Thesis (M.R.E.)--Cincinnati Christian Seminary, 1987. / Abstract. Includes bibliographical references (leaves 165-166).

People with advanced dementia often struggle to maintain relationships and can ultimately experience social death before their physical death. Social death occurs when a person is no longer treated as an active agent in their relationships. Relationship-centred care acknowledges the relational nature of care-giving and care-receiving, validating the support needs of both care-givers, and the person receiving care. In the context of care-giving and care-receiving, a person with advanced dementia can become viewed as a passive recipient of care. In the context of caring for people with advanced dementia, more needs to be understood about how caring relationships can be sustained until the end of life in a way which challenges the social death of people with advanced dementia, and supports carers. Understandings of, and assumptions about, the effect of dementia on personhood directly affect the way people with dementia are perceived by others, the quality of their relationships, the quality of their care and the quality of their life. Dementia is often associated with the loss of the person. Kitwood (1997) has been highly influential within dementia care in challenging the loss of personhood, and reconsidering the grounds of personhood, emphasising relationships over cognition. Kitwood’s often cited definition of personhood is: ‘a standing or status bestowed on one human being, by another, in the context of relationship’ (Kitwood 1997 p8). Kontos (2004) however, critiques this social interactionist view of personhood, suggesting it potentially relegates the ‘body’ to a symbolic position rather than guaranteeing personhood. Her work examines the way that personhood is embodied, and how this persists when a person has advanced dementia. She suggests that attention to the embodied aspects of personhood could act as an important counter to the social death of people with advanced dementia, increasing the scope and opportunities for interpersonal relationships, and improved quality of care and quality of life. Zeiler (2013) and Jenkins (2013) develop this theory further, describing intercorporeal personhood springing forth through, and in, interaction, enabling individuals who cannot express themselves without support to do so in interactions. The principle aim of this doctoral research is to examine the care-giving/care-receiving relationship, in palliative dementia care, through the theoretical lenses described above. The research took place in a care home called ‘Primrose Hill’ (a pseudonym): a specialist dementia care home (without nursing), with an increasingly frail population with multiple co-morbidities. Fifteen residents died during the 10 months of the study. The research employed an ethnographic approach, using participant observation alongside interviews and group discussions with staff. Attention was given to how people with dementia responded to care and how they were positioned within the caring relationship; were they seen as passive recipients of care or as active agents, objects or subjects? The approach was appreciative in intent, based on the assumption that care home staff, and people with dementia who live in care homes, through their experience of the human encounter, have important things to teach families, and others working in dementia care, including policy makers and care regulators. When articulated and shared, their experiences can challenge the stereotype of dementia as a ‘death that leaves the body behind’. The empirical analysis revealed three keys facets which shape the caring relationship: body work (direct hands-on bodily care); recognising and supporting selfhood; witnessing and responding to suffering. These three facets of palliative dementia care are examined and reveal the way that people with dementia, even in the advanced stages, continue to experience and respond to the world, and those around them, until they die. This is used to develop the conceptual underpinning of relationship-centred palliative dementia care. The Senses Framework (Nolan et al 2006), which sets out the conditions required for relationship-centred care to occur, is expanded to incorporate embodied selfhood and intercorporeal personhood. The research concludes by arguing, using Ethic of Care theory as an interpretive framework, that an expanded understanding of personhood that includes the ‘body’ is vital, not only at the frontline, but also at a political and societal level, if care is to have integrity.

No description available.

Conselho Nacional de Desenvolvimento CientÃfico e TecnolÃgico / No Brasil, a populaÃÃo de idosos està em crescimento contÃnuo, causando um aumento da demanda por instituiÃÃes de longa permanÃncia para idosos. PorÃm, estudos no Nordeste brasileiro sobre a saÃde bucal em idosos institucionalizados sÃo praticamente inexistentes. Este estudo teve como objetivo analisar as condiÃÃes de saÃde bucal em idosos institucionalizados de 65 anos e mais em um asilo no MunicÃpio de Fortaleza / CE, Brasil. Foi realizado um estudo transversal com 160 indivÃduos (95,2% da populaÃÃo-alvo), consistindo de consulta aos prontuÃrios, aplicaÃÃo de um questionÃrio estruturado prÃ-testado e exame bucal. Na anÃlise estatÃstica, foram utilizados testes T, Kruskal-Wallis e regressÃo linear mÃltipla. A idade mÃdia foi de 76,6 anos. O Ãndice CPO-D (29,73) dos idosos asilados foi elevado. O componente dente perdido apresentou o maior valor (28,42); 109 (68,1%) idosos nÃo possuÃam nenhum dente hÃgido; 93 (58,1%) eram totalmente desdentados e 56 (35,0%) apresentavam dentes com raÃzes expostas. Dos 573 dentes presentes, 256 (44,6%) necessitavam de algum tipo de tratamento, sendo 194 (75,8%) para extraÃÃo dentÃria. Dos idosos, 112 (70%) nÃo faziam uso de prÃtese superior e 130 (81,3%) de prÃtese inferior. Quanto à necessidade de prÃtese, 135 (84,4%) necessitavam de algum tipo de prÃtese superior e 142 (88,7%) de prÃtese inferior. A maioria dos sextantes examinados (83,8%) apresentava cÃlculo dentÃrio. Sobre os cuidados e prÃticas em saÃde bucal, apenas 17 idosos (10,6%) nÃo faziam higiene oral. Poucos idosos tinham visitado o dentista nos Ãltimos trÃs meses. A extraÃÃo dentÃria predominou como o motivo da Ãltima visita ao dentista. Idade, instruÃÃo educacional e higiene oral apresentaram significÃncia (p<0,05) para o CPO-D mÃdio na regressÃo linear mÃltipla. Os dados mostram que a maioria dos idosos apresenta saÃde bucal precÃria. Assim, sÃo indispensÃveis intervenÃÃes focalizadas nessas populaÃÃes, como educaÃÃo em saÃde e tratamento precoce. / In Brazil, the elderly population has been growing continuously, leading to a higher demand for long-term institutions for the elderly. In spite of that, studies on the oral health of institutionalized elderly in northeast Brazil are virtually non-existent. The objective of the present study was to analyze the oral health conditions in institutionalized elderly of 65 year-olds or older in a nursing home in the city of Fortaleza / CE, Brazil. A cross-sectional study was conducted with 160 individuals (95.2% of the target population), consisting of the analysis of patient records, application of a questionnaire and oral examination. In statistic analysis, T-Student, Kruskal-Wallis and multiple linear regression tests were performed. Their mean age was 76.6 years. The DMFT index (29.73) was high. Lost teeth represented the highest proportion (28.42); 109 (68.1%) elderly did not have any healthy teeth; 93 (58.1%) were total edentates and 56 (35.0%) had teeth with exposed roots. Of 573 teeth present in total, 256 (44.6%) required some kind of treatment, and 194 (75.8%) of them dental extraction. Of the study population, 112 (70%) did not use any upper prosthesis, and 130 (81.3%) did not use any lower prosthesis. The need of an upper prosthesis was detected in 135 elderly (84.4%) and of a lower prosthesis in 142 (88.7%). The majority of sextants examined (83.8%) had dental calculus. About practices and care in oral health, only 17 individuals (10.6%) did not clean their mouth. Few elderly had visited the dentist at last three months. The dental extraction predominated as the reason at last time of going to dentist. Age, educational level and oral hygiene entered in the multiple linear regression. These data show that most of the elderly had poor oral health. Interventional measures focused on these populations, such as health education and preventive treatment, are, therefore, necessary.

One of the most striking dimensions of population change in Canada is the marked increase of elderly persons in proportion to the total population. This phenomenon, particularly pronounced in British Columbia (B.C.), reflects in large measure the attractiveness of regions within B.C, where climatic conditions are probably the most moderate in Canada. This large concentration of the elderly creates a significant housing problem because the elderly, on the whole, have lower incomes than other housing consumers and are thus at a disadvantage in securing adequate accommodation. An attempt is made to evolve an approach to the problem of housing the needy elderly which will be generally applicable in Canada and particularly applicable in B.C. It is contended that there is need for an administrative system designed to coordinate the diverse public and private organizations that are involved, or potentially involved, in providing housing and complementary services for the needy elderly. Coordination is required at several levels including coordination of planning and welfare agencies, coordination of efforts of municipalities in housing programs designed to serve residents of several municipalities, and coordination of private housing and service agencies with complementary public housing and service agencies. As a basis for investigation it is hypothesized that: In British Columbia, the Provincial Government ought to be responsible for establishing the objectives, policies and administrative framework necessary to encourage joint participation of federal, provincial and local governments and private enterprises in implementation of a comprehensive housing program for the elderly. The hypothesis stresses the importance of objectives and policies as a necessary basis of a housing program. While Provincial responsibility is emphasized, the ideal situation would entail joint Federal - Provincial participation in the definition of housing objectives and policies because of their joint participation in financing of these programs. Accordingly, it is proposed that the overall administrative framework use the "Urban Development Board", an administrative device designed to foster effective and coordinated joint Federal - Provincial action. The Provincial Government is alone constitutionally capable of establishing the necessary administrative machinery to implement housing programs at the local level. The key issue is whether to entrust the program to a dominant Provincial mechanism or to a strongly empowered local agency. Emphasis is placed on the human ecology of the problem. The problem of housing the elderly is expected to be pronounced in regions with climatic amenity, and particularly in urban areas of those regions. In addition, the requirements of an administrative system to implement a housing program are developed and a range of alternative administrative devices analyzed in light of these criteria. The analysis suggested that the local housing authority approach could produce a coordinated housing program at the local level of Government. The Provincial Government would make housing a mandatory function of local government, at the same time providing the necessary powers and financial resources for local housing authorities. The Provincial government would coordinate the programs of all local housing authorities and administer a system of grants-in-aid to these authorities in proportion to the need and in relation to Provincially established priorities. Because of the strength of voluntary philanthropic housing effort in B. C., it is suggested that the local housing authority be closely affiliated for coordination purposes with a proposed Housing Council to be comprised of representatives of those private organizations providing housing and collateral services. The case-study method is used to determine the utility of the recommended administrative system within the context of a specific area. The focus of the case study is on the administrative arrangements for housing the elderly at the local level. Proposed changes in Federal - Provincial relations on housing problems are not examined because a case study cannot identify the influence of non-existent administrative systems. The study serves to illustrate the potential role of a local housing authority although the mechanics of implementing the approach are not detailed. The hypothesis fails to assert explicitly that the Federal and Provincial Governments should jointly participate in formulating objectives and policies and that a housing program for the elderly should not be conceived independently of an overall housing program. Subject to these limitations, the hypothesis is considered valid. / Applied Science, Faculty of / Community and Regional Planning (SCARP), School of / Graduate

This study attempts to explore some of the social aspects of boarding homes for the aged in order to learn what problems are met in operating such homes and what adjustments can be made to solve them. Sixteen boarding homes in Vancouver were visited and the operators were interviewed. These interviews were the basis of the chapters on the boarding homes themselves. In addition other types of institutions were considered, with one or two being visited and investigated. The study made by the Committee on the Care of the Aged was used for background as were two other studies made.by the writer in order to determine where old people in one area, of the city were living. Supplementary material was of course drawn from, reference reading. The study includes chapters on general facilities offered in. boarding homes, on bedroom and bathroom facilities and on the serving of meals. The use of leisure time was considered to be vitally important. Perhaps the most significant factor in successful operation of a boarding home is the personal relationships involved. A very deliberate effort was made to keep conclusions and recommendations, at a practical level. It was recognized that private rooms and a comprehensive, well-planned recreation program are desirable, but no such sweeping changes from the present accommodations were even suggested. The licensing system has had a major role in raising standards and improving practises, and will continue to do so in the future. One inescapable conclusion is that there is a. serious shortage of boarding homes, for old people, as well as; of all other types of accommodation geared for their needs. No attempt has been made in the present survey to assess the extent of this shortage nor to propose how or by whom the shortage could be rectified. It is hoped only that this study might be helpful to persons who are dealing directly with boarding homes for the aged. / Arts, Faculty of / Social Work, School of / Graduate

[no abstract included] / Arts, Faculty of / Social Work, School of / Graduate

The increasingly popular recreational activity of cottaging has a marked spatial impact. In the past, planners have foregone the opportunity to guide and direct cottage development, other than by traditional zoning and subdivision techniques. The provision of public sercices or utilities is a valid method of development control which has been largely overlooked. This investigation of cottaging in the Squamish-Lillooet Regional District examines the potential of this technique, concentrating on those strategic public services which can be provided by the government to individual lots (road, water, sewer and electricity). The study was based on 117 questionnaire returns. It was found that the majority of cottagers in the study area have low levels of the public services under discussion. However, many cottagers indicated dissatisfaction with existing low service levels. When these individuals were included with those who had high levels of services, this combined sub-sample constituted a majority of the population. The discrepancy between existing and preferred levels of services for many cottagers is a function of several factors. For example, infrequent use of the cottage apparently results in a tradeoff between the desire for the convenience offered by high levels of services and a variety of other factors, including the economics of providing the services, and certain aspects of the cottager's life style. A trend indicating that more frequent use of the cottage is accompanied by higher service preferences, supports this conclusion. The study reveals that cottages offer relaxation, isolation, and peace and quiet, and that the cottage is used as a base for outdoor recreational activity. Most cottagers in the Squamish-Lillooet Regional District feel that their cottage area is currently at an optimum density and want neither higher levels of services nor more people. Planners can now utilize these findings to determine the levels of services that should be offered, weighing the cottagers' preferences against considerations of environmental quality and density. In addition, it is suggested that the provision of either high or low levels of services will attract different kinds of people, thus segregating the cottage population. / Applied Science, Faculty of / Community and Regional Planning (SCARP), School of / Graduate

<p>A methodology is developed to evaluate residential energy cost reduction options in response to increasing concern over rising fuel costs and diminishing energy reserves. Energy use factors such as climate and local geographic features are identified and energy monitoring techniques are proposed.</p> <p> A flexible, computer-based decision and risk analysis tool is developed as a tool for the economic comparison of energy saving options. Single- and multi-variable sensitivity analysis is performed. A multi-criteria optimization method is presented which includes performance and cost factors. An efficient HV AC control program is developed using multiple sensors and fully automatic control.</p> <p> Finally, a case study of two energy saving alternatives is conducted for two cities in different climatic regions. The results show that the desirability of various energy saving options is a function of local climate conditions, rate of energy cost increase and predicted savings attributable to the options.</p> / Master of Science

Med den snabba utvecklingen av Internetteknologi växer området förhemautomatisering alltmer. Intresset och efterfrågan för teknik inom smarta hemhar ökat avsevärt i Sverige. Teknik inom smarta hem förser hushåll medintelligenta levnadsmiljöer för daglig bekvämlighet. Syftet med denna studie är attframställa information från svenska konsumenter om deras uppfattade fördelar ochrisker kring smarta hem. För att kunna generera denna data har vi genomfört enenkätundersökning och detta dokumentet lyfter fram de upplevda fördelarna ochriskerna med smarta hem från flera perspektiv av svenska konsumenter runt omhela Sverige. Resultaten av studien kan vara till hjälp för framtida svenskalagstiftande organ, beslutsfattare och tillverkare av smarta hem för att mildra desäkerhetsfrågor och risker som svenska konsumenter lyfter fram. / With the rapid development of Internet technology, the field of home automation isexpanding. The interest and demand for smart home technologies has increasedsignificantly in Sweden. Smart home technology provides households withintelligent living environments for daily convenience. The purpose of this study is toextract the information from Swedish consumers about their perceived benefits andrisks of smart homes. To be able to generate this data we have executed a surveyand this paper highlights the perceived benefits and risks of smart homes frommultiple perspectives of Swedish consumers. The results of the study can behelpful in future for Swedish law making agencies, policymakers and smart homedevice manufacturers to mitigate the security issues and risks mentioned bySwedish consumers.