Importance of Optimizing Visual Acuity in Vulnerable Seniors Living in an Institution

Visual acuity is an important measurement taken during an eye exam for checking an individual’s ability to see properly and to guide the adjusting of ocular refraction. It is a routine test usually done in a few minutes and with no particularly difficulty. However, this measurement can be more difficult to do in seniors with cognition or communication disabilities. For example, this may be true for a senior with dementia or suffering from aphasia following a stroke. The purpose of this article is to present certain aspects of population aging, data connected with institutionalization of seniors, various conditions that are more prevalent with age, as well as specific factors demonstrating the importance of optimizing vision in seniors. Lastly, this article will provide an overview of various scales available for measuring visual acuity

Match between needs and services for participation of older adults receiving home care : Appraisals and challenges

Abstract : Purpose. This paper aims to explore the match between needs and services related to participation for frail older adults receiving home care. Design/methodology/approach. A qualitative multiple case study was conducted with 11 triads each involving an elder, a caregiver and a healthcare provider working in a Health and Social Services Centers (HSSCs). Findings. Although HSSCs in Québec are supposed to promote social integration and participation of older adults, services provided to the older adults in this study focused mainly on safety and independence in personal care, dressing, mobility and nutrition, without fully meeting older adults’ needs in these areas. Discrepancies between needs and services may be attributable to the assessment not covering all the dimensions of social participation or accurately identifying older adults’ complex needs; older adults’ and their caregivers’ difficulties identifying their needs and accepting their limitations and the assistance offered; healthcare providers’ limited knowledge and time to comprehensively assess needs and provide services; guidelines restricting the types and quantity of services to be supplied; and limited knowledge of older adults, caregivers and healthcare providers about services and resources available in the community. Originality/value. To improve and maintain older adults’ participation, a more thorough assessment of their participation, especially in social activities, is required, as is greater support for older adults and their families in using available community resources. It is also important to review the services provided by HSSCs and to optimize partnerships with community organizations

Prevalence of physical and verbal aggressive behaviours and associated factors among older adults in long-term care facilities

BACKGROUND: Verbal and physical aggressive behaviours are among the most disturbing and distressing behaviours displayed by older patients in long-term care facilities. Aggressive behaviour (AB) is often the reason for using physical or chemical restraints with nursing home residents and is a major concern for caregivers. AB is associated with increased health care costs due to staff turnover and absenteeism. METHODS: The goals of this secondary analysis of a cross-sectional study are to determine the prevalence of verbal and physical aggressive behaviours and to identify associated factors among older adults in long-term care facilities in the Quebec City area (n = 2 332). RESULTS: The same percentage of older adults displayed physical aggressive behaviour (21.2%) or verbal aggressive behaviour (21.5%), whereas 11.2% displayed both types of aggressive behaviour. Factors associated with aggressive behaviour (both verbal and physical) were male gender, neuroleptic drug use, mild and severe cognitive impairment, insomnia, psychological distress, and physical restraints. Factors associated with physical aggressive behaviour were older age, male gender, neuroleptic drug use, mild or severe cognitive impairment, insomnia and psychological distress. Finally, factors associated with verbal aggressive behaviour were benzodiazepine and neuroleptic drug use, functional dependency, mild or severe cognitive impairment and insomnia. CONCLUSION: Cognitive impairment severity is the most significant predisposing factor for aggressive behaviour among older adults in long-term care facilities in the Quebec City area. Physical and chemical restraints were also significantly associated with AB. Based on these results, we suggest that caregivers should provide care to older adults with AB using approaches such as the progressively lowered stress threshold model and reactance theory which stress the importance of paying attention to the severity of cognitive impairment and avoiding the use of chemical or physical restraints

Importance d’optimiser l’afférence visuelle chez la personne âgée vulnérable vivant en institution

L’acuité visuelle est une mesure importante effectuée lors de l’examen visuel afin de vérifier la capacité d’une personne à bien voir et guider l’ajustement de la réfraction oculaire. Il s’agit d’un test de routine qui s’effectue généralement en quelques minutes et sans difficulté particulière. Cette mesure peut par contre être plus difficile à obtenir chez la personne âgée atteinte de troubles de la cognition ou de la communication. Ceci pourrait être le cas par exemple chez la personne âgée atteinte de démence ou celle souffrant d’aphasie suite à un accident vasculaire cérébral. Le but de cet article est de présenter certains aspects du vieillissement de la population, des données liées à l’institutionnalisation de la personne âgée, diverses conditions plus prévalentes liées à l’âge, ainsi que des facteurs particuliers démontrant l’importance d’optimiser la vision chez les personnes âgées. Finalement, cet article fera un survol de diverses échelles disponibles pour mesurer l’acuité visuelle

The R1 subunit of herpes simplex virus ribonucleotide reductase is a good substrate for host cell protein kinases but is not itself a protein kinase

UI - 98104124NRC publication: Ye

Development of a delirium risk screening tool for long-term care facilities.

Objectives: To develop a delirium risk screening tool for use in long-term care (LTC) facilities. Methods: The sample comprised residents aged 65 and over of 7 LTC facilities in Montreal and Quebec City, Canada, admitted for LTC. Primary analyses were conducted among residents without delirium at baseline. Incident delirium was diagnosed using multiple data sources during the 6-month follow-up. Risk factors, all measured at or prior to baseline, included the following 6 groups: sociodemographic, medical, cognitive status, physical function, agitated behaviour, and symptoms of depression. Variables were analyzed individually and by group using Cox regression models. Clinical judgement was used to select the most feasible among similarly performing factors. Results: The cohort comprised 206 residents without delirium at baseline; 69 cases of incident delirium were observed (rate 7.6 per 100 person-weeks). The best-performing screening tool comprised 5 items, with an overall area under the curve of 0.82 (95% CI 0.76, 0.88). These items included brief measures of cognitive status, physical function, behavioral, and emotional problems. Using cut-points of 2 (or 3) over 5,Objectives: To develop a delirium risk screening tool for use in long-term care (LTC) facilities. Methods: The sample comprised residents aged 65 and over of 7 LTC facilities in Montreal and Quebec City, Canada, admitted for LTC. Primary analyses were conducted among residents without delirium at baseline. Incident delirium was diagnosed using multiple data sources during the 6-month follow-up. Risk factors, all measured at or prior to baseline, included the following 6 groups: sociodemographic, medical, cognitive status, physical function, agitated behaviour, and symptoms of depression. Variables were analyzed individually and by group using Cox regression models. Clinical judgement was used to select the most feasible among similarly performing factors. Results: The cohort comprised 206 residents without delirium at baseline; 69 cases of incident delirium were observed (rate 7.6 per 100 person-weeks). The best-performing screening tool comprised 5 items, with an overall area under the curve of 0.82 (95% CI 0.76, 0.88). These items included brief measures of cognitive status, physical function, behavioral, and emotional problems. Using cut-points of 2 (or 3) over 5, the scale has a sensitivity of 90% (63%), specificity of 59% (85%), and positive predictive value of 52% (66%). Conclusion: This brief screening tool allows nurses to identify LTC residents at increased risk for delirium. These residents can be targeted for closer monitoring and preventive interventions