Using an analysis of secondary data from the Health and Retirement Survey, this thesis provides the groundwork for understanding factors for nursing home placement using matching techniques to understand the differences between those persons with similar health characteristics who are not residents of nursing homes, and who are temporary residents or permanent residents of nursing homes. / Fisher Institute for Wellness and Gerontology

No description available.

Die Betreuung von Menschen mit Demenz wird immer mehr zu einer gesellschaftlichen Zukunftsaufgabe, mit der in Pflegeeinrichtungen, in ambulant betreuten Wohnformen, wie auch individuell im eigenen zu Hause umzugehen ist. Wie gut das Leben mit einer Demenz gelingen kann, wird auch maßgeblich durch die architektonische Gestaltung des Wohnumfelds bestimmt. Durch eine demenzsensible Architektur können eine Verbesserung der Alltagsaktivität, der Selbständigkeit, und insbesondere der Lebensqualität von Menschen mit Demenz und ihren Angehörigen erzielt werden. Eine ganz zentrale Rolle spielen dabei die Fragen: Wie können Wohn- und Lebensarrangements gestaltet werden, um den Menschen mit Demenz bestmöglich in seinen Bedürfnissen zu unterstützen? Und wie gelingt es durch architektonische und technische Lösungen pflegende Angehörige, ehrenamtlich Betreuende und professionell in der gesundheitlichen Versorgung Tätige in den notwendigen Erfordernissen der Versorgung und Betreuung von Menschen mit Demenz zu unterstützen? Nur durch eine ganzheitliche Betrachtung des Themas wird es unter den Bedingungen des demografischen Wandels auch zukünftig gelingen, wirtschaftliche Konzepte zu generieren, die eine entsprechende Versorgung der Menschen mit Demenz gewährleisten. Insbesondere in schrumpfenden Regionen und Märkten wird dies zu einer zentralen Zukunftsfrage werden. Der vorliegende Tagungsband vermittelt einen Überblick über das Thema „Architektur für Menschen mit Demenz“, indem neueste Erkenntnisse aus Wissenschaft und Praxis der architektonischen Gestaltung verschiedener Wohn- und Lebensarrangements für Menschen mit Demenz dargestellt werden.

This thesis analyses thirteen key literary texts taken from the last century of Canadian English-language publishing to assess how each text reveals, reinforces, and /or resists narratives of natural-aging, decline, progress and positive-aging. When considered together, these texts illustrate overall patterns in the evolution of age-related beliefs and behaviours. Stories have a potential emotional impact that scholarly readings do not, and thus the reading and study of these texts can serve to promote conscious intellectual consideration of the issues surrounding age and aging. My analysis focuses on how our Canadian literature envisages aging into old age, primarily addressing stories set in late-life-care facilities and comprising what I am naming our ‘nursing-home-narrative genre.’ Although my chapters follow a chronological progression, beginning with Catharine Parr Traill’s 1894 Pearls and Pebbles and concluding with Janet Hepburn’s 2013 Flee, Fly, Flown, I am not arguing that each age-related belief is replaced by a succeeding one. I would assert instead that over time Canadians have accumulated an assortment of age ideologies, some of which mesh and some of which duplicate or even contradict others. For example, although many people have embraced new positive-aging ideologies, aging-as-decline narratives still circulate strongly. Using social and literary theory as support, I argue that the selected literary texts of my analysis (Traill, Wilson, Laurence, Shields, Wright, Barfoot, Munro, Tostevin, Gruen, Hepburn, King) reveal a genre that is evolving quickly in both form and content. The nursing-home-narrative genre begins with gothic stories of fear of the nursing home, of aging and of death, expands to include darkly humorous stories featuring increasingly empowered residents successfully living within care homes, and is introducing, during the twenty-first century, fantastical stories of escape from the home and of return to youthful behaviours and preferable habitats. This most recent narrative joins the earlier ones to create a new master narrative in which aging people can overcome fear with agency and thus ultimately reject the nursing home and old age itself. However, in the most compelling of the new agency and escape narratives, authors lay a thin icing of entertainment over a dark undercurrent of reality.

No description available.

Providing care for people with dementia is an increasing societal challenge. In Nursing Homes, Assisted Living Facilities and Housing alike, dementia-friendly concepts are needed. Whether it is possible to live well with dementia is determined by many factors, among which the architectural design of the living environment plays a major role. Dementia-friendly architectural concepts support the everyday activities, independence, and quality of life not only of people with dementia, but also their care givers. The following issues need to be addressed: Which living and care arrangements support best the needs of people with dementia? How can architectural and technological concepts support family care givers, professional care providers, and volunteers? Only a holistic approach to the provision of care for people with dementia will allow the generation of economically sustainable concepts. These are especially in demand in light of the demographic changes our society encounters and will become a key issue for the future development of shrinking regions. This book is a collection of the contributions to the symposium “Architecture for People With Dementia” which took place in Dresden, Germany, in May of 2014. It provides an overview on this important topic and includes new insights form research and care practice on the architectural design of various living and care arrangements of people with dementia.

Bakgrund: Måltiden är central för en människas fysiska och psykiska välmående. Malnutrition är ett vanligt problem i den äldre populationen. Syfte: Att undersöka hur personer boende på två vård- och omsorgsboenden för äldre i Uppsala län upplever sin måltidsmiljö samt hur det egna behovet av egenvårdsstöd och inflytande möts under måltiden utifrån faktorerna fysisk och social måltidsmiljö, hjälpmedel, egenvård och självbestämmande. Metod: Studien har en kvalitativ ansats. Åtta informanter på vård- och omsorgsboenden för äldre i Uppsala län intervjuades, informanterna valdes genom ett strategiskt urval. Tillstånd för studien anskaffades hos boendets verksamhetschef. Intervjuerna transkriberades sedan och analyserades utifrån enligt Graneheim och Lundmans (2004) innehållsanalys. Resultat: Intervjuerna resulterade i 15 kategorier och fem teman som beskrev informanternas erfarenhet av måltiden, hjälp, hjälpmedel och känsla av delaktighet i matsalen. Informanterna förmedlade en varierad bild av den sociala måltidsmiljön, likväl den fysiska. Informanterna är alla individer och har en högst personlig åsikt om vad man äter och hur man beter sig i matsalen. Individens personliga inställning färgar också upplevelsen av måltidssituationen. Slutsats: Individer som lever och bor på särskilt boende för äldre har olika viljor och preferenser vad gäller vilka faktorer som påverkar till en positiv måltidsmiljö. Förändringsideér hos de äldre finns men forum för påverkan saknas, vilket kan resultera i en känsla av vanmakt. Vetskap om rätten till anpassad hjälp och stöttning vid måltiden varierar. Upplevelser av för lite hjälp och avsaknad av anpassade hjälpmedel medför en negativ påverkan på individens självupplevda egenvårdskapacitet. / Background: The meal is central to a person's physical and mental well-being. Malnutrition is a common problem among the elderly population. Objective: To study what the elderly people living in two nursing homes in Uppsala had to say about their physical and social meal environment and need of self-care support and the feeling of influence during the meal based on factors of social and physical environment, aid, self-care and influence. Method: Qualitative interview study. Eight residents living in 2 nursing homes in Uppsala were interviewed using a strategic sample. Permission for the study was obtained by the clinic manager. The interviews were transcribed and analyzed by a content analysis according to Graneheim and Lundman (2004). Result: The interviews resulted in 15 categories and five themes which described the informants' experience of the meal, help, aids and sense of influence in the dining room. The informants presented a varied picture of the social meal environment, as well as the physical. The informants are all individuals and have a personal opinion on what to eat and how to behave in the dining room. The individual's personal attitude also colors the experience of the meal situation. Conclusions: Elderly residents living in nursing homes have different desires and preferences regarding the factors that influence a positive meal environment. There is a lot of ideas among the elderly, but a lack of forum for influence can result in a feeling of powerlessness. The knowledge about the right to customized help and support during the meal varies among the elderly. Experiences of too little help and lack of acquired aids has a negative impact on patient self-care capacity.

This research evaluates Quebec's health care policy by analyzing how the partnership metaphor is implemented in policy and practice. The partnership construction is identified in 4 interpretive communities within long-term community services to the elderly population. This analysis focuses on the placement decision for cognitively impaired clients in home care. Interpretive policy analysis is employed to examine 3 policy documents and 3 client files, while grounded theory serves to analyze 13 semi-structured interviews with 2 administrators and 3 open triads of client, caregiver, and case manager. The findings show partnership to be an egalitarian, collaborative ideal widely adopted but with little consensus on the pertinent objects and actors. Important differences emerge in how partnership is applied to the placement decision, indicating a too flexible application. Specific restrictions are recommended on the application of the partnership metaphor in order to improve community services and organizational structures in health care.

Syftet Att undersöka vilken effekt reminiscens- och musikterapi har på äldre deprimerade personer på äldreboende. Metod: Litteratursökning utfördes i databaserna CHINAL, Medline, Psycinfo samt Scopus. Till grund för resultatet valdes n=13 artiklar med kvantitativ design. Urvalet av artiklarna till resultatet har utförts med hjälp av inklusionskriterier, relevant abstract och publicerade mellan 2000-2013. Artiklarna skulle motsvara syfte och frågeställningar samt uppfylla hög eller medelpoäng i kvalitetsgranskningen. Resultat: Reminiscensterapi kunde reducera och minska depressiva symtom hos äldre personer på äldreboende. Musikterapi kunde också vara en effektiv åtgärd för att minska depression hos äldre personer på äldreboende. Ett annat resultat som framkom var att sömnen kan förbättras av musikterapi. Slutsats: Reminiscens- och musikterapi kunde minska depression hos äldre personer som bor på äldreboende, genom att musik stimulerar limbiska systemet och reminiscensterapin låter de äldre att återberätta och leva på nytt genom sina minnen. Det kan vara värdefullt för de äldre att vårdgivare på äldreboende lär sig grunder för reminiscens och musikterapi för att kunna använda det i den dagliga vården av de äldre för att minska depression men även som en förebyggande åtgärd.

This study has explored the culture of nursing home life as experienced by elderly nursing home residents in Taiwan in order to understand, describe and interpret their care needs. In December 2006, the elderly represented 10% of the total population of Taiwan, and this proportion is predicted to increase steadily. In turn, this increase suggested that Taiwan would see ever greater numbers of elderly people with chronic illnesses and physical and mental disabilities. To care for these people, nursing homes have expanded rapidly throughout Taiwan. However, the quality of care provided in these nursing homes has become an urgent matter of concern. Though meeting the residents' care needs is essential for the provision of the best quality care, a review of the available literature shows that the care needs of the elderly residents within the nursing home context are poorly understood, both in Taiwan and internationally. To address this gap in present understanding, a focused ethnographic approach, using participant observation, in-depth interviews and a review of documents, was undertaken between July 2005 and February 2006. The key participants were sixteen elderly residents who were 65 years old and over, had no cognitive impairment and had lived in the nursing home selected for the present study for at least six months. Eight nurses, six nursing assistants, one private nursing assistant, one orderly, one physician's assistant and four family members were also interviewed, with questions put to them being based on the data generated from the observation and in-depth interviews with the elderly residents. All interviews were recorded on a digital recorder and transcribed verbatim. Following this, the data gathered from the in-depth interviews, the participant observation and the review of documents was sorted and indexed using the qualitative software program, NVivo7. A five-step analytic process, based on concepts discussed in previous literature, was used to trace the emerging themes. Nine major care needs were identified by the elderly residents. These included basic functional care needs, emotional support care needs, economic care needs, psychological care needs, environmental care needs, social support care needs, professional care needs, religious care needs and preparation for death care needs. Three themes of nursing home culture were generated; these were collective life, care rituals and embedded beliefs. The findings of the study indicate that the structure and culture of the nursing home contribute to several care needs remaining unmet. In addition, the results reveal that it is necessary to satisfy economic care needs before other care needs can be resolved. These findings fill an important gap in nursing knowledge regarding the delivery of better quality care in nursing homes. They also provide relevant information to nursing practice, nursing education and Taiwanese long-term care policy-making, and provide a sound basis for future residential care research.