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Biomedical subjects

G M Gutman

Publications and source records attributed to G M Gutman.

13 recordsLinked to original sources
PubMed2001

Contribution of self-reported health ratings to predicting frailty, institutionalization, and death over a 5-year period.

Cross-sectional data from Phase 1 of the Canadian Study of Health and Aging was used to examine the relationship between two self-report health measures: "How would you say your health is these days?"(HEALTH) and "How much do your health troubles stand in the way of your doing the things you want to do?"(TROUBLE). The contribution of these measures to predictive models for institutionalization and mortality is examined, using linked data from Phases 1 and 2. Their relationship to a proposed frailty measure is also examined. At CSHA-1, a majority of respondents perceived that they were in good health and did not feel that their health problems interfered with their preferred activities. At all frailty levels, a majority of both males and females rated their health as "very good" or "pretty good." As frailty increased, health problems increasingly interfered with normal activities. Logistic regression of the longitudinal data indicated that, despite their correlation, HEALTH and TROUBLE cannot act as proxies for each other. They appear to predict independently; adding one to the other significantly improved prediction of institutionalization and mortality.

Activities of Daily Living↗
PubMed2001

Self-care among older adults: an analysis of the objective and subjective illness contexts.

OBJECTIVES: The authors hypothesize that older adults diagnosed with arthritis show a greater reliance on objective factors in their self-care behaviors, whereas those diagnosed with heart problems or hypertension demonstrate a greater reliance on more general belief-laden factors. METHODS: A total of 794 older adults (mean age = 69.3) who were professionally diagnosed with arthritis, heart problems, or hypertension completed a telephone survey about a number of aspects of their illness condition and their general well-being. RESULTS: The results from the hierarchical regression analyses indicate that objective factors and illness-specific beliefs are better predictors of self-care behavior in the arthritis group, whereas general beliefs (e.g., self-efficacy and general well-being) are better predictors of such behavior in the heart problems and hypertension groups. DISCUSSION: The analyses support the authors' hypothesis. The results are discussed in the context of expanding the Health Belief Model of self-care.

Aged↗
PubMed1993

Adult day care centres in British Columbia: client characteristics, reasons for referral and reasons for non-attendance.

This paper discusses a 1989 study of new admissions to 22 adult day care centres in British Columbia and compares it to similar studies in the U.S. The B.C. study investigated clients' characteristics, reasons for referral to the centres, and why some referrals did not attend. Of the new admissions, 63% were female and 30% lived alone. Compared to those in American studies, B.C. clients were older and more likely to live with a spouse. The primary medical conditions of B.C. clients were related to diseases of the circulatory system. As for daily activities, 58% could not bathe without supervision and 43% required assistance with dressing. Some 37% were unable to prepare their own meals; 31% needed help with housekeeping and 62% with shopping. The proportion of clients with mental diseases (38%) was similar to that in American adult day care centres. The three most common reasons for referring clients to adult day care centres were: to assist those who were socially isolated; to give family caregivers some respite; and to give clients emotional help. Perceptions varied as to why referred clients did not attend: for continuing care staff there were psychosocial factors; for adult day care staff it was related to characteristics of the service delivery system; and clients themselves cited functional, physical and operational factors (e.g., problems related to hearing and vision, transportation or physical barriers).

Activities of Daily Living↗
PubMed1993

Adult Day Care centres in British Columbia: models, characteristics and services.

Adult Day Care (ADC) is increasingly being recognized as an important sub-system of the continuing care system. This paper reviews models developed in the United States and Britain and compares them, and the services they offer, with centres in British Columbia, Canada. Data on British Columbia are from a study in which all 49 centres in the province provided detailed information about their staffing, operating characteristics, activities and services. The study found B.C. compared favourably in providing services needed by ADC clients. Key differences between the B.C. centres and those in the U.S. and U.K. were: a larger proportion of B.C. centres were not affiliated with any other organization; B.C. centres admitted a range of clients and were less likely to cater exclusively to special needs groups; and, B.C. centres were more likely than centres in the U.S. to provide a number of services such as: dental care, transportation, bathing and physiotherapy.

Adult↗
PubMed1986

Client transfers in long-term care: five years' experience.

This paper reports the home-facility and level of care changes, discharges, and deaths over a five-year period for 1,653 clients newly admitted in 1978 to a long-term care program in British Columbia, Canada. Five years after admission, of clients initially admitted to care at home (N = 1241), 34.3 per cent were still in the program (14.5 per cent unchanged; 6.7 per cent at home but at a higher level of care, and 11.7 per cent in facilities). Of the remainder, 38.9 per cent had died and 26.8 per cent had been discharged. Findings for those initially admitted to care in facilities (N = 412) are remarkably similar. After five years, 28.4 per cent of these clients were still in the program; 39.3 per cent had died. Moves from facility to home care were few (2.4 per cent). Despite their advanced age at admission (mean = 74.7, S.D. 14.6), one-third were still in the program five years later, some with status virtually unchanged.

Aged↗
PubMed1984

Placement changes in long-term care: three years' experience.

This paper describes the place and level of care of an urban and a semi-rural health unit for which 1,653 clients began their experience in British Columbia's Long-Term Care (LTC) program and where they were one and three years later. Three years after admission, 54 per cent of 759 clients initially admitted at home to the lowest level of care were still active clients: 25.8 per cent unchanged, 11.3 per cent at home but at a higher level of care, 16.9 per cent had moved to facilities, 25.4 per cent had died; the remainder of this group had been discharged from LTC. A similar proportion of the 184 clients admitted to the lowest level of care in facilities were still in the program at the end of three years. In contrast, 25 per cent of those admitted to the highest level of care at home (N = 60) and 14.1 per cent of those admitted to the highest level in facilities (N = 64) remained in the program after three years. The potential of the study data for planning purposes is suggested.

Aged↗
PubMed1982

Acute-care hospitalizations and long-term care: an examination of transfers.

A Long-term Care Program was introduced throughout British Columbia, Canada, on January 1, 1978. This comprehensive community-based program emphasizes home care. A longitudinal study was started of all persons (N = 3518) admitted to the program that year in two health districts, one urban and one semirural. An examination of the relationship between acute-care hospitalization and long-term care (LTC) involved determining (1) the number of admissions (N = 364) to LTC directly from acute-care settings versus the number (N = 1287) entering directly from the community, (2) the number of LTC persons who were hospitalized at least once in the first 12 months after admission to LTC, and (3) the outcomes of these hospitalizations. Persons from the urban area who entered the LTC Program from an acute-care hospital were much more likely to be institutionalized than were those from the semirural area. In the LTC facility group, 388 persons (19.9 per cent) experienced at least one acute-care hospitalization during the first year of the program. More than 50 per cent of those transferred to an acute-care hospital for the first time returned to the same location and level of care afterward; 14 per cent died. These descriptive analyses may be of interest to health-care planners and to those who care for the LTC elderly either at home or in a facility.

Aged↗
PubMed1978

Issues and findings relating to multi-level accommodation for seniors.

Tenants in self-contained suites and board-residence in a building also offering personal care were interviewed pre- and post-move and were compared with tenants in more traditional retirement housing, offering only self-contained suites, with applicants who did not move in and with elderly nonapplicants. There was no evidence of differential decline, relative to controls, in the self-reported health status, level of interaction with family and friends, or in the activity level of those who moved to the multilevel facility. If anything, benefits accrued from the move in the form of higher morale and increased interaction with neighbors. Furthermore, more in the multi-level tenant group than in any other group felt that they had more friends and that they were "getting out" and "dressing up" to a greater extent than when interviewed 18 mo earlier. These findings should help to allay the fears of those concerned that the well-elderly might find it depressing to be among those less competent and that the availability of on-site meals, housekeeping and nursing services, and recreation might foster dependency and/or disengagement from the broader community.

Age Factors↗
PubMed1977

Feldenkrais versus conventional exercises for the elderly.

Tenants in retirement housing given a 6-week program of Feldenkrais exercises were compared with a group given conventional exercises and with control groups given no exercises. Analysis of covariance of preliminary and subsequent measurements failed to yield any significant differences between groups. Measurements included height, weight, blood pressure, heart rate, balance, flexibility, morale, self-perceived health status and level of performance of activities of daily living, also the number of body parts difficult to move or giving rise to pain. Several possible reasons are given for the results. Attention is drawn to the necessity of medically screening and monitoring elderly registrants for exercise programs since it is apparent that some sign up who should not.

Activities of Daily Living↗
PubMed1976

Mortality rates among relocated extended-care patients.

Eighty-one male extended-care patients relocated due to planned demolition of the building in which their ward was located were followed for 21 mo. from the date of transfer. No increase in mortality rate was detected during the first 3 mo. post-relocation, an interval usually associated with high mortality in elderly persons involuntarily relocated. During the first year after relocation, the death rate was 33.33%, compared to an average annual death rate of 41.20% during the 5 years preceding the move. At 21 mo., half the relocated population were alive. These data contrast with previous studies, most of which show increased mortality after relocation, and lead us to concur with those who suggest that the degree of environmental change involved may be a key factor in explaining variance in relocation effects.

Adult↗