The main goal of this research has been to investigate elderly people's needs, perceptions, fears, hopes, and expectation regarding elderly care, including ethical issues linked to assistive technologies. As faith seems to take an important place in how some elders face the aging process, the spiritual dimension was also included. Therefore, the research was conducted among 15 church congregants. Results show that most respondents fear the physical and mental decay due to aging, often resulting in becoming a burden to someone else, along with abandonment and lack of financial resources. Most ethnic groups perceive that other cultures take better care of their elders than their own. Faith seems to offer a great support, as it gives the confidence that divine power will always be there for them even beyond death. The respondents in this research suggest that guidance should be provided in a more structured way, more focus should go on the youth and the elderly, more activities should be organized and practical information should be shared. Regarding the ethical issues of assistive technologies, they are not well informed about their possibilities but acknowledge their potential usefulness, combined with human care. They don't want technology to be too intrusive in their daily life, but they are willing to sacrifice (part of) their privacy for more (medical) safety. There is a general concern that the access to qualitative care would be depending on financial resources.

A study entitled `Phenomenological study of ageing amongst the older persons in Zambia' was undertaken with the purpose of gaining an understanding of the ageing phenomenon within the Zambian context and provide frameworks that could be used by policy-makers and health professionals to formulate guidelines or interventions relevant to the lived experiences of older persons and the meaning attached to ageing or being old, and consequently maintain or improve the quality of life of older persons of Zambia. The objectives of the study were to describe (1) the lived experiences of the older persons of Zambia, and (2) the meaning they attached to ageing or being old within the Zambian context. A transcendental phenomenological design within the qualitative naturalistic approach was used to guide the research process and to assist the researcher to reach the purpose and objectives of the study. Focus group and in-depth individual interviews were conducted to generate data from twenty-seven (27) informants. Fifteen (15) informants participated in the focus group interviews and twelve (12) in in-depth individual interviews. In total, 24 in-depth individual interviews were conducted in term of two interviews per informants, and two focus group interviews. Data collection covered a period of three months. Coliazzi (1978) and Giorgi (1985) techniques for qualitative data analysis were used and verbatim excerpts form the transcribed interviews were used to support the themes that emerged from data and to provide a richer picture of the situation. Three frameworks derived from the findings of this study: (1) framework of the lived experiences of older persons of Zambia, (2) framework of the meaning of ageing or being old and (3) framework for understanding ageing within the Zambian context. The researcher believed that these frameworks would make a meaningful contribution toward the understanding and the development of policies and interventions that would assist in enhancing or maintaining the quality of life of older people of Zambia. The main findings of the results of this study indicated three most significant dimensions of the lived experiences of the older persons (health, socio-economic and psychosocial) that need to be taken into account when planning for any programs or interventions aimed at maintaining or improving the quality of life of older persons of Zambia. These interventions and programs should also address the negative feelings or meanings attached to the above experiences. The main findings of the results of this study also showed that the meaning of being old or ageing in Zambia does not depend on the health, socio-economic and psychosocial living experiences of the older person but it depends largely on the inner values of the older persons, such as spiritual, emotional and cultural beliefs. This means that maintaining or improving the quality of life of older persons in Zambia would require comprehensive programs or interventions that should take into account the health, socio-economic, psychosocial, spiritual, emotional and cultural needs of the older people. / Health Studies / D. Litt. et Phil. (Health Studies)

In South Africa prior to 1994, community-based care and support services were established for whites only. The majority of older African (black) persons received informal support from their adult children and relatives. This has waned over the years due to the social and economic changes that have put into doubt the continued viability of such support. The Older Persons Act of 2006 requires social workers to establish community-based care and support services for older persons. Hence, the study was conducted to understand the factors that influence social workers in establishing CBCSS for older persons in Bloemfontein in the Free State Province. A qualitative research method was undertaken to accomplish the goal of the study. Purposive and snowball sampling techniques were used to identify suitable participants. Face-to-face semi-structured interviews were conducted with fifteen social workers who provide services to older persons. The data was analysed through Tesch’s (cited by Creswell, 2009:186) eight steps of qualitative analysis and data verification was conducted following Guba’s (Kreftling, 1991) model. The major finding is that there is a need for social workers to specialise in older persons programmes (gerontology). For the programmes to be a success, it is recommended that the Department of Social Development (DSD) strive to retain social workers who are knowledgeable and experienced in older persons programmes. / Social Work / M.A. (Social Science)

"February 20, 2003" / Includes bibliographical references (leaves 586-603) / xvii, 603 leaves : ill. ; 30 cm. / Title page, contents and abstract only. The complete thesis in print form is available from the University Library. / Investigates the level of resident participation in decision-making in aged care hostels in South Australia. / Thesis (Ph.D.)--University of Adelaide, Dept. of Psychology, 2003

A study entitled `Phenomenological study of ageing amongst the older persons in Zambia' was undertaken with the purpose of gaining an understanding of the ageing phenomenon within the Zambian context and provide frameworks that could be used by policy-makers and health professionals to formulate guidelines or interventions relevant to the lived experiences of older persons and the meaning attached to ageing or being old, and consequently maintain or improve the quality of life of older persons of Zambia. The objectives of the study were to describe (1) the lived experiences of the older persons of Zambia, and (2) the meaning they attached to ageing or being old within the Zambian context. A transcendental phenomenological design within the qualitative naturalistic approach was used to guide the research process and to assist the researcher to reach the purpose and objectives of the study. Focus group and in-depth individual interviews were conducted to generate data from twenty-seven (27) informants. Fifteen (15) informants participated in the focus group interviews and twelve (12) in in-depth individual interviews. In total, 24 in-depth individual interviews were conducted in term of two interviews per informants, and two focus group interviews. Data collection covered a period of three months. Coliazzi (1978) and Giorgi (1985) techniques for qualitative data analysis were used and verbatim excerpts form the transcribed interviews were used to support the themes that emerged from data and to provide a richer picture of the situation. Three frameworks derived from the findings of this study: (1) framework of the lived experiences of older persons of Zambia, (2) framework of the meaning of ageing or being old and (3) framework for understanding ageing within the Zambian context. The researcher believed that these frameworks would make a meaningful contribution toward the understanding and the development of policies and interventions that would assist in enhancing or maintaining the quality of life of older people of Zambia. The main findings of the results of this study indicated three most significant dimensions of the lived experiences of the older persons (health, socio-economic and psychosocial) that need to be taken into account when planning for any programs or interventions aimed at maintaining or improving the quality of life of older persons of Zambia. These interventions and programs should also address the negative feelings or meanings attached to the above experiences. The main findings of the results of this study also showed that the meaning of being old or ageing in Zambia does not depend on the health, socio-economic and psychosocial living experiences of the older person but it depends largely on the inner values of the older persons, such as spiritual, emotional and cultural beliefs. This means that maintaining or improving the quality of life of older persons in Zambia would require comprehensive programs or interventions that should take into account the health, socio-economic, psychosocial, spiritual, emotional and cultural needs of the older people. / Health Studies / D. Litt. et Phil. (Health Studies)

In South Africa prior to 1994, community-based care and support services were established for whites only. The majority of older African (black) persons received informal support from their adult children and relatives. This has waned over the years due to the social and economic changes that have put into doubt the continued viability of such support. The Older Persons Act of 2006 requires social workers to establish community-based care and support services for older persons. Hence, the study was conducted to understand the factors that influence social workers in establishing CBCSS for older persons in Bloemfontein in the Free State Province. A qualitative research method was undertaken to accomplish the goal of the study. Purposive and snowball sampling techniques were used to identify suitable participants. Face-to-face semi-structured interviews were conducted with fifteen social workers who provide services to older persons. The data was analysed through Tesch’s (cited by Creswell, 2009:186) eight steps of qualitative analysis and data verification was conducted following Guba’s (Kreftling, 1991) model. The major finding is that there is a need for social workers to specialise in older persons programmes (gerontology). For the programmes to be a success, it is recommended that the Department of Social Development (DSD) strive to retain social workers who are knowledgeable and experienced in older persons programmes. / Social Work / M.A. (Social Science)

Úlceras por Pressão (UPP) são áreas de necrose isquêmica em partes moles, causadas por uma pressão prolongada maior que a capilar, com ou sem cisalhamento, relacionada à postura e frequentemente localizada junto a uma proeminência óssea em indivíduos com predisposição clínica. Os fatores extrínsecos pressão, fricção, cisalhamento, umidade e alterações de temperatura são relacionados à engenharia biomédica e decorrem da interação do paciente com a superfície de suporte. Já os intrínsecos, notadamente relacionados às condições de saúde, envolvem o desequilíbrio nutricional e as afecções clínicas, tanto as que diminuem a oxigenação tecidual, como as que implicam no comprometimento da mobilidade. Por ser mais prevalente entre os idosos e por decorrer de múltiplas causas e mecanismos patogênicos, as UPP são classificadas como uma Síndrome Geriátrica. Embora associada principalmente a gerontes, o aporte financeiro empregado no grupo de feridas crônicas, como as UPP, remonta o 3o maior bloco de gastos em saúde no mundo. As UPP são frequentes em pacientes hospitalizados, porém ultrapassam este ambiente, havendo expressiva incidência em residentes de Instituições de Longa Permanência para Idosos (ILPIs). No Brasil, as ILPIs são órgãos sociais, o que gera uma lacuna legal quanto à responsabilidade clínica sobre seus residentes e, consequentemente, sobre as afecções que os acometem, particularmente as UPP. Estas feridas são passíveis de prevenção, destacando-se então o cuidador de idosos, ocupação que vem aumentando em número e importância com o envelhecimento da população e que, no entanto, nem sempre é devidamente instruído. Por meio de uma vasta revisão de literatura, esta dissertação objetivou pontuar os fatores relevantes envolvidos na patogenia das UPP, além das especificidades do indivíduo idoso e do ambiente das ILPIs. Neste contexto, o produto final elaborado foi um guia para prevenção de UPP em ILPIs. / Pressure Ulcers (PU) are areas of localized soft tissue ischemic necrosis caused by prolonged pressure higher than the capillary pressure with or without shear, related to posture which usually occurs over a bony prominence in individual with certain clinical susceptibilities. Extrinsic factors – such as pressure, friction and shear, moisture and temperature changes – are related to biomedical engineering and come from the interaction patient-surface. On the other hand, intrinsic factors are related to health conditions and correspond to nutritional imbalance and/or conditions that decrease tissue oxygenation or impair mobility. Since it features different pathogenic mechanisms and it is more prevalent among the elderly, the PU group is classified as a geriatric syndrome. Worldwide, PU are estimated to be the 3rd largest consumer of resources, plus the social burden and consequences of this condition. PU are quite common in hospitals, however there are several cases among the elderly living in Long-Term Care Facilities (LTCFs). In Brazil, these institutions are supported by social organizations, what produces legal gaps with respect to the residents’ clinical responsibility, and reduces the chances of preventing avoidable diseases as PU. The number of elderly caregivers tends to grow accordingly to the population ageing, creating a window of opportunity for continued education of this group of workers. Through an extensive literature review, this thesis aimed to highlight the relevant findings of the different factors involved in PU pathogenesis as well as to ascertain the particularities of elderly individuals and the specific environment of LTCFs. The final product is a PU prevention guide suitable to use in Brazilian long-term care facilities.

Úlceras por Pressão (UPP) são áreas de necrose isquêmica em partes moles, causadas por uma pressão prolongada maior que a capilar, com ou sem cisalhamento, relacionada à postura e frequentemente localizada junto a uma proeminência óssea em indivíduos com predisposição clínica. Os fatores extrínsecos pressão, fricção, cisalhamento, umidade e alterações de temperatura são relacionados à engenharia biomédica e decorrem da interação do paciente com a superfície de suporte. Já os intrínsecos, notadamente relacionados às condições de saúde, envolvem o desequilíbrio nutricional e as afecções clínicas, tanto as que diminuem a oxigenação tecidual, como as que implicam no comprometimento da mobilidade. Por ser mais prevalente entre os idosos e por decorrer de múltiplas causas e mecanismos patogênicos, as UPP são classificadas como uma Síndrome Geriátrica. Embora associada principalmente a gerontes, o aporte financeiro empregado no grupo de feridas crônicas, como as UPP, remonta o 3o maior bloco de gastos em saúde no mundo. As UPP são frequentes em pacientes hospitalizados, porém ultrapassam este ambiente, havendo expressiva incidência em residentes de Instituições de Longa Permanência para Idosos (ILPIs). No Brasil, as ILPIs são órgãos sociais, o que gera uma lacuna legal quanto à responsabilidade clínica sobre seus residentes e, consequentemente, sobre as afecções que os acometem, particularmente as UPP. Estas feridas são passíveis de prevenção, destacando-se então o cuidador de idosos, ocupação que vem aumentando em número e importância com o envelhecimento da população e que, no entanto, nem sempre é devidamente instruído. Por meio de uma vasta revisão de literatura, esta dissertação objetivou pontuar os fatores relevantes envolvidos na patogenia das UPP, além das especificidades do indivíduo idoso e do ambiente das ILPIs. Neste contexto, o produto final elaborado foi um guia para prevenção de UPP em ILPIs. / Pressure Ulcers (PU) are areas of localized soft tissue ischemic necrosis caused by prolonged pressure higher than the capillary pressure with or without shear, related to posture which usually occurs over a bony prominence in individual with certain clinical susceptibilities. Extrinsic factors – such as pressure, friction and shear, moisture and temperature changes – are related to biomedical engineering and come from the interaction patient-surface. On the other hand, intrinsic factors are related to health conditions and correspond to nutritional imbalance and/or conditions that decrease tissue oxygenation or impair mobility. Since it features different pathogenic mechanisms and it is more prevalent among the elderly, the PU group is classified as a geriatric syndrome. Worldwide, PU are estimated to be the 3rd largest consumer of resources, plus the social burden and consequences of this condition. PU are quite common in hospitals, however there are several cases among the elderly living in Long-Term Care Facilities (LTCFs). In Brazil, these institutions are supported by social organizations, what produces legal gaps with respect to the residents’ clinical responsibility, and reduces the chances of preventing avoidable diseases as PU. The number of elderly caregivers tends to grow accordingly to the population ageing, creating a window of opportunity for continued education of this group of workers. Through an extensive literature review, this thesis aimed to highlight the relevant findings of the different factors involved in PU pathogenesis as well as to ascertain the particularities of elderly individuals and the specific environment of LTCFs. The final product is a PU prevention guide suitable to use in Brazilian long-term care facilities.

Text in German / Die gesellschaftliche Situation ändert sich stetig. Während früher alte Menschen zu Hause von ihren Familien gepflegt wurden, übernehmen heutzutage oft Altenpfleger diese schwere Aufgabe. Betrachtet man die Altenpflege, so lässt sich erkennen, dass die Pflege alter, kranker oder im Sterben liegender Menschen für die Mitarbeiter physisch und psychisch sehr belastend ist. Angesichts dieser Tatsache, besteht die Notwendigkeit ein differenziertes Personalentwicklungskonzept, das biblisch diakonische Grundprinzipien widerspiegelt, zu formulieren. Die vorliegende Arbeit zeigt deren Möglichkeiten und Potentiale auf. Sie untersucht und beschreibt entsprechende Prinzipien, unter anderem anhand des Ansatzes H.U.M.O.R. und des Modells „Pflege den Pflegenden". Diese Konzepte wurden im „Luise-Schleppe-Haus und Schloss", einer der traditionsreichsten Altenhilfeeinrichtungen Baden-Württembergs entwickelt. Die Darstellung und Untersuchung dieser Konzepte, sowie die Sichtung weiterführender Literatur eröffnet neue Perspektiven für die Personalentwicklung in der Altenhilfe. Der christlich ethische Aspekt von Führung wird berücksichtigt. Auf der Basis der erarbeiteten Prinzipien der Mitarbeiterentwicklung gibt die Masterarbeit Anregungen für die Praxis. Formerly elderly people were taken care of at home by their families. Nowadays this difficult task is often assigned to professional nurses. In closer analysis of their task it becomes evident that helping the very old, ill and dying people constitutes a physical and mental strain. This necessitates the development a differentiated concept of human resource development that reflects the fundamental Biblical diaconal principles. This dissertation analyses the opportunities and potentials of such a concept. It researches and describes appropriate principles, amongst others the approach of H.U.M.O.R. and the model of Care for Caregivers (Pflege den Pflegenden). These concepts were developed in the "Luise-Schleppe-Haus und Schloss", a geriatric facilities in Baden-Württemberg, Germany, of long standing. The analysis combined with further literature opens up new perspectives for the human resource development in the care for the elderly and the ethical aspects of leaderhship in this context. / Systematic Theology and Theological Ethics / M. Th. (Christian Leadership in Context)

Text in German / Die gesellschaftliche Situation ändert sich stetig. Während früher alte Menschen zu Hause von ihren Familien gepflegt wurden, übernehmen heutzutage oft Altenpfleger diese schwere Aufgabe. Betrachtet man die Altenpflege, so lässt sich erkennen, dass die Pflege alter, kranker oder im Sterben liegender Menschen für die Mitarbeiter physisch und psychisch sehr belastend ist. Angesichts dieser Tatsache, besteht die Notwendigkeit ein differenziertes Personalentwicklungskonzept, das biblisch diakonische Grundprinzipien widerspiegelt, zu formulieren. Die vorliegende Arbeit zeigt deren Möglichkeiten und Potentiale auf. Sie untersucht und beschreibt entsprechende Prinzipien, unter anderem anhand des Ansatzes H.U.M.O.R. und des Modells „Pflege den Pflegenden". Diese Konzepte wurden im „Luise-Schleppe-Haus und Schloss", einer der traditionsreichsten Altenhilfeeinrichtungen Baden-Württembergs entwickelt. Die Darstellung und Untersuchung dieser Konzepte, sowie die Sichtung weiterführender Literatur eröffnet neue Perspektiven für die Personalentwicklung in der Altenhilfe. Der christlich ethische Aspekt von Führung wird berücksichtigt. Auf der Basis der erarbeiteten Prinzipien der Mitarbeiterentwicklung gibt die Masterarbeit Anregungen für die Praxis. Formerly elderly people were taken care of at home by their families. Nowadays this difficult task is often assigned to professional nurses. In closer analysis of their task it becomes evident that helping the very old, ill and dying people constitutes a physical and mental strain. This necessitates the development a differentiated concept of human resource development that reflects the fundamental Biblical diaconal principles. This dissertation analyses the opportunities and potentials of such a concept. It researches and describes appropriate principles, amongst others the approach of H.U.M.O.R. and the model of Care for Caregivers (Pflege den Pflegenden). These concepts were developed in the "Luise-Schleppe-Haus und Schloss", a geriatric facilities in Baden-Württemberg, Germany, of long standing. The analysis combined with further literature opens up new perspectives for the human resource development in the care for the elderly and the ethical aspects of leaderhship in this context. / Systematic Theology and Theological Ethics / M. Th. (Christian Leadership in Context)