Home-dwelling Older Women Research Articles

The Meaning of Home for Aging Women Living Alone in North Eastern Ontario

The experience and meaning of home for older, community dwelling women, who live alone was investigated. With the older demographic expanding and resources being directed at keeping older adults in their home, an expanded knowledge base is required. Interviews were conducted with seven home dwelling older women. Semi structured questions targeted the meaning of home for the participants. The theme of precariousness dominated the findings, including precariousness of formal and informal care, precariousness of winter and that home is not precarious. The study confirms that home is the preferred location for aging women. Health policy and services should continue to be implemented to accommodate this preference. Future research is needed to confirm the findings with a larger sample, incorporating additional life circumstances and to investigate the impact of factors such as winter weather and financial vulnerability on women’s ability to remain at home as they age.

Combined resistance and balance-jumping exercise reduces older women's injurious falls and fractures: 5-year follow-up study.

previously, a randomised controlled exercise intervention study (RCT) showed that combined resistance and balance-jumping training (COMB) improved physical functioning and bone strength. The purpose of this follow-up study was to assess whether this exercise intervention had long-lasting effects in reducing injurious falls and fractures. five-year health-care register-based follow-up study after a 1-year, four-arm RCT. community-dwelling older women in Finland. one hundred and forty-five of the original 149 RCT participants; women aged 70-78 years at the beginning. participants' health-care visits were collected from computerised patient register. An injurious fall was defined as an event in which the subject contacted the health-care professionals or was taken to a hospital, due to a fall. The rate of injured fallers was assessed by Cox proportional hazards model (hazard ratio, HR), and the rate of injurious falls and fractures by Poisson regression (risk ratio, RR). eighty-one injurious falls including 26 fractures occurred during the follow-up. The rate of injured fallers was 62% lower in COMB group compared with the controls (HR 0.38, 95% CI 0.17 to 0.85). In addition, COMB group had 51% less injurious falls (RR 0.49, 95% CI 0.25 to 0.98) and 74% less fractures (RR 0.26, 95% CI 0.07 to 0.97). home-dwelling older women who participated in a 12-month intensive multi-component exercise training showed a reduced incidence for injurious falls during 5-year post-intervention period. Reduction in fractures was also evident. These long-term effects need to be confirmed in future studies.

Exercise and vitamin D in fall prevention among older women: a randomized clinical trial.

While vitamin D supplementation and exercise are recommended for prevention of falls for older people, results regarding these 2 factors are contradictory. To determine the effectiveness of targeted exercise training and vitamin D supplementation in reducing falls and injurious falls among older women. A 2-year randomized, double-blind, placebo-controlled vitamin D and open exercise trial conducted between April 2010 and March 2013 in Tampere, Finland. Participants were 409 home-dwelling women 70 to 80 years old. The main inclusion criteria were at least 1 fall during the previous year, no use of vitamin D supplements, and no contraindication to exercise. Four study groups, including placebo without exercise, vitamin D (800 IU/d) without exercise, placebo and exercise, and vitamin D (800 IU/d) and exercise. The primary outcome was monthly reported falls. Injurious falls and the number of fallers and injured fallers were reported as secondary outcomes. In addition, bone density, physical functioning (muscle strength, balance, and mobility), and vitamin D metabolism were assessed. Intent-to-treat analyses showed that neither vitamin D nor exercise reduced falls. Fall rates per 100 person-years were 118.2, 132.1, 120.7, and 113.1 in the placebo without exercise, vitamin D without exercise, placebo and exercise, and vitamin D and exercise study groups, respectively; however, injurious fall rates were 13.2, 12.9, 6.5, and 5.0, respectively. Hazard ratios for injured fallers were significantly lower among exercisers with vitamin D (0.38; 95% CI, 0.17-0.83) and without vitamin D (0.47; 95% CI, 0.23-0.99). Vitamin D maintained femoral neck bone mineral density and increased tibial trabecular density slightly. However, only exercise improved muscle strength and balance. Vitamin D did not enhance exercise effects on physical functioning. The rate of injurious falls and injured fallers more than halved with strength and balance training in home-dwelling older women, while neither exercise nor vitamin D affected the rate of falls. Exercise improved physical functioning. Future research is needed to determine the role of vitamin D in the enhancement of strength, balance, and mobility. clinicaltrials.gov Identifier: NCT00986466.

Item non-response when measuring elder abuse: influence of methodological choices

Efficient actions to fight elder abuse are highly dependent on reliable dimensions of the phenomenon. Accurate measures are nevertheless difficult to achieve owing to the sensitivity of the topic. Different research endeavours indicate varying prevalence rates, which are explained by different research designs and definitions used, but little is known about measurement errors such as item non-responses and how outcomes are affected by modes of administration. A multi-national study was developed to measure domestic abuse against home-dwelling older women (aged >60 years) in Europe. The measurement instrument covered six forms of abuse, adapted from the Conflict Tactics Scale. 2880 individuals were interviewed by three different data collection methods (i.e. postal, face-to-face, telephone). Principal component analysis of missing values of 34 indicators of abuse showed various patterns of item non-response. Moreover, principal component analysis indicated several response patterns across different types of data collection. A binary logistic regression explained that item non-response and abuse prevalence is influenced by individual characteristics (social status, vulnerability), method effects such as content (sensitivity), the order of the questions (forms of abuse), by type of data collection and the presence of assistance in survey completion. The discussion revolves around how these findings could help improving measuring elder abuse. Advantages and disadvantages of the questionnaire and type of data collection methods are discussed in relation to three potential types of response errors: item positioning effect, acquiescence and social desirability.

Lebensqualität älterer Frauen bei Abhängigkeit und Gewalt

Quality of life is largely determined by changing biographical contexts of a person's behavioural action. In later age, health and social relationships are major determinants for a "good life". A decline in health status may lead to the need for support which may result in further dependency; thus, social relations play an even more important role for older people. Relationships characterised by strain and tension may increase the risk of exposure to force and violence. This article investigates the influence of dependency and abuse on the subjective quality of life of older people. The dataset was drawn from an Austrian survey of 593 home-dwelling older women aged 60 and over (71.0 ± 8.1 years). Quality of life was assessed by the EUROHIS-QOL Scale, dependency by the degree of need for support with respect to activities of daily living and by the levels of care allowance received by this cohort. Following the Conflict Tactics Scales (CTS), six different types of abuse have been operationalised by 34 indicators. The data were analysed by descriptive statistics, confirmatory factor analysis and structural equation modelling. With increasing dependency the subjective quality of life of older women decreases. At the same time it is reduced by the experience of abuse in the close social environment. Neglect, psychological abuse and the violation of personal liberties and rights can be identified as factors which have a negative impact on quality of life. It is also noted that neglect can be found particularly among women with a greater need for support and a higher level of care allowance, which is a particularly problematic situation. Dependency and abuse are major risk factors for low quality of life in old age. The results stress the importance of raising general awareness on violence and highlight the social taboos around the issue of abuse against older people, especially in the case of increasing dependency. In addition, the results point to an increasing demand for specific measures of health promotion and prevention activities addressing vulnerable older people.

Effects of Exercise on Health-Related Quality of Life and Fear of Falling in Home-Dwelling Older Women

This randomized, controlled trial evaluated the effects of exercise on health-related quality of life (HRQoL) and fear of falling (FoF) among 149 home-dwelling older women. The 12-mo exercise program was intended to reduce the risk of falls and fractures. HRQoL was assessed by the RAND-36 Survey, and FoF, with a visual analog scale, at baseline, 12 mo, and 24 mo. On all RAND-36 scales, the scores indicated better health and well-being. The exercise had hardly any effect on HRQoL; only the general health score improved slightly compared with controls at 12 mo (p = .019), but this gain was lost at 24 mo. FoF decreased in both groups during the intervention with no between-groups difference at 12 or 24 mo. In conclusion, despite beneficial physiological changes, the exercise intervention showed rather limited effects on HRQoL and FoF among relatively high-functioning older women. This modest result may be partly because of insufficient responsiveness of the assessment instruments used.

TESTING THERAPEUTIC LIFE REVIEW OFFERED BY HOME CARE WORKERS TO DECREASE DEPRESSION AMONG HOME-DWELLING OLDER WOMEN

The purpose of the study was to test a psychosocial intervention, therapeutic life review, offered by home care workers to decrease depression among home-dwelling older women. A quasi-experimental, one-group time-series design measured the effect of a once-a-week, 40-minute therapeutic life review intervention, delivered for six weeks by home care workers, on the depression scores of women 65 years and older, compared to their scores during the ten weeks prior to the intervention. Over time, depression scores improved with a significant decrease in depression immediately following the six-week intervention. Based on these findings, we concluded that home care workers can deliver a community-based psychosocial intervention that decreases depression in their home-dwelling clients.

Risk Factors for Falling in Home-Dwelling Older Women With Stroke

Background and Purpose— Much of our knowledge of risk factors for falls comes from studies of the general population. The aim of this study was to estimate the risk of falling associated with commonly accepted and stroke-specific factors in a home-dwelling stroke population. Methods— This study included an analysis of prospective fall reports in 124 women with confirmed stroke over 1 year. Variables relating to physical and mental health, history of falls, stroke symptoms, self-reported difficulties in activities of daily living, and physical performance tests were collected during home assessments. Results— Risk factors for falling commonly reported in the general population, including performance tests of balance, incontinence, previous falls, and sedative/hypnotic medications, did not predict falls in multivariate analyses. Frequent balance problems while dressing were the strongest risk factor for falls (odds ratio, 7.0). Residual balance, dizziness, or spinning stroke symptoms were also a strong risk factor for falling (odds ratio, 5.2). Residual motor symptoms were not associated with an increased risk of falling. Conclusions— Interventions to reduce the frequency of balance problems during complex tasks may play a significant role in reducing falls in stroke. Clinicians should be aware of the increased risk of falling in women with residual balance, dizziness, or spinning stroke symptoms and recognize that risk assessments developed for use in the general population may not be appropriate for stroke patients.