Social Environment of Older People during the First Year in Senior Housing and Its Association with Physical Performance

Factors Related to Physical Activity among Older Adults Who Relocated to a New Community after the Kumamoto Earthquake: A Study from the Viewpoint of Social Capital

Previous studies have shown an association between social capital and physical activity in older adults. Older adults who relocated after the Kumamoto earthquake may become physically inactive, and the extent of this inactivity may be buffered by social capital. Accordingly, this study applied the social capital perspective to examine factors that affect the physical activity of older adults who relocated to a new community after the Kumamoto earthquake. We conducted a self-administered mail questionnaire survey with 1494 (613 male, 881 female, mean age 75.12 ± 7.41 years) evacuees from temporary housing in Kumamoto City, aged 65 years and above, who relocated to a new community after the earthquake. We performed a binomial logistic regression to examine the factors affecting participants' physical activity. The results showed that physical inactivity (decreased opportunities for physical activity, decreased walking speed, and no exercise habits) was significantly associated with non-participation in community activities, lack of information about community activities, and being aged 75 years and over. Lack of social support from friends was significantly associated with lack of exercise habits. These findings encourage participation in community activities, alongside giving and receiving social support in health activities that target older adults who relocated to new communities after the earthquake.

Mental, Physical and Social Functioning in Independently Living Senior House Residents and Community-Dwelling Older Adults

Senior houses provide social interaction and support, potentially supporting older people's physical and mental functioning. Few studies have investigated functioning of senior house residents. The aim was to compare functioning between senior house residents and community-dwelling older adults in Finland. We compared senior house residents (n = 336, 69% women, mean age 83 years) to community-dwelling older adults (n = 1139, 56% women, mean age 74 years). Physical and mental functioning were assessed using the SF 36-Item Health Survey. Loneliness and frequency of social contacts were self-reported. The analyses were adjusted for age, socioeconomic factors and diseases. Physical functioning was lower among men in senior houses compared to community-dwelling men (mean 41.1 vs. 46.4, p = 0.003). Mental functioning or the frequency of social contacts did not differ between type of residence in either sex. Loneliness was higher among women in senior houses compared to community-dwelling women (OR = 1.67, p = 0.027). This was not observed in men. Results suggest that women in senior houses had similar physical and mental functioning compared to community-dwelling women. Male senior house residents had poorer physical functioning compared to community-dwelling men. Women living in senior houses were lonelier than community-dwelling women despite the social environment.

Identification of Sarcopenic Obesity in German Nursing Home Residents-The Role of Body Composition and Malnutrition in the BaSAlt Cohort-Study

Background: Sarcopenic obesity (SO) is a phenotype, which is defined by reduced muscle strength, muscle mass, and obesity. Limited mobility leads to increased sedentary behavior and decreased physical activity. Both sarcopenia and obesity are aggravated by these factors. In combination, SO is an additional challenge for the setting nursing home (NH). Previous studies have shown a low prevalence of residents with SO in comparable settings, such as community-dwelling. We hypothesize that the BaSAlt cohort also has a small proportion of residents with SO. Methods: For the analysis, 66 residents (women: 74.2%) aged ≥ 65 years from NH, were screened for SO based on EWGSOP2 specifications and cut-off values to classify obesity. Results: Severe sarcopenia was quantified in eleven residents (16.7%). The majority of sarcopenic residents were women (n = 10) compared to men (n = 1). However, no SO could be identified by assessment of body mass index, fat mass in percentage, and fat mass index. Conclusion: As expected, the setting-specific cohort showed a low number of SO. Furthermore, no case of SO was identified in our study. Sarcopenia was associated with an increased fat-free mass in NH residents. Nevertheless, sarcopenia and obesity play important roles in the preservation of residents’ health.

BaSAlt - A mixed-methods study protocol on setting-based physical activity promotion and counseling in nursing homes

Introduction

Physical activity (PA) is a major contributor to healthy aging. However, physical inactivity is prevalent among the elderly in Germany, particularly in institutionalized settings such as nursing homes. This paper aims to describe the study objectives, design, methods, assessment types, collection schedules and considerations for analyzing the data within the BaSAlt study on facilitators and barriers for PA promotion in nursing homes.

Methods

We designed the BaSAlt study as a participatory intervention study with multiple measurement points in six to eight nursing homes with a total of approx. 200 residents using four main modules: (1) setting-level analysis of physical activity patterns, physical activity-related climate and physical activity-related interaction with ‘significant others,’ and organizational facilitators and barriers to physical activity, (2) physical-activity related individual-level analysis of objective and self-reported physical activity and sedentary behavior, a geriatric assessment with established procedures, assessment of people's activity and health biographies (biographical mapping) as well as their motivational, subjective well-being and distress status, and (3) a counseling module that integrates counseling at the setting level as well as individual physical activity counseling for residents. In module (4) evaluation, the effects of integrated counseling with regard to the implementation of PA promotion strategies are analyzed.

Discussion

This study will extend our knowledge of physical activity promotion in German nursing homes. Its findings will inform governmental authorities, care professionals, and academics on how to reach a particular group, characterized by inactivity, multimorbidity, and a high prevalence of dementia, residing in nursing homes, a setting that will gain further relevance in the future.

"I Trust in Staff's Creativity"-The Impact of COVID-19 Lockdowns on Physical Activity Promotion in Nursing Homes Through the Lenses of Organizational Sociology

Objectives: The health-enhancing benefits or regular physical activity (PA) reach into old age. With the emergence of the coronavirus disease of 2019 (COVID-19) pandemic and the associated national lockdowns and restrictions, nursing home residents were restrained from being physically active. In our study, we aimed to assess the impact of the COVID-19-related restrictions on PA promotion in nursing homes from an organizational-sociological lens. Methods: We collected data in eight nursing homes in Germany. Data collection included (i) semistructured interviews focusing on COVID-19-related restrictions and their effects on nursing homes from the home administrators' perspectives; (ii) open-ended surveys with nursing home staff and relatives focusing on daily routines and contact restrictions; and (iii) collection of documents such as care concepts, mission statements, and weekly activity plans. We analyzed all data with a reflexive thematic analysis approach. Results: We identified three stages of COVID-19-related changes in nursing homes that impacted PA promotion, as follows: (1) external closure and search for emergency control, (2) organizational adaptations to create a livable daily life in the internal environment, and (3) slow reintegration of interactions with the external organizational environment. Document analysis revealed that PA promotion was not part of decision programs or internal staff work descriptions. Rather, PA promotion was delegated to external service providers. The assignment of PA promotion to external providers was not structurally anchored in decision programs, which makes PA promotion not sustainable, particularly during unforeseen events that limit access to the organization. During the pandemic, executive staff believed in internal staff to buffer competencies with regard to PA promotion. Thus, executive staff often considered PA promotion relevant, even during the pandemic, but thought that PA promotion is a task that can be fulfilled by unqualified but motivated internal staff. Conclusion: While our study participants showed a high level of coping-capacity belief, it remains unclear which long-term impacts of COVID-19 on PA promotion in nursing homes are to be expected. At the practice level, executive staff in nursing homes that aim to promote PA within their organization should become aware that PA promotion needs to be incorporated into organizational structures to be implemented and continued in challenging times such as in a pandemic.

Older People’s Preferences for Housing and Environment Characteristics

Population ageing presents significant challenges for many countries, one of which is the provision of adequate housing. Developing understanding of the needs and preferences of ageing societies will be crucial in order to assist in the provision of suitable housing and communities that are sustainable in the long term. While a preference to ‘age in place’ is clear in the literature, comparatively less academic research is available on older people’s preferences for more specific housing and environment attributes. The aim of this study is to identify the main housing and environment characteristics that are linked to the health and wellbeing of the elderly and determine the preferences for such characteristics via a survey with UK residents aged 55+. The results indicate a strong preference for independent living and an increasing desire for bungalows in later life. Housing conditions, energy efficiency, thermal comfort, and home adaptions to facilitate ageing in place are particularly important housing characteristics to older people. The location and environment are also key drivers of housing preferences; a safe neighbourhood, accessibility to amenities, public transport, and a clean and walkable environment are particularly important. Preferences varied with age, but gender has a less significant impact on the preferences expressed. The findings of this study will be valuable for stakeholders engaged in housing policy and provision for older people.

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.

Deciding How to Stay Independent at Home in Later Years: Development and Acceptability Testing of an Informative Web-Based Module

Background

Seniors with loss of autonomy may face decisions about whether they should stay at home or move elsewhere. Most seniors would prefer to stay home and be independent for as long as possible, but most are unaware of options that would make this possible.

Objective

The study aimed to develop and test the acceptability of an interactive website for seniors, their caregivers, and health professionals with short interlinked videos presenting information about options for staying independent at home.

Methods

The approach for design and data collection varied, involving a multipronged, user-centered design of the development process, qualitative interviews, and end-user feedback to determine content (ie, needs assessment) in phase I; module development (in English and French) in phase II; and survey to test usability and acceptability with end users in phase III. Phase I participants were a convenience sample of end users, that is, seniors, caregivers, and professionals with expertise in modifiable factors (eg, day centers, home redesign, equipment, community activities, and finances), enabling seniors to stay independent at home for longer in Quebec and Alberta, Canada. Phase II participants were bilingual actors; phase III participants included phase I participants and new participants recruited through snowballing. Qualitative interviews were thematically analyzed in phase II to determine relevant topics for the video-scripts, which were user-checked by interview participants. In phase III, the results of a usability questionnaire were analyzed using descriptive statistics.

Results

In phase I, interviews with 29 stakeholders, including 4 seniors, 3 caregivers, and 22 professionals, showed a need for a one-stop information resource about options for staying independent at home. They raised issues relating to 6 categories: cognitive autonomy, psychological or mental well-being, functional autonomy, social autonomy, financial autonomy, and people involved. A script was developed and evaluated by participants. In phase II, after 4 days in a studio with 15 bilingual actors, 30 videos were made of various experts (eg, family doctor, home care nurse, and social worker) presenting options and guidance for the decision-making process. These were integrated into an interactive website, which included a comments tool for visitors to add information. In phase III (n=21), 8 seniors (7 women, mean age 75 years), 7 caregivers, and 6 professionals evaluated the acceptability of the module and suggested improvements. Clarity of the videos scored 3.6 out of 4, length was considered right by 17 (separate videos) and 13 participants (all videos together), and 18 participants considered the module acceptable. They suggested that information should be tailored more, and that seniors may need someone to help navigate it.

Conclusions

Our interactive website with interlinked videos presenting information about options for staying independent at home was deemed acceptable and potentially helpful by a diverse group of stakeholders.