Needs Of Older Adults Research Articles

Nursing Support of the Spiritual Needs of Older Adults Living With Dementia: A Narrative Literature Review.

Across this literature review (n = 10), supporting spirituality in the nursing care of older adults with dementia is concerned with supporting religious activity, enabling connections, nurses' reflections on their own spirituality, and nonverbal communication. The benefits from the support of spirituality were seen to be reciprocal and to occur in everyday nursing.

Risk factors for hospital re-presentation among older adults following fragility fractures: protocol for a systematic review.

BackgroundAfter being discharged from hospital following the acute management of a fragility fracture, older adults may re-present to hospital emergency departments in the post-discharge period. Early re-presentation to hospital, which includes hospital readmissions, and emergency department presentations without admission may be considered undesirable for individuals, hospital institutions and society. The identification of modifiable risk factors for hospital re-representation following initial fracture management may prove useful for informing policy or practice initiatives that seek to minimise the need for older adults to re-present to hospital early after they have been discharged from their initial inpatient care. The purpose of this systematic review is to identify correlates of hospital re-presentation in older patients who have been discharged from hospital following clinical management of fragility fractures.Methods/DesignThe review will follow the PRISMA-P reporting guidelines for systematic reviews. Four electronic databases (PubMed, CINAHL, Embase, and Scopus) will be searched. A suite of search terms will identify peer-reviewed articles that have examined the correlates of hospital re-presentation in older adults (mean age of 65 years or older) who have been discharged from hospital following treatment for fragility fractures. The Effective Public Health Practice Project Quality Assessment Tool for Quantitative Studies will be used to assess the quality of the studies. The strength of evidence will be assessed through best evidence synthesis. Clinical and methodological heterogeneity across studies is likely to impede meta-analyses.DiscussionThe best evidence synthesis will outline correlates of hospital re-presentations in this clinical group. This synthesis will take into account potential risks of bias for each study, while permitting inclusion of findings from a range of quantitative study designs. It is anticipated that findings from the review will be useful in identifying potentially modifiable risk factors that have relevance in policy, practice and research priorities to improve the management of patients with fragility fractures.Systematic review registrationPROSPERO CRD42015019379

Students Explore Supportive Transportation Needs of Older Adults

Students in an undergraduate applied research in aging class learned about qualitative research methods by analyzing previously collected narratives. The interviews were with 32 participants who were national experts in senior transportation in the United States. The purpose of the study was to explore the specialized supportive mobility needs of community-residing older adults. The policy goal of the study was to expand the discussion on levels of assistance needed in senior transportation. The educational goal of the study was to expose undergraduate students to qualitative research methods, having them analyze transcripts and audio recordings. In preparation for the research, students reviewed the current literature in transportation and aging and learned that the ability to get to where you want to go, when you want to go there, is a key factor for aging-in-place in our communities. When that ability is compromised, the informal network of family and friends may not be a sustainable transportation option. Students were divided into three analysis groups by the domains of challenges, strategies, and policies and coded themes and subthemes through an iterative process. An important subtheme that emerged was the connection of community mobility to health care outcomes.

The residential continuum from home to nursing home: size, characteristics and unmet needs of older adults.

Older adults with care needs live in a variety of settings-from traditional community housing to nursing homes. This analysis provides new estimates of the size and characteristics of the older population across settings and examines unmet needs for assistance. Data are from the 2011 National Health and Aging Trends Study (N = 8,077). Multinomial logistic regressions focus on people in settings other than nursing homes who are at risk for unmet needs, defined as receiving help or having difficulty with household, self-care, or mobility activities (N = 4,023). Of 38.1 million Medicare beneficiaries ages 65 and older, 5.5 million (15%) live in settings other than traditional housing: 2.5 million in retirement or senior housing communities, nearly 1 million in independent- and 1 million in assisted-living settings, and 1.1 million in nursing homes. The prevalence of assistance is higher and physical and cognitive capacity lower in each successive setting. Unmet needs are common in traditional community housing (31%), but most prevalent in retirement or senior housing (37%) and assisted living settings (42%). After controlling for differences in resident characteristics across settings, those in retirement or senior housing communities have a higher likelihood of unmet needs than those in traditional community housing, while those in independent or assisted living settings have a lower relative likelihood. Substantial numbers of older adults, many with care needs, live in a continuum of settings other than traditional community housing. Unmet needs are prevalent among older adults with limitations across all settings and warrant further investigation and monitoring.

Barriers to outdoor physical activity and unmet physical activity need in older adults

ObjectiveTo profile participants based on reported outdoor physical activity barriers using a data-driven approach, describe the profiles and study their association with unmet physical activity need. MethodCross-sectional analyses of 848 community-dwelling men and women aged 75–90 living in Central Finland in 2012. Barriers to outdoor physical activity and unmet physical activity need were enquired with a questionnaire. The latent profiles were identified by profiling participants into latent groups using a mixture modeling technique on the multivariate set of indicators of outdoor physical activity barriers. A path model was used to study the associations of the profiles with unmet physical activity need. ResultsFive barrier profiles were identified. Profile A was characterized with minor barriers, profile B with weather barriers, profile C with health and weather barriers, profile D with barriers concerning insecurity, health and weather; and profile E with mobility and health barriers. The participants in the profiles differed in the proportion of individual and environmental barriers. The risk for unmet physical activity need was highest among people whose severe mobility difficulties restricted their outdoor physical activity. ConclusionOutdoor physical activity barriers reflect the imbalance in person–environment fit among older people, manifested as unmet physical activity need.

Nursing Home Living: The Complexities and Potential

Elise M. Beaulieu (2012). A Guide for Nursing Home Social Workers, 2nd Edition. Springer Publishing Co., New York, 389 pp., $60.00 (paper). Sandra J. Gaffney (2012). Making Myself at Home in a Nursing Home. Vanderbilt University Press, Nashville, TN, 170 pp., $22.95 (paper). Gayle Appel Doll (2012). Sexuality and LongTerm Care: Understanding and Supporting the Needs of Older Adults. Health Professions Press, Baltimore, MD, 267 pp., $38.95 (paper).

Recreation, Physical Activities and Health Needs of Older Adults

The benefits of physical activities on health and well-being of humans, in the present and later life, are well documented in many fields of study including gerontology. Adopting the continuity theory of aging and theory of selective optimization with compensation, this paper reviewed empirical works on the interplay of recreation, physical activity and the well-being of older adults. This is with a view to stimulating further research and insight into the understanding of well being of older adults. The paper concludes that a community-based intervention that will encourage active participation may go a long way in meeting the recreation needs of the elderly in Nigeria.

Community leader perceptions of the health needs of older adults.

The purpose of this needs assessment was to determine community leader perceptions of health-related needs and resources available to rural-dwelling older adults as part of a community-academic partnership in the rural Midwest. A community advisory board, in accordance with community-based participatory research principles, was influential in study design and implementation. Key informant interviews (N = 30) were conducted with community leaders including professionals from schools, businesses, churches, and health care as well as government officials. Thematic analysis revealed "Family Is Central," "Heritage," "Strength," and "Longevity" as important themes related to older adults and their health care needs within the community. "Close-knit" and "Church Is Central" were also identified as important aspects of elder care. Community leaders perceived the "Rural Economy," "Distance to Resources," and "Seasonal Resources" as significant barriers for older adults. This work contributes important insights into community leaders' perceptions of health needs and challenges faced by older adults in rural settings.

Are Methadone Counselors Properly Equipped to Meet the Palliative Care Needs of Older Adults in Methadone Maintenance Treatment? Implications for Training

Today's methadone patients differ greatly from those of the past. Because of the rise of polydrug use and the HIV and hepatitis epidemics, treatment has become much more complex, which multiply the concerns and complexities of treatment. Patients entering methadone programs are also more commonly presenting at ages well into their 50s, 60s, and 70s; and this phenomenon of high rates continues to grow. The majority of these individuals in treatment have presented with a number of significant comorbid medical conditions that will progress and eventually lead to death. This aging cohort must be approached with a modified treatment plan that focuses on management and promoting healthy aging, while attending to their maximum delay of illness, disease, and disability. This article argues that it is necessary for counselors working with this group to adopt a palliative care philosophy. This article also makes recommendations in areas that counselors need to be knowledgeable and skilled in to provide appropriate palliative services specific to this aging population with multiple needs as they near end of life.

Environmental Predictors of Unmet Home-and Community-Based Service Needs of Older Adults

Home- and community-based services (HCBS) for many older adults are an essential component of aging-in-place. Andersen developed the contemporary model used to predict service use. Researchers have modified the model to examine need. Studies that attempt to predict unmet needs have explained only 10% to 15% of the variance. This study is based on the supposition that lack of accounting for environmental factors has resulted in such small explanatory power. Through the use of 2008 Southeastern Pennsylvania Household Health Survey data, this exploratory study modeled predictors of unmet HCBS needs. Findings reveal that lack of access to healthy foods and poor housing quality have a significant relationship to unmet HCBS needs. This model predicted 54% of the variance. Results reveal environmental questions to ask, a way to identify older adults with unmet HCBS needs and environmental barriers that if addressed may reduce older adults' eventual need for health services and HCBS.

Meeting the Mental Health Needs of Older Adults in All Practice Settings

ABSTRACTIntegration of mental health services in occupational therapy practice with older adults, meaning evaluation and intervention for mental health concurrent with rehabilitation for physical disabilities, is critical to providing quality care. This approach has been suggested in the context of primary care, but should be carried out across practice settings. Although mental health conditions have detrimental effects on the well-being of elders, seniors do not commonly seek out mental health services. For elders with late life and mild depressive symptoms, medications have only modest effects creating a strong need for nonpharmacological interventions. Although there are therapists addressing mental health in conjunction with treatment for physical disabilities, this is not the norm. In this issue/opinion paper, I argue for better integration of physical and mental health services in occupational therapy practice with older adults and in the education of occupational therapy practitioners.

Perspectives of Clinicians and Social Services Personnel on Needs of Older Adults with HIV Who Access Healthcare at a Major Metropolitan

We explored the perspectives of clinicians (nurses, nurse practitioners, and physicians) and social services personnel (i.e., case coordinators, social workers) on the needs of older adults living with HIV and who receive healthcare at a major metropolitan hospital. We utilized a small qualitative study (n=10) as a means of developing an understanding of the perspectives shared within the framework of inter-professional collaboration for purposes of quality care for older adult patients with HIV. Five themes emerged from our qualitative research study. The first theme involves the idea of access to healthcare while the second theme suggests that older adults with HIV experience psychological issues. Third, older adults with HIV demonstrate high levels of adherence to medication regimens. Next, HIV is no longer viewed as a ‘death sentence’. Finally, education across disciplines and professions is necessary.

Technology: Education and Training Needs of Older Adults

The impact of the global aging of the population on social, economic, political, and health care institutions is unequaled. Parallel to this, evolving developments in technology promise opportunities for sales and product development to support positive aging. Older adults are excited to utilize technologies that they perceive as practical. However, age, education, technical knowledge, and technological anxiety affect interest in new technologies, creating a technology divide. Providing more accessible and relevant technologies for today's older adults may make the technology more universally accessible. This article reports the results of a survey on technology and education among a sample of 77 adults between the ages of 52 and 92 who attended a week-long lifelong-learning event at Indiana University. Familiarity with technology, age, education, and gender were found to be correlated with familiarity with new technologies as well as operating and shopping for new electronic devices.

Physician's Guide to Assessing and Counseling Older Drivers. Second edition.

This excellent work was created by the American Medical Association (AMA) with support from the National Highway Traffic and Safety Administration (NHTSA) to help physicians address preventable motor vehicle injuries, because “Currently, motor vehicle injuries are the leading cause of injury-related deaths among 65-to-74-year-olds and the second leading cause (after falls) among 75-to-84-year-olds” (p. ix). The so-called “silver tsunami” of aging Americans will only exacerbate these alarming statistics. The AMA and NHTSA see this as a tool for physicians “to forge a link between public health and medicine” (p. ix) by assessing and counseling older drivers to enhance driving safety and “ease the transition to driving retirement if and when it becomes necessary” (p. ix). This comprehensive work has an excellent format, is highly readable, and includes relatable patient vignettes. Beginning with an overview of “Safety and the Older Drive with Functional or Medical Impairments” and including the “Physician's Plan for Older Drivers' Safety (PPODS)” chart (p. 6), ten chapters cover everything from performing a thorough physical and mental assessment of patients to broaching the issue of driving and “Counseling the Patient Who Is No Longer Safe to Drive.” The text states that “For most of us, driving is a symbol of independence and self-esteem. When an individual retires from driving, he/she not only loses a form of transportation, but all the emotional and social benefits derived from driving” (p. 49). The “Ethical and Legal Responsibilities of the Physician” regarding counseling of patients who are no longer safe to drive and legal ramifications of reporting unsafe drivers, including maintaining patient confidentiality, are discussed at length. Chapter 8, “State Licensing and Reporting Laws,” offers a detailed state-by-state list of motor vehicle licensing and reporting requirements and contacts. Chapter 9 outlines “Medical Conditions and Medications that May Affect Driving,” and Appendix A offers current procedural terminology (CPT) codes. A chapter is devoted to “The Driver Rehabilitation Specialist,” a specialized occupational therapist who can offer adaptive driving instruction and suggest vehicle modifications. These specialists are still fairly rare. The book's final chapter, “Moving Beyond this Guide: Future Plans to Meet the Transportation Needs of Older Adults,” includes among its recommendations “increased availability and affordability of driver rehabilitation” (p. 187). Appendix B, “Patient and Caregiver Educational Materials,” offers four patient and caregiver self-assessment tools and recommendations, and it includes a list of resources that offer additional information. Older drivers often find it very difficult to honestly assess their abilities to operate motor vehicles as health issues arrive. Loved ones and caregivers find it equally difficult to broach this subject. This work offers physicians excellent guidelines and recommendations to assist their older patients and families in assessing these issues and making lifestyle changes as needed. It is up to the individual library to determine if an actual copy of this work should be in the collection, but certainly physicians should be made aware of it.

Sexuality and Long-Term Care: Understanding and Supporting the Needs of Older Adults

In this book, Gayle Appel Doll tackles an element of holistic care that unnecessarily daunts many health care professionals. Doll is the director of the Kansas State University Center on Aging and ...

Schizophrenia Remission Is Unstable in Older Adults

Schizophrenia Remission Is Unstable in Older Adults

DSM-5 Research: Assessing the Mental Health Needs of Older Adults from Diverse Ethnic Backgrounds

This article analyzes current trends and limitations in the design of the Diagnostic and Statistical Manual of Mental Disorders (DSM) with a focus on its application to older adults from diverse ethnic backgrounds. An analysis of 54 articles published between 2001 and 2011 in 4 social science databases that discussed DSM and its applicability to assessing ethnically diverse older adults' mental health revealed 5 major themes: (1) assessment issues related to acculturation, (2) limitations with “culture” elements, (3) health disparities, (4) evidence-based practice with dementia, and (5) prevalence of anxiety and depression. Contributors to the DSM-5 must examine limitations, be mindful of cultural elements, and formulate culturally and age-sensitive diagnostic criteria. It is suggested that cultural competence trainings focus on the needs of elderly of color to help this population express culturally relevant and personally unique experiences in the diagnostic process. These considerations must also be inclusive of national and international populations facing mental health challenges.

Improving mental health through ‘giving’ activities

Joseph Cipriani discusses the need of older adults in care homes to engage in altruistic activities and provides examples of how these needs can be met.

Religious Congregations and the Growing Needs of Older Adults with HIV

By 2015, half of those with HIV will be over age 50. This group has a high level of needs, lacks social supports, and will need to access community services such as those provided by religious congregations. We examined whether disclosure to a congregation would pose a barrier to accessing congregational services among adults 50 and older with HIV (n = 819). Fifty-three percent had disclosed, but those who did not disclose generally remained engaged with their congregations. Findings suggest that congregations can be a feasible source of support for older adults with HIV.

Assessing the risk of dementia in the aging population

A method for determining which patients are at a high risk of developing dementia could improve preventative care, early diagnosis, and the identification of individuals for clinical trials. The late-life dementia risk index has been developed to fulfill this need in older adults, but does the model provide sufficient accuracy and reliability in assessing such risk?