The theme of diploma thesis is processing of the design documentation of a home for the elderly people in the town Blansko. The house with four floors is partly basement. The building is operationally divided into several separate parts. The mainly part of building is for living of elderly people. The rest of the building consists of several partial operational units. The house is designed of the construction system Porotherm. The pitched roof is double layer with a wooden load-bearing structure.

Abuse towards older people is a global public health and human rights concern and considered a hidden pandemic due to underreporting. It has been estimated that 1 in 6 people aged 60 and older have experienced abuse at some point, with World Health Organization estimating that only 4% of cases are reported. Often older adults do not recognise their situation as an abusive one or may be reluctant to disclose because the abuser is a family member, often an adult child for which the older person feels responsible for. People living with dementia and older persons with significant health concerns are especially vulnerable to elder abuse, with estimates showing that 2 in every 3 people living with dementia have experienced some form of abuse. Rigorous data on the extent of the problem globally is limited, with studies often excluding the self-report of older adults with cognitive impairment, such as dementia. Lack of disclosure may therefore be amplified in people living with dementia with limitations in insight, recall or communication skills. These realities keep elder abuse hidden, while often relying on the self-report of perpetrators to disclose abuse. Screening and identifying elder abuse, especially amongst people with cognitive impairments, are complex. Very little research is published on elder abuse in South Africa, with a complete absence of prevalence estimates, routine reporting, or monitoring and surveillance of issues relating to elder abuse. From the limited data available, elder abuse in South Africa is a serious concern. In South Africa older persons are now, more than ever, expected to manage households, rear children, and financially support their entire household with their pensions. This shift in role makes them especially vulnerable to the impact of the country's high rates of poverty, unemployment, and crime, especially within the home environment. These structural and social determinants of violence are poorly understood in the context of elder abuse. In particular, there is a serious lack of local evidence that supports the understanding, risk, and measurement of elder abuse in South Africa. This study therefore proposed to address these gaps through four sub-studies designed to describe the landscape of elder abuse in South Africa. These sub-studies had the following aims: 1. To provide a situational analysis on current service provisions for dementia and elder abuse for older adults, including people living with dementia and their families (sub-study 1). 2. To cross-culturally adapt the Elder Abuse Screening Tool (EAST) and the Caregiver Abuse Screen (CASE) in South Africa, to detect self-reported abuse and risk of abusing from older persons' and potential perpetrators' perspectives (sub-study 2). 3. To examine the nature of self-reported elder abuse using the Elder Abuse Screening Tool (EAST) to generate evidence on the prevalence, predictors, and perpetrators of abuse (substudy 3). 4. To estimate the prevalence and predictors of risk of abusing using the Caregiver Abuse Screen (CASE) amongst household informants, including carers for people living with dementia (sub-study 4). Sub-study 1: “Dementia in South Africa: a situational analysis” This study comprises of two parts. Part I presents a situational analysis that was conducted in three phases: (1) a desk review guided by a comprehensive topic guide which included the World Health Organization's (WHO) Global Dementia Observatory indicators; (2) multi-sectoral stakeholder interviews to verify the secondary sources used in the desk review, as well as identify gaps and opportunities in policy and service provisions and (3) a SWOT-analysis examining the strengths, weaknesses, opportunities and threats in current care and support provisions in South Africa. Findings highlight the gaps and opportunities with current service provisions and show how structural factors create barriers to diagnosis, support and care. These barriers to diagnosis, care and support create risk for elder abuse and neglect as families and people living with dementia are largely unsupported by formal, community-based services. Part II expands this analysis and provides a closer look at the insights gained from stakeholders interviewed and reports on the status of elder abuse support provisions in South Africa. We found that, like in the case of dementia services, support provisions for elder abuse are poor. While there is a lack of data on the nature and extent of the problem, experts agree that underreporting is a big problem, and that people living with dementia are at greater risk of elder abuse that may include extreme forms of violence. Sub-study 2: “Cross-cultural adaptation of the EAST and CASE screening tools for elder abuse in South Africa” We tested the cultural appropriateness of the EAST (Elder Abuse Screening Tool) and the CASE (Caregiver Abuse Screen) in two regions (Western Cape and Limpopo) and four languages in South Africa (English, Afrikaans, isiXhosa and Northern Sotho (Sepedi)), using a cognitive interviewing methodology. Findings show that questions in the EAST and CASE are generally well understood, but that adaptations of both tools are necessary for use within South Africa. Older persons' fear, knowledge and experience of crime also showed that strangers may deliberately use deception to build trust and abuse. Further validation is needed to determine suitable scoring and use by health and social care practitioners. Sub-study 3: “Prevalence, perpetrators, and predictors of self-reported elder abuse in South Africa: findings from a household survey” Informed by the cognitive interviews in sub-study 2, the adapted EAST was used in a household survey to screen 490 older people for self-reported elder abuse across two areas, Cape Town (Western Cape) and Dikgale (Limpopo). One in ten older adults screened positive for abuse, of which financial abuse was most common. Perpetrators of elder abuse were most often a non-family member with whom the older adult had a relationship with. Higher prevalence of self-reported abuse was strongly predicted by higher levels of the respondent's own functional impairment. This is one of the first studies that explore the relationship between dementia, functional impairment, and elder abuse at a community level in South Africa. Sub-study 4: “Risk of elder abuse in South Africa: a survey of household informants” Within the same household survey, we screened informants of the older adults using the CASE. We found that risk of elder abuse was very high, with half of participants screening positive for abusive dispositions toward an older person. Carers of people living with dementia were four times more likely to be at risk of abusing compared to carers of people free of dementia. However, our multivariate model showed that more severe psychological and behavioural symptoms and increased carer burden are the main associations with elder abuse in this population. Supporting carers to manage stress and reduce burden includes the effective management of neuropsychiatric symptoms and has potential to reduce risk for elder abuse. Overall, the findings of this study showed that elder abuse and risk of abusing is high in South Africa, with perpetrators often being a non-family member with whom the older person has a personal relationship with, or a family member. It provides an important contribution to the available evidence base on elder abuse in a low-or-middle-income country like South Africa and gave insight into understanding elder abuse in context to support targeted efforts to reduce risk of abuse and provide adequate services for older adults, including people living with dementia.

No / This paper examines key challenges and strategies for including older people with dementia in an ethnographic study of quality of life in institutional care settings. The methods of interview and observation are described in relation to meeting four research challenges: verbal communication impairment, memory loss, decision-making capacity, and emotional disposition. A range of strategies for privileging the voice of the person with dementia is recommended which include: using different methods bespoke to each person with dementia; greater flexibility and time; preliminary meetings with the person with dementia; discussions with formal and informal carers; and research training. The researchers also conclude that the use of observation and interview are 'meaning-making occasions' which are qualitatively different but equally valuable for understanding quality of life in care settings.

The purpose of this study was to determine if there is a difference in functional communication skills between elderly persons in nursing homes and those living independently in the community. Thirty non-institutionalized elderly subjects were given the Western Aphasia Battery (WAB) screening tool. These scores were compared to WAB screening scores obtained from 20 institutionalized subjects. The difference between these scores was statistically significant. The institutionalized subjects' scores were also correlated with a Facilitators Evaluation of Communication Skills (FECS) inventory. Results showed a moderate correlation between the institutionalized subjects' WAB screening score and their FECS rating. The benefits of a screening tool for elderly populations are discussed.

Det är viktigt med insikt och ökad kunskap om den äldre individens behov och individuella upplevelser för att kunna bemöta individen och utforma vården efter dennes egna villkor. Denna kunskap är viktig att ha med sig som socionom, då ens yrkesroll kan komma att beröra äldre individer som målgrupp. Denna studie har genomförts i USA (Florida) med syfte att undersöka vad livskvalitet innebär för äldre människor på över 65 år, och vilka vardagliga situationer de kopplar livskvalitet till. I denna studie är livskvalitet beskrivet utifrån respondenternas egna personliga upplevelser av begreppet och dess innebörd. Sju semistrukturerade intervjuer har genomförts med individer mellan åldrarna 71-94. Vi kom i kontakt med dem genom en verksamhet i Florida, som erbjuder hemtjänstlösningar till äldre människor som är i behov av vård och omsorg i det egna hemmet. I vår studie har vi använt oss av en kvalitativ undersökningsmetod, och utgått ifrån innehållsanalys som metod för att analysera vårt insamlade material. Denna studies resultat mynnade ut i tre teman som visar på viktiga kriterier för den äldre individen att uppleva livskvalitet. Dessa teman är: Självständighet, social gemenskap och meningsfullhet. Självständighet var viktigt för våra respondenter då det innebar att få vara autonoma i vardagen. Social gemenskap innefattar att synliggöras och bekräftas av omgivningen. Temat meningsfullhet kopplas till att våra respondenter ser en mening i deras primära krets, och begriplighet med deras nuvarande tillvaro. Att synas, höras och märkas är studiens titel, dessa ord är byggstenarna för ett förgyllt åldrande, då vi i vår uppsats fokuserat på den positiva aspekten av livskvalitet i samband med ett åldrande.

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Magister Curationis - MCur / Studies have indicated that the global population of older people will reach 1.53 billion by 2050. The ageing population is a large consumer of health-care services and this remains a global concern due to the impact on existing health care systems. To have an adequately prepared workforce, nurses must have enough knowledge and skills to care for older people and positive attitudes toward them. This is because nurses’ attitudes towards older people might influence the quality of care they provide. Studies have documented nurses’ reluctance to care to work with older people, but little is known about the attitudes and knowledge of nursing students towards caring for older people in South Africa. The aim of this study was to examine undergraduate nursing students’ knowledge about ageing and their attitudes towards caring for older people. A quantitative descriptive survey, utilizing a self-administered questionnaire was used. A pre-tested self-report questionnaire was used to collect the data from a stratified sample of 240 nursing students across 5 levels of Bachelor of Nursing programme, from the foundation year to the 4th year.. Data were analyzed using SPSS version 25. The response rate was 100%. The findings showed that the first- and second-year students had minimal clinical exposure to older people while the third and fourth year had extensive contact with patients in clinical and other health settings. The students had an average level of knowledge with a generally positive attitude towards older people, though significant differences were found between the year levels. Just over half of the respondents reported that they intend to work with older people after graduation. The study recommended the improved training of nursing students in caring for older people.

Population aging is occurring all over the world as fertility declines and life expectancy rises.China, as the developing country with the largest population, is also experiencing thisphenomenon. However, the pension insurance system and health care system for theelderly has not been developed well enough. There is a growing need for the society toaddress the current living situation and needs of the elderly in China.The theoretical framework is design for aging and ritual designs. Sustainable thinking andhuman centered design thinking is used through the whole design process. By applyingcollaborate design methods such as interviews, some important aspects in old people’s lifewere been found out and medicine issues is the one of them. Most elderly have the issue offorgetting to take medicines and taking wrong medicines. These issues may cause greatdangers to the elderly with specific diseases such as high blood pressure.In the end, with the interaction and direct conversation with the Chinese elderly, the designsolution to medicine issues shapes the design proposal: a medicine calendar. The medicinecalendar can help the elderly remember to take their medicine properly and improve theirexperience of taking medicines. It can also draw the attention of the society to take theseniors’ life experience into account.

Numerous Thai older people fall each year. Although it has been shown that only 3.1% of fallers sustained fractures (Nevitt, Cumming, Kidd, & Black, 1989), injuries in older people are often more serious. For example, hospital charges for older adult fall injuries are about US $2,000 per person higher than for young fallers (Ellis & Trent, 2001). Moreover, falling can lead to social isolation, physical restraint, disability and institutionalisation (Donald & Bulpitt, 1999; Tideiksaar, 1994). Therefore falling in old age results in a considerable burden on, not only the individual concerned, but also the whole society. Internationally, a successful falls prevention program usually employs a multidimensional approaches (Alexander & Edelberg, 2002; Mosley, Galindo- Ciocon, Peak, & West, 1998). However, limited information about fall prevention has been reported in Thailand. A survey indicated that Thai elderly fall outside their homes which is different from the findings in Western countries (Jitapunkul et al., 1998). This suggests that adoption of fall prevention strategies from Western countries might not be successful in Thailand. Prior to this study, details of fall circumstances in terms of location, time, associated activity, hazards and type of falls in Thai older people were not available. Moreover, there was no information about fear of falling and activity restriction. These are important fall consequences that impact on quality of life and themselves are risk factors for falls. The purpose of this study was to determine the prevalence of fear of falling, and to describe activity restriction in fallers and non-fallers, and the circumstances associated with falls in Thailand. No fear of falling measurement tools for Thai older people were available prior to the study. / Therefore the Survey of Activities and Fear of Falling in the elderly (SAFE) has been modified for use with Thai elderly people. The SAFE was translated to Thai by a certified translator, checked for cultural relevance and back-translated by a second translator; reliability testing then took place in Thailand. Face validity and cultural appropriateness were tested with a sample of convenience of 10 bilingual Thai elderly people living in Perth, Australia. After translation into Thai, 4 items showed less than 80% agreement and required adjustment to capture the equivalent meaning of the original version. The ‘take a show/wash yourself with a basin of water’ was added because the participants reported that taking a tub bath is not common or traditional in Thailand. However, the item ‘take a tub bath’ was retained until the examination in the main study confirmed that less than 1% of Thai older persons had taken a tub bath and inclusion of the item confounded actual fear of falling results. Interrater reliability was tested; nine 4th year occupational therapy students and 15 older persons living in the Chiang Mai community were recruited. The intraclass correlation coefficient of fear of falling of activities done, activities not done and activity restriction scores were .9845, .9236 and .9718 respectively (p < 0.001). Four raters and 50 older community dwellers participated in the intrarater and test-retest reliability tests. The results showed that intrarater reliability of all raters exceed 0.8 in every scores (p < .001). / The test-retest also demonstrated good reliability: .9960, .9376 and .9849 (p < 0.0001) for fear of falling of activities done, activities not done and activity restriction scores respectively. Five hundreds and forty six Thai older adults were then recruited by multistage random sampling. Fall history, fall circumstances, fear of falling and activity restriction data were obtained by structured interview and using the Thai version of the SAFE. The results demonstrated that prevalence of falls, fear of falling and activity restriction in Thai older people were 21%, 48% and 18%, respectively. Comparison between fallers and non-faller showed that fallers were more likely to be older (p < .001), female [χ2(1, N = 546) = 6.133; p = .013], not married [χ2 (4,N=546)=61.102;~= .001], living alone[χ2 (l,N=546)=4.313;p= ,041, rated their health as poorer [χ2 (4, N = 546) = 13.232; p < .001], had fear of falling [χ2 (1, N = 546) = 6.265; p = .015] and activity restriction [χ2 (1, N = 546) = 5.488; p = ,0271]. Older persons with a fear of falling tended to be older (p = .005), lower educated (p < .001), female [χ2 (1, N = 546) = 29.602; p = .001], rated their health as poorer [χ2 (4, N = 546) = 69.70; p < .001], had fallen [? (1, N = 546) = 6.265; p = ,0151 and had activity restriction [χ2 (l, N = 546) = 23.267; p < .001]. Older adults who curtailed their activities tended to be married [χ2 (1, N = 546) = 6.188; p = ,0131, rated their health as poorer [χ24, N = 546) = 14.302; p = ,0061, have a fall history [χ2 (1, N = 546) = 5.488; p = ,0271 and have a fear of falling [χ2(1, N = 546) = 23.267; p < .001]. / Using Chi-square test, the results showed that there were significant associations between falls and fear of falling χ2(l,N=546)=6.265;p=.015], falls and activity restriction [χ2 (l,N= 546) = 5.488; p = ,0271] and fear of falling and activity restriction [χ2 (1, N = 546) = 23.267; p < .001]. Fall circumstances of 114 falls demonstrated that most falls took place outdoors (65%), were associated with work (40%), involved environmental hazards (76%), occurred during the daytime (90%). Moreover most falls were falls on the same level from slipping, tripping or stumbling (61%). Logistic regression analysis indicated that risk factors for fear of falling in Thai older people were age (odds ratio = 1.025), unmarried-female (odds ratio = 5.979), married female (odds ratio = 1.903), poor self perceived health (odds ratio = 3.383) and more than 2 falls experience (odds ratio = 7.202). The protective factors were unmarried marital status for men (odds ratio = 0.344) and level of education (odds ratio = 0.933 2 or less falls and = 0.5625 if more than 2 falls in 12 months). The logistic model also provided a logistic equation for individual prediction of probability of fear of falling. To calculate the probability of having fear of falling, 6 parameters are required: age, gender, marital status, level of education, self-perceived health and number of falls in the past 12 months. The equation predicts with 70% accuracy and can be used for screening fear of falling in Thai elderly people. In conclusion, this study has modified a measurement tool (the SAFE Thai version) and developed a screening tool (logistic equation) for fear of falling. Both of them appear to be appropriate to further examine FOF in Thai elderly. The survey results showed a considerably number of Thai elderly people have fall experiences, fear of falling and activity restriction. / The predisposing factors for each problem have been identified. The association between 3 problems implicated that fear of falling and activity restriction interventions are necessary for fall prevention. The fall circumstances data show that conditions of falls in Thai elderly people were similar and dissimilar to those in Western countries. The preventive efforts to reduce falls should consider these distinctive fall circumstances.

<p>Abstract</p><p>Elderly people are going to be a growing number in Europe. Between one third are going to be 60 years or older at 2025. For Sweden the situation is going to be similar. A reduced muscle function could lead to complications for the individual to perform daily tasks and will lead to a higher rate for falling and getting bone fractures. The positive sides are that for men and women there are a possibility for maintaining physical function and strength even in older years. The purpose of this study was to investigate the possibility of gaining strength in M. Quadriceps femoris among five elderly people. The training schedule followed over 6 weeks of time with training sessions twice a week, training the Quadriceps muscle with one set of each training session. The result shows that for the three people that completed the study, all of them managed to gain strength. Further the study examines resistance training comparing single and multiple sets. Is there any difference in gaining strength between training programs with single set training versus multiple sets training?</p>