Nocturia is not associated with falls among the elderly: a population study in the city of Sao Paulo

Introduction: the present study aims to evaluate the association between nocturia and falls in a group of community-living elderly men in the city of Sao Paulo (Brazil). Material and methods: under the coordination of the Pan American Health Organization and World Health Organization, a multicenter study named Health, Welfare and Aging (SABE Study) is being conducted to evaluate the living and health conditions of older people in Latin America and Caribbean. In Brazil, this study is evaluating the elderly population (60 years or more) in Sao Paulo since 2000. The presence of nocturia was taken as the response ""yes"" to the question ""Do you need to void three times or more at night?"". The presence of falls was also taken as the response ""yes"" to the question ""Did you have any fall during the last 12 months?"" The intergroup analysis used was the logistic regression. Results: total of 865 men was interviewed, mean age 68 years. It was observed high prevalence of nocturia and falls in all groups, with higher prevalence of both in the eldest group (p < 0.001), however, the association of nocturia and falls was not statistically significant in any of the groups (p = 0.45). Conclusion: this is one of the pioneering studies that assess only the male population, showing that nocturia was not significantly associated with falls. Nocturia and falls are highly prevalent conditions in the elderly, but no association was found between both, so that these variables may be correlated to age and other clinical conditions. (C) 2010 AEU. Published by Elsevier Espana, S.L. All rights reserved.

Betydelsen av taktil massage i omvårdnaden av dementa patienter- En systematisk litteraturstudie

Syftet med denna systematiska litteraturstudie var att se vilka effekter taktil massage ger hos personer med demens. Sökning av artiklar har gjorts på databaserna CINAHL, ELIN@Dalarna och PubMed där sökorden dementia, massage, nursing, older people, Therapeutic touch och touch användes i olika kombinationer. Litteraturstudien består av kvantitativa och kvalitativa artiklar. Artiklarna skulle vara vetenskapliga och inte publicerade före 1995, de skulle även svara på syfte och frågeställning. För att säkerställa att kvalitén på artiklarna var hög granskades de med en granskningsmall. Sammanlagt ligger fjorton artiklar till grund för resultatet i denna litteraturstudie. Resultatet visade att taktil massage har goda effekter i omvårdnaden av dementa. Personalen upplevde att de dementa blev hjälpta av taktil massage. De dementa sänkte sina röster och hade inte samma skrikbeteende som innan. Studierna har också visat att tablettanvändning minskade hos patienterna då de regelbundet fick taktil massage. Personalen växte som vårdare då de använde sig av taktil massage. Efter att projektet var avslutat så kände personalen en bättre sammanhållning i gruppen.

Taktil massage vid vård av personer med demens och äldre personer med demensliknande symtom

Tactile massage in the care of people with dementia and older people with dementia- like symtoms

Anhörigas upplevelser i samband med vård av en äldre person i hemmet : En litteraturöversikt

SAMMANFATTNINGSyftet: Syftet med denna systematiska litteraturstudie var att studera hur anhöriga till äldre personer upplevde sin situation i i samband med att de vårdade sina äldre hemma, hur de hanterade sin situation, samt vilka strategier de använde sig av för att hantera sin roll som anhörigvårdare. Metod: Databaserna Cinahl och Medline användes i sökningarna efter relevanta artiklar. Sökord som användes var relative and older people and home care, home health care and family caregiver elderly people, family caregivers and care givers of aging people, elderly people and family care givers of aging people, family care givers of older people, family caregivers and frail elderly, family caregiver and older people and home care, home care older people and family caregivers older people, family caregivers older people. Efter genomläsning bedömdes 16 artiklar vara användbara i resultatet. Dessa kom från vetenskapliga tidskrifter och artiklarna innehöll både kvalitativa studier som kvantitativa studier. Resultat: De flesta anhörigvårdare var kvinnor, de kunde uppleva en högre belastning än män. De anhöriga påverkades både mentalt, fysiskt och emotionellt. De kände sig bundna men kunde även känna ett välbefinnande i vården av den äldre personen. Anhöriga upplevde sin roll som anhörigvårdare till äldre personer i hemmen som att de var delaktiga i omsorgen genom praktiskt som känslomässigt stöd. Deras situation hade även inverkan på deras upplevelse av stress och hur de hanterade situationen. En del äldre anhörigvårdare var själva äldre och i behov av hjälp. Konsekvenserna av deras reaktioner/upplevelser beskrevs som både subjektiv och objektiv belastning. Samt att de även var mindre benägna att söka stöd i form av avlastning för sina äldre personer. Slutsats: Rollen som anhörigvårdare till äldre personer som vårdas i hemmen innebar förändringar i anhörigas livssituation, de fick ta ett stort ansvar för den äldre personen. De upplevde stora påfrestningar både känslomässigt som praktiskt, många kände sig ensamma utan stöd, andra hade olika sätt att hantera sin situation. Äldre anhörigvårdare var mer utsatta för belastning av olika skäl när de vårdade äldre personer i hemmet, dels var de själva äldre samt att de själva kunde vara i behov av hjälp för sina hälsoproblem. Kvinnorna var den grupp anhörigvårdare som upplevde störst belastning i vården av äldre personer i hemmet. När det gällde att söka hjälp och stöd såg det olika ut bland anhörigvårdarna, trots att kvinnorna upplevde störst belastning var de minst benägna att söka hjälp.

Värdigt liv och välbefinnande, enligt vem? : en kvalitativ studie om brukare och biståndshandläggares beskrivningar av ett värdigt liv och välbefinnande : Dignity and well-being, according to whom? : a qualitative study of elderly and assistance officer´s descriptions of a dignified life and wellbeing

We are two students named Susanne Grönlund and Anna Zaar and have jointly worked together this c-essay called "dignity and well-being according to whom? The paper is written at Högskolan dalarna in Falun.The purpose of this study was to investigate how the elderly and assistance officer describes dignity and well-being and how it is consistent with the government's bill on the national values that the National Board has developed.Our empirical study consists of four qualitative interviews, two older people dependent on community care and two assistance officers. The study's theoretical basis is Antonovsky's salutogenic approach and SOC. The survey focuses on different themes such as dignity, integrity, participation, treatment, wellbeing, security and meaningfulness which are also central themes in the Government Bill on the national values for elderly.The results show that the respondents believe that a life of dignity is difficult to define and also a subjective experience. The results also show a consistency between what the elderly, assistance officer and the national values that define dignity and well-being. Social Services Act, national values should serve as a starting point for municipalities to improve elderly care, thereby creating a sense of coherence for the individual. Keywords: Elder care, dignity, integrity, participation, attitude, well-being, security and meaningfulness.

e-infrastruktur som stöd för hemtjänsten

The annual cost of home care services of transport in Falun/Borlänge, is now at 31 million kronor. It is clear from previous research that it is possible to reduce these costs through a restructuring of the existing home-help service. The restructuring aims to have a higher proportion of older people, who are in need of care, to live in special accommodation, in order to reduce transport costs. Therefore there is a need for systems that allow home-help service to plan their operations in such a way that transport is working as efficiently as possible. Through better planning, there are profits to be done. The rewards are not only of an economic nature but also include a reduced environmental impact, better working environment, improving road safety, and better service. One way to achieve this is to give home-help service personnel better navigation aid when they move between the customers. The thesis describes such a solution through a developed prototype based on a standardized interaction between a planning and a navigation service. The thesis describes such a solution through a developed prototype based on a standardized interaction between a planning and a navigation service. Development work has also been a first step in developing a standardized information infrastructure for home-help service. The purpose of the thesis is, on the basis of theory and the experience we have acquired through the development of the prototype, to discuss general issues which are of interest when developing standardized information infrastructure.

Pensionärsjävlar : revolt mot eller ett upprepande av negativa ålderskoder?

Old bastard – rebellion against or a repetition of negative age codes? In contemporary media and scientific contexts, it has become increasingly popular to launch today’s elderly as different from previous generations of older people, especially emphasized is that today’s elderly will have more attitude and set higher demands on society. The TV-series Pensionärsjävlar is based on this idea of today’s and tomorrow’s elderly as different and more rebellious than previous generations. The purpose of this article is to analyze and discuss how age and age codes are used as a prerequisite for, but also are challenged in the series. The result shows that chronological age is almost absent in the series, instead age coding is performed by physical attributes and verbal acts. Most common attributes are those connected to decreased functionality, such as walker, wheelchair, walking stick etcetera. The most common taboo joked about is sexuality, and other common themes are decreased functionality,child/youth- like behavior and traffic. In the article I discuss how these themes and attributes are negotiated in relation to age.  

Förändrade intimitetsformer bland äldre i det senmoderna samhället

Changing forms of intimacy among older people in late modern society The purpose of this paper is to draw attention to a neglected reality in Swedish social research: New romantic relationships in later life. Our theoretical points of departure are the transformation of intimacy and the transition from a culture of marriage to a culture of divorce. We ask if the transformation of intimacy has reached later life and investigate late life divorce, attitudes to and choice of union form in late life heterosexual relationships, relationship history and the importance of a relationship for life satisfaction. The results, which are based both on demographic data and a survey to 60–90 year old Swedes (n=1225), show that changing relationship patterns in late modern Sweden have reached older people. In romantic relationships initiated in later life LAT is the preferred union form, followed by cohabitation, while marriage is a rare choice. In some respects this makes older people an avant-garde in the investigation of alternative union forms. The results also show the importance of romantic relationships for life satisfaction in later life – independent of union form. Finally we criticize Swedish census data, which is based on civil status, for giving a somewhat distorted image of older people’s family and romantic lives.    

Factors associated with evidence-based practice among registered nurses in Sweden : a national cross-sectional study

Background: Evidence-based practice (EBP) is emphasized to increase the quality of care and patient safety. EBP is often described as a process consisting of distinct activities including, formulating questions, searching for information, compiling the appraised information, implementing evidence, and evaluating the resulting practice. To increase registered nurses' (RNs') practice of EBP, variables associated with such activities need to be explored. The aim of the study was to examine individual and organizational factors associated with EBP activities among RNs 2 years post graduation. Methods: A cross-sectional design based on a national sample of RNs was used. Data were collected in 2007 from a cohort of RNs, included in the Swedish Longitudinal Analyses of Nursing Education/Employment study. The sample consisted of 1256 RNs (response rate 76%). Of these 987 RNs worked in healthcare at the time of the data collection. Data was self-reported and collected through annual postal surveys. EBP activities were measured using six single items along with instruments measuring individual and work-related variables. Data were analyzed using logistic regression models. Results: Associated factors were identified for all six EBP activities. Capability beliefs regarding EBP was a significant factor for all six activities (OR = 2.6 - 7.3). Working in the care of older people was associated with a high extent of practicing four activities (OR = 1.7 - 2.2). Supportive leadership and high collective efficacy were associated with practicing three activities (OR = 1.4 - 2.0). Conclusions: To be successful in enhancing EBP among newly graduated RNs, strategies need to incorporate both individually and organizationally directed factors.

Äldre och ensamhet : En kartläggning av sociala insatser för äldre personer i Dalarnas kommuner

Det finns begränsat med forskning kring hur biståndshandläggare inom äldreomsorgen arbetar med ensamhet hos äldre personer. Med anledning av detta är studiens huvudsakliga syfte att undersöka hur biståndshandläggare i Dalarnas kommuner arbetar med att utreda sociala behov till följd av ensamhet hos äldre personer samt att ta reda på vilka kommunala sociala insatser som erbjuds för dessa individer och på vilka grunder. Studien är genomförd utifrån en kvantitativ ansats, där vi har använt oss av en enkät, som innehåller frågor som avser att besvara syftet. Tolkningsramen för analysen av det empiriska materialet utgörs av Lipskys teori om gräsrotsbyråkrati. Studiens resultat visar att det finns behov av att både utöka och utveckla kommunernas utbud av sociala insatser för äldre personer samt att utveckla rutiner för hur man ska arbeta med ensamhet hos äldre personer. Studien påvisar ett behov av mer forskning, både internationell och nationell, kring hur biståndshandläggare arbetar med att identifiera ensamhet hos äldre personer.

Samtal sent i livet : Samtalsstöd för äldre ur ett professionellt perspektiv

Studiens syfte är att undersöka hur omsorgspersonal inom äldreomsorgen upplever äldres behov av samtalsstöd. Metoden som har använts är kvalitativ i form av individuella semistrukturerade intervjuer med sex informanter som arbetar som omsorgspersonal inom den kommunala äldreomsorgen. De teoretiska utgångspunkter som har tillämpats är socialkonstruktionism samt Erik Homburger Eriksons teori om människans livsstadier. Resultatet av studien visar att det enligt omsorgspersonalen finns ett samtalsbehov hos brukare inom äldreomsorgen som inte alltid kan tillgodoses idag på grund av omsorgspersonalens tidsbrist samt avsaknad av kompetens i att möta djupa frågor. Kuratorer inom äldreomsorgen skulle kunna bidra med samtalsstöd för äldre samt vara ett stöd för anhöriga och personal. Resultatet antyder till att behovet av kuratorer inom äldreomsorgen kommer att öka. Framtidens äldre förmodas ställa mer krav än de gör idag på att få samtalsstöd eftersom denna insats blir högre och mer accepterad i samhället.

Från ord till handling : En kvalitativ studie om värdegrund och socialt innehåll för äldre på särskilt boende

Socialstyrelsens brukarundersökning visar att äldre som bor på särskilt boende är mest missnöjda med de aktiviteter och den sociala samvaron som verksamheten erbjuder. Äldreomsorgen bygger på den nationella värdegrunden som innefattar att den äldre ska få leva ett värdigt liv och känna välbefinnande, men det är inte klart hur denna värdegrund påverkar personalens arbetssätt eller de sociala aktiviteter som erbjuds. Vår studie angriper denna fråga. Fem särskilda boenden var representerade både från kommunala och privata vårdgivare i två olika kommuner. Semistrukturerade intervjuer genomfördes med de särskilda boendes enhetschefer, som sedan transkriberades och tematiskt analyserades. Vårt resultat tyder på att den nationella värdegrunden inom äldreomsorgen tolkas olika på alla de särskilda boendena. Alla enhetschefer la stor vikt på personcentrerad vård, men trots det så erbjöd man liknade sociala aktiviteter ofta då som gruppaktivitet. Resultaten diskuterar vi med hänvisning till Aktivitetsteorin och Gerotranscendenceteorin.

Can therapy dogs evoke awareness of one's past and present life in persons with Alzheimer's disease?

BACKGROUND: Persons with Alzheimer's disease (AD) sometimes express themselves through behaviours that are difficult to manage for themselves and their caregivers, and to minimise these symptoms alternative methods are recommended. For some time now, animals have been introduced in different ways into the environment of persons with dementia. Animal-Assisted Therapy (AAT) includes prescribed therapy dogs visiting the person with dementia for a specific purpose. AIM: This study aims to illuminate the meaning of the lived experience of encounters with a therapy dog for persons with Alzheimer's disease. METHOD: Video recorded sessions were conducted for each visit of the dog and its handler to a person with AD (10 times/person). The observations have a life-world approach and were transcribed and analysed using a phenomenological hermeneutical approach. RESULTS: The result shows a main theme 'Being aware of one's past and present existence', meaning to connect with one's senses and memories and to reflect upon these with the dog. The time spent with the dog shows the person recounting memories and feelings, and enables an opportunity to reach the person on a cognitive level. CONCLUSIONS: The present study may contribute to health care research and provide knowledge about the use of trained therapy dogs in the care of older persons with AD in a way that might increase quality of life and well-being in persons with dementia. IMPLICATIONS FOR PRACTICE: The study might be useful for caregivers and dog handlers in the care of older persons with dementia.

Vitamin D intake and vitamin D status of Australians

The main source of vitamin D for Australians is exposure to sunlight. Thus, levels of serum 25-hydroxyvitamin D3, the indicator of vitamin D status, vary according to the season and are lower at the end of winter.

In Australia and New Zealand, the prevalence of vitamin D deficiency varies, but is acknowledged to be much higher than previously thought. One study found marginal deficiency in 23% of women, and another frank deficiency in 80% of dark-skinned and veiled women. The groups at greatest risk of vitamin D deficiency in Australia are dark-skinned and veiled women (particularly in pregnancy), their infants, and older persons living in residential care.

Only a few foods (eg, fish with a high fat content) contain significant amounts of vitamin D. In Australia, margarine and some milk and milk products are currently fortified with vitamin D.

The average estimated dietary intake of vitamin D for men is 2.6–3.0 µg/day and for women is 2.0–2.2 µg/day. The estimated dietary requirement of vitamin D is at least 5.0 µg/day and may be higher for older people.

Adequate intake of vitamin D is unlikely to be achieved through dietary means, particularly in the groups at greatest risk, although vitamin D-fortified foods may assist in maintaining vitamin D status in the general population.

An appropriate health message for vitamin D needs to balance the need for sunshine against the risk of skin cancer.