Journal of the American Geriatrics Society
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Comparative Study
Evaluation of continuing education for long-term care personnel: impact upon attitudes and knowledge.
Nursing assistants (aides) and licensed practical nurses (LPNs) from three proprietary nursing homes participated in a continuing education program designed to enhance knowledge and attitudes about the elderly in long-term care. The program covered six weeks for the initial 115 aides and one full-day seminar for the 83 LPNs. ⋯ Results indicated overall favorable changes for both aides and LPNs, particularly in the areas of increased knowledge and more positive attitudes. The data suggest that continuing education is an effective means of influencing the knowledge and attitudes of personnel in long-term care facilities, and it should be a first step toward improving the quality of care for elderly residents.
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An increasing percentage of the burn victims admitted to the Western Pennsylvania Hospital and Burn Care Center are aged 65 or older. Among 108 such elderly patients admitted during the past six years, 68 died and 40 survived--a mortality rate of 63 percent. Those who died of burns (average age 76.4) had burns over 44.8 percent of the mean body surface, whereas the survivors (average age 73.5) had burns over a smaller area (16.7 percent). ⋯ Ninety percent of the survivors returned to their homes after treatment. Although the mortality for elderly burn patients remains high, the favorable results in rehabilitation of the survivors are encouraging. Increased attention should be paid to safety programs for the elderly and those who care for them to prevent such serious accidental injuries.
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In 15 elderly patients who had seizure disorders, venous blood (standard venipuncture) was compared with capillary blood (finger lancet puncture) as the source of the specimen for determination of serum phenytoin concentration. The values obtained by the two procedures were similar (r = 0.99). ⋯ Either method provides an adequate blood sample for determination of phenytoin, and both may be used interchangeably. Capillary samples may be preferable for aged patients in whom venipuncture proves difficult or painful.
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The relationship between leisure satisfaction and morale was examined within the context of leisure behavior, health, age, and socioeconomic status. Interviews were conducted with 104 noninstitutional adults aged 65 or older living in an urbanized area. ⋯ Multivariate analysis indicated that the most important predictors of morale were leisure satisfaction and socioeconomic status. Self-rated health, the illness index, and age were much less significant as predictors.
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The clinical management of grief involves issues that demonstrate the integration of psychosocial risk factors into clinical practice. Recommendations for the clinical management of grief are based on a review of the pattern of morbidity and mortality of bereavement, of the emotional response to conjugal loss, and of several postulated pathogenetic mechanisms.