Thesis (M.A.) - Simon Fraser University, 2005. / Theses (Dept. of Gerontology) / Simon Fraser University. Also issued in digital format and available on the World Wide Web.

Thesis (M.A.)--Marshall University, 2003. / Title from document title page. Document formatted into pages; contains ii, 46 p. Includes vita. Includes bibliographical references (p. 43).

The projected growth of persons ages 65 and older in the U.S. over the next few decades will usher in an era of unprecedented numbers of seniors licensed to drive. For some members of this group, there will come a time where driving will have to cease due to a variety of factors. At that juncture in their lives, these seniors may have to consider transportation alternatives other than the personally operated vehicle. The objective of this study is to evaluate potential changes in transit market share arising from travel behavior changes of seniors who lose their driving privileges. This includes determining seniors interest in, ability to, and subsequent use of public transit. First, a literature review of developments that have impacted senior travel behavior is presented. Developments such as the changing demographics of seniors, senior socio-economic status, the process of driving retirement, and factors influencing transit use by seniors are presented. Estimates of the numbers of licensed and former drivers are derived for the year 2030 using several methodological approaches. Trip rates are applied to the predicted non-driving population to derive estimates of the potential demand for transit and subsequent market share. Discussion of the estimated market share results also incorporates a descriptive overview of senior travel behavior as derived from analyses of publicly available datasets followed by focus group results illustrating the experiences of seniors and their transportation choices.Recommendations range from transit agencies engaging in direct "generational" marketing to seniors in order to understand their transportation needs as well as perceptions about transit, promoting the use of transit, and demonstrating the viability of transit for specific trip purposes and partner with rideshare providers. Despite the predicted increase in transit market shares attributable to the senior population, transit providers have extensive work to do to change the perceptions of transit service provision and subsequently encourage the use of such services by senior populations in forthcoming generations if transit is to become a viable transportation alternative for those seniors ceasing to drive.

Guaranteed cohabitation of elderly couples is a new law that gives elderly couples the right to live together in special housing. Even if only one of the spouses has an administrator’s decision to live in special housing. The aim of this study is to describe and understand how three municipalities materialize the social rights guaranteed for the elderly couples’ cohabitation. This qualitative study is based on four semi-structured interviews and official documents. Those who participated in the study work as various officials and the aim of the interviews were to find out how the officials work and offer the guaranteed cohabitation of elderly couples in their community.  The results of the study show that the officials have a good discretion when it comes to working with the guaranteed cohabitation of elderly couples. Although the guarantee cohabitation of elderly couples gives elderly couples the right to live together. There are not any rules or guidelines to how the rights should be implemented. So each municipality can decide for themselves how they want to provide elderly couples cohabitation.

Diss. (sammanfattning) Stockholm : Karol. inst., 2004. / Härtill 4 uppsatser.

Thesis (Ph. D.)--State University of New York at Binghamton, Decker School of Nursing, Rural Nursing, 2009. / Includes bibliographical references.

Submitted by Aelson Maciera (aelsoncm@terra.com.br) on 2017-08-03T19:00:02Z No. of bitstreams: 1 DissALCM.pdf: 1925747 bytes, checksum: a2061ae118cc5edbf3ec5d6b5c0711ce (MD5) / Approved for entry into archive by Ronildo Prado (ronisp@ufscar.br) on 2017-08-08T14:22:11Z (GMT) No. of bitstreams: 1 DissALCM.pdf: 1925747 bytes, checksum: a2061ae118cc5edbf3ec5d6b5c0711ce (MD5) / Approved for entry into archive by Ronildo Prado (ronisp@ufscar.br) on 2017-08-08T14:22:19Z (GMT) No. of bitstreams: 1 DissALCM.pdf: 1925747 bytes, checksum: a2061ae118cc5edbf3ec5d6b5c0711ce (MD5) / Made available in DSpace on 2017-08-08T14:22:27Z (GMT). No. of bitstreams: 1 DissALCM.pdf: 1925747 bytes, checksum: a2061ae118cc5edbf3ec5d6b5c0711ce (MD5) Previous issue date: 2017-02-21 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / Introduction: Frailty, defined as a multifactorial syndrome that can cause functional disability and an increased risk of comorbidities. Older people in a context of high social vulnerability may present greater risk of frailty. The identification of frailty’s levels and associated factors in the elderly in situations of social vulnerability is fundamental for a social care and health care therapy. Objective: To identify the factors associated with frailty in the elderly living in the context of high social vulnerability. Methodology: This is a correlational, cross-sectional research. The data collection was carried out at the participants' home with application of the instruments: Socio-demographic Questionnaire; Fried Frailty Phenotype Assessment; Mini Mental State Examination; Geriatric Depression Scale; Katz Index of Independence in Activities of Daily Living; Lawton And Brody Instrumental Activities Of Daily Living; Advanced Daily Life Activity Questionnaire - FIBRA network; International Physical Activity Questionnaire; Timed Up and Go Test; and Social Support Scale of the Medical Outcome Study. The Research Ethics Committee of the Federal University of São Carlos approved the project (Opinion No. 1,207,390). Logistic regression was performed to analyze the data. Results: Of the 304 elderly evaluated, 56,9% were female, 53,5% were aged between 60 and 69 years, 12.2% were classified as non-fragile, 60.5% as pre-fragile and 27.3% classified as fragile. The main factors associated with fragility in the studied sample were presence of depressive symptoms (OR: 1.9 95% CI: 1,1 – 3,7), mobility deficit (OR: 3.0 95% CI: 1,5 – 5,8), occurrence of two or more falls within 12 months (OR: 3,1 95% CI: 1,4 – 7,1) and low level of physical activity (OR: 5.2 95% CI: 2,5 – 11,0). Conclusion: The associated factors confirm the relationship between deficits in the physical and psychological aspects resulting from the aging process and socioeconomic conditions with the presence of frailty, in order to meet the national and international publications on the subject. The present study presented contributions so that new public policies can be created and new actions can be planned and implemented by health institutions and professionals, aiming at the promotion of health, prevention of associated factors, reversion and impediment of the progress of frailty, considering the negative impact it generates on the life of the elderly individual. / Introdução: A fragilidade, definida como uma síndrome multifatorial que pode ocasionar incapacidade funcional e maior risco de comorbidades. Idosos em contexto de alta vulnerabilidade social podem apresentar maior risco de fragilidade. A identificação de níveis de fragilidade e fatores associados em idosos em situação de vulnerabilidade social é fundamental para uma adequada assistência social e em saúde. Objetivo: Identificar os fatores associados à fragilidade em idosos que residem em contexto de alta vulnerabilidade social. Método: Trata-se de uma pesquisa correlacional, de corte transversal. A coleta de dados foi realizada no domicílio dos participantes com aplicação dos instrumentos: Caracterização Sociodemográfica; Avaliação do Fenótipo de Fragilidade de Fried; Mini Exame do Estado Mental; Escala de Depressão Geriátrica; Escala de Independência em Atividades de Vida Viária de Katz; Escala de Independência de Atividades Instrumentais de Vida Diária de Lawton e Brody; Questionário de Atividades Avançadas de Vida Diária – Rede FIBRA; Questionário Internacional de Atividade Física; Teste Timed Up and Go; e Escala de Apoio Social do Medical Outcome Study. O projeto foi aprovado pelo Comitê de Ética em Pesquisa da Universidade Federal de São Carlos (Parecer nº 1.207.390). Para análise dos dados foi realizado regressão logística. Resultados: dos 304 idosos avaliados, 56,9% eram do sexo feminino, 53,5% possuía idade entre 60 a 69 anos, 12,2% foram classificados como não-frágeis, 60,5% pré-frágeis e 27,3% foram classificados como frágeis. Os principais fatores associados a fragilidade na amostra estudada foram presença de sintomas depressivos (OR: 1,9 95% IC: 1,1 - 3,7), déficit de mobilidade (OR: 3,0 IC 95%: 1,5 - 5,8), ocorrência de duas ou mais quedas dentro de 12 meses (OR: 3,1 IC 95%: 1,4-7,1) e baixo nível de atividade física (OR: 5,2 IC 95%: 2,5 - 11,0). Conclusão: Os fatores associados encontrados confirmam a relação entre déficits nos aspectos físicos e psicológicos decorrentes do processo de envelhecimento e condições socioeconômicas com a presença da fragilidade, indo ao encontro das publicações nacionais e internacionais sobre o tema. O presente estudo apresentou contribuições para que novas políticas públicas possam ser criadas e novas ações possam ser planejadas e implantadas por instituições e profissionais de saúde, visando a promoção de saúde, prevenção de fatores associados, reversão e impedimento do progresso da fragilidade, considerando-se o impacto negativo que essa gera na vida do indivíduo idoso.

A Síndrome da Fragilidade no Idoso (SFI) é entendida como uma síndrome clínica caracterizada pelo declínio funcional dos sistemas fisiológicos resultando na diminuição de energia e resistência do organismo. É determinada por fatores de risco sociais, biológicos, ambientais e psicológicos. O objetivo geral desta investigação foi: analisar os fatores de risco para a SFI visando contribuir para a elaboração de Diagnósticos de Enfermagem (DE) relacionados a esta condição clínica. Já os objetivos específicos foram caracterizar o perfil socioeconômico e demográfico, de morbidades crônicas e de condições de saúde dos idosos; identificar os fatores associados à SFI a partir do perfil socioeconômico e demográfico de morbidades crônicas e de condições de saúde dos idosos; verificar a prevalência da SFI a partir da aplicação da Escala de Fragilidade de Edmonton (EFS), verificar a associação entre os fatores de risco para SFI com os níveis da EFS e relacionar as características definidoras dos DE em idosos na comunidade e hospitalizados com as características dos fatores de risco para a SFI. Caracteriza-se por um estudo transversal com abordagem quantitativa, realizado com 306 idosos que frequentam 11 grupos de convivência do município de Frederico Westphalen/RS. Os dados foram coletados por meio de um instrumento contendo questões socioeconômicas e demográficas, morbidades crônicas e de condições de saúde com posterior aplicação da EFS. Para a análise dos dados, foi utilizado o programa estatístico SPSS versão 18.0. O projeto de pesquisa foi submetido ao Comitê de Ética da URI – campus de Frederico Westphalen, o qual foi aprovado e registrado sob o número CAEE 0046.0.284.000-11. Como resultados do estudo, constatou-se, o predomínio do sexo feminino 196 (64,1%) e da cor branca 249 (81,4%), a maioria que vive com o cônjuge ou companheiro (a) 216 (70,8%), e mora em casa própria 291 (95,1%), reside ou residiu a maior parte de sua vida na área rural. Observa-se ainda que 272 (89,2 %) idosos sabem ler e estudaram de 1 a 4 anos 138 (63,4%), 267 (87,5 %) idosos são aposentados. Constatou-se que 182 (59,5%) idosos apresentaram HAS, 163 (54,5%) Depressão, 100 (32,7 %) Doença do coração, 14 (4,6%) Derrame cerebral, 40 (13,1%) Problemas renais e 39 (12,8%) Câncer e Diabetes Mellitus. Quanto às variáveis de condições de saúde, a presença de fraqueza no corpo foi referida por 141 (46,2%) idosos e a queda no último ano ocorreu em 121 (39,7%) idosos. Sendo assim, obteve-se uma prevalência de SFI de 39,2 % (n=62), sendo que, dentre os sujeitos do estudo, 17,3% (19) são do sexo masculino e 21,9% (43) do sexo feminino. Os fatores de risco que permaneceram associados à SFI, após o ajuste pela análise multivariada, foram: idade (p=0,002), fraqueza no corpo (p=0,001), presença de morbidades crônicas (p=0,042), convívio social (p=0,046) e quedas (p=0,011). De posse dos fatores de risco para a SFI, realizou-se uma relação entre as características definidoras de Diagnósticos de Enfermagem (DE) presentes em idosos na comunidade e hospitalizados presentes na literatura com as características dos fatores de risco para a SFI. / The Fragility Syndrome in the Elderly (SFI) is understood as a syndrome characterized by the functional decline of the physiologic systems resulting in lower energy and resistance of the organism. It is determined by social, biological, environmental and psychological risk factors. The common goal of this research was: to analyze the risk factors for the SFI, aiming to contribute to the development of Nursing Diagnoses (DE) related to this clinical condition, with the following specific goals: to characterize the socioeconomic and demographic profile of chronic morbidity and health conditions of the elderly; identify the risk factors for SFI from the socioeconomic and demographic profile of chronic morbidities and health conditions of the elderly; assess the prevalence of SFI from the application of the Scale of Fragility from Edmonton (EFS), check the association between the risk factors for SFI with the levels of the EFS and relate the defining characteristics of DE in hospitalized elderly in the community and with the characteristics of risk factors for SFI. It is characterized by a cross-sectional study with a quantitative approach, conducted with 306 elderly people who attend support groups, from the city of Frederico Westphalen / RS. The data were collected by using an instrument containing demographic and socioeconomic issues, chronic morbidities and health conditions with subsequent application of the EFS. To the statistical analysis it was built a program SPSS version 18.0. The research project was submitted to the Ethics Committee of URI – campus of Frederico Westphalen, which was approved and registered under the number CAEE 0046.0.284.000-11. As the results of the study, it was regarded indicators the predominance of females 196 (64.1%), the prevalence of white 249 (81.4%) and most of them live with their husband/wife or partner 216 (70 8%), live in their own home 291 (95.1%) and live or has resided most of their life in rural areas. It was also noticed that 272 (89.2%) elderly can read and studied from1 to 4 years 138 (63.4%). It is emphasized that 267 seniors are retired and the monthly income that prevailed is from 1 to <2 wages. In the case of chronic morbidities, it was found that 182 (59.5%) elderly showed HAS, 163 (54.5%) depression, 100 (32.7%) heart disease, 14 (4.6%) Stroke, 40 (13.1%) Kidney problems and 39 (12.8%) Cancer and Diabetes Mellitus. Regarding to the variables of health conditions, it is emphasized the presence of weakness in the body reported by 141 (46.2%) elderly. Another relevant factor is the presence of fall in the last year, which occurred in 121 (39.7%) elderly. Thus, we obtained a prevalence of SFI in 39.2% (n = 62), being that, among the study subjects, 17.3% (19) are male and 21.9% (43) female. The risk factors that remained associated with the SFI, after the adjustment by the multivariate analysis were: age (p = 0.002), weakness in the body (p = 0.001), presence of chronic morbidities (p = 0.042), social interaction (p = 0.046) and falls (p = 0.011). In possession of the risk factors for the SFI, it was done a relationship with the defining characteristics of nursing diagnoses (DE) present in the elderly in the community and hospitalized in the literature with the characteristics of risk factors for SFI. / La Síndrome de la Fragilidad en el Anciano (SFI) es entendida como una síndrome clínica caracterizada por la declinación funcional de los sistemas fisiológicos resultando en la disminución de energía y resistencia del organismo. Es determinada por factores de riesgo sociales, biológicos, ambientales y psicológicos. El objetivo general de esta investigación fue: analizar los factores de riesgo para a SFI visando contribuir para la elaboración de Diagnósticos de Enfermería (DE) relacionados a esta condición clínica; y los objetivos específicos: caracterizar el perfil socioeconómico y demográfico, de morbosidades crónicas y de condiciones de salud de los mayores; identificar los factores de riesgo para SFI a partir del perfil socioeconómico y demográfico de morbosidades crónicas y de condiciones de salud de los ancianos; verificar la prevalencia de la SFI a partir de la aplicación de la Escala de Fragilidad de Edmonton (EFS), verificar la asociación entre los factores de riesgo para SFI con los niveles de la EFS y relacionar las características definitorias de la disfunción eréctil en los ancianos hospitalizados en la comunidad y con las características de los factores de riesgo para la SFI. Se caracteriza por un estudio transversal con abordaje cuantitativo, realizado con 306 ancianos que frecuentan 11 grupos de convivencia del municipio de Frederico Westphalen/RS. Los datos fueron colectados por medio de un instrumento conteniendo cuestiones socioeconómicas y demográficas, morbosidades crónicas y de condiciones de salud con posterior aplicación de la EFS. Para el análisis estadístico fue utilizado o programa estadístico SPSS (StatisticalPackage for Social Sciences) versión 18.0. El proyecto de investigación fue sometido al Comité de Ética de URI – campus de Frederico Westphalen, lo cual fue aprobado y registrado bajo el número CAEE 0046.0.284.000-11. Como resultados del estudio se constató el predominio del sexo femenino 196 (64,1%) y del color blanca 249 (81,4%), la mayoría vive con el cónyuge o compañero (a) 216 (70,8%), y vive en casa propia 291 (95,1%), reside o residió la mayor parte de su vida en el área rural. Aún se observa que 272 (89,2 %) ancianos saben leer y estudiaron de 1 a 4 años 138 (63,4%), 267 (87,5 %) son jubilados. Se constató que 182 (59,5%) ancianos presentaron HAS, 163 (54,5%) Depresión, 100 (32,7 %) Enfermedad del corazón, 14 (4,6%) Derrame cerebral, 40 (13,1%) Problemas renales y 39 (12,8%) Cáncer y Diabetes Mellitus. Cuanto a las variables de condiciones de salud, se enfatiza la presencia de flaqueza en el cuerpo referida por 141 (46,2%) ancianos. Otro factor que se debe poner de relieve es la presencia de caída en el último año, que ocurrió en 121 (39,7%) mayores. Siendo así, obtuvimos una prevalencia de SFI de 39,2 % (n=62), siendo que, de entre los sujetos del estudio, 17,3% (19) son del sexo masculino y 21,9% (43) del sexo femenino. Los factores de riesgo que permanecieron asociados con la SFI, después el ajuste por el análisis multivariado fueron: edad (p=0,002), flaqueza en el cuerpo (p=0,001), presencia de morbosidades crónicas (p=0,042), convivio social (p=0,046) y caídas (p=0,011). De pose de los factores de riesgo para la SFI, se realizó una relación con las características que definen DE en ancianos en la comunidad y hospitalizados presentes en la bibliografía con las características de los factores de riesgo para la SFI.

Este estudo teve como objetivo compreender formas de ser cuidadora de idosos a partir das histórias de vida de cuidadoras residentes no município de Farroupilha. O referencial teórico para este estudo baseou-se nos conceitos relacionados à velhice, redes de apoio, trabalho, cuidador e políticas. Foram entrevistadas 03 mulheres que cuidam de mães dependentes, tendo as cuidadoras idade superior a 50 anos e suas mães com idade superior a 80. Ao longo desta pesquisa, deu-se voz a fala das cuidadoras, procurando identificar a rede de apoio por elas acionadas, bem como os principais sentimentos presentes na relação do cuidado. Foi empregada a técnica das Histórias de Vida, podendo destacar como principais temas abordados pelas entrevistadas a rotina, rede de apoio formal e informal, trabalho, sentimentos presentes no cuidado. Este material foi analisado a partir da proposta de análise de conteúdo. Os resultados mostram a importância da rede na vida das cuidadoras, destacando a subdivisão entre rede formal e informal de apoio. Foi possível perceber que a rede de apoio informal surge de forma espontânea para suprir deficiências ainda presentes na rede formal. Quanto à rotina, esta serve como fator organizador das atividades do dia das cuidadoras, não sendo possível definir se quem determinou a rotina atual foi a cuidadora ou a mãe. Em relação ao trabalho, as cuidadoras lidaram de maneiras distintas em relação a este. Há uma ligação íntima entre o trabalho formal e a atividade de ser cuidadora. Ser cuidadora influenciou as filhas tanto no momento da saída do trabalho quanto na retomada do mesmo. Frente a estas realidades verificamos que embora algumas ações já estejam acontecendo, muito ainda há para ser feito. A partir daí, pudemos propor ações e/ou políticas que possam vir a contribuir para que as cuidadoras de idosos consigam dar o suporte necessário para suas mães. / The purpose of this study was to understand some ways to be an elderly caregiver from histories of life of elderly caregivers residents in the city of Farroupilha. The theory for this study was based on the concepts related to the oldness, supporting nets, working, minders and policies. Three women had been interviewed whom are caregivers of dependent mothers, the formers being more than 50 years and the mothers aged over 80 years. Throughout this research, voice was given to the keepers, trying to identify the supporting net they set, as well as the main feelings related to the people they look after. The technique of Histories of Life was used, can be detach as the main subjects taking by the interviewed the routine, the formal and informal supporting net, working, feelings to the people they look after. This material was analysed based on the proposal of analysis of content. The results show the importance of the net for the caregivers life, detaching the subdivision between formal and informal supporting net. It was possible to perceive that the informal supporting net appears spontaneously to cover deficiencies in the formal net. Regarding the routine, it works as an organizing factor for the daily activities of the caregivers, not being possible to define whether the actual routine was determined by the keeper or the mother. As for the work, the caregivers had dealt in different ways. There is a close relation between the formal work and the activity of being a caregiver. Becoming a caregiver had influenced the daughter both when leaving the formal work and when retaken it. In front of this realities it is possible to notice that although some actions have already being taken, there is still a lot to be done. Starting from there, it was possible to consider some actions and/or policies that can eventually contribute to the elderly caregivers to obtain the necessary support for their mothers.

For more than four decades, researchers have found depression to be a common mental illness among the elderly (Charatan, 1975; Sreevani & Reddemma, 2012). In Malaysia, the rates of depression among elderly residents of institutions are 67% higher than among elderly adults residing at home (Al-Jawad, Rashid, & Narayan, 2007). As in the United States, elderly Malaysian women are twice as likely to be diagnosed with depressive symptoms as elderly men (Salimah et al., 2008). Time and again, research has revealed that depression is a significant problem for individuals later in life and may affect their psychological well-being. The purpose of this cross-sectional study was to examine the relationship among depression and factors of psychological well-being among Malay, Chinese, and Indian elderly women living in four Rumah Seri Kenangans (RSKs), or public welfare institutions in Malaysia. Face-to-face interviews were conducted from August to October 2013 to measure participants' baseline depression, perceived social support, spiritual intelligence, self-esteem, and level of social desirability. A diverse group of 163 elderly women participated in this study, including 84 ethnic Malays (51.5%), 43 ethnic Chinese (26.4%), and 36 ethnic Indians (22.1%) with an average age of 70 (SD = 7.10). The results indicated that there were significant differences between the three ethnic groups in terms of their depression, spiritual intelligence, and perceived social support. Chinese elderly women were found to have higher baseline rates of depression, lower spiritual intelligence, and lower perceived social support than Malay as well as Indian elderly women. The results indicated that 37% of the combination of spiritual intelligence, perceived social support, self-esteem, and social desirability significantly predicted depression among elderly female participants (F(4,127)=22.77, p < .001). However, only perceived social support and self-esteem were found to be significant predictors of depression among the elderly women of the selected RSKs. These results led to some important implications for practitioners working with the elderly population in institutions, as well as for counselor educators. Limitations and recommendations for future research are also provided.