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Con Wright G, Özdemir Ocaklı B. The Impact of Age-Based COVID-19 Pandemic Regulations on Older People in Turkey: A Capability Approach. J Aging Soc Policy 2024:1-21. [PMID: 39374406 DOI: 10.1080/08959420.2024.2403827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Accepted: 06/24/2024] [Indexed: 10/09/2024]
Abstract
Older adults all around the world encountered numerous challenges during the COVID-19 pandemic. Some of these challenges were pertinent to biological factors, like the risk of infection, while others resulted from social factors, like ageism and government regulations. Employing a capability approach, this study examined how age-based pandemic regulations that were imposed in Turkey affected the freedom and social environment of older adults. We used Bachhi's What is the Problem Represented to Be? (WPR) approach to analyze the memorandums issued by the central government between March 11, 2020, and June 30, 2021. Our analysis revealed that the problem is represented in these memorandums as older people's increased vulnerability to health risks, which resulted in violations of their mobility and health capabilities, as well as (mis)recognition of diversity within the older population. These findings provide vital insight into how age-based pandemic regulations define the problem based exclusively on chronological age, thereby creating circumstances that compromise older people's capabilities beyond simply maintaining health. Thus, we recommend that policymakers pay closer attention to both the intended and unintended consequences of any proposed regulations, and account for individuals' capabilities rather than merely their functionings.
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Affiliation(s)
- Gülçin Con Wright
- Assistant Professor, Faculty of Arts & Sciences, Sociology Department, TED University, Ankara, Turkey
| | - Burcu Özdemir Ocaklı
- Associate Professor, Faculty of Health Sciences, Department Social Work, Ankara University, Ankara, Turkey
- Associate Professor, Center on Ageing Studies Implementation and Research, Ankara University, Ankara, Turkey
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Chen M, Bolt G, Hooimeijer P. The impact of residential environment on older people's capabilities to live independently: a survey in Beijing. BMC Public Health 2024; 24:843. [PMID: 38500091 PMCID: PMC10949666 DOI: 10.1186/s12889-024-18262-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Accepted: 03/03/2024] [Indexed: 03/20/2024] Open
Abstract
BACKGROUND Studies have shown how environmental factors influence older people's health and functional limitations, which are crucial for achieving healthy aging. However, such a healthy aging model has been criticized for defining health as an absence of disease, because chronic conditions cannot be reversed through medical treatments. In response to such critiques, this study refers to Huber's positive health definition, arguing that health should not be defined as the absence of disease but as the ability to adapt and self-manage in the face of social, physical, and emotional challenges. There is a need to develop a community-based approach to healthy aging that considers how the residential environment enables older people to adapt and self-manage. Drawing on Sen's capability approach, this study proposes that such a community-based approach should provide a supportive environment to enable older people's capabilities to live independently. METHODS Using hierarchical multiple regression analysis of data from 650 older people (60 years and older) surveyed in Beijing, we unravel which features of the residential environment support older people' s capabilities to live independently and how these impacts differ depending on older people's frailty levels. RESULTS The results show that four environmental factors, namely perceived accessibility (B = 0.238, p < 0.001 for physical capability, B = 0.126, p < 0.001 for social capability, B = 0.195, p < 0.001 for psychological capability), pleasant surroundings (B = 0.079, p < 0.05 for physical capability, B = 0.065, p < 0.05 for social capability), meeting opportunities (B = 0.256, p < 0.001 for social capability, B = 0.188, p < 0,001 for psychological capability, and life convenience B = 0.089, p < 0.05 for physical capability, B = 0.153, p < 0.001 for psychological capability) positively affect older people's capabilities to live independently. These four environmental factors cause differences in older people's capabilities between different neighborhood types. Moderation analysis shows that meeting opportunities are more relevant for frail older people (B = 0.090, p < 0.001 for social capability, B = 0.086, p < 0.01 for psychological capability). CONCLUSIONS This study contributes to the literature by emphasizing the role of supportive residential environments in enabling older people to live independently. Furthermore, we identify four environmental factors that support older people's capabilities. Results can be used to develop effective community-based environmental support to enable older people to live independently.
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Affiliation(s)
- Mengyuan Chen
- Department of Human Geography and Spatial Planning, Faculty of Geosciences, Utrecht University, Princetonlaan 8a, 3584CB, Utrecht, The Netherlands.
| | - Gideon Bolt
- Department of Human Geography and Spatial Planning, Faculty of Geosciences, Utrecht University, Princetonlaan 8a, 3584CB, Utrecht, The Netherlands
| | - Pieter Hooimeijer
- Department of Human Geography and Spatial Planning, Faculty of Geosciences, Utrecht University, Princetonlaan 8a, 3584CB, Utrecht, The Netherlands
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Vos den Ouden W, Janssen M, van Boekel L, Leenders R, Luijkx K. The impact of social network change due to spousal loss: A qualitative study on experiences of older adults who are aging in place. DEATH STUDIES 2022; 47:559-573. [PMID: 35979614 DOI: 10.1080/07481187.2022.2108942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Spousal loss due to nursing home admission or death is challenging for the well-being of the remaining partner and for aging in place. We explored: "How does social network change due to spousal loss impact older adults who are aging in place?." In-depth interviews were held with six older women who were aging in place and who lost their spouses in the past two years. Narrative analysis was conducted. Results indicate that the impact varies in three dimensions and that variations within dimensions follow three themes. The results emphasize the complexity of impact and the urgent need for a person-centred approach toward older adults after spousal loss.
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Affiliation(s)
- Willeke Vos den Ouden
- Department Tranzo, Tilburg School of Social and Behavioural Sciences, Tilburg University, Tilburg, The Netherlands
| | - Meriam Janssen
- Department Tranzo, Tilburg School of Social and Behavioural Sciences, Tilburg University, Tilburg, The Netherlands
| | - Leonieke van Boekel
- Department Tranzo, Tilburg School of Social and Behavioural Sciences, Tilburg University, Tilburg, The Netherlands
| | - Roger Leenders
- Department of Organization Studies, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands
- Jheronimous Academy of Data Science, Hertogenbosch, The Netherlands
| | - Katrien Luijkx
- Department Tranzo, Tilburg School of Social and Behavioural Sciences, Tilburg University, Tilburg, The Netherlands
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Older people's experiences of dignity and support with eating during hospital stays: analytical framework, policies and outcomes. AGEING & SOCIETY 2021. [DOI: 10.1017/s0144686x21000568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Abstract
There is growing recognition of the importance of dignity and support with eating as markers of high-quality and older-person-centred hospital services. We use data on these markers from the national Adult Inpatient Survey for England to build up statistical evidence on older people's experiences. We find that poor and inconsistent experiences of being treated with dignity and respect, and of receiving support with eating, affect a substantial proportion of inpatients across the vast majority of acute hospital trusts. There has been remarkably little change over time, although small improvements provide some grounds for optimism relating to policy developments in the period following the Francis Inquiry. Amongst people over 65, the prevalence of inconsistent and poor experiences of dignity and support with eating was higher amongst the ‘oldest of the old’ (inpatients aged over 80), individuals who experience a long-standing limiting illness or disability, and women. The highest rates of prevalence were observed amongst disabled women over 80. Perceptions of inadequate nursing quantity and quality, and lack of choice of food, stand out from logistic regression analysis as having consistent, large associations with lack of support with eating. These factors provide potential policy levers since they are within the control of hospitals to a certain extent. In drawing lessons from our analysis for inspection, regulation and monitoring, we highlight the importance of inequalities analysis – including systematic disaggregation and separate identification of at risk sub-groups (e.g. older disabled women) – rather than relying on a ‘population average approach’.
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Van Loon MS, Widdershoven G, Van Leeuwen K, Bosmans J, Metselaar S, Ostelo R. 'Implementing a broad quality of life tool for determining care wishes and needs of older adults living at home. Home Health Care Serv Q 2021; 40:262-275. [PMID: 34467831 DOI: 10.1080/01621424.2021.1968986] [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: 10/20/2022]
Abstract
The aim was to investigate the views of stakeholders on the practical relevance of a broad quality of life (QoL) outcome tool for care in older adults: the Extended Quality of Life Tool (EQLT). We conducted individual interviews and focus groups with a variety of stakeholders involved in the care for older adults which were analyzed using a framework analysis. Stakeholders considered relevant: focus on the client perspective; perspective on QoL broader than health; the possibility to take diversity into account; and the possibility to determine a minimum level of QoL. Three facilitators for implementation of the tool were mentioned as well as four barriers. The EQLT can support conversations with clients about their needs and wishes, thus enabling decisions about care services based on a broad set of domains of QoL. Implementation of the tool should take into account the facilitators and barriers identified in the current study.
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Affiliation(s)
- M S Van Loon
- Amsterdam UMC, Department of Ethics, Law & Humanities, Amsterdam Public Health Research Institute, Vu University Amsterdam, Amsterdam, the Netherlands.,Department of Health Sciences, Faculty of Science, Vu University Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
| | - G Widdershoven
- Amsterdam UMC, Department of Ethics, Law & Humanities, Amsterdam Public Health Research Institute, Vu University Amsterdam, Amsterdam, the Netherlands
| | - K Van Leeuwen
- Department of Health Sciences, Faculty of Science, Vu University Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
| | - J Bosmans
- Department of Health Sciences, Faculty of Science, Vu University Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
| | - S Metselaar
- Amsterdam UMC, Department of Ethics, Law & Humanities, Amsterdam Public Health Research Institute, Vu University Amsterdam, Amsterdam, the Netherlands
| | - R Ostelo
- Department of Health Sciences, Faculty of Science, Vu University Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
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Szabó Á, Hyde M, Towers A. One slope does not fit all: longitudinal trajectories of quality of life in older adulthood. Qual Life Res 2021; 30:2161-2170. [PMID: 33843014 DOI: 10.1007/s11136-021-02827-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/12/2021] [Indexed: 11/25/2022]
Abstract
PURPOSE Maintaining or improving quality of life (QoL) in later life has become a major policy objective. Yet we currently know little about how QoL develops at older ages. The few studies that have modelled QoL change across time for older adults have used 'averaged' trajectories. However, this ignores the variations in the way QoL develops between groups of older adults. METHODS We took a theoretically informed 'capabilities approach' to measuring QoL. We used four waves of data, covering 6 years, from the New Zealand Health, Work and Retirement Study (NZHWR) (N = 3223) to explore whether distinct QoL trajectories existed. NZHWR is a nationally representative longitudinal study of community-dwelling adults aged 50 + in New Zealand. Growth mixture modelling was applied to identify trajectories over time and multinomial regressions were calculated to test baseline differences in demographic variables (including age, gender, ethnicity, education and economic living standards). RESULTS We found five QoL trajectories: (1) high and stable (51.94%); (2) average and declining (22.74%); (3) low and increasing (9.62%); (4) low and declining (10.61%); (5) low and stable (5.09%). Several differences across profiles in baseline demographic factors were identified, with economic living standards differentiating between all profiles. CONCLUSIONS The trajectory profiles demonstrate that both maintaining and even improving QoL in later life is possible. This has implications for our capacity to develop nuanced policies for diverse groups of older adults.
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Affiliation(s)
- Ágnes Szabó
- School of Health Sciences, Massey University, Wellington, New Zealand.
- School of Health, Victoria University of Wellington, Easterfield Building on Kelburn Parade, Wellington, 6012, New Zealand.
| | - Martin Hyde
- Centre for Innovative Ageing, Swansea University, Swansea, Wales, UK
| | - Andy Towers
- School of Health Sciences, Massey University, Wellington, New Zealand
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Ageing as well as you can in place: Applying a geographical lens to the capability approach. Soc Sci Med 2020; 288:113525. [PMID: 33234454 DOI: 10.1016/j.socscimed.2020.113525] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 08/05/2020] [Accepted: 11/10/2020] [Indexed: 11/21/2022]
Abstract
Despite policy commitments to support ageing in place, we know very little about the everyday realities and experiences of older people living in different environmental circumstances, with varying personal capabilities. This paper: 1) examines the valued place-based functionings of older people through the use of geo-spatial and in-situ methods, where functionings are defined as states of being and doing, and place-based functionings are defined as places, activities, interactions, routes, and routines that support these beings and doings; and 2) demonstrates the utility of a capability approach by amalgamating the interconnected concepts 'ageing in place' and 'ageing well'. Three in-depth individual experiences of ageing at home in a Dublin (Ireland) suburb show how differing health and mobility challenges are managed, and illustrate how conceptions of ageing well in place can be identified from geographically-grounded lifeworlds. Participants' place-based functionings are identified by combining qualitative and geo-spatial approaches through the use of annotated maps, using data obtained from traditional interviews, go-along interviews, and mapping exercises. Results demonstrate the diversity of place-based functionings valued by each individual, and how functionings are negotiated depending on different needs, wishes, and health or mobility challenges. Results also highlight the importance of supportive environments and social supports in enabling older people to realise their most valued functionings over time, which include being able to get out and about, engage and connect with others, carry out daily tasks and errands confidently, and remain independent. By paying attention to subjectively valued place-based functionings, as well as the specific supports required to sustain them, we can facilitate older people to not just age in place, or age well, but to age - as well as they can - in place.
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Nivestam A, Petersson P, Westergren A, Haak M. Older person’s experiences of benefits gained from the support and advice given during preventive home visits. Scand J Caring Sci 2020; 35:1096-1103. [PMID: 33128293 PMCID: PMC9292410 DOI: 10.1111/scs.12923] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 07/15/2020] [Accepted: 10/05/2020] [Indexed: 01/20/2023]
Abstract
Background Life expectancy is increasing all over the world. To be able to support this positive development, health interventions focusing on promotion and prevention are crucial. Preventive home visits represent one example of a health intervention which addresses both promotion through a supportive dialogue and prevention by giving advice. However, to give support and advice that older persons experience as beneficial, there is a need for more research. Aim The aim of this study was to explore older person’s experiences of the benefits gained from the support and advice given during the preventive home visit. Method Individual semi‐structured interviews were conducted with 13 older persons, median age 77 years old, living at home, who had received a preventive home visit. The interviews were analysed with content analysis. Findings The overarching theme Becoming empowered and recognised as a person was experienced as the major benefit of the support and advice given during the preventive home visit. The support and advice generated conditions for the person to become empowered, by contributing to a feeling of control and preparedness for the future. Furthermore, the support and advice given contributed to a feeling of becoming recognised as a person, as an outcome of the supportive dialogue and the assessment of their health, behaviour and their surrounding environment. Conclusion The support and advice given during the preventive home visit were experienced as person‐centred, and conditions for becoming empowered were created. In order to create a positive outcome from the support and advice given during the preventive home visit, it seems important to focus on providing both a supportive dialogue and a structured assessment.
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Affiliation(s)
- Anna Nivestam
- Department of Nursing and Health Sciences Kristianstad University Kristianstad Sweden
- Department of Health Sciences Lund University Lund Sweden
| | - Pia Petersson
- Department of Nursing and Health Sciences Kristianstad University Kristianstad Sweden
| | - Albert Westergren
- Department of Nursing and Health Sciences Kristianstad University Kristianstad Sweden
- Department of Health Sciences Lund University Lund Sweden
| | - Maria Haak
- Department of Nursing and Health Sciences Kristianstad University Kristianstad Sweden
- Department of Health Sciences Lund University Lund Sweden
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Mitra S, Brucker DL. Disability and aging: From successful aging to wellbeing through the capability and human development lens. Disabil Health J 2020; 13:100924. [DOI: 10.1016/j.dhjo.2020.100924] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Revised: 03/13/2020] [Accepted: 03/22/2020] [Indexed: 11/30/2022]
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Yeung P, Severinsen C, Good G, O'Donoghue K. Social environment and quality of life among older people with diabetes and multiple chronic illnesses in New Zealand: Intermediary effects of psychosocial support and constraints. Disabil Rehabil 2020; 44:768-780. [PMID: 32623910 DOI: 10.1080/09638288.2020.1783375] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Purpose: In older people with diabetes, multimorbidity is highly prevalent and it can lead to poor quality of life. The overall purpose of this study was to examine the association between the social environment, psychosocial support and constraints, and overall quality of life among older people with and without with diabetes and multiple chronic illnesses.Methods: Self-reported data from participants in a cohort study of older New Zealanders was analysed. Responses from 380 older people diagnosed with diabetes and multiple chronic illnesses were compared with 527 older people with no health issues on indicators related to the associations of neighbourhood, health and ageing, using structural equation modelling.Results: The final model suggests that social provision, purpose in life and capabilities mediated between the social environment and quality of life, indicate that older people with positive social environment (i.e., neighbourhood advantage, residential stability) are much less likely to experience depression due to having good social support, meaningful life purpose and opportunities to engage.Conclusions: Perceived neighbourhood advantages, such as positive neighbourhood qualities, social cohesion and housing satisfaction, along with the focus on increasing social support, enhancing purpose in life and supporting one's capability to achieve, may serve as protective factors against depression.IMPLICATIONS FOR REHABILITATIONEnvironmental and personal circumstances can contribute to quality of life among older people with diabetes and multimorbidity.By providing older people with diabetes and multiple chronic illnesses a socially just environment that challenges ageism and other forms of oppression, this could reduce social disparities in health, improve inclusion and access to resources.Social and healthcare professionals are encouraged to design clinical care guidelines and rehabilitation goals from a wholistic and person/client centred approach to support older people with diabetes and multiple chronic illnesses.
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Affiliation(s)
- Polly Yeung
- School of Social Work, Massey University, Palmerston North, New Zealand
| | | | - Gretchen Good
- School of Health Sciences, Massey University, Palmerston North, New Zealand
| | - Kieran O'Donoghue
- School of Social Work, Massey University, Palmerston North, New Zealand
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11
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The Living Standards Capabilities for Elders scale (LSCAPE): adaptation and validation in a sample of Spanish seniors. AGEING & SOCIETY 2020. [DOI: 10.1017/s0144686x20000446] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
AbstractLiving standards capabilities are an important determinant of healthy ageing. The Living Standards Capabilities for Elders scale (LSCAPE) is the main instrument available to assess living standards capabilities among older adults based on Sen's Capability Approach. The objectives of this study were: (a) to adapt and validate LSCAPE for use in the Spanish population; (b) to examine the dimensionality, validity and reliability; and (c) to establish the convergent validity of LSCAPE using self-reported measures of quality of life and income. The LSCAPE was administered to 441 Spanish seniors aged 65 and over. Confirmatory Factor Analysis (CFA) was used to analyse the dimensionality, validity and reliability. Discriminant and convergent validity of the model were assessed using Average Variance Extracted (AVE). Reliability was shown by Composite Reliability (CR) and Cronbach's alpha. Convergent validity was tested by correlating the LSCAPE scales and sub-scales with the Short-form Health Survey (SF-12) sub-scales. CFA showed that the LSCAPE Six-factor Model fits well to the data, showing Standardised Root Mean Square Residual < 0.09 (0.084), Comparative Fit Index and Tucker–Lewis Index > 0.9 (0.925 and 0.917, respectively). LSCAPE showed also good reliability (CR indices > 0.7) and validity (AVE > 0.5) measures. Finally, LSCAPE had moderate to strong associations with SF-12 sub-scales (>0.6) and a moderate relationship with income (>0.3). Thus, LSCAPE has been demonstrated to be a reliable and valid instrument in measuring living standards capabilities among the Spanish older population.
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Mitra S, Brucker DL, Jajtner KM. Wellbeing at older ages: Towards an inclusive and multidimensional measure. Disabil Health J 2020; 13:100926. [PMID: 32354618 DOI: 10.1016/j.dhjo.2020.100926] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Revised: 02/28/2020] [Accepted: 03/22/2020] [Indexed: 11/24/2022]
Abstract
BACKGROUND With population aging, there is a growing need to measure and monitor the wellbeing of older people, including older people with disabilities. OBJECTIVE To estimate the extent of wellbeing for individuals age 60+ in the U.S. overall and across disability status, this paper develops a measure of wellbeing at older ages that is multidimensional and disability inclusive. METHODS Rates of multidimensional wellbeing among American older adults overall and among older adults with disabilities were estimated using multivariate regression analysis and data from the Panel Study of Income Dynamics matched with the 2013 Disability and Use of Time Supplement. Multidimensional wellbeing was defined as the simultaneous achievement of outcomes in five dimensions: material wellbeing, health status, personal activities, social connections/relationships, and economic security. RESULTS Among all older adults, 33% experience multidimensional wellbeing. However, only 4-18% of older adults with disabilities experience wellbeing. Wellbeing varies across the dimensions of wellbeing for this subpopulation. Persons with disabilities experience as much wellbeing as persons without disabilities in terms of health insurance status and social connections/relationships. In contrast, for material wellbeing, health status and personal activities, older persons with disabilities less often experience wellbeing. DISCUSSION This paper brings to light a disability gap in the experience of wellbeing among older adults in the U.S. There is a need for research which can inform the development of policies and practices that will enhance wellbeing for older people with disabilities, including material wellbeing, health and personal activities.
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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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14
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Botes R, Vermeulen KM, Gerber AM, Ranchor AV, Buskens E. Health-related quality of life and well-being health state values among Dutch oldest old. Patient Prefer Adherence 2019; 13:721-728. [PMID: 31190754 PMCID: PMC6522649 DOI: 10.2147/ppa.s193171] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Accepted: 02/23/2019] [Indexed: 11/23/2022] Open
Abstract
Background: Valuing hypothetical health states is a demanding personal process, since it involves the psychological evaluation of hypothetical health states. It seems plausible that elderly individuals will value hypothetical health states differently than the general population. It is, however, important to understand the psychological division that oldest old subgroups construct between acceptable and unacceptable health states. This information can produce important evidence regarding well-being and disability conceptualization. Objective: To investigate how Dutch oldest old, conceptualize health-related quality of life health states when compared to well-being health states. In addition, we aim to compare subgroups, based on dependency classification. Methods: Ninety-nine elderly living in the Groningen, Hoogeveen and Veendam areas of the Netherlands participated in the study. Respondents were classified into three groups based on dependency levels. The respondents were asked to value hypothetical health states, a generic preference-based HRQoL and a well-being instrument, using a visual analog scale. Results: All three groups ranked the same health states, from both questionnaires, below the average across the health states. The health-related quality of life health states was consistently ranked lower than the current well-being health states. Conclusions: Health state valuations performed by the oldest old indicate that conceptually, respondents view below average health-related and well-being health states as undesirable. The results indicated that the oldest old do view deficits in health-related health states as more important than deficits in well-being health states. Since the oldest old performed the valuations, focused interventions to improve below average health-related outcomes might be the most cost-effective way to increase oldest old well-being outcomes.
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Affiliation(s)
- Riaan Botes
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, 9700 RB, The Netherlands
- Correspondence: Riaan BotesDepartment of Epidemiology, University Medical Center Groningen, University of Groningen, PO Box 30.001, Groningen9700 RB, The NetherlandsTel +312 779 359 7351Email
| | - Karin M Vermeulen
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, 9700 RB, The Netherlands
| | - Anthonie M Gerber
- Department of Basic Medical Sciences, Faculty of Health Sciences, University of the Free State, Bloemfontein, 9300, South Africa
| | - Adelita V Ranchor
- Department of Health Psychology, University Medical Center Groningen, University of Groningen, Groningen, 9700 AD, The Netherlands
| | - Erik Buskens
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, 9700 RB, The Netherlands
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