Int J Gen Med. 2012; 5: 231-40
Tomstad ST, Söderhamn U, Espnes GA, Söderhamn O

Being at risk of undernutrition is a global problem among older people. Undernutrition can be considered inadequate nutritional status, characterized by insufficient food intake and weight loss. There is a lack of Norwegian studies focusing on being at risk of undernutrition and self-care ability, sense of coherence, and health-related issues among older home-dwelling people.To describe the prevalence of being at risk of undernutrition among a group of older home-dwelling individuals in Norway, and to relate the results to reported self-care ability, sense of coherence, perceived health and other health-related issues.A cross-sectional design was applied. A questionnaire with instruments for nutritional screening, self-care ability, and sense of coherence, and health-related questions was sent to a randomized sample of 450 persons (aged 65+ years) in southern Norway. The study group included 158 (35.1%) participants. Data were analysed using statistical methods.The results showed that 19% of the participants were at medium risk of undernutrition and 1.3% at high risk. Due to the low response rate it can be expected that the nonparticipants can be at risk of undernutrition. The nutritional at-risk group had lower self-care ability and weaker sense of coherence. Living alone, receiving help regularly to manage daily life, not being active and perceived helplessness emerged as predictors for being at risk of undernutrition. The results indicate difficulties in identifying people at nutritional risk and supporting self-care activities to maintain a good nutritional status.Health care professionals have to be able to identify older home-dwelling people at risk of undernutrition, support self-care activities to enable people at risk to maintain a sufficient nutritional status, and be aware that older people living alone, who receive help, feel helpless, and are inactive are especially vulnerable.

Unskilled health care assistants are caring for the elderly in a system that has failed to adjust to ageing patients, according to the chief executive of the Royal College of Nursing.

Source:Elderly care should be better regulated, says nursing leader

Nurs Older People. 2011 Nov; 23(9): 31-5
Bradbury-Jones C, Irvine F, Jones C, Kakehashi C, Ogi A

The aim of this study was to gain insight into registered nurses’ experiences of caring for older people in the UK and Japan.Critical incident technique was used because of its ability to capture actual incidents from practice. Written, anonymous self-report data were collected during 2010. Participants were asked to recall two critical incidents where they had felt either rewarded or challenged at work. Data were analysed using thematic analysis.Analysis revealed striking similarities in the experiences of nurses from both countries. Four main themes emerged: the challenges of a complex work environment; the challenges of resolving ethical conflicts; the rewards of establishing meaningful relationships; and the rewards of achieving excellence in individual patient care.The study provides new evidence from two different countries that although there are some challenges, nurses reap many rewards from working with older people.

Future Child. 2011; 21(2): 117-40
Bookman A, Kimbrel D

Although most Americans know that the U.S. population is aging, they are far less informed about the reality of providing elders with personal care, health care, and social support. Families-particularly women-have always been critical in providing elder care, but the entry of so many women into the paid labor force has made elder care increasingly difficult. Ann Bookman and Delia Kimbrel show how changes in both work and family life are complicating families’ efforts to care for elderly relatives. Because almost 60 percent of elder caregivers today are employed, many forms of caregiving must now be “outsourced” to nonfamily members. And because elders are widely diverse by race and socioeconomic status, their families attach differing cultural meanings to care and have widely different resources with which to accomplish their care goals. Although the poorest elders have access to some subsidized services, and the wealthiest can pay for services, many middle-class families cannot afford services that allow elders to age in their homes and avoid even more costly institutional care. Six key groups–health care providers, nongovernmental community-based service providers, employers, government, families, and elders themselves–are engaged in elder care, but their efforts are often fragmented and uncoordinated. All six groups must be able to work in concert and to receive the resources they need. Both employer and government policies must be improved. Although large businesses have taken up the elder care challenge, most small and mid-sized firms still do not offer flexible work arrangements. Social Security and Medicare have provided critical support to families caring for elders, yet both face significant financial shortfalls. The Older American Act and the National Family Caregiver Support Program have broadened access to elder services, but need updating to address the needs of today’s employed caregivers and elders who want to “age in place.” And just over half of the nation’s workforce is eligible for the unpaid leave benefits provided by the Family and Medical Leave Act. The authors close by reflecting on the need for a coordinated, cross-sector movement to create an “aging-friendly” society in the United States-a society that values well-being across the life span and supports citizens from diverse cultures and income levels as they age.

The government will be urged to cap the bills people face for caring for the elderly when the Commission on Funding of Care and Support publishes its report on the issue next week.

Health chiefs raised fears last night that the Chancellor, George Osborne, could veto proposals to overhaul long-term care of the elderly because of their £2bn-plus cost to the public purse. They warned that hospitals could face a crisis in the pressure of caring for an ageing population and that there would be more “terrible” instances of neglect and abuse of the vulnerable pensioners.

Countries must face up to the challenge of caring for ageing populations, according to the Organisation for Economic Cooperation and Development.

Geriatr Psychol Neuropsychiatr. 2011 Mar 1; 9(1): 91-100
Rigaud AS, Pino M, Wu YH, DE Rotrou J, Boulay M, Seux ML, Hugonot-Diener L, DE Sant’anna M, Moulin F, LE Gouverneur G, Cristancho-Lacroix V, Lenoir H

The increasing number of people suffering from Alzheimer’s disease raises the question of their caring at home, especially when the disease causes disability and negative consequences in daily life such as isolation, falls, wandering, errors in drug taking. Furthermore, caregivers bear a substantial burden that can have adverse effects on their physical and mental health. New technologies of information could play an additional role as care providers without substituting family or professional caregivers help. A review of literature focused on the different technological solutions conceived for patients suffering from Alzheimer’s disease and their carers shows that these appliances could help to provide reminders in daily life (drugs, tasks and appointments, meals cooking), to activate residual cognitive resources by computerized cognitive stimulation intervention, to reduce stress, anxiety and depressive symptoms in patients by visual contact with families and professionals (webconference), to contribute to patients safety by detecting falls and wandering, and to help families in the caring of patients with computerized information and counselling interventions. We also discuss the current limitations for a widespread use of these technologies and outline future research avenues. True needs of end-users are still poorly known and should be more clearly defined. Simplicity of the use of these appliances should be further improved. Demonstration of medical and social benefits for elderly people should be carried out in randomized, controlled studies. Ethical reflexion should be developed in conjunction with the use of these gerontechnologies. Finally, the economical model which would enable the providing of these appliances to the largest number of patients and caregivers should be implemented. Although these gerontechnologies are promising, research is still needed to tailor them properly to the needs of end-users, assess their benefit in ecological context of people with Alzheimer’s disease in order to provide them with appropriate tools in daily life.

“A Bittersweet Season” by New York Times reporter Jane Gross chronicles the author’s challenges negotiating the labyrinthine world of elderly care, after she became caregiver to her fiercely independent but aging mother.

Gransnet, a social networking site for Britain’s 14m grandparents, aims to counter deeply ingrained ageism Back in 1965, the chief executive of Elizabeth Arden wrote in Forbes magazine: “We don’t want to be connected with older women.” Not much has changed. Today there are more than 20 million Britons over 50; yet, despite our numbers, we can be forgiven for feeling that we are ever so slightly …