This study investigates the impact of self- and other-report cognitive competence, anxiety and obsessive-compulsive behaviors on depression using a population sample from the archival data of the Clinical Assessment Scales of the Elderly (CASE). Structural Equation Modeling was used to test predictions of the abovementioned variables. Participants were a matched self-and other-report subset (N=123) of the CASE standardization sample (N=2,000). Structural equation modeling was used to test predictions. The results revealed that age does not predict self-report cognitive competence or other-report cognitive competence. A small covariance (0.42) was found between the errors of self-report cognitive competence and other-report cognitive competence. The data reports self-report depression mediates both self-report anxiety and self-report obsessive compulsive behaviors. Statistically significant large effects were found between self-report cognitive competence and all variables; self-report anxiety (0.72), self-report depression (0.62), and self-report obsessive compulsive behaviors (0.71). Moderate to large effects were found for other-report cognitive competence and all variables; other-report anxiety (.063), other-report depression (0.63), and other-report obsessive compulsive behaviors (0.35). The correlations between the anxiety and depression measures confirm the current literature regarding depression and anxiety. In this study depression has been found to have a mediating effect on both anxiety and obsessive compulsive behaviors in an elderly sample. The inclusion of obsessive compulsive behaviors as a measure of anxiety in this model has empirically demonstrated the variability of the presentation of depression. Psychological self-report measures continue to be the best determinant of a patient’s internal functioning. Research in the area of the presentation of depression in the elderly merits further investigation.

Benzodiazepines are drugs used to treat insomnia and anxiety. This group of drugs should be prescribed with the duty of care to the elderly because of it´s negative effects. Life expectancy is increasing because of the progress of drug development. Aging brings physical and psychological changes leading to changes in pharmacokinetic and pharmacodynamic features. Drug treatment is becoming increasingly widespread and contributes to the increasing number of interactions and complications for the elderly. The aim of the study was to illuminate the consequences of long-term use of benzodiazepines in the elderly. The study was conducted as a literature review based on 14 scientific articles that were analyzed. The result showed that the theme benzodiazepine use among the elderly could be divided into three categories; consequences out of long-term use, benzodiazepine users experiences and the nursing perspective. The category of impact out of long-term use of benzodiazepines revealed three sub-categories: physical consequences, psychological consequences and social consequences. Information and education to the elderly patients is important to make the elderly aware of the negative effects that may arise out of a long-term use of benzodiazepines. It is essential that nurses already in their basic education acquire more knowledge about benzodiazepine use among elderly in order to address these problems in the nursing care.

This study investigates the impact of self- and other-report cognitive competence, anxiety and obsessive-compulsive behaviors on depression using a population sample from the archival data of the Clinical Assessment Scales of the Elderly (CASE). Structural Equation Modeling was used to test predictions of the abovementioned variables. Participants were a matched self-and other-report subset (N=123) of the CASE standardization sample (N=2,000). Structural equation modeling was used to test predictions. The results revealed that age does not predict self-report cognitive competence or other-report cognitive competence. A small covariance (0.42) was found between the errors of self-report cognitive competence and other-report cognitive competence. The data reports self-report depression mediates both self-report anxiety and self-report obsessive compulsive behaviors. Statistically significant large effects were found between self-report cognitive competence and all variables; self-report anxiety (0.72), self-report depression (0.62), and self-report obsessive compulsive behaviors (0.71). Moderate to large effects were found for other-report cognitive competence and all variables; other-report anxiety (.063), other-report depression (0.63), and other-report obsessive compulsive behaviors (0.35). The correlations between the anxiety and depression measures confirm the current literature regarding depression and anxiety. In this study depression has been found to have a mediating effect on both anxiety and obsessive compulsive behaviors in an elderly sample. The inclusion of obsessive compulsive behaviors as a measure of anxiety in this model has empirically demonstrated the variability of the presentation of depression. Psychological self-report measures continue to be the best determinant of a patient’s internal functioning. Research in the area of the presentation of depression in the elderly merits further investigation.

The purposes of this study were to evaluate the frequency of documented prognosis discussions among terminally ill cancer patients, to identify correlates of having documented prognosis discussions, and to describe the content of prognosis discussions as documented in patient medical records. Sample data were collected from the randomly selected medical records of inpatients (n=210) aged 65 years or older and admitted with diagnoses of brain, pancreas, liver, gall bladder, or inoperable lung cancer from six large Connecticut hospitals. A standardized instrument was used to extract data concerning patient demographics, hospital course, prognosis discussions, and evidence of advance care planning. Prognosis discussions were recorded in 79 (38%) of medical records and were correlated with emergency admission status (p=0.004) and longer length of hospital stay (p=0.003) on multivariate analysis. Of the documented prognosis discussions, 63% were within one week of admission but after the first day, and 57% included the patient, 76% included the family, 77 % included the doctor, and 69% did not include another health staff member (n=79). Life sustaining treatment discussions and DNR orders were both associated with prognosis discussions (p=0.001 and p=0.001, respectively) and were more often documented after the prognosis discussions. Prognosis discussions included planning for care and treatment in 33 (42%) of discussions documented. In conclusion, we found that prognosis discussions were infrequently documented during the hospitalization of terminally ill patients diagnosed with cancer. We also found that advance care planning, such as discussions of life sustaining treatment and DNR orders, was significantly associated with prognosis discussions and more often occurred after prognosis was discussed.

No description available.

The purpose of this study was to explore specific types of informal social relationships- family or friends formed in nursing homes and to determine how each affected the health of the elderly, especially in the areas of loneliness and depression. A face-to-face interview using four structured questionnaires was adopted for this descriptive study design. The main outcomes of depression and loneliness were measured by the Geriatric Depression Scale (GDS) and University of California Loneliness Scale (UCLA). The Duke Inventory Social Support Scale, measuring both family and friend support separately, measured predictor variables of family and friend support. Eighty-seven percent of participants completed the study. The results indicate that friend support was a more reliable factor for predicting the levels of loneliness and depression after controlling for all other co-founding variables. The findings will help nurses and other health care personnel when assessing the social support networks, beliefs and preferences of older adults to plan and implement the best practices. This will also offer health care facilities suggested ways to reduce or combat loneliness and depression among the elderly people. / Thesis (Master, Nursing) -- Queen's University, 2010-09-16 20:34:22.965

The safety of antipsychotic use in elderly persons has recently been questioned. The incidence of adverse events (AEs) (extrapyramidal syndromes (EPS), cerebrovascular and cardiac events, and all-cause mortality) in the elderly users of first-generation antipsychotics (FGAs) and second-generation antipsychotics (SGAs) was compared. Risks of AEs in antipsychotic-exposed persons and non-exposed individuals were also assessed. A population-based retrospective cohort study was conducted in the elderly Manitoba residents who received their first antipsychotic medication between April 1, 2000 and March 31, 2007. Cox proportional hazards models were built to compare risks of AEs in FGA and SGA users, as well as in non-exposed subjects. SGAs were associated with a lower risk of all-cause mortality (adjusted HR 0.683, 95% CI 0.577–0.809) and a higher risk of myocardial infarction (1.614 [1.024–2.543]) compared to FGAs. No significant differences between FGAs and SGAs were found for cerebrovascular events, cardiac arrhythmia and congestive heart failure (CHF) but a higher incidence of EPS was observed for FGAs compared to risperidone. Both FGA and SGA users were at a higher risk of cerebrovascular events (FGAs 1.415 [1.114–1.797]; SGAs 1.611 [1.388–1.869]) and CHF (FGAs 1.228 [0.893–1.689]; SGAs 1.242 [1.003–1.536]) compared to non-exposed subjects. Only FGA-users were at a higher risk of death compared to non-exposed subjects (FGAs 1.387 [1.065–1.805]; SGAs 0.824 [0.708–0.959]). Both FGA and risperidone use were associated with a higher risk of EPS (FGAs 3.503 [2.271–5.403]; risperidone 1.733 [1.214–2.472]). Both classes of antipsychotics might lead to potentially life-threatening AEs. Neither FGAs nor SGAs seem to have a superior overall safety profile. Antipsychotic pharmacotherapy should be prescribed in elderly persons after careful consideration of all risks and benefits.

Perceived control (PC), the degree to which individuals believe they have direct influence over events in their life, is often found to be associated with emotional well-being. Moreover, for over three decades, research has demonstrated that PC fosters health in advanced age. The mediational role of health in the PC and emotion relationship was investigated. Community-dwelling older adults (n = 232) were examined via secondary data analysis from the Aging in Manitoba (AIM) project and the Successful Aging Study (SAS). Separate mediational models were assessed for two different health mediators, self-rated health and health-related restrictions, and for positive and negative emotions. PC was found to benefit both physical and emotional well-being. The evidence of mediation was most compelling in the prediction of negative emotions and health-related restrictions. Findings have implications for treatment interventions in hopes to foster PC which in turn, should promote health and enhance later life emotional well-being.

Konflikter kan påverka individen både positivt och negativt beroende på individens beredskap att hantera konflikten. Vårdpersonal har ett fysiskt påfrestande arbete. Detta är en kvalitativ studie som handlar om hur uppgiftsrelaterade konflikter påverkar individers motivation samt arbetsprestation inom äldreomsorgen. En intervjustudie genomfördes med deltagare som arbetar inom vård och omsorg, deltagarna var undersköterskor. Samtliga undersköterskor beskrev att det förekommer mycket konflikter inom deras arbetsbransch. Undersköterskor har beskrivit upplevelser som framkommit i samband med uppgiftsrelaterade konflikter emellan kollegor. Resultat som framkom var att motivation samt arbetsprestation påverkades då uppgiftsrelaterade konflikter uppstod. Motivationen kunde påverkas eftersom att undersköterskorna kunde känna negativ stämning efter konflikter. Detta fick undersköterskorna att känna nedstämdhet. Det framkom även att ledningen har en inverkan på undersköterskornas motivation. Upplevelserna från undersköterskorna har varierat beroende på konflikt och individ.

The goal of the project presented in this study is to provide a rehabilitation system which is game based in a home environment for elderly people in order to reduce the cognitive decline and halting the progression of memory deficit problems. Recently it has been discovered that cognitive training can initiate brain flexibility and strengthen the neuromodulatory system which controls learning. At the same time we need to consider that elderly people may become stressed while using any type of technology, let alone a video game. That said, another main goal of the project is to reduce the stress level of the player while interacting with the game. The results showed that the stress reducing features used in this study was mostly effective but one of the main problems was most of the participants not having much experience with using a computer which made them more stressed.