Bakgrund Undernäring uppstår om en individs näringsintag är mindre än dennes näringsbehov och är vanligt förekommande hos äldre patienter. Sjuksköterskan har ett viktigt ansvar att identifiera patienter med risk för undernäring och förebygga undernäring, då det skapar ett onödigt lidande för patienten. Syfte Syftet var att genom en litteraturstudie undersöka vilka åtgärder sjuksköterskan vidtar kliniskt och effekten av att åtgärder sätts in vid risk för undernäring, samt sjuksköterskors grundläggande kunskap om nutrition för att förhindra att lidande till följd av undernäring hos äldre uppstår. Metod Originalartiklar söktes i databaserna PubMed och Cinahl. Abstracts lästes igenom för att identifiera artiklar som svarade på denna studies syfte. Artiklarna kvalitetsbedömdes och deras resultat granskades. Resultat Sjuksköterskor förhindrar undernäring genom att tidigt göra en riskbedömning, där viktutveckling, BMI och ätsvårigheter uppmärksammas. Genom att administrera näringsberikad kost och mellanmål, kan sjuksköterskan förebygga undernäring hos äldre patienter, vilket kunde noteras på ett förbättrat BMI och MNA-poäng. Sjuksköterskor upplever sig inte ha den grundläggande kunskapen om nutrition som krävs. Slutsats Energi- och proteinberikning kan vara en effektiv åtgärd för att minska risken för undernäring. Om åtgärder sätts in redan vid risk för undernäring, kan en effekt noteras i ett ökat BMI och MNA-poäng. Sjuksköterskor upplever att de saknar kunskap om nutrition. / Background Malnutrition is developed if a person’s food intake is less than the nutritional requirements and is common among elderly patients. The nurse has an important role to identify patients with risk of malnutrition and to prevent malnutrition, since it is an unnecessary suffering for the patient. Objective A literature study was performed to investigate which nursing interventions nurses use, the effect if these interventions start at an early point and nurses’ knowledge about nutrition to prevent malnutrition and suffering. Method Original articles were searched for in the data bases PubMed and Cinahl. Abstracts were read through, to identify articles that answered this study’s objective. The qualities of the articles were valued and the results were analysed. Just the results that is relevant for this study is present. Results Nurses can prevent malnutrition by using risk assessment tools, where the patients’ weight development, BMI and eating difficulties are continuously registered. There is some evidence that energy and protein fortification can decrease a patient’s risk of getting malnourished. This could be presented with an improved BMI and MNA score. Nurses believe that they have a lack of knowledge about nutrition. Conclusion Nurses can prevent malnutrition by doing a risk assessment. Energy and protein fortification can serve as an effective intervention to prevent malnutrition in the elderly, which could be seen as an increased BMI and MNA score. Nurses believe that they have a lack of knowledge about nutrition.

BACKGROUND: Constipation is highly prevalent in older adults and may be associated with greater frequency of acute exacerbation of chronic obstructive pulmonary disease (AECOPD). We investigated the prevalence of lower defecation frequency (DF) and risk factors (including AECOPD) associated with lower DF among hospitalized elderly patients. METHODS: We conducted a retrospective case-control study in a community hospital of Southeast Ohio. Adults aged 65 years or older admitted during 2004 and 2006 were reviewed (N = 1288). Patients were excluded (N = 212) if their length of stay was less than 3 days, discharge diagnosis of Clostridium difficile-associated diarrhea, death or ventilator- dependent respiratory failure during hospitalization. Lower DF was defined as either an average DF of 0.33 or less per day or no defecation in the first three days of hospitalization; cases (N = 406) and controls (N = 670) were included for the final analysis. RESULTS: Approximately 38% had lower DF in this patient population. Fecal soiling/smearing of at least two episodes was documented in 7% of the patients. With the adjustment of confounders, AECOPD (adjusted odds ratio [AOR] =1.47, 95% confidence interval [CI] =1.01-2.13) and muscle relaxant use (AOR =2.94; 95% CI =1.29-6.69) were significantly associated with lower DF. Supplementation of potassium and antibiotic use prior to hospitalization was associated with lower risk of lower DF. CONCLUSIONS: Approximately 38% of hospitalized older adults had lower DF. AECOPD and use of muscle relaxant were significantly associated with lower DF; while supplementation of potassium and antibiotic use were protective for lower DF risk after adjusting for other variables.

In the planning and delivery of services the voice and choice of consumers have appeared as the foremost key factors. For a large number of organisations the received feedback from customers about the quality of services, which are the criteria and indication of their level of satisfaction play a crucial role in the improvement of quality. Although across developed western communities, the importance of customers’ views has gained acceptance, few studies have been dedicated to the exploration of the voice of the residents in care homes. The review of the literature regarding residents’ satisfaction and quality in care homes revealed that the voices of residents in care homes are usually not heard or are absent. Moreover, the adoption of quality improvement tools in health care has lagged behind that in other industries and there is generally a failure to use an appropriate methodology in care homes, one based on residents’ voice, for improving quality. As a result, the main aim of this research is to investigate residents’ voice regarding improving their satisfaction in care homes. Further, the researcher seeks to obtain data by using an appropriate methodology to assist care home managers in enhancing the quality of the services they offer by assigning weights to quality indicators pertaining to improving quality and residents’ levels of satisfaction. For this purpose, this research employs both qualitative and quantitative approaches to develop a research process entailing: (1) a comprehensive literature review to recognise the phenomenon; (2) interviews with fifteen older people who lived in three different care homes in order to discover the most important residents’ needs and requirements in such homes; (3) a resident survey with one hundred and two residents in thirty five care homes. These were conducted to assess their preferences for the importance of demanded qualities; their satisfaction with provided services and the attributes of each demanded quality based on the Kano model, in order to identify the priority of improvement. Next, (4) there was the development of the House of Quality (HoQ) to optimize quality to assure residents’ satisfaction; and finally, (5) an evaluation study was conducted with thirteen service providers, in order to assess the accuracy and appropriateness of the methodology. This research has contributed towards a better understanding of the residents’ voice, and applying it for enhancing quality and residents’ satisfaction in care homes. For the first time residents’ requirements are prioritised and classified in this context through accurate methods. Moreover, an understanding of the attributes of care home residents’ needs in relation to a Kano model has been elicited. The novelty of this proposed methodology is in utilising the Quality Function Deployment (QFD) in care homes to translate the voice of residents’ regarding their requirements into service planning. The research methodology and results facilitate care home managers with a hierarchy for improvement planning at both service and executive management levels.

An increase in postural sway is one of the risk factors that have been linked to an increased incidence of falls in the older adult population. Researchers have shown that peripheral sensation is crucial in maintaining a static posture for adults of all ages. It has been reported that older adults have decreased tactile sensation of the plantar surface of their feet. and when the sensory feedback was increased older adults had improved postural control. It was hypothesized that facilitation of the sole of the foot with the use of a semirigid foot orthotic would result in improved postural stability in older adults. Twenty-seven volunteers (19 females, 8 males, mean age: 87 ± 5 yrs) were recruited as subjects from a retirement community. All subjects were supplied with the SmartStep™ Stabilization System. There were a total of 5 Test Days for each subject. The first 2 Test Days were performed while the subjects wore their own shoes, while the last 3 Test Days were performed while the subjects wore the SmartStep™. Test Days 1 and 2 were performed 48 hours apart. Test Day 3 occurred 2 to 4 weeks after Test 2. Test Days 4 and 5 occurred 4-weeks after the prior Test Day. During the 8-weeks between Test Days 3 and 5, subjects were asked to wear the SmartStep™ as their daily shoe. Clinical measures of balance, force plate measurements, sensation testing, and confidence and activity scales were collected on all subjects throughout the eight week test period. Statistical significance was found for 3 of the clinical measures. The Timed “Up & Go” improved from 17.25 to 15.47 sec. The Functional Reach and Lateral Reach Tests demonstrated a decline in scores during the eight weeks. There was only 1 statistically significant finding for the force plate measures. The center of pressure displacement in the anteriorposterior direction was increased from 4.6 to 5.3 cm. No significant differences where reported for any other dependent variable. The results did not indicate statistically that the in-shoe orthotic enhanced postural stability in this group of subjects. However, there were indications that there was a subset of the current population that benefited from the intervention and this needs to be investigated further.

<p>Bilingualism and its effect on individuals have been studied within different disciplines. Although the first psychological study of bilingualism was couducted by Cattell as early as 1887, only a few studies have exclusively investigated the effect of bilingualism on memory systems’ functioning. In the field of cognitive psychology of bilingualism, there is some evidence for the positive influence of bilingualism on children’s cognitive ability across various domains but there is little knowledge about the relationship between bilingualism and memory in a lifespan perspective. This thesis’s main aim was to investigate memory systems’ functioning and development in bilingual individuals. To this end, two studies were performed: a cross-sectional study of bilingual children (Study I) and a longitudinal study of young and older adults (Study II). The purpose of Studies I and II was to determine whether there are differences between monolinguals and bilinguals regarding various memory systems’ functioning. Study I compared monolingual and bilingual children’s performance on episodic and semantic memory, and Study II investigated performance on episodic and semantic memory in bilingual younger and older adults. Specifically, these studies aimed to examine a) which memory systems will be affected more as a function of language, and b) to what extent the differences would manifest themselves during a subject’s lifespan. The purpose of Study III was to explain the relation among word representations, lexical access and lexical selection in a bilingual word production paradigm. In this study, a model of bilingual production was developed to explain the results and clarify the role of automatic and controlled processes in using two languages. The results of Studies I and II showed a superiority of bilinguals over monolinguals as well as a variation of association between memory performance and bilingualism across different periods of adulthood. It appears that the lifelong experience of managing two languages enhances control processes, which in turn play an important role in enhancing memory performance. Using a “dual mechanism model”, Study III explains the efficiency of inhibitory processing when having two languages activated.</p>

In recent years, the increase in the amount of elderly people has gained importance and significance and has become one of the major social challenges for most developed countries. More than one third of elderly fall at least once a year and often are not able to get up again unsupported, especially if they live alone. Smart homes can provide efficient and cost effective solutions, using technologies in order to sense the environment and helping to understand the occurrence of a possible dangerous situation. Robotic assistance is one of the most promising technologies for recognizing a fallen person and helping him/her in case of danger. This dissertation presents two methods, to detect first and then to recognize the presence or non-presence of a human being on the ground. The first method is based on Kinect depth image, thresholding and blob analysis for detecting human presence. While, the second is a GLCM feature-based method, evaluated from two different classifiers, namely Support Vector Machine (SVM) and Artificial Neural Network (ANN) for recognizing human from non-human. Results show that SVM and ANN can classify the presence of a person with 76.5 and 85.6 of accuracy, respectively. This shows that these methods can potentially be used to recognize the presence or absence of fallen human lying on the floor.

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Susirgimai dažnas palydovas senėjimo procese. Vyresnio amžiaus žmonės dažniau turi fizinių sveikatos problemų, kurios yra sudėtinės, lėtinės. Beveik visada augantis sergančiųjų priežiūros poreikis skatina santykių šeimoje pasikeitimą. Iš naujo skirstomos užduotys ir atsakomybė bei atsisakoma ankstesnių vaidmenų. Susirgus sutuoktiniui, kuriam reikalinga kito sutuoktinio slauga labai svarbi funkcija yra tarpusavio priklausomybė. Tradiciškai tai apima dalijimąsi namų ruošos ir priežiūros darbais, pajamomis ir kitais ištekliais. Senėjant labai svarbūs tampa ir kiti tarpusavio priklausomybės aspektai – rūpinimasis, priežiūra ir slauga, ligos ar neįgalumo atveju. Daugiausiai problemų iškyla tada, kai rūpinimasis kitu. Tuomet pereina iš nepriklausomybės nuo kitų į priklausomybę nuo slaugomo sutuoktinio. Darbo objektas: pagyvenusio amžiaus sutuoktinio patirtis. Darbo tikslas: Išanalizuoti pagyvenusio amžiaus patirtį, slaugant sutuoktinį. Uždaviniai: 1. Atskleisti, kaip slaugantieji sutuoktiniai suvokia pirmuosius ligos požymius; 2. Atskleisti, kaip sutuoktinio slauga pakeičia šeimos socialinę aplinką; 3. Atskleisti sunkumus su kuriais susiduria sutuoktiniai slaugymo procese. Tyrimu siekiama atskleisti slaugos šeimoje: pagyvenusio amžiaus sutuoktinio patirtis. Remtasi interpretuojamąja – konstruktyvistine ontologine ir epistemologine pozicija. Tyrime dalyvauti buvo pakviesti 6 moterys ir 1 vyras, kurių amžius virš septyniasdešimtpenkių metų ir slaugo savo sutuoktinius. Gauti duomenys... [toliau žr. visą tekstą] / Diseases common for crinkle. Older people are more likely to have physical health problems that are complex, chronic. Almost always a growing need to promote patient care through family relationships. Re-allocated tasks and responsibilities and from previous roles. Illness of a spouse who needs nursing care of the other spouse is a very important feature of mutual dependence. Traditionally, this involves the sharing of housework and care work, income and other resources. With the population becomes very important and other issues of mutual dependence - care, nursing care, illness or disability case. Most problems arise when caring for each other. Then the transition from independence to dependence on others from caring for a spouse. The object: the expierence of elderly spouse. Aim: To analyze the experience of the elderly, nursing a spouse. Objectives: 1. Reveal how nursing spouses are aware of the disease, 2. To reveal how spouse care for the family social environment changes, 3. Reveal the difficulties faced by spouses of nursing care. The study aims to reveal the care in the family: older spouse experience. Was based on interpretative - constructivist ontological and epistemological position. The study had been invited to participate in six women and one man aged over seventy five years old the nurses and their spouses. The obtained data were analyzed on the basis of case study method, through the conceptual categories and themes through the analysis method. The analysis... [to full text]

Elderly people’s experiences of what embodies a rewarding old age and vitality form a vital premise for developing comprehensive age-related services.This study sought to increase knowledge and deepen understanding of elderly people ́s life. The objective: This study aimed to investigate how lightand nature influence elderly people ́s experience of health and well-beingin Iceland. Method: We applied the Vancouver School phenomenological method to data accumulated from,interviews with 10people(6women and 4men) with anaverage age of 80.9 years. Participants were residents of Reykjavík, Hafnarfjörður,and Mosfellsbær. Findings: Participants reported that light and nature were important. Although individual definitions varied, they loved nature and described it as akin to life itself. Twilight had a special place, bringing a sense of romance. All participants felt physically and mentally healthy during the interview process. Nevertheless, each of them had experienceda variety of health-related difficulties in the past. They felt that vitality and mental and physical equilibrium form the basis of are warding old age. Conclusion: From birth,an individual is part of his environment, which shapes him. This process is always active(i.e., anindividual re-analyses and values his health and well-being as conditions change). Although the values forming that basis vary, an individual must establish a balance between body and soul to feel healthy and achievewell-being. The findings reported here throw light on those factors which elderly people feel promote health and well-being, and are of value for those who study, teach and provide services for them.

The Swedish Agency for Higher Education evaluated in 2007 the nursing programs at Swedish Universities, and confirmed that several programs lacked definition of the main subject of the discipline;- namely caring- and/or nursing. The caring science disciplines showed indications of increasing signs of fragmentation, in that sub-disciplines were evolving. There is a unique foundation of theoretical knowledge that is specific for the caring professions grounded in caring theory and philosophy. For some reason the theoretical foundation and contexture of providing care seems to fade off with time in clinical practice, as well as an explicated theory-practice gap; that theory does not go along with clinical practice. An assumption in this thesis is that caring theory somehow seems to evaporate; as nurses become clinically active- caring theory does not seem to be much reflected upon.The overall aim was to investigate into the meaning of caring to nurses in municipal elderly care, and into their explicit and implicit understanding of caring theory in their daily practice.The theoretical perspective was caring science, while the epistemological frame was of a phenomenological hermeneutical life world approach. Data was gathered by interviews with nurses working in elderly care and analyzed to grasp the structure of the phenomenon of caring in theory and practice. The thesis comprises four studies of which three empirical was consolidated with a Jean Watson’s specific caring theory, ending up in a better understanding of the approach of caring in nursing and the role of theory in practice. The findings of the studies show that the lived experience of caring as narrated by the participating nurses comprises both implicit and explicit theoretical foundation to existential caring theory. The explicit use of theory or certain theoretical affiliation was not obvious; rather what may be theoretical inputs was expressed as the importance of being present and the necessity of having a health perspective in caring. By illuminating caring and concepts from caring theory, the meaning of caring in their professional lived experience, the primary intention or choice of working as nurses became apparent again. There seems to be different perspectives related to caring theory, but as the empirical findings shows, there is a consensus behind what caring is, both in theory and in practice. As a result from the analysis the aim of caring itself may be more salient and focused if based on existential phenomenological caring concepts and theory, as this corresponds with the nurses understanding of holistic intentional caring with a health perspective. A gap exists, but is more related to organizational restrictions such as role constraints and time pressure than to the meaning of caring in theory and practice. Mediating care is a concept that embraces the implications of all the outcome concepts of the analysis and it has the possibility of being the expression of immanent and transcendent dimensions in caring. Mediating care represents the expression of our understanding of life, our values and norms. It is given expression through the insights into, and the ways we connect to one another, our ability as carers (nurses) to reach out to another in his or her being, as well the understanding of ones own being in caring. Theoretical and practical reflection and cultivation of clinical sensibility has the opportunity of inspiring for an expanded caring consciousness, manifested in the mediation of care.