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3In the Netherlands, there has been much debate on the question whether elderly people over 70 who are tired of life and who consider their life to be completed, should have legal options to ask for assisted dying. So far there has been little research into the experiences of these elderly people. In order to develop deliberate policy and care that targets this group of elderly people, it is necessary to understand their lifeworld. The aim of this paper is to describe the phenomenon ‘life is completed and no longer worth living’ from a lifeworld perspective, as it is lived and experienced by elderly people. Between April to December 2013, we conducted 25 in-depth interviews. A reflective lifeworld research design, drawing on the phenomenological tradition, was used during the data gathering and data analysis. The essential meaning of the phenomenon is understood as ‘a tangle of inability and unwillingness to connect to one's actual life’, characterized by a permanently lived tension: daily experiences seem incompatible with people's expectations of life and their idea of whom they are. While feeling more and more disconnected to life, a yearning desire to end life is strengthened. The experience is further explicated in its five constituents: 1) a sense of aching loneliness; 2) the pain of not mattering; 3) the inability to express oneself; 4) multidimensional tiredness; and 5) a sense of aversion towards feared dependence. This article provides evocative and empathic lifeworld descriptions contributing to a deeper understanding of these elderly people and raises questions about a close association between death wishes and depression in this sample.
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INTRODUCTION: Sufficient high quality dietary protein intake is required to prevent or treat sarcopenia in elderly people. Therefore, the intake of specific protein sources as well as their timing of intake are important to improve dietary protein intake in elderly people.
OBJECTIVES: to assess the consumption of protein sources as well as the distribution of protein sources over the day in community-dwelling, frail and institutionalized elderly people.
METHODS: Habitual dietary intake was evaluated using 2- and 3-day food records collected from various studies involving 739 community-dwelling, 321 frail and 219 institutionalized elderly people.
RESULTS: Daily protein intake averaged 71 ± 18 g/day in community-dwelling, 71 ± 20 g/day in frail and 58 ± 16 g/day in institutionalized elderly people and accounted for 16% ± 3%, 16% ± 3% and 17% ± 3% of their energy intake, respectively. Dietary protein intake ranged from 10 to 12 g at breakfast, 15 to 23 g at lunch and 24 to 31 g at dinner contributing together over 80% of daily protein intake. The majority of dietary protein consumed originated from animal sources (≥60%) with meat and dairy as dominant sources. Thus, 40% of the protein intake in community-dwelling, 37% in frail and 29% in institutionalized elderly originated from plant based protein sources with bread as the principle source. Plant based proteins contributed for >50% of protein intake at breakfast and between 34% and 37% at lunch, with bread as the main source. During dinner, >70% of the protein intake originated from animal protein, with meat as the dominant source.
CONCLUSION: Daily protein intake in these older populations is mainly (>80%) provided by the three main meals, with most protein consumed during dinner. More than 60% of daily protein intake consumed is of animal origin, with plant based protein sources representing nearly 40% of total protein consumed. During dinner, >70% of the protein intake originated from animal protein, while during breakfast and lunch a large proportion of protein is derived from plant based protein sources.
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This paper describes the approach used to identify elderly people’s needs and attitudes towards applying ambient sensor systems for monitoring daily activities in the home. As elderly are typically unfamiliar with such ambient technology, interactive tools for explicating sensor monitoring –an interactive dollhouse and iPad applications for displaying live monitored sensor activity data– were developed and used for this study. Furthermore, four studies conducted by occupational therapists with more than 60 elderly participants –including questionnaires (n=41), interviews (n=6), user sessions (n=14) and field studies (n=2)– were conducted. The experiences from these studies suggest that this approach helped to democratically engage the elderly as end-user and identify acceptance issues.
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In my work as a nurse and, later, as a clinical nurse specialist, I often encountered older people whose treatment for depression – performed according to the relevant guidelines – was inadequate, causing the depression to become chronic in nature. When the course of a depression becomes this adverse, with no improvement in sight, with the patient, his loved ones, and the treatment providers feeling helpless, and with the burden on the patient and his or her family being unrelenting, the clinical problem is enormous for all concerned. The helplessness that I experienced as a practitioner led me to think that when depression becomes chronic in nature, there may be a “missing link” in the known chain of cause and effect. That link might consist of a particular aspect of treatment that largely escapes the notice of practitioners, causing the patient’s feelings of depression to persist – in other words, dealing with the patient's unmet needs. My assumption was that the consequences of depression can be expressed in “unmet needs” but that there is a reciprocal relationship in this regard whereby the depression creates needs on the one hand, while unmet needs have an unfavourable effect on the course of the depression on the other. There has been very little research on the unmet needs of older people with depression and the reciprocal relationship referred to above, an observation that inspired me to undertake this study. To place the research in a more specific context, I formulated the general research problem as follows: There has been insufficient research exploring the consequences of a depressive disorder for the daily lives of older people. It is thus unclear to what extent the course of depression in later life is associated with unmet needs, particularly with regard to the individual’s ability to play a role in society. Read more: https://research.vu.nl/en/publications/needs-of-elderly-people-with-late-life-depression-challenges-for-
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The continuing aging of the population sparked off a public discussion on the extent of state care of elderly people. A historical evaluation of the Dutch system of family care is an essential part in the above discussion, especially regarding options like self-aid and 'mantelzorg'. Using population registers, household stutters of elderly people in the periode 1920-1940 were reconstructed for two different regions in the Netherlands. The most important conclusion of this investigation is that the Dutch elderly were, in most cases, living independently, as head (or wife of the head) of the household in which they were residing.
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The aim of this systematic review was to examine the association between malnutrition and oral health in older people (≥ 60 years of age). A comprehensive systematic literature search was performed in four databases (PubMed, CINAHL, Dentistry and Oral Sciences Source, and Embase) for literature from January 2000 to May 2020. Both observational and intervention studies were screened for eligibility. Two reviewers independently screened the search results to identify potential eligible studies, and assessed the methodological quality of the full-text studies. A total of 3240 potential studies were identified. After judgement for relevance, 10 studies (cross-sectional (n = 9), prospective cohort (n = 1)) met the inclusion criteria. Three studies described malnourished participants as having fewer teeth, or functional (tooth) units (FTUs), compared to well-nourished participants. Four studies reported soft tissue problems in malnourished participants, including red tongue with blisters, and dry or cracked lips. Subjective oral health was the topic in six studies, with poorer oral health and negative self-perception of oral health in malnourished elderly participants. There are associations between (at risk of) malnutrition and oral health in older people, categorized in hard and soft tissue conditions of the mouth, and subjective oral health. Future research should be focused on longitudinal cohort studies with proper determination of malnutrition and oral health assessments, in order to evaluate the actual association between malnutrition and oral health in older people.
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A Dutch healthcare organisation modernizes its real estate portfolio to meet today’s requirements and acquired an office building for conversion into a nursing home for elderly with dementia. The purpose of the research has been to study the design principles for elderly with dementia, for innovative and smart application in work processes and the acquired building.
Methods – Using multiple-method qualitative research design, bachelor thesis students of a university of applied sciences explored the reconstruction of the acquired building and related healthcare processes.
Results – Application of design principles for the elderly with dementia were studied, among which were interior design, catering process, and connection with the neighbourhood. Feasible interior ideas were elaborated, intentions for change in the catering process were confirmed by stakeholders, and an action plan for neighbourhood connections was delivered. Elements are being used for a final design. Implementation has to be checked with close scrutiny.
Originality – The application of design principles for elderly with dementia (design, favourable state, beautiful moments) together with changes in work processes of health care employees aiming at patient-centred care is a new combination.
Practical or social implications – When a healthcare organisation chooses a new care concept, not only the surroundings change. Also, the processes around people and the way we take care of them change. In many ways a new concept can only succeed when the employees and the way they work change as well.
MULTIFILE
In Leading to engage Karolien Dons explores the ways in which musicians and elderly participants of a collaborative music activity experience and contribute to the sense of inclusion. Through qualitative research strategies involving a theory-generating ethnographic exploration of existing practices and a theory-validating case study of one practice, it aims to provide a description and understanding of the phenomenon from the perspective of the diverse participants.
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Inaugural lecture, delivered upon public acceptance of the endowed professorship in Professionalisation of Nursing and Care in Elderly Care by Prof. Dr. Robbert J.J. Gobbens at Tilburg University on 29 September 2023.
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This paper presents the results of a study on how elderly people perceive an intelligent system, embedded in their home, which should enable them to live independently longer. Users of a motion sensor system were interviewed about their experiences. A sensor system that autonomously works as well as a manipulated version was studied. The manipulation contained a touch screen that informed the users if the gathered information was correct before sending it to caregivers, so more control over personal information was provided. To test the use intention of the motion sensor system Spiekermann’s Ubiquitous Computing Acceptance Model of was used. This study shows that people, who perceive more control over their wellbeing, show more use intention. And that the subjective norm influences their acceptance. This study shows that acceptance models for Ambient Intelligence application in care situations need to be developed.
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