What it's like to grow older: the aging perceptions of people with an intellectual disability in Ireland

Nature and extent of intellectual disability nursing research in Ireland: a scoping review to inform health and health service research

OBJECTIVES

To capture the extent and nature of intellectual disability nursing publications in Ireland.

DESIGN

Scoping review using Arksey and O'Malley approach.

DATA SOURCES

Six databases (PsycINFO, CINAHL, Medline, Academic Search Complete, Scopus, Embase) were searched along with a web-based search of the eight academic institutions delivering intellectual disability nurse education in Ireland for publications indexed from the earliest available date to the 31 December 2020.

ELIGIBILITY CRITERIA

Publications by an academic, practitioner or student working in intellectual disability practice or education in Ireland relating to intellectual disability nursing, care or education.

DATA EXTRACTION AND SYNTHESIS

Data pertaining to type of paper/design, authors (academic/professional/student), year, collaboration (national/international), topic/content area and title were extracted from each paper. Data were analysed by two authors using Colorafi and Evans content analysis steps where data was tabulated, and a narrative synthesis undertaken.

RESULTS

The reporting of the review is in line with the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) and PRISMA extension for Scoping Reviews Checklist. Database and web-based searching resulting 245 articles meeting the criteria for this review. Through content analysis the 245 articles were mapped onto six themes: supporting inclusion, future planning, aspects of health, interventions, education, professional development and research, and personal and professional accounts of caring.

CONCLUSIONS

This review highlights the extent and nature of intellectual disability publications by academic, practitioner or student working in intellectual disability nursing in Ireland together with opportunities for future growth and development. From the findings it is apparent that there is an ongoing need for intellectual disability nurses to define their role across the full trajectory of health provision and to make visible their role in person-family centred support, inclusion, and contributions in health education, health promotion and health management.

Ambivalence among staff regarding ageing with intellectual disabilities: Experiences and reflections

This study explores the experiences and reflections of staff in intellectual disability (ID) services concerning ageing with ID. Qualitative interviews were conducted with 24 staff members in group homes and daily activity centres. The findings showed that the staff were uncertain about the signs of ageing in people with intellectual disabilities; they compared the life conditions of these people with conditions in older people without intellectual disabilities. Their emphasis on an active lifestyle was very strong. The staff members also mentioned uncertainty about how to facilitate assistive devices and whether 'ageing in place' was the best solution. The overall theme was manifested as ambivalence where notions of older people with intellectual disabilities seemed incompatible with notions of old age in general and could be explained by the theoretical concept of age coding. The findings of this study indicate the need to provide education about ageing to staff working in ID services.

Poor medication adherence to bisphosphonates and high self-perception of aging in elderly female patients with osteoporosis

Non-adherence to bisphosphonates exposes the elderly female osteoporosis patients to an increased risk of fracture. This was one of the first studies to explore the relationship between medication adherence and self-perception of aging. Feelings of lacking control and expectations for negative events, beliefs of illness's chronic duration nature, and its linkage with aging were associated with of poor medication adherence.

INTRODUCTION

To examine the relationship between medication adherence to bisphosphonates and self-perception of aging in elderly female patients with osteoporosis.

METHODS

This was a cross-sectional survey. A convenience sample of 245 elderly female patients with osteoporosis prescribed regular oral bisphosphonate therapy was recruited from three tertiary hospitals in China. Sociodemographic and osteoporosis-related data, Morisky Medication Adherence Scale-8 (MMAS-8) and Aging Perceptions Questionnaire (APQ) data were collected.

RESULTS

Mean adherence score measured by MMAS-8 was 4.46(SD = 1.91; range, 0.25-7.00). Percentages of good and poor adherence were 28.6 and 71.4 %, which showed a poor medication adherence. Six domains of APQ statistically significantly associated with medication adherence. Interestingly, with control of age, educational status, marital status, and symptoms accompanying osteoporosis as covariates in the multivariate linear regression model, the effects of three domains disappeared. Significantly, worse adherence was observed in those patients who had higher feelings of lack of control, more expectations for negative events, more beliefs of osteoporosis's chronic duration nature and its linkage with aging.

CONCLUSIONS

We conclude that feelings of lacking control, expectations for negative events, beliefs of illness's chronic duration nature, and its linkage with aging were associated with poor medication adherence in elderly female patients with osteoporosis. Concerns about self-perception of aging need to be addressed in order to improve medication adherence.

Successful ageing for people with an intellectual disability

PURPOSE OF REVIEW

Successful ageing has not yet been defined in people with an intellectual disability. The purpose of this review is to discuss and define successful ageing in the context of intellectual disability and to propose strategies to improve health and wellbeing for this population.

RECENT FINDINGS

People with an intellectual disability experience higher rates of diabetes, hypertension, obesity and cardiovascular disease, and higher rates of mental disorders than people without an intellectual disability. People with an intellectual disability engage in more passive leisure activities because many active leisure activities require the participation of or assistance by others. Health promotion programmes tailored to people with an intellectual disability consisting of exercise and health education can result in more positive attitudes toward exercise and improvements in psychosocial outcomes.

SUMMARY

With modifications for people with an intellectual disability, the concept of successful ageing can be used as a template for development of strategies to improve health and wellbeing for people with an intellectual disability as they age. Targeted programmes focused on health promotion and prevention of age-related morbidities is required. There is a need for policies addressing positive ageing, including social participation and maximizing community participation. Appropriate and ongoing education for people with an intellectual disability and their carers on healthy living in areas of physical, social, and cognitive activity, nutrition and avoidance of risk factors is essential.

Healthy Aging and Concerns Among Elderly Japanese: A Text Analysis Approach

Japan is facing an unprecedented aging society. In 2013, 25.1% of the total population in Japan was 65 years old and over. One third of the population in Japan will be at least 65 years old in 2035; healthy aging is crucial for public health and society in Japan. Under the budget limitations of social security, policies and frequent policy changes have created great uncertainty and concern for the elderly population. Given these circumstances, we conducted questionnaire surveys in 2010 to examine concerns in this age-group. In 2010, we sent questionnaires to university graduates 65 years old and older, randomly selected from a list of an alumni association of 11 universities. The questionnaires were open-ended and asked them to write any concerns that they had about health care, health policy, health systems, and their future. We received 344 responses. Among those who responded, 271 (78.8%) respondents said that they had concerns. We conducted a text analysis (Trend Search-Keyword Associator 2008) and extracted the keywords from their responses. The keywords that were extracted frequently included hospitals, doctors, health-care system, health care, Japanese government policies, government, medical insurance system for the elderly, support, increase, copayment, health (their own), scarcities, and burdens. In this study, many elderly people in Japan are concerned about health-care expenditures, health-care systems, and health policies. This may be caused by frequent health policy changes and uncertainty due to frequent administration changes such as the lack of clarity concerning raising the out of pocket payment rate from 10% to 20% for elderly people under budget constraints in Japan. Correct policy making and determination to eliminate the concerns from this vulnerable population in Japan are necessary for healthy aging.