Thesis (doctoral)--Umeå University, 2005. / Includes bibliographical references.

The purpose of our qualitative study is to investigate how the caretakers, in the elderly care, interpret and manage the issue of alcohol problems in elderly people. We have been performing semi-structured interviews on 9 people, on different levels in the elderly care. There were 3 elderly care managers, 1 nurse, 1 assistance administrator and 4 auxiliary nurses, who all, at some level, work with alcohol problems in elderly people. Those interviews were performed singularly, with one exception: we interviewed an elderly care manager and her 2 auxiliary nurses at the same time. To analyse our empirics, we have used the theories of Power and Ageism. Our study shows that the auxiliary nurses, who are the ones who must deal with these problems, have great difficulties to perform their work because they have no qualified knowledge about alcohol problems. In addition, they almost never get the proper information, they don’t have access to guidelines about handling people with alcohol problems and they don’t receive support from their superiors. They have to make the most difficult decisions for themselves without any resources or other guidance.

published_or_final_version / Medical Sciences / Master / Master of Medical Sciences

Geriatric Education Centers (GECs), as funded by the Health Resources and Services Administration, promote interdisciplinary geriatric education and training for more than 35 health-professions disciplines including medicine, dentistry, pharmacy, nursing, and social work. GECs are charged with becoming self-sustaining beyond the period of their funding. Sustainability in this application means that a GEC can fund itself through the generation of multiple revenue sources. This study seeks to explore changes in the structure, activities, and relationships of GECs over time in their pursuit of sustainability, and hypothesizes that GECs have shifted from the old economy, or the public good knowledge regime, to the new economy, or the academic capitalist knowledge/learning regime, and from the manufacturing to the networking economy. The theoretical framework of academic capitalism and the knowledge/learning regime will be used as a lens in this qualitative multiple case study.Sources included structured, in-depth, on-site interviews and observations, as well as documentary and virtual (website) evidence. While GECs are engaging in market-like behaviors, creating markets and circuits of knowledge, developing interstitial and intermediary organizations, and expanding managerial capacity, they have been unable to connect with related markets, as these markets lack a profit motive, and have ultimately been unsuccessful in their pursuit of sustainability. Continued federal funding for GECs is justified based on the public good argument that without public encouragement, these services would not be provided by the private sector. The study concludes with recommendations to enhance opportunity structures for GECs.

Muzikos terapija – tai paslauga klientui, bendradarbiavimas naudojant muziką, įvairias muzikines veiksenas bei susikuriančius tarpusavio ryšius, siekiant palaikyti pagyvenusių ir senų žmonių sveikatingumą ir gyvenimo kokybę. Darbo tikslas - muzikos terapijos metodų taikymo socialiniame darbe su pagyvenusiais ir senais žmonėmis tyrimas. Darbo uždaviniai – 1) atskleisti pagyvenusių ir senų žmonių problemas; 2) apžvelgti socialinio darbo ypatumus su pagyvenusiais ir senais žmonėmis; 3) išanalizuoti gerontologinės / geriatrinės muzikos terapijos taikymo praktiką; 4) ištirti pagyvenusių ir senų žmonių gyvenimo kokybės pokyčio tendencijas, taikant muzikos terapijos metodus socialinio darbo kontekste. Siekiant atskleisti muzikos terapijos metodų taikymo reikšmę pagyvenusių ir senų žmonių gyvenimo kokybei, buvo atlikta literatūros analizė ir empirinis tyrimas. Pasirinktas tyrimo metodas – aprašomasis kokybinis, kuriuo siekiama įvairiapusiškai pažinti ir aprašyti unikalią žmonių patirtį ir pamatyti tikroviškesnį vaizdą apie muzikos terapijos metodų taikymo galimybes socialiniame darbe su pagyvenusiais ir senais žmonėmis, siekiant geresnės gyvenimo kokybės. Duomenims rinkti naudotas pusiau struktūruoto interviu metodas. Tyrime dalyvavo 8 senelių globos namų gyventojai, kurie daugiau nei metus lanko muzikos terapijos užsiėmimus. Tyrimo analizės metu paaiškėjo, kad iš keturių pagrindinių muzikos terapijos metodų – dainavimo, muzikos komponavimo, muzikinės improvizacijos ir muzikos... [toliau žr. visą tekstą] / Music therapy is a service for a customer, a communication by using music, different musical activities and created interactive contacts in order to maintain health and life quality of elderly people. The aim of this work is to research use of methods of musical therapy in social work with elderly people. The tasks of the work are: 1) to reveal problems of elderly people; 2) to review peculiarities of social work with elderly people; 3) to analyze the practice of the application of gerontologic/geriatric musical therapy; 4) to research the tendencies of changing of life quality of elderly people by using methods of music therapy in the context of social work. Seeking to show the meaning of application of music therapy for elderly people, the analysis of literature and the empiric research has been done. A chosen method of the research is a descriptive qualitative method. This method is used in order to know and to describe a unique experience of elderly people and to see a more realistic view of possibilities of using methods of music therapy in social work with elderly people. For the accumulation of data the structured interview method has been used. The eight members of a nursing home, who more then a year have been participating in music therapy, were involver in the research. During the research analysis it came clear that out of four methods of music therapy – singing, music composition, music improvisation and listening to the music – the singing is more adequate... [to full text]

Siekiant sėkmingai taikyti muzikos terapiją, joje naudojamas veiklas ir metodusbūtina kruopščiai parinkti ir pritaikyti klientų poreikiams. Tyrimas atskleidžia kurios muzikos terapijos veiklos tinka Gerantologijos centre gyvenantiems žmonėms. Darbo tikslas – parinkti neformaliai muzikos terapijai tinkamas muzikines veiklas, įvertinti jų tinkamumą pagyvenusiems žmonėms ir jas išbandyti praktikoje, tiriant jų efektyvumą konkrečioje situacijoje. Uždaviniai: 1) Apžvelgti mokslinę literatūrą, atskleidžiančią pagrindinius MT principus bei analogiškų tyrimų patirtį pasaulyje. 2) Išanalizuoti muzikos terapeutų rekomenduojamus metodus ir priemones. 3) Remiantis profesionalių muzikos terapeutų sukurtais ir taikytais metodais, pasiūlyti muzikines veiklas, naujus metodus ir pedagogines priemones tinkamas pagyvenusiems žmonėms. 4) Pagyvenusiems žmonėms taikyti įvairias rekomenduojamas muzikines veiklas ir tirti įvairius tos veiklos komponentus bei poveikius. Tyrimas pradėtas nuo literatūros šaltinių analizės. Išanalizuoti pasaulio mokslininkų atlikti muzikos terapijos tyrimo rezultatai, patvirtinantys muzikos terapijos veiksmingumą daugelio senatvinių ar pagyvenusiems žmonėms būdingų ligų gydymui. Tyrimų aprašymuose minimos pasiteisinusios muzikinės veiklos. Atlikto tyrimo apraše pateikiama tyrimo eiga, pristatomos tyrimo metu naujai sukurtos ir papildomai ištirtos muzikinės veiklos. Apibendrinus tyrėjo ir tyrimą stebėjusio medicininio personalo pastebėjimus nustatyta, kad Gerentologijos... [toliau žr. visą tekstą] / In order to apply music therapy successfully, it is necessary to carefully select and apply activities and methods to the needs of the patients. The research will reveal which musical therapy activities are appropriate to the elderly patients of Geriatric center. Study goal is to elect relevant music therapy activities for informal music therapy, to evaluate their suitability for elderly people and to try those activities in practice while studying their effectiveness in each situation. Tasks are: 1) To review scientific literature while revealing the main music therapy principles and analogical research experience in the world. 2) To analyse recomended methods and measures. 3) To offer music activities, new methods, and pedagogical measures for elderly people based on created and applyed methods by professional music therapists. 4) To apply various recomended activities for elderly people and to research different components and effects. The research was started by analysing scientific resources. Musical therapy results, presented by world scientists, were analysed and they confirm this music therapy effectiveness for the treatment of the majority deseases common for elderly population. Research focused on the most effective music therapies. The study described the research process and presented new and additionally developed musical therapies. Using date observed by researcher and medical staff it is confimed that for the patients in Geriatric Center the most effective... [to full text]

Background: High demands are today placed upon Swedish elderly care nurses as more elderly live with multimorbidity while the hospital bed capacity is becoming lower.  Aim: The aim of the study was to explore nurses’ perception of decision-making in situations with acutely ill patients in nursing homes and which factors may influence the decision about transferring patients to the emergency department or not.  Method: This is a qualitative study with a phenomenographic approach. Semi-structured interviews have been conducted with 11 nurses working in nursing homes. The data analysis was based on Dahlgren and Fallsberg (1991) data analysis.  Result: Three different description categories were presented, which describes variations of the nurses’ perceptions. Feeling comfortable in making the decision; which involved the nurses feeling confident in the decision-making about transferring patients to the emergency department or not. Hesitant in making the decision; which described how nurses perceived the decision-making as problematic, with regard to transferring patients to the emergency department. Many wishes to consider in taking the decision; which explained how nurses’ decision-making was influenced by requests from the patients or from people close to them. Conclusion:  The study reflected how  supporting and aggravating factors could influence how nurses in nursing homes perceived the decision-making and how nurses have to take in consideration different opinions concerning the decision making process of transferring patients to the emergency department or not.  The result could provide an idea of what support nurses need in order to avoid unnecessary patient transfer to the emergency department.

<p>The international concern about human rights, gender equality, domestic violence and the increase in the aging populations has brought elder abuse into the public focus. Elder abuse is a complex, multi-faceted health, social, criminal justice, international public health and human rights issue. The widely divergent and varying definitions is a controversial problem to understanding elder abuse. The elderly have been excluded from national gender-based programs on domestic violence and the abuse of women and children. In South Africa victims of elder abuse are often physically and or cognitively unable to speak for themselves which necessitates that the public be empowered and trained to become advocates for the aged. Lachs &amp / Pillemer ( 2004 : 1265 ) states that &ldquo / the physical and psychological impairement of elder persons could be predisposing factors for elder abuse &ldquo / . Statistical evidence on the incidence and prevalence rates of elder abuse is lacking as elderly persons are reluctant to identify care givers for fear of abandonment, retaliation and being left destitute ( Lachs &amp / Pillemer, 2004 : 1265 ). Despite the Bill of Rights as set out in the South African Constitution and the Older Persons Act, No. 13 of 2006 which was developed to deal with the empowerment and protection of elder persons and promote and maintain their status, rights, safety, security and well being the abuse of elder person continues to occur ( Older Persons Act, No. 13 of 2006 ). This qualitative research study is allied with the phenomenological approach in an attempt to understand elder person&rsquo / s perception, viewpoints and perspectives from their lived experiences and personal lives. Three (3) focus group discussions and eighteen (18) one-on-one interviews were conducted with elder persons living in the suburbs of Cape Town. Data from participants were audio-taped, transcribed verbatim before an inductive analysis lead to the emergence of broad themes and patterns. The main findings of the research study concluded that elderly persons were informed but not empowered about financial, emotional and verbal abuse. The abuse of the elder person in old age homes also featured prominently. The findings of the research study can be used to provide education and empower elder persons and the general public on specific aspects related to elder abuse which are : Financial, Emotional, Verbal and the abuse by staff at old age homes. These findings could be utilized by health and social welfare advocates and organisations who offer community educational and development programs to advocate against elder abuse.</p>

No abstract available. / Thesis (M.Med.)-University of Natal, 1986.

Introduction: Although drug-related problems (DRPs) are known to be prevalent in elderly patients, there are not many studies that have been performed in geriatric outpatients at public health facilities in South Africa. Thus, the prevalence of DRPs in elderly outpatients attending Addington Hospital was investigated and suitable preventive intervention strategies to overcome or minimise these DRPs were developed. Research Methodology: The study was conducted in two phases. Phase 1 was conducted in March and April 1998, during which 281 elderly patients on chronic medical treatment were chosen for the study by systematic random sampling, according to specific inclusion criteria. Data collection was via a retrospective review of the elderly patient's medical notes and by personally interviewing the patient. Two research instruments were used in this phase. The customised Patient Profile (PF) form helped to delineate DRPs in the elderly patients. A Prescription Intervention Form (PIF) was used to inform the prescriber of the DRP and to make recommendations to change the drug therapy in order to overcome the DRP. In phase 2 of the study, intervention strategies were devised to address some of the major DRPs identified in phase 1 of the study. A patient counselling leaflet, prescribing guidelines for geriatric patients and a protocol for counselling of in-patients were developed. In addition, two DRP reporting systems were developed for surveillance of adverse drug reactions and medication errors during dispensing. Results and Discussions: Most geriatric subjects suffered from multiple, chronic conditions, these being hypertension (64.8%) followed by ischaemic heart disease (43.8%), musculoskeletal disorders (arthritis or gout) (42.7%), diabetes (29.2%), chronic obstructive airways disease (13.2%), hypercholesteremia (11.7%) and arrythmias (atrial fibrillation) (11.0%). The 281 patients were taking 1730 prescribed drugs, with a mean of 6.2 (range 3 to 15) prescribed drugs per patient. An astounding 45.6% of the total geriatric patients were taking or using between 7 to 9 medicines and 10.3% were taking or using between 10 to 15 medicines. The antihypertensives (15.9%) were the most widely prescribed drugs followed by medicines acting on CNS (10.9%), coronary vasodilators (9.1%), diuretics (9.1%) and medicines acting on the musculoskeletal system (8.7%). A total of 856 actual DRPs experienced by 262 geriatric patients (93.2%) ranged from 1 to 11 DRPs. The greater the number of prescribed drugs the greater the actual DRPs experienced by geriatric patients (p = 0.000). The most common DRPs were those involved in drug safety (56.6%); effectiveness of the drug therapy (20.8%); compliance (7.8%) and indication of drug therapy (7.6%). 159 elderly patients (56.6%) experienced 223 adverse effects either with their current or past prescribed medicines. The most common ADRs were as follows: gastro-intestinal ulceration (11.0%), cough (9.3%), diuretic side effects (dehydration, fatigue, hypotension, etc) (7.1%), constipation (6.8%), equilibrium problems (6.4%) and headaches (6.4%). For those DRPs warranting interventions, the mean number of prescription interventions in the entire sample population of 281 elderly patients was 0.65 ± 1.16. 87 elderly patients (30.1 %) had from 1 to 4 interventions on their current prescription. The most common prescription interventions were on problems involving drug therapy monitoring (26.9%), safety of drug therapy (26.5%), indication of drug therapy (17.5%), prescribing errors (15.3%) and prescription information omission (11.1 %). The three intervention strategies and DRPs surveillance reporting systems were successfully devised and developed. Conclusions: A profile related to the elderly patient's medical history and pharmacotherapy was completed for each of the 281 patients. General trends of prescribing pattern prevalence of DRPs and the prescribed inappropriate medication was established. The interventions of problem prescriptions were based on a newly developed PIF. The development and implementation of suitable intervention strategies to minimise DRPs were as follows: a compliance information leaflet, prescribing guidelines and the protocol for counselling in-patients. A medication error form as well as an adverse drug reaction reporting forms was developed for surveillance of DRPs. The recommendations for clinical practice and directions for future research that are presented should help to make drug therapy in the elderly safer and more effective. / Thesis (M.Pharm.)-University of Durban-Westville, 2000.