Säilyykö myönteinen elämänasenne vanhuudessa?

Tutkimuksen tarkoituksena oli arvioida 70-vuotiaiden, kotona asuvien ikäihmisten koettua elämänasennetta sekä seurata sen pysyvyyttä ja siinä tapahtuneita muutoksia 20 vuoden seuranta-aikana. Lähtötutkimus toteutettiin postikyselynä vuonna 1991, jolloin tutkimuskohteena olivat kaikki vuonna 1920 syntyneet (N=1530) kotona asuvat turkulaiset. Heidät tutkittiin uudelleen vuonna 2001 (n=656), 2006 (n=304) and 2011 (n=156). Elämänasennetta arvioitiin kysymyksillä elämään tyytyväisyydestä, tarpeellisuuden tunteesta, tulevaisuuden suunnitelmista, elämänhalusta, masentuneisuudesta ja yksinäisyydestä. Kysymyksistä muodostettiin summamuuttuja, jonka arvo 1 edustaa positiivista elämänasennetta ja arvo 0 negatiivista elämänasennetta. Lähtötilanteessa vastaajilla oli varsin myönteinen elämänasenne (summamuuttujan arvo 0.83). Heillä oli elämänhalua ja he olivat elämäänsä tyytyväisiä. Seuranta osoitti, että kotona asuvien ikäihmisten elämänasenne heikkeni tilastollisesti merkitsevästi ikävuosien 70 ja 80 välillä (0.83:sta 0.75:een), kun taas ikävuosien 80, 85 ja 90 välillä muutosta ei enää tapahtunut

Experienced Quality of Life and Cultural Activities in Elderly Care

We investigated if cultural activities are associated with improved quality of life experiences of older people. In 2012, older people in five care units were invited to participate more cultural activities (study group) than usual. Each person in the study group had a tailored cultural plan integrated into the care plan. Older people in traditional care units (control group) did not have such cultural plans.One hundred sixty-one persons from care units in two cities in Finland participated in 2012 and 161 persons in 2014 in a cross-sectional study. Their quality of life was assessed with the World Health Organization's Quality of Life WHOQOL-BREF (Field Trial Version) enquiry. The quality of life variable contained four domains. physical, psychosocial, social and environment. The values of these domains underwent multivariate analysis of variance of the following explanatory variables: intervention group, age (80 years old), education background, marital status, gender and comorbidities. The domains of the participants' self-rated experience were also assessed.The quality of life experience was similar at baseline in 2012 in both study groups. In 2014 the study group rated the quality of life (pOlder people in care units need cultural activities as a necessary part of their care. The care provided in the care units does not put enough emphasis on this need. With individually tailored cultural activities set down in a cultural plan, care providers can ensure a better quality of life for older people.</p

Caring for a Person With Dementia on the Margins of Long-Term Care: A Perspective on Burden From 8 European Countries

© 2017 AMDA – The Society for Post-Acute and Long-Term Care Medicine Objectives To explore associations between carer burden and characteristics of (1) the informal carer, (2) the person with dementia, and (3) the care support network in 8 European countries. Design Cross-sectional study. Setting People with dementia judged at risk of admission to long-term care (LTC) facilities in 8 European countries (Estonia, Finland, France, Germany, Netherlands, Spain, Sweden, United Kingdom). Participants A total of 1223 people with dementia supported by community services at home or receiving day care or respite care and their informal carers. Measurements Variables regarding the informal carer included familial relationship and living situation. Variables relating to the person with dementia included cognitive functioning (S-MMSE), neuropsychiatric symptoms (NPI-Q), depressive symptoms (Cornell depression scale), comorbidity (Charlson Comorbidity Index), and physical functioning (Katz Activity of Daily Living [ADL] Index). The care support network was measured using hours of caregiving (ADLs, instrumental ADLs [IADLs], supervision), additional informal care support, and service receipt (home care, day care). Experience of carer burden was recorded using the Zarit Burden Interview. Logistic regression analysis was used to determine factors associated with high carer burden. Results Carer burden was highest in Estonia (mean 39.7/88) and lowest in the Netherlands (mean 26.5/88). High burden was significantly associated with characteristics of the informal carer (family relationship, specifically wives or daughters), of the person with dementia (physical dependency in ADLs; neuropsychiatric symptoms, in particular nighttime behaviors and irritability), the care support network (hours of caregiving supervision; receipt of other informal care support) and country of residence. Conclusion A range of factors are associated with burden in informal carers of people with dementia judged to be on the margins of LTC. Support for informal carers needs to take account of gender differences. The dual challenges of distressed behaviors and difficulties in ADLs by the person with dementia may be addressed by specific nonpharmacological interventions focusing on both elements. The potential protective effect of additional informal support to carers highlights the importance of peer support or better targeted home support services. The implementation of appropriate and tailored interventions to reduce burden by supporting informal carers may enable people with dementia to remain at home for longer

A collaborative approach to home care delivery for older clients: Perspectives of home care providers

A collaborative approach to home care (HC) delivery for older clients has taken centre stage (Nies, 2006). In Finland, public home help and home health care services have been combined to form the home care unit, whose goal is to provide a collaborative approach to care delivery through cooperation and sharing of responsibilities. In this model, the general practitioner (GP), home care nurses (HCN) and home help workers (HHW) care for shared clients. GPs and HCNs provide health care, such as monitoring of clients’ health status, and HHWs assist with personal care tasks such as dressing, washing and meal preparation. As the needs of older clients are multiple, collaboration is needed as one professional group cannot take sole responsibility (Nies, 2006). This paper reports on a study undertaken to examine home care unit care providers’ perspectives of the collaborative approach to HC delivery for older clients

Pharmaceutical Care as Described by Home-Dwelling Older People in Finland

Background and Objective. Pharmaceutical care is one of the most important therapeutic tools in older people care. The aim of this study was to describe the knowledge and attitudes of older home-dwelling people’s about their perceptions of pharmaceutical care and use of medication. Material and Methods. The data were collected using theme interviews with 16 older Finnish people (born 1920). Inductive content analysis was used in analyzing the data. Results. Older people’s knowledge about their pharmaceutical care varied widely: some had precise knowledge whereas others had none. Guidance in pharmaceutical care was not readily available. The interviewees took a positive attitude toward their pharmaceutical care and favored a minimum use of medication. Being able to cope independently with their pharmaceutical care strengthened the older people’s sense of control over their lives. Conclusions. The study offers new knowledge about the significance of older people’s individual pharmaceutical care at home. By listening to and utilizing older people’s experiences, we can recognize the factors that promote the independent coping and inclusion of older people in their pharmaceutical care. This enables health care providers to increase the safety and quality of pharmaceutical care for older people

Koettu terveys, elintavat ja fyysinen toimintakyky - vuosina 1920 ja 1940 syntyneiden kohorttien vertailu

Tutkimuksen tarkoituksena oli vertailla vuosina 1920 (n = 1032) ja 1940 (n = 956) syntyneiden 70-vuotiaiden kotona asuvien turkulaisten koettua terveyttä, elintapoja ja fyysistä toimintakykyä. Tiedot koetusta terveydestä, elintavoista (tupakointi, alkoholinkäyttö ja painoindeksi) ja fyysisestä toimintakyvystä (päivittäiset toiminnot, välineelliset toiminnot ja päivittäisiä toimintoja haittaavat oireet) kerättiin kyselylomakkeiden ja haastatteluiden avulla. Tulosten mukaan vuonna 1940 syntyneet kokivat terveytensä ja fyysisen toimintakykynsä paremmiksi kuin vuonna 1920 syntyneet. Lisäksi 1940 syntyneillä oli vähemmän päivittäistä toimintaa haittaavia oireita kuin vuonna 1920 syntyneillä. Alkoholin käyttö ja ylipaino sen sijaan olivat yleisempiä 1940 syntyneiden kuin 1920 syntyneiden keskuudessa. Tulokset ovat tärkeitä suunniteltaessa ennaltaehkäiseviä palveluita ikääntyville