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Dissertations / Theses on the topic 'Older people with disabilities'
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1
Wang, Shuang. "Fuzzified scoring of the functional assessment instrument." Diss., Columbia, Mo. : University of Missouri-Columbia, 2007. http://hdl.handle.net/10355/4984.
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Thesis (M.S.)--University of Missouri-Columbia, 2007.The entire dissertation/thesis text is included in the research.pdf file; the official abstract appears in the short.pdf file (which also appears in the research.pdf); a non-technical general description, or public abstract, appears in the public.pdf file. Title from title screen of research.pdf file (viewed on November 6, 2007) Includes bibliographical references.
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Oftedahl, Linda. "Hopelessness and hours of services received by elderly and disabled clients." Online version, 2001. http://www.uwstout.edu/lib/thesis/2001/2001oftedahll.pdf.
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Whiteley, Anna. "Understanding and experiencing ageing : the perspectives of older people with intellectual disabilities." Thesis, University of Edinburgh, 2016. http://hdl.handle.net/1842/25491.
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Background: This thesis contains two elements: the first is a systematic review examining some of the determinants of quality of life for people with intellectual disability. Understanding these determinants can drive improvement at both individual and societal level. Yet there are a number of quality of life measures which might confound findings between studies. This systematic review sought to identify factors that influence quality of life using self-report on one measure developed for use with people with intellectual disability, the ‘Quality of Life Questionnaire’ (Schalock & Keith 1993). The second element is an empirical study that aims to explore the lived experience of aging for older adults with intellectual disability. There are noted differences between people with and without disability as they grow older, for example in terms of health and social opportunity. Previous studies have not consistently sought the experience of the people with intellectual disability themselves, or have used participants not traditionally considered older adults. This study aims to address gaps and further our knowledge in the lived experience of getting older for older adults with intellectual disability. Method: Within the systematic review a systematic search of relevant studies to 20th January 2015 was completed using a specified inclusion criteria, yielding 13 peerreviewed journal articles. These were scored on 11-point purpose-designed quality criteria. For the empirical study semi-structured interviews were completed with ten participants with intellectual disability (age range 60 – 74 years, five female) regarding their understanding of getting older and their experience of ageing. Nine transcribed interviews were analysed using interpretative phenomenological analysis. Results: The systematic review found that living in a semi-independent environment or an urban setting, being employed, being involved in domestic and community activities, receiving social support and possessing social skills and self-determination were factors that improved quality of life for people with intellectual disability. Three major themes emerged from the empirical study data when participants discussed getting older: ‘Not changed by ageing’, ‘Thinking about the ageing process’ and ‘What happens when getting older’. Participants tended to feel that they were still the same due to continuation of the same activities and social support. They demonstrated confusion in the ageing process, considering the process ‘inevitable’ but insignificant, although also recognising some changes associated with the process. They discussed their views about what they considered happens when people get older, which tended to be stereotypical and often negative. However they also reflected on their own experiences and how they had changed. Discussion: The methodological quality of the studies reviewed was found to be generally low due to a range of factors including study design, measurement of intellectual disability and reporting of sample demographics and results and therefore conclusions should be treated with caution. This highlights a need for further research with people with intellectual disability of a higher methodological quality. The empirical study is discussed in reference to previous research and gerontological theories of ageing. The study highlighted that staff or family did not broadly discuss ageing with participants and their views often changed over the course of the interviews from more physical and negative aspects to how ageing impacted them. This research demonstrated older adults with intellectual disability do have opinions on ageing. Further exploration with people with intellectual disability on this topic is to be encouraged in the future to develop a more balanced view.
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Lee, Jae Chul. "Health disparities in access to health care for older people with disabilities." Diss., Connect to online resource - MSU authorized users, 2008.
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Thesis (Ph.D.)--Michigan State University. Rehabilitation Counselor Education , 2008.Title from PDF t.p. (viewed on July 2, 2009) Includes bibliographical references (p. 128-144). Also issued in print.
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Fleming, Alfred Andrew. "Older Men Working it Out A strong face of ageing and disability." Thesis, The University of Sydney, 2001. http://hdl.handle.net/2123/852.
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This hermeneutical study interprets and describes the phenomena of ageing and living with disability. The lived experiences of 14 older men and the horizon of this researcher developed an understanding of what it is like for men to grow old and, for some, to live with the effects of a major disability. The study is grounded in the philosophical hermeneutics of Gadamer and framed in the context of embodiment, masculinity, and narrative. I conducted multiple in-depth interviews with older men aged from 67 to 83 years of age. Seven of the participants had experienced a stroke and I was able to explore the phenomenon of disability with them. Through thematic and narrative analyses of the textual data interpretations were developed that identified common meanings and understandings of the phenomena of ageing and disability. These themes and narratives reveal that the men's understandings are at odds with conventional negative views of ageing and disability. These older men are 'alive and kicking', they voice counternarratives to the dominant construction of ageing as decline and weakness, and have succeeded in remaking the lifeworld after stroke. Overall I have come to understand an overarching meaning of older men 'working it out' as illustrative of a strong face of ageing and disability. Older men seek out opportunities to participate actively in community life and, despite the challenges of ageing and disability, lead significant and meaningful lives. These findings challenge and extend our limited understandings of men's experiences of ageing and living with disability. This interpretation offers gendered directions for policy development, clinical practice, and future research.
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Fleming, Alfred Andrew. "Older Men Working it Out A strong face of ageing and disability." University of Sydney. Behavioural and Community Health Sciences, 2001. http://hdl.handle.net/2123/852.
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This hermeneutical study interprets and describes the phenomena of ageing and living with disability. The lived experiences of 14 older men and the horizon of this researcher developed an understanding of what it is like for men to grow old and, for some, to live with the effects of a major disability. The study is grounded in the philosophical hermeneutics of Gadamer and framed in the context of embodiment, masculinity, and narrative. I conducted multiple in-depth interviews with older men aged from 67 to 83 years of age. Seven of the participants had experienced a stroke and I was able to explore the phenomenon of disability with them. Through thematic and narrative analyses of the textual data interpretations were developed that identified common meanings and understandings of the phenomena of ageing and disability. These themes and narratives reveal that the men�s understandings are at odds with conventional negative views of ageing and disability. These older men are �alive and kicking�, they voice counternarratives to the dominant construction of ageing as decline and weakness, and have succeeded in remaking the lifeworld after stroke. Overall I have come to understand an overarching meaning of older men �working it out� as illustrative of a strong face of ageing and disability. Older men seek out opportunities to participate actively in community life and, despite the challenges of ageing and disability, lead significant and meaningful lives. These findings challenge and extend our limited understandings of men�s experiences of ageing and living with disability. This interpretation offers gendered directions for policy development, clinical practice, and future research.
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Meyer, Tania. "A social work perspective on the socio-emotional experience of older persons with visual impairments." Thesis, Link to the online version, 2006. http://hdl.handle.net/10019/1112.
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Kueffler, Mark L. "Awareness and use of assistive technology among older adults with vision impairments in the Midwestern United States." Online version, 2003. http://www.uwstout.edu/lib/thesis/2003/2003kuefflerm.pdf.
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Kleist, Kyle A. "A survey of transportation availability and consumer satisfaction among elderly and disabled individuals in Pierce County, Wisconsin." Online version, 2004. http://www.uwstout.edu/lib/thesis/2004/2004kleistk.pdf.
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Hyatt, Alicia M. "Who am I? the strength and structure of identity in individuals with dementia /." View electronic thesis, 2008. http://dl.uncw.edu/etd/2008-3/rp/hyatta/aliciahyatt.pdf.
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Jenkins, Robert Ivor. "Meeting the health needs of older people with learning disabilities : the role of nurses." Thesis, University of South Wales, 2011. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.534413.
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Blodgett, Elizabeth Geneva. "The intersection of age and eligibility variation in health services use for medicare beneficiaries /." Pullman, Wash. : Washington State University, 2010. http://www.dissertations.wsu.edu/Thesis/Spring2010/E_Blodgett_041910.pdf.
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Thesis (Master of health policy and administration)--Washington State University, May 2010.Title from PDF title page (viewed on July 6, 2010). "Department of Health Policy and Administration." Includes bibliographical references (p. 26-30).
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Hovda, Theodore James. "Lower extremity strength and its association with physical function and disability." Electronic thesis, 2002. http://dspace.zsr.wfu.edu/jspui/handle/10339/208.
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Patterson, Donald Jay. "Assisted cognition : compensatory activity assistance technology /." Thesis, Connect to this title online; UW restricted, 2005. http://hdl.handle.net/1773/6853.
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Rall, Bethany Ann. "Effect of recreation and leisure on the life quality of older adults with developmental disabilities." CSUSB ScholarWorks, 2003. https://scholarworks.lib.csusb.edu/etd-project/2359.
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The purpose of this study is to examine improved life quality indicators of older adults with developmental disabilties who are actively participating in the Senior Facilitation Program, a program designed for seniors with developmental disabilities which allows them to make individual choices about their leisure pursuits.
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Wong, Wai-lung, and 黃偉龍. "Fall efficacy and reinvestment in older adults." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2003. http://hub.hku.hk/bib/B31257483.
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Borodacz, Lucie. "Development of Fingerfood recipes for meals for home usage among older people with eating disabilities." Thesis, Högskolan Kristianstad, Fakulteten för naturvetenskap, 2021. http://urn.kb.se/resolve?urn=urn:nbn:se:hkr:diva-22576.
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Background: In the context of demographic changes and age-related diseases, there is a need to focus on the health of older people. Eating disabilities, such as difficulties to use cutlery, caused by various diseases (Parkinson's disease, consequences of a stroke) are becoming more frequent and solutions must be put in place. Objective: The purpose of this study is to create recipes of Fingerfoods for older adults over 65 years old with eating disabilities. These recipes should be prepared at home and rich in protein and energy. Design: A creative design was used to create products, and several variations were created from a basic recipe. The differences between the variations of a recipe are the ingredients that can be substituted or changed in quantity. Materials and Methods: Concerning the physical analysis, texture measurements, viscosity, and colorimetry were performed. The sensory evaluation was a hedonic test to measure the appreciation of the panel according to several criteria: appearance, smell, taste, texture, and overall appreciation. Results: The samples, according to the type of product, were measured for their hardness, their adhesiveness, their viscosity, and their colour. Results also show the appreciation of each sample, the comparisons of the appreciations, the ideas for improvement of the participants, and correlations between different data sets. Discussion: Results have been analysed and used to select the suitable recipes at each phase of the study. The milkshake was preferred when vanilla whey protein was added. The cheese balls were preferred with more chicken and less cheese. Soy flour was appreciated equally or more than wheat flour in the fish cakes and the salty muffins while chickpea flour was the least liked. In the set of recipes proposed for sensory evaluation, the most protein-rich ones were the most appreciated. Conclusion: In the end, four recipes have been selected based on the physical analysis, the sensory evaluation, and the nutritional content. The expected amount of protein was achieved for all productsISBN: 978-91-87973-61-1
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Fuess, Billings S. "The post institutional adjustment of elderly mentally retarded and developmentally disabled persons : a population study /." The Ohio State University, 1987. http://rave.ohiolink.edu/etdc/view?acc_num=osu1487327695620283.
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Ellingsberg, Carol E. "CCTV use by visually impaired seniors living independently in community settings." Online version, 2002. http://www.uwstout.edu/lib/thesis/2002/2002ellingsbergc.pdf.
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Xiang, Wanlin. "Design of a new grab bar for older adults." Thesis, Georgia Institute of Technology, 2013. http://hdl.handle.net/1853/48942.
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Toilet grab bars were intended to facilitate independent and safe toilet transfer for people with different abilities. However, standard grab bars require too much effort from older adults who typically transfer to the toilet in a standing position rather than a sitting position. Among existing grab bars, grab bars on both sides of the toilet worked best for older adults because they allowed older adults to use both arms to get on and off the toilet. However, based on our observation, these grab bars were not effective to assist older adults to get in and out of the wheelchair. Additionally, these grab bars are too far apart that older adults have to use their shoulders rather than arms, which arise problems because shoulder are typically weaker than arms. This study intends to solve this problem by developing a new grab bar which would be safer, easier and more comfortable to use. Based on the literature review, analysis of existing grab bars and observation, a new concept of grab bars was generated and a functional prototype was constructed for user testing. The prototype was proved to be safe, easy and comfortable to use in the entire transfer process and it reduced the use of wheelchairs as well.
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Zhu, Bing Yu. "A feasibility study of the application of European long-term-care model to Macau LTC system." Thesis, University of Macau, 2012. http://umaclib3.umac.mo/record=b2595816.
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Palmer, Andrew Demetrius. "The Impact of Communication Impairments on the Social Relationships of Older Adults." PDXScholar, 2015. https://pdxscholar.library.pdx.edu/open_access_etds/2344.
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Communication forms the foundation of social interaction. For older adults, however, there is known to be an increased risk of developing conditions that interfere with the ability to communicate. These conditions may occur for a variety of reasons, including age-related changes in physical or sensory functioning, injury, and disease. It is estimated that 55% of all Medicare beneficiaries have a communication impairment of some kind. Social contact is known to be vital for older adults' mental and physical health but, because communication impairments often co-occur with other types of disability, it is difficult to generalize about the relative impact of a communication impairment on the social relationships of older adults. Specific aims of the study were to examine whether the severity of a communication impairment is associated with social measures, whether there is an interaction between communication impairments and physical disability, and to examine the role of relationship-control strategies in maintaining access to a larger or more supportive social network. A mixed-methods study design was employed. Community-dwelling older adults were surveyed about the size and diversity of their social networks, frequency of social interactions, and physical and mental health (n = 240) and qualitative data were collected from a smaller subsample. Findings demonstrated that communication impairment was a significant independent predictor for key characteristics of social relationships, including the composition of the social network, certain types of social support, the frequency of social participation, and social self-efficacy. Communication impairment was a significant predictor for higher levels of loneliness and depression. In addition two distinct pathways between communication impairment and psychological well-being were identified, with social self-efficacy and reassurance of worth as mediators. Additional insights were provided by the qualitative results. These findings may guide future clinical practice and research by providing a better understanding of the role of communication in health, disability, and the risk of social isolation.
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Marquis, Ruth. "The meaning of quality in living service environments: An analysis of the experiences of people with disabilities, elderly people and service workers." Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 1998. https://ro.ecu.edu.au/theses/976.
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The purpose of the study was to examine the experiences of both people with disabilities and elderly people and to identify their perceptions of quality as it relates to living in a service or being supported by a service to live in the community. The study was naturalistic in design and used a phenomenological approach and inductive analysis. It involved immersion in living services for a two year period, in-depth interviews with people living and working in services and participant observation. Fifty service users between the ages of twenty-one and ninety-six, and twenty-six service workers between the ages of twenty-six and fifty-four were informants in the study. The study comprised of three phases, the first phase involved repeated in-depth interviews with service users in two disability and two aged care living services to examine the experiences of people living in services and their perceptions of quality. As a result of the consistency with which relationships with key staff members emerged in the context of quality experiences, selected service workers who were named by service users were also interviewed. The findings in this phase indicated that relationships experienced by service users in their encounters with service workers were more significant in service users' evaluation of quality than tangible acts of physical and environmental care. Relational experiences of people living in services were variable. Some informants experienced consistent validation and socio-emotional support, whilst others experienced role distancing and negative communication experiences. Service workers who were interviewed as a result of being identified by service users in the context of quality, attached importance to the relational domain in the acts and behaviours of providing a service. They also attached personal meaning to their roles as service workers and shared the view that their role as service worker was underpinned by an ethos of communality. The second phase of the study involved accessing another five disability and five aged care services to collect further data to support or refute the findings from phase one. As a result a large data bank was established to confirm the consistency with which relational experiences in living services were linked to perceptions of quality by both service users and service providers. Acts and behaviours which were consistently present in the context of quality were also identified and the need for emotional support in the living context was further confirmed. The third phase of the study involved an in-depth analysis and identification of commonly experienced categories of relationships between service users and workers. Relationships were categorised into ethical and technical living service experiences and exemplars used to illustrate findings. Data analysis indicated that service experiences lie on a continuum, with mutually supportive relationships between service users and workers at one end, and physical and psychological abuse at the other. Experiences were variable in singular service contexts. This highlighted the individual nature of service relationships between service users and workers and the need to articulate human service as relationship. It also highlighted the inadequacies of using standard measures to evaluate quality in living services.
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Elliott, Sheryl DeJoy. "The Historical, Political, Social, and Individual Factors That Have Influenced the Development of Aging and Disability Resource Centers and Options Counseling." PDXScholar, 2013. https://pdxscholar.library.pdx.edu/open_access_etds/1072.
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This thesis reports on the perspectives and experiences of policymakers, advocates, agency supervisors, and experts in the field of gerontology, about the development of Aging and Disability Resource Centers (ADRC) programs and Options Counseling (OC). By examining the foundations upon which ADRCs and OC are built, this study sought to inform future research about the effectiveness of existing practice, increase understanding of best practices, and clarify whether these emerging services are accomplishing original goals.
ADRCs and OC intend to address long-term care issues and healthcare needs by providing a single entry point to the social service system. ADRCs offer information, assistance, and OC to people of all ages, incomes, and disabilities, and promote long-term care options that honor independence and respect for the needs and preferences of individuals, their families, and caregivers. They are the latest iteration of policymakers' efforts to provide affordable home-and community-based care for older persons and their caregivers.
A total of fifteen qualitative interviews were conducted and analyzed using grounded theory methods. Key persons interviewed included experts in the area of aging, aging policy, and aging. Participants were recruited through referrals suggested by Portland State University's (PSU) Institute on Aging (IOA) staff. In addition, several key experts known to the researcher through affiliation with PSU's IOA agreed to be interviewed. Snowball sampling was then used to locate additional key experts.
Interview participants were classified as advocates, state decision makers, policy makers, or academicians. Advocates included national and state directors of agencies that promote the development and management of effective services to aging adults. State decision makers included state directors, ADRC directors and supervisors, and program analysts. Policy makers interviewed were national program directors responsible for shaping the future of developing programs to assist older adults. Academicians who participated in the study have been instrumental in developing and researching practices that promote well-being for the aging and the aged. These key experts were selected based on their knowledge and ability to inform the strengths, weakness, and development of ADRCs and Options Counseling. Many have been instrumental in health and aging policy and service development and research, and possess insider knowledge not available to the general public regarding attitudes and interests motivating the actors.
Findings indicate that ADRCs and OC are designed to manage within existing social service systems. They can benefit some individuals by providing more options and support in accessing public and private services. It remains to be seen whether they have the capacity to ameliorate some existing system-level problems. Findings highlight program strengths and weaknesses, sustainability issues, and policymakers, state decision makers', and providers' commitment to sustaining ADRCs and OC.
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Wardell, F. A. "An examination of the voluntary provision of care for adults with learning disabilities, mental health problems, physical disabilities and older people : Grampian, Highland and Edinburgh." Thesis, University of Aberdeen, 2007. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.590998.
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Recent government social policies, including those promoting community care and active citizenship, and specific volunteering policy (such as Millenium Volunteers and Project Scotland) have outlined an extended role for volunteers and voluntary organisations in the planning, design and delivery of services. In broad terms, these initiatives assume an untapped pool of volunteers ready and willing to be actively and meaningfully engaged. This research comprises two naturalistic studies which examine the assumptions underlying government policies including engagement, placement, organisation, management and retention of volunteers. Evidence was gathered by direct consultation with active volunteers (n=117) and their managers (n=72). Participants were recruited from organisations working with adults with learning disabilities, mental health problems, physical disabilities and older people across Scotland. This research found that volunteers become involved for many reasons: some young people consider their voluntary work as a ‘stepping-stone’ to employment, others, who feel themselves socially isolated for a number of reasons, report that volunteering is a useful way to gain social support. Volunteers require different levels of training, support and supervision. Tensions may inevitably arise between volunteering as a freely chosen activity by an individual and volunteering as part of contracted service provision by an increasingly professional voluntary organisation. For agencies to meet the demands of contracted service provision clearly defined procedures for selection, induction, training and supervision may be required. Given the inevitable resource implications this has for volunteer-engaging organisations is it unlikely that such an expansion in roles for volunteers would be cost-free. Organisations face a challenge to adapt effectively to the requirements of social policy while maintaining the enthusiasm and commitment of a diverse pool of volunteers.
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Bennett, DeeDee Marie. "A comparative analysis of state emergency plans improving response to vulnerable populations /." Thesis, Atlanta, Ga. : Georgia Institute of Technology, 2009. http://hdl.handle.net/1853/29774.
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Thesis (M. S.)--Public Policy, Georgia Institute of Technology, 2009.Committee Chair: Mitchell, Helena; Committee Member: Clark, Jennifer; Committee Member: Elliott, Michael. Part of the SMARTech Electronic Thesis and Dissertation Collection.
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Otters, Rosalie V. "Vision Impairment and Depression in the Older Adult." Thesis, University of North Texas, 2005. https://digital.library.unt.edu/ark:/67531/metadc4848/.
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The older adult population in the United States is rapidly expanding both because of longer life expectancies as well as the aging of the baby boomers. While vision impairment is a growing concern among older adults, there have been few, mostly small studies, of the impact of vision impairment on this population. The present study uses a national data set, the Second Supplement on Aging (1994 -1996) from the National Health Interview Survey, in a cross-sectional study of 9,447 civilian non-institutionalized persons, aged 70 years and over at the time of their interview. The SOA II has been studied in the context of a social theory of aging that emphasizes interdependence through the life course using a stress process model that has been refined into a disability model. Disability is understood as a social construction outcome rather than as a medical outcome. Vision impairment is the stressor which is mediated by health (falls, functioning and self-health report), financial resources (education, income and having only public health insurance) and social support (marital, living along, having no living children, social activities in number and intensity). Depression is a possible, but not a necessary result of vision impairment. Disability may result when a medical pathology leads to an impairment which results in a functional limitation and finally a social disability. This secondary analysis used a multinomial logistic regression for both the whole sample as well as separately for each gender. For the whole sample the results indicate that a typical profile of a vision-impaired older adult depressed some/all of the time, would be a younger-old White woman (aged 70-74 years old) who has fallen in the past 12 months, has difficult with one or more Activities of Daily Living or with both one or more Activities of Daily Living and Instrumental Activities of Daily Living, has a poor to fair self-heath report, a family income under $20,000, a high school or less education, lives alone, has a living child and lacks social activities in number and intensity. In the gender samples, only the female sample at the some/all of the time depression category is significant. Older vision-impaired adults, especially older women who have more social supports are less likely to be depressed and so disabled. There is a need for social policies that will educate, encourage and support older vision-impaired adults as they seek to compensate for the loss of vision, often late in life.
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Smith, Irmhild Wrede. "The effect of structured exercise and stuctured reminiscing on agitation and aggression in geriatric psychiatric patients /." Access Digital Full Text version, 1996. http://pocketknowledge.tc.columbia.edu/home.php/bybib/11976676.
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Thesis (Ed.D.)--Teachers College, Columbia University, 1996.Typescript; issued also on microfilm. Sponsor: Susan W. Salmond. Dissertation Committee: Marvin Sontag. Includes bibliographical references (leaves 73-87).
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Cermak, Tracy. "Developmentally Disabled Older Adults in Georgia: Rural, Metropolitan, and Urban Long Term Housing Availability." Atlanta, Ga. : Georgia State University, 2009. http://digitalarchive.gsu.edu/gerontology_theses/15/.
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Thesis (M.A.)--Georgia State University, 2009.Title from title page (Digital Archive@GSU, viewed July 29, 2010) Ann Pearman, committee chair; Erin Ruel, Dennis Thompson, committee members. Includes bibliographical references (p. 73-81).
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Cole, Marsha Dee. "The effects of quality of social networks on psychological well-being in the visually impaired elderly." CSUSB ScholarWorks, 2003. https://scholarworks.lib.csusb.edu/etd-project/2174.
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Easterling, Calvin Henry. "The Developmentally Disabled Elderly in Canada: Access to Health Care and Social Services." Thesis, University of North Texas, 1992. https://digital.library.unt.edu/ark:/67531/metadc332746/.
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The accessibility, predictors, and use of health care and social services among developmentally disabled elderly adults in Canada were examined using a nationally representative social survey. The first research hypothesis is that the independent variables will contribute significantly to the prediction of the dependent variables. A second hypothesis is that the slope of any given independent variable will not equal zero. The results of this research show that the illness (need) variables are the most predictive correlate of the utilization of health care and social services. The predisposing variables have secondary explanatory power, with the enabling variables accounting for the least amount of variance. The hypotheses were tested by step-wise multiple regression analysis using SPSS-X.
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Dietz, Tracy L. "Predictors of Health Care and Social Service Utilization and Perceived Need Among the Disabled Elderly in Canada." Thesis, University of North Texas, 1992. https://digital.library.unt.edu/ark:/67531/metadc500776/.
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The world has experienced a tremendous growth in its elderly population. With the aging of the population, policy makers are concerned about the health of these elderly as well as their utilization of health care and social services and perceived need for additional services. The Canadian elderly population is similar to other elderly populations in that a few tend to be the heaviest users of the available services. The predictors of this utilization behavior and perceived need primarily include need variables, such as the number of limitations of daily living -- both ADLs and IADLs, and functional limitations. In addition, enabling variables, such as income, work activity and geographic region of residence were also found to be significant.
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Schor, Mark Melvin. "Therapeutic Effects of Group Counseling with Visually-Impaired Elderly Adults." Thesis, North Texas State University, 1987. https://digital.library.unt.edu/ark:/67531/metadc331653/.
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The purpose of this study was twofold: (a) to determine the therapeutic effectiveness of group counseling with visually-impaired elderly adults, and (b) to provide information concerning the effectiveness of group counseling to practitioners in the field. The study reviewed the literature regarding aging and vision, psychosocial reactions to vision loss, and group counseling with the visually-impaired and the elderly.
Twenty subjects, who were above age 65 and had recently experienced a severe loss of vision, were selected to participate in the study. Ten subjects were assigned to an experimental counseling group and 10 subjects were assigned to a no-treatment control group. The experimental group participated in 1-1/2 hour group sessions once a week for 10 weeks.
Both the experimental group and the control subjects were administered pre- and post-tests. The tests measured depression, anxiety, self-esteem, and life satisfaction.
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Nussbaum, Paul David 1963. "Qualitative aspects of memory performance in depressed versus demented elderly." Thesis, The University of Arizona, 1987. http://hdl.handle.net/10150/276623.
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This study investigated quantitative and qualitative aspects of memory in three age-and-education-matched groups (1) 38 normal elderly, (2) 15 patients with dementia of the Alzheimer's type (DAT), and (3) 26 depressed elderly. Three clusters of dependent variables were used to examine group differences: (1) standard psychometric (Wechsler Memory Scale logical memory and visual reproduction subtests), (2) verbal recall measures (free recall measures of primary memory, secondary memory, prior item intrusions and extra list intrusions), and (3) verbal recognition memory measures (true positive, false positive, true negative, and false negative responses). Analyses of variance, with specified contrasts, found the DAT patients to demonstrate a pervasive memory impairment affecting both the qualitative and quantitative memory indices compared to depressed and normal elderly. The depressed elderly demonstrated impairment, compared to normal elderly, on tasks requiring effortful processing. Findings support pervasive memory loss in DAT patients and do not support clear memory impairment in the present depressed sample.
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Wong, Wai-lung, and 黃偉龍. "The role of movement specific reinvestment, fall efficacy and perception in walking and falling in community-dwelling older adultsin Hong Kong." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2012. http://hub.hku.hk/bib/B48521760.
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In six experiments, the relationships between history of falls, reinvestment, fear of falling, perception, balance ability and walking ability of community-dwelling older adults was investigated. In addition, the Movement Specific Reinvestment Scale (MSRS) (Masters, Polman, & Hammond, 1993; Masters, Eves, & Maxwell, 2005) was further validated, using a Chinese version (MSRS-C). In the first experiment (Chapter 2), it was shown that elder fallers scored significantly higher than non-fallers on both the movement self-consciousness and the conscious motor processing components of the MSRS-C. The conscious motor processing component of the MSRS-C was found to discriminate previous faller from non-faller status. In the second experiment (Chapter 3), findings demonstrated that internal focus of attention was greater in elder repeat fallers and increased as task demands increased.
However, external focus of attention increased in both elder repeat fallers and elder non-fallers as task demands increased. Elder repeat fallers scored significantly higher than elder non-fallers on the MSRS-C. In the third and fourth experiments (Chapter 4), it was revealed that elder fallers demonstrated greater fear of falling and a higher propensity for movement specific reinvestment than non-fallers. Elderly people perceived stairs as steeper than they were and judged stairs as steeper when making visual-matching and verbal-report estimates that required conscious involvement compared to haptic estimates that are thought to require little conscious involvement. Overestimations when making explicit, conscious judgments were reduced by carrying out a concurrent secondary task during estimation, but there was little effect of the secondary task on implicit, non-conscious judgments of steepness. In Chapter 5, focus group work was conducted to investigate whether (1) elderly people respond differently when asked to complete the MSRS-C in respect of contexts that are not directly related to balance or locomotion and (2) elderly people are better able to differentiate a 4-point Likert response format when completing the MSRS-C than the original 6-point format. Experiment five (Chapter 6) further validated the MSRS-C based on the findings from Chapter 5. Results revealed that both the MSRS-C (general) and MSRS-C (walking) can be used with a six-point or a four-point response format to differentiate elderly Chinese fallers from non-fallers. The overall findings were discussed in the context of theories of motor learning and reinvestment. Implications for rehabilitation training were elucidated.published_or_final_version
Human Performance
Doctoral
Doctor of Philosophy
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Smith, Jan Elizabeth. "Needs, characteristics and experiences from minority ethnic adults with learning disabilities and minority ethnic older people living in care homes across England : an exploratory mixed methods study." Thesis, University of Kent, 2013. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.595300.
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Zingmark, Magnus. "Occupation-focused and occupation-based interventions for community-dwelling older people : Intervention effects in relation to facets of occupational engagement and cost effectiveness." Doctoral thesis, Umeå universitet, Arbetsterapi, 2015. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-100064.
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Background Occupation-focused and occupation-based interventions can potentially promote occupational engagement among community-dwelling older people, but there is limited evidence to identify the most effective and cost-effective interventions. For independent-living older people, there is a lack of evidence to determine if occupation-focused and occupation-based interventions have an effect on their occupational engagement. For older people who need assistance because of bathing disabilities, there is limited evidence of the effects of occupation-focused and occupation-based interventions on their occupational engagement or for reducing or omitting their need for assistance. Finally, there is limited evidence to determine if occupation-focused and occupation-based interventions implemented for community-dwelling older people are cost effective. Aim The aim of this thesis was to evaluate the effects and cost effectiveness of occupation-focused and occupation-based interventions for two groups of community-dwelling older people, independent-living, community-dwelling older people and older people with bathing disabilities. Method Studies I and II were based on an exploratory randomized controlled trial. One hundred and seventy seven persons, 77–82 years, single living, and without need for home help were randomized to a no-intervention control group or to one of three occupational therapy interventions focused on promoting occupational engagement: an individual intervention, an activity group or a discussion group. In study I, effect sizes for leisure engagement and ability to perform activities of daily living (ADL) tasks were estimated for each intervention in relation to the control group to identify the most effective intervention at 3 and 12 months after baseline. In study II, the effects on quality adjusted life years (QALYs) and the total costs for the intervention, social services provided by the municipality and health care were used evaluate cost-effectiveness. Study III was a quasi-experimental clinical trial and included 95 persons, 65+, who had applied for municipality-based home help with bathing. For participants in the intervention group, occupational therapists implemented occupation-focused and occupation-based interventions. No occupational therapy intervention was implemented for those in the control group, but they were allocated home help services if judged to need it based on an assessment by a municipality care manager. Evaluations of ADL ability, self-rated health and allocated home help were implemented at baseline and after 15 weeks. Study IV involved the use of decision-modeling based on a five state Markov model that included levels of dependency in ADLs, place of residency and death. Probabilities for transitions between states in the model, QoL scores and societal costs for each state were derived from previous research. Overall, the model was based on research indicating that more severe levels of dependency reduced QALY scores and increased societal costs. Previous trials have provided evidence that an occupation-focused and occupation-based intervention implemented to reduce bathing disabilities increased the probability of independence of home help. The Markov model was used to evaluate cost-effectiveness over 8 years for an intervention compared to no intervention. Results The results of study I indicated that each intervention had a small positive effect on minimizing a decline in leisure engagement and/or ADL, but no intervention was clearly superior. In study II, the results indicated that the interventions delivered in a group format positively affected self-rated health. The discussion group was the most cost-effective intervention. The results of study III indicated that the intervention had no effect on ADL ability or self-rated health. There was, however, a large difference in the allocation of home help at follow up, indicating that the intervention was effective in reducing dependency on home help for bathing. The results of study IV indicated that compared to no intervention, the intervention resulted in a positive accumulation of QALYs and lower costs for every year during the entire 8 year period. Conclusion This thesis provides evidence to support the implementation of occupation-focused and occupation-based interventions for independent-living, community-dwelling older people in order to reduce their decline in occupational engagement and improve their self-rated health; the interventions also have the potential to be cost effective. This thesis also provides evidence that an occupation-focused and occupation-based intervention implemented for older people with bathing disabilities was effective in promoting independence from home help for bathing. Finally, an occupation-focused and occupation-based intervention that increased the probability of being independent of home help for bathing had a positive impact on the long term accumulation of QALYs and reduced societal costs and, therefore, can be considered very cost effective.
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Boxenbaum, Eva. "The partnership metaphor in Quebec health care policy : the decision-making process with cognitively impaired elderly clients in home care." Thesis, McGill University, 2001. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=33063.
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This research evaluates Quebec's health care policy by analyzing how the partnership metaphor is implemented in policy and practice. The partnership construction is identified in 4 interpretive communities within long-term community services to the elderly population. This analysis focuses on the placement decision for cognitively impaired clients in home care. Interpretive policy analysis is employed to examine 3 policy documents and 3 client files, while grounded theory serves to analyze 13 semi-structured interviews with 2 administrators and 3 open triads of client, caregiver, and case manager. The findings show partnership to be an egalitarian, collaborative ideal widely adopted but with little consensus on the pertinent objects and actors. Important differences emerge in how partnership is applied to the placement decision, indicating a too flexible application. Specific restrictions are recommended on the application of the partnership metaphor in order to improve community services and organizational structures in health care.
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Jackson, Charles J. J. "Developing a community development outreach ministry in the church." Theological Research Exchange Network (TREN), 2006. http://www.tren.com/search.cfm?p064-0123.
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Poier, Paloma Hohmann. "Avaliação da oscilação corporal e marcha de idosos com a utilização de um andador com suporte de tronco desenvolvido na UTFPR." Universidade Tecnológica Federal do Paraná, 2013. http://repositorio.utfpr.edu.br/jspui/handle/1/744.
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Introdução: A instabilidade postural é uma das causas de incapacidade no individuo idoso e o uso de andadores é uma das estratégias para gerar maior estabilidade e segurança na manutenção da postura ortostática e na realização da marcha. Existem atualmente andadores considerados especiais por utilizarem coletes e sistemas de sustentação ou suporte parcial do corpo. Apesar dos benefícios da utilização destes andadores, estes apresentam alto custo. Com o intuito de se apresentar uma alternativa de qualidade e baixo custo, desenvolveu-se um andador com suporte de tronco confeccionado com PVC na UTFPR. O suporte de tronco acoplado ao andador tem o objetivo de suportar o peso do usuário no caso de uma queda. Objetivo: Avaliar a influência da utilização do andador desenvolvido com suporte de tronco, na oscilação corporal e marcha de idosos com instabilidade postural. Método: Foram realizados testes visando analisar a resistência mecânica do material utilizado e ensaios com o andador já construído. O PVC mostrou ser um material com alta resistência nos testes de flexão e impacto. A massa máxima suportada pelo andador no teste realizado foi de aproximadamente 226 kg. Após a avaliação do equipamento, 9 idosos com instabilidade postural foram submetidos à avaliação da oscilação corporal ou estabilometria e, 3 idosos à análise de marcha, sem e com a utilização do andador desenvolvido. Resultados: Com a utilização do andador desenvolvido houve diminuição da oscilação corporal em todos os idosos participantes. Sem a utilização do equipamento o valor médio da estabilometria foi de 10,297 cm² e com o andador foi de 3,264 cm². Na avaliação da análise de marcha com sensores acelerômetros localizados na articulação do quadril, sem o andador desenvolvido, os idosos tiveram uma maior extensão e menor flexão e, com o andador estes valores inverteram-se. Com o andador, a média da flexão direita passou de 15,33° para 20,67° e a extensão de 10° para 7,33°. O tempo necessário para realização de um percurso de 12 metros foi maior com a utilização do andador desenvolvido. Os resultados apontam para uma melhora na estabilidade e equilíbrio do idoso com a utilização do andador. A análise da marcha demonstrou uma reorganização da amplitude da passada, mas sem uma alteração significativa.Introduction: Postural instability is one of the causes of disability in the elderly and the use of walkers is one of the strategies to generate greater stability and safety in the maintenance of orthostatic posture and gait. There are currently walkers considered to be specials because they have braces and support systems or offer partial support of the body. Despite the benefits of using these walkers, they are very expensive. In order to present an alternative of quality and low cost, a walker with trunk support was developed, made of PVC. The trunk support attached to the walker is intended to support the weight of the user in the event of a fall. Objective: To evaluate the influence of the use of the walker with trunk support on body sway and gait of the elderly with postural instability. Method: Tests were carried out to analyze the mechanical resistance of the material used as well as the structure of the walker. PVC has proven to be a material with high resistance when submitted to flexion and impact tests. The maximum mass supported by the walker in the test was approximately 226 kg. After testing the equipment, 9 elderly with postural instability were submitted to evaluation of the body sway or stabilometry, and 3 elderly to gait analysis, with and without the use of the walker developed. Results: Using the walker there was a decrease of body sway in all elderly participants. Without the use of the equipment the stabilometry average value was 10,297 cm² and when using the walker it was 3.264 cm². In the evaluation of gait analysis with accelerometer sensors located at the hip joint, without the walker the elderly had greater hip extension and lower hip flexion and, with the walker the results had inverted values. For that, the average flexion on the right hip rose from 15.33° to 20.67° and the extension decreased from 10° to 7.33°. The time needed to finish a course of 12 meters was higher using the walker. The results point to an improvement in stability and balance for the elderly using the walker. The gait analysis demonstrated a reorganization of the length of the stride but without a significant change.
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Summers, Michael. "Great expectations : a policy case study of four case management programs in one organisation /." Connect to thesis, 2007. http://repository.unimelb.edu.au/10187/2182.
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Four different case management programs delivered by UnitingCare Community Options (UCCO) in the eastern suburbs of Melbourne were examined against the expectations of case management as a policy solution to a range of perceived policy problems at the micro-, meso- and macro-levels. The micro-level expectations were related to client and family experiences of the service system and outcomes. At the meso-level expectations were focused on perceived service delivery problems such as poor matching of services to the needs of ‘complex’ clients including a lack of integration, flexibility and responsiveness to clients’ needs and preferences. Perceived macro-level policy problems were concerned with a variety of issues including increasing rates of institutionalisation, increasing costs to governments, lack of economic efficiency and the desire to create market or quasi-market conditions in the community care service delivery sector. (For complete abstract open document)
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Chan, Yin-sang. "Elderly planning in Hong Kong." [Hogn Kong] : University of Hong Kong, 1989. http://sunzi.lib.hku.hk/hkuto/record/B42574134.
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Saad, Paulo Murad. "Support transfers between the elderly and the family in Southeast and Northeast Brazil /." Digital version accessible at:, 1998. http://wwwlib.umi.com/cr/utexas/main.
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J-Lyn, Khoo Yvonne. "Exergaming acceptance and experience in healthy older people and older people with musculoskeletal pain." Thesis, Teesside University, 2014. http://hdl.handle.net/10149/320050.
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The research reported in the thesis investigated exergaming acceptance and expe-rience in older people with special reference to technology acceptance, flowstate, chronic pain and balance control. In recent years, there has been an increasing amount of literature on the beneficial effects of exergaming on older people’s health, well-being and balance, including the use of exergaming as a method of pain con-trol. Nevertheless, when taken separately, specific studies vary in methodology and in type(s) of exergaming topics studied. Health benefits from exergaming may only be gained if older people take part in it. There is evidence in the literature to indicate that usage of a technology is preceded by user acceptance. Few studies, to date, have investigated how older people perceive and experience exergaming in relation to their perceived abilities and future intention to use it, from a technology acceptance point of view. Therefore, the purpose of this thesis was to see if (1) the exergaming technology was acceptable to healthy older people and older people with chronic pain and (2) it had any effect in the self-reported health status, pain conditions and balance in older people with chronic pain. The current thesis consists of two separate studies. In Study 1, twenty-eight healthy older people participated in six 40-minute exergaming sessions within a three-week period. In Study 2, fifty-four older people with chronic musculoskeletal pain attended a twelve 40-minute exercise intervention within a six-week period, either randomised into an exergaming group (IREXTMsystem) or standard physical exercises. A modified version of the Unified Theory of Acceptance and Use of Technology (UTAUT) was analysed at baseline and upon completion of the intervention, including specific time points throughout the study. Self-perceived chronic pain and flow state were analysed at baseline and after exercise intervention. Rate of perceived expended physical and mental effort was recorded after every exercise session and compared between groups. Heart rate was recorded in the second study. Postural sway was assessed at the start and the end of the intervention with Centre of Pressure data being extracted via a Kistler force plate (AP SD, AP range ,ML SD, ML range and CoP velocity), where the conditions were quiet bipedal standing with eyes open and eyes closed. Evidence from both studies showed that exergaming technology was acceptable to healthy older people and older people with chronic musculoskeletal pain. Recorded high levels of flow indicated the occurrence of flow during the intervention. Perfor-mance expectancy emerged as the strongest predictor of older people’s behavioural intention to use exergaming. Previous behaviour was an important influence of future behaviour, within the context of exergaming. In Study 1, there were significant increases throughout the intervention in most of the flow state variables except challenge-skill-balance, paradox of control and transformation of time. Thematic analysis of olde rpeople’s responses relating to exergaming revealed that enjoyment was the most frequently cited theme. The significant increase of perceived physical exertion suggested that exergaming provided light-to-moderate intensity exercise for this cohort of healthy older people. In Study 2, an interesting pattern emerged over time where earlier on in the interven-tion, effort expectancy significantly predicted older people’s behavioural intention to use exergaming (instead of performance expectancy). This role was then taken over by performance expectancy midway through the intervention. This indicated that this sample of older people with chronic pain prioritised their personal ability to play the exergames, after which, they then considered the usability of the exergaming technology in choosing whether to use it in future, if it were readily made available. In addition, there was evidence of improvement in post-intervention pain intensity in the exergaming group, suggesting that exergaming may have alleviated older people’s experience of pain to some extent. Flow levels significantly increased from the start to the end of the intervention. Significant improvements over time in postural sway parameters in the control and exergaming groups suggested that short-term exercise contributed to improved balance in older people with chronic musculoskeletal pain. The indication of improved postural sway due to significant mediolateral reductions in the eyes-closed condition in the both groups suggested that older people with chronic pain could benefit from at least subtle improvements in balance after taking part in short-term exercise. Nevertheless, exergaming may have an effect on postural sway when visual sensory information is removed, as found in the experimental group that demonstrated a statistically significantly lower reduction of CoP excursion in the medio-lateral direction, than in the control group.
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Cruice, Madeline. "Communication and quality of life in older people with Aphasia and healthy older people /." St. Lucia, Qld, 2001. http://www.library.uq.edu.au/pdfserve.php?image=thesisabs/absthe16486.pdf.
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Kung, Francis Tat-yan. "Chronic pain in older people." Connect to thesis Connect to thesis, 2001. http://adt1.lib.unimelb.edu.au/adt-root/public/adt-VU2001.0028/index.html.
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Conroy, Simon. "Preventing falls in older people." Thesis, University of Nottingham, 2009. http://eprints.nottingham.ac.uk/11058/.
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Falls are a major cause of injury fear of falling and death affecting 24% of older people annually. Falls have a major impact on hospital services, are an important cause of carer strain and admission to long term care. Multifactorial interventions delivered to fallers are effective in reducing falls rates by 25%. However, no UK studies have evaluated the role of screening older people living in the community and offering those at high risk a falls prevention programme. This work describes two studies – the evaluation of a postal falls risk screening tool, and a randomised controlled trial assessing the benefits of offering a falls prevention programme to those identified as being at high risk. 335 older people were recruited into the screening study, using a modified version of the Falls Risk Assessment Tool. The sensitivity was 79%, specificity 58%, positive predictive value 50% and the negative predictive value 83%. In the RCT, 364 community-dwelling older people at high risk of falls were randomised into a pragmatic, multicentre trial evaluating falls prevention programmes. 181 were allocated to the control group and 183 to the intervention. The primary outcome was the rate of falls; the adjusted IRR was 0.73 (0.51-1.03), p=0.071. There were no significant differences between the groups in terms of the proportion of fallers, recurrent fallers, medically verified falls, injurious falls, time to first fall or time to second fall. Nor were there significant differences in terms of institutionalisation, mortality, basic or extended activities of daily living, or fear of falling. Further work on testing falls prevention interventions for acceptability is required, followed by a further adequately powered RCT to determine the clinical effectiveness of a systematic screening programme and intervention. At present, there is insufficient evidence for health care commissioners to recommend screening and intervention for falls.
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Quinn, Helen Louise. "Microneedle technology for older people." Thesis, Queen's University Belfast, 2016. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.709697.
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It is evident that the global population is ageing, with an increasing proportion of people aged over 65 years. Typically associated with a high proportion of morbidity and mortality, care of the increasing ageing population presents a challenge, with age-appropriate research required to promote and facilitate healthy ageing. In the present work, a novel drug delivery technology, designed to enhance transdermal drug delivery, was considered in the context of its potential future use in the older population. Microneedles (MNs) consist of a plurality of tiny projections in the micron scale, arranged on a base plate, for application to the skin. This thesis considers the use of MNs by the older population from a number of perspectives, encompassing possible clinical uses, the possible impact of age-related changes in the skin and the feasibility and acceptability of the technology. Transdermal delivery of three drugs, commonly prescribed for secondary prevention of cardiovascular disease, was investigated, successfully demonstrating in vitro co-delivery of the drugs, using both a dissolving and a hydrogelforming MN platform, achieving clinically relevant concentrations of each. MN arrays were successfully applied by a group of volunteers aged over 65 years, with breach of the stratum corneum confirmed using optical coherence tomography and 55.7% of the MN height observed to penetrate. Skin recovery was demonstrated to occur at a slower rate in those aged over 65 years than in a comparative group of volunteers aged 20 - 30 years, but was still predicted to regain original barrier function within 1.5 h of MN treatment. Qualitative methods were employed to collect the views and opinions of older people and community pharmacists regarding MNs, who were positive about the technology, identifying a number of benefits to MN-mediated drug delivery in older people. Concerns centred on practical issues associated with age-related functional decline, including, for example, reduced dexterity. This thesis is the first comprehensive investigation into the use of MNs by the older population, providing an initial demonstration of MN delivery of multiple drugs, for future extension to a relevant in vivo model. The ongoing involvement of end-users and healthcare practitioners is recommended to facilitate future acceptance of MN technology by the older population and design of an age-appropriate delivery platform.
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Charlesworth, Patricia Falcone. "Creating an evaluation tool to measure the effects of program impact on the clients of the Lehigh County Senior Citizen's Center." Instructions for remote access. Click here to access this electronic resource. Access available to Kutztown University faculty, staff, and students only, 1995. http://www.kutztown.edu/library/services/remote_access.asp.
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Thesis (M.P.A.)--Kutztown University of Pennsylvania, 1995.Source: Masters Abstracts International, Volume: 45-06, page: 2936. Abstract precedes thesis as [2] preliminary leaves. Typescript. Includes bibliographical references (leaves 60-61).
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Wong, Shui-wah Kitty. "An evaluation of the housing provision and its related services for the elderly in public rental housing." Hong Kong : University of Hong Kong, 2000. http://sunzi.lib.hku.hk:8888/cgi-bin/hkuto%5Ftoc%5Fpdf?B23339627.
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