Bakgrund: Vården av äldre med BPSD är både fordrande och tidsomfattande och ställer höga krav på sjuksköterskors kompetens i bemötande och i omvårdnad. Många äldre med BPSD har omfattande symtom som är svåra att komma tillrätta med av omvårdnadspersonal, sjuksköterskor och personens anhöriga. Genom att undersöka närmare på olika omvårdnadsåtgärder/strategier som distriktsköterskor och sjuksköterskor använder sig av i vården av personer med demens kan en uppfattning erhållas om vilka strategier och tillvägagångssätt det finns att tillgå och som kan ha betydelse för äldre med demens och vilka strategier, tillvägagångssätt det finns anledning att undersöka närmare. Syfte: Studiens syfte var att belysa distriktsköterskors strategier för att minska beteendemässiga och psykiska symtom hos äldre med demens inom korttidsboende. Metod: I denna studie användes en induktiv ansats där datamaterialet analyserades med kvalitativ innehålls analys. Åtta distriktsköterskor och sjuksköterskor inom korttidsboende intervjuades. Resultat: Ur analysen identifierades ett tema Strävan mot harmoni och välbefinnande hos personen med demens samt tre kategorier; Hjälpmedel i omvårdnadsarbetet, Fokusera patienten som person, Involvera anhöriga som medaktör med sex underkategorier. Konklusion: Studien visar att personcentrerad vård där individuella omvårdnadsstrategier tillämpas i syfte att minska BPSD är ett grundläggande förhållningssätt i vården. Med hjälp av BPSD registret, NPI skattningsskala, anhörigas stöd, levnadsberättelse och där läkemedel inte är ett förstahandsval, kan individuella vård- och bemötandeplaner upprättas som har betydelse för äldre med BPSD. / Care of the elderly with behavioral BPSD is many times a both demanding and timeextensive nursing work with high demands on nurses’ skills in response and in treatment. Many older people with BPSD experiencing mentally illness as can be difficult to deal with by health care workers, nurses and the person`s relatives. By examining various nursing strategies as district nurse`s and nurses using in healthcare of people with dementia can an idea be obtained which strategies and approaches may be of importance to elderly with dementia and what strategies and approaches there is reason to investigate further. Purpose: The study’s purpose was to highlight district nurses’ strategies to reduce behavioral and psychological symptoms of dementia on the elder with dementia in short-term accommodation. Method: Qualitative content analysis with an inductive approach was used in the study. Eight district nurses and general nurses within short- time accommodation where interviewed. Results: From the analysis the theme Pursuit of harmony and Well-being of people with dementia was identified and three categories; Resources in nursing works, Focus the patient as a person, Involve relatives as co-workers with six subcategories. Conclusion: The study shows that person- centered care their individual inpatient care strategies are applied in order to reduce BPSD is a basic approach in care. Using BPSD, NPI estimation scale, relatives’ support, life story and their drugs are not a first choice can induce care and treatment plans can be established that matter for elderly with BPSD.

Nous nous interrogeons sur les enjeux de la présence animale au sein d’une institution médico-sociale pour tenter de répondre aux controverses juridiques, mais également managériales, que soulève cette question. Notre questionnement s’inscrit dans une évolution sociétale favorable à la reconnaissance citoyenne de la personne âgée dépendante, et plus particulièrement dans ses droits sociaux et culturels. Notre problématique renvoie aux questions essentielles sur le pouvoir d’une personne vieillissante de décider elle-même de la conduite de sa vie. C’est ce que nous étudions au travers de cet outil particulier, mais symptomatique en milieu institutionnel, qu’est l’animal d’accompagnement social.Nous débutons notre travail autour d’une réflexion pratique et théorique d’un projet d’introduction d’un chien éduqué dans un établissement d’hébergement pour personnes âgées dépendantes. Nous y abordons tout d’abord les questions liées à la connaissance et à la compréhension des usagers que les activités de médiation animale mettent en exergue (1ère partie), puis à partir de ce constat, de développer les aspects managériaux qui s’y trouvent liés en leurs propensions à insérer un projet dans un cadre institutionnel et en leurs facultés d’introduire un nouvel espace de réflexion et de construction du sens (2ème partie) - le résumé de l’ensemble de ces éléments constituant le cahier des charges de la médiation animale. / We are researching the implications of animal assisted therapy within a social care facility in an attempt to respond to the legal and managerial controversies surrounding the scheme. Our research is part of a societal trend towards recognizing the citizen rights of dependent elderly people, and in particular their social and cultural rights. We are studying important questions relating to the power of ageing people to make their own decisions about their lives. That is our main aim in researching the use of companion animals, which may be a revealing tool when used in an institutional setting.We will begin our work by discussing the practical and theoretical implications of the plan to introduce a trained dog into a nursing home for dependent elderly people. We will first discuss the issues related to the knowledge and understanding of the users which will be highlighted through animal assisted therapy (1st part). Secondly, we will develop the managerial implications related to the implementation of this idea in an institutional framework and the possibility of introducing a new space for reflection and the construction of meaning (2rd part). These elements will be used to develop specifications for the animal assisted therapy project.

Made available in DSpace on 2016-04-27T18:47:20Z (GMT). No. of bitstreams: 1 Claudia Cristina Mussolini.pdf: 5103559 bytes, checksum: 952d3dbe93a9759e8c64b64fc8538643 (MD5) Previous issue date: 2007-02-16 / Assistive devices are used by elderly people to help them in their daily tasks, at work and in their integration with the community. Such devices contribute to the improvement of the elderly s functional capacity. During our field research, our attention was drawn to the fact that some of the elderly people devised and made their own assistive devices. In order to understand such behavior, our study employed a quantitative approach through semi-structured interviews with five elderly people, residents of the city of São Paulo, Brazil. Results showed that through a facilitating physical and social environment, defined types of self-efficacy expression were enabled (BANDURA, 1977;1991;1993), thus allowing those elderly people to efficiently devise, make and use albeit with some functional limitations the device that they needed. Furthermore, the assistive device built by the elderly serves as a continuous feedback for their self-esteem, since it bears the marks of their identity and life history traits. The presence of self-efficacy in the elderly s personality is an inner resource capable of minimizing the effects of functional incapacities, which may, in turn, affect their well-being and quality of life during their ageing process. Therefore, geriatric assistance programs should support and encourage the creative and productive potential of older individuals as a means to ensure their social integration and participation / Dispositivos assistivos são utilizados por idosos para auxiliá-los nas atividades de vida diária, no trabalho e na integração com a comunidade, tendo como objetivo principal a melhora da capacidade funcional. Em nossa experiência de campo, chamou a nossa atenção, o fato de alguns idosos utilizarem dispositivos assistivos idealizados e construídos por eles mesmos. Para entender este comportamento, nosso estudo utilizou-se da abordagem qualitativa, através de entrevistas semi-estruturadas com cinco idosos moradores da Cidade de São Paulo. Como resultado, percebemos que através de um ambiente físico e social facilitador houve a possibilidade da expressão da auto-eficácia (BANDURA, 1977;1991;1993) contribuindo para que estes idosos mesmo com algumas limitações funcionais - fossem capazes de pensar, construir e usar com eficiência o dispositivo que lhe faltava. Além disso, o dispositivo assistivo construído serve de constante feedback para a auto-estima dos idosos, pois traz em si marcas da sua identidade e da sua história de vida. A presença da auto-eficácia na personalidade dos idosos serve como um recurso interno para minimizar os efeitos das incapacidades funcionais que podem afetar o bem-estar e a qualidade de vida no envelhecimento. Cabe, portanto, aos programas com caráter gerontológico estimular o potencial vivencial e criativo deste segmento garantindo a sua integração e atuação social

This diploma thesis aims at the influence of social support of an elderly person on his everyday activities. Thesis consists of theoretical and practical parts. The theoretical part describes topics involving old age and social support of an elderly person. The practical part includes field research in form of interviews. The main goal of this thesis was to find out, what influence has the social support on everyday life of an home living elderly person.

Theoretical concepts: The central topic of my thesis is the life satisfaction of the elderly, although this concept is perceived very subjectively. Moreover, it varies even in one person at different life stages and it depends on various circumstances and events that accompany people on their life journeys. However, experiencing satisfaction always requires the saturation of one's needs, physical ones as well as mental, social and spiritual ones. Most of the times, one is able to provide for their needs, or at least affect them, through their activities and their will, but the older ones grows, the more one becomes dependent on others in this respect. This task is usually taken in part by one's family members who are willing to help and take care of their close relative, but there also arise situations where one has to entrust themselves into the hands of health professionals, especially nurses. The nurses' tasks do not just include staffing surgeries, but it is necessary for them to pay attention to the individual needs of their clients. Importance of both these components of care is entirely equivalent, because treatment success depends largely on the psychological state, defined by the satisfaction of the clients' life needs, and, on the other hand, the measure a patients' well-being is strongly influenced by the state of their health depending on successful treatment. Professional care that their clients receive is often linked to the placement of the elderly in some health institutions; possibly there may be a situation when an elderly person stays in their home and receives care from field medical staff for only a few hours a day. In any case, the objective of such care, through whatever methods it is provided, should be to achieve the highest possible degree of satisfaction of elderly individuals. Objectives of the thesis: To find out about subjective evaluation of life satisfaction of the elderly depending on their age To find out about subjective evaluation of life satisfaction of the elderly depending on their sex To find out about subjective evaluation of life satisfaction of the elderly depending on institution type Hypotheses: H1: Men are more satisfied than women H2: Satisfaction of the elderly decreases as they grow older H3: The most satisfied are the elderly who use the services of ADP Methods: The method of quantitative research was used in the practical part. For this purpose, the reduced SQUALA standardized questionnaire was used. It had been transferred to interview form due to the age of the target group of the elderly. The obtained data was processed with Microsoft Office Excel and some calculations were made with the Statistica programme. Answers from one hundred respondents were obtained as part of the survey; the respondents came from South Bohemia, particularly from the Český Krumlov and České Budějovice regions. Three types of health care institutions were contacted: a home care agency, retirement homes and hospital aftercare wards. Fifteen elderly persons were obtained for cooperation in the home care agency, 39 persons in retirement homes and 46 persons in hospitals. Results: The results of the survey show that satisfaction of the elderly is most affected by the type of health institution used, i.e. by the environment in which they are provided with health care. Definitely the most satisfied are the people who use the services of the home care agency. On the other hand, age or sex did not play a significant role when evaluating life satisfaction. Conclusion: The importance of this thesis may lie mostly in the opportunity to use the acquired knowledge, regarding the satisfaction of the elderly and the factors that influence this satisfaction, to improve the quality of care provided by nurses and other health staff.

Fundação Carlos Chagas Filho de Amparo a Pesquisa do Estado do Rio de Janeiro / O presente estudo investigou o perfil epidemiológico dos pacientes assistidos no Centro de Fisioterapia Domiciliar, no Rio de Janeiro. A amostra estudada foi composta por todos os pacientes atendidos no período de 1 de janeiro de 1999 a 1 de janeiro de 2009, totalizando 1.203 indivíduos de ambos os sexos. De acordo com a metodologia adotada, a estatística descritiva foi utilizada para atingir os objetivos do estudo. Os dados coletados nos prontuários dos sujeitos do estudo foram organizados nos seguintes itens: faixa de idade, sexo e bairros (área de moradia dos pacientes). Com relação às doenças crônicas, foram analisados: os diferentes tipos de doenças, o tempo da patologia ao iniciar o tratamento e o nível de dependência. Com relação ao tratamento domiciliar de fisioterapia, foram analisados: o tipo de tratamento aplicado, o objetivo do tratamento, o tempo de permanência no tratamento e o nível de melhora obtido pelos pacientes. A análise comparativa utilizou o teste Qui-quadrado de Pearson e o linear, para as tendências estudadas. Todos os cálculos foram efetuados usando o software estatístico SPSS 16.0. Os resultados mostraram que o perfil epidemiológico do paciente atendido no Centro de Fisioterapia Domiciliar, no Rio de Janeiro é: idoso, com idade média de 75,8 anos, do sexo feminino, com sequela de AVC, acometido até um ano atrás (do início do tratamento), está restrito ao leito, com dependência de terceiros para deambular. O perfil do tratamento de fisioterapia domiciliar utilizado é do tipo motor com o objetivo de treino de marcha e equilíbrio; o tempo de permanência no tratamento é em média de 5,8 meses, com o resultado de boa melhora, que corresponde à recuperação da metade ou mais dos objetivos propostos na avaliação inicial. Confirmou-se que existe associação da idade com o nível de dependência dos pacientes, e que quanto maior a idade, maior a frequência encontrada na restrição ao leito total. Concluiu-se que a fisioterapia domiciliar é uma assistência prevalentemente geriátrica, e que é viável a estruturação de um modelo de fisioterapia domiciliar mais inclusivo e gratuito, com uma provável rotatividade de vagas por alta, em torno de 17% ao mês. / This study investigated the epidemiological profile of patients attended at the Home-Based Physiotherapy Center in Rio de Janeiro. The study sample was made up of all the patients attended between January 1, 1999, and January 1, 2009, totaling 1,203 individuals of both sexes. In accordance with the methodology adopted, descriptive statistics were used to reach the study objectives. The data collected from the study subjects medical files were organized into the following categories: age group, sex and district (area where the patients lived). The following were analyzed in relation to chronic diseases: different types of chronic disease, duration of the pathological condition at the start of treatment and level of dependence. Regarding the home-based physiotherapy, the following were analyzed: type of treatment applied, treatment objective, duration of the treatment and degree of improvement attained by the patients. The comparative analysis used the Pearson chi-square test and the linear test on the study trends. All the calculations were made using the SPSS 16.0 statistical software. The results showed that the epidemiological profile of the patients attended at the Home-Based Physiotherapy Center in Rio de Janeiro was as follows: elderly, with a mean age of 75.8 years; female; presenting sequelae from a stroke that occurred up to one year before the start of treatment; bedridden; and dependent on third parties to walk around. The home-based physiotherapy treatment used had a profile of motor type, with the aim of gait and balance training. The mean duration of the treatment was 5.8 months, resulting in a good improvement that corresponded to achievement of half or more of the objectives proposed at the initial assessment. It was confirmed that there was an association between age and the patients level of dependence, and that the greater their age was, the more often a totally bedridden condition was found. It was concluded that the home-based physiotherapy was predominantly geriatric and that it was viable to structure a more inclusive and free-of-charge home-based physiotherapy model, with probable rotation of places according to discharge, of around 17% per month.

O propósito deste trabalho é investigar a pessoa e o papel do cuidador familiar de pessoa idosa como ser humano sujeito à necessidade de cuidado. Além disso, propõe-se ações de cuidado integral para o cuidador, tendo em vista mais qualidade de vida para si e para a pessoa por ele cuidada. Portanto, o primeiro capítulo apresenta, com o auxílio de teóricos da área geronto-geriátrica e com os resultados de uma pesquisa de campo, quem são os cuidadores familiares, quais são seus sentimentos e suas necessidades, bem como quais são os impactos da atividade de cuidar. O segundo capítulo desenvolve a compreensão dos conceitos cuidado e cuidar de si a partir da Teologia e da Filosofia. Também verifica o que a Bíblia diz sobre o cuidado, passando pela interpretação de alguns textos, em especial, o de Lc 10.25-37. Este exercício fornece elementos para uma prática em relação a pessoas que exercem e que carecem de cuidados. Assim, o terceiro capítulo, apresenta indicações de cuidado integral para o cuidador familiar, para que ele desenvolva a prática do cuidado de si, como também indica elementos de como a comunidade cristã pode cuidar do cuidador, buscando exercitar a proposta da Igreja do Cuidado. / The purpose of this paper is to investigate the role that caretakers of elderly people as a human being subject to the need of care. Also actions of care are suggested to the caretaker regarding more quality of life to himself/herself and to the person being taken care of. Therefore, the first chapter presents, with the help of theorists from the geriatric area and with the results of a Field research who the Family caretakers are what are their feelings and needs, as well as the impacts of the activity of caretaking. The second chapter develops the comprehension of concepts as care and self caring from Theology and Philosophy. Also examines what the Bible says about care going through the interpretation of some texts, especially of Lc 10.25-37. This activity offers elements to a practice in relation to people who give and need care. The third chapter presents indications of care to the Family caretaker, so that she/he develops the care towards herself/himself as well as it indicates elements of how a Christian community can take care of the caretaker by exercising the proposal of the Church of Care

Fundação Carlos Chagas Filho de Amparo a Pesquisa do Estado do Rio de Janeiro / O presente estudo investigou o perfil epidemiológico dos pacientes assistidos no Centro de Fisioterapia Domiciliar, no Rio de Janeiro. A amostra estudada foi composta por todos os pacientes atendidos no período de 1 de janeiro de 1999 a 1 de janeiro de 2009, totalizando 1.203 indivíduos de ambos os sexos. De acordo com a metodologia adotada, a estatística descritiva foi utilizada para atingir os objetivos do estudo. Os dados coletados nos prontuários dos sujeitos do estudo foram organizados nos seguintes itens: faixa de idade, sexo e bairros (área de moradia dos pacientes). Com relação às doenças crônicas, foram analisados: os diferentes tipos de doenças, o tempo da patologia ao iniciar o tratamento e o nível de dependência. Com relação ao tratamento domiciliar de fisioterapia, foram analisados: o tipo de tratamento aplicado, o objetivo do tratamento, o tempo de permanência no tratamento e o nível de melhora obtido pelos pacientes. A análise comparativa utilizou o teste Qui-quadrado de Pearson e o linear, para as tendências estudadas. Todos os cálculos foram efetuados usando o software estatístico SPSS 16.0. Os resultados mostraram que o perfil epidemiológico do paciente atendido no Centro de Fisioterapia Domiciliar, no Rio de Janeiro é: idoso, com idade média de 75,8 anos, do sexo feminino, com sequela de AVC, acometido até um ano atrás (do início do tratamento), está restrito ao leito, com dependência de terceiros para deambular. O perfil do tratamento de fisioterapia domiciliar utilizado é do tipo motor com o objetivo de treino de marcha e equilíbrio; o tempo de permanência no tratamento é em média de 5,8 meses, com o resultado de boa melhora, que corresponde à recuperação da metade ou mais dos objetivos propostos na avaliação inicial. Confirmou-se que existe associação da idade com o nível de dependência dos pacientes, e que quanto maior a idade, maior a frequência encontrada na restrição ao leito total. Concluiu-se que a fisioterapia domiciliar é uma assistência prevalentemente geriátrica, e que é viável a estruturação de um modelo de fisioterapia domiciliar mais inclusivo e gratuito, com uma provável rotatividade de vagas por alta, em torno de 17% ao mês. / This study investigated the epidemiological profile of patients attended at the Home-Based Physiotherapy Center in Rio de Janeiro. The study sample was made up of all the patients attended between January 1, 1999, and January 1, 2009, totaling 1,203 individuals of both sexes. In accordance with the methodology adopted, descriptive statistics were used to reach the study objectives. The data collected from the study subjects medical files were organized into the following categories: age group, sex and district (area where the patients lived). The following were analyzed in relation to chronic diseases: different types of chronic disease, duration of the pathological condition at the start of treatment and level of dependence. Regarding the home-based physiotherapy, the following were analyzed: type of treatment applied, treatment objective, duration of the treatment and degree of improvement attained by the patients. The comparative analysis used the Pearson chi-square test and the linear test on the study trends. All the calculations were made using the SPSS 16.0 statistical software. The results showed that the epidemiological profile of the patients attended at the Home-Based Physiotherapy Center in Rio de Janeiro was as follows: elderly, with a mean age of 75.8 years; female; presenting sequelae from a stroke that occurred up to one year before the start of treatment; bedridden; and dependent on third parties to walk around. The home-based physiotherapy treatment used had a profile of motor type, with the aim of gait and balance training. The mean duration of the treatment was 5.8 months, resulting in a good improvement that corresponded to achievement of half or more of the objectives proposed at the initial assessment. It was confirmed that there was an association between age and the patients level of dependence, and that the greater their age was, the more often a totally bedridden condition was found. It was concluded that the home-based physiotherapy was predominantly geriatric and that it was viable to structure a more inclusive and free-of-charge home-based physiotherapy model, with probable rotation of places according to discharge, of around 17% per month.

Please read the abstract in the section 00front of this document / Dissertation (MA (Social Work))--University of Pretoria, 2006. / Social Work and Criminology / Unrestricted

Mon poste de psychologue clinicienne au sein d’une maison de retraite m’a sensibilisée à la souffrance psychique des aides-soignantes. A partir de l’écoute des aides-soignantes dans le cadre de ma mission de support technique à l’équipe, émerge la plainte récurrente d’un déficit égotiste de désinvestissement émotionnel et affectif et la non reconnaissance de la pénibilité de leur tâche, qui me conduit à poser l’hypothèse d’un burn out. La recherche porte donc sur le Syndrome d’Épuisement Professionnel. Elle étudie les relations complexes entre le personnel médico-social aides-soignantes et la cadre de santé, et entre la personne âgée et sa fille. Un questionnaire clinique a fait ressortir l’ampleur du ressenti subjectif d’être épuisé. L’échelle standardisée MSP de Louise Lemyre, celle du ressenti subjectif d’être stressé. Le stress étant convoqué dans la position conceptuelle théorique retenue du Syndrome d’Épuisement Professionnel.L’analyse de ces deux ressentis a révélé les rapports complexes entre soignante–soignée et la cadre et entre fille–mère et grand-mère. C’est ainsi que l’enjeu narcissique du personnel fait ressurgir les origines archaïques de la sexualité infantile dans le lien intime au corps. En même temps, à cause d’une féminisation généralisée de la profession, la spécificité de la fonction du Féminin Psychique s’impose.Cette recherche souhaite apporter, grâce à ce Féminin Psychique, un éclairage autre sur la position intermédiaire de la Cadre. Le statut de bonne ou mauvaise mère que les aides-soignantes lui reconnaissent, aggrave ou diminue le Syndrome d’Épuisement Professionnel et le stress. Enfin, cette recherche insiste une nouvelle fois sur la nécessité impérieuse de la formation permanente institutionnelle et du travail d’élaboration psychique de ces personnels et ce, à périodicités constantes. / As a psychologist in an EHPAD (a regulated home for dependent seniors), I became very much aware of the auxiliary nurses’ psychological sufferings. Listening to them during my team-supporting mission, I heard a recurring complaint emerge, that of an egotistical deficit of emotional and affective disinvestment and of a lack of recognition of the painfulness of their task. This has led me to hypothesize professional exhaustion. The research in this thesis therefore focuses on the burn out syndrome. It studies the complex relations between the auxiliary nurses as medico-social staff and the health manager in charge as well as between the elderly person and his/her daughter.A clinical questionnaire highlighted the depth of the subjective feeling of exhaustion while Louise Lemyre’s standardized scale highlighted the depth of the subjective feeling of stress, an operational notion in the theoretical concept of burn out.The analysis of both feelings revealed the complex relations between patient-auxiliary nurse and manager as well as between daughter-mother and grandmother. The narcissism at stake with the staff reactivates the archaic origins if child sexuality in the nursing place. A t the same time, because of the general feminization of the profession, the specificity of the feminine psyche is of foremost importance.Thanks to this notion, the research paper aims to shed a different light on the intermediary position of the manager. The status of good or bad mother figure that auxiliary nurses grant her worsens or lessens the burn out and stress.Last, this research paper further insists on the absolute necessity of permanent institutional training and of psychic elaborative work for the staff at regular intervals.