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From the Italian National Dementia Plan to the Dementia Friendly Communities
117-142Views:77This article explores various aspects related to dementia care and support in Italy. It begins by discussing the National Dementia Plan of Italy, highlighting its goals and initiatives. It then focuses on the Veneto Region and their innovative approach to supporting people with dementia through the implementation of the Dementia Map, an online support system. The article also highlights the importance of dissemination publications in raising awareness and sharing knowledge about dementia care practices. Furthermore, it delves into the pilot project of Abbiategrasso, the first Dementia Friendly City in Italy, showcasing the efforts made to create a community that is inclusive and supportive of individuals with dementia. The experiences and lessons learned from this project serve as valuable insights for other communities aiming to become dementia friendly. In conclusion, the article emphasizes the significance of collaborative efforts, innovative approaches, and community engagement in improving the lives of individuals with dementia and their caregivers. It underlines the importance of continuous advancements in dementia care and the need for ongoing support systems to meet the evolving needs of those affected. The bibliography provides a list of relevant sources and references that further explore the topics covered in the article.
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Early recognition of dementia within the family
17-18Views:120The awareness of communities with dementia in Western Europe has moved closer to recognizing priority issues such as the environment or climate change. Dementia-friendly communities how have a history of 30 years and have achieved significant results through their work, both for those affected by the disease and those not directly affected. It probably affects many families, the topic is also getting into the spotlight in Hungary.
Without specific and detailed statistics and databases, dementia currently exists in the latent zone. The vast majority of the literature defines dementia as a diesease for which there is no treatment or cure. The effect of dementia is considered primarily as problems in the brain that negatively affect clear thinking, memory processes and result in additional emotional turbulence. Dementia is known as an age-related condition.
In general, dementia is identified as senility, incorrectly. Dementia can occur in different areas and at different levels in individual patients. As a result, families affected by the disease often face serious difficulties in identifying the disease. Without proper and detailed knowledge of the diagnosis, many families struggle with the situation of self care solutions at home. This personal involvement not only imposes a significant financial and emotional burden on the family but also often leads to separation and isolation, which can have additional negative effects on the disease itself and even on the mental health of the patient’s family members.
The global extent of dementia is generally known only to experts in the field, and to this day there is still a lack of adequate representation in the wider social dialogue. There is a unique and innovative incentive in Gyöngyös where Matralab’s integrated care centers offer day-care activities and solutions to support and provide experts advice to families with dementia. The project is implemented at the regional level, where 25 municipalities start monitoring the conditions and impacts of dementia in the region. As dementia is a prevalent and identifiable condition, affected families need help and support at the widest possible level.
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Dementia and family. The role of Alzheimer cafe in reducing the burden of caregiving families
34-46.Views:268In the last years, the international researches have turned towards families caring for elderly people with dementia /see the works of Zarit et al. 1985, 2005; Aneshensel et al. 1995; and Kaplan 1996/. The majority of these researchers analysed the stress burden of the caring family member and its consequences, role conflicts, and the tensions in the caregiving family (Zarit et al. 1985; Aneshensel et al. 1995; Kaplan 1996; Zarit et al. 2005). The revelation that in terms of Romania, we know nothing or almost nothing about the burden of families caring for elderly people with dementia and its effect on the primary carer, played was an important factor in the choice of topic. This is why, in a vast empirical analysis, in Transylvania, 50 interviews and questionnaire surveys were made with people caring for elderly with dementia in their own homes and 50 families whose relatives with dementia have been moved to a long-term residential home in the past 12 months from the time of the survey. Gathering data took three years (2015–2017). The research included the inquiry interview with the primary caregiver family member, in which we assessed the functional barriers and the psychosocial difficulties (Szabó 2000). The analysis of the levels of social skills was built upon this, and it unfolded the main characteristics of self-sufficiency, existing social skills, and social adaptation. This survey pointed out the everyday tasks in which the client requires help. With regard to family care, we have also analysed the independent living ability of people with dementia. These three angles offered the guidelines for the assessment of “objective burden” of the caring family member. Reviewing the distribution of caring tasks within the family is based on this, which helps us finding out who the key persons are, the ones undertaking the primary caregiving duties. For analysing the formation of roles within the family, we have devised our own criteria (Szabó–Kiss 2015). Starting from the objective burden, in regard to the “subjective burden”, we have obtained valuable indications about the emotional effect of caregiving family member. The detailed assessment of self-sufficiency through which we have analysed the measure of functional degradation of people living with dementia, was added to the devices of the analysis (Szabó 2000). The internationally approved scale of memory and behavioural problems (Zarit 1985) is connected to this, which measures the distractive attitude of the person living with dementia and its effect on the primary caregiver. The survey of the primary caregiver’s burdening is also connected (Zarit 1985), and so is the assessment of the negative and positive attitude towards the caregiving tasks (Farran et al. 1999). A six-step focus group is added to the devices of the research, in which the primary caregivers, by hearing each other’s cases and following thematic questions, open up more easily about the critical periods of caregiving and the pivotal factors of institutional placement.
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Application of Hungarian version of Test Your Memory (TYM-HUN)
25-33.Views:1220The change in brain functions is a natural consequence of aging, e.g. difficult to recall names, to remember numbers, to learn new things. However, mental decline and dementia are not part of natural aging. Dementia is primarily a disease of the elderly. Neuropathology of Alheimer’s dementia starts long before the clinical symptoms of dementia, part of a mild cognitive impairment (MCI) might be due to this. At this stage, recognizing the cognitive dysfunction may give the opportunity to slow down the progression, respectively as soon as causal treatment becomes available, it could be used. The Hungarian version of "Test Your Memory" (TYM-HUN) is a suitable short self-test test for screening dementia and is also expected to be useful to detect MCI.
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Staff Training and Stress in Long Term Care Facilities Special Care Units for Alzheimer's Elders
43-44Views:67Objective:
Special Care Units (SCU) in long term care health facilities are named to indicate "unique to diagnosis" or a level of care. The purpose of this study was to explore perceptions among caregivers and licensed nurses in selected nursing homes in Ohio and Pennsylvania and New York, as they pertained to the differences in care to Alzheimer's elders in SCUs. It examined the education and experience of staff and the satisfaction of this staff as it pertained to stress and wages.Background:
Long-term caregivers often experience stress, resulting in "burn-out" as a consequence of limited training, levels of care required, cognitive decline of elders and family expectations. The caregivers, on SCUs, environmentally designed for the elders with cognitive decline, need specialized training in the physical and mental dimensions of the various forms of dementia, Alzheimer's type.Methods:
The study used a qualitative research design with a survey questionnaire and one-on-one interviews with administrators and human resource directors. A pilot study of SCUs in Ohio and Pennsylvania and New York was initiated. The population was the employees of these SCU. The levels of employees questioned included: Executive director/Administrator, nurses, nurse aides, housekeepers and activities staff, laundry and social service workers. The procedure was standardized to enhance the reliability of the data. The respondents were notified in advance of the specific application of their answers and were afforded the opportunity to receive a monetary donation to the SCU of their respective facilities.
An Eden Alternative Home, with a program of goals and missions characterizing enhancement of an elder's life, a home-like environment and family-centered staff and care, in a very rural area of Pennsylvania, was also engaged to contrast and compare the hypotheses of the study.Results:
On the SCU, less than 5 percent of the staff had received training specific to the care of the Alzheimer's elders. In the Eden Home, 100 percent of the staff had received training specific to the care of the Alzheimer's elders. On the SCU, less than 18 percent were satisfied with the quality and quantity of specialized and extensive training. In the Eden Home, 100 percent of the staff was satisfied with their specific training. On the SCU, using a Leiken scale, more than 55 percent felt that they should receive higher wages. In the Eden home, the results were the same. However, the longevity of the employees was 13.5 years as opposed to only 3.25 years in the SCU in other homes.Conclusion:
These findings suggest there is a need to examine, expand and intensify the training of all caregivers on a special unit for the elders afflicted with dementia, Alzheimer's type. -
The role of urban green spaces in the well-being of people with dementia and their carers
50-77Views:225The aim of our empirical research was to explore how walking in green spaces in urban neighbourhoods contributes to the well-being of people with dementia and their informal carers. The study involved 3 caregiver – care recipient dyads, with carers keeping diary entries of regular walks together for a month (April-May 2021). In addition to the diary writing, carers completed a quantitative questionnaire as part of their research, in which they assessed their own and their relative's mental and mood state and their interaction before, during and after the walk. Based on the assessments of the questionnaires received from the 39 walks, results showed significant improvements in mental state and mood for both carers and cared-for persons, as well as in the way their dyads interacted with each other as a result of the walk. This trend was also supported and explained by the textual content of the diary entries. Thus, our small sample study was able to demonstrate that in the case of the caregiver – care recipient dyads we studied, a walk in an urban green environment had a positive effect on the mood and mental state of both partners, as well as on their cooperation. The significance of our results is that they support the role of urban green spaces in health promotion among chronic patients and their informal caregivers in a national sample: walking in nature can thus be considered a low-cost, generally positive and relatively easy and accessible intervention with a high impact.
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The impact of Covid-19 pandemic on older adults with dementia and their caregivers: a narrative review
46-49Views:57The purpose was to gather the existing literature, provide an up-to-date overview and, in the future, to continue the research for this important topic.
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The rights of psychiatric patients, especially in the field of dementia care
84-85Views:25Given the demographics of Hungary's population, the aging process and the change in the age composition project an increasingly worrying future. In an aging society, both the provision of care within the social sector and the provision of specialist care within the health sector are facing an ever-increasing anomaly. The growing number of people over the age of 65, including mostly demented people, as well as people who are limited in self-care and need professional help, must be provided to an increasing extent by the care systems. We are facing a current problem that has affected almost every family directly or indirectly. It is not only the provision of professional care that must be solved for the family members, but also the knowledge of the legal regulation of the special situation during the care, the knowledge of the rights and obligations for the care provider, as well as for the patients and their relatives.
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Starting from scratch: realities of older Maltese ex-sisters
7-8Views:45Statistics have revealed how not only globally but also in Malta the number of women religious has decreased. This study delved into the experiences of older ex-sisters from apostolic congregations who held simple vows, lived in the convent, subsequently leaving the congregation.
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Insights into the lived experience of Long-Term Care and End of Life Transitions in Malta
3-4Views:45In this keynote presentation, I explore the profound implications of the global demographic shift towards an ageing population. I delve into the challenges and opportunities presented by this shift, using Malta as a unique case study with 25% of its citizens aged 60 and older. The dense population poses challenges for infrastructure, healthcare access, and the overall well-being of older individuals.
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Prevention is the key - a multidimensional model for social well-being of the elderly
15-16Views:69Our research group identified a huge need for research on social well-being in the elderly population. In Hungary so far not much has been published in this topic, however, understanding the key elements of well-being is a growing area of research in gerontology all around the world, since it is crucial how we manage our lives in old age.
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Alzheimer's disease in the context of social work from the perspective of family caregivers
29-30Views:40In the context of rising quality of life and improving living conditions, as well as improving health care, people are now living to a higher age than in the past. Alzheimer's disease is the most common form of dementia in European countries. As a result of the development of the disease, individuals are often dependent on the help and care of other people, in most cases family members. This care interferes with the functioning of the family, so monitoring the needs and assistance for family members is essential.
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Physical Restraint Use within Maltese Long-Term Care Settings
9-10Views:41The holistic study looked at the locally unexplored environment, providing a platform of knowledge base and information on physical restraint use. The project secured relevant information focal to the older person residents, health care providers and policy makers within long-term care settings.
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Prelevance of falls in seniors hospitalized on gerontopsychiatric department, their risk factors and possibilities of preventive interventions
34-37Views:122Introduction:
Falls and associated injuries are a serious problem for seniors in the home as well as in the medical environment. The main goal was to approach the issue of falls in the elderly in hospital facilities with regard to gerontopsychiatric issues and psychiatric treatment.
Methodology:
We used a questionnaire to find out the prevalence of falls in the elderly, the use of preventive measures and their effectiveness. The questionnaire had three sections that focused on demographics, medication, fall during hospitalization, a "Simple Screening Tool for Risk Assessment," and questions for nurses about the use of preventative measures. The sample consisted of 113 seniors in the age category over 65 years hospitalized in the psychiatric hospital Hronovce.
Results:
Based on the data obtained, there were no significant differences in the incidence of falls when comparing the age category up to 75 years and over 75 years. We can state that gerontopsychiatric patients are at risk of falling, regardless of their age. Of all participating survey respondents 46.9% fell and 53.1% did not fall during the study period, with 31% of patients falling repeatedly and 15.9% of patients fell once. In the survey sample 100% of respondents were taking psychotropic drugs, 46.9% were taking risk medication - benzodiazepines, and these respondents had a fall at least once during their hospitalization. We found out that the risk of falling is increased by almost half in patients with nocturnal disorientation, sensory disorders and dementia. In the group of respondents (56.7%) who needed help with movement, falls occurred more often than in patients without restricted movement ability, but the differences were not significant. Problems with defecation led to a higher prevalence of falls. Among seniors who fell, there were 14.2% of them who did not have a problem with defecation compared to 32.7% who had a problem with defecation or suffered from incontinence. Nurses used the most frequently some environmental adjustments in 66.4%, increased supervision of high-risk patients in 52.2%, and nurses used multiple interventions in 67.3% of cases as preventive measures against falls in the observed group of patients. Nurses considered as proven interventions: increased supervision of high-risk patients (16.0%), use of compensatory aids when walking (5.0%), suitable footwear, (14.0%), adjustments of the environment (29%) rehabilitation exercises (13.0%), adherence to a drinking regime (7.0%).
Conclusion:
In seniors with mental illness there was a higher incidence of falls regardless of age, the use of psychopharmacological treatment, especially in the form of benzodiazepines, led to a higher incidence of falls. Nursing staff used multiple interventions. The adjustment of the environment and the use of suitable anti-slip footwear proved to be the most effective.
Contact:
doc. PhDr. Ľubica Libová PhD.
Vysoká škola zdravotníctva a sociálnej práce sv. Alžbety,n.o. Bratislava; FZaSP sv. Ladislava, ul. Slovenská 11 940 52 Nové Zámky, Slovenská republika
+421 903169357
lubica.libova@gmail.comPREVALENCIA PÁDOV U SENIOROV HOSPITALIZOVANÝCH NA GERONTOPSYCHIATRICKOM ODDELENÍ, ICH RIZIKOVÉ FAKTORY A MOŽNOSTI PREVENTÍVNYCH INTERVENCIÍ
Kľúčové slová: Pády seniorov. Prevencia. Rizikové faktory.
Úvod:
Pády a s nimi spojené úrazy predstavujú závažný problém u seniorov v domácom ako aj v zdravotníckom prostredí. Hlavným cieľom bolo priblížiť problematiku pádov u seniorov v nemocničných zariadeniach z ohľadom na gerontopsychiatrickú problematiku a psychiatrickú liečbu.
Metodika:
Na zistenie prevalenciu pádov seniorov, používanie preventívnych opatrení a ich efektivitu sme použili protokol. Protokol mal tri časti, ktoré boli zamerané na demografické údaje, medikáciu, pád počas hospitalizácie, „Jednoduchý skríningový nástroj na posúdenie rizika“ a otázky pre sestry o používaní preventívnych opatrení. Výberový súbor tvorilo 113 seniorov vo vekovej kategórii nad 65 rokov hospitalizovaných v psychiatrickej nemocnici Hronovce.
Výsledky:
Na základe získaných údajov pri porovnaní vekovej kategórie do 75 rokov a nad 75 rokov neboli významné rozdiely vo výskyte pádu. Môžeme konštatovať, že gerontopsychiatrickí pacienti sú rizikový pre pád bez ohľadu na svoj vek. Zo všetkých zúčastnených respondentov prieskumu počas sledovaného obdobia spadlo 46,9 % a nespadlo 53,1 %, pričom 31 % pacientov spadlo opakovane, 15,9 % pacientov spadlo raz. V prieskumnej vzorke 100% respondentov užívalo psychofarmaká z nich 46,9% užívalo rizikovú medikáciu - benzodiazepíny a u týchto respondentov sa vyskytol pád počas hospitalizácie najmenej raz. Zistili sme, že riziko pádu sa zvyšuje takmer o polovicu u pacientov s nočnou dezorientáciou, zmyslovými poruchami a demenciou. V skupine respondentov (56,7%), ktorí potrebovali pomoc pri pohybe sa vyskytol pád častejšie ako u pacientov bez obmedzeného pohybu ale rozdiely neboli významné. Problémy s vyprázdňovaním viedli k vyššej miere prevalencie pádov. Spadlo 14,2 % seniorov, ktorí nemali problém s vyprázdňovaním oproti 32,7%, ktorí mali problém s vyprázdňovaním alebo trpeli inkontinenciou. Najčastejšie sestry používali ako preventívne opatrenia voči pádom v skúmanom súbore pacientov úpravu prostredia v 66,4 % , zvýšený dohľad nad rizikovými pacientmi v 52,2 %, viacnásobné intervencie používali v 67,3 % prípadov. Pričom ako osvedčené intervencie považovali sestry: zvýšený dohľad/dozor nad rizikovými pacientmi (16,0 %), používanie kompenzačných pomôcok pri chôdzi (5,0 %), vhodnú obuv, (14,0 %), úpravu prostredia ( 29%) rehabilitačné cvičenie (13,0 %), dodržiavanie pitného režimu (7,0 %).
Záver:
U seniorov s duševným ochorením bol vyšší výskyt pádov bez ohľadu na vek, užívanie psychofarmakologickej liečby najmä vo forme benzodiazepínov viedlo k väčšiemu výskytu pádov. Ošetrujúci personál používal viacnásobné intervencie. Ako najúčinnejšie sa osvedčilo upravenie prostredia a používanie vhodnej protišmykovej obuvi.
Korešpondujúci autor:
doc. PhDr. Ľubica Libová PhD.
Vysoká škola zdravotníctva a sociálnej práce sv. Alžbety,n.o. Bratislava; FZaSP sv. Ladislava, ul. Slovenská 11 940 52 Nové Zámky, Slovenská republika
+421 903169357
lubica.libova@gmail.com
Zber dát prebiehal so súhlasom etickej komisie zdravotníckeho zariadenia a s informovaným súhlasom respondentov. -
Active Ageing Good Practices Promoting Intergenerational Communication and Understanding
5-6Views:62Persistent negative stereotypes on the aging process and the older person are noticeable within the current youth-orientated culture. Older persons may also hold negative stereotypes about the younger generation. These undesirable typecasts co-exist because younger and older persons often have limited contact with each other. Indeed, the younger generation, only gets to engage in communication with the older person within the family unit, rarely outside their own familial structures. Similarly, older persons, residents of long-term care have limited opportunities of interacting with the younger generation.