摘要:

ABSTRACT:Rapid, reliable and valid assessment of the functional status of elderly persons is a prerequisite for the efficient provision of appropriate types of services. The Functional Assessment Inventory, a 30‐minute, multidimensional functional assessment questionnaire, is an abbreviated modification of the OARS Multidimensional Functional Assessment Questionnaire. It was administered by interviewers to a stratified sample of 244 elderly persons in a rural county of Florida, in four service settings. These four sites were: nursing homes (63 subjects), adult congregate living facilities (ACLF) (62 subjects), adult day care programs (60 subjects), and senior centers (59 subjects). Patterns of functional impairment for each setting were identified. Nursing home patients showed impairment in all dimensions (physical, mental, economic, social, and activities of daily living) with mental and ADL impairments predominating. ACLF subjects showed social, mental and ADL impairments. Subjects in adult day care and senior centers were less generally impaired on all dimensions, with physical, mental and ADL impairments predominating in the day care subjects, and social impairments predominating in the senior center subjects. The respondent refusal rate was less than 10 percent. The findings suggest potential for the widespread use of the new shorter Functional Assessment Inventory for determining the type, level, and appropriateness of services for the elderl

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1981.tb01744.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY

摘要:

ABSTRACT:For the Geriatric Institutions of Geneva, geriatrics is not just a convenient term for concealing large gaps in present medical knowledge, but a specialized branch of medicine specifically adapted to the urgent needs of the growing older adult population. These Institutions constitute a 276‐bed hospital, an 80‐bed extended‐care facility, and a large consultation service for ambulatory patients. The staff comprises over 50 physicians and psychiatrists, multidisciplinary paramedical personnel, and a large complement of social workers. The three main goals are to: 1) address the complex medical needs of the older patient; 2) motivate the staff about the specific problems of the elderly and how to deal with them; and 3) promote awareness in the community of the complexity of problems associated with geriatric patients. The model of geriatric healthcare delivery developed and practiced in Geneva is “Integrated Medicine.” This is not simply a multidisciplinary approach to the multiple disorders of elderly patients, but also a particular philosophy of management with objectives specifically adapted to their unique pathophysiologic, psychiatric and social needs. The model is described as it pertains to preventive medicine, diagnosis, therapeutics, and prognosis. Integrated Medicine is not a panacea, yet it constitutes a step toward developing a health‐care delivery system specifically adapted to the geriat

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1981.tb01745.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY

摘要:

ABSTRACT:A research study was designed to develop information about the day‐to‐day symptoms of older persons that often are not reported to professionals. As one aspect of the research, the subjects (N = 132) were asked: 1) if they had had any of a predetermined list of 20 symptoms during the previous month; 2) to whom did they report these symptoms; and 3) if no one had been told, what was the reason for not reporting. About half of the subjects had experienced difficulty in sleeping, tiredness, nervousness, feeling blue, unsteadiness on feet, and forgetfulness. A slight majority told someone (a professional, family member, or friend) about their symptoms, but a large proportion did not tell anyone. Most symptoms (56 percent) were not reported to health professionals. When another person was told, usually the recipient of the information was as likely to be a family member or friend as a professional. Reasons for not telling anyone included: the symptom was “no big deal”; “nobody cares”; “nothing can be done about it”; and “don't want to bother people.” The data are discussed in terms of the implications for health education of older people and family members, and for the attitudes and behaviors of h

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1981.tb01746.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY

摘要:

ABSTRACT:The brains of 102 octogenarians were weighed and examined at autopsy. The heaviest weighed 2075 gm, and the lightest 818 gm. They were classified by sex and by the pathologic changes. These brains were definitely lighter than the accepted normal, but somewhat heavier than a previously reported series of nonagenarian brains which showed a greater percentage of pathologic lesions.

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1981.tb01747.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY

摘要:

ABSTRACT:Two cases are reported of left atrial myxoma in elderly patients, diagnosed by combined M‐mode and bidimensional echocardiography. One patient was an 80‐year‐old man presenting with typical signs of mitral obstruction by an atrial tumor. His symptoms were erroneously attributed to chronic bronchitis until an echocardiogram was obtained. The other patient was a 70‐year‐old woman with atrial fibrillation of one year's duration. Left atrial myxoma, although rarely observed in the elderly, may be diagnosed easily by means of echocardiography. Some cases may prove amenable to surgical

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1981.tb01748.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY

摘要:

ABSTRACT:Hairy cell leukemia has been described as chiefly a disease of the middle‐aged. A patient is reported in whom hairy cell leukemia developed at age 90, the oldest age recorded for onset of the disease. An estimation of age‐specific incidence rates revealed no major difference in incidences between the middle‐aged and the elderly popula

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1981.tb01749.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY

摘要:

ABSTRACT:Sliding hiatal hernia occurs in the elderly with a symptom complex which differs from that seen in younger persons. A comparison of the symptoms of this disease in 66 older patients with the symptoms in 154 younger patients revealed four categories in the elderly: digestive, anemic, anginal, and pseudoneoplastic. Of these, the digestive‐tract abnormality, even though the most common, was the least characteristic and was caused by the associated pathologic lesions rather than by the hiatal hernia itsel

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1981.tb01750.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY

摘要:

ABSTRACT:An overview of the problem of abuse of the elderly is presented in an effort to guide future research. Categories of caretakers for the aged include formal (i.e., institutional settings) and informal (e.g., family, neighbors, sitters). Data are presented from a task force report on the status of nursing homes in the State of Texas. Categories of abuse are discussed under four divisions: physical, psychologic, material, and fiscal. Deliberate physical abuse by formal caretakers was the least common; physical neglect was far more common, e.g., the development of decubitus ulcers, inadequate nutrition, improper medication, and vermin infestation. Psychologic abuse was most frequent in the area of benign neglect, with patients regarded as “going to die anyway.” A tendency toward infantilization by formal caretakers was observed. Material abuse included primarily theft, chiefly of personal items rather than medication items. Fiscal abuse included embezzlement of patients' trust funds, improper charges for service, failure to notify the State of the death or departure of a patient, abuse of drugs, and artificial upgrading of Medicaid recipients' classifications. Possible causes of abuse are revie

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1981.tb01751.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY

摘要:

ABSTRACT:In a long‐term care facility, the fecal guaiac test for occult blood was used as a screening method to detect gastrointestinal (GI) bleeding lesions. The study involved 450 chronically ill hospitalized patients whose average age was 70 years. Each underwent 6 fecal guaiac tests for three consecutive days while receiving a standardized meat‐free, high‐fiber diet. The 21 patients in whom the fecal hemoccult test yielded positive findings were further studied with x‐ray upper GI series, barium enema, and fiberoptic examination of the upper and lower GI tract when necessary. In 4.7 percent of this population, the guaiac test gave positive results, which usually involved only 1 or 2 of the 6 guaiac slides. On further study it was found that 2 patients had large‐bowel tumors, 5 had duodenal ulcers, 1 had gastric cancer, and 7 had diverticulosis. The incidence of colon cancer in this population was the same as that reported in other studies, but the incidence of duodenal ulcers was high. In 20 of the 21 patients with positive test findings, a lesion of the GI tract was found. The therapeutic implications of such screening are important. This study emphasizes the value of routine fecal hemoccult testing of whole institutional populations once or twi

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1981.tb01752.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY

摘要:

ABSTRACT:The relationship between auditory acuity and performance on the Mental Status Questionnaire (MSQ, Kahn et al) was investigated in 27 residents of two skilled nursing facilities. Statistically significant correlations between auditory acuity and MSQ total scores were obtained at 500 Hz, 1000 Hz, 2000 Hz, 3000 Hz, 4000 Hz, and 6000 Hz, but not at 8000 Hz. The correlations between auditory acuity and individual item scores, however, were statistically significant for only those items for which nursing home personnel believed the opportunity existed for residents to hear the answers. These findings are interpreted as providing strong support for a causal relationship between sensory acuity and test performance, indicating that the cognitive capabilities of elderly persons can be underestimated because of their reduced sensory acuity.

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1981.tb01753.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY