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Results for “Institutionalization”

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At least 757 records · Page 42Linked to original sources

PubMed1990

Dental behavioral aspects of a non-institutionalized elderly population.

Various studies have shown an increase in utilization of dental services among the elderly in the last three decades. This study aimed at evaluating utilization rate of non-institutionalized geriatric population in Jerusalem and determining reasons for non-utilization. To eliminate the factor of accessibility of services, a Jerusalem neighborhood with a dental geriatric clinic was selected and all residents were notified. A second letter requesting cooperation with a dentist who would be visiting their homes was sent, and was followed by a phone call. According to a list provided by the municipality, 175 homes were visited; only 87 were examined, 21.7% refused; 4.6% were disqualified for health problems, 13.7% died and 10.3% moved. Testing included: a clinical dental examination, an interview regarding number of visits at a dental clinic and reasons for non-utilization of services. Results indicated that 42.4% had visited a dentist during the last year and 37.6% had not seen a dentist for more than 5 years. Of those who had not seen a dentist for more than a year, 62.7% indicated having no problems, 9.8% indicated a financial barrier, 7.8% indicated no services available, 5.9% were too busy and only 3.9% indicated fear as the reason for non-utilization. Though the sample was relatively small, accessibility and availability of dental services have proven to be factors which increase utilization.

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PubMedDate not supplied

Mental status and functional abilities: change in institutionalized elderly women.

A study of 40 institutionalized elderly women was undertaken to determine if changes occurred in mental status and functional abilities over the course of 1 year. Although a number of studies examine factors that impact on successful adaptation in persons admitted to long-term care facilities, the longitudinal changes on functional abilities and mental status have not been addressed. These variables were examined in relation to the concept of self-care, which has been applied to the elderly only recently. Findings indicate a decline in mental status and an increase in functional dependency. Nursing implications and questions that merit further study in the area of self-care are presented.

Activities of Daily Living↗

PubMedDate not supplied

Effects of chlorhexidine spray on plaque and gingival health in institutionalized persons with mental retardation.

In this study, eight institutionalized males received a 0.12% chlorhexidine gluconate spray twice daily. A second group of eight males received a placebo spray in the same manner. The results indicated that pump-administered chlorhexidine spray can effectively reduce plaque and gingivitis in patients with mental retardation who are unable to brush their own teeth.

Adult↗

PubMedDate not supplied

The effectiveness of sponge-type intraoral applicators for applying topical fluorides in institutionalized older adults.

Many older adults who reside in nursing homes have disabilities which limit their capacity to benefit from the usual protocols for prevention of dental caries. This is a report of a study of the effectiveness of an alternative method of applying topical fluoride in the institutionalized elderly. Fluoride gel (1.1% NaF) was applied to the facial tooth surfaces of 10 elderly nursing home residents using a sponge-type intraoral applicator (IA). Subsequently, the same subjects rinsed with a commercial fluoride solution (0.05% NaF). Salivary fluoride levels were then assessed by the Taves (1968) method. The IA with fluoride produced significantly higher salivary fluoride levels over a period of three hours compared with rinsing.

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PubMedDate not supplied

Non-institutionalized elderly dental patients in Israel: socio-demographics, health concerns, and dental anxiety.

The purpose of this study was to evaluate which factors might influence health care attitudes such as anxiety about dental care by older adults in Israel. The study population consisted of 103 non-institutionalized patients (46 men and 57 women) over the age of 65 who attended a dental clinic that provided services for older adults during a one-year period. Socio-demographic information and information about the subjects' general health and their level of concern about health problems were obtained from self-reported questionnaires, while the dental anxiety level was found by means of a dental anxiety scale (DAS). Ninety-nine percent of the patients suffered from a major systemic disease such as diabetes, hypertension, atherosclerosis, respiratory disease, and rheumatic disease. Both unmarried and first-time patients expressed high anxiety scores. Patients with 12 or fewer years of formal schooling demonstrated significantly higher dental anxiety. Among patients who regularly attended a synagogue or a social club, concern about oral health was significantly higher than for the rest (p < 0.02). No association was found between having dentures and gender, or between having dentures and level of education. The reason for visiting the clinic (inability to eat, pain, or esthetics) was not associated with any other health concern or with dental anxiety levels. This study determined that patients who were unmarried, less educated, or attending the facility for the first time were more likely to experience dental anxiety. These patients merit special consideration.

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PubMed1994

The prevalence of macular degeneration in a cohort of institutionalized geriatric glaucoma patients.

Four hundred and twenty-five eyes of 213 instiutionalized geriatric patients (mean age 83.9 years), were studied. Fundus could be seen in 136 patients, in 234 glaucomatous eyes and in 37 eyes without glaucoma. A separate group of 100 control patients, matched according to age, sex and reasons for institutionalizing (mean age 81.3 years) was also studied. Fundus could be seen in 78 patients. There was no difference in the occurrence of diabetes mellitus among the study group and controls, but cerebral thrombosis occurred statistically significantly more often in glaucoma patients than in the controls. Macular degeneration occurred in 41% (56/136) of the glaucoma patients; in 27% (63/234) of glaucomatous eyes and in 43% (16/37) of nonglaucomatous eyes. Macular degeneration occurred bilaterally in less than half of the glaucoma patients. Macular degeneration occurred in 37% (29/78) of the control patients and bilaterally in most of the patients.

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PubMed1993

Oral health status and treatment needs of non-institutionalized persons aged 60+ in Adelaide, South Australia.

There has been a growing recognition of the need to obtain information about the oral health of older Australians. The aim of this report is to provide descriptive epidemiological information about the oral health and treatment needs of non-institutionalized older adults in Adelaide. Data from interviews with 178 persons aged 60+ were obtained from a pilot study. Clinical data were available for 106 persons who participated in oral examinations. Among the 52.9 per cent of dentate persons, the prevalence of root decay (27.1 per cent) was slightly higher than coronal decay (23.6 per cent). Some 28.1 per cent of dentate persons had a serious periodontal condition, defined as the presence of four or more teeth with at least 5 mm or more of periodontal attachment loss and periodontal pocketing of 4 mm or more at one or more of those teeth. The majority of persons (83.8 per cent) wore one or two dentures. Disorders associated with dentures were frequent, affecting 77.4 per cent of upper denture wearers and 72.5 per cent of lower denture wearers. Persons who were older, who had lower educational attainment or lower household incomes were disadvantaged in aspects of oral health status and dental caries. However, there were no consistent associations between chronic medical conditions and oral disorders. Despite the high prevalence of oral impairment, reflecting extensive disease activity in the past, high levels of untreated disease were relatively uncommon. Instead, a high prevalence of oral disorders created a substantial need for basic forms of dental treatment in this group.

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PubMed1977

Individual psychotherapy with the institutionalized aged.

Contrary to the predisposition of many mental health professionals, this paper contends that insight-oriented, dynamically-based, individual psychotherapy is an effective treatment modality with the institutionalized elderly. Issues such as dependency, transference and countertransference, contrasts to psychotherapy with younger patients, and methodological modifications are discussed, and clinical examples are offered.

Adjustment Disorders↗

PubMed1990

Withdrawal of maintenance digoxin from institutionalized elderly.

Chronic use of digitalis is common amongst the institutionalized elderly. Associated with digitalis use is the potential for toxicity and/or adverse reactions. In this study maintenance digoxin was withdrawn from 14 elderly nursing home residents in sinus rhythm. Subjects were followed over 18 months for evidence of dysrhythmia or heart failure. One resident had an episode of supraventricular tachycardia which required digoxin to be restarted. One resident developed left heart failure, treated with oral diuretic. For 12 of the 14 residents, withdrawal of maintenance digoxin was achieved without deleterious effect. This study suggests that maintenance digoxin may be withdrawn safely in elderly nursing home residents in sinus rhythm and without history of atrial dysrhythmia.

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PubMed1997

Effect of micronutrient supplementation on infection in institutionalized elderly subjects: a controlled trial.

To determine the impact of a trace element and vitamin supplementation on infectious morbidity, a double-blind controlled trial was performed on 81 elderly subjects in a geriatric center during a 2-year period. Subjects were randomly assigned to one of four treatment groups, and received daily: placebo; trace elements/zinc 20 mg; selenium 100 micrograms); vitamins (vitamin C 120 mg; beta-carotene 6 mg; alpha-tocopherol 15 mg); or a combination of trace elements and vitamins at equal doses. (1) Before supplementation, low serum values in vitamin C, folate, zinc and selenium were observed in more than two thirds of the patients. (2) After 6 months of supplementation, a significant increase in vitamin and trace element serum levels was obtained in the corresponding treatment groups: a plateau was then observed for the whole study. (3) Subjects who received trace elements (zinc and selenium) alone or associated with vitamins had significantly less infectious events during the 2 years of supplementation. These results indicate that supplementation with low doses of vitamins and trace elements is able to rapidly correct corresponding deficiencies in the institutionalized elderly. Moreover, zinc and selenium reduced infectious events.

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PubMedDate not supplied

Relationship between clock-drawing and neuropsychological and functional status in elderly institutionalized patients with schizophrenia.

OBJECTIVE: The authors sought to examine the usefulness of the clock-drawing test (CDT) as a measure of general cognitive and adaptive functioning in elderly patients with schizophrenia. METHODS: CDT performance of elderly institutionalized patients with schizophrenia were contrasted with a comparison group, similar in age. Cognitive and functional status was examined using an expanded battery from the Consortium to Establish a Registry for Alzheimer's disease and the Psychogeriatric Dependency Rating Scale. RESULTS: Patients (N=21) performed more poorly overall on the CDT than the comparison group (N=21), with greater clock number and hand errors. Production of the clock's gestalt did not differ between groups. In patients, overall CDT performance and clock hand placement were significantly correlated with general cognitive functioning, memory, visuoconstruction, and word-list generation. CDT global and hand placement performances corresponded to patients' general orientation. CONCLUSIONS: Impaired CDT performance in elderly patients with schizophrenia is not attributable to normal aging. Also, the CDT uniquely relates to an array of cognitive abilities in this population, validating its multicognitive character and implicating multiple brain regions. The CDT's tolerability and brevity make it attractive for use in geriatric schizophrenia.

Adaptation, Psychological↗

PubMed1981

Aspiration pneumonia in institutionalized children. A retrospective comparison of treatment with penicillin G, clindamycin and carbenicillin.

The antibiotic therapy of aspiration pneumonia was retrospectively reviewed in 74 institutionalized children with lung abscess (10), necrotizing pneumonia (12), and pneumonitis (52). Anaerobic bacteria were isolated in 69 patients (93%); and in 67 (90.5%), they were mixed with aerobic bacteria. Penicillin G was given to 20 patients, clindamycin to 20, and carbenicillin to 34. Gentamicin was concurrently given to 35 of the patients. The mean duration of therapy in the three types of pulmonary infection was: lung abscess 30.2 days, necrotizing pneumonia 26.6 days, and pneumonitis 15.1 days. The mean duration of fever after initiation of therapy was 5.8 days, 8.1 days, and 3.4 days, respectively. The mean time for radiologic clearance was 35.6 days for lung abscess, 39.2 days for necrotizing pneumonia, and 13.5 days for pneumonitis. The three antibiotics were equally effective in all patients, including those from whom Bacteroides fragilis was recovered.

Bacteroides fragilis↗

PubMed1984

Behavioural assessment of disturbed, institutionalized retardates.

While behavioural assessment has had wide application in a number of educational and treatment settings, relatively little has been done to develop programmes specifically for use with retardates who have been institutionalized for the treatment of disturbed behaviour. As a result, the development of appropriate procedures for the latter group requires extrapolation from the use of behavioural techniques in other settings. The current literature on behavioural assessment stresses the importance of identifying meaningful response units and their controlling variables, if efficacious treatment programmes are to be mounted. To be maximally useful, assessment must provide a relatively simple description in objective, non-inferential terms of how a patient responds to the demands of daily living. While many reports of treatment programmes focus on the assessment of a single, narrowly defined variable, the occurrence of which can be readily counted, this is not appropriate for the initial assessment procedures of a residential treatment centre. What is required is an omnibus approach which samples the patient's responses to a broad array of environmental situations which are relevant to the centre and its population. A review of available behavioural scales reveals that there are very few reliable omnibus scales available for use with retardates and none which adequately assesses the behavioural concommitants of disturbed retardates. To deal with this group of patients, it is proposed that, initially, two scales be used to sample both normal and maladaptive behaviour. A number of suggestions have been made for implementing behavioural assessment procedures in residential treatment centres, especially for disturbed retardates.

Activities of Daily Living↗

PubMed1989

[Importance of medical information for the institutionalized patient].

Medical information given to patients, notably to psychiatric patients, is guided by laws. Before starting any treatment the patient's informed consent is needed. One of the criteria of validity for such a consent is adequate information of the subject. This study shows that certain factors interfere with the institutionalized patient's initial knowledge about medication, hospitalization and illness. It points out that learning is diminished by two factors: the diagnostic of schizophrenia and the length of stay in the hospital. However learning is not changed by severity of symptoms. On the other hand the initial knowledge level is diagnosis independent but altered in case of intense psychiatric symptomatology. Possible explanations of these data are discussed. In conclusion, the importance of the variable of learning capacity is shown in the practice of the informed consent for psychiatric patients. The learning capacity must be taken into account when the patient is informed. Finally, additional research on that subject is indicated particularly concerning the persons disabled by schizophrenia.

Chronic Disease↗

PubMed2003

School climate and the institutionalization of the CATCH program.

School climate refers to various physical and psychosocial structures that shape schools' social and physical environments. The Child and Adolescent Trial for Cardiovascular Health (CATCH) study provided an opportunity to study how aspects of school climate are associated with continued implementation of the CATCH program. Nutrient analysis of menus, observations of physical education (PE) classes, and teacher and staff self-reports were used to measure CATCH program components. Results of this study indicate that aspects of school climate were associated with continued implementation of the CATCH classroom component but not the CATCH food service or PE components. These findings have implications for how we plan for the progression of innovative school health promotion programs from the initial trial stage to institutionalization. Measures of school climate may be useful in determining a school's readiness to adopt and implement an innovative health promotion curriculum.

Adolescent↗

PubMed1985

Institutionalizing social support through the church and into the community.

The positive influence of social support on such health related outcomes as patient adherence to medical regimens and stress reduction at the worksite has captured the attention of public health researchers and practitioners alike. Yet, the broader social outcome of building community competency to undertake and sustain health related solutions without constant intervention from professionals still remains elusive. The difficulty may lie with the need to uncover on each occasion the various roles and functions of social support structures that may or may not exist in a given community. The intent would then be to graft an intervention onto these existing roles and functions in order to mirror the naturally occurring social support structures. A conceptual framework that has been used to institutionalize health related activities through the role and function of the black Church, as a social unit of identity and solution for rural black communities in North Carolina, is put forth for consideration.

Black or African American↗

PubMed1977

Rehabilitation of the institutionalized patient: description of a programme and follow-up of 60 patients.

The programme in an intensive rehabilitation unit in a large psychiatric hospital is described. Features include the use of non-medical staff as primary therapists, the use of a mini-bus to facilitate regular visits by patients to their home areas, the inclusion of the mini-bus driver on weekly staff conferences, the use of sociodrama, the re-organization of hospital money payments to patients, the promotion of relations with community-based facilities through occasional "teach-in" days, and a special liaison social worker providing intensive follow-up after discharge. Rehabilitation was prolonged (average stay about one year) and about half of those selected for rehabilitation from the long-stay wards were discharged. Follow-up showed that these patients benefited from discharge, in spite of a relatively high incidence of psychopathology and of social problems. Those transferred back to long-stay wards showed increased institutionalization.

Community Mental Health Services↗

PubMed1980

Themes elicited by the Senior Apperception Test in institutionalized older adults.

The Senior Apperception Test was administered to 40 older adults of both sexes ranging in age from 61 to 97 years (M age = 78.4 years) to investigate the themes elicited by the 16 SAT stimulus cards. All volunteers were screened to exclude individuals with: 1) cognitive impairments, or 2) any gross auditory, visual, and/or tactile impairment. Results found no consistent pattern of sex differences in responses. A thematic analysis illustrates that content themes depicting affiliation and physical limitations along with themes of dependency and description were the most predominant themes for an institutionalized older adult sample. The majority of the story outcomes were of an ambivalent nature and a neutral tenor. The implications of the results were discussed.

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