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Lanthier-Labonté S, Chaudhury H, Wong J, Hung L. Dementia-Friendly Transportation Services: A Scoping Review. THE GERONTOLOGIST 2024; 64:gnae047. [PMID: 38767432 PMCID: PMC11200191 DOI: 10.1093/geront/gnae047] [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] [Received: 03/09/2023] [Indexed: 05/22/2024] Open
Abstract
BACKGROUND AND OBJECTIVES Transportation is an important component of dementia-friendly communities. People living with dementia have the right to access transportation services to keep their mobility in their community, which is essential for independence, well-being, and quality of life. This scoping review maps the literature on dementia-friendly transportation services and explores their characteristics to inform future development and research. RESEARCH DESIGN AND METHODS Empirical quantitative and qualitative studies in English or French that informed on transportation services for people living with dementia in the community were searched in 15 databases. Two authors independently screened records and charted relevant characteristics from selected publications. Important findings were summarized with a narrative synthesis approach. RESULTS Thirty-five studies informed on important dimensions of transportation services in urban and/or rural context: availability, accessibility, acceptability, adaptability, and affordability. Important insights were identified: the importance of staff training and attitude, and the challenges of availability of affordable services in the rural context. Emerging policy and program intervention areas include the need for access to quiet areas in transit hubs, training to use mass public transit and mobility management. DISCUSSION AND IMPLICATIONS The literature on dementia-friendly transportation services is important in the expansion and maintenance of mobility for people living with dementia in the community. The scope of the existing scientific literature remains limited. Although several studies indicated a clear need for better access to dementia-friendly transportation services, the best practices still need to be demonstrated in the scientific literature.
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Affiliation(s)
- Stéphanie Lanthier-Labonté
- Department of Gerontology, Simon Fraser University, Vancouver, British Columbia, Canada
- Department of Community Health Sciences, Faculty of Medicine and Health Sciences, University of Sherbrooke, Quebec City, Quebec, Canada
| | - Habib Chaudhury
- Department of Gerontology, Simon Fraser University, Vancouver, British Columbia, Canada
| | - Joey Wong
- School of Nursing, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Lillian Hung
- School of Nursing, The University of British Columbia, Vancouver, British Columbia, Canada
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Stinchcombe A, Hopper S, Mullen N, Bédard M. Canadian Older Adults' Perceptions of Transitioning from Driver to Non-Driver. Occup Ther Health Care 2021; 38:110-130. [PMID: 34156891 DOI: 10.1080/07380577.2021.1936338] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Accepted: 05/22/2021] [Indexed: 10/21/2022]
Abstract
Ceasing driving is associated with many negative outcomes. We examined the perceived impact of driving cessation among current older drivers. Transcripts from 92 interviews with participants from several locations across Canada were analyzed using inductive thematic analysis. We identified five themes: planning for mobility change, mobility supports and neighborhoods, financial security, fearing loss of control and independence, and coping and acceptance as a part of aging. Findings highlight diverse attitudes toward driving cessation, ranging from avoidance to acceptance, and emphasize the importance of tailored resources for drivers at various stages of behavior change.
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Affiliation(s)
- Arne Stinchcombe
- Department of Recreation and Leisure Studies, Brock University, St. Catharines, Canada
| | - Shawna Hopper
- Department of Recreation and Leisure Studies, Brock University, St. Catharines, Canada
| | - Nadia Mullen
- Centre for Research on Safe Driving, Lakehead University, Thunder Bay, Canada
| | - Michel Bédard
- Centre for Research on Safe Driving, Lakehead University, Thunder Bay, Canada
- Northern Ontario School of Medicine, Thunder Bay, Canada
- St. Joseph's Care Group, Thunder Bay, Canada
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Pickering J, Crooks VA, Snyder J, Milner T. "If you have a pain, get on a plane": qualitatively exploring how short-term Canadian international retirement migrants prepare to manage their health while abroad. Trop Dis Travel Med Vaccines 2021; 7:10. [PMID: 33845906 PMCID: PMC8042851 DOI: 10.1186/s40794-021-00136-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Accepted: 03/30/2021] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Every year, tens of thousands of older Canadians travel abroad during the winter months to enjoy warmer destinations that offer social and recreational opportunities. How do these Canadians prepare to manage their health while abroad? In this analysis we explore this question by developing a typology of preparatory strategies. METHODS Semi-structured interviews were conducted with 19 older Canadians living seasonally in Yuma, Arizona (United States). Interviews were transcribed verbatim and thematically analysed to form the basis of a typology of preparatory strategies. RESULTS Four distinct preparatory strategies form the typology that summarizes how Canadian international retirement migrants prepare to manage their health while abroad. First, some participants became thoroughly prepared by gathering information from multiple sources and undertaking specific preparatory activities (e.g., visiting a travel medicine clinic, purchasing travel health insurance, bringing prescription refills). Second, some participants were preparation-adverse and relied on their abilities to address health needs and crises in-the-moment. Third, some participants became well informed about things they could do in advance to protect their health while abroad (e.g., purchasing travel health insurance) but opted not to undertake preparatory actions. A final group of participants prepared haphazardly. CONCLUSIONS This typology can assist health care providers in international retirement migrant destinations to appreciate differences among this patient population that is often characterized as being relatively homogenous. More research is needed to determine if these preparatory strategies are common in other mobile populations and if they are found in other destinations popular with international retirement migrants.
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Affiliation(s)
- John Pickering
- Simon Fraser University, 8888 University Dr, Burnaby, BC, V5A 1S6, Canada.
| | - Valorie A Crooks
- Simon Fraser University, 8888 University Dr, Burnaby, BC, V5A 1S6, Canada
| | - Jeremy Snyder
- Simon Fraser University, 8888 University Dr, Burnaby, BC, V5A 1S6, Canada
| | - Trudie Milner
- Yuma Regional Medical Center, 2400 S Avenue A, Yuma, AZ, 85364, USA
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Stasiulis E, Rapoport MJ, Sivajohan B, Naglie G. The Paradox of Dementia and Driving Cessation: "It's a Hot Topic," "Always on the Back Burner". THE GERONTOLOGIST 2021; 60:1261-1272. [PMID: 32301497 DOI: 10.1093/geront/gnaa034] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Despite the well-recognized difficulty that persons with dementia and family carers experience in the decision making and transition to nondriving, there are few interventions and resources to support them. As part of our ongoing research to develop a driving cessation toolkit that addresses this gap, we sought to examine the context-specific factors relevant to its effective implementation in settings that support older adults with dementia. RESEARCH DESIGN AND METHODS A qualitative descriptive approach was used to explore the perspectives of Alzheimer Society (AS) staff in their work of supporting people with dementia and family carers within the context of driving cessation. Individual in-depth interviews were conducted with 15 AS staff members in 4 Canadian provinces. Data were examined using interpretative thematic analysis. RESULTS The study results revealed an overarching paradox that despite the importance of driving cessation in people with dementia, it continues to be largely avoided at the individual and system levels. This is explored via the themes of (a) paradox of importance and avoidance identified in AS settings; (b) lack of awareness and understanding about dementia and driving among people with dementia and family carers; (c) distress and avoidance rooted in ongoing system issues; and (d) moving driving cessation to the "front burner." DISCUSSION AND IMPLICATIONS Viewed through the emerging social health paradigm, which focuses on the social and emotional consequences of dementia, our results highlight the urgent need to mobilize our communities, medical education systems, and transportation authorities to finally resolve the dementia and driving cessation paradox.
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Affiliation(s)
- Elaine Stasiulis
- Rotman Research Institute, Baycrest Health Sciences, Toronto, Ontario, Canada.,Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
| | - Mark J Rapoport
- Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.,Department of Psychiatry, University of Toronto, Ontario, Canada
| | - Brintha Sivajohan
- Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Gary Naglie
- Department of Medicine and Rotman Research Institute, Baycrest Health Sciences, Toronto, Ontario, Canada.,Departments of Medicine and Institute of Health Policy, Management and Evaluation, University of Toronto, Ontario, Canada
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Miller J, Ward C, Lee C, D'Ambrosio L, Coughlin J. Sharing is caring: The potential of the sharing economy to support aging in place. GERONTOLOGY & GERIATRICS EDUCATION 2020; 41:407-429. [PMID: 29364788 DOI: 10.1080/02701960.2018.1428575] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
This article explores innovative applications of sharing economy services that have the potential to support a population aging in place, especially the "oldest old," aged 85 and older, and their caregivers. A mixed-methods study conducted by the MIT AgeLab examined perceptions of and experiences with sharing economy services, ultimately finding opportunities and barriers to use. Thus, although sharing economy services have potential to support aging in place, to do so successfully will require reconstructing how older adults, family caregivers, aging service professionals, gerontology educators, and gerontology students conceptualize and deliver care to an aging population. We suggest examples for gerontology educators to integrate into their classrooms to further cultivate an appreciation among students of multiple approaches to intervention, including those that leverage sharing economy and technology-enabled platforms to support older adults and their caregivers.
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Affiliation(s)
- Julie Miller
- Massachusetts Institute of Technology AgeLab , Cambridge, Massachusetts, United States
| | - Carley Ward
- Massachusetts Institute of Technology AgeLab , Cambridge, Massachusetts, United States
| | - Chaiwoo Lee
- Massachusetts Institute of Technology AgeLab , Cambridge, Massachusetts, United States
| | - Lisa D'Ambrosio
- Massachusetts Institute of Technology AgeLab , Cambridge, Massachusetts, United States
| | - Joseph Coughlin
- Massachusetts Institute of Technology AgeLab , Cambridge, Massachusetts, United States
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Ryvicker M, Bollens-Lund E, Ornstein KA. Driving Status and Transportation Disadvantage Among Medicare Beneficiaries. J Appl Gerontol 2020; 39:935-943. [PMID: 30362863 PMCID: PMC6486463 DOI: 10.1177/0733464818806834] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Transportation disadvantage may have important implications for the health, well-being, and quality of life of older adults. This study used the 2015 National Health Aging Trends Study, a nationally representative study of Medicare beneficiaries aged 65 and over (N = 7,498), to generate national estimates of transportation modalities and transportation disadvantage among community-dwelling older adults in the United States. An estimated 10.8 million community-dwelling older adults in the United States rarely or never drive. Among nondrivers, 25% were classified as transportation disadvantaged, representing 2.3 million individuals. Individuals with more chronic medical conditions and those reliant on assistive devices were more likely to report having a transportation disadvantage (p < .05). Being married resulted in a 50% decreased odds of having a transportation disadvantage (p < .01). Some individuals may be at higher risk for transportation-related barriers to engaging in valued activities and accessing care, calling for tailored interventions such as ride-share services combined with care coordination strategies.
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Dabelko-Schoeny H, Fields NL, White K, Sheldon M, Ravi K, Robinson SR, Murphy IE, Jennings C. Using Community-Based Participatory Research Strategies in Age-Friendly Communities to Solve Mobility Challenges. JOURNAL OF GERONTOLOGICAL SOCIAL WORK 2020; 63:447-463. [PMID: 32458771 DOI: 10.1080/01634372.2020.1769787] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Revised: 05/12/2020] [Accepted: 05/12/2020] [Indexed: 06/11/2023]
Abstract
The number of older adults is steadily increasing in the United States and across the globe. Aging is linked to an increased risk of disability. Disabilities that limit one or more major life activities such as seeing, hearing, walking, and motor skills impact a person's ability to drive a car. Low utilization of alternative transportation by older adults and people with disabilities may put them at risk for social isolation. Social isolation is associated with a variety of negative health outcomes. While communities are challenged to create available, acceptable, accessible, adaptable and affordable mobility options, there are widely held, inaccurate biases around older adults' abilities to contribute to the development and improvement of alternative transportation options. Gerontological social workers are well-positioned to address this bias. This paper presents a case study of a large metropolitan county in the Midwest where community-based participatory research (CBPR) strategies were used to engage older residents to support the development of alternative transportation options supporting the tenets of environmental justice.
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Affiliation(s)
| | - Noelle L Fields
- School of Social Work, The University of Texas at Arlington , Arlington, Texas, USA
| | - Katie White
- Age-Friendly Communities, Columbus and Franklin County, College of Social Work, The Ohio State University , Columbus, Ohio, USA
| | - Marisa Sheldon
- Age-Friendly Communities, Columbus and Franklin County, College of Social Work, The Ohio State University , Columbus, Ohio, USA
| | - Kristen Ravi
- College of Social Work, the University of Tennessee-Knoxville , Knoxville, Tennessee, USA
| | - Sarah R Robinson
- School of Social Work, The University of Texas at Arlington , Arlington, Texas, USA
| | - Ian E Murphy
- College of Social Work, The Ohio State University , Columbus, Ohio, USA
| | - Claire Jennings
- Age-Friendly Communities, Columbus and Franklin County, College of Social Work, The Ohio State University , Columbus, Ohio, USA
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Sefcik JS, Bradway CK, Cacchione PZ. Transportation of Older Adults: Common Behaviors Interfering With Safety. Res Gerontol Nurs 2019; 12:184-192. [PMID: 31158297 DOI: 10.3928/19404921-20190522-03] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Accepted: 02/27/2019] [Indexed: 11/20/2022]
Abstract
There is a dearth of evidence on safely transporting frail older adults in the community. Therefore, the purpose of the current study was to gain a better understanding of behavioral expression exhibited by older adults during van transportation and to learn what actions van assistants and van drivers take to prevent or address behavioral expressions, which can create potential challenges to safe transportation. A qualitative descriptive approach was used and included four focus groups of van assistants and van drivers (N = 32) at one urban Program of All-Inclusive Care for the Elderly (PACE), which routinely transports approximately 90% of enrollees to and from the PACE center. Conventional content analysis was used to analyze the data. Four themes emerged. The first two themes were common behaviors: Removing Seat Belts and Verbal Behaviors. The remaining two themes addressed unusual behaviors that left lasting impressions: Physical Aggression and Conflict Between Passengers. Van assistants and van drivers used redirection and reassurance as preventive interventions to keep everyone safe. Transportation of PACE enrollees requires well-trained and astute van assistants and van drivers skilled with preventing and diffusing potentially unsafe behaviors. [Res Gerontol Nurs. 2019; 12(4):184-192.].
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Dickerson AE, Molnar LJ, Bédard M, Eby DW, Berg-Weger M, Choi M, Grigg J, Horowitz A, Meuser T, Myers A, O’Connor M, Silverstein NM. Transportation and Aging: An Updated Research Agenda to Advance Safe Mobility among Older Adults Transitioning From Driving to Non-driving. THE GERONTOLOGIST 2017; 59:215-221. [DOI: 10.1093/geront/gnx120] [Citation(s) in RCA: 66] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2016] [Indexed: 11/13/2022] Open
Affiliation(s)
- Anne E Dickerson
- Department of Occupational Therapy, East Carolina University, Greenville, North Carolina
| | - Lisa J Molnar
- University of Michigan Transportation Research Institute and Center for Advancing Transportation Leadership and Safety (ATLAS Center), Ann Arbor, Michigan
| | - Michel Bédard
- Centre for Research on Safe Driving, Lakehead University, Thunder Bay, Ontario, Canada
| | - David W Eby
- Department of Occupational Therapy, East Carolina University, Greenville, North Carolina
| | - Marla Berg-Weger
- Geriatric Education Center, Saint Louis University School of Social Work, Missouri
| | - Moon Choi
- Graduate School of Science and Technology Policy, Korea Advanced Institute of Science and Technology, Daejeon, South Korea
| | - Jenai Grigg
- Holy Family University, Philadelphia, Pennsylvania
| | - Amy Horowitz
- Graduate School of Social Service, Fordham University, New York
| | - Thomas Meuser
- Department of Sociology, Gerontology & Gender, University of Missouri—St. Louis
| | - Anita Myers
- School of Public Health and Health Systems, University of Waterloo, Ontario, Canada
| | - Melissa O’Connor
- Department of Human Development and Family Science, North Dakota State University, Fargo
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