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Golbach RDJ, Kleinenberg-Talsma N, van der Lucht F, Hobbelen JSM, Jager-Wittenaar H, Finnema EJ. Understanding frailty and its opposites from community-dwelling older peoples' perspectives: A phenomenological qualitative study. INTERNATIONAL JOURNAL OF NURSING STUDIES ADVANCES 2024; 7:100238. [PMID: 39310677 PMCID: PMC11416217 DOI: 10.1016/j.ijnsa.2024.100238] [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: 02/12/2024] [Revised: 08/15/2024] [Accepted: 09/04/2024] [Indexed: 09/25/2024] Open
Abstract
Background the global population is ageing. As older people become more susceptible to frailty, an increase in frailty prevalence is also expected. Although frailty has been defined before in research, older peoples' perceptions of frailty do not always coincide with those used in research or medical settings. Further exploring community-dwelling older people's viewpoints regarding frailty is essential for tailored care and policy. Aim the aim of this study was to explore the perspectives of Dutch community-dwelling older people regarding frailty and its opposing concepts. Methods a phenomenological qualitative study was conducted for which we carried out semi-structured interviews with independently living older people aged ≥65. Following the interviews, the participants filled out the Tilburg Frailty Indicator. Results the different domains of frailty: 'physical', 'psychological', and 'social', were recognized by participants. In addition, other aspects, such as financial capacity and digital functioning, have been identified. Four aspects of the meaning of frailty were identified in the category of other frailty definitions: 'dependency', 'frailty as getting hurt', 'frailty as prone to deterioration', and 'frailty as experiences of loss and sacrifice'. Participants also described the opposites of frailty, which could also be distinguished according to the 'physical', 'psychological', and 'social' domains. In addition, participants mentioned the following concepts as opposing frailty: 'vitality', 'resilience', 'independence', 'autonomy', and 'ambition'. Conclusion we found that frailty and its opposites share similar aspects, including physical, psychological, and social dimensions. Additionally, older people perceived cognition as an essential aspect of frailty. The psychological dimension seemed more dominant in concepts opposed to frailty, which raises opportunities to focus on the positive aspects and build on older people's (psychological) capabilities in managing frailty and its consequences. Based on these findings, policymakers and care professionals should consider the perspectives of older people regarding frailty and its opposing concepts.
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Affiliation(s)
- Rianne DJ Golbach
- Department of Science in Healthy Ageing and Healthcare (SHARE), University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
- Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences, Groningen, the Netherlands
- FAITH research, Groningen/Leeuwarden, the Netherlands
| | - Nanda Kleinenberg-Talsma
- Department of Science in Healthy Ageing and Healthcare (SHARE), University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
- Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences, Groningen, the Netherlands
- FAITH research, Groningen/Leeuwarden, the Netherlands
| | - Fons van der Lucht
- Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences, Groningen, the Netherlands
- FAITH research, Groningen/Leeuwarden, the Netherlands
- National Institute of Public Health and the Environment, Centre for Health and Society, Bilthoven, the Netherlands
- Aletta Jacobs School of Public Health, Groningen, the Netherlands
| | - Johannes SM Hobbelen
- Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences, Groningen, the Netherlands
- FAITH research, Groningen/Leeuwarden, the Netherlands
- Department of General Practice and Elderly Care Medicine, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Harriët Jager-Wittenaar
- Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences, Groningen, the Netherlands
- FAITH research, Groningen/Leeuwarden, the Netherlands
- Department of Gastroenterology and Hepatology, Dietetics, Radboud University Medical Center, Nijmegen, the Netherlands
- Vrije Universiteit Brussel, Faculty of Physical Education and Physiotherapy, Department Physiotherapy and Human Anatomy, Research Unit Experimental Anatomy, Belgium
| | - Evelyn J Finnema
- FAITH research, Groningen/Leeuwarden, the Netherlands
- Department of Health Sciences, Section of Nursing Research, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
- Research Group Nursing Diagnostics, Hanze University of Applied Sciences, Groningen, the Netherlands
- Research Group Living, Wellbeing and Care for Older People, NHL Stenden University of Applied Sciences, Leeuwarden, the Netherlands
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Lewis ET, Howard L, Carroll UR, Howie A, Kenning G, Withall A, Rockwood K, Cardona M, Radford K, Schreyenberg K, Peters R. Looking out across the front yard: aboriginal peoples' views of frailty in the community - A qualitative study. ETHNICITY & HEALTH 2024:1-21. [PMID: 39278212 DOI: 10.1080/13557858.2024.2402527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/02/2024] [Accepted: 09/04/2024] [Indexed: 09/18/2024]
Abstract
OBJECTIVE Frailty is one of the most significant challenges to healthy ageing. Aboriginal Australians experience some of the highest levels of frailty worldwide, and despite this, no studies have explored frailty from an Aboriginal perspective. This is important because Aboriginal understandings and priorities in frailty may differ from Western/mainstream frailty frameworks. Furthermore, this lack of research severely hampers healthcare planning and service delivery. As a starting point, this study aims to understand the experiences, attitudes, and perceptions that Aboriginal older adults hold regarding frailty. DESIGN A qualitative study that utilized the Indigenous research method of Yarning for data collection as a culturally appropriate process for engaging Aboriginal peoples. Yarning circles and one-on-one yarns with 22 Aboriginal adults aged 45+ years living in one Australian capital city took place online and over the phone to explore the views that Aboriginal adults hold around frailty. Data were analysed thematically by Aboriginal researchers. RESULTS Seven key thematic areas were identified: (1) Keep in with culture; (2) Physical markers of frailty; (3) Frailty throughout the life course; (4) Social, cultural, and psychological understandings of frailty; (5) We want information about frailty; (6) Appropriate and positive wording; (7) Frailty assessment. CONCLUSIONS There was interest and engagement in the concept of frailty by Aboriginal older adults and approaches to frailty that extend beyond the physical to address cognitive, psychosocial, cultural and spiritual domains are likely to be more acceptable to this population. Culture and community connectivity are essential elements in preventing and alleviating frailty and have wider positive implications for Aboriginal health and wellbeing. Existing tools in practice to assess frailty are not aligned with Aboriginal cultural norms. Culturally appropriate frailty assessment methods co-designed with the community which incorporate holistic and multidimensional approaches are urgently needed.
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Affiliation(s)
- Ebony T Lewis
- School of Population Health, University of New South Wales, Sydney, Australia
- The George Institute for Global Health, Barangaroo, Australia
- UNSW Ageing Futures Institute, University of New South Wales, Sydney, Australia
| | - Leanne Howard
- School of Population Health, University of New South Wales, Sydney, Australia
| | - Uncle Robert Carroll
- School of Population Health, University of New South Wales, Sydney, Australia
- Sydney Region Aboriginal Corporation, Penrith, Australia
| | - Adam Howie
- School of Population Health, University of New South Wales, Sydney, Australia
| | - Gail Kenning
- School of Population Health, University of New South Wales, Sydney, Australia
- UNSW Ageing Futures Institute, University of New South Wales, Sydney, Australia
- Big Anxiety Research Centre, University of New South Wales, Sydney, Australia
| | - Adrienne Withall
- School of Population Health, University of New South Wales, Sydney, Australia
- UNSW Ageing Futures Institute, University of New South Wales, Sydney, Australia
| | | | - Magnolia Cardona
- School of Population Health, University of New South Wales, Sydney, Australia
- Institute for Evidence Based Healthcare, Bond University, Gold Coast, Australia
| | - Kylie Radford
- UNSW Ageing Futures Institute, University of New South Wales, Sydney, Australia
- Neuroscience Research Australia, Randwick, Australia
| | | | - Ruth Peters
- The George Institute for Global Health, Barangaroo, Australia
- UNSW Ageing Futures Institute, University of New South Wales, Sydney, Australia
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Nyende A, Ellis-Hill C, Mantzoukas S. A Sense of Control and Wellbeing in Older People Living with Frailty: A Scoping Review. JOURNAL OF GERONTOLOGICAL SOCIAL WORK 2023; 66:1043-1072. [PMID: 37139581 DOI: 10.1080/01634372.2023.2206438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 04/19/2023] [Accepted: 04/20/2023] [Indexed: 05/05/2023]
Abstract
A sense of control is important for supporting older people living with frailty to develop adaptive functioning to optimize wellbeing. This scoping review examined the literature on the sense of control and wellbeing in older people living with frailty within their everyday life and care service use. Nine databases were searched using the timeframe 2000 to 2021 to identify key ideas regarding control and wellbeing in older people with frailty. The review highlighted three major themes: a) Control as conveyed in bodily expressions and daily activities, b) Sense of control and influence of place of residence, and c) Control within health and social care relationships. Maintaining a sense of control is not only an internal feeling but is impacted by physical and social environments. Greater focus is needed on the nature of relationships between older people living with frailty and those who work alongside them, which support control and wellbeing.
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Affiliation(s)
- Adam Nyende
- Faculty of Health and Social Sciences, Bournemouth University, Bournemouth, UK
| | - Caroline Ellis-Hill
- Faculty of Health and Social Sciences, Bournemouth University, Bournemouth, UK
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Dury S, Brosens D, Pan H, Principi A, Smetcoren AS, Perek-Białas J, De Donder L. Helping Behavior of Older Adults during the Early COVID-19 Lockdown in Belgium. Res Aging 2023; 45:8-20. [PMID: 35635381 PMCID: PMC9152631 DOI: 10.1177/01640275221105231] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
This study aimed to understand whether older adults not only received but also provided help during the first COVID-19 lockdown in Belgium, which factors motivated them to help, and whether older adults differed from younger age groups in terms of helping behavior and motives. Bivariate analyses were performed using data generated from an online cross-sectional survey in Belgium (N = 1892).The results showed that older adults who received help also provided it. This "interdependence" - mutual or reciprocal dependence - occurred regardless of age. In terms of motives for providing help, both older adults and their younger peers were primarily motivated by present-oriented and emotion-related motivation: older people were motivated to provide help by altruistic values and humanism, and enhancement motives linked to self-development.Policy implications of these results entail: during crisis situations, make use of the bond between older adults and their neighbors, such as caring communities.
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Affiliation(s)
- Sarah Dury
- Adult Educational Sciences, 70493Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Dorien Brosens
- Adult Educational Sciences, 70493Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Honghui Pan
- Adult Educational Sciences, 70493Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Andrea Principi
- Centre for Socio-Economic Research on Ageing, IRCCS INRCA, Ancona, Italy
| | - An-Sofie Smetcoren
- Adult Educational Sciences, 70493Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | | | - Liesbeth De Donder
- Adult Educational Sciences, 70493Vrije Universiteit Brussel (VUB), Brussels, Belgium
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Dierckx E, Duppen D, Hoens S, Switsers L, Smetcoren AS, De Donder L, D-SCOPE. Effectiveness, satisfaction and meaningfulness of a 6-step detection and prevention program for frail community-dwelling older adults: a mixed-method evaluation. BMC Geriatr 2022; 22:966. [DOI: 10.1186/s12877-022-03504-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Accepted: 10/05/2022] [Indexed: 12/15/2022] Open
Abstract
Abstract
Background:
As people age, the risk of becoming frail increases, often leading to negative outcomes and less well-being. Within the light of prevention, early detection and guidance to the right care and support is crucial. This study aimed to give an overview of the descriptive results of the D-SCOPE program and evaluate the process.
Methods:
The D-SCOPE program was developed as a detection and prevention program for frail community-dwelling older adults. The program creates a continuum of care and support, consisting of 6 steps: (1) Targeted case-finding using risk profiles for purposeful selection, (2) Preventive home-visit by an older volunteer, (3) Home visits by a professional, (4), Warm referral, (5) Monthly follow-up and (6) Long-term follow-up by home visit. The effectiveness of this program, in terms of satisfaction and meaningfulness, was studied quantitatively by means of a randomized controlled trial amongst 869 people with a frailty risk profile and qualitatively by 15 focus groups interviews.
Results:
The quantitative study revealed that 83.9% of the participants found the different home visits within the D-SCOPE program useful. The focus group interviews shed light on several issues and advantages: a more efficient case finding due to the applied risk factors for frailty, a more intensive tailor-made care and support due to the warm referral, the importance of both small-scaled and larger interventions based on the wishes irrespective of the state of frailty of the older persons, the focus on a strengths-based instead of a deficit-based approach and the follow up as being one of the greatest strengths of the project. However, to fully understand the benefits of the program a shift in mind from intervention to prevention is necessary.
Conclusions:
Our quantitative data show that most participants found the home visits meaningful and were satisfied with the intervention. The qualitative findings provided more insights into the experiences of the participants with the process. Based on these insights of the 6-step model of preventive home visits, municipalities and organizations can apply this model to carry out more targeted home visits.
Trial registration:
This trial was registered at ClinicalTrials.gov, on 30/05/2017, identifier: NCT03168204.
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Paine N, Lowe M, Rachele J, Turrell G. “I'm definitely not socially excluded!”- Perceptions of social exclusion among Australian government housing residents aged 80 and older who live alone. J Aging Stud 2022; 61:101011. [DOI: 10.1016/j.jaging.2022.101011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 02/01/2022] [Accepted: 02/22/2022] [Indexed: 11/24/2022]
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de Groot AJ, Wattel EM, van Dam CS, van Balen R, van der Wouden JC, Hertogh CMPM. Referral to geriatric rehabilitation: a scoping review of triage factors in acutely hospitalised older patients. Age Ageing 2022; 51:6527383. [PMID: 35150588 PMCID: PMC8840799 DOI: 10.1093/ageing/afac015] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE Old or frail acutely hospitalised patients can benefit from geriatric rehabilitation but criteria concerning referral decisions are unclear. This review presents an overview of clinical factors associated with referral to geriatric rehabilitation that may further consensus between hospital and rehabilitation professionals on triage. DESIGN Scoping review. METHODS A review was conducted following Arksey and O'Malley's framework. The search included literature concerning a broad spectrum of acutely hospitalised patients and factors associated with their referral to geriatric rehabilitation. RESULTS Selected abstracts were categorised into distinct geriatric rehabilitation care pathways such as stroke, hip fracture, amputation of lower limb, cardiac and oncologic rehabilitation. Abstracts on internal medical patients were further reviewed and 29 studies were included. A total of 13 studies focused on factors identifying rehabilitation needs and 16 on factors associated with outcome of geriatric rehabilitation. Triage factors were diverse and included frailty status, functional decline, cognitive symptoms and multimorbidity. Mood symptoms and living situation further specified post-acute care needs. In overview, triage factors could be characterised as demographic (n = 4), diagnosis-related (n = 8), mental (n = 6), functional (n = 10) or multi-domain (n = 12) and mapped in a transitional care pathway. CONCLUSIONS AND IMPLICATIONS Frailty and functional decline are characteristics frequently associated with referral to geriatric rehabilitation of acutely hospitalised internal medical patients. A comprehensive geriatric assessment or a simpler multi-domain set of tests reveals rehabilitation needs and approximates a functional prognosis. Professional consensus on factors and timing of triage in hospital is within reach.
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Affiliation(s)
- Aafke J de Groot
- Department of Medicine for Older People and Amsterdam Public Health research institute, Amsterdam UMC, Vrije Universiteit, Amsterdam, The Netherlands
| | - Elizabeth M Wattel
- Department of Medicine for Older People and Amsterdam Public Health research institute, Amsterdam UMC, Vrije Universiteit, Amsterdam, The Netherlands
| | - Carmen S van Dam
- Department of Internal Medicine and Geriatrics, Amsterdam UMC, Vrije Universiteit, Amsterdam, The Netherlands
| | - Romke van Balen
- Department of Public Health and Primary Care, Leiden University Medical Centre, Leiden, The Netherlands
| | - Johannes C van der Wouden
- Department of Medicine for Older People and Amsterdam Public Health research institute, Amsterdam UMC, Vrije Universiteit, Amsterdam, The Netherlands
| | - Cees M P M Hertogh
- Department of Medicine for Older People and Amsterdam Public Health research institute, Amsterdam UMC, Vrije Universiteit, Amsterdam, The Netherlands
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Lette M, Stoop A, Nijpels G, Baan C, de Bruin S, van Hout H. Safety risks among frail older people living at home in the Netherlands - A cross-sectional study in a routine primary care sample. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e469-e477. [PMID: 33201562 PMCID: PMC9292903 DOI: 10.1111/hsc.13230] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Revised: 08/28/2020] [Accepted: 10/20/2020] [Indexed: 06/11/2023]
Abstract
Frail older people face a range of problems and risks that could undermine their ability to live safely at home. A comprehensive overview of these risks, from a multidimensional perspective, is currently lacking. This study aims to examine the prevalence of risks in multiple domains of life among frail older people living at home. We used cross-sectional data from 824 people aged 65 years and older, who received a comprehensive geriatric assessment (the interRAI Home Care [interRAI-HC]) between 2014 and 2018, as part of routine care from 25 general practices in the region of West-Friesland, the Netherlands. The interRAI-HC identifies amenable risks related to people's clinical conditions, functioning, lifestyle and behaviour, and social and physical environment. Descriptive statistics were used to examine population characteristics (age, gender, marital status, living arrangements and presence of chronic conditions) and prevalence of risks. Most common risks were related to people's clinical conditions (i.e cardio-respiratory health, urinary incontinence, pain), functioning (i.e. limitations in instrumental activities of daily living and mood) and social environment (i.e. limitations in informal care and social functioning). More than 80% of frail older people faced multiple risks, and often on multiple domains of life simultaneously. People experiencing multiple risks per person, and on multiple domains simultaneously, were more often widowed and living alone. The multidimensional character of risks among frail older people living at home implies that an integrated approach to care, comprising both health and social care, is necessary. Insight in the prevalence of these risks can give direction to care allocation decisions.
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Affiliation(s)
- Manon Lette
- Department of General Practice and Elderly Care MedicineAmsterdam Public Health Research InstituteAmsterdam University Medical Centres – VU UniversityAmsterdamThe Netherlands
- National Institute for Public Health and the EnvironmentBilthovenThe Netherlands
- SIGRAAmsterdamThee Netherlands
| | - Annerieke Stoop
- Department of General Practice and Elderly Care MedicineAmsterdam Public Health Research InstituteAmsterdam University Medical Centres – VU UniversityAmsterdamThe Netherlands
- National Institute for Public Health and the EnvironmentBilthovenThe Netherlands
- Scientific Centre for Transformation in Care and Welfare (Tranzo)University of TilburgTilburgThe Netherlands
| | - Giel Nijpels
- Department of General Practice and Elderly Care MedicineAmsterdam Public Health Research InstituteAmsterdam University Medical Centres – VU UniversityAmsterdamThe Netherlands
| | - Caroline Baan
- National Institute for Public Health and the EnvironmentBilthovenThe Netherlands
- Scientific Centre for Transformation in Care and Welfare (Tranzo)University of TilburgTilburgThe Netherlands
| | - Simone de Bruin
- National Institute for Public Health and the EnvironmentBilthovenThe Netherlands
| | - Hein van Hout
- Department of General Practice and Elderly Care MedicineAmsterdam Public Health Research InstituteAmsterdam University Medical Centres – VU UniversityAmsterdamThe Netherlands
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Beeris C, Niemeijer A, Machielse A. Count Your Life by Smiles and Tears: An Integrative Review on Resilience and Growing Older. Gerontol Geriatr Med 2022; 8:23337214221119050. [PMID: 36090316 PMCID: PMC9449508 DOI: 10.1177/23337214221119050] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 07/15/2022] [Accepted: 07/25/2022] [Indexed: 11/15/2022] Open
Abstract
The concept of “resilience” is considered helpful in understanding how people
navigate adversities typical to later life. It is also a concept of growing
interest internationally in research and in social policy and (social) practice.
This article employs an integrative review methodology to explore current trends
in theoretical and empirical research on resilience. A total of 25 quantitative
and qualitative studies from 2011 to 2020 are included in this review. Findings
indicate how the reviewed studies typically define resilience from three
perspectives: resource-based, outcome-based, and process-based perspectives of
resilience. In the results of the same studies, the resource-based and
outcome-based perspectives are elaborated upon while detailed results from a
process-based perspective are lacking. Additionally, even though adversity is
recognized as a key element in conceptualizing resilience, it is scarcely
defined if defined at all in the reviewed studies. Further research is
recommended in this article to contribute to a realistic and encouraging
narrative on growing older in social policy and (social) practice.
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Affiliation(s)
- Chloe Beeris
- University of Humanistic Studies, Utrecht, The Netherlands
| | | | - Anja Machielse
- University of Humanistic Studies, Utrecht, The Netherlands
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Golovchanova N, Owiredua C, Boersma K, Andershed H, Hellfeldt K. Presence of Meaning in Life in Older Men and Women: The Role of Dimensions of Frailty and Social Support. Front Psychol 2021; 12:730724. [PMID: 34539530 PMCID: PMC8448055 DOI: 10.3389/fpsyg.2021.730724] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Accepted: 08/03/2021] [Indexed: 11/15/2022] Open
Abstract
Presence of meaning in life is an important component of eudemonic wellbeing while aging. While subjective health and interpersonal relationships are among important sources of meaning for older adults, less research has explored the gender differences in the potential contribution of these sources to the presence of meaning in late life. The current study aims to examine the associations of frailty dimensions (daily activities, health problems, and psychosocial functioning) and social support with the presence of meaning in late life, and whether these associations differ for older men and women. The study employs the data from the 65+ and Safe Study - a cross-sectional survey of residents of senior apartments. The data were collected in 2019 in a mid-sized Swedish municipality (N=618; age range from 64 to 106years, 60.5% female). Results showed significant associations of health problems, psychosocial functioning, and social support with the presence of meaning in life. Further, the results demonstrated no statistically significant gender differences in the associations between frailty dimensions, social support, and presence of meaning. However, since the interaction between health problems and gender approached statistical significance, this association was further explored indicating a more detrimental role of health problems in relation to the presence of meaning in life among older men than among older women. Overall, the study highlights the importance of physical and psychosocial health and social support for the presence of meaning in life among older adults and warrants further research on possible gender differences in the relation between health problems and meaning in late life.
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Experiences of social frailty among rural community-dwelling and assisted-living older adults: a qualitative study. AGEING & SOCIETY 2021. [DOI: 10.1017/s0144686x21000830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Abstract
Although social frailty has been described from a theoretical perspective, the lived experiences of older adults regarding social frailty are yet unknown. In this paper, we aim to (a) gain more in-depth insights into community-dwelling and assisted-living older adults’ experiences of social frailty and (b) explore the differences in these experiences between these two groups. We conduct a thematic analysis of 38 interviews with community-dwelling and assisted-living older adults in rural villages the Netherlands. We structure our findings along three overarching themes which highlight different aspects of the social frailty experiences of our participants: (a) present resources and activities to fulfil social needs, (b) resources and activities that have been lost, and (c) how they manage and adapt to changes in resources and activities over time. Loneliness is only reported among the community-dwelling participants, while the loss of mobility and participation in (social) activities is experienced most strongly by the assisted-living participants. These findings challenge the widespread policies and practices of ageing in place. We conclude that for some older adults, living in assisted arrangements is preferred over ageing in place, as doing so can prevent social frailty. The key reason for this is that life in assisted living is likely to bring about new social resources and activities, which may serve to fulfil the social needs of older adults.
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Van der Elst MCJ, Schoenmakers B, Verté D, De Donder L, De Witte N, Dury S, Fret B, Luyten J, Schols JMGA, Kempen GIJM, De Lepeleire J. The relation between age of retirement and frailty in later life? A cross-sectional study in Flemish older adults. Arch Gerontol Geriatr 2021; 96:104473. [PMID: 34246958 DOI: 10.1016/j.archger.2021.104473] [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: 02/01/2021] [Revised: 06/22/2021] [Accepted: 06/25/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Policymakers in several European countries, concerned about the sustainability of their pension system, have raised the statutory retirement age. While several studies investigated the effect of retirement on health, the relationship between retirement and frailty is neglected. Notwithstanding, frailty is associated with adverse outcomes. OBJECTIVE The aim of this study was to examine the relationship between age of retirement and frailty in later life. METHODS Data of the Belgian Ageing Studies, a cross-sectional research project was used. The present study includes N=12659 participants (>60y) in 83 Flemish municipalities. To address reverse causality, only participants not retired because of health-related reasons were included. The Comprehensive Frailty Assessment Instrument, a multidimensional frailty scale with four domains (physical, psychological, social and environmental) was used to operationalize frailty. Univariate general linear regression analyses (GLM) were performed for scores on the total frailty scale and the four subdomains separately. The analysis was done for men and women separately, since both groups have different labor trajectories. RESULTS The present study found a negative association between age of retirement and physical frailty for both men and women in later life, and total frailty for men, although the differences were small. No evidence was found for a relation between age of retirement and the other subdomains of frailty. CONCLUSIONS The results suggest that age of retirement is not a clinically relevant predictor for frailty in later life. Differences within and between subpopulations (e.g., profession) can shed a new light on this relation.
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Affiliation(s)
- Michael C J Van der Elst
- Care and Public Health Research Institute, Department of Health Services Research, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands; Department of Public Health and Primary Care, University of Leuven, Kapucijnenvoer 33 bus 7001 B-3000 Leuven, Belgium.
| | - Birgitte Schoenmakers
- Department of Public Health and Primary Care, University of Leuven, Kapucijnenvoer 33 bus 7001 B-3000 Leuven, Belgium.
| | - Dominique Verté
- Department of Educational Sciences, Vrije Universiteit Brussel, Pleinlaan 2, B-1050 Brussels, Belgium.
| | - Liesbeth De Donder
- Department of Educational Sciences, Vrije Universiteit Brussel, Pleinlaan 2, B-1050 Brussels, Belgium.
| | - Nico De Witte
- Department of Educational Sciences, Vrije Universiteit Brussel, Pleinlaan 2, B-1050 Brussels, Belgium; Faculty of Education, Health and Social Work, University College Ghent, Gent, Belgium.
| | - Sarah Dury
- Department of Educational Sciences, Vrije Universiteit Brussel, Pleinlaan 2, B-1050 Brussels, Belgium.
| | - Bram Fret
- Department of Educational Sciences, Vrije Universiteit Brussel, Pleinlaan 2, B-1050 Brussels, Belgium.
| | - Jeroen Luyten
- Leuven Institute for Healthcare Policy, Department of Public Health and Primary Care, University of Leuven, Kapucijnenvoer 35 bus 7001 B-3000 Leuven, Belgium.
| | - Jos M G A Schols
- Care and Public Health Research Institute, Department of Health Services Research, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands; Care and Public Health Research Institute, Department of Family Medicine, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands.
| | - Gertrudis I J M Kempen
- Care and Public Health Research Institute, Department of Health Services Research, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands.
| | - Jan De Lepeleire
- Department of Public Health and Primary Care, University of Leuven, Kapucijnenvoer 33 bus 7001 B-3000 Leuven, Belgium.
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European consensus on core principles and future priorities for geriatric rehabilitation: consensus statement. Eur Geriatr Med 2019; 11:233-238. [DOI: 10.1007/s41999-019-00274-1] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2019] [Accepted: 11/08/2019] [Indexed: 10/25/2022]
Abstract
Abstract
Purpose
In response to the growing recognition of geriatric rehabilitation and to support healthcare providers which need strategies to support older people with frailty who have experienced functional decline, we developed a consensus statement about core principles and future priorities for geriatric rehabilitation.
Methods
We used a three-stage approach to establish consensus—preparation, consensus and review.
Results
The consensus statement is grouped under 11 headings from (1) “Definition of GR” to (11) “Effective strategies to develop GR in Europe”, which define geriatric rehabilitation in a way that is compatible with existing service models across Europe. Additionally future goals around research and education are highlighted.
Conclusion
The definitions of the consensus statement can provide a starting point for those wishing to further develop geriatric rehabilitation in their jurisdiction and help to develop strategic alliances with other specialties, serving as a basis for a pan-European approach to geriatric rehabilitation.
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