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Golant SM. Dwellings occupied by mobility-limited older people emerge as strong control centers and more age-friendly places. J Aging Stud 2024; 70:101245. [PMID: 39218493 DOI: 10.1016/j.jaging.2024.101245] [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: 10/23/2023] [Revised: 05/31/2024] [Accepted: 06/05/2024] [Indexed: 09/04/2024]
Abstract
The future will witness the substantial worldwide growth of older people with functional limitations or disabilities who have difficulties leaving their dwellings and traveling to their neighborhoods or other community destinations to realize their obligatory and discretionary needs and goals. This commentary offers conceptual arguments and literature findings proposing that the dwellings of this vulnerable population deserve new scrutiny because they have become more salient and positively experienced places to live where their occupants can maintain their independence and age in place. The catalyst for this commentary is the emergence of gerontechnological innovations relying on digital and sensor technologies, offering these older occupants a new category of dwelling connectivity solutions-constituting a paradigm shift-whereby goods, care, services, social supports, and information and leisure activities can be delivered to their houses and apartments. Incorporating this technological component has transformed their dwellings into dynamic "control centers," connecting their occupants in real-time with the resources and activities offered in other places. These solutions enable older people to cope more effectively with declines and losses because their ability to live independently is less threatened by challenges they face accessing destinations with inadequate transportation options and less age-friendly land use or physical design features. By occupying more supportive, safer, and connected dwellings, these older people have overall more positive and salient residential mastery emotional experiences and feel more competent and in control of their lives and environment. Planning or policy recommendations directed to the World Health Organization (WHO) and its age-friendly city/community agenda follow from its conclusions. They highlight how dwelling environments containing gerontechnological solutions are becoming more critical influences of "active aging." The commentary recommends that WHO allocates more resources to dwelling interventions that increase the awareness, availability, usability, and acceptability of these gerontechnological solutions, thus reducing the disincentives for older people to be adopters.
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Affiliation(s)
- Stephen M Golant
- Department of Geography, University of Florida, Gainesville, FL 32606, United States of America.
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Bergqvist M, Bastholm-Rahmner P, Modig K, Gustafsson LL, Schmidt-Mende K. Proud but Powerless: A Qualitative Study of Homecare Workers´ Work Experiences and Their Suggestions for How Care for Homebound Older Adults Can Be Improved. JOURNAL OF GERONTOLOGICAL SOCIAL WORK 2024; 67:841-860. [PMID: 38753563 DOI: 10.1080/01634372.2024.2355154] [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: 06/13/2023] [Accepted: 05/10/2024] [Indexed: 05/18/2024]
Abstract
Many older adults with complex care needs live at home due to ageing-in-place policies. This study explored homecare workers' experiences and suggestions for improvements of care. Twelve semi-structured interviews were analyzed thematically, and revealed pride, capability, and satisfaction in their work, yet they feel undervalued and lack support. They advocate for integrated care models, recognition of their competence, flexible work approaches, and committed leadership. This would enhance patient care and address their own working conditions, addressing concerns from being relegated to the bottom of the hierarchy. They emphasize the need for comprehensive approaches, spanning from housekeeping to end-of-life palliative care.
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Affiliation(s)
- Monica Bergqvist
- Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institutet, Stockholm, Sweden
- Academic Primary Health Care Centre, Region Stockholm, Stockholm, Sweden
| | - Pia Bastholm-Rahmner
- Academic Primary Health Care Centre, Region Stockholm, Stockholm, Sweden
- Department of Laboratory Medicine, Karolinska Institutet, Division of Clinical Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - Karin Modig
- Institute of Environmental Medicine, Unit of Epidemiology, Karolinska Institutet, Stockholm, Sweden
| | - Lars L Gustafsson
- Department of Laboratory Medicine, Karolinska Institutet, Division of Clinical Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - Katharina Schmidt-Mende
- Academic Primary Health Care Centre, Region Stockholm, Stockholm, Sweden
- Department of Neurobiology and Care Sciences and Society, Division of Family Medicine and Primary Care, Karolinska Institutet, Stockholm, Sweden
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Wong N, Jeong S, Reddy M, Stamatis C, Lattie E, Jacobs M. Voice Assistants for Mental Health Services: Designing Dialogues with Homebound Older Adults. DIS. DESIGNING INTERACTIVE SYSTEMS (CONFERENCE) 2024; 2024:844-858. [PMID: 39045493 PMCID: PMC11262314 DOI: 10.1145/3643834.3661536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/25/2024]
Abstract
The number of older adults who are homebound with depressive symptoms is increasing. Due to their homebound status, they have limited access to trained mental healthcare support, which leaves this support often to untrained family caregivers. To increase access, a growing interest is placed on using technology-mediated solutions, such as voice-assisted intelligent personal assistants (VIPAs), to deliver mental health services to older adults. To better understand how older adults and family caregivers intend to interact with a VIPA for mental health interventions, we conducted a participatory design study during which 6 older adults and 7 caregivers designed VIPA-human dialogues for various scenarios. Using conversation style preferences as a starting point, we present aspects of human-likeness older adults and family caregivers perceived as helpful or uncanny, specifically in the context of the delivery of mental health interventions, which helps inform potential roles VIPAs can play in mental healthcare for older adults.
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Affiliation(s)
- Novia Wong
- University of California, Irvine, Irvine, California, USA
| | | | - Madhu Reddy
- University of California, Irvine, Irvine, California, USA
| | | | - Emily Lattie
- Northwestern University, Evanston, Illinois, USA
| | - Maia Jacobs
- Northwestern University, Evanston, Illinois, USA
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Jesus AG, de Lima MP, Vilar M, Pachana NA. Homebound elderly people psychotherapeutic intervention (HEPPI): Exploring the mediating role of loneliness. Arch Gerontol Geriatr 2024; 118:105308. [PMID: 38101250 DOI: 10.1016/j.archger.2023.105308] [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: 09/25/2023] [Revised: 11/22/2023] [Accepted: 12/01/2023] [Indexed: 12/17/2023]
Abstract
OBJECTIVES The present study aimed to explore whether the Homebound Elderly People Psychotherapeutic Intervention (HEPPI), a home-delivered ten-week cognitive-emotional intervention, was effective in reducing self-reported loneliness among homebound older adults presenting mild cognitive impairment and psychological symptomatology. Effects of HEPPI in total, social, and emotional loneliness, compared with a treatment-as-usual group, were investigated at post-intervention and 3-month follow-up. In addition, the potential role of social and emotional loneliness as mediators of the HEPPI impact on episodic memory and symptoms of depression and anxiety was examined. METHODS This study built upon the data of a previously conducted randomized controlled trial. Participants were randomly assigned to the HEPPI group (n = 98) or the treatment-as-usual group (n = 101) and completed baseline, post-intervention, and 3-month follow-up assessments, including measures of loneliness (UCLA - Loneliness scale), episodic memory (Wechsler Memory Scale-III), depressive symptoms (Geriatric Depression Scale-30), and anxiety symptoms (Geriatric Anxiety Inventory). Data were analyzed on an intention-to-treat basis employing linear mixed models and mediation analyses for repeated measures. CLINICALTRIALS gov identifier: NCT05499767. RESULTS Compared with usual care controls, the HEPPI participants reported a significant immediate decrease in total and social loneliness, but these effects were not maintained at a 3-month follow-up. The reduction in immediate perceived social loneliness significantly mediated the improvement of depressive symptoms. CONCLUSIONS The current findings suggest that HEPPI potentially reduced total and social loneliness of the homebound older population immediately post-intervention, and such decrease in social loneliness may be a relevant mechanism for improving their short-term depressive symptomatology.
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Affiliation(s)
- Andreia G Jesus
- Faculty of Psychology and Educational Sciences, University of Coimbra, Rua do Colégio Novo, 3000-115, Coimbra, Portugal.
| | - Margarida Pedroso de Lima
- Faculty of Psychology and Educational Sciences, University of Coimbra, Rua do Colégio Novo, 3000-115, Coimbra, Portugal
| | - Manuela Vilar
- Faculty of Psychology and Educational Sciences, University of Coimbra, Rua do Colégio Novo, 3000-115, Coimbra, Portugal
| | - Nancy A Pachana
- School of Psychology, The University of Queensland, Sir Fred Schonell Dr, St Lucia, QLD, 4072, Australia
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Haverhals LM, Manheim C, Vega Lujan D. Experiences of Veterans, Caregivers, and VA Home-Based Care Providers before, during, and Post-Hurricane Ian. Geriatrics (Basel) 2024; 9:10. [PMID: 38247985 PMCID: PMC10801461 DOI: 10.3390/geriatrics9010010] [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: 12/08/2023] [Revised: 12/22/2023] [Accepted: 01/05/2024] [Indexed: 01/23/2024] Open
Abstract
On 28 September 2022, Hurricane Ian pummeled parts of south Florida. Disaster and climate change research has shown that disasters exacerbate inequalities, especially amongst older and physically vulnerable people. Florida has a large population of Veterans managing multiple chronic health conditions and receiving long-term care in-home from Veterans Health Administration (VA) programs, including Home Based Primary Care and Medical Foster Home. To describe how VA staff provided high quality care during and after the hurricane, and how Veterans and caregivers accessed needed healthcare and supports post-hurricane, we conducted a site visit to Lee County, Florida area in May 2023, conducting N = 25 interviews with VA staff, Veterans, and caregivers. Findings from qualitative thematic analysis showed that while some Veterans and caregivers experienced significant challenges during and after the hurricane, including displacement and difficulty accessing oxygen, they felt highly supported by VA care teams. Staff efforts post-hurricane focused on improving care coordination in anticipation of future disasters, especially around communicating with Veterans and their caregivers, and a VA workgroup formed to implement changes. As climate change causes more severe hazard events, lessons learned from this project can better support healthcare staff, older adults, and their caregivers before and after major disasters.
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Affiliation(s)
- Leah M. Haverhals
- Denver-Seattle Department of Veterans Affairs (VA) Center of Innovation for Veteran-Centered & Value-Driven Care, Rocky Mountain Regional VA Medical Center, Aurora, CO 80045, USA; (C.M.); (D.V.L.)
- Health Care Policy & Research, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
| | - Chelsea Manheim
- Denver-Seattle Department of Veterans Affairs (VA) Center of Innovation for Veteran-Centered & Value-Driven Care, Rocky Mountain Regional VA Medical Center, Aurora, CO 80045, USA; (C.M.); (D.V.L.)
| | - Deisy Vega Lujan
- Denver-Seattle Department of Veterans Affairs (VA) Center of Innovation for Veteran-Centered & Value-Driven Care, Rocky Mountain Regional VA Medical Center, Aurora, CO 80045, USA; (C.M.); (D.V.L.)
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Palmer JL, Stallings DT, Yoo JH, Lorenz RA, Lach HW. Experiences of Older Adults During COVID-19: Loss, Boredom, Uncertainty, Worry, and Resilience. J Gerontol Nurs 2023; 49:27-32. [PMID: 37256759 DOI: 10.3928/00989134-20230512-04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
The coronavirus disease 2019 (COVID-19) pandemic and resulting instructions to stay home and social distance enhanced concerns of the impact of social isolation on the physical and mental well-being of older adults. Eighteen community-dwelling older adults participated in interviews describing their experiences early in the COVID-19 pandemic. Participants experienced loss of activities, routines, and social connection, and feelings of worry and uncertainty. Nevertheless, participants were hopeful about the future and demonstrated resilience in overcoming boredom as they became intentional in finding new activities and using technology to maintain connection with others. Older adults may need support in such situations to manage boredom and uncertainty and avoid social isolation. [Journal of Gerontological Nursing, 49(6), 27-32.].
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Liu Y, Jiao D, Yang M, Cui M, Li X, Zhu Z, Sawada Y, Watanabe Miura K, Watanabe T, Tanaka E, Anme T. Role of Multifaceted Social Relationships on the Association of Loneliness with Depression Symptoms: A Moderated Mediation Analysis. Healthcare (Basel) 2022; 11:healthcare11010124. [PMID: 36611584 PMCID: PMC9819800 DOI: 10.3390/healthcare11010124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 12/28/2022] [Accepted: 12/29/2022] [Indexed: 01/04/2023] Open
Abstract
Strong relationship exists between loneliness and depression in older adults. However, the effect of multifaceted social relationships on the relationship between loneliness and depression has not been explored. The purpose of the current study was to find out how multifaceted social relationships affect the aforementioned processes. We investigated and evaluated the loneliness status, depression symptoms, social relationships, and demographic information of 1116 older adults aged ≥65 years living in rural Japan. The final 555 participants were included in the analysis. Statistical evidence showed a direct effect between loneliness and depression symptoms. Additionally, the mediation model found that social curiosity and participation acted as mediators between loneliness and depression symptoms. Further, independence and participation, independence, and feeling safe played a conditional moderating role in the model of loneliness-social curiosity-depression symptoms and loneliness-participation-depression symptoms, respectively. Interaction can be an individual moderator in the link between loneliness and depression symptoms without any mediator. The moderated mediation model suggests that social curiosity and participation could mediate the association between loneliness and depression symptoms. In this process, independence, participation, and feeling safe may act as moderators.
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Affiliation(s)
- Yang Liu
- School of Comprehensive Human Science, University of Tsukuba, Tsukuba 3058577, Japan
| | - Dandan Jiao
- School of Comprehensive Human Science, University of Tsukuba, Tsukuba 3058577, Japan
- Department of Nursing, The First Affiliated Hospital, College of Clinical Medicine of Henan University of Science and Technology, Luoyang 471003, China
| | - Mengjiao Yang
- School of Comprehensive Human Science, University of Tsukuba, Tsukuba 3058577, Japan
- Department of Cardiovascular Surgery, Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, China
| | - Mingyu Cui
- School of Comprehensive Human Science, University of Tsukuba, Tsukuba 3058577, Japan
| | - Xiang Li
- School of Comprehensive Human Science, University of Tsukuba, Tsukuba 3058577, Japan
| | - Zhu Zhu
- School of Comprehensive Human Science, University of Tsukuba, Tsukuba 3058577, Japan
| | - Yuko Sawada
- Department of Physical Therapy, Morinomiya University of Medical Sciences, Osaka 5598611, Japan
| | | | - Taeko Watanabe
- Faculty of Nursing, Shukutoku University, Chiba 2608701, Japan
| | - Emiko Tanaka
- Faculty of Nursing, Musashino University, Tokyo 1358181, Japan
| | - Tokie Anme
- Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 3058577, Japan
- Correspondence: ; Tel.: +81-029-853-3436
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