memory training is a potential intervention for retaining memory and reducing dementia risk in older adults with mild cognitive impairment (MCI).
this study examined the effect of virtual interactive ...working memory training (VIMT) in older adults with MCI.
single-blind, two-arm parallel-group, randomised controlled design.
retirement homes, institutions, and communities.
a total of 66 older adults with MCI were recruited (mean age: 78.5 ± 7.6 years).
participants were randomly assigned to the experimental group (VIMT, n = 33) or active control group (n = 33). The VIMT program used the CogniPlus (includes four training modules). Both groups attended 45 min sessions 3 times per week, a total of 36 sessions. The primary outcome was working memory; secondary outcomes were immediate memory, delayed memory, subjective memory complaints and global cognitive function. All variables were measured at pre-test, post-test, and 3-month follow-up.
between group, the effect of working memory adjusted mean difference by 1.75 (95% CI: 0.56 to 2.94; P < 0.01) at post-test. The results were analysed by a generalised estimating equation, which indicated that VIMT group significantly improved working memory at post-test (P = 0.01) relative to the active control group.
the applied VIMT program can enable older adults with MCI to maintain their working memory and reduce the rate of cognitive deterioration.
This trial was registered on ClinicalTrials.gov (no.: NCT02462135).
The mental health of an increasing ageing population is an important part of healthcare. Research has explored means to enrich the lives of older adults living in residential settings, including ...approaches like the Eden Alternative. This is a cross-sectional, qualitative study with a quantitative component. It looks at common mental health conditions (CMHCs) in residential-living older adults in South Africa and describes their experiences of intergenerational interactions with playschool children. Participants completed a questionnaire which included the Geriatric Depression Scale and Geriatric Anxiety Scale and a semi-structured interview. Anxiety and depression were common in the sample with limited awareness of non-pharmacological therapy available at the facility. The intergenerational interactions were experienced positively with emerging themes of belonging, sense of purpose, reminiscence and positive affective experiences, but influenced by participants' preconceptions of children. The study concludes that intergenerational interactions may serve as adjunctive therapy in managing CMHCs in residential-living older adults. Recommendations are made for successful implementation of such programs.
Aims
To estimate and model the types and frequencies of care that nurses and carers self‐identify as being missed in the Australian residential aged care sector.
Background
The study advances missed ...care research to explore how the care of elderly Australians is compromised.
Methods
A multi‐variate approach was used to apply the consensus scores of 2,467 staff to missed opportunities for resident health promotion and restorative care.
Results
Eight latent care variables have direct predictor effects on missed Australian residential aged care, all of which are largely under the control of residential care management, with the exception of the physical locality of the aged care settings.
Conclusion
Missed care, associated with maximizing the residents’ life potential, relieving their distress and maintaining their current health can be quantified and predicted.
Implications for Nursing Management
Aged care policies that maximize adequate staffing numbers with appropriate levels of skill are paramount to minimizing missed Australian residential care.
In Australia and many other countries internationally, aged care services are provided to older people in their own homes or residential care facilities. The majority of these services are funded by ...the federal government using taxpayer contributions from the general public. However, the monetary value Australians place on aged care services, and the factors that predict this value, have not been examined. We, therefore, sought to determine the general public's willingness to pay (WTP) for aged care services and examine which factors influence this WTP. A cross-sectional contingent valuation survey was administered to a nationally representative cohort of 10,285 Australians between September and October 2020 from the general population aged 18 years and over. Respondents were asked to indicate their WTP values for satisfactory and high-quality aged care services to be provided in the future. A two-part regression model was used to explain what factors explained variation in WTP. In total, 80% (61%) of respondents were willing to pay to access satisfactory (high) quality home care (counterpart figures for residential care were 64% (45%)). On average, respondents were willing to pay between $126 and $158 ($145 and $237) per week to receive satisfactory-quality (high-quality) home care and between $333 and $520 ($308 and $680) per week for satisfactory-quality (high-quality) residential care. Respondents were willing to pay an additional $120 per week on average to access high-quality aged care. Higher WTP values were generally associated with being younger, male, recent experience with aged care through a close family member accessing aged care and ability to pay. These results suggest general public support for payment of individual co-contributions to access aged care services in the future.
•We determined how much Australians value quality gradations in aged care services.•Australians are willing to pay between $126 and $237 per week to receive home care.•Australians are willing to pay $333 to $680 per week for residential care.•Australians are willing to pay $120 more weekly to access higher-quality aged care.•These figures differed according to subgroups such as gender and location.
Only a few studies have been conducted so far on the long-term impact of war. We investigated whether a life-long impact of the war experiences could be detected in advanced-agers who have ...successfully overcome all life's challenges. The participants in this study were oldest-old (80+ years) residents of retirement homes in Zagreb (Croatia), who were divided into two groups – ‘war-exposed’ and ‘not-exposed’ – according to their direct war experience (First World War, Second World War, Croatian Homeland War). Within this 1906–1928 birth cohort, a higher percentage of participants with war experiences reached extreme longevity (95+ years). We found no significant difference (p < 0.01) between the two groups concerning demographic and socio-economic characteristics, their life satisfaction, their self-rated current health and functional ability status. Despite numerous similarities, several traits related to life-history, current quality of life, attitudes and reflections distinguish the group of participants with direct war experience. The kind of war involvement – active military service, imprisonment in concentration camps or prisons, forced migration due to war and war-related death of close family members – stretched through various aspects of the life-history features, quality of life and attitudes. It differed for men and women, so it is no wonder that the significance pattern in the two genders mostly seems mutually exclusive. Socio-economic situations strongly differed by gender and according to the kind of war exposure, amplifying the differences within the ‘war-exposed’ group in terms of the life-long impact of wars on their lives. Therefore, we could claim that the war experiences were not the same for everybody, and that they had lasting consequences on the lifecourse of persons who directly faced war-related events. The results also point to the high resilience capacity as a common feature among persons who survived direct exposure to at least two wars and yet survived to exceptionally old age.
Elaboration of the Gothenburg model of person‐centred care Britten, Nicky; Moore, Lucy; Lydahl, Doris ...
Health expectations : an international journal of public participation in health care and health policy,
June 2017, Volume:
20, Issue:
3
Journal Article
Peer reviewed
Open access
Background
Person‐centred care (PCC) is increasingly advocated as a new way of delivering health care, but there is little evidence that it is widely practised. The University of Gothenburg Centre ...for Person‐Centred Care (GPCC) was set up in 2010 to develop and implement person‐centred care in clinical practice on the basis of three routines. These routines are based on eliciting the patient's narrative to initiate a partnership; working the partnership to achieve commonly agreed goals; and using documentation to safeguard the partnership and record the person's narrative and shared goals.
Objective
In this paper, we aimed to explore professionals' understanding of PCC routines as they implement the GPCC model in a range of different settings.
Methods
We conducted a qualitative study and interviewed 18 clinician‐researchers from five health‐care professions who were working in seven diverse GPCC projects.
Results
Interviewees’ accounts of PCC emphasized the ways in which persons are seen as different from patients; the variable emphasis placed on the person's goals; and the role of the person's own resources in building partnerships.
Conclusion
This study illustrates what is needed for health‐care professionals to implement PCC in everyday practice: the recognition of the person is as important as the specific practical routines. Interviewees described the need to change the clinical mindset and to develop the ways of integrating people's narratives with clinical practice.
This study undertakes a spatial analysis of an Australian aged care setting where residents receive person-centred support in a specially-designed home-like environment. Focus groups were conducted ...with staff to explore the impact of the built environment in a new residential aged care setting that has implemented a Household Model of care for people living with mental health conditions. Drawing on Actor-Network Theory and proxemics, we mapped how the built environment supports improved behaviours and care practices in four areas: food preparation and dining, sleep and self-care, site layout, and relationships.
•The built environment is key to successfully delivering a Household Model of residential aged care.•A lens of scale (proxemics) is useful in analysing the effects of the built environment on care.•Dining, relationships, sleep, hygiene, social connections and community participation are all affected by the built environment.•Staff practices are influenced by the built environment at a range of scales (bathrooms /bedrooms, site layout and the neighbourhood it is located within).•The built environment can be considered an active participant in caregiving activities (illustrated here as an actant within an Actor Network Theory network).
The work presents the possibilities of using PVC window units in the historical buildings. There are reasons of their widespread use in projects of adaptation of historical buildings for modern use. ...The analysis of possible replacement options of window units of the historical heritage is done according to their architectural and historical values of the exterior and the interior. A review is made of the existing technological capabilities of modern PVC window systems used in the historical buildings. Examples of application of PVC window units in historical buildings of various architectural styles are given. Examples of structural solutions of window units and stained glass windows made of PVC in historical heritage are considered. The analysis of perspective ways of the use of modern types of translucent fillings in historical buildings can significantly improve the energy performance of these buildings and provide them with conditions that meet the modern requirements of comfort and safety.
Aims and objectives
To describe nurses’ experiences of palliative care for older people with advanced dementia living in residential aged care units.
Background
Dementia is a global health problem ...and the number of older people with dementia who need palliative care is increasing. Previous research has revealed that care for older people with dementia in the final stage of life is usually complex. However, little is known about how nurses experience palliative care for older people with advanced dementia living in residential aged care units.
Method
Nine individual, semi‐structured face‐to‐face interviews with nurses working in residential aged care units for older people with advanced dementia in palliative care in Western Sweden were analysed using qualitative inductive content analysis. The COREQ checklist was followed.
Results
The nurses considered that palliative care for older people with advanced dementia is a complex and challenging form of care. In particular, they identified three challenges that must be met: developing specialised knowledge and skills, developing teamwork as a working method and creating a caring relationship.
Conclusions
The results of our analysis indicate that if nurses are aware of and understand that the challenges are essential for “joining all the pieces together,” the palliative care for older people with advanced dementia may become a positive experience for nurses and may increase their sense of satisfaction and security in their professional role.
Relevance to clinical practice
For the palliative care to be successful, the nurses need to “join all the pieces together,” that is succeed in developing specialised knowledge and skills, developing teamwork as a working method and creating a caring relationship to establish a person‐centred care with the older person with advanced dementia and with his or her relatives.
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