Thesis (Ph. D.)--Duquesne University, 2003. / Title from document title page. Abstract included in electronic submission form. Includes bibliographical references (p. 200-206) and index.

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The elderly are a rapidly growing population in the United States and have the highest rate of TBI-related hospitalization. Across all levels of severity, elderly persons have uniformly poorer outcomes including quality of life, community integration, disability, and mortality, but there is a significant lack of published research regarding communication outcome in the elderly population. The likelihood that speech-language pathologists (SLPs) will clinically treat elderly clients with TBI is great; understanding the effects that age of injury has on communication may inform clinicians’ abilities to accurately and efficiently assess, diagnose, and treat the elderly. The present study examined the relationship between age of onset of injury and severity of communication deficits following traumatic brain injury (TBI); the study included a review of published research and a survey of SLP estimates of severity of impairment. Limitations of the study and directions for further research are discussed. / text

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Abstract: Introduction: The International Resident Assessment Instrument (InterRAI) is a service and needs assessment tool that the Ministry of Health (MoH) was recommended to use by a report “Assessment Processes for Older People” in 2003, authored by the New Zealand Guidelines Group (NZGG). The MoH has implemented a New Zealand wide pilot in order to test the feasibility of InterRAI’s use in the elderly population in New Zealand. Aim: The aim of the dissertation is to provide a descriptive analysis of data from the Canterbury District Health Board (CDHB) Pilot Trial of an InterRAI Homecare Assessment form as a means of assessing the care requirements of the elderly. The data had been collected from 264 people on one, two or three different occasions/assessments. Elderly in the CDHB’s population catchment’s area were assessed between 2005 and 2006, with participants throughout Christchurch and surrounding localities, e.g. Rangiora and Kaiapoi. At the time of assessment approximately 80% were community dwelling and about 20% were inpatients. The data were collected from 264 people on one, two or three different assessment occasions. Methods: The CDHB pilot study data was present in two databases, which was transferred and reformatted from an Excel Spreadsheet format to a statistical programme format for analysis, SAS-9 (2004). The elderly were assessed initially once (called Time One) but some were assessed multiple times, i.e. all participants 264 were assessed once (Time One), 147 (56.7 %) were assessed twice, 65 (24.6%) three times and ten (3.6%) four times. The results presented here are mainly of the first assessment only, as this is the total sample. Results and Discussion: There are 178 females and 86 males, ranging in age from 64 - 95, all English speaking and mainly, New Zealanders, of which most are married or are widowed. The mean and median ages are around 80 years of age. Overall, the reason for movement of elderly, i.e. change in Residential Type was ADL Decline. There was also some correlation with elderly person’s home environment. Possibly the only reason for a non-routine visit to hospital for an elderly person was that the person was alone i.e. no other means of help was available to them. The lack of secondary helpers for the elderly was also important in both elderly person’s movement and non-routine visits to hospital. Conclusions: The results have provided new information for the CDHB. However, more work is required, such as the ethnicity, age–gender range and service use. The CDHB are planning to implement the InterRAI assessment process, into the CDHB’s service delivery, for the elderly population, in Canterbury. Recommendations: Some more time dependent data needs to be analysed i.e. trend analysis across assessments. Further research could focus on two categories, disease coding and medicine usage.

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