Zeitschrift Fur Gerontologie Und Geriatrie最新文献

Background: Even before the COVID-19 pandemic, informal caregivers (iPP) were under significant burden but rarely utilized formal support services. During the pandemic this situation intensified. It remains unclear whether these challenges persist in the post-pandemic period.

Objective: (1) Are there differences in the objective and subjective burdens of iPP in the pre-post pandemic comparison? (2) To what extent were formal support services utilized in the pre- and post-pandemic comparison?

Material and methods: The secondary data analysis is based on pre-pandemic data from the Benefits of Being a Caregiver study (October 2019-February 2020, N = 489) and post-pandemic data from the Progression in Home Care study (September 2022-May 2023, N = 471). Propensity score matching was performed to reduce systematic differences. In the evaluation χ² tests or Fisher's exact tests as well as (Welch's) t‑tests or nonparametric tests were used.

Results: The objective burden decreased significantly after the pandemic; however, approximately 30.0% of iPP providing over 10 hours of care per day remained highly burdened. The subjective burden remained consistently high. The use of formal services increased in specific areas (caregiver counselling, household assistance, voluntary care services, medical care, therapeutic services) but overall remained at a low level. All effect sizes were small, except for a large effect for medical care utilization.

Conclusion: Even after the pandemic iPP continue to show high levels of subjective and objective burden, which is associated with an increased risk of health impairments. To counteract this, the utilization of formal relief services should be specifically increased.

Background: Care facilities in Germany report a high use of psychotropic drugs among residents with dementia. Nurses are primarily responsible for the care of residents, which is why expertise in dealing with people with dementia, non-drug strategies for challenging behavior and psychotropic drugs as long-term or on-demand medication should be strengthened.

Aim of the study: Based on a practical analysis in nursing homes, the application-oriented PhasaPII project developed a self-study course for care teams on the knowledge-based use of psychotropic drugs as long-term or on-demand medication and alternative courses of action in residential long-term care. The self-study course "Psychotropic drugs in residential geriatric care" is available online and free of charge for caregivers.

Methods: Expert interviews with facility managers and nursing service managers and focus groups with nursing teams in seven cooperating facilities on the use of psychotropic drugs in inpatient long-term care formed the basis for the development of the course. The interviews and focus groups were evaluated using content analysis according to Mayring [22].

Results: The qualitative survey shows a high need for specialist knowledge among carers of residents with dementia. The learning content is divided into 10 lessons so that participants can explore the complex topic of psychotropic drugs from different perspectives.

Discussion and outlook: Collaboration with care facilities in the project was difficult due to staff shortages and time constraints. The self-study course is a building block for the responsible management of medication for residents with dementia.

Purpose: This study was designed to examine the metaphorical perceptions and cognitive structures of aged individuals with chronic diseases towards death.

Methods: The research was conducted as a qualitative study based on metaphor analysis. Data were collected using a semi-structured interview form that investigated the metaphorical perceptions of 15 individuals with chronic diseases towards death and a form that was asked to be explained with drawing technique. In the semi-structured interview form "Death is like … because …", metaphor expression was included, and in the other part "Describe your thoughts about death with drawings", the form containing the expression was used. The data were analyzed using the content analysis technique. The study was conducted and reported according to the COREQ checklist.

Results: It was determined that the old individuals with chronic diseases who participated in the study produced 4 metaphors with the writing technique and 4 metaphors with the drawing technique. As metaphors, the themes of end of life and a new beginning, extinction and feeling of emptiness, journey of life, salvation and reunion were determined.

Conclusion: As a result of the study, it was determined that old individuals with chronic diseases had anxiety about death. In addition, it was determined that old individuals had negative and positive cognitive schemas about death. In this context, old individuals with chronic diseases may need psychosocial support systems.

Background: Heat protection in inpatient care facilities can prevent heat-related mortality and morbidity among people in need of care and relieve the burden on nursing personnel.

Objective: The research project "Heat protection measures in inpatient and outpatient care (HISTA)", funded by the GKV-Spitzenverband (Statutory Health Insurance Umbrella Organization), investigates which heat protection measures have been implemented in inpatient care facilities to date and which challenges are perceived in their implementation.

Methods: An online survey was conducted in 2024 among a random sample of managers of inpatient care facilities. A descriptive and statistical evaluation was carried out.

Results: A total of 282 people participated in the survey. The majority considered heat protection to be important. Heat protection measures are implemented to varying degrees. The need for support is seen particularly in the financing of technical and construction measures.

Discussion: The implementation of heat protection measures depends on the available options and resources. Heat protection should be seen as a task for society as a whole, which would ensure not only obligations to provide heat protection but also financing.

People have the right to accept or refuse medical treatment provided they give voluntary, prior and informed consent. When capacity to consent is impaired, autonomy can be preserved through a clear, legally valid advance directive. Cognitive impairments, such as dementia, increase the risk of compromised capacity to consent. This study examines the prevalence of advance directives among patients at German memory clinics and explores predictors influencing their presence, focusing on compliance with informed consent standards.Using an observational cross-sectional design, 289 outpatients were assessed. Data included the presence of advance directives, circumstances of their creation and the patient characteristics age, gender, education, cognitive status, physical and mental health, need for autonomy in medical decision-making and health literacy. Descriptive statistics were calculated, and multivariable logistic regression models were applied to analyze the data.The results indicate that age is the strongest predictor for the presence of advance directives. Beyond age, specific events or experiences, rather than personal traits, may prompt individuals to create advance directives.

Introduction and aim: In view of the aging population it is crucial to identify modifiable risk factors for dementia. This narrative review article summarizes the evidence on the association between loss of vision and loss of cognition, two conditions common in old age.

Methods: For this review article a literature search was conducted across several databases using MeSH terms and relevant studies on visual function and cognition were identified. To be included studies had to have longitudinally investigated the association between visual function and the incidence of dementia or cognition.

Results: From the 7961 articles a multistage screening based on predefined criteria identified 16 relevant studies that investigated loss of vision as a risk factor for loss of cognition and dementia. Of these 14 could observe an association between poorer visual function and an increased loss of cognition or risk of dementia after adjusting for confounders. The strength of this risk was more pronounced in some studies depending on 1) the severity of the visual impairment (dose-response relationship) and 2) the simultaneous presence of hearing deficits.

Discussion: Poorer visual function is associated with an increased risk of newly occurring cognitive loss and/or dementia. This highlights the clinical relevance of ophthalmological care in the prevention of cognitive loss and dementia. Evidence from interventional studies and larger longitudinal studies that assess other visual qualities apart from visual acuity is currently lacking.

Background: Visual impairment increases with age and can adversely affect the quality of life of older people. Ophthalmological care in nursing homes is often inadequate, leading to poor detection and treatment of visual problems. The prevention program "Good vision in care facilities" ("Gutes Sehen in Pflegeeinrichtungen") of the Institute for the Blind Foundation (Blindeninstitutsstiftung) aims to promote the eye health of residents through targeted measures and the training of qualified vision officers.

Objective: The aim was to evaluate the prevention program from the perspective of the vision officers, focusing on their role, the performance of vision assessments, the improvement of the living environment and the qualification measures.

Method: A qualitative evaluation study was conducted through guideline-based interviews with eight vision officers from seven nursing homes. The data were analyzed using Mayring's structured content analysis.

Results: Vision officers consider their role to be important but the success of implementation depends on the available resources. The performance of vision assessment varies due to cognitive impairment and motivation of the residents. Barriers to accessibility were primarily addressed when minimal effort was required. Face to face training sessions contribute significantly to awareness due to their practical content and interaction.

Conclusion: The sustainable implementation of the prevention program requires resource allocation by nursing home management. The qualification of several vision officers in each facility could increase the success of the program. Alternative methods of vision assessment for cognitively impaired residents should be developed.

Background: The needs and support requirements of double duty caregivers (DDC) by healthcare professionals differ depending on whether they identify themselves as a professional nurse or family caregiver in private care arrangements. Questions of identity are usually not addressed by the DDCs. Resulting misunderstandings have the potential for conflict, which places additional strain on DDCs.

Aim: The aim of this article is to present the essential characteristics of DDCs based on a model corresponding to their identity either as a professional nurse or family caregiver in a private care arrangement.

Methods: A secondary analysis of 32 articles identified after a systematic literature search for a scoping review on the topic was carried out. A total of 18 articles were included in the qualitative content analysis according to Kuckartz and Rädiker.

Results: A model of Continuum of Self-Positioning of Double Duty Caregivers was developed. It describes the characteristics DDCs show in four contexts: caregiving context, family context, healthcare system context, own workplace. Depending on the understanding of their own role in the different care settings, they are able to develop a better understanding of their identity either as a professional nurse or family caregiver, whereby the transitions are fluid.

Conclusion: There are characteristics that can be assigned to the respective presumed identity of the DDCs. Knowing this enables healthcare professionals and family members to interact appropriately with DDCs and thus minimize the potential for conflict.

Vision is a significant determinant of quality of life and autonomy in older people. It declines with age due to natural processes. In the general population this is exacerbated by age-related eye diseases, such as cataract, age-related macular degeneration, glaucoma and diabetic retinopathy. The resulting impairments can lead to reduced mobility, independence and mental health and physiological ageing processes of the eye and disease-related changes in visual function are therefore associated with increased morbidity, such as an increased risk of falls and depression. Treatment, prevention and rehabilitation measures can significantly reduce the impairment of older people caused by age-related eye diseases. In order to keep pace with the increasing demand for care and to maintain vision at the highest possible level into old age, not only targeted and timely ophthalmological care are necessary but also more prevention in the field of age-related eye diseases.