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At least 19 recordsLinked to original sources
PubMed2003

Old-age homes and services: old and new approaches to aged care.

Although generational co-residence continues to be the dominant form of housing and care for Indian elders and only 1% live in old-age homes, the numbers and types of these homes are growing. This article describes a recent study of 48 old-age homes in different parts of India, approximately 12%-15% of all homes. They included the more traditional free homes for the aged poor who have no family to care for them and the more recent for-pay homes for the middle-class. A small number of day-care centers, also a new phenomenon, were investigated. Two- to three-hour structured interviews were conducted with managers, supervisors, and trustees, augmented by a checklist of environmental and neighborhood features. Most homes house small numbers of residents, have common spaces for dining, TV and prayer, have access to medical care and transportation, provide meals and some assistance with activities of daily living, and are open to all castes. All are run by non-governmental organizations (NGOs), only one-third with any government assistance. Free homes tend to be bigger and older, serve nonaged clients, have less privacy and emphasize occupational therapy and income-generating activities, and are more like board-and-care homes. For-pay homes have more privacy and western-style amenities, focus on local community outreach and provide fewer meals. The gradual increase of all old-age homes has given rise to debates about their appropriate roles in Indian society and about their quality. Government grants to NGOs for homes and day-care centers (often considered more appropriate support for elders) are limited. With the National Policy on Older Persons looking to NGOs and village councils to be the primary sources of non-familial aged care, several ways to build their capacity are suggested.

Aged↗
PubMed2002

Orientation towards living in an old age home: an instrument to predict use of an old age home.

BACKGROUND: This study presents an alternative assessment method for establishing the demand for an old age home among a community-dwelling older population. The instrument, called 'orientation towards admission into an old age home', represents the intensity of the need for admission as expressed by older people themselves. Therefore it is indicative of the 'subjective demand'. METHODS: Using a longitudinal design (1993-98), the study tests whether a stronger orientation towards admission into an old age home leads to use of an old age home. This assessment method is compared with another method of assessing 'subjective demand', that is by those who have applied for and are waiting for admission. Additionally, the method is compared with an 'objective' indicator of demand, that is, the level of physical impairments and age of the elderly person. RESULTS: Results show that the subjective demand as measured by the 'orientation toward admission into an old age home' is indeed related to actual use of an old age home. The subjective demand as measured by being on a waiting list is not significantly related to the use of an old age home. The level of physical impairments (the objective demand) and age are sometimes, but not always, significantly related to the use of an old age home. CONCLUSION: The instrument 'orientation' provides us with a valuable instrument in assessing 'subjective demand' for an old age home among community-dwelling older people.

Activities of Daily Living↗
PubMed2006

Prevalence of tuberculous infection and active tuberculosis in old age homes in Hong Kong.

OBJECTIVES: To assess the prevalence of tuberculous infection and active tuberculosis (TB) in old age homes in Hong Kong and to determine whether there is institutional transmission in these homes. DESIGN: Cross-sectional. SETTING: Old age homes. PARTICIPANTS: Total of 2,243 residents, representing 84.6% of all residents in 15 old age homes; 1,698 were women, and 545 were men, with an average age of 82. MEASUREMENTS: All residents had a questionnaire-based interview, medical record review, two-stage tuberculin testing using two units purified protein derivative-RT23, and a chest x-ray. Those with radiological abnormalities had sputum examined for acid-fast bacilli. RESULTS: The estimated prevalence rate of active TB in this population was 669 per 100,000, significantly higher in men than in women (1,101 per 100,000 vs 530 per 100,000). The proportion with positive tuberculin reactivity (> or =10 mm induration) after two-stage testing was 68.6%, significantly higher in men than in women. There was no evidence of active transmission of disease in these old age homes, with restriction fragment length polymorphism (RFLP) analysis performed on five cases of active pulmonary TB in the home with the highest rate of TB showing unique RFLP patterns. CONCLUSION: The rate of active TB and TB infection in old age homes in Hong Kong is still high. Because treatment for latent TB carries a high risk for liver dysfunction in this population, clinicians and other healthcare workers need a high index of suspicion and to diagnose and treat this disease as early as possible to prevent transmission.

Aged↗
PubMed2003

Outreach pharmacy service in old age homes: a Hong Kong experience.

BACKGROUND: To explore drug-related problems in old age homes in Hong Kong through outreach pharmacy service. METHODS: A standard form was used by outreach pharmacists to identify drug-related problems at old age homes. Homes were selected through random sampling, voluntary participation or adverse selection. Initial observation and assessment were performed in the first and second weeks. Appropriate advice and recommendations were given upon assessment and supplemented by a written report. Educational talks were provided to staff of the homes in addition to other drug information materials. At week 7 to 9, evaluations were carried out. RESULTS: Eighty-five homes were assessed and identified to have problems in the drug management system. These problems could generally be classified into physical storage (8.8%), quality of storage (19.2%), drug administration system (13.3%), documentation (16.4%), and drug knowledge of staff of homes (42.2%). Quality of drug storage was the most common problem found, followed by documentation and drug knowledge (73%, 50% and 44% of points assessed with problems, respectively). Apart from lack of drug knowledge and unawareness of potential risks by staff, minimal professional standards unmet may be fundamentally related to lack of professional input and inadequacy in legislation. Most homes demonstrated significant improvements upon simple interventions, from a majority of homes with more than 10 problems to a majority with less than 5 problems. CONCLUSIONS: Diverse problems in drug management are common in old age homes, which warrants attention and professional inputs. Simple interventions and education by pharmacists are shown to be effective in improving the quality of drug management and hence care to residents. While future financing of old age home service can be reviewed within the social context to provide incentives for improvement, review of regulatory policy with enforcement may be more fundamental and effective in upholding the service standard.

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PubMed1997

Old-age homes & the profile of their residents.

Studies conducted on old-age homes and their inmates are reviewed. Though institutionalization of the elderly is a new phenomenon in India, a number of old-age homes have come up and there is a need for many more homes in India. Investigations with regard to the status of the aged in the changing social structure have more or less concluded on the breaking down of kinship and family organisations which has put the elderly in a state of helplessness, isolation and economic dependence.

Aged↗
PubMed2000

The composition of old age homes in South Africa in relation to the residents and nursing personnel.

This research project is the first phase of a larger study aimed at describing and exploring the cost-effective utilisation of nursing personnel in old age homes in South Africa. The aim in the first phase was to describe the composition of the residents and nursing personnel of old age homes in South Africa. An exploratory and descriptive survey was conducted and the data was collected by means of a questionnaire. The questionnaire also included data on the financial implications of utilising professional nursing personnel to manage the care of the frail residents/older persons in old age homes in South Africa. The questionnaires were mailed to 612 old age homes published in the Hospital and Nursing Yearbook of 1997 (100% sample). A total of 145 (23.69%) questionnaires were returned and included in the descriptive data analysis. The residents are mainly female (77%), older than 85 years of age, belong to the white race group (83.74%) and are highly dependent on nursing care and supervision (69.7%). Old age homes are mainly managed/controlled by welfare organisations and lay health care workers are utilised to a large extent (42.22% of the nursing workforce) to render nursing care to the frail residents. The cost-effective utilisation of nursing personnel (registered and enrolled), as well as the utilisation of lay health workers in old age homes, needs to be critically examined.

Age Distribution↗
PubMed2004

Association between functional dental state and dietary intake of Chinese vegetarian old age home residents.

OBJECTIVE: To examine the association between dental functional status and dietary intakes of Chinese vegetarian old age home residents. SUBJECTS AND METHODS: A cross-sectional survey was performed in a group of 76 older vegetarian Chinese women living in an old age home. Oral examination was performed by a dental surgeon. Sixty-eight of them had a 24-hour food record by direct observation, analysed by a Chinese food composition table. Nutritional status was measured by Body Mass Index (BMI), and the functional status by modified Barthel Index (BI). RESULTS: Forty-two subjects (55.3%) were edentulous; 59 subjects (77.6%) had chewing difficulties; 35 subjects (46%) had poor dental functional status defined by having five or less functional teeth unit (FTU). When compared with those older people with better dental functional status, the poor dental functional status group was more likely to have chewing difficulties, tolerate soft diet only, and be functionally dependent (BI < 15/20). Poor dental functional status was associated with lower mean daily fibre intake, but not with intakes of macronutrients and micronutrients, after adjustment by BI categories. CONCLUSION: Poor dental functional status is associated with impaired chewing and lower fibre intake in Chinese vegetarian old age home residents, but it is not associated with reduced intakes of macronutrients or micronutrients.

Activities of Daily Living↗
PubMed1999

Outcome of psychogeriatric intervention in an old-age home: a 3 years follow-up study.

Psychogeriatrics and especially psychiatric services in nursing and old-age homes are sorely lacking in research. Four years ago we developed and implemented a model for service delivery for old-age homes within our hospitals' catchment area. In the first year of operation 48 of 373 residents (13%) were evaluated and treated by a psychogeriatrician. The aim of the present study was to evaluate outcome of these patients three years later. All patients and medical records were re-assessed. During the three-year period 16/48 subjects (33.3%) passed away; of these half were previously diagnosed as suffering from a major depressive episode. None of the subjects who died had attempted suicide. Following a preliminary diagnosis of affective spectrum disorder, 4/48 patients (8.3%) were re-diagnosed at follow up as suffering from dementia. Full or partial remission of the original symptomatology was achieved in 18/32 surviving subjects (50.7%); mostly depressed or anxious patients. We conclude that although mortality rate among elderly psychiatric patients is high persistent interventions lead to successful remission in the majority of patients.

Aged↗
PubMed2006

Prevalence and determinants of positive tuberculin reactions of residents in old age homes in Hong Kong.

OBJECTIVE: To determine the prevalence of tuberculous infection and the predictors of positive tuberculin reactivity in old age home residents in Hong Kong. DESIGN: Cross-sectional study. METHODS: A questionnaire-interview and review of medical records were carried out, together with measurement of weight and height/arm span and assessment of nutritional status. A one-stage tuberculin skin test (TST) was performed using two units of PPD RT23. An induration > or = 10 mm was considered as positive. RESULTS: Of 3682 residents (71.7% participation, mean age 82 years) who agreed to undergo a TST, 46.3% had a positive reaction. Factors associated with a significantly higher risk of a positive TST included being male, an ex- or current smoker and having a past history of tuberculosis (TB). Factors associated with reduced positive tuberculin reactivity included older age groups (> 70 years), a history of cancer and chronic obstructive pulmonary disease and low body mass index quartiles. CONCLUSION: In old age homes, the high prevalence of latent tuberculous infection is responsible for the high rate of active TB due to reactivation. Early diagnosis and treatment are necessary to prevent transmission of disease in these crowded environments with susceptible individuals.

Age Factors↗
PubMed1999

Alcohol problems among residents in old age homes in the city of Mannheim, Germany.

OBJECTIVE: This study aims to determine the prevalence of alcohol problems among residents in old age homes, its demographic and clinical features, and its association with the risk of falling. METHOD: All residents (n = 1922) living in 20 randomly selected residential and nursing homes in the city of Mannheim, Germany, were included. Based on routine documentation, details of their sociodemographic features, medical diagnoses made upon admission, and current medication were compiled. The home staff filled out for each resident a standardised assessment sheet on activities of daily living-impairment (Barthel Index), behaviour problems, alcohol consumption, and frequency of falls. RESULTS: According to the diagnoses of the primary care physicians, 7.4% of the residents had mental and behavioural disorders due to alcohol (ICD-10: F10). Rates were particularly high among men, and younger and single or divorced residents. A high percentage of those with a diagnosis of alcohol abuse/dependence (41.1%) were transferred from mental hospitals. Home staff reported current alcohol abuse/dependence among 3.4% of all residents. The risk of falling was significantly elevated (Odds ratio: 2.65; p<0.01) among those with current alcohol problems. CONCLUSION: The results corroborate the findings from other studies wherein residents of old age homes constitute a group at risk of alcohol abuse and dependence. Alcohol problems were more the cause for, rather than the consequence of, home admission.

Accidental Falls↗
PubMed1982

Elderly persons in old-age homes. A medical, psychiatric and social investigation.

A survey of 100 consecutive admissions to homes for elderly Whites in Cape Town showed that an interplay of social, physical and psychiatric factors was responsible for most of the referrals, although psychiatric factors contributed to more than 50% of them. The largest proportion (37%) suffered from confusional states, 31% were diagnosed as having a senile organic condition and 25% showed moderate to severe depression. These old people were physically very frail; 53% had incapacitating muscular weakness or stiff and painful joints, 35% had a significant degree of deafness, 25% had a visual defect and 23% were incontinent. The findings indicate that old-age homes deal with a considerable amount of physical and mental ill health, and they are therefore an essential part of health services. The residents of old-age homes were much older than elderly people in the community, as well as being more socially isolated and very disadvantaged in terms of income and family and social support.

Activities of Daily Living↗
PubMed1978

Investigations on the fauna of beds in flats, children's sanatoria and old-age homes.

An analysis was carried of the fauna found in 338 beds from two old-age homes and from flats inhabited by asthmatic children. During hospitalization of these children the fauna in the flats was compared with that found in beds used by them in sanatoria. The most abundant species proved to be Dermatophagoides pteronyssinus that is also widely spread in other countries of Europe. The bed fauna in the sanatoria is very poor, corresponding to the improved state of health of patients during hospitalization. The authors assume that the low population density of fauna is influenced by constant airing of rooms and by strict separation of bedrooms from dining halls and other premises. Also the number of mites in different padding material used in mattresses was evaluated and an analysis of the general fauna per bed was carried out.

Aged↗
PubMed2000

Crusted (Norwegian) scabies in two old-age home residents.

Scabies is commonly seen in hospitals, where it frequently affects geriatric and convalescent patients. The clinical features of the classic form of scabies are well recognised. Crusted (Norwegian) scabies, which is a hyperinfestation variant of scabies, is very contagious and can present as other dermatoses, thus delaying the correct diagnosis and management. Two residents of different old-age homes presented with hyperkeratotic skin eruptions, which later proved to be crusted scabies. In both cases, the scabies was initially misdiagnosed as eczema. The delay in making a correct diagnosis led to an outbreak of scabies in the old-age home in which one of the patients was residing.

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PubMed1984

Poorhouses and the origins of the public old age home.

Public welfare in America--and its often ungainly structures--is as old and as varied as the history and social experiences of the last three hundred years. In the nineteenth century the poorhouse became the central arch of public welfare policy. Even in the twentieth century it did not disappear, but was gradually transformed into the public old age home.

Child Welfare↗