Exploring Videoconferencing for Older Adults with Cognitive Concerns Using a Dramaturgical Lens.

This scoping review analyses existing literature on older adults’ participation in artistic activities. It identifies gaps in this research topic and suggests new directions for research. We followed the five-step process defined by Arksey and O’Malley (2005) and extended by Levac et al. (2010). Four electronic databases were searched, and 129 peer-reviewed articles were included in the scoping review. Research into older adults’ participation in artistic activities has grown in the last ten years. However, empirical papers tend to focus on the outcomes of older people’s participation in artistic activities, in particular the benefits. Most papers centred on facilitators to examine the antecedents of this type of participation among people in late life. Research about experiences, potentially negative consequences or barriers to older adults’ participation in artistic activities have been largely overlooked. We identified several gaps in the literature, which we classified as: related to the artistic activities that were considered; the potential costs and barriers for older adults’ participation in artistic activities; older adults’ voices and their diversity; the life course perspective; and a contextual view of research on the topic. These gaps suggest challenges that future research on older adults’ participation in artistic activities should consider.

Facilitators and Barriers of Social Participation of Older Adults: Systematic Review of Qualitative Studies

Exploring facilitators and barriers of older adults’ outdoor mobility: A walk-along study in Singapore

By searching the keywords of “older adult” and “computer” in ERIC, Academic Search Premier, and PsycINFO, this study reviewed 70 studies published after 1990 that address older adults' computer learning and usage. This study revealed 5 prominent themes among reviewed literature: (a) motivations and barriers of older adults' usage of computers, (b) age-related differences in computer learning and usage, (c) instructional tips and design, (d) changes in attitudes and benefits, and (e) Internet usage. The limitations of the studies are reviewed and suggestions for future research are discussed.

The aim of this research study is to collaboratively generate insights in the current institutional long-term care environment for activity and mobility of older adults, and of solutions that could be used to increase the activity and improve the mobility of the older adults. This research constitutes a qualitative study with a critical approach. Data were collected using photo-elicitation in four long-term care units in Finland during the spring of 2022. Older adults participated in individual data collection sessions which combined photographing and discussion. Staff members individually took photographs and later participated in a group discussion based on the photographs. Reflexive thematic analysis was used to analyse all data together. Ten older adults and 12 staff members participated in the research study. Four themes were identified: (1) facilities should be designed and equipped for their users, (2) moving in the institutional environment, (3) passivity as a norm, and (4) nurses should act differently and have the resources to do so. To increase the activity and improve the mobility of older adults, improvements are needed in terms of the design of facilities, opportunities for freedom of movement, outdoor activity, daily life activities, exercise, nurses' role in activating older adults and resources. Increased attention to the support of activity and mobility could benefit older adults in institutional long-term care. Physical activity promotion should be incorporated as an integral part of nursing practice. Directors of units were consulted when planning the study. Older adults and nurses contributed to the data collection and interpretation of data. (ADDRESSING): What problem did the study address? ○Older adults have recurrently been reported as living inactive lives in institutional long-term care. ○There is evidence of the relationship between the environment and the activity and mobility of older adults, but there seems to be a research-practice gap in terms of implementing activity- and mobility-promoting environments. ○Older adults and staff members are important in developing practice and change-oriented knowledge that can be used to increase the activity and improve the mobility of older adults in institutional long-term care. What were the main findings? ○Various environmental improvements are recommended to increase the activity and improve the mobility of older adults in institutional long-term care settings. ○Improvements for the design of facilities, opportunities for freedom of movement, outdoor activity, daily life activities, exercise, nurses' role in activating older adults and resources for activity support would benefit older adults' activity and mobility. Where and on whom will the research have an impact? ○Increasing the activity of older adults requires better activity promotion and mobility support by nurses in institutional care. Sufficient education and resources should be organized for activity promotion, in addition to a care and organizational culture that values activity. ○Environmental aspects to promote activity and mobility need to be considered already at the planning, building and renovating phases of facilities. ○Policymakers and care organizers should consider evidence of the harms and benefits of different institutional living environments when making decisions on organizing care. The study is reported using the Consolidated Criteria for Reporting Qualitative Research (COREQ).

Older adults' participation in gambling is increasing internationally. Due to their lifestage, older adults may be vulnerable to gambling-related harm. When investigating older adults' gambling, researchers have mostly focused on the individual characteristics of ‘problem gamblers’. Less is known about the socio-cultural, environmental and commercial factors that may influence older adults' gambling behaviours. Utilising Social Practice Theory, this critical qualitative inquiry of N = 40 Australian older adults (aged 55 and over) explored how social practices influenced gambling participation. Using a Constructivist Grounded Theory approach, data were interpreted using a reflexive thematic analysis. Theme 1 identified how gambling practices fulfilled older adults' social needs. Gambling was embedded in social activities and created a sense of belonging. Theme 2 highlighted how gambling became an everyday part of some participants' lives, with a range of routines constructed around gambling. While social factors influenced routinised gambling behaviours, the accessibility of gambling products in everyday settings contributed to engagement with gambling. This study demonstrates that a range of social, environmental and commercial factors may influence and routinise the gambling practices of older adults. Interventions aimed at preventing and reducing routine gambling participation among older adults should acknowledge the interplay between agency and social structure. Public health responses should aim to disrupt routine behaviours associated with gambling for older adults.

There is a lack of studies focused explicitly on the impact of the home environment on older adults’ sedentary behaviour (SB) and physical activity (PA). The present study aims to investigate older adults’ perception of their home environment and its impact on their PA and SB. A qualitative exploratory research design was employed to conduct 33 in-depth interviews (IDIs) and five focus group (FGs; n=16) with older adults (mean age 71.7 ± 5.2 years). Using reflexive thematic analysis as an inductive coding approach, four themes were generated from the data set and were interpreted using the socio-ecological model (SEM): (I) Home layout and PA, (II) Space designation within the home, (III) Electronic equipment, furniture and material within the home space, (IV) Changing infrastructure within the home space. The findings highlight the significance of person-environment interaction at different layers of the SEM. Older adults have a significant influence on the physical environment of the home and how it is organized in terms of allocating space and equipment. However, utilization of space, and its intentional use (for active or sedentary behaviour) is also crucial, emphasizing individuals’ autonomy, freedom and control within the home environment. Moreover, both interpersonal and intrapersonal factors act as facilitators or barriers regarding necessary modifications within the home space to promote a conducive environment for PA. The current findings provide insight into the interaction of personal, social, community, and physical environment factors to these older adults’ PA and SB in their homes. Moreover, motivating older adults to develop more intention to have positive control over their environment is important. Further, promoting the notion of ‘think small for large effects’ within the home space will enable older adults to map out small-scale activities (such as avoiding screens in the bedroom or moving PA equipment to a convenient place) instead of making large-scale, less realistic infrastructure changes.

Background Successful ageing-in-place is dependent on the design and features of the home. In some cases, home modifications or relocation may be required. Accessible, affordable, age-friendly housing for older adults is required to encourage forward planning. Aims/objectives To understand the views of middle and older aged adults and individuals with older relatives, about home safety, ageing in place and housing accessibility. Material and methods A qualitative descriptive approach, using reflexive thematic analysis was used. Data were gathered through semi-structured interviews with 16 participants, comprising eight middle- older aged people and eight individuals with older relatives. Results Seven themes were identified. Most participants accepted the ageing process and could recognise home environment hazards and potential future housing needs. Others were determined to remain independent at home and resistant to making future changes until necessary. Participants were interested in obtaining more information about how to improve home safety or services to support ageing-in-place. Conclusion Most older adults are open to conversations about planning for ageing-in-place and would like further information on home safety and home modifications. Educational forums and tools (such as flyers or checklists) which assist older people to plan future housing needs are recommended. Significance Many older people are living in homes that present hazards and limited accessibility as they age. Earlier planning could lead to home modifications which will improve the capacity to age in place. Action to provide earlier education is needed as the population ages and suitable housing for older people is limited. Key points for occupational therapy Decision-making around home safety among the ageing population can be compromised by lack of awareness, inadequate access to information and the sudden onset of age-related changes. An education guide or tool to support forward planning and housing decisions may improve early awareness among the ageing population.

Background Although death and grief are universal experiences, older adults with intellectual disabilities have historically been excluded from mourning, due to assumptions about their capacity. This study explores how they experience and express grief after the loss of close individuals. Method Based on qualitative data from semi-structured interviews with 92 older adults with mild to moderate intellectual disabilities residing in long-term care facilities in Chile, a reflexive thematic analysis was conducted to identify key themes. Results Five main themes emerged: emotional awareness of loss; diverse expressions of grief; disenfranchised mourning; environmental and relational disruptions; and the role of supports. Participants demonstrated symbolic, somatic, and relational ways of processing grief, despite structural and communicative barriers. Conclusion Findings underscore the need to recognise and support the grieving processes of older adults with intellectual disabilities through inclusive practices, communicative supports, and accessible rituals that honour their emotional and relational needs.

Telemedicine Uptake Among Older Adults During the COVID-19 Pandemic.

Background:Older adults with frailty are at risk of rapid health decline and poor outcomes, including end of life. While advance care planning (ACP) can support person-centred care, how to assess and support older adults’ ACP readiness remains unclear. Health and social care practitioners, and family caregivers, are often main providers of care, but their role in ACP is poorly understood.Objectives:To understand the readiness of older adults with frailty to engage in ACP from the perspectives of older adults, family caregivers, and health and social care practitioners.Design:An exploratory qualitative interview study informed by the COM-B system (individual-level behaviour change) and the Ecological Systems Theory (system-level influences).Methods:Semi-structured qualitative interviews with older adults (mild to moderate frailty), unpaid family caregivers, and health and social care practitioners in Japan. The topic guide was informed by the theoretical frameworks, exploring individual- and system-level factors influencing readiness. Reflexive thematic analysis was conducted to generate themes within and across the participant data sets.Results:Twenty-nine interviews were conducted with 32 participants: older adults (n = 10), caregivers (n = 6), and health (n = 6) and social care practitioners (n = 10). Three themes were generated: (1) ‘Leave decision-making to family’ and Bridging family dynamics – older adults delegate decisions, practitioners navigate complex family relationships; (2) ‘ACP is not part of our role’: Diverging role expectations among practitioners, and hesitation to engage in ACP – differing perceived practitioners responsibilities limit willingness to initiate ACP; (3) Transitional period: Social norms around death and dying, family structures, and health and social care systems – shifts in systemic and social aspects shape ACP readiness.Discussion:ACP readiness among this population is not solely an individual decision but is shaped by relationships, systemic, and societal factors. Enhancing ACP readiness requires a system-wide approach that incorporates family involvement and interdisciplinary collaboration and is adapted to the local context.Trial registration:Not applicable.

PurposeThere is a lack of studies focused explicitly on the impact of the home physical environment on older adults’ sedentary behaviour (SB) and physical activity (PA). Therefore, the present study aims to investigate older adults’ perception of their home environment and its impact on their PA and SB.MethodsA qualitative exploratory research design, based on in-depth interviews (IDIs) and focus groups discussions (FGDs) with older adults was conducted from 1st August 2022 to 31st December 2022. We identified four major themes: (I) Home layout and PA, (II) Space designation within the home, (III) Electronic equipment, furniture and material within the home space, (IV) Changing infrastructure within the home space. We analysed the data through reflexive thematic analysis using NVivo 10 software.ResultsOlder adults valued the physical environment, and they managed their indoor space to control environment by structuring and restructuring to make it conducive for PA. Outdoor space such as garden was also an important factor for older adults’ PA. Moreover, older adults being autonomous and without any restrictions spent a substantial amount of time on utilizing electronic media. Further modification (such as adaptive aids, modification in the bathroom and etc) within the home space assist them in daily activities.ConclusionThe findings suggest that both indoor and outdoor space play an important role in enhancing PA level and minimizing SB. Although space is important but how space is used, and its intention of use is also very crucial. The study finding also supported and recommended the notion of ‘think small for large effects’ within the home space. Instead of building the indoor facilities (such as indoor gyms, swimming pool and etc) older adults should mapped out small-scale activities such as avoiding screens in bedroom or removing clutter to increase space for activity.

Sexuality contributes to health and wellbeing, but it is often overlooked as an important occupation for older adults. Older adult studies focus on decreased participation and functioning in sexual acts. This study aimed to obtain perspectives and explore understandings and experiences of sexuality and of support needs, for typically ageing adults. Seventy-five older adults aged 60 years and older participated in the online cross-sectional survey. Participants were primarily from Australia, the United States, and the United Kingdom. Closed questions were analyzed using descriptive and inferential statistics, and reflexive thematic analysis was used for open questions. Throughout the ageing process, older adults continued to value their sexuality, expression, desire, and identity, though meanings and participation changed. Changes and challenges were overcome through openness, exploration, curiosity, valued relationships, and adaptations to ways of doing. Older adults identified being dissatisfied with current sexual health supports, resources, and services. Healthcare professionals need to develop intervention knowledge to address diverse needs, and better support older adults in sexuality through open discussion, addressing psychological, social, and health concerns as part of everyday practice. The development of standardized assessments and resources with consumer collaboration will ensure resources address multifaceted components of sexuality, and older adults' needs.

There is a need for further research on older adults' experiences of fall risk screening to improve health communication strategies. The purpose of this study was to describe and explore older adults' experiences of being screened for risk of an injurious fall, using the first-time injurious falls (FIF) screening tool. A qualitative study with five focus group interviews was carried out including 17 older adults (11 women and six men, with a mean age of 77.4years) who were recruited from two primary healthcare rehabilitation clinics in Sweden. Data were analyzed using reflexive thematic analysis. The analysis generated one overarching theme, "Screening for fall risk promotes engagement by raising older adults' awareness of their own abilities", and four categories; "Screening may motivate to take action but can also create a false sense of security", "Self-sufficiency is affected by the screening result and level of control over the environment", "Easy-to-perform and helps to facilitate a discussion with the healthcare professional" and "Ideas of how FIF tool could be used in healthcare". Older adults considered screening for fall risk to be meaningful insofar as it raises awareness of their own abilities and motivates them to prevent falls. On the other hand, a low fall risk could create a false sense of security, and lack of control over environmental factors related to fall risk could negatively impact their sense of self-sufficiency. They emphasized the need to receive support from healthcare providers and to be involved in care decisions if the screening indicates a high fall risk.

Older adults have a strong desire to self-manage their overall well-being, including their mental health. However, there is a risk that low mood could be associated with aging, normalized and accepted, and impacts help-seeking behavior by older adults. Thus, the current study explored how older adults in New Zealand manage low mood. This qualitative descriptive study was embedded in a study exploring community-dwelling older adults' well-being. Semi-structured interviews were conducted with 37 older adults aged between 66 and 99 years (mean age = 83 years). Reflexive thematic analysis was used to analyze the data. Four themes emerged: (1) Noticing, Normalizing, and Thinking Differently; (2) Engaging in Meaningful Activities; (3) Connecting With Others; and (4) Seeking Help. Importantly, older adults developed positive ways of managing low mood. Successful strategies older adults implemented can be shared, challenging stereotypes that low mood is specifically part of the aging process. For nurses, greater awareness of the strategies older adults use to combat low mood is vital to ensure they can maintain overall well-being. [Journal of Gerontological Nursing, 51(4), 29-35.].