Using a sample of octogenarians from the Swiss Interdisciplinary Longitudinal Study on the Oldest Old, the authors investigated the predictive validity of an expanded working definition of frailty based on deficiencies in mobility, memory, energy, and physical or sensory capacities and analyzed the resulting health transitions. The five domains were considered as predictors of the onset of dependence in activities of daily living (ADLs) and death using logistic multilevel and Cox survival regression models. Health transitions were studied with Markov chains. Deficiencies in memory, energy, and sensory capacities contributed to the prediction of the onset of ADL dependence and death in participants free of physical pains and mobility impairments. With two domains affected, frailty in very old persons indicated an increased risk of adverse outcomes. The study of transitions showed that ADL-independent frailty was a highly probable and relatively long transitional stage between robustness and ADL dependence

The aim of this paper is to investigate the interface between the formal and informal support provided to very old people against a background of increasing need for care and a decreasing number of potential informal caregivers. We used a sample of 323 community-dwelling octogenarians participating in the Swiss Interdisciplinary Longitudinal Study on the Oldest Old (SWILSOO) ({n} = 1441 interviews). Descriptive analyses and a multilevel model were used to test whether formal and informal services complemented or substituted one another. The study revealed that the amount of informal services increased significantly as the frequency of formal aid increased, indicating that the two networks were complementary in the majority of the cases. In 21.2% of the cases, the formal network partly substituted the informal network (as an adjustment) and only in 6.4% of the cases did the informal support end after the formal support had increased (radical substitution). The concern that the introduction of formal services may curb the readiness of relatives and friends to provide care is thus unfounded

While research focuses mainly on support provided to the elderly, this paper deals with the very old as a support provider to his family as much as a care recipient from both his family and a formal network. We hypothesize that elders with declining health will try to maintain the provision of services, even when they require and receive help.A total of 340 octogenarians from the Swiss Interdisciplinary Longitudinal Study on the Oldest Old (SWILSOO) were interviewed up to five times over five years (N=1225 interviews). A multilevel model was applied to assess the effects of health, controlled for socio-demographic and family network variables, on the frequency of services that the old persons provided to their family and received from their family and formal networks. Health is operationalized in three statuses: ADL-dependent, ADL-independent frail, and robust.While the recourse to the informal network increased progressively with the process of frailty, the recourse to the formal network drastically increased for ADL-dependent individuals. Being ADL-dependent seriously altered the capacity to provide services, but ADL-independent frail persons were providers with the same frequency as the robust oldest old, showing their ability to preserve a principle of reciprocity in their exchanges with their family network. This continuity of roles may help frail persons to maintain their self-esteem and well-being.

Auf der Basis einer Sekundäranalyse der Antworten von 1726 westschweizerischen Lehrpersonen, die im Schuljahr 2009/2010 in einer neunten Klasse unterrichteten, zeigt dieser Beitrag deren Einstellungen und Praktiken im Bereich der Zusammenarbeit vor der Einführung des Plan d’études romand, des neuen Lehrplans für die gesamte Westschweiz, auf. Wir zeigen, dass westschweizerische Lehrpersonen im Allgemeinen gegenüber der Arbeit im Team positiv eingestellt sind und dass eine Mehrheit von ihnen angibt, einen gewissen Teil ihrer Arbeit bereits in Zusammenarbeit mit Kolleginnen und Kollegen zu erledigen.

Sur la base des cinq premières années de l’étude d’une cohorte d’octogénaires suisses participant à la Swiss Interdisciplinary Longitudinal Study on the Oldest-Old (SWILSO-O), cet article propose une définition opérationnelle de la fragilité utilisant cinq dimensions de la santé (la mobilité, les capacités sensorielles, l’énergie, la mémoire et les troubles physiques) ainsi que sa validation. Nous constatons la coexistence d’une diversité de conditions de santé dans le grand âge avec la fragilité sans dépendance fonctionnelle comme situation majoritaire. L’analyse de segments de trajectoire de santé illustre que la fragilité n’est généralement pas un état transitoire de courte durée et que les atteintes des dimensions de la fragilité peuvent s’accumuler progressivement. La vie dans la fragilité, en plus de représenter une situation de risques accrus de chutes, de maladies, de consultations médicales, d’hospitalisation, de dépendance fonctionnelle et de décès, entraîne une transformation des relations familiales sous l’effet d’une asymétrie croissante des services échangés et un besoin accru en aide formelle.