Search results for: older LTC residents

Authors: Ruttana Phetsitong, Patama Vapattanawong, Malee Sunpuwan, Marc Voelker

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The majority of care for older people at home in Thai society falls upon caregivers resulting in caregiver’s mental health problem. Beyond individual characteristics, household factors might have a profound effect on the caregiver’s mental health. But reliable data capturing this at the household level have been limited to date. The objectives of the present study were to explore the levels of Thai caregiver’s mental health and to investigate the factors affecting the mental health at household level. Data were obtained from the 2011 National Survey of Thai Older Persons conducted by the National Statistical Office of Thailand. Caregiver’s mental health was measured by using the 15- items-short version of the Thai Mental Health Indicator (TMHI-15) developed by the Department of Mental Health, the Ministry of Public Health. Multivariate logistic regression models were used to explore the impact of potential factors on caregiver’s mental health. The THMI-15 produced an overall average caregiver mental health score of 30.9 out of 45 (SD 5.3). The score can be categorized into good (34.02-45), fair (27.01-34), and poor (0-27). Duration of care for older people, household wealth, and functional dependency of the older people significantly predicted total caregiver’s mental health. Household economic factor was key in predicting better mental health. Compared to those poorest households, the adjusted effect of the fifth quintile household wealth was high (OR=2.34; 95%CI=1.47-3.73). The findings of this study provide a fuller picture to a better understanding of the level and factors that cause the mental health of Thai caregivers. Health care providers and policymakers should consider these factors when designing interventions aimed at alleviating caregiver’s psychological burden when provided care for older people at home.

Keywords: caregiver’s mental health, household, older people, Thailand

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Authors: Estrella C. Damaris, Ingrid A. Olais, Gloria P. Uicab

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This study explores the relationship between the level of functionality and cognitive impairment in older adult women from the south-east of Mexico. It is a descriptive, cross-sectional study; performed with 172 participants in total who attended a health institute and live in Merida, Yucatan Mexico. After a non-probabilistic sampling, Barthel and Pfeiffer scales were applied. The results show statistically significant correlation between the cognitive impairment (Pfeiffer) and the levels of independence and function (Barthel) (r =0.489; p =0.001). Both determine a dependence level so they need either a little or a lot of help. Society needs that the older woman be healthy and that the professionals of mental health develop activities to prevent and rehabilitate because cognitive impairment and function are directly related with the quality of life.

Keywords: functionality, cognition, routine activities, cognitive impairment

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Authors: Peyman Rezaei Hachesu, Vahideh Zareh Gavgani, Zahra Salahzadeh

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To survey the attitudes, awareness, and practice of Evidence Based Medicine (EBM), and to determine the barriers that influence apply’ EBM in therapeutic process among clinical residents in Iran.We conducted a cross sectional survey during September to December 2012 at the teaching hospitals of Tehran University of Medical Sciences among 79 clinical residents from different medical specialties. A valid and reliable questionnaire consisted of five sections and 27 statements were used in this research. We applied Spearman and Mann Whitney test for correlation between variables. Findings showed that the knowledge of residents about EBM is low. Their attitude towards EBM was positive but their knowledge and skills in regard with the evidence based medical information resources were mostly limited to PubMed and Google scholar. The main barrier was the lack of enough time to practicing EBM. There was no significant correlation between residency grade and familiarity and use of electronic EBM resources (Spearman, P = 0.138). Integration of training approaches like journal clubs or workshops with clinical practice is suggested.

Keywords: evidence-based medicine, clinical residents, decision-making, attitude, questionnaire

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Authors: Zaiton Osman, Imbarine Bujang, Azaze-Azizi Abdul Adis, Grace Phang Ing, Mohd Rizwan Abdul Majid, Izyanti Awang Razli

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Retirement forces older workers to disconnect with their previous behavioural patterns and economic position. Transition and adjustment from working life to retirement places create psychological pressure and financial distress on older workers, especially those with dependent children. Bridge employment provides a solution for older workers to continue working after retirement while transitioning into retirement slowly and smoothly. As losing the job role has a significant impact on the psychological well-being of retirees, engageing in bridge employment helps to fulfill the important psychological functions of older workers by providing an adaptive style to retirement. This study investigates the influence of retirement planning and job satisfaction on bridge employment. A self-administered questionnaire was used in this study and a total of 523 samples were collected for nine major district in Sabah. Data were analysed using Partial Least Square (PLS) method wersion 2.0. The result shows a significant relationship between retirement planning and job satisfaction on bridge employment, explaining 4.7% the variance in bridge employment and job satisfaction was found to be the strongest predictor of bridge employment.

Keywords: ageing population, retirement planning, job satisfaction, bridge employment

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Authors: J. Koiso-Kanttila, A. Soikkeli, A. Aapaoja

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Construction in Finland is focusing increasingly on renovation instead of conventional new construction, and this trend will continue to grow in the coming years and decades. Renovation of the large number of suburban residential apartment buildings built in the 1960s and 1970s poses a particular challenge. However, renovation projects are demanding for the residents of these buildings, since they usually are uninitiated in construction issues. On the other hand, renovation projects generally apply the operating models of new construction. Nevertheless, the residents of an existing residential apartment building are some of the best experts on the site. Thus, in this research project we applied a relational model in developing and testing at case sites a planning process that employs interactive planning methods. Current residents, housing company managers, the city zoning manager, the contractor’s and prefab element supplier’s representatives, professional designers and researchers all took part in the planning. The entire interactive planning process progressed phase by phase as the participants’ and designers’ concerted discussion and ideation process, so that the end result was a renovation plan desired by the residents.

Keywords: apartment building renovation, interactive planning, project alliance, user-orientedness

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Authors: Metee Pigultong

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The research aims at 1) composition of meditation music, 2) study of the meditation time reliability. The population is the older adults who meditated practitioners in the Thepnimitra Temple, Don Mueang District, Bangkok. The sample group was the older persons who meditated practitioners from the age of 60 with five volunteers. The research methodology was time-series to conduct the research progression. The research instruments included: 1) meditation music, 2) brain wave recording form. The research results found that 1) the music combines the binaural beats suitable for the meditation of the older persons, consisting of the following features: a) The tempo rate of the meditation music is no more than 60 beats per minute. b) The musical instruments for the meditation music arrangement include only 4-5 pieces. c) The meditation music arrangement needs to consider the nature of the right instrument. d) Digital music instruments are suitable for composition. e) The pure-tone sound combined in music must generate a brain frequency at the level of 10 Hz. 2) After the researcher conducted a 3-weeks brain training procedure, the researcher performed three tests for the reliability level using Cronbach's Alpha method. The result showed that the meditation reliability had the level = .475 as a moderate concentration.

Keywords: binaural beats, music therapy, meditation, older person, the Buddhist meditated practitioners

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Authors: Demosthenes Panagiotakos

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The aim of the present work was to evaluate dietary habits’ inflammatory potential with various components of arterial blood pressure (hypertension, mean arterial pressure (MAP) and pulse pressure (PP)) in a sample of older Mediterranean people without known cardiovascular disease. During 2005-2011, 2,813 older (aged 65-100 years) individuals from 21 Mediterranean islands and the rural Mani region (Peloponnesus) were voluntarily enrolled. Standard procedures were used to determine arterial blood pressure, as well as PP and MAP, and for the evaluation of dietary habits, lifestyle, anthropometric and clinical characteristics of the participants. A dietary inflammatory index (DII) was assessed based on the participants specific dietary habits, and its calculation was based on a standard procedure. It was reported that the higher the DII level of a diet (adherence to a more pro-inflammatory diet) the greater was the likelihood of having an older adult hypertension [OR=3.82 (95% CI): 1.24 to 11.71]. Moreover, the higher the level of DII (more pro-inflammatory dietary habits) the greater were the levels of MAP [b-coefficient (95% CI): 7.23 (+1.86 to +12.59)] and PP, [b-coefficient (95% CI): 10.86 (+2.70 to +19.01)]. Diet’s inflammatory potential is related with various components of arterial pressure. Adherence to a more pro-inflammatory diet seems to be associated with increased arterial peripheral resistance and arterial stiffness.

Keywords: dietary inflammatory index, hypertension, mean arterial pressure, elderly

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Authors: Hong Wu, Naiji Lu

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Improvement of health behavior among people with chronic diseases is vital for increasing longevity and enhancing quality of life. This paper researched the causal effects of informal care on the compliance with doctor’s health advices – smoking control, dietetic regulation, weight control and keep exercising – among older people with chronic diseases in China, which is facing the challenge of aging. We addressed the selection bias by using propensity score matching in the estimation process. We used the 2011-2012 national baseline data of the China Health and Retirement Longitudinal Study. Our results showed informal care can help improve health behavior of older people. First, informal care improved the compliance of smoking controls: whether smoke, frequency of smoking, and the time lag between wake up and the first cigarette was all lower for these older people with informal care; Second, for dietetic regulation, older people with informal care had more meals every day than older people without informal care; Third, three variables: BMI, whether gain weight and whether lose weight were used to measure the outcome of weight control. There were no significant difference between group with informal care and that without for BMI and the possibility of losing weight. Older people with informal care had lower possibility of gain weight than that without; Last, for the advice of keeping exercising, informal care increased the probability of walking exercise, however, the difference between groups for moderate and vigorous exercise were not significant. Our results indicate policy makers who aim to decrease accidents should take informal care to elders into account and provide an appropriate policy to meet the demand of informal care. Our birth policy and postponed retirement policy may decrease the informal caregiving hours, so adjustments of these policies are important and urgent to meet the current situation of aged tendency of population. In addition, government could give more support to develop organizations to provide formal care, such as nursing home. We infer that formal care is also useful for health behavior improvements.

Keywords: chronic diseases, compliance, CHARLS, health advice, informal care, older people, propensity score matching

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Authors: Abdul-Ganiyu Fuseini, Bernice Redley, Helen Rawson, Lenore Lay, Debra Kerr

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Aim: The study aimed to develop and validate a culturally appropriate patient-reported outcome measure for measuring dignity for older adults during acute hospital admissions. Design: A three-phased mixed-method sequential exploratory design was used. Methods: Concept elicitation and generation of items for the scale was informed by older adults’ perspectives about dignity during acute hospitalization and a literature review. Content validity evaluation and pre-testing were undertaken using standard instrument development techniques. A cross-sectional survey design was conducted involving 270 hospitalized older adults for evaluation of construct and convergent validity, internal consistency reliability, and test–retest reliability of the scale. Analysis was performed using Statistical Package for the Social Sciences, version 25. Reporting of the study was guided by the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist. Results: We established the 15-item Hospitalized Older Adults’ Dignity Scale that has a 5-factor structure: Shared Decision-Making (3 items); Healthcare Professional-Patient Communication (3 items); Patient Autonomy (4 items); Patient Privacy (2 items); and Respectful Care (3 items). Excellent content validity, adequate construct and convergent validity, acceptable internal consistency reliability, and good test-retest reliability were demonstrated. Conclusion: We established the Hospitalized Older Adults Dignity Scale as a valid and reliable scale to measure dignity for older adults during acute hospital admissions. Future studies using confirmatory factor analysis are needed to corroborate the dimensionality of the factor structure and external validity of the scale. Routine use of the scale may provide information that informs the development of strategies to improve dignity-related care in the future. Impact: The development and validation of the Hospitalized Older Adults Dignity Scale will provide healthcare professionals with a feasible and reliable scale for measuring older adults’ dignity during acute hospitalization. Routine use of the scale may enable the capturing and incorporation of older patients’ perspectives about their healthcare experience and provide information that informs the development of strategies to improve dignity-related care in the future.

Keywords: dignity, older adults, hospitalisation, scale, patients, dignified care, acute care

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Authors: Janet Ige, Paul Pilkington, Selena Gray, Jane Powell

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Older adults from socially disadvantaged groups and Black and Minority Ethnic (BME) groups experience a higher burden of physical inactivity. Physical inactivity among BME groups is associated with the disproportionately higher level of health inequalities. People from minority ethnic groups encounter more barriers to physical activity. However, this is not often reported. There is very limited review-level evidence on the barriers and facilitators of physical activity among older adults from BME groups in the UK. This study aims to answer the following research question: what are the barriers and facilitators of physical activity participation among adults and older adults from BME background in the UK? To address this, we conducted a review of qualitative studies investigating the barriers and opportunities for physical activity among of BME adults and older adults in the UK. Method: This study is nested in an interpretive paradigm of meta-ethnography. A structured search for published literature was conducted on 6 electronic databases (MEDLINE, PsychINFO, Cumulative Index to Nursing & Allied Health Literature, Applied Social Sciences Index and Abstracts, Cochrane Database of Systematic Reviews, Allied and Complementary Medicine) from January 2007 to July 2017. Hand searching of the reference list of publications was performed in addition to a search conducted on Google Scholar to identify grey literature. Studies were eligible provided they employed any qualitative method and included participants identified as being BME, aged 50 and above, living in any community within the UK. In total, 1036 studies were identified from the structured search for literature, 718 studies were screened by titles after duplicates were removed. On applying the inclusion and exclusion criteria, a final selection of 10 studies was considered eligible for synthesis. Quality assessment was performed using the Critical Appraisal Skills Programme tool. Logic maps were used to show the relationship between factors that impact on physical activity participation among adults and older adults Result: Six key themes emerged from the data: awareness of the links between physical activity and health, interaction, and engagement with health professionals, cultural expectations and social responsibilities, appropriate environment, religious fatalism and practical challenges. Findings also showed that the barriers and facilitators of physical activity exist at the individual, community, and socio-economic, cultural and environmental level. There was a substantial gap in research among Black African groups. Findings from the review also informed the design of an ongoing survey investigating the experience and attitude of adults from Somali backgrounds towards physical activity in the UK. Conclusion: Identifying the barriers and facilitators of physical activity among BME groups is a crucial step in addressing the widening inequality gap. Findings from this study highlight the importance of engaging local BME residents in the design of exercise facilities within the community. This will ensure that cultural and social concerns are recognized and properly addressed.

Keywords: BME, UK, meta-ethnographic, adults

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Authors: Rui Lin, Jimmy Xiangji Huang, Gary Spraakman

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This forthcoming systematic review will underscore the imperative of leveraging technology to mitigate social isolation in older adults, particularly in the context of unprecedented global challenges such as the COVID-19 pandemic. With the continual evolution of technology, it becomes crucial to scrutinize the efficacy of interventions and discern how they can alleviate social isolation and augment social well-being among the elderly. This review will strive to clarify the best methods for older adults to utilize cost-effective and user-friendly technology and will investigate how the adaptation and execution of such interventions can be fine-tuned to maximize their positive outcomes. The study will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines to filter pertinent studies. We foresee conducting an analysis of articles and executing a narrative analysis to discover themes and indicators related to quality of life and, technology use and well-being. The review will examine how involving older adults at the community level, applying top practices from community-based participatory research, can establish efficient strategies to implement technology-based interventions designed to diminish social isolation and boost digital use self-efficacy. Applications based on mobile technology and virtual platforms are set to assume a crucial role not only in enhancing connections within families but also in connecting older adults to vital healthcare resources, fostering both physical and mental well-being. The review will investigate how technological devices and platforms can address the cognitive, visual, and auditory requirements of older adults, thus strengthening their confidence and proficiency in digital use—a crucial factor during enforced social distancing or self-isolation periods during pandemics. This review will endeavor to provide insights into the multifaceted benefits of technology for older adults, focusing on how tailored technological interventions can be a beacon of social and mental wellness in times of social restrictions. It will contribute to the growing body of knowledge on the intersection of technology and elderly well-being, offering nuanced understandings and practical implications for developing user-centric, effective, and inclusive technological solutions for older populations.

Keywords: older adults, health service delivery, digital health, social isolation, social well-being

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Authors: Marianne Paimre

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The COVID-19 crisis has prompted older people to adopt new technologies to facilitate their daily life. This study explored the relationships between socioeconomic indicators, technology acceptance, online health information seeking (OHIS), and health behavior (HB), including readiness for COVID-19 vaccination among Estonian older adults. A cross-sectional survey was conducted among 501 people aged ≥ 50 in 2020. Its findings indicate that the more recurrent the need for health information was (rho = .11, p<.05), and the more regularly one searched for it (rho = .14, p<.01), the more willing a person was to get vaccinated. Also, interest in digital applications corresponded to vaccination readiness (rho = .25, p<.001). However, this relationship did not emerge in the case of other health behaviors such as healthy diet and exercise. Differences in health information behavior (HIB) should be considered when developing effective means of health communication designed especially for crisis situations.

Keywords: older adults, technology acceptance, health information behavior, health behavior, COVID-19 pandemic

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Authors: Abdessalam Hijab, Eric Henry, Hafida Boulekbache

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The complexity of the city makes sustainable management of the urban environment more difficult. Managers are required to make significant human and technical investments, particularly in household waste collection (focus of our research). The aim of this communication is to propose a collaborative geographic multi-actor device (MGCD) based on the link between information and communication technologies (ICT) and geo-web tools in order to involve urban residents in household waste collection processes. Our method is based on a collaborative/motivational concept between the city and its residents. It is a geographic collaboration dedicated to the general public (citizens, residents, and any other participant), based on real-time allocation and geographic location of topological, geographic, and multimedia data in the form of local geo-alerts (location-specific problems) related to household waste in an urban environment. This contribution allows us to understand the extent to which residents can assist and contribute to the development of household waste collection processes for a better protected urban environment. This suggestion provides a good idea of how residents can contribute to the data bank for future uses. Moreover, it will contribute to the transformation of the population into a smart inhabitant as an essential component of a smart city. The proposed model will be tested in the Lamkansa sampling district in Casablanca, Morocco.

Keywords: information and communication technologies, ICTs, GeoWeb, geo-collaboration, city, inhabitant, waste, collection, environment

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Authors: Melissa Anguah Nortey

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As populations around the globe continue to age rapidly in an era of increasing life expectancies, the financial wellbeing of older adults becomes crucial. This has led to an extensive discourse on financial literacy and its role in attaining financial wellbeing. In Ireland, the aging demographic presents both opportunities and challenges concerning financial literacy and wellbeing. In addition to increasing life expectancy, evolving pension systems make it imperative for older adults to manage their finances effectively to sustain their quality of life in later years. However, research and relevant financial reports indicate that financial literacy levels among older populations in Ireland lags behind other European countries. Against this backdrop, the current study seeks to identify the financial literacy needs of older adults required to attain wellbeing in older age. Financial wellbeing refers to the ability to confidently manage money and be in a position to meet current and future financial needs. In recent years, the importance of financial wellbeing has been recognized globally due to its significant impact on mental and physical health, relationships, and overall quality of life. In regards to such global recognition, the Sustainable Development Goals (SDGs) outline an ambitious agenda to achieve global prosperity by 2030 by meeting objectives such as eradicating extreme poverty (SDG 1) and ensuring good health and well-being (SDG3). To achieve financial wellbeing, the importance of financial literacy is underscored as a key factor. Research has shown that financial literacy and responsible financial behavior are positively associated with financial wellbeing in retirement and in older age. Older persons are more vulnerable to financial mistakes and fraud due to declining financial literacy, making it essential for them to possess a strong understanding of financial concepts. Studies highlight the benefits of financial literacy for older persons to include the ability to maintain financial resilience. Moreover, financial literacy contributes to the physical and mental well-being of older adults. Older persons however face challenges such as declining cognitive abilities and health factors like increased medical expenses, which can negatively impact their financial literacy levels and reduce financial resilience. To address these challenges, recommendations from extant studies encourage financial literacy programs tailored for older adults should consider their cognitive abilities and health factors. Efforts to increase financial literacy in Ireland was borne out of a need to fill an information gap in understanding financial literacy. In contrast to several Northern European nations, Ireland exhibits low levels of financial literacy. The National financial Literacy strategy in Ireland was launched late 2023 to help increase the financial literacy needs of Irish people. So far, the Department of Finance has conducted a stakeholder engagement process to gather insights on existing financial literacy initiatives in Ireland. Subsequently, based on the findings of this assessment and informed by international best practices, the Department will initiate the development of a national strategy for financial literacy. The main aim of this qualitative research is thus to find out what knowledge and skills people in Ireland need to ensure financial wellbeing into older age.

Keywords: financial literacy, financial wellbeing, Ireland, older persons

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Authors: Peter Brink

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Much of the research examining sexuality in long-term care focus on individual experiences, specifically their past, present, and future lived experiences. We know little about long-term care home policies, how they relate to the LGBT community, or how accommodating long-term care homes are to the LGBT+ community. In many ways, residents who identify as LGBT+ have been invisible in long-term care homes. Up until the not-to-distant past, homosexuality was illegal, and discrimination was acceptable. Canada’s LGBT population has also suffered because of the HIV/AIDS epidemic. For these and other reasons, members of the LGBT community might resist entering long-term care or attempt to keep their sexuality secret. The goal of any long-term care home is to be a welcoming place, to display signs of inclusion, and to help residents and staff feel that they are embraced. From the perspective of the long-term care home, it is possible that many of these facilities do not necessarily see the need to mention gender identity or sexual orientation in their welcoming materials. However, from the perspective of the invisible minority, it may be important that these homes be more than just welcoming. This study examined the role of institutional policies in long-term care for residents who identify as LGBT.

Keywords: long-term care, LGBT, HIV/AIDS, policy

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Authors: Karen Armstrong

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Although invisible and fleeting, time is an essential variable in perception. Ritual is proposed as an antithesis to the passage of time, a way of linking our narratives with the past, present and future. This qualitative exploration examines a variety of award winning twentieth-century children’s picture books, specifically regarding the issues of time’s urgency and ritual with respect to children and grandparents. The paper will begin with a consideration of issues of time from the area of psychology, with regard to age, specifically contrasting later age and childhood. Next the value of ritual as represented by the presence of grandparents in children’s books. Specific instances of the contributions of grandparents or older adults with regard to this balancing function between time’s urgency and ritual will be discussed. Recommendations for future research include a consideration of grandparents’ or older characters’ depictions in books for older children.

Keywords: children's picture books, grandparents, ritual, time

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Authors: Smriti Mishra, Jaydip Barman, Shashi Kant Pandey

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Many scholars suggest that waterfront development projects have an all round impact on cities. However, their research stops short of considering the perception of local residents, of what they think about the impact of such developments and the kind of waterfront development which they would prefer to support. Therefore, this paper attempts to address this imbalance in the literature by analysing a survey of residents' perceptions of such developments. The paper discusses the issue in the Indian context by considering Sabarmati Riverfront Development Project (SRFD) of Ahmadabad. It gives an overview of the project components of the SRFD; discusses its development issues and concerns associated with it. It further examines the structural relationship between socio-economic and demographic attributes of local residents and their attitudes and perception towards the economic impact of such developments. The study suggests that the economic component that riverfront development will attract more investment in their community and that riverfront development will increase real estate tax revenue emerged as strong components. While the economic component of substantial premiums to developers, land owners and local government and the other of cost of developing riverfront facilities are too much of a burden on government and public sector agencies appear to be weaker economic components of the perceived economic impacts of urban riverfront development. This paper also gives an overview of the urban waterfront development in the global scenario. It highlights the need to consider residents perception in the development of such projects.

Keywords: urban waterfront development, riverfront, economic impact, resident perception, SRFD

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Authors: Zita Fomukong Andam

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The decision on where to host sport events does not depend on the national politicians or specific international sport event bodies but also involves the residents of the hosting country. Sport tourism is one of the fast growing industries in the world. Cameroonians consider sport as a point of unity and growth within the country. It has a huge variety of sporting activities like swimming, canoe racing, tug of war and most especially soccer well known as football. The football national team made an impact in 1990 at the FIFA world cup. They also won the African Nations Cup five times. Being the winner of the 2017 African Cup of Nations, they are to host the 2019 African cup of Nations. The purpose of this research is to analyse the impacts of sport tourism event in Cameroon and specifically examine how this event influences the residents. A deep research discourse conducted with randomly selected 300 inbound residents and 200 Cameroonian residents living abroad. Survey questionnaires, interviews and direct observations were carried out as a method of collecting data. The results showed that sport events brings a lot of prestige and honor to the country; generate revenues to the country’s economy and particularly to the local businesses. On the other hand, the results showed that the local residents lose their intimacy, privacy, and their daily life routine is affected. In addition to this, they face negative social inequalities and environmental impacts. Understanding these results the national government and international bodies might be able to contribute to future studies and propose efficient measures to maximize the positive benefits and minimize the negative benefits.

Keywords: sport Tourism, economic impact, resident altitude, african Cup of nations

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Authors: Marianne Simons, Sinan Kurt, Marjolein Stefens, Kai Karos, Johan Lataster

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As cultural diversity within older populations in European countries increases, the role of cultural background should be taken account of in aging studies. Bonding social capital (BSC), containing someone’s socio-emotional resources, is recognised as an important ingredient for wellbeing in old age and found to be associated with someone’s cultural background. The current study examined the association between BSC, loneliness and wellbeing in a sample including older Turkish migrants with a collectivistic cultural background and native Dutch older adults, both living in the Netherlands, characterised by an individualistic culture. A sample of 119 Turkish migrants (64.7% male; age 65-87, M(SD)=71.13(5.04) and 124 native Dutch adults (32.3% male, age 65-94, M(SD)= 71.9(5.32) filled out either an online or printed questionnaire measuring BSC, psychological, social and emotional well-being, loneliness and relevant demographic covariates. Regression analysis - including confounders age, gender, level of education, physical health and relationship - showed positive associations between BSC and respectively emotional, social and psychological well-being and a negative association with loneliness in both samples. Moderation analyses showed that these associations were significantly stronger for the Turkish older migrants than for their native peers. Measurement invariance analysis indicated partial metric invariance for the measurement of BSC and loneliness and non-invariance for wellbeing, calling for caution comparing means between samples. The results stress the importance of BSC for wellbeing of older migrants from collectivistic cultures living in individualistic countries. Previous research, shows a trend of older migrants displaying lower levels of BSC as well as associated variables, such as education, physical health, and financial income. This calls for more research of the interplay between demographic and psychosocial factors restraining mental wellbeing of older migrant populations. Measurement invariance analyses further emphasize the importance of taking cultural background into account in positive aging studies.

Keywords: positive aging, cultural background, wellbeing, social capital, loneliness

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Authors: Maureen Kamau, Gulnaz Mohamoud, Adelaide Lusambili, Njeri Nyanja

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Life expectancy has increased over the last century amongst older individuals, and in particular, those 60 years and over. The World Health Organization estimates that the world's population of persons over 60 years will rise to 22 per cent by the year 2050. Ageing is associated with increasing disability, multiple chronic conditions, and an increase in the use of health services. These multiple chronic conditions are managed with polypharmacy. Polypharmacy has numerous adverse effects including non-adherence, poor compliance to the various medications, reduced appetite, and risk of fall. Studies on polypharmacy and ageing are few and poorly understood especially in low and middle - income countries. The aim of this study was to explore the knowledge, attitudes and beliefs of older people towards polypharmacy. A qualitative study of 15 patients aged 60 years and above, taking more than five medications per day were conducted at the Aga Khan University using Semi-structured in-depth interviews. Three interviews were pilot interviews, and data analysis was performed on 12 interviews. Data were analyzed using NVIVO 12 software. A thematic qualitative analysis was carried out guided by Braun and Clarke (2006) framework. Themes identified; - knowledge of their co-morbidities and of the medication that older persons take, sources of information about medicines, and storage of the medication, experiences and attitudes of older patients towards polypharmacy both positive and negative, older peoples beliefs and their coping mechanisms with polypharmacy. The study participants had good knowledge on their multiple co-morbidities, and on the medication they took. The patients had positive attitudes towards medication as it enhanced their health and well-being, and enabled them to perform their activities of daily living. There was a strong belief among older patients that the medications were necessary for their health. All these factors enhanced compliance to the multiple medication. However, some older patients had negative attitudes due to the pill burden, side effects of the medication, and stigma associated with being ill. Cost of healthcare was a concern, with most of the patients interviewed relying on insurance to cover the cost of their medication. Older patients had accepted that the medication they were prescribed were necessary for their health, as it enabled them to complete their activities of daily living. Some concerns about the side effects of the medication arose, and brought about the need for patient education that would ensure that the patients are aware of the medications they take, and potential side effects. The effect that the COVID 19 pandemic had in the healthcare of the older patients was evident by the number of the older patients avoided coming to the hospital during the period of the pandemic. The relationship with the primary care physician and the older patients is an important one, especially in LMICs such as Kenya, as many of the older patients trusted the doctors wholeheartedly to make the best decision about their health and about their medication. Prescription review is important to avoid the use of potentially inappropriate medication.

Keywords: polypharmacy, older patients, multiple chronic conditions, Kenya, Africa, qualitative study, indepth interviews, primary care

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Authors: Kalpana Goel

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Australian social work schools are finding it difficult to find appropriate placements for the increasing number of international students enrolled in their Master of Social Work qualifying (MSWQ) programs. Anecdotally, it has been noticed that fewer social work students are ready to work with older people whose numbers are rising globally. An innovative and unique placement for international students enrolled in the MSWQ at one Australian university was organised in partnership with a community-based service working with older clients to meet two objectives: increasing the number of suitable placements for international students and preparing social work students to work with older people. Creative activities and projects were designed to provide meaningful engagement and experience in working with older people in the community. Students participated in a number of projects that were matched with their interest and capability in a 500-hour placement. The students were asked to complete an online survey after all work for the placement had been completed. The areas of assessment were: self-perceived change in perception towards age and older people, valued field placement experiences including reflective practice, knowledge and skill development, and constraints and challenges experienced in the placement. Findings revealed students’ increased level of confidence in applying social work theory to practice, developing effective communication and interpersonal skills, and use of innovation and creativity in preparing well-being plans with older adults. Challenges and constraints related to their limited English language ability and lack of cultural knowledge of the host society. It was recognised that extra support for these students and more planning in the beginning phase of placement are vital to placement success. Caution in matching students with clients of similar cultural background must be exercised to ensure that there is equity in task allocation and opportunities for wider experiences.

Keywords: field placement, international students, older people, social work

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Authors: W. Pungchompoo, A. Richardson, L. Brindle

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Background: The developing of a culturally acceptable end of life survey (the VOICES-ESRD/Thai questionnaire) is an essential instrument for evaluation health services provision of older persons with ESRD in Thailand. The focus of the questionnaire was on symptoms, symptom control and the health care needs of older people with ESRD who are managed without dialysis. Objective: The objective of this study was to develop and adapt VOICES to make it suitable for use in a population survey in Thailand. Methods: The mixed methods exploratory sequential design was focussed on modifying an instrument. Data collection: A cognitive interviewing technique was implemented, using two cycles of data collection with a sample of 10 bereaved carers and a prototype of the Thai VOICES questionnaire. Qualitative study was used to modify the developing a culturally acceptable end of life survey (the VOICES-ESRD/Thai questionnaire). Data analysis: The data were analysed by using content analysis. Results: The revisions to the prototype questionnaire were made. The results were used to adapt the VOICES questionnaire for use in a population-based survey with older ESRD patients in Thailand. Conclusions: A culturally specific questionnaire was generated during this second phase and issues with questionnaire design were rectified.

Keywords: VOICES-ESRD/Thai questionnaire, cognitive interviewing, end of life survey, health services provision, older persons with ESRD

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Authors: Cory B. Lord

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Falls among the elderly population has become an area of concern in healthcare today. The negative impacts of falls lead to increased morbidity, mortality, and financial burdens for both patients and healthcare systems. Falls in the United States is reported at an annual rate of 36 million in those aged 65 and older. Each year, one out of four people in this age group will suffer a fall, with 20% of these falls causing injury. The setting for this Doctor of Nursing Practice (DNP) project was a memory care unit in an assisted living community, as these facilities house cognitively impaired older adults. These communities lack fall prevention programs; therefore, the need exists to add to the body of knowledge to positively impact this population. The objective of this project was to reduce fall rates through the implementation of the Center for Disease Control and Prevention (CDC) STEADI (stopping elderly accidents, deaths, and injuries) program. The DNP project performed was a quality improvement pilot study with a pre and post-test design. This program was implemented in the memory care setting over 12 weeks. The project included an educational session for staff and a fall risk assessment with appropriate resident referrals. The three aims of the DNP project were to reduce fall rates among the elderly aged 65 and older who reside in the memory care unit, increase staff knowledge of STEADI fall prevention measures after an educational session, and assess the willingness of memory care unit staff to adopt an evidence-based a fall prevention program. The Donabedian model was used as a guiding conceptual framework for this quality improvement pilot study. The fall rate data for 12 months before the intervention was evaluated and compared to post-intervention fall rates. The educational session comprised of a pre and post-test to assess staff knowledge of the fall prevention program and the willingness of staff to adopt the fall prevention program. The overarching goal was to reduce falls in the elderly population who live in memory care units. The results of the study showed, on average that the fall rate during the implementation period of STEADI (μ=6.79) was significantly lower when compared to the prior 12 months (μ= 9.50) (p=0.02, α = 0.05). The mean staff knowledge scores improved from pretest (μ=77.74%) to post-test (μ=87.42%) (p=0.00, α= 0.05) after the education session. The results of the willingness to adopt a fall prevention program were scored at 100%. In summation, implementing the STEADI fall prevention program can assist in reducing fall rates for residents aged 65 and older who reside in a memory care setting.

Keywords: dementia, elderly, falls, STEADI

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Authors: Ya-Hui Lee, Ching-Yi Lu, Hui-Chuan Wei

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The purpose of this research was to explore the relation between proactive coping and well-being of middle-aged adults. We conducted survey research that with t-test, one way ANOVA, Pearson correlation and stepwise multiple regression to analyze. This research drew on a sample of 395 participants from the senior learning centers of Taiwan. The results provided the following findings: 1.The participants from different residence areas associated significant difference with proactive coping, but not with well-being. 2. The participants’ perceived of financial level associated significant difference with both proactive coping and well-being. 3. There was significant difference between participants’ income and well-being. 4. The proactive coping was positively correlated with well-being. 5. From stepwise multiple regression analysis showed that two dimensions of proactive coping had positive predictability. Finally, these results of this study can be provided as references for designing older adult educational programs in Taiwan.

Keywords: middle-age and older adults, learners, proactive coping, well-being

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Authors: Amy Darwin, Claire Blacklock

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Background: Existing literature about delivering evidence-based mental health and psychosocial support (MHPSS) in emergency settings is limited. It is difficult to monitor and evaluate the approach to MHPSS in informal refugee camps such as ‘The Jungle’ in Calais, where there are multiple service providers and where the majority of providers are volunteers. AIM: To identify experiences of MHPSS delivery by service providers in an informal camp environment in Calais, France and describe MHPSS barriers and opportunities in this type of setting. Method: Qualitative semi-structured interviews were conducted with 13 individuals from different organisations offering MHPSS in Calais and analysed using conventional content analysis. Results: Unsafe, uncertain and unsanitary conditions in the camp meant MHPSS was difficult to implement, and such conditions contributed to the poor mental health of the residents. The majority of MHPSS was offered by volunteers who lacked resources and training, and there was no overall official camp leadership which meant care was poorly coordinated and monitored. Strong relationships existed between volunteers and camp residents, but volunteers felt frustrated that they could not deliver the kind of MHPSS that they felt residents required. Conclusion: While long-term volunteers had built supportive relationships with camp residents, lack of central coordination and leadership of MHPSS services and limited access to trained professionals made implementation of MHPSS problematic. Similarly, the camp lacked the necessary infrastructure to meet residents’ basic needs. Formal recognition of the camp, and clear central leadership were identified as necessary steps to improving MHPSS delivery.

Keywords: calais, mental health, refugees, the jungle, MHPSS

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Authors: Ajit Kumar Sah, Rajesh Kumar Jha, Phoolgen Sah, Dev Kumar Shah

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Older individuals often suffer from multiple systemic diseases and are particularly more vulnerable to potentially inappropriate medicine prescribing. Inappropriate medication can cause serious medical problem for the elderly. The purpose of this study was to determine the prevalence of potentially inappropriate medicine (PIM) prescribing in older Nepalese patients in a medicine outpatient department. Beers’ criteria are the most widely used tools to assess PIM to elderly patients. Prospective observational analysis of drugs prescribed in medicine out-patient department (OPD) of a hospital of Bharatpur, Chitwan, Nepal during November 2011 to October 2012 to 869 older adults aged 65 years and above. The use of potentially inappropriate medications (PIM) in elderly patients was analyzed using Beers Criteria updated to 2013. In the 869 patients included the average number of drugs prescribed per prescription was 5.56. The most commonly used drugs were atenolol (24.3%), amlodipine (23.16%), paracetamol (17.6%), salbutamol (15.72%) and vitamin B complex (13.26%). The total number of medications prescribed was 4833. At least one instance of PIM was experienced by approximately 26.3% of patients when evaluated using the Beers criteria. Potentially inappropriate medications are highly prevalent among older patients attending medical OPD and are associated with a number of medications prescribed. Further research is warranted to study the impact of PIMs towards health-related outcomes in these elderly.

Keywords: Beers criteria, elderly, polypharmacy, potentially inappropriate medicines

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Authors: Xi Vivien Wu, Emily Neo Kim Ang, Yi Jung Tung, Wenru Wang

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Background and Objective: The increase in life expectancy and emphasis on self-reliance for the older adults are global phenomena. As such, lifelong learning in the community is considered a viable means of promoting successful and active aging. This systematic review aims to examine various lifelong learning programs for community-dwelling older adults and to synthesize the contents and outcomes of these lifelong learning programs. Methods: A systematic search was conducted in July to December 2016. Two reviewers were engaged in the process to ensure creditability of the selection process. Narrative description and analysis were applied with the support of a tabulation of key data including study design, interventions, and outcomes. Results: Eleven articles, which consisted of five randomized controlled trials and six quasi-experimental studies, were included in this review. Interventions included e-health literacy programs with the aid of computers and the Internet (n=4), computer and Internet training (n=3), physical fitness programs (n=2), music program (n=1), and intergenerational program (n=1). All studies used objective measurement tools to evaluate the outcomes of the study. Conclusion: The systematic review indicated lifelong learning programs resulted in positive outcomes in terms of physical health, mental health, social behavior, social support, self-efficacy and confidence in computer usage, and increased e-health literacy efficacy. However, the lifelong learning programs face challenges such as funding shortages, program cuts, and increasing costs. A comprehensive lifelong learning program could be developed to enhance the well-being of the older adults at a more holistic level. Empirical research can be done to explore the effectiveness of this comprehensive lifelong learning program.

Keywords: community-dwelling older adults, e-health literacy program, lifelong learning program, the wellbeing of the older adults

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Authors: Sanja Obradovic, Vladimir Stojanovic

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The purpose of this paper is to examine the attitudes of residents toward sustainable tourism development in the Bačko Podunavlje Biosphere Reserve (BPBR) in northwestern Serbia. BPBR is a part of 'the European Amazon', world's first five-country Transboundary UNESCO Biosphere Reserve 'Mura-Drava-Danube'. Sustainable tourism development requires the engagement of local residents. Within the initial stage of tourism development, it is important to address residents' attitudes from the early beginning, thus further involve the local community through all phases of development, which in return will largely influence overall success. Data were collected through in-person (face-to-face) questionnaire. The research also addresses the quality of the sustainable tourism attitude scale (SUS-TAS), perceived as an instrument to measure local communities' attitudes towards sustainable tourism development. SUS-TAS has seven variables, which are named as environmental sustainability, perceived social cost, long-term planning, perceived economic benefit, community center economy, ensuring visitor satisfaction, and maximizing community participation. Data were analyzed using SPSS. Findings indicate that residents have a positive attitude toward the development of sustainable tourism in the BPBR. They also recognized the importance of environmental sustainability and preservation for future generations. The study shows that BPBR has a very good community to support sustainable tourism activities in each area considered.

Keywords: biosphere reserve, local resident's attitude, sustainable tourism attitude scale, SUS-TAS, sustainable tourism

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Authors: Elaine Wong Yee-Sing

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Older adults are at high risk of chronic health conditions in Singapore. A closer examination at all facets of their aging process has revealed that they may not be necessary aging well. This demands for an increasing healthcare services brought to their home environment due to limited mobility and in the interest of time management. The home environment is an ideal setting to implement self-directed health promoting activities at their convenience and enable family’s support and motivation. This research protocol aims to explore their healthcare concerns, and creation of age appropriate interventions targeted to improve their chronic disease biomarkers. Convenience sampling of 130 families residing in private housing within five major districts in Singapore will be selected to participate in the health intervention. Statistical Package for Social Science 25 will be used to examine the pre and post screening results of their lipid, glycaemia and anthropometric outcomes. Using focus interviews, data results will be translated and transcribed to investigate on enablers, barriers and improvement on these services. Both qualitative and quantitative research outcomes are crucial to examine the impact of these services for these older adults living in private housing as they are not exposed to government subsidized community health programs. It is hypothesized that provision of relevant yet engaging health programs at their homes may mitigate the rising burden of chronic health conditions and result in successful aging outcomes among older Singaporeans.

Keywords: chronic diseases, health program, older adults, residential homes

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Authors: Da Jiang, Helene H. Fung, Jennifer C. Lay, Maureen C. Ashe, Peter Graf, Christiane A. Hoppmann

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Being alone is often equated with loneliness. Yet, recent findings suggest that the objective state of being alone (i.e., solitude) can have both positive and negative connotations. The present research aimed to examine (1) affective experience in daily solitude; and (2) the association between everyday affect in solitude and well-being. We examined the distinct roles of culture and immigration in moderating these associations. Using up to 35 daily life assessments of momentary affect, solitude, and emotional well-being in two samples (Vancouver, Canada, and China), the study compared older adults who aged in place (local Caucasians in Vancouver Canada and local Hong Kong Chinese in Hong Kong, China) and older adults of different cultural heritages who immigrated to Canada (immigrated Caucasians and immigrated East Asians). We found that older adults of East Asian heritage experienced more positive and less negative affect when alone than did Caucasians. Reporting positive affect in solitude was more positively associated with well-being in older adults who had immigrated to Canada as compared to those who had aged in place. These findings speak to the unique effects of culture and immigration on the affective correlates of solitude and their associations with well-being in old age.

Keywords: solitude, emotion, age, immigration, culture

Procedia PDF Downloads 156