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Melchiorre MG, Socci M, Lamura G, Quattrini S. Perceived Loneliness, Social Isolation, and Social Support Resources of Frail Older People Ageing in Place Alone in Italy. Healthcare (Basel) 2024; 12:875. [PMID: 38727432 PMCID: PMC11083615 DOI: 10.3390/healthcare12090875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Revised: 04/11/2024] [Accepted: 04/19/2024] [Indexed: 05/13/2024] Open
Abstract
This paper presents some findings from the IN-AGE ("Inclusive ageing in place") study, which the authors carried out in 2019 in Italy. It explores the available social support resources for frail older people with functional limitations ageing in place alone, and possible links between their social isolation and perceived loneliness. The authors conducted qualitative/semi-structured interviews involving 120 participants aged 65 years and over, and used a mixed-methods analysis (quantitative/qualitative). The main results show the family as the main help resource for daily activities, but also for intimate confidences against social isolation, especially when said relatives live close. Family confidants are less present when seniors are supported by friends/neighbours or/and public services. Moreover, the family is valuable for decreasing loneliness, although not always. However, some older people feel particularly alone when they are supported by public services. Such a complex context draws attention on the need of support for frail seniors living alone and could provide insights for policymakers on adequate policies for preventing and managing loneliness and social isolation in later life. This is especially relevant when family (and other) resources are not available or scarce, also considering the opportunities offered by technology, which can help seniors remain socially connected to relatives, friends and their overall community.
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Affiliation(s)
| | - Marco Socci
- Centre for Socio-Economic Research on Ageing, IRCCS INRCA—National Institute of Health and Science on Ageing, Via Santa Margherita 5, 60124 Ancona, Italy; (M.G.M.); (G.L.); (S.Q.)
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Allen JC, Rickards TS, Roberts CLH, Baird ES. Aging in Place and 'The Little Things': Prioritizing Mobile Health and Social Care in Rural Communities. J Aging Soc Policy 2024:1-17. [PMID: 38564337 DOI: 10.1080/08959420.2024.2323880] [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: 04/03/2023] [Accepted: 01/05/2024] [Indexed: 04/04/2024]
Abstract
Older adults are more frequently wanting to age in place. Governments are seeking cost-effective and efficient methods of supporting aging populations. Older adults who want to stay in their homes for as long as possible encounter multiple barriers, including struggling to maintain their homes, inadequate levels of social and healthcare support, and the lack of financial capacity to pay for home support services. The Mobile Seniors' Wellness Network (MSWN), a multi-disciplinary and person-centered mobile health and social support intervention study was designed to investigate and support aging in place for older adults living in rural New Brunswick, Canada. Secondary analysis of case notes and exit interviews using content analysis revealed concerns with the lack of affordable and mobile care services for vulnerable rural older adults. Older adults revealed that their needs include "the little things" rather than grand gestures or sweeping policies to age in place such as assistance with grounds and home maintenance, in addition to relational and person-centered health and social care in the home. Reliance on private service delivery and volunteer organizations can increase the likelihood that older adults will experience a breakdown of social support networks tied together loosely by friends, family, and their communities. When services are unattainable aging in place becomes an unreachable goal.
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Affiliation(s)
- Joshua C Allen
- Research Services, Horizon Health Network, Saint John, Canada
- Fredericton Downtown Community Health Centre, Horizon Health Network, Fredericton, NB, Canada
| | - Tracey S Rickards
- Faculty of Nursing, University of New Brunswick, Fredericton, NB, Canada
| | | | - Eve S Baird
- Research Services, Horizon Health Network, Saint John, Canada
- Fredericton Downtown Community Health Centre, Horizon Health Network, Fredericton, NB, Canada
- Faculty of Nursing, University of New Brunswick, Fredericton, NB, Canada
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Jia Q, Duan Y, Gong R, Jiang M, You D, Qu Y. Living arrangements and depression of the older adults- evidence from the Chinese longitudinal healthy longevity survey. BMC Public Health 2023; 23:1870. [PMID: 37759168 PMCID: PMC10523833 DOI: 10.1186/s12889-023-16730-4] [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: 01/25/2023] [Accepted: 09/10/2023] [Indexed: 09/29/2023] Open
Abstract
BACKGROUND The mental health and living arrangements of older adults are worthy of attention. Previous studies have pointed out that the living arrangements may be related to older adults' depression. However, it has not been found that studies concern the relationship between actual living arrangements, living arrangement preferences, and the fit between living arrangement preferences and reality and depression in older adults, so we carried out this study. METHODS The data from the Chinese longitudinal healthy longevity survey were used in this study. With the older adults' depression as the dependent variable and the living arrangement related variables as the independent variable, we constructed three binary-logistic regression analysis models to explore the potential relationship between living arrangement related variables and depression in older adults. RESULTS We found that the actual living arrangements, living arrangement preferences, and the fit between living arrangement preferences and reality are significantly correlated with depression in older adults. Specifically, older adults living alone or only with the spouse are at greater risk of depression. Older adults who prefer living alone or only with the spouse are at relatively low risk of depression. Older adults whose living arrangement preferences do not match reality have a higher risk of depression. CONCLUSION The living arrangement related variables are significantly correlated with depression in older adults. In addition to the actual living arrangements, living arrangement preferences and whether the living arrangement preferences fit with reality are also related to the depression of older adults.
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Affiliation(s)
- Qingwen Jia
- Organization and Personnel Department, Children's Hospital of Hebei Province, Shijiazhuang, China
| | - Yanhan Duan
- Medicine-Education Coordinateion and Medical Education Research Center, Hebei Medical University, Shijiazhuang, China
| | - Rui Gong
- Department of Adult Internal Medicine, Children's Hospital of Hebei Province, Shijiazhuang, China
| | - Meijun Jiang
- Graduate School, Hebei Medical University, Shijiazhuang, China
| | - Dianping You
- Party and Government Integrated Office, Children's Hospital of Hebei Province, Shijiazhuang, China
| | - Yi Qu
- Scientific Research Division, Children's Hospital of Hebei Province, 133 Jianhua Street, Yuhua District, Shijiazhuang, Hebei, China.
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Determining the correlation between old age adaptation, aging in place and depression in older adults: A descriptive correlational study. Arch Psychiatr Nurs 2023; 43:153-161. [PMID: 37032010 DOI: 10.1016/j.apnu.2023.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2022] [Revised: 01/15/2023] [Accepted: 02/20/2023] [Indexed: 03/08/2023]
Abstract
We conducted this study to determine the correlation between old age adaptation, aging in place, and depression in older adults. We carried out the descriptive correlational study with older adults (n:319) Ağrı Provincial Directorate of Health between October 2021 and April 2022. "SPSS 25 and Amos 23 programs" were used in the analysis of the data. Python 3.11.1, Microsoft Power BI programs were used for machine learning and graphical visualizations. In the study, it was determined that the model for the relationship between aging at a place level, adaptation difficulty in older adults level, and geriatric depression level was significant (F(2,316) = 37.002, p = 0.001). The aging in place level and the adaptation difficulty in older adults level explain 18.5% of the total variance of the level of geriatric depression. In the regression model, it was determined that the increase in the level of aging in place (t = -6.081, p < 0.001) and the decrease in the level of adaptation difficulty in older adults (t = 4.107, p < 0.001) of the participants caused a statistical decrease in the level of "Geriatric Depression." It has been determined that adaptation difficulty in older adults has a moderator role in the relationship between geriatric depression level and aging in place level. In our data set, while the estimate of the presence of depression was 40 % with logistic regression analysis, it was 97 % with Random Forest. The study determined that as the level of aging in -place increased and the adaptation difficulty in older adults decreased, and depression decreased.
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McGrath M, Bagul D, Du Toit SHJ. Barriers and facilitators of meaningful engagement among older migrants living with dementia in residential aged care facilities: A mixed studies systematic review. Scand J Occup Ther 2022; 29:530-541. [PMID: 33761300 DOI: 10.1080/11038128.2021.1898675] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 02/24/2021] [Accepted: 02/28/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Migrants with dementia living in residential care may be at risk of disengagement. OBJECTIVE To synthesize research relating to the meaningful engagement of migrants with dementia who are living in residential care. METHOD Mixed studies systematic review following PRISMA guidelines. Nine electronic databases were searched for relevant studies. Studies were eligible for inclusion if they reported original research relating to meaningful engagement of migrants with dementia living in residential aged care and were published in English. Two independent reviewers screened the title and abstracts, full texts of eligible studies and conducted a quality appraisal of included texts. A convergent qualitative synthesis approach was used. RESULTS From 1460 articles, 14 papers representing 12 studies were included. Facilitators of meaningful engagement included: the presence of cultural artefacts in the care environment, the use of multimodal communication and a shared but flexible understanding of residents' culture. Barriers were the absence of a common language and a task-orientated approach to care. CONCLUSIONS Migrants with dementia who are living in residential care are at increased risk of disengagement. Our review highlights the need for culturally congruent residential care to go beyond issues of language and to consider how occupations can be tailored to support ongoing participation and engagement.
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Affiliation(s)
- Margaret McGrath
- Sydney School of Health Sciences, University of Sydney, Camperdown, Australia
| | - Deepali Bagul
- Sydney School of Health Sciences, University of Sydney, Camperdown, Australia
| | - Sanetta H J Du Toit
- Sydney School of Health Sciences, University of Sydney, Camperdown, Australia
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Lotfalinezhad E, Nadrian H, Kousha A, Andersen-Ranberg K, Asghari Jafarabadi M, Sohrabi A, Hashemiparast M, Honarvar MR, Freeman S. Design, implementation and evaluation of informal home care support intervention program for lonely older adults in the community: Protocol for a feasibility study. PLoS One 2022; 17:e0273924. [PMID: 36044533 PMCID: PMC9432751 DOI: 10.1371/journal.pone.0273924] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 07/23/2022] [Indexed: 11/19/2022] Open
Abstract
Background Providing lonely older adults with informal home care services is important to improving their health and quality of life. The study aims to evaluate the feasibility of design, implementation and evaluation of an informal home care support intervention program (HoSIP) for community-dwelling lonely older adults in Gorgan, Iran. Method/design This feasibility study is a mixed-method with a concurrent nested design. Lonely older adults will be enrolled as the HoSIP intervention group and will receive 12-weeks of informal home care service by peer supporters. The purpose of this feasibility study is to determine the recruitment capability and resulting sample characteristics, data collection procedure and outcome measures, the acceptability and suitability of the intervention and study procedures, the resource and ability to manage the study and intervention, and preliminary evaluation of participant response to intervention. Primary outcomes including participant feelings of loneliness, quality of life, general health, social network, social support, and self-care ability, will be assessed at baseline and post-intervention for the intervention and control groups. Semi-structured interviews will be conducted immediately after the intervention using content qualitative approach to describe participants’ experiences with HoSIP. Discussion Through this study we will examine the feasibility of delivering informal home care services to community-dwelling lonely older adults in a developing country through employing a concurrent nested mixed-method design. Trial registration IRCT20190503043455N
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Affiliation(s)
- Elham Lotfalinezhad
- Aging Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran
- Department of Health Education and Promotion, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Haidar Nadrian
- Medical Education Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
- * E-mail:
| | - Ahmad Kousha
- Department of Health Education and Promotion, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Karen Andersen-Ranberg
- Department of Clinical Research, Consultant Physician, Dept. of Geriatrics, Odense University Hospital, University of Southern Denmark, Odense, Denmark
| | - Mohamed Asghari Jafarabadi
- Cabrini Research, Cabrini Health, Malvern, Victoria, Australia
- School of Public Health and Preventative Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Victoria, Australia
- Road Traffic Injury Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Ahmad Sohrabi
- Cancer Control Research Center, Cancer Control Foundation, Iran University of Medical Sciences, Tehran, Iran
| | - Mina Hashemiparast
- Department of Health Education & Promotion, School of Public Health, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Mohammad Reza Honarvar
- Health Management and Social Development Research Center, Golestan University of Medical Sciences, Gorgan, Iran
| | - Shannon Freeman
- Faculty of Nursing, University of Northern British Columbia, Prince George, Canada
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Dupuis-Blanchard S, Thériault D, Caissie J. Exploring French Canadian high school students' interest in and perspectives of a career with older adults. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e1070-e1077. [PMID: 34258802 DOI: 10.1111/hsc.13514] [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: 01/06/2021] [Revised: 06/23/2021] [Accepted: 06/28/2021] [Indexed: 06/13/2023]
Abstract
For the next 30 years, population aging will impact many facets of our society. Of specific concern is future human resources in the aging sector and related health fields. Every year, high school students make decisions related to their future careers, but few express interests in a career in aging. The goal of this study was to explore high school students' interest in and perspectives of a career in the field of aging. The specific objectives of the study were to identify high school students' perspectives of older adults, explore their level of interest in an aging-related career and understand the reasons for their level of interest for a career in aging. In this qualitative descriptive study, 41 French-speaking students in Grades 10 and 11 from an eastern Canadian province participated in a total of five focus group discussions where an educational video complemented the semi-structured interviews. Content analysis produced four common themes: perspectives of aging and older adults, exposure to aging in school, reasons for disinterest and increasing awareness and interest. Results indicate a lack of aging content or intergenerational activities in schools, whereas students made suggestions for better integration of aging content in the school curriculum. Future research with school guidance counsellors or educators would be beneficial in understanding aging content integration and student exposure to aging. Study limitations are also presented.
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Affiliation(s)
| | | | - Julie Caissie
- School of Nutrition and Family Studies, Université de Moncton, Moncton, New Brunswick, Canada
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A Mixed-Methods Analysis of Care Arrangements of Older People with Limited Physical Abilities Living Alone in Italy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182412996. [PMID: 34948603 PMCID: PMC8700972 DOI: 10.3390/ijerph182412996] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 11/25/2021] [Accepted: 12/06/2021] [Indexed: 11/16/2022]
Abstract
Older people with limited physical abilities, who live alone without cohabiting family members, need support ageing in place and to perform daily living activities. In this respect, both the available informal and formal care seem crucial. The present study aimed to explore the current role of the care arrangements of older people, especially if they have functional limitations. Qualitative interviews were carried out in 2019 within the “Inclusive ageing in place” (IN-AGE) research project, involving 120 older people who lived at home, alone, or with a private personal care assistant (PCA) in three Italian regions (Lombardy, Marche, and Calabria). A mixed-methods analysis was conducted. Results showed that support networks are still mainly made up of family members, but also of domestic home help (DHH) and PCAs, friends/neighbours, and public services, albeit the latter provide support in a residual way, while the former is not as intensive as it was in the past. Frequency and geographical/living proximity of help play a role, emerging also as a territorial differentiation. The paucity or absence of support, especially from the family, risks compromising the ability of ageing in place. It seems, thus, necessary to innovate and improve, in particular, home services, also through real formal and informal care integration.
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Ethier A, Carrier A. A Scoping Review of the Implementation of Local Health and Social Services for Older Adults. Healthc Policy 2021; 17:105-118. [PMID: 34895413 PMCID: PMC8665730 DOI: 10.12927/hcpol.2021.26654] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
BACKGROUND Implementing elder-dedicated local health and social services (LHSS) is primary for older Canadian adults to age in place. However, there is currently no synthesis of the factors (barriers and facilitators) involved in LHSS implementation. OBJECTIVE This study aimed to synthesize current knowledge about the institutional factors involved in elder-dedicated LHSS implementation by describing them and their influence. METHODS A scoping review was conducted using eight databases and the grey literature. Data were analyzed thematically. RESULTS A total of 23 documents led to the identification of 15 inter-influencing factors (12 barriers and 11 facilitators). Indeed, 20 connections were noted among factors, mostly among barriers. DISCUSSION AND IMPLICATION Although some barriers and facilitators also affect the implementation of services dedicated to the general population in Canada, the interplay between agism and power issues needs to be taken into consideration for a successful elder-dedicated LHSS implementation.
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Affiliation(s)
- Alexandra Ethier
- PhD Student, Faculté de médecine et des sciences de la santé, Université de Sherbrooke; Student, Research Centre on Aging, CIUSSS de l'Estrie - CHUS, Sherbrooke, QC
| | - Annie Carrier
- Professor, École de réadaptation, Faculté de médecine et des sciences de la santé, Université de Sherbrooke; Researcher, Research Centre on Aging, CIUSSS de l'Estrie - CHUS, Sherbrooke, QC
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Schütz N, Saner H, Botros A, Pais B, Santschi V, Buluschek P, Gatica-Perez D, Urwyler P, Müri RM, Nef T. Contactless Sleep Monitoring for Early Detection of Health Deteriorations in Community-Dwelling Older Adults: Exploratory Study. JMIR Mhealth Uhealth 2021; 9:e24666. [PMID: 34114966 PMCID: PMC8235297 DOI: 10.2196/24666] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 02/27/2021] [Accepted: 04/23/2021] [Indexed: 01/29/2023] Open
Abstract
Background Population aging is posing multiple social and economic challenges to society. One such challenge is the social and economic burden related to increased health care expenditure caused by early institutionalizations. The use of modern pervasive computing technology makes it possible to continuously monitor the health status of community-dwelling older adults at home. Early detection of health issues through these technologies may allow for reduced treatment costs and initiation of targeted preventive measures leading to better health outcomes. Sleep is a key factor when it comes to overall health and many health issues manifest themselves with associated sleep deteriorations. Sleep quality and sleep disorders such as sleep apnea syndrome have been extensively studied using various wearable devices at home or in the setting of sleep laboratories. However, little research has been conducted evaluating the potential of contactless and continuous sleep monitoring in detecting early signs of health problems in community-dwelling older adults. Objective In this work we aim to evaluate which contactlessly measurable sleep parameter is best suited to monitor perceived and actual health status changes in older adults. Methods We analyzed real-world longitudinal (up to 1 year) data from 37 community-dwelling older adults including more than 6000 nights of measured sleep. Sleep parameters were recorded by a pressure sensor placed beneath the mattress, and corresponding health status information was acquired through weekly questionnaires and reports by health care personnel. A total of 20 sleep parameters were analyzed, including common sleep metrics such as sleep efficiency, sleep onset delay, and sleep stages but also vital signs in the form of heart and breathing rate as well as movements in bed. Association with self-reported health, evaluated by EuroQol visual analog scale (EQ-VAS) ratings, were quantitatively evaluated using individual linear mixed-effects models. Translation to objective, real-world health incidents was investigated through manual retrospective case-by-case analysis. Results Using EQ-VAS rating based self-reported perceived health, we identified body movements in bed—measured by the number toss-and-turn events—as the most predictive sleep parameter (t score=–0.435, P value [adj]=<.001). Case-by-case analysis further substantiated this finding, showing that increases in number of body movements could often be explained by reported health incidents. Real world incidents included heart failure, hypertension, abdominal tumor, seasonal flu, gastrointestinal problems, and urinary tract infection. Conclusions Our results suggest that nightly body movements in bed could potentially be a highly relevant as well as easy to interpret and derive digital biomarker to monitor a wide range of health deteriorations in older adults. As such, it could help in detecting health deteriorations early on and provide timelier, more personalized, and precise treatment options.
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Affiliation(s)
- Narayan Schütz
- Gerontechnology and Rehabilitation Group, ARTORG Center for Biomedical Engineering Research, University of Bern, Bern, Switzerland
| | - Hugo Saner
- Gerontechnology and Rehabilitation Group, ARTORG Center for Biomedical Engineering Research, University of Bern, Bern, Switzerland.,Department of Cardiology, University Hospital Bern, University of Bern, Bern, Switzerland.,I.M. Sechenov First Moscow State Medical University, Moscow, Russian Federation
| | - Angela Botros
- Gerontechnology and Rehabilitation Group, ARTORG Center for Biomedical Engineering Research, University of Bern, Bern, Switzerland
| | - Bruno Pais
- La Source, School of Nursing Sciences, HES-SO University of Applied Sciences and Arts of Western Switzerland, Lausanne, Switzerland
| | - Valérie Santschi
- La Source, School of Nursing Sciences, HES-SO University of Applied Sciences and Arts of Western Switzerland, Lausanne, Switzerland
| | | | - Daniel Gatica-Perez
- Idiap Research Institute, Martigny, Switzerland.,École Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
| | - Prabitha Urwyler
- Gerontechnology and Rehabilitation Group, ARTORG Center for Biomedical Engineering Research, University of Bern, Bern, Switzerland.,Department of Neurology, University Hospital Bern, University of Bern, Bern, Switzerland
| | - René M Müri
- Department of Neurology, University Hospital Bern, University of Bern, Bern, Switzerland
| | - Tobias Nef
- Gerontechnology and Rehabilitation Group, ARTORG Center for Biomedical Engineering Research, University of Bern, Bern, Switzerland.,Department of Neurology, University Hospital Bern, University of Bern, Bern, Switzerland
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Nyqvist F, Häkkinen E, Renaud A, Bouchard L, Prys C. Social Exclusion Among Official Language Minority Older Adults: A Rapid Review of the Literature in Canada, Finland and Wales. J Cross Cult Gerontol 2021; 36:285-307. [PMID: 34101062 PMCID: PMC8421303 DOI: 10.1007/s10823-021-09433-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/11/2021] [Indexed: 11/26/2022]
Abstract
It has been suggested that older adults from minority linguistic and ethnic communities face higher risks of being socially excluded. The aim of this review was, therefore, to explore and review social exclusion studies conducted among official language minority older adults in three countries, namely Canada, Finland and Wales. A rapid review approach was used to review scientific literature in line with six social exclusion domains. The literature searches were made in Finnish, Swedish, English, French and Welsh and were restricted to research published within the timeline of 2001 – September 2019 and yielded 42 articles. The included studies were categorized into three different domains: socioeconomic influences, social participation and societal conditions. Converging and diverging patterns of social exclusion in old age were identified between the linguistic minorities. Linguistic barriers regarding access to health care and receiving health information were common across the three linguistic contexts, whereas exclusion from social participation was noticed amongst the linguistic minorities in Canada and Wales. Some connections between belonging to a linguistic minority and being exposed to a lower socioeconomic status and higher poverty risk were made, however, these findings were not robust across all three countries. The findings indicated that experiences of exclusion could be considered fairly common among linguistic minority older adults. We conclude that the research evidence presented in the review sheds light on issues of social inequality in old age between linguistic majorities and minorities, thus identifying important aspects of social exclusion to guide future research as well as policy and practice.
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Affiliation(s)
- Fredrica Nyqvist
- Faculty of Education and Welfare Studies, Social Policy, Åbo Akademi University, Strandgatan 2, 65100, Vasa, Finland.
| | - Emilia Häkkinen
- Faculty of Education and Welfare Studies, Social Policy, Åbo Akademi University, Strandgatan 2, 65100, Vasa, Finland
| | - Alexandre Renaud
- Faculty of Social Sciences, University of Ottawa, Ottawa, Canada
| | - Louise Bouchard
- Faculty of Social Sciences, University of Ottawa, Ottawa, Canada
| | - Cynog Prys
- School of History, Philosophy and Social Science, Bangor University, Bangor, Wales
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12
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Mayo CD, Kenny R, Scarapicchia V, Ohlhauser L, Syme R, Gawryluk JR. Aging in Place: Challenges of Older Adults with Self-Reported Cognitive Decline. Can Geriatr J 2021; 24:138-143. [PMID: 34079607 PMCID: PMC8137463 DOI: 10.5770/cgj.24.456] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background An emergent concern related to the aging and the increased risk of cognitive decline is the institutionalization of older adults. Evidence has shown that aging in place leads to many benefits, including higher quality of life. In order to support older adults, it is imperative that we understand the challenges people with changes in cognition face while aging in place. Methods A total of sixteen older adults with self-reported cognitive decline and six informal caregivers of individuals reporting cognitive decline, all of whom are living in independent residences, participated. Focus group sessions with semi-structured interviews were conducted, followed by thematic qualitative data analyses. Results Thematic analyses led to the identification of six challenges to aging in place, including: 1) memory decline, 2) emotional challenges/low mood, 3) social isolation/loneliness, 4) difficulty with mobility and physical tasks, 5) difficulties with activities of daily living/instrumental activities of daily living, and 6) lack of educational resources on cognitive change. Conclusion The themes identified in the current study represent common challenges in aging in place for older adults with self-reported cognitive decline. Identification of these themes allows for important next steps, which can focus on supports through targeted interventions.
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Affiliation(s)
- Chantel D Mayo
- Department of Psychology, University of Victoria, BC, Canada.,Institute on Aging and Lifelong Health, University of Victoria, BC, Canada
| | - Rebecca Kenny
- Faculty of Medicine, University of British Columbia, BC, Canada
| | - Vanessa Scarapicchia
- Department of Psychology, University of Victoria, BC, Canada.,Institute on Aging and Lifelong Health, University of Victoria, BC, Canada
| | - Lisa Ohlhauser
- Department of Psychology, University of Victoria, BC, Canada.,Institute on Aging and Lifelong Health, University of Victoria, BC, Canada
| | - Robin Syme
- CanAssist, University of Victoria, BC, Canada
| | - Jodie R Gawryluk
- Department of Psychology, University of Victoria, BC, Canada.,Institute on Aging and Lifelong Health, University of Victoria, BC, Canada.,CanAssist, University of Victoria, BC, Canada.,Division of Medical Sciences, University of Victoria, BC, Canada
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13
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Ryu SI, Cho B, Chang SJ, Ko H, Yi YM, Noh EY, Cho HR, Park YH. Factors Related to Self-Confidence to Live Alone in Community-Dwelling Older Adults: A Cross-Sectional Study. BMC Geriatr 2021; 21:291. [PMID: 33947334 PMCID: PMC8097788 DOI: 10.1186/s12877-021-02214-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Accepted: 04/07/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Many older adults prefer to live alone in their own homes, with age-related issues in physical movement, regardless of their cultural background. Importantly, however, to identify the features of successfully ageing in place (AIP), and foster independent living among these individuals, this study explored their level of self-confidence to live alone and its related factors. METHODS We conducted a cross-sectional study using secondary data from an earlier study with older adults living alone in South Korea recruited by convenience sampling methods (N = 936, mean age = 77.1 years, 76.1% female). Data regarding the general, health-related, and social characteristics as well as self-confidence to live alone were collected via face-to-face interviews in 2019. Self-confidence to live alone was measured with a numeric rating scale of 0 to 10. RESULTS The average self-confidence score to live alone was 6.59. A regression analysis showed that mould exposure at home, depression, emergency department visits, and loneliness hinder self-confidence to live alone. Meanwhile, such self-confidence was facilitated by independency in instrumental activities of daily living (IADL), interactions with family members, social service utilisation, and social support. CONCLUSIONS This study suggests that healthcare providers need to consider the importance of self-confidence to live alone and influencing functional, mental, social, and environmental factors to promote quality of life as well as successful AIP for older adults living alone. Further, self-confidence to live alone could be a new practical index in the field of health and ageing to screen the successful AIP of older adults living alone.
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Affiliation(s)
- So Im Ryu
- College of Nursing, The Research Institute of Nursing Science, Seoul National University, Seoul, 103, Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
| | - BeLong Cho
- Department of Family Medicine, College of Medicine, Seoul National University, Seoul, 103, Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
- Institute on Aging, Seoul National University College of Medicine, 71 Ihwajang-Gil, Jongno-gu, Seoul, 110-810, Republic of Korea
| | - Sun Ju Chang
- College of Nursing, The Research Institute of Nursing Science, Seoul National University, Seoul, 103, Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
- College of Nursing, Seoul National University, Seoul, 103, Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
| | - Hana Ko
- College of Nursing, Gachon University, 191 Hambakmoero, Yeonsu-gu, Incheon, 21936, Republic of Korea
| | - Yu Mi Yi
- College of Nursing, Kyungnam College of Information and Technology, 45 Jurye-ro, Sasang-gu, Busan, 47011, Republic of Korea
| | - Eun-Young Noh
- College of Nursing, The Research Institute of Nursing Science, Seoul National University, Seoul, 103, Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
| | - Hye Ryung Cho
- College of Nursing, Seoul National University, Seoul, 103, Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
| | - Yeon-Hwan Park
- College of Nursing, The Research Institute of Nursing Science, Seoul National University, Seoul, 103, Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.
- College of Nursing, Seoul National University, Seoul, 103, Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.
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14
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Paris M, Bigonnesse C. Favoriser le développement de l’habitation communautaire pour personnes francophones aînées vivant en situation linguistique minoritaire : résultats d’une recherche-action en partenariat avec une communauté rurale du Nouveau-Brunswick. REFLETS: REVUE D’INTERVENTION SOCIALE ET COMMUNAUTAIRE 2021; 27:60. [DOI: 10.7202/1093099ar] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
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15
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Campbell-Enns HJ, Campbell M, Rieger KL, Thompson GN, Doupe MB. No Other Safe Care Option: Nursing Home Admission as a Last Resort Strategy. THE GERONTOLOGIST 2020; 60:1504-1514. [PMID: 32589225 PMCID: PMC7681216 DOI: 10.1093/geront/gnaa077] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Nursing homes are intended for older adults with the highest care needs. However, approximately 12% of all nursing home residents have similar care needs as older adults who live in the community and the reasons they are admitted to nursing homes is largely unstudied. The purpose of this study was to explore the reasons why lower-care nursing home residents are living in nursing homes. RESEARCH DESIGN AND METHODS A qualitative interpretive description methodology was used to gather and analyze data describing lower-care nursing home resident and family member perspectives regarding factors influencing nursing home admission, including the facilitators and barriers to living in a community setting. Data were collected via semistructured interviews and field notes. Data were coded and sorted, and patterns were identified. This resulted in themes describing this experience. RESULTS The main problem experienced by lower-care residents was living alone in the community. Residents and family members used many strategies to avoid safety crises in the community but experienced multiple care breakdowns in both community and health care settings. Nursing home admission was a strategy used to avoid a crisis when residents did not receive the needed support to remain in the community. DISCUSSION AND IMPLICATIONS To successfully remain in the community, older adults require specialized supports targeting mental health and substance use needs, as well as enhanced hospital discharge plans and improved information about community-based care options. Implications involve reforming policies and practices in both hospital and community-based care settings.
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Affiliation(s)
| | - Megan Campbell
- Department of Community Health Sciences, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
| | - Kendra L Rieger
- College of Nursing, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
| | - Genevieve N Thompson
- College of Nursing, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
| | - Malcolm B Doupe
- Department of Community Health Sciences, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
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16
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Granbom M, Nkimbeng M, Roberts LC, Gitlin LN, Taylor JL, Szanton SL. "So I am Stuck, but it´s OK": Residential Reasoning and Housing Decision-Making of Low-Income Older Adults with Disabilities in Baltimore, Maryland. ACTA ACUST UNITED AC 2020; 48:43-59. [PMID: 33731975 DOI: 10.1080/08882746.2020.1816782] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Housing preferences and housing decision-making in later life are critical aspects of aging in place, which is a public health priority in many Western countries. However, few studies have examined the economic, social, and health factors that guide older adults' preferences and decisions about where to live, and even less so among older adults with low income or disabilities who may face greater barriers to aging in place. We sought to understand what housing decision-making and residential reasoning means for low-income older adult homeowners in Baltimore, Maryland. Using a grounded theory approach, we interviewed 12 adults with disabilities in June 2017 and February 2018. Our findings revealed how the strong desire to age in place turned into the realization that they had to age in place due to limited resources and options. The core category "shifting between wanting to age in place and having to age in place" was influenced by family needs, being a homeowner, the neighborhood, and coping at home. In conclusion, for low-income older adults with disabilities, it is important to acknowledge that sometimes aging in place may be equivalent to being stuck in place.
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Affiliation(s)
- Marianne Granbom
- Center for Innovative Care in Aging, Johns Hopkins School of Nursing, Baltimore, MD 21205, USA.,Department of Health Sciences, Lund University, 22100 Lund, Sweden
| | - Manka Nkimbeng
- Center for Innovative Care in Aging, Johns Hopkins School of Nursing, Baltimore, MD 21205, USA.,School of Public Health, University of Minnesota, Minneapolis, MN 55455, USA
| | - Laken C Roberts
- Center for Innovative Care in Aging, Johns Hopkins School of Nursing, Baltimore, MD 21205, USA
| | - Laura N Gitlin
- Center for Innovative Care in Aging, Johns Hopkins School of Nursing, Baltimore, MD 21205, USA.,College of Nursing and Health Professions, Drexel University, Philadelphia, PA 19102, USA
| | - Janiece L Taylor
- Center for Innovative Care in Aging, Johns Hopkins School of Nursing, Baltimore, MD 21205, USA
| | - Sarah L Szanton
- Center for Innovative Care in Aging, Johns Hopkins School of Nursing, Baltimore, MD 21205, USA
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Schwei RJ, Amesoudji AW, DeYoung K, Madlof J, Zambrano-Morales E, Mahoney J, Jacobs EA. Older adults' perspectives regarding peer-to-peer support programs and maintaining independence. Home Health Care Serv Q 2020; 39:197-209. [PMID: 32525461 PMCID: PMC8227957 DOI: 10.1080/01621424.2020.1778594] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Peer to peer (P2P) support has been suggested as one community program that may promote aging in place. We sought to understand challenges older adults have maintaining their independence and to identify how P2P support facilitates independence. We completed 17 semi-structured interviews with older adults receiving P2P support in 3 cities in the United States. Study team members coded data using deductive and inductive conventional content analysis. Participants identified declining abilities, difficulties with mobility, and increasing cost of living as challenges to independence. P2P support facilitated independence and provided them with a new friend. The qualitative findings indicate that maintaining independence as an older adult in the United States has many challenges. P2P programs have an important role in helping older adults stay in their home by supporting mobility and promoting social engagement.
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Affiliation(s)
- Rebecca J Schwei
- BerbeeWalsh Department of Emergency Medicine, School of Medicine and Public Health, University of Wisconsin Madison , Madison, Wisconsin, USA
| | - Amy W Amesoudji
- School of Medicine and Public Health, University of Wisconsin Madison , Madison, WI, USA
| | | | - Jenny Madlof
- Ferd & Gladys Alpert Jewish Family Service of West Palm Beach , West Palm Beach, FL, USA
| | | | - Jane Mahoney
- Department of Medicine, School of Medicine and Public Health, University of Wisconsin Madison , Madison, WI, USA
| | - Elizabeth A Jacobs
- Departments of Medicine and Population Health Department of Medicine, Dell Medical School, The University of Texas at Austin , Austin, TX, USA
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18
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McCormack GR, Cabaj J, Orpana H, Lukic R, Blackstaffe A, Goopy S, Hagel B, Keough N, Martinson R, Chapman J, Lee C, Tang J, Fabreau G. A scoping review on the relations between urban form and health: a focus on Canadian quantitative evidence. HEALTH PROMOTION AND CHRONIC DISEASE PREVENTION IN CANADA-RESEARCH POLICY AND PRACTICE 2019; 39:187-200. [PMID: 31091062 DOI: 10.24095/hpcdp.39.5.03] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
INTRODUCTION Despite the accumulating Canadian evidence regarding the relations between urban form and health behaviours, less is known about the associations between urban form and health conditions. Our study aim was to undertake a scoping review to synthesize evidence from quantitative studies that have investigated the relationship between built environment and chronic health conditions, self-reported health and quality of life, and injuries in the Canadian adult population. METHODS From January to March 2017, we searched 13 databases to identify peer-reviewed quantitative studies from all years that estimated associations between the objectively-measured built environment and health conditions in Canadian adults. Studies under-taken within urban settings only were included. Relevant studies were catalogued and synthesized in relation to their reported study and sample design, and health outcome and built environment features. RESULTS Fifty-five articles met the inclusion criteria, 52 of which were published after 2008. Most single province studies were undertaken in Ontario (n = 22), Quebec (n = 12), and Alberta (n = 7). Associations between the built environment features and 11 broad health outcomes emerged from the review, including injury (n = 19), weight status (n = 19), cardiovascular disease (n = 5), depression/anxiety (n = 5), diabetes (n = 5), mortality (n = 4), self-rated health (n = 2), chronic conditions (n = 2), metabolic condi-tions (n = 2), quality of life (n = 1), and cancer (n = 1). Consistent evidence for associations between aggregate built environment indicators (e.g., walkability) and diabetes and weight and between connectivity and route features (e.g., transportation route, trails, pathways, sidewalks, street pattern, intersections, route characteristics) and injury were found. Evidence for greenspace, parks and recreation features impacting multiple health outcomes was also found. CONCLUSION Within the Canadian context, the built environment is associated with a range of chronic health conditions and injury in adults, but the evidence to date has limitations. More research on the built environment and health incorporating rigorous study designs are needed to provide stronger causal evidence to inform policy and practice.
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Affiliation(s)
- Gavin R McCormack
- Department of Community Health Science, Cumming School of Medicine, University of Calgary, Alberta, Canada.,Faculty of Environmental Design, University of Calgary, Alberta, Canada
| | - Jason Cabaj
- Department of Community Health Science, Cumming School of Medicine, University of Calgary, Alberta, Canada.,Alberta Health Services, Alberta, Canada
| | - Heather Orpana
- Public Health Agency of Canada, Ottawa, Ontario, Canada.,School of Psychology, University of Ottawa, Ontario, Canada
| | - Ryan Lukic
- Department of Community Health Science, Cumming School of Medicine, University of Calgary, Alberta, Canada
| | - Anita Blackstaffe
- Department of Community Health Science, Cumming School of Medicine, University of Calgary, Alberta, Canada
| | - Suzanne Goopy
- Faculty of Nursing, University of Calgary, Alberta, Canada
| | - Brent Hagel
- Department of Community Health Science, Cumming School of Medicine, University of Calgary, Alberta, Canada.,Department of Paediatrics, Cumming School of Medicine, University of Calgary
| | - Noel Keough
- Faculty of Environmental Design, University of Calgary, Alberta, Canada
| | | | | | - Celia Lee
- Sustainable Calgary, Alberta, Canada
| | | | - Gabriel Fabreau
- Department of Community Health Science, Cumming School of Medicine, University of Calgary, Alberta, Canada
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Abstract
ABSTRACTGiven the urgency of finding cost-effective and innovative solutions to providing community services for aging in place, novel solutions that take advantage of existing infrastructure are clearly needed. In this sequential mixed-method study, we chose to explore the role that nursing homes could play in offering services to a non-traditional target population, namely seniors with loss of independence living in the community. Forty-two (n = 42) nursing homes in the province of New Brunswick completed an online survey, and 10 agreed to participate in face-to-face interviews. Results show that 100 per cent of participants agreed that nursing homes could offer services to seniors in their communities for aging in place. Results suggest that nursing homes are cost-effective, innovative solutions for aging in place.
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Thériault D, Dupuis-Blanchard S. Maintien à domicile : capacité d’offre de services communautaires actuels et futurs au Nouveau-Brunswick. ACTA ACUST UNITED AC 2018. [DOI: 10.7202/1046505ar] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
La présente étude comporte trois objectifs : 1) déterminer l’état actuel des services offerts pour le maintien à domicile; 2) explorer la nature de la planification des services futurs pour le maintien à domicile; et 3) exposer les défis reliés aux services et les moyens qui s’offrent aux organismes pour que les services répondent le plus efficacement possible aux besoins des personnes âgées francophones. De type séquentiel exploratoire mixte, cette étude a permis de recueillir des données qualitatives pour bonifier des résultats quantitatifs. Quarante-neuf gestionnaires ont répondu au questionnaire en ligne et 11 entrevues ont été réalisées. Huit thèmes communs ont été dégagés en lien avec les objectifs, thèmes qui montrent une préoccupation pour la viabilité des services communautaires en maintien à domicile.
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Affiliation(s)
| | - Suzanne Dupuis-Blanchard
- Professeure agrégée, Titulaire de la Chaire de recherche en santé CNFS-Université de Moncton sur le vieillissement, École de science infirmière, Université de Moncton. Auteure pour la correspondance
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