Health Matters
Anxiety in Later Life: Improving the Well-being of Older Australians
Paper Presentation in a Themed Session Danny Hills, Sharon Hills, Tracy Robinson
Anxiety likely affects more than a million older Australians. It is associated with other physical and mental disorders, reduced quality of life, disability, and increased healthcare utilisation. Yet the symptoms of anxiety in later life are often unrecognised and untreated. In this multi-state study, general practice nurses (GPNs) utilised a short, validated, age-appropriate screening instrument in the annual seventy-five years and older health assessment (75+ HA) in primary care, with an enhance referral pathway for assessment and treatment by a General Practitioner (GP). Almost 20% of older people who were screened had clinically significant symptoms of anxiety (CSSA). GPNs reported that screening and referral was effectively integrated into the 75+ HA. As a result of our research, we are developing an evidence informed, low intensity, general practice-based intervention that can be delivered by GPNs, in an effort to reduce the debilitating effects of anxiety experienced by so many older Australians.
The Construction of a Supporting Model for Family Caring for People with Dementia: A Preliminary Study of Barriers and Needs
Paper Presentation in a Themed Session Chia- Ming Yen
This study firstly explores the barriers among family caregivers of people with dementia. Then it moves to look at the needs among family caregivers of people with dementia. Five domains of needs from family caregivers will be examined, including knowledge of dementia and caring skills to cope with problem behaviours, medication and comorbidity management, family relationship and psychological supports, resources and benefits, and education and skills training. In this study patients with different type of dementia and at different stages of disease processes will be included. Lastly, this study gainsa complete picture to construct the supporting model in terms of needs for family caregivers with people of dementia. the study is divided into two phases. In phase one, an in-depth interview and medical (care) notes taking will be adopted. Thirty-eight participants will be recruited from the outpatients of Neurology and Geriatrics Departments of a teaching hospital in Taichung to participate in interviews and medical (care) notes. The participants are divided into three groups, Group one and two contain ten participants respectively. Group three includes eighteen participants. Participants from group one are the primary family caregivers regardless of age and gender. Group two contains people who are diagnosed with dementia including Alzheimer’s disease, vascular dementia and other types of dementia, and regardless the stage of disease process. That is he or she is in his/her early, mild and server stages of dementia. Group three contains eighteen healthcare professionals including physicians, nurses, social workers, and paid carers. At phase two, ten participants will be selected to participate in Delphi questionnaires. This study will systematically examine the barriers and needs of family caregivers of people with dementia. In the end, the supporting model of needs for family caregivers will be constructed which will be expected to provide healthcare professionals more concise information and insights about the problems.
Similarities and Differences when Comparing Older People with Severe Mental Illness and A Population-based Study of Older People: Care and Living Conditions for Older People with Severe Mental Illness
Paper Presentation in a Themed Session Cristina Joy Torgé, Marie Ernsth Bravell, Per Bülow, Monika Wilinska, Pia Helena Bülow, Magnus Jegermalm
After the 1995 Swedish psychiatric reform, people with SMI age in the community instead of institutions. However, there is a huge lack of knowledge about their living situation. The aim of the study is to investigate living conditions, social networks, health and care of older people with SMI (SMI-O) in comparison to other older people. For this analysis, we use descriptive statistical analysis to compare groups of older persons from two samples: 1) inventories of people with SMI, conducted every fifth year in one Swedish municipality from 1996 to 2011 (SMI-O) and 2) population-based study of older people, conducted in the same municipality with similar questions (OCTO-2). The mean ages in the groups were similar (SMI-E: 76; OCTO-2: 78) but the distribution of men and women differed (35/65%; 48/52%) as did the proportion of persons living alone (83%; 48%). The samples had similar frequencies in social contacts (51%; 52%) but SMI-E reported significantly more problems in performing personal and instrumental daily activities. As SMI-E is a vulnerable group compared to older people in general, understanding their support needs is required.
A Case Study of an Old Woman With a Fracture of the Metacarpal Bone
Paper Presentation in a Themed Session Daichi Narita, Hisae Ishii, Shohei Higashida, Ukyo Nakaki, Hiromi Nakamura
This study reports the importance of appropriate selection of splints in occupational therapy interventions for an old woman with a metacarpal fracture. The patient was a seventy-year-old woman. She was a wife and an office worker. Her dominant side was the right. She fractured her left little finger due to falling during walking. At the initial evaluation brought the following results: 1) Complaining pain when moving metacarpophalangeal joints, 2) Unable to use her left hand due to anxiety, and 3) 25/100 in Quick-Disability Arm Shoulder and Hand (Q-DASH), indicating difficulties in using both hands. Based on her hope of going back to work and resuming her hobby activity (playing Ukulele), her short-term goals were 1) Performing ADL, housekeeping, and work-related activities with both hands at four-week post-surgery, and 2) Performing those activities with no splint at six-week post-surgery when observing bone adhesion. The interventions were: (1) A typical operation for fixation, (2) Tailoring sprints according to her recovery, (3) Mobilization aiming at contracture prevention, and (4) Encouragements of using the injured hand. The provided splints were: 1) A Knuckle splint at the week-three, 2) A Buddy splint at the week-four, and 3) A Dynamic splint at the week-six post-surgery, respectively. At the week-ten post-surgery, she complained no pain, 2/100 in Q-Dash, and performing work and hobby activities with no issue. The originality of this study was the introduction of appropriate splints and the usage of the hand from the early stage.
