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Bakgrund: Sveriges befolkning blir allt äldre och behovet av vård och omsorg ökar, vilket kan leda till ökad risk för vårdskador, onödiga väntetider och annat som leder till ökade kostnader. Tidigare forskning har visat på att e-hälsa kan användas för att minska denna risk. Syfte: Syftet var att undersöka effekten av e-hälsa för äldre personer. Metod: En litteraturöversikt med adherence som teoretisk utgångspunkt har genomförts. 16 stycken artiklar med kvantitativ design har analyserats. Resultat: Resultatet visade på förbättrad hälsa och kognitiv förmåga, ökad delaktighet och kvalitet i vården samt minskade antal sjukhusvistelser och dödsfall. Slutsats: Resultatet kan bero på den ökade tillgängligheten och kostnadseffektiviteten samt att upplevelsen av e-hälsa var positiv. Därför bör information om e-hälsa spridas, och det bör användas och anpassas för äldre personer inom samtliga delar och nivåer av vården; under alla vårdutbildningar, på sjukhus och vårdcentraler, inom kommuner och regioner samt nationellt såväl som internationellt. / Background: The Swedish population is getting older and the need for care is increasing, which can lead to increased risk of health care injuries, unnecessary waiting times and other things that lead to increased costs. Earlier research has shown that e-health can be used to reduce this risk. Aim: The aim was to study the effect of e-health on elderly people. Method: A literature review with the term adherence as a theoretical starting point was conducted. 16 articles with quantitative design have been analyzed. Result: The result showed improved health and cognitive ability, increased participation and quality of care as well as reduced number of hospital stays and deaths. Conclusion: This result may be due to increased accessibility and cost-effectiveness and that the experience of e-health was positive. Therefore, information about e-health should be spread, and it should be used and adapted for elderly people in all parts and levels of care; during all health care educations, at hospitals and health centres, within municipalities and regions and both nationally and internationally.

ABSTRACT Over the last few decades, the number of elderly has increased in Sweden and many other countries in the world. Swedish society has struggled to provide support to meet the needs of this group of elderly. Many older people wish to move from their present homes into homes for the elderly where they can receive full support and services. Numerous older people report a lack of ability to cope with all of their household needs and daily activities. As people get older, there are different dimensions of changes, including becoming frail and unwell. This study includes 10 interviews with older people. Participants were informed of the ethical issues related to this study and then gave their consent. The interviews examined older peoples understanding and experiences of security and vulnerability when living at home. The work reflects on themes such as security, insecurity, health and social capital. The study aims to contribute increased knowledge to the field about this group of elderly and to broaden our knowledge of how the field of social work can better relate to this group based on these findings. The study participants were able to describe their perceptions of dimensions of safety in the home and the impact of vulnerability due to health difficulties. Results showed gender differences with women being more fearful than the men as well as a strong connection with impaired health. The women also had different feelings of vulnerability and a lack of social capital. All of the male participants claimed to be secure in their own homes. At the same time, they were very concerned about problems on the horizon related to changes in the welfare system. Several of the women had concrete strategies to protect themselves.  These strategies included: door chains, security alarms, visible deterrents such as a police hat placed out in the house and visible from the outside. Participants also completed safety steps such as checking their doors multiple times. Finally, this study reminds us that the needs and concerns of older people are an area of importance in the broader social arena.

Le vieillissement de la population conduit à de nouveaux enjeux sociétaux. Une des implications de ce vieillissement concerne la question du maintien de la mobilité des plus âgés afin de préserver leur autonomie le plus longtemps possible. Jusqu'à présent et pour quelques décennies encore, l'essentiel de la mobilité est assurée par l'usage de la voiture. La conduite automobile est une activité complexe qui requiert des capacités sensorielles, fonctionnelles mais aussi des capacités cognitives. Or le vieillissement, même normal, s'accompagne d'une légère détérioration de ces différentes fonctions. Les personnes âgées sont toutefois peu impliquées dans les accidents corporels de la route. En effet, pour beaucoup de conducteurs, la mise en place de stratégies de régulation de la conduite leur permet de continuer à conduire de manière sécuritaire. Ces stratégies consistent en une diminution de leur exposition routière, en diminuant le nombre de kilomètres qu'ils parcourent ou en évitant certaines situations de conduite, avec à terme un arrêt définitif de la conduite. La littérature montre que ce processus de régulation se met en place progressivement dans l'âge et s'accentue avec l'aggravation des déficits. Elle montre également que ce processus se met en place différemment chez les hommes et chez les femmes. Le but de cette thèse est d'approfondir les recherches déjà menées sur le processus de régulation chez les hommes et les femmes âgés, en prenant en compte des déficits sensoriels, physiques et cognitifs, et en s'intéressant particulièrement à la pré-démence et à la démence. Ainsi, nous montrons que les femmes régulent plus, plus tôt, et pour des raisons difficiles à appréhender, alors que les hommes régulent davantage leur conduite en fonction de leur état de santé. Du fait que plus de femmes s'arrêtent de conduire à un stade pré-démentiel, la démence ne joue pas sur la restriction de leur activité de conduite, en distance parcourue ou en évitements de situations de conduite. Elle impacte directement l'arrêt de la conduite. En revanche, chez les hommes qui s'arrêtent moins en phase pré-démentielle, la démence impacte tout le processus de régulation de la conduite, de la restriction à l'arrêt. Concernant les déficits cognitifs, ils ont un effet sur le début du processus de régulation de la conduite des hommes comme des femmes, mais pas sur l'arrêt de la conduite des femmes car elles s'arrêtent avant une dégradation de ces fonctions. D'autres facteurs vont impacter la régulation de la conduite des hommes comme celle des femmes, et d'autres facteurs ont un effet spécifique chez les hommes ou chez les femmes. Notre travail aura contribué à mieux comprendre le processus de régulation dans son ensemble chez les hommes et chez les femmes séparément. Une des perspectives de ce travail sera d'étudier les conséquences de l'arrêt de la conduite avec des conséquences probablement différentes chez les hommes et les femmes. démence ; pré-démence ; facteurs associés ; 3-Cités ; MG-Cog CAPA ; SAFEMOVE / Abstract With increased life expectancy comes an aging of the population, and creates new societal challenges. One challenge of demographic aging is to maintain the independence and mobility of seniors for as long as possible. Today, and likely for decades to come, the private automobile is often the mainstay of personal mobility. Driving a car remains a complex activity, requiring sensory and functional capacities, and also certain cognitive capacities. But the aging process causes a progressive deterioration of these various capacities. In spite of which seniors remain under-represented in road trauma statistics! This can be explained by senior drivers adapting they driving habits in favor of better safety. Typical adaption strategies aim to reduce their exposure to traffic dangers, by driving less and by avoiding at-risk situations, ending up by not driving at all. Available study-reports suggests that such a strategy of adaption occurs progressively, as a reaction to the aging process, and so is accentuated by aggravation of a driver's deficiencies. This literature also suggests that the adaption process may occur differently for men and for women. The aim of the current study has been to further investigate the process of adaption, for senior men and women. Taking into account the decline of sensory, physical and cognitive capacities and with particular attention to the periods just before and after the onset of geriatric senility. Hence we establish that women adapt more their driving habits, and sooner too but for no obvious reason, whilst men tend to adapt in closer correlation with their state of health. As there are many women who have stopped driving already before senility, senility is not then a major influence on the distances they drive nor the situations they avoided, but rather impacts directly the decision to stop driving. Regarding cognitive deficiencies, they influence the adaption process right from the start, both for men and for women, but do not explain that women cease to drive long before a significant decline has occurred. Certain other factors influence the strategies of adaption for both men and women alike, whilst there are still other factors having a specific effect either on men or else on women. Our work in this study has led to a better understand of the adaption process (of driving habits by seniors), as a whole, and for men and women separately. A possible follow-on would be to investigate the impact that ceasing to drive then has, probably different, on the lives of men and of women

In order to support a standardized and uniform documentation one can use different types of aids such as influencing attitudes, provide training and customize tools for documentation. This study looks at documentation in elderly care from the personnel’s perspective and seeks to better understand their view of and experience with documentation in relation to the aids described above. By holding semi-structured interviews with 12 people working with elderly care qualitative data were obtained and later analyzed using Interpretative Phenomenological Analysis (IPA). A range of different thoughts and attitudes towards documentation were found, some that could facilitate documentation, but also some that could hinder a good documentation practice. Also different insecurities were found such as lack of experience/knowledge about documentation, technology or language. Colleagues are a great resource for helping and educating personnel but it might be hard for them to explain some things they do if they aren’t aware of how they do it. It might also take time to readjust to new procedures such as a common information structure, especially for the experienced workers that have formed routines for how to do things. Contextual factors are important and the documentation systems have the ability to make or break the users.

Attempts to measure self concept in the elderly have been characterized by a variety of differing definitions of self concept, and differing methodological procedures. Previous investigations have used instruments which are stereotypic and not ecologically valid for elderly, test formats which make excessive demands on some elderly persons' cognitive and sensory-motor abilities, and administration procedures which penalize the less psychologically sophisticated older person, factors precluding adequate assessment of self concept in the elderly. In order to address the limitations of previous research, the present investigation developed and tested the Ecological Q-sort, a self concept instrument designed especially for use with the elderly. Items for the Ecological Q-sort were life situations which were ecologically representative and meaningful for older persons as self-defined by them. Two forms of the Ecological Q-sort were developed: the pictorial form consisting of pictorial representations of situations plus one sentence descriptions of situations; another form consisted of only one sentence written descriptions of situations.

Background: In an ever-changing society with inadequate resources, the elderly are easily forgotten. Despite the risk of side-effect, pharmaceutical drugs are added to promote their quality of life. Instead of drugs as a first step, perhaps one can give man's best friend a chance. Aim: The aim of this study was to illuminate the therapy dog’s impact on the quality of life of the elderly person. Method: This study was a qualitative literature-based study with an inductive approach, using a qualitative content analysis of the results from eight qualitative scientific articles. Result: The study resulted in three themes and eight sub-themes. The therapy-dog had a positive impact on the quality of life of the elderly person, both subjective and objective. The experience of well-being was created by the therapy-dog's influence to develop old memories, the feeling of harmony, and a break from everyday life. New opportunities were created when the care dog motivated the elderly to dare to open up, activate, and seek new relationships. Conclusion: The result shows that the meetings with the therapy-dog had positive impacts on several fronts of the elderly. What counts as beneficial impacts is subjective as well as relative. Contrary to everything positive, negative impacts may also occur. Conclusions that can be deduced from this study’s result are that the therapy-dog as an implementation contributes positively to the elderly's quality of life. It should be noted, however, that this intervention is not for everyone as there are allergies, fears, negative impacts and general dislike towards dogs and that this has to be respected. Keywords: Elderly, animal assisted therapy, health, quality of life.

Bakgrund: Endast en knapp tredjedel av män över 65 år har visat sig uppnå Världshälsoorganisationens (WHO) rekommendation om 150 minuter fysisk aktivitet per vecka. Äldre kvinnors upplevelser kring motiverande faktorer för utövande av fysisk aktivitet har studerats, men motsvarande studie för män har inte kunnat identifieras.   Syfte: Syftet med studien var att undersöka vilka faktorer som män i åldrarna 65 – 80 år upplever har betydelse för utövandet av fysisk aktivitet.   Metod: En kvalitativ studie med semistrukturerade intervjuer genomfördes. Fem män mellan 71–78 år intervjuades. Deltagarna rekryterades enligt ett bekvämlighetsurval. Intervjumaterialet bearbetades med kvalitativ innehållsanalys.   Resultat: Fyra kategorier med underkategorier av betydelse för utövande av fysisk aktivitet framkom; ”främjande av fysisk aktivet”, ”positiv social påverkan och positiv inställning”, ”försvårande av fysisk aktivitet”, ”tidskrävande arbete och sjukdomar”, ”fysisk aktivitet i livets olika perioder”, ”fysisk aktivitet som ung och fysisk aktivitet idag och ”oro för framtiden”.   Slutsats: Det finns många faktorer som män mellan 65 - 80 år upplever har betydelse för utförandet av fysisk aktivitet. Faktorer som upplevdes främja fysisk aktivitet, faktorer som upplevdes försvåra och oro inför framtiden framkom. Faktorer av betydelse för utövandet av fysisk aktivitet bör identifieras för att stärka möjligheterna till utförandet för varje individ. / Background:  Less than a third of men older than 65 years old were physically active more than 150 minutes per week, which is the recommendation from the World Health Organization (WHO). In elderly women, the impact on performance of physical activity has been investigated, but a corresponding study for elderly men has not been found.   Purpose:  The purpose of this study was to investigate key factors that men in the age of 65-80 experienced had impact on performing physical activity.   Method: A qualitative study using semi-structured interviews were used. Five men between 71-78 years old were interviewed. Qualitative content analysis was performed when analysing the data. Results: Four categories with subcategories that impact on the performance of physical activity emerged; “promotion of physical activity”, positive social affection and positive determination, “obstruction of physical activity”, time consuming work and diseases “physical activity during different periods in life”, physical activity in adolescent and physical activity today, and “worries about the future”. Conclusions: There are several key factors that men, in the age of 65 – 80 years, experience have an impact on physical activity performance. Factors that promote and hinder physical activity and worries for the future emerged. Factors with significant importance on performing physical activity should be identified for increasing the possibilities for each individual to become physically active.

Background: Chronic Kidney Disease (CKD) is a worldwide public health problem. There are few studies in Latin America, especially in primary care settings. Our objective was to determine the prevalence, stages, and associated factors of CKD in primary care setting. Methods: We did a retrospective secondary analysis of a database from the Diabetes and Hypertension Primary Care Center of the Peruvian Social Security System (EsSalud) in Lima, Peru. We defined CKD as the presence of eGFR <60 mL/min and/or albuminuria >30 mg/day in 24 h, according to Kidney Disease: Improving Global Outcomes (KDIGO). Factors associated with CKD were evaluated with Poisson Regression models; these factors included age, gender, type 2 diabetes mellitus (DM2), hypertension (HTN), body mass index (BMI), and uric acid. Associations were described as crude and adjusted prevalence ratios (PR) and their 95% confidence intervals (95% CI). Results: We evaluated 1211 patients (women [59%], mean age 65.8 years [SD: 12.7]). Prevalence of CKD was 18%. Using the estimated glomerular filtration rate (eGFR), the prevalence was 9.3% (95% CI 5.3 – 13.3) in patients without HTN or DM2; 20.2% (95% CI 17.6 – 22.8) in patients with HTN, and 23.9% (95% CI 19.4 – 28.4) in patients with DM2. The most common stages were 1 and 2 with 41.5% and 48%, respectively. Factors associated with CKD in the adjusted analysis were: age in years (PR = 1.03, 95% CI 1.01 – 1.04), DM2 (PR = 3.37, 95% CI 1.09 – 10.39), HTN plus DM2 (PR = 3.90, 95% CI 1.54 – 9.88), and uric acid from 5 to <7 mg/dL (PR = 2.04, 95% CI 1.31 – 3.19) and ≥7 mg/dL (PR = 5.19, 95% CI 3.32 – 8.11). Conclusions: Prevalence of CKD in the primary care setting population was high. CKD is more frequent in the early stages of the disease, and individuals with hypertension, DM2, older age and hyperuricemia have higher prevalence of CKD.

Abstract Elderly people, because of the frail health condition and consequent problems, have in most cases substantial difficulties living at home. Despite the need for widened nursing home custody, the field of quality institutional elderly care in Slovenia in the past did not undergo comprehensive research. The purpose of this two-part study was to investigate the quality of institutional elderly care and elderly care offered in Slovenian nursing homes. Additional purpose was to evaluate nursing staff members about their willingness, knowledge, skills and importance to meet residents’ physical and psychosocial nursing care needs. Also, a part of this research was bound for recognition of maltreatment and nursing staff members’ well-being. The qualitative and quantitative research methods were used. The quality of institutional elderly care and elderly care offered were researched by interviewing the parties involved in elderly care, residents, relatives and nursing staff members (N=48). The data for quantitative research was collected by surveying nursing staff by using a structured questionnaire (N=148). All data have been collected in three public and one private nursing home located in two major cities of Ljubljana and Maribor. Collected data was examined by content analysis method and statistical analysis, to corroborate findings across data sets, reducing the impact of potential biases that can exist in a single study. Triangulation was used to approach to data analysis to synthesize data from multiple sources. Main categories of quality institutional elderly were formulated as attentive care, optimal custody and holistic approach. The most important issue of quality institutional elderly care was formulated as meeting needs on time. Nursing staff members were found to be better skilled in meeting physical than psychosocial needs of residents. Maltreatment was recognised as neglect of care due to postponed duties or hastiness in nursing interventions resulting in discomfort of residents. Factors in connection to quality of institutional elderly care were expressed as quality of nursing care, friendly relationship, meaningful activities, pleasant dwelling environment and versatile assistance. The obtained findings were presented in form of proposals to improve quality of institutional elderly care in Slovenian nursing homes, and could be used to develop institutional elderly care and improve dwelling. In addition many specific terms have been extracted during the analysis process that may contribute to development of gerontological nursing care rationale in Slovenia.