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Institutionalized,
non-invalid old people
Mª Jesús Rojas Ocaña, Ángela
Mª Toronjo Gómez, Juan Bautista Rodríguez Rodríguez,
Ana Abreu Sánchez, Margarita Rodríguez Pérez,
Mª del Valle López Santos
SUMMARY
The admission to
a residence has been termed “institutionalization” in
order to differentiate it from community care and to emphasise its
nature as a specialization. On admission to a centre, old people
who are not invalid cease to perform certain tasks because of adjustment,
which can result in passive behaviour; this in turn creates dependency.
All old people, on entering a geriatric centre for the first time,
undergo a period of adaptation and observation that lasts 20 days,
after which they are evaluated by a Technical Committee.
General objective: To evaluate the influence of
institutionalization on an old person’s autonomy on admittance
to a geriatric residence for non-invalids, and the comparison with
their behaviour after the period of adaptation.
Material and method: A pre-experimental design with a pre-and post-test
study of a single group during two different periods, that is to
say, a measurement before and after of an intervention which in
this case is defined as time.
Dependent Variables: Level of Autonomy: to measure
the capacity of an old person in relation to everyday activities
using the Barthel Scale: (ABVD) Basic Activities of Daily Life;
and the Lawton Scale: (AIVD) Instrumental Activities of Daily Life.
Independent Variable: Admission of the old person
into the Institution. This is the variable that could modify, or
otherwise, the level of autonomy.
Socio-demographic Variables: Age; Sex; Background; Civil Status;
Acquisitive Capability; Reason for Admission.
Subjects for study: All the old people admitted
to the “Residencia Mixta de Pensionistas” in Huelva
from January 2002 to the last week of April 2002, totalling about
30 old people.
Data analysis: The statistical analysis was performed
using the Epiinfo 6.0 and SPSS V.10 program. The test was non-parametric
or consisted of the random distribution of average samples linked
to the Wilcoxon Test since it did not conform to the conditions
of normal distribution and because the sample was less than 30.
This was done in order to compare proportions with the McNemman
Test. Levels of probability less than 0.05 were considered significant.
Results: Forty per cent of residents were between
75 and 79 years of age, none less than 70. There were more men than
women. At the time of admission, the Barthel Index showed an average
of 97 points with a SD: 3. And after the period of adaptation fell
to 92 with a SD: 6. The first measurement using the Lawton Index
showed total independence to be at 45%. After 20 days, 100% of residents
had become dependent or needed assistance. Not a single resident
remained totally independent.
Argument: There exists a significant relation
between the autonomy and independence of an old person and his deterioration
due to institutionalization. Activities that underwent greatest
functional deterioration were walking and ascending and descending
stairs. Also washing clothes, house cleaning, preparing meals and
shopping.
Conclusions: Within the programme of adaptation
in an institution, priority must be given to the organisational
adaptation of the centre to the needs of the users and not the contrary.
The user’s family should be involved as much as possible in
order to preserve the physical and psychological autonomy of the
old person at all times.
KEY WORDS
Institutionalization, behaviour,
dependency, adaptation.
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