Zeitschrift Fur Gerontologie Und Geriatrie最新文献

Background: Models that actively involve people living with dementia and their relatives as well as experts from various healthcare settings in research have not yet been implemented in the context of health services research in the German language. Such models are necessary to actively involve the perspectives of "co-researchers" and address topics pertaining to the everyday lives of people living with dementia and their relatives as well as individuals working in healthcare practice.

Objective: The aim of this study is to develop a preliminary framework for joint research.

Material and methods: The procedure used in this research features a participatory approach involving stakeholders recruited from different groups of people, including people living with dementia, their relatives and experts from long-term and acute inpatient settings. A participatory research model was translated into German and discussed, debated and agreed upon in virtual meetings with the stakeholders. The results were discussed in a workshop with the goal of determining the types of support that were considered necessary for "co-researchers". All meetings were documented in protocols that were analyzed both deductively and inductively.

Results: A total of 13 stakeholders participated in this project. The preliminary framework for joint research contains basic principles, activities and support requirements for joint research.

Conclusion: In addition to experts from various healthcare settings, people living with dementia and their relatives both want to and can be actively involved in research. To refine the preliminary framework, it continues to be tested and developed in the context of participatory research projects at the German Center for Neurodegenerative Diseases (DZNE) site Witten.

Background: Luebeck Scale of Basic Mobility (LSBM) assesses seven phases of mobility from the prone position to walking. It was validated on geriatric patients who were unable to complete the timed up and go test (TUG). It showed no floor effect. A ceiling effect is to be assumed for more mobile patients.

Objective: To test whether additional measurement of the time required for the transfers (→ t-LSBM) in more mobile patients results in a change-sensitive instrument and what time requirement can be expected for the individual tasks.

Material and methods: In geriatric patients who had completed the TUG on admission to hospital, the LSBM including the time required for the transfers and the TUG were recorded twice with an interval of at least 10 days. The correlations between severity, transfer time and TUG were calculated, as well as the effect size for sensitivity to change.

Results: In this study 85 patients (65.9% women) aged 81.6 ± 6.0 years were recruited, 75 of whom were available for the follow-up examination after a mean of 12.9 days. The sum score of the LSBM decreased from 5.00 ± 2.94 to 3.28 ± 2.23 (p < 0.001), the cumulative time required in the t‑LSBM from 60.3 ± 26.2 to 46.2 ± 18.8 s with a nearly identical effect size of 0.77. This was 0.56 for the TUG.

Conclusion: The LSBM is highly sensitive to change even in patients who are able to walk. If all tasks can be completed independently, a supplementary time recording (→ t-LSBM) is recommended to prevent a ceiling effect. This creates a mobility test that is suitable for all geriatric hospital patients and provides the information on mobility in the room required for therapy and discharge planning.

Background: Many older people are affected by immobility, which can eventually lead to becoming bedridden. Being bedridden is a significant issue for those affected as it carries considerable physical, psychological and social risks and has far-reaching consequences for a person's ability to participate.

Objective: Whether and to what extent can spatial sociology concepts be used and applied to demonstrate the effects on the participation of bedridden people in residential care facilities and what contribution can they make in this context?

Method: The basic assumptions of the sociology of space and Martina Löw's specific concept of spatial sociology are briefly introduced. The fundamental understanding of social spaces as products of a practice of arranging people and things according to structures is used to analyze practices that promote or hinder participation. In this context, a concept of participation is outlined that defines participatory opportunities as the relationship between the capacity to arrange elements into sociospatial configurations and the risk of being merely arranged by others. This analytical framework is then be tested by applying it to two case studies drawn from an observational study on the design of social interactions in nursing homes. Finally, an initial reflection is offered on whether and how spatial sociology can contribute to enhancing the participation of bedridden individuals.

Results: Applying a spatial-sociological perspective to questions of participation in bedriddenness raises awareness of the consequences of placing people in relation to one another and to the objects in their surroundings. The arrangement of residents in relation to and among other "care-related objects" creates a relational space with specific possibilities for perception and interaction. Residents' freedom of action within these functional arrangements is limited. In order to improve their opportunities for participation, institutional processes of arranging people and objects must be reflected upon and "environments" must be designed to be open.

Discussion: There is a need for research on the participation of bedridden people that focuses on the relationship between space, participation and immobility at the spatiosociological level.

Background: Depression is a common but often overlooked problem in the care of older people. It impairs the quality of life, worsens the course of somatic diseases and causes high healthcare costs.

Objective: To investigate the prevalence of depressive symptoms in patients receiving acute geriatric treatment, taking gender-specific differences and correlations with cognitive and functional impairments into account.

Material and methods: Retrospective analysis of anonymized data from 345 patients who were treated in an acute geriatric inpatient ward at a German university hospital in 2019. The geriatric depression scale (GDS-15), the mini-mental status test (MMST), Barthel index and documented depression diagnoses at admission were recorded.

Results: Complete data were available for 286 patients and of these 36.8% showed noticeable depressive symptoms (GDS-15 > 5) but only 10.4% had a previous diagnosis of depression. There were no significant gender-specific differences. The MMST correlated negatively with the GDS-15 in women, while the Barthel Index showed no correlation.

Discussion: Depressive symptoms are common in geriatric settings. Gender differences may play a lesser role in older age. The lack of correlation between depressive symptoms and functional impairments but the partial correlation with cognitive impairments, points to the diagnostic challenge of age-related multimorbidity. The discrepancy between noticeable depressive symptoms and few documented diagnoses of depression indicates possible gaps in the prehospital detection and recording of depressive disorders.

Background: Aged members of religious orders talked about their lives.

Aim of the study: The aim of this study is to describe how identity work is manifested in old age among members of religious orders.

Material and methods: Narrative interviews were conducted. Transcripts were analyzed using thematic analysis and communicatively validated in group discussions by the interviewees.

Results: Interviews with 21 people aged 80-98 years were analyzed. It was found that the majority of the aged members of religious orders were concerned with questions of their own identity. An important area of their identity work is faith. They reflect on who God is for them and develop new images of God and themselves.

Discussion: The results of the study suggest that even people with a high degree of life course continuity question their identity in old age and engage intensively in exploratory processes.

Background: A discharge letter analyzer was developed in the Bielefeld Geriatrics Living Laboratory at Bielefeld University of Applied Sciences in cooperation with the Catholic Hospital Association East Westphalia (Katholische Hospitalvereinigung Ostwestfalen). This can support quality assurance in the area of discharge management.

Methods: The discharge letter analyzer uses text mining methods to find information in the respective discharge letters. Data are extracted from the free text as well as numerical values from the documented assessments. In the project the cases were assigned to diagnostic categories through both deductive and inductive category development and the collection of keywords by the medical staff involved.

Results: With the help of the analyzer patients could be assigned to different diagnostic categories. It was found that the majority of cases were treated due to multifactorial or fall-related indications. In addition, the patients improved in various tests over the course of treatment. Most patients could be discharged back home after treatment.

Conclusion: The results show that discharge management requires a special focus on fall-related and neurodegenerative diseases in the subsequent treatment. Due to the predominant discharge of patients to their homes, there is a significant focus on outpatient care. In principle, a measurable improvement can be achieved through inpatient treatment.

Background: Old age and service centers (ASZ) in Munich offer preventive and care services for older people. As initiating contact with existing support services is a barrier, the street work project "Senior citizens visited by experts in the community" (SAVE) was introduced. Since 2019 SAVE experts have been providing advice to older people who are in public spaces and appear to be in need of support. The aim of our study was to examine the implementation of SAVE to identify recommendations for action.

Method: The SAVE evaluation is based on a mixed methods multistage design with a participatory approach. Firstly, secondary data (SAVE statistics, project documents) were analyzed. In addition, participant observations (n = 4), a focus group (n = 6) and interviews with SAVE experts (n = 4) and ASZ managers (n = 5) were conducted. To integrate the data the respective results were compared, triangulated and jointly interpreted.

Results: According to the statistics (period: January 2020-June 2023) the project reached 1546 people (57% women, 2847 contacts). Common problems identified included physical and mental illnesses, financial difficulties and loneliness. The derived recommendations for action address the following topics: SAVE requirements profile, basic equipment, implementation, orientation phase, public awareness and collegial cooperation.

Conclusion: The SAVE project offers an innovative way of reaching older people in their community by providing information, building relationships, giving on-site counselling and providing additional support. The project can be seen as an important measure to prevent distress among older people.