In the spring of 2007, the Women’s Foundation of California and the California Endowment created what would become the Elder Women’s Initiative, (EWI) which focuses on building a social movement for elder women and their allies with specific attention to healthcare and economic security. This study is largely descriptive and focuses on how state and non-state actors participated in the Elder Women’s Initiative. I looked at ways in which their unique roles can shape the scope of the movement and in what capacity the notion of advocacy is defined. I used feminist and social movements theory to frame my study. The data collection was multi-phased: the first was interviews with state leaders at the policy and community-based level, and the second was “Speak-Outs” or community listening sessions in three geographic areas in California. During the Speak-Outs, which recruited elder women and their allies from low-income communities in California, the women were able to testify about their experiences with the aging process. They also spoke with policymakers about how to collaborate in building the movement. While the Elder Women’s Initiative raised more questions than it answered, participants identified several concrete recommendations were identified about how to build the movement. The current political landscape in California is fraught with tension over the recent budget crises. It is important for future researchers to examine the ways in which the EWI fits into the policy process and how women across California can experience dignified and healthy aging. / text

Unintentional weight loss is a common and significant problem among nursing home residents and an important indicator of malnutrition. Nursing home residents who lose more than 5% of their body weight in one month or 10% of body weight in six months are at increased risk for morbidity and mortality. Licensed nurses, who are responsible for maintaining the health and well-being of nursing home residents, have been shown to be deficient in nutrition knowledge. Little is known about the relationship between nurse nutrition knowledge and unintentional weight loss in nursing home residents.The purpose of this study was to revise a nurse nutrition questionnaire to reduce respondent burden and to examine the psychometric properties of the revised instrument. The revised instrument was then used to describe the relationship between nurse nutrition knowledge and unintentional weight loss in nursing homes across Northeast Indiana.A descriptive, correlational, and non-experimental design was used to describe the relationship between nurse nutrition knowledge and unintentional weight loss (UWL) in nursing home residents in Northeast Indiana. Licensed nurses (N = 101) from nine nursing homes were recruited for this study. Nurse nutrition knowledge was measured using a revised nutrition questionnaire (NKQ-R) and weight loss data was obtained from the Nursing Home Compare Database.Content validity of the NKQ-R was acceptable. Item analysis demonstrated six items below the acceptable point biserial of .15, and one question demonstrated a very high P value of 98 and had a nonfunctioning distracter response. Four of these problematic items were in subscale `3' (nutritional deficiencies of institutionalized older adults). Consistent with findings from previous studies, nurses scored below average on the nurse nutrition questionnaire, however relationships between nurse nutrition knowledge and unintentional weight loss were not supported. Level of nurse education was positively correlated with NKQ-R scores. Nursing home ownership type was significantly related to NKQ-R scores and unintentional weight loss; nurses working in not-for-profit nursing homes scored higher on the NKQ-R than nurses working in not-for-profit nursing homes, and not-for-profit nursing homes had a lower incidence of UWL than the for-profit nursing homes in this study.

THW

Background: Malnutrition is a nursing issue that causes both physical and psychological suffering of those who are affected. In order to achieve care that is safe and has a good quality, it must be based on the assessment and actions of the state. District nurses play a central role in this work. Aim: The aim of this study was to describe the district nurses' work with identifying and addressing malnutrition in older people in nursing Home Care of the Community. Method: Six interviews with district nurses were conducted. The data were analyzed using qualitative content analysis with an inductive approach Results: From the results of the analysis two categories emerged: observations for finding signs of malnutrition, treatment and following up by malnutrition. Conclusion: Cooperation in the form of communication and information within the care team, together with the patient and their relatives, were found to be important for the patient's nutritional needs and should be identified and addressed in order to avoid the risk of malnutrition. The results that emerge can contribute to new knowledge that can help to identify older persons in order to get early and appropriate interventions and thus reducing the suffering that is caused by malnutrition. / Bakgrund: Malnutrition är ett omvårdnadsproblem som medför både fysiskt och psykiskt lidande för den som drabbas. För att uppnå en vård som är säker och har god kvalitet, måste den baseras på bedömning samt åtgärder av nutritionsproblemet. Distriktssköterskan har en central roll i detta arbete. Syfte: Syftet med studien var att beskriva distriktssköterskors arbete med att identifiera och åtgärda malnutrition hos äldre personer inom kommunal hemsjukvård. Metod: Sex intervjuer med distriktssköterskor genomfördes. Datamaterialet analyserades med kvalitativ innehållsanalys med induktiv ansats. Resultat: Ur analysen av datamaterialet framträdde två kategorier; Observationer för att finna tecken på malnutrition, behandling och uppföljning av malnutrition. Konklusion: Samarbete i form av kommunikation och information inom vårdteamet och tillsammans med patienten och dess anhöriga, visade sig vara av vikt för att patientens nutritionsbehov ska kunna identifieras och tillgodoses för att inte riskera malnutrition. Resultatet som framkom kan bidra med kunskap som kan underlätta att identifiera äldre personer tidigt och med adekvata insatser förmå att minska lidandet som malnutrition medför.

The aim of this essay was to describe and interpret the managements and organizations impact regarding the caregivers working conditions. To examine this we used a qualitative method. We completed two group interviews and five individual interviews with a total of fifteen enrolled nurses that worked within elderly care. In our interviews we found that the enrolled nurses felt that the organizations economic interests collided with their personal values regarding good quality elderly care. We also found that the caregivers experienced that they had an impact on their working conditions and that their employer was the main reason for making it possible.

Abstract Objectives: This research project was undertaken to review two commonly used screening instruments for the elderly who attend at hospital emergency departments in Ontario. These instruments were then contrasted with a new potential screening instrument made up of items drawn from the Minimum Data Set-Acute Care instrument (MDS-AC Version 1_CAN). The hypothesized outcome was better specificity and sensitivity utilizing the newly prepared instrument in predicting at an earlier point if an elderly emergency department patient would become an alternate level of care (ALC) patient. The ability of the screener to predict negative outcomes (delirium, longer length of stay) was also analyzed. Methods: One dataset from a previous International Resident Assessment Instrument (interRAI) organization study in southern Ontario completed in 2000 was utilized to inform this research. Each of the commonly used screening instruments was crosswalked to the MDS-AC items, then both univariate and bivariate analyses were completed. Three research questions were then posed. By testing various logistic regression models, the research looked to establish whether the newly developed instrument would be able to perform comparably to the other two currently-used instruments, and whether it would be more effective in predicting ALC status and particular adverse patient outcomes. Results: The newly-developed instrument was found to perform more accurately. While several variables were tested, a core number were found to be more strongly predictive of future need for ALC status. Conclusions: Future research in this area is recommended.

This quantitative study examined body image and disordered eating in older males. Using a series of questionnaires and demographic questions, two research questions were explored: a) What are the characteristics of older males in terms of eating and body image? and b) Are disordered eating behaviors among older males related to dissatisfaction with body image, specifically physical appearance or physical functioning? Paired samples t-tests revealed that older males rated their ideal body figure as significantly smaller than their current figure, t(35) = -5.53, p < .01, which indicates the presence of body dissatisfaction. Twenty percent of participants were found to be at risk for disordered eating attitudes and behaviors. Furthermore, a correlation was found between disordered eating attitudes and body dissatisfaction particularly as it relates to physical appearance, (r(33) = -.486, p < .01).

Atlikus tyrimą nustatyti dažniausi pagyvenusio amžiaus žmonių, hospitalizuotų į vidaus ligų skyrių, sveikatos sutrikimai: depresijos simptomai, dauginė patologija, atminties ir pusiausvyros sutrikimai, sensorinių pojūčių pokyčiai, judėjimo, suvokimo sutrikimai bei mažesnis arba didesnis funkcinis nesavarankiškumas. Vyresnių pacientų amžius, lytis bei potencialūs rizikos veiksniai neigiamai susiję su daugeliu pagyvenusio amžiaus žmonių fizinės ir psichinės sveikatos aspektų. Vyresnis amžius didino pagyvenusio amžiaus žmonių fizinės sveikatos bei funkcinės ir pažinimo funkcijų sutrikimus. Moterys dažniau nei vyrai nurodė svorio kritimą ir skundėsi skausmu. Pacientai, turėję atminties sutrikimų, dažniau patyrė griuvimą, atsirado pragulos, buvo nesavarankiški kasdienėje veikloje, turėjo depresijos ir delyro simptomų, nelaikė šlapimo ir išmatų bei skundėsi dvigubu nelaikymu. Nepakankamos mitybos, nelaikantys išmatų, turėję atminties, judėjimo sutrikimų ar ilgai negalėję vaikščioti dažniau turėjo pragulų (p<0,05). Staiga pablogėjus sveikatai gydymas stacionare nevienareikšmiai įtakojo paciento sveikatos būklę: sumažėjo (ar išnyko) ryškūs psichinės sveikatos sutrikimai. Bendravimo sutrikimai ir kasdienė funkcinė veikla nepakito, šlapimo nelaikymas išliko. Instrumentinė kasdienė veikla, lyginant paciento gebėjimus iki hospitalizavimo ir tyrėjo numatytus gebėjimus išrašant iš ligoninės, pablogėjo. Išrašant pacientus iš ligoninės, sumažėjo antibiotikų ir padidėjo psichotropinių... [toliau žr. visą tekstą] / Most common health problems of the hospitalized elderly are the following: symptoms of depression, polypathology, memory and balance disorders, changes of sensory organs, disorders of locomotion, disorders of perception, and the functional dependence of lower or higher degree. The older age of the studied subjects, gender and the potential risk factors had a negative influence on physical and mental health of the elderly.The disorders of physical health, functional and cognitive functions of the elderly increased with the older age. Women more frequently reported weight loss and complained of pain. Patients with memory disorders, more frequently had falls, were dependent in activities of daily living, had bedsores, symptoms of depression and delirium, bladder and bowel incontinence, and double incontinence. Patients with insufficient intake of diet, having bowel incontinence, disorders of memory or being confined to bed more frequently had bedsores (p<0.05). Treatment of acute health deterioration in in-patient clinic had the positive influence on patient‘s health condition: dramatic disorders of mental health (symptoms of delirium, disorders of perception, thinking, memory) reduced (or disappeared). Disorders of communication (self-expression and ability to understand others), problem of bladder incontinence, daily functional dependence did not change. Instrumental activities of daily living deteriorated for discharge period if compared to patient‘s abilities prior to... [to full text]

The body composition is changing with age: the lean body mass – first of all the skeletal muscle mass and later the bone mineral content – reduces and the fat mass increases, also the regional re-distribution of fat mass occurs. The combination of low muscle mass and low muscle strength or physical performance is called sarcopenia. The aim of this study was to investigate and evaluate the body composition in elderly and the associations of body components in age-related sarcopenia. We examined 151 male and 203 female aged 60 years and older. Body composition was investigated using dual energy x-ray absorptiometry. In men with age-related sarcopenia, microbiopsy of skeletal muscle was performed. It was found that in men, the lowest lean mass and bone mineral content (BMC) were at the age of 80 years and older. In women, there were no differences in lean mass between age groups, and the lowest bone mineral content was found in the age group 80 years and older. Bone mineral content was associated with lean mass in both genders, and in women BMC also was associated with fat mass. In men with age-related sarcopenia, appendicular skeletal muscle mass was the most consistently associated with the total body, total hip and femoral neck bone mineral density (BMD). In women, the fat mass was the most significant determinant of bone mineral density. Cross-sectional area of skeletal muscle fiber was positively associated with lean mass, leg muscle mass, thigh circumference and total hip... [to full text] / Senstant kūno sudėtis keičiasi: liesoji masė – pirmiausiai skersaruožių raumenų masė ir kaulų mineralų masė – mažėja, o riebalų masė didėja ir vyksta riebalų masės regioninis persiskirstymas. Maža raumenų masė ir maža raumenų jėga arba fizinė funkcija yra vadinama sarkopenija. Siekdami ištirti ir įvertinti senų žmonių kūno sudėtį ir jos sudėtinių dalių tarpusavio sąsajas esant sarkopenijai, ištyrėme šešiasdešimties metų ir vyresnio amžiaus 151 vyrą ir 203 moteris. Kūno sudėtis buvo tirta dvisrautės radioabsorbciometrijos metodu, vyrams, kuriems nustatyta senatvinė sarkopenija, atlikta skersaruožių raumenų mikrobiopsija. Mūsų tyrimas parodė, kad vyrų liesoji masė bei vyrų ir moterų kaulų mineralų masė yra mažiausios 80 metų bei vyresnio amžiaus grupėje. Moterų liesoji masė amžiaus grupėse nesiskiria. Vyrų kaulų mineralų masė teigiamai koreliuoja su liesąja mase, o moterų kaulų mineralų masė teigiamai koreliuoja su liesąja mase ir riebalų mase. Esant senatvinei sarkopenijai vyrams galūnių raumenų masė yra reikšmingiausias veiksnys, nulemiantis viso kūno, bendrą šlaunikaulio ir šlaunikaulio kaklo KMT. Riebalų masė yra reikšmingiausias veiksnys nulemiantis moterų KMT esant sarkopenijai. Nustatėme, kad vyrų miocito plotas teigiamai susijęs su viso kūno liesąja mase, kojos raumenų mase, šlaunies apimtimi ir su bendru šlaunikaulio KMT.

Excessive abdominal obesity, coupled with a decline in muscle mass and physical function that is exacerbated by sedentary living, contributes substantively to the disease and disability common to our aging population. The Senior Study, a randomized controlled trial designed to investigate the health benefits associated with performing resistance exercise (RE), aerobic exercise (AE), or a combination of both exercise modalities (RAE) for six months in the absence of caloric restriction, was conducted on otherwise healthy but abdominally obese, sedentary men (n=57) and women (n=79) between the ages of 60 and 80. The purpose of the first manuscript (Chapter 3) was to compare the effects of exercise modality on visceral obesity and insulin resistance in the Senior Study. All exercise groups significantly reduced total abdominal and visceral fat (P<0.05) and waist circumference (P<0.001), which measure explained 30% of the variance in total abdominal fat changes (P<0.001). AE and RAE improved insulin sensitivity (P<0.05), but the RE group did not (P>0.1). The greatest insulin sensitivity increase was observed within the RAE group (48% increase, P<0.001). The purpose of the second manuscript (Chapter 4) was to evaluate the effects of exercise modality on cardiorespiratory and functional fitness in the Senior Study. AE and RAE increased cardiorespiratory fitness (P<0.001), whereas RE did not (P>0.1). All exercise groups improved functional fitness performance (P<0.001), but age- and sex-specific percentile ranking improvement within RAE was greater than AE (P<0.01). RE and RAE significantly increased skeletal muscle (P<0.01), predominantly in the upper body, while AE did not (P=1.0). AE and RAE reduced total fat (P<0.001). Both fat loss and muscle gain were independent predictors of improvements in functional fitness (P<0.05). The findings from these studies demonstrate conclusively that a combined resistance and aerobic exercise program without caloric restriction is an optimal strategy for the therapeutic reduction of health risk in abdominally obese men and women. While each exercise modality offers distinct benefits and remains a viable option for needs-based exercise prescription, the combination was associated with the greater simultaneous improvements to body composition, insulin resistance, and cardiorespiratory and functional fitness than either resistance or aerobic exercise alone. / Thesis (Ph.D, Kinesiology & Health Studies) -- Queen's University, 2007-09-13 13:21:31.772