Simon Fraser University Gerontology Research Centre

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Modifications to the hospital physical environment : effect on older adults retention of post-discharge instructions

Author: 
Peer reviewed: 
No, item is not peer reviewed.
Date created: 
2007
Abstract: 

This study was conducted in two (originally identical) hospital bedrooms in a community hospital in Burnaby, British Columbia. For the study, one patient room was left in its original state; the second was modified to reduce visual and auditory distraction. In each room, older adults watched a video recording of different post-discharge instructions. After each viewing, and after approximately 24 hours, their learning/retention was tested. While in each room, video equipment and other non-invasive technology recorded physical movements/fidgeting. A significant interaction was found between room type, instruction type and order. Subsequent analyses found that the oldest participants had the most difficulty when faced with learning the more difficult instructions in the "typical" room. Movement/fidget data suggest that participants were less stressed while receiving instruction in the modified room rather than "typical" room. Participants overwhelmingly preferred the modified room and expressed comfort with the use of video to receive post-discharge instruction. NOTE: This thesis constitutes Study 3a of the following report series:(1) Gutman, G.M., Love, T., Parke, B., & Friesen, K. (2006). Towards more elder friendly acute hospitals: Study 1: The physical environment in ACE units: Design specifics and staff ratings Final report. Vancouver, BC: Gerontology Research Centre, Simon Fraser University.(2) Gutman, G.M., Sarte, A., Parke, B., & Friesen, K. (2006). Towards more elder friendly acute hospitals: Study 2: The elder friendliness of the physical environment of medical and surgical units in the Fraser Health Authority: Final report. Vancouver, BC: Gerontology Research Centre, Simon Fraser University.(3) Gutman, G.M., & Love, T. (2008, January). Towards more elder friendly hospitals: Final report - Studies 3b and 3c. [Report submitted to Fraser Health Geriatric Clinical Service Planning and Delivery Team]. Vancouver, BC: Gerontology Research Centre, Simon Fraser University.

Document type: 
Thesis
File(s): 
Senior supervisor: 
Dr. Gloria Gutman
Department: 
Arts and Social Sciences: Gerontology
Thesis type: 
(Thesis) M.A.

Widows helping others : creating a brighter future together

Author: 
Date created: 
1988
Abstract: 

This publication is a collection of observations and insights I that we hope will be useful to individual widows and their support I groups across the province and the country. It is not our intent to duplicate the many excellent resource materials for widows produced in recent years, but rather to applaud the ones we have discovered and to offer the reader a flavour of the groups on the West Coast of British Columbia. The pages that follow incorporate a wealth of information from a variety of different sources: (1) results from the research literature; (2) informal comments at Board meetings and the Conference; (3) results of formal and informal evaluation procedures; (4) summaries of the conference addresses and workshops; and (5) an inspirational address a message from the President of the Board. Our purpose in filling these pages is to provide further evidence of the effectiveness of widows' support, the strength of our common bond, and the uniqueness of each group experience. We hope our story will give you courage to face the future and inspire you to Join a group that will meet your needs, to inject new enthusiasm into the group to which you already belong, or to start a group yourself.

Document type: 
Book
File(s): 

Younger adults in long-term care facilities : a review of the literature concerning their characteristics and environmental design, staffing and programming needs

Author: 
Date created: 
1989
Abstract: 

Concern over provision of long-term care for an increasing seniors' population has tended to obscure the fact that younger persons may also require this level of care. This report focuses on the non-geriatric population in long-term care: specifically, on adults between the aged of 20-64. Within this group, the emphasis is on those requiring facility care. While there is general consensus (Ontario Medical Association Committee on Rehabilitation, 1980a and b; Reinecke, 1979; Nichols, 1978) that everything possible should be done to enable younger adult disabled persons to live out their lives in the community, it is recognized that for some individuals with severe congenital or accident-caused disabilities, community living is impossible. Others require periodic admission to an institution in order to continue to live most of the time in the community. Still others enter an institution at the late stages of a progressive deteriorating illness which they and/or their family caregivers can no longer manage in a community setting. For all of these groups, the objective must be to construct institutions that will best meet their physical and psycho-social needs -- that is, that provide the best possible physical care in the least restrictive, most emotionally and intellectually satisfying environment possible.Table of Contents: I INTRODUCTION. II CHARACTERISTICS OF YOUNGER ADULTS IN LONG-TERM CARE FACILITIES: Diagnosis; Age Distribution; Sex and Marital Status; Functional Abilities; Age at Onset of Disability. III ADMISSION CRITERIA AND TURNOVER RATES IN YOUNG DISABLED UNITS: Age; Mental Status and Physical Condition; Turnover Rates; Average Length of Stay. IV GOALS AND OBJECTIVES OF YOUNG DISABLED UNITS. V DESIGN RECOMMENDATIONS: Size of Unit; Location of Unit; Type of Rooms; Other Recommendations. VI STAFFING REQUIREMENTS: Type of Staff Needed; Staff-to-Patient Ratio; Volunteers; Selection and Training. VII THERAPEUTIC PROGRAMS: General Recommendations; Recommendations Concerning Recreational/Leisure Programs; Recommendations Concerning Counselling; a) Educational and occupational; b) Sex; c) Marital and family; d) Counselling aimed at countering resentment and fostering acceptance of disability. VIII DISCUSSION. REFERENCES.

Document type: 
Technical Report
File(s): 

You do have choices : a practical guide to financial decisions for women of all ages

Date created: 
2000
Abstract: 

Reliable information is an important source of financial power for women of all ages. Throughout your life, you make a wide range of financial and other decisions that have a long lasting impact on your future security. Perhaps you are making decisions right now without realizing that you have many choices. We wrote this booklet to help remedy that information gap. We hope it will guide you in planning a more secure financial future. The information in this booklet is for you whether you are in the labour force, self-employed, or do unpaid work at home. Whether or not you work for pay, you need to know about income security programs and how your husband or partner's decisions will affect your life.Contents: Introduction; PART ONE - When You Are In A Relationship: Living Common-law; How a Relationship Can Affect You Financially; If Your Relationship Breaks Down-Separation and Divorce; Child Support; Spousal Support; Dividing Assets; Dividing Pension Benefits; Dividing Canada Pension Plan Benefits. PART TWO-When You Are in the Work Force: Employment Trends; Time Out From Paid Work; What Working Women Need To Know; Employment Standards; Union Agreements; Planning While You Are Working; Keeping Your Skills Sharp; Job Counselling. PART THREE-When You Are Out of Work: Employment Insurance (El); Social Assistance. PART FOUR-Planning Your Retirement: Deciding When to Retire; What's Available When You Retire; Government Benefits; Old Age Security; Guaranteed Income Supplement (GIS); Spouse's Allowance & the Widowed Spouse's Allowance; Canada Pension Plan; Regular Retirement Benefits; Survivor & Death Benefits; Applying Early for CPP; Workplace Pensions (Registered Pension Plans); Registered Retirement Savings Plans (RRSPs); Key Points to Remember; Working Together for Change. Conclusion. Resources.

Document type: 
Book
File(s): 

Assisted living : a potential solution to Canada's long-term care crisis

Author: 
Date created: 
2001
Abstract: 

By 2020, 29% of Canada's seniors will be in the 75-84 age bracket, and 13% will be aged 85 and over. How they live and who will look after them will become increasingly urgent problems. While Canada has primarily depended on extended family and nursing homes to care for their elderly, Dr. Stephen Golant, a U.S.-Canada senior Fulbright scholar, suggests there is another way. Over a five-month period spent at Simon Fraser University's Gerontology Research Centre, Dr. Golant evaluated the current state of Canada's housing policy for the elderly and urged all levels of government to look at new strategies to provide for this growing group of elderly seniors. In particular, Dr. Golant suggests the establishment of Assisted Living Facilities, a more resort-like setting targeted at upper-middle and high income seniors.

Document type: 
Book
File(s): 

Towards more elder friendly acute hospitals : study 2 : the elder friendliness of the physical environment of medical and surgical units in the Fraser Health Authority - final report

Date created: 
2005
Abstract: 

The purpose of Study Two of the Towards More Elder Friendly Acute Hospitals Project, entitled "The Physical Environment of Medical and Surgical Units in the Fraser Health Authority," was to determine the elder-friendliness of the physical environment in a sample of existing medical and surgical units in the Fraser Health Authority. For purposes of this study, "elder-friendly" was defined as having environmental design features that are considerate of the special safety, physical, social, and psychological needs of older adults. While it is generally assumed that the physical environment of hospitals in most jurisdictions, including the Fraser Health Authority, are not elder-friendly, it was considered important to empirically establish that this was indeed the case. We hypothesized that existing medical and surgical units meet only minimal compliance with "elder-friendly" design guidelines as outlined in the chronic/long-term care literature. Data gathered in Study Two support this hypothesis, and provide information on what are typical physical environmental features of medical and surgical units in the Fraser Health Authority. The study highlights priority areas in which renovations should be undertaken if Fraser Health wishes, at some future date, to better preserve and support older patients' functional ability. The primary and more immediate goal of Study Two, was to provide information that, when combined with information from Study One and the longterm care design literature, would enable the study team to proceed to Study Three. In Study Three, "typical" versus more "ideal" units will be compared in terms of their elder-friendliness. Findings from Study One are the subject of a separate report and will not be discussed here.

Document type: 
Technical Report
File(s): 

Towards more elder friendly hospitals : final report - studies 3b and 3c

Date created: 
2008
Abstract: 

Deconditioning and loss of functional status occurs at high rates among elderly persons admitted to hospitals, independent of their medical condition. Design of the physical environment is one of several explanations as to why this may occur. The two pilot studies described in this report tested selected environmental modifications designed to overcome some of the physical barriers to safe independent transfer, mobility, and toileting identified in Studies 1 and 2 of the Towards More Elder Friendly Acute Hospitals Research Project. One pilot study (Study 3b) took place in two originally identical bedrooms at Burnaby Hospital, a community hospital located in Burnaby, British Columbia. The second (Study 3c) took place in two adjacent bathrooms. In both Studies 3b and 3c, one room remained "as is " and the other was modified; 36 community-dwelling volunteers aged 75+ performed a series of tasks in both the original and the modified bedrooms and the two toilet areas. Order of exposure to the "typical" and modified rooms was counterbalanced. Three types of data were collected: subjective, physiological and video. The environment modifications of interest were rated by participants for ease of use, for helpfulness, and/or for appeal and they were asked to respond to questions such as "what did you like most/least about the rooms and why"? Heart rate was measured as participants rested in each bedroom and postural sway was recorded as they transferred from the bedroom to the bathroom and while they pretended to use the toilet and "freshen up" at the sink. To document gross movement, gestures, coping actions and facial expressions, high resolution webcams were mounted in the bedrooms and bathrooms and a camcorder followed the participants throughout the study. A number of lessons were learned from the study about relatively inexpensive design features that if implemented in new construction and retrofitting, have the potential to increase the elder friendliness of FH hospitals (e.g. movement activated lighting at the entrance to the bathroom). A number of useful lessons were also learned concerning equipment and procedures for remote monitoring of physiological functioning and stress. The report ends with a series of recommendations that include recognizing the diversity of the frail elder population of British Columbia and designing physical space in hospitals to meet the needs of patients with multiple chronic physical and/or cognitive impairments.

NOTE: The following thesis constitutes Study 3a of this report series: Love, T. (2007). Modifications to the hospital physical environment: Effect on older adults' retention of post-discharge instructions. M.A. Thesis, Department of Gerontology (Supervisor: G. Gutman).

Document type: 
Technical Report
File(s): 

Urban-rural comparison of adult day care centres in British Columbia

Date created: 
1991
Abstract: 

In 1979, Adult Day Care became a part of the B.C. Ministry of Health's Continuing Care Program. By 1989, there were 49 centres in operation in the province and it was felt timely to undertake a comprehensive review of the Adult Day Care component of the Continuing Care Program. As part of that review and as an aid for future planning, the Simon Fraser University Gerontology Research Centre was commissioned to conduct a study that would provide information concerning: 1. activities and services provided by the 49 centres; 2. characteristics of the clients currently being served; 3. reasons clients are referred to Adult Day Care; 4. reasons some referred clients do not attend; and 5. the referral process and the interface between the Long Term Care Program and Adult Day Care.

Document type: 
Technical Report
File(s): 

Towards more elder friendly acute hospitals : study 1 : the physical environment in ACE units : design specifics and staff ratings - final report

Date created: 
2006
Abstract: 

Report submitted to: Fraser Health Geriatric Clinical Service Planning and Delivery Team, January 17, 2006. Three facts about seniors are well known: (1) their numbers and proportion in the population served by the Fraser Health Authority (FHAA), the province and the country are increasing; (2) they constitute a substantial proportion of the inpatient hospital population, it has, in fact, been estimated that in most jurisdictions nationally and internationally, they may constitute the majority in medical and surgical wards other than pediatrics or obstetrics/gynecology; (3) a third fact is that substantial proportions of seniors have accidents in hospitals and/or lose functional status between admission and discharge at a rate above and beyond what is to be expected from their admitting diagnosis. While there may be various contributing factors, the focus of the study described in this report, and the broader project of which it is a part, is on the physical environment. A key question is whether there are aspects of the physical environment of hospitals, and in particular, interior design of patient private and public areas, that can be altered in ways that will improve older patient outcomes.

Document type: 
Technical Report
File(s): 

Technology innovation for an aging society : blending research, public and private sectors

Author: 
Date created: 
1998
Abstract: 

This volume originated with a workshop held in Vancouver immediately prior to the 1995 Annual Meeting of the Canadian Association on Gerontology. A group of individuals from the public policy, corporate and research sectors were invited to come together to explore issues relating to the development and market expansion of new technologies designed to enhance the health and quality of life of 'at risk' seniors. Among topics of concern were how to reconcile market imperatives with social and public policy agendas; how to effectively research and market technology to older persons; how to ensure consumer protection without destroying producers' incentives for innovation, and generally, how to increase the availability, affordability, and use of appropriately designed technology by and for the benefit of seniors. The workshop featured more than a dozen outstanding speakers from Canada, the United States and Europe. Eight of them accepted an invitation to expand their workshop remarks into formal written form - the chapters that follow this introduction are the result.TABLE OF CONTENTS: 1. Introduction: Technology, Aging and Disability in Canada / Gloria Gutman; 2. Bringing the Product from the Design Concept to the Marketplace / Geoff Fernie; 3. How to Effectively Research and Market Technology to Older People / Margaret Wylde; 4. Technological Approaches to Management of 'Problem' Behaviours in Home and Institutional Settings / Gloria Gutman; 5. A Picture is Worth a Thousand Words: Using Video-based Technology to Understand Behaviour Problems in Long Term Care Settings / Bettye Rose Connell; 6. Environmental Design: Enabling Technology for an Aging Society / Gary Scott Danford and Edward Steinfeld; 7 Stair Safety and Accessibility: Standards Development in the Building and Housing Industry / Jake Pauls; 8. Blending Research, Private and Public Sector Agendas in the Information Economy / Satya Brink; 9. TIDE - Technology for the Integration of Disabled and Elderly People: A European Model for Research and Development in Assistive Technology / Rosalyn Moran and Egidio Ballabio.

Document type: 
Book
File(s):