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- Go to article: Care Needs of Older Broome County Residents: A Survey of Elders Receiving Care Through the Continuum
- Go to article: Identifying Older Adults at Risk for Depression in Senior Centers: The Educating About and Screening Elders for Depression Model
Case mangers must deal with the ever-changing makeup of their client population as well as those who provide managed services to these clients. There is great ethnocultural diversity in the elder population, and statistics contend that it will only increase with time. Similarly, the majority of long-term-care providers have been consistently female and of color. Providing culturally competent services becomes more complex when long-term-care providers and clients possess different identities, countries of origins, and social statuses. This article examines a framework that addresses the complex, multidimensional, and bidirectional process that occurs between providers and consumers of any cultural makeup called cultural responsiveness.
This article is about the importance of retaining a focus on the humanity of older adults while rendering care to them through community and long-term care services. It is written from my experience as a director of a community service (Adult Day Health Care [ADHC] program), a program officer at a foundation devoted to improving health care for older Americans, a researcher who spent years conducting interviews with staff workers in long-term care services, and from the perspective of a professional and personal caregiver and friend to many elders living in the community—in their own homes and in nursing homes. From these diverse professional and personal roles and perspectives, I have learned that the formation of authentic human relationships, which go beyond the routine medical, nursing, and social work approach to care, can play a vital role in healing and addressing loneliness in elders—and transform the lives of their personal and professional caregivers as well. A focus on humanity need not cost money or place a heavy demand on the worker. In fact, it can be one of the most cost-effective approaches to improving quality in health care, attracting workers to the field of long-term care, and boosting the morale of both caregivers and care recipients.
- Go to article: Social Withdrawal of Persons With Vascular Dementia Associated With Disturbance of Basic Daily Activities, Apathy, and Impaired Social Judgment
Social Withdrawal of Persons With Vascular Dementia Associated With Disturbance of Basic Daily Activities, Apathy, and Impaired Social Judgment
Patients with vascular dementia (VaD) are often isolated, withdrawn from society because of negative symptoms and functional disabilities. The aim of this study was to detect factors associated with social withdrawal in patients with VaD. The participants were 36 institutionalized patients with VaD. Social withdrawal was assessed with the social withdrawal of the Multidimensional Observation Scale for Elderly Subjects (MOSES). Possible explanatory variables were the MOSES items depression and self-care, Cognitive Abilities Screening Instrument (CASI), apathy evaluation scale (AES), and Behavioral Pathology in Alzheimer’s Disease Frequency-Weighted Severity Scale (BEHAVE-ADFW). Multiple regression analyses were conducted for two groups: Analysis 1 was performed in all patients (N = 36) and Analysis 2 was performed in the patients with the ability to move by themselves (i.e., independent walking or independent movement with a cane or a wheelchair; n = 28). In Analysis 1, MOSES item social withdrawal was correlated with AES and MOSES item self-care. In Analysis 2, MOSES item social withdrawal was correlated with AES and CASI domain abstraction and judgment. Decreased social activities of VaD were not related to general cognitive function or depression. Disturbed activities of daily living (ADLs) for self-care may involve decreased frontal lobe function, indicating that comprehensive rehabilitation for both ADL and dementia are needed to improve the social activities of patients with VaD.
- Go to article: A Survey of Self-Management and Intrusiveness of Illness in Native Americans With Diabetes Mellitus
Diabetes mellitus (DM) has emerged as an important focus of national public health efforts because of the rapid increase in the burden of this disease. In particular, DM disproportionately affects Native Americans. Adequate management of DM requires that patients participate as active partners in their own care and much of patient activation and empowerment can be attributed to their experience with DM and self-care. That is, the degree to which the patient feels the disease intrudes on his or her daily life would impact the motivation for self-care. We conducted a study in collaboration with 2 tribal nations in Oklahoma, collecting data on survey questions regarding intrusiveness of illness and self-management behaviors from a sample of 159 members of the Chickasaw and Choctaw Nations. Previously validated variables measuring intrusiveness of illness and self-care were included in the survey. Descriptive statistics and bivariate analyses illustrated the distribution of these variables and identified possible tribal and gender differences. Our findings showed that our sample adjusted well to DM and in general exhibited high compliance to self-care. However, our findings also revealed striking gender differences where female respondents were better adjusted to their disease, whereas male respondents reported higher adherence to self-management. Findings from our study, particularly those that describe tribal differences and gender disparities, can inform strategies for case management and patient interactions with providers and the health care system.