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Ellison C, Struckmeyer L, Kazem-Zadeh M, Campbell N, Ahrentzen S, Classen S. A Social-Ecological Approach to Identify Facilitators and Barriers of Home Modifications. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18168720. [PMID: 34444467 PMCID: PMC8391256 DOI: 10.3390/ijerph18168720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 08/02/2021] [Accepted: 08/13/2021] [Indexed: 11/16/2022]
Abstract
Aging individuals may face difficulty with independently navigating and interacting with their home environment. Evidence-based interventions promoting home modifications are needed to support aging-in-place across the lifespan. This study identified the facilitators and barriers to implementing home modifications from the perspectives of residents and professionals (N = 16). Guided by a social-ecological model, researchers utilized directed content analysis of focus group interviews. While participants discussed facilitators and barriers mainly on the individual level, factors were presented at the relationship, community, and societal level of the model. Overall, the findings suggest a potential for targeted interventions on all levels of the model to promote adoption of home modifications.
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Affiliation(s)
- Carlyn Ellison
- Department of Occupational Therapy, University of Florida, Gainesville, FL 32611, USA; (L.S.); (S.C.)
- Correspondence:
| | - Linda Struckmeyer
- Department of Occupational Therapy, University of Florida, Gainesville, FL 32611, USA; (L.S.); (S.C.)
| | - Mahshad Kazem-Zadeh
- Rinker School of Construction Management, College of Design, Construction and Planning, University of Florida, Gainesville, FL 32611, USA;
- Shimberg Center for Housing Studies, University of Florida, Gainesville, FL 32611, USA;
| | | | - Sherry Ahrentzen
- Shimberg Center for Housing Studies, University of Florida, Gainesville, FL 32611, USA;
| | - Sherrilene Classen
- Department of Occupational Therapy, University of Florida, Gainesville, FL 32611, USA; (L.S.); (S.C.)
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Donovan NJ, Blazer D. Social Isolation and Loneliness in Older Adults: Review and Commentary of a National Academies Report. Am J Geriatr Psychiatry 2020; 28:1233-1244. [PMID: 32919873 PMCID: PMC7437541 DOI: 10.1016/j.jagp.2020.08.005] [Citation(s) in RCA: 160] [Impact Index Per Article: 40.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Accepted: 08/13/2020] [Indexed: 01/31/2023]
Abstract
The authors of this review both served on the National Academy of Science, Engineering, and Medicine Committee that produced the report, "Social Isolation and Loneliness in Older Adults: Opportunities for the Health Care System." In 2018, the AARP Foundation commissioned the National Academies to establish a committee to research and develop a report on social isolation and loneliness in persons 50 years of age and older. Emphasis was placed upon the role of the healthcare system in addressing this fundamental public health problem. The committee released the report in February 2020 as the Corona Virus Disease 2019 pandemic was beginning to spread to North America. In this review, the authors share central findings and conclusions from the report as well as how these findings may be relevant to the care and well-being of older adults during this historic pandemic. The health protective benefits of social distancing must be balanced by the essential need for sustaining social relationships.
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Affiliation(s)
- Nancy J Donovan
- Division of Geriatric Psychiatry, Department of Psychiatry (NJD), Brigham and Women's Hospital, Boston, MA; Department of Neurology (NJD), Brigham and Women's Hospital, Boston, MA; Department of Psychiatry (NJD), Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Dan Blazer
- Department of Psychiatry and Behavioral Sciences (DB), Duke University Medical Center, Durham, NC.
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Baron M, Fletcher C, Riva M. Aging, Health and Place from the Perspective of Elders in an Inuit Community. J Cross Cult Gerontol 2020; 35:133-153. [PMID: 32409899 DOI: 10.1007/s10823-020-09398-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
This paper explores perspectives of Inuit elders on the relationships between aging, health and place. Their views are important to consider in the context of a growing proportion and number of older people in Arctic communities, a new sociological condition. Developing policies and programs to promote healthy aging in Inuit communities is challenging as there is little known about the social and living conditions that promote healthy aging in the Arctic. In this study twenty Inuit aged between 50 to 86, from one community in Nunavut, participated to in-depth qualitative interviews. Themes discussed included aging and health, housing conditions, community conditions, land-based activities, medical and leisure travel outside of the community, and mobility and accessibility. Preliminary analyses of the qualitative data were validated in the community through a focus group with four participants and an interpreter. Interviews and the focus group transcripts were analysed using thematic content analyses and NVivo 12 qualitative data analysis program (QSR International Pty Ltd. 2017). Participants reported that spending time with children, having social support, living in houses adapted to aging health conditions, having access to community activities and services, and time spent on the land were the main resources supporting their health. Several factors limited the availability of these resources. These include: lack of accessibility to resources; structural factors impacting their availability; and natural and social changes in interpersonal relationships. Participants also stressed the importance of being able to grow old in their own community. Knowledge generated in this project contributes to policies and programs targeting housing and community conditions to support healthy aging, and aging in place, in Inuit Nunangat.
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Affiliation(s)
- Marie Baron
- VITAM Centre de Recherche en Santé Durable, 2601, Chemin de la Canardière, Bureau G-2316, Québec, QC, G1J 0A4, Canada.
- Faculté de Sciences Infirmières, Université Laval, Quebec City, QC, Canada.
| | - Christopher Fletcher
- Département de Médecine Sociale et Préventive, Université Laval, Quebec City, QC, Canada
| | - Mylène Riva
- Canada Research Chair in Housing, Community and Health; Institute for Health and Social Policy and Department of Geography, McGill University, Montreal, QC, Canada
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Rahman A, Akbar D, Rolfe J, Nguyen J. Developing a population wide cost estimating framework and methods for technological intervention enabling ageing in place: An Australian case. PLoS One 2019; 14:e0218448. [PMID: 31242208 PMCID: PMC6594731 DOI: 10.1371/journal.pone.0218448] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Accepted: 06/03/2019] [Indexed: 11/19/2022] Open
Abstract
Purpose Ageing in place is one of the greatest desires of elderly people. Assistive digital technologies could potentially delay the institutionalization of the elderly people and allow them ageing in place. This study develops a population-wide cost estimating framework for adopting digital technologies that can improve the quality of life of elderly people through examining an Australian region. Methods We developed a five-stage cost estimation framework, which involved progressive forecasting of elderly population and direct cost estimation methods. The forecasting and cost estimation models have been set for a 10-year period because the prediction accuracy from cross-sectional data is better in the short to medium term compared to the long-term. For cost estimation, we categorised the ageing population on the basis of the number of chronic diseases that they have contracted. Costs of assistive technologies were collected from open sources. The model has been tested in the Fitzroy and Central West, a regional area of Queensland in Australia. A stakeholder panel discussion in a workshop format was used to validate the appropriateness of the proposed framework and the study findings. Results This study identified eight common chronic diseases with different comorbidity patterns in Australia. We also identified the required assistive technologies to assist patients with chronic diseases. This study estimated that annual per capita cost for technological intervention could range from AUD 4,169 to AUD 7,551 on the basis of different price margins of the technologies. Conclusion The approach of categorising the aged cohorts on the basis of the number of chronic diseases helps estimate population-wide costs compared to using single technology intervention costs for a particular chronic disease cohort. The cost estimation framework and the method developed in this study can assist the government to estimate costs for ageing-in-place programs.
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Affiliation(s)
- Azad Rahman
- School of Business and Law, Central Queensland University, Rockhampton, QLD, Australia
- * E-mail:
| | - Delwar Akbar
- School of Business and Law, Central Queensland University, Rockhampton, QLD, Australia
| | - John Rolfe
- School of Business and Law, Central Queensland University, Rockhampton, QLD, Australia
| | - Julie Nguyen
- School of Health, Medical & Applied Sciences, Central Queensland University, Rockhampton, QLD, Australia
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Abstract
ABSTRACTPerson-centred provision of long-term care (LTC) requires information on how individuals value respective LTC services. The literature on LTC preferences has not been comprehensively reviewed, existing summaries are contradictory. An explorative, scoping review was conducted to provide a thorough methodological description and results synthesis of studies that empirically investigated LTC preference outcomes based on respondents’ statements. A wide search strategy, with 18 key terms relating to ‘LTC’ and 31 to ‘preferences’, was developed. Database searches in PubMed, Ovid and ScienceDirect were conducted in February 2016. The 59 studies meeting the inclusion criteria were grouped and methodically described based on preference elicitation techniques and methods. Despite substantial methodological heterogeneity between studies, certain findings consistently emerged for the investigated LTC preference outcomes. The large majority of respondents preferred to receive LTC in their known physical and social environment when care needs were moderate, but residential care when care needs were extensive. Preferences were found to depend on a variety of personal, environmental, social and cultural aspects. Dependent individuals aspired to preserve their personal and social identity, self-image, independence, autonomy, control and dignity, which suggests that LTC preferences are a function of the perceived ability of a specific LTC arrangement to satisfy peoples’ basic physiological and mental/social needs. Research on LTC preferences would greatly profit from a standardisation of respective concepts and methods.
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Kitase Y, Vallejo JA, Gutheil W, Vemula H, Jähn K, Yi J, Zhou J, Brotto M, Bonewald LF. β-aminoisobutyric Acid, l-BAIBA, Is a Muscle-Derived Osteocyte Survival Factor. Cell Rep 2018; 22:1531-1544. [PMID: 29425508 PMCID: PMC5832359 DOI: 10.1016/j.celrep.2018.01.041] [Citation(s) in RCA: 114] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2017] [Revised: 11/03/2017] [Accepted: 01/12/2018] [Indexed: 01/04/2023] Open
Abstract
Exercise has beneficial effects on metabolism and on tissues. The exercise-induced muscle factor β-aminoisobutyric acid (BAIBA) plays a critical role in the browning of white fat and in insulin resistance. Here we show another function for BAIBA, that of a bone-protective factor that prevents osteocyte cell death induced by reactive oxygen species (ROS). l-BAIBA was as or more protective than estrogen or N-acetyl cysteine, signaling through the Mas-Related G Protein-Coupled Receptor Type D (MRGPRD) to prevent the breakdown of mitochondria due to ROS. BAIBA supplied in drinking water prevented bone loss and loss of muscle function in the murine hindlimb unloading model, a model of osteocyte apoptosis. The protective effect of BAIBA was lost with age, not due to loss of the muscle capacity to produce BAIBA but likely to reduced Mrgprd expression with aging. This has implications for understanding the attenuated effect of exercise on bone with aging.
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Affiliation(s)
- Yukiko Kitase
- Department of Anatomy and Cell Biology, School of Medicine, Indiana University, Indianapolis, IN 46202, USA.
| | - Julian A Vallejo
- Department of Biomedical Sciences, School of Medicine, University of Missouri-Kansas City, Kansas City, MO 64108, USA; Department of Oral & Craniofacial Sciences, School of Dentistry, University of Missouri-Kansas City, Kansas City, MO 64108, USA
| | - William Gutheil
- Division of Pharmaceutical Sciences, School of Pharmacy, University of Missouri-Kansas City, Kansas City, MO 64108, USA
| | - Harika Vemula
- Division of Pharmaceutical Sciences, School of Pharmacy, University of Missouri-Kansas City, Kansas City, MO 64108, USA
| | - Katharina Jähn
- Department of Osteology and Biomechanics, University of Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Jianxun Yi
- Kansas City University of Medicine and Bioscience, Kansas City, MO 64106, USA
| | - Jingsong Zhou
- Kansas City University of Medicine and Bioscience, Kansas City, MO 64106, USA
| | - Marco Brotto
- Bone-Muscle Collaborative Science, College of Nursing & Health Innovation, University of Texas-Arlington, Arlington, TX 76019, USA
| | - Lynda F Bonewald
- Department of Anatomy and Cell Biology, School of Medicine, Indiana University, Indianapolis, IN 46202, USA; Department of Orthopaedic Surgery, School of Medicine, Indiana University, Indianapolis, IN 46202, USA.
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Fong BYF, Law VT. Aging in Place. SUSTAINABLE HEALTH AND LONG-TERM CARE SOLUTIONS FOR AN AGING POPULATION 2018. [DOI: 10.4018/978-1-5225-2633-9.ch014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Aging is a function of time and is a natural and integral part of the life cycle. Aging process differs among individuals and brings all kinds of changes, affecting not just the physical body and its functions, but also to the social, psychological and financial situations to individuals. Aging in place (AIP) is a common preference among older people for remaining in their local community and maintaining their social networks throughout the aging process. Issues about appropriateness of aging in place, long-term care, and residential homes are discussed. Some models and recommendations are discussed, completed with thoughts on future studies.
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Vivoda JM, Heeringa SG, Schulz AJ, Grengs J, Connell CM. The Influence of the Transportation Environment on Driving Reduction and Cessation. THE GERONTOLOGIST 2017; 57:824-832. [PMID: 27342439 PMCID: PMC6281339 DOI: 10.1093/geront/gnw088] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2016] [Accepted: 04/12/2016] [Indexed: 11/14/2022] Open
Abstract
Purpose of the Study Driving is by far the most common mode of transportation in the United States, but driving ability is known to decline as people experience age-related functional declines. Some older adults respond to such declines by self-limiting their driving to situations with a low perceived risk of crashing, and many people eventually stop driving completely. Previous research has largely focused on individual and interpersonal predictors of driving reduction and cessation (DRC). The purpose of this study was to assess the influence of the transportation environment on DRC. Design and Methods Data were combined from the Health and Retirement Study, the Urban Mobility Scorecard, and StreetMap North America (GIS data). Longitudinal survival analysis techniques were used to analyze seven waves of data spanning a 12-year period. Results As roadway density and congestion increased in the environment, the odds of DRC also increased, even after controlling for individual and interpersonal predictors. Other predictors of DRC included demographics, relationship status, health, and household size. Implications The current study identified an association between the transportation environment and DRC. Future research is needed to determine whether a causal link can be established. If so, modifications to the physical environment (e.g., creating livable communities with goods and services in close proximity) could reduce driving distances in order to improve older drivers' ability to remain engaged in life. In addition, older individuals who wish to age in place should consider how their local transportation environment may affect their quality of life.
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Affiliation(s)
- Jonathon M Vivoda
- Department of Sociology and Gerontology, Miami University, Oxford, Ohio
| | | | - Amy J Schulz
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor
| | - Joe Grengs
- Department of Urban and Regional Planning, University of Michigan, Ann Arbor
| | - Cathleen M Connell
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor
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Yang YT, Lin NP, Su S, Chen YM, Chang YM, Handa Y, Khan HAA, Elsa Hsu YH. Value-added strategy models to provide quality services in senior health business. Int J Qual Health Care 2017; 32:1-5. [PMID: 28637191 DOI: 10.1093/intqhc/mzx072] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2016] [Accepted: 06/15/2017] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE The rapid population aging is now a global issue. The increase in the elderly population will impact the health care industry and health enterprises; various senior needs will promote the growth of the senior health industry. Most senior health studies are focused on the demand side and scarcely on supply. Our study selected quality enterprises focused on aging health and analyzed different strategies to provide excellent quality services to senior health enterprises. DESIGN We selected 33 quality senior health enterprises in Taiwan and investigated their excellent quality services strategies by face-to-face semi-structured in-depth interviews with CEO and managers of each enterprise in 2013. SETTING A total of 33 senior health enterprises in Taiwan. PARTICIPANTS Overall, 65 CEOs and managers of 33 enterprises were interviewed individually. INTERVENTION(S) None. MAIN OUTCOME MEASURE(S) Core values and vision, organization structure, quality services provided, strategies for quality services. RESULTS This study's results indicated four type of value-added strategy models adopted by senior enterprises to offer quality services: (i) residential care and co-residence model, (ii) home care and living in place model, (iii) community e-business experience model and (iv) virtual and physical portable device model. The common part in these four strategy models is that the services provided are elderly centered. These models offer virtual and physical integrations, and also offer total solutions for the elderly and their caregivers. Through investigation of successful strategy models for providing quality services to seniors, we identified opportunities to develop innovative service models and successful characteristics, also policy implications were summarized. CONCLUSIONS The observations from this study will serve as a primary evidenced base for enterprises developing their senior market and, also for promoting the value co-creation possibility through dialogue between customers and those that deliver service.
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Affiliation(s)
- Ya-Ting Yang
- Institute of Health Policy and Management, National Taiwan University, No. 17, Xu-Zhou Road, Taipei 100, Taiwan
- Golden Dream Think Tank and Research Center, 250 WuHsing St., Taipei 110, Taiwan
- School of Health Care Administration, College of Management, Taipei Medical University, 250 WuHsing St., Taipei 110, Taiwan
| | - Neng-Pai Lin
- Institute of Health Policy and Management, National Taiwan University, No. 17, Xu-Zhou Road, Taipei 100, Taiwan
| | - Shyi Su
- Department of Health Business, HungKuang University, No. 34 Chung-Chie Rd., Sha Lu, Taichung City 443, Taiwan (R.O.C.)
| | - Ya-Mei Chen
- Institute of Health Policy and Management, National Taiwan University, No. 17, Xu-Zhou Road, Taipei 100, Taiwan
| | - Yao-Mao Chang
- School of Health Care Administration, College of Management, Taipei Medical University, 250 WuHsing St., Taipei 110, Taiwan
| | - Yujiro Handa
- Southern TOHOKU Research Institute for Neuroscience, Southern TOHOKU General Hospital, 7-1 15 Yatsuyamada, Koriyama-shi, Fukushima 963-8563, Japan
| | - Hafsah Arshed Ali Khan
- International Center for Health Information Technology (ICHIT), Taipei Medical University, 250 WuHsing St., Taipei 110, Taiwan
| | - Yi-Hsin Elsa Hsu
- Golden Dream Think Tank and Research Center, 250 WuHsing St., Taipei 110, Taiwan
- School of Health Care Administration, College of Management, Taipei Medical University, 250 WuHsing St., Taipei 110, Taiwan
- Executive Master Program of Business Administration in Biotechnology, College of Management, Taipei Medical University, 250 WuHsing St., Taipei 110, Taiwan
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Brotto M, Bonewald L. Bone and muscle: Interactions beyond mechanical. Bone 2015; 80:109-114. [PMID: 26453500 PMCID: PMC4600532 DOI: 10.1016/j.bone.2015.02.010] [Citation(s) in RCA: 193] [Impact Index Per Article: 21.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2014] [Revised: 01/27/2015] [Accepted: 02/08/2015] [Indexed: 02/08/2023]
Abstract
The musculoskeletal system is significantly more complex than portrayed by traditional reductionist approaches that have focused on and studied the components of this system separately. While bone and skeletal muscle are the two largest tissues within this system, this system also includes tendons, ligaments, cartilage, joints and other connective tissues along with vascular and nervous tissues. Because the main function of this system is locomotion, the mechanical interaction among the major players of this system is essential for the many shapes and forms observed in vertebrates and even in invertebrates. Thus, it is logical that the mechanical coupling theories of musculoskeletal development exert a dominant influence on our understanding of the biology of the musculoskeletal system, because these relationships are relatively easy to observe, measure, and perturb. Certainly much less recognized is the molecular and biochemical interaction among the individual players of the musculoskeletal system. In this brief review article, we first introduce some of the key reasons why the mechanical coupling theory has dominated our view of bone-muscle interactions followed by summarizing evidence for the secretory nature of bones and muscles. Finally, a number of highly physiological questions that cannot be answered by the mechanical theories alone will be raised along with different lines of evidence that support both a genetic and a biochemical communication between bones and muscles. It is hoped that these discussions will stimulate new insights into this fertile and promising new way of defining the relationships between these closely related tissues. Understanding the cellular and molecular mechanisms responsible for biochemical communication between bone and muscle is important not only from a basic research perspective but also as a means to identify potential new therapies for bone and muscle diseases, especially for when they co-exist. This article is part of a Special Issue entitled "Muscle Bone Interactions".
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Affiliation(s)
- Marco Brotto
- Muscle Biology Research Group-MUBIG, UMKC School of Nursing & Health Studies, 2464 Charlotte, USA; UMKC School of Medicine, 2464 Charlotte, USA
| | - Lynda Bonewald
- Bone Biology/Mineralized Tissue Research Program, Department of Oral and Craniofacial Sciences, UMKC School of Dentistry, 650 East 25th Street, Kansas City, MO 64108, USA
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