Ciudadanía activa y personas mayores: viejos conceptos, nuevos abordajes. Una revisión sistemática y metasíntesis cualitativa / Being an active citizen and the elderly: old concepts, new approaches. A systematic review and qualitative meta-synthesis

Las políticas de envejecimiento activo presentan el concepto de «ciudadanía activa» como un desafío clave en el ámbito del envejecimiento para los próximos años. La ciudadanía activa ha sido definida de diferentes maneras, en la mayoría de los casos de forma complementaria, describiendo un eclecticismo de actividades participativas que incluye la política, el mercado y la acción comunitaria y voluntaria. El término se sitúa en diferentes contextos como la política formal, el trabajo remunerado, la sociedad civil y el hogar. Este trabajo, a partir de una revisión sistemática, identifica el contexto en el que emerge este concepto en relación con las personas mayores y las personas con demencia, analizando las diferentes expresiones de ciudadanía activa utilizadas y aportando elementos clave a tener en cuenta en la formulación de políticas en un contexto de acelerado envejecimiento demográfico y donde la demencia es una prioridad de salud pública. La noción de ciudadanía activa en la vejez supone un paso adelante que parte del envejecimiento activo a un concepto más amplio que integra el principio de igualdad entre las personas con independencia del género, edad y necesidad de apoyos

The politics of active ageing present active citizenship of the elderly as a key challenge for the coming years. Active citizenship has been defined in different ways (as complimentary in most cases), outlining an eclecticism of participatory activities that includes political engagement in a participatory and deliberative manner, as well as community and voluntary action. This term is found in different contexts such as formal politics, work, civil society, and the home. This paper, based on a systematic review, identifies the context in which this concept emerges in relation to older people and people with dementia. It also analyses the different expressions of active citizenship used, and provides key elements to be taken into account in the formulation of policies in a context of accelerated demographic ageing and where dementia is a public health priority. The notion of active citizenship in old age is a step forward from active ageing to a broader concept that integrates the principle of equality between people irrespective of gender, age and the need for support

[Being an active citizen and the elderly: Old concepts, new approaches. A systematic review and qualitative meta-synthesis]. / Ciudadanía activa y personas mayores: viejos conceptos, nuevos abordajes. Una revisión sistemática y metasíntesis cualitativa.

The politics of active ageing present active citizenship of the elderly as a key challenge for the coming years. Active citizenship has been defined in different ways (as complimentary in most cases), outlining an eclecticism of participatory activities that includes political engagement in a participatory and deliberative manner, as well as community and voluntary action. This term is found in different contexts such as formal politics, work, civil society, and the home. This paper, based on a systematic review, identifies the context in which this concept emerges in relation to older people and people with dementia. It also analyses the different expressions of active citizenship used, and provides key elements to be taken into account in the formulation of policies in a context of accelerated demographic ageing and where dementia is a public health priority. The notion of active citizenship in old age is a step forward from active ageing to a broader concept that integrates the principle of equality between people irrespective of gender, age and the need for support.

El valor de «sentirse como en casa» en los centros residenciales: lo pequeño es hermoso / The value of «feeling at home» in nursing homes. Small is beautiful

No disponible

Estudio de la implicación en un grupo de personas con demencia con atención tradicional y un grupo con atención centrada en la persona / Study of engagement in a group of people with dementia in traditional care settings and a group with person centred care

Introducción. Las personas con demencia en contexto residencial presentan un grado elevado de apatía y desconexión con el entorno. La ausencia de estimulación y la baja frecuencia de actividades personalizadas, características en los centros residenciales, podrían ser elementos contextuales que favorecen estos comportamientos. El modelo de atención centrado en la persona (MACP) promueve la participación de las personas en actividades cotidianas acorde con sus recursos, sus intereses y necesidades. El objetivo de este estudio es comparar la frecuencia de conductas de implicación y desimplicación en las actividades cotidianas en 2 grupos de usuarios residentes en unidades psicogeriátricas, asistido uno de ellos según el modelo tradicional y el otro según el MACP. Metodología. Participaron en el estudio 28 sujetos con deterioro cognitivo y residentes en unidades psicogeriátricas: 14 usuarios de una unidad tradicional (grupo control) y 14 en una unidad en la que se incorporaron intervenciones relativas al MACP (grupo experimental). Los grupos fueron equivalentes en deterioro cognitivo, capacidades funcionales y años de ingreso. Se utilizó el Registro de Implicación/Engagement para observar en ambos grupos la frecuencia de 12 categorías de comportamiento de implicación en 2 períodos diferenciados: antes de las intervenciones asociadas al MACP y 18 meses después de haber comenzado las mismas. Resultados. Ambos grupos vieron incrementada la frecuencia de sus conductas de implicación en el período post; sin embargo, el grupo experimental disminuyó los comportamientos de desimplicación, mientras que el grupo control los aumentó. Conclusiones. Acorde con los datos, intervenciones asociadas al MACP podrían minimizar los comportamientos de desconexión con el entorno que suceden en el contexto residencial vinculando a las personas al contexto y facilitando la participación e implicación en las actividades de la vida diaria (AU)

Introduction. People with dementia in the residential care setting have a high level of apathy and disengagement. The lack of stimulation and customised activities, a common aspect in residential centres, could be contextual elements that promote these behaviours. The person-centred care model (PCCM) promotes the participation of people in their daily activities in relation to their resources, interests, and needs. The aim of this study is to compare the frequency of engagement behaviours in the daily activities in two groups of users residing in Psychogeriatric Units, one receiving a traditional care model and the other assisted under PCCM. Methodology. The study involved 28 patients with cognitive impairment in Psychogeriatric Units, 14 of whom were in a traditional unit (control group), and 14 were in a unit where PCCM (experimental group) was implemented. Groups were equivalent in cognitive impairment, functional capabilities, and years in the long-term care institution. The Registering Engagement Instrument (REI) was used to observe the frequency of 12 categories of engagement behaviour in two distinct periods in both groups: before the interventions associated with PCCM, and 18 months after starting them. Results. Both groups increased the frequency of their engagement behaviours in the post-evaluation, but the experimental group decreased their disengagement behaviours while the control group increased them. Conclusions. According to the data, PCCM interventions could reduce disengagement behaviours in the residential context, and could facilitate the participation and involvement in the activities of daily living (AU)

[Study of engagement in a group of people with dementia in traditional care settings and a group with person centred care]. / Estudio de la implicación en un grupo de personas con demencia con atención tradicional y un grupo con atención centrada en la persona.

INTRODUCTION: People with dementia in the residential care setting have a high level of apathy and disengagement. The lack of stimulation and customised activities, a common aspect in residential centres, could be contextual elements that promote these behaviours. The person-centred care model (PCCM) promotes the participation of people in their daily activities in relation to their resources, interests, and needs. The aim of this study is to compare the frequency of engagement behaviours in the daily activities in two groups of users residing in Psychogeriatric Units, one receiving a traditional care model and the other assisted under PCCM. METHODOLOGY: The study involved 28 patients with cognitive impairment in Psychogeriatric Units, 14 of whom were in a traditional unit (control group), and 14 were in a unit where PCCM (experimental group) was implemented. Groups were equivalent in cognitive impairment, functional capabilities, and years in the long-term care institution. The Registering Engagement Instrument (REI) was used to observe the frequency of 12 categories of engagement behaviour in two distinct periods in both groups: before the interventions associated with PCCM, and 18 months after starting them. RESULTS: Both groups increased the frequency of their engagement behaviours in the post-evaluation, but the experimental group decreased their disengagement behaviours while the control group increased them. CONCLUSIONS: According to the data, PCCM interventions could reduce disengagement behaviours in the residential context, and could facilitate the participation and involvement in the activities of daily living.

Validity and reliability of the Spanish version of Caregiver Abuse Screen (CASE).

Detection of elder abuse risk is a critical issue because a lot of cases remain hidden. Screening tools can be used to detect elder abuse. However, few tools have been developed for use with caregivers. The purpose was to develop a translation and adaptation of a Spanish version of the Caregiver Abuse Screen (CASE) and to assess its validity and reliability. The CASE was then used with 211 primary caregivers. Validity and reliability were evaluated, as well as the factorial structure of the instrument. This version showed good psychometric properties. It was found to have strong internal consistency and split-half reliability as well as allowing for a good replication of the original factorial structure. Additionally, several variables related to elder abuse were linked to the CASE such as depression, burden, frequency, and reactions to problem behaviors. The version developed showed sufficient validity and reliability and could be considered as a suitable instrument to assess risks of elder abuse in a Spanish-speaking context.

Efectos del Modelo de Atención Centrado en la Persona en la calidad de vida de personas con deterioro cognitivo de centros gerontológicos / Effects from the Person Centered-Care Model on quality of life of cognitive impaired persons from gerontological centers

Introducción. El Modelo de Atención Centrado en la Persona ha suscitado creciente interés para su aplicación en centros gerontológicos. Sin embargo, hay escasas aportaciones sobre su impacto en nuestro contexto. El objetivo del trabajo consiste en establecer las consecuencias que para la calidad de vida de residentes con deterioro cognitivo, tienen las intervenciones asociadas al Modelo de Atención Centrado en la Persona en el Proyecto «Etxean Ondo». Material y métodos. Se seleccionó a 119 residentes con deterioro cognitivo, 59 en el grupo control y 60 en el grupo experimental. Los sujetos de cada grupo fueron distribuidos según su deterioro cognitivo: leve o grave. Se implantaron cambios en los entornos físico, y organizativo para la promoción de autonomía y bienestar. Se evaluó la calidad de vida, antes de las intervenciones y 6 meses después, utilizándose las escalas Fumat (deterioro cognitivo leve) y Qualid (deterioro cognitivo grave). Se utilizó t de Student para las comparaciones de medias. Resultados. En las comparaciones intergrupo, se identificaron diferencias significativas en la escala Fumat a favor del grupo control con deterioro cognitivo leve. Estas diferencias no se registraron en la evaluación posterior. El grupo experimental con deterioro cognitivo grave mejoró significativamente en la escala Qualid en la evaluación posterior. En las comparaciones intragrupo, se registraron mejoras significativas en la calidad de vida de los sujetos del grupo experimental, tanto con deterioro cognitivo grave como leve. Conclusiones. Los hallazgos avalan la efectividad de las intervenciones e identifican cuestiones metodológicas y conceptuales que deberán considerarse en el análisis de los efectos del Modelo de Atención Centrado en la Persona (AU)

Introduction. The Model of Person Centered Care has attracted increasing interest for use in gerontology centers. Therefore, the contributions about its impact are scarce in our context. The objective of this paper is to establish the impact that the interventions associated with the Model of Person Centered Care in the «Etxean Ondo» Project have on the quality of life of residents with cognitive impairment. Material and methods. One hundred and ninetten residents with cognitive impairment were selected: 59 in the control group and 60 in the experimental group. Subjects in each group were sorted by cognitive impairment: mild or severe. Changes were implemented in the physical and organizational environments for the promotion of autonomy and wellbeing. Quality of life was assessed before and 6 months after intervention using the Fumat Scales (mild cognitive impairment) and Qualid (severe cognitive impairment). The t-Student test was used for comparison of means. Results. In intergroup comparisons, significant differences in the Fumat Scale for the control group with mild cognitive impairment were initially identified. These differences were not recorded in the post assessment. The experimental group with severe cognitive impairment was significantly improved in the Qualid Scale post assessment. In intragroup comparisons, significant improvements were evident in the quality of life of experimental subjects, both with severe cognitive impairment (Qualid) and mild (Fumat). Conclusions. The findings support the effectiveness of the interventions and identify methodological and conceptual issues that have been considered to analyze the Model of Person Centered Care efects (AU)

[Effects from the Person Centered-Care Model on quality of life of cognitive impaired persons from gerontological centers]. / Efectos del Modelo de Atención Centrado en la Persona en la calidad de vida de personas con deterioro cognitivo de centros gerontológicos.

INTRODUCTION: The Model of Person Centered Care has attracted increasing interest for use in gerontology centers. Therefore, the contributions about its impact are scarce in our context. The objective of this paper is to establish the impact that the interventions associated with the Model of Person Centered Care in the «Etxean Ondo¼ Project have on the quality of life of residents with cognitive impairment. MATERIAL AND METHODS: One hundred and ninetten residents with cognitive impairment were selected: 59 in the control group and 60 in the experimental group. Subjects in each group were sorted by cognitive impairment: mild or severe. Changes were implemented in the physical and organizational environments for the promotion of autonomy and wellbeing. Quality of life was assessed before and 6 months after intervention using the Fumat Scales (mild cognitive impairment) and Qualid (severe cognitive impairment). The t-Student test was used for comparison of means. RESULTS: In intergroup comparisons, significant differences in the Fumat Scale for the control group with mild cognitive impairment were initially identified. These differences were not recorded in the post assessment. The experimental group with severe cognitive impairment was significantly improved in the Qualid Scale post assessment. In intragroup comparisons, significant improvements were evident in the quality of life of experimental subjects, both with severe cognitive impairment (Qualid) and mild (Fumat). CONCLUSIONS: The findings support the effectiveness of the interventions and identify methodological and conceptual issues that have been considered to analyze the Model of Person Centered Care efects.

Perceived economic situation, but not education level, is associated with disability prevalence in the Spanish elderly: observational study.

BACKGROUND: The aim of this paper is to ascertain if the subjective perception of the economic situation of a household is associated with the prevalence of disability in old age, net of education level. Subjective economic perception is less non-response biased. Knowing if the self-perceived economic situation is related to disability over and above education level has important implications both for understanding the mechanisms that lead to disability and for selecting policies to reduce it. METHODS: This is a transversal study based on the pilot of the ELES survey, which is a representative survey of non-institutionalised Spaniards aged 50 and over. Only individuals whose job income levels were fixed before becoming disabled were selected to avoid the main source of reverse causality. Disability was defined as having difficulty in carrying out any of 12 activities of daily living. Education level, difficulty in making ends meet, self-perceived relative economic position of the household, age, gender, psychological disposition, and alcohol and tobacco consumption were introduced as independent variables in binary logistic models. RESULTS: The working sample is made up of 704 individuals of aged 60 and over. The subjective household economic situation, measured in two different ways, is strongly and consistently related with the prevalence of disability net of age, gender, education level and psychological disposition. After adjusting for age and gender, education level is no longer associated with disability. However, having economic difficulties has the same effect on disability prevalence as being 10 years older, or being a woman instead of a man. CONCLUSIONS: As the economic situation of the elderly is much easier to improve than their formal education, our findings support feasible interventions which could lead to a reduction in the prevalence of disability.