This article presents a communication framework, devised by the authors, that could be used by healthcare professionals who come into contact with people who have dementia. The framework is based on four key concepts: validation, emotion, reassure and activity (VERA). It describes a stage-by-stage process of communication that guides nurses towards providing compassionate and caring responses. The framework was developed in response to students who said they find it useful to have structured guidance on how to interact with people who have dementia. The VERA framework offers a means of interpreting communication and responding appropriately.

For elderly living in the community, alcohol misuse is not uncommon. Experience of professionals of social care services to face alcoholism misuse has rarely been assessed. The work of these professionals is to allow aged people to stay at home in spite of impaired physical and/or mental age-related abilities. We studied the experienced difficulties and feelings of professional caregivers for ten aged subjects with alcohol misuse compared to ten aged subjects without, to identify their needs in terms of training for the home care service associations. The participants took part in an interview and completed a research questionnaire concerning their reactions to alcohol misuse in elderly subjects. No significant difference was found between the responses from the two groups. All participants felt powerless in front of the denial of the alcohol misuse by the patients and experienced difficulties with the behavior of some family members. They reported that they would be comforted by the opportunity to share their experiences with colleagues and people in charge. They hoped to meet specialized teams in the field of addictions to develop skills for supporting elderly people with regard of alcohol misuse. Presently, the services in charge of the aged people should review the interventions and training of their employees, especially of those caring for subjects with alcohol misuse, to improve the quality of their actions in an evolving environment.

OBJECTIVE: To identify predictive indicators of institutionalization of the elderly. METHODS: A case-control study was carried out with 991 elderly individuals in the city of Pelotas, (Southern Brazil), from 2007 to 2008. The cases of institutionalized elderly adults (n = 393) were detected using a census of all long-stay institutions for the elderly in the city. The population controls (n = 598) were randomly selected using a comprehensive health survey. Pearson’s chi-square test and linear trends were used to compare groups in the crude analysis; and the binary logistic regression model of the adjusted analysis, with the effects expressed as odds ratios. RESULTS: Institutionalization was more frequent in females (OR = 1.96, 95%CI 1.31, 2.95). Elderly with advanced age (OR = 3.23 and OR = 9.56 for age groups 70-79 and > 80 years, respectively), those who lived without a partner (single, divorced or widowed), and those who had no formal schooling or had a functional disability preventing them from performing basic activities for daily living were more likely to be institutionalized. An inverse trend between the incidence of elderly institutionalization and the level of physical activity was observed, where somewhat active and inactive subjects were more likely to be institutionalized (OR = 1.71 and OR = 4.73, respectively). CONCLUSIONS: Of the factors examined, age > 80 years, living without a partner and being physically inactive were the indicators most strongly associated with institutionalization. The encouragement of informal care through cultural and educational activities focused on the role of the family in caring for the elderly can prevent the institutionalization of these individuals.

The aim of this study was to gain insight into registered nurses’ experiences of caring for older people in the UK and Japan.Critical incident technique was used because of its ability to capture actual incidents from practice. Written, anonymous self-report data were collected during 2010. Participants were asked to recall two critical incidents where they had felt either rewarded or challenged at work. Data were analysed using thematic analysis.Analysis revealed striking similarities in the experiences of nurses from both countries. Four main themes emerged: the challenges of a complex work environment; the challenges of resolving ethical conflicts; the rewards of establishing meaningful relationships; and the rewards of achieving excellence in individual patient care.The study provides new evidence from two different countries that although there are some challenges, nurses reap many rewards from working with older people.

Although most Americans know that the U.S. population is aging, they are far less informed about the reality of providing elders with personal care, health care, and social support. Families-particularly women-have always been critical in providing elder care, but the entry of so many women into the paid labor force has made elder care increasingly difficult. Ann Bookman and Delia Kimbrel show how changes in both work and family life are complicating families’ efforts to care for elderly relatives. Because almost 60 percent of elder caregivers today are employed, many forms of caregiving must now be “outsourced” to nonfamily members. And because elders are widely diverse by race and socioeconomic status, their families attach differing cultural meanings to care and have widely different resources with which to accomplish their care goals. Although the poorest elders have access to some subsidized services, and the wealthiest can pay for services, many middle-class families cannot afford services that allow elders to age in their homes and avoid even more costly institutional care. Six key groups–health care providers, nongovernmental community-based service providers, employers, government, families, and elders themselves–are engaged in elder care, but their efforts are often fragmented and uncoordinated. All six groups must be able to work in concert and to receive the resources they need. Both employer and government policies must be improved. Although large businesses have taken up the elder care challenge, most small and mid-sized firms still do not offer flexible work arrangements. Social Security and Medicare have provided critical support to families caring for elders, yet both face significant financial shortfalls. The Older American Act and the National Family Caregiver Support Program have broadened access to elder services, but need updating to address the needs of today’s employed caregivers and elders who want to “age in place.” And just over half of the nation’s workforce is eligible for the unpaid leave benefits provided by the Family and Medical Leave Act. The authors close by reflecting on the need for a coordinated, cross-sector movement to create an “aging-friendly” society in the United States-a society that values well-being across the life span and supports citizens from diverse cultures and income levels as they age.