Homes for the aged. Medical search

Facilities which provide nursing supervision and limited medical care to persons who do not require hospitalization.

Geriatric long-term care facilities which provide supervision and assistance in activities of daily living with medical and nursing services when required.

Community health and NURSING SERVICES providing coordinated multiple services to the patient at the patient's homes. These home-care services are provided by a visiting nurse, home health agencies, HOSPITALS, or organized community groups using professional staff for care delivery. It differs from HOME NURSING which is provided by non-professionals.

Public or private organizations that provide, either directly or through arrangements with other organizations, home health services in the patient's home. (Hospital Administration Terminology, 2d ed)

Hospital-sponsored provision of health services, such as nursing, therapy, and health-related homemaker or social services, in the patient's home. (Hospital Administration Terminology, 2d ed)

Long-term maintenance hemodialysis in the home.

Childbirth taking place in the home.

Living facilities for humans.

Persons who assist ill, elderly, or disabled persons in the home, carrying out personal care and housekeeping tasks. (From Slee & Slee, Health Care Terms. 2d ed, p202)

Visits to the patient's home by professional personnel for the purpose of diagnosis and/or treatment.

The gradual irreversible changes in structure and function of an organism that occur as a result of the passage of time.

Housing for groups of patients, children, or others who need or desire emotional or physical support. They are usually established as planned, single housekeeping units in residential dwellings that provide care and supervision for small groups of residents, who, although unrelated, live together as a family.

Use of any infusion therapy on an ambulatory, outpatient, or other non-institutionalized basis.

The at-home administering of nutrients for assimilation and utilization by a patient who cannot maintain adequate nutrition by enteral feeding alone. Nutrients are administered via a route other than the alimentary canal (e.g., intravenously, subcutaneously).

Age as a constituent element or influence contributing to the production of a result. It may be applicable to the cause or the effect of a circumstance. It is used with human or animal concepts but should be differentiated from AGING, a physiological process, and TIME FACTORS which refers only to the passage of time.

Services for the diagnosis and treatment of diseases in the aged and the maintenance of health in the elderly.

Studies in which the presence or absence of disease or other health-related variables are determined in each member of the study population or in a representative sample at one particular time. This contrasts with LONGITUDINAL STUDIES which are followed over a period of time.

An aspect of personal behavior or lifestyle, environmental exposure, or inborn or inherited characteristic, which, on the basis of epidemiologic evidence, is known to be associated with a health-related condition considered important to prevent.

Care over an extended period, usually for a chronic condition or disability, requiring periodic, intermittent, or continuous care.

The contamination of indoor air.

The total number of cases of a given disease in a specified population at a designated time. It is differentiated from INCIDENCE, which refers to the number of new cases in the population at a given time.

The performance of the basic activities of self care, such as dressing, ambulation, or eating.

Social and economic factors that characterize the individual or group within the social structure.

A nursing specialty in which skilled nursing care is provided to patients in their homes by registered or licensed practical NURSES. Home health nursing differs from HOME NURSING in that home health nurses are licensed professionals, while home nursing involves non-professional caregivers.

Long-term care facilities which provide supervision and assistance in activities of daily living with medical and nursing services when required.

Families who care for neglected children or patients unable to care for themselves.

Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group.

General and comprehensive nursing practice directed to individuals, families, or groups as it relates to and contributes to the health of a population or community. This is not an official program of a Public Health Department.

Evaluation of the level of physical, physiological, or mental functioning in the older population group.

Maleness or femaleness as a constituent element or influence contributing to the production of a result. It may be applicable to the cause or effect of a circumstance. It is used with human or animal concepts but should be differentiated from SEX CHARACTERISTICS, anatomical or physiological manifestations of sex, and from SEX DISTRIBUTION, the number of males and females in given circumstances.

Elements of limited time intervals, contributing to particular results or situations.

Housing arrangements for the elderly or aged, intended to foster independent living. The housing may take the form of group homes or small apartments. It is available to the economically self-supporting but the concept includes housing for the elderly with some physical limitations. The concept should be differentiated from HOMES FOR THE AGED which is restricted to long-term geriatric facilities providing supervised medical and nursing services.

Studies in which subsets of a defined population are identified. These groups may or may not be exposed to factors hypothesized to influence the probability of the occurrence of a particular disease or other outcome. Cohorts are defined populations which, as a whole, are followed in an attempt to determine distinguishing subgroup characteristics.

An infant during the first month after birth.

Design of patient care wherein institutional resources and personnel are organized around patients rather than around specialized departments. (From Hospitals 1993 Feb 5;67(3):14)

Elements of residence that characterize a population. They are applicable in determining need for and utilization of health services.

Studies in which individuals or populations are followed to assess the outcome of exposures, procedures, or effects of a characteristic, e.g., occurrence of disease.

The frequency of different ages or age groups in a given population. The distribution may refer to either how many or what proportion of the group. The population is usually patients with a specific disease but the concept is not restricted to humans and is not restricted to medicine.

The administrative process of discharging the patient, alive or dead, from hospitals or other health facilities.

Studies used to test etiologic hypotheses in which inferences about an exposure to putative causal factors are derived from data relating to characteristics of persons under study or to events or experiences in their past. The essential feature is that some of the persons under study have the disease or outcome of interest and their characteristics are compared with those of unaffected persons.

The caring for individuals in institutions and their adaptation to routines characteristic of the institutional environment, and/or their loss of adaptation to life outside the institution.

Contamination of the air by tobacco smoke.

Older adults or aged individuals who are lacking in general strength and are unusually susceptible to disease or to other infirmity.

Allied health personnel who assist the professional nurse in routine duties.

Evaluation undertaken to assess the results or consequences of management and procedures used in combating disease in order to determine the efficacy, effectiveness, safety, and practicability of these interventions in individual cases or series.

The inhabitants of rural areas or of small towns classified as rural.

Persons who provide care to those who need supervision or assistance in illness or disability. They may provide the care in the home, in a hospital, or in an institution. Although caregivers include trained medical, nursing, and other health personnel, the concept also refers to parents, spouses, or other family members, friends, members of the clergy, teachers, social workers, fellow patients.

Nursing care of the aged patient given in the home, the hospital, or special institutions such as nursing homes, psychiatric institutions, etc.

Instinctual patterns of activity related to a specific area including ability of certain animals to return to a given place when displaced from it, often over great distances using navigational clues such as those used in migration (ANIMAL MIGRATION).

Studies in which variables relating to an individual or group of individuals are assessed over a period of time.

An acquired organic mental disorder with loss of intellectual abilities of sufficient severity to interfere with social or occupational functioning. The dysfunction is multifaceted and involves memory, behavior, personality, judgment, attention, spatial relations, language, abstract thought, and other executive functions. The intellectual decline is usually progressive, and initially spares the level of consciousness.

Falls due to slipping or tripping which may result in injury.

The exposure to potentially harmful chemical, physical, or biological agents in the environment or to environmental factors that may include ionizing radiation, pathogenic organisms, or toxic chemicals.

A systematic collection of factual data pertaining to health and disease in a human population within a given geographic area.

Performance of activities or tasks traditionally performed by professional health care providers. The concept includes care of oneself or one's family and friends.

The number of males and females in a given population. The distribution may refer to how many men or women or what proportion of either in the group. The population is usually patients with a specific disease but the concept is not restricted to humans and is not restricted to medicine.

Devices designed to provide personal protection against injury to individuals exposed to hazards in industry, sports, aviation, or daily activities.

Persons functioning as natural, adoptive, or substitute parents. The heading includes the concept of parenthood as well as preparation for becoming a parent.

Specialized health care, supportive in nature, provided to a dying person. A holistic approach is often taken, providing patients and their families with legal, financial, emotional, or spiritual counseling in addition to meeting patients' immediate physical needs. Care may be provided in the home, in the hospital, in specialized facilities (HOSPICES), or in specially designated areas of long-term care facilities. The concept also includes bereavement care for the family. (From Dictionary of Health Services Management, 2d ed)

Delivery of health services via remote telecommunications. This includes interactive consultative and diagnostic services.

Procedures for finding the mathematical function which best describes the relationship between a dependent variable and one or more independent variables. In linear regression (see LINEAR MODELS) the relationship is constrained to be a straight line and LEAST-SQUARES ANALYSIS is used to determine the best fit. In logistic regression (see LOGISTIC MODELS) the dependent variable is qualitative rather than continuously variable and LIKELIHOOD FUNCTIONS are used to find the best relationship. In multiple regression, the dependent variable is considered to depend on more than a single independent variable.

Inhaling and exhaling the smoke of burning TOBACCO.

Statistical measures of utilization and other aspects of the provision of health care services including hospitalization and ambulatory care.

A set of techniques used when variation in several variables has to be studied simultaneously. In statistics, multivariate analysis is interpreted as any analytic method that allows simultaneous study of two or more dependent variables.

The care and management of property.

The level of health of the individual, group, or population as subjectively assessed by the individual or by more objective measures.

A social group consisting of parents or parent substitutes and children.

A generic concept reflecting concern with the modification and enhancement of life attributes, e.g., physical, political, moral and social environment; the overall condition of a human life.

Size and composition of the family.

Freedom from exposure to danger and protection from the occurrence or risk of injury or loss. It suggests optimal precautions in the workplace, on the street, in the home, etc., and includes personal safety as well as the safety of property.

The aggregate of social and cultural institutions, forms, patterns, and processes that influence the life of an individual or community.

Systematic gathering of data for a particular purpose from various sources, including questionnaires, interviews, observation, existing records, and electronic devices. The process is usually preliminary to statistical analysis of the data.

Federal program, created by Public Law 89-97, Title XVIII-Health Insurance for the Aged, a 1965 amendment to the Social Security Act, that provides health insurance benefits to persons over the age of 65 and others eligible for Social Security benefits. It consists of two separate but coordinated programs: hospital insurance (MEDICARE PART A) and supplementary medical insurance (MEDICARE PART B). (Hospital Administration Terminology, AHA, 2d ed and A Discursive Dictionary of Health Care, US House of Representatives, 1976)

Damage inflicted on the body as the direct or indirect result of an external force, with or without disruption of structural continuity.

The qualitative or quantitative estimation of the likelihood of adverse effects that may result from exposure to specified health hazards or from the absence of beneficial influences. (Last, Dictionary of Epidemiology, 1988)

Small-scale tests of methods and procedures to be used on a larger scale if the pilot study demonstrates that these methods and procedures can work.

Ongoing scrutiny of a population (general population, study population, target population, etc.), generally using methods distinguished by their practicability, uniformity, and frequently their rapidity, rather than by complete accuracy.

Facilities or services which are especially devoted to providing palliative and supportive care to the patient with a terminal illness and to the patient's family.

The tendency of an individual or individuals to rely on others for advice, guidance, or support.

Predetermined sets of questions used to collect data - clinical data, social status, occupational group, etc. The term is often applied to a self-completed survey instrument.

The ratio of two odds. The exposure-odds ratio for case control data is the ratio of the odds in favor of exposure among cases to the odds in favor of exposure among noncases. The disease-odds ratio for a cohort or cross section is the ratio of the odds in favor of disease among the exposed to the odds in favor of disease among the unexposed. The prevalence-odds ratio refers to an odds ratio derived cross-sectionally from studies of prevalent cases.

The levels of excellence which characterize the health service or health care provided based on accepted standards of quality.

Federal program, created by Public Law 89-97, Title XIX, a 1965 amendment to the Social Security Act, administered by the states, that provides health care benefits to indigent and medically indigent persons.

Medical and nursing care of patients in the terminal stage of an illness.

The status during which female mammals carry their developing young (EMBRYOS or FETUSES) in utero before birth, beginning from FERTILIZATION to BIRTH.

The degree to which the individual regards the health care service or product or the manner in which it is delivered by the provider as useful, effective, or beneficial.

Earth or other matter in fine, dry particles. (Random House Unabridged Dictionary, 2d ed)

Country located in EUROPE. It is bordered by the NORTH SEA, BELGIUM, and GERMANY. Constituent areas are Aruba, Curacao, Sint Maarten, formerly included in the NETHERLANDS ANTILLES.

Knowledge, attitudes, and associated behaviors which pertain to health-related topics such as PATHOLOGIC PROCESSES or diseases, their prevention, and treatment. This term refers to non-health workers and health workers (HEALTH PERSONNEL).

Voluntary cooperation of the patient in following a prescribed regimen.

Female parents, human or animal.

Research aimed at assessing the quality and effectiveness of health care as measured by the attainment of a specified end result or outcome. Measures include parameters such as improved health, lowered morbidity or mortality, and improvement of abnormal states (such as elevated blood pressure).

Educational attainment or level of education of individuals.

The seeking and acceptance by patients of health service.

Organized efforts by communities or organizations to improve the health and well-being of the child.

Efforts and designs to reduce the incidence of unexpected undesirable events in various environments and situations.

Various material objects and items in the home. It includes temporary or permanent machinery and appliances. It does not include furniture or interior furnishings (FURNITURE see INTERIOR DESIGN AND FURNISHINGS; INTERIOR FURNISHINGS see INTERIOR DESIGN AND FURNISHINGS).

The degree to which individuals are inhibited or facilitated in their ability to gain entry to and to receive care and services from the health care system. Factors influencing this ability include geographic, architectural, transportational, and financial considerations, among others.

A statistical technique that isolates and assesses the contributions of categorical independent variables to variation in the mean of a continuous dependent variable.

Those unable to leave home without exceptional effort and support; patients (in this condition) who are provided with or are eligible for home health services, including medical treatment and personal care. Persons are considered homebound even if they may be infrequently and briefly absent from home if these absences do not indicate an ability to receive health care in a professional's office or health care facility. (From Facts on File Dictionary of Health Care Management, 1988, p309)

The process of accepting patients. The concept includes patients accepted for medical and nursing care in a hospital or other health care institution.

The period of confinement of a patient to a hospital or other health facility.

A stratum of people with similar position and prestige; includes social stratification. Social class is measured by criteria such as education, occupation, and income.

The legal relation between an entity (individual, group, corporation, or-profit, secular, government) and an object. The object may be corporeal, such as equipment, or completely a creature of law, such as a patent; it may be movable, such as an animal, or immovable, such as a building.

Diagnostic, therapeutic and preventive health services provided for individuals in the community.

Organized periodic procedures performed on large groups of people for the purpose of detecting disease.

A form of bronchial disorder with three distinct components: airway hyper-responsiveness (RESPIRATORY HYPERSENSITIVITY), airway INFLAMMATION, and intermittent AIRWAY OBSTRUCTION. It is characterized by spasmodic contraction of airway smooth muscle, WHEEZING, and dyspnea (DYSPNEA, PAROXYSMAL).

An indicator of body density as determined by the relationship of BODY WEIGHT to BODY HEIGHT. BMI=weight (kg)/height squared (m2). BMI correlates with body fat (ADIPOSE TISSUE). Their relationship varies with age and gender. For adults, BMI falls into these categories: below 18.5 (underweight); 18.5-24.9 (normal); 25.0-29.9 (overweight); 30.0 and above (obese). (National Center for Health Statistics, Centers for Disease Control and Prevention)

The application of heat to raise the temperature of the environment, ambient or local, or the systems for accomplishing this effect. It is distinguished from HEAT, the physical property and principle of physics.

Diseases which have one or more of the following characteristics: they are permanent, leave residual disability, are caused by nonreversible pathological alteration, require special training of the patient for rehabilitation, or may be expected to require a long period of supervision, observation, or care. (Dictionary of Health Services Management, 2d ed)

Levels within a diagnostic group which are established by various measurement criteria applied to the seriousness of a patient's disorder.

The status of health in rural populations.

The statistical reproducibility of measurements (often in a clinical context), including the testing of instrumentation or techniques to obtain reproducible results. The concept includes reproducibility of physiological measurements, which may be used to develop rules to assess probability or prognosis, or response to a stimulus; reproducibility of occurrence of a condition; and reproducibility of experimental results.

A range of values for a variable of interest, e.g., a rate, constructed so that this range has a specified probability of including the true value of the variable.

A situation in which the level of living of an individual, family, or group is below the standard of the community. It is often related to a specific income level.

The status of health in urban populations.

Studies which start with the identification of persons with a disease of interest and a control (comparison, referent) group without the disease. The relationship of an attribute to the disease is examined by comparing diseased and non-diseased persons with regard to the frequency or levels of the attribute in each group.

Health services required by a population or community as well as the health services that the population or community is able and willing to pay for.

A method of comparing the cost of a program with its expected benefits in dollars (or other currency). The benefit-to-cost ratio is a measure of total return expected per unit of money spent. This analysis generally excludes consideration of factors that are not measured ultimately in economic terms. Cost effectiveness compares alternative ways to achieve a specific set of results.

The largest country in North America, comprising 10 provinces and three territories. Its capital is Ottawa.

Method in which repeated blood pressure readings are made while the patient undergoes normal daily activities. It allows quantitative analysis of the high blood pressure load over time, can help distinguish between types of HYPERTENSION, and can assess the effectiveness of antihypertensive therapy.

The integration of epidemiologic, sociological, economic, and other analytic sciences in the study of health services. Health services research is usually concerned with relationships between need, demand, supply, use, and outcome of health services. The aim of the research is evaluation, particularly in terms of structure, process, output, and outcome. (From Last, Dictionary of Epidemiology, 2d ed)

Conversations with an individual or individuals held in order to obtain information about their background and other personal biographical data, their attitudes and opinions, etc. It includes school admission or job interviews.

Care of patients by a multidisciplinary team usually organized under the leadership of a physician; each member of the team has specific responsibilities and the whole team contributes to the care of the patient.

Public attitudes toward health, disease, and the medical care system.

Absolute, comparative, or differential costs pertaining to services, institutions, resources, etc., or the analysis and study of these costs.

The practice of assisting women in childbirth.

Interfacility or intrahospital transfer of patients. Intrahospital transfer is usually to obtain a specific kind of care and interfacility transfer is usually for economic reasons as well as for the type of care provided.

Regular course of eating and drinking adopted by a person or animal.

A medical specialty concerned with the provision of continuing, comprehensive primary health care for the entire family.

The teaching or training of patients concerning their own health needs.

Studies to determine the advantages or disadvantages, practicability, or capability of accomplishing a projected plan, study, or project.

Statistical models in which the value of a parameter for a given value of a factor is assumed to be equal to a + bx, where a and b are constants. The models predict a linear regression.

The use of electronic equipment to observe or record physiologic processes while the patient undergoes normal daily activities.

Persistently high systemic arterial BLOOD PRESSURE. Based on multiple readings (BLOOD PRESSURE DETERMINATION), hypertension is currently defined as when SYSTOLIC PRESSURE is consistently greater than 140 mm Hg or when DIASTOLIC PRESSURE is consistently 90 mm Hg or more.

A distribution in which a variable is distributed like the sum of the squares of any given independent random variable, each of which has a normal distribution with mean of zero and variance of one. The chi-square test is a statistical test based on comparison of a test statistic to a chi-square distribution. The oldest of these tests are used to detect whether two or more population distributions differ from one another.

A housing and community arrangement that maximizes independence and self-determination.

Designs for approaching areas inside or outside facilities.

Support systems that provide assistance and encouragement to individuals with physical or emotional disabilities in order that they may better cope. Informal social support is usually provided by friends, relatives, or peers, while formal assistance is provided by churches, groups, etc.

The external elements and conditions which surround, influence, and affect the life and development of an organism or population.

Evaluation of the nature and extent of nursing problems presented by a patient for the purpose of patient care planning.

The actual costs of providing services related to the delivery of health care, including the costs of procedures, therapies, and medications. It is differentiated from HEALTH EXPENDITURES, which refers to the amount of money paid for the services, and from fees, which refers to the amount charged, regardless of cost.

Divisions of the year according to some regularly recurrent phenomena usually astronomical or climatic. (From McGraw-Hill Dictionary of Scientific and Technical Terms, 6th ed)

Studies designed to assess the efficacy of programs. They may include the evaluation of cost-effectiveness, the extent to which objectives are met, or impact.

Statistical interpretation and description of a population with reference to distribution, composition, or structure.

The surface of a structure upon which one stands or walks.

The at-home administering of nutrients for assimilation and utilization by a patient whose sole source of nutrients is via solutions administered intravenously, subcutaneously or by some other non-alimentary route.

Health insurance to provide full or partial coverage for long-term home care services or for long-term nursing care provided in a residential facility such as a nursing home.

A general concept referring to the organization and administration of nursing activities.

Statistical models which describe the relationship between a qualitative dependent variable (that is, one which can take only certain discrete values, such as the presence or absence of a disease) and an independent variable. A common application is in epidemiology for estimating an individual's risk (probability of a disease) as a function of a given risk factor.

Care alleviating symptoms without curing the underlying disease. (Stedman, 25th ed)

The inhabitants of a city or town, including metropolitan areas and suburban areas.

Educational institutions.

All deaths reported in a given population.

Systematic identification of a population's needs or the assessment of individuals to determine the proper level of services needed.

Any type of research that employs nonnumeric information to explore individual or group characteristics, producing findings not arrived at by statistical procedures or other quantitative means. (Qualitative Inquiry: A Dictionary of Terms Thousand Oaks, CA: Sage Publications, 1997)

A status with BODY WEIGHT that is grossly above the acceptable or desirable weight, usually due to accumulation of excess FATS in the body. The standards may vary with age, sex, genetic or cultural background. In the BODY MASS INDEX, a BMI greater than 30.0 kg/m2 is considered obese, and a BMI greater than 40.0 kg/m2 is considered morbidly obese (MORBID OBESITY).

Small-arms weapons, including handguns, pistols, revolvers, rifles, shotguns, etc.

The presence of co-existing or additional diseases with reference to an initial diagnosis or with reference to the index condition that is the subject of study. Comorbidity may affect the ability of affected individuals to function and also their survival; it may be used as a prognostic indicator for length of hospital stay, cost factors, and outcome or survival.

Health care institutions operated by private groups or corporations for a profit.

An ulceration caused by prolonged pressure on the SKIN and TISSUES when one stays in one position for a long period of time, such as lying in bed. The bony areas of the body are the most frequently affected sites which become ischemic (ISCHEMIA) under sustained and constant pressure.

Devices, not affixed to the body, designed to help persons having musculoskeletal or neuromuscular disabilities to perform activities involving movement.

A regimen or plan of physical activities designed and prescribed for specific therapeutic goals. Its purpose is to restore normal musculoskeletal function or to reduce pain caused by diseases or injuries.

Behaviors expressed by individuals to protect, maintain or promote their health status. For example, proper diet, and appropriate exercise are activities perceived to influence health status. Life style is closely associated with health behavior and factors influencing life style are socioeconomic, educational, and cultural.

The branch of medicine concerned with the physiological and pathological aspects of the aged, including the clinical problems of senescence and senility.

The technique that deals with the measurement of the size, weight, and proportions of the human or other primate body.

The physical activity of a human or an animal as a behavioral phenomenon.

The monitoring of the level of toxins, chemical pollutants, microbial contaminants, or other harmful substances in the environment (soil, air, and water), workplace, or in the bodies of people and animals present in that environment.

PRESSURE of the BLOOD on the ARTERIES and other BLOOD VESSELS.

A province of Canada lying between the provinces of Manitoba and Quebec. Its capital is Toronto. It takes its name from Lake Ontario which is said to represent the Iroquois oniatariio, beautiful lake. (From Webster's New Geographical Dictionary, 1988, p892 & Room, Brewer's Dictionary of Names, 1992, p391)

The mass or quantity of heaviness of an individual. It is expressed by units of pounds or kilograms.

Organized services to provide health care for children.

Depressive states usually of moderate intensity in contrast with major depression present in neurotic and psychotic disorders.

Physical activity which is usually regular and done with the intention of improving or maintaining PHYSICAL FITNESS or HEALTH. Contrast with PHYSICAL EXERTION which is concerned largely with the physiologic and metabolic response to energy expenditure.

State of the body in relation to the consumption and utilization of nutrients.

Subsequent admissions of a patient to a hospital or other health care institution for treatment.

Health care services provided to patients on an ambulatory basis, rather than by admission to a hospital or other health care facility. The services may be a part of a hospital, augmenting its inpatient services, or may be provided at a free-standing facility.

Typical way of life or manner of living characteristic of an individual or group. (From APA, Thesaurus of Psychological Index Terms, 8th ed)

Hospital department responsible for the administration and provision of immediate medical or surgical care to the emergency patient.

The physical space or dimensions of a facility. Size may be indicated by bed capacity.

Disturbances in mental processes related to learning, thinking, reasoning, and judgment.

Persons living in the United States having origins in any of the black groups of Africa.

Techniques for measuring blood pressure.

A component of the Department of Health and Human Services to oversee and direct the Medicare and Medicaid programs and related Federal medical care quality control staffs. Name was changed effective June 14, 2001.

A group of people with a common cultural heritage that sets them apart from others in a variety of social relationships.

Can we create a therapeutic relationship with nursing home residents in the later stages of Alzheimer's disease? (1/747)

1. Despite their entrance into advanced illness, the majority (83%) of participants in the study displayed evidence of having begun a therapeutic relationship with their assigned advanced practice nurse. 2. With one exception, those participants who did not evidence development of the relationship had severely limited speech, perseverative speech, or did not speak at all. 3. It is time to challenge the assumption that individuals in the middle and later stages of Alzheimer's disease are not good candidates for developing a therapeutic relationship. (+info)

Changes in behavioural characteristics of elderly populations of local authority homes and long-stay hospital wards, 1976-7. (2/747)

Behavioural characteristics of the elderly populations of seven local authority residential homes and three long-stay hospital wards were assessed in 1976 and 1977 with the Crichton Royal behavioural rating scale. In 1977 the levels of behavioural problems had increased in the residential homes, but declined in the hospital wards. Differences between the homes had decreased as the overall level of problems increased. The findings suggested that the additional burden of caring for increasing numbers of severely disabled elderly people was affecting the balance of institutional care, and a radical reappraisal of present patterns of care may be necessary to meet their future needs. (+info)

Admission and adjustment of residents in homes for the elderly. (3/747)

This paper discusses the relationship between psychological variables, a brief cognitive measure and a behavioural rating scale, and the subsequent adjustment of a group of elderly people newly admitted to a social services home for the elderly. It shows that, in this sample, three groups can be identified: a fairly independent group of people who show no apparent deterioration in functioning during the first year of admission; a more dependent group who show loss of functioning during the same period; and a third group who show an immediate negative effect from admission, and who have a poor outcome. We comment on the lack of evidence in support of a general negative relocation effect, and on the value of the procedures used. (+info)

Small bowel bacterial overgrowth in subjects living in residential care homes. (4/747)

OBJECTIVES: in elderly people, bacterial overgrowth of the small bowel may be occult. The significance of positive breath tests are uncertain: many fit elderly subjects with positive tests show no evidence of malabsorption. We assessed the prevalence and significance of bacterial overgrowth in the small bowel in a relatively unselected elderly population. METHODS: residents of seven elderly people's homes had a glucose hydrogen breath test. A medical history and anthropomorphic measurements were recorded. Volunteers with positive breath tests were given doxycycline. After 4 months all volunteers were reassessed. RESULTS: of 140 residents, 62 were tested. Nine (14.5%) had a positive breath test. There was no difference in anthropomorphic and bowel habit data between those with positive and those with negative breath tests. After 4 months of antibiotic treatment, volunteers with a positive breath test had increased weight and body mass index, while those with a negative test had decreased weight and body mass index. CONCLUSIONS: the percentage of volunteers with a positive breath test was much lower than in previous studies. This may be due to the relatively unselected nature of the volunteers. Treatment of bacterial overgrowth resulted in a small but significant improvement in anthropometric indices. The lack of association of positive breath tests with baseline anthropomorphic measurements or bowel habit highlights the occult nature of the bacterial overgrowth and questions its clinical importance. (+info)

Nasal colonization by Staphylococcus aureus in active, independent, community seniors. (5/747)

OBJECTIVE: to evaluate the prevalence of nasal colonization with Staphylococcus aureus (SA) in active, independent community seniors and old people in a nursing home. DESIGN: cross-sectional brief questionnaire and screening culture of anterior nares specimens from 165 elders at a community centre and cross-sectional data from a recent survey in a nursing home. RESULTS: the prevalence of SA colonization in community seniors (27%) was similar to that in the nursing home (29%). The proportion of SA isolates that were methicillin-resistant was much lower in the community seniors (2.3%) than in the nursing-home residents (31%). There was less antibiotic resistance in those living at home. CONCLUSION: in community seniors the prevalence of SA colonization was similar to that in nursing-home residents, but the prevalence of methicillin-resistant SA was lower. Susceptibility patterns of antibiotics tested against the SA showed less resistance than isolates from nursing-home patients. (+info)

Consequences of MRSA carriage in nursing home residents. (6/747)

A prospective cohort study with 1 year follow-up evaluated the relation between MRSA carriage and mortality, likelihood of hospitalization and functional status in residents of a nursing home for the elderly. Included were all 447 residents living in the home in early June 1994. From all patients, swabs were taken from nose, throat and perineum. Additional swabs (sputum, urine or wounds) were taken when indicated. The relative risk (RR) of dying within 6 months in MRSA carriers compared to non-carriers was 2.29 (95% CI = 1.04-5.04). This RR remained stable (1.57-2.40) after adjustment for co-variables using Mantel-Haenszel stratified analysis. After I year, the RR was reduced to 1.30 (95% CI = 0.65-2.58). Univariate survival analysis confirmed a difference in survival between carriers and non-carriers after 6 months (log-rank P = 0.04) and no difference after 1 year. Cox regression analysis resulted in a hazard ratio for dying within 6 months of 1.73 (95% CI = 0.72-4.17). No relation was found between carriage and either likelihood of hospitalization or indicators of functional status. These results are compatible with a possible relation between 6 months mortality and MRSA carriage in nursing home patients. It calls for a large scale, multicentre cohort study in order to either confirm or refute these findings. (+info)

Socioeconomic differences in general practice consultation rates in patients aged 65 and over: prospective cohort study. (7/747)

OBJECTIVE: To examine socioeconomic differences in general practice consultation rates among patients aged 65 years and over. DESIGN: Secondary analysis of data from the fourth national survey of morbidity in general practice. SETTING: 60 general practices in England and Wales. SUBJECTS: 71 984 people aged 65 years and over. MAIN OUTCOME MEASURES: Annual contact rates and home visiting rates with general practitioners and practice nurses. RESULTS: Social class differences in tact rates were greatest in 65-74 year olds, with rates 23% higher in patients from social class V than in class I (4.82 v 3.93 per person). In 75-84 year olds there was no clear association between social class and contact rates, and in people aged >/=85 years contact rates were highest in patients from class I. Home visiting rates were twice as high in patients from class V as in patients from class I (1.38 v 0.66 per person). Contact rates were 17% higher in people living in communal establishments and 8% higher in those living alone than in those living with others but not in a communal establishment. 66% of contacts with patients in communal establishments and 26% of those with patients living alone were in patients' homes compared with 18% with those living in standard accommodation. These differences persisted after adjustment in a generalised linear model. CONCLUSIONS: Elderly people show socioeconomic differences in consultation rates. The extra workload generated by elderly people living alone and in communal establishments suggests additional payments to general practitioners are needed. (+info)

Cost-effectiveness of screening compared to case-finding approaches to tuberculosis in long-term care facilities for the elderly. (8/747)

BACKGROUND: To determine if the more interventionist approach of screening with the tuberculin test and chemoprophylaxis for high-risk positive reactors to control tuberculosis in long-term care facilities is cost-effective when compared to the case-finding and treatment approach. METHOD: A decision-analysis model was designed wherein systematic screening with the tuberculin skin test of all elderly patients newly admitted to facilities was compared to public health interventions restricted to investigation of cases and contacts with symptoms of tuberculosis after suspected exposure. Differences in life-years (LY), quality-adjusted life-years (QALY), cost per QALY and LY gained, annual cost per 1000 institutional patients were calculated in a health-care system perspective. RESULTS: In every situation analysed, screening and chemoprophylaxis were more effective. The cost per LY gained was within an acceptable range: $3437 per LY with a 0.6% nosocomial transmission rate and $7552 per LY when no nosocomial transmission was postulated. CONCLUSION: Screening plus chemoprophylaxis for high-risk reactors is more cost-effective than case-finding. This holds even when nosocomial transmission is assumed not to occur in facilities. (+info)

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Can we create a therapeutic relationship with nursing home residents in the later stages of Alzheimer's disease? (1/747)

Changes in behavioural characteristics of elderly populations of local authority homes and long-stay hospital wards, 1976-7. (2/747)

Admission and adjustment of residents in homes for the elderly. (3/747)

Small bowel bacterial overgrowth in subjects living in residential care homes. (4/747)

Nasal colonization by Staphylococcus aureus in active, independent, community seniors. (5/747)

Consequences of MRSA carriage in nursing home residents. (6/747)

Socioeconomic differences in general practice consultation rates in patients aged 65 and over: prospective cohort study. (7/747)

Cost-effectiveness of screening compared to case-finding approaches to tuberculosis in long-term care facilities for the elderly. (8/747)

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