Family advocacy roles and highly dependent residents in nursing homes

A developing critique has questioned the practical utility of user rights policy initiatives for highly dependent residents of nursing homes. This paper seeks to extend this critique to the advocacy roles that families have been accorded within the policy initiatives, The discussion is based on a qualitative research study of family participation in six aged care units, The paper argues that the capacity of families to act as advocates for highly dependent nursing home residents is is limited by the their weak position within the organisations and the complexity of their relations with staff It questions both the applicability and the appropriateness of rights models which do not take sufficient account of the structure and meaning of care.

Aluminum Concentrations in Water of Elderly People`s Houses and Retirement Homes and Its Relation with Elderly Health

The purpose of this study was to determine the concentrations of aluminum (Al) and other metals in water samples from elderly people`s houses and retirement homes. Forty-six duplicate water samples from kitchen taps were collected in Ribeiro Preto/SP, Brazil. Metal levels were measured by atomic absorption spectrophotometer. Aluminum concentration exceeded the maximum allowed values in 26% of samples according to the Decree 518/2004 of the Brazilian Health Ministry. It was noted that 11% of elderly living at monitored houses, as well as 19% living at retirement homes presented Alzheimer disease diagnostic. These results suggest taking into account Al risks among vulnerable elderly population groups.

Explicit evidence-based prescribing criteria - an important step in achieving quality therapeutics in nursing homes

Reaction between 5-(4-amino-2-thiabutyl)-5-methyl-3,7-dithianonane-1, 9-diamine (N3S3) and 5- methyl-2,2-bipyridine-5-carbaldehyde and subsequent reduction of the resulting imine with sodium borohydride results in a potentially ditopic ligand (L). Treatment of L with one equivalent of an iron( II) salt led to the monoprotonated complex [Fe(HL)](3+), isolated as the hexafluorophosphate salt. The presence of characteristic bands for the tris( bipyridyl) iron( II) chromophore in the UV/vis spectrum indicated that the iron( II) atom is coordinated octahedrally by the three bipyridyl (bipy) groups. The [Fe( bipy) 3] moiety encloses a cavity composed of the N3S3 portion of the ditopic ligand. The mononuclear and monomeric nature of the complex [Fe(HL)](3+) has been established also by accurate mass analysis. [Fe(HL)](3+) displays reduced stability to base compared with the complex [Fe(bipy)(3)](2+). In aqueous solution [Fe(HL)](3+) exhibits irreversible electrochemical behaviour with an oxidation wave ca. 60 mV to more positive potential than [Fe(bipy)(3)](2+). Investigations of the interaction of [Fe(L)](2+) with copper( II), iron( II), and mercury( II) using mass spectroscopic and potentiometric methods suggested that where complexation occurred, fewer than six of the N3S3 cavity donors were involved. The high affinity of the complex [Fe(L)](2+) for protons is one reason suggested to contribute to the reluctance to coordinate a second metal ion.

Exposure to airborne ultrafine particles from cooking in Portuguese homes

Cooking was found to be a main source of submicrometer and ultrafine aerosols from gas combustion in stoves. Therefore, this study consisted of the determination of the alveolar deposited surface area due to aerosols resulting from common domestic cooking activities (boiling fish, vegetables, or pasta, and frying hamburgers and eggs). The concentration of ultrafine particles during the cooking events significantly increased from a baseline of 42.7 μm2/cm3 (increased to 72.9 μm2/cm3 due to gas burning) to a maximum of 890.3 μm2/cm3 measured during fish boiling in water, and a maximum of 4500 μm2/cm3 during meat frying. This clearly shows that a domestic activity such as cooking can lead to exposures as high as those of occupational exposure activities.

Exposure to airborne ultrafine particles from cooking in portuguese homes

Cooking was found to be a main source of submicrometer and ultrafine aerosols from gas combustion in stoves. Therefore, this study consisted of the determination of the alveolar deposited surface area due to aerosols resulting from common domestic cooking activities (boiling fish, vegetables, or pasta, and frying hamburgers and eggs). The concentration of ultrafine particles during the cooking events significantly increased from a baseline of 42.7 mu m(2)/cm(3) (increased to 72.9 mu m(2)/cm(3) due to gas burning) to a maximum of 890.3 mu m(2)/cm(3) measured during fish boiling in water, and a maximum of 4500 mu m(2)/cm(3) during meat frying. This clearly shows that a domestic activity such as cooking can lead to exposures as high as those of occupational exposure activities.

Operation modes for the electric vehicle in smart grids and smart homes : present and proposed modes

This paper presents the main operation modes for an electric vehicle (EV) battery charger framed in smart grids and smart homes, i.e., are discussed the present-day and are proposed new operation modes that can represent an asset towards EV adoption. Besides the well-known grid to vehicle (G2V) and vehicle to grid (V2G), this paper proposes two new operation modes: Home-to-vehicle (H2V), where the EV battery charger current is controlled according to the current consumption of the electrical appliances of the home (this operation mode is combined with the G2V and V2G); Vehicle-for-grid (V4G), where the EV battery charger is used for compensating current harmonics or reactive power, simultaneously with the G2V and V2G operation modes. The vehicle-to-home (V2H) operation mode, where the EV can operate as a power source in isolated systems or as an off-line uninterruptible power supply to feed priority appliances of the home during power outages of the electrical grid is presented in this paper framed with the other operation modes. These five operation modes were validated through experimental results using a developed 3.6 kW bidirectional EV battery charger prototype, which was specially designed for these operation modes. The paper describes the developed EV battery charger prototype, detailing the power theory and the voltage and current control strategies used in the control system. The paper presents experimental results for the various operation modes, both in steady-state and during transients.

Cognition and psychopathology in nonagenarians and centenarians living in geriatric nursing homes in Switzerland: a focus on anosognosia.

BACKGROUND: The number of nonagenarians and centenarians is rising dramatically, and many of them live in nursing homes. Very little is known about psychiatric symptoms and cognitive abilities other than memory in this population. This exploratory study focuses on anosognosia and its relationship with common psychiatric and cognitive symptoms. METHODS: Fifty-eight subjects aged 90 years or older were recruited from geriatric nursing homes and divided into five groups according to Mini-Mental State Examination scores. Assessment included the five-word test, executive clock-drawing task, lexical and categorical fluencies, Anosognosia Questionnaire-Dementia, Neuropsychiatric Inventory, and Charlson Comorbidity Index. RESULTS: Subjects had moderate cognitive impairment, with mean ± SD Mini-Mental State Examination being 15.41 ± 7.04. Anosognosia increased with cognitive impairment and was associated with all cognitive domains, as well as with apathy and agitation. Subjects with mild global cognitive decline seemed less anosognosic than subjects with the least or no impairment. Neither anosognosia nor psychopathological features were related to physical conditions. CONCLUSIONS: Anosognosia in oldest-old nursing home residents was mostly mild. It was associated with both cognitive and psychopathological changes, but whether anosognosia is causal to the observed psychopathological features requires further investigation.

A longitudinal study on delirium in nursing homes.

OBJECTIVE: To investigate the evolution of delirium of nursing home (NH) residents and their possible predictors. DESIGN: Post-hoc analysis of a prospective cohort assessment. SETTING: Ninety NHs in Switzerland. PARTICIPANTS: Included 14,771 NH residents. MEASUREMENTS: The Resident Assessment Instrument Minimum Data Set and the Nursing Home Confusion Assessment Method were used to determine follow-up of subsyndromal or full delirium in NH residents using discrete Markov chain modeling to describe long-term trajectories and multiple logistic regression analyses to determine predictors of the trajectories. RESULTS: We identified four major types of delirium time courses in NH. Increasing severity of cognitive impairment and of depressive symptoms at the initial assessment predicted the different delirium time courses. CONCLUSION: More pronounced cognitive impairment and depressive symptoms at the initial assessment are associated with different subsequent evolutions of delirium. The presence and evolution of delirium in the first year after NH admission predicted the subsequent course of delirium until death.

IPH response to DSD Consultation 'Warmer healthier homes'

Fuel Poverty remains a huge concern across the island with growing numbers of people at risk of being unable to heat their homes. Recession is placing more people at risk of being unable to heat their homes. IPH welcomed DSD commitment to review the 2004 Strategy and the emphasis placed on public health impacts in the consultation, recommending that improving the health of fuel-poor householders is explicitly recognised as a key outcome of the new strategy.

VFM Aduit of Statutory Residential Homes for Older People - Executive Summary - March 2007 (PDF 430 KB)

VFM Audit of Statutory Residential Homes for Older People - Executive Summary (March 2007)

VFM Audit of Statutory Residential Homes for Older People - March 2007 (PDF 1314 KB)

VFM Audit of Statutory Residential Homes for Older People - Final Report (March 2007)