Objective. To assess the effectiveness of an intervention planned and implemented by regional geriatric care teams in order to prevent disability in an elderly population. Design. Randomized, controlled trial with intention-to-treat and subgroup analyses. Subjects and setting. All home-dwelling persons aged 85 years or older in the City of Oulu (n = 555, 67%), including 486 persons with a history of recurrent falls or at least one risk factor for disability in the activities of daily living (ADL) or mobility. Interventions. Programme consisting of home exercise, walking exercise, group exercise, and self-care exercise. Main outcome measures. Change in ADL and mobility during the intervention. Results. Change in ADL performance did not differ (p = 0.462) but a positive change was found in mobility performance (p = 0.013) in the intervention subjects (n = 243) compared with the controls (n = 243). At the end of the intervention period, severe mobility restrictions existed similarly in intervention and control subjects: 48 (34%) and 46 (31%) (p = 0.650) respectively. Frequency of admissions into long-term institutional care were similar in intervention and control groups: 15 (7%) and 13 (6%) (p = 0.669). Impaired balance existed in fewer intervention subjects (64, 45%) than controls (89, 59%) (p = 0.015). Frequency and times of home exercise activity reduced in control subjects (p < 0.001) but did not change in subjects assigned to home exercise intervention (p > 0.05). Conclusion. A pragmatic intervention slowed down the reduction of movement performance but positive effects could not be found in subjects with severe movement and any ADL dysfunction. Positive effects were also found in balance performance.
Growing numbers of older people relocate to senior housing, when their physical or mental performance declines. The relocation is known to be one of the most stressful events in the life of older people and affect their mental and physical well-being. More information about the relationships between mental and physical parameters is required. We examined self-reported mental well-being of 81 older people (aged 59–93, living in northern Finland), and changes in it 3 and 12 months after relocation to senior housing. The first measurement was 3 months and the second measurement 12 months after relocation. Most participants were female (70%). Their physical performance was also measured, and associations between these two were analyzed. After 12 months, mental capability was very good or quite good in 38% of participants, however 22% of participants felt depressive symptoms daily or weekly. Moreover, 39% of participants reported daily or weekly loneliness. After 12 months participants reported a significant increase in forgetting appointments, losing items and difficulties in learn new things. They felt that opportunities to make decisions concerning their own life significantly decreased. Furthermore, their instrumental activities of daily living (IADL), dominant hand’s grip strength and walking speed decreased significantly. Opportunities to make decisions concerning their life, feeling safe, loneliness, sleeping problems, negative thoughts as well as fear of falling or having an accident outdoors were associated with these physical parameters. In addition to assessing physical performance and regular exercise, the various components of mental well-being and their interactions with physical performance should be considered during adjustment to senior housing.
Aim: The study aimed to describe and explain the self‐assessed gerontological nursing competence levels of Finnish nursing students and factors relating to it.Design: A cross‐sectional study design, reported by The Strengthening the Reporting of Observational studies in Epidemiology guidelines.Methods: Data were collected with the GeroNursingCom instrument, which features 53 items relating to 11 competence factors. The K‐clustering technique and the Chi‐squared, Kruskal‐Wallis and Mann Whitney tests were used to analyse the data.Results: Seven hundred and ninety‐nine nursing students from nine randomly selected higher education institutions were invited to participate in 2019. Three distinct student profiles were identified according to the data (N = 274): Profile A—lower intermediate competence (23.1% of students), Profile B—intermediate competence (45.8%) and Profile C—high competence (31.1%). The strongest competence area for all students was appreciative encounter and interaction, and the weakest was supporting the older person’s sexuality. Nursing students have diverse backgrounds and their overall competence in gerontological nursing is shaped in part by their previous education, motivations and work experience.Relevance to clinical practice: Recognizing students’ different gerontological nursing competence profiles enables the implementation of targeted education to improve competence in clinical practice.
Increasing numbers of older people relocate into senior housing when their physical performance declines. The change in social environment is known to affect their wellbeing, providing both challenges and opportunities, but more information on the relations between social and physical parameters is required. Thus, we elicited perceptions of the social environment of 81 older people (aged 59–93 years, living in northern Finland) and changes in it 3 and 12 months after relocation to senior housing. We also measured their physical performance, then analysed associations between the social and physical variables. Participants reported that they had freedom to do whatever they liked and generally had enough contact with close people (which have recognized importance for older people’s wellbeing), but changes in their physical condition limited their social activity. Moreover, their usual walking speed, dominant hand’s grip strength and instrumental activities of daily living (IADL) significantly decreased. The pleasantness of the residential community, peer support, constraints on social activity imposed by changes in physical condition, meaningful activity at home and meeting close people all affected these physical performance parameters. Clearly, in addition to assessing physical performance and encouraging regular exercise, the complex interactions among social factors, physical performance and wellbeing should be considered when addressing individuals’ needs.
6 September 2022 in Disability and Rehabilitation: Assistive Technology
The behavioural activity pattern is a behavioural and biological 24-hour rhythm. Ageing, diseases and memory disorders can change this pattern. Home care staff can utilize knowledge about the behav...