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Mroz EL, Ali T, Piechota A, Matta-Singh TD, Abboud A, Sharma S, Monin JK, Fried TR. Personal Health Planning in Adult-Child Former Caregivers of Parents Living With Dementia. Am J Health Promot 2024; 38:402-411. [PMID: 37770019 PMCID: PMC10922991 DOI: 10.1177/08901171231204670] [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] [Indexed: 10/03/2023]
Abstract
PURPOSE To examine how former caregivers for parents living with dementia engage in personal health planning. DESIGN An inductive, qualitative study. SETTING Virtual, audio-recorded, semi-structured interviews. PARTICIPANTS Thirty-two midlife former primary caregivers for parents who died following advanced dementia 3 months to 3 years prior. METHOD Participants responded to a series of open-ended interview prompts. Interview recordings were transcribed and evaluated by a trained, diverse team to generate Consensual Qualitative Research (CQR) domains and categories. RESULTS Caregivers developed health planning outlooks (ie, mindsets regarding willingness and ability to engage in personal health planning) that guided health planning activities (ie, engaging in a healthy lifestyle, initiating cognitive/genetic testing, maintaining independence and aging in place, ensuring financial and legal security). An agentic outlook involved feeling capable of engaging in health planning activities and arose when caregivers witnessed the impact and feasibility of their parents' health planning. Anxiety-inducing and present-focused outlooks arose when caregivers faced barriers (eg, low self-efficacy, lack of social support, perception that parent's health planning did not enhance quality of life) and concluded that personal health planning would not be valuable or feasible. CONCLUSION Caregiving for a parent living with dementia (PLWD) shapes former caregivers' personal health planning. Interventions should support former caregivers who have developed low self-efficacy or pessimistic views on healthy aging to support them in addressing health planning activities.
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Affiliation(s)
- Emily L. Mroz
- Section of Geriatrics, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA
| | - Talha Ali
- Department of Community Health, Tufts University, Medford, MA, USA
| | - Amanda Piechota
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT, USA
| | | | - Anissa Abboud
- Department of Health Policy, Yale School of Public Health, New Haven, CT, USA
| | - Shubam Sharma
- Department of Psychological Science, Kennesaw State University, Kennesaw, GA, USA
| | - Joan K. Monin
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT, USA
| | - Terri R. Fried
- Section of Geriatrics, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA
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Liu C, Hu J, Bai X. A Systematic Review of Literature on Caregiving Preparation of Adult Children. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6295. [PMID: 37444143 PMCID: PMC10341992 DOI: 10.3390/ijerph20136295] [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: 06/07/2023] [Accepted: 06/27/2023] [Indexed: 07/15/2023]
Abstract
With the increasing life expectancy and ageing population, long-term care has become an urgent policy issue worldwide. The informal care provided by family members, particularly adult children, is a key aspect of long-term care. However, socioeconomic transformations have resulted in changing family and demographic structures and increased geographic mobility, reducing the capacity of families to provide informal care and meet the caregiving needs of older adults. For ageing families, care preparation can be an effective method for coping with eldercare challenges, and care preparation is attracting increasing attention from researchers. This study seeks to conduct a systematic review for studies on caregiving preparation by adult children that were retrieved from six databases, to synthesise the available evidence, and to identify knowledge gaps and opportunities for future investigations. The characteristics and main themes of eighteen reviewed articles were identified and analysed. This study discussed various conceptualisations of caregiving preparation by adult children, the prevalence of caregiving preparation, the factors related to caregiving preparation, and the related consequences. On the basis of the systematic review findings, several limitations of the literature and directions for future research were proposed to promote care preparedness and the well-being of ageing families.
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Affiliation(s)
- Chang Liu
- Department of Applied Social Sciences, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Hong Kong 999077, China; (J.H.)
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Maxfield M, Pituch KA. Profiles in Dementia-Related Anxiety: A Latent Profile Analysis. J Gerontol B Psychol Sci Soc Sci 2022; 77:2182-2191. [PMID: 35678193 DOI: 10.1093/geronb/gbac082] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Indexed: 01/12/2023] Open
Abstract
OBJECTIVES Dementia-related anxiety (DRA) is the concern about current or future cognitive decline and potential diagnosis of Alzheimer's disease or related dementias (ADRD). Existing research suggests that DRA likely develops due to diverse reasons (e.g., family ADRD history, self-perceived risk, and health-related anxiety), and approaches to managing DRA likely differ as well (e.g., future planning). This study aimed to identify profiles in DRA. METHOD In a cross-sectional study, a convenience sample of U.S. adults ranging in age from 18 to 82 (N = 492, Mage = 49.25, standard deviation [SDage] = 15.43) completed online assessments of characteristics associated with DRA. Latent profile analysis was used to uncover distinct DRA profiles and promote understanding of individual characteristics associated with varying levels of DRA; multinomial regression assessed if the profiles are further distinguished by covariates. RESULTS The resulting four-profile model reveals profile differences are largely due to DRA, self-perceived ADRD risk, and preparedness for future care needs; health-related anxiety, age, ADRD exposure, and anticipated ADRD stigma contribute to profile differences as well. Profiles of the youngest and oldest groups reported the lowest and highest levels of preparedness for future care, along with the lowest DRA and self-perceived risk. Several covariates, particularly those assessing general psychological functioning, were also related to profile membership. DISCUSSION The resulting profiles point to several factors associated with elevated anxiety about ADRD, which do not fully match the risk factors for ADRD.
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Affiliation(s)
- Molly Maxfield
- Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, Arizona, USA.,Center for Innovation in Healthy and Resilient Aging, Arizona State University, Phoenix, Arizona, USA
| | - Keenan A Pituch
- Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, Arizona, USA
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Choi SL, Shin SH, Allen RS. How widowhood status relates to engagement in advance care planning among older adults: does race/ethnicity matter? Aging Ment Health 2022; 26:604-613. [PMID: 33380176 DOI: 10.1080/13607863.2020.1867823] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVES This study investigated whether and to what extent widowhood status is related to engagement in advance care planning (ACP), and further whether race/ethnicity moderated the relation. METHODS We analyzed a total of 11,257 older Americans from the Health and Retirement Study using random-effect regression models after controlling for covariates and year-fixed effects. RESULTS We found that both being a widow/widower ever and having been widowed for a longer period of time were associated with a higher probability of engagement in ACP. Specifically, we found that a one-year increase in the number of years since spousal death was associated with 1.02 (p < 0.05, 95% CI = 1.00, 1.03) changes in the odds ratios of informal ACP; however, inclusion of a quadratic term indicated that this association reversed after the peak. Moreover, our findings suggested a moderating effect of race/ethnicity on the relations of the length of time since spousal loss with engagement in ACP. Specifically, the odds of widowed non-Hispanic Blacks discussing with someone the care or medical treatment (informal ACP) and having a living will (formal ACP) were 0.96 (p < 0.05, 95% CI = 0.93, 1.00) and 0.88 (p < 0.05, 95% CI = 0.79, 0.97) times that of non-widowed non-Hispanic Whites. Compared with their non-Hispanic White counterparts, widowed non-Hispanic Blacks were less likely to engage in ACP, and the negative relations were exacerbated when they became widows/widowers. CONCLUSION We elaborated on these findings and discussed their implications for understanding the moderating effect of race/ethnicity on the relation between late-life widowhood and engagement in ACP. In order to develop programs that enhance engagement in ACP and reduce racial/ethnic disparities, research must incorporate intersectionality theory with attention to motivations and decision-making style among diverse widows/widowers. The findings from this study could help inform policy makers when developing public health programs and health care reimbursement programs that enhance engagement in ACP among widows/widowers.
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Affiliation(s)
- Shinae L Choi
- Department of Consumer Sciences, The University of Alabama, Tuscaloosa, AL, USA
| | - Su Hyun Shin
- Department of Family and Consumer Studies, The University of Utah, Salt Lake City, UT, USA
| | - Rebecca S Allen
- Alabama Research Institute on Aging, The University of Alabama, Tuscaloosa, AL, USA.,Department of Psychology, The University of Alabama, Tuscaloosa, AL, USA
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Miller LM, Solomon DN, Whitlatch CJ, Hiatt SO, Wu CY, Reynolds C, Au-Yeung WTM, Kaye J, Steele JS. The Remote Assessment and Dynamic Response Program: Development of an In-Home Dementia-Related Care Needs Assessment to Improve Well-Being. Innov Aging 2022; 6:igac006. [PMID: 35402736 PMCID: PMC8985764 DOI: 10.1093/geroni/igac006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2021] [Indexed: 02/05/2023] Open
Abstract
Background and Objectives The Remote Assessment and Dynamic Response (READyR) Program was developed in order to address the current lack of early-stage dementia care planning programs that assess the care needs of persons with dementia. The goal was to create a program informed by care values and ongoing ecologically valid data. The objectives of this study are to describe the development and design process of the READyR Program, and to evaluate the utility of the READyR Program for identifying dementia-related care needs. Research Design and Methods A prototype of the web-based READyR Program tool was first created using digital activity data that were collected by previous studies using a platform of multimodal sensors installed in the homes of older adult couples with and without dementia. Digital activity data were then mapped onto potential care values (e.g., safety & autonomy) to create a values-based needs assessment that is tailored to the individual care dyad. Next, evaluation of the READyR Program by 11 professional dementia care coordinators and case managers (across 3 semistructured focus groups) was used to explore the utility of READyR for assessing dementia-related needs. Qualitative description using conventional content analysis was used to iteratively code focus group data and to describe prevalent themes. Results Prevalent focus groups themes included barriers to (e.g., family relationship strain) and facilitators of (e.g., tailored assessments) the optimal process for assessing dementia-related care needs by care coordinators, as well as advantages to (e.g., providing new objective insights into function, and routines) and disadvantages of (e.g., bringing up new questions about care) incorporating the remote monitoring data into a values-based needs assessment. Discussion and Implications READyR has the potential to help family members, as well as care coordinators and providers, gain insight into the values-based care needs of persons with early-stage dementia. Clinical Trials Registration Number: NCT04542109.
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Affiliation(s)
- Lyndsey M Miller
- School of Nursing, Oregon Health and Science University, Portland, Oregon, USA
- Oregon Center for Aging & Technology (ORCATECH), Oregon Health and Science University, Portland, Oregon, USA
| | - Diane N Solomon
- School of Nursing, Oregon Health and Science University, Portland, Oregon, USA
| | | | - Shirin O Hiatt
- School of Nursing, Oregon Health and Science University, Portland, Oregon, USA
| | - Chao-Yi Wu
- Oregon Center for Aging & Technology (ORCATECH), Oregon Health and Science University, Portland, Oregon, USA
- NIA-Layton Aging & Alzheimer’s Disease Research Center, Oregon Health and Science University, Portland, Oregon, USA
| | - Christina Reynolds
- Oregon Center for Aging & Technology (ORCATECH), Oregon Health and Science University, Portland, Oregon, USA
- NIA-Layton Aging & Alzheimer’s Disease Research Center, Oregon Health and Science University, Portland, Oregon, USA
| | - Wan-Tai Michael Au-Yeung
- Oregon Center for Aging & Technology (ORCATECH), Oregon Health and Science University, Portland, Oregon, USA
- NIA-Layton Aging & Alzheimer’s Disease Research Center, Oregon Health and Science University, Portland, Oregon, USA
| | - Jeffrey Kaye
- Oregon Center for Aging & Technology (ORCATECH), Oregon Health and Science University, Portland, Oregon, USA
- NIA-Layton Aging & Alzheimer’s Disease Research Center, Oregon Health and Science University, Portland, Oregon, USA
| | - Joel S Steele
- Department of Psychology, Portland State University, Portland, Oregon, USA
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Li Y, Sun Y, Li J, Jia J. Patterns and Predictors of Preparation for Future Care Among Older Rural Chinese Adults: A Latent Profile Analysis. J Appl Gerontol 2021; 41:207-216. [PMID: 34886703 DOI: 10.1177/0733464820964148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
This study aimed to identify profiles of preparation for future care (PFC) among older rural Chinese adults. A total of 481 older adults were recruited. PFC was evaluated using Preparation for Future Care Needs and respondents' social services knowledge. Information on individual characteristics, physical health indicators, mental health, and support system was collected. Four profiles of PFC were identified: scarce-preparation (22.42%), high-avoidance/low-action (26.91%), moderate-preparation (44.17%), and high-avoidance/high-action (6.50%). The scarce-preparation and high-avoidance/low-action profiles had the lowest levels of social services knowledge. Multinomial logistic regression showed that older adults in moderate-preparation and high-avoidance/high-action profiles had fewer illnesses, exercised more frequently, and had higher loneliness levels compared with those in the scarce-preparation profile. Compared with high-avoidance/low-action persons, high-avoidance/high-action persons had fewer illnesses, exercised more frequently, and had lower self-esteem and higher loneliness levels. People who performed poorly in physical health indicators and well in mental health need to increase PFC.
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Affiliation(s)
- Yuqin Li
- Shandong University, Jinan, China
- Shandong Management University, Jinan, China
| | | | - Junxin Li
- Johns Hopkins University, Baltimore, MD, USA
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Maxfield M, Pituch KA. COVID-19 worry, mental health indicators, and preparedness for future care needs across the adult lifespan. Aging Ment Health 2021; 25:1273-1280. [PMID: 33043689 DOI: 10.1080/13607863.2020.1828272] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVE The COVID-19 pandemic has been a source of worry for many, but older adults have been identified as more vulnerable to serious cases and may therefore feel more concerned about the virus. We assessed whether COVID-19 worry was related to indicators of mental health and preparedness for future care, in an adult lifespan sample. METHOD An online study (n = 485; age 18-82, M = 49.31, SD = 15.39) included measures of COVID-19 worry, depression, general anxiety, health anxiety, hostile and benevolent ageism, preparedness for future care, and demographic information. RESULTS Age and living alone were positively associated with greater COVID-19 worry, as were health anxiety, general anxiety, benevolent ageism, and preparedness for future care needs via gathering information. A significant interaction indicated that among individuals reporting lower health anxiety, greater preference for gathering information was positively associated with greater COVID-19 worry; however, for individuals having high health anxiety, gathering information about future care was not related to COVID-19 worry, as their COVID-19 worry levels were moderately high. CONCLUSION Older age was associated with greater COVID-19 worry, perhaps in response to the much publicized greater risk for negative outcomes in this population. In spite of this specific concern, indicators of older adults' continued mental health emerged. Preparedness for future care is also highlighted, as well as clinical implications.
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Affiliation(s)
- Molly Maxfield
- Edson College of Nursing and Health Innovation, Arizona State University, Tempe, AZ, USA
| | - Keenan A Pituch
- Edson College of Nursing and Health Innovation, Arizona State University, Tempe, AZ, USA
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8
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Bai X, Liu C, Song Y, Sörensen S. Adaptation and Validation of the Preparation for Future Care Needs Scale for Chinese Older Adults in Hong Kong. THE GERONTOLOGIST 2021; 62:e357-e368. [PMID: 34166488 PMCID: PMC9372894 DOI: 10.1093/geront/gnab089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Indexed: 11/19/2022] Open
Abstract
Background and Objectives Care planning can protect against or offset potential stressors in the caregiving stage and mitigate their detrimental effects. This study aimed to translate, adapt, and validate 2 short forms of the multidimensional, theory-guided scale measuring preparation for future care needs (PFCN) among Chinese older adults in Hong Kong. Research Design and Methods Data were derived from a cross-sectional survey of 862 community-dwelling individuals aged 60 years and older. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were conducted to assess the structural validity of the scales. Criterion-related validity, known-groups validity, and internal consistency were also examined. Results EFA yielded a 14-item 4-factor (awareness, avoidance, decision making, and concrete planning) model, which was supported by CFA and explained 68.9% of the total variance. CFA also supported the structural validity of the 5-item scale. Criterion-related validity of the 2 scales was supported by their significant and positive correlations with domain-specific planning behaviors for retirement. Known-groups validity of the 2 scales was demonstrated by significant differences in scores between male and female older adults and scores between different educational levels and socioeconomic status. Cronbach’s alphas for the internal consistency of the 14-item and 5-item scales were 0.889 and 0.774, respectively. Discussion and Implications PFCN scales enable researchers and service practitioners to accurately understand and assess older adults’ processes and efforts in care planning, facilitate the identification of individuals at risk from inadequate planning, and inform the development of interventions to enhance care preparation in target domains.
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Affiliation(s)
- Xue Bai
- Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hong Kong, China.,Institute of Active Ageing, The Hong Kong Polytechnic University, Hong Kong, China
| | - Chang Liu
- Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hong Kong, China
| | - Yajun Song
- School of Social and Public Administration, East China University of Science and Technology, Shanghai, China
| | - Silvia Sörensen
- Warner School of Education and Human Development, University of Rochester, Rochester, New York, USA
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Yun SW, Greenberg J, Maxfield M. Preparation for Future Care Needs in Middle-Aged and Older Adults: What Promotes Feeling of Preparedness? Am J Hosp Palliat Care 2020; 38:972-978. [PMID: 33353403 DOI: 10.1177/1049909120981577] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To examine whether demographic, dementia-related, and control-related variables predict preparation for future care needs (PFCN) in a sample of middle-aged and older adults. PFCN is defined in this study as a self-perceived sense of preparedness for one's own future care needs, including general awareness of future care needs, gathering relevant information, decision-making about care preferences, concrete planning, and non-avoidance of care planning. METHODS Participants (N = 122; age 40 to 88 years: M = 65.83, SD = 9.80) completed self-report measures in an in-person study. Hierarchical multiple regression was calculated to predict PFCN. RESULTS Being female, having more positive dementia attitudes, higher attribution to powerful others for health condition(s), and more completed end-of-life (EOL) planning significantly predicted greater PFCN. CONCLUSION Findings indicate a positive relationship between objective (completed EOL planning items) and subjective (PFCN) components of planning, thus highlighting the importance of taking concrete steps in EOL planning to yield greater feelings of preparedness, which has been associated with positive psychological outcomes.
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Affiliation(s)
- Stacy W Yun
- Department of Psychology, 14676University of Colorado Colorado Springs, Colorado Springs, CO, USA
| | - Jeff Greenberg
- Department of Psychology, 8041University of Arizona, Tucson, AZ, USA
| | - Molly Maxfield
- Edson College of Nursing and Health Innovation, 7864Arizona State University, Phoenix, AZ, USA
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Lai FHY, Yan EWH, Tsui WS, Yu KKY. A randomized control trial of activity scheduling for caring for older adults with dementia and its impact on their spouse care-givers. Arch Gerontol Geriatr 2020; 90:104167. [DOI: 10.1016/j.archger.2020.104167] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 06/14/2020] [Accepted: 06/28/2020] [Indexed: 01/05/2023]
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Gorenko JA, Konnert C, Speirs C. Does Caregiving Influence Planning for Future Aging?: A Mixed Methods Study Among Caregivers in Canada. Res Aging 2020; 43:203-213. [PMID: 32762538 DOI: 10.1177/0164027520948172] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
A mixed method design was used to examine how caregiving and transitioning a family member into long-term care (LTC) influence planning. Participants, aged 50+ from the community, completed self-report questionnaires. Quantitative data evaluated differences between three groups (non-caregivers, caregivers, caregivers with experience in assisting with a LTC transition); and predictive effects of caregiving, care expectations and social support to planning. Interviews among a subsample of caregivers examined how experiences of caregiving, including assisting in a transition to LTC, and social support influenced planning. Results indicated that: (1) caregivers with LTC transition experience planned significantly more than non-caregivers, (2) caregiving, care expectations, and social support significantly predicted of planning, and (3) future care expectation was an important mechanism in the relationship between caregiving and planning. These findings underscore the impact of caregiving experiences on expectations of future care needs and preparation for future care needs, and the importance of social support.
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Affiliation(s)
- Julie A Gorenko
- Department of Psychology, 2129University of Calgary, Alberta, Canada
| | - Candace Konnert
- Department of Psychology, 2129University of Calgary, Alberta, Canada
| | - Calandra Speirs
- Department of Psychology, 2129University of Calgary, Alberta, Canada
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12
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Kokorelias KM, Gignac MAM, Naglie G, Rittenberg N, MacKenzie J, D’Souza S, Cameron JI. A grounded theory study to identify caregiving phases and support needs across the Alzheimer’s disease trajectory. Disabil Rehabil 2020; 44:1050-1059. [DOI: 10.1080/09638288.2020.1788655] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Kristina M. Kokorelias
- Rehabilitation Sciences Institute, Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Monique A. M. Gignac
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
- Institute for Work and Health, Toronto, Canada
| | - Gary Naglie
- Department of Medicine, Faculty of Medicine, University of Toronto, Toronto, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada
- Rotman Research Institute, Baycrest Health Sciences, Toronto, Canada
| | - Nira Rittenberg
- Department of Occupational Science and Occupational Therapy, Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Jennifer MacKenzie
- Department of Occupational Science and Occupational Therapy, Faculty of Medicine, University of Toronto, Toronto, Canada
- Ontario Shores Centre for Mental Health Sciences, Geriatric Transitional Unit, Whitby, Canada
| | - Samantha D’Souza
- Department of Occupational Science and Occupational Therapy, Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Jill I. Cameron
- Rehabilitation Sciences Institute, Faculty of Medicine, University of Toronto, Toronto, Canada
- Department of Occupational Science and Occupational Therapy, Faculty of Medicine, University of Toronto, Toronto, Canada
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13
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Li Y, Jia J, Zhao X, Zhang D. Preparation for future care moderates the relationship between loneliness and depression among Chinese rural older adults: A cross-sectional study. Geriatr Nurs 2020; 41:641-647. [PMID: 32387000 DOI: 10.1016/j.gerinurse.2020.04.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2019] [Revised: 04/01/2020] [Accepted: 04/06/2020] [Indexed: 12/01/2022]
Abstract
Loneliness has been identified as a risk factor for depression, while preparation for future care (PFC) can be a protective factor. Little is known about their complex relationships in older adults in China. This study aimed to explore whether PFC moderated the association between loneliness and depression. A total of 481 older adults aged 60 years and above were recruited in rural Shandong, China. After excluding those whose data missing rates were over 15%, data were analyzed for a total of 436 participants. Loneliness, PFC, and depression were measured. Statistical analyses included descriptive analysis, and moderating effects analyses. Our findings showed that PFC and its related dimensions can moderate the relationship between loneliness and depression. When the level of PFC and its dimensions were higher, the effect of loneliness on depression was weaker. PFC should be taken into consideration when interventions are being developed to reduce depression in older adults.
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Affiliation(s)
- Yuqin Li
- School of Philosophy and social development, Shandong University, Jinan, Shandong, China; College of Humanities, Shandong Management University, Jinan, Shandong, China
| | - Jihui Jia
- School of Nursing, Shandong University, Jinan, Shandong, China
| | - Xia Zhao
- School of Nursing, Shandong University, Jinan, Shandong, China.
| | - Dan Zhang
- School of Nursing, Shandong University, Jinan, Shandong, China.
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Allen RS, Oliver JS, Eichorst MK, Mieskowski L, Payne-Foster P, Sörensen S. Preparation and Planning for Future Care in the Deep South: Adapting a Validated Tool for Cultural Sensitivity. THE GERONTOLOGIST 2019; 59:e643-e652. [PMID: 30239703 DOI: 10.1093/geront/gny102] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND AND OBJECTIVES This study describes the adaptation and validation of Sörensen et al. (2017)'s preparation for future care (PFC) scale with diverse samples including rural dwelling African Americans and certified nursing assistants (CNAs), and subsequent psychometric development. RESEARCH DESIGN AND METHODS Responses to the five-subscale PFC survey from 33 rural African American men across 12 months and cognitive interviews with a subset of 12 of these men are described. Psychometric refinement included descriptive qualitative analyses of consultations with experienced lay research advisors (N = 4 and N = 7) regarding potential changes to the PFC and a confirmatory factor analysis of the resultant scale (N = 138). RESULTS Cognitive interviews with rural African American men revealed difficulty understanding Eurocentric questions. Emergent themes included emotional avoidance of planning, considerations of nursing homes and possible care providers, and coping strategies. In two consultation meetings, trained lay research advisors recommended language modifications to the original questions and response options. Factor analyzing the resultant scale revealed support for the original subscale constructs (acceptable fit: χ2 = 205.03, df = 124, p < .001; root mean square error of approximation = .069 [.052-.085]; comparative fit index = .93; Tucker-Lewis index = .91). DISCUSSION AND IMPLICATIONS PFC and engagement in advance care planning is uncommon among African Americans, possibly due to distrust of and lack of cultural competency among health care professionals. The resulting tool and response options may be used as an interview guide/survey with African Americans to gain understanding about their preparation for future health care needs.
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Affiliation(s)
- Rebecca S Allen
- Alabama Research Institute on Aging, The University of Alabama, Tuscaloosa.,Department of Psychology, The University of Alabama, Tuscaloosa
| | - JoAnn S Oliver
- Alabama Research Institute on Aging, The University of Alabama, Tuscaloosa.,Capstone College of Nursing, The University of Alabama, Tuscaloosa
| | - Morgan K Eichorst
- Salem Veterans Affairs Medical Center, U.S. Department of Veterans Affairs, Virginia
| | - Lisa Mieskowski
- Alabama Research Institute on Aging, The University of Alabama, Tuscaloosa.,Department of Psychology, The University of Alabama, Tuscaloosa
| | - Pamela Payne-Foster
- Alabama Research Institute on Aging, The University of Alabama, Tuscaloosa.,Department of Community Medicine and Population Health, Institute for Rural Health Research, The University of Alabama, Tuscaloosa
| | - Silvia Sörensen
- Warner School for Education and Human Development, University of Rochester, New York
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