The roles and clinical activities of registered nurses and nurse practitioners in practices caring for older adults.

BACKGROUND: Population aging and physician shortages have motivated recommendations of increased use of registered nurses in care provision; little is known about RN and NP employment in primary care and geriatric practices or service types each provide. PURPOSE: Determine current RN and NP employment frequency in practices in the U.S., identify services provided by RNs, and whether NP presence in practice is associated with the types and frequency of services provided by RNs. METHODS: National survey of 410 primary care and geriatric clinicians. FINDINGS: Only half of practices employed RNs. RNs most frequently provide teaching or education for chronic disease management. RNs provide significantly more primary care and geriatric services when practices employed a NP. DISCUSSION: Reasons for RN underuse in practices should be identified, clinical placements in such practices should increase, and NP education programs should include care models using RNs to their full scope of practice.

Using the 4Ms framework to teach geriatric competencies in a community clinical experience.

BACKGROUND: As the population of older adults in the US steadily increases and becomes more diverse, there is an urgent need to integrate geriatric competencies into baccalaureate nursing education. PURPOSE: To integrate the Institute for Healthcare Improvement 4 Ms Framework into an existing baccalaureate nursing community clinical experience to build geriatric and interprofessional competencies and promote positive health outcomes. METHODS: As part of the Geriatric Workforce Enhancement Program, 15 students worked with bilingual social workers and community health workers in an affordable housing urban highrise, assessed building residents and implemented personalized plans of care using the 4Ms framework (what matters to the individual, medications, mentation, and mobility). RESULTS: Students demonstrated competence conducting cognition and depression screening, medication review, and functional and fall risk assessments. Student self-rated achievement of learning objectives ranged from 4.3 to 4.8 (1-5 scale). A retrospective pretest-posttest survey suggested learning about the importance of interprofessional teamwork, and integration of person-centered values when providing care to older adults in the community. Students reflected on barriers to health for older adults in low socioeconomic states and the importance of improving care across the continuum. CONCLUSION: The 4Ms framework provided a valuable construct to guide the community experience and teach geriatric evidence-based practice to nursing students.

A Simple Framework of Smart Geriatric Nursing considering Health Big Data and User Profile.

The National Bureau of Statistics of China shows that the population over 65 years old in China exceeds 166 million accounting for 11.93% of the total population by the end of 2018. The importance and severity of taking care of the elderly are becoming increasingly prominent. High-quality and meticulous care for the daily life of the elderly needs helpful and advanced sciences and technologies. Smart geriatric nursing is a must. Basing on the professional knowledge of geriatric nursing, this paper proposes a framework of smart geriatric nursing which consists of three aspects of smart nursing: smart geriatric nursing in physical health using biosensor and advanced devices, smart geriatric nursing in mental health based on user profile, and smart geriatric nursing for daily life based on big data in health. The deployment of the proposed method relies on the technologies of the Internet of Things (IoT), user profile system, big data, and many other advanced information technologies. The framework of methods can provide a useful reference for the systematic technical scheme of smart geriatric nursing in an aging society.

The geriatric workforce in Romania: the need to improve data and management.

Facing severe under-funding and significant workforce maldistribution, the health system in Romania is challenged to provide adequate care for the ageing population. The aim of this article is to connect health labour market data of the geriatrics workforce in Romania with individual perceptions of front-line workers in geriatrics in order to better understand the 'human' factors of effective health workforce development. Comprehensive health workforce data are not available; we therefore used a rapid scoping review and interviews to combine quantitative and qualitative data sources, such as the 'Healthcare Facility Activity Report', policy documents and available reports. They show that despite a consistent increase in the overall number of geriatricians, their majority is based in Bucharest, the capital city. The initial review points to possible geriatrician burnout, caused in part by high workload. The geriatrics workforce in Romania is poorly developed. Significant efforts are still needed to create policies addressing inflows and outflows, training, maldistribution and inefficiencies related to their practice. Addressing burnout by improving teamwork and collaboration is vital for maintaining and improving the workforce morale and motivation. Two major policy recommendations emerged: an urgent need for better health workforce data in Romania and development of more effective workforce management.

Partnership integration for rural health resource access.

Increasing numbers of older adults are residing in rural areas of the USA. Many of these individuals experience greater rates of chronic diseases and lower income levels compared to their urban-residing counterparts. Aging in rural environments creates greater challenges in the provision of funding, staff and resources to meet the needs of these older adults, and contributes to immense health disparities and health inequities. Urban and rural older adult residents alike need healthcare, gerontological and public health resources to promote successful aging in place. Due to the nature of rural environments, many of these resources often exist great distances from these residents, which creates access challenges. There are also limitations in locally available facilities and trained practitioners, resulting in resource shortages for addressing chronic health conditions. The creation and use of interdisciplinary partnerships provides this much-needed support while addressing ever-increasing funding and staffing limitations. This article provides an innovative conceptual interdisciplinary partnership model that combines nursing, public health and gerontology to address the health and social challenges that rural-residing older adults face. Although well-trained practitioners who work within their discipline are an important contributor to assist with the needs of rural-residing older adults, this silo approach is expensive, inefficient, and clearly cannot support all of the needs for older adults in this type of environment. There is a need to blend the complementary skills provided by each of the presented disciplines so that the focus of the interdisciplinary partnership is on person-centered care addressing the health disparities and health inequities experienced by these older adults. To illustrate the integration of nursing, public health and gerontology disciplines, these disciplines are initially combined and presented as dyads, and are then incorporated into the full conceptual model. The dyads are public health and gerontology, public health and nursing, and gerontology and nursing. Steps are provided for the development of this (or any) interdisciplinary partnership. An example of the model's use through clinical and non-clinical disciplines and a community engagement framework is also described. Interdisciplinary approaches focused on person-centered care provide more well-rounded health and social support for rural older adults than any one discipline in isolation. Allocation of shared resources, roles, responsibilities and expenses allows practitioners engaged in interdisciplinary teams to provide superior economic and capacity efficiency. This efficiency is crucial at a time when many entities experience limitations in sustainable resources. Thus, practitioners and community agencies collaborating through interdisciplinary partnerships are better able to address the complex issues experienced by rural-residing community members.

Intrinsic motivation and turnover intention among geriatric nurses employed in nursing homes: the roles of job burnout and pay satisfaction.

Background: Few studies have examined intrinsic motivation that is related to turnover intention among geriatric nurses employed in nursing homes in China. Objectives: This study aims at investigating the relationship between intrinsic motivation and turnover intention among geriatric nurses employed in nursing homes in China by analyzing the mediating roles of job burnout and pay satisfaction. Methods: Based on multistage stratified random sampling, a total of 1212 geriatric nurses was investigated by a questionnaire in China. Structural equation models were employed to test the hypotheses. Results: Intrinsic motivation was negatively related to turnover intention (ß = -0.063), and job burnout (ß = -0.072) and pay satisfaction (ß = -0.014) played significant mediating roles in the relationship between intrinsic motivation and turnover intention. Conclusions: Findings revealed that intrinsic motivation, pay satisfaction and job burnout were strong predicators of turnover intention. The results may provide implications to lessen turnover intention among geriatric nurses employed in nursing homes.

Engaging knowledge users in a systematic review on the comparative effectiveness of geriatrician-led models of care is possible: A cross-sectional survey using the Patient Engagement Evaluation Tool.

BACKGROUND: A systematic review (SR) was conducted to evaluate the comparative effectiveness of geriatrician-led models of care, and an integrated knowledge translation (iKT) approach facilitated SR relevance. Activities to engage knowledge users (KUs) in the SR were evaluated for perceived level of engagement. STUDY DESIGN AND SETTING: KUs included patients, caregivers, geriatricians, and policymakers from three Canadian provinces. Activities included 1) modified Delphi to select outcomes; 2) cross-sectional survey to select outcome measures, and 3) in-person meeting to discuss SR findings. KU engagement was assessed using the Patient Engagement Evaluation Tool (PEET) after the second and third activities. KUs rated the extent of successful engagement using a 7-point Likert scale ranging from "no extent" to "very large extent." RESULTS: In total, 15 KUs completed the PEET: eight geriatricians, four policymakers, two patients, and one caregiver. Median engagement scores across all activities (median range: 6.00-6.50) indicated that KUs felt engaged. Differences were observed for activity type; perceived engagement at in-person meeting resulted in higher meta-criteria scores for trust (P = 0.005), legitimacy (P = 0.003), fairness (P = 0.013), and competency (P = 0.035) compared with online activities. CONCLUSIONS: KUs can be engaged meaningfully in SR processes. Their perceived engagement was higher for in-person than for online activities.

Geriatric Trends Facing Nursing with the Growing Aging.

This article expands on the Gerontological Society of America leaders' work to explore challenges facing healthcare providers in preparing for an aging population. Traditional medicine and models of care may no longer meet complex patient needs. Older patients present with multifaceted issues while living longer with chronic health conditions. The changing environment requires a cross-disciplinary perspective. Changes in reimbursement are in the early stages of implementation and will be used to evaluate measurable outcomes. Preparing to care for this population can only occur with enough health professionals and expanded use of advance practice nurses. Health improvement is economically advantageous.

Implementation of Intentional Touch for Geriatric Patients with Chronic Pain: A Qualitative Pilot Study.

BACKGROUND: Intentional Touch (InTouch) refers to a soft physical touch with the aim to ease complaints and enhance well-being. Central questions were perception of InTouch by nurses and patients and possible effects on pain perception. PATIENTS AND METHODS: InTouch was developed by stakeholder involvement. Nurses working in geriatric care received expert training in InTouch. Semi-structured interviews and participant observation (including video recording) were conducted with nurses applying and patients with chronic pain receiving InTouch after the beginning of the intervention and after 4 weeks. Interviews were analyzed based on Qualitative Content Analysis and video recordings based on Qualitative Visual Analysis. RESULTS: Six elderly patients with chronic pain and 6 nurses were included. Nurses and patients equally described relaxation, well-being, and a sensation of warmth during the intervention. Patients reported no pain during the intervention. After the intervention, 3 patients each experienced pain relief or no change. Patients described better drive and positive feelings, and nurses felt empowered in their nursing work. Empathetic attention had special importance for improving the therapeutic relationship. CONCLUSION: The results of this study suggest that InTouch promoted relaxation, well-being, and pain relief for elderly people suffering from chronic pain and may contribute positively to the therapeutic relationship.

A modified Delphi and cross-sectional survey to facilitate selection of optimal outcomes and measures for a systematic review on geriatrician-led care models.

OBJECTIVE: The objective of this study was to identify relevant outcomes and measures to inform a systematic review (SR) on the comparative effectiveness of geriatrician-led care models. STUDY DESIGN AND SETTING: In the modified Delphi to select outcomes for inclusion in the SR, knowledge users (KUs) from Ontario, Alberta, and Saskatchewan rated outcome importance using a Likert scale. A survey was then completed by geriatricians to determine optimal measures for selected outcomes. Findings were analyzed using frequencies, means, and standard deviations (SDs). RESULTS: Thirty-three KUs (patients, caregivers, policymakers and geriatricians) rated 27 outcomes in round 1 of the modified Delphi. Top-rated outcomes included function (mean 6.85 ± SD 0.36), cognition (6.47 ± SD 0.72), and quality of life (6.38 ± SD 0.91). Twenty-three KUs participated in round 2 and rated 24 outcomes. Top-rated outcomes in round 2 were function (6.87 ± SD 0.34), quality of life (6.45 ± SD 1.10), and cognition (6.43 ± SD 0.73). The survey was completed by 22 geriatricians and the highest ranked measures were Activities of Daily Living (function), Mini-Mental State Examination (cognition), and the Medical Outcomes Study SF-36 (quality of life). CONCLUSION: We identified the most relevant outcomes and measures for patients, caregivers, policymakers, and geriatricians, allowing us to tailor the SR to KU needs.

The Association Between Chronic Condition Symptoms and Treatment Burden in a Skilled Nursing Population.

The purpose of the current study was to determine the relationship between chronic condition symptoms and treatment burden in older adults transitioning from skilled nursing facilities to home. Treatment burden is defined as the burden associated with adhering to a prescribed chronic condition self-management regimen. Analysis of correlations between chronic condition symptoms and treatment burden revealed that symptoms and treatment burden are positively correlated (p < 0.05). Multivariate analysis (adjusted R2 = 0.40, F[10, 63] = 5.96, p < 0.001), controlling for other known antecedents of treatment burden, demonstrated that fatigue (standardized beta coefficient = 0.47, p < 0.001) predicted higher levels of treatment burden. Post hoc analysis revealed caregiver presence partially mediated the effect of fatigue on treatment burden, decreasing treatment burden during transition. Findings support existing transitional care literature suggesting that clinical assessment, including symptom screening, treatment of symptoms, and/or intervention reducing the impact of symptoms on patients' health and well-being, may lower treatment burden, thus improving self-management adherence. [Journal of Gerontological Nursing, 44(12), 45-52.].

Influence of Nurse Staffing Levels on Resident Weight Loss Within German Nursing Homes.

In Germany, there is no empirical evidence regarding the relationship between nurse staffing levels and care outcomes in nursing homes. The current study explored differences in nurse staffing levels between facilities with and without resident weight loss. The analyses were conducted at the facility level (N = 166) and involved weight loss assessment of 8,665 residents. Separate models for residents with and without cognitive impairment were computed. The regression analyses showed that nursing facilities where no weight loss occurred among residents without cognitive impairment had a lower number of residents per RN and additional care staff. However, no differences were found between facilities with and without weight loss among residents with cognitive disabilities. Further research is needed to identify factors leading to weight loss among residents with cognitive disabilities, including teamwork and work climate in nursing homes. [Res Gerontol Nurs. 2018; 11(1):48-56.].

Are even geriatric patients becoming older and older? : Changes in the age structure of geriatric inpatients in the course of two decades.

BACKGROUND: The life expectancy of the German population has steadily risen in the course of the past decades. As especially the oldest members of the population are treated in geriatric clinics, it would be of interest to investigate whether the increase in population age can also be found among geriatric inpatients. PATIENTS AND METHODS: The demographic data of inpatients of a geriatric clinic in Hannover in the years 1994, 2004 and 2014 were analyzed according to age, gender and classification as acute care or geriatric rehabilitation. RESULTS: The mean patient age rose by 6 years in the past two decades. This was the case for both men and women but the age of men (+7.5 years) rose more than that of women (+4.9 years). Whereas the patient average age increased, especially in the first decade (+3.9 years), this increase slowed down in the following decade (+1.7 years). The 80 to 89-year-old patients remained the biggest and steadily increasing group (in 1994: 41.1%, 2004: 46.9% and 2014: 51.3%). The greatest increase, however, was found for those aged 90 years and older (1994: 4.8%, 2004: 12.2% and 2014: 17.7%). CONCLUSION: The results confirm the professional experiences of many geriatricians in that they care for an increasingly aging clientele. Particularly very old male patients in geriatric clinics are increasing. All health professional groups involved will have to face this challenge.

["Because we feel, we have to do something" - Barriers in the prevention of violence and key areas requiring action : A qualitative interview study with professional nurses and managers in the field of elderly care]. / "Weil wir spüren, da müssen wir was tun" ­ Barrieren in der Gewaltprävention sowie zentrale Handlungserfordernisse : Eine qualitative Interviewstudie mit professionellen Pflegefachkräften und Führungskräften aus dem Bereich Altenpflege.

BACKGROUND: In recent years, politics and society have shown an increasing interest in the prevention of violence. Despite the scientific studies and prevention programs that have been conducted over the past few years, there is no indication that the prevalence of violence in elderly care is falling. A high number of unreported cases may still be assumed. OBJECTIVE: The present study examined the barriers in transferring research knowledge into practice. Furthermore, it dealt with the requirements of an interventional approach which is practical and which effectively addresses the barriers. MATERIAL AND METHODS: The data were collected in qualitative interviews (n = 20) and analyzed by using qualitative content analysis. RESULTS: The study revealed uncertainties in dealing with violence. The institutions lacked a clear definition of violence and the respondents did not have a clear concept of when and where violence starts. A high proportion of the respondents stated that violence occurred in various forms in daily nursing care but that there were no specific strategies for action. Only very few cases were documented at all. Moreover, a lack of practical further training was reported. The visibility of these barriers opens up new approaches to developing preventive measures which work in practice. CONCLUSION: A common definition of violence, clear and binding standards, regular training and education measures are central to the prevention of violence in care.

Nursing care needs and services utilised by home-dwelling elderly with complex health problems: observational study.

BACKGROUND: In Norway, as in many Western countries, a shift from institutional care to home care is taking place. Our knowledge is limited regarding which needs for nursing interventions patients being cared for in their home have, and how they are met. We aimed at assessing aspects of health and function in a representative sample of the most vulnerable home-dwelling elderly, to identify their needs for nursing interventions and how these needs were met. METHODS: In this observational study we included patients aged 75+ living in their own homes in Oslo, who received daily home care, had three or more chronic diagnoses, received daily medication, and had been hospitalized during the last year. Focused attention and cognitive processing speed were assessed with the Trail Making Test A (TMT-A), handgrip strength was used as a measure of sarcopenia, mobility was assessed with the "Timed Up-and-Go" test, and independence in primary activities of daily living by the Barthel Index. Diagnoses and medication were collected from electronic medical records. For each diagnosis, medication and functional impairment, a consensus group defined which nursing service that the particular condition necessitated. We then assessed whether these needs were fulfilled for each participant. RESULTS: Of 150 eligible patients, 83 were included (mean age 87 years, 25% men). They had on average 6 diagnoses and used 9 daily medications. Of the 83 patients, 61 (75%) had grip strength indicating sarcopenia, 27 (33%) impaired mobility, and 69 (83%) an impaired TMT-A score. Median amount of home nursing per week was 3.6 h (interquartile range 2.6 to 23.4). Fulfilment of pre-specified needs was >60% for skin and wound care in patients with skin diseases, observation of blood glucose in patients taking antidiabetic drugs, and in supporting food intake in patients with eating difficulties. Most other needs as defined by the consensus group were fulfilled in <10% of the patients. CONCLUSIONS: We identified a very frail group of home-dwelling patients. For this group, resources for home nursing should probably be used in a more flexible and pro-active way to aim for preserving functional status, minimize symptom burden, and prevent avoidable hospitalisations.

Associations Between Age, Psychosocial Work Conditions, Occupational Well-Being, and Telomere Length in Geriatric Care Professionals: A Mixed-Methods Study.

OBJECTIVE: We identified associations between age, psychosocial work characteristics, occupational well-being, and-as a measure of biological age-leukocyte telomere length in geriatric care professionals. METHODS: This is a multisource study of self-reports on psychosocial work characteristics, standardized physician's evaluations of health, and relative telomere length measures of peripheral blood leukocytes. We included 141 geriatric care professionals. Telomere length was assessed by an improved polymerase chain reaction (PCR)-based method. RESULTS: Increased depersonalization was associated with shorter telomeres. Their association with age was not moderated by psychosocial work conditions. There was, however, a significant three-way interaction of social support and work ability with the age-telomere association. Additionally, social support and adverse general health moderated the age-telomere length relationship. CONCLUSIONS: A supportive work environment and work-related health may influence the association between age and telomere length.

Representações sociais de qualidade de vida por idosos: contribuição para o cuidado de enfermagem / Social representations of quality of life by elderly: contribution to nursing care

Representações sociais (RS) sobre qualidade de vida de idosos. Objetivos: Identificar as RS construídas por idosos sobre qualidade de vida (QV); Analisar as práticas de cuidado adotadas pelos idosos, relacionadas à QV; Verificar relações existentes entre as ações promovidas em prol de um envelhecimento ativo e as RS dos idosos sobre a QV; Discutir as implicações das RS construídas pelos idosos para as ações de promoção da saúde e QV. Método: Pesquisa qualitativa, exploratória, analítica e explicativa, com abordagem processual da Teoria das Representações Sociais. Técnicas de produção de dados: observação participante; questionário sobre dados sócio-demográficos; entrevista em profundidade. Participaram 30 idosos do Programa Academia Carioca de Saúde de uma Clínica da Família do Rio de Janeiro. A análise das entrevistas foi pelo software Alceste e os dados sociodemográficos por estatística descritiva e percentual. O software gerou cinco classes lexicais. Resultados: As RS de QV se constroem sustentadas nos determinantes sociais de saúde, nas condições de alimentação, moradia, financeira e social, elementos esses que vêm ao encontro do discurso da produção social da saúde. Possuem uma visão global e holística e as práticas de cuidado à saúde evidenciam uma atitude ativa frente ao envelhecimento, com intuito de prevenir ou amenizar as consequências de agravos das doenças crônicas não transmissíveis (DCNT). Conclusão: As atividades físicas e sociais ocorridas no grupo promovem melhorias nas condições de saúde física, psicológica e social, com mudanças positivas nas atitudes frente a QV e bem-estar com ações preventivas e de cuidado de si. Demonstrou-se a importância da aplicabilidade das Políticas Públicas de Saúde em benefício da população idosa. O Programa Academia Carioca de Saúde enquadra-se como colaborador para diminuir a mortalidade por DCNT.(AU)

The Influence of Skill Development Training Program for Spiritual Care of Elderly Individual on Elderly Care Technician Students' Perception of Spiritual Support.

Spiritual care means helping an individual protect, maintain and gain all the dimensions of his/her existence. Elderly care technicians face numerous cases or crisis situations in which elderly individuals from different backgrounds question the meaning and value of life. Elderly care technicians must acknowledge that the spirituality is an important element in the way an elderly individual receives healthcare and they must be equipped for this matter. This study was conducted in order to examine the influence of "Skill Development Training Program for Spiritual Care of Elderly Individual," which was carried out with students from elderly care program, on the perception of spirituality support in a pretest-posttest quasi-experimental study design with control group. As the data collection form, "Spiritual Support Perception" (SSP) scale was used. The mean scores of the intervention group after the training and after one month are 50.39 ± 5.34 and 51.13 ± 4.98, respectively, and those of the control group are 43.16 ± 4.83 and 42.72 ± 4.48. A statistically significant difference was found between the mean scores of the intervention group from the pretest and the posttests immediately after the training and one month after the training (f = 94.247, p = 0.001). In the control group, however, there was no significant change in the SSP mean scores (f = 0.269, p = 0.77). As a result, this study pointed out the necessity of such training programs for healthcare professionals to make a distinction between their professional duties and their own personalities in order to offer spiritual care to the elderly individual.

Cognitive and functional assessment about elderly people users of health public service / Evaluación funcional y cognitiva de los ancianos usuários de los servicios de salud pública / Avaliação cognitiva e funcional de idosos usuários do serviço público de saúde

Objective: To evaluate the functional capacity, cognition and mood in three different care models for older adults. Method: A cross-sectional study conducted in 2014 with 140 older adults (37 institutionalized, 53 hospitalized and 50 outpatients). The MMSE, Clock Drawing Test (CDT), Activities of Daily Living Scale - ADLs (Katz, Lawton) and the Geriatric Depression Scale (GDS) were applied. Results: Of those institutionalized, the majority were totally dependent for ADLs and 100% presented cognitive decline. Of those hospitalized and the outpatients, the majority were independent for ADLs, with 62.3% and 48.0% presenting cognitive decline, respectively. The minority presented depressive symptoms. The results indicated that age was a predictor of cognitive decline and the likelihood of prevalence in hospitalized and outpatient older adults increased by 8.7% for each year of life. Conclusion: It is important to pay attention to the cognitive and functional performance of older adults with the aim of preventing their decline, which is so frequent in the public health services in Brazil.

Objetivo: Evaluar la capacidad funcional, cognitiva y el estado de ánimo en tres modelos diferentes de la atención a las personas mayores. Método: Estudio transversal comparativo realizado en el año 2014 con 140 ancianos (37 institucionalizados, 53 hospitalizados y 50 ambulatorios). Aplicado el MMSE, test del reloj, Actividades de la Vida Diaria Escala (Katz, Lawton) y Escala de Depresión Geriátrica. Resultados: El institucionalizada, la mayoría totalmente dependiente para ADL y el 100% tenían deterioro cognitivo. En hospitales y clínicas, muchos independiente para ADL, con el 62,3% y el 48% con el deterioro cognitivo, respectivamente, la minoría tenía síntomas depresivos. Los resultados indicaron que la edad es un predictor de deterioro cognitivo y las posibilidades de prevalencia en hospitalizados y ambulatorios ancianos aumento del 8,7% por cada año de vida. Conclusión: Cabe destacar la importancia de dar atención al rendimiento cognitivo y funcional de las personas mayores a la prevención disminución de éstos, tan frecuentes en los servicios de salud pública en Brasil.

Objetivo: Avaliar a capacidade funcional, cognitiva e humor em três diferentes modelos de atenção ao idoso. Método: Estudo seccional, comparativo, realizado em 2014 com 140 idosos (37 institucionalizados, 53 hospitalizados e 50 ambulatoriais). Aplicou-se o MEEM, Teste do Desenho do Relógio (TDR), Escala de Atividades de Vida Diária - AVDs (Katz, Lawton) e Escala de Depressão Geriátrica (EDG). Resultados: Dos institucionalizados, a maioria estava totalmente dependente para AVDs e 100% apresentaram declínio cognitivo. No hospital e ambulatório, maioria independente para AVDs, sendo 62,3% e 48% com declínio cognitivo, respectivamente. A minoria apresentou sintomas depressivos. Os resultados indicaram que a idade foi preditor de declínio cognitivo e as chances de prevalência em idosos hospitalizados e ambulatoriais aumentam 8,7 % para cada ano de vida. Conclusão: Destaca-se a importância de se dedicar atenção ao desempenho cognitivo e funcional dos idosos objetivando a prevenção do declínio destes, tão frequentes nos serviços públicos de saúde no Brasil.

Perfil de idosos que cuidam de outros idosos em contexto de alta vulnerabilidade social / Profile of older adults caring for other older adults in contexts of high social vulnerability

Objetivo: Caracterizar os cuidadores idosos que cuidam de outros idosos em contexto de alta vulnerabilidade social. Métodos: Estudo descritivo e transversal, realizado com 40 cuidadores idosos utilizando-se: questionário para caracterização do cuidador, Mini Exame do Estado Mental, Índice de Katz, Escala de atividades instrumentais de vida diária de Lawton, Escala de Depressão Geriátrica e o fenótipo de fragilidade proposto por Fried. Para as análises, utilizou-se o Stata versão 11.0, de forma descritiva. Resultados: Houve predomínio do sexo feminino, da faixa etária de 60 a 69 anos, de indivíduos casados, com ensino primário, aposentados. Não possuíam plano de saúde. A maioria era pré-frágil, hipertensa e independente tanto para as atividades instrumentais quanto para as atividades básicas de vida diária. Não apresentavam indícios de sintomas depressivos, nem de alterações cognitivas. Conclusão: Conhecer o perfil dos cuidadores idosos é imprescindível para subsidiar os serviços de saúde no planejamento de uma assistência de qualidade.