Frederick Ehrlich

A Comparison of Caregivers for Elderly Stroke and Dementia Victims

To compare elderly co‐resident caregivers of stroke and dementia patients on measures of burden and psychological morbidity.

Risk factors for stress in elderly caregivers

This cross‐sectional study examined 99 elderly coresident stroke and dementia caregivers who had been in the caregiving role for at least 6 months, to identify risk factors for subjective burden and psychological morbidity. A worsening in the quality of relationship between the caregiver and patient, being a spouse, shorter length of caregiving, poor caregiver self‐rated health, greater physical disability and behaviour/mood disturbance in the patient were found to be risk factors for burden. For psychological morbidity, risk factors also included behaviour/mood disturbance as well as female gender and low participation in life activities. These results demonstrate the multifactorial nature of caregiver stress in the elderly.

The Sydney Holocaust study: posttraumatic stress disorder and other psychosocial morbidity in an aged community sample.

We investigated the psychological status and social functioning of Holocaust survivors. From 814 responses to a community survey of Jewish elders (aged 60 years or older), survivors (n = 100), refugees who had not experienced the Holocaust (n = 50), and Australian/English-born persons (n = 50), were randomly selected for semistructured interview, which included Posttraumatic Stress Disorder (PTSD) assessment, ratings on the General Health Questionnaire, Brief Psychiatric Rating Scale, Impact of Event Scale, Mini-Mental Status Examination, and Instrumental Activities of Daily Living and Social Functioning. On all psychological measures, survivors were functioning worse than refugees and Australian/English-born persons. The 3 groups were similar in social and instrumental functioning. The more severe the trauma the greater the level of psychological morbidity. Despite normal social and daily functioning, psychological morbidity following massive trauma endures.

Planning for Young Adults with Brain Damage in New South Wales.

Adults with brain damage may have acquired it from three principal causes: from developmental disability or in very early life as a result of illness; in early adult life mainly from trauma, usually road accidents; and in late life due to dementia but also stroke and tumour. Whilst the resulting disabilities can be very similar, requiring comparable management strategies and causing similar stresses for their carers, there are very diverse avenues for service provision for these three categories, the only common feature perhaps being under-provision. There may be a case for “brain damaged persons unite!” with the prospect of more rational provision of support.

Bed rest in a sydney teaching hospital

This paper looks at two surveys of bed rest, conducted in a general hospital. The first survey, conducted early one afternoon, assessed the prevalence of bed rest within the hospital. It was found that most of the patients (67%) were in bed, and nearly half of those (42%) were in bed for reasons other than being too sick or unsafe to be up, or because bed rest was part of their treatment. A second survey, in which a sample of general hospital patients was repeatedly observed throughout the day, found that patients with no requirements for bed rest spent 63% (95% confidence limits: 51-75%) of the active part of the day in bed. It may be that because of the nature of hospital design, many patients are unnecessarily confined to bed because there is simply nowhere else to go. Inappropriate use of bed rest has implications for patient health and the utilization of scarce hospital resources.