Impacto de los resultados a medio plazo de la prescripción inadecuada en los pacientes ancianos dados de alta desde una unidad de corta estancia / Impact of medium-term outcomes of inappropriate prescribing in older patients discharged from a short stay unit

OBJETIVO: Estudiar la asociación entre prescripciones potencialmente inapropiadas (PPI) y eventos adversos a los 30 y 180 días tras el alta de una unidad de corta estancia (UCE). MATERIAL Y MÉTODO: Estudio analítico observacional de cohortes retrospectivo que incluyó pacientes ≥ 75 años al alta de una UCE. Se utilizó la versión2 de los criterios STOPP-START. La variable resultado fue la presencia de algún evento adverso a 30 y 180 días. RESULTADOS: Se incluyeron 179 pacientes con una media de 84 (DE:5) años. La presencia de ≥ 1PPI al alta no se asoció con la aparición de algún evento adverso a los 30 ni a los 180días de manera global. La presencia de ≥ 1PPI al alta de fármacos del proceso cardiovascular tuvo mayor riesgo de presentar algún evento adverso a los 30 días del alta (OR ajustada 2,1; IC 95%: 1,0-3,2; p = 0,045), los fármacos del proceso "neuropsiquiátrico y riesgo de caídas" se relacionaron con deterioro funcional a los 30 días del alta (OR ajustada 6,3; IC 95%: 1,7-22,5; p = 0,005), y la omisión de fármacos del sistema cardiovascular se asoció con el reingreso a los 180 días (OR ajustada 3,6; IC95%: 1,5-8,3, p = 0,003). CONCLUSIONES: La presencia de eventos adversos de pacientes ancianos dados de alta de una UCE podría relacionarse con PPI detectadas por algunos criterios STOPP-START, y concretamente con los fármacos de los procesos cardiovasculares, neuropsiquiátrico y relacionado con las caídas

OBJECTIVE: To study the association between the potential inappropriate prescriptions (PIP) and the 30 and 180-day adverse event rate after discharge from a Short Stay Unit (SSU). METHODOLOGY: A retrospective cohort observational study was conducted on patients aged ≥ 75 years discharged from an SSU from February to April, 2014. STOPP-START criteria version2 was used. The main outcome was 30 and 180-day adverse event rate after being discharged. RESULTS: A total of 179 patients, with a mean age of 84 (SD5) years were included. The presence of ≥ 1PIP after being discharged was not associated with a 30 and 180-day composite adverse event. Patients with ≥1PIP related to a cerebro-cardiovascular process were at higher risk of an adverse event at 30 days after discharge (adjusted OR, 2.1; 95% CI: 1.0-3.2; P = .045), those with ≥1PIP related to neuropsychiatric process and risk of fall were at higher risk of increased 30-day functional impairment (adjusted OR, 6.3; 95% CI: 1.7-22.5; P = .005), and those with ≥ 1PIP related to omission of cardiovascular system were at higher risk of 180-day hospital readmission (adjusted OR, 3.6; 95% CI: 1.5-8.3; P = .003). CONCLUSIONS: The presence of adverse events in older patients discharged from SSU may be associated with PIP, identified by STOPP-START criteria, and more specifically with drugs related to cardiovascular, neuropsychiatric disorders, and falls

Relationship between the levels of family burden in caring for older people with the incidence of mistreatment

Background: Caring for older people can be a burden for the family that led to mistreatment. Objective: To determine the relationship between the levels of family burden in caring for older people with the occurrence of mistreatment incidence. Design and participants: A cross sectional study design was conducted with 135 older people who live with their family as respondents. Setting: 135 families with older people at Kelurahan/Village of Harjamukti area, Kecamatan/ District of Cimanggis, Depok city. Method: This study applied probability sampling technique with multistage cluster sampling. Results: Family characteristics show that almost half of older people were caring by family members (caregivers) who were aged 20-39 years, nearly all caregivers were women, family income mostly less than UMK, families mostly monosyllabic nation Betawi and caregivers mostly were their own child. Most of the families stated that no expense in caring for the older people (89.6%), but there are still families who feel the burden of caring. The highest type of mistreatmet of the older people is psychological mistreatments. Conclusions: From the statistical test obtained by p value equals to 0.553, it was concluded there was no correlation between the incidences of any family burden with mistreatment

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The Factors Associated With Older Adults Receiving Care in Jamaica / Factores Asociados con los Adultos Mayores que Reciben Cuidados en Jamaica

ABSTRACT Objective: To ascertain the level of care and the predisposing, enabling and need factors associated with care received by older adults using Andersen's framework. Methods: The 2012 Jamaica Survey of Living Conditions was used to conduct descriptive, bivariate and binary logistic analyses for the receipt of care among older adults defined by activities of daily living (ADL) and the instrumental activities of daily living (IADL) measures. The ADL sample comprised 3152 older adults and the IADL sample comprised 3141 older adults. Results: Approximately 16% of older adults received ADL care and significant binary logistic associations with age, area of residence, living arrangements, source of financial support, disability, and perceived health status were found. Approximately 69% received IADL care and significant binary logistic associations with gender, age, employed, living arrangements, wealth status, source of financial support, satisfaction with life accomplishments, disability and perceived health status were found for those receiving IADL care. Conclusion: Predisposing, enabling and need factors of the Andersen framework predict ADL and IADL care. Therefore, plans for care of older adults must address those 70 years or older who live alone, have a disability, a chronic illness and rate their health poorly.

RESUMEN Objetivo: Determinar el nivel de cuidados y los factores predisponentes, capacitantes y de necesidad asociados con el cuidado recibido por los adultos mayores, usando el modelo de Andersen. Métodos: La Encuesta de Condiciones de Vida en Jamaica 2012 fue utilizada para realizar análisis descriptivos, bivariantes y logísticos binarios en relación con el recibimiento de cuidados entre los adultos mayores, definidos por las medidas de las actividades de la vida diaria (AVD) y las actividades instrumentales de la vida diaria (AIVD). La muestra de AVD abarcó 3152 adultos mayores y la muestra de AIVD abarcó 3141 adultos mayores. Resultados: Aproximadamente el 16% de los adultos mayores recibieron cuidados de AVD, y en su análisis se hallaron asociaciones logísticas binarias significativas con la edad, el área de residencia, la situación de vivienda, la fuente de apoyo financiero, la discapacidad y el estado de salud percibido. Aproximadamente el 69% recibió cuidados de AIVD, y en su análisis se hallaron asociaciones logísticas binarias con el género, la edad, los empleados, la situación de vivienda, la situación económica, la fuente de apoyo financiero, la satisfacción con los logros de vida, la discapacidad, y el estado de salud percibido. Conclusión: Los factores predisponentes, capacitantes y de necesidad del modelo de Andersen predicen los cuidados de AVD y AIVD. Por lo tanto, los planes para el cuidado de adultos mayores tienen que abarcar a aquellas personas de 70 años o más que viven solas, tienen una discapacidad, una enfermedad crónica, y valoran su salud como pobre.

Develando la experiencia de un grupo de personas mayores en un centro de día / Unveiling the experience of a group of elderly people in a day care center

Objetivo: El envejecimiento de la población representa uno de los grandes desafíos para Latinoamérica, tanto para los servicios de salud como para los servicios sociales de apoyo a las personas mayores. La introducción de los centros de día para personas mayores, como un nuevo servicio gerontológico, se transformará en una pieza crítica de los servicios ofrecidos a las personas mayores que viven en la comunidad, generando las bases para construir un sistema de cuidado y atención especializada dirigida a este grupo etario. El objetivo de este estudio es evaluar la experiencia de un grupo de personas mayores pertenecientes a un centro de día de una municipalidad de Santiago, Chile. Métodos: Estudio cualitativo descriptivo con uso de técnica de grupo focal y análisis de contenido que devela la experiencia de 37 personas mayores asistentes a un centro de día. Resultados: Los principales resultados de este estudio fueron: a) mejoría en la funcionalidad, b) empoderamiento de las personas mayores y c) mayor inserción social. Conclusiones: La experiencia de las personas mayores es evaluada como positiva, reconociendo mejorías en aspectos claves de su vida cotidiana y que tienen el potencial de contribuir a mejorar y fortalecer la funcionalidad y aspectos de la salud mental de las personas mayores. Estos resultados aportan evidencia científica latinoamericana a la evaluación de la experiencia de las personas mayores con este nuevo servicio geriátrico

Background: Chile is a country that will continue aged at an accelerated rate as a result of a progressive decline in the birth rate, adequate access to health and a sustained increase in life expectancy. The aging population is one of the major challenges for the country as well as for health and for social services to support aged population. Introducing the Day Care Centers for aged people, as a new gerontological service, will become a critical part of the services offered to the elderly living in the community, creating the foundations for an specialized system of care directed this age group. The aim of this study is to evaluate the experience of a group of elderly people from a day care center of a municipality of the Metropolitan Region. Methods: Descriptive qualitative study with focus group and content analysis that reveals the experience of 37 older people attending at day care center. Results: The main results of this study were: (a) improvement in functionality, (b) empowerment of older persons, and (c) greater social inclusion. Conclusion: The experience of older persons is assessed as positive by themselves. Older people recognized improvements in key aspects of their daily lives and have the potential to contribute to improving and strengthening the functionality and mental health of elderly people. These results provide evidence for national evaluation of this new geriatric service

A cost of living longer: Projections of the effects of prospective mortality improvement on economic support ratios for 14 advanced economies.

The economic implications of increasing life expectancy are important concerns for governments in developed countries. The aims of this study were as follows: (i) to forecast mortality for 14 developed countries from 2010 to 2050, using the Poisson Common Factor Model; (ii) to project the effects of the forecast mortality patterns on support ratios; and (iii) to calculate labour force participation increases which could offset these effects. The forecast gains in life expectancy correlate negatively with current fertility. Pre-2050 support ratios are projected to fall most in Japan and east-central and southern Europe, and least in Sweden and Australia. A post-2050 recovery is projected for most east-central and southern European countries. The increases in labour force participation needed to counterbalance the effects of mortality improvement are greatest for Japan, Poland, and the Czech Republic, and least for the USA, Canada, Netherlands, and Sweden. The policy implications are discussed.

Family, welfare state generosity and the vulnerability of older adults: A cross-national study.

The availability of family can be considered a protective factor for aging well. In this article, we examine to what extent the family situation of older people creates vulnerability with respect to their quality of life. Because not everyone is vulnerable to the same degree, we try to identify the conditions under which older people benefit more from having family resources. Based on the resources perspective, we argue that the impact of family resources on life satisfaction is stronger for older people with fewer resources at both the individual level (material, physical and non-familial social resources) and the country level (welfare state services targeted at older adults). To test our hypotheses we make use of the fourth wave of the European Values Study, and the MULTILINKS Social Policy Indicators database. In general our data offer support for the idea that the presence of intimate family ties (with partner and children) can be considered an important resource for achieving psychological well-being, whereas their absence or loss may act as a constraint. Our vulnerability argument is partly supported by the findings. Partner resources are more important for the life satisfaction of older people with a low education and health problems. Similarly, having children only improves the life-satisfaction of lower educated older adults. However, family resources are not more important for older people with fewer material resources or for older people living in countries with low services levels targeted at older adults.

Old age security in rural China: there is a long way to go.

OBJECTIVE: We aimed to examine the current developments and challenges confronted by old age security in rural China. DATA SOURCES: This study is based on the data from PubMed, Elsevier, Wiley, EBSCO, EMBASE, SCI Expanded, ProQuest, Google, and CNKI which is the most informative database in Chinese. STUDY SELECTION: Articles were selected with the search terms "rural", "China", "old", "older", or "elder", "elderly", or "aged", "aging", "security", "culture", "value", "medical insurance" or "community based medical insurance" or "cooperative medical scheme". Related websites and yearbooks were searched as well. RESULTS: The socio-economic development has made the burden of traditional care for the rural elderly heavier than ever, and new challenges are emerging in rural communities, such as poor economic, deteriorating natural environment and health crisis. CONCLUSIONS: The governments should improve the scale and caliber of rural old age security and strengthen regulations with great efforts in developing the rural economy and protecting the natural environment of rural communities.

Experience of socioeconomic-related inequality in dental care utilization among Thai elderly under universal coverage.

AIM: To assess the socioeconomic-related inequality in dental care utilization among Thai elderly and to determine factors associated with the observed inequality after the country achieved universal coverage. METHODS: The data were taken from the nationally representative Thailand Health & Welfare Survey 2007. Data of 10,096 Thai elderly (aged over 60 years) were selected. Descriptive analyses of the features of dental care utilization among Thai elderly were carried out, in addition to the concentration index (Cindex ) being used to quantify the extent of socioeconomic-related inequality in dental care utilization. Logistic regression was used to determine factors associated with inequality in dental care. RESULTS: Socioeconomic-related inequality in dental care utilization among Thai elderly was shown. Also, utilization was more concentrated among wealthier older adults, as shown by the positive value of Cindex (equals 0.244). The poor elderly, however, were more likely to utilize dental care at public facilities, particularly primary care facilities. Multivariate analysis showed that certain demographic, socioeconomic and geographic characteristics were particularly associated with poor-rich differences in dental care utilization among Thai elderly. CONCLUSIONS: Although socioeconomic-related inequality in dental care utilization among Thai elderly exists, the pro-poor utilization at public facilities, particularly primary care facilities, substantiates the concerted effort to reducing inequality in dental care utilization for Thai elderly.

The impact of health changes on labor supply: evidence from merged data on individual objective medical diagnosis codes and early retirement behavior.

The justification bias in the estimated impact of health shocks on retirement is mitigated by using objective health measures from a large, register-based longitudinal data set including medical diagnosis codes, along with labor market status, financial, and socio-economic variables. The duration until retirement is modeled using single and competing risk specifications, observed and unobserved heterogeneity, and flexible baseline hazards. Wealth is used as a proxy for elapsed duration to mitigate the potential selection bias stemming from conditioning on initial participation. The competing risk specification distinguishes complete multiperiod routes to retirement, such as unemployment followed by early retirement. A result on comparison of coefficients across all states is offered. The empirical results indicate a strong impact of health changes on retirement and hence a large potential for public policy measures intended to retain older workers longer in the labor force. Disability responds more to health shocks than early retirement, especially to diseases of the circulatory, respiratory, and musculoskeletal systems, as well as mental and behavioral disorders. Some unemployment spells followed by early retirement appear voluntary and spurred by life style diseases.

Autonomia e direito à informação: contribuições para a gestão do cuidado de idosos hospitalizados / Autonomía y derecho a la información: contribuciones para la gestión del cuidado de ancianos hospitalizados / Authonomy and right to information: contributions for the elder inmate care management

Estudo do tipo exploratório-descritivo que teve como objetivo verificar se os profissionais de enfermagem respeitam o direito à informação e o exercício da autonomia dos idosos hospitalizados, previstos em lei. Participaram 24 idosos de um município do interior do Estado do Paraná - Brasil, que responderam a um questionário, no domicílio, após a alta hospitalar. Dentre os resultados, obteve-se que 17 (70,8 por cento) desconheciam os seus direitos; 10 (41,7 por cento) não receberam informações sobre as normas e rotinas da instituição; para 12 (50 por cento) as dúvidas referentes à sua doença e evolução não foram esclarecidas; 13 (54,3 por cento) não foram informados sobre os cuidados recebidos; 17 (70,8 por cento) afirmaram que gostariam de participar das decisões sobre o seu cuidado, mas para 21 (87,5 por cento) essa conduta não foi possibilitada pela enfermagem. Quanto às informações/orientações sobre cuidados após a alta hospitalar, 10 (41,7 por cento) não foram orientados a respeito, 10 (41,7 por cento) receberam informações da equipe médica e somente 2 (8,3 por cento) receberam da enfermagem. Conclui-se que, nas instituições onde os sujeitos deste estudo estiveram internados, há necessidade de a enfermagem cumprir a legislação que diz respeito ao fornecimento de informações e ao exercício da autonomia do idoso.

An exploratory descriptive study which aimed at verifying if the nursing professionals pay the respect to the right to information and the authonomy exercise of elderly inmates, predicted by the Law. Twenty-four elderly people, from a city of Parana state, in Brazil, took part in the study. They answered to a questionnaire, at their domicile, after their discharge from hospital. Among the results we had: 17 (70,8 percent) elderly did not know their rights; 10 (41,7 percent) did not receive information about the institution rules and routines; 12 (50 percent) did not get their doubts, related to the disease and their health situation evolution, cleared; 13 (54,3 percent) were not informed about the received care; 17 (70,8 percent), said they would like to take part on the decisions about their treatment, but for 21 (87,5 percent) informed that such participation was not allowed by the nursing team. In relation to the care after the discharge from hospital, 10 (41,7 percent) did not receive any information about it, 10 (41,7 percent) received such information from the physician team and only 2 (8,3 percent) received it from the nursing team. In conclusion, at the institutions where this study's participants were interned, the nursing staff needs to act according to what the elderly Law lays down, on the sense of providing suitable and sufficient information, as well as promoting this group autonomy.

Estudio de tipo exploratorio descriptivo que tuvo como objetivo verificar si los profesionales de enfermería promueven la autonomía y el derecho a la información de ancianos hospitalizados, previstos en la ley. Participaron 24 ancianos de una municipalidad del interior del Estado de Paraná, Brasil, que respondieron a un cuestionario, en domicilio, tras el alta hospitalar. De entre los resultados se obtuvo: 17 (70,8 por ciento) ancianos desconocían sus derechos; 10 (41,7 por ciento) no recibieron informaciones sobre las normas y rutinas de la institución; 12 (50 por ciento) no tuvieron respuestas para sus dudas referentes a la enfermedad y a la evolución de su cuadro de salud; 13 (54,3 por ciento) no fueron informados sobre los cuidados recibidos; 17 (70,8 por ciento) comentaron que a ellos les gustaría participar de las decisiones sobre su tratamiento/cuidado y 21 (87,5 por ciento) informaron que en ningún momento esa participación fue permitida por la enfermera. En cuanto a las informaciones sobre los cuidados tras el alta hospitalar, 10 (41,7 por ciento) no recibieron ninguna información al respecto, 10 (41,7 por ciento) recibieron informaciones del equipo médico y solamente 2 (8,3 por ciento) se refirió a que ese procedimiento fue realizado por algún miembro del equipo de enfermería. En conclusión, en las instituciones donde los participantes de este estudio fueron hospitalizados, el personal de enfermería tiene que actuar de acuerdo con lo que la ley establece, en el sentido de proporcionar información, así como promover el ejercicio de la autonomía de las personas ancianas.

Conocimiento y expectativas de las personas mayores sobre los servicios sociales dirigidos a este colectivo en la Comunidad Autónoma de Galicia / Knowledge and expectations among older adults of social services for the elderly in the Autonomous Region of Galicia (Spain)

Objetivo: la información y el conocimiento que poseen las personas mayores acerca de los servicios sociales pueden contribuir tanto al acceso a éstos como a la eliminación de mitos y estereotipos negativos vinculados a su finalidad y a sus usuarios. El objetivo del presente trabajo es analizar el conocimiento que tienen las personas mayores de la Comunidad Autónoma de Galicia sobre los servicios sociales dirigidos a este colectivo, así como identificar sus expectativas de uso futuro y las características que considerarían idóneas para lograr una mejor calidad y atención en los mismos. Material y métodos: se analizan los ítems correspondientes al apartado de servicios sociales del «Cuestionario de necesidades y demandas de usuarios y no usuarios de servicios sociales para personas mayores», que fue aplicado a una muestra de 1.101 personas de 60 y más años de la Comunidad Autónoma de Galicia. Resultados: el conocimiento que poseen los mayores gallegos es, en general, escaso. Los servicios más conocidos son los más tradicionales, como las residencias, y la principal fuente de la que obtienen la información son los familiares y amigos, y los medios de comunicación. El conocimiento se ve influido fundamentalmente por determinadas variables, como la edad, el nivel de estudios y el hábitat. Conclusiones: es necesario llevar a cabo una mayor difusión de los servicios sociales entre las personas mayores y especialmente entre las personas de mayor edad, con menores niveles educativos y del ámbito rural

Introduction: information and knowledge among the elderly on social services can contribute both to their access to these services, as well as to the elimination of myths and negative stereotypes pertaining to these services and their users. The aim of this study was to analyze knowledge of the social services availableto the elderly among older adults in the Autonomous Region of Galicia, as well as to identify their expectations of future use and the characteristics that they consider suitable to improve theirquality of life and obtain the most appropriate care.Material and methods: the items in the Social Services section of the «Needs and Requests of Users and Non-Users of Social Services for the Elderly Questionnaire» were analyzed and applied to a sample of 1,101 participants aged 60 years and older inthe Autonomous Region of Galicia.Results: knowledge of the available social services was generally limited among elderly individuals in Galicia. The best-known services were traditional services, such as nursing homes, and the main sources from which the elderly received information were family, friends and the media. Knowledge was mainly influencedby specific variables such as age, educational level, and habitat. Conclusions: information on social services to the elderly should be disseminated, especially among older adults with lower levels of education and those living in rural areas (AU)

Modelos factoriales confirmatorios de las escalas de Ryff en una muestra de personas mayores / Factorial confirmatory models of Ryff’s scales in a sample of elderly people

En los últimos años distintos trabajos han intentado analizar la estructura del constructo bienestar. Como objetivo de nuestro trabajo pretendemos analizar la estructura factorial de las escalas de Ryff, pero en una subpoblación específica, la población mayor, en la que esta variable resulta fundamental en todos los modelos teóricos que analizan su calidad de vida. La muestra estaba compuesta por 169 sujetos, mayores de 65 años, de la Comunidad Valenciana y se utilizaron las escalas de Ryff, en la versión de 54 ítems. Previo a los análisis se realizó un agrupamiento de los ítems originales en 18 indicadores, tres por factor. Posteriormente se realizaron una serie de análisis factoriales confirmatorios que incluían la mayor parte de los modelos teóricos puestos a prueba en la literatura tanto en población general de distintos países, como en subpoblaciones específicas. En cuanto a los resultados, los valores de ajuste obtenidos fueron similares a los encontrados en la mayoría de los trabajos, encontrándose un mayor apoyo empírico para los modelos de seis factores oblicuos defendidos por los autores de las escalas, así como a una modificación de cinco factores que colapsaba las dimensiones de dominio del ambiente y autoaceptación en un solo factor, también oblicuos (AU)

Several recent works have analysed the factorial structure of well-being measures. The aim of our study is to analyse the factorial structure of a widely used well-being scale, Ryff’s Scales of Psychological Well-being, but in a specific subpopulation of the Spanish population, the elderly. For this particular subpopulation, the construct of well-being has been employed in most theoretical models that explain quality of life, and its role is therefore pivotal. The sample comprised 169 elderly people (65 years or more), sampled within the Valencian Community. The 54-item version of Ryff’s scales was used. An item parcelling process was analytically employed before confirmatory factor analyses, allowing a total of 18 well-being indicators. Confirmatory factor analyses were specified and tested, including all theoretical and empirical solutions found in the literature, either in the general population or in specific populations of different cultural contexts. Goodness-of-fit results were similar to the ones found in the literature. Best solutions were a six-factor model with correlated factors, as defended by the authors, and a five-factor correlated solution, collapsing environmental mastery and self-acceptance into a single factor (AU)

Análisis y satisfacción del Servicio de Ayuda a Domicilio en la provincia de Almería (España) / Analysis and satisfaction of the home help service in Almería province (Spain)

El aumento de la dependencia para la realización de Actividades de la Vida Diaria exige respuestas político-sociales de cara a tomar responsabilidades ante este nuevo y emergente reto social. El presente estudio da a conocer las características de la prestación del Servicio de Ayuda a Domicilio (SAD) en la provincia de Almería, respecto a actividades de carácter doméstico, personal y educativo, además de evaluar la satisfacción de los usuarios. Así, observamos como el SAD más demanda-do es el relacionado con actividades domésticas, seguido de las actividades de carácter personal y educativo. Existe una mayor prevalencia en el uso por parte del género femenino, aumentando la diferencia respecto al mas-culino a medida que aumenta la edad. La mayoría de los sujetos que utilizan la ayuda doméstica se sitúan en los grupos de 70-79 y 80-89 años, no observándose diferencias en función del estado civil en el uso de actividades relacionadas con el vestido y el aseo. Es considerablemente alto el grado de satisfacción con el servicio y el trato del personal responsable, mientras que aproximadamente el 35% no considera suficiente la prestación que recibe

The increase of the dependency to make Activities of the Daily Living requires political and social answers for this new and emergent social challenge. The present paper presents the characteristics of the Home Help Service (SAD) in the province of Almería, with respect to activities of domestic, personal and educative character, besides to evaluate the satisfaction of the users. Thus, we observed as the demanded SAD more is the related one to domestic activities, followed of the activities of personal and educative character. A greater prevalence in the use for the women exists, increasing the difference with respect to the men as it increases the age. Most of the subjects that use the domestic aid are located in the groups of 70-79 and 80-89 years, not being observed differences based on the civil state in the use of activities related to the dress and the cleanliness. The degree of satisfaction, with the service and the treatment of the responsible personnel, is considerably high, whereas approximately 35% don’t consider the benefit sufficient that receives

Apoyo social percibido: características psicométricas del cuestionario Caspe en una población urbana geriátrica / Perceived social support: psychometric properties of CASPE questionnaire in urban not institutionalized elderly population

Examinamos las características psicométricas de un nuevo cuestionario breve de Apoyo Social Percibido, denominado CASPE, en una muestra comunitaria de 207 personas mayores. Los parámetros del CASPE muestran valores aceptables: 0,65 para la consistencia interna Alfa, y 0,77 para la fiabilidad por el método de dos mitades. La correlación positiva significativa con otra medida de Apoyo Social (0,625, p= 0,000), la correlación negativa y significativa con las medidas de estrés (-0,220, p= 0,002) y ansiedad (-0,1635, p= 0,020), y la evaluación positiva emitida por los expertos (75%), aportan indirectamente validez al cuestionario. La solución trifactorial hallada (máxima verosimilitud con rotación varimax) explica el 62,5% de la varianza. Por todo ello, el CASPE, siendo susceptible de mejora, se presenta como un instrumento válido para la evaluación del Apoyo Social Percibido (AU)

We examined the psychometric properties of a new brief Inventory of Perceived Social Support, called CASPE, in a community based sample of 207 elderly people. The CASPE exhibited acceptable parameter values: internal Alpha consistency (0,65), and split half reliability (0,77). A positive significant correlation with other measurement of Social Support (0,625, p= 0,000), a negative significant correlation measures of stress, (-0,220, p= 0,002) and anxiety (-0,1635, p= 0,020), and the positive evaluation by experts judges (75%) provides indirect validation. The three factor solution found (maximum likelihood with varimax rotation) explained the 62,5% of variance. Thus the CASPE could be improved, this fact notwithstanding it appears to be a valid tool for assessment of Perceived Social Support (AU)

[Changes in needs for assistance and care after hip fractures in the elderly]. / Veränderungen des Hilfe- und Pflegebedarfs nach hüftnahen Frakturen im höheren Lebensalter.

For the prevention and rehabilitation of fall-related fractures, not only functional status is important. It is necessary to describe the level of help and care needed at the time the fracture happened and its changes after a certain period. Investigations of the changes in the need of help and care after a fall-related fracture hardly exist for the Federal Republic of Germany. The first step in the present investigation was to analyze the changes in the need of help and care. In a second step, different developments of changes in the need of help and care after a fall-related hip fracture should be identified. Data for the present analysis were taken from a prospective 12-month observational survey (Fractures in late life). A total of 332 people aged 65 and over were assessed at two timepoints (T1-within the first 4 days post-fracture and T2-six months later by phone call). The assessed aspects were formal and informal support, financial support, ability to walk, cognition (only at T1) and form of housing. After the fall-related fracture the strain of formal and informal support increases. The strain of financial support and institutional care also increases. 20% of the patients achieved for the first time the criteria for the lowest level in the legal care system of Germany which indicates a higher level of need of care. 5% of the patients achieved post-fracture a higher level in the legal care system. Six different groups of patients could be identified by cluster analyses. They show differences in the changes in the ability to walk, form of housing, mortality and level of care and help. The different health status before and after the fall-related fracture leads to different developments post-fracture. In prevention and rehabilitation of patients with fall-related fractures, the individual needs of the subgroups should be taken into consideration.