Can the internet improve the well-being of the elderly?

In this paper we report on a project that aimed to evaluate the potential of the Internet to reduce social isolation amongst the elderly, and thereby, improve psychosocial functioning. Twenty residents of a retirement village volunteered to be given access to, and training in, the use of computers and the Internet. After 3 months, they exhibited little change in measures of self-esteem, positive affect, personal well-being, optimism and social connectedness. However, they reported that they found the use of the Internet to be of great benefit. Over the 12 months of the study 12 participants discontinued their involvement for a variety of reasons. After 12 months, the eight participants who remained in the study again reported a range of positive outcomes however, quantitative survey data did not confirm these findings of a generally-positive experience. This discrepancy between the qualitative (interview) data and the quantitative (survey) data suggests that impact of the Internet on the wellbeing of the elderly may be more complex than suggested, and broader than was assessed psychometrically. We make specific recommendations about the introduction of computers to elderly with care both in how participants are selected and how their well being is monitored subsequently.

Dilettantism in investigating the impact of the internet on the wellbeing of the elderly

The surge of interest in the social impacts of the Internet has led information systems experts to apply methods and theories garnered from disciplines such as psychology and sociology. As researcher look across disciplines for methods and explanations of outcomes, they run the risk of researching badly. This may be because they are inexperienced in the theory or method, or because the theory or method is not entirely applicable to the context that challenges them. Thus, in the search for the novelty necessary to achieve publications, and given the lack of experience in applying information systems to issues beyond the corporate sphere, research that does not hold water is being undertaken. This is of particular interest because it is not necessarily being undertaken by the novice. The research reported here was undertaken by experienced researchers using experimental and interview methods with which they had experience in other disciplines (psychology and economics). However, the context of researching the impact of the Internet on the quality of life of first time users over the age of 65 was sufficiently different as to render the methods and possibly the theory inappropriate. This dilettantism must be recognized for what it is.

Household structure and consumption insurance of the elderly

This paper examines the role of household formation in providing consumption insurance to the elderly. Using data from the Consumer Expenditure Surveys, raw tabulations of per adult equivalent consumption indicate that the elderly who live alone have higher levels of well-being relative to those who live with others. This is misleading, however, because the decision to live alone is clearly endogenous. The empirical estimation accounts for this endogeneity using data from the Panel Study of Income Dynamics. The results provide evidence that household formation plays a significant role in maintaining consumption levels. Without the opportunity to live with others, the welfare gap measured by the difference between per adult equivalent consumption levels of dependent and independent livers would be even larger. These findings suggest that co-residing with others effectively supplements social security, pensions, and private savings and helps the elderly to smooth consumption in old age.

Mind and body: how the health of the body impacts on neuropsychiatry

It has long been established in traditional forms of medicine and in anecdotal knowledge that the health of the body and the mind are inextricably linked. Strong and continually developing evidence now suggests a link between disorders which involve Hypothalamic-Pituitary-Adrenal axis (HPA) dysregulation and the risk of developing psychiatric disease. For instance, adverse or excessive responses to stressful experiences are built into the diagnostic criteria for several psychiatric disorders, including depression and anxiety disorders. Interestingly, peripheral disorders such as metabolic disorders and cardiovascular diseases are also associated with HPA changes. Furthermore, many other systemic disorders associated with a higher incidence of psychiatric disease involve a significant inflammatory component. In fact, inflammatory and endocrine pathways seem to interact in both the periphery and the central nervous system (CNS) to potentiate states of psychiatric dysfunction. This review synthesizes clinical and animal data looking at interactions between peripheral and central factors, developing an understanding at the molecular and cellular level of how processes in the entire body can impact on mental state and psychiatric health.

Consistency of the Health of the Nation Outcome Scales (HoNOS) at inpatient-to-community transition

OBJECTIVES: The Health of the Nation Outcome Scales (HoNOS) are mandated outcome-measures in many mental-health jurisdictions. When HoNOS are used in different care settings, it is important to assess if setting specific bias exists. This article examines the consistency of HoNOS in a sample of psychiatric patients transitioned from acute inpatient care and community centres.

SETTING: A regional mental health service with both acute and community facilities.

PARTICIPANTS: 111 psychiatric patients were transferred from inpatient care to community care from 2012 to 2014. Their HoNOS scores were extracted from a clinical database; Each inpatient-discharge assessment was followed by a community-intake assessment, with the median period between assessments being 4 days (range 0-14). Assessor experience and professional background were recorded.

PRIMARY AND SECONDARY OUTCOME MEASURES: The difference of HoNOS at inpatient-discharge and community-intake were assessed with Pearson correlation, Cohen's κ and effect size.

RESULTS: Inpatient-discharge HoNOS was on average lower than community-intake HoNOS. The average HoNOS was 8.05 at discharge (median 7, range 1-22), and 12.16 at intake (median 12, range 1-25), an average increase of 4.11 (SD 6.97). Pearson correlation between two total scores was 0.073 (95% CI -0.095 to 0.238) and Cohen's κ was 0.02 (95% CI -0.02 to 0.06). Differences did not appear to depend on assessor experience or professional background.

CONCLUSIONS: Systematic change in the HoNOS occurs at inpatient-to-community transition. Some caution should be exercised in making direct comparisons between inpatient HoNOS and community HoNOS scores.

New meaning for the emotional state of the elderly, from a leisure standpoint

Continuing developments in science and technology that affect many dimensions of human life, especially those related to longevity, require responses from social policies and programmes to enable quality-of-life improvements in every sector, including leisure. To contribute to research in this area, this qualitative study sought to identify the perceptions of and meanings attached to participation in (active outdoor) leisure by a group of elderly citizens of Araras, São Paulo State, Brazil. Data were collected via questionnaires administered to a mixed-gender sample of 100 persons, aged between 60 and 80 years, after they had participated in an outdoor adventure/leisure programme. The data were subjected to thematic content analysis. The study revealed that the participants identified positive emotional effects as a result of their participation, relating to their sense of belonging to a group, to their increased quality of life and to their ability to remain physically active.

Study of the elderly females' voice by phonetography

This study was carried out to investigate the voice characteristics of 40 healthy females with no voice disorders, ranging in age from 60 to 84 years ((X) over bar = 68.2 +/- 5.74 years). Measurements over all the entire phonational range were obtained by phonetography. The subjects were asked to sustain the vowel /a/ in modal register for a minimum of 5 seconds in the highest and lowest intensities after hearing the semitones C, E, G, and A, over all phonational ranges. The results indicated expansion of the low and reduction of high ends of the pitch range, decrease of the pitch numbers of the vocal range, restriction of the lowest and highest limits of the intensity, and reduction of either the maximum phonational range and the phonetogram area. The phonetography technique has shown efficacy to investigate the voice characteristics of elderly females.

Influenza among the elderly in the Americas: A consensus statement

Influenza exacts a heavy burden on the elderly, a segment of the population that is estimated to experience rapid growth in the near future. In the past decade most developed and several developing countries have recommended influenza vaccination for those > 65 years of age. The World Health Organization (WHO) set a goal of 75% influenza vaccination coverage among the elderly by 2010, but it was not achieved. In 2011, the Technical Advisory Group at the Pan American Health Organization, Regional Office of WHO for the Americas, reiterated the influenza vaccine recommendation for older adults. Relatively little information has been compiled on the immunological aspect of aging or on reducing its impact, information particularly relevant for clinicians and gerontologist with firsthand experience confronting its effects. To fill this data gap, in 2012 the Americas Health Foundation (Washington, D.C., United States) and the nonprofit, Fighting Infectious Diseases in Emerging Countries (Miami, Florida, United States), convened a panel of Latin American clinicians and gerontologists with expertise in influenza to discuss key issues and develop a consensus statement. The major recommendations were to improve influenza surveillance throughout Latin America so that its impact can be quantified; and to conduct laboratory confirmation of influenza for all patients who have flu-like symptoms and are frail, immunosuppressed, have comorbidities, are respiratory compromised, or have been admitted to a hospital. The panel also noted that: since evidence for antivirals in the elderly is unclear, their use should be handled on a case-by-case basis; despite decreased immunological response, influenza vaccination in older adults is still crucial; indirect immunization strategies should be encouraged; and traditional infection control measures are essential in long-term care facilities.

Age declaration, mortality and selected socioeconomic characteristics of the elderly

Includes bibliography

Living conditions of the elderly: development and family context

Includes bibliography

The nurse and the care to the elderly women: a social phenomenological approach

Objective: To understand how nurses see care delivery to elderly women. Methods: In this phenomenological study, ten nurses working at Primary Health Care Units were interviewed between September 2010 and January 2011. Results: In care delivery, nurses consider the elderly women's knowledge background and biographical situation, and also value the family's participation as a care mediator. These professionals have the acuity to capture these women's specific demands, but face difficulties to deliver care to these clients. Nurses expect to deliver qualified care to these women. Conclusion: The theoretical and methodological approach of social phenomenology permitted revealing that the nurse designs qualified care to elderly women, considering the possibilities in the context. This includes the participation of different social actors and health sectors, assuming collective efforts in action strategies and professional training, in line with the particularities and care needs of elderly women nurses identify.

Assessment of functional capacity of the elderly associated with the risk for pressure ulcer

OBJECTIVE: To characterize the elderly with physical limitations; to assess functional capacity as it relates to physical mobility, cognitive status and level of functional independence in activities of daily living, and to relate functional capacity to the risk for pressure ulcers. METHODS: A quantitative cross-sectional approach, conducted in households in the city of João Pessoa (PB) with seniors who presented physical limitation. Fifty-one elderly were investigated in a two-stage cluster sampling design. RESULTS: There was evidence of impairments in functional capacity of the elderly aged 80 years or more, with more severe physical limitations, cognitive impairment and a higher level of dependency for activities. Significant differences were observed between the level of functional independence in performing activities of daily living and the risk of pressure ulcers. CONCLUSION: This study allowed for the identification of the elderly in functional decline and at risk for developing pressure ulcers, supporting the implementation of preventive actions at the household level.

Effect of preventive interventions in mentally ill parents on the mental health of the offspring: systematic review and meta-analysis

Mental illness in parents affects the mental health of their children. A systematic review and a meta-analysis of the effectiveness of interventions to prevent mental disorders or psychological symptoms in the offspring were performed.