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Long-term Care in old people of 75 and more years old on Home Care Service.

Long-term Care in old people of 75 and more years old on Home Care Service. Nuria Rodriguez Avila Montserrat Puig Llobet University of Barcelona. Index. Definition Theory Spanish context Methods Results Discussion Conclusion References. Definition.

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Long-term Care in old people of 75 and more years old on Home Care Service.

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  1. Long-term Care in old people of 75 and more years old on Home Care Service. Nuria Rodriguez Avila Montserrat PuigLlobet University of Barcelona

  2. Index • Definition • Theory • Spanish context • Methods • Results • Discussion • Conclusion • References

  3. Definition The concept: Quality of life is relatively "new“. This concept has relations with: • Happiness. • Welfare. • Satisfaction of needs. The World Health Organization (WHO) in 1994 say that the Quality of life is: "Perception of the individual is in life position on the context of the culture and system of values. Also, it is relating to its objectives, expectations, standard and worries".

  4. Definition (Life Quality Models) The life quality models try to determine which are the multidimensional factors to explain the quality of life by: • Subjective indicators (by person). • Objective indicators (by professionals). The reference models are : • The World Health Organization Quality of Life (WHOQOL-100). • The Quality of Life Model Fernandez-Ballesteros (1992). For old people, the quality of life is marked by the interrelation with the person and environment, also in factors as: • Autonomy. • Health Status. • Family relations. • Economic Situation . • Social relations. To analyze thequality of life is important the social role of old people with chronic illness (disease).

  5. Theory The sociological theories on the social aging have a strong relation to the social functions. The Paradigm of functionalism (Talcott Pasrson) gives importance to process of socialization (the social role and the function of social institutions). The social theory of the Dissociate by Cumming and Henry (1961), they try to explain why old people need others persons.

  6. Spanishcontext According to the UN (2002) Spain is the county with the largest number of old people. The increase of the life expectancy is one of the factors to analyze in the quality of life. The change in the family structure, together other social changes and insufficient resources make that the informal care system (family care) is not enough to care dependent old people. In Spain, the formal care resources for old people with dependence (handicap) are classified in: • Home Care Service • Welfare centers and alternative systems. • Non-profit organizations and the social works.

  7. Spanishcontext Since 2007 we have a new a Law of the Dependence (handicap), It has been created to provide services and resources to old people with dependence and handicap. Catalog of service are: • Telecare Service. • Home Care Service (formal and Informal care). • Nursing home Center, (Day or Night). • Geriatric Institutions.

  8. Methods General objective: was to determine which are the subjective and objective elements to identify a level in quality of life in old people with dependence. Population of study: was the old people inside the ATDOM Home Care Service. Universe: 75 and more years old. Location: The Basic Area of health of Vilafranca of Penedès (Public Service). Framework: was the sociological theories , paradigm of funcionalism ( Parson). Methodology used on this study was: • Qualitative (interviews face to face) : We interview a 10% of the total population of the database (ATDOM Progam,) and we tried to maintain the structure of aged and gender stratus. • Quantitative: We used others surveys of Catalonia and Vilafranca del Penedes.

  9. Grafic 1 . Population in Vilafranca del Penedès (2005) by gender and aged. Fuente: www.ajvilafranca.es

  10. Table 1 Population of ATDOM Program Table 2 Sample of ATDOM program

  11. Table 3: Variables Study

  12. Long-term care in aging with handicap

  13. Interviews and instruments • Data collection was performed from face to face interview in 2007. There have been a total of 59 interviews:- 26 old people with illness (handicap o dependency),- 22 family caregivers- 11 nurses in the ATDOM program. • The questionnaires includes: Type of questions: • Closed Questions. • Semi-closed questions. • Open questions. Validated test • Zarit Test (overwork of caregivers). • Katz Index (Independence in Activities of Daily Living -ADL). • The LawtonIndex (Instrumental Activities of Daily Living -IADL). • Mini-Review Nutritional Assessment . • Instrument for Social Resources (PAHO).

  14. Example of questions

  15. Results • The women are representative in the ATDOM Program (61% are women). • The older people express their health status as regular. They have more that one illness (Comorbity) and they take a lot of medicines at the same time. • They are satisfied and feel well with their caregivers (formal and informal care). • However, they are not familiarized with the health resources available in the city. • The Old people needs: • Care in the daily living (hygiene) (ADL- Kartz index). • Care in the instrumental activity daily living (shopping) (IADL, Lawton Index) .

  16. The style of life for dependent old people are: • Diet poor in fruits and vegetables • Good level of protein. • Poor hydration,. • They are going out for walking a few times.

  17. The older people perceive a good quality of life when: • Best level of health and autonomy. • More family relationship. • More social relationship. • More economic resources.

  18. Quality of life: “Me cuesta decirlo, a lo mejor tener más dinero (para arreglo, ropa) pero la salud, la salud es lo principal de todo” (E.03) “Salud, dinero y amor” (E.05, E.19) “Tener salud y autonomía” (E.09, E.10) “Tener salud, poder caminar” (E.08) “Tener salud y dinero” (E.12) “Tener salud y adaptarse” (E.20) “Tener salud y compañía” (E.21, E.24) “Tener salud y ayuda” (E.23) “Tener 50 años menos, ser más joven y poder trabajar (risas), me gustaría llevar un camión de basura. Que toda la familia tenga salud” (E.13).

  19. LifeQualityModelforOldPeople in ATDOM program

  20. Discussion The old women receive more informal care. The perception of the health state for old person is regular , nevertheless, a high percentage of the majority has more than one chronic illness. Observations: • They do not eat enough fruit and vegetables that the WHO recommend daily. • They eat less proportion of the rest population. • The hydration of old people are quite precarious, they drink less than one daily liter of water. • The physical activity is going out to walk inside and outside a few times. • They receive visits from the relatives and friends. • The factors to determinate a quality of life are: the adaptation of personal situation, to have resources, to have health, to have loved, to have autonomy, to be well attended by the relatives. • The adaptability and social rol are important to maintain a good levels of satisfaction.

  21. Conclusions • The old people with dependence perceive a good quality of life with some limitations. • The social rol change with the new social context. • To know the quality of life level allows to detect needs and disabilities on time. • The need to promote activities for a healthy aging and to take care of family caregivers. • The functions of nursing professionals in ATDOM program are contributing to improve the quality of life for dependent old people and theirs family.

  22. Others questions • We want to make a big sample of the ATDOM Program and study the outside dependent old people. • To do this study in other population with the same characteristics to make corporations.

  23. References • Pérez A. El cuidador primario de familiares con dependencia: Calidad de vida, apoyo social y salud mental. Tesis Doctoral. Salamanca: Universidad de Salamanca, 2006. • Fernández-Mayoralas G, Rojo F, Prieto M.E, León, B, Martínez P, Forjaz M.J, Frades B, García C. El significado de la salud en la calidad de vida de los mayores. Madrid: 2007. • Fernández-Ballesteros R, Zamarrón M.D, Maciá, A. Calidad de vida en la vejez en distintos contextos. Madrid: Ministerio de Trabajo y Asuntos sociales. IMSERSO, 1996. • Walker A. Calidad de vida de las personas mayores. Análisis comparativo europeo. Revista Española de Geriatría y Gerontología 2004; 39, 3: 8-17. • Gómez Vela M, Sabeh E. Calidad de vida. Evolución del concepto y su influencia en la investigación y la práctica. Instituto Universitario de Integración en la Comunidad. Facultad de Psicología. Universidad de Salamanca. 2006. • Rubio Herrera R. Modelos y teorías desde la perspectiva sociológica. Tratado de psicogerontología. Valencia: Editorial Promolibro, 1996. • Parsons T. El sistema Social. Madrid: Alianza, 1999. • Bazo M.T, García B. Envejecimiento y Sociedad: Una perspectiva internacional 2º ed. Madrid: Editorial Medica Panamericana, 2006. • Ministerio de Trabajo y Asuntos Sociales. Bases demográficas. Libro Blanco sobre la atención a las personas en situación de dependencia en España. Madrid: Secretaría de Estado de Servicios Sociales, Familias y discapacidad. IMSERSO, 2004.

  24. Articles • Puig LLobet, M., LluchCanut, MT, Sabater Mateu, P., Rodríguez Ávila, N.”Calidad de vida y necesidades de formación de las cuidadoras formales de personas mayores dependientes institucionalizadas”. Enfermería global: Revista electrónica semestral de enfermería, Nº. 19, 2010. ISSN 1695-6141. Pág.1-6. • Puig Llobet, M., Rodríguez Ávila, N. “Valoración de enfermería en los cuidados domiciliarios a personas dependientes de más de 75 años”. Enfermería 21. Metas. Vol .julio/agosto (12/6). 2009. ISSN 138-7262 y el Depósito Legal M-43015-1997. Pág. 63-67. • Puig, M., Lluch, T., Rodríguez Ávila, N.“Valoración de enfermería: detección de la soledad y del aislamiento social en los ancianos de riesgo”. Gerokomos. 2009. Vol. 20-nº 1. ISSN 1134-928X. Pág. 9-14. • Rodríguez N. Manual de SociologíaGerontológica. Textos Docents 320. Departament de SociologiaiAnàlisi de les Organitzacions. Barcelona: Universitat de Barcelona, 2006.

  25. Statistics for life expectation and health Hans Rosling shows the best stats you've ever seen http://www.ted.com/talks/hans_rosling_shows_the_best_stats_you_ve_ever_seen.html. Principals indicators used: • Life expectation • Human Development Index (HDI)

  26. THANK YOU VERY MUCH MUCHAS GRACIAS MOLTES GRACIES

  27. Contact Dra. Nuria Rodríguez Ávila Dept. Sociologia i A.O. Despatx 4119. Universitat de Barcelona Avda. Diagonal 690 08034 Barcelona, España Tel/Fax: +34 934021805 E-mail: nrodriguez@ub.edu Dra. Montserrat Puig Llobet DepartamentInfermeriaSalut Pública, Mental i Maternoinfantil. C/ FeixaLlarga, s/n. Despatx 307 Campus de Bellvitge. 08907  Hospitalet de Llobregat Telèfon: 934024237 Fax: 934024297 E-mail: monpuigllob@ub.edu Research topics:: Quality of life, Aging Nursing diagnostic, Public Health..

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