No abstract available.
Hospices* ; Institutionalization*

PURPOSE: This study aims to explore general perception types about the life of institutionalized elderly and thus to provide the basic data for nursing intervention for them. METHOD: This study used a Q methodology. A Q sample was developed through a review of related literature and descriptions of ordinary people about the life of institutionalized elderly. Thirty-eight statements made up the finalized Q sample. RESULTS: The results revealed three different types of the general people's perception about the life of institutionalized elderly. Type 1 is an optimistic group which expects modernized institutions. This group focuses on social relationships enjoying a variety of cultural life. Type 2 is a positive group which pursues independence. They are open-minded about the use of the institution and are not ashamed of the life in the institution. Type 3 is a conservative group which disapproves institutionalization. The members of this group strongly disapprove the institution itself and have negative views on institutionalization. These three types share certain common features while having distinctive characteristics showing individual views and traits about the life of the institutionalized elderly. CONCLUSION: This study will provide us the basic data to understand institutionalized elderly and to develop nursing intervention for them.
Aged* ; Humans ; Institutionalization ; Nursing

BACKGROUND: The Philippines has, mandatory service policies to address the insufficiency and maldistribution of human resources particularly for health services. Despite being perceived as an appropriate intervention to bridge the aforementioned HRH gaps, the past and present implementations of such programs in the country have never been formally studied.

OBJECTIVE: This paper aimed to present the history of mandatory service programs in the Philippines, look at their natures, and see how their different implementations relate to each other.

METHODOLOGY: Using a qualitative document analysis method, administrative issuances and reports relevant to past and current implementations of mandatory service policies in the Philippines were obtained and reviewed.

RESULTS: Mandatory service programs have been implemented in the country by institutions from both the private and public sectors as early as 1968. The focus of such has been mostly for government positions and specialized professions including physicians and scientists. While extensive efforts have been made through the years, the policies demonstrated fragmentation and recurring gaps in implementation. Such gaps include the lack of enabling policy mechanisms, formal monitoring and evaluation, and program institutionalization.

CONCLUSION: The historical narrative of return service programs in the country is a potential source for the development of an overarching mandatory service policy framework for human resources in the Philippines, one that is specific to the context and setting of the country. By articulating policy issues identified, this paper provided a stepping-off point for future mandatory service program policy planning, implementation, evaluation, and institutionalization in the Philippines.

Voiding dysfunction is very common in Alzheimer's disease, especially urinary incontinence with reported frequencies of 11-90%. Urinary incontinence occurs secondarily from dementia, can result in medical morbidity, impaired self-esteem of the patents, caregiver's stress, early institutionalization of the patients, and considerable financial cost. Many studies have found that the frequency and severity of incontinence is positively correlated with the severity of dementia and the inability to walk or transfer. Research on the management of urinary incontinence in demented patients has focused almost exclusively on toileting programs and drug treatments for detrusor overactivity. To date, anticholinergic and antispasmodic medications have not been shown to be effective in treating incontinence in demented persons. Therefore we have to study about the etiology and treatment of Alzheimer's disease.
Alzheimer Disease ; Dementia* ; Humans ; Institutionalization ; Urinary Incontinence

Caring for people with dementia is associated with multiple devastating social, financial, physical, and psychological challenges. There is strong evidence that multicomponent tailored caregiver intervention is effective in improving caregiver well-being and delaying institutionalization. In US, the government is actively funding for developing caregiver program and to prove its efficacy through randomized controlled trials (RCTs) to translate into practice. Even with the introduction of Korean Long-term Care Plan, still, the most of the patients with dementia are being cared by the family members. The distress of caregiving is enormous, but structured therapeutic intervention program which efficacy is proven through RCT is very insufficient in Korea. The purpose of this article is to review the caregiver intervention programs of ongoing clinical trials comparing US and Korea, and to propose a tailored, therapeutic intervention program (I-CARE; A multicenter, randomized trial to assess efficacy of therapeutic intervention programs for decreasing caregiver burden in dementia caregiver) for hospital-care in Korea.
Caregivers* ; Dementia* ; Financial Management ; Humans ; Institutionalization ; Korea ; Long-Term Care

OBJECTIVES: The purpose of this study was to examine the determinants of care burden of caregivers in patients with dementia. METHODS: 128 dementia patients and patients' caregivers participated in this study. Care burden using the BI ; cognition using the K-MMSE ; dementia severity using the CDR ; activities of daily living using the S-ADL and the S-IADL ; behaviour problems using NPI were measured. RESULTS: The results showed that care burden was related significantly with the K-MMSE, the CDR, the S-ADL, the SIADL and the NPI total score. Of the behavior problems, agitation/aggression, anxiety, disinhibition, irritability, and aberrant behavior correlated positively with care burden of caregivers. Regression analysis indicated that agitation/aggression, anxiety, the CDR contributed to care burden. CONCLUSION: Agitation/aggression, anxiety and dementia severity contributed to care burden of caregivers. The identified determinants of care burden and the stress of caregivers suggest areas of therapeutic intervention to reduce caregiver's burden so that the institutionalization can be delayed.
Activities of Daily Living ; Anxiety ; Caregivers* ; Cognition ; Dementia* ; Humans ; Institutionalization

The importance of palliative care for terminal cancer patients has been emphasized globally. Korea has formulated and implemented its policy for cancer control as it drew up a 10-year plan for cancer patient care. We examined Korea's National Cancer Act and the second 10-year plan for cancer patient care, which are legal grounds for palliative care projects for terminal cancer patients, to check the current status of Korea's efforts to establish a hospice and palliative care system. Institutionalization of hospice and palliative care has been developed within a framework of the national cancer project. Efforts such as expansion of hospice units, experts training and quality improvement should continue after the reimbursement of hospice and palliative care begins in 2013.
Hospices ; Humans ; Institutionalization ; Korea ; Palliative Care ; Patient Care ; Quality Improvement

Behavioral and psychological symptoms in dementia (BPSD) are one of the common causes leading to significant impairment in quality of life for both patients and their caregivers, as well as an increased risk of institutionalization. In the treatment of BPSD, the first step is to check medical illness, and environmental status that can cause BPSD. When BPSD are associated with medical illness or environmental status, it is important to correct this condition for treatment of BPSD. However, if BPSD are very severe enough to be dangerous to patients or others and are not treatable by nonpharmacological approaches, pharmacological treatments could be considered. In pharmacological approaches, it is important to select relevant drugs according to the target symptoms, such as psychosis, depression, agitation, sleep disturbance, and so on. Due to the altered pharmacokinetics and pharmacodynamics, drug dosages for the patients with dementia should be started very low and increased slowly.
Caregivers ; Dementia* ; Depression ; Dihydroergotamine ; Drug Therapy* ; Humans ; Institutionalization ; Pharmacokinetics ; Psychotic Disorders ; Quality of Life ; Resin Cements

The authors studied organic brain syndrome, using organic brain syndrome scale of the Diagnostic Interview Schedule for DSM-Ⅲ, in the subjects of 65 males and 231 females at the homes for the aged in the Taegu and Kyong-buk areas. The authors collected the data during the period from June to August, 1986, and applied ANOVA and x²-test in order to compare various psychologic factors in relation to the organic brain syndrome. The results could be summarized as follows: The elderly males (15%) showed high OBS scores of 12 and over, while ninety elderly females (39%) showed the same scores. Among those psychosocial factors, age, education, birth place, occupation, religion, history before institutionalization are significantly related to the OBS scores.
Aged* ; Appointments and Schedules ; Brain* ; Daegu ; Education ; Female ; Homes for the Aged ; Humans ; Institutionalization ; Male ; Occupations ; Psychology ; Residence Characteristics

Alzheimer's disease and other dementias are common degenerative disorders in the elderly. Most dementia patients are cared for at home by family members. Although caregiving is associated with significant psychological and physical morbidity of caregivers, there are wide individual differences among caregivers in how well they are adapt to caregiving demands. Recent data suggest that caregiver variables can be important determinants of dementia patients' institutionalization and that dementia patients living with highly distressed caregivers may exhibit higher frequencies of behavioral problems and agitation than those living with less distressed caregivers. Caregiver stress may be reduced with special attention paid to the treatment and management of behavioral and functional symptoms in dementia patient. Caregiver education and coping skills should also be emphasized to reduce caregiver's stress and morbidity.
Adaptation, Psychological ; Aged ; Alzheimer Disease ; Caregivers* ; Dementia* ; Dihydroergotamine ; Education ; Humans ; Individuality ; Institutionalization