101
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Narushima M, Kawabata M. "Fiercely independent": Experiences of aging in the right place of older women living alone with physical limitations. J Aging Stud 2020; 54:100875. [PMID: 32972619 PMCID: PMC7480772 DOI: 10.1016/j.jaging.2020.100875] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Revised: 08/22/2020] [Accepted: 08/26/2020] [Indexed: 10/31/2022]
Abstract
This study explores the experience of aging among older Canadian women with physical limitations who live by themselves. While aging in place has been a policy priority in rapidly greying Canada, a lack of complementary public supports poses challenges for many older adults and their family members. Employing a qualitative methodology, and drawing from the notion of aging in the right place, we collected personal narratives of 12 women (aged 65 to 92) in two geographic areas in Ontario, including residents of regular houses, apartments, condominiums, assisted living and community housing for seniors. Through thematic analysis, we identified four overarching themes: 1) striving to continue on "at home", 2) living as a "strong independent woman", 3) the help needed to support their "independence", and 4) social activities to maintain self. Our findings illustrate how, despite their mobility limitations, older women can change their residential environment and their behavior by deploying the coping strategies and resources they have developed over time. However, we also found that older women are largely silent about their needs, and that experiences varied depending on life histories, health conditions, and the availability of supports in their wider environment (home care, alternative housing options, accessible transportation, opportunities for social and physical activities). We hope these findings will incite further studies and discussion to help make aging in the right place a real choice for anyone who wishes to do so.
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Affiliation(s)
- Miya Narushima
- Department of Health Sciences, Brock University, 1812 Sir Isaac Brock Way, St. Catharines, Ontario L2S 3A1, Canada.
| | - Makie Kawabata
- Department of public health Nursing, Kansai University of International Studies, 1-18 Aoyama, Shijimi-cho, Miki, Hyogo 673-0521, Japan.
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102
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Golant SM. The distance to death perceptions of older adults explain why they age in place: A theoretical examination. J Aging Stud 2020; 54:100863. [PMID: 32972627 PMCID: PMC7489887 DOI: 10.1016/j.jaging.2020.100863] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 08/10/2020] [Accepted: 08/13/2020] [Indexed: 12/11/2022]
Abstract
Older persons prefer to age in place or stay put in their current dwellings and move less frequently than any other age group. However, current residential mobility theories do not fully account for these preferences and behaviors because they focus on why older people move rather than on why they remain in their dwellings and do not consider the temporal or human developmental context of these residential decisions. It is essential to understand why older persons are reluctant to move because their ability to age successfully-have healthy, independent, active, and enjoyable lives-depends on where they live. When they stay put, they also rely more on family caregivers and paid home care providers to maintain their independence, rather than on the supportive services offered by senior group facilities, such as assisted living. They demand more home modification and financial service products, and their residential decisions influence the supply of housing that younger populations can potentially buy or rent. This paper's theoretical analysis proposes that Carstensen's socioemotional selectivity theory (SST), a lifespan theory of motivation, improves our understanding of why older persons age in place-either in their dwellings or more broadly in their communities. It offers an alternative interpretation of how life-changing events, such as retirement, lower incomes, spousal death, physical limitations, and health declines, influence their residential decisions. Whereas residential mobility theories view these transitions as disruptions that change the appropriateness or congruence of where older people live, SST proposes that older persons perceive these events as signs or cues that they are closer to death and must differently prioritize their goals and emotional experiences. Feeling their time is "running out," older persons are motivated to stay put because moving requires preparations that are physically and emotionally trying and they are able to adapt to their current housing shortcomings. Their residential environments are now also a source of difficult-to-replace positive emotions and provide them with a supportive network of intimate and reliable interpersonal relationships. It is challenging for them to learn how to safely and efficiently conduct their usual activities and routines in another location and to establish new residential attachments and social connections. They would benefit from any net positive emotional payoffs only in a distant future, an unattractive prospect when they perceive a limited time left to live. Empirical studies must test the theoretical propositions presented in this paper. However, the disproportionally large projected future growth of the age 75 and older population with a heightened awareness of their limited time left to live should be a strong rationale for such investigations.
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Affiliation(s)
- Stephen M Golant
- Department of Geography, University of Florida, Gainesville, Florida 32611, USA.
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103
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Age-Friendly Features in Home and Community and the Self-Reported Health and Functional Limitation of Older Adults: the Role of Supportive Environments. J Urban Health 2020; 97:471-485. [PMID: 32601773 PMCID: PMC7392977 DOI: 10.1007/s11524-020-00462-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
This study aims to identify age-friendly community features that are associated with better health for older adults. This cross-sectional study utilized the 2015 AARP Age-Friendly Communities (AFC) Survey, which includes 66 home and community features that fall within the eight domains specified by the World Health Organization (WHO)'s age-friendly cities guidelines. Two measures of health (self-rated health and functional limitations) were examined using multi-level linear and logistic regressions. Both a greater perceived availability of age-friendly features in communities and a good person-environment fit were associated with better self-rated health and a lower likelihood of reporting functional limitations. The domains of outdoor spaces and buildings, transportation, and social participation and inclusion were consistently associated with these outcomes. Promoting age-friendliness in outdoor spaces and buildings, transportation, and social participation and inclusion domains by providing green spaces, neighborhood safety programs, transportation options, and social opportunities may be the most effective way to support healthy and active aging.
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104
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Tang F, Zhang W, Chi I, Li M, Dong XQ. Importance of Activity Engagement and Neighborhood to Cognitive Function Among Older Chinese Americans. Res Aging 2020; 42:226-235. [PMID: 32266866 PMCID: PMC10481429 DOI: 10.1177/0164027520917064] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/08/2023]
Abstract
This study investigates the differential associations of activity engagement and perceived neighborhood characteristics (i.e., cohesion, disorder, sense of community) with cognitive measures. Using data of 2,713 Chinese older adults in Chicago, who completed two interviews between 2011 and 2015, we identified three activity domains: reading, social, and games. In general, engagement in more reading and social activities was associated with better baseline cognitive function, but the positive effects tapered off over time in some cases. Neighborhood cohesion had both direct and indirect effects on cognitive function. Engagement in social activities mediated the neighborhood cohesion effects, that is, living in a cohesive neighborhood promoted social activities and consequently benefited cognitive function. Findings speak to the importance of activity engagement and neighborhood cohesion for cognition among the U.S. Chinese older adults. Future research is needed to investigate the longitudinal relationships of activity engagement and environmental factors with cognitive change.
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Affiliation(s)
- Fengyan Tang
- School of Social Work, University of Pittsburgh, PA, USA
| | - Wei Zhang
- Department of Sociology, University of Hawai’i at Mānoa, Honolulu, Hawai’i
| | - Iris Chi
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, USA
| | - Mengting Li
- Institute for Health, Health Care Policy and Aging Research, Rutgers, The State University of New Jersey, New Brunswick, NJ, USA
| | - Xin Qi Dong
- Institute for Health, Health Care Policy and Aging Research, Rutgers, The State University of New Jersey, New Brunswick, NJ, USA
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105
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Ho SH, Tan DPS, Tan PJ, Ng KW, Lim ZZB, Ng IHL, Wong LH, Ginting ML, Yuen B, Mallya UJ, Chong MS, Wong CH. The development and validation of a prototype mobility tracker for assessing the life space mobility and activity participation of older adults. BMC Geriatr 2020; 20:251. [PMID: 32698799 PMCID: PMC7374961 DOI: 10.1186/s12877-020-01649-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Accepted: 07/13/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND There is increasing interest in examining the life space mobility and activity participation of older adults in the community using sensor technology. Objective data from these technologies may overcome the limitations of self-reported surveys especially in older adults with age-associated cognitive impairment. This paper describes the development and validation of a prototype hybrid mobility tracker for assessing life space mobility and out-of-home activities amongst 33 community-ambulant older adults in Singapore. METHODS A hybrid mobility tracker was developed by combining a passive Global Positioning System logger, tri-axial accelerometer and radio-frequency identification. Objective measures of life space, derived from 1 week of tracking data using Geographic Information Systems, were the maximum Euclidean distance from home (Max Euclid) and the area of the minimum convex polygon surrounding all GPS waypoints (MCP area). Out-of-home activities were quantified by visually identifying the total number of activity nodes, or places where participants spent ≥5 min, from mobility tracks. Self-reported measure of life space in 4 weeks was obtained using the University of Alabama at Birmingham Study of Life Space Assessment (UAB-LSA) questionnaire. Self-reported out-of-home activities were recorded daily in a travel diary for 1 week. Bivariate correlations were used to examine convergent validity between objective and subjective measures of life space and out-of-home activities. RESULTS The mean age of participants was 69.2 ± 7.1 years. The mean UAB-LSA total score was 79.1 ± 17.4. The median (range) Max Euclid was 2.44 km (0.26-7.50) per day, and the median (range) MCP area was 3.31 km2 (0.03-34.23) per day. The UAB-LSA total score had good correlation with Max Euclid (r = 0.51, p = 0.002), and moderate correlation with MCP area (r = 0.46, p = 0.007). The median (range) total number of activity nodes measured by tracker of 20 (8-47) per week had a good correlation with the total activity count recorded in the travel diaries of 15 (6-40) per week (r = 0.52, p = 0.002). CONCLUSIONS The tracking system developed to understand out-of-home travel was feasible and reliable. Comparisons with the UAB-LSA and travel diaries showed that it provided reliable and valid spatiotemporal data to assess the life space mobility and activity participation of older adults.
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Affiliation(s)
- Soon Hoe Ho
- Geriatric Education and Research Institute Ltd, 2 Yishun Central 2, Singapore, 768024, Singapore
| | - Dion Piu Sern Tan
- NDR Medical Technology Pte Ltd, 75 Ayer Rajah Crescent #02-19, Singapore, 139953, Singapore
| | - Pey June Tan
- Geriatric Education and Research Institute Ltd, 2 Yishun Central 2, Singapore, 768024, Singapore
| | - Ka Wei Ng
- NDR Medical Technology Pte Ltd, 75 Ayer Rajah Crescent #02-19, Singapore, 139953, Singapore
| | - Zoe Zon Be Lim
- Geriatric Education and Research Institute Ltd, 2 Yishun Central 2, Singapore, 768024, Singapore
| | - Isabel Hui Leng Ng
- Geriatric Education and Research Institute Ltd, 2 Yishun Central 2, Singapore, 768024, Singapore
| | - Lok Hang Wong
- Geriatric Education and Research Institute Ltd, 2 Yishun Central 2, Singapore, 768024, Singapore
| | - Mimaika Luluina Ginting
- Geriatric Education and Research Institute Ltd, 2 Yishun Central 2, Singapore, 768024, Singapore
| | - Belinda Yuen
- Lee Kuan Yew Centre for Innovative Cities, Singapore University of Technology and Design, 8 Somapah Road, Singapore, 487372, Singapore
| | - Ullal Jagadish Mallya
- Department of Geriatric Medicine, Khoo Teck Puat Hospital, 90 Yishun Central, Singapore, 768828, Singapore
| | - Mei Sian Chong
- Geriatric Education and Research Institute Ltd, 2 Yishun Central 2, Singapore, 768024, Singapore.,The Geriatric Practice, 38 Irrawaddy Road #09-21, Mount Elizabeth Novena Specialist Centre, Singapore, 329563, Singapore
| | - Chek Hooi Wong
- Geriatric Education and Research Institute Ltd, 2 Yishun Central 2, Singapore, 768024, Singapore. .,Department of Geriatric Medicine, Khoo Teck Puat Hospital, 90 Yishun Central, Singapore, 768828, Singapore. .,Health Services and Systems Research, Duke-NUS Medical School, 8 College Road, Singapore, 169857, Singapore.
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106
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Lu S. Perceived Housing Conditions, Home Satisfaction, Control Beliefs over Aging Experience, and Life Satisfaction among Chinese Older Adults: A Path Analysis Study. JOURNAL OF AGING AND ENVIRONMENT 2020. [DOI: 10.1080/26892618.2020.1793441] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Affiliation(s)
- Shiyu Lu
- Sau Po Centre on Ageing, The University of Hong Kong, Pokfulam, Hong Kong
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107
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Owens OL, Beer JM, Revels AA, White K. The Lived Experiences of Older Low-Income African Americans Living Alone: Implications for Aging in Place in the United States. JOURNAL OF AGING AND ENVIRONMENT 2020. [DOI: 10.1080/26892618.2020.1780662] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Otis L. Owens
- College of Social Work, University of South Carolina, Columbia, SC, USA
| | - Jenay M. Beer
- College of Public Health and School of Social Work, University of Georgia, Athens, GA, USA
| | - Asa A. Revels
- Department of Health Promotion, Education, and Behavior, University of South Carolina, Columbia, SC, USA
| | - Kellee White
- School of Public Health, University of Maryland, College, MD, USA
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108
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Duan-Porter W, Ullman K, Rosebush C, McKenzie L, Ensrud KE, Ratner E, Greer N, Shippee T, Gaugler JE, Wilt TJ. Interventions to Prevent or Delay Long-Term Nursing Home Placement for Adults with Impairments-a Systematic Review of Reviews. J Gen Intern Med 2020; 35:2118-2129. [PMID: 31898134 PMCID: PMC7352002 DOI: 10.1007/s11606-019-05568-5] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Revised: 11/05/2019] [Accepted: 11/20/2019] [Indexed: 12/14/2022]
Abstract
BACKGROUND With continued growth in the older adult population, US federal and state costs for long-term care services are projected to increase. Recent policy changes have shifted funding to home and community-based services (HCBS), but it remains unclear whether HCBS can prevent or delay long-term nursing home placement (NHP). METHODS We searched MEDLINE (OVID), Sociological Abstracts, PsycINFO, CINAHL, and Embase (from inception through September 2018); and Cochrane Database of Systematic Reviews, Joanna Briggs Institute Database, AHRQ Evidence-based Practice Center, and VA Evidence Synthesis Program reports (from inception through November 2018) for English-language systematic reviews. We also sought expert referrals. Eligible reviews addressed HCBS for community-dwelling adults with, or at risk of developing, physical and/or cognitive impairments. Two individuals rated quality (using modified AMSTAR 2) and abstracted review characteristics, including definition of NHP and interventions. From a prioritized subset of the highest-quality and most recent reviews, we abstracted intervention effects and strength of evidence (as reported by review authors). RESULTS Of 47 eligible reviews, most focused on caregiver support (n = 10), respite care and adult day programs (n = 9), case management (n = 8), and preventive home visits (n = 6). Among 20 prioritized reviews, 12 exclusively included randomized controlled trials, while the rest also included observational studies. Prioritized reviews found no overall benefit or inconsistent effects for caregiver support (n = 2), respite care and adult day programs (n = 3), case management (n = 4), and preventive home visits (n = 2). For caregiver support, case management, and preventive home visits, some reviews highlighted that a few studies of higher-intensity models reduced NHP. Reviews on other interventions (n = 9) generally found a lack of evidence examining NHP. DISCUSSION Evidence indicated no benefit or inconsistent effects of HCBS in preventing or delaying NHP. Demonstration of substantial impacts on NHP may require longer-term studies of higher-intensity interventions that can be adapted for a variety of settings. Registration PROSPERO # CRD42018116198.
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Affiliation(s)
- Wei Duan-Porter
- Center for Care Delivery and Outcomes Research, VAHSRD Minneapolis VA Health Care System, Minneapolis, MN, USA.
- University of Minnesota Medical School, Minneapolis, MN, USA.
| | - Kristen Ullman
- Center for Care Delivery and Outcomes Research, VAHSRD Minneapolis VA Health Care System, Minneapolis, MN, USA
| | - Christina Rosebush
- Center for Care Delivery and Outcomes Research, VAHSRD Minneapolis VA Health Care System, Minneapolis, MN, USA
- School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Lauren McKenzie
- Center for Care Delivery and Outcomes Research, VAHSRD Minneapolis VA Health Care System, Minneapolis, MN, USA
| | - Kristine E Ensrud
- Center for Care Delivery and Outcomes Research, VAHSRD Minneapolis VA Health Care System, Minneapolis, MN, USA
- University of Minnesota Medical School, Minneapolis, MN, USA
- School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Edward Ratner
- University of Minnesota Medical School, Minneapolis, MN, USA
- Geriatric Research Education & Clinical Center, Minneapolis VA Health Care System, Minneapolis, MN, USA
| | - Nancy Greer
- Center for Care Delivery and Outcomes Research, VAHSRD Minneapolis VA Health Care System, Minneapolis, MN, USA
| | - Tetyana Shippee
- School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Joseph E Gaugler
- School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Timothy J Wilt
- Center for Care Delivery and Outcomes Research, VAHSRD Minneapolis VA Health Care System, Minneapolis, MN, USA
- University of Minnesota Medical School, Minneapolis, MN, USA
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109
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Isaacson M, Tripathi A, Samanta T, D’Ambrosio L, Coughlin J. Giving Voice to the Environment as the Silent Partner in Aging: Examining the Moderating Roles of Gender and Family Structure in Older Adult Wellbeing. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E4373. [PMID: 32570808 PMCID: PMC7345893 DOI: 10.3390/ijerph17124373] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Revised: 06/15/2020] [Accepted: 06/16/2020] [Indexed: 11/17/2022]
Abstract
Gerontological scholarship has long seen the environment to be a silent partner in aging. Environmental Gerontology, an established approach in Social Gerontology, has shown how the everyday lives of older adults are deeply entangled in socio-spatial environments. Adopting an Environmental Gerontology approach, we explore social and cultural dimensions of the association between out-of-home mobility and wellbeing among older adults in a north western city of India. This was established by combining high resolution time-space data collected using GPS receivers, questionnaire data and time diaries. Following a multi-staged analytical strategy, we first examine the correlation between out-of-home mobility and wellbeing using bivariate correlation. Second, we introduce gender and family structure into regression models as moderating variables to improve the models' explanatory power. Finally, we use our results to reinterpret the Ecological Press Model of Aging to include familial structure as a factor that moderates environmental stress. Findings emphasize the central role that social constructs play in the long-established relationship between the environment and the wellbeing of older adults.
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Affiliation(s)
- Michal Isaacson
- Gerontology Department, University of Haifa, Haifa 3498838, Israel
| | - Ashwin Tripathi
- Indian Institute of Technology, Gandhinagar, Gujarat 382355, India; (A.T.); (T.S.)
| | - Tannistha Samanta
- Indian Institute of Technology, Gandhinagar, Gujarat 382355, India; (A.T.); (T.S.)
| | - Lisa D’Ambrosio
- AgeLab, Massachusetts Institute of Technology, Cambridge, MA 02139, USA; (L.D.); (J.C.)
| | - Joseph Coughlin
- AgeLab, Massachusetts Institute of Technology, Cambridge, MA 02139, USA; (L.D.); (J.C.)
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110
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Emerging evolution trends of studies on age-friendly cities and communities: a scientometric review. AGEING & SOCIETY 2020. [DOI: 10.1017/s0144686x20000562] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
AbstractPopulation ageing, together with urbanisation, has become one of the greatest challenges throughout the world in the 21st century. Approximately one million people turn 60 each month worldwide. By 2050, more than 20 per cent of the global population is predicted to be 60 years old or above. Thus, an increasing need is evident for age-friendly communities, services and structures. Numerous studies on age-friendly cities and communities (AFCCs) have been conducted over the past decade. The large volume literature makes it necessary to figure out key areas and the evolution trends of studies on AFCCs. Therefore, this paper aims to provide a comprehensive review of existing literature pertaining to AFCCs. A total of 231 collected publications are analysed and visualised by CiteSpace. According to the keywords and document co-citation networks that are generated, the foundation, hot topics and domains of AFCC research are grouped. Three major themes, namely the characteristics of AFCCs, the application of the World Health Organization's framework in urban and rural areas worldwide, and the measurement of cities’ and communities’ age-friendliness, are identified. In addition, a roadmap of AFCC research is developed. The results of this research will therefore benefit researchers and practitioners.
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111
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Franke T, Sims-Gould J, Chaudhury H, Winters M, McKay H. Re-framing mobility in older adults: an adapted comprehensive conceptual framework. QUALITATIVE RESEARCH IN SPORT, EXERCISE AND HEALTH 2020; 12:336-349. [DOI: 10.1080/2159676x.2019.1575269] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/25/2018] [Accepted: 01/02/2019] [Indexed: 07/19/2023]
Affiliation(s)
- Thea Franke
- Center for Hip Health and Mobility, University of British Columbia, Vancouver, BC, Canada
| | - Joanie Sims-Gould
- Center for Hip Health and Mobility, University of British Columbia, Vancouver, BC, Canada
| | - Habib Chaudhury
- Department of Gerontology, Simon Fraser University, Vancouver, BC, Canada
| | - Meghan Winters
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada
| | - Heather McKay
- Center for Hip Health and Mobility, University of British Columbia, Vancouver, BC, Canada
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112
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Zhou W, Oyegoke AS, Sun M, Zhu H. Older Clients' Pathway through the Adaptation System for Independent Living in the UK. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17103640. [PMID: 32455789 PMCID: PMC7277662 DOI: 10.3390/ijerph17103640] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 05/07/2020] [Accepted: 05/12/2020] [Indexed: 11/23/2022]
Abstract
Housing adaptation is recognized as an effective intervention for successful independent living and has been given a greater political priority. However, the current adaptation implementation is fragmented and sometimes confusing. This study is aimed at examining blockages in the adaptation system in the United Kingdom (UK) and identifying practical ways to tackle them. It adopted a mixed-method sequential explanatory research strategy. A questionnaire survey was first conducted in all local authorities in England, Scotland and Wales. This was followed by individual interviews and a focus group with professionals and older clients. The study found that multiple organizations are involved during the delivery of housing adaptations; poor cooperation between them is a major barrier to a seamless service. The adaptation process involves five key stages; there are many inconsistencies and inequities in the process across local authorities. Significant delays are found at all stages, the average length of time taken to complete an adaptation is unacceptably long. There are also many inconsistencies and inequities across different local authorities. This study identified some common deficiencies, which cause inefficiencies and ineffectiveness in housing adaptation practices and makes some recommendations on specific actions that need to be taken at both national and local levels to address them.
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Affiliation(s)
- Wusi Zhou
- School of Public Administration, Hangzhou Normal University, Hangzhou 311121, China;
- Correspondence:
| | | | - Ming Sun
- School of Architecture, Design and the Built Environment, Nottingham Trent University, Nottingham NG1 4FQ, UK;
| | - Hailong Zhu
- School of Public Administration, Hangzhou Normal University, Hangzhou 311121, China;
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113
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Stephens C, Allen J, Keating N, Szabó Á, Alpass F. Neighborhood environments and intrinsic capacity interact to affect the health-related quality of life of older people in New Zealand. Maturitas 2020; 139:1-5. [PMID: 32747034 DOI: 10.1016/j.maturitas.2020.05.008] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Revised: 05/06/2020] [Accepted: 05/12/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Following the WHO 2015 policy framework, we tested the effects of older people's intrinsic capacity and their perceptions of their neighborhood environments on mental and physical health-related quality of life (QoL) outcomes across two years. STUDY DESIGN Participants (mean age = 66) were drawn from two waves of a longitudinal study of aging (n = 2910) in 2016 and 2018. Regression analyses tested the main and interaction effects of intrinsic capacity and neighborhood factors on health-related QoL at T2 (controlling for T1). MAIN OUTCOME MEASURES Intrinsic capacity was assessed with number of chronic conditions. Neighborhood perceptions was assessed with measures of housing suitability, neighborhood satisfaction, and neighborhood social cohesion. Health-related QoL was assessed with SF12 physical and mental health component scores. RESULTS Perceptions of greater neighborhood accessibility and more trust among neighbours were associated with better mental health-related QoL two years later, but not to changes in physical health-related QoL. A significant interaction between intrinsic capacity and neighborhood access to facilities on physical health-related QoL over time showed that those reporting lower neighborhood access experienced a stronger impact of intrinsic capacity on physical health-related QoL. CONCLUSIONS The neighborhood environment is important to the wellbeing of older people and is amenable to policy interventions. We need more work on the aspects of the immediate environment that support QoL in older age. This study points to the need for accessible facilities and cohesive neighborhoods to support health.
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Affiliation(s)
| | - Joanne Allen
- School of Psychology, Massey University, Palmerston North, New Zealand.
| | - Norah Keating
- Centre for Innovative Ageing, Swansea University, Swansea, Wales, UK; Optentia Research Unit, North-West University, South Africa.
| | - Ágnes Szabó
- School of Health, Victoria University of Wellington, Wellington, New Zealand.
| | - Fiona Alpass
- School of Psychology, Massey University, Palmerston North, New Zealand.
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114
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Schafer MH, Settels J, Upenieks L. As Goes the City? Older Americans' Home Upkeep in the Aftermath of the Great Recession. SOCIAL PROBLEMS 2020; 67:379-397. [PMID: 32362689 PMCID: PMC7176998 DOI: 10.1093/socpro/spz022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The private home is a crucial site in the aging process, yet the upkeep of this physical space often poses a challenge for community-dwelling older adults. Previous efforts to explain variation in disorderly household conditions have relied on individual-level characteristics, but ecological perspectives propose that home environments are inescapably nested within the dynamic socioeconomic circumstances of surrounding spatial contexts, such as the metro area. We address this ecological embeddedness in the context of the Great Recession, an event in which some U.S. cities saw pronounced and persistent declines across multiple economic indicators while other areas rebounded more rapidly. Panel data (2005-6 and 2010-11) from a national survey of older adults were linked to interviewer home evaluations and city-level economic data. Results from fixed-effects regression support the hypothesis that older adults dwelling in struggling cities experienced an uptick in disorderly household conditions. Findings emphasize the importance of city-specificity when probing effects of a downturn. Observing changes in home upkeep also underscores the myriad ways in which a city's most vulnerable residents- older adults, in particular-are affected by its economic fortunes.
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Park S, Smith J, Dunkle RE, Ingersoll-Dayton B, Antonucci TC. Health and Social-Physical Environment Profiles Among Older Adults Living Alone: Associations With Depressive Symptoms. J Gerontol B Psychol Sci Soc Sci 2020. [PMID: 28637214 DOI: 10.1093/geronb/gbx003] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVES We examined differences in depressive symptoms among people 65 and older who live alone, exploring whether these differences are associated with both health and environmental contexts. METHOD Data are from the 2006 wave of Health Retirement Study (N = 2,956, age range: 65-104). We used a two-step cluster analytical approach to identify subgroups of health-limitation profiles and environmental profiles. Logistic regression models determined associations between subgroups and depressive symptoms. RESULTS Cluster analysis identified four health-profile subgroups (sensory-cognitively impaired, physically impaired, multiply impaired, and healthy) and three different physical-social environmental-profile subgroups (physically average/socially unsupported, physically unsupported/socially supported, and physically supported/socially above average). Compared to members of healthier groups, members of the multiply impaired group were the oldest and were more likely both to live in senior housing and to have depressive symptoms if they lived in a physically average/socially unsupported environment. Members of the sensory-cognitively impaired group were more likely to have depressive symptoms when they lived in a physically unsupported/socially supported environment. DISCUSSION Findings regarding the range of both health and social-physical environmental profiles as well as the associations between person-environment profiles combinations (fit) and depressive symptomatology have important policy and intervention implications.
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Affiliation(s)
- Sojung Park
- Brown School of Social Work, Washington University in Saint Louis, Missouri
| | - Jacqui Smith
- Department of Psychology and Institute for Social Research, Ann Arbor
| | - Ruth E Dunkle
- School of Social Work, University of Michigan, Ann Arbor
| | | | - Toni C Antonucci
- Department of Psychology and Institute for Social Research, Ann Arbor
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116
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Seifert A. Day-to-Day Contact and Help Among Neighbors Measured in the Natural Environment. Innov Aging 2020; 4:igaa009. [PMID: 32352040 PMCID: PMC7181409 DOI: 10.1093/geroni/igaa009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Empirical evidence suggests that the concept of "neighboring" (i.e., social contact and social support within a neighborhood) is related to between-person differences in well-being among older adults. However, little is known about the within-person differences in older adults' everyday lives, which limits the ecological validity of prior findings. This study examined within-person associations between neighboring and the existence of positive valence, loneliness, and attachment to one's neighborhood. RESEARCH DESIGN AND METHODS The sample consisted of 4,620 observations of 20 days, drawn from 77 adults aged between 61 and 90 years. A mobile application on a smartphone was used for data collection. RESULTS The results of the multilevel analysis suggest that daily contact with one's neighbors was not significantly associated with daily positive valence, but it was positively related to daily feelings of not being alone and daily attachment to one's neighborhood. DISCUSSION AND IMPLICATIONS The study makes noteworthy contributions to the field of gerontology by applying a micro-longitudinal research design to assess real-life within-person information.
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Affiliation(s)
- Alexander Seifert
- Institute of Sociology, University of Zurich, Switzerland
- University Research Priority Program (URPP) “Dynamics of Healthy Aging”, University of Zurich, Switzerland
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117
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Abstract
AbstractMaintaining physical, psychological and social wellbeing is integral to older adults being able to age well in their community. Therefore, an environment that facilitates and supports ageing well is imperative. The aim of this study was to explore the views of older people about their preparation for ageing well in a rural community. Forty-nine community-dwelling older people aged between 65 and 93 years participated in a semi-structured and digitally recorded interview. The resulting qualitative data were analysed using a thematic approach. Three main themes were identified: (a) ‘sensible planning: the right place and the right people’; (b) ‘remaining independent: “it's up to me”’; and (c) ‘facing challenges: “accepting my lot”’. Findings from this study identify that across all age groups, these older people were actively and realistically preparing for ageing well. All valued their independence, believing individually they were responsible for being independent and planning for their future. Consequently, environmental planners, policy makers and practitioners need to understand that older people are a heterogeneous group and ageing policies should be geared towards older people's individual abilities and circumstances. Consideration of diversity enables inclusion of older people with a wide range of abilities and needs to achieve the perceived goals of ageing well.
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118
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Kahlert D, Ehrhardt N. Out-of-Home Mobility and Social Participation of Older People: a Photo-Based Ambulatory Assessment Study. JOURNAL OF POPULATION AGEING 2020. [DOI: 10.1007/s12062-020-09278-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
AbstractResearch has shown that social participation contributes to older people’s healthy ageing. Out-of-home mobility may promote higher levels of social participation among older people. However, mobility and social participation are sophisticated constructs. Social participation can be distinguished among different levels, such as being alone, being alone surrounded by others, interacting with others or engaging in activities together. Social participation and time spent in out-of-home-mobility can be difficult to remember and therefore difficult to assess. Picture-based ambulatory assessment provides valid and reliable information about people’s mobility as well as their level of participation with high ecological validity. The aim of the study was to investigate older people’s level of social participation and its association with high or low out-of-home mobility. In sum, 23072 pictures (mean per person = 2307; SD = 686.7) involving ten older people (mean age = 75.4 years; SD = 7.5 years) living in southwestern Germany were analysed. They were asked to wear a wearable camera for two consecutive days. Images were automatically captured every 15 seconds. Image analysis shows that study participants spent most of their time alone (at approximately 35% of analysed time). Out-of-home mobility was associated with higher levels of social participation, such as helping others (chi2 = 200,664, df = 5, p < .001). Picture-based ambulatory assessment can assist in the gathering of necessary sophisticated information that is difficult to assess via questionnaires or other similar methods.
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119
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Wahl HW, Gerstorf D. Person–Environment Resources for Aging Well: Environmental Docility and Life Space as Conceptual Pillars for Future Contextual Gerontology. THE GERONTOLOGIST 2020; 60:368-375. [DOI: 10.1093/geront/gnaa006] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Indexed: 11/13/2022] Open
Abstract
Abstract
A variety of different disciplines in the study of aging have long acknowledged that individual functioning and development are profoundly shaped by the contexts people live in. The Gerontologist has played a central role in publishing and fostering theoretical and empirical work geared toward better understanding many of the questions that revolve around the how and the why. To illustrate, we consider in a first step the environmental docility hypothesis and the life space construct as two landmark concepts published in The Gerontologist and review how these—in conjunction with the later introduced proactivity perspective—have shaped for decades and continue to shape the larger field of (contextual) gerontology. In a second step, we discuss how these two entirely separate conceptualizations could be integrated in a late pas-de-deux. In doing so, we also make use of Wahl & Gerstorf's conceptual framework for studying COntext Dynamics in Aging (CODA) to discuss how these classic concepts can promote future gerontological research.
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Affiliation(s)
- Hans-Werner Wahl
- Network Aging Research
- Institute of Psychology, Heidelberg University, Heidelberg, Germany
| | - Denis Gerstorf
- Department of Psychology, Humboldt University, Berlin, Germany
- Department of Human Development and Family Studies, Pennsylvania State University, University Park, Pennsylvania
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120
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Traoré M, Vuillermoz C, Chauvin P, Deguen S. Influence of Individual and Contextual Perceptions and of Multiple Neighborhoods on Depression. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E1958. [PMID: 32192057 PMCID: PMC7143570 DOI: 10.3390/ijerph17061958] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Revised: 03/02/2020] [Accepted: 03/09/2020] [Indexed: 11/16/2022]
Abstract
The risk of depression is related to multiple various determinants. The consideration of multiple neighborhoods daily frequented by individuals has led to increased interest in analyzing socio-territorial inequalities in health. In this context, the main objective of this study was (i) to describe and analyze the spatial distribution of depression and (ii) to investigate the role of the perception of the different frequented spaces in the risk of depression in the overall population and in the population stratified by gender. Data were extracted from the 2010 SIRS (a French acronym for "health, inequalities and social ruptures") cohort survey. In addition to the classic individual characteristics, the participants reported their residential neighborhoods, their workplace neighborhoods and a third one: a daily frequented neighborhood. A new approach was developed to simultaneously consider the three reported neighborhoods to better quantify the level of neighborhood socioeconomic deprivation. Multiple simple and cross-classified multilevel logistic regression models were used to analyze the data. Depression was reported more frequently in low-income (OR = 1.89; CI = [1.07-3.35]) or middle-income (OR = 1.91; CI = [1.09-3.36]) neighborhoods and those with cumulative poverty (OR = 1.64; CI = [1.10-2.45]). In conclusion, a cumulative exposure score, such as the one presented here, may be an appropriate innovative approach to analyzing their effects in the investigation of socio-territorial inequalities in health.
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Affiliation(s)
- Médicoulé Traoré
- INSERM, Sorbonne Université, Institut Pierre Louis d’Épidémiologie et de Santé Publique, IPLESP, Department of social epidemiology, F75012 Paris, France; (C.V.); (P.C.); (S.D.)
| | - Cécile Vuillermoz
- INSERM, Sorbonne Université, Institut Pierre Louis d’Épidémiologie et de Santé Publique, IPLESP, Department of social epidemiology, F75012 Paris, France; (C.V.); (P.C.); (S.D.)
| | - Pierre Chauvin
- INSERM, Sorbonne Université, Institut Pierre Louis d’Épidémiologie et de Santé Publique, IPLESP, Department of social epidemiology, F75012 Paris, France; (C.V.); (P.C.); (S.D.)
| | - Séverine Deguen
- INSERM, Sorbonne Université, Institut Pierre Louis d’Épidémiologie et de Santé Publique, IPLESP, Department of social epidemiology, F75012 Paris, France; (C.V.); (P.C.); (S.D.)
- EHESP School of Public Health, F35043 Rennes, France
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121
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Au A, Lai DWL, Yip HM, Chan S, Lai S, Chaudhury H, Scharlach A, Leeson G. Sense of Community Mediating Between Age-Friendly Characteristics and Life Satisfaction of Community-Dwelling Older Adults. Front Psychol 2020; 11:86. [PMID: 32194465 PMCID: PMC7064721 DOI: 10.3389/fpsyg.2020.00086] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Accepted: 01/13/2020] [Indexed: 01/07/2023] Open
Abstract
The growth of age-friendly community initiatives underscores a paradigmatic shift from the individual to the community, addressing dynamic transactions between people and the environment they are living in. The purpose of the present study is to address the gap in existing research by examining the psycho-social effects of the sense of community in mediating between WHO domains of age-friendliness and the life satisfaction of older adults. Data were obtained from 898 participants in Hong Kong. Path analysis was conducted. Two AFC domains, Social Participation as well as Community Support and Health Services, were found to be associated with life satisfaction. Sense of community was found to mediate between these two domains and life satisfaction. The implications of these findings are discussed with reference to developing opportunities in social participation of older adults and enhancing community/health support services in the context of developing sustainability in the community.
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Affiliation(s)
- Alma Au
- Department of Applied Social Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong
| | - Daniel W. L. Lai
- Department of Applied Social Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong
| | - Ho-ming Yip
- Department of Applied Social Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong
| | - Stephen Chan
- Department of Applied Social Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong
| | - Simon Lai
- Department of Applied Social Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong
| | - Habib Chaudhury
- Department of Gerontology, Simon Fraser University, Burnaby, BC, Canada
| | - Andrew Scharlach
- School of Social Welfare, University of California, Berkeley, Berkeley, CA, United States
| | - George Leeson
- Oxford Institute of Population Ageing, University of Oxford, Oxford, United Kingdom
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122
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Affiliation(s)
- Helena Müller
- Research Training Group “Doing Transitions”, Goethe University, Frankfurt, Germany
| | - Frank Oswald
- Interdisciplinary Aging Research (IAW), Goethe University, Frankfurt, Germany
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123
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Ahn M, Kang J, Kwon HJ. The Concept of Aging in Place as Intention. THE GERONTOLOGIST 2020; 60:50-59. [PMID: 30605499 DOI: 10.1093/geront/gny167] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES This study aimed to frame the aging in place (AIP) concept within an extended theory of planned behavior (TPB) model incorporating environmental domains. The proposed model depicts the direct and indirect effects of environmental domains on AIP intention. The environmental domains related to meanings of home embrace personal, built, and interpersonal environments. As partial mediators between the environmental domains and AIP intention, TPB components (attitude, subjective norm, and perceived behavioral control toward AIP) were included to the model. METHODS The study sample comprised older adults aged 60 and older living in their own homes in the United States. Participants (N = 650) were obtained through an online survey with a nationwide sample. Path analyses were used to test hypothesized relationships within the proposed model. RESULTS The results confirmed the significant mediating role of the TPB components between the path from personal, built, and interpersonal environments to AIP intention. Except for one built environmental construct (housing satisfaction), personal and interpersonal environmental constructs were found to indirectly affect AIP intention. One of the interpersonal environmental constructs, social connectedness, was revealed as the strongest factor in this relationship. IMPLICATIONS One major implication was drawn from the role of social connectedness and neighborhood satisfaction toward AIP intention. These factors operate beyond an individual level and are closely interrelated. Because social connectedness can be promoted or discouraged by community-level physical or social interventions, the findings of this study confirm the critical role of community-level planning and programs to support healthy aging among older adults.
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Affiliation(s)
- Mira Ahn
- School of Family and Consumer Sciences, Texas State University, San Marcos
| | - Jiyun Kang
- School of Family and Consumer Sciences, Texas State University, San Marcos
| | - Hyun Joo Kwon
- Department of Interior and Environmental Design, Pusan National University, Busan, Republic of Korea
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124
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Schlomann A, Seifert A, Zank S, Woopen C, Rietz C. Use of Information and Communication Technology (ICT) Devices Among the Oldest-Old: Loneliness, Anomie, and Autonomy. Innov Aging 2020; 4:igz050. [PMID: 31911953 PMCID: PMC6938466 DOI: 10.1093/geroni/igz050] [Citation(s) in RCA: 53] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Indexed: 01/28/2023] Open
Abstract
Background and Objectives A good person–environment-fit has positive effects on well-being in old age. As digital technologies are an integral part of older adults’ environments, we predicted that the use of information and communication technologies (ICT) is associated with subjective well-being among the oldest-old. Specifically, we compared different user groups of ICT devices (nonusers, users of nonweb-connected ICT, users of web-connected ICT) and analyzed the relations among ICT use and three domains of subjective well-being (loneliness, anomie, autonomy). Research Design and Methods We performed a quantitative data analysis using data from the first representative state-wide survey study in North-Rhine Westphalia, Germany on quality of life and well-being of the oldest-old (n = 1,698; age range: 80–103; 9% long-term care). Multiple regression analyses were applied. Results The findings revealed that 25.9% of all individuals aged 80 years and older reported using web-connected ICT, in contrast to 38.5% who do not use ICT at all. Individuals who used web-connected ICT reported lower levels of loneliness and anomie, and higher levels of autonomy. These differences remain significant when controlling for indicators of social inclusion and individual characteristics. Discussion and Implications This study investigated an underexplored group in terms of ICT use, shedding light on the relationship between ICT use and subjective well-being. The oldest-old generally use ICT in their everyday life but an age-related digital divide still exists. To avoid negative consequences of nonuse digital infrastructures and technology training for older adults need to be established.
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Affiliation(s)
- Anna Schlomann
- Department of Special Education and Rehabilitation Science, Faculty of Human Sciences, University of Cologne, Germany
| | - Alexander Seifert
- University Research Priority Program "Dynamics of Healthy Aging", Switzerland.,Center of Competence for Gerontology, University of Zurich, Switzerland
| | - Susanne Zank
- Department of Special Education and Rehabilitation Science, Faculty of Human Sciences, University of Cologne, Germany
| | - Christiane Woopen
- Cologne Center for Ethics, Rights, Economics, and Social Sciences of Health (CERES), Germany.,Research Unit Ethics, Faculty of Medicine and University Hospital Cologne, University of Cologne, Germany
| | - Christian Rietz
- Mixed Methods Research, Faculty of Educational and Social Sciences, Heidelberg University of Education, Germany
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125
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Shi C, Hu B. Preferences for Formal Social Care in Rural and Urban China: Evidence from a National Survey. JOURNAL OF GERONTOLOGICAL SOCIAL WORK 2020; 63:19-40. [PMID: 31885325 DOI: 10.1080/01634372.2019.1709246] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Revised: 12/22/2019] [Accepted: 12/22/2019] [Indexed: 06/10/2023]
Abstract
This study investigates older people's preferences for social care in rural and urban China. The data come from the China Longitudinal Aging Social Survey (CLASS) which collected information from a nationally representative sample of 10,682 Chinese older people aged 60 and over in 2014. Guided by the ecological model of aging, multilevel logistic regression analyses were conducted to identify the factors associated with preferred care arrangements. We found that older people in urban China are more likely than those in rural China to accept care home services or prefer government-provided care. Educational qualifications and the number of surviving children strongly and consistently predict older people's preferences for formal care in both rural and urban China. Proximity to care home facilities and higher income are associated with an increase in the willingness to live in a care home in urban China, but they are not significant predictors of preferences for formal care in rural China. We argue that a one-size-fits-all social care policy may not be well-received in the Chinese older population. The government may want to consider social care policies where support is tailored to suit older people's varied preferences.
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Affiliation(s)
- Cheng Shi
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, China
- Centre for Social Welfare Studies, Beijing Normal University, Beijing, China
| | - Bo Hu
- Care Policy and Evaluation Centre (CPEC), Department of Health Policy, London School of Economics and Political Science, London, UK
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126
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Advancing understanding of person-environment interaction in later life: One step further. J Aging Stud 2019; 51:100821. [DOI: 10.1016/j.jaging.2019.100821] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2019] [Revised: 09/30/2019] [Accepted: 10/05/2019] [Indexed: 11/21/2022]
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127
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Calderón-Larrañaga A, Vetrano DL, Welmer AK, Grande G, Fratiglioni L, Dekhtyar S. Psychological correlates of multimorbidity and disability accumulation in older adults. Age Ageing 2019; 48:789-796. [PMID: 31579908 PMCID: PMC6814086 DOI: 10.1093/ageing/afz117] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Revised: 07/08/2019] [Accepted: 08/15/2019] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND/OBJECTIVES attitudes toward life and health are emerging as important psychological contributors to health heterogeneity in ageing. We aimed to explore whether different psychological factors were associated with the rate of chronic disease and disability accumulation over time. DESIGN population-based cohort study between 2001 and 2010. SETTING Swedish National study on aging and care in Kungsholmen. SUBJECTS adults aged 60 and older (N = 2293). METHODS linear mixed models were employed to study the association of life satisfaction, health outlook, resistance to illness, sickness orientation, and health worry with the rate of accumulation of chronic diseases and impaired basic and instrumental activities of daily living. Models were adjusted for demographic, clinical, social, personality and lifestyle factors. Analyses were repeated after excluding individuals with multimorbidity or disability at baseline. RESULTS high life satisfaction and positive health outlook were consistently associated with a lower rate of accumulation and progression of multimorbidity (β -0.064 95% confidence interval [CI] -0.116, -0.011; β -0.065 95% CI -0.121, -0.008, respectively) and disability (β -0.063 95% CI -0.098, -0.028; β -0.042 95% CI -0.079, -0.004, respectively) over time. This was true even for people without multimorbidity or disability at baseline and after adjusting for all covariates. CONCLUSIONS positive attitudes toward life in general and health in particular may be especially important in old age, when the cumulative effects of biological and environmental deficits lead to accelerated health decline. These findings should encourage researchers to use measures of psychological well-being to better understand the multifactorial and diverse process of ageing.
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Affiliation(s)
- Amaia Calderón-Larrañaga
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm University, Stockholm, Sweden
| | - Davide Liborio Vetrano
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm University, Stockholm, Sweden
- Department of Geriatrics, Università Cattolica del Sacro Cuore, Rome, Italy
- Centro di Medicina dell’Invecchiamento, IRCCS Fondazione Policlinico “A. Gemelli”, Rome, Italy
| | - Anna-Karin Welmer
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm University, Stockholm, Sweden
| | - Giulia Grande
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm University, Stockholm, Sweden
| | - Laura Fratiglioni
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm University, Stockholm, Sweden
- Stockholm Gerontology Research Center, Sweden
| | - Serhiy Dekhtyar
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm University, Stockholm, Sweden
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128
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Lee H, Park S, Changu L. The effect of living in communal homes on the depressive symptoms of older women living in rural areas: the mediating role of the socio-physical environment. J Women Aging 2019; 32:68-90. [PMID: 31663838 DOI: 10.1080/08952841.2019.1681887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
This study examined the effects of the village communal living model on depressive symptoms, focusing on mediating roles of perceived environment among rural older women in South Korea. Data came from the sample of residents in 18 housings and their peers in the conventional housing (n = 168). Propensity score analysis and structural equation modeling were used. The results showed the effect of living in VCH on depressive symptoms was mediated distinct aspect of socio-physical environment.
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Affiliation(s)
- Hyunjoo Lee
- Department of Social Welfare, Daegu University, Gyeongsan-si, Republic of Korea
| | - Sojung Park
- Brown School of Social Work, Washington University in Saint Louis, Saint Louis, Missouri, USA
| | - Lee Changu
- Heungdeok Community Welfare Center, Munkyung-si, Korea
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129
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Zhang CQ, Chung PK, Zhang R, Schüz B. Socioeconomic Inequalities in Older Adults' Health: The Roles of Neighborhood and Individual-Level Psychosocial and Behavioral Resources. Front Public Health 2019; 7:318. [PMID: 31709222 PMCID: PMC6823619 DOI: 10.3389/fpubh.2019.00318] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Accepted: 10/15/2019] [Indexed: 11/19/2022] Open
Affiliation(s)
- Chun-Qing Zhang
- Department of Sport and Physical Education, Faculty of Social Sciences, Hong Kong Baptist University, Kowloon Tong, Hong Kong.,School of Psychology, Faculty of Health Sciences, Curtin University, Bentley, WA, Australia
| | - Pak-Kwong Chung
- Department of Sport and Physical Education, Faculty of Social Sciences, Hong Kong Baptist University, Kowloon Tong, Hong Kong
| | - Ru Zhang
- Department of Sports Science and Physical Education, Faculty of Education, The Chinese University of Hong Kong, Hong Kong, China
| | - Benjamin Schüz
- Institute for Public Health and Nursing, University of Bremen, Bremen, Germany
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130
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Vitorino LM, Low G, Lucchetti G. Is the Physical Environment Associated with Spiritual and Religious Coping in Older Age? Evidence from Brazil. JOURNAL OF RELIGION AND HEALTH 2019; 58:1648-1660. [PMID: 30927202 DOI: 10.1007/s10943-019-00796-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
In this cross-sectional Brazilian survey, we examined associations between aspects of physical environment (PE) and spiritual/religious coping (SRC) behaviors. Our studied sample was 77 nursing homes (NH) and 326 community-dwelling residents (CDRs). Aspects of the PE were measured using the environmental domain of the WHOQOL-BREF. SRC was assessed using the BRIEF SRC scale. The PE was significantly associated with positive SRC alone and differed between the two studied samples. "Feeling safe in daily life" and "having access to health services" were positively associated with positive SRC behaviors in NH residents. "Having access to information" and "adequate transport" were significant among CDRs. Positive SRC behaviors are influenced by PE and should be considered in geriatric and gerontology care.
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Affiliation(s)
- Luciano Magalhães Vitorino
- Faculty of Medicine, Federal University of Juiz de Fora, Juiz de Fora, Brazil.
- Faculty of Medicine of Itajubá, Av. Rennó Júnior, N° 368, São Vicente, Itajubá, Minas Gerais, 37502-138, Brazil.
| | - Gail Low
- Faculty of Nursing, 4rd Floor Edmonton Clinical Health Academy, University of Alberta, Edmonton, AB, T6G 1C9, Canada
| | - Giancarlo Lucchetti
- School of Medicine, Federal University of Juiz de Fora, Luz Interior Street, N° 150, apt 601, Estrela Sul, Juiz de Fora, 36030-776, Brazil
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131
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The temporal aspects of mobility intentions: older people's reflections on present and future support arrangements. AGEING & SOCIETY 2019. [DOI: 10.1017/s0144686x19001223] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
AbstractDiscourses on later-life housing and care are polarised. Ageing in place – typically in one's long-term dwelling – is often presented as the most desirable living arrangement, while moving to a congregate environment tends to be regarded as a last resort. Such polarised discourses obscure older people's experiences as they contemplate needs for housing, health and social care. To expand current understandings of mobility intentions, this paper examines ‘time work’ – or actions undertaken to exert some agency over time – as older people with chronic health conditions and disabilities navigate present and future support arrangements. Based on an interpretive analysis of qualitative interviews with 22 older persons receiving home care in Ontario, Canada, I identify three themes that highlight the temporal aspects of mobility intentions: (a) maintaining continuity with the past and present, (b) constructing alternative futures and (c) facing precarity. Focusing on time work shows how people make sense of ageing in place and/or relocating not only in relation to their physical, social and psychological capacities, but also in relation to perceptions of the past, present and future. Time work, moreover, has implications for feelings of security in the present and a sense of control over the future. Based on these findings, I make suggestions for developing a comprehensive continuum of supports, so all older people can make meaningful choices concerning housing and care.
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132
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Granbom M, Perrin N, Szanton S, Cudjoe TK, Gitlin LN. Household Accessibility and Residential Relocation in Older Adults. J Gerontol B Psychol Sci Soc Sci 2019; 74:e72-e83. [PMID: 30388250 PMCID: PMC6748711 DOI: 10.1093/geronb/gby131] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES It is unclear how home environmental factors influence relocation decisions. We examined whether indoor accessibility, entrance accessibility, bathroom safety features, housing type, and housing condition were associated with relocations either within the community or to residential care facilities. METHODS We used prospective data over 4 years from the nationally representative National Health and Aging Trends Study in the United States of Medicare beneficiaries 65 years and older living in the community (N = 7,197). We used multinomial regression analysis with survey weights. RESULTS Over the 4 years, 8.2% of the population moved within the community, and 3.9% moved to residential care facilities. After adjusting for demographics and health factors, poor indoor accessibility was found to be associated with moves within the community but not to residential care facilities. No additional home environmental factors were associated with relocation. DISCUSSION One-floor dwellings, access to a lift, or having a kitchen, bedroom, and bathroom on the same floor may help older adults age in place. Understanding which modifiable home environmental factors trigger late-life relocation, and to where, has practical implications for developing policies and programs to help older adults age in their place of choice.
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Affiliation(s)
- Marianne Granbom
- Department of Community-Public Health, Center for Innovative Care in Aging,
School of Nursing, Johns Hopkins University, Baltimore, Maryland
- Department of Health Sciences, Lund University, Sweden
| | - Nancy Perrin
- Department of Community-Public Health, Center for Innovative Care in Aging,
School of Nursing, Johns Hopkins University, Baltimore, Maryland
| | - Sarah Szanton
- Department of Community-Public Health, Center for Innovative Care in Aging,
School of Nursing, Johns Hopkins University, Baltimore, Maryland
| | - Thomas K.M. Cudjoe
- Center on Aging and Health, Johns Hopkins Medical Institutions,
Baltimore, Maryland
| | - Laura N Gitlin
- Department of Community-Public Health, Center for Innovative Care in Aging,
School of Nursing, Johns Hopkins University, Baltimore, Maryland
- College of Nursing and Health Professions, Drexel University,
Philadelphia, Pennsylvania
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133
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Amoah PA. The Relationship among Functional Health Literacy, Self-Rated Health, and Social Support among Younger and Older Adults in Ghana. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16173188. [PMID: 31480487 PMCID: PMC6747074 DOI: 10.3390/ijerph16173188] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Revised: 08/22/2019] [Accepted: 08/26/2019] [Indexed: 11/16/2022]
Abstract
It is well established that health literacy positively affects health outcomes, and social support influences this association. What remains unclear is which aspect of social support (instrumental, informational, and emotional support) is responsible for this effect and whether the influence differs from one population group to another. This study addresses these lacunae. It examines the impact each type of support makes on the relation between functional health literacy (FHL) and self-rated health status among younger and older adults in Ghana. Data were pooled from two cross-sectional surveys, together comprising 521 participants in the Ashanti Region. The results indicated that young adults were more likely to possess sufficient FHL and perceive their health more positively than older adults. While FHL was positively associated with health status, the relation was stronger when young adults received a high level of emotional support. Among older persons, informational support substantially moderated the association between FHL and health status. Thus, social support modifies the relations between FHL and health status among younger and older adults in different ways and to different degrees. Therefore, interventions to improve FHL and health amongst younger and older adults should pay due regard to relevant aspects of social support.
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Affiliation(s)
- Padmore Adusei Amoah
- School of Graduate Studies; Asia Pacific Institute of Ageing Studies; Centre for Social Policy & Social Change, Lingnan University, Hong Kong (SAR).
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134
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Park S, Kwon E, Kim B, Han Y. Person-Environment Fit Approach to Trajectories of Cognitive Function Among Older Adults Who Live Alone: Intersection of Life-Course SES Disadvantage and Senior Housing. J Gerontol B Psychol Sci Soc Sci 2019; 74:e1-e12. [PMID: 31038160 PMCID: PMC6703233 DOI: 10.1093/geronb/gbz025] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES Drawing from life course and environmental perspectives, we examined the trajectory of cognitive function and how senior housing moderates the effects of life-course socioeconomic status (SES) disadvantage among older people living alone over time. METHOD Six waves of the Health and Retirement Study (HRS) were used with multilevel growth modeling to analyze developmental patterns of cognitive function over time and how various forms of life-course SES disadvantage affect cognitive function depending on senior housing residency status. RESULTS At baseline, we found a positive role of senior housing in four subgroups: SES disadvantage in childhood only, unstable mobility pattern (disadvantage in childhood and old age only), downward mobility (no disadvantage in childhood, but in later two life stages), and cumulative disadvantage (all three life stages). Over time, the positive role of senior housing for the unstable and the most vulnerable group persisted. DISCUSSION Our findings provide a much-needed practical and theoretical underpinning for environmental policy-making efforts regarding vulnerable elders who live alone.
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Affiliation(s)
- Sojung Park
- Brown School of Social Work, Washington University in Saint Louis, Missouri
| | - Eunsun Kwon
- Department of Social Work, St. Cloud State University, Minnesota
| | - BoRin Kim
- Department of Social Work, University of New Hampshire, Durham
| | - Yoonsun Han
- Department of Social Welfare, Seoul National University, Seoul, Korea
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135
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Gaugler JE, Bain LJ, Mitchell L, Finlay J, Fazio S, Jutkowitz E. Reconsidering frameworks of Alzheimer's dementia when assessing psychosocial outcomes. ALZHEIMER'S & DEMENTIA (NEW YORK, N. Y.) 2019; 5:388-397. [PMID: 31463361 PMCID: PMC6708985 DOI: 10.1016/j.trci.2019.02.008] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
The purpose of this introductory article to the special issue on psychosocial outcome measures in Alzheimer's & Dementia: Translational Research & Clinical Interventions is to outline new frameworks to more effectively capture and measure the full range of how people living with Alzheimer's dementia and their family caregivers experience the disease process. Specifically, we consider the strengths and weaknesses of alternative perspectives, including person-centered, strength-based, and resilience-focused approaches that may complement and extend the dominant deficit paradigm to reflect the entirety of the dementia experience. Our aim is to encourage innovative methods to measure psychosocial aspects of Alzheimer's dementia and caregiving that have not yet received sufficient attention, including resources (e.g., services and supports) and positive caregiver and care recipient outcomes (e.g., positive mood and adaptation).
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Affiliation(s)
- Joseph E. Gaugler
- Division of Health Policy and Management, School of Public Health, The University of Minnesota, Minneapolis, MN, USA
| | | | | | - Jessica Finlay
- Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
| | - Sam Fazio
- Care and Support, Alzheimer's Association, Chicago, IL, USA
| | - Eric Jutkowitz
- Department of Health Services, Policy & Practice, School of Public Health, Brown University, Providence, RI, USA
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Hale K, Østbye T, Perera B, Bradley R, Maselko J. A Novel Adaptation of the HOME Inventory for Elders: The Importance of the Home Environment Across the Life Course. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E2826. [PMID: 31398802 PMCID: PMC6719999 DOI: 10.3390/ijerph16162826] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Revised: 07/27/2019] [Accepted: 07/28/2019] [Indexed: 12/14/2022]
Abstract
The context in which dependents, regardless of age, receive care affects their health. This study adapted the Home Observation for Measurement of the Environment (HOME) Inventory, originally designed for child development research, to assess the quality of stimulation and support available to elders in their habitual households in Sri Lanka. Whether the adapted domains correlated with indicators of health and well-being in ways consistent with the child development literature was then examined. Through mixed-methods research based on 248 household surveys, four focus groups, and 15 interviews, three domains emerged: Physical Environment, Variety of Stimulation, and Emotional and Verbal Responsiveness. Regression modeling revealed that a higher quality physical home environment correlated with two measures of cognitive function after adjusting for covariates, but no consistent association with two psychological well-being scales. In contrast, higher Variety of Stimulation scores correlated with better cognitive function and lower psychological distress. There was no consistent correlation between Responsiveness and selected health outcomes. Qualitative data indicate that elders are active household contributors who strive to achieve harmonious relations with coresident kin. These findings reveal notable synergies between early and late life efforts to improve cognitive and psychological health, and highlight household considerations for future healthy aging research.
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Affiliation(s)
- Kathryn Hale
- Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA.
| | - Truls Østbye
- Department of Family Medicine and Community Health, Duke University School of Medicine, Durham, NC 27710, USA
- Center for Aging Research and Education, Duke-NUS Medical School, Singapore 169857, Singapore
| | - Bilesha Perera
- Department of Community Medicine, Faculty of Medicine, University of Ruhuna, Galle 80000, Sri Lanka
| | - Robert Bradley
- Department of Psychology, Arizona State University, Tempe, AZ 85287, USA
| | - Joanna Maselko
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
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Andersson MA, Wilkinson LR, Schafer MH. Does the Association Between Age and Major Illness Vary by Healthcare System Quality? Res Aging 2019; 41:988-1013. [DOI: 10.1177/0164027519864720] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This study builds on research into global aging, by offering a multiple-indicator test of whether national healthcare system quality modifies the association between age and major illness. Recent individual-level data on morbidity among respondents aged 50 or older (16 countries; 2014 European Social Survey) are merged with nation-level healthcare indicators. Healthcare system quality is assessed using a subjective, evaluation-based approach and an objective, attributable-mortality approach. Lagged nation-level economic and health indicators are controlled to help isolate healthcare system effects. Results across subjective and objective approaches to healthcare system quality are strikingly consistent. While older individuals showed approximately a 10% reduction in probability of major illness when residing in countries with higher healthcare quality, associations between age and morbidity indices combining number and severity of illness showed greater modification by healthcare quality, with reductions around 18%. Taken together, results are suggestive of healthcare’s protective role in reducing age-related illness and disability.
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138
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Yeung P, Breheny M. Quality of life among older people with a disability: the role of purpose in life and capabilities. Disabil Rehabil 2019; 43:181-191. [PMID: 31335217 DOI: 10.1080/09638288.2019.1620875] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Purpose: Purpose in life and capabilities are two significant individual elements that enhance quality of life among older people. Capabilities refers to the extent to which older people are free to make choices that are important to them. At present, it is not known how purpose in life interacts with capabilities to influence quality of life for those living with a disability. This study examined the extent to which purpose in life and capabilities interacts with health status to affect quality of life, particularly for older people with a disability.Methods: Self-report data from participants in a longitudinal cohort study of older New Zealanders were analyzed. Responses from 452 older people with a disability were compared with 3299 age- and gender-matched older people without a disability on indicators related to health and aging. The associations were tested using hierarchical regression. Mediational impact of purpose in life and capabilities were tested via path analysis.Results: Mental health, physical health, purpose in life, and capabilities accounted for a significant amount of variance in quality of life for older people with a disability. Purpose in life and capabilities were significant unique mediators for older people with a disability.Conclusions: Purpose in life may help older people with a disability to deal with early onset stressors or changes in mental and physical health to maintain overall quality of life. The role of capabilities suggests that the social environment and access to resources and choices are important in ensuring that older people aging with or into a disability achieve quality of life in a socially just environment.Implications for rehabilitationsPurpose in life and capability are unique mediators of the relationship between health status and quality of life.Purpose in life may act as an effective buffering mechanism to deal with disability in later life while capability can empower older people with a disability to achieve quality of life in a just environment.The notion of successful aging with disability should be re-defined as using psychological, social support, and healthcare resources to live a life consistent with personal values in the context of disabilityRather than emphasizing structural factors and physical functioning in activity participation, older people with disability should be supported to decide and pursue their own preferences.Rehabilitation professionals can work flexibly with older people with disability to maximize their resilience, dignity, autonomy and choice, and positive connection to others.
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Affiliation(s)
- Polly Yeung
- School of Social Work, Massey University, Palmerston North, New Zealand
| | - Mary Breheny
- School of Health Sciences, Massey University, Palmerston North, New Zealand
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139
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Bigonnesse C, Chaudhury H. The Landscape of “Aging in Place” in Gerontology Literature: Emergence, Theoretical Perspectives, and Influencing Factors. JOURNAL OF AGING AND ENVIRONMENT 2019. [DOI: 10.1080/02763893.2019.1638875] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
| | - Habib Chaudhury
- Department of Gerontology, Simon Fraser University, Vancouver, British Columbia, Canada
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140
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Fernández-Ballesteros R, Sánchez-Izquierdo M, Olmos R, Huici C, Caprara MG, Santacreu M, Ribera Casado JM, Cruz-Jentoft A. Development and validation of a paternalism and autonomist care assessment. J Adv Nurs 2019; 75:3166-3178. [PMID: 31287167 DOI: 10.1111/jan.14154] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Revised: 05/28/2019] [Accepted: 07/03/2019] [Indexed: 11/30/2022]
Abstract
AIM There is a need for a validated instrument to measure the type of care (paternalism or person-centred) provided for older adults. Since paternalism and person-centred care are the most important caregiving styles in the field of care and as they are usually opposed, the study aims to develop and establish psychometrics data of an instrument to identify paternalistic and autonomist behaviours in older adults care contexts, which can help to enhance care practice. DESIGN Instrument development. METHODS After observing and standardizing behaviours in formal care contexts in 2016, an instrument was developed and proceeding to a first validation using standard validation techniques among caregivers in two care settings during 2016-2017: senior citizen centres and older adult day care centres. RESULTS The Paternalist/Autonomist Care Assessment (PACA) is a 30-item, behaviour-based instrument which measures both the appraisal of caregivers on elements of care (Care Appraisal Scale- PACA-Appraisal) and the occurrence of behaviours (Occurrence of Care in Context- PACA-Occurrence). The Paternalist/Autonomist Care Assessment (PACA) was validated in 160 professional caregivers and was able to discriminate two factors: paternalistic or overprotective behaviours and autonomist behaviours. However, these factors were not fully dichotomous and were shown to coexist to some degree. CONCLUSION The instrument displayed good psychometric properties to measure paternalism and autonomy in older adult care. Moreover, it showed that the two types of care are not antagonistic and can coexist, with overprotective behaviours being more frequent in contexts of care for more dependent persons. IMPACT There are no validated instruments to measure paternalism and person-centred behaviour in care contexts. The two measures yielded by the PACA show good construct and concurrent empirical validity, internal consistency, and convergent and discriminant validity. Family caregiver, professional caregivers, nurses, older adults.
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Affiliation(s)
| | | | - Ricardo Olmos
- Department of Methodology, Autonomous University of Madrid, Madrid, Spain
| | - Carmen Huici
- Department of Social Psychology and Organizations, National University of Distance Education (UNED), Madrid, Spain
| | - María Giovanna Caprara
- Department of Personality, Evaluation and Psychological Treatments, National University of Distance Education (UNED), Madrid, Spain
| | - Marta Santacreu
- Department Psychology, Universidad Europea Madrid, Madrid, Spain
| | | | - Alfonso Cruz-Jentoft
- Servicio de Geriatría, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria, Madrid, Spain
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141
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Kim J, Kim J, Han A. Leisure Time Physical Activity Mediates the Relationship Between Neighborhood Social Cohesion and Mental Health Among Older Adults. J Appl Gerontol 2019; 39:292-300. [PMID: 31271089 DOI: 10.1177/0733464819859199] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Neighborhood social cohesion can contribute to leisure time physical activity (LTPA) involvement and psychological well-being. In spite of the value of neighborhood social cohesion for health benefits, there is a dearth of empirical study that explores how neighborhood social cohesion influences LTPA and mental health among older adults. Therefore, this study aimed to investigate the association among neighborhood social cohesion, light-to-moderate and vigorous LTPA, and mental health in a representative sample of U.S. older adults (n = 6,412). Structural equation modeling (SEM) analysis revealed that older adults who perceived neighborhood social cohesion were more likely to participate in light-to-moderate and vigorous LTPA, which in turn resulted in better mental health. This study confirmed the importance of neighborhood social cohesion in promoting older adults' health-related behaviors and mental health. The practical implications on how to promote mental health among older adults, as well as future research directions were discussed.
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Affiliation(s)
| | | | - Areum Han
- Texas State University, San Marcos, USA
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142
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Teixeira Vaz C, de Souza Andrade AC, Proietti FA, Coelho Xavier C, de Lima Friche AA, Teixeira Caiaffa W. A multilevel model of life satisfaction among old people: individual characteristics and neighborhood physical disorder. BMC Public Health 2019; 19:861. [PMID: 31269940 PMCID: PMC6607521 DOI: 10.1186/s12889-019-7228-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Accepted: 06/24/2019] [Indexed: 11/17/2022] Open
Abstract
Background Considering the lack of studies that examine built environmental factors associated with life satisfaction among old people in developing countries, particularly those focused on Brazil, the aim of this study was to estimate the prevalence of life satisfaction among old adults residents in a Brazilian urban center and to investigate its association with individual characteristics and objective measures of the built environment. Methods A household survey (N = 832) in Belo Horizonte, Minas Gerais, Brazil (2008–2009) and a Systematic Social Observation (SSO) was used in this study. Life satisfaction was assessed through Self-Anchoring Ladder Scale, developed by Cantril, in 1965. Participants’ answers were categorized as satisfied (rungs 6–10) and dissatisfied (rungs 0–5). A Multilevel Poisson regression analysis with robust variance was performed. Results The prevalence of satisfaction with life was approximately 82%. Higher prevalence of life satisfaction was significantly associated with old people who reported higher incomes, higher religious participation, who practice physical activity and who perceive their health as good and very good. In contextual level, results showed that when the contextual features were adjusted separately by the individual characteristics they were no longer significant. The results also showed a lower prevalence of life satisfaction among those living in neighborhoods with higher physical disorder, even after adjusting for individual and other contextual characteristics. Conclusions The present findings suggest that life satisfaction should be assessed whenever evaluating urban redevelopment programs designed to improve neighborhood characteristics, reducing physical disorder, especially among old adults.
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Affiliation(s)
- Camila Teixeira Vaz
- Department of Physical Therapy, Federal University of Juiz de Fora - Campus Governador Valadares, Rua São Paulo 745, Governador Valadares, 35010-180, Brazil. .,Faculty of Medicine, Federal University of Minas Gerais, Avenida Alfredo Balena 190, Belo Horizonte, 30130-100, Brazil. .,Belo Horizonte Observatory for Urban Health, Avenida Alfredo Balena 190, Belo Horizonte, 30130-100, Brazil.
| | - Amanda Cristina de Souza Andrade
- Faculty of Medicine, Federal University of Minas Gerais, Avenida Alfredo Balena 190, Belo Horizonte, 30130-100, Brazil.,Belo Horizonte Observatory for Urban Health, Avenida Alfredo Balena 190, Belo Horizonte, 30130-100, Brazil.,Institute of Public Health, Federal University of Mato Grosso, Avenida Fernando Corrêa 2367, Cuiabá, 78060-900, Brazil
| | - Fernando Augusto Proietti
- Belo Horizonte Observatory for Urban Health, Avenida Alfredo Balena 190, Belo Horizonte, 30130-100, Brazil.,Faculty of Health and Human Ecology, Rua São Paulo 958, Vespasiano, 33200-000, Brazil
| | - César Coelho Xavier
- Belo Horizonte Observatory for Urban Health, Avenida Alfredo Balena 190, Belo Horizonte, 30130-100, Brazil.,Faculty of Health and Human Ecology, Rua São Paulo 958, Vespasiano, 33200-000, Brazil
| | - Amélia Augusta de Lima Friche
- Faculty of Medicine, Federal University of Minas Gerais, Avenida Alfredo Balena 190, Belo Horizonte, 30130-100, Brazil.,Belo Horizonte Observatory for Urban Health, Avenida Alfredo Balena 190, Belo Horizonte, 30130-100, Brazil
| | - Waleska Teixeira Caiaffa
- Faculty of Medicine, Federal University of Minas Gerais, Avenida Alfredo Balena 190, Belo Horizonte, 30130-100, Brazil.,Belo Horizonte Observatory for Urban Health, Avenida Alfredo Balena 190, Belo Horizonte, 30130-100, Brazil
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Bates L, Wiles J, Kearns R, Coleman T. Precariously placed: Home, housing and wellbeing for older renters. Health Place 2019; 58:102152. [DOI: 10.1016/j.healthplace.2019.102152] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Revised: 05/28/2019] [Accepted: 06/05/2019] [Indexed: 11/30/2022]
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144
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Fernández-Ballesteros R, Sánchez-Izquierdo M, Olmos R, Huici C, Ribera Casado JM, Cruz Jentoft A. Paternalism vs. Autonomy: Are They Alternative Types of Formal Care? Front Psychol 2019; 10:1460. [PMID: 31316428 PMCID: PMC6611139 DOI: 10.3389/fpsyg.2019.01460] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Accepted: 06/07/2019] [Indexed: 11/13/2022] Open
Affiliation(s)
| | | | - Ricardo Olmos
- Department of Methodology, Autonomous University of Madrid, Madrid, Spain
| | - Carmen Huici
- Department of Social Psychology and Organizations, National University of Distance Education, Madrid, Spain
| | | | - Alfonso Cruz Jentoft
- Servicio de Geriatría, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria, Madrid, Spain
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145
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Stakeholders’ Views on Responsible Assessments of Assistive Technologies through an Ethical HTA Matrix. SOCIETIES 2019. [DOI: 10.3390/soc9030051] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Assessments of novel assistive technologies for use in home-based services has been documented to be performed in a variety of ways and often with a rather narrow focus on safety and effect or effectiveness. In order better to understand the place for wider forms of assessments of assistive technologies, the current study presents a combination of the Ethical Matrix and the Socratic approach for assessment of health technologies—the Ethical HTA Matrix. This matrix was filled with content based on a case of a GPS localization system, which was validated by stakeholders. In a next step, central decision-makers in assistive technologies and stakeholders were interviewed concerning their views on this methodology. Mainly, the matrix was seen as very comprehensive, but too detailed with an abundance of information. Nevertheless, some informants suggested concrete uses of the matrix in their organizations. Some understood the matrix more as an epistemic tool aiming at providing an overview of the state of knowledge, while others identified a normative potential in the matrix that could be implemented in health innovation processes for the home-based services, in particular when discussing novel solutions and working methods with health professionals and care workers.
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146
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Seifert A, König R. Help From and Help to Neighbors Among Older Adults in Europe. FRONTIERS IN SOCIOLOGY 2019; 4:46. [PMID: 33869369 PMCID: PMC8022689 DOI: 10.3389/fsoc.2019.00046] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Accepted: 05/06/2019] [Indexed: 05/30/2023]
Abstract
Neighborhoods can be a valuable source of social support particularly for older adults. Such support can be mutual; however, the influential factors in giving and receiving are unclear. This study investigated neighborhood help among the older European population using representative data for 17 countries from the Survey of Health, Ageing and Retirement in Europe (SHARE). The analyses were based on 104,059 observations of 39,113 respondents aged 50 years and older. In general, ~6% of all respondents provided recently neighborhood help, and 4% received help. Moreover, the results indicate a high degree of reciprocity in giving and receiving neighborhood help. However, the situation varied widely among age groups and countries. Our multilevel results suggest that the provision and receipt of help are driven by personal characteristics (age, sex, education, income, and retirement), health resources (subjective health, activities of daily living, and instrumental activities of daily living), living situation (homeownership, location, and length of time in a residence), social factors (marital status, partner, parents, and children), and contextual factors (gross domestic product, social expenditures, poverty rate, Gini index, population density, country-centered satisfaction with life, living, and relationships).
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Affiliation(s)
- Alexander Seifert
- University Research Priority Program “Dynamics of Healthy Aging”, University of Zurich, Zurich, Switzerland
- Institute of Sociology, University of Zurich, Zurich, Switzerland
| | - Ronny König
- Institute of Sociology, University of Zurich, Zurich, Switzerland
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Mock SE, Walker EP, Humble ÁM, de Vries B, Gutman G, Gahagan J, Chamberland L, Aubert P, Fast J. The Role of Information and Communication Technology in End-of-Life Planning Among a Sample of Canadian LGBT Older Adults. J Appl Gerontol 2019; 39:536-544. [PMID: 31068036 DOI: 10.1177/0733464819848634] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
To better understand the role of technology in later-life planning among older lesbian, gay, bisexual, and trans (LGBT) adults, we conducted focus groups to explore factors linked to diverse sexual orientations and gender identities. Twenty focus groups were facilitated across Canada with 93 participants aged 55 to 89. Constant comparative analysis yielded four categories: (a) fear, (b) individual benefits, (d) social elements, and (d) contextual elements. Fear related to technology and fear of end-of-life planning. Individual benefits referred to technology as a platform for developing LGBT identities and as a source of information for later-life planning. Social elements were establishment and maintenance of personal relationships and social support networks. Contextual elements referred to physical and situational barriers to technology use that limited access and usability. These findings can inform technological practice and services to enhance later-life planning.
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Affiliation(s)
| | | | - Áine M Humble
- Mount Saint Vincent University, Halifax, Nova Scotia, Canada
| | | | - Gloria Gutman
- Simon Fraser University, Vancouver, British Columbia, Canada
| | | | | | - Patrick Aubert
- Simon Fraser University, Vancouver, British Columbia, Canada
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148
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Schmidt LI, Wahl HW. Predictors of Performance in Everyday Technology Tasks in Older Adults With and Without Mild Cognitive Impairment. THE GERONTOLOGIST 2019; 59:90-100. [PMID: 29878116 DOI: 10.1093/geront/gny062] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Indexed: 11/14/2022] Open
Abstract
Background and Objectives The ability to use everyday technology has become a key competence for conducting activities of daily living, maintaining an autonomous life, as well as participating in society. However, studying this issue in older adults needs more attention, particularly among those with mild cognitive impairment (MCI). Research Design and Methods We assessed the performance of N = 80 older adults (M = 73 years) in a range of tasks representing important life domains, i.e., using a blood pressure monitor, a mobile phone, and an eBook reader. Thirty-nine participants had been diagnosed with MCI by experienced geropsychiatrists and 41 healthy controls were matched for age, sex, and education. Standardized observation based on video-recording and coding was combined with cognitive testing and assessment of social-cognitive variables (self-efficacy, perceived obsolescence, attitudes towards technology). Results Cognitively healthy participants outperformed those with MCI regarding completion time and errors. An interaction effect of device and study group indicated larger differences in completion time for tasks with multilayered interfaces. In hierarchical regression models, aggregated cognitive factors (fluid and memory component) predicted performance and interactions with education level emerged. Obsolescence, addressing a perceived lack of competence to cope with modern society, mediated the effect of cognitive status on performance, both regarding time (partial mediation, adj.R2 = 28%) and errors (full mediation, adj.R2 = 23%). Discussion and Implications Findings show that social-cognitive factors contribute to differences in performance on everyday technology tasks in addition to cognitive abilities. Training programs may profit from considering respective individual resources or limitations in the cognitive, personality-related or emotional-motivational domain.
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Affiliation(s)
- Laura I Schmidt
- Department of Health Psychology, Institute of Psychology, Germany
| | - Hans-Werner Wahl
- Network Aging Research & Institute of Psychology, Heidelberg University, Germany
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149
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Wang MS. Is Home the Best Place for Aging? the Complex Landscape of Eldercare. SOCIAL WORK IN PUBLIC HEALTH 2019; 34:330-342. [PMID: 31039678 DOI: 10.1080/19371918.2019.1606753] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Current long-term care policy prioritizes eldercare in home and community settings rather than institutions in order to reduce government spending and maintain the quality of life for frail elders. A considerable body of literature has adopted Andersen's behavioral model and geographical perspectives to illustrate the links between related factors and the arrangements for care. By synthesizing Andersen's behavior model and geographic dimension of care, this study investigates the complex landscape of eldercare and shows how multilevel factors (individual, community, and macro-level) affect frail elders, their caregivers, and family members involved in services and care.
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Affiliation(s)
- Ming Sheng Wang
- a Department of Social Work , National Taipei University , New Taipei City , Taiwan
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150
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Leung DDM. Influence of functional, psychological, and environmental factors on falls among community-dwelling older adults in Hong Kong. Psychogeriatrics 2019; 19:228-235. [PMID: 30378205 DOI: 10.1111/psyg.12386] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Revised: 08/29/2018] [Accepted: 09/24/2018] [Indexed: 10/28/2022]
Abstract
AIM The growth of the ageing population has been rapid. However, this ageing population is not homogeneous; individuals have different levels of functionality and psychosocial status, and some are members of at-risk or high-risk groups. As such, studies on the functional, psychological, and environmental factors of falls among community-dwelling older adults are imperative. By investigating the effect of life satisfaction, as well as environmental and functional factors, on falls among community-dwelling older adults in Hong Kong, this study aims to address this concern. METHODS The study recruited 249 participants. Both self-reported questionnaires and home safety assessments were administrated. RESULTS Logistic regression analysis showed that life satisfaction and instrumental activities of daily living were significant predictors of falls. Significant differences between fallers and non-fallers were found in functional and psychological areas. The presence of home hazards was low and not associated with falls in this population. However, this variable was negatively associated with life satisfaction and predicted by one of its domains, satisfaction of possession. CONCLUSION These results can help health-care and social service providers to identify the needs and types of support required for effective fall prevention and to better tailor and target community intervention for older adults.
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Affiliation(s)
- Daniel D M Leung
- Department of Social Work, The Chinese University of Hong Kong, Hong Kong.,Sau Po Centre on Ageing, The University of Hong Kong, Hong Kong.,Hong Kong Psychological Society, Hong Kong.,British Psychological Society, Leicester
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