Day 1 :
Keynote Forum
Justine McGovern
City University of New York
Keynote: Improving quality of life for diverse older adults living with dementia in new york: toward a dementia friendly bronx
Biography:
Justine McGovern was awarded her doctorate of Social Work from New York University in 2012. She is an Associate Professor in the City University of New York's (CUNY) Lehman College Department of Social Work, where she is also the Interim Director of the CUNY Institute for Health Equity and Co-coordinator of the Interdisciplinary Minor in Aging. She has published and presented internationally, and has over 20 years of practice in urban social work.
Abstract:
With a rapidly aging diverse population, the borough of the Bronx in New York City has the worst social and health outcomes among older adults in the city, and some of the highest rates of older adults aging in place. Neighborhoods in the Bronx tend to be ill-equipped to meet a wide range of expanding needs of diverse older adults. Moreover, the number of community-based older adults living with dementia in the Bronx is not only growing, but also is considered to be vastly under-representative of reality. A confluence of factors, including cultural differences such as language, health beliefs and beliefs about aging among diverse older residents and care providers, community-members' distrust of institutions, and a lack of services tailored to the needs of diverse older adults, contributes to poor understanding of cognitive impairment and poor outcomes for those living with dementia and their carers. Building on a UK-based model, the Dementia-Friendly Bronx Project aims to increase community awareness about dementia to reduce hardship and improve quality of life for individuals living with dementia in Bronx neighborhoods. The project is a collaboration between Lehman College, a City University of New York (CUNY) senior college located in the Bronx, and Chicago-based partners. While the model has been translated across the world and the US, few major urban centers with vastly diverse senior populations have attempted to create dementia friendly communities. Chicago has done so by focusing on a neighborhood rather than an entire city, with positive outcomes. This paper will track the evolution of the project, share results of the collaboration to date, and articulate implications for replicating the model in diverse urban environments. Significantly, the project is the first of its kind in New York City.
- Ageing Biology | Elderly Care | Geriatric Services | Geriatrics and General Practice | Gerontology | Geriatrics and Mental Health | Geriatrics and Neurological Disorders | Palliative Nursing
Location: Webinar
Session Introduction
Theodora Aligizaki
University of Crete, Greece
Title: The experience of aging in a nursing home: biographies and dominant Discourses of aging in different social contexts
Biography:
Theodora Aligizaki has completed her BSc and MSc degrees in the field of Psychology and nowadays she is a Phd Student in the field of Sociology focusing on Social Gerontology. Since 2016 she is working as a psychologist in elderly centers in Norway and Greece. She has presented 6 research projects in conferences around Europe and her research interests includes: the experience of elderly population living in nursing homes, the experiences of elderly people who define themselves as drug users and the experience of elderly people who identify themselves as members of the Lgbt+ community.
Abstract:
In the present dissertation, the researcher studies the aging experience in a nursing-care home while working as a psychologist in the same institution. Methodologically, she uses “Narrative Gerontological Analysis” by interviewing elderly residents and making participatory observations. This dual role raises ethical concerns about whether the position of authority in the elderly center (psychologist) is affecting this specific vulnerable population. But through theories such as “Levina's ethics” and “self-subjugation” according to Foucault, her dual role will not be approached as divided, but as a single-holistic role, in which the implementation of a holistic care is a key concern. Specifically, the researcher, both before and at the end of the research process, establishes a continuous relationship with the participants, based on the ethics principle, according to Levina. The research aims, to understand the effective functioning of the narratives of the participants in relation to experience “aging in a nursing home”. According to literature, narratives help individuals who live in an elderly center, to build a cohesive self in the present, or resist to various forms of oppression. This transcendental analysis states that individuals in their narratives are not pathetic carriers of the dominant Discourses, but at the same time they express their knowledge resistance to them and deconstruct them. By giving individuals the opportunity to relate their experiences, the researcher recognizes their need for resistance against dominant Discourses of aging, aiming to create a quality of life that is not defined by social stereotypes about "successful aging" but it is created from the voices of elderly people themselves.
Migita M. D’cruz
National Institute of Health & Neuro Science, India
Title: Rise in the number of geriatric patients attending psychiatric emergency services in a tertiary hospital during the COVID-19 lockdown period
Biography:
Migita M. D’cruz is a specialist of geriatric, working in Griatrics Clinic and Services; She is from Department of Psychiatry, National Institute of Mental Health and Neuro Science, India
Abstract:
Introduction: Older adults are at disproportionate risk of serious disease and mortality due to the novel coronavirus (COVID-19) pandemic. Further, the global response to the lockdown has rendered older adults particularly vulnerable to loneliness and social isolation due to the physical distancing and shelter in place mandate. We hypothesized that both these factors would lead to an increase in geriatric mental health problems during the COVID-19 pandemic.
Material and Methods: We undertook a clinical audit of all geriatric patients (above 60 years of age) attending the psychiatry emergency services at a tertiary care hospital. This audit was conducted over a period of 52 days dating from the cessation of non-essential services at the hospital as part of the national response to the COVID-19 pandemic (lockdown).
We used descriptive statistics to summarize the number, age, sex, presenting complaint and diagnoses of our patients. We further compared the average number of geriatric patients attending the psychiatry emergency services in the hospital during the lockdown to that of geriatric patients attending the same in the year before the lockdown.
Results: A total of 116 geriatric patients attended the psychiatry emergency services during the lockdown period. Of these, 63 were male and 53 female. The average number of geriatric patients attending the emergency services daily during this period (µ1 2.23) was significantly higher (z 5.36, p ≤ 0.01) than the average number of patients attending the emergency services in the year preceding the lockdown (µ2 1.34).
The most common presenting complaint was agitation in the preceding weeks. The most common diagnoses were late onset schizophrenia spectrum disorders followed by major neurocognitive disorders and affective disorders.
Discussion: The COVID-19 pandemic and the global response to the same constitute life events for older adults. They may contribute to biological, psychological and social risk factors for mental health problems in older adults during this period. The increase in geriatric patients attending our emergency services, despite an increase in restrictions on mobility which act as barriers in the pathway to care, is worrying. Under stimulation in older adults during this period may contribute to an increase in agitation.
William Garbrah
University of Eastern Finland, Finland
Title: The development and validation of gerontological nurse teacher scale
Biography:
William Garbrah is a Registered Nurse and a Public Health Nurse. He also holds a Master’s Degree in Health Sciences (International health) from University of Tampere - Finland. William has been a Senior Lecturer in nursing since 2010 and is currently pursing Doctoral Programme in Nursing Science. He has experience publishing in reputed peer reviewed journals.
Abstract:
Several studies have advocated for having gerontological nurse teachers with special commitment to implement an aged-friendly curriculum, in order to facilitate student nurses’ interest in gerontology careers. However, there is no existing instrument to assess whether gerontological nurse teachers possess such competences. This study describes the development and validation of an instrument for assessing the competence of gerontological nurse teachers. A total of 43 items categorized into seven constructs for the Gerontological Nurse Teacher Scale (GeNTS) emerged from the literature review in 2017. Experts (N=19) then participated in a two-round Delphi feedback for content validity in May 2018. A pre-pilot study was then undertaken in October 2018 among undergraduate nursing students (n=7) to ensure readability and understandability, followed by a pilot study on undergraduate nursing students (n=196) for psychometric assessment. Based on experts’ feedback and psychometric assessment, the final version of GeNTS consists of 33 items across five constructs namely: knowledge and interest; theoretical course and practical training development; leadership; gerontology career promotion and concerns about aging. The items are score on a five-point Likert scale from 1 = completely disagree to 5 = completely agree.
Antonio Caballer
Jaume I University, Spain
Title: An indoor positioning system for monitoring the behaviour of older people in their homes
Biography:
Antonio Caballer has completed his PhD from Jaume I University. He is an Associate Professor in the Department of Developmental, Educational and Social Psychology and Methodology of Jaume I University. He has published in reputed journals and has been working in differents projects about older adults. He is interested in assesing loneliness and social isolation with Infomation and Communication Technologies.
Abstract:
The increase in older people wishing to live alone in their own homes has increased studies of monitoring systems to improve the quality of life of older people, their families and carers. The aim of the communication is to present the results of the evaluation of the degree of acceptability and satisfaction with the Senior Monitoring application. At the end of the study, an acceptability scale was passed to the 11 elderly participants (six women and five men) with an average age of 68 years and a standard deviation of 8 years. The scale consists of six Likert items with five response categories that assess two dimensions: usability and satisfaction. The average usability was 12.18 points (SD = 1.99) and the average satisfaction was 12.91 points (SD = 2.21); quite high values. As a qualitative assessment, several people expressed the wish that the device would be able to place the person away from home. The Senior Monitoring application has been evaluated satisfactorily by the study participants. New studies are opened in the use of conversational devices that allow the evaluation of aspects such as loneliness, depression, well-being through the analysis of behavioral data collected at home through conversational devices.
Emam M. Esmayel
Internal medicine department, Egypt.
Title: Decreased muscle function in elderly patients with chronic kidney disease
Biography:
I am Emam M. Esmayel. I am working on Zagazig faculty of medicine, in Internal medicine department, Egypt.
Abstract:
Up till now, there is still discrepancy about muscle function in older adults with chronic kidney disease ( CKD ). In this study we assessed function of upper limb muscles using Hand grip strength (HGS) measurement by hand dynamometer, and lower limb muscles function using Timed Up and Go test (TUGT) in 73 elderly CKD patients. The study included also 73 healthy participants, as control. The difference between pre dialysis (37patients) and hemodialysis (36 patients) CKD patients, as regards HGS and TGUT was also assessed.
Our results showed significant decline in upper limb muscle function in CKD patients, as evidenced by the significantly lower HGS value in comparison with the participants in the control group (30.1 ± 3.9 kg vs. 34.8 ± 3.2 kg) with p value= 0.008 .Our results showed also significant decline in lower limb muscle function in CKD patients, as evidenced by the significantly prolonged TUGT value in comparison with the participants in the control group (15.5 ± 1.5 sec. vs. 7.8 ± 1.2 sec., p<0.001). Our results revealed significant decrease in HGS, and significant prolongation of TGUT in hemodialysis compared to pre-dialysis CKD patients .
Assessment of muscle function by handgrip strength and timed up and go test may be of value for the nephrologist to better manage CKD.
David Kaufman
Simon Fraser University, Canada
Title: Social engagement for aging well: Theoretical and practical perspectives
Biography:
David Kaufman is a Professor in the Faculty of Education and Associate Member of the Gerontology Department and Faculty of Health Sciences at Simon Fraser University. He has presented more than 200 lectures and/or workshops worldwide and has published more than 120 peer-reviewed articles and three books. He serves as a reviewer for many journals, granting agencies and professional associations, and has received more than $4 million in funding. He currently is funded through an AGE-WELL Canadian National Centres of Excellence grant to study digital games and digital storytelling for older adults.
Abstract:
Older adults are prominent digital game players with the number of older adults who play digital games increasing from 9% in 1990 to 34% in 2014 and continuing to increase since then. With the increased popularity of digital games among older adults, it is useful to investigate how this form of leisure activity may be benefiting the older generation through enhanced cognitive skills and social connectedness. These aspects have been identified by older adults as main concerns about aging. This study employed a closed-ended cross-sectional survey developed by the author and his team aimed at understanding older adults’ (aged 55 years and older) experiences of playing digital games and their opinions regarding these. The questionnaire included questions about older adult respondents’ characteristics, experiences of playing digital games, patterns of playing, and opinions about digital games. It was administered to older adults in shopping malls, local community centers, nursing homes and seniors’ centers. Participants’ chose mental exercise, followed by enjoyment, as the most commonly selected benefits of digital game playing. The majority of respondents also reported an increase in all five specific cognitive benefits listed in the questionnaire: focusing attention, memory, reaction speed, problem-solving, and reasoning. Many reported that digital games also increased the socio-emotional benefits of developing self-confidence, dealing with loneliness, and connecting with family. In conclusion, digital games appear to hold great promise for enhancing older adults’ cognitive skills and social lives, but more targeted interventions are needed to understand how to unlock these benefits.
Tran Thi Minh Thi
Vietnam Academy of Social Sciences, Vietnam
Title: Intergenerational perception of living arrangement in the old age: Familization and rising market of elder care in Vietnam
Biography:
Tran Thi Minh Thi is the Director of the Institute for Family and Gender Studies, Vietnam Academy of Social Sciences. She gained Master degree of Sociology at the University of Washington, US and PhD degree of Sociology at Kyoto University, Japan. She is a principal member in studies on gender, welfare, care, community development, health, and family. Her recent studies on the elderly issues included: “Construction of effective network for well-being of the leftbehind elderly in rural community through cooperative studies between Ha Tinh and Quang Ngai provinces, Vietnam and Minamata city, Japan” funded by TOYOTA in 2015; “Elderly Care in Transforming Vietnam: Policy and Structural Perspectives”. 2015-2016, funded by Vietnam Government in 2016-2016; and “Strengthening social engagement in elderly care in changing economic and family structure in Asia: Policy and practical dialogues between local communities in Vietnam and Japan”, funded by the Toyota Foundation in 2017-2018.
Abstract:
Asian societies are known of our strong connection among family members and filial piety is a highly valued practice in Confucian culture. In Vietnam, family is long-term seen as being significant for elder care. The traditional concept that parents should live with their older children as an alternative to financial support, improve the efficiency of the provision of care, and increase the emotional support the parties can provide for each other. Due to increasingly migrating, working pressure, and individualization, there is an increasing withdrawal of family caregivers from caregiving upward their parents. Meanwhile, Vietnam is observing changes in demographics and family structure such as fast increase of population aged from 65, the extension of life expectancy, which is linked to an increase in the number of elders in need of care, drop in fertility rate, resulting in a shrinking supply of family caregivers.
Using our very new dataset from the national study on Family Values in Contemporary Vietnam, which surveyed 1750 people aged from 16 to 70 in 2017, this paper would analyze the role of modern family in care relations from the perspectives of old and young generation and the interaction between family network, professional practice and government in care policy within Vietnamese aging context by analyzing questions on current and old age living arrangement (i.e. living alone, living with spouse, living with sons, living with daughters, living in residential care center/nursing home and living with relatives/others) with involvement of the public policies and services.
Muhammad Hammad
Mediclinic Welfare Hospital, UAE
Title: New approach to dizziness with clinical method
Biography:
Muhammad Hammad has done his education in bachelor of medicine and bachelor of surgery from Hamdard University during 2000-2005. He then worked as trainee resident medical officer at National institute of cardiovascular diseases at Karachi from 2006-2007. Dr Hammad is the member of Royal College Of Emergency Medicine MRCEM at London, UK. During 2007-2009 at Patel general hospital he served as resident medical officer in intensive care unit in Pakistan. Then he moved to Aga Khan University hospital to serve as emergency postgraduate resident from 2010-2011. From 2011-2015 he worked as Emergency doctor at Al Dhaid hospital. Currently he is working as an Emergency Doctor at Mediclinic Welcare hospital, Dubai.
Abstract:
Introduction: Dizziness is the most common condition or symptom to be present in Emergency departments or rooms in most of the part of the world. It can easily be miss- diagnosed as Central verses Peripheral Vertigo if not deal with proper history and examination in EDs by Emergency Physicians or clinicians. Dizziness cane be defined as ‘’Spinning movement in surroundings’’ or whirlpool like feeling. Dizziness is common among elderly age with many different reasons apart from Peripheral or Central causes of Vertigo which includes Risk of Fall, Trauma, Dietary intake, Walking aids, Organic diseases, Vision problems etc. My presentation will focus on new method of Diagnosing Dizziness in Emergency Departments as quick and easy three steps which includes Three clinical tests which are 1. Nystagmus, 2. Skew test and 3. Head thrust test. 40 years old female known case of I.H.D, HTN and DM presented with moderate dizziness which is since one month and gradually increasing, associated with nausea, vomiting and headache. She also fell down twice in this month. She doesn’t use walking aids. She lives alone. On multiple medications for her comorbidities. She was at the shopping mall and suddenly felt quite dizzy and became better but not settled and now in E.D. History of fall: If yes then preceding symptoms, clear cause of fall etc. Palpitation, use of medications which can cause dizziness, consumption of alcohol, walking aids, previous episodes. Different meaning for the different patient- Some describe as Disequilibrium, Light headedness, etc. Vertigo: Sensation of disorientation in space with the hallucination of movement. BPPV: Most commonly recognized form of vertigo. Attributed to calcium debris within the semicircular canal (canalithiasis).I feel like the room is spinning when I turn my head Lasts seconds, but may feel destabilized for hours after an attack. No ear pain, tinnitus, or hearing loss.
Diagnosis usually made by history:
• Dix Hallpikemaneuver
• Positive in 50-80% of patients
• Canalithrepositioning maneuvers
Medical therapy usually not helpful due to transient symptoms
Meniere’s disease:
• Excess endolymphaticfluid pressure
• Episodic, acute vertigo lasts minutes to hours
• Unilateral tinnitus, hearing loss, ear fullness
Vestibular Neuritis:
• Viral or post viral inflammatory disorder.
• Rapid onset of severe persistent vertigo with nausea, vomiting, ataxia.
• Sometimes combined with unilateral hearing loss (labyrinthitis)
• Steroid taper.
• Dramamine, meclizine (H1 blockers), benzodiazepines
Labryinthine Concussion:
• Traumatic vestibular injury following head trauma
• Transverse fractures of the temporal bone
Acute Vestibular Syndrome: Acute vestibular syndrome (AVS) is characterized by the rapid onset (over seconds to hours) of vertigo, nausea/ vomiting, and gait unsteadiness in association with head motion intolerance and nystagmuslasting days to weeks. Of the 2.6 million emergency department visits for dizziness or vertigo annually in the United States, APV is diagnosed in nearly 150 000. Small observational studies suggest perhaps 25% of acute vestibular syndrome presentations to the emergency department represent posterior circulation infarctions.CT scans have low sensitivity (approximately 16%) for acute infarction, particularly in the posterior fossa, and brain MRI is not always readily available. Studies also suggest that false-negative MRI can occur with acute vertebrobasilar strokes.
Angie Ng Kwee Sew
Econ Healtcare Group Pte Ltd, Singapore
Title: Care of the elderly: Golden or Burden?
Biography:
Angie Ng has more than 40 years of extensive healthcare experience working in the public and private hospitals both in Malaysia and Singapore providing nursing leadership, management, and nursing education expertise. She obtained her Doctorate in Education from the University of Western Australia at the age of 53 competing among the younger generations. Currently, she is the Director of Nursing in one of the largest private nursing home in Singapore.
Abstract:
The healthcare for the elderly has indeed arrived at the right moment, at a time when the elderly population in the world is increasing and needs better attention. The increase in life expectancy is glaring across the globe and Singapore is no exception. The government has been building many nursing homes to accommodate to the increase needs of our elderly. However, our biggest challenge is getting the right attitude and competent staff to provide this delicate care for our elderly. The reality of caregiving is, it is stressful, and be it at home or nursing home or skilled nursing facilities. Unfortunately, not everyone is suited to this role. It really takes a special commitment to any caregiver to provide care to the elderly with passion. Even more so when our caregivers are foreigners and many of them came over for just a job. Let's face it, caring for the elderly is a very labor intensive job, and is emotionally trying to say the least. Even more trying is the added responsibility when the elderly has behavior issues or getting sicker. On the other side of the coin, I passionately believe that ageing means changing- a potentially rich progression through life. We can’t avoid the process of growing older, but we can avoid atrophy of the spirit. Caring for the elderly is like taking care of our young children, they are most precious and vulnerable. Hence, it reflects poorly on caregivers when they are mistreated when they are admitted to our facilities as our duty is to look after and cherish them.