Vad händer när en äldre person vill sälja bostaden och flytta till något som är lättare skött? Finns det möjligheter för äldre människor att bo kvar på landsbygden i samma by som innan? Vilka möjligheter finns för äldre personer som vill flytta till en mindre bostad? Kan ett koncept tas fram just för detta uppdrag? Detta examensarbete behandlar problematiken kring hur äldre personer står inför en utmaning att komma till ett enklare boende som är mer anpassat för den äldre i funktions- ochunderhållssyfte. Examensarbetet bygger på ett pågående projekt som äger plats i Norr Amsberg, en liten by tre kilometer norr om Borlänge.Detta examensarbete bygger på en kvalitativ metod då inga beräkningar skall utföras. Faktaunderlag för denna studie kommer från intervjuer, forskningsartiklar och statistik.Sex intervjupersoner har intervjuats under detta arbete, två forskare som finns stationerade i Falun, tre äldre personer som har passerat sextiofem år och slutligen eldsjälen som startat igång projektet gällande seniorbostäder i Norr Amsberg. Detta ger en bred grund att stå på för att dra de slutsatser som har upprättats i rapporten.Ett koncepthus har att ritats fram under tidensgång där hänsyn har tagits till de intervjuades önskemål som utseende, funktionskrav och platsplacering. Huset uppfyller allatillgänglighetskrav som en modern bostad innehåller. Byggnaden som tas fram är ett koncept och inte den färdiga produkten.Viktiga slutsatser som har framkommit under denna studie är hur viktigt boendets utformning är och hur den påverkar äldre betydligt mer än vad man allmänt tror och att behovet kommer öka markant gällande anpassade boenden i framtiden. Vikten av boendets utformning och hur den påverkar äldre är några stora nyckelfaktorer som samtliga kommuner lär ta till sig när planering av en typ av ”mellan boende” för äldre ska tas fram. / What happens when an elderly person wants to sell the property and move on to somethingthat is easier to handle? Are there opportunities for older people to live in the same city asbefore? What opportunities are there for elderly people who want to move to a smallerresidence? Can a concept be drawn up just for this assignment?This degree project will address the problem of how elderly people face a challenge to get toa simpler accommodation that is more suited to the elderly for functional and maintenancepurposes. The thesis is based on an ongoing project that takes place in Norr Amsberg, a smalltown three kilometer north of Borlänge.In this degree project, a qualitative method will be used which means no calculations isneeded. Thus, facts will be gathered from interviews, research articles and statistics.Six people have been interviewed during this project. Those who have been interviewed aretwo scientists who are stationed in Falun, three older people who have passed sixty-five yearsof ages and finally the enthusiast who started whole project in Norr Amsberg. This provides abroad ground for the conclusions drawn in the report.A concept house has been drawn up during this time, taking account of the wishes of theinterviewees as appearance, functional requirements and location. The house has allaccessibility requirements that a modern home will have. The building that is produced is aconcept and not the finished product.Important conclusions that have been made during this study are how important the housingdesign is and how it affects the elderly significantly more than is generally believed and thatthe need will increase significantly in terms of custom housing in the future. The importanceof housing design and how it affects older people are some major key factors that allmunicipalities learn to address when planning a type of "senior housing" for elderly people.

Bakgrund: Sjukvården står inför utmaningar då andelen äldre personer i befolkningen ökar och det är därför av största vikt att främja hälsosamt åldrande. Distriktssköterskan spelar en viktig roll i det hälsofrämjande och sjukdomsförebyggande arbetet då många sjukdomar kan förebyggas genom hälsosamma levnadsvanor. Riktade hälsosamtal är en metod för att främja hälsa och friskt åldrande. Motiverande samtal användes som teoretisk förankring i arbetet.    Syfte: Studiens syfte var att undersöka distriktssköterskors erfarenheter och upplevelser av hälsosamtal med 70-åringar i primärvården. Metod: Kvalitativ metod med semistrukturerade intervjuer användes. Tre fokusgruppsintervjuer genomfördes med totalt 14 deltagare. Manifest innehållsanalys genomfördes enligt Graneheim och Lundman med induktiv ansats. Resultat: Distriktssköterskorna erfor att hälsosamtalet underlättades av specifika verktyg då hälsokurvan gav ökad medvetenhet om hälsorisker och förutbestämd samtalsteknik var fördelaktigt för samtalet. Det framkom utmaningar med hälsosamtalets genomförande på grund av motstånd, språk och åldersrelaterade faktorer. Organisatoriska förutsättningar i form av tillräckligt med tid, stöd och samverkan var nödvändiga för hälsosamtalets genomförande. Slutsats: Hälsosamtal med 70-åringar har god potential för upptäckt och förebyggande av hjärt- och kärlsjukdom och diabetes typ 2. Metoden behöver anpassas för åldersgruppen och organisatoriska förutsättningar är betydande för att hälsosamtalet ska ge ändamålsenlig effekt. Hälsosamtal med 70-åringar är ett sätt att använda resurser effektivt för att säkerställa hållbar hälso- och sjukvård. / Background: Healthcare faces challenges with the growing elderly population, necessitating a focus on promoting healthy aging. District nurses play a significant role in health promotion and disease prevention. Targeted health dialogues are a method for promoting health and healthy aging. Motivational interviewing was used as the theoretical framework in the study.   Aim: The aim of the study was to investigate district nurses' experiences of health dialogues with 70-year-olds in primary care. Method: A qualitative method with semi-structured interviews was utilized. Three focus group interviews were conducted involving a total of 14 participants. Content analysis was performed according to Graneheim and Lundman with an inductive approach. Results: District nurses experienced that the health dialogues were facilitated by specific tools, the health curve increased awareness of health risks and a predetermined conversational technique was beneficial for the conversation. Challenges arose due to resistance, language and age-related factors. Organizational conditions such as sufficient time, support and cooperation were necessary for the implementation of health dialogues. Conclusion: Health dialogues with 70-year-olds have potential for detection and prevention of cardiovascular disease and type 2 diabetes. The method needs to be adapted for the age group, and organizational conditions are necessary. Health dialogues with 70-year-olds are a way to use resources efficiently to ensure sustainable healthcare.

O Wisconsin Card Sorting Test (WCST), instrumento psicológico freqüentemente utilizado em processos de avaliação neuropsicológica, examina as funções executivas: planejamento, flexibilidade do pensamento, memória de trabalho, monitoração e inibição de perseverações. Destacou-se na literatura internacional na última década, sobretudo em pesquisas aplicadas na clínica neurológica, psiquiátrica e psicológica. Dentro deste contexto, o presente estudo objetivou desenvolver normas avaliativas para adultos da região de Ribeirão Preto (SP) e verificar a validade do WCST no contexto brasileiro. Foram avaliados dois conjuntos de voluntários: um grupo estratificado e representativo de universitários de Ribeirão Preto (SP), composto por 223 estudantes de 23 cursos de ensino superior, de 18 a 30 anos, com boa saúde geral e nível intelectual mediano ou superior. O segundo grupo foi composto por dois subgrupos de idosos: o primeiro com 36 pacientes, em fase inicial da Doença de Alzheimer (DA), de Ribeirão Preto (SP) e, o segundo, com 50 idosos saudáveis da região de Porto Alegre (RS). Todos foram avaliados individualmente pela forma impressa do WCST. Inicialmente foram elaborados referenciais normativos do teste para universitários do contexto sócio-cultural da região de Ribeirão Preto (SP). Comparando-se o desempenho no WCST dos universitários brasileiros com amostra equivalente americana, por meio do Teste t de Student (p 0,05), observou-se desempenho inferior nos estudantes de Ribeirão Preto. As especificidades de desempenho entre estas amostras sugerem interação de fatores sócio-culturais nas habilidades executivas, variável que não pode ser desprezada na interpretação dos resultados. A seguir, examinou-se a validade do WCST, por meio de Análise dos Componentes Principais, no grupo de 223 universitários. Estes resultados foram comparados à estrutura fatorial originalmente descrita com universitários americanos, encontrando-se estruturas e cargas fatoriais dos componentes do teste virtualmente idênticas, confirmando sua validade de construto. Desta forma, o WCST demonstrou estabilidade em sua estrutura interna e em sua capacidade de acessar as funções executivas, de forma segura, também no contexto sócio-cultural brasileiro. Na seqüência das análises, elaborou-se tabela preliminar do desempenho típico no WCST de idosos com DA, permitindo identificar sua condição de maior ou menor prejuízo cognitivo em relação a este grupo de referência. A seguir foi realizada análise comparativa dos desempenhos no WCST dos idosos saudáveis e com DA (validade discriminante). Foi realizada análise multivariada (MANOVA) dos resultados destas duas amostras, encontrando-se diferenças significativas entre eles (valor de Lambda de Wilks = 0,594, F = 3,460, p < 0,001), indicando validade discriminativa do WCST na realidade brasileira. Ultrapassando os objetivos iniciais, foram realizadas análises qualitativas das respostas dos universitários ao WCST, buscando-se identificar possíveis razões de fracasso no teste (não concluir as seis categorias classificatórias) em pessoas com elevado potencial cognitivo. A partir desta análise foram identificados diferentes processos arbitrários de raciocínio e de falhas no funcionamento da atenção em adultos, confirmando evidências da literatura acerca da complexidade das funções executivas, exigindo avaliação qualitativa e ecologicamente orientada para complementar as informações quantitativas do WCST, de modo a subsidiar adequadas hipóteses interpretativas de seus resultados. / The Wisconsin Card Sorting Test (WCST) is a psychological instrument used in neupsychological assessment which examines executive functions: planning, thought flexibility, work memory, monitoring and perseveration inhibiting. This instrument has stood out the last decade, especially in studies on applied, clinical neurology, psychiatry and psychology. Within this context, the present study aimed to develop assessment norms for the WCST in adults from the region of Ribeirão Preto (SP), and verify its validity in the brazilian culture. Two sets of volunteers were assessed: a stratified and representative group of college students from Ribeirão Preto (SP), composed of 223 18-30 years-old, average/superior intellectual-level participants with good health from 23 different graduation courses. The second group comprised two subsets of elderly persons, the first one with 36 patients from Ribeirão Preto (SP) in the initial stage of Alzheimer\'s Disease (AD), and the second subset with 50 healthy, elderly participants from Porto Alegre (RS). All participants were individually assessed using the printed version of the WCST. Initially, normative references were designed for college students from the sociocultural context of Ribeirão Preto region. Comparisons between Brazilian college students and a similar north-American sample using Student\'s t-test (p 0,05) show inferior performance in the Brazilian sample, suggesting the interaction of sociocultural factors in executive functions, which is a variable that cannot be excluded in the interpretation of the results. After this, the validity of the WSCT was assessed in the college students? sample through Principal Component Analysis. These results were compared to the original factorial structure described within the north-American sample, showing virtually identical factorial structures and loads for the components of the test, thus confirming its construct validity. This way, the WCST showed stability in its internal structure, as well as for the ability to safely assess executive functions in the brazilian sociocultural context. In the following analyses, a preliminary table of the AD subset?s typical performance in the WSCT was designed, allowing the identification of bigger or smaller cognitive impairment compared to this reference group. After this, a comparative analysis was performed between the performances of the two subsets of elderly participants (discriminative analysis). A Multivariate Analysis (MANOVA) of those two samples showed significant differences between them (Wilks? Lambda-value = 0,594, F = 3,460, p < 0,001), indicating WCST discriminative validity for the brazilian reality. The initial aims of this study were overcome by performing qualitative analyses of the college students group?s WCST responding, in order to identify possible reasons for test failure (not completing the six classificatory categories) in persons with high cognitive potential. These analyses show different arbitrary processes of thought, as well as attention functioning failures in adults. These results confirm the evidences from the literature about executive functions complexity, which requires qualitative, ecologically-oriented analysis for complementing WCST quantitative information, in order to subsidize adequate interpretative hypotheses of its results.

Dans ce manuscrit, nous proposons un système d'analyse automatique des mouvements 3D entemps réel permettant l'évaluation des capacités fonctionnelles chez les personnes âgées àdomicile. Dans un premier temps, l'objectif est de contribuer à maintenir l'indépendancefonctionnelle de cette population et permettre une détection précoce d'une décompensationmotrice pour faciliter une démarche de rééducation. Pour quantifier la qualité d'équilibre d'unsujet en temps réel, nous avons conçu un système en utilisant le capteur Kinect et permettantd'analyser un test clinique simple et validé en rééducation gériatrique: le Timed Up and Go (TUG).Trois expériences, réalisées dans des environnements hétérogènes (laboratoire, hôpital de jouret domicile) ont montré une bonne fiabilité de la mesure des paramètres identifiés. Ellespermettent notamment d'attribuer une note de contrôle moteur indiquant la fragilité motrice.Dans un second temps, nous avons proposé une chaîne de traitement vidéo permettantd'augmenter la robustesse d'analyse de différentes phases du TUG : détection automatique de laposition assise, segmentation du patient et extraction de 3 articulations du corps. Les résultats deces travaux nous permettent d'envisager plusieurs perspectives. Tout d'abord, nous pensonseffectuer des expérimentations sur une population plus large afin de confirmer la fiabilité dusystème. Puis, différentes améliorations techniques et ergonomiques seraient nécessaires pourfaciliter l'utilisation grand public. Enfin, il serait intéressant d'étendre la méthodologie proposéepour d'autres tests cliniques en vue de prolonger l'autonomie à domicile. / We propose in this manuscript a realtime3D movement analysis system for inhomefunctionalabilities assessment in aged adults. As a first step, the purpose is to maintain the functionalindependence of this population and to allow an earlier detection of a motor decompensation inorder to facilitate a rehabilitation process. To quantify the equilibrium quality of a subject, webuilt a system using the Kinect sensor in order to analyze a simple clinical test validated in geriatricrehabilitation: the Timed Up and Go (TUG). Three experiments conducted in heterogeneousenvironments (laboratory, day hospital and home) showed good measurement reliability of theidentified parameters. In particular, they allow to assign a motor control note indicating themotor frailty. Then, we proposed a video processing chain to increase the robustness of theanalysis of the various TUG phases: automatic detection of the sitting posture, patientsegmentation and three body joints extraction. The results of this work allow us to considerseveral perspectives. First, we believe conduct experiments on a larger population in order toconfirm the system reliability. Then, various technical and ergonomic improvements would benecessary to facilitate general public use. Finally, it would be interesting to extend the proposedmethodology for other clinical test to prolong the autonomy at home.

O Wisconsin Card Sorting Test (WCST), instrumento psicológico freqüentemente utilizado em processos de avaliação neuropsicológica, examina as funções executivas: planejamento, flexibilidade do pensamento, memória de trabalho, monitoração e inibição de perseverações. Destacou-se na literatura internacional na última década, sobretudo em pesquisas aplicadas na clínica neurológica, psiquiátrica e psicológica. Dentro deste contexto, o presente estudo objetivou desenvolver normas avaliativas para adultos da região de Ribeirão Preto (SP) e verificar a validade do WCST no contexto brasileiro. Foram avaliados dois conjuntos de voluntários: um grupo estratificado e representativo de universitários de Ribeirão Preto (SP), composto por 223 estudantes de 23 cursos de ensino superior, de 18 a 30 anos, com boa saúde geral e nível intelectual mediano ou superior. O segundo grupo foi composto por dois subgrupos de idosos: o primeiro com 36 pacientes, em fase inicial da Doença de Alzheimer (DA), de Ribeirão Preto (SP) e, o segundo, com 50 idosos saudáveis da região de Porto Alegre (RS). Todos foram avaliados individualmente pela forma impressa do WCST. Inicialmente foram elaborados referenciais normativos do teste para universitários do contexto sócio-cultural da região de Ribeirão Preto (SP). Comparando-se o desempenho no WCST dos universitários brasileiros com amostra equivalente americana, por meio do Teste t de Student (p 0,05), observou-se desempenho inferior nos estudantes de Ribeirão Preto. As especificidades de desempenho entre estas amostras sugerem interação de fatores sócio-culturais nas habilidades executivas, variável que não pode ser desprezada na interpretação dos resultados. A seguir, examinou-se a validade do WCST, por meio de Análise dos Componentes Principais, no grupo de 223 universitários. Estes resultados foram comparados à estrutura fatorial originalmente descrita com universitários americanos, encontrando-se estruturas e cargas fatoriais dos componentes do teste virtualmente idênticas, confirmando sua validade de construto. Desta forma, o WCST demonstrou estabilidade em sua estrutura interna e em sua capacidade de acessar as funções executivas, de forma segura, também no contexto sócio-cultural brasileiro. Na seqüência das análises, elaborou-se tabela preliminar do desempenho típico no WCST de idosos com DA, permitindo identificar sua condição de maior ou menor prejuízo cognitivo em relação a este grupo de referência. A seguir foi realizada análise comparativa dos desempenhos no WCST dos idosos saudáveis e com DA (validade discriminante). Foi realizada análise multivariada (MANOVA) dos resultados destas duas amostras, encontrando-se diferenças significativas entre eles (valor de Lambda de Wilks = 0,594, F = 3,460, p < 0,001), indicando validade discriminativa do WCST na realidade brasileira. Ultrapassando os objetivos iniciais, foram realizadas análises qualitativas das respostas dos universitários ao WCST, buscando-se identificar possíveis razões de fracasso no teste (não concluir as seis categorias classificatórias) em pessoas com elevado potencial cognitivo. A partir desta análise foram identificados diferentes processos arbitrários de raciocínio e de falhas no funcionamento da atenção em adultos, confirmando evidências da literatura acerca da complexidade das funções executivas, exigindo avaliação qualitativa e ecologicamente orientada para complementar as informações quantitativas do WCST, de modo a subsidiar adequadas hipóteses interpretativas de seus resultados. / The Wisconsin Card Sorting Test (WCST) is a psychological instrument used in neupsychological assessment which examines executive functions: planning, thought flexibility, work memory, monitoring and perseveration inhibiting. This instrument has stood out the last decade, especially in studies on applied, clinical neurology, psychiatry and psychology. Within this context, the present study aimed to develop assessment norms for the WCST in adults from the region of Ribeirão Preto (SP), and verify its validity in the brazilian culture. Two sets of volunteers were assessed: a stratified and representative group of college students from Ribeirão Preto (SP), composed of 223 18-30 years-old, average/superior intellectual-level participants with good health from 23 different graduation courses. The second group comprised two subsets of elderly persons, the first one with 36 patients from Ribeirão Preto (SP) in the initial stage of Alzheimer\'s Disease (AD), and the second subset with 50 healthy, elderly participants from Porto Alegre (RS). All participants were individually assessed using the printed version of the WCST. Initially, normative references were designed for college students from the sociocultural context of Ribeirão Preto region. Comparisons between Brazilian college students and a similar north-American sample using Student\'s t-test (p 0,05) show inferior performance in the Brazilian sample, suggesting the interaction of sociocultural factors in executive functions, which is a variable that cannot be excluded in the interpretation of the results. After this, the validity of the WSCT was assessed in the college students? sample through Principal Component Analysis. These results were compared to the original factorial structure described within the north-American sample, showing virtually identical factorial structures and loads for the components of the test, thus confirming its construct validity. This way, the WCST showed stability in its internal structure, as well as for the ability to safely assess executive functions in the brazilian sociocultural context. In the following analyses, a preliminary table of the AD subset?s typical performance in the WSCT was designed, allowing the identification of bigger or smaller cognitive impairment compared to this reference group. After this, a comparative analysis was performed between the performances of the two subsets of elderly participants (discriminative analysis). A Multivariate Analysis (MANOVA) of those two samples showed significant differences between them (Wilks? Lambda-value = 0,594, F = 3,460, p < 0,001), indicating WCST discriminative validity for the brazilian reality. The initial aims of this study were overcome by performing qualitative analyses of the college students group?s WCST responding, in order to identify possible reasons for test failure (not completing the six classificatory categories) in persons with high cognitive potential. These analyses show different arbitrary processes of thought, as well as attention functioning failures in adults. These results confirm the evidences from the literature about executive functions complexity, which requires qualitative, ecologically-oriented analysis for complementing WCST quantitative information, in order to subsidize adequate interpretative hypotheses of its results.

Se trataba de explorar la realidad de las personas mayores, recoger sus opiniones, actitudes, vivencias y valoraciones sobre su participación social, desde los parámetros que ofrece la educación social, alejados del asistencialismo. La metodología utilizada es cualitativa, a través de entrevistas semiestructuradas a los mayores. Pretendiendo una utilidad práctica de la investigación desde el trabajo de los educadores sociales. Todo ello enmarcado en las grandes transformaciones que este colectivo está experimentando en nuestra sociedad, tanto cuantitativa como cualitativamente, y del que sin duda, acontecerá en las próximas décadas. Se pretende desmontar falsos estereotipos tradicionales acerca de los mayores, contemplando esta etapa como una más en la vida de los individuos, con sus potencialidades, concibiendo la educación como la gran posibilitadora para una óptima integración social y realización personal. Terminamos presentando unas conclusiones que sintetizan l a labor realizada a la vez que formula unas orientaciones para el trabajo socioeducativo con los mayores. / We tried to explore the reality of older people, gather opinions, attitudes, experiences and evaluations of their social participation, since the parameters offered by social education, away from welfarism.The methodology that have been used is qualitative, through semi-structured interviews for the eldery. Pretending a practical uses of research from the work of social educators. All of this in the great changes that this group is experiencing in our society, both quantitatively and qualitatively, and which undoubtedly will happen in the coming decades.The aim is to remove false stereotypes about the elderly, contemplating this stage as one more in the lives of individuals, with their potential, conceiving education as the great enabler for social integration and optimal personal development.Ending with some conclusions that summarize the work done while formula guidelines for social educational work with adults.