. The effect on ADL was evaluated using the Barthel Index. These outcome measures were followed up at 3 and 6 months by blinded assessors and analysed using the intention-to-treat principle. The evaluation of the applicability of the high-intensity functional weight-bearing exercise programme showed that there was a high rate of attendance, a relatively high achieved intensity in the exercises, and all except two adverse events were assessed as minor or temporary and none led to manifest injury or disease. No statistically significant differences were observed in applicability when comparing participants with dementia and participants without dementia. In addition, the applicability of the programme was not associated with the participants’ cognitive function. Significant long-term effects of the exercise programme were seen regarding functional balance, gait ability and lower-limb strength in comparison with the control activity. The intake of the protein-enriched energy supplement did not increase the effect of the training. Age, sex, depression, dementia disorder, nutritional status, and level of functional balance capacity did not influence the effect on functional balance of the high-intensity functional weight-bearing exercise programme. There were no significant differences between the groups regarding overall ADL performance. Analyses for each item revealed that a significantly smaller proportion of participants in the exercise group had deteriorated regarding indoor mobility at 3 and 6 months. For people with dementia, there was a significant difference in overall ADL performance in favour of the exercise group at 3 months, but not at 6 months. In a systematic review, randomised controlled trials, evaluating the effects of physical exercise among people with dementia, were identified according to pre-defined inclusion criteria. Two reviewers independently extracted predetermined data and assessed methodological quality. Ten studies were included in the review and the majority of the participants were older people with Alzheimer’s disease living in residential care facilities. Four studies reached “moderate” methodological quality and six “low”. The results showed that among older people with Alzheimer’s disease in residential care facilities, combined functional weight-bearing exercise over 12 months at an intended moderate intensity seems applicable for use regarding attendance and adverse events and there is some evidence that the exercise improves walking performance and reduces ADL decline. Furthermore, there is some evidence that walking exercise over 16 weeks performed individually, where the participant walks as far as possible during the session, reduces decline in walking performance, but adverse events need to be evaluated. In conclusion, among older people who are dependent in ADL, living in residential care facilities, and have an MMSE score of 10 or more, a high-intensity functional weight-bearing exercise programme is applicable for use and has positive long-term effects on functional balance, gait ability, and lower-limb strength and seems to reduce ADL decline related to indoor mobility. An intake of a protein-enriched energy supplement immediately after the exercise does not appear to increase the effect of the training. In people with dementia, the exercise programme may prevent decline in overall ADL performance, but continuous training may be needed to maintain that effect. The positive results regarding applicability and effects of combined functional weight-bearing exercise among people with dementia is confirmed when the scientific literature is systematically reviewed. It seems to be important that exercise interventions among people with dementia last for at least a few months and that the exercises are task-specific and intended to challenge the individual’s physical capacity. Whether physical exercise can improve cognitive functions among people with dementia remains unclear. There is a need for more exercise studies of high methodological quality among people with dementia disorders.

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Kueffler, Mark L. "Awareness and use of assistive technology among older adults with vision impairments in the Midwestern United States." Online version, 2003. http://www.uwstout.edu/lib/thesis/2003/2003kuefflerm.pdf.

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