Dans les trente prochaines années la génération du baby boom va atteindre le troisième âge et participer au vieillissement de la société. Cette population aura un besoin massif d’aide et de soins dont il n’est pas garanti que l’on puisse les assurer. Les nouvelles technologies adressées aux personnes âgées peuvent aider à résoudre ce problème mais pour cela il est indispensable que les aînés les acceptent. L’objectif de cette thèse est d’offrir un moyen de mesurer l’acceptation de ces technologies et de prédire leur utilisation. L’analyse de la documentation scientifique a permis d’identifier un modèle ayant les qualités requises pour cela, le modèle d’acceptation technologique proposé par Davis en 1989 (Technology Acceptance Model, TAM). Ce modèle se révèle parcimonieux et bien documenté mais il n’existait qu’en langue anglaise. D’autre part, la documentation scientifique montrait que la technologie la plus répandue parmi la population âgée et dépendante était la téléalarme. Ainsi, il a été décidé de traduire en français, adapter et valider un questionnaire issu du TAM pour prédire l’utilisation de la téléalarme par les personnes âgées dépendantes. Quatre études ont donc été menées, la première a consisté en une série d’entretiens, la deuxième en un questionnaire papier, et les deux dernières en un questionnaire par téléphone. Ce travail a abouti à l’obtention d’un instrument à dix items dont les qualités psychométriques se sont révélées acceptables. Le TAM fonctionne de la manière attendue il est donc possible de prédire l’utilisation de la téléalarme. Cependant deux limites doivent nuancer ces résultats, la première est que les études réalisées sont transversales ce qui empêche de parler de validité prédictive, la seconde et la modeste variance expliquée du questionnaire en français comparativement aux résultats publiés. En conclusion, le modèle doit s’enrichir de concepts spécifique à la population âgée afin d’affiner ses prédictions. / In the next thirty years the baby boomers are going to reach the third age and participate in the ageing of the whole French society. But no one can guarantee that their massive need of assistance and care will be provided. Information and communication technologies have the potential to help the elderly but only if they accept it. The aim of this thesis is to build a tool to assess the acceptance of these technologies and to predict their use. The scientific literature analysis revealed that the technology acceptance model proposed by Davis in 1989 had all the required qualities to build this tool. This model shows itself parsimonius and well documented but only existed in English. According to the literature the most widespread technology among the dependent elderly was the warning alarm. Thus, it was decided to translate into French, to adapt and to validate a questionnaire stemming from the technology acceptance model to predict the use of the warning alarm by dependent elderly. Four studies were thus led, the first consisted in a series of qualitative interviews, the second used a paper a pencil questionnaire, and both last ones in a phone questionnaire. This work ended in a ten items instrument with acceptable psychometric properties. The technology acceptance model works as expected and thus it is possible to predict the use of the remote alarm by dependent elderly. However, two shortcomings have to qualify these results, first the studies presented are cross-sectional which prevents from testing predictive validity, second the amount of explained variance by the questionnaire in French is limited compared with the published results. Finally, the model need to incorporate elderly specific constructs in order to make more accurate predictions.

根據衛生署資料顯示，民國八十六年時，台灣地區六十五歲以上老年人口保險總數占總保險人口的8.95%，然而醫療費用卻占總醫療費用的27.09%，此現象跟台灣社會邁入高齡化之後，疾病型態慢性化的傾向有密切關係。在此情形之下，除了醫療服務需求，更迫切的是後續性的長期照護需求。個人長期照護的支出中，約有85%~90%是屬於生活照顧的部分，只有10%~15%屬於醫療照護的支出。全民健保財務之推估基礎，原係以急性醫療保健服務為主，長期照護服務給付歸由理論上屬急性醫療性質之全民健保給付略顯牽強，因此，長期照護服務建立其自給自足的財務體系有其必要性。 目前世界各地人口老化的趨勢使得長期照護的需求逐漸增加，不少國家為平衡公共部門、區域社會與家計間費用負擔，已紛紛建立長期照護服務體系。歸納已被採行的財源籌措方式，計有1.強制性健康保險(statutory health insurance)；2.租稅融通支應社會福利；3.儲金帳戶制度(saving account)；4.自付額(out-of-pocket payments)；5.宗教慈善團體。或者可由以上五類為基準，進行不同程度的搭配採行。現階段我國可行之財源籌措方式可分為以下數類：1.以社會保險方式辦理：2.以社會福利方式辦理：3.以商業保險方式辦理：4.以國民年金搭配其它方式辦理。 本研究首先對長期照護費用進行估算，推估方式將採取分別估算我國長期照護人數以及每人每年長期照護費用，在結合兩者得出1999年至2041年之長期照護費用估計，並觀察長期照護費用占該年度GDP比例。在2001年(民國90年)長期照護費用約為246億元，占該年GDP的0.23%；在2040年為8,791億元，占GDP的0.73%。 本論文討論的長期照護財源籌措方式包括社會保險、租稅融通、國民年金給付自付部分長期照護費用、年金及社會保險結合以及其它方式等。在社會保險方式之下，觀察被保險人、保險對象以及有酬就業者的主要工作收入負擔長期照護保險費用的程度和能力。其中保險對象在40、45和50歲以上負擔的三個方案，將分別在15、10和5年後，達到每月負擔1,000元左右。 租稅融通方式當中，將觀察長期照護經費占總稅收、社會福利支出以及歲出預歲的比例，以及各稅目的負擔情況，以了解政府經濟財政對長期照護經費的負擔能力。發現長期照護以社會福利方式開辦，採取稅收方式融通長期照護費用，加徵的稅額將占總稅收的1.5%左右(以1997,1998資料計算)；並且會使總稅收占GDP比例增加0.23%-0.24%。 以國民年金給付來自付部分長期照護費用方式當中，本研究發現，國民年金的調整條件符合「至少達到每月平均消費水準50%」的方案中，該國民年金給付對於長期照護費用的支應具降低總費用負擔6%至28%的效果。 另外，研究發現以國民年金結合社會保險方式，65歲以上被保險人之保險費，以國民年金給付來支付，則所支付的長期照護保險費總額，占國民年金的總額比例為1/5至1/20之間呈現遞減的狀態。顯示此方式對國民年金而言具可負擔性及可行性，並且可達到政府以移轉支付來補助長期照護保險費，減輕年輕保險對象之保險費用負擔的效果。

<p> Den här uppsatsen är resultatet av en kvalitativ studie med syftet att granska, analysera och diskutera förutsättningarna för livskvalitet på särskilda boenden för äldre, ett eftersatt forskningsområde år 2009. De frågor som jag ville besvara var vilka tillvägagångssätt som användes för att skapa livskvalitet samt hur det arbetet kunde förstås ur ett individperspektiv. Utgångspunkten var en filosofisk livskvalitetsteori med objektiva dimensioner. Jag valde att vända mig till särskilda boenden med somatisk inriktning och metoden som användes var semistrukturerade intervjuer med sex enhetschefer inom äldreomsorgen i tre utvalda kommuner. Resultatet visade, bland annat, att de flesta av boendena arbetade aktivt med att förbättra det sociala innehållet, mycket tack vare regeringens stimulansbidrag. Främst var det gemensamma aktiviteter som kunde erbjudas. Andra områden var mer eftersatta. Resultatet visade även att förutsättningarna på särskilda boenden riskerar att inbjuda till en passivisering av individen och en uppluckring av identiteten. Det var tydligt hur personalens inställning och kunskaper samt andra resurser kunde förhindra det.</p>

The overall purpose of this master essay is to investigate whether there is an interest among people near retirement to contribute with their knowledge and experience after they reach the defined retirement age. Furthermore, I would like to investigate if they want to continue with their old jobs, full time/part time or to do something else, which is beneficial to the society. I also want to find out how the older people view themselves to continuing to work. Also which types of social and structural barriers that might exist for them and why. The aim is also to investigate what types of knowledge and experience they believe could be used in the future community. For that purpose I have structured interview questions and conducted eight individual interviews. Below is a brief summary of the main results. The study shows that there is a general interest in working after retirement. Most people prefer to work only part-time. Participation and influence is meaningful to the individuals. It is seen as having a positive impact on individuals, groups and societal perspectives. At the individual level, the relationship between the possibility to choose both type of work and working hours and the desire to continue working, is very strong. The choice contributes to the feeling that life is meaningful. That proved to be of great motivation to participate in the working life. The study shows the importance of paying attention to flexible working hours adapted at individual level. The results also show that the elderly are often pictured as competent, knowledgeable and skilled people, which resources can be utilized in the society. It also appeared that older people are carriers of knowledge and experiences, which can be taken care of and transferred on to the younger generations instead of being lost. The study pointed out that there is manual work situations particularly risky for older people. It also revealed negative factors such as competition for the jobs between younger and older people, which can create an opinion in society against letting older people work. The results also indicate that the mixture of older and younger people creates a knowledge and experience transfer which creates new approaches to working tasks. It also emerged a number of factors that influence an individual's choice to attend to work; Important to take an individual approach, assess the participant’s interests and abilities for the particular job, his desired working hours and the need of upgrading or retraining.

Bakgrund: Den äldre populationen ökar och många av de äldre lider av flera olika sjukdomar. Därmed ökar behovet av professionell och god omvårdnad. Den äldre människan som ofta lider av flera sjukdomar bor vanligtvis sista tiden av sitt liv på vård- och omsorgsboende. Äldre människor vårdas inte utifrån ett palliativt perspektiv trots att behov föreligger. Palliativ vård kopplas ofta ihop med människor som är under 65 år och har en obotlig sjukdom exempelvis cancer. Syfte: Att belysa hur den äldre människan vårdas i livets slut på vård- och omsorgsboende, ur de äldres, de närståendes och vårdpersonalens perspektiv. Metod: En litteraturstudie inspirerad av Friberg (2006). Tio kvalitativa artiklar och en kvantitativ artikel har analyserats och strukturerats utifrån den teoretiska referensramen. Teoretisk referensram: Den palliativa vårdens fyra hörnstenar; Symtomkontroll, teamarbete, kommunikation/delaktighet och närståendestöd. Resultat: Samtliga områden visade på stora brister i omvårdnaden om den äldre personen. Sjuksköterskan var ofta ensam i beslutet angående symtomlindring. De äldre kände sig i vägen och till besvär. Vårdpersonalen önskade mer handledning av sjuksköterskan. Närstående saknade information och delaktighet i beslut som rörde livsuppehållande åtgärder. Diskussion: Kunskap, information och kommunikationsbrist har visat sig leda till bristande omvårdnad kring den äldre personen på vård- och omsorgsboenden. Tydligare riktlinjer, samtal och en sammanhållen arbetsgrupp behövs för att kunna möta den äldre personens individuella behov. / Background: The population of elderly people is increasing and many of those suffer from multiple illnesses, thereby the need for professional and high quality care increases. The elderly suffering from multiple illnesses usually live their final years in nursing homes, and are not cared for throw a palliative approach, despite the need for it. Palliative care is often associated with people younger than 65 years and with an incurable disease, such as cancer.  Aim: To illustrate how elderly people are cared for during end- of- life in nursing homes, from the elderly, next of kin and nursing staff perspective. Method: A literature review inspired by Friberg (2006). Ten qualitative articles and one quantitative article have been analyzed and structured using the theoretical framework. Theoretical framework: The corner stones of palliative care; symptom control, teamwork, communication / involvement and support to next of kin. Result: All areas were lacking in the care of the elderly. The nurse was often alone in the decision making process regarding symptom relief for the elderly. The elderly felt that they were in nuisance and in the way for the staff. The caring staff wanted more guidance from the registered nurse. Next of kin were missing information and participation in decision making process concerning life prolonging measures. Discussion: Lack of knowledge, information and communication are shown and was leading to inadequate caring for the elderly in nursing homes. Clearer guidelines, dialogue, and a good teamwork are needed to meet the older person's individual needs.

Studies show that 10-15 percent of Sweden's population, 65 years or older are estimated to have depression or depression symptoms. The symptoms of depression among elderly people are less than symptoms of young people. This could cause that elderly people with depression are not always discovered. Studies show that elderly people who live in residential homes show more signs of depression than elderly people living at home. If elderly people live in a supporting environment, can it prevent that a depression developed. The prevention of depression among elderly people is a topic that is not discussed among previously research. The purpose of this study is to examine how the unit managers of the residential homes for elderly people look at the prevention of depression. This study is qualitative where six unit managers in charge of residential homes have been interviewed. The interviews were based on different themes; how the unit managers approach the prevention of depression among elderly people and how they describe the discretion to take preventive treatment for depression among elderly people, also the unit manager views on elderly peoples depression. The study is made in a small number of municipalities which means that it can not be generalized. The result may not be the same if the study had been made on a larger scale. The results of the study show that the unit managers of the residential homes for elderly people work to prevent depression in different ways. An explanation of why the unit managers works different are based on the unit manager ideas and interpretations of depression among elderly people. Also the unit manager priorities, past experience, number of years as a professional and their views about elderly people’s depression are factors that affect the unit manager work. The unit manager views on its way to approach the prevention of depression, the political guidelines and decisions have impact on the way the unit manager work to prevent depression among elderly people in the residential home.

Den här uppsatsen är resultatet av en kvalitativ studie med syftet att granska, analysera och diskutera förutsättningarna för livskvalitet på särskilda boenden för äldre, ett eftersatt forskningsområde år 2009. De frågor som jag ville besvara var vilka tillvägagångssätt som användes för att skapa livskvalitet samt hur det arbetet kunde förstås ur ett individperspektiv. Utgångspunkten var en filosofisk livskvalitetsteori med objektiva dimensioner. Jag valde att vända mig till särskilda boenden med somatisk inriktning och metoden som användes var semistrukturerade intervjuer med sex enhetschefer inom äldreomsorgen i tre utvalda kommuner. Resultatet visade, bland annat, att de flesta av boendena arbetade aktivt med att förbättra det sociala innehållet, mycket tack vare regeringens stimulansbidrag. Främst var det gemensamma aktiviteter som kunde erbjudas. Andra områden var mer eftersatta. Resultatet visade även att förutsättningarna på särskilda boenden riskerar att inbjuda till en passivisering av individen och en uppluckring av identiteten. Det var tydligt hur personalens inställning och kunskaper samt andra resurser kunde förhindra det.

Senėjimas – daugiafaktorinis procesas. Pamažu silpnėja vyresnio amžiaus žmonių apykaitos procesai, organizmas eikvoja daug mažiau energijos, ne tokie produktyvūs kai kurie hormonai, kraujyje padidėja cholesterolio kiekis, sulėtėja įvairių virškinimo liaukų sekrecija, atsiranda kitų organizmo fiziologinių ir biocheminių procesų lėtėjimo požymių. Vyresniame amžiuje būdingi tiek fiziologiniai, tiek biocheminiai procesai yra dėsningi, o mitybai čia tenka svarbiausias vaidmuo. Todėl buvo atliktas mitybos ypatumų ir sveikatos nusiskundimų tyrimas, paremtas vyresnio amžiaus (56 – 74m.) žmonių, gyvenančių Klaipėdos mieste apklausa, kurios rezultatai pateikiami šiame darbe. Darbo tikslas – ištirti Klaipėdos miesto vyresnio amžiaus (56 – 74 metų) žmonių mitybos ypatumus ir sveikatos nusiskundimus bei duoti pasiūlymus jų korekcijai. Darbo uždaviniai: 1. Ištirti vyresnio amžiaus vyrų ir moterų sveikatą: a) išanalizuoti vyrų ir moterų subjektyvų savo sveikatos vertinimą ir nusiskundimus; b) įvertinti vyresnio amžiaus žmonių mitybos vertingumą ir sveikatos būklę; c) nustatyti rūkymo, alkoholio vartojimo ir mitybos įpročius bei jų įtaką sveikatai; 2. Nustatyti vyresnio amžiaus žmonių fizinio aktyvumo ir sveikatos būklės ryšį; 3. Pateikti rekomendacijas vyresnio amžiaus žmonių mitybos ir sveikatos gerinimui. Tyrimo metodika. Tiriamasis objektas – vyresnio amžiaus (56 – 74 metų) Klaipėdos miesto gyventojai, priklausantys pensininkų klubams, tremtinių sąjungai, liaudiškam šokių... [toliau žr. visą tekstą] / Senescence – polysemantic process. Slow to fail metabolism, organism waste less energy, some of hormones became not such productive, in blood increased amount of cholesterol, slowup secretion of various digestive glands, upstarted organism deceleration symptoms of physiological and biochemistical processes. In elderly age physiological and biochemistical processes are regular, but the main job dependence for the nutrition. So was accomplished test of the nutrition peculiarities and complaints of health, sustained of questioning by elderly people ( 56-74 old years), which are living in Klaipeda city and get results from questioning is submiting in this graduation dissertation. Aim of the study: to find out the nutrition peculiarities of elderly people (56-74 old years) and their complaints of health in Klaipeda city and give suggestions of their correction. Tasks of the study: 1. To find out the health of elderly men and women: a) to traverse men‘s and women‘s subjective evaluation and complaints of their health; b) to evaluate elderly people nutriont of food and state of health; c) to ascertain wonts of smoking, using alcohol, habits of nutrition and their influence on the health; 2. To ascertain physical activity and state of health relation of elderly people; 3. To give recommendations for betterment nutrition and health of the elderly people. Methods. The object of my investigation – the elderly people ( 56-74 old years ) of Klaipeda city, wich depends... [to full text]

Magistro baigiamajame darbe nagrinėjama senų ir pagyvenusių asmenų socialiniai ryšiai ir jų priklausomybė nuo gyvenimo kokybės. Darbo tikslas — ištirti Vilniaus miesto senų ir pagyvenusių asmenų socialinius ryšius ir nustatyti jų ryšį su gyvenimo kokybe. Tikslui pasiekti numatyti šie darbo uždaviniai: 1) Remiantis literatūros šaltiniais išanalizuoti senų ir pagyvenusių asmenų palaikomų socialinių ryšių ypatybes bei jų gyvenimo kokybės aspektus; 2) Įvertinti senų ir pagyvenusių asmenų palaikomus socialinius ryšius, bei atlikti socialinių ryšių priklausomybės nuo gyvenimo kokybės analizę; 3) Parengti rekomendacijas apie senų ir pagyvenusių asmenų socialinius ryšius, jų palaikymą bei juos įtakojančius veiksnius darbuotojams, bei įstaigoms, teikiančioms seniems ir pagyvenusiems asmenims paslaugas namuose. Tyrimo objektas — senų ir pagyvenusių asmenų socialiniai ryšiai. Tyrimas atliktas apklausiant Vilniaus miesto socialinės paramos centro Pagalbos į namus skyriaus paslaugų gavėjus — tyrimo metu buvo naudojama respondentų kiekybinės apklausos anketa. Didžioji dalis tyrime dalyvavusių asmenų yra vieniši (78,3 proc.), tyrimo dalyvių amžius pasiskirstęs nuo 60 iki 95 metų amžiaus. Darbe aptariamas gyventojų senėjimas, situacija Lietuvoje, bei požiūris į senus ir pagyvenusius asmenis, senų ir pagyvenusių asmenų socialinių ryšių ypatybės, jų palaikymą įtakojantys veiksniai, senų vaidmenų praradimas ir perėjimas prie naujų. Taip pat aptariami ir gyvenimo kokybės aspektai, veiksniai... [toliau žr. visą tekstą] / The Social relationships and theirs dependence on quality of life is analyzing in this Master Study. The purpose of this study is to analyze old and elderly people of Vilnius city socials relationships and to condition their dependence on quality of life. These tasks are setting to reach the study purpose: 1) to analyze nonfiction of old and elderly people supportive social relationships points and their quality of life dimensions; (2) to evaluate supportive social relationships of old and elderly people and to do analysis of social relationships dependence on quality of life; (3) to give recommendation for workers and institutions, which are organizing service at home for old and elderly people about their social relationships, social relationships keeping and subjects, which influence to social relationships. The Object of this study is social relationships of old and elderly people. The service‘s recipients of Helping ant home section of Vilnius city Social Support Centre were interviewed. The quantitative questionnaire was using in this study. The most part of questioning’s participants were lonely people (78.3 %). The questioning’s participant’s age was range from 60 to 95 years old. In this study are discussing the ageing of population, situation of Lithuania, attitude to old and elderly people, social relationships points of old and elderly people, subjects which influence to social relationships keeping, also the loss of old roles and transit to new roles. There are... [to full text]

Darbo objektas: Vidutinio ir vyresnio amžiaus skirtingos gyvensenos žmonių sveikatos, fizinio aktyvumo ypatumai ir gyvensenos sąsaja su gyvenamąja aplinka. Darbo problema – vykstant sparčiam technikos progresui stebimas visuotinis fizinio aktyvumo mažėjimas ir didėjantis fizinis pasyvumas. Fizinio aktyvumo stoka lemia daugelį lėtinių ligų, tarp jų širdies ir kraujagyslių ligas, kurios pirmauja pasaulyje mirčių skaičiumi. Žmogui senstant fizinis aktyvumas mažėja ir tai padidina rizikos tikimybę sveikatos atžvilgiu. Darbo tikslas – nustatyti praktikuojančių skirtingą gyvenseną vidutinio ir vyresnio amžiaus žmonių sveikatos, fizinio aktyvumo ypatumus ir gyvensenos sąsają su gyvenamąja aplinka. Darbo uždaviniai: 1. Nustatyti fizinio aktyvumo ypatumus būdingus skirtingos gyvensenos vidutinio ir vyresnio amžiaus žmonėms; 2. Nustatyti sveikatos ypatumus būdingus skirtingos gyvensenos vidutinio ir vyresnio amžiaus žmonėms; 3. Nustatyti gyvensenos ir gyvenamosios aplinkos sąsajas. Darbe keliamos hipotezės: 1. Sveiką gyvenseną praktikuojantys asmenys turi mažiau sveikatos negalavimų; 2. Asmenys gyvenantys arčiau žaliųjų erdvių dažniau būna fiziškai aktyvūs. Išvados: 1. Sveiką gyvenseną praktikuojantys respondentai fiziškai aktyvesni nei nepraktikuojantys sveikos gyvensenos darbinėje veikloje, pagal laiką sugaištą einant ir grįžtant iš darbo ir mankštinimosi dažnį laisvalaikiu (p<0,05). 2. Analizuojant nustatytų ligų paplitimą tarp sveiką gyvenseną praktikuojančių ir... [toliau žr. visą tekstą] / Object of work: middle-aged and elderly people of different lifestyles health, physical activity and lifestyle characteristics relationship with the living environment. Work problems: during the rapid technological progress it is observed decrease in general physical activity and higher rates of physical inactivity. Lack of physical activity leads to many chronic diseases, such as cardiovascular disease, which leads the world in number of deaths. Physical activity decreases with age and this increases the probability of a risk to the health. Work object: to identify middle-aged and elderly people practicing different lifestyles, health, physical activity characteristics and lifestyle relationship with the living environment. Goals: 1. To identify the features of physical activity in relation to the health of middle-aged and elderly people with different lifestyles; 2. To identify specific health key characteristics of middle-aged and elderly people practising different lifestyles; 3. To identify lifestyle and living environment relationships. Hypothesis: 1. Individuals practicing a healthy lifestyle have fewer health complaints; 2. People living in rural areas tend to be more physically active. Conclusions: 1. Respondents practicing a healthy lifestyle are more physically active than those who do not practice healthy lifestyle at work based on time spent going to and returning from work and exercise frequency (p <0,05) during leisure time. 2. There is no significant... [to full text]