Older Adults' Needs for Assistance as a Function of Living Environment

Service Availability, Service Use, and Psychological Well-Being of Older Residents of Residential Care Facilities and Nursing Homes

THE PROBLEM

The availability and use of certain services that can compensate for older adults' decreased abilities and capabilities may help them maintain their independence and improve their psychological well-being. Therefore, this study investigated whether service availability and service use were associated with the psychological well-being of residents of residential care facilities and nursing homes.

THE RESOLUTION

Residents who used services that provide help with activities of daily living and instrumental activities of daily living were more likely to report a worse mood, poor psychological health, and low self-efficacy compared with those living in facilities where the services were not available. On the other hand, older residents who used social and wellness-related services were more likely to have a better mood, good psychological health, and high self-efficacy.

TIPS FOR SUCCESS

Senior living facilities should consider providing more social and wellness-related services and encourage residents' use of such services to improve their psychological well-being.

Mental Well-Being of Older People in Finland during the First Year in Senior Housing and Its Association with Physical Performance

Growing numbers of older people relocate to senior housing, when their physical or mental performance declines. The relocation is known to be one of the most stressful events in the life of older people and affect their mental and physical well-being. More information about the relationships between mental and physical parameters is required. We examined self-reported mental well-being of 81 older people (aged 59⁻93, living in northern Finland), and changes in it 3 and 12 months after relocation to senior housing. The first measurement was 3 months and the second measurement 12 months after relocation. Most participants were female (70%). Their physical performance was also measured, and associations between these two were analyzed. After 12 months, mental capability was very good or quite good in 38% of participants, however 22% of participants felt depressive symptoms daily or weekly. Moreover, 39% of participants reported daily or weekly loneliness. After 12 months participants reported a significant increase in forgetting appointments, losing items and difficulties in learn new things. They felt that opportunities to make decisions concerning their own life significantly decreased. Furthermore, their instrumental activities of daily living (IADL), dominant hand’s grip strength and walking speed decreased significantly. Opportunities to make decisions concerning their life, feeling safe, loneliness, sleeping problems, negative thoughts as well as fear of falling or having an accident outdoors were associated with these physical parameters. In addition to assessing physical performance and regular exercise, the various components of mental well-being and their interactions with physical performance should be considered during adjustment to senior housing.

The Association between Freedom of Choice and Effectiveness of Home Care Services

OBJECTIVES

The aim of this paper is to study home care clients' freedom to choose their services, as well the association between the effectiveness of home care services and freedom of choice, among other factors.

METHODS

A structured postal survey was conducted among regular home care clients (n = 2096) aged 65 or older in three towns in Finland. Freedom of choice was studied based on clients' subjective experiences. The effectiveness of the services was evaluated by means of changes in the social-care-related quality of life. Regression analyses were used to test associations.

RESULTS

As much as 62% of home care recipients reported having some choice regarding their services. Choosing meals and visiting times for the care worker were associated with better effectiveness. The basic model, which included needs and other factors expected to have an impact on quality of life, explained 15.4% of the changes in quality of life, while the extended model, which included the freedom-of-choice variables, explained 17.4%. The inclusion of freedom-of-choice variables increased the adjusted coefficient of determination by 2%. There was a significant positive association between freedom of choice and the effectiveness of public home care services.

CONCLUSION

Freedom of choice does not exist for all clients of home care who desire it. By changing social welfare activities and structures, it is possible to show respect for clients' opinions and to thereby improve the effectiveness of home care services.

Older Adults' Medication Management in the Home: How can Robots Help?

Successful management of medications is critical to maintaining healthy and independent living for older adults. However, medication non-adherence is a common problem with a high risk for severe consequences [5], which can jeopardize older adults' chances to age in place [1]. Well-designed robots assisting with medication management tasks could support older adults' independence. Design of successful robots will be enhanced through understanding concerns, attitudes, and preferences for medication assistance tasks. We assessed older adults' reactions to medication hand-off from a mobile manipulator robot with 12 participants (68-79 yrs). We identified factors that affected their attitudes toward a mobile manipulator for supporting general medication management tasks in the home. The older adults were open to robot assistance; however, their preferences varied depending on the nature of the medication management task. For instance, they preferred a robot (over a human) to remind them to take medications, but preferred human assistance for deciding what medication to take and for administering the medication. Factors such as perceptions of one's own capability and robot reliability influenced their attitudes.