Filters
Assessing the Needs of Elderly People in a Home Environment: Perspectives from Patients, Caregivers, and a Family Nurse
Background: Social demographic changes contribute to increased life expectancy and disability. The ability to maintain independence depends on receiving appropriate support. This study aimed to analyze the needs of individuals over 75 years of age living in a home environment. Methods: A cross-sectional study assessed support needs from the perspectives of the patient, caregiver, and researcher. The following research tools were used: Camberwell Assessment of Need for the Elderly (CANE), Mini-Mental State Examination (MMSE), Barthel Index, and Geriatric Depression Scale (GDS). Results: The average total number of needs reported by the patients was 5.0 ± 2.9, by caregivers 6.63 ± 2.98, and by researchers 5.76 ± 3.43. The most frequently reported unmet needs were related to Accommodation, Company, and Eyesight/Hearing/Communication. A higher number of met needs (p = 0.006) and total needs (p = 0.011) was observed in individuals aged 85 and older and in seniors who had a caregiver (p < 0.001). Lower functional ability was an indicator of a higher number of met needs (p < 0.001). Cognitive function did not affect the number of reported needs. A correlation was found between the number of needs and depressive symptoms. The total number of needs reported by patients was significantly lower than the number reported by healthcare personnel and caregivers. Conclusions: The CANE questionnaire enabled the identification of individual care needs in the elderly. Although unmet needs were in areas that could be easily addressed, elderly individuals did not receive adequate support. Researchers and caregivers identified more met and unmet needs than the elderly individuals themselves.
The value of the COVID-19 Yorkshire Rehabilitation Scale in the assessment of post-COVID among residents of long-term care facilities
The COVID-19 Yorkshire Rehabilitation Scale (C19-YRS) is a patient-reported outcome measure designed to assess the long-term effects of COVID-19. The scale was validated and is commonly used in the general population. In this study, we assess the utility of the C19-YRS in evaluating the post-COVID burden among residents of long-term care facilities with a mean age of 79. C19-YRS and Barthel index evaluations were performed among 144 residents of long-term care facilities reporting new or worsened symptoms or functioning three months after convalescence from COVID-19. The C19-YRS-based screening showed that 70.9% of COVID-19 convalescents had ≥1 complaint three months after recovery. The highest C19-YRS-scored symptoms (indicating a higher burden) were breathlessness, fatigue, and cognitive and continence problems; however, symptomatology was very heterogeneous, revealing a high complexity of the disease in older persons. The mean total C19-YRS score was higher in hospitalized patients (n = 78) than in the outpatient group (n = 66) (p = 0.02). The functioning subscale of the C19-YRS strongly correlated with the Barthel index, with r = −0.8001 (p < 0.0001). A moderately strong correlation existed between retrospectively reported C19-YRS-based functioning and the Barthel index score reported before illness (r = 0.7783, p < 0.0001). The C19-YRS is instrumental in evaluating the consequences of COVID-19 among long-term-care residents. The assessment allows for a broad understanding of rehabilitation needs.
Body compositions phenotypes of older adults with COPD
PurposeChanges in nutritional status are important extrapulmonary manifestations of the chronic obstructive pulmonary disease (COPD). The study aimed to assess the prevalence of different body composition phenotypes in older patients with COPD and to investigate the relationship between these phenotypes and the severity of the disease, as well as physical performance of the subjects.Patients and methodsThe study included 124 subjects aged ≥60 with COPD. In all of them body composition analysis and muscle strength measurement were performed. Additionally, data from patients’ medical records were analyzed. Study sample was divided into four groups based on the phenotypic body composition: normal phenotype (N), sarcopenia, obesity and sarcopenic obesity (SO).ResultsIncidence of sarcopenia was significantly higher in patients with severe or very severe COPD based on GOLD in comparison with subjects with mild or moderate obstruction (p = 0.043). Participants with sarcopenia, obesity and SO had lower results of the 6-min walk test than subjects with N (225.77 m, 275.33 m, 350.67 m, 403.56 m, respectively). Moreover, sarcopenia and SO had lower results than obesity (p = 0.001, p = 0.041, respectively).ConclusionSarcopenia is common in patients with advanced COPD. Sarcopenia and SO are associated with poorer physical performance. All older people with COPD should routinely have their body composition assessed, instead of simply measuring of body weight or body mass index (BMI).