Experiences Of Older Adults Research Articles

Healthcare Experiences and Needs of Older Adults Living With HIV: A Qualitative Study.

To explore the healthcare experiences and needs of older adults living with HIV in Sweden. A phenomenological study using qualitative thematic analysis. Data were gathered through semistructured qualitative interviews and analysed using thematic analysis. A purposive sample of individuals ageing and living with HIV was recruited for this study. A total of 22 participants aged 65 years and older, with a mean age of 75 years, participated in the study. Living with HIV meant a need to rely on consistent healthcare and treatment over the course of one's lifetime. The experiences of older adults were described under four themes: relying on access to health care, desiring involvement and shared decision-making, the importance of trust and confidentiality and experiences of stigma in healthcare visits. Living and ageing with HIV involved recurring exposure and vulnerability in healthcare encounters, and experiences of being exposed to HIV-related stigma, especially outside HIV clinics. Continuity and being seen as a person in healthcare encounters were important. Enhancing HIV knowledge alongside fostering supportive attitudes and approaches of healthcare professionals is critical for ensuring high-quality and nondiscriminating health care. Meeting the needs of older adults living with HIV requires a person-centred approach, including active involvement and shared decision-making between patients and healthcare providers. This study describes the healthcare experiences and needs of older adults, aged 65 years and older, living with HIV, a population that is not typically investigated in qualitative research. Living and ageing with HIV means a vulnerability where the attitudes of professionals and the active involvement of the patient become significant for quality care. The findings can help with the implementation of policies and practices for the care of older adults living with HIV. The Consolidated Criteria for Reporting Qualitative Studies (COREQ) was used. Patient representatives were involved in discussions on data collection and the development of the interview guide.

The Lived Experiences of Older Adults with Systemic Lupus Erythematosus: Patient Perspectives.

Little is known about perceptions of aging among individuals living with systemic lupus erythematosus (SLE). Gaining this knowledge could help to identify targets for future behavioral interventions aimed at successful aging with SLE. This qualitative study sought to elicit the lived experiences, and essence, of aging from older adults with SLE. We conducted semi-structured interviews with adults ≥65 years of age with SLE seen at a single tertiary center. Qualitative data were analyzed thematically using a phenomenological approach. We collected data on sociodemographic characteristics and disease features prior to each qualitative interview. Among 30 participants with mean age of 71.3 years and mean SLE duration of 26.3 years (range 5 to 62 years), four overarching themes emerged to describe the essence of aging with SLE: SLE and comorbid conditions, cumulative impact of SLE symptoms, SLE disease trajectory, and self-perceptions of aging. Older adults with SLE shared variable aging experiences, including perspectives on multimorbidity and disease trajectory and self-perceptions of aging. We identified both positive and negative self-perceptions of aging, often informed by participants' lived experiences of cumulative impact of SLE symptoms and SLE disease trajectory and underscoring the diversity of their experiences. Understanding self-perceptions of aging in this population could inform development of evidence-based strategies to empower older adults with SLE to harness their positivity and resilience and thus improve health-related outcomes, including health-related quality of life.

Home-Based, Low-Intensity, Gamification-Based, Interactive Physical-Cognitive Training for Older Adults Using the ADDIE Model: Design, Development, and Evaluation of User Experience.

Declines in physical and cognitive function are natural biological processes, leading to an increased risk of falls. Promising evidence suggests that combined physical-cognitive exercise has beneficial effects in improving both physical and cognitive health. Although moderate-to-high exercise intensity is commonly recommended, it might be impractical for older adults facing physical limitations or contraindications. Thus, low-intensity exercise is a viable option. The main barriers to engaging in exercise in older adults include transportation, time, motivation, and enjoyment. To overcome these challenges, a home-based, gamification-based training system may provide an effective approach to enhance exercise adherence. This study aimed to develop and evaluate the usability of a low-intensity, gamification-based, interactive physical-cognitive exercise for older adults in a home-based setting. The prototype of a game-based physical-cognitive exercise was created following the ADDIE model (analysis, design, development, implementation, and evaluation) and assessed for user experience in older adults. A total of 15 older adults engaged in the game-based physical-cognitive exercise at home for 60 minutes per day, 3 days per week, for 4 weeks. The usability of the game-based training system was evaluated using the system usability scale (SUS) after completion of a 4-week training program. As for satisfaction, the 8-item Physical Activity Enjoyment Scale (PACES) questionnaire was used to assess participants' enjoyment level after 1 week and 4 weeks of training. Descriptive statistics were used to illustrate the SUS score. A Wilcoxon signed-rank test was used to compare the PACES scores between the first week and the end of the 4-week period, with significance set at P<.05. As for experts' consensus, the game-based training consisted of 3 games: Ocean Diver, Road Runner, and Moving and Memorizing. The games had 3 levels of difficulty: beginner, intermediate, and advanced. A computer vision-based system was selected as the delivery platform for a home setting. The total SUS score for all participants was mean 87.22 (SD 5.76), indicating the user's perception of the usability of a system ranging from good to excellent. At the end of the 4-week training, the total PACES score was significantly greater than the first week, suggesting an improvement in enjoyment (first week: mean 44.93, SD 3.99 vs fourth week: mean 50.53, SD 4.70; P=.001). The prototype of low-intensity, gamification-based, interactive physical-cognitive training was designed and developed using the ADDIE model, which included both experts and end users in the process. The findings showed that the exergame prototype was a usable and practical approach for a home-based setting, enhancing older adults' enjoyment and motivation. Further research is warranted to determine the effectiveness of such gamification-based training in promoting physical and cognitive functions.

Older Adults' Needs and Wishes for Contact With the Outdoors at Residential Care Facilities: Implications for Theory and Practice.

Aim: This qualitative study aimed to explore needs and wishes of older adults concerning their perceived need for contact with outdoor environments at residential care facilities (RCFs) and what implications it has for theory and practice. Background: There is increased awareness of the importance of health-promoting everyday environments for persons with special needs. Therefore, it is important to include the experiences of older adults at RCFs in research. Methods: Twelve older adults from three Swedish RCFs participated in semistructured walking interviews. Results: Two categories were identified concerning the needs and wishes of older adults for contact with outdoor environments. The first category, Outdoor environments as part of everyday life, describes aspects of normality linked to outdoor stays at RCFs. The second category, Getting outdoors in practice, describes supportive and hindering aspects of outdoor stays, as well as accessibility regarding different body positions and access to personal support. Conclusion: It was found in this study that the needs and wishes of older adults are important to consider to increase their opportunities for outdoor stays. Their needs and wishes could also be included in briefs and programs for the design and planning of new construction or refurbishment of RCFs. The results of the study can serve as the basis for further discussions concerning older adults' outdoor stays and the accessibility of outdoor environments. Further, the results are intended to facilitate practical knowledge that is useful for care workers and managers at RCFs and to support decision makers, property developers, architects, and planners.

Affective Experiences of Older Adults Enrolled in a Multi-Component Health Promotion Program: A Focu-Group Study

The purpose of this qualitative study using focus groups was to explore the affective experiences of older adults enrolled in Bingocize®, a health promotion program that combines bingo and exercise after program facili-tators received a supplemental training developed by a recreational therapist titled, FUNctional Movement. The training emphasized participant enjoyment and autono-my support utilizing The Self-Determination Enjoyment Enhancement Service Delivery Model. Focus groups, comprised of 17 participants across three sessions, re-vealed that while the supplemental training may have improved engagement, many were unaware of the fall prevention components of Bingocize®. Focus group themes included autonomy sup-port, enjoyment, future desired activities, and barriers to physical activity. This may highlight a need to explicitly incorporate fall prevention and functional movement into Bingocize® training for facilitators. Additionally, integrating health education topics like sexual health and incontinence into Bingocize® could address participant needs and enhance program offerings. These findings may provide insights for refining Bin-gocize® training, aligning it more closely with participant expectations through a rec-reational therapy approach to physical activity in long-term care settings. The authors provide practice recommendations.

Social Inclusion Through Making Neighbourhood Connections: Experiences of Older Adults With Intellectual Disabilities of Local Volunteering and Leisure, Facilitated by Local Connectors

ABSTRACTBackgroundThe social networks of adults with intellectual disabilities are often small and may be limited to family, paid staff and others with disabilities. This study explored the social inclusion of six individuals who joined mainstream leisure clubs or became local volunteers.MethodThis qualitative intervention study provided structured support and education to local connectors, existing members of clubs/organisations who provided one‐to‐one support to new members with intellectual disabilities. After 4 months, qualitative interviews were conducted to explore the experiences of the six participants with disability. Data were analysed using content analysis.FindingsIndividuals joining mainstream leisure clubs or volunteering, with natural supporters, creates opportunities for making new acquaintances and expanding social networks. Finding local connectors and opportunities for shared volunteering or leisure activities based on personal goals/interests are key to individuals forming new acquaintances close to where they live. Barriers and facilitators to participation are identified.ConclusionsAdults with intellectual disabilities becoming volunteers or joining mainstream leisure clubs has the potential to lead to enhanced opportunities for social inclusion in their neighbourhoods. Implications for policy and practice are examined. Recommendations for further research are explored. A Valued Social Role Checklist developed from this study offers a tool when sourcing social roles.

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.

Experiences of Older Adults with Heart Failure Using Telemedicine During the COVID-19 Pandemic: A Qualitative Study.

Background: Telemedicine (TM) usage increased rapidly during the COVID-19 pandemic. This study is part of a larger mixed-methods study comparing TM and in-person visits of older adults with heart failure (HF) and describes patient's TM experiences during the pandemic. Methods: This study employed qualitative design using survey responses and individual interviews. Study eligibility requirements included >55 years old, HF diagnosis, and TM visit between September 1, 2020 and May 31, 2021, at one of two participating health systems in the southern United States. Results: Twenty-two TM recipients completed qualitative interviews, and 91 of 125 online survey respondents answered open-ended questions. Data were gathered, sorted, and revealed five themes. Discussion: Interview respondents identified benefits, e.g., convenience, inclusion, decreased exposure, and problems, e.g., connectivity issues, inadequate equipment, and medical conditions impacting use. Recommendations included allocating sufficient appointment time, tailoring visits, and increasing written communication. This study was part of a larger clinical trial registered at ClinicalTrials.gov: NCT04304833.

What Are the Perspectives and Experiences of Older Adults of Existing Integrated Care Services in the Mid-West Region of Ireland?

Abstract Background Substantial investment has been provided by the HSE in the form of The Integrated Care Programme for Older People (ICPOP) Community Specialist Teams (CSTs) for older people. These teams aim to provide timely specialist multi-disciplinary assessment and intervention to help maintain older adults’ independence and ability to live well at home. Little is known about older adult’s views or experiences of this service. This study aimed to resolve this research gap by exploring older adults’ experiences of CSTs within the Irish Healthcare context. Methods A qualitative descriptive research design was employed to explore this research area and a semi structured topic guide was developed. Purposive non-probability sampling was used to recruit 13 older adults who had completed intervention with the CSTs. Individual semi-structured interviews were completed with each participant and were transcribed verbatim. A reflexive approach to thematic analysis was used to guide analysis of the generated data. Results Four themes were identified, older people had limited knowledge of the service and experienced accessibility issues in attending CST within a HUB setting (Theme 1). Older people experienced positive and co-ordinated care by CST (Theme 2). Older people described that they valued the self-management education and support from attending CST that enabled to manage their long-term conditions effectively and maintain their independence (Theme 3). Once discharged from CST older people described positive emotional and physiological impact of CST that enabled them to be more confident to manage daily life at home (Theme 4). Conclusion It was evident from the data that CST had a positive impact on supporting older people to remain independent at home and increased their confidence in self- management of their long-term conditions. Further research would be beneficial to address ways to improve the delivery of care for the complex needs older persons within CSTs as they describe accessibility issues in attending the service.

"Doing Housework with a Walker? No Way!": Exploring the Perceptions of Community-Dwelling Frail Older Adults and Their Informal Caregivers on "Informal Caregiver-Induced Forced Immobility".

Family caregivers should focus on maintaining independence when assisting older adults with mobility. This may, however, bring about a counterproductive effect, namely Informal Caregiver-induced Forced Immobility (ICFI). This study explored the perceptions and experiences of older adults and their informal caregivers regarding ICFI. This qualitative study used a conventional content analysis approach and was conducted from January to September 2023 in Tabriz, Iran. Twenty older adults (aged 60 years and above) who had used a mobility aid, such as a cane or walker, and 14 informal caregivers were purposefully (purposive sampling) selected to participate in the study. Individual semi-structured interviews were conducted until data saturation was achieved. MAXQDA ver. 20.0 software (VERBI Software, Germany) was used to manage and analyze the data. Based on the participants' perceptions, ICFI means that for an older adult, "social interaction/social participation is limited," "performing activities of daily living is disallowed," and "engaging in physical activities and exercising is prohibited." Our findings revealed the concept of ICFI from various perspectives in Iranian families with older adults, leading to a clearer understanding of this phenomenon. This aspect should be considered when developing intervention strategies for the care of older adults in home and residential care settings by, health practitioners, gerontologists, and policymakers. This research can serve as a foundation for future studies to develop pertinent indicators and tools for measuring ICFI in the hope of providing sufficient evidence to support interventions that aim to prevent or stop ICFI.

Lifetime Revictimization: Evidence From the Wisconsin Longitudinal Study.

Despite the documented increasing prevalence of elder abuse victimization and its devastating health effects, a life-course view of the victimization experiences of older adults has rarely been adopted in the elder abuse literature. The current study investigated lifetime links between victimization experiences by examining the indirect effect of adverse childhood experiences (ACE) on elder abuse victimization via intimate partner violence (IPV) victimization in middle adulthood, and whether this indirect association would differ by gender. Using data from the Wisconsin Longitudinal Study, we analyzed the previous and current victimization experiences of a total of 5,391 older adults in their early 70s and estimated mediational and moderated mediation models. The key results indicated that a higher ACE score was associated with exposure to IPV victimization in middle adulthood, which was in turn associated with exposure to elder abuse victimization. This indirect association was stronger for women than for men. Regarding specific types of childhood victimization, parental physical abuse, sexual abuse, and witnessing domestic violence significantly predicted elder abuse victimization via IPV victimization. Our results support the phenomenon of lifetime victimization, whereby an individual experiences reoccurring forms of victimization across the life course from childhood to late adulthood. Findings highlight the compelling need for the assessment of cumulative victimization experiences and their impact on elder abuse victims. A life-course-based, trauma-informed approach would greatly enhance prevention and intervention services for elder abuse.

“I am growing, but I don’t give up”: Spiritual experiences of older adults in Ghana

Religion and spirituality are considered to be helpful resources during late adulthood where declines and losses are presumably pronounced. In Ghana, religion and spirituality are integral aspects of everyday life. The purpose of the study was to explore and understand how older adults experience and make meaning of their lives using spirituality as a lens. Twelve community-dwelling older adults (age range = 60–81 years) in Ghana were interviewed. Thematic analysis was used to analyze the data. The findings indicated that God or the divine guides the navigation of life situations and infuses life with spiritual goals and concerns. Older adults practiced acceptance and gratitude in both positive and negative circumstances and maintained optimism and hope in other situations. The meaning-making model provided a useful framework for interpreting these findings. Limitations of the study were discussed, and suggestions for future research were offered.

Enhancing older Veterans' care: Insights from medication reviews and deprescribing interventions

BackgroundPatient experience during and after health care is a critical indicator of quality of care that encompasses effective communication, respect, dignity, and emotional support. However, qualitative studies exploring the experiences of older adults after deprescribing interventions are sparse, highlighting a knowledge gap. This project seeks to address this gap by exploring Veterans’ experiences during and after a deprescribing intervention provided by a pharmacist.This study aims to: 1. Assess Veteran's experience of the process of their Comprehensive Medication Review and deprescribing intervention visit; 2. Assess the Veteran's experience with the outcomes of their Comprehensive Medication Review and deprescribing intervention. MethodData was collected from 17 Veterans through semi-structured interviews using an interview guide. The Veteran Affairs study site utilizes the VIONE polypharmacy risk calculator to identify high-risk Veterans; the majority of these Veterans were on at least 10 medications. The interview transcripts were analyzed using inductive content analysis. Two research team members independently coded the data for categories and themes. Similarities were identified, and any divergence was discussed and resolved. To enhance the validity of the findings, member checking was performed with Veterans to confirm the results. Result and discussionMost Veterans viewed the process of the pharmacists' visits and recommendations positively. They expressed confidence in pharmacists' knowledge and instructions. They appreciated the clarity of information pharmacists provided about the purpose, proper administration, and interactions of their medications. These enhanced the Veterans’ ability to manage their medication regime. They also desired an increased frequency of interactions with their pharmacist due to these positive interactions. Veterans appreciated interprofessional collaboration between pharmacists, physicians, and other providers. Veterans expressed how pivotal lab test results were for evaluating medication recommendations and effectiveness. Most Veterans reported positive outcomes and/or indicated there were no negative effects as a result of their recent medication changes. Some reported seeking additional information from their providers regarding suggested medication changes to validate recommendations. There was some uncertainty about whether there would be follow-up visits with the professional after the medication change and who should initiate this. A minority indicated problems associated with prior medication discontinuation before the deprescribing intervention and how this limited their openness to future opportunities of deprescribing. ConclusionThis exploration of Veterans' experiences with the process and outcomes of a deprescribing service affirms its importance and overall success in this site as part of the unique publicly funded Veteran healthcare system in the US. Equally important, the positive Veteran response suggests the value of exploring its potential to benefit patients experiencing polypharmacy across a range of other sites and systems.

Successes and Shortcomings of COVID-19 Vaccine Access for Older Americans.

To understand perceived facilitators and barriers older adults experienced in accessing coronavirus disease 2019 (COVID-19) vaccines. An electronic survey was distributed to older adults and those familiar with experiences of older adults accessing COVID-19 vaccines. Analysis included descriptive statistics and directed content analysis of open-ended responses, guided by the National Institute on Aging Health Disparities Research Framework. Most participants (n = 294) identified as White (79.5%), 33.8% identified as Hispanic, 8.1% identified as Black, and 12.4% identified as Other. Two thirds of respondents were male (68.6%), and the median age was 67 years. Five key themes emerged: Availability and Accessibility, Information, Cost, Safety and Side Effects, and Sense of Security. Barriers and facilitators to accessing COVID-19 vaccines for older populations paralleled those seen in other demographics. Similar needs likely exist for access to other vaccines and health care in general. Vaccine rollouts, particularly in public health emergencies, must be carried out with care and an awareness of the barriers faced by vulnerable groups. [Journal of Gerontological Nursing, 50(9), 12-17.].

“Racialized persons have a completely different experience”: the experiences of older adults with the Toronto Police Service

PurposeThis paper aims to provide an in-depth examination of culturally and linguistically diverse older adults’ perceptions of and experiences with the Toronto Police Service to inform the development of a training curriculum for police officers working with older persons.Design/methodology/approachA qualitative descriptive study using virtual focus groups with 26 older adults from Toronto was conducted.FindingsThree main themes emerged: understanding intersectionality; the impact of police officer attitudes and biases; and the need for age-friendly policing. Although many older adults rely on police services to keep them safe, there is dissatisfaction with some aspects of how police interact with older adults, particularly from minority groups.Originality/valueParticipants were older adults from culturally, ethnically and linguistically diverse backgrounds who are not usually included in studies on improving police services.

Older Adults Experience with a Layperson-Supported Digital Mental Health Intervention for Depression: Qualitative Insights on Engagement.

This qualitative study examines the experiences of older adults with Empower@Home, an older adult-centered, layperson-supported internet-based cognitive behavioral therapy (iCBT) program for depression, with a focus on engagement-related factors. Adults aged 50 or older with at least mild depressive symptoms were recruited from multiple resources. A random subset of participants was invited for a semi-structured qualitative interview during a post-intervention assessment conducted over the phone (N = 148). Interviews were recorded and transcribed verbatim. Transcripts were coded in a multi-phase, team-based approach utilizing inductive coding techniques, followed by thematic analysis to identify key themes. Six key themes regarding engagement emerged: the importance of a structured, skills-based, and self-paced approach; the essential role of weekly coaching for accountability, web interface's ease of use and accessibility; narrative engagement dynamics; enhanced learning through multimodal instruction; and tailoring challenges in iCBT. Older adult-centered, layperson-supported, and multimodal iCBT can effectively engage older adults in managing their mental health. iCBT programs can be integrated into various community aging settings. By leveraging each setting's strengths and involving a range of professionals, these programs can play an important role in enhancing older adults' mental health.

Social capital and successful aging among senior park golfers

Park golf, which evolved from golf, is one of South Korea’s fastest-growing sports. As park golf has become increasingly popular, specifically among older adults, its advantages and disadvantages must be identified. This study aims to explore the experiences of older adults engaged in park golf, specifically focusing on how playing park golf fosters social capital and contributes to successful aging among senior park golfers. Twenty senior park golfers participated in detailed interviews. The qualitative data analysis shows that this study’s participants constituted a formal group. Five main themes were identified from the data analysis: (a) reciprocity, (b) bonding networks, (c) bridging networks, (d) social participation, and (e) health. Moreover, our findings provide empirical evidence that playing park golf can create social capital related to successful aging among seniors.

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.

Exploring the Experiences of Community-Dwelling Older Adults on Using Wearable Monitoring Devices With Regular Support From Community Health Workers, Nurses, and Social Workers: Qualitative Descriptive Study.

The use of wearable monitoring devices (WMDs), such as smartwatches, is advancing support and care for community-dwelling older adults across the globe. Despite existing evidence of the importance of WMDs in preventing problems and promoting health, significant concerns remain about the decline in use after a period of time, which warrant an understanding of how older adults experience the devices. This study aims to explore and describe the experiences of community-dwelling older adults after receiving our interventional program, which included the use of a smartwatch with support from a community health workers, nurses, and social workers, including the challenges that they experienced while using the device, the perceived benefits, and strategies to promote their sustained use of the device. We used a qualitative descriptive approach in this study. Older adults who had taken part in an interventional study involving the use of smartwatches and who were receiving regular health and social support were invited to participate in focus group discussions at the end of the trial. Purposive sampling was used to recruit potential participants. Older adults who agreed to participate were assigned to focus groups based on their community. The focus group discussions were facilitated and moderated by 2 members of the research team. All discussions were recorded and transcribed verbatim. We used the constant comparison analytical approach to analyze the focus group data. A total of 22 participants assigned to 6 focus groups participated in the study. The experiences of community-dwelling older adults emerged as (1) challenges associated with the use of WMDs, (2) the perceived benefits of using the WMDs, and (3) strategies to promote the use of WMDs. In addition, the findings also demonstrate a hierarchical pattern of health-seeking behaviors by older adults: seeking assistance first from older adult volunteers, then from social workers, and finally from nurses. Ongoing use of the WMDs is potentially possible, but it is important to ensure the availability of technical support, maintain active professional follow-ups by nurses and social workers, and include older adult volunteers to support other older adults in such programs.

Indian dance (Bharatanatyam) to ease social loneliness and isolation in older adults

ABSTRACT Older adults worldwide are facing disproportionate levels of isolation and loneliness. The current frameworks for understanding social isolation and loneliness include factors such as the physical and mental health of the individuals, loss of friends and family, level of education, relationships, and the built environment. While these models are useful, they fail to consider the individual experiences of older adults holistically; as an example, they do not include older adults’ relationship with themselves as they navigate the many challenges of life. In this article, I propose a novel framework for describing social isolation and loneliness in older adults that includes relationships to their changing bodies and experiences, to history and literature, and to nature and current events. Considering this revised framework, I summarize my observations as a teaching artist using Bharatanatyam, a 2,000-year-old Indian traditional dance form, in alleviating loneliness and isolation. Outcomes are in the form of qualitative narratives that are thematically united and presented. Given the highly communicative and relational nature of Bharatanatyam, I hypothesize that immersion in Bharatanatyam will enable connections of various kinds. This article describes three ways in which Bharatanatyam is particularly well-suited to build connections; these are 1. Connection with oneself in body, mind, and psyche; 2. Connection to tradition and history and 3. A systematic structure of relating to others, to the nature and environment, and current events.