Due to the impending "elder boom" the need for gerontological social workers is increasing. This study examined what attracted workers to enter this field and what motivates them to stay. The research also focused on the relationship between the social worker's commitment and their perceived need for training and education in the field of gerontology.

Background: Geriatric impairments and obstructive sleep apnea (OSA) are prevalent among patients with atrial fibrillation (AF) and adversely impact patient’s long-term outcomes. Little is known, however, about the association between OSA and frailty, cognitive performance, and AF-related quality of life in older men and women with AF. Objective: To examine the association of OSA with frailty, cognitive performance, and AF- related quality of life among older adults with AF. Methods: Data from the Systemic Assessment of Geriatrics Elements-AF study were used which includes participants ≥ 65 years with AF and a CHA2DS2-VASc ≥ 2. Multivariable adjusted logistic regression models were used to examine the association between OSA, as measured by the STOP-BANG questionnaire, and geriatric impairments including frailty, cognitive performance, and AF-related quality of life. Results: A total of 970 participants with AF (mean age 75 years, 51% male) were included in the analysis. Among the 680 participants without a medical history of OSA, 179 (26%) participants had low risk of OSA, 360 (53%) had an intermediate risk, and 141 participants (21%) had a high risk for OSA. Compared to those with low risk of OSA, those at intermediate or high risk for OSA were significantly more likely to be frail (aOR= 1.66, 95% CI: 1.08–2.56; aOR= 3.00, 95% CI: 1.69-5.32, respectively) after adjusting for sociodemographic, clinical, and health behavioral variables. Risk of OSA was not associated with cognitive performance and AF- related quality of life after adjusting for several potentially confounding factors. Conclusions: Older adults with AF who are at intermediate or high risk for OSA have a greater likelihood of being frail. Our findings identify a group of patients at high risk who would benefit from early screening for OSA. Future longitudinal studies are needed to assess the effect of OSA treatment on frailty, physical functioning, and QoL among patients with AF.

This study is the first of its kind undertaken at Groote Schuur Hospital. It is an attempt to provide a holistic profile of their elderly patients with a view to encouraging further, more specific research, and to provide information for use in the planning of efficient health care for the aged. The study was based on three premises: (i) there is an interrelationship between the ageing process and disease; (ii) a non-disease-specific approach which focusses on the functional status of elderly patients can be used as a predictor of health services consumption; and (iii) any study which promotes understanding of the dynamics of health care of the elderly must also take into account the ageing process and its effect on a particular population within a specific social context. The research spanned 52 weeks (1 March 1989 - 27 February 1990). A sample of nine patients per week was selected from the total population of patients aged 65 and over admitted to the Emergency Unit of Groote Schuur Hospital. Two adult female researchers, using structured questionnaires, constructed in English and comprising subtests, utilising indexes and scales, interviewed respondents and/or household members in their own homes. Data was also obtained from the hospital files. Although essentially descriptive by nature, use was made of groups in regard to variables such as "first admission" (admission to the Emergency Unit), and "readmission" (a previous overnight admission in the preceding year). Statistical analysis, where indicated, was by means of non-parametric tests.

Background: 130,000 - 150,000 people in Sweden suffer from dementia and the patient group is growing all over the world. The disease affects a person's ability to communicate. The cognitive difficulties of these patients present challenges for correct pain assessment. Aim: The purpose of the study was to investigate challenges, and which methods and instruments the nurse uses to identify and relieve pain in dementia patients. Method: A literature review of ten original articles. Results were analyzed qualitatively.  Result: Two main themes with sub-themes have been identified. Challenges for correct pain assessment in patients with dementia, with sub-themes Disease symptoms that complicate pain assessment and Organizational factors and the need for more knowledge. The second main theme is Identifying pain in patients with dementia, with sub-themes Meeting and interpreting the patient's expression of pain and Pain assessment tools and pain relief. Conclusion: There are challenges for the nurse in assessing pain in people with dementia. What complicates pain assessment is the patients inability to express themselves verbally. More knowledge among staff is needed to increase quality. This also includes clearer guidelines for pain assessment, as well as resources/time. / Bakgrund: I Sverige lider 130 000 – 150 000 personer av demenssjukdom. Patientgruppen är växande både i Sverige och världen. Sjukdomen påverkar en persons förmåga att kommunicera. Denna patientgrupps kognitiva svårigheter innebär utmaningar för korrekt smärtskattning. Syfte: Syftet var att undersöka utmaningar, och vilka metoder och instrument sjuksköterskan använder, för att identifiera och lindra smärta hos patienter med demens. Metod: Litteraturöversikt med tio originalartiklar vars resultat analyserades med kvalitativ innehållsanalys. Resultat: För att besvara syftet har två huvudteman med underteman identifierats- Utmaningar för korrekt smärtbedömning hos patienter med demens, med underteman Sjukdomssymtom som försvårar smärtbedömning samt Organisatoriska faktorer och behovet av mer kunskap. Andra huvudtemat är Att identifiera smärta hos patienter med demens, med underteman Att möta och tolka patientens uttryck för smärta och Smärtbedömningsinstrument och smärtlindring. Slutsatser: Det finns stora utmaningar för sjuksköterskan att bedöma smärta hos personer med demenssjukdom, trots befintliga metoder/smärtskattningsinstrument. Det som primärt försvårar smärtbedömning hos patientgruppen är när den kognitiva försämringen påverkar patientens förmåga att uttrycka sig verbalt. För att öka kvalité inom området behövs större kunskap hos personal, tydligare riktlinjer för hur smärtskattningen ska genomföras samt resurser och tid.

Att förebygga ohälsa och att stärka det friska är centralt för att stödja ett hälsosamt åldrande. Missnöjdhet med måltidsupplevelsen är en bidragande orsak till lågt näringsintag, något som i sin tur är en riskfaktor för undernäring. För att kompensera för nedsatt aptit och matlust är det viktigt att måltidsupplevelsen upplevs bra. Syftet med studien är att undersöka hur boende inom vård- och omsorgsboende beskriver sin måltidsupplevelse. För att besvara syftet användes en litteraturstudie av kvalitativ ansats med deskriptiv design där sju studier från Australien, England, Kanada, Spanien, Sverige, USA och Wales kvalitetsgranskades och analyserades. Resultatet från studien kan sammanfattas i tre huvudteman; självbestämmande, identitet och social gemenskap. Resultatet visar att de boende själva vill vara med och utforma sin måltidssituation. De flesta boende upplever det positivt att äta och umgås med andra. Det sociala samspelet under måltiderna ger möjlighet för sociala relationer och en känsla av vardaglighet och normalitet. De tillfrågade önskade att få behålla sin individualitet och bli behandlade som enskilda personer med individuella preferenser. Ett personcentrerat arbetssätt kan förbättra både nutritionsstatus och måltidsupplevelsen samt stärka de boendes egenvårdsförmåga och självbestämmande. Det i sin tur kan leda till friskare individer med högre livskvalité. / Health promotion and disease prevention are central in supporting healthy aging. Dissatisfaction with the meal experience is a contributing factor to low nutritional intake, which in turn is a risk factor for malnutrition. To compensate for decreased appetite and promote healthy eating habits it is important with a good meal experience. The purpose of this literature study was to investigate how residents and staff in care and nursing homes over the age of 65 described the meal experience. To answer the purpose, a literature study of qualitative approach with a descriptive design was used. Seven studies from Australia, England, Canada, Spain, Sweden, USA and Wales were first quality reviewed and then analyzed. The results from the study can be summarized in three main themes: self-determination, identity and social community. The results shows that the residents want to be involved in designing their own meal situation. Most residents would like to eat and socialize with others during mealtimes. Social interactions during the meals provides the opportunity for social relationships and a feeling of normality. The residents wanted to maintain their individuality and to be treated as individuals with individual preferences. A person-centered approach can improve both nutritional status and the meal experience, as well as strengthen the residents' self-care ability and self-determination. This in turn can lead to healthier individuals with a higher quality of life.

Introduction: The aging population is a rapidly growing demographic in the United States. Isolation, limited autonomy, and declining physical and mental health render many older adults vulnerable to elder mistreatment (EM). The purpose of this study was to assess the prevalence and correlates of EM among a sample of older adults using legal assistance services in Atlanta, Georgia. Methods: Researchers administered surveys to consenting older adults (aged 60þ) in 5 metro Atlanta community centers that hosted legal assistance information sessions as part of the Elderly Legal Assistance Program. The surveys screened for risk factors and prevalence of EM risk using valid and reliable measures and included additional questions regarding demographics characteristics and healthcare use behaviors. Results: Surveys were completed by 112 participants. Findings reveal that 32 (28.6%) respondents met the criteria for elder abuse / neglect risk; 17 (15.2%) respondents met criteria for depression; and 105 (93.7%) had visited a healthcare provider during the past 6 months. Conclusion: The rates of EM risk in this sample were higher than those previously reported in research. Findings support continued examination of unique risks that may be present among older adults who may be possibly facing legal issues. Additionally, the reported frequency of healthcare visits among participants reveals a promising opportunity to examine development of a more widespread EM screening approach to be conducted in non-emergency settings. Interdisciplinary collaboration is required to inform screening approaches that account for complexities that EM cases present. [West J Emerg Med. 2013;14(4):309–315.]

Home health clinicians are uniquely qualified to fully evaluate patient falls risk and carry out clinical interventions to reduce risk. The objectives of this article are to give home health providers an update on the risk factors for falling, review the current guideline recommendations for prevention of falls, and provide a stepwise approach to evaluate patients and apply the clinical literature to decrease falls in older patients living at home. Many falls may be prevented with patient screening, assessment of risk, and modification of risk factors. Since the risk of falling is an interaction between three groupings of patient-specific factors, namely, environmental factors, diseases/disorders, and medication use, a multifactorial fall risk assessment can help identify the factors to consider modifying in an individual patient.

The following was a research practicum instituted as an actual project for the State of Montana Welfare Department between June, 1970, and May, 1971. The project had a two-fold purpose in being conceived: one purpose was to fulfill a graduate school academic requirement; and the second purpose was to fulfill a responsibility to the people of Montana who would eventually gain some benefits from this project. The series of written documents that follow are the description of that project's conception and actualization in six Montana counties. The first part is the project idea and theory; the next two parts consist of the means by which the project was implemented; and the final two parts constitute the interim and final reports and evaluations of the project.

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