The general objectives of the study were to evaluate a social work support group programme with informal caregivers that aimed to enhance the quality of care provided to older persons in an urban and rural community setting in Namibia. In order to achieve the general objectives of the study, the following specific objectives were formulated: * To explore how informal caregiving situations in urban and rural communities lead to elder abuse and neglect. * To describe existing literature on the various factors that contribute to elder abuse and neglect within community settings. * To develop a support group programme for informal caregivers of older persons in urban and rural community settings that aimed at preventing elder abuse and neglect. * To implement and evaluate the effectiveness of the support group programme for informal caregivers that aimed at preventing elder abuse and neglect. The thesis consists of 5 sections: Section A consists of the problem statement, research objectives, central theoretical argument and the theoretical approaches that underpin the study. Furthermore, the research methodology, the definition of key concepts and the limitation of the study are presented. Section B contains four articles that together formed part of the research outcomes. Each article can function independently with it’s own objectives and distinctive content. However, each article is also a sub-project of the umbrella research study. Therefore, some of the data have to be repeated in different sections. The four articles are: Article 1: Informal caregiving, elder abuse and neglect in urban and rural areas of the Khomas region in Namibia: A needs assessment A needs assessment on informal caregiving situations and how it may lead to elder abuse and neglect of older persons from an urban and rural constituency in the Khomas region was explored. Data was collected through in-depth interviews with professional and community leaders. In addition, focus group discussions were held with older persons and informal caregivers in the urban and rural constituency. Article 2: Factors contributing to elder abuse and neglect in community settings In this article, a comprehensive review of the literature pertaining to the risk and protective factors to elder abuse and neglect was done. The ecological theory was worthwhile to describe the risk factors to elder abuse and neglect. Article 3: Designing a social work support group programme with informal caregivers of older people in Namibia A social work support group programme was developed for informal caregivers of older persons in community settings. The eight-week support group programme was developed based on a needs assessment and a comprehensive literature review, and included the following topics; the normal processes of aging, handling of difficult caregiving situations, caregiver stress, self-care of the caregiver, elder abuse and neglect and caregiver grief and loss. The planning model for group work was also utilised to design the group. Article 4: Evaluation of the effectiveness of a support group programme with informal caregivers to prevent elder abuse and neglect An eight-week support group programme with ten female informal caregivers from an urban group and twelve informal caregivers from a rural group setting was implemented and evaluated. Standardized measuring instruments that assessed the outcome of the group at pre-test, post-test and postponed post-test were the Zarit Burden Interview (ZBI), Potentially Harmful Behaviour (PHB) scale and the Caregiver Abuse Screen (CASE). The Group Engagement Measure (GEM) assessed the group processes at the fourth, sixth and eight group sessions. In addition, open-ended questions were used to collect qualitative data. The quantitative and qualitative evaluations indicated that both the urban and rural groups gained knowledge on aging and caregiving, and caregivers acquired vital qualities such as patience, compassion and communication skills. The process evaluation showed that caregivers from the urban group were more engaged in the group process than the rural group. Elder abuse was underreported in the study, while personal stress of caregivers reduced significantly because of the intervention. Section C consists of the summary of the most important findings and conclusions to the research study. In addition recommendations are provided. Section D consists of the annexures to the research report, such as the measuring instruments and interview schedules used for data collection. Section E contains a consolidated list of references. / PhD (Social Work), North-West University, Potchefstroom Campus, 2014

Age brings about that physical strength diminishes and in many cases there is also a loss of social contact. Older people possess years of knowledge based on experience which can be applied effectively in a service centre to the advantage of other older people. Amongst others, Section A contains the problem statement, research objectives and procedures that were undertaken. The overarching aim of this investigation was to establish the role of the retired volunteer in the functioning of Potchefstroom Service Centre for Older People. To reach the aim, the following objectives were aimed at: Obiective 1. To establish what the reasons are for retired people to become involved in Potchefstroom Service Centre of Older People as volunteers. Obiective 2. To establish in what area of the service centre retired people are involved as volunteers. Obiective 3. To establish the psychosocial functioning, self-perception, work values and profile of the retired volunteer involved in Potchefstroom Service Centre for Older People. Obiective 4. To determine what volunteers of the service centre for older people expect of the staff regarding, for instance, acknowledgement, responsibilities and remuneration. Section B contains the two articles in which the outcomes of the research were reported. Article 1 pertains to the reasons why older people become involved in service centres as volunteers and in which areas. Article 2 enters into the psychosocial functioning, self-perception, work values, profile and expectations of the retired volunteer. In Section C a synopsis of the most important findings and conclusions regarding the investigation was presented in its entirety. Additionally, recommendations were made and the contribution of the investigation was highlighted. Section D contains addendums to the research report such as the self-compiled questionnaire and the standardised questionnaire. The dissertation was concluded in Section E with a comprehensive reference list. / Thesis (M.A. (MW))--North-West University, Potchefstroom Campus, 2009.

Age brings about that physical strength diminishes and in many cases there is also a loss of social contact. Older people possess years of knowledge based on experience which can be applied effectively in a service centre to the advantage of other older people. Amongst others, Section A contains the problem statement, research objectives and procedures that were undertaken. The overarching aim of this investigation was to establish the role of the retired volunteer in the functioning of Potchefstroom Service Centre for Older People. To reach the aim, the following objectives were aimed at: Obiective 1. To establish what the reasons are for retired people to become involved in Potchefstroom Service Centre of Older People as volunteers. Obiective 2. To establish in what area of the service centre retired people are involved as volunteers. Obiective 3. To establish the psychosocial functioning, self-perception, work values and profile of the retired volunteer involved in Potchefstroom Service Centre for Older People. Obiective 4. To determine what volunteers of the service centre for older people expect of the staff regarding, for instance, acknowledgement, responsibilities and remuneration. Section B contains the two articles in which the outcomes of the research were reported. Article 1 pertains to the reasons why older people become involved in service centres as volunteers and in which areas. Article 2 enters into the psychosocial functioning, self-perception, work values, profile and expectations of the retired volunteer. In Section C a synopsis of the most important findings and conclusions regarding the investigation was presented in its entirety. Additionally, recommendations were made and the contribution of the investigation was highlighted. Section D contains addendums to the research report such as the self-compiled questionnaire and the standardised questionnaire. The dissertation was concluded in Section E with a comprehensive reference list. / Thesis (M.A. (MW))--North-West University, Potchefstroom Campus, 2009.

Orientador: Roberto Vilarta / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Educação Fisica / Made available in DSpace on 2018-08-08T08:38:41Z (GMT). No. of bitstreams: 1 Sonati_JaquelineGirnos_M.pdf: 1133241 bytes, checksum: faed2971306c1273c3d1fdf02aa92496 (MD5) Previous issue date: 2007 / Resumo: Segundo a Organização Mundial da Saúde (OMS,1995) os programas desenvolvidos na área de nutrição vêm apresentando formas de melhorar a qualidade de vida daqueles que estão no processo de envelhecer. A expectativa de vida tem aumentado de forma significativa nos últimos anos, evidenciando a importância de se preparar à população adulta para um envelhecimento de sucesso. Este estudo tem por objetivo o desenvolvimento de uma caracterização da etapa de transição da idade adulta para a terceira idade quanto aos aspectos do estado nutricional e da composição corporal correlacionados com a análise da percepção de aspectos da qualidade de vida de pessoas nestas faixas etárias. O estudo avaliou 13 adultos e 34 idosos de um bairro na periferia de Campinas sendo avaliados: índice de massa corporal, composição corporal pelo método de bioimpedância tetrapolar e a qualidade de vida com a aplicação do instrumento de inquérito Whoqol-bref. A análise estatística correlacionou o estado nutricional, segundo classificação de Lipschitz e segundo padrão da Organização Mundial da Saúde, com aspectos da percepção da qualidade de vida, comparando os dados obtidos em grupos de adultos e idosos. Os resultados mostraram predominância numérica da população feminina entre os idosos, baixa escolaridade incluindo nível de analfabetismo alto, baixa renda familiar, alto índice de sobrepeso e percentual de gordura corporal acima da normalidade. Quanto à qualidade de vida, apesar da limitação do número de indivíduos e de não ser observada diferença significativa entre grupos, notou-se tendência de melhor percepção de aspectos específicos da qualidade de vida entre os indivíduos idosos quando comparados com os adultos / Abstract: According to the World Health Organization (OMS, 1995), the nutrition area developed programs have been improving the life quality for those who are aging. Life expectancy has been expanding among the years, proving how important is to prepare the adult population for a health aging.This study objective is to perform a transition stage characterization development from those at the adult age to the third age, considering the nutritional aspects as also the corporal composition correlated with the perception analysis of quality aspects from those within at this aging group. The study evaluated a sample of 13 adults and 34 elderly from a Campinas city suburb, being appraised: body mass index, bioimpedance body composition and the life quality evaluation through the Whoqol-bref inquiry instrument. The statistical analysis correlated the nutritional status, according the Lipschitz classification as also against the World Health Organization pattern, within aspects of life quality perception, comparing the gathered data between the adult and elderly groups.The result displays female population predominance among the elderly, a low education level including highly illiteracy, insignificant family wages, overweight and corporal fat index above the normality. As for the life quality, despite the number of individuals evaluated and the absence of significant difference among groups, it has been noticed a better perception tendency of some specific aspects of the life quality at the elderly group when compared with the adult / Mestrado / Atividade Fisica, Adaptação e Saude / Mestre em Educação Física

In light of current population dynamics across Europe, employability has been highlighted in policy circles as a way to enhance the employment situation for older people and to extend working lives. This research examines the concept of employability in the context of older workers (aged 50-64) in a number of European countries. The definition of employability is elaborated through prior research to develop a conceptual framework for analysis. This multidimensional framework is then applied using multiple waves of the English Longitudinal Study of Ageing (ELSA) and the Survey of Health, Ageing, and Retirement in Europe (SHARE). The analysis identifies the associations of indicators representing the dimensions of employability on labour market status through a cross-sectional approach, before expanding to explore their relationship with labour market transitions in and out of employment. This is first done using English data before introducing macroeconomic variables in a multilevel model of 13 European countries to incorporate the cultural and contextual factors that may impact trends in labour market outcomes of older workers. Overall, the findings suggest that, while some of the conceptual dimensions of employability are associated with labour market outcomes, many of these relationships relate to broader socio-economic factors as well as the contextual environment in which older workers find themselves. In other words, for policy approaches to improve employment in later life, a focus on the concept of employability may be a less effective approach than concentrating on more specific factors that shape the structure of opportunities for older workers.

Background: To be able to live independently, older persons can use technology-based health communication (HC) for support, guidance, and contact with health care professionals within their home environment. Informal caregivers who assist in different situations can also find support in their caring role using technology. The study of mobile technologies is an important research area in gerontechnology. Nevertheless, there is a gap of research in technology-based HC utilized by older persons, including preferences related to cognitive impairment (CI) in a home environment. Aim: The overall aim of the thesis was to define the concept and describe experiences of HC within the home environment from a gerontechnological perspective. The aim of Study I was to identify and construct the meaning of HC from the perspective of older persons in need of care in the home environment and their informal caregivers. The aim of Study II was to describe how older persons with CI experienced technology-based HC through the use of a mobile application in order to facilitate a sense of coherence. Method: This thesis has a naturalistic approach. In Study I, the evolutionary model of concept analysis was used, based on a systematic literature review including 29 studies. In Study II, semi-structured interviews were conducted with 16 older persons with CI. The transcripts were analyzed with a deductive thematic analysis. Findings: The defining attributes of the concept HC identified in Study I were: Resources of the recipient, Influence on decisions, and Advantages of tailored information. These attributes led to the following descriptive definition of HC: Tailored information, based on needs and resources of the recipient influence care decisions. The findings of Study II resulted in an overall theme: A technology that supports but creates challenges. Further, the analysis yielded the following three themes, with associated subthemes: Making sense of mobile technologies, Mastering mobile technologies, and Added value to use mobile technologies. Conclusion: Technology-based HC utilized by older persons and their informal caregivers within the home environment emphasizes suiting needs, capacity and preferences to be considered useful. Influences of the context, the home environment also needs to be taken into account when developing technology-based HC and mobile technologies for this purpose.

Although a great deal is known about the etiology of falls in elderly individuals, fall accidents continue to represent a significant burden to elders residing in long-term care facilities. It has been stated that 75% of deaths due to falls in the United States occur in the 13% of the population age 65 and over. The first objective of the study was to identify which fall-predictor variables acknowledged in the research literature are associated with increased fall frequency with the older population. Identifying specific predictor variables related to a high occurrence of falls in long-term care setting can assist in the redesign of tools and programs aimed to recognize fall risk, and prevent fall-related accidents and fatalities in the geriatric population. The second objective of the study was to identify which combination of predictor variables could better predict the frequency of falls. A history of falls variable was the only predictive variable that differed significantly between groups of residents who had sustained subsequent falls and those who had not. Other variables including age, mental status, day number of stay, elimination, visual impairment, confinement, blood pressure drop, gait and balance, and medication were found to not be statistically significant between groups of fallers and non-fallers. In this setting, the current design of the tool had limited accuracy and exhibited an inability to effectively discriminate between resident populations at risk of falling and those not at risk of falling. Consequently, the current fall risk assessment tool is not adequate for assessing fall risk in this clinical setting. / Master of Science

Bakgrund  Venösa bensår är vanligaste typen av bensår och orsakas i de flesta fall av en nedsatt cirkulation i nedre extremitet, venös insufficiens. De venösa bensåren är oftast svårläkta med lång duration och har hög återfallsrisk. En åldrande kropp ger risk för lång läkningsprocess. Då venösa bensår är vanligast hos den äldre befolkningen och i takt med en åldrande befolkning förväntas problemen med venösa bensår öka. Att belysa hur de äldre personerna upplever att leva med venösa bensår, borde även vara av intresse för sjukvårdspersonal som troligtvis kommer möta dessa personer. Detta kan bidra till en helhetssyn där personen och upplevelsen sätts i fokus. Syfte Syftet var att belysa den äldre personens upplevelse av att leva med venösa bensår. Metod För att besvara syftet valdes en icke-systematisk litteraturöversikt som metod. I denna litteraturöversikt har 15 artiklar inhämtats från databaserna CINAHL och PubMed. Artiklarna analyserades med en integrerad analys och kvalitetsgranskades med Sophiahemmets högskolas bedömningsunderlag.  Resultat  De venösa bensåren bidrog till att många äldre drar sig undan från sociala sammanhang på grund av skam, smärta och immobilitet. Självkänslan påverkas då många upplevde en penibel känsla när såren luktande och vätskade igenom. Förbanden doldes i många fall med långa kläder och det var svårt att hitta skor som passade de lindande fötterna. Smärta och rädsla försvårade de äldre personernas möjlighet till fysisk aktivitet.  Slutsats Sammanfattningsvis visar denna litteraturöversikt att många äldre personer med venösa bensår upplever att livet begränsats ur ett socialt, emotionellt och fysiskt perspektiv. Många äldre personer med venösa bensår upplever otillräcklig kommunikation med sjuksköterskan. Många upplevde bristande förtroende för sjuksköterskan på grund av inkonsekventa och utdragna behandlingar som inte gav resultat. Det saknas ny och relevant forskning gällande de äldre personernas upplevelse av att leva med venösa bensår och mer forskning behövs för att optimera upplevelsen och öka välbefinnandet. / Background Venous leg ulcers are the most common type of leg ulcer and are caused in most cases by a reduced circulation in the lower extremity, venous insufficiency. The venous leg ulcers usually have a difficulty to heal with a long duration and have a high risk of recurrence. An aging body carries the risk of a long healing process. As venous leg ulcers are most common in the older population and in step with an aging population, the problems with venous leg ulcers are expected to increase. To highlight how older people experience living with venous leg ulcers, it should also be of interest to healthcare professionals who are likely to meet these people. This can contribute to a holistic view where the person and the experience are put in focus. Aim The aim was to highlight the older persons’ experience living with venous leg ulcers. Method To answer the purpose of this study, a non-systematic literature review was undertaken. This study has included 15 articles collected from the databases CINAHL and PubMed. The articles were analysed with an integrated method and Quality controlled with Sophiahemmet University’s assessment basis. Results Many older persons experienced that venous leg ulcers contributed to withdrawing from social contexts due to shame, pain, and immobility. Self-esteem was affected when many experienced an unpleasant feeling when the ulcers smelled and exuded. The bandages were often hidden with long clothes and there were difficulties to find fitting shoes to fit the wrapped feet. Pain and fear complicated the older persons ability to participate in physical activities. Conclusions In conclusion, this literature review shows that many older persons with venous leg ulcers experience that their life has been limited from a social, emotional, and physical perspective. Many older people with venous leg ulcers experience insufficient communication with the nurse. Many experienced a lack of trust in the nurse due to inconsistent and protracted treatments that did not yield results. There is a lack of new and relevant research regarding the older persons experience of living with venous leg ulcers and more research is needed to optimize the experience and increase well-being.

Background Malnutrition among older persons with dementia is a common issue due to the consequences of the diagnosis, such as physical hindrances or forgetting to eat. Preventative work, against malnutrition for example, is part of the work responsibility of a registered nurse (Swedish Society of Nursing (SSN, 2011).  Aim The aim was to describe how Cape Town Care home nurses work to identify and prevent malnutrition in older persons with dementia. Method A qualitative method was used with semi structured-interviews conducted with six nurses working at six different care homes in the Cape Town Area. A qualitative content analysis was used to analyse the interviews.   Result It was found that nurses work differently in their preventative work, depending on the policies of the care home. Some uses assessments for identifying malnutrition while others rely on their capacity of observation. There were no standardized aids used overall on the care homes to ensure quality of the work.   Conclusion It is important to look beyond the diagnosis of dementia in order to work according to a person-centered perspective with the residents wishes and autonomy in focus. To identify risks of malnutrition; identification is key in the preventative work. The nurses used their skills and experience, rather than standardized assessment aids, to observe changes in the residents’ behavior and outlook.

Bakgrund: Akutsjukvård innefattar olika typer av vård på avdelningar på och utanför ett sjukhus. Inom akutsjukvård kan miljön upplevas stressande för de äldre personerna som är känsliga för bland annat ljud och ljus. Ett personcentrerat bemötande kan hjälpa dem i situationen. Bemötandet är därför en av sjuksköterskans uppgifter inom akutsjukvård. Syfte: Att belysa äldre personers upplevelser av att vårdas inom akutsjukvård. Metod: Arbetet utformades som en strukturerad litteraturöversikt vilken fokuserade på äldre personer över 65 år. Resultatet sammanställdes utifrån 13 vetenskapliga artiklar som var publicerade mellan årtalen 2012–2023 i databaserna CINAHL, PubMed och APA PsycINFO. De delar av resultaten i de inkluderade vetenskapliga artiklarna som svarade mot arbetets syfte markerades och överfördes till post-it-lappar som parades ihop efter liknande betydelse och framkomna kategorier. Resultat: De äldre personerna upplevde miljön inom akutsjukvård som stressfylld och med bristfällig information samt kommunikation vilket sågs främst vid utskrivningen. Bemötandet visade sig spela en betydande roll för deras känsla av respekt, värdighet och delaktighet i många vårdsituationer, detta visade sig svårt att möta inom just akutsjukvård. De äldre personerna delade med sig av flest negativa upplevelser av personalen och organisationen inom akutsjukvård. Slutsats: De äldre personernas upplevelser visade att det fanns förbättringspotential inom miljö, omvårdnad, bemötande och utskrivning i området akutsjukvård för dem äldre personerna. / Background: The acute care included different kinds of care in separate wards in and outside the hospital setting. The environment in the acute care setting could be experienced as stressful for the older persons who were sensitive to noise and lighting among other things. A person-centered care could help them in this situation. The nurse in acute care setting therefore had personal treatment as a work task. Aim: To explore the older persons experiences of care in the acute care setting. Method: This study was designed as a structured literature review with focus on older persons over 65 years. The results are compiled of data from 13 research articles published between the years 2012-2023 from the databases CINAHL, PubMed and APA PsycINFO. The parts of the results who met the study’s aim was marked and transferred to post-it-notes witch was paired by similar meaning and emerged categories. Results: The older persons experienced the environment in the acute care setting as stressful and with flaws in information and communication regarding their care mainly at discharge. The treatment was shown to be a part of their sense of respect, dignity, and participation in their care, this proved difficult to achieve in the acute care setting. The older people shared mainly negative experiences with the staff and organization in the acute care. Conclusions: The older persons experiences of the acute care setting have shown potential to advance in environment, care, treatment, and discharge in area of the acute care for older persons.