Dentistry for the homebound and institutionalized: the University of Manitoba's Home Dental Care Program.
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Too often survey reports, studies and well advised considerations by health researchers follow one another and pile up without any real application in the day-to-day life. For example, most health professionals and health care workers and even the public in general have deplored the fact, when they read the study done by Brodeur and Simard in 1982 on the dental health of the elderly, that 72 per cent of the Quebecers of 65 years of age and older were edentulous. Yet, since this study has been published, there has been no blitz or systematic action to improve the dental health of the elderly. Unless I'm mistaken, efforts were made mostly to promote prevention among the younger generations. In the Quebec Province, the works of Dr Vallée have of course fostered some progress in the field of Geriatric Dentistry. However, it must be said again that real positive actions for the elderly patients remain few if not exceptional. Perhaps are we right when we say that seniors as a social group are somewhat neglected. Perhaps also do we consider them as a group for which there is not much left to be done... In reality, dental healthwise, is there anything better than to wish for the young generations not to have the deplorable fate of the elderly?
The scores of two samples of 200 subjects each on five factors of a measure of adaptive behavior were subjected to cluster analysis using two hierarchical agglomerative clustering methods. Three clusters were found that proved stable across clustering methods, subject samples, and time points 3 years apart. In addition, cluster membership was shown to be meaningfully associated with a number of demographic characteristics and neurological and sensory handicaps. The three-cluster solution thus possesses some desirable features, but its practical utility remains to be demonstrated.
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All aged persons being helped by community nursing-services, the house-helper service, the housekeeper service, or living in a home for the aged or in an apartment for seniors in a representative area of the city of Zurich are compared to all patients in nursing-homes of the city. This study included the size of social network measured by the number of different regular visitors, the number of different medications taken daily, the cognitive abilities measured by the Mini Mental Status, the activities of daily living and the social skills rated by the care-givers as well as the intensity of the care given. The groups were similar in age and sex-distribution but the nursing-home patients differed significantly in all other parameters from the others. In contrast, no significant differences could be found between persons receiving care in their homes and those in institutions for the aged.
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The maladaptive behavior of 474 persons from a residential facility for mentally retarded individuals was investigated. Eleven independent variables pertaining to demographic and environmental characteristics were initially related to the frequency and topography of residents' maladaptive behavior. Multiple regression analysis revealed that maladaptive behaviors were related to sex, social age, chronological age, resident's time spent on outside activities, number of residents per direct-care staff member, presence of sensory handicaps, and ambulation. Results were related to existing literature and discussed in terms of their use for intervention efforts and differential assignment of resources.
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The effects of age on the adaptive behavior of individuals with Down syndrome and matched individuals in other diagnostic categories were compared in three studies. The only study that provided evidence of a decline in competence among older individuals with Down syndrome was the one study in which the oldest age category was 60 years and over. In that study, a significant Age X Diagnosis interaction was found for the Motor Development factor of the Client Development Evaluation Report, reflecting a sharp drop in the scores of some of the oldest subjects with Down syndrome. These results resemble those of other recent research in two respects: the age at which the decline in competence occurred and the nature of that decline.
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