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PubMed1993

Health, double jeopardy, and culture: the use of institutionalization by African-Americans.

Elderly African-Americans are admitted to nursing homes at between half and three-quarters of the rate of elderly whites. This review examines the theoretical approaches and the nature of the evidence typically brought to bear in addressing this issue. The double jeopardy hypothesis effectively describes but does not explain apparent racial inequities in the use of institutional care. Explanations based on the hypothesized African-American subculture will remain inadequate until they are grounded in data and take into account inequality.

Black or African American↗
PubMed1997

The contribution of attachment to burden in adult children of institutionalized parents with dementia.

The impact of adult attachment to parents, perceived disease severity, and caregiving behaviors, moderated by perceived caregiving adequacy, were investigated in 108 adult children of patients with dementia. Multiple regression analyses indicated that attachment style, the trait aspect of attachment, predicted both aspects of caregiver burden: caregiving difficulty and psychological symptomatology. Attachment preoccupation, the state aspect of attachment, predicted psychological symptomatology. No other variables, including demographics, were significant predictors. This suggests that a secure attachment style appears to protect caregivers from some of the strain of caregiving. Preoccupation with the attachment relationship contributed to burden in this population.

Aged↗
PubMed1986

Occupational risk of hepatitis B from institutionalized mentally retarded HBsAg carriers: a prospective study.

In an institution for the mentally retarded, a total of 13 (2.4%) susceptible employees seroconverted for hepatitis B during 539 person-years. Two of them developed acute hepatitis B; the cost of their medical care and temporary disability was $7,772. Eleven seroconverters had no elevation of serum alanine aminotransferase, and all seroconverters recovered without chronic sequelae. Nine converters acquired antibody to HBsAg alone; three of these had no client contact. Difficulty in identifying nonoccupational causes of hepatitis B infection in the institutional setting often leads to labeling of all seroconversions as occupationally acquired. Hepatitis B vaccine is recommended for client-care personnel.

Adult↗
PubMed1983

Music programs for the institutionalized elderly in a midwestern metropolitan area.

This investigation concerned the status of music programs in licensed nursing homes in St. Louis, Missouri. Data were obtained by means of a mailed questionnaire, interviews with selected administrators, and visits to selected homes. Almost all of the institutions surveyed offered musical activities for their residents. In many instances, these consisted largely of recreational singing or visits to the institution by outside performing ensembles. In a few instances, more complete music programs were offered, in which residents benefited not only from the use of music for recreation but also from its educational and therapeutic potential.

Aged↗
PubMed1991

Risk factors associated with falls and injuries among elderly institutionalized persons.

A case-control study among 184 matched pairs of patients 65 years of age and older was undertaken to identify risk factors associated with falls and injuries in a long-term care facility in Baltimore, Maryland, in 1984-1985. Patients were matched on length of stay. Variables of interest included sociodemography, functional status, medications, and diagnoses. For all levels of care combined, the following factors were associated (p less than or equal to 0.01) with increased falls: being able to walk (relative odds (RO) = 4.0), age 90 years and older (RO = 3.8), a history of falling (RO = 5.0), and taking a vasodilator (RO = 3.0). Among the 184 fallers, the diagnosis of dementia (RO = 7.5) or taking a diuretic (RO = 7.2) was positively associated with injury (p less than or equal to 0.01). In each of the analyses, medications were associated with falls or injuries, suggesting a feasible intervention. The combination of a history of falling, being able to walk, and being 90 years of age or older increased the relative odds to 51.9 and could alert clinicians to identify and monitor high-risk elderly persons in need of preventive measures.

Accidental Falls↗
PubMedDate not supplied

A model for linking networks in social work practice with the institutionalized elderly.

The authors describe a demonstration project that used network theory as a framework for a broad-range ecological approach to social work practice in long-term care facilities for the elderly. The importance of developing and maintaining social supports and the reciprocal benefits in linking kinship, friendship, formal caregiving, and mutual-aid networks are examined. Examples of the practical applications of network theory are presented also.

Aged↗
PubMed2000

Dignity or denial? Decisions regarding initiation of dialysis and medical therapy in the institutionalized severely mentally retarded.

Decisions regarding health care of the severely mentally retarded can be difficult. We present 2 cases of patients with severe mental retardation who lived in long-term care facilities. Both patients had progressive loss of renal function and eventually reached end-stage renal disease. In each case, the decision was made not to initiate dialysis. We discuss issues of dialysis and medical care of the severely mentally retarded and advocate using the principles of "best respect" and "best interest" in making medical decisions in this population.

Adult↗