Este estudo, teve como objetivo, verificar as formas de comunicação utilizadas nas Unidades Básicas de Saúde para o atendimento aos idosos e suas consequências no controle da saúde. Buscou-se através da pesquisa qualitativa, apreender como ocorria a comunicação, entre esta população e os profissionais de saúde em quatro Unidades Básicas de Saúde do município de Porto Feliz-SP, que atuam com equipes da Estratégia Saúde da Família. Foram realizadas 20 entrevistas com idosos de ambos os sexos, sendo 14 idosos, do sexo feminino e com idade entre 60 a 69 anos, 11 idosos. Chama a atenção que os idosos participantes da pesquisa na faixa etária entre 70 à 79 anos de idade, tenham um número maior de homens: 5 homens e 3 mulheres. Na faixa etária de 80 à 89 anos apenas uma mulher e nenhum homem. Os idosos entrevistados apresentaram baixo grau de escolaridade. Quanto às formas de comunicação utilizadas nas Unidades Básicas de Saúde, pudemos apreender através das observações e dos discursos dos idosos, duas categorias centrais de análise classificados em: comunicação assertiva e comunicação bloqueada, das quais emergiram duas unidades temáticas: elemento verbal e elemento não verbal. Na unidade temática, elemento verbal da comunicação assertiva, emergiram as seguintes unidades de registro: tonalidade da voz, reciprocidade de intenção e tecnologia. Na unidade temática, elemento não verbal, emergiram as seguintes unidades de registro: gestual, escuta e olhar. Quanto à comunicação bloqueada, foi desvelado na unidade temática elemento verbal, as seguintes unidades de registro: barreira psicossocial e rotinas de agendamento; na unidade temática elemento não verbal, as seguintes unidades de registro: barreira física, ausência da escuta e gestual. Neste estudo, a subjetividade que envolve o processo de comunicação, a cultura local e os fatores psicossociais revelaram aspectos positivos e negativos, sentimentos de satisfação e insatisfação vivenciados pelos idosos. Estes aspectos apreendidos nas formas de comunicação utilizadas pelas Unidades Básicas de Saúde do município de Porto Feliz-SP, mostraram não trazer consequências totalmente prejudiciais ao controle da saúde dos idosos, porém os aspectos negativos devem ser evitados, objetivando maior facilidade e agilidade no atendimento ao idoso. A conscientização da equipe de saúde sobre a importância da comunicação em saúde, através do aprimoramento constante, fortalece e permite a criação de tecnologia inovadora para o atendimento em saúde, favorecendo ao controle da saúde dos idosos, sua eficácia e consequentemente melhor qualidade de vida para esta população. / The present study aimed to verify the forms of communication used in Basic Health Units for elderly care and its consequences in health management. The intention of using qualitative research was to learn how the communication among this population and health professionals occurred in four of the Basic Health Units of the city of Porto Feliz, São Paulo, by working with teams from the Family Health Strategy. Twenty interviews were conducted with elderly of both genders, the majority of which (14) were female. 11 elderly aged between 60-69 years old were interviewed. The fact that men outnumbered women by 5 to 3 in participants aged between 70 and 79 years old must be emphasized. At the age of 80 to 89 years old there was only one woman and no men. The elderly interviewed presented low educational level. In regard to forms of communication used in Basic Health Units, two central categories of analysis were observed through comments and speeches of the elderly, classified as: assertive communication and blocked communication, from which emerged two thematic units: verbal and nonverbal elements. In the thematic unit, verbal element of assertive communication emerged as the following recording units: tone of voice, reciprocity of intention and technology. In the thematic unit, nonverbal element appeared as the following recording units: gesture, listening and looking. As for blocked communication, the following recording units were unveiled in the thematic unit for verbal element: psychosocial barrier and scheduling routines. And for thematic unit for nonverbal element: physical barrier, lack of listening and gestures. In this study, the subjectivity regarding the communication process, local culture and psychosocial factors revealed positive and negative aspects, pleasant and unpleasant feelings experienced by the elderly. These aspects learned through forms of communication of the Basic Health Units of Porto Feliz SP did not show to cause harmful consequences to control the elderly health, however, negative aspects should be prevented in order to achieve a more prompt and agile attendance to the elderly. The health team awareness about the importance of health communication, through constant improvement, strengthens and promotes the creation of innovative technology for health attendance, enabling to control the elderly health, its effectiveness and, consequently, a better quality of life for this population.

The American population is aging; by 2030, people over the age of 65 may comprise as much as 20% of the population (Niedert, 2006). As many as 80% of the people in this age group live with at least one chronic illness, and 4.5% of elderly persons in the United States live in nursing homes (Boyle & Holben, 2006). As individuals age into late adulthood, they may experience lessening abilities to think clearly and to move as dexterously as well as a decline in bodily functions that may inhibit their ability to perform tasks of daily living (Boyle & Holben, 2006). These experiences also hinder nutrient intake.

Cognitive decline is increasingly recognized as a side effect of chemotherapy. However, cognitive decline doesn't occur in all patients receiving chemotherapy, and there is variability in the cognitive domains affected (Ahles; JCO,Oct 20, 2012:3675-3686). Safety pharmacogenomics, i.e. using genetic variations to predict response/toxicity, offers an exciting approach to identify the subset of patients most likely to suffer from cognitive decline post chemotherapy. Consequently specific therapeutic interventions can be developed to target this group of patients, and/or alternate chemotherapeutic regimens can be used to limit toxicity, thereby offering a way to individualize therapy while minimizing toxicity. In our research we studied the effect of 16 SNPs in 6 genes on cognition in a sample of healthy older adults. We found that SNPs that affect serotonin, dopamine and glutamate levels in the brain influence cognition in a healthy sample of older adults, possibly in a domain specific manner. This allowed us to identify a group of healthy adults who inherently have lower cognitive functioning in some domains but that is still within the normal range. In addition individuals with SNPs that previously were associated with lower levels of myeloperoxidase performed better on the executive functions, verbal memory, verbal IQ and IQ. SNPs associated with lower levels were also associated with improvement in self reported verbal and visual memory post chemotherapy. APOE E2 allele was associated with higher cognitive performance compared to other alleles. However we didn't see an effect of APOE post chemotherapy. In chapter five, the effects of 31 SNPs in 15 genes on cognition post chemotherapy were evaluated in community dwelling lymphoma patients. Changes in the domains of verbal memory, visual perceptual memory, and attention of the Multiple Ability Self Report Questionnaire were observed following chemotherapy, but only when groups were stratified by genotype. Contrary to what we might expect, patients showed improvements in function after chemotherapy. However, using patient stratification based on genotype, specific groups of patients had a measurable decline in cognitive function post chemotherapy. Interestingly a SNP in the DNA replication enzyme and the target of doxorubicin topoisomerase II was associated with varying degree of self reported attention; specifically the AA genotype of rs471692 was associated with statistically significant decline in attention post chemotherapy. This indicates that cognitive changes following chemotherapy can be subtle, and stratification by genotype helps us in identifying susceptible individuals and provides some insights on the inconsistencies that are frequently reported in the literature. These results allow for identifying genetic risk factors associated with chemotherapy-induced cognitive changes, which will ultimately help in developing therapeutic approaches for the management of those deficits. Strategies to avoid chemotherapy-induced cognitive changes will be prospectively evaluated in future studies and include alternative chemotherapy and less toxic regimens, intervention strategies to improve cognitive abilities, and drug therapy to improve cognition in patients who develop chemotherapy-induced cognitive changes. The overarching goals of our studies are to help improve cancer patients' quality of life while maintaining or improving cancer cure rates.

As the son of parents of the "baby boomer" generation I foresee the immanent increased demand for assisted living for the elderly. By 2030 an estimated 20 percent - one in five Americans - will be 65 or older. Unless attention is paid now to advancing the designs and opportunities for assisted-living, there will either be a distinct lack of available options, or worse, the continuation of out-dated designs that simply will not be a marketable. Contemporary thinking with regard to the design of places of residence for the elderly has changed dramatically from the days of outdated structures and philosophies. In my research, I have seen a shift toward the concept of community rather than institution. Owing to cultural change that will surely be the future of assisted living design strategy. Yet, the shift is still in the rut of scaling designs to accommodate up to only a few dozen individuals. While I understand the rationale of such designs, I foresee a shortcoming to that approach. If the design idea is the drive toward the feeling of "home" then I feel it to be conceivable for an expansion of the current model to include multiple neighborhoods of residences, subsidiary structures, and more connection to a feeling of neighborhood and social interaction; the attributes of a true "community." What are missing are the environments that appeal to younger citizens. Baby boomers, easily described as much more educated, well-informed, well traveled, financially successful and much more discerning will not find the traditional options appealing or acceptable. My primary method of research for such an endeavor falls under the classification of Qualitative Research; the category that focuses on personal and informal social science. My design intention is not to separate and isolate the population of those seeking assisted living. Instead, offer more than just a place to live. I intend to discover validity for the concept of a larger networked residential community with more opportunity for social interaction and active lifestyle extending beyond what currently exists.

There is an underlying hope that those whom are elderly can exist in a place of happiness, comfort, security and familiarity; and can do so by aging in a place which complies with an understanding of their needs as older adults. However, along with aging comes a negative association of dependence and deterioration. Therefore, it is intuitive to have a connection between both the aging process and the design process. Creating a product which brings a positive association with senior housing and aging in place is the underlying goal within the project and overall design. With the increasing population of those 65 and older, there is a higher need for the placement of individuals who can no longer live independently or those who do not have family available to care for them. More specifically, the views of caring for elderly within Latin American cultures have a highly negative connotation towards the placement of older relatives outside of their proper family home. So how does the problem of increasing need for senior housing become solved with those who reject the idea of senior housing facilities and nursing homes? In order to change the perception of senior housing within Latin America, there needs to be an element of identity and familiarity to the home. It is that sense of identity and familiarity which will produce a product of belonging and comfort that promotes a positive lifestyle within senior housing. In order to directly address the Latin American culture, the proposed site will be located in an island which shares both United States values and views along with their own rich culture and history. Designing within the tropical conditions and cultural traditions of Puerto Rico will give its elderly a new and essential residential typology. It is extremely important to choose an environment which is beginning to acknowledge the change in demographic and economy that requires a more positive form of assisted living facilities and senior housing. Through a methodology which involves analyzing Puerto Rican cultural elements and conditions, the thesis will result into an understanding of cultural spatial traditions and customs. Accordingly, by taking these cultural conditions and implementing them into an senior housing program, it will bring a sense of home and place which is not found in the majority of elderly housing facilities within Puerto Rico.

Medication therapy is the most prevalent and critical intervention of health delivery and the source of most errors in healthcare. Medication errors and associated adverse drug events (ADE) have serious health and economic ramifications, and in elderly patients ADE are the leading cause of morbidity and mortality. Medication reconciliation is the process of evaluating current medication treatment to manage the risk and optimize the outcomes of medication treatment by detecting, solving, and preventing ADEs. This education project answered the question whether education provided to long term care staff would improve knowledge of medication reconciliation and be retained over time. The education program was developed through results of a literature search to identify evidence-based standards for medication reconciliation. The guiding theory for program was Kurt Lewin's theory of planned change. The test was developed on the medication reconciliation content and arrangements made for each of the 30 participants who were RNs, LPNs, and CMAs to take the test before and after the education program and again at 30 and 45 days. Results showed statistically significant improvement (p < 0.05) with knowledge of medication reconciliation retained at 30- and 45-days post intervention. Positive social change is possible as nurses and CMAs in the long-term care facility use the knowledge of medication reconciliation to improve patient medication safety for the long-term care residences in the facility. Through appropriate reconciliation, medication errors and ADEs can be reduced or prevented and patient outcomes improved.

The purpose of this study was to gain a better understanding of music therapy among the elderly. This qualitative study utilized interviews as a means to extract themes from the experiences of music therapists who have provided music therapy to the elderly. Results were transcribed to written form. Qualitative analysis procedures were followed to identify themes and subthemes. Areas of particular interest to the social work profession were the emotional, social, physical, and mental benefits and challenges of music therapy among the elderly. Through the guidance of systems theory and the concept of holism, spiritual benefits and challenges were also introduced.

As the baby boomer generation continues growing older, the geriatric community, and their needs grow larger. Many of those needs will necessitate the assistance of social workers’ knowledgeable of geriatrics. Research suggests that many social workers have negative attitudes toward older adults and show little interest in working with the population. The research question of this study was, does social workers’ personal, educational, and professional experience in geriatrics influence their knowledge on aging, and attitudes toward older adults? The researcher hypothesized that social workers with more experience have more knowledge on aging and view older adults more positively. Quantitative and Qualitative data was collected through the administration of a survey created through the online platform Qualtrics. Study participants consisted of 33 social workers located in the state of California. The data was analyzed using univariate and bivariate tests such as frequency, percentage, Pearson r correlation coefficient, and One-Way ANOVA, through the JMP data analysis software program. Additionally, the researcher read over study participants written responses in order to identify themes that emerged. Significant findings were found that supported the hypothesis. A significant relationship was found between social workers’ professional experience (number of years of job experience caring for an older adult), and their knowledge on aging (Facts on Aging II score). Also, the effect of study participants reported education level on their attitudes toward older adults, and knowledge on aging were also significant. Finally, nearly half of study participants reported some degree of interest in working with older adults, while the other half were either impartial or uninterested. The themes identified by the researcher, identified in participants written explanation of their level of interest in working with older adults, suggests that social workers’ interest in working with older adults is influenced by the degree to which they perceive the work as important, enjoyable, and fulfilling their professional goals. The results and findings of this study could contribute to the body of research focused on identifying what influences social workers’ interest for working in geriatrics.

The aging population in the United States will increase drastically in the next decades. Consequently, the field of aging will need more social workers. Beyond the usual cognitive decline of this stage in life, older adults may face conditions that include cognitive impairment, such as Alzheimer’s disease and Parkinson’s disease. This research studied the extent to which personal experience and previous work exposure influences social work students’ interest in working with the elderly with cognitive impairment. This study used a cross-sectional survey design and collected the participants’ answers using a survey which was sent out through classroom visits and online via email; participants’ answers (n=133) were analyzed using a quantitative method. Results suggested that previous work exposure to an elderly with cognitive impairment has influence on the students’ current interest, while previous experience through interaction with family and friends was not an influence. Findings from this study may help promote the creation of internships or other ways of supporting social work students interested in developing a career in aging, as an increase in the number of future social workers in this field will help fulfill the needs of older adults.

Falls are a major public health concern and contribute significantly to mortality and morbidity in the older adult population. Each year, approximately 3 million older adults are treated in emergency departments for fall-related injuries and at least 300,000 older people are hospitalized for hip fractures. The purpose of this project was to improve the participants' knowledge and highlight interventions to reduce the incidence of falls and injuries as a result of falls. The project was developed using the Stop Accidents, Deaths and Injuries (STEADI) toolkit, the Iowa model of evidence-based practice to promote quality of care, and the Lewin's change theory. The practice-focused question related to whether fall prevention would improve following the implementation of a staff education project using the STEADI toolkit. Twenty-six nurses were assessed to determine their knowledge deficits. Pretest and posttest data were analyzed, and as a result of the staff education initiative, the nurses' knowledge increased by 99.25%. Prior to the session, the facility had not participated in a fall-prevention initiative. This project offered a practical solution to the educational gaps identified at the practice setting. Adopting the STEADI toolkit at the practice setting is expected to improve patient safety, reduce falls with injuries and prevent fall-related deaths.