The accessibility, predictors, and use of health care and social services among developmentally disabled elderly adults in Canada were examined using a nationally representative social survey. The first research hypothesis is that the independent variables will contribute significantly to the prediction of the dependent variables. A second hypothesis is that the slope of any given independent variable will not equal zero. The results of this research show that the illness (need) variables are the most predictive correlate of the utilization of health care and social services. The predisposing variables have secondary explanatory power, with the enabling variables accounting for the least amount of variance. The hypotheses were tested by step-wise multiple regression analysis using SPSS-X.

Submitted in fulfillment of the requirements of the Degree of Master of Technology: Food and Nutrition Consumer Science, Durban University of Technology, 2011. / Background: South Africa, a richly diverse developing country has been faced by the consequences of transition attributed to urbanisation and acculturation. A Westernised lifestyle has, therefore, resulted in increasing disease patterns that are characterized by a combination of poverty-related diseases together with the emerging chronic diseases. The shift to a Westernised lifestyle has resulted to a shift in the composition of dietary staples leading to dietary factors related to an increase in lifestyle diseases. These include a high fat, low fibre diet, as well as an inadequate intake of fruits and vegetables. However, this in turn has led to higher energy intakes with insufficient and imbalanced micronutrient intake. Research conducted amongst the elderly in South Africa has clearly indicated that the elderly live within a limited financial budget leading to extreme levels of food insecurity and the social burden of being the head of the household, in addition to being the caregiver to grandchildren and sick children. Due to the current living status the elderly encounter reduced food intake in addition to a reduced variety in their diet, therefore, micronutrient deficiencies are common amongst this age group. Therefore, a consumption of energy-dense foods, particularly staple foods, to stretch the food budget which are more affordable and thus allow for an increased consumption is evident. Aim: To determine the socio-demographic profile, health and nutritional status in relation to the dietary intake patterns to reflect malnutrition among free living elderly (60yrs+) in Verulam. Methodology: Fifty nine randomly selected men and 191 women aged 60+ participated on a voluntary basis in this study. A descriptive survey method was used for this cross sectional study. Trained fieldworkers assisted with the administration of all questionnaires and a registered nurse measured blood pressure. Socio-demographic questionnaires were administered to determine the socio-economic characteristics of the elderly within this community. Anthropometric measurements determined the Body Mass Index according to the World Health Organisation and Asian cut-off points to indentify the risk factors. The Health questionnaire identified the health status correlated to the respondent’s profundity of disease and deficiencies associated to dietary patterns. Blood pressure measurements were taken to determine the hypertension prevalence related to the dietary intake. Two 24-Hour Recall questionnaires were completed by the 250 respondents to identify actual vii food intake and measured against the Dietary Recommended Intake (DRIs). A food frequency questionnaire (FFQ) determined the respondent’s food variety score over a period of one week. The socio-demographic questionnaire, health questionnaire, food frequency questionnaire and anthropometric measurements were captured on an Excel® spread sheet by the researcher and analyzed for descriptive statistics using the Statistical Package for the Social Sciences (SPSS) version 17.0 with the assistance of a statistician. The 24-Hour Recall data were captured and analyzed by a nutrition professional using the MRC Food Finder® version 3.0 software, based on the South African Food Composition tables. Results: The majority of the respondent’s role in the family was mothers (70.8%) and lived in an urban area (68.8%). In addition, 73.2 percent (n=183) of the respondents shared the house with one to five people, and lived in a brick house (74.4%, n=186) with more than 3 rooms (74.0%, n=185). The elderly in this sample were pensioners and, therefore, 76.0 percent (n=190) received state grants of which the total household income ranged between R1001-R1500 (35.2%, n=88). Food insecurity is prevalent as reported by 28.4 percent. Primary school was the highest level of education completed by 52.4 percent (n=131) and English is the most spoken language amongst this group (74.0%, n=185). Women had higher BMI values particularly in the overweight (18.32%, n=35) and obese I and II (58.6%, n=112) categories when compared with men. Blood pressure measurements indicated that 60.0 percent (n=150) of the respondents suffered from hypertension. The use of chronic medication was reported by 84.4 percent (n=212). The total range of individual food items consumed by an individual during the seven-day data collection period measured by the (FFQ) was between 4-66 foods. However, the highest consumption was four food items by 23.2 percent (n=58) of the respondents. The summary of the food variety within food groups indicated a high dietary diversity, of which the other vegetable group reported the highest individual mean FVS (±SD) of 10.86 (±5.82), followed by other fruit, cereal, flesh and Vitamin A rich groups with 5.73 (±4.41), 5.03 (±1.85), 4.08 (±2.23) and 2.43 (±1.09) respectively. The nutrient analysis indicated a deficient intake by both men and women of all the nutrients, except for the mean (±SD) total protein in the women 45.10 (±12.55) and carbohydrate 212.83 (±36.97) in the men. The energy contribution indicated 98.3 percent (n=58) men and 85.72 percent (n=158) women consumed <100 percent of the EER for viii energy. However, the findings from the Top 20 food items measured by the 24-Hour Recall indicated that this community’s diet is largely carbohydrate-based, containing primarily starchy staple foods, sufficient intake of animal products, and insufficient intakes of dairy foods, fruit and vegetables, possibly resulting in the micronutrient deficiencies. The energy distribution of the macronutrients from the average of both 24-Hour Recalls indicates that both men and women are in range of 15-30 percent total fat intake, 10-15 percent protein and 55-75 percent carbohydrate. Conclusion: The results of the study reflect that the elderly in this community are faced with poverty, food insecurity as well as social factors thus contributing to a compromised nutritional status. The progression of malnutrition in particular overnutrition is experienced by the majority of the respondents in this study, however, an increased BMI and the prevalence of hypertension is a risk marker for noncommunicable diseases. However, the high prevalence of inadequate food and nutrient intake amongst elderly discloses the need for nutrition interventions and should be aimed at modifying the elderly food choices when purchasing food, healthier food preparation methods, increasing fruit and vegetable portions and improving daily physical activity to attain a better quality of life. / DUT Postgraduate Development and Support Directorate (PGD)

No description available.

Thesis (MA)--Stellenbosch University, 2003 / ENGLISH ABSTRACT: Ageing is a fact of life. It often gives rise to unfortunate consequences. Physical infirmities; senile dementia; emotional disturbance. Indeed, the effects of the ageing process can be such as to render a person incapable of performing the ordinary and normal functions of life. In such a case, institutionalisation presents itself as a prospect to enable an aged person to cope with the ordinary day-to-day activities of living. The purpose of institutionalisation is to improve the quality of life of the elderly. In considering the process, a number of important facets need to be borne in mind. Firstly, the process must be seen in relation to the condition of the person being institutionalised. Secondly, the process must be seen as a matter of extraordinary change in the life of the aged person. This implies a detailed explanation and full disclosure of the process envisaged, and, if needs be, appropriate counselling of the person concerned. Thirdly, there must be sympathetic and sensitive assistance given to the aged person in adapting to a new situation. Fourthly, a continuing and intimate interest in, and concern for, the aged person on the part of the family must be accentuated and impressed. This gives rise to the importance of visitation on the part of the family. Its meaning and purpose must be understood. The need for meaningful visitation must be stressed, and the status of a respected member of the family must be emphasised. The aged person must never be cut-off, separated or neglected. Visits must not be a coincidental, haphazard and aimless occurrence. Visitation must always be directed at improving the quality of life of the aged person. The aged person, despite her advanced years and debilitated condition, remains a person with thoughts, feelings, emotions, difficulties and problems. She needs time and attention. The normal or regular pattern of visitation does not, by and large, accomplish these ends. Something more is required. Specialised visitation. This is something different from ordinary, normal, social visitation. It is more intense, more concentrated and more regular. It embodies consistent and continuous contract. It is directed at effectiveness. It is never haphazard or aimless and always has as its objective an improved quality of life for the aged. The specialised visitor and the resident come to know each other well; they come to trust each other, and they come to realise that the object of the visit is more than an exchange of frivolities. Specialised visitation manifests a concern for the aged; it offers them support, stability, certainty and security. This is so because the specialised visitor responds to an inner conviction, an infinite calling, and an earnest urging. It is not a task but a vocation. Many factors contribute to the enhancement of the quality of life of the elderly : three may be mentioned. Institutionalisation, visitation and the role undertaken by the specialised visitor. / AFRIKAANSE OPSOMMING: Veroudering is 'n gegewe feit wat dikwels tot ongelukkige toestande soos fisiese swakhede, seniliteit en emosionele versteuring lei. Die gevolge van veroudering kan inderdaad 'n persoon verhinder om die alledaagse en normale funksies van lewe uit te voer. In sulke gevalle bied institusionalisering die moontlikheid dat 'n bejaarde persoon wel kan handel met die gewone dag-tot-dag aktiwiteite van die lewe. Die doel van institusionalisering is die verbetering van die kwaliteit van lewe van die bejaarde. In die beskouing van hierdie proses moet 'n aantal fasette in aanmerking geneem word. Eerstens, moet die proses in verhouding tot die toestand waarm die persoon wat geïnstitusionaliseeer word verkeer, gesien word. Tweedens, die proses verteenwoordig 'n buitengewone verandering in die lewe van die bejaarde persoon. Om dit te vergemaklik moet 'n gedetaileerde verduideliking en volle openbaarmaking van die proses wat voorlê aan die persoon gegee word en, indien nodig, toepaslike berading aan die persoon verskaf word. Derdens, die persoon moet simpatieke en sensitiewe bystand in die proses van aanpassing tot die nuwe situasie verleen word. Vierdens,die gesin van die persoon moet baie duidelik onder die indruk gebring word van die belang van voortgesette en intieme belangstelling in die persoon deur hulself Hierdie aspek bring die belangrikheid van besoek deur die gesin na vore. Die betekenis en doel van besoek moet deeglik verstaan word. Die behoefte van betekenisvolle besoek moet benadruk word en die status van die persoon as gerespekteerde lid van die gesin beklemtoon word. Die bejaarde mag nooit afgesny, afgesonder of verwaarloos word nie. Besoeke mag nie toevallig, planloos en doelloos geskied nie. Besoeke moet altyd gerig wees op die verbetering van die kwaliteit van die lewe van die bejaarde. Ten spyte van haar gevorderde jare en afgetakelde toestand bly die bejaarde persoon iemand met eie denke, gevoelens, emosies, moeilikhede en probleme. Sy benodig tyd en aandag. Die gewone of gereelde patroon van besoek bereik oor die algemeen nie hierdie doeleindes nie. Iets meer word vereis, naamlik gespesialiseerde besoek. Dit is duidelik verskillend van die gewone, normale sosiale besoek. Dit is meer intensief, meer gekonsentreerd en meer gereeld. Dit beliggaam bestendige en deurlopende kontak. Dit is gerig op doelbereiking. Dit is nooit planloos of doelloos nie en het altyd as oogmerk om die kwaliteit van lewe van die bejaarde te verbeter. Die gespesialiseerde besoeker en die inwoner leer mekaar goed ken sodat hulle mekaar vertrou, en besef dat die oogmerk van die besoeke meer behels as 'n uitruil van beuselagtighede. Gespesialiseerde besoek druk 'n besorgdheid VIT die bejaarde uit. Dit gee aan hulle ondersteuning, stabiliteit, sekerheid en sekuriteit. Dit is so omdat die gespesialiseerde besoeker vanuit 'n innerlike oortuiging, 'n onbegrensde roeping en 'n ernstige lewensdrang optree. Dit is nie 'n taak nie maar 'n roeping. Baie faktore dra by tot die verhoging van die kwaliteit van lewe van bejaardes. Drie hiervan is institusionalisering, besoek en die rol wat die gespesialiseerde besoeker onderneem.

Thesis (MSocialWork) -- University of Stellenbosch, 2002. / ENGLISH ABSTRACT: Since 1988 it became practice for welfare organisations to submit an evaluation of their welfare programme as part of their application for state funding for the next year. Included in this evaluation is a section on the cost efficiency of the programme. After the first democratic election in 1994 a number of processes were started to develop new welfare policies for the country. In all of these processes cost efficiency is seen as a principle, but in spite of this, so it seems from the documents, is the evaluation of cost efficiency still a problem. The question therefore arises: What is the present status of the evaluation of the cost efficiency of social services after twelve years of program evaluation? Only a few studies on the methodology of the evaluation of cost efficiency within the South African context were found through the literature study. An exploratory study was therefore undertaken to determine what the reasons could be why so little progress was made with cost effiency evaluation. The empirical study focussed on residential facilities for older persons and was done within one welfare organisation in the Western- and Southern Cape. A sample of twenty managers was randomly selected and fifteen respondents returned the questionaire. It is a potential danger that managers of residential facilities for older persons could see the evaluation of the services rendered as just another administrative task, because of the very strong link between evaluation and the application for state funding. The researcher therefore wanted to ascertain what the attitude of the managers is towards the evaluation of their services, and especially the evaluation of the cost-efficiency thereof. It was found that the managers are positive towards program evaluation and the evaluation of cost efficiency, but the majority of them responded that the lack of guidelines and manuals is a deficiency. The lack of proper measuring instruments was also stressed. The research also shown that the managers conceptualize cost efficiency mainly in terms of costs and not as a relation between the outcomes of the programme and the costs thereof. The managers of residential facilities uses the evaluation document that was send out by the department, because it forms part of the application for state funding. This means that the level of program evaluation is actually determined by the department. It was found that this document focused mainly on the measuring of inputs and outputs and not so much of the evaluation of the outcomes of the programme. Based on the results of the study the researcher proposed guidelines to promote the evaluation of the cost efficiency of social services. / AFRIKAANSE OPSOMMING: Dit is sedert 1988 praktyk dat vrywillige welsynsorganisasies jaarliks 'n evaluering van hulle maatskaplikewelsynsprogram moet indien as deel van die aansoek om staatsubsidie vir die volgende jaar. By hierdie evaluering van die maatskaplikewelsynsprogramme is die evaluering van die kostedoeltreffendheid van die program ingesluit. Na die eerste demokratiese verkiesing in 1994 het verskeie prosesse aan die gang gekom om nuwe maatskaplikewelsynsbeleid vir Suid-Afrika te ontwikkel. In al die dokumente wat deur die prosesse ontwikkel is, word die kostedoeltreffendheid van maatskaplikewelsynsdienste as 'n belangrike beginsel gestel. Tog blyk dit, uit die verslae van sommige van die prosesse, dat die evaluering van kostedoeltreffendheid 'n probleem blyk te wees. Die vraag ontstaan dan tereg: Wat is die huidige stand van die evaluering van die kostedoeltreffendheid van maatskaplikewelsynsprogramme twaalf jaar sedert die implementering van programevaluering? Uit die literatuurstudie het dit geblyk dat daar min studies in Suid-Afrika bestaan wat handel oor die metodiek van kostedoeltreffendheidsevaluering van maatskaplikewelsynsprogramme. Verkennende navorsing is onderneem om vas te stel waarom daar oënskynlik min vordering gemaak is met die evaluering van kostedoeltreffendheid van maatskaplikewelsynsprogramme. Die empiriese studie het gefokus op residensiële fasiliteite vir ouer persone en die navorsing is uitgevoer by een welsynsorganisasie in die Wes- en Suid-Kaap. 'n Steekproef van twintig bestuurders is op ewekansige wyse geselekteer en vyftien respondente het die vraelys teruggestuur. Die gevaar bestaan dat, vanweë die sterk verband tussen die evaluering van die program en die aansoek vir subsidie, die evaluering van die maatskaplikewelsynsprogram bloot net as nog 'n administratiewe taak gesien kan word. Daarom wou die navorser vasstel wat die bestuurders van residensiële versorgingsprogramme vir ouer persone se houding jeens programevaluering en die evaluering van die kostedoeltreffendheid van die program is. In die studie is bevind dat die bestuurders positief jeens programevaluering en die evaluering van die kostedoeltreffendheid van die programme is, maar die oorgrote meerderheid bestuurders het aangedui dat hulle dit as 'n leemte sien dat daar min riglyne of handleidings bestaan. Die gebrek aan meetinstrumente is ook beklemtoon. Uit die studie het dit verder geblyk dat die bestuurders die konsep kostedoeltreffendheid hoofsaaklik in terme van koste verstaan, en nie in terme van 'n verhouding van die uitkomste van die program tot die koste daarvan nie. Die bestuurders van residensiële fasiliteite voltooi jaarliks die evalueringsdokument van die betrokke staatsdepartement, omdat dit deel vorm van die aansoekprosedure vir staatsubsidie. Hierdie dokument bepaal derhalwe die vlak van programevaluering. Dit het uit die studie geblyk dat die dokument wat gebruik word grootliks fokus op die meting van insette en uitsette en nie soseer op die uitkomste van die welsynsprogramme nie. Gebaseer op die bevindinge van die navorsing is riglyne voorgestel wat sal meewerk om die evaluering van die kostedoeltreffendheid van maatskaplike dienste te bevorder.

published_or_final_version / Social Work / Master / Master of Social Work

published_or_final_version / Social Work / Master / Master of Social Work

published_or_final_version / Urban Planning / Master / Master of Science in Urban Planning

University of Macau / Faculty of Social Sciences. / Department of Government and Public Administration

Changes in the gait characteristics, such as walking speed and stride length, of a person living at home can be used to presage cognitive decline, predict fall potential, monitor long-term changes in cognitive impairment, test drug regimens, and more. This thesis presents a novel approach to gait analysis in a smart-home environment by leveraging new advances in inexpensive sensors and embedded systems to create novel solutions for in-home gait analysis. Using a simple, non-invasive hardware system consisting entirely of wall-mounted infrared and radio frequency sensor arrays, data is collected on the gait of subjects as they pass by. This data is then analyzed and sent to a clinician for further study. The system is non-invasive in that it does not use cameras and could be built into the molding of a home so that it would be nearly invisible. In a finished prototype version, the system presented in this thesis could be used to analyze the gait characteristics of one or more subjects living in a home environment while ignoring the data of visitors and other non-subject cohabitants. The ability to constantly collect data from a home environment could provide thousands of observations per year for clinical analysis. Providing such a robust data set may allow people with gait impairment to live at home longer and more safely before transitioning to a care facility, have a reduced fall risk due to better prediction, and live a healthier life in old age.