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Dec 2020
K. Gusdal AnnelieCorresponding author
School of Health, Care, and Social Welfare, Mälardalen University, Eskilstuna/Västerås, Sweden
More than 90% of people with dementia develop behavioral and psychological symptoms of dementia. First-line care strategies in dementia care should consider a combination of pharmacological and non-pharmacological interventions. The present single-case research study aimed to evaluate the use of virtual reality in the context of behavioral and psychological symptoms of dementia, quality of life, and medication use among people with dementia. Ten persons with dementia used virtual reality for a mean of twice per week for eight weeks. In each virtual reality session, lasting for a maximum of 30 minutes, the persons with dementia chose one to three short films from 11 different films: a hen run, a farm with animals, two cafés, an old-fashioned grocery shop, a local river, a square in the local city, a museum, a castle, a fishing boat and an Austrian mountain scenery. Quantitative and qualitative data were collected pre-, during, and post-intervention. No major differences in the quantitative data in terms of behavioral and psychological symptoms of dementia, quality of life, or medication use were observed. However, the qualitative data showed that the use of virtual reality provided the persons with dementia with short-term enjoyment, heightened energy and alertness, and an experience of reminiscence. The use of virtual reality may therefore serve as a complementary tool to the existing non-pharmacological management techniques of people with dementia in nursing homes.
Apr 2020 DOI 10.14302/issn.2692-5257.ijgp-20-3299
Luis Turabian JoseCorresponding author
Specialist in Family and Community Medicine, Health Center Santa Maria de Benquerencia, Regional Health Service of Castilla la Mancha (SESCAM), Toledo, Spain
The coronavirus disease 2019 (COVID-19) pandemic is something new that baffles us. The dominant health model and the theory that supported it until before COVID-19 are refuted or invalidated by observing the current tragically situation, which also implies lasting changes in that new medical model. Consequently, once the urgency of the epidemic is over, the conceptual and organizational building of medical care can no longer be rebuilt in the same way. Based on the COVID-19 experience, it is necessary to rethink what kind of knowledge can emerge. Some of the concepts with clinical-epidemiological implications that have to be re-evaluated since the COVID-19 pandemic are: 1. Large epidemics or changes do not arise from an event similar to the "Big Bang", but rather they develop slowly and underground, so a surveillance system must be instituted; 2. Re-evaluate what we understand by "evidence-based medicine"; 3. Patient-centered care is inadequate and must be replaced by community-centered care; 4. Telecare and changes in the organization of consultations; 5. Hospitals and health centers are "biological bombs" that act as vectors of disease and must change their architecture, organization and use; 6. The end of the nursing home model; 7. Change of habits; and 8. Social media can democratize information and help communities organize.
Jan 2019 DOI 10.14302/issn.2474-7785.jarh-19-2608
W. Harvey PeterCorresponding author
Conjoint Clinical Professor, Deakin University, School of Medicine, Faculty of Health
In the light of various complaints about the quality of care provided by and operation of aged care facilities across Australia, the Commonwealth Government has announced a Royal Commission into the activities of the sector. As the proportion of Australians over 65 continues to grow with the ageing of the ‘Baby Boomer’ generation, more Australians are seeking secure aged care arrangements to meet their increasingly complex living and healthcare needs. We hear much comment today about the concept of healthy ageing and the importance of older people staying connected to and active in their communities. Not only does this ongoing connectivity support better lifestyles and health status, it provides an avenue for older people to contribute to the support of others once their more formal working lives are concluded. Unfortunately, the gap between the rhetoric and the reality of ageing in Australia is strained and it appears that much about the operations of the aged care sector today is less than satisfactory. While some well-funded retirees can afford comfortable and fulfilling living arrangements, many others are left in less ideal circumstances. With aged care organisations currently building the next generation of ‘hotel’ style living arrangements for cashed up self-funded retirees, others are being left behind financially and in terms of the quality of their care. At the same time, maltreatment and abuse of residents is coming to light, as in the ‘Oakden Nursing Home’ situation in South Australia, for example. Consequently, the Federal Government has now launched a formal inquiry into the activities of organisations running aged care facilities in Australia. The inquiry is designed to assess the operation of this industry with a focus on the economics of aged care centres, the quality of care, the food and recreational activities provided and the challenge of staffing these facilities to keep residents safe and well as they age in dignity.
Jun 2017 DOI 10.14302/issn.2474-7785.jarh-17-1575
Renaux CharlotteCorresponding author
Univ.Lille, CNRS, UMR9193 – SCALab – Sciences Cognitives et Sciences Affectives, F-59000 Lille, France ;
Background and Objective: Behavioral procedures have proven to be effective with elderly adults in nursing home. The purpose of this study was to evaluate the effectiveness of a shaping procedure as a means of increasing writing performance. More specifically, our aim was to reeducate a motor behavior in a patient for whom the behavior was no longer present. Materials and Methods: The participant was an elderly (76-year-old) who had sequelae from a cardiovascular accident since 2011, and was asked to write some selected words. Data were collected though face-to-face interviews then analyzed using cotation methods. Results: The shaping and chaining procedures were efficient and performance of writing increased, even for infrequent words. Conclusion: Increasing writing performance is possible for the elderly people, even if they have suffered from cardiovascular accidents in the past. Here we used a successful brief shaping procedure to enhance quickly that ability.
Apr 2017 DOI 10.14302/issn.2474-7785.jarh-17-1483
Dorfman JonCorresponding author
Department of Surgery, University of Massachusetts Memorial Medical Center Worcester, MA
Background: Discharge disposition planning begins at admission and is frequently one of the first questions posed to healthcare providers by patients and families. We hypothesized that pre-injury functional status would predict discharge disposition. Methods: We linked prospective data from the Worcester, MA cohort of the Global Longitudinal Study of Osteoporosis (GLOW) study and the UMassMemorial Level 1 Trauma Center Registry to determine predictors of discharge disposition for female geriatric (over the age of 55) trauma patients using bivariate comparisons and multivariable modeling. Results: 154 women of 5,091 in the Worcester GLOW cohort were evaluated for traumatic injury at UMassMemorial and were discharged alive either to their home (n=30) or to rehabilitation, skilled nursing, or nursing home facilities (n=124). The mean age was 79 years and the majority (99%) was white. There were no statistically significant differences in comorbidities or injury severity score between the groups. All women with femur fractures were discharged to a facility. The most common injury among women discharged home was traumatic brain injury. While univariate analysis revealed differences in pre-injury activity status, only age remained statistically different in a logistic regression model predicting discharge to facility (OR 2.61 per additional 10 years of age, 95% CI 1.62 to 4.19, p<0.0001). Conclusions: The majority of elderly women are not discharged home after injury. Pre-injury activity status was not associated with discharge disposition when accounting for other factors. It appears that physical function, which deteriorates with age, is a proxy for aging in older women at risk for osteoporosis.