Quasi-experimental pilot study to improve mobility and balance in recurrently falling nursing home residents by voluntary non-targeted side-stepping exercise intervention.

BACKGROUND: Side-stepping is a potential exercise program to reduce fall risk in community-dwelling adults in their seventies, but it has never been tested in nursing home residents. This was a pilot quasi-experimental study to examine the feasibility and potential mobility and balance benefits of an intervention based on voluntary non-targeted side-stepping exercises in nursing home residents who fall recurrently. METHODS: Twenty-two participants were recruited and non-randomly assigned to an intervention group ([Formula: see text]11, side-stepping exercises, STEP) participating in an 8-week protocol and to a control group ([Formula: see text]11, usual physiotherapy care, CTRL). They were clinically assessed at 4-time points: baseline, after 4 and 8 weeks, and after a 4-week follow-up period (usual physiotherapy care). Statistical differences between time points were assessed with a Friedman repeated measures ANOVA on ranks or a one-way repeated measures ANOVA. RESULTS: Compared to baseline, significant benefits were observed in the STEP group at 8 weeks for the Timed Up and Go ([Formula: see text]0.020) and 6-minute walking test ([Formula: see text]0.001) as well as for the Berg Balance Scale ([Formula: see text]0.041) and Mini motor test ([Formula: see text]0.026). At follow-up, the Tinetti Performance Oriented Mobility Assessment and Berg Balance Scale significantly worsened in the STEP group ([Formula: see text]0.009 and [Formula: see text]0.001, respectively). No significant differences were found between the groups at the same time points. CONCLUSIONS: Our intervention was feasible and improved mobility and balance after almost 8 weeks. Studies with larger samples and randomized control trials are needed to consolidate our preliminary observations and confirm the deterioration of some tests when side-stepping exercises are discontinued. TRIAL REGISTRATION: Identifier: ISRCTN13584053. Retrospectively registered 01/09/2022.

Is the Snoezelen method a non-pharmacological alternative for patients with neurocognitive disorders? / La méthode Snoezelen : une alternative thérapeutique chez les patients ayant des troubles cognitifs ?

Neuropsychiatric disorders are one of the frequent complications of neurocognitive disease, and have an impact on the quality of life of patients and caregivers. Non-phamacologic interventions are recommended as first-line treatment. The Snoezelen method is a multisensory stimulation method based on the assumption that acting on sensoriality can improve neuropsychiatric symptoms and thus quality of life, but its level of evidence is controversial. To explore this, we performed a systematic literature review of randomized controlled articles focusing on the use of the Snoezelen method in patients with cognitive disorders. Eighteen studies were included. The clinical outcomes studied were multiple (behavior, mood, cognition, functional capacities and biomedical parameters). When the Snoezelen method was compared to the "standard activities" group, it appears to be effective on short-term behavior. This was more negligible when the method was compared to others non-pharmacological interventions. Although the Snoezelen method could be effective on mood, cognition, and functional abilities, its level of evidence remains low. Furthers mixed studies (quantitative and qualitative) would be an interesting approach to delve into this topic in the most holistic way by integrating the patients, the caregivers and the cost of the method.

La prise en soin des symptômes neuropsychiatriques de patients ayant des troubles neurocognitifs est basée sur des traitements non médicamenteux. Certains auteurs suggèrent que la méthode Snoezelen pourrait être une alternative thérapeutique. L'objectif de cette revue de littérature était de faire une recherche systématique des essais contrôlés et randomisés ayant analysé l'effet de la méthode Snoezelen sur les patients âgés ayant des troubles cognitifs. Le processus de sélection a permis d'inclure 18 études, ayant des méthodologies hétérogènes. Dans plusieurs études, la méthode Snoezelen pourrait avoir un effet bénéfique, à court terme, sur les troubles du comportement, sur l'humeur, la cognition, ou les capacités fonctionnelles. Cependant, la méthode Snoezelen ne semblait pas être supérieure à d'autres interventions non médicamenteuses et certaines études montraient des résultats discordants. Finalement, le niveau de preuve d'efficacité de la méthode Snoezelen reste faible et des études mixtes (quantitatives et qualitatives) seraient intéressantes à mener pour évaluer l'intérêt de la méthode Snoezelen sur des profils spécifiques de patients ayant des troubles neurocognitifs.

Defining Your "Life Territory": The Meaning of Place and Home for Community Dwellers and Nursing Home Residents-A Qualitative Study in Four European Countries.

The meaning of place and home for community dwellers and nursing home residents remains unclear. We explored the relationship between older people and their "life territory", to propose a working definition of this concept, which could be used to orient policy decisions. Individual, semi-structured interviews were performed with older people, nursing home staff, and representatives of local institutions/elected officials in four European countries (France, Belgium, Germany, Italy). Interviews were transcribed and analysed using thematic analysis. In total, 54 interviews were performed. Five main themes emerged: (i) working definition of "your life territory" (a multidimensional concept covering individual and collective aspects); (ii) importance of the built environment (e.g., public transport, sidewalks, benches, access ramps); (iii) interactions between nursing homes and the outside community (specifically the need to maintain interactions with the local community); (iv) a sense of integration (dependent on social contacts, seniority in the area, perceived self-utility); and (v) the use of new technologies (to promote integration, social contacts and access to culture). This study found that the "life territory" of older people is a multidimensional concept, centred around five main domains, which together contribute to integrating older people into the fibre of their community.

Being useful among persons aged over 65: social representations from a cross-sectional European study.

BACKGROUND: There is a compelling need to prepare our societies and healthcare systems to deal with the oncoming wave of population ageing. The majority of older persons maintain a desire to be valued and useful members of society and of their social networks. AIMS: We sought to investigate the perception of usefulness among persons aged 65 years and over in four European countries. METHODS: We performed a cross-sectional survey with a representative sample of individuals aged 65 years or older from the population of retired persons (including recently retired persons and oldest-old individuals) from 4 European countries selected using quota sampling. In February 2016, an internet questionnaire was sent to all selected individuals. The characteristics used for the quota sampling method were sex, age, socio-professional category, region, city size, number of persons in household, autonomy, marital status, place of residence, income and educational status. The questionnaire contained 57 questions. Sociodemographic characteristics were recorded. Responses were analysed with principal components analysis (PCA). RESULTS: A total of 4025 persons participated; 51% were males, and 70% were aged 65-75 years. PCA identified six classes of individuals, of which two classes (Classes 2 and 3) were characterized by more socially isolated individuals with little or no sense of usefulness, low self-esteem and a poor sense of well-being. These two classes accounted for almost 20% of the population. Younger and more autonomous classes reported a more salient sense of usefulness. CONCLUSIONS: The loss of the sense of usefulness is associated with dissatisfaction with life and a loss of pleasure, and persons with profiles corresponding to Classes 2 and 3 should, therefore, be targeted for interventions aimed at restoring social links.

[Complementary and alternative medicine: what place in geriatric medicine?] / Médecines complémentaires et alternatives : quelle signification en gériatrie ?

This article is about the development of complementary and alternative medicine in geriatrics. He questions the meaning of his practices - and more broadly that of relational and non-drug care - as well as their application in the field in the aging sector. Indeed, the promotion of non-drug therapies by the high health authority, the growing role of actors in relational care or the emergence of practices complementary attest to a new dynamic of care in favor of a more global approach to support. If this dynamic was initially deployed in oncology, through supportive care, other sectors - and in particular geriatrics - are opening up to these practices in a logic of personalization of care. As such, the establishment of centers of activity and adapted care reflects a new model of support specific to aging focused on the specific needs of people weakened by age and disease. This work responds to the need to better understand this field as a whole and to highlight the plural issues, societal or medical, scientific, in connection with the process of their integration in geriatrics.

[Towards a personalized support necessary but complex to implement. The exemple of oncogeriatric care]. / Vers un accompagnement personnalisé nécessaire mais complexe à mettre en œuvre ? L'exemple de la prise en charge oncogériatriqueL'exemple de la prise en charge oncogériatrique.

The considerable developments in the field of oncology have led to increased life expectancy and are contributing to conceptual changes in the care and management of patients. As such, the introduction of supportive care represents the archetype of a new "person-centred" approach and its characteristic needs. While the chronicity of the disease reflects advances in treatment, it also raises questions about a particularly long, cumbersome and painful treatment process for an aging and vulnerable population. In this perspective, the emergence of oncogeriatrics reflects the desire to personalize support and to take greater account of the specific needs of the elderly population. However, oncogeriatrics, a relatively new discipline, remains unstructured in the field. The dynamics of humanizing care inevitably come up against complex clinical situations, requiring reflection on its interest and limitations in its application. Thus, the purpose of this article is to propose an inventory of oncogeriatric care by raising a complex articulation between "theory of care" and "its implementation in the field".

[Defining and understanding the burn out of gerontological caregivers]. / Définir et comprendre le burn out des soignants exerçant en gérontologie.

The malaise in the gerontology sector can be accounted for and new explanations for caregiver burnout can be proposed. Through a review of the literature, an overview of the issue can be drawn up and a theoretical and clinical reflection can be initiated. After having contextualized the extent of the phenomenon, we will present the plural conceptions of burn out and its origin. A new look will be taken at this syndrome by raising a set of factors potentially involved in the exhaustion of caregivers.

[Towards a personalized support necessary but complex to implement. The exemple of oncogeriatric care]. / Vers un accompagnement personnalisé nécessaire mais complexe à mettre en œuvre ? L'exemple de la prise en charge oncogériatrique.

The considerable developments in the field of oncology have led to increased life expectancy and are contributing to conceptual changes in the care and management of patients. As such, the introduction of supportive care represents the archetype of a new "person-centred" approach and its characteristic needs. While the chronicity of the disease reflects advances in treatment, it also raises questions about a particularly long, cumbersome and painful treatment process for an aging and vulnerable population. In this perspective, the emergence of oncogeriatrics reflects the desire to personalize support and to take greater account of the specific needs of the elderly population. However, oncogeriatrics, a relatively new discipline, remains unstructured in the field. The dynamics of humanizing care inevitably come up against complex clinical situations, requiring reflection on its interest and limitations in its application. Thus, the purpose of this article is to propose an inventory of oncogeriatric care by raising a complex articulation between "theory of care" and "its implementation in the field".

[Elderly people and new technologies: friends or enemies?] / Les personnes âgées en Ehpad et les nouvelles technologies.

Faced with the ageing of the French population, it is essential to envisage new technologies to improve the living conditions of elderly people and enable them to communicate more effectively. A study sought to understand the views of senior citizens and the caregivers who look after them regarding these new tools, their appropriation, the support required and their uses. This analysis highlights areas to reflect upon and improve in terms of the services which need to be provided to overcome the reticence of certain users.