Relocation among ethnic elders. A review--part 2

Perspective of Family Members of Transitions to Alternative Levels of Care in Anglo-Saxon Countries

This scoping review explores circumstances surrounding the decision about, and eventual experience of, transitioning older adults into alternative levels of housing (ALH), such as long-term care. This topic is examined from a family member perspective, given their exposure and involvement in the care of older adult relatives during this transitional period. The scoping review methodology is based on the framework of Arksey and O'Malley and subsequent recommendations from Levac, Colquhoun, and O'Brien. Approximately 470 articles were reviewed covering the period between 2000 and November 2014; 37 articles met inclusion criteria. A temporal organization of themes was used to describe the experiences of family members in the pretransition, active transition, and posttransition periods of moving older adult relatives into ALH. This paper highlights the transitional period as a time of crisis, with a lack of planning, support, and transparent discussion. This study identifies a need for future research on the potential benefits of family support groups, interim transitional housing options, different models of ALH, changing roles in the posttransition period, and the need for a comprehensive list of housing options for older adults. Results have the potential to inform policy/practice and improve the lives of older adults and their family.

Assessing future care preparation in late life: Two short measures

The purpose of this article is to introduce 2 short forms of the previously published measure of preparation for future care (PFC). Community-dwelling older adults ages 65-94 who had completed the 29-item Preparation for Future Care Needs scale were randomly divided into scale development (n = 697) and scale validation (n = 690) samples. Fifteen items were selected using exploratory and confirmatory factor analyses on the scale development and scale validation samples, respectively. Consistent with PFC theory, the 5 subscales of the original long-form measure (Awareness, Gathering Information, Decision Making, Concrete Planning, Avoidance of Care Planning) were maintained. A 5-item scale with acceptable score reliability and validity was also developed. Compared to the long form, these short forms are more easily incorporated into epidemiologic studies and can be used in medical, psychology, and social work practice to initiate discussions about long-term care planning. (PsycINFO Database Record

Management of Relocation in Cognitively Intact Older Adults

Relocation, a major life transition that can affect health positively and negatively, is moving from one permanent home to another. Many older adults will relocate at some time during their life. Relocation is also a complex process that requires careful consideration and planning before the move (i.e., pre-location) and adjustment to the new home after the move (i.e., post-relocation). The current article is a summary of content based on a comprehensive evidence-based practice guideline focused on management of relocation in cognitively intact older adults. The guideline was designed to be used across diverse settings by nurses and other providers. Pre-relocation guidelines include assessment for the need for relocation, interventions prior to moving, and outcomes for evaluation of the pre-relocation process. For post-relocation, content focuses on assessment of risks for not adjusting after the move as well as intervention guidelines to promote adjustment and outcomes for evaluation. Implications include advocacy for older adults by using the guideline, disseminating it, and conducting future research. [Journal of Gerontological Nursing, 42(11), 14-23.].

Nutritional status and eating habits of older Manitobans after relocating to a personal care home

We explored the effect of relocating to a personal care home (PCH) on older adults' nutritional status and eating habits. Fourteen Caucasian older adults (F=57%) with a mean age of 83 years (standard deviation = 9.79) consented to participate. Anthropometric information (height, weight, bioelectrical impedance analysis), biochemical and clinical information (diagnoses, data from scales measuring risk or function), and dietary information (three-day plate waste analysis) were collected at time points A (two to three months after relocation) and B (six to seven months after relocation) through face-to-face interviews and medical chart reviews, and from nursing staff. At time B, cognitive function declined (z = -2.185, p<0.05) and the number of medications prescribed increased (z = -2.00, p<0.05). Levels of 25-hydroxyvitamin D were insufficient among 83% of participants at both time points. Mean serum albumin was 34.4 ± 7.2 g/L at time B, and the prevalence of potential nutritional risk increased from 57% to 77%. Dietary intake was inadequate at both time points. Nutritional risk became more prevalent at time B. Protein-energy malnutrition and other nutritional inadequacies may result if dietary intakes do not improve. Strategies to improve dietary intakes should be implemented within PCHs to reduce potential malnutrition.

Psychometric testing of an instrument to measure the experience of home

Research related to quality of life in long-term care has been hampered by a paucity of measurement tools sensitive to environmental interventions. The primary aim of this study was to test the psychometric properties of a new instrument, the Experience of Home (EOH) Scale, designed to measure the strength of the experience of meaningful person-environment transaction. The instrument was administered to 200 older adults in diverse dwelling types. Principal components analysis provided support for construct validity, eliciting a three-factor solution accounting for 63.18% of variance in scores. Internal consistency reliability was supported with Cronbach's alpha of .96 for the entire scale. The EOH Scale is a unique research tool to evaluate interventions to improve quality of living in residential environments.

Health-Related Decision-Making by Older Adults and Their Families

Helping frail and vulnerable individuals and their families to make the best health-related decision is difficult even in the best of circumstances. Decision-making as a discrete action is often discussed in the health care literature, but the concept that decision-making is a process is largely ignored. Understanding the basic elements of the decision-making process used by older adults and their family, or support individual(s) may help health care team members offer more substantial and meaningful assistance to the individuals who are trying to make tough health-related decisions. Full information needs to be available so all participants involved in the process can make reasonable decisions. The decision-making process is highly contextual and is based on how realistic the decision-making goals are and how congruent the experiences versus perceived expectations are, as well as the quality of options available.

The willingness to eat. An investigation of appetite among elderly people

The aim of this study was to identify and describe factors of importance with regard to appetite among elderly people. A qualitative approach was used and the method was grounded theory. Fifteen elderly people were interviewed using a method with two overall questions. The results show that the willingness to eat plays a central role in appetite among elderly people. The appetite is a state on a sliding scale, from good to poor appetite. Factors affecting the appetite include six categories: mood, personal values, wholesomeness, food, eating environment and meal fellowship. When planning and realizing nursing actions concerning eating, the willingness to eat has to be observed. The desire within every individual has to be given consideration, including all factors as well as how they affect each other. The willingness to eat contains internal factors dependent on mood and personal values, as well as external factors dependent on wholesomeness, food, eating environment and meal fellowship. These factors contain qualitative dimensions, which affect elderly people's appetites as well as their quality of life to a varying extent. Through this, it can be seen that there is a connection between their desire or willingness to eat and their will to live.