Lived Experience Of Older Adults Research Articles

A Hybrid Concept Analysis of Frailty Among Older Adults Living in the Community.

To analyse the concept of frailty through a literature review and in-depth interviews. A hybrid model of concept analysis. The theoretical phase identified 43 articles for reviewing the definition and measurement of frailty. Seven frail older adults were invited in the fieldwork phase for in-depth interviews. In the final analysis phase, results from the fieldwork and theoretical phases were integrated to obtain a final definition of frailty. Attributes of frailty were heterogeneous, involving dynamic/bidirectional, multidimensional and multiple systems. The antecedents of the concept were exposure to various stimuli and challenges in responding to these stimuli. Consequences included losing autonomy and adverse health outcomes. Four themes of frailty were identified based on the fieldwork data: 'accumulation of functional decline', 'powerlessness of coping with', 'vicissitudes of lived experience' and 'loss of autonomy and positivity'. The final definition of frailty was 'a dynamic and fluctuating process of powerlessness to manage biopsychosocial and environmental stimuli, involving functional decline and vicissitudes of life, which results in losing autonomy and positivity or adverse health outcomes'. Characterising the definition of frailty is essential for nurses to address the lived experiences of older adults when providing person-centred care and for developing interventions that meet the needs of frail older adults. Since some discrepancies existed in the definition of frailty from individual perception of older adults, combined in-depth interviews with a theoretical literature review were used to provide comprehensive insight. This concept analysis provides guidelines of training for nurses and opportunities to improving quality of life for community dwelling older adults. N/A. No Patient or Public Contribution.

Navigating the Silver Seas of Ageing: A Phenomenological Study on Life Course Impacts on Older Adults in Senior Living Facilities

This study examined the lived experiences of older adults in senior living facilities, focusing on the impact of their life course on their well-being. In-depth, semi-structured, one-on-one interviews were used to collect data from 28 older adults from six senior living facilities, and the results were thoroughly analysed. Using Moustakas’ transcendental phenomenology and the modified Stevick–Colaizzi–Keen analytical method, five main themes emerged: the influence of the life course on later life, linked lives, attachment through the life course, cultivation of memories and longing for intergenerational relationships. The findings indicated that life course experiences impacted later life in senior living facilities differently for each participant. While some developed meaningful experiences and supportive connections that cushioned the feelings of loss and loneliness, others struggled with a sense of familiarity, identity and security. The findings extend existing knowledge and provide valuable implications for academics, senior living facilitators, government policy, hospitality and healthcare providers.

IBD Is Like a Tree: Reflections From Older Adults With Inflammatory Bowel Disease.

Despite the growing proportion of older adults with inflammatory bowel disease (IBD), their lived experience is not well understood. IBD literature is generally focused on younger adults, and few studies are qualitative. Older adults may report well-being differently than younger adults, so it is important that we learn about their goals and priorities with a chronic disease. The study sought to understand the lived experience of older adults with IBD and explore their perceptions and priorities. We conducted in-depth interviews with patients ≥60 years of age with IBD to evaluate the impact and perception of IBD in the context their overall health and life. We used a hybrid inductive-deductive thematic analysis of our transcripts to identify underlying patterns. We achieved thematic saturation after 22 interviews. We produced 4 major themes: (1) having IBD at an older age, (2) financial ramifications of IBD at an older age, (3) expectations for a meaningful life, and (4) unmet needs. Prominent subthemes included (1) ageism, loss of autonomy, and barriers to healthcare; (2) retirement and insurance issues; (3) redefining quality of life and gratitude; and (4) social isolation and navigating daily life with IBD. Having IBD later in life presents unique challenges. Physicians treating older patients should consider age-sensitive communication, susceptibility to social isolation, and practices for healthy aging in the context of IBD. Patient priorities for further investigation include more representation in the media and educational material tailored for older adults with IBD.

Older adults' lived experiences of thermal comfort in senior-friendly accommodations for healthy aging in humid tropics

PurposeAs climate change disproportionately affects vulnerable populations, ensuring thermal comfort for older adults is magnified in tropical senior living environments. This study explores the lived experiences of older adults' thermal comfort in senior living facilities in a tropical climate and how these experiences impact their overall well-being.Design/methodology/approachEmploying Moustakas' transcendental phenomenology and the Modified Stevick-Colaizzi-Keen method, this study investigated older adults' thermal experiences through semi-structured interviews with 28 participants in six urban senior living facilities in Malaysia.FindingsFour primary themes emerged: fabric and function; atmospheric conditions and living dynamics; thermal dynamics and environmental comfort; temperature tensions of stress, sound, and sensitivity. Our findings underscore the importance of considering the multisensory and multi-faceted nature of thermal comfort for older adults, considering sensory aspects, early life experiences, cultural practices, and personal preferences, particularly in tropical climates.Originality/valueAs one of the first to explore the thermal comfort of older adults in senior-friendly accommodations in a tropical climate, the findings provide a comprehensive understanding of older adults' diverse thermal comfort needs and offer practical recommendations for environments that support healthy aging. By integrating insights from hospitality, gerontology, and environmental studies, this research contributes to the promotion of public health and aligns with global objectives to improve the well-being of the aging population.

"We do not go outside, though We want to": Unequal Access to Public Transport and Transport-Related Social Exclusion of Older Adults in Dhaka, Bangladesh.

This study investigated key physical and social barriers to accessing public transport in Dhaka, Bangladesh, and how the unequal accessibility of transport leads to the social exclusion of older adults. Employing a transport disadvantage perspective and drawing on visual surveys and in-depth interviews, the study explores the context and lived experiences of older adults using public transport in their everyday lives. Difficulty in accessing buses due to overcrowding and congestion, struggling to get on rickshaws due to height, avoiding CNG (an autorickshaw) and cabs due to high fares, disliking Laguna (a small four-wheeler human haulier for carrying passengers) for compact seating arrangements, undesirable behavior, and social attitudes discourage older adults from participating in social activities and produce a feeling of social isolation and exclusion. Hence, more inclusive transport policies are essential in low- and middle-income countries to reduce transport-related social exclusion and improve the well-being of older adults.

Embodied navigation: the influence of lived experience on physical activity and sedentary behavior among older adults

ABSTRACT Purpose The impact of a sedentary lifestyle on health and well-being is well recognized. However, there is limited understanding of how a lifetime of physical activity and sedentary behaviour influences an active lifestyle in older adults. The aim of this study was to describe how lived experience of physical activity and sedentary behaviour impacts daily activities among older adults, from a life course perspective. Methods Qualitative content analysis was used; individual telephone interviews were conducted with fourteen older adults aged 71 to 92 years. The participants received initial support from community care and lived in ordinary housing in southern Sweden. Results The interviews yielded one theme, “Navigating with an embodied activity compass,” and two sub-themes: “Being guided by the past” and “Unveiling pathways through body awareness.” Conclusions Our study highlights how older adults’ lived experiences of physical activity, with their connections to body awareness and acceptance, impact daily physical activity. These findings offer new knowledge for clinical practitioners balancing recommendations of sedentary behaviour and physical activity, to promote healthy daily physical activity among older adults. Future research and policies should consider the lived experiences of older adults when addressing public health matters related to sedentary behaviour and physical activity.

The lived experience of frailty: beyond classification and towards a holistic understanding of health

Key summary pointsAimWe cross-sectionally described measured characteristics and lived experiences of older adults classified as frail by three different scales in The Irish Longitudinal Study on Ageing (TILDA).FindingsDespite being classified as frail, more than 60% rated their health positively, and over 77% engaged in active leisure activities at least once a month.MessageThis study challenges the excessively negative perceptions of frailty, underscoring the need for a holistic understanding of frailty beyond classification scales.

Anxiety during the Corona Virus Disease (COVID-19): The Lived Experience of Older Adults

This qualitative study explored the lived experience of Maltese older adults experiencing symptoms of anxiety during the coronavirus disease pandemic. The study was carried out through an interpretative phenomenological analysis approach. The participants (7 Maltese older adults) were recruited through purposive and snowball sampling, and semi-structured interviews were utilised to collect data. A cluster of 4 emergent Group Experiential Themes comprising of 13 subthemes highlighted the high levels of fear, as well as the different cognitive processes and attitudes that led to and maintained the experience of anxiety. The challenges of living through the pandemic included social isolation, safety measures, the long-term living outcomes of the pandemic and reflections on vulnerability. Resilience, coping strategies, and support systems played crucial roles throughout this period. Results framed within a Dynamic Biopsychosocial Model revealed that biological, psychological and social factors influencing anxiety evolved with the pandemic, shaping participants' perceptions. Measures supporting older adults to soften the negative mental health outcomes and possible traumas due to death of loved ones or long-term hospitalization should be prioritized.

NCI-Delirium Model: Co-caring to decrease the incidence of delirium among hospitalized older adults.

Delirium negatively impacts the health and wellbeing of older adults and their family carers and contributes to unnecessary high healthcare costs, estimated at $8.8 billion per year in Australia. Improvements to clinical practice are urgently needed, particularly now, as the COVID-19 pandemic is placing an enormous burden on our hospitals. 
 Innovative strategies that support partnerships with family carers have been reported as key to improved patient outcomes and satisfaction with care, particularly for older adults unable to participate in their own care. This is because carers have intimate knowledge of a family member’s cognitive state to identify early subtle changes others might not. Carers also provide valuable reassurance and familiarity to the older adults during their treatment and can orient them to place and time. 
 Founded on our clinical observations, informed by a scoping review of the literature (in press) and co-designed with carers, consumers, clinicians and policy analysts, we developed a new model of delirium care: NCI-Delirium. NCI-Delirium is a validated, scalable, low risk model that values the lived experience of older adults and carers. NCI-Delirium supports the integration of carers as partners in the care of the older adult from admission into the acute care setting. To support the integration of carers as partners, they are offered a web-based Delirium Toolkit that contains: an education package to build awareness and skill development (e.g., delirium risk factors, therapeutic and preventive strategies and non-pharmacological interventions to manage the reorientation of the hospitalised older adult); a 7-item psychometrically tested screening tool designed for carers to identify delirium symptoms and people at risk of delirium; access to support resources (e.g., counselling, social prescriptions, peer-support); and a co-designed discharge plan with the health team. 
 Preliminary results suggest that NCI-Delirium improves health service delirium outcomes. Carer involvement in this research, and the introduction of their perspectives, has elevated carers’ key relationships with clinicians. Our co-designed solution to support the integration of carers as partners in delirium management has improved carers’ caregiving burden, psychological wellbeing and knowledge of delirium. This translatable co-designed model of care provides the much needed rich and robust clinical, implementation and economic evidence, to address the risk factors associated with the prevalence of delirium in hospitalised older adults. It is anticipated that the model will transform how we integrate carers as partners in care to improve clinical practice, patient and carer experiences; and reduce caregiving burden.
 Globally, the identification and management of risk for delirium is imperative. Delirium is a potentially life-threatening condition, and not well detected in the acute or community care setting. If carers are integrated and supported as partners in care, the capacity to identify symptoms and support the diagnosis of delirium should increase, potentially reducing functional decline, transition to residential aged care facilities and mortality rates. The next steps are to evaluate this co-designed web-based delirium model of care for use by carers in the community and residential aged care setting.

HEAVY DRINKING, MENTAL HEALTH PROBLEMS AND RECOVERY IN OLDER ADULTS: EXPLORING SUPPORT NEEDS

Abstract Many older adults who consume alcohol at harmful levels experience mental health problems. Common life events such as retirement, bereavement, and declining health, can contribute to anxiety and depression, with alcohol consumption being used as a coping mechanism. Tailored support is crucial to address the unique needs of older adults facing both alcohol misuse and mental health problems. These patients often fall into gaps between services (family practice/alcohol/mental health), which are unable to meet their complex support needs. This qualitative study aimed to understand the lived experiences of older adults with co-occurring heavy drinking and mental health problems, support received and unmet needs. We conducted semi-structured interviews with 14 older adults living in the North of England (completed Summer 2023). Thematic analysis and constant comparison were employed in data analysis. Findings highlighted the importance of age-tailored initiatives such as access to mental health support while actively drinking, supervised detoxification, increased peer support and services that are age inclusive and friendly. Risk factors such as grief, loneliness, financial problems and undiagnosed trauma in older adults contributed to development of these conditions. Older adults need services to work together, integrated around patient needs and addressing heavy drinking and mental health concerns at the same time. Future research should focus on improving mental health literacy and, developing holistic and preventive interventions to address risk factors for co-occurring alcohol and mental health problems in older adults.

Why Gerontology Needs Anthropology: Toward an Applied Anthropological Gerontology.

In this essay, we argue that gerontologists should increase their engagement with anthropologists to increase transdisciplinary collaboration, fulfill the interdisciplinary promise of gerontology as a field, and to ensure the work of anthropologists is formed by, and employed in, situations where meaningful engagement with practitioners and policymakers can lead to social change. Anthropology is the study of human societies in historical, biological, and sociocultural context, comprising a holistic field of study that can contribute unique methods, approaches, and theories to the field of gerontology. Although increasing amounts of anthropological scholarship have focused on older adulthood, this critical work of anthropologists still needs to be utilized by those in positions of power to enact change. Furthermore, the work conducted by anthropologists of aging has not consistently been recognized as anthropological scholarship. Therefore, a notable gap exists between the promise of the anthropology of aging and the utilization of the field, its findings, and engagement with the broader gerontological academy. As such, the contributions of anthropology to aging scholarship and the resulting reduction in inequities in the aging experience are not always adequately recognized. By examining the history of anthropology's engagement with aging and the lifecourse, we argue for a more applied anthropological gerontology. We conclude with a call to action to ensure that anthropological gerontology is seen as a fundamental branch of scholarship, both within anthropology and gerontology, which can be used to improve the lived experiences of older adults globally.

What If the Clinical and Older Adults' Perspectives about Frailty Converge? A Call for a Mixed Conceptual Model of Frailty: A Traditional Literature Review.

Existing frailty models have enhanced research and practice; however, none of the models accounts for the perspective of older adults upon defining and operationalizing frailty. We aim to propose a mixed conceptual model that builds on the integral model while accounting for older adults' perceptions and lived experiences of frailty. We conducted a traditional literature review to address frailty attributes, risk factors, consequences, perceptions, and lived experiences of older adults with frailty. Frailty attributes are vulnerability/susceptibility, aging, dynamic, complex, physical, psychological, and social. Frailty perceptions and lived experience themes/subthemes are refusing frailty labeling, being labeled "by others" as compared to "self-labeling", from the perception of being frail towards acting as being frail, positive self-image, skepticism about frailty screening, communicating the term "frail", and negative and positive impacts and experiences of frailty. Frailty risk factors are classified into socio-demographic, biological, physical, psychological/cognitive, behavioral, and situational/environmental factors. The consequences of frailty affect the individual, the caregiver/family, the healthcare sector, and society. The mixed conceptual model of frailty consists of interacting risk factors, interacting attributes surrounded by the older adult's perception and lived experience, and interacting consequences at multiple levels. The mixed conceptual model provides a lens to qualify frailty in addition to quantifying it.

Real-world lived experience of older adults with type 1 diabetes after an automated insulin delivery trial.

First-generation closed-loop automated insulin delivery improves glycaemia and psychosocial outcomes among older adults with type 1 diabetes in clinical trials. However, no study has previously assessed real-world lived experience of older adults using closed-loop therapy outside a trial environment. Semi-structured interviews were conducted with older adults who were pre-existing insulin pump users and previously completed the OldeR Adult Closed-Loop (ORACL) randomised trial. Interviews focused on perceptions of diabetes technology use, and factors influencing decisions regarding continuation. Twenty-eight participants, mean age 70 years (SD 5), were interviewed at median 650 days (IQR 608-694) after their final ORACL trial visit. At interview, 23 participants (82%) were still using a commercial closed-loop system (requiring manual input for prandial insulin bolus doses). Themes discussed in interviews relating to closed-loop system use included sustained psychosocial benefits, cost and retirement considerations and usability frustrations relating to sensor accuracy and system alarms. Of the five participants who had discontinued, reasons included cost, continuous glucose monitoring-associated difficulties and usability frustrations. Cost was the largest consideration regarding continued use; most participants considered the increased ease of diabetes management to be worth the associated costs, though cost was prohibitive for some. Almost 2 years after completing a closed-loop clinical trial, closed-loop automated insulin delivery remains the preferred type 1 diabetes therapy for the majority of older adult participants. Chronological age is not a barrier to real-world successful use of diabetes technology. Identifying age-related barriers, and solutions, to diabetes technology use among older adults is warranted.

Older adults’ experiences during the COVID-19 pandemic: a qualitative systematic literature review

ObjectivesRelatively little is known about the lived experiences of older adults during the COVID-19 pandemic. We systematically review the international literature to understand the lived experiences of older adult’s experiences during the pandemic.Design and methodologyThis study uses a meta-ethnographical approach to investigate the included studies. The analyses were undertaken with constructivist grounded theory.ResultsThirty-two studies met the inclusion criteria and only five papers were of low quality. Most, but not all studies, were from the global north. We identified three themes: desired and challenged wellbeing; coping and adaptation; and discrimination and intersectionality.Overall, the studies’ findings were varied and reflected different times during the pandemic. Studies reported the impact of mass media messaging and its mostly negative impact on older adults. Many studies highlighted the impact of the COVID-19 pandemic on participants' social connectivity and well-being including missing the proximity of loved ones and in consequence experienced an increase in anxiety, feeling of depression, or loneliness. However, many studies reported how participants adapted to the change of lifestyle including new ways of communication, and social distancing. Some studies focused on discrimination and the experiences of sexual and gender minority and ethnic minority participants. Studies found that the pandemic impacted the participants’ well-being including suicidal risk behaviour, friendship loss, and increased mental health issues.ConclusionThe COVID-19 pandemic disrupted and impacted older adults’ well-being worldwide. Despite the cultural and socio-economic differences many commonalities were found. Studies described the impact of mass media reporting, social connectivity, impact of confinement on well-being, coping, and on discrimination. The authors suggest that these findings need to be acknowledged for future pandemic strategies. Additionally, policy-making processes need to include older adults to address their needs. PROSPERO record [CRD42022331714], (Derrer-Merk et al., Older adults’ lived experiences during the COVID-19 pandemic: a systematic review, 2022).

Green space and the health of the older adult during pandemics: a narrative review on the experience of COVID-19.

Aging is an inevitable process that leads to changes in various dimensions of older adult life, including physical, psychological, and social aspects. Unfortunately, older adults are more susceptible to health problems caused by adverse experiences such as the Corona outbreak. The current study examines the lived experience of older adults in facing the conditions of the Corona epidemic to see how green spaces at various scales can influence the physical and mental health of this group. Relevant articles published, from 2019 to February 17, 2023, were searched using in the Scopus and Web of Science databases. Eligible studies published in English and all studies passed a quality evaluation. In the final search, 40 articles were selected and analyzed. The majority of studies conducted during the pandemic categorized the impact of green spaces on the health of older adults into three main categories: Place-based attribute, Process, and Function. The findings of this study demonstrated that people were using private green spaces (gardens, balconies, etc.), small local green public spaces, sitting and gathering spaces in the neighborhood, nearby open spaces, and urban green-blue spaces throughout the epidemic era. They visited green spaces outside the city and urban areas, including urban gardens, agricultural areas, forestlands, and pastures. In this research, we investigated the characteristics of these spaces and classified them into four physical categories: urban landscape, land use, activity, movement, and accessibility. The results showed that exposure to nature or green space improved physical and mental health and increased attention and decision-making quality in older people. We have proposed design implications recommendations for crises to improve safety, security, and social capital by increasing the safe access of older adults to diverse and high-quality green spaces on different scales, which will ultimately enhance the physical and mental health of people in different age groups.

Navigating the twilight years: Supporting older adults’ orientation and wayfinding in senior living facilities

In their twilight years, spatial disorientation can cause significant challenges for older adults, leading them to become perpetually disoriented or rely more on environmental cues and others for navigation. Unfortunately, wayfinding within senior living facilities is often an afterthought for senior living facility planners. This study explores the lived experiences of older adults coping with spatial disorientation and wayfinding in senior living facilities and the consequential impact on their physical, social, and psychosocial well-being. Data were collected from 28 older adults in six senior living facilities within three urban locations. The study used one-on-one, semi-structured, in-depth interviews and the Modified Stevick-Colaizzi-Keen analysis method guided by Moustakas’ transcendental phenomenology. Five primary themes emerged: spatial disorientation, wayfinding, self-evident stimuli, visual cues and constancies, and digital wayfinding decision junctions. Through a “looking out from the inside” approach, the findings have valuable implications for academics, senior-friendly environments, government policymakers, hospitality and healthcare industries.

Age-related digital disparities, functional limitations, and social isolation: unraveling the grey digital divide between baby boomers and the silent generation in senior living facilities

Objectives The onset of the digital age has sparked a significant age-related digital divide, detrimentally affecting older adults. The age-related digital disparities and the gray digital divide between the Baby Boomers and the Silent Generation in senior living facilities remains an exigent issue. This study explored the lived experiences of older adults as they confront the challenges posed by age-related digital disparities inherent in the gray digital divide in senior living facilities. Methods In-depth, semi-structured interviews and observations were conducted with 28 older adults living in six senior living facilities in three urban locations. Moustakas’s transcendental phenomenology was employed, and the Modified Stevick-Colaizzi-Keen method was used to analyze the data. Results This study identified six main themes: barriers to connectivity, digital literacy, generational-rooted perceptions, navigating technology with functional limitations, social isolation, and end-of-life planning. Conclusion The gray digital divide disproportionately affects older adults in senior living facilities. The study emphasizes the need for tailored interventions and targeted support to address the specific needs of each cohort and reduce age-related disparities. Addressing these disparities has significant implications for academics, policy-makers, senior living accommodations, and technology developers.

Exploring the Lived Experiences of Older Adults in Iran During the COVID-19 Pandemic: A Phenomenological Study

Objectives Since older people make up a great percent of the population is Iran, and they experienced higher mental, physical, and emotional pressures due to quarantine and lockdown during the COVID-19 pandemic, the present study aims to investigate the lived experiences of older adults during the COVID-19 pandemic in Iran. Methods & Materials This qualitative phenomenological study was conducted in Fars, Kermanshah, and Tehran provinces of Iran from October 1, 2021 to January 30, 2022. The data were collected through interviewing 16 older adults. Data analysis was done by Smith’s interpretative phenomenology analysis. Results Of 16 older adults, 9 were male and 7 were female, with a mean age of 73 years. Their lived experiences were classified into three main categories: Psychological tensions, resilience (healing) measures, and economic tensions. Conclusion Iranian older people experienced various types of tensions during the COVID-19 pandemic. Social distancing and quarantine increased the concerns about their mental health. Therefore, it is very important to identify and analyze the psychological concepts and protective factors along with preparing practical guidelines to protect their mental health during the COVID-19 pandemic.

Exploring the implications for occupational therapy in relation to assistive-technology access and use in urban and rural Canadian communities

ABSTRACT This study investigated the lived experience of older adults living in urban and rural geographies to identify and describe important contextual differences and clinical implications for occupational therapists. Community-dwelling older adults (N = 42) were recruited for this study which employed semi-structured interviews conducted over 19 months. A thematic analysis was undertaken to develop our qualitative findings. Two themes emerged, (1) Links to occupational therapy (2) Assistive technologies awareness and use. Occupational therapists utilizing a person-centered approach that considers personalities, infrastructure, care partner engagement, and geographical context, are more likely to achieve the best outcomes. Rural older adults are an underserved population, while urban older adults experience infrastructure barriers to engage with assistive technologies. Occupational therapists can serve as advocates along with their clients to improve equitable access to assistive technology for all.

How to live longer: lived experience of older adults in Thailand

How to live longer: lived experience of older adults in Thailand