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Evaluation of physical activity programmes for elderly people - a descriptive study using the EFQM’ criteria
Socioeconomic status, poverty, and race have been found to be correlated with ACSC rates [8-10]. Several studies have examined the associations between ACSCs and demographics using small areas of analysis (typically ZIP code) and have found that ACSCs are higher in lowincome areas and areas with higher concentrations of racial and ethnic minorities [11,12]. The elderly population has not been studied much in this context, because they are thought to be relatively well-insured. However, Billings, Anderson, and Newman [11] found that socioeconomic class is important, even among the insured populations, concluding that barriers to accessing ambulatory care may extend beyond affordability to other factors, such as transportation or knowledge about how to engage the...
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Time trends in leisure time physical activity and physical fitness in elderly people: 20 year followup of the Spanish population national health survey (1987-2006)
Poverty is higher in remote rural areas and in inner cities, but the rural elderly are much more likely to be poor than those living in urban areas. Thirteen percent of rural elders 60 years and older were poor in 2000, compared with nine percent of elders living in a metro area [20]. Thus we expect to find the most evidence of impeded access for the poor elderly who reside in rural areas. We interact the proportion of elderly in poverty with the proportion in rural areas to include in the model. We also expect that elderly living among elderly in rural areas may have greater access impedance than elderly...
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Health and aging in elderly farmers: the AMI cohort
However, variation in need in smaller areas within HRRs, such as the Primary Care Service Areas (PCSAs), has been documented – which means that small local area shortages of physicians may still exist [18]. One study finds that policies aimed at increasing physician supply in rural areas have been successful [24]. Another finds that international medical graduates (IMGs) have disproportionately located in U.S. counties of greatest need, compared to U.S. medical graduates [25]. Other literature examines the importance of non-physician clinicians in health care [26,27]. States with the highest ratios of non-physician clinicians (nurse practitioners, physician assistants, and advanced practice nurses) to physicians were also the most rural. All things considered, the very recent...
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Relationship between anthropometric variables and nutrient intake in apparently healthy male elderly individuals: A study from Pakistan
The Reschovsky and Staiti study [28] interviewed both patients and physicians, and provides considerable insight regarding differences in physical accessibility across the urban-rural continuum. The nationally representative survey was fielded in urban, suburban, and remote rural regions. Persons in remote rural regions had significantly longer travel times to see physicians and specialists than persons in metropolitan areas (2 minutes longer to see a physician and 34 minutes longer to see a specialist). However, persons in isolated rural areas were significantly less likely to say they couldn't get an appointment soon enough, and only persons in adjacent (suburban) metropolitan areas complained more about transportation problems. We include in our model a variable reflecting the percent of...
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Spatial analysis of elderly access to primary care services
A growing body of literature argues that the availability and mix of physician specialties in areas is important for health outcomes. Areas with fewer specialists but higher generalists per capita were found to have better health outcomes or quality of care [21,22]. Goodman [23] found that greater physician supply is associated with both higher area income and lower mortality rates, and argued that regional variations in health outcomes and physician supply will exist as long as there are differences across communities in economic status. A long-standing tenet of state and federal physician workforce policy is that the provision of income supplements to physicians in rural areas will help attract physicians to these areas....
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Serum cytokine profiles in healthy young and elderly population assessed using multiplexed bead-based immunoassays
Managed care prevalence in the market can also impact the climate in which the elderly seek care. The availability of managed care plans for the elderly could improve elderly access to and utilization of preventive care services, if the Medicare managed care plans fulfill their promise – more specifically, the management and coordination of care. A growing body of literature has found that Medicare beneficiaries in HMOs receive more preventive services and have better outcomes than their FFS counterparts. Rizzo [29] found that Medicare beneficiaries enrolled in HMOs received significantly and substantially higher preventive care services than beneficiaries in traditional FFS. Other research has found that managed care may improve access for the...
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Determinants of Healthy Eating in Community-dwelling Elderly People
Among seniors, food choice and related activities are affected by health status, biological changes wrought by aging and functional abilities, which are mediated in the larger arena by familial, social and economic factors. Determinants of healthy eating stem from individual and collective factors. Individual components include age, sex, education, physiological and health issues, psychological attributes, lifestyle practices, and knowledge, attitudes, beliefs and behaviours, in addition to other universal dietary determinants such as income, social status and culture. Collective determinants of healthy eating, such as accessible food labels, an appropriate food shopping environment, the marketing of the “healthy eating” message, adequate social support and provision of effective, community-based meal delivery...
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Walking behaviour of healthy elderly: attention should be paid
Variable descriptions are presented in Tables 1 and 2, and construction of variables is described in the Methods section, below. Spatial regression methods and the rationale for using the spatial spillovers model are presented in the Methods section, below, with a discussion of what spatial spillovers are and why they might manifest themselves and cause problems in regression. Regression results are presented in Table 4, where both heteroskedasticity-consistent OLS and spatial lag regression models are presented. Table 3 presents sample statistics, including the mean, median, standard deviation, minimum, and maximum for each variable. Variable descriptions (Tables 1 and 2) reveal that there are many different units of measurement in the analysis – rates...
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Toll-Free Numbers for Nutrition & Health Information
The greatest limitation of traditional epidemiological indicators is their inability to reflect the “capacity of an individual to perform tasks and activities”13. Self-perceived measures convey more information about the way a certain disease is affecting the individual’s daily routine and the population in general than the measurements collected from a clinical environment5. Clinical indicators are important for the assessment of oral health and treatment needs; nevertheless, their limitations must be considered11. The combined clinical and subjective indicators define a multi-dimensional assessment of the oral health condition1. Locker10 (1998) explains that the quality of life indicators related to oral health were defined...
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Nutritional Status and Associated Factors in Institutionalized Elderly
A representative random systematic sampling of clusters from 183 elderly people aged 65 and over was selected from the old age groups of Joaçaba, SC. Previous to the commencement of the research, workshops with the participants were conducted in order to discuss the method of performance of the interviews12. A pilot test was done to calibrate the 5 surveyors in relation to the observation of the clinical condition examined, and the (kappa) agreement test was used for these measurements until an adequate value was obtained. For the analysis of the results, the Spearman correlation test was used to verify correlations...
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Reporting heterogeneity in self-assessed health among elderly Europeans
The abuse of older people by family members dates back to ancient times. Until the advent of initiatives to address child abuse and domestic violence in the last quarter of the 20th century, it remained a private matter, hidden from public view. Initially seen as a social welfare issue and subsequently a problem of ageing, abuse of the elderly, like other forms of family violence, has developed into a public health and criminal justice concern. These two fields – public health and criminal justice – have therefore dictated to a large extent how abuse of the elderly is viewed, how it is analysed, and how it is dealt with. This chapter focuses...
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Health-related behavior and quality of life among the elderly: a population-based study
It is generally agreed that abuse of older people is either an act of commission or of omission (in which case it is usually described as ‘‘neglect’’), and that it may be either intentional or unintentional. The abuse may be of a physical nature, it may be psychological (involving emotional or verbal aggression), or it may involve financial or other material maltreatment. Regardless of the type of abuse, it will certainly result in unnecessary suffering, injury or pain, the loss or violation of human rights, and a decreased quality of life for the older person (4). Whether the behaviour is termed abusive, neglectful or exploitative will probably depend on how frequently the mistreatment occurs,...
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Hematopoiesis is not clonal in healthy elderly women
These demographic changes are taking place in developing countries alongside increasing mobility and changing family structures. Industrialization is eroding long-standing patterns of interdependence between the generations of a family, often resulting in material and emotional hardship for the elderly. The family and community networks in many developing countries that had formerly provided support to the older generation have been weakened, and often destroyed, by rapid social and economic change. The AIDS pandemic is also significantly affecting the lives of older people. In many parts of sub-Saharan Africa, for instance, children are being orphaned in large numbers as their parents die from the disease. Older people who had anticipated support from their children in old age are...
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Selecting the best anthropometric variables to characterize a population of healthy elderly persons
Displacing older people as heads of households and depriving them of their autonomy in the name of affection are cultural norms even in countries where the family is the central institution and the sense of filial obligation is strong (11). Such infantilization and overprotection can leave the older person isolated, depressed and demoralized, and can be considered a form of abuse. In some traditional societies, older widows are abandoned and their property seized. Mourning rites of passage for widows in parts of Africa and India include practices that elsewhere would certainly be considered cruel, for example sexual violence, forced levirate marriages (where a man is obliged by custom to marry the childless widow of...
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Oral Health Status among Elderly Hill Tribe Villagers in Mae Sot, Thailand
This definition of elder abuse has been heavily influenced by the work done in Canada, the United Kingdom and the United States. Studies conducted in China (Hong Kong SAR), Finland, Greece, India, Ireland, Israel, Norway, Poland and South Africa have approached the topic in distinctly different ways (8). Norwegian researchers, for instance, identified abuse with a ‘‘triangle of violence’’ that includes a victim, a perpetrator and others, who – directly or indirectly – observe the principal players. In countries such as China, that emphasize harmony and respect within society, neglecting the care of an older person is considered an act of elder abuse. If family members fail to fulfil their kinship obligations to provide...
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Quality of Life of the Elderly People in Einme Township Irrawaddy Division, Myanmar
In the United Republic of Tanzania, some 500 older women are murdered each year following accusations against them of witchcraft. The problem is particularly serious in Sukumaland in the north of the country. Large numbers of older women are driven from their homes and communities in fear of being accused of witchcraft, and end up living destitute in urban areas. Belief in witchcraft has existed in Sukumaland for centuries, though the violence surrounding it has increased sharply in recent years. This may in part be due to increased poverty caused by too many people living off too little land, as well as an overall lack of...
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Factors Influencing Health Promoting Behaviors among the Elderly Under the Universal Coverage Program, Buriram Province, Thailand
Community leaders in Sukumaland are calling for a strong lead from the Government. One was quoted as saying: ‘‘It is a question of educating the people. In other areas of the country where people are better educated, we don’t face this problem.’’ Until recently, the Government was reluctant to acknowledge that belief in witchcraft still existed. Now the subject is being widely discussed and officially condemned. In 1999, the Tanzanian Government made witchcraft the theme for International Women’s Day. A local nongovernmental organization and HelpAge International are also taking measures to improve the security of older women in the United Republic of Tanzania. They aim to change attitudes...
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Quick Facts about Programs of All-Inclusive Care for the Elderly (PACE)
A quarter of a century ago, the proportion of older people living in institutions in developed countries had reached an estimated 9% (22). Since that time, there has been a shift in emphasis towards care in the community and the use of less restrictive residential settings. Current rates of use of nursing homes are in the range of 4–7% in countries such as Canada (6.8%), Israel (4.4%), South Africa (4.5%) and the United States (4%). In most African countries, older people can be found in long-stay hospital wards, homes for the destitute and disabled, and – in some sub-Saharan countries – in witches’ camps. Social, economic and cultural changes taking place in some...
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Elderly people´s definition of quality of life
In Latin America, the rates of institutionalization of older people range from 1% to 4%. Institutional care is no longer considered unacceptable for an older person but is seen as an alternative for families. The government-sponsored asilos, large institutions resembling the early English workhouses, have been converted into smaller facilities with professional staff from many disciplines. Other homes are operated by religious communities of immigrant origin. Figures for rates of institutionalization are not available in the countries of the former Eastern European bloc, because the authorities at the time did not allow publication of such information. Despite the fact that a vast literature exists on the quality of care in institutional settings, and that cases of...
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LONG-TERM FITNESS TRAINING IMPROVES THE CIRCADIAN REST-ACTIVITY RHYTHM IN HEALTHY ELDERLY MALES
Most of the early work on abuse of the elderly was limited to domestic settings and carried out in developed countries. In seeking explanations for elder abuse, researchers drew from the literature in the fields of psychology, sociology, gerontology and the study of family violence. To accommodate the complexity of elder abuse and the many factors associated with it, researchers have turned to the ecological model, which was first applied to the study of child abuse and neglect (24) and has been applied more recently to elder abuse (25, 26). The ecological model can take into account the interactions that take place across a number of systems. As described in Chapter 1, the...
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The Effectiveness of Educational Intervention in the Health Promotion in Elderly people
Early researchers in the field played down individual personality disturbances as causal agents of family violence in favour of social and cultural factors (27). More recently, though, research on family violence has shown that abusers who are physically aggressive are more likely to have personality disorders and alcohol-related problems than the general population (28). Similarly, studies restricted to violence against older people in domestic settings have found that aggressors are more likely to have mental health and substance abuse problems than family members or caregivers who are not violent or otherwise abusive (29–31). Cognitive and physical impairments of the abused older person were strongly identified in the early studies as risk factors for abuse. However, a...
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Socioeconomic position and health in a population of Brazilian elderly: the Bambuí Health and Aging Study (BHAS)
Living arrangements, particularly overcrowded conditions and a lack of privacy, have been associated with conflict within families. Although abuse can occur when the abuser and the older person suffering abuse live apart, the older person is more at risk when living with the caregiver. The early theories on the subject also sought to associate dependency with increased risk of abuse. At first the emphasis focused on the dependency of the victim on the caregiver or abuser, though later case work identified abusers who were dependent on the older person – usually adult children dependent on elderly parents for housing and financial assistance (32). In some of these cases a ‘‘web of interdependency’’ was evident...
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Historical and current predictors of self-reported health status among elderly persons in Barbados
In the early theoretical models, the level of stress of caregivers was seen as a risk factor that linked elder abuse with care of an elderly relative (36, 37). While the popular image of abuse depicts a dependent victim and an overstressed caregiver, there is growing evidence that neither of these factors properly accounts for cases of abuse. Although researchers do not deny the component of stress, they tend now to look at it in a wider context in which the quality of the overall relationship is a causal factor (30, 34, 38). Some of the studies involving caregiver stress, Alzheimer disease and elder abuse suggest that the nature of the relationship between...
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An e-Health System for the Elderly (Butler Project): A Pilot Study on Acceptance and Satisfaction
According to the focus group study in South Africa mentioned earlier, much of the abuse – and particularly domestic violence – occurred as a result of social disorder, exacerbated by crime, alcohol and drugs. Similar conclusions came from an exercise conducted by seven male community leaders of the Tamaho squatter camp in Katlehong, South Africa (15). Drawing a link between poverty and violence, they described how dysfunctional family life, a lack of money for essentials, and a lack of education and job opportunities have all contributed to a life of crime, drug peddling and prostitution by young people. In this society, older people are viewed as targets for abuse and exploitation, their vulnerability being...
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Weight loss and malnutrition in the elderly
Mistreatment of older people has been identified in facilities for continuing care (such as nursing homes, residential care, hospitals and day care facilities) in almost every country where such institutions exist. Various people may be responsible for the abuse: a paid member of the staff, another resident, a voluntary visitor, or relatives or friends. An abusive or neglectful relationship between the older person and their caregiver at home may not necessarily end once the older person has entered institutional care; the abuse may sometimes continue in a new setting. A distinction must be made between individual acts of abuse or neglect in institutional settings and institutionalized abuse – where the prevailing regime of the institution...
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Cognitive Stimulation Programs in Healthy Elderly: A Review
In a seminal study in New Haven, CT, United States, data from a comprehensive annual health and welfare study of a representative sample of 2812 older people were merged with the database of the local agency concerned with adult abuse for each year over a 9-year period (50). Information for the health survey was recorded by nurses, who saw the older people at a hospital for the first year’s data collection and every third year after that. In the intervening years, data were updated by telephone. Information about abuse and neglect was obtained by case workers using existing protocols after investigating claims of mistreatment, usually by a home visit....
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Abuse of the elderly
The impact that physical and psychological violence have on the health of an older person is exacerbated by the ageing process and diseases of old age. It is more difficult for the elderly to leave an abusive relationship or to make correct decisions because of the physical and cognitive impairments that usually come with old age. In some places, kinship obligations and the use of the extended family network to resolve difficulties may also lessen the ability of older people, particularly women, to escape from dangerous situations. Often, the abuser may be the abused person’s only source of companionship. Because of these and other considerations, preventing elder abuse presents a whole host of problems...
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Impact of oral health on quality of life among the elderly population of Joaçaba, Santa Catarina, Brazil
The objective of this study was to investigate the impact of oral health conditions on the quality of life of elderly people in Joaçaba - SC, in Southern Brazil. A survey based on systematic sampling of clusters was carried out with 183 elderly people that belong to old age groups. The survey was conducted in order to assess the oral conditions of the participants (use of and need for prosthesis) based on the criteria from the World Health Organization publication “Oral Health Surveys, Basic Methods”, 4th edition. The oral health impact profile (OHIP) was used to evaluate the impact of...
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ArticleGait analysis comparing Parkinson’s disease with healthy elderly subjects
Premium and cost sharing subsidies will be available through the Exchange for individuals with incomes up to 400 percent of the Federal Poverty Level (FPL)4 who do not qualify for Medi-Cal and do not have any family members with an offer of affordable job-based coverage. 5 A separate Small Business Health Options Plan (SHOP) exchange will offer coverage to firms of 50 or fewer workers between 2014 and 2016, after which time it will be open to firms of 100 or fewer workers. Small businesses with low-wage workforces may be eligible for tax credits through the SHOP exchange.6 e ACA will expand Medi-Cal to adults and children in families with incomes up...
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Nine Out of Ten Non-Elderly Californians Will Be Insured When the Affordable Care Act is Fully Implemented
e Affordable Care Act (ACA) will significantly expand access to affordable health coverage in California starting in 2014. Californians with the lowest incomes will have access to coverage under the expansion of Medi-Cal, while millions of low- and middle-income families will be eligible for subsidies through the California Health Benefit Exchange (the Exchange). Demand for health insurance in the state will also increase as a result of the minimum coverage requirement. e level of enrollment in the new and expanded programs and the resulting share of Californians who gain coverage under the ACA will depend on a range of factors, including the ease of enrollment and retention, outreach strategies, and...
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