scholarly journals Ordinary care in extraordinary times

Author(s):  
S. Patel ◽  
A. Gannon ◽  
M. Cryan ◽  
N. McDonnell ◽  
S. Rafiq ◽  
...  

The Coronavirus Disease 2019 (COVID-19) has accounted for more than 25 000 cases in Ireland with approximately 28% of the clusters in nursing homes as of June 2020. The older population is the most vulnerable to serious complications from this illness and over 90% of deaths due to COVID-19 to date have been in patients over the age of 65. Continuing to provide routine care within nursing homes in these challenging times is an essential part of ensuring that presentations to hospitals for non-essential reasons are minimized. In this article, we describe a project being undertaken by a rural Psychiatry of Old Age Service in the northwest of Ireland. We aim to provide ordinary care in extraordinary times by using mobile tablets within the nursing homes and long-stay facilities in our region for remote video consultations during the COVID-19 crisis.

Author(s):  
Vaillant Ciszewicz AJ ◽  
◽  
Guerin O ◽  

Older people living in nursing homes often present with psychological symptoms such as depression, anxiety and apathy. Numerous studies focused on the effects of Virtual Reality (VR) in the older population. This innovative approach could lead to a significant reduction in psychological disorders in older adults and improve their quality of life.


2020 ◽  
Author(s):  
Bernhard Michalowsky ◽  
Wolfgang Hoffmann ◽  
Jens Bohlken ◽  
Karel Kostev

Abstract Background There is little evidence about the utilisation of healthcare services and disease recognition in the older population, which was urged to self-isolate during the COVID-19 lockdown. Objectives We aimed to describe the utilisation of physician consultations, specialist referrals, hospital admissions and the recognition of incident diseases in Germany for this age group during the COVID-19 lockdown. Design Cross-sectional observational study. Setting 1,095 general practitioners (GPs) and 960 specialist practices in Germany. Subjects 2.45 million older patients aged 65 or older. Methods The number of documented physician consultations, specialist referrals, hospital admissions and incident diagnoses during the imposed lockdown in 2020 was descriptively analysed and compared to 2019. Results Physician consultations decrease slightly in February (−2%), increase before the imposed lockdown in March (+9%) and decline in April (−18%) and May (−14%) 2020 compared to the same periods in 2019. Volumes of hospital admissions decrease earlier and more intensely than physician consultations (−39 versus −6%, respectively). Overall, 15, 16 and 18% fewer incident diagnoses were documented by GPs, neurologists and diabetologists, respectively, in 2020. Diabetes, dementia, depression, cancer and stroke were diagnosed less frequently during the lockdown (−17 to −26%), meaning that the decrease in the recognition of diseases was greater than the decrease in physician consultations. Conclusion The data suggest that organisational changes were adopted quickly by practice management but also raise concerns about the maintenance of routine care. Prospective studies should evaluate the long-term effects of lockdowns on patient-related outcomes.


2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Abdu Oumer Abdu ◽  
Imam Dagne Yimamu ◽  
Ahmed Ale Kahsay

Abstract Background A nutritional problem, especially under nutrition is one of the common public health problems in older population causing greater mortality and economic loss in developing countries. However, evidences on the risk factors for increased nutritional risk among older population is not well stated in Ethiopia. This study aimed to assess the nutritional status and predictors of malnutrition among older adults (> = 65 years) in Eastern Ethiopia. Methods A community-based analytical survey was conducted among randomly selected 592 older people aged above 65 years of age in Harari region. Subjects were selected using multistage sampling pretested Full Mini Nutritional Assessment (MNA) tool was used to classify as malnourished (MNA score < 17), at risk of malnutrition (MNA score of 17 to 23.5) and otherwise normal. Validated geriatric depression scale short form (15 items) was employed to screen for depression. Data were presented using statistical tables, frequency, percentage, and graphs. Ordinary logistic regression was employed to identify predictors of malnutrition and plum method was used to generate odds ratio. The level of statistical significance was declared at P-value less than 5%. Chi-square test, crude and adjusted odds ratio with 95% confidence was reported. Results A total of 592 respondents (93.4%) were interviewed. About 306 (51.7%) and 93 (15.7%) were found to be at risk of malnutrition and malnourished respectively. The predicted log odds of being malnourished was higher among those from rural residents (AOR = 2.08: 1.25–3.45), not on working (AOR = 1.31: 95% CI: 0.87–1.95) and did not have health insurance (AOR = 1.58; 95% CI; 0.97–2.58). Those with chronic pain (AOR = 1.70; 95% CI: 1.15–2.51), previous hospitalization (AOR = 1.59: 95% CI: 1.27–2.38) and not able to cover their personal expense (AOR =1.61: 95% CI: 1.12–2.30) were predictors of malnutrition. The relationship between previous hospitalizations with malnutrition among older adults people is moderated significantly by the presence of chronic pain (β = 0.113, p = 0.015). Conclusions Malnutrition among old age is a public health concern that needs attention. Economical vulnerability, residence, depression, presence of chronic disease, and hospitalization were important risk factors for malnutrition among old age.


2020 ◽  
Vol 21 (4) ◽  
pp. 209-216
Author(s):  
Jiska Cohen-Mansfield

Purpose The impact of COVID-19 has most dramatically affected the older population, and nursing homes have become infection hotspots. As a response, governments have ordered isolation of older adults in geriatric institutions owing to the high risk of critical illness and mortality. The purpose of this paper is to discuss the potential impact of current policies on nursing homes and community-based care and provide suggestions for improvement in care. Design/methodology/approach Taking the situation in Israel as an example, the author discussed major systemic problems pertaining to long-term care facilities and to community based care; the neglect of mental health; systemic deficiencies in end of life care; and the need to revise communications concerning COVID-19. Findings Within each of the identified areas, recommended changes in strategy, policy and practice can help mitigate the dramatic impact of COVID-19 on the living experience of the older population. Originality/value Drawing on the Israeli experience, this paper presents current shortcomings in the policy response to COVID-19 regarding nursing homes and community-based care and provides recommendations that are applicable to other contexts as well. Although some of these have been suggested or even practiced in some locations, many continue to be neglected and have not been discussed even as COVID-19 continues to infect societies around the globe.


Author(s):  
Betty Havens

Community support services represent an important resource for older persons. Their significance will grow as the older population increases in size in the North American Region. It is essential for the well-being of society that an adequate array of services for older persons be developed. Community support services must be provided in sensitive and personalized ways—and must respect the dignity and integrity of older persons. Community support services promote the independence of older persons; they prevent or defer recourse to more expensive and less personally desirable forms of caring services, such as nursing homes and geriatric services. Therefore, community support services may be said to have supportive, preventive and rehabilitative functions and to play an integrative role in terms of family and community life.


2017 ◽  
Vol 21 (3) ◽  
pp. 317-333 ◽  
Author(s):  
Christine E Swane

Old persons in nursing homes suffer from complex diseases, pain and the loss of physical functions and memory. They embody the notion of ‘deep old age’, the ‘fourth age’, as recipients of personal care, medicine, meals and organised activities. People in nursing homes are also part of a society in which media have become a regular feature of everyday life. Based on ethnographic fieldwork in Danish nursing homes, this article explores old persons’ subjective interaction with media technologies and material objects. Embodiment and agency are central analytical concepts for understanding residents’ use of media artefacts when the body is in pain and loses functionality. With theories of domestication and biographical situation, this article reveals how media are important for residents in making an institutional dwelling ‘their home’. Media seem to bridge the gap between institutionalisation and a long life’s preferences and participation in social and cultural worlds. This article forms part of ‘Media and the Ageing Body’ Special Issue.


2020 ◽  
Vol 11 (5) ◽  
pp. 9-13
Author(s):  
V.N. Egorova ◽  
◽  
U.A. Azarova ◽  

Currently, the questions of how older people fit into the context of modern reality, to what extent their inherent life ideas are consistent with existing social norms are becoming relevant. The history of the development of attitudes towards the elderly, the position of old people is constantly changing. It is known that the life of old people largely depends on their social status in society. The article presents the results of studying the attitude of young people and people of mature age in Yakutia to old age and readiness to care for the elderly. The study involved representatives of young and mature age in the amount of 222, including 109 men, 113 women. 142 (64%) respondents live in cities, 80 (36%) - in rural areas. 68 (31%) of the respondents have higher education, the rest - secondary, 85.3% of the respondents are of mature age and 14.7% of young people live with their parents. The analysis of ethnographic works, folklore materials was used as research methods; survey method. The reliability of the difference in indicators was checked using the angular Fisher transformation. Analysis of the research results allows us to note that respondents treat elderly people with patience and care, however, young people tend to be indifferent to aging parents. The attitude towards the placement of parents in nursing homes is also noticeably different: young people are ready to place their parents in nursing homes if the circumstances are difficult. Comparison was also made of the opinions of representatives of different nationalities about their attitude to old age, and their willingness to care for elderly parents, it found that they also differ. Comparison of the research indicators showed that there is a high connection with the family among representatives of the small peoples of the north, they are also more re- sponsible for their parents, although in other nations, the readiness to care for the elderly is high among the Yakuts (p <0.05). In the future, the study of attitudes towards old age will be relevant, since the aging of the population is observed throughout the world.


Stanovnistvo ◽  
2002 ◽  
Vol 40 (1-4) ◽  
pp. 35-52 ◽  
Author(s):  
Biljana Radivojevic

This study analyzes the level and structure of old age population mortality in Yugoslavia with an aim to determine the intensity of realized changes and to provide an answer to how much they are significant and to approach the positive trends noted in developed countries in the latest period. Although it was insufficiently represented in the demographic analysis, the analysis of mortality in old people is gaining importance in the world. Apart from the reasons which result from the increase in the number of old people and thus their greater participation in the total number of deceased, enviable results have been achieved in decreasing old age mortality, which are more and more in focus of interest. While earlier research reported on the dominant influence of the decrease of younger age mortality to the increase of the expectation of life at birth, recent analysis precisely confirm the importance of decreasing mortality in old people. In mortality conditions from 1997/98, an additional 13.4 years of life in average is expected for men in Yugoslavia, and 15.2 for women. During more than five decades, the anticipated life expectancy for people over the age of 65 increased for only 1.2 years for men and 1.9 years for women. Out of that, the greatest increase was realized in the period 1950/51 - 1960/61 in both sexes. A small decrease in the average life expectancy was marked with men in the period 1960/61 - 1970/71, and with women in the latest period. Otherwise, all up to the eighties, the annual rate of increase was considerably lower than the rate of increase for zero year. It was only in the period 1980/81-1990/91 that faster growth had an anticipated life expectancy for the 65 years old. However, during the nineties unfavorable changes continued with the older, especially, female population. When comparing the values of the average life expectancy for people over 65 in Yugoslavia with corresponding values in developed countries, the lagging in average amounted to about 3 years for the male and about 5 years for the female population. In Japan in 1998 it amounted to 17.1 years, namely 22.0 years respectively. However, it is interesting that all up to the seventies these indexes were almost at the same level in our country and Japan, and only after this period the differences appeared as a consequence of putting an end to the positive tendencies in differential mortality by age, even in the increase rate with the older population in Yugoslavia. On the other hand, the anticipated life expectancy for the age of 65 (for both sexes) was increased by 40%, in Japan from 1970 to 1998, in contrast to an increase of 9% for 0 age. In the same period in Yugoslavia, although there was a considerably lower increase percentage, it was still more significant with newborns (above 6% for both sexes), than with population older than 65 (under 5%). Hence, such an inclination and intensity of changes resulted, in relation to Japan, in a relatively greater lagging with people aged 65 than with 0 age. The anticipated life expectancy for people aged 85 and over, in the whole observed period, increased only by 8% with the male population and 10% with the female population of Yugoslavia. Its present level is the result of small changes in the mortality rates of the oldest population. In average, people aged 85 + will live another 4.2, namely 4.4 years respectively under the assumed mortality from 1997/98. At the same time the Japanese men are expected to live another 5.4, and Japanese women another 7.2 years. Therefore, middle aged and old population in Yugoslavia has had unfavorable mortality tendencies in relation to the young population, more distinct beginning from the seventies, and especially with men. The nineties were again unfavorable for the old population, this time especially for the female population, where a slight decrease of this rate was marked. Having in mind the changes and achieved level of anticipated life expectancy in developed countries, it can be said that the deviations in relation to the rates in our country are significant, relatively greater with the older population. For this reason, mortality reduction of the old age population is a chance for an increase in the life span, although all possibilities in our country, for the decrease of mortality with the young as well, especially newborns, have not been exploited. In that sense, it seems that the greatest importance would be control of cardiovascular illnesses and risk factors regarding individual behavior.


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