Дисертації з теми "Older people – Care – Congresses"
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1
Kiraly, Zoltan. "Pastoral care of older adults." Theological Research Exchange Network (TREN), 2002. http://www.tren.com.
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Zhang, Xuetai. "Community-based care for the frail elderly in urban China /." Hong Kong : University of Hong Kong, 2002. http://sunzi.lib.hku.hk/hkuto/record.jsp?B24873457.
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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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5
Hope, Suzanne Victoria. "Hypoglycaemia in older people with diabetes." Thesis, University of Exeter, 2016. http://hdl.handle.net/10871/21935.
Повний текст джерелаАнотація:
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.
6
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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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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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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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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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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King, Anna Irene Ivy. "Creating sustainable home care services for older people." Thesis, University of Auckland, 2010. http://hdl.handle.net/2292/5765.
Повний текст джерелаАнотація:
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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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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Nie, Yajie. "Modelling long-term care for older people China." Thesis, University of Southampton, 2017. https://eprints.soton.ac.uk/408221/.
Повний текст джерелаАнотація:
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.
14
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.
Повний текст джерелаАнотація:
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.
15
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).
16
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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17
Jörgensen, Diane Mary. "Factors influencing entry to residential care among older people." Thesis, University of Auckland, 2006. http://hdl.handle.net/2292/1762.
Повний текст джерелаАнотація:
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.
18
Stephen, Audrey I. "Exploration and development of bereavement care for older people." Thesis, Robert Gordon University, 2011. http://hdl.handle.net/10059/658.
Повний текст джерелаАнотація:
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.
19
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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20
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.
Повний текст джерелаАнотація:
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.
21
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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22
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.
Повний текст джерелаАнотація:
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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Moran, Shane. "China's aged care crisis : problems, resources, solutions." Thesis, View thesis, 2000. http://handle.uws.edu.au:8081/1959.7/23015.
Повний текст джерелаАнотація:
China is currently facing what I expect to be its most significant challenge to date - a crisis in the care of its rapidly ageing population. The causes of this crisis are complex and multi-faceted and its implications far-reaching from the social, economic and political perspectives. This thesis examines the causes and consequences of the impending aged care crisis in China, with a particular focus on the urban elderly. In addition to extensive interviews with government officials, a sample of 2,000 retires and their children were surveyed in Shanghai as part of my research. My findings from the Research Survey and Questionnaire, together with my observations from site visits to numerous aged care crisis and the associated problems. Of primary concern is the fact that the Chinese government does not have in place an appropriate aged care structure nor a strategy to implement systems to cope with the impending crisis. I conclude that it is imperative the Chinese government recognises both the immediacy and scale of the crisis and acts accordingly. Failure to do so may result in both significant social unrest and severe economic consequences. Recommendations are offered for consideration by the Chinese government in an effort to manage the impending aged care crisis in China.
25
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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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.
Повний текст джерелаАнотація:
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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Gibney, Jennifer Mary. "Improving the oral health of older people in hospital." Thesis, The University of Sydney, 2018. http://hdl.handle.net/2123/20256.
Повний текст джерелаАнотація:
The aim of this research was to improve oral health outcomes for older people whilst they are in an acute care ward of a hospital. Whilst a number of studies had looked at the oral health of older people, there has been a limited number undertaken in an acute care setting and none that looked specifically at the role of nurses in the delivery of oral health care procedures. Four studies were therefore undertaken in two major tertiary referral hospitals in Sydney NSW. The first study involved a survey of nurses and found a combination of patient, nurse and systems barriers impacting oral hygiene practices. The second study sought to determine the prevalence of poor oral health among older patients upon admission to acute care wards and again seven days into their hospitalization. It found that, for the majority, oral health did not improve during their stay. As a result of these two studies two interventions were undertaken. The initial intervention introduced an oral hygiene procedure that met the needs of both the patient (best practice based on dental evidence) and the nurses in an attempt to address some of the barriers identified. An Oral Health Therapist (OHT) conducted a once daily oral hygiene routine (mouth, teeth, dentures) to ascertain the most efficacious oral-care procedures. Oral health was assessed at admission and day 7. The results showed a significant improvement in oral health specifically oral cleanliness over the period. Based on these findings, the OHT then trained the nurses in the oral health routine identified and the nurses undertook the same procedure over the same time frame. The results again showed a significant improvement in the patients’ oral health between admission and day seven demonstrating that, given direct education and training in the correct procedures, nurses could improve oral cleanliness to the same degree as an OHT. As part of nursing lead intervention, we developed a nurse education and training program that enabled nurses to deliver such care aided when necessary by a dental professional. This thesis has therefore shown that the barriers to nurse led oral health care on an acute ward can be overcome with the training and support of a dental professional. It has also provided guidance on how such a training program should be designed. Key words- dental care, aged, inpatients, oral health, patient care, nurse education and training
30
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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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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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.
Повний текст джерелаАнотація:
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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Toye, Christine. "Perceived social support of family members of aged care facility residents and its relationship with family members well-being and their support of relatives in residential care." Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 2000. https://ro.ecu.edu.au/theses/1358.
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When elderly people are cared for In Aged Care Facilities (ACFs) it is known that their family members frequently suffer negative effects. These effects may be alleviated by social support and, because they feel better, family members may then offer more support to residents. In this study, the researcher tested a model with a sample of 213 family members of ACF residents. Predictive relationships were hypothesised among incentives for family members to support residents, stress related factors, the perceived formal and Informal support of family members, their psychological wellbeing, and the support they offered to residents. The researcher also developed the Relatives' of Aged Care Residents Assessment of Staff Support Tool (RACRASST) to measure family members' perceptions of support from the staff. The researcher developed the RACRASST from data obtained at interviews with family members of ACF residents and ACF staff, and from a review of the literature. The instrument underwent testing and refinement procedures, including a factor analysis. The test-retest reliability co-efficient for the scale was found to be 0.99 over 2-3 days. As used In the study, the RACRASST was a 29-ltem unidimensional scale. Response options ranged from Strongly Disagree to Strongly Agree. A not applicable option was retained to identify Items needing review. Items referred to staff/family member communication, staff care activities, staff use of the environment, and family members' perceptions of a reliable alliance between themselves and the staff. The instrument was re-examined during the study and two items were deleted because of a high percentage of missing/not applicable responses. Cronbach's alpha co-efficient for the 27-item RACRASST was 0.96. Findings of model testing confirmed hypothesised positive predictive relationships between residents' family members' well-being (the dependent variable) and both family members' perceptions of the residents' adjustment and the length of stay. Pressures related to the placement were confirmed as negatively predicting well-being In family members, and the degree to which family members felt attached to residents was confirmed as positively predicting their self-reported support of residents. The familial relationship between the family member and the resident was also confirmed as predicting family members' well-belng. Support from ACF staff was not a significant predictor of family members' well-being, and well-being failed to predict family members' support for residents. An empirical model was also developed. This model accounted for 47% of the variance in family members' well-belng and 23% of the variance In family members' self-reported support for residents. Family members' perceptions of their informal support were found to account for 7% of the variance In support for residents and 5% of the variance in pressures experienced because of the placement. Pressures in family members negatively predicted their health and well-belng, and being a residents' daughter was a positive predictor of pressures. The main conclusion is that informal support is potentially highly beneficial to residents' family members. Accordingly, it is recommended that ACF staff facilitate supportive relationships among family members and residents. Further research to develop and test the RACRASST and to test the empirical model is also recommended.
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Leary, Mary A. "Policy intersections or policy chasms state elder mobility policy, practice and long-term care reform /." Fairfax, VA : George Mason University, 2008. http://hdl.handle.net/1920/3139.
Повний текст джерелаАнотація:
Thesis (Ph.D.)--George Mason University, 2008.Vita: p. 169. Thesis director: Laurie A. Schintler. Submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy in Public Policy. Title from PDF t.p. (viewed July 7, 2008). Includes bibliographical references (p. 142-168). Also issued in print.
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張學泰 and Xuetai Zhang. "Community-based care for the frail elderly in urban China." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2002. http://hub.hku.hk/bib/B31243903.
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Chua, Aniceta. "Care workers’ views on social support for older people in Sweden." Thesis, Umeå universitet, Institutionen för socialt arbete, 2019. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-160498.
Повний текст джерелаАнотація:
This study seeks the views of care workers working with older people about what impact social support resources has on the living conditions of older people. Social support was conceptualised in the study as support received from family members or close friends of the older people. Care workers were asked to share their views about social support for older people receiving care support in institutional setting or receiving home-based support services. This qualitative investigation involved eight care workers working with older people in Sweden. It has been argued in the study that care workers proving support for older people could have useful information about the social support of older people because they would have witnessed interactions between older people and their immediate network members. Qualitative interviews were conducted with eight care workers providing care support in institutions and home-based to explore their perspectives on the impact of social support on older people. Data from the interviews were analysed using thematic analysis. It was revealed from the views of care workers that both family and friends were engaged in different ways to provide support for older people, although not at all times. Managing loneliness, satisfaction with life and feeling better about themselves emerged as the ways social support impacted on the living conditions of older people. The care workers highlighted certain activities or areas that could ensure continuity of social support for older people. These included family members having regular contact with older people, older people acknowledging the need for support. Implications of the study for the practice of care for older people were highlighted.
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Yuen, Hon-lam Joseph. "An evaluative study on the effectiveness of using reality orientation approach to confused elderly living in care and attention home." Click to view the E-thesis via HKUTO, 1997. http://sunzi.lib.hku.hk/hkuto/record/B42128444.
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Lee, Yin King. "Promoting psychosocial health of elderly residential care home residents implementation of a Tai Chi program /." online access from Digital Dissertation Consortium, 2006. http://libweb.cityu.edu.hk/cgi-bin/er/db/ddcdiss.pl?3254572.
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Namiki, Satoko. "Navigating the Health Care System: Movement and Meaning for Older People with Dementia." Thesis, Griffith University, 2014. http://hdl.handle.net/10072/365242.
Повний текст джерелаАнотація:
Older people with dementia are significant users of both long-term care and acute care services. The transitions between these services are not always smooth and very little is known about the meaning that such transitions have for people with dementia. This study aimed to explore the journeys of residential aged care facility (RACF) residents with dementia as they transition through the acute care system, and to investigate the system features and continuity of care (COC) issues that serve to shape the meanings that these transitions have for these people. The study addresses the following two research questions:
1. What meanings do people with dementia construct from their multiple transition experiences?
2. What are the factors that affect COC, and therefore, have an impact on the transition experiences of people with dementia through the system?
This study was guided by a critical social constructionism paradigm and employed a whole-system design and narrative methods. This approach enabled the researcher to explore ‘the person in the system’. Data were collected through mixed methods including transfer tracking, formal interviews, observations, chart audit, and document review. Data analysis was undertaken using a narrative analysis approach that acknowledged people’s ability to construct their own meaning within particular contexts.Thesis (PhD Doctorate)
Doctor of Philosophy (PhD)
School of Nursing
Griffith Health
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Häggström, Elisabeth. "Municipal care for older people : experiences narrated by caregivers and relatives /." Stockholm : Gävle : Neurotec Department, Division of Gerontological Science, Karolinska institutet ; University of Gävle, 2005. http://diss.kib.ki.se/2005/91-7140-186-5/.
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McClean, Pamela. "Antimicrobial prescribing and infection control in care homes for older people." Thesis, Queen's University Belfast, 2012. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.579743.
Повний текст джерелаАнотація:
Introduction: Antimicrobial prescribing has been reported to be sub-optimal in care homes; however, prior to this research there was no information in relation to antimicrobial use in Northern Ireland's (NI's) care homes. Furthermore, the factors having an impact on infection control practices in NI's care homes had not been identified. Methods: Two point prevalence surveys (PPS) were conducted in 30 nursing homes and 30 residential homes, to determine the prevalence of antimicrobial prescribing and any associations with resident or institutional factors. Findings from the PPS in nursing homes informed the development of a pilot intervention study for the management of urinary tract infections (UTIs). Qualitative research was conducted to investigate the experience of nursing home staff who were involved in a previous infection control education and training intervention study and to explore the feasibility of introducing widespread Meticillin-resistant Staphylococcus aureus (MRSA) decolonisation to the nursing home setting. Appropriate quantitative and qualitative analyses were performed for all studies. Results: The PPS identified a high rate of antimicrobial prescribing in nursing (April 2009, l3%; November 2009, 11%) and residential homes (November 2010, 9%; April 2011, 9%) with variability evident both within and between homes. Antimicrobials were most frequently prescribed for UTIs. In the pilot UTI intervention study, fewer (-38%) antimicrobials were prescribed and fewer (-7%) residents were treated for suspected UTIs. However, the number of urine dipstick tests and urine samples which were sent to the laboratory remained high. The qualitative study found that the factors influencing infection control and MRSA decolonisation in nursing homes were organisational (e.g. time, financial resources, environmental, management and culture); external (e.g. hospitals and general practitioners); and residents and families. Conclusion: The four studies have shown that care homes require further support to optimise antimicrobial prescribing, the management of UTIs and infection control
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Holder, Jacquetta Mary. "Ploicies and Perspectives on Closing Independent Care Homes for Older People." Thesis, University of Kent, 2008. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.499751.
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Fong, Florence Meng Soi. "Intergenerational relations and the care of older people in Hong Kong." Thesis, University of Sheffield, 2009. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.505556.
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McCarty, Lisa. "Evaluating the quality of care within residential services for older people." Thesis, University of Hull, 2001. http://hydra.hull.ac.uk/resources/hull:8429.
Повний текст джерелаАнотація:
The quality of care within residential services for older people has been a source of concern within health and social care for some time. Several attempts have been made to develop a means of assessing the quality of care; however, the nature and quality of these varies enormously. The Quest process of evaluation, which was designed as a means of assessing service quality according to the structure and process of care, is presented as a possible means of improving upon current practice. The Quest system incorporates four measures: the Service Profile, the Support Questionnaire, the Observation Profile and the Occupational Stress Indicator. The Service Profile is essentially descriptive in nature, and the Occupational Stress Indicator is a published, standardised measure. The remaining Quest measures, however, were only recently developed and therefore lack evidence in support of their psychometric properties. The present study was designed to assess the validity and reliability of the Quest system within residential services for older people. The exploration of validity and reliability took several forms, incorporating both qualitative and quantitative methodologies. The overall findings of the discussion group and assessment of face validity advocated the credibility of the dimensions of support that underpin the Quest system. With regards to reliability, the findings supported the reliability of the Observation Profile but identified that further work was needed to ascertain the reliability of the Support Questionnaire. Issues relevant to the interpretation of the results were discussed along with the reasons why a number of formal assessments of validity could not be made. Further work to explore the psychometric properties of the Quest system was recommended before it can be confidently applied to residential services for older people.
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Kono, Makoto. "The welfare mix in the care of older people in Japan." Thesis, University of Sheffield, 1997. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.412577.
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Fernandez, Plotka Jose-Luis. "Utilisation and service productivities in community social care for older people." Thesis, London School of Economics and Political Science (University of London), 2005. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.423140.
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Chevannes, Mel. "Modernity, management and community care : implications and consequences for older people." Thesis, Keele University, 1996. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.319220.
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Menzies, Laura. "Integrating housing into the whole system of care for older people." Thesis, University of Liverpool, 2015. http://livrepository.liverpool.ac.uk/2024519/.
Повний текст джерелаАнотація:
The ageing population in the UK is placing huge pressure on Health and Social Care, exacerbated by current economic pressures to cut costs. The British Government is politically driving integrated care, to encourage the different services that constitute the whole system of care to work together in order to reduce fragmentation and overlap in the system. However, methods for effective partnership working towards integrated care are not well researched. This thesis details an action research project to virtually integrate Housing into the whole system of care in Conwy in particular, concluding that the methods used provide an appropriate approach for partnership working towards integrated care, thus addressing this gap. Housing plays an important role in the whole system of care for older people as a person's home environment has a high impact on their wellbeing. Poor quality housing can negatively impact on health, and care can be provided in the home due to the government's emphasis on 'ageing in place'. However, whilst the importance of considering Housing's role in the whole system of care is identified in government policy, efforts towards achieving integrated care do not commonly include Housing departments or providers. The thesis concludes that only types of housing which inherently include care (e.g. extra care, care homes) are integrated into the system, despite the fact that residents can access care in any type of housing. Soft systems methodology (SSM) is used to identify the whole system of care in Conwy, Wales. A Steering Group was established to develop an Older Persons' Housing Strategy (OPHS) for Conwy, one of the aims of which was to integrate Housing into the whole system of care. The local authority act as the 'strategic enabler' in achieving this. Each Steering Group member was interviewed to establish their role within the system, and their worldviews on it. This enabled the Steering Group to develop a shared vision for the OPHS, which is a key feature of successful partnerships to achieve integrated care. Support is identified as an appropriate integrating function and examined to establish appropriate operations structures. Through a survey of support services in Wales, it is identified that support, provided by wardens in sheltered housing, is currently going through a transition period, due to changes to funding guidelines for support. Many local authorities in England are now using offsite support, but the impacts of this are not well researched. This research provides an evidence base for practitioners looking to change the structure of their warden service. This is based on a SWOT analysis of onsite and offsite support, conducted from the data gathered during the survey. Local authorities can capitalise on the changes being made to warden services, taking the opportunity to upskill wardens and using support to integrate Housing into the care system by signposting other services. Finally, focus groups were conducted with older people to ensure the OPHS met their needs. This also served to triangulate the findings of the SSM and the survey, demonstrating the effectiveness of combining these methods.