[Evaluation of Pharmacists' Active Intervention to Reduce Potentially Inappropriate Medications in Special Older Adult Nursing Home].

Currently, elderly care facilities that do not offer long-term care are not required to employ pharmacists, and duties such as the dispensing and distribution of medicines are entrusted to external pharmacies. Pharmacists seldom spend sufficient time at the facilities for elderly people requiring special care. Thus, in many cases, the pharmacists have insufficient knowledge of the residents' medication status, leading to their inability in determining whether the residents are receiving a suitable drug therapy. We previously documented various problems in the practices adopted by nursing staff (with negligible intervention by pharmacists) for assisting residents in taking their medications. In the present pilot study, we attempted to eliminate the use of potentially inappropriate medications by stationing a pharmacist at a nursing home for 24 h every week (3 d/week). We proactively collected information from nurses and other nursing staff and observed the residents' actual living conditions and medication use. As a result of this intervention, 56 prescriptions were changed. However, only two of these were changed exclusively based on the prescription information. Most prescriptions were able to change based on the information obtained by the pharmacist present at the facility. Therefore, pharmacists' presence at the facility (at least for a few hours) is necessary, as they can actively intervene and collaborate with other staff to prevent the use of potentially inappropriate medications.

Investigation of antimicrobial therapy for aspiration pneumonia in elderly nursing homes: a retrospective observational study in Japan

Objective: Poor prognostic factors in the treatment of infectious diseases in home care have not been studied to date. Further, there have been no studies on the appropriate use of antimicrobial agents for aspiration pneumonia in elderly nursing home. Therefore, this study was retrospectively investigated the status of antimicrobial use for aspiration pneumonia in elderly nursing homes, and the clinical efficacy of each antimicrobial therapy. Methods: Patients who received antimicrobial therapy for aspiration pneumonia between 2020 and 2022 were included. This study was investigated the compliance of antimicrobial therapy with recommended Japanese guidelines. The clinical efficacy and safety of the recommended and non-recommended antimicrobial therapies were examined. Results: Fifty patients with aspiration pneumonia were administered antimicrobials. The rate of compliance to the guidelines for the appropriate selection, dose, and duration of antimicrobials were 46%, 66%, and 66%. This investigation indicated that all three indicators were appropriate showed a higher clinical cure rate and lower mortality rate than those in groups for which all three indicators were inadequate (clinical cure, 91.7% vs. 0%, p = 0.008; 30-days mortality, 8.3% vs. 33.3%, p = 0.371). In addition, appropriate drug selection resulted in lower mortality, and appropriate dosing duration was significantly associated with better clinical cure rates (p<0.0001). Conclusions: Overall, the appropriate use of antimicrobials according to the guidelines appears to be associated with improved clinical outcomes in the treatment of aspiration pneumonia in elderly nursing homes (AU)

Promoting the Integration of Elderly Healthcare and Elderly Nursing: Evidence from the Chinese Government.

The increase of the aging population in China and the rise of the concept of healthy aging have accelerated the transformation and upgrading of the traditional elderly nursing pattern. Nevertheless, there is a critical limitation existing in the current situation of China's elderly care, i.e., the medical institutions do not support elderly nursing and the elderly nursing institutions do not facilitate access to medical care. To eliminate the adverse impact of this issue, twelve ministries and commissions of the Chinese government have jointly issued a document, i.e., the Several Opinions on Further Promoting the Development of Combining the Healthcare with the Elderly care (SOFPDCHE), to provide guidance from the government level for further promoting the integration of elderly healthcare and elderly nursing. Under this background, this paper constructs a healthcare-nursing information collaboration network (HnICN) based on the SOFPDCHE, proposing three novel strategies to explore the different roles and collaboration relationships of relevant government departments and public organizations in this integration process, i.e., the node identification strategy (NIS), the local adjacency subgroup strategy (LASS), and the information collaboration effect measurement strategy (ICEMS). Furthermore, this paper retrieves 484 valid policy documents related to "the integration of elderly healthcare and elderly nursing" as data samples on the official websites of 12 sponsored ministries and commissions, and finally confirms 22 government departments and public organizations as the network nodes based on these obtained documents, such as the National Health Commission of the People's Republic of China (NHC), the Ministry of Industry and Information Technology of the People's Republic of China (MIIT), and the National Working Commission on Aging (NWCA). In terms of the collaboration effect, the results of all node-pairs in the HnICN are significantly different, where the collaboration effect between the NHC and MIIT is best and that between the NATCM and MIIT is second best, which are 84.572% and 20.275%, respectively. This study provides the quantifiable results of the information collaboration degree between different government agencies and forms the optimization scheme for the current collaboration status based on these results, which play a positive role in integrating elderly healthcare and elderly nursing and eventually achieving healthy aging.

Immune Response 5-7 Months after Vaccination against SARS-CoV-2 in Elderly Nursing Home Residents in the Czech Republic: Comparison of Three Vaccines.

BACKGROUND AND AIMS: Elderly nursing home residents are especially prone to a severe course of SARS-CoV-2 infection. In this study, we aimed to investigate the complex immune response after vaccination depending on the convalescence status and vaccine. METHODS: Sampling took place in September-October 2021. IgG antibodies against spike protein and nucleocapsid protein, the titer of virus neutralization antibodies against delta and (on a subset of patients) omicron, and cellular immunity (interferon-gamma release assay) were tested in nursing home residents vaccinated with Pfizer, Moderna (both 30-31 weeks after the completion of vaccination), or AstraZeneca (23 weeks) vaccines. The prevalence with 95% confidence intervals (CI) was evaluated in Stata version 17. RESULTS: 95.2% (95% CI: 92.5-97.1%) of the 375 participants had positive results of anti-S IgG, 92.8% (95% CI: 89.7-95.2%) were positive in virus neutralization assay against delta, and 89.0% (95% CI: 84.5-92.5%) in the interferon-gamma-releasing assay detecting cellular immunity. Results of the virus neutralization assay against omicron correlated with those against delta but the neutralization capacity was reduced by about half. As expected, the worst results were found for the AstraZeneca vaccine, although the vaccination-to-test period was the shortest for this vaccine. All immune parameters were significantly higher in convalescent residents than in naive residents after vaccination. No case of COVID-19 occurred during the vaccination-to-test period. CONCLUSIONS: A high immune response, especially among vaccinated convalescents (i.e., residents with hybrid immunity), was found in elderly nursing home residents 5-7 months after vaccination against SARS-CoV-2. In view of this, it appears that such residents are much better protected from COVID-19 than those who are only vaccinated and the matter of individual approach to the booster dose in such individuals should be further discussed.

Incidence and outcomes of COVID-19 first wave pandemic in a French nursing home with residents suffering from severe mental illnesses.

During the first wave of COVID-19, nearly 50% of France's fatalities occurred in nursing homes. Older people with mental health disorders are considered to be more prone to infections when epidemics arise. To test this hypothesis, we conducted a retrospective descriptive and comparative study of the incidence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in a cohort of elderly residents with or without severe mental illness (SMI) living in a French nursing home facility. This was done during the first lockdown from March 17th until May 11th, 2020. Our study included 72 participants of 75 residents, of whom 58 contracted COVID-19, 14 developed a severe form requiring hospitalisation, and 14 died. The disease was significantly less frequent in residents with SMI 15(62%) than those without SMI 43 (89.6%). In regression analysis, a higher level of autonomy was significantly associated with a lower disease incidence. Once contracted, residents with or without SMI differed significantly neither on morbidity nor mortality. The period of survival did not either significantly differ between the two groups. As a potential explanation, we suggested that pathological social withdrawal added to stigmatisation could have protected SMI residents from contracting the disease.

Continence Status and Presence of Pressure Skin Injury among Special Elderly Nursing Home Residents in Japan: A Nationwide Cross-Sectional Survey.

Urinary and fecal incontinence as well as skin pressure injury are common healthcare problems in nursing homes; however, the prevalence and related risk factors were not well understood in the Japanese special elderly nursing home settings. We surveyed the prevalence of urinary, fecal and double incontinence, and skin pressure injury among the elderly living in special elderly nursing homes in Japan. A nationwide cross-sectional epidemiological survey was conducted with a total of 4881 residents. The prevalence of urinary, fecal and double incontinence was 82.9%, 68.9% and 64.9%, respectively. Skin pressure injury was found in 283 residents (283/4881, 5.8%). Age, Care-Needs level, loss of voiding desire, and fecal incontinence were significant risk factors for urinary incontinence. Residential period, Care-Needs level, loss of voiding and defecation desires, and urinary incontinence were significant risk factors for fecal incontinence. Only male sex was a significant risk factor for skin pressure injury. Our study revealed continence status and the prevalence of pressure skin injury among older adult residents who receive end-of-life care in special elderly nursing homes in Japan. Further studies should be conducted to examine whether recovery of urinary and fecal sensations improves continence status.

Development and psychometric testing of the Gerontological Nursing Competence (GeroNursingCom) instrument.

AIM: To develop and psychometrically test an instrument - GeroNursingCom - that measures gerontological nursing competence of nursing students. DESIGN: An instrument development guided by COSMIN guidelines. METHOD: The development and testing of the GeroNursingCom instrument proceeded according to four distinct phases: (a) establishing a theoretical background; (b) testing face and content validity; (c) examining structural validity; and (d) testing internal consistency. The items of instrument were based on a theoretical framework developed from a comprehensive literature review and focus group interviews with experts (N = 27) in spring 2018. Content validity was assessed by nine experts in gerontological nursing, while face validity was tested in a pilot study including 36 nursing students. Structural validity was examined with exploratory factor analysis with 267 nursing students from nine universities of applied sciences. The internal consistency was established with Cronbach's alpha. The data were collected in spring and autumn 2019. The data analysis was conducted with multivariate statistical methods. RESULTS: The GeroNursingCom development and testing process yielded an instrument that includes 53 items across 11 factors: (a) appreciative encounters and interactions with older people; (b) medication for older people; (c) nutrition for older people; (d) safe living environment for older people; (e) supporting the functioning of older people; (f) end-of-life care; (g) developing one's competencies; (h) supporting an older person's mental well-being; (i) supporting an older person's sexuality; (j) guiding self-care among older people; and (k) responding to challenging situations. The instrument was able to explain 66.15% of the total observed variance, while Cronbach's alpha values for individual items varied from 0.75-0.89. CONCLUSION: TheGeroNursingCom instrument can be used to measure gerontological nursing competence among nursing students to improve gerontological nursing education and/or geriatric care. IMPACT: Graduating nursing students must develop versatile competencies to face the multiple needs of older patients and curriculums need to be further developed to ensure students are prepared for gerontological nursing.

The effect of a multicomponent exercise programme onelderly adults' risk of falling in nursing homes: A systematic review.

OBJECTIVE: To determine the effect of a multi-component exercise programme on elderly adults' risk of falling in nursing homes. METHODS: A computerised search of published randomised controlled trials in the English language was performed using PubMed, Cochrane Library, the Cumulative Index of Nursing and Allied Health Literature, Physiotherapy Evidence Database (PEDro), and the Institute for Scientific Information up to December 2017. We included highquality articles that reported a score of ≥5 on the Physiotherapy Evidence Databasescale which compared multicomponent exercise with a single exercise programme in nursing homes, with the risk of falling as an outcome, among participants aged ≥65 years. RESULTS: A total of 8 articles, comprising 382 participants, were included. All these articles scored 6-8 points out of 10 on the PEDro scale, with an average of 6.7 points. The mean age of participants in the included articles was ranged from 76±8.0 to 92±2.0 years, and286 (75%) participants were females. A multi-component exercise programme in the experimental group, which had 204 (53.4%) subjects significantly reduced the risk of falling in nursing homes compared to a single-exercise programme, which was used in the control group that had 178(46.6%) subjects. CONCLUSIONS: A multi-component exercise programme was found to be useful for reducing elderly adults' risk of falling in nursing homes.

Perfil e Diagnósticos de Enfermagem em Idosos Submetidos ao Tratamento Cirúrgico de Fratura de Fêmur / Profile and Nursing Diagnoses in the Elderly Undergoing Surgical Treatment of Femoral Fractures / Perfil e Diagnóstico de enfermería en ancianos sometidos a tratamiento quirúrgico de fracturas femorales

Objetivo: Descrever o perfil dos pacientes idosos submetidos ao tratamento cirúrgico para correção de fratura de fêmur, bem como identificar os principais diagnósticos de enfermagem. Método: trata-se de estudo retrospectivo, com abordagem quantitativa, por meio de análise de 20 prontuários dos pacientes. Resultados: predominou as cirurgias no sexo feminino (65%), com comorbidade de hipertensão associada (60%) e diabetes mellitus (20%). A queda foi o principal fator de fratura do fêmur (55%). Observou-se predominância dos seguintes diagnósticos de enfermagem em 100% dos pacientes: deambulação prejudicada, risco de infecção no sítio cirúrgico, risco de queda, dor aguda e integridade tissular prejudicada. Conclusão: A análise dos prontuários permitiu a identificação de nove diferentes diagnósticos de enfermagem, sendo que o papel da enfermagem fica evidenciado desde a prevenção até aspectos relativos ao tratamento e reabilitação

Objective: To describe the profile of elderly patients undergoing surgical treatment to correct femoral fractures, as well as to identify the main nursing diagnoses. Method: this is a retrospective study, with a quantitative approach, through the analysis of 20 patient records. Results: female surgeries predominated (65%), with associated hypertension comorbidity (60%) and diabetes mellitus (20%). The fall was the main factor of fracture of the femur (55%). There was a predominance of the following nursing diagnoses in 100% of patients: impaired walking, risk of infection at the surgical site, risk of falling, acute pain and impaired tissue integrity. Conclusion: The analysis of medical records allowed the identification of nine different nursing diagnoses, with the role of nursing being evident from prevention to aspects related to treatment and rehabilitation.

Objetivo: Describir el perfil de pacientes de edad avanzada sometidos a tratamiento quirúrgico para corregir fracturas femorales, así como identificar los principales diagnósticos de enfermería. Método: este es un estudio retrospectivo, con un enfoque cuantitativo, a través del análisis de 20 registros de pacientes. Resultados: predominaron las cirugías femeninas (65%), con comorbilidad de hipertensión asociada (60%) y diabetes mellitus (20%). La caída fue el principal factor de fractura del fémur (55%). Hubo un predominio de los siguientes diagnósticos de enfermería en el 100% de los pacientes: dificultad para caminar, riesgo de infección en el sitio quirúrgico, riesgo de caídas, dolor agudo e integridad tisular deteriorada. Conclusión: El análisis de los registros médicos permitió la identificación de nueve diagnósticos de enfermería diferentes, siendo evidente el papel de la enfermería desde la prevención hasta los aspectos relacionados con el tratamiento y la rehabilitación.

A sexualidade de idosos dependentes / The sexuality of dependent elderly

O envelhecimento populacional mundial e também no Brasil tem trazido novos desafios para os serviços de saúde. A sexualidade na terceira idade é marcador relevante e significativo de qualidade de vida e saúde. Este trabalho faz parte de uma pesquisa nacional intitulada Estudo Situacional dos Idosos Dependentes que residem com suas Famílias visando a subsidiar uma Política de Atenção e de Apoio aos Cuidadores. O estudo foi realizado em oito municípios brasileiros (Porto Alegre, Rio de Janeiro, Fortaleza, Recife, Manaus, Brasília, Teresina, Araranguá) com idosos dependentes, seus cuidadores familiares e profissionais, profissionais de saúde e gestores. O recorte feito neste estudo buscou compreender a sexualidade em idosos dependentes e suas características. Foi realizada uma análise qualitativa de entrevistas com idosos dependentes. Os achados apontam para uma diferença de gênero sobre o entendimento e a vivência da sexualidade nos idosos. Homens com uma ênfase no desempenho e ato sexual e as mulheres com uma visão e compreensão mais ampliada sobre o sexualidade. Por outro lado, identificou-se uma significativa invisibilidade sobre o assunto perante os próprios pesquisadores. Foi possível constatar que a sexualidade do idoso é modulada pela percepção de gênero e é um tema pouco estudado e de difícil abordagem em cenários de pesquisa e de atenção à saúde. Foram produzidos também outros dois artigos com metodologia quantitativa e um sumário executivo que estão em anexo no final da dissertação.

Worldwide and in Brazil the population is aging, this has brought new challenges for health services. Sexuality in old age is a relevant and significant marker of quality of life and health. This work is part of a national survey entitled Situational Study of Elderly Dependents who live with their Families in order to subsidize a Policy of Care and Support for Caregivers. The study was carried out in eight Brazilian cities (Porto Alegre, Rio de Janeiro, Fortaleza, Recife, Manaus, Brasília, Teresina, Araranguá) with dependent elderly people, their family and professional caregivers, health professionals and managers. The cut made in this study sought to understand sexuality in dependent elderly people and their characteristics. A qualitative analysis of interviews with dependent elderly people was carried out. The findings point to a gender difference in the understanding and experience of sexuality in the elderly. Men with an emphasis on performance and sexual intercourse and women with a broader view and understanding of sexuality. On the other hand, a significant invisibility on the subject was identified before the researchers themselves. It was possible to verify that the sexuality of the elderly is modulated by the perception of gender and is a poorly studied and difficult to approach topic in research and health care settings. Two other articles were also produced with quantitative methodology and an executive summary that are attached at the end of the dissertation.

Segurança do paciente idoso sob o ponto de vista do enfermeiro em uma ILPI / Elderly patient safety from the nurse's point of view in an LSIE

Objetivo: Descrever a segurança do paciente na perspectiva dos enfermeiros, técnicos de enfermagem e cuidadores de idosos, acreditando serem estes os profissionais que mantêm maior proximidade do paciente. Método: Estudo de revisão literária desenvolvida através de artigos científicos. А busca eletrônica foi conduzida nas bases de dados BDENF - bibliografia especiаlizаdа na Área de Enfermagem do Brasil - na SciELО - Scientific Electrоnic Librаry Оnline - e em livros relаciоnаdоs com o tema. Resultado: O enfermeiro, enquanto coordenador da equipe de enfermagem, não pode perder de vista que deve liderar a equipe com o compromisso de sempre buscar seu aprimoramento técnico-científico e ético. Conclusão: Frente à magnitude da temática segurança do paciente, que avanços no cenário atual das organizações de saúde sejam desafiadores, todavia algumas considerações, no que tange à assistência e ao ensino e pesquisa, tornam-se pertinentes, a fim de contribuir com a instituição pesquisada e de consolidar uma cultura de segurança profícua e construtiva

Objective: to describe patient safety from the perspective of nurses, provide nursing services and care for the elderly, believing that they are the professionals who maintain the patient's closest proximity. Method: It is a study of literary review carried out through scientific articles. An electronic search was conducted in the following databases: (BDENF) - Special Bibliographies in the Brazilian Nursing Area and in SciELO - Scientific Electronic Library Оnline and reliacción how books. Result: The nurse, as coordinator of the nursing team, cannot lose sight of the exercise of his / her role of responding is a team committed to always seek technical-scientific and ethical improvement. Conclusion: in view of the magnitude of the patient safety issue, which promotes the current perspective of women's health organizations, and some considerations about teaching and research assistance become forward-looking. to consolidate a constructive and constructive safety culture

Profissional Enfermeiro: Competências e habilidades para a avaliação multidimensional da pessoa idosa / Professional Nurses: Skill and abilities to a multidimensional evaluation of elderly people / Profesional Enfermero: Competencias y habilidades para la evaluación multidimensional de la persona idosa

O estudo objetivou avaliar quais as competências e habilidades adquiridas pelos enfermeiros, durante sua formação profissional, para realizar a avaliação multidimensional da pessoa idosa. Trata-se de uma pesquisa descritiva, com abordagem qualitativa, desenvolvida com enfermeiros que atuam em unidades básicas de saúde. O estudo evidenciou que a maioria dos profissionais não se sentem aptos para atenderem a população idosa, no que se refere à realização da avaliação multidimensional.

The objective of this study was to avaliate which skills and required abilities by the professional nurses during their professional formation to realize multidimensional evaluation of elderly people. It's a descriptive research, with qualitative approach, developed with nurses that act in basic units of health. The study evidenced that the marjority of professional don't feel capable to take care elderly people, in order to realize multidimensional avaliation.

El estudio objetivó evaluar cuáles las cometencias y habilidades adquiridas por los enfermeros durante su formación profesional para realizar la evaluación multidimensional de la persona de edad. Se trata de una investigación descriptiva, con abordaje cualitativo, desarrollada con enfermeros que actúan en unidades básicas de salud. El estudio evidenció que la mayoría de los profesionales no se sienten aptos para atender a la población anciana, en lo que se refiere a la realización de la evaluación multidimensional.

Training model and practical effect of nurse specialist in geriatrics in Guangdong Province / 现代临床护理

Objective To explore the training model of nurse specialists in geriatric and study its practical effect. Methods Forty-two nurse specialist participating in the training courses in geriatrics were enrolled in the study. The training was divided into 2 stages: the first one was for 1 month theoretical study together with 2 months clinical practice; the second was for 9 months clinical research on a specific topic. The examinations were done both at the two stages. They were interviewed on their views on theoretical study and internship at the end of first stage. Results The degree of satisfaction with the theoretical course was 91.6%, and the satisfaction degree of internship was 92.9%. The average scores at the end of the final examination and graduation examination were more than 85 points. Toally they were funded with 4 muncipal scientific research programs and 3 municipal patents, and published 9 academic papers. Conclusions The standardized training model is accessible for the nursing because of the training content and form. This model is feasible and effective, and it is worth applying and popularizing in the training of nurse specialist in the future.

Study on nursing service needs among elderly people lived in nursing institutions in Fuzhou / 中国实用护理杂志

Objective To investigate nursing care needs of elderly nursing homes residents in Fuzhou, to help to improve nursing care quality provided by elderly nursing homes. Methods A total of 120 elderly residents from 10 elderly nursing homes in Fuzhou were investigated with a self-developed questionnaire focusing on nursing care needs of elderly nursing home residents. The questionnaire included the following two parts: the general information of the elderly residents and the needs of disease care, basic nursing care, daily life care as well as psychological care. Results The retrieving rate was 95.8%(115/120). The overall nursing care needs of elderly nursing home residents was at the middle level (2.59 ±0.80), the highest demand for nursing care was disease care (3.34±1.07), followed by psychological care (2.56±0.93), basic nursing care (2.20±1.15) and daily life care (2.23±0.97). The single living elderly residents got lower scores than the couple living elderly residents in disease care, basic nursing care 3.19±1.07, 2.06±1.10 vs. 3.78±0.96, 2.62±1.20 (t=2.656, t=2.311, P<0.05). Over 90 years old age groups got lower scores than the other age groups in the disease care, 2.25 ±0.69, 3.80 ±0.72, 3.35 ±1.09, which showed significant difference (F=7.10, P < 0.05). The elderly suffering from hypertension, diabetes, cardiovascular disease varied in the demand for different care. Conclusions The overall nursing care needs of elderly nursing home residents was at the middle level. Staying with spouse, age, disease state are the influencing factors of nursing care needs of elderly nursing home residents.

Type 2 diabetes mellitus treatment patterns in U.S. nursing home residents.

BACKGROUND: The prevalence of type 2 diabetes mellitus (diabetes) in nursing home residents (NHRs) is increasing, concurrently with obesity and other comorbid conditions. NHR would benefit greatly from antidiabetic medications that would improve glycemic control and give a lower risk of hypoglycemia but that do not contribute to weight gain in obese individuals. OBJECTIVE: To examine the prescription patterns to NHRs with diabetes, including the use of newer injectable therapies such as glucagon-like peptide-1 (GLP-1) receptor agonists. METHODS: Treatment patterns of diabetes in NHR were analyzed using Minimum Data Set records and prescription claims from the Omnicare Senior Health Outcomes data repository (May 2011-September 2012). RESULTS: The prevalence of diabetes in this population of 229,283 NHRs was 35.4%. Among the 44,665 NHRs with diabetes and prescription claims data, the prevalence of obesity (40.3%) and multiple comorbidities (100%) was high. Approximately 20% of the NHRs with diabetes were aged <65 years. Overall, 20% of NHRs had diabetes that was untreated with medications during the study period. Insulin was the mainstay of treatment (>80%), followed by oral agents (54%). GLP-1 receptor agonist use was low (0.5%) and associated with poor treatment persistence. CONCLUSION: Considerations other than glycemic control may drive prescribing decisions, contrary to recommendations from the American Diabetes Association, American Medical Directors Association, and European Association for the Study of Diabetes.

Síndrome da fragilidade e sua relação com aspectos emocionais, cognitivos, físicos e funcionais em idosos institucionalizados / Frailty syndrome and your correlation with emotional, cognitive, physical and functional aspects in institutionalized elderly

O objetivo do estudo foi avaliar a fragilidade de idosos residentes em uma Instituição de Longa Permanência da cidade de Santos (SP) e correlacionar aspectos da síndrome manifesta com sintomas depressivos, desempenho cognitivo, físico e funcional nessa população. Foram avaliados 20 idosos institucionalizados, sendo estes na sua maioria (n=18; 90%), classificados como frágeis, e correlacionando-se com deficit cognitivo (r=-0,470; p=0,04), baixo desempenho físico (r=-0,437; p=0,05), e funcional (r=-0,529; p=0,02) na população estudada.

The objective of the study was to evaluate the frailty in elderly residents in a nursing home of the Santos city and correlate aspects of this syndrome with depressive symptoms, cognitive domain, physical and functional performance in this sample. Twenty institutionalized elderly were evaluated, which are mostly classified as frail (n = 18; 90%) and were correlated with cognitive impairment (r = -0.470; P = 0.04), low physical (r = -0.437; P= 0.05), and functional performance (r = -0.529; P = 0.02) in the study population.

Therapeutic touch in dementia care.

Touch, in its purest sense, is considered by many as a core aspect of care-giving and of the nurse-patient relationship. Touch is a fundamental element in nursing work and one of the most personally experienced of all communicative sensations. Some believe it to be the 'mother of the senses', symbolising caring and providing validation of existence as an individual ( Autton 1989 , Estabrooks and Morse 1992 , Weiss 1992).