The increased incidence of chronic illness among the elderly makes long-term care a health concern as the population ages. Little is known about the impact of chronic confusion on the family. This study used a qualitative approach to look at the impact on the caregiving wife of caring for a chronically confused, elderly husband. Six wives whose elderly husbands experienced chronic confusion and who lived alone with their husband were interviewed using the phenomenological method described by Giorgi (1975). The findings indicated that there is a substantial impact when the husband depends on his caregiving wife to remain in the home, especially when the wife is older and experiences chronic illness herself. Overall, these negative effects were congruent with those reported by other researchers, suggesting that the general impact of long-term care is burden. The themes in the caregivers' accounts revolved around three main concerns: the management of the husband's dependency, the maintenance of the family as a unit, and the acceptance of the caregiving situation. Chronic confusion occurred with other chronic illnesses and compounded the husbands' impairments. Interpersonal relations were also adversely affected, and the wives had to learn to take control of the family amidst physical strain and social isolation. The caregiver found that her life came to revolve around the needs of her husband; she derived meaning from fulfilling her perceived duty as a wife. The presence of chronic illness and aging intensified her experience of burden. Despite the costs to her well-being, the wife was devoted to maintaining her husband at home. The caregiving wife needs support to deal with the husband's care and its negative consequences, but her desire to remain as independent as possible appears to conflict with her utilization of outside support. Nursing intervention should be directed toward assisting the caregiver to cope with the husband's care and with its negative effects on her. Nursing education should prepare the practitioner with a broad background in community health nursing, gerontology, and geriatrics to enable her to provide nursing care to these kinds of families. Future nursing research should focus on furthering the understanding of the impact of caregiving as a basis for planning the most helpful interventions to support the caregiver. / Applied Science, Faculty of / Nursing, School of / Graduate

The purpose of the study was to design a reliable and valid assessment instrument that would provide a multidimensional profile of the elderly resident of a long term care facility. Use of this instrument would be a method of collecting and corrmunicating information concerning the full range of problems experienced by this group, in a form that is suitable for use at different levels of decisionmaking. The instrument consists of 31 unweighted items measuring functioning in 5 essential areas - cognitive, physical, emotional, social, and instrumental. Ratings were based on the observations of long term care staff who were in close contact with the individual over extended periods. Reliability and validity were tested using a non random sample of 76 elderly residents of one extended care unit. Both test-retest and interjudge reliability proved to be high and item analysis indicated that, with the exception of 2 items, the instrument provides levels of functioning appropriate to the sample population. The instrument also showed a high degree of internal consistency with the 3 major components identified as - cognitive behaviour, independence in daily living, and physical functioning. The validity of the instrument and its subsections was demonstrated through significant relationships with external criteria, namely - the number of problems listed on the multidisciplinary problem-oriented record, a health index measure, and a mental status rating. Further evidence of the instrument's validity was its ability to predict, retrospectively, 72 percent of the sample deaths in the first year following admission. Although only a preliminary form of analysis, this showed that a high level of mental functioning, combined with a low level of independence in daily living, was predictive of death within 3 to 9 months in the sample population. The implications of these results are discussed along with suggestions for further research in the area. Finally, potential uses for the assessment instrument in the field of long term care are provided. / Applied Science, Faculty of / Nursing, School of / Graduate

Orientador: Ibsen Bellini Coimbra / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Educação / Made available in DSpace on 2018-08-07T23:17:03Z (GMT). No. of bitstreams: 1 Ricci_NataliaAquaroni_M.pdf: 749854 bytes, checksum: 6d38565ef0ceed8c74de281e2e869d5b (MD5) Previous issue date: 2006 / Resumo: O processamento do controle postural tem início com a comunicação entre o ambiente e corpo, feita por meio dos sistemas sensoriais. Com o envelhecimento, estes sistemas são afetados pela diminuição da reserva funcional e/ ou doenças, predispondo o idoso à instabilidade e quedas. Objetivo: Analisar a influência das informações sensoriais no equilíbrio estático de idosos, comparando-os, em grupos, quanto ao histórico de quedas (sem queda, uma queda e quedas recorrentes) no último ano. Método: Pesquisa descritiva comparativa de corte transversal. Amostra constituída por idosos da comunidade cadastrados em unidade de saúde da família, selecionados e divididos por grupos em consulta ao banco de dados de pesquisa populacional sobre envelhecimento no município de Amparo (SP). Cada grupo foi reduzido a 32 sujeitos por filtro de gênero e faixa etária. O protocolo de avaliação incluiu dados sociodemográficos, clínicofuncionais, psicocognitivos e de equilíbrio estático. O equilíbrio foi avaliado pelo CTSIB que analisa a capacidade de manutenção da estabilidade frente a seis condições de conflitos sensoriais. Foi realizada análise descritiva e inferencial dos dados por meio dos testes de Qui-quadrado, ANOVA, Teste-T e Correlação de Pearson; todos com nível de significância a 5%. Resultados: Houve maior número de casos anormais ao CTSIB para o Grupo de quedas recorrentes em relação ao Grupo sem quedas nas condições 4 (p=0,012) e 5 (p=0,017); e ao Grupo de uma queda na condição 4 (p=0,052). Quanto ao tempo despendido, o Grupo de quedas recorrentes permaneceu menos tempo do que o Grupo sem quedas nas condições 4 (p=0,043), 5 (p=0,042) e 6 (p=0,052). Na progressão do CTSIB, os Grupos sem quedas e uma queda apresentaram menor tempo despendido da condição 4 para a 5 (p=0,016 e p=0,012, respectivamente) e o Grupo de quedas recorrentes teve menor desempenho da condição 1 para a 2 (p=0,039) e da 4 para a 5 (p=0,001). A idade foi a variável de maior associação com a informação sensorial nos três grupos. Conclusão: Os resultados revelam que a interação sensorial nos idosos difere quanto ao histórico de quedas e que no Grupo de quedas recorrentes há maior dependência no sistema somatossensorial e visual. Com esses dados, é possível direcionar o processo de reabilitação e prevenção por meio do treinamento e/ou compensação das estratégias deficitárias e diminuição da dependência sensorial / Abstract: The processing of postural control starts with the environment and body communication, through sensorial systems. Because of the ageing, these systems are affected by the functional decrease and/or diseases, predisposing the elderly to instability and falls. Objective: This work is aimed at analyzing the influence of sensorial information in the elderly¿s static balance comparing them in groups, according to the report of falls (without fall, one fall and recurrent falls) in the last year. Method: A transversal descriptive comparative research. The sample was composed by community-dwelling elderly, which were registered in the Health Family Unit. They were selected and divided into groups by means of consultation of the database on a population research about aging in the Municipal District of Amparo (SP). Each group was reduced to 32 subjects by gender and age filter. The evaluation protocol included socialdemographic, health, physical, psychological and cognitive status, and static balance performance data. The balance was evaluated by CTSIB, which analyzes the stability maintenance capacity according to six sensorial conflicts conditions. The descriptive and inferential analysis was accomplished by means of the tests: Qui-squared, ANOVA, T-Test and Pearson Correlation; with significance level of 5%. Results: There was a larger number of CTSIB abnormal cases for the Group of recurrent falls in comparison to the Group without falls in the conditions 4 (p=0.012) and 5 (p=0.017); and to the Group of one fall in the condition 4 (p=0.052). As for the time performance, the Group of recurrent falls remained less time than the Group without falls in the conditions 4 (p=0.043), 5 (p=0.042) and 6 (p=0.052). In relation to the CTSIB progression, the Groups without falls, and one fall presented less time from the condition 4 to 5 (p=0.016 and p=0.012, respectively); and the Group of recurrent falls had a worse performance from the condition 1 to 2 (p=0.039) and from the condition 4 to 5 (p=0.001). The variable age was presented the largest association with the sensorial information for all the groups. Conclusion: The results showed that the sensorial interaction in the elderly varies according to the history of falling. They also revealed that there is a larger dependence on the visual and somatosensory systems for the Group of recurrent falls. In this way, it is possible to guide the rehabilitation process and prevention with training and/or compensation of deficient strategies and decrease the sensorial dependence / Mestrado / Mestre em Gerontologia

Orientadores: Maria Elena Guariento, Carmen Silvia Passos Lima / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-24T13:11:23Z (GMT). No. of bitstreams: 1 BortolansaPacagnella_AnaBeatriz_M.pdf: 920417 bytes, checksum: 3b9eb0a9a4bf6e5a00576a95037731e5 (MD5) Previous issue date: 2013 / Resumo: As doenças neoplásicas incidem mais frequentemente na população idosa, e, embora ainda não se tenha comprovação definitiva, podem ter um curso mais grave na medida em que se associam com outras enfermidades crônicas, com incapacidade funcional e com as síndromes geriátricas. Um dos recursos para melhorar esse quadro constitui-se na detecção precoce e fácil acesso ao tratamento. O presente estudo buscou avaliar algumas características sociodemográficas (idade, sexo, IDH-M, distância entre município de origem e Campinas) dos idosos com neoplasia atendidos em três das oito unidades do complexo hospitalar da Universidade Estadual da Campinas - SP (Unicamp), na busca de traçar um perfil loco - regional dessa classe de enfermidades no segmento idoso da população, e de avaliar, ainda que indiretamente, a qualidade da assistência oferecida aos idosos portadores de doenças oncológicas. Os dados sociodemográficos forma confrontados com o tempo entre primeira consulta na Unicamp e início do tratamento. Foram analisados os registros de idosos, de ambos os sexos, com diagnóstico de câncer e que foram atendidos no Gastrocentro, Hemocentro, ou Hospital de Clínicas / Unicamp, no período de janeiro de 2.000 a julho de 2010. Os dados foram obtidos junto ao Serviço de Estatística do Câncer vinculado à Fundação Oncocentro de São Paulo. Dos 5.891 registros avaliados, 66,3% eram de homens, sendo que 48,8% dos pacientes tinham entre 60 a 69 anos; 67,1% provinha de municípios que distavam até no máximo 50 km de Campinas, e 22,3% eram desse município. Além disso, 65,3% dos pacientes avaliados provinham de municípios com IDH-M entre 0,707 e 0,740. Apenas IDH-M (p = 0,003) e distância entre município de origem e Campinas (p = 0,019) mostraram associação com tempo entre primeira consulta e início do tratamento antineoplásico. Esse estudo permite constatar a relevância dos indicadores sociais no que se refere ao acesso ao tratamento antineoplásico na população idosa / Abstract: Oncologic diseases are more frequent in the elderly population, and although we do not have definitive proof yet, the elders may have a more severe course when associated with other chronic diseases, functional disability and geriatric syndromes. A resource to improve this situation is based on the early detection and easy access to treatment. This study aimed to assess sociodemographic characteristics (age, gender, HDI-M, distance between the city of origin and Campinas) of the elderly with cancer treated at three of the eight units of the hospital complex at the University of Campinas ¿ SP, Brazil (Unicamp), trying to delineate loco regional profile of this class of diseases in the elderly segment of the population, and to assess, even indirectly, the quality of care provided to elderly patients with malignancies. Sociodemographic data were faced with the time between first consultation at Unicamp and early treatment. It was analyzed the elderly profiles, of both sexes, diagnosed with cancer and who were treated at Gastrocentro, Hemocentro and Clinic Hospital of Unicamp, from January, 2000 to July, 2010. The data were obtained from the Statistical Service of Cancer linked to the Oncocentro Foundation in the State of São Paulo. From the 5,891 evaluated profiles, 66.3% were men, and 48.8% of the patients were between 60-69 years old; 67.1% came from municipalities that were far until a maximum of 50 km from Campinas and 22.3 % were from Campinas. In addition, 65.3% of patients were from municipalities with HDI-M between 0.707 and 0.740. Only HDI-M (p = 0.003) and distance between the city of origin and Campinas (p = 0.019) were associated with time between first consultation and beginning of anticancer treatment. This study highlights the relevance of social indicators to access the anticancer treatment in the elderly / Mestrado / Gerontologia / Mestra em Gerontologia

Orientador: Maria José D'Elboux / Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Enfermagem / Made available in DSpace on 2018-08-27T08:50:00Z (GMT). No. of bitstreams: 1 Silva_VanessaAbreuda_D.pdf: 2181192 bytes, checksum: f2b09456b1f7e48f3b035d252adb01da (MD5) Previous issue date: 2014 / Resumo: Este estudo teve como objetivo analisar os desfechos e fatores associados à síndrome da fragilidade de idosos atendidos em serviço de geriatria de um hospital escola. Trata-se de um estudo quantitativo, comparativo e com delineamento longitudinal, integrante da pesquisa maior intitulada "Qualidade de vida em idosos: indicadores de fragilidade e de bem-estar subjetivo", que compreende duas fases. Na Fase 1 (2005-2007), foram avaliados 150 idosos em acompanhamento no ambulatório de geriatria. Na Fase 2 (2013), os idosos foram novamente contatados, por telefone ou visita domiciliar, e submetidos, após o consentimento, a uma entrevista para a coleta de dados sociodemográficos, de saúde e funcionalidade. Foi adotado o fenótipo de fragilidade de Fried et al., 2001. Os desfechos estudados foram: queda, hospitalização, comorbidade e óbito. Na fase 2, dos 150 idosos participantes da primeira fase, 71 evoluíram a óbito e 25 foram excluídos. Assim, a amostra contou com 54 idosos respondentes, com predomínio do sexo feminino e idade igual ou superior a 80 anos. No que diz respeito à saúde e à funcionalidade, houve diferença estatisticamente significante entre todas as variáveis estudadas, com exceção do número de hospitalizações e do número de quedas. É notável o declínio da funcionalidade desses idosos, avaliada por meio dos instrumentos: SPPB, MIF e AIVD, cujas médias dos seus escores reduziram significativamente. O estado cognitivo também apresentou diferença estatística com redução da média do escore do MEEM na fase 2 (p<0,001). Quanto à fragilidade, houve aumento na média do número de critérios (3,83) quando comparados à fase 1 (2,43), e a maioria dos idosos pontuou para todos os critérios de fragilidade, com exceção para o critério "perda de peso não intencional". Houve aumento na proporção de idosos classificados como frágeis (50,0% fase 1 e 88,9% fase 2) e nenhum idoso foi considerado não frágil. O desfecho queda (fase 2) associou-se a hospitalização e com os critérios de fragilidade exaustão e perda de peso não-intencional na fase 1. O idoso que relatou hospitalização na fase 1 teve maior risco de hospitalização na fase 2. Do mesmo modo o desfecho comorbidade (Índice de Comorbidade de Charlson) foi associado a própria comorbidade na fase 1. Sobre o desfecho óbito verificou-se diferença significativa para a variável idade, níveis de fragilidade, comorbidade e o critério de fragilidade baixo nível de atividade física. Este estudo longitudinal proporcionou maior conhecimento sobre os eventos adversos da síndrome da fragilidade em idosos em acompanhamento ambulatorial / Abstract: This study aimed to analyze the outcomes and factors related to the frailty syndrome in a population of elderly patients treated in the outpatient geriatric service of a teaching hospital. This quantitative, comparative and longitudinal study is part of the larger research project "Quality of life in the elderly: frailty and subjective welfare indicators", conducted at the Geriatric Clinic of the Hospital of the State University of Campinas. This study used a convenience sample and had two phases (Phase 1 and 2). In Phase 1 (2005-2007),150 elderly patients followed up at the geriatric clinic were assessed. In Phase 2 (2013), the elderly were contacted again by phone or home visit and, after their consent, they were interviewed to collect sociodemographic and health data. Moreover, frailty was assessed according to the frailty criteria defined by Fried et al. (2001). The following events were considered as outcomes: fall, hospitalization, comorbidity and death. In Phase 2, of the 150 participants in Phase1, 71 died and 25 were excluded. Thus, Phase 2 sample had 54 respondents, predominantly women, and the rate of 80-year-old or older patients almost doubled (34% in Phase 1 and 64.4% in Phase 2). Concerning health and functionality, there was a statistically significant difference between all variables under study, except for number of hospitalizations and number of falls. The decline of functionalityis marked among these elderly and it was assessed using the tools SPPB, FIM and IADL, whose average scores decreased considerably. The cognitive state also showed a statistical difference, with a decrease in the average MMSE score in Phase 2 (p<0.001). As to frailty, the average number of criteria increased in Phase 2 (3.83) when compared to Phase 1 (2.43), and most of the elderly scored on all frailty criteria, except for "unintentional weight loss". The rate of the elderly classified as frail increased (50% in Phase1 and 88.9% in Phase 2) and none of the elderly was considered as non-frail. The outcome fall (Phase 2) was related to hospitalization and to the frailty criteria "exhaustion" and "unintentional weight loss" in Phase 1. Also was observed that the elderly who were hospitalized in Phase 1 were at a higher risk of hospitalization in Phase 2. As regards the outcome comorbidity (Charlson Comorbidity Index), the variable associated was comorbidity itself. Concerning the outcome death, we observed a significant difference in age, levels of frailty, comorbidity, and in the frailty criterion "low level of physical activity". This longitudinal study provided a more comprehensive knowledge of the adverse events of the frailty syndrome in the elderly followed up at an outpatient geriatric clinic. Therefore, we expect to contribute to more efficient public policies for the elderly population, considering the phenomenon of population aging and the magnitude of the frailty syndrome / Doutorado / Enfermagem e Trabalho / Doutora em Ciências da Saúde

<p>Kvalitet života u vezi sa zdravljem kod starih je najznačajniji aspekt kvaliteta života uop&scaron;te, a<br />merenje kvaliteta života ima značajno mesto u praksi zdravstvene za&scaron;tite i naučnoistraživačkom<br />radu. Cilj istraživanja je bio da se primenom modifikovanog McMaster Health Index Questionnaire<br />utvrde fizička, socijalna i emotivna dimenzija kvaliteta života starih, kao i da se defini&scaron;e validni<br />instrument za procenu kvaliteta života u vezi sa zdravljem kod starih u na&scaron;im uslovima. Istraživanje<br />je sprovedeno u periodu 1998-2000 u obliku studije preseka, putem anketnog upitnika na uzorku<br />stanovni&scaron;tva Novog Sada starosti 60 i vi&scaron;e godina (n=373). Inicijalni anketni upitnik je poslužio za<br />analizu pojedinih domena zdravlja a iz njega su korelacionim analizama izdvojeni ajtemi za &scaron;est<br />skala: fizičko funkcionisanje, samozbrinjavanje, osećanje u vezi korisnosti u dru&scaron;tvu, osećanja u<br />vezi života, socijalno funkcionisanje i samoprocena. Za svaku skalu i za ukupni indeks kvaliteta<br />života (QOL-OLD indeks) je izračunat transformisani skor (ranga 0-100) kao i uticaj pojedinih<br />skala na ukupni indeks kvaliteta života u odnosu na zdravlje. Indeks kvaliteta života QOL-OLD<br />(ranga 0-100) predstavlja sumarnu numeričku vrednost dobijenu iz svih &scaron;est domena. Za svaku<br />skalu kao i za sumarni Indeks utvrđena je pouzdanost i validnost pomoću svetski prihvaćenih<br />kriterijuma za Cronbach Alpha vrednost. Analizom je izdvojeno &scaron;est skala koje imaju uticaj na<br />kvalitet života starih i utvrđeno je da je uticaj fizičkog zdravlja, posmatran kroz skalu fizičkog<br />funkcionisanja i skalu samozbrinjavanja, dominantan i čini 39,3% u globalnom kreiranju indeksa<br />kvaliteta života. Svaki domen kao i ukupni QOL-OLD indeks je analiziran u odnosu na neke<br />sociodemografske determinante za koje se pokazalo da imaju uticaj na pojedine domene kao i na<br />ukupni kvalitet života u odnosu na zdravlje kod starih. Izdvajanjem ajtema iz modifikovanog<br />McMaster Health Index Questionnaire dobijen je skraćeni i validan upitnik za procenu kvaliteta<br />života starih u populaciji ali iza procenu kvaliteta života kod pojedinaca iste starosti.</p> / <p>Health related quality of life of the elderly is the most important aspect of quality of<br />life concept in general, and it&#39;s measurement has an important place in health care<br />practice and scientific work. The aim of this study was to determine physical, social<br />and emotional dimension of health related quality of life among elderly, using<br />modified McMaster Health Index questionnaire, as well as to construct valid<br />instrument for health related quality of life assessment among elderly for our<br />theritory. Cross sectional study was performed during 1998-2000. through poll, on the<br />Novi Sad population sample aged 60 and above (n=373). Initial questionnaire was<br />used for the purpose of analysis of certain health domains, and by using correlation<br />analysis to extract items for six scales: physical functioning, selfcare, social<br />usefulness, emotions about life, social functioning and self perception. Transformed<br />score (range 0-100) was calculated for each scale separatly and for total health related<br />quality of life index (QOL-OLD) as well as percentage influence of each scale on<br />QOL-OLD index. Health related quality of life index (QOL-OLD) presents summar<br />numeric value calculated from all six domains. For each scale and for QOL-OLD<br />validity and reliability was determined using Cronbach alpha value. Analysis<br />extracted six scales which influence quality of life among elderly, and results showed<br />that physical health, covered with physical functioning scale and selfcare scale, has<br />dominant influence (39,3%) in creating global QOL-OLD index. Each domain and<br />QOL-OLD index was analyzed considering some socio-demographic determinants<br />which showed impact on single domains and on total QOL-OLD index. Extracting<br />items from initial modified McMaster Health Index Questionnaire enabled<br />construction of shortened and valid questionnaire for assessment health related quality<br />of life among elderly in the population but also for individuals of same age.</p>

Charles University, Faculty of Pharmacy in Hradec Králové Department of Social and Clinical Pharmacy Candidate: Yuliia Kliui Consultant: PharmDr. Martin Doseděl PhD. Title of the diploma thesis: The Analysis of Senior's Opinions on Self-treatment by non- steroidal anti-inflammatory drugs Introduction: Due to their significant analgesic and antiphlogistic effects are non-steroidal anti-inflammatory drugs one of the most prescribed drugs. According to the high number of side effects and drug-drug interactions, it is important to pay attention to their presence in patient's medication. The importance of drug related problems increases in polymorbid and geriatric patients, who's medication can be altered by the presence of non-steroidal anti-inflammatory drugs, which can lead to unwanted complications. Aim of study: The principal aim of the theoretical part is to elaborate a review of the drug related problems concerning the side effects and drug-drug interactiond of NSAIDs. The practical part analyses via a question-study the senior's opinion and experiences on self- medication by analgesics focusing on ibuprofen. Methods: A cross sectional study have been conducted in the city of Kharkov in Ukraine. The data have been collected during an interview with a questionnaire. The used questionnairre has...

The Analysis of Senior's Opinions on Self-treatment by non-steroidal anti-inflammatory drugs II Author: Jana Čižmárová Supervisor of the thesis: PharmDr. Martin Doseděl, Ph.D. Department: Department of Social and Clinical Pharmacy Background: Self-medication is a growing trend in a society with widespread use of over- the-counter medicines. Among the OTC medicines, analgesics belong to the drugs with the highest consumption. They are also popular in the group of seniors, who often suffer from chronic pain, mainly of the musculoskeletal system. Aim of study: In the theoretical part to carry out a review of published papers concerning safety of self-medication with analgesics and non-steroidal anti-inflammatory drugs. In the practical part, by performing a questionnaire survey to acquire and analyze the attitudes of seniors regarding self-medication with analgesics and anti-inflammatory drugs focused on ibuprofen. Methods: An observational cross-sectional study was carried out in the facilities for seniors of the Trenčín region. The survey was conducted by interview with senior using questionnaire sheets. The research took place in the period July to September 2019. Results: 64.0 % of seniors suffered from almost every day or daily pain, mainly from musculoskeletal pain. The main counselling subject...

The Analysis of Seniors' Opinions on Self-treatment by Non-steroidal Anti-inflamatory Drugs III Charles University, Faculty of Pharmacy in Hradec Králové Department of: Social and Clinical Pharmacy Candidate: Marek Procházka Consultant: PharmDr.Martin Doseděl, Ph.D. Background: Self-treatment is one of the approaches in managing pain which is still gaining higher level of importance even amongst seniors. One of the most favourite over the counter (OTC) analgesics is ibuprofen, however its use can be associated with certain drug related problems (DRP). The potential of DRPs is increasing with age which makes seniors more sensitive to them. Aim of study: 1) To create an overview of DRPs of OTC analgesics, focusing on paracetamol (acetaminophen). 2) Through the survey find out the knowledge and experience of seniors with self-treatment by OTC analgesics. The other aim was to evaluate their sources of information concerning ibuprofen and their preferences to each product. Methods: The observable cross-sectional study was made through social media and in Královéhradecký region. In the first case the questionnaire was spread through social media- Facebook. In the second case standardised conversation with questionnaire lists was applied with seniors above 60 years of age. The research was anonymous and...

Background: Palliative care is required for patients who have no chance of curative treatment. The age group 65 and older is a growing population. Palliative care for the elderly was uniquely challenging and differed from palliative care for younger patients. Palliative care for the elderly was not about prolonging life, it was about making the last phase of life as comfortable as possible. Aim: The aim was to describe nurses’ experiences of working with palliative care of the elderly. Method: A literature-basedstudy was conducted. Seven articles were analyzed according to Friberg’s five-stepmodel. Results: Three main themes emerged: feelings of insufficiency, working with aperson-centered approach and collegial cooperation. Seven sub-themes were identified: insufficiency in supporting relatives, insufficiency in giving satisfactory palliative care, a caring relationship, working for the patient’s best interest, the nurse’s need of support, lack of cooperation with physician and the nurse’s supportive role. Conclusion: when nurses were caring for the dying elderly, nurses were in need of more support. / Arbete som sker i närvaro av döden kan vara utmanande och innebär att ställas inför svåra situationer. Palliativ vård erbjuds till människor som är i livets slut samt där botande behandling inte längre är möjligt. Fokus för vården är då istället att lindra patientens lidande och främja patientens livskvalitet. Detta litteraturbaserade examensarbete beskriver sjuksköterskors upplevelser av arbetet inom palliativ vård av äldre. Det föreligger anledning att beskriva sjuksköterskors upplevelser av arbetet inom palliativvård av äldre eftersom åldersgruppen 65 år och äldre är en växande population som dessutom klassas som sårbar. Sjuksköterskor upplevde arbetet inom palliativ vård av äldre som känslomässigt utmanande med situationer som kantats av otillräcklighet, bristande samarbete och frånvaro av stöd. Trots detta belyste sjuksköterskor vikten av att arbeta utifrån ett personcentrerat förhållningssätt genom att skapa en vårdande relation med patienten och arbeta för patientens bästa. För att kunna bedriva en god palliativ vård för äldre är det viktigt att sjuksköterskor ges möjlighet till stöd för att minska känslan av otillräcklighet och för att hantera psykiska påfrestningar.