O presente trabalho consistiu em investigar e refletir, sob o ponto de vista clínico, a respeito do processo de implantação de um serviço de Psicologia clínica voltada à saúde da pessoa idosa, num centro de referência do idoso da cidade de São Paulo, contemplado no Sistema Único de Saúde, o SUS. O interesse por esta pesquisa foi despertado pela necessidade de se compreender as demandas específicas desse tipo de população, para buscar manejos adequados ao atendimento clínico do idoso. Empregamos como método de investigação a pesquisa-ação, que serviu para apresentação e análise das ações propostas ao longo da criação do serviço de Psicologia frente às problemáticas e necessidades clínicas dessa população. A fim de tecer considerações teóricas e clínicas sobre o processo de implantação e a especificidade dessa clínica, partimos da teoria psicanalítica winnicottiana sobre o processo maturacional, das contribuições de Safra e da noção do conceito de perdão em Arendt. Assim, a partir da experiência de implantação e da reflexão desse processo, chegamos a uma concepção de clínica do envelhecimento, a qual contempla alguns eixos clínicos, tais como: 1) a necessidade de a pessoa idosa, na velhice, contar com um ambiente de alteridade que oferte e sustente um lugar ético de interlocução para revisão do sentido da vida; 2) uma clínica oriunda do diálogo contínuo acerca da desconstrução do self e da elaboração dos lutos, aspectos estes que favorecem a possibilidade de o idoso acolher a velhice e a sua própria morte como respostas ao percurso de vida; 3) a necessidade de se viver as várias facetas do perdão, como oportunidade de abrir novos espaços, a fim de sonhar um fim último possível e destinar a continuidade da vida para as futuras gerações; 4) a urgência de reflexões clínicas quando as necessidades acima descritas não são possíveis e se instauram situações de adoecimento e intensas agonias; 5) a presença do clínico como testemunho da vida e da morte / This work investigated and reflected, in light of a clinical view, about the implementation process of a Psychological Clinic Service that focused on the health of the elderly, in a reference centre for the aged in the city of São Paulo, contemplated by Sistema Único de Saúde (SUS). The interest for this specific research arose due to the need to understand the specific demands of this population, in order to search for proper management for the elderly therapy setting. Action research was the investigation method chosen to present and analyze the actions proposed throughout the design of the Psychology Service, considering the problems and the needs of this particular population. For the theoretical and clinical considerations about the implementation process and the setting specificity, we addressed the Winnicottian Psychoanalytic Theory about the maturational process, the contributions of Safra and the concept of forgiveness from Arendt. Therefore, having as starting points the implementation experience and the reflection on the process, we conceive the concept of the ageing clinic that addresses some clinical axis, such as: 1) the necessity of the elderly, at the old age, to rely on an environment of alterity that provides and supports an ethical space of interaction to revisit the meaning of life; 2) a clinic that continuously establishes a dialogue with the deconstruction of the self and the elaboration of mournings, aspects that create room for the elderly to welcome old age and their own death as part of the life course; 3) the need to live the various aspects of forgiveness, as an opportunity to open new spaces, in order to dream with a possible end and ensure life continuity to the future generations; 4) the call for clinical reflections when the needs previously described are not possible, and when we have situations of illnesses and intense agony; 5) the presence of the clinician as a testimony of life and death

INTRODUÇÃO: As quedas envolvendo idosos são problemas que trazem sobrecarga tanto de ordem sócio-econômica quanto de saúde pública e são transtornos, para essa população e para seus familiares, além de trazer aumento no risco de morte para esse grupo. A falta de equilíbrio nessa faixa etária é uma das principais causas das quedas e o fisioterapeuta encontra, em sua prática clínica, grandes desafios para gerenciar esse problema, pois há falta de dados científicos que definam qual o programa de treinamento mais adequado, principalmente em termos de prescrição de exercícios. OBJETIVO: Investigar as correlações entre os efeitos de um programa de exercícios cinesioterapêuticos gerais para idosos saudáveis previamente sedentários, com o equilíbrio estático e dinâmico desses indivíduos. MÉTODOS: O estudo foi desenvolvido no Laboratório de Fisioterapia e Reatividade Comportamental do Centro de Docência e Pesquisa em Fisioterapia da Faculdade de Medicina da USP. Participaram do estudo, 32 mulheres, com idade média de 68,6 anos, ativas na comunidade, livres de disfunções (cardiopulmonar, neurológica ou muscular) ou de doenças crônicas que afetassem a habilidade de exercitar-se. Após uma série de testes de avaliação do desempenho funcional (pré-teste), as participantes foram distribuídas, por sorteio, em dois grupos com dezesseis integrantes cada: o grupo A submeteu-se ao programa de exercícios gerais, e o grupo B foi o grupo-controle. As participantes do grupo A submeteram-se ao treinamento por quatro meses, duas vezes por semana, em sessões de uma hora de exercícios, atingindo entre 40% e 70% da freqüência cardíaca máxima estimada. O grupo controle participou de atividades recreativas de coordenação motora manual. No final dos treinamentos, os participantes dos dois grupos submeteram-se a uma nova avaliação de desempenho funcional (pós-teste imediato), utilizando o mesmo protocolo do pré-teste. A análise dos dados constou de identificação das características dos participantes por grupos no pré-teste, o estudo dos efeitos do treinamento no desempenho físico dos participantes, por grupos (pós-teste imediato) e, finalmente, o estudo das correlações encontradas entre as variações das variáveis testadas e as variações dos índices de equilíbrio estático e dinâmico. RESULTADOS: Houve aumento da correlação entre equilíbrio estático e equilíbrio dinâmico após a aplicação do programa dos exercícios, houve uma tendência de haver maior impacto da melhora da flexibilidade dos indivíduos sobre o equilíbrio estático, a força dos músculos flexores dos quadris parece ter influência na performance do equilíbrio estático e dinâmico, sendo mais importante para o equilíbrio estático e tendência a favor de haver relação entre um melhor equilíbrio estático quando há fortalecimento associado dos músculos extensores do joelho. CONCLUSÃO: Este estudo demonstrou que o treinamento de exercícios gerais teve efeito benéfico para a população idosa estudada e trouxe indícios de que há efeitos das várias modalidades de treinamento, embutidas nos exercícios gerais, sobre a melhora do seu equilíbrio e que tais modalidades podem ser incluídas em um programa para idosos visando à melhora do equilíbrio / Introduction: Falls involving elderly people are problems that brings both economics and public health overload and are a disturbance for them and their relatives, besides it brings a mortality enhance for the group. Unbalance at this age is the main cause of falls, and the physicaltherapist finds, on his clinic, a big challenge to deal, because there´s no cientific datas which explain the best training program, especially to physical activity prescriptions. Objective: To investigate the correlations between a general kinesiotherapeutic exercise program effect on healthy elders who once used to be sedentary and their static and dynamic balance. Method: This study was developed at Laboratorio de Fisioterapia e Comportamento da Faculdade de Medicina da Universidade de São Paulo-USP. It was 32 women, 68,6 years average, active, without any disfunctions (cardiopulmonary, neurological or muscleskeletical) or any chronic disease which could affected their exercise ability. After carring out functional evaluation tests (pretest), the participants were shared out, by raffle, in two groups with sixteen people each: the A group underwent a general exercise program, and the B group was the control group. The A group participants underwent a four months training, two times a week, one hour exercise each appointment, reaching between 40% and 70% of the maximum heart rate. The control group attended recreational motor coordination activities. At the end of the training, all participants underwent a new functional evaluation (postest), using the same pretest protocol. The data analysis found the participant caracteristics at the pretest, the study of effects at the physical performance training by group (postest), and the study of the correlations between variation factors tested and variations of the static and dynamic balance. Results: There was a positive correlations between static and dynamic balance after the program application, there was a tendencis of flexibility improvement over static balance, the hip flexors muscle has na influence at the static and dynamic balance, and it was important to help the static balance when there is a knee extensors strength. Conclusion: This study showed that general exercises training had a positive effect for the elderly group and brought signs that exist others modalities of training that can help the balance and those modatlities could be included on a elderly program looking for a balance enhance

The world population is ageing, and this is also relevant to South Africa. At the same time the potential support ratio (the number of persons aged 15 to 64 years per one older person aged 65 years or older) is falling, and the dependency burden on potential workers increases. To alleviate the financial burden on the aged, and their families, it has become necessary to develop a financial plan to cover the cost of frail care. The overall purpose of this research is to determine whether any financial plans exist which are relevant. If nothing existed, a plan had to be developed. The research methodology for this study comprised the following steps: Firstly, the demographics of the world and South Africa were researched. The concept of frail (long-term) care in the United States of America and New Zealand was investigated to determine what is available. The subsidisation concept of the South African Government towards caring for the elderly was also investigated. Secondly, a questionnaire was sent to the residents of five retirement complexes in George to determine their interest in such a plan. The records of the frail care unit that these residents utilise were analysed to determine the number of residents needing frail care. A comparative study of the cost of frail care in the Southern Cape was undertaken. Thirdly, two options to partly subsidise the cost of frail care were examined, where the first option covers the running cost, and the second option, subsidising one third of the frail care cost, builds up a sustainable fund after the first five year period. The funds of the second option can then be utilised in the subsequent years to increase the subsidisation portion of frail care cost. The final step of this study entailed the formulation of recommendations to implement the frail care nursing levy as soon as possible, with special attention given to the following: a) It must be compulsory for new residents to join the fund. b) A yearly capital amount of R100 000 or more is needed to sustain the fund. c) A contract must be drafted to set out all the rules and regulations to the residents. d) An attitude change amongst some residents is required. Individuals must realise that the success of this plan depends upon themselves and with the necessary support could make a significant contribution towards their own peace of mind if and when frail care is needed.

No description available.

Satsningen på trygghetsbostäder ligger i en ökad utmaning av äldre som upplever otrygghet eller isolering i sina hem. Kraven för att kunna flytta till ett trygghetsboende är att den äldre ska ha fyllt 70 år, ha stöd av hemtjänst och uppleva sig otrygg eller isolerad. Få studier berör vad som påverkar äldre att vilja flytta till ett trygghetsboende och hur de sedan upplever boendet. Syftet med denna studie är att undersöka vilka faktorer som påverkar äldres val av att flytta till ett trygghetsboende och hur de sedan upplever det att bo där. Empirin har samlats in via en kvalitativ studie I form av halvstrukturerade intervjuer med äldre boende på ett trygghetsboende. För att analysera empirin har Nahemow och Lawtons (1973) ekologiska modell använts. Resultatet visar på att äldre väljer att flytta på grund av otillgängliga bostäder, ensamhet, nedsatt hälsotillstånd och begränsad rörelseförmåga. Valet av trygghetsboende som boendeform grundar sig i närheten till andra äldre och omsorgspersonal, tillgängliga utrymmen och gemensamma aktiviteter. Upplevelsen av boendet varierar beroende på den äldres erfarenhet, personlighet och förmåga. De flesta äldre upplever sig självständigare, tryggare och i mindre utsträckning ensamma i deras hem på trygghetsboendet. / The investment in social housing lies in an increased challenge of older people who experience insecurity or isolation in their homes. The requirements for moving to a social housing are that the elderly must have reached the age of 70, have support from home care and feel unsafe or isolated. Few studies are about why the elderly want to move to a social housing and how they then experience the accommodation. The aim of this study is to investigate what factors affect older people's choice of moving to a social housing and how they then experience it to live there. The empirical data has been collected through a qualitative study in the form of semi-structured interviews with elderly residents in a social housing. Nahemow and Lawton's (1973) ecological model has been used to analyze the empirical data. The results show that older people choose to move due to inaccessible housing, loneliness and reduced health status and mobility. The choice of social housing as a form of housing is based on the closeness of other elderly and care staff, accessible spaces and joint activities. The experience of the accommodation varies depending on the experience, personality and ability of the elderly. Most elderly find themselves more independent, safer and feeling less alone in their homes in the social housing.

Syftet med studien är att uppmärksamma äldre döva. Genom kvalitativa undersökningar belysa äldre dövas tankar och farhågor om att åldras och eventuellt vara i behov av äldreomsorg, utifrån perspektiven social konstruktion och stigmatisering. Studiens fem informanter var, en från biståndsenheten, en äldrevägledare samt tre äldre döva personer för att få ett brett perspektiv på problemområdet. För att skapa det empiriska materialet användes semistrukturerade intervjuguider. Empirin har analyserats med meningskategorisering i programmet Nvivo-12 för att få fram relevanta och trovärdiga resultat. Inom tidigare forskning var det svårt att finna artiklar som tar upp ämnet äldre döva, vilket understryker behovet av ytterligare forskning kring ämnet. Vi har i vårt resultat kunnat urskilja att det finns en diskriminering av äldre döva i processen kring äldreomsorg. Vi fann också att hörande, som inte har någon dövkunskap, som kommer i kontakt med döva konstruerar egna uppfattningar om dövas livsvillkor, utifrån okunskap och samhällsnormer. Resultat av studien visar också att det finns möjligheter till förbättring där vissa städer efter påtryckningar av dövrörelsen har öppnat äldreomsorg för döva samt medborgarkontor

Bakgrund Känslan av ensamhet är en utmaning som ofta följer åldrandet. Denna subjektiva upplevelse kan vara både frivillig och ofrivillig. Ofrivillig ensamhet kan vara plågsam och påverka personens hälsa negativt. Äldre som bor på särskilda boenden befinner sig i en särskilt utsatt situation, där flytten ofta medför betydande förändringar i deras livssituation. Dessa förändringar kan inkludera minskade sociala relationer, interaktioner och nätverk. Det är därför av yttersta vikt ur ett hälsoperspektiv att förstå och hantera känslor av ensamhet bland äldre på särskilda boenden (SÄBO), samt identifiera effektiva omvårdnadshandlingar som kan förebygga och minska ensamhetskänslor bland dessa personer. Syfte Syftet var att beskriva omvårdnadshandlingar som minskar och förebygger känslan av ensamhet hos äldre boende på SÄBO. Metod En icke-systematisk litteraturöversikt utfördes baserad på 15 vetenskapliga originalartiklar med både kvalitativ och kvantitativ design. Artiklarna har inhämtats från databaserna PubMed, CINAHL och PsycInfo med hjälp av sökord i olika kombinationer. Artiklarna har genomgått kvalitetsgranskning utifrån Sophiahemmet Högskolas bedömningsunderlag för vetenskaplig klassificering och kvalitet. Resultat Resultatet visar att terapi, meningsfulla sociala interaktioner och deltagande i aktiviteter har positiv effekt när det gäller att förebygga och minska ensamhet bland äldre på särskilda boenden. Integrering av dessa aspekter i äldreomsorgsprogram är viktigt för att förbättra äldres livskvalitet och välbefinnande. Resultatet analyserades med en integrerad dataanalys, och sammanställdes i tre huvudkategorier: Terapi, Meningsfulla sociala interaktioner och relationer, och Deltagande i aktiviteter. Slutsats Terapiformer såsom skratt-terapi, djurassisterad terapi och trädgårdsterapi, tillsammans med delaktighet i meningsfulla aktiviteter, positiva relationer med personalen och samhällsengagemang, har identifierats som viktiga faktorer som kan förbättra äldres psykiska och fysiska välbefinnande samtidigt som de reducerar känslor av ensamhet. Vidare kan terapiformer som främjar KASAM-aspekter (sammanhang, meningsfullhet, begriplighet och hanterbarhet) spela en viktig roll i att minska ensamhet och främja äldres övergripande välbefinnande. En stark KASAM kan bidra till att minska risken för ensamhet genom att öka förmågan att förstå, hantera och hitta mening i sociala relationer och aktiviteter. / Background The feeling of loneliness is a common challenge in the aging process, a subjective feeling that can be voluntary or involuntary. Involuntary loneliness can severely impact an individual's health. Older adults in special housing for the elderly are particularly susceptible to this issue, as moving to such facilities often leads to significant life changes, including reduced social connections, interactions, and support networks. From a healthcare perspective, it is crucial to understand and address loneliness among elderly residents in special housing for the elderly. Effective nursing interventions must be identified and implemented to prevent and alleviate loneliness in this population, as it has far-reaching implications for their overall well-being. Aim The aim was to describe nursing interventions that reduce and prevent the feeling of loneliness among elderly residents in special care facilities. Method A non-systematic literature review was conducted, based on 15 scientific original articles with both qualitative and quantitative designs. The articles were retrieved from the databases PubMed, CINAHL, and PsycInfo using various combinations of search terms. The articles underwent quality assessment based on the evaluation criteria of Sophiahemmet University for scientific classification and quality. Results The results indicate that therapy, meaningful social interactions, and participation in activities have a positive impact on preventing and reducing loneliness among older individuals in special housing for the elderly. The integration of these aspects into elderly care programs is essential for enhancing the quality of life and well-being of the elderly residents.The results were analyzed using integrated data analysis and categorized into three main themes: Therapy, Meaningful social interactions and relationships, and Participation in activities. Conclusions Therapeutic methods like laughter therapy, animal-assisted therapy, and horticultural therapy, in combination with engaging activities, positive staff relationships, and community involvement, play a pivotal role in improving the mental and physical well-being of older adults and mitigating loneliness. Additionally, therapies that focus on aspects of KASAM (Coherence, Comprehensibility, Manageability, and Meaningfulness) are vital in reducing feelings of loneliness and enhancing the overall well-being of older individuals. A robust sense of KASAM helps diminish the risk of loneliness by strengthening the ability to understand, manage, and find meaning in social relationships and activities.

Självförsummelse är ett fenomen som är vanligast bland personer som har nedsatt beslutsfattande till följd av olika kognitiva funktionsnedsättningar som demens. Fenomenet handlar om personer som har uppenbara behov, men av olika skäl tackar nej till stöd. Fenomenet i sin tur utgör en utmaning för biståndshandläggare som arbetar med målgruppen. Denna studie syftade till att få en förståelse och fördjupad kunskap om hur biståndshandläggare arbetar med äldre personer med demens, samt hur de bemöter utmaningarna när självförsummelse är aktuellt. Studien lyfte även fram vilka stöd biståndshandläggare har i arbetet och hur biståndshandläggare upplever stöden. Metoden som applicerades i studien var kvalitativ metod i form av semistrukturerade intervjuer med fem biståndshandläggare. Det teoretiska ramverket i studien består av styrkeperspektiv, lösningsfokuserad praktik samt omsorgsrationalitet. Utifrån intervjuerna analyserades empirin med tematisk analys. Det huvudsakliga resultatet av studien var att biståndshandläggare möter flera utmaningar i arbetet med målgruppen. Vidare visade studien att biståndshandläggare utvecklat egna strategier för att möta utmaningarna i arbetet. En genomgående utmaning i arbetet är socialtjänstlagens betoning på självbestämmande samtidigt som äldre personer med demens har svårigheter att tillgodose sina behov. Studien visade även att den svåraste utmaningen är hur biståndshandläggare ska hanterat dilemmat kring personens autonomi och självbestämmande som är reglerad av socialtjänstlagen, samtidigt som biståndshandläggaren försöker tillgodose stödbehovet hos äldre personer med demens och som uppvisar självförsummande beteende. Studien visade även att biståndshandläggarna upplever att deras stöd i arbetet till viss del är tillräckligt, men vissa biståndshandläggare önskar mer kompetensutveckling kring demens. / Self-neglect is a phenomenon that is prevalent within individuals who have low decision-making abilities as a result of cognitive impairment like dementia. The phenomenon is about people that have obvious needs but resists care. The phenomenon in turn creates a challenge for professionals who work with them. The purpose of this study was to explore and gain a deeper understanding for how social workers meet the challenges in working with elderly people with dementia who self-neglect. This study also had an aim to highlight the different support systems that social workers can utilize when met with challenges, and how they experience these support systems. Strengths-perspective, solution-focused practice and care rationality were used as the theoretical framework for the study. Through a qualitative approach, semi-structured interviews were conducted with five social workers. The empirical material was then analyzed using thematic-analysis which showed that social workers meet great challenges when working with the described demographic. The analysis showed that social workers have adapted and developed their own strategies in order to meet these challenges. The study concluded that the hardest challenge arises when social workers meet the dilemma of conserving a self-neglecting person’s autonomy and self-determination, which is regulated by law, while simultaneously trying to meet their needs. The study further showed that some social workers perceived their support systems as adequate, while some other social workers expressed the need of competence development pertaining to dementia.

Culture, resource, and regulatory concerns are elevating the importance of business expansion inthe contemporary world. Everyone, including service providers, must overcome the obstacles.Change readiness assists individuals and organizations in accepting and embracing obstacles. This study seeks to evaluate the different types of services offered to the elderly as well as the obstacles that arise when attempting to expand them, taking into account the diverse cultural backgrounds of the country's population, the dearth of available resources, and regulatory hurdles. In this research, a qualitative method was undertaken, followed by an exploratory analysis. This thesis investigates the service offerings and problems of eleven Bangladeshi service providers using primary data gathered from semi-structured interview. This also utilizes previous scholarly articles and published data from other academic sources.The study's findings highlight service provider challenges and offer a research paradigm for theservice business, notably elderly care. The results indicate that the majority of aged care services provided by different institutions are identical. Healthcare, along with other services like social and recreational programs, and educational and training courses, are all part of this category. Italso demonstrates that cultural, resource, and regulatory constraints are major roadblocks to this industry's development. Furthermore, research finding shows, currently providers are not ready tomeet the incremental demand and subsequent changes will take place in the near future.This thesis contributes to the literature on business development by examining organizational readiness to change (ORC) and the challenges faced by business. Despite focusing on a singlenation, this research provides a comprehensive evaluation of the importance of organizational change preparedness for service growth. This study suggested a conceptual model that relates institutional care obstacles from the provider's perspective.

Close to two million of Sweden's population are born abroad. Within this population group, many people fall under the target group "elderly". This means that there is a large group of elderly people with a different cultural background. In recent years, professional elderly care has been challenged by cultural frameworks of interpretations. It is therefore possible, with the help of a cultural interpretation framework, to claim that the professional elderly care work should consider how individuals and groups make decisions about their background, beliefs and culture. The aim with this study is to highlight the meaning of treatment in the professional elderly care work with regard to cultural challenges. In elderly care, a good treatment is crucial to promoting good health, care and well-being. The treatment is an important determining factor for elderly care experiences. Listening, responding and prioritizing the elderly's needs can be a challenge for the care staff, especially within cultural interpretation frameworks where background, beliefs and culture can differ from how it is in Sweden. With the help of a cultural interpretation framework, it can therefore be argued that care staff in their treatment must take into account how individuals and groups define themselves in relation to origin, religion and culture. It is an important care practice to highlight the meaning of treatment in the professional elderly care work with regard to cultural challenges.