Older Citizens Research Articles

Supporting Ageing Populations in Developing Countries: A Comparative Analysis of Pension Schemes and Policy Insights

The rapid growth of the elderly population is a major global demographic and social issue. Unfortunately, there is a shortage of pension plans and social security programmes for this population in developing countries, which has severe consequences for their quality of life and well-being. In this article, we aim to better understand the pension systems in developing country contexts such as Ghana, Pakistan, and Myanmar by reviewing official government materials (for example, pension reports) and the published literature to suggest relevant policy recommendations. We observed several policy implementation gaps and inequities in pension schemes for older people, specifically for informal and private sector workers. Considering the size of formal versus informal economies and the level of development index of each country, we suggest a wide variety of options for pension policies, financing, designing cash benefits, and pension payments to cover all older citizens. This article addresses the unmet needs of the elderly and their wider economic sustainability to ensure social justice and resource utilisation. Governments in developing countries should embrace and establish unique, inclusive, and friendly policies encompassing the informal sector to warrant older adults’ functional and social well-being with dignity and honour.

Between conflict and reciprocal habituation: Human-wild boar coexistence in urban areas

Urbanization is an ongoing global environmental change. Wildlife may respond using anthropized environments and resources, which is known as synurbization, creating human-wildlife interactions. Wild boar (Sus scrofa) populations have become common in urban areas, including the metropolitan area of Barcelona. Humans respond to wild boars in urban environments either habituating, with lower conflict perception and higher wild boar acceptance, or sensitizing, with reduced tolerance towards wild boars. Since citizen response influences conflict management, this study analysed the drivers of human responses, which should allow adopting socially-accepted measures to manage synurbic wild boar populations. Interviews to 1956 Barcelona citizens were performed, grouping the response variables to score citizen and urban characteristics, as well as citizen lay-knowledge, emotions, experiences, and perception of wild boar. Five citizen clusters were identified: cluster 1 (3.3 %), highly habituated and active wild boar feeder; cluster 2 (11.3 %), habituated to wild boars with positive feelings; cluster 3 (19.8 %), not habituated nor sensitized, willing to maintain urban wild boar populations; cluster 4 (29.1 %), sensitized and concerned, defending to reduce wild boar; and cluster 5 (40.1 %), highly sensitized and proposing to reduce or even eliminate wild boar. Positive attitudes associated wild boar to aesthetic value, closeness to nature and sympathy, and were more frequent in young citizens with urban background and high education, animal lovers habituated to wild boar through contact without negative experiences. Conversely, negative attitudes were concerned about city fouling, safety or health, accepted lethal management measures, and were more frequent in older citizens with rural background, lower education, low contact with wild boar or sensitized through negative experiences. We document for the first time the sensitization and reciprocal habituation of humans to wild boar in urban areas. The identification of the drivers of citizen attitudes towards urban wildlife should be useful to design socially-accepted management measures.

Protecting the Rights of Older Citizens in the Kyrgyz Republic: International and Constitutional Legal Framework of State Policy

The statistical data related to the life expectancy of the population of Kyrgyzstan, international legal and domestic legal acts that define the foundations of the state policy of the Kyrgyz Republic in the field of protecting the rights of older citizens are considered.

Negative perceptions of older adults and life satisfaction among community-dwelling older citizens in Japan

Background With the rapid aging of the population, increasing life satisfaction among older adults is essential. Negative perceptions of older adults are internalized, leading to poor mental health. This study hypothesized that participants with more negative perceptions of older adults would have lower life satisfaction. Methods A cross-sectional survey of older adults was conducted across five wards and four cities in Tokyo, Japan. Participants responded to questions regarding demographics, life satisfaction, and negative perceptions of older adults. Data from 285 participants (264 women, M = 71.97 years) were analyzed. Results The intraclass correlation coefficient for life satisfaction concerning residential areas was. 03 (95% confidence interval [CI] = [-.03, .10]). Instead of multilevel models, a multiple regression model with life satisfaction as the dependent variable and negative perceptions of older adults and demographics as the independent variables yielded the best fit. Results indicated that participants with more negative perceptions of older adults reported lower life satisfaction (β = -.16, 95% CI = [-.28, -.04], p = .008), supporting our hypothesis. Conclusions This study was constrained by limited variance in residential areas and a predominantly female participant pool. Previous studies have shown that higher life satisfaction is associated with increased social participation and extended life expectancy, and interventions aimed at enhancing life satisfaction in older adults are significant. Further exploration is warranted to ascertain whether a causal relationship exists, wherein more negative perceptions of older adults diminish life satisfaction.

Fragility Fracture Network-Japan: The challenge of establishment of a national hip fracture database and successful achievement of nationwide health system change for hip fracture care in Japan

BackgroundIn April 2022, a new reimbursement scheme for hip fracture was implemented by the Japanese health ministry. Japan is one of the world's most aged societies, facing a significant, rapidly growing burden of osteoporosis and fragility fractures. The incidence of hip fractures is projected to increase from 240,000 in 2020 to 320,000 by 2040. In 2015, Fragility Fracture Network-Japan (FFN-Japan) was formally established as a nonprofit organization in order to create the optimal fragility fracture care system in Japan. MethodsFFN-Japan launched the Japan National Hip Fracture Database (JNHFD) in 2017, initially with only eight participating hospitals across Japan. The number of patients enrolled from May 2017 to the end of 2020 in the JNHFD from the 16 hospitals registered the patients during this period with amounting to 4271 patients in total. FFN-Japan invited officials from the Ministry of Health, Labor and Welfare (MHLW) to participate in round table meetings to discuss the data collected in the JNHFD and to consider opportunities for nationwide improvement in hip fracture care. ResultsThe proportion of patients who underwent surgery within 36 h of arrival at hospital was 48.1% in 2018, 58.6% in 2019, and 44.9% in 2020 indicating the delay of surgery. Regarding secondary fracture prevention, initiation of osteoporosis treatment during the in-patients was 60.2% in 2018, 54.0% in 2019, and 64.5% in 2020 indicating the inadequate post fracture care. In April 2022, the Central Social Insurance Medical Council of the Japanese MHLW announced a new reimbursement scheme for hip fracture care including two key components: Early surgery (within 48 h from injury) and Secondary fracture prevention immediately after fracture. DiscussionThe new reimbursement scheme of hip fracture care in Japan will catalyze and underpin major improvements on acute multidisciplinary care and post-fracture care with secondary fracture prevention. FFN-Japan played a key role on these policy changes to the health system by means the close collaboration and ongoing communication with the government. ConclusionWithin five years of establishment of the JNHFD, FFN-Japan in collaboration with visionary leaders from the Japanese government have successfully achieved a major reform of the Japanese health system's reimbursement of hip fracture care. This reform has laid the foundation for transformation of management of this debilitating and life-threatening injury that currently afflicts almost a quarter of a million older Japanese citizens each year.

‘It can be difficult to help them’

Older marginalized citizens with severe substance use are presently a growing population in Denmark. They struggle with comprehensive and complex needs for care and treatment, which put high demands on health and care professionals working with them. Yet, the complexity of their needs for care and the care provided to them is highly understudied. We take our empirical point of departure in an anthropological pilot study of care work in private homes and retirement homes in two municipalities, where we followed care professionals on their shifts and interviewed them in order to identify challenging situations in daily care. Building on Mol’s concept of logic of care (Mol 2008), we examine how the care professionals in their everyday work with substance using older citizens faced dilemmas in the provision of care within the logics of on the one hand Danish standards for “correct” care and on the other respecting the autonomy of substance using citizens.

Methodological Approaches to Assessing the Quality of Life of Older People in Russia

The paper presents the core findings of a study on improving methodological approaches to adequate assessment of dynamics of the quality of life of older people in Russia. The author has identified challenges in implementing some international recommendations on the topic thereon. These challenges resulted from differences in the socio-economic development of the Russian Federation and its ethnocultural traditions. The article defines domestic information and statistical base for studying the quality of life of the population, in particular, the older population.The author describes a system of basic indicators that includes key measures of health status of older people, their financial security and economic activity. Based on the proposed approach and official statistics, the situation with the older generation in Russia in 2010–2020 is analyzed. An assessment is made of the significance of both positive trends in improving the quality of life in the older generation (increased life expectancy, improved health, increased economic activity of the population aged 60 years and older), as well as unresolved problems, primarily, relatively low level of pensions compared to the subsistence level and high degree of interregional differentiation of pensions.The paper concludes with proposals concerning directions and sequence of organizational and financial measures aimed at improving the quality of life of pensioners, proposed by the author, based on specific results of statistical analysis. Among the top priorities are: indexation of pensions for non-working pensioners ahead of the inflation rate, indexation of pensions for working pensioners at 1/2 of the inflation rate, registration and, if necessary, organization of medical and social services for older citizens living alone.

Perspectives of older people on environmental sustainability: A cross-cultural validation study between five countries

The global agenda to move societies towards a more sustainable course of development also affects the lives of older people in our ageing populations. Therefore, it is important to understand the drivers, intentions and behaviours concerning sustainability among older adults. The aim of this study is to translate and cross-culturally validate an existing instrument (SustainABLE-16 Questionnaire), developed in the Netherlands, which measures how older people view the theme of environmental sustainability in their daily lives, for use in Romania, Poland, North Macedonia and Israel. The SustainABLE-16 covers three domains: 1) Pro-environmental behaviours; 2) Financial position; and 3) Beliefs. The scale was translated in Romanian, Polish, Macedonian, Albanian and Hebrew. Its 16 items were appraised for relevance by older people and experts in the field. A total of 2299 older people, including the original Dutch respondents, were included for the assessment of the level of measurement invariance across six languages, spoken in five countries. As the initial validation of the SustainABLE-16 did not meet internationally-recognised fit requirements, the shorter SustainABLE-8 was validated instead. This instrument proved valid for use in all participating countries (configural validity). Subsequently, increasingly constrained structural equation models were applied to test their fit with the data, ensuring that the fit did not deteriorate. The test results of measurement invariance across the countries indicated that items were stable, achieving partial scalar invariance, with five items demonstrating full scalar invariance. The shorter SustainABLE-8 functions uniformly across all language groups and can, therefore, be used to evaluate sustainable practices among older people. A better understanding of the drivers and practices among older citizens across Europe could, in turn, feed into more fitting public policies on sustainability in the built environment.

Egyptian framework for an age-friendly built environment

In recent years, the Egyptian demographic has changed with an increasing number of older citizens who require special attention. The World Health Organization (WHO) identified 2020–2030 as the “Decade of Healthy Ageing” in response to the worldwide demographic changes. Many international organizations have identified the built environment features of age‐friendly communities, yet they have not been thoroughly analyzed in the Egyptian context. Today, urban designers and city planners have to establish age-friendly communities that can facilitate well-being in old age. The paper aims to provide “Egyptian framework for an age-friendly built environment E-FAB”, that can help architects, urban designers, and decision-makers evaluate Egyptian urban communities towards being age-friendly. The E-FAB is created and designed based on an analytical theoretical approach focused on active older people’s definitions, needs, their relation to the built and social environments, and previous practices of age-friendly cities and communities. In addition, a comparative analysis between previous studies in age-friendly communities. Then, the paper conducted semi-structured interviews targeting active older people, aiming to refine and rank the built environment features of the E-FAB by using SPSS. The findings revealed that the E-FAB is expected to be an initial simple evaluating framework that could contribute positively to improving Egyptian urban areas to be more friendly to older people and address their needs in the built environment.

Self-efficacy as a mediator between frailty and falls among community-dwelling older citizens.

Frailty is one of the most challenging issues among older adults, and the relationship between frailty and falls has already been assessed numerous times in literature. In the present study, we explored the mediating role of self-efficacy related to falls (FSe) in the relationship between frailty and fall risk. In a cross-sectional design, 1080 community-dwelling older adults from Rotterdam (Netherlands) and Valencia (Spain) completed a questionnaire and data were then analyzed via mediation analysis using a bootstrapping approach. Results show that higher frailty is associated with higher fall incidence, and higher FSe is a partial mediator of this association, with a confidence interval for the indirect effect of 0.131-0.247. Moreover, results showed gender differences in FSe levels; women had lower FSe scores. Deepening research on the construct of FSe may give potential explanations that account for the emerged gender differences, and it could be more targeted in fall prevention programs.

Social Capital and Voluntary Activities among Older Adults in Tehran

Introduction: Social capital encompasses material and spiritual resources which enable individuals to establish stable networks of institutionalized relationships. Participation in voluntary public service activities at the community level serves as an indicator of social capital. This study aims to assess social capital and voluntary activities among older adults living in Tehran in 2021.
 Methods: This cross-sectional study included 384 older adult citizens residing in Region 19, selected through random sampling. Data collection involved a standardized questionnaire comprising three sections: demographic information, measuringsocial capital, and voluntary activity assessment.
 Results: The study found that 99/7% of respondents had an average social capital score (150-75). Additionally, 99/4% of the respondents exhibited a high level of engagement in voluntary activities. A significant relationship was observed between social capital ,age (P≤0/001) ,and marital status (P≤0/001). However, no significant relationship was found between voluntary activity and demographic information.
 Conclusion: This study suggests that older adults in Tehran possess a reasonable level of social capital and engage actively in voluntary activities. To harness this potential, effective planning and policies must be implemented to align with the needs and goals of society.

COVID-19 Mortality and the Structural Characteristics of Long-Term Care Facilities: Evidence from Sweden

As in many countries around the globe, older citizens in long-term care facilities (LTCFs) in Sweden were hit hard by the Coronavirus pandemic, but mortality varied greatly between different facilities. Current knowledge about the causes of this variation is limited. This article closes this gap by focusing on the link between the structural characteristics of LTCFs—ownership, size, and staffing—and the risk of dying from COVID-19 in Sweden during 2020. Having utilized both individual- and facility-level data, our results suggest that lower staff turnover, having a nurse employed at the facility, and smaller facility size are associated with an decreased risk of dying from COVID-19. Ownership type is not directly associated with COVID-19-related mortality, but public facilities have lower staff turnover and fewer personnel with additional employment than privately run facilities, while privately run LTCFs more often have a nurse employed at the facility.

ХАРАКТЕРИСТИКА ИНВАЛИДНОСТИ И РЕАБИЛИТАЦИИ ВСЛЕДСТВИЕ ПАТОЛОГИИ ОРГАНА ЗРЕНИЯ У ПОЖИЛЫХ АРХАНГЕЛЬСКОЙ ОБЛАСТИ

Significance. Due to population ageing, analyzing medical and social status of the elderly becomes relevant in the Russian Federation. Sensory deficiency syndrome is one of the most important for assessing human performance of patients. With the loss of sensory functions, patients lose the ability to self-care, often becoming disabled. The purpose of the study was to analyze disability due to diseases of the visual organ and accessory organs of the eye and rehabilitation of persons over 60 years recognized as disabled in the Arkhangelsk region in 2018-2022. Material and methods. The research base was compiled based on individual rehabilitation and habilitation programs (n=1548) for elderly people over 60 with visual impairments, submitted to the Federal State Information System “Unified Automated Vertically Integrated Information and Analytical System for Conducting Medical and Social Expertise” of the Arkhangelsk Region for 2018-2022. Results. Based on the data, it can be concluded that the first disability group prevailed throughout the five years under study, while the third group remained in the minority. Analysis of the leading diseases shows that glaucoma is on the top, accounting for about 50.4% of all cases of disability. Analysis of rehabilitation facilities shows that means of transportation and assistance in movement prevail. Analysis of individual rehabilitation and habilitation programs shows that vocational rehabilitation, employment in particular, is recommended only to some citizens, due to the existing disease and age. Discussion. In the presence of a pathology of the organ of vision, older citizens are more likely to immediately receive a more severe disability group. Among the leading causes of disability of the elderly, diseases resulting from comorbidity rank first. These data put forward the need for a multidisciplinary approach to the elderly, which can be achieved through the geriatric approach in ophthalmological, geriatric follow-up. At the same time, it would be logical to consider the possibility of correcting visual deficits in rehabilitation measures for the elderly disabled, yet only 29.5% of people received aids aimed at correcting the vision deficit. The data suggest the need to change the approach to the health of the elderly, focusing on improving their human performance rather than on diagnoses, and to pay more attention to those types of diseases that lead to more severe disability groups. Conclusion. It is necessary to change the attitude towards disability of the elderly – to move towards a “preventive” policy and create organizational solutions for such diseases, for example, a system of offices for prevention of certain diseases (a “glaucoma prevention office”, office of the elderly”), to introduce screening methods not only at the level of an ophthalmologist, but also a geriatrician, a district therapist, a physician.

SUPPORT FOR THE ELDERLY IN POLAND - IN SEARCH OF NEW SOLUTIONS IN THE FIELD OF SOCIAL SERVICES

According to the Central Statistical Office data, the share of older people, i.e., aged 60 years and more in the total of Polish population will be over 32% in 2060. Thus there is a necessity for actions aimed at supporting older citizens who require various support, depending on their health status, psycho-physical condition and individual needs. The spectrum of activities for older people should be wide and differentiated due to the internal diversity of the aging population. The purpose of the article is to deliberate strategic assumptions and examples of actions implemented in local communities, such as community-based services offered by the social assistance system, in the context of deinstitutionalization process. The article presents selected results of the latest work of the Institute of Labour and Social Affairs conducted within the project entitled "Development and pilot implementation of mechanisms and plans for the deinstitutionalisation of social services”, carried out jointly with the Ministry of Family and Social Policy.

OLDER PEOPLE'S PERCEPTIONS OF THEIR RIGHTS

This article has allowed to identify the opinions of elderly citizens on their rights, who in this difficult period of life continue to individually face their problems and needs. Poor information of pensioners accentuates the manifestation of discrimination, isolation, and indifference toward this group of population. Although R. Moldova has a rich agenda of normative acts that must work in our society in favour of elderly citizens, social, medical, economic institutions, etc., continues the production of age segregation processes, which is felt by the interviewed seniors. To reduce the daily tensions and worries of the elderly, it is necessary to create institutions (at all levels) that would provide support, protection and insurance with the rights of older citizens, becoming the key solution to their problems.

AGING EDUCATION IN THE UNITED STATES: WHERE WE ARE AND HOW DID WE GET HERE?

Abstract Aging education at the precollege level is relatively new in the United States, making its debut in the literature in the 1960s (Myers, 1977). The first White House Conference on Aging (WHCoA) in 1961, centered on the need for aging education and recommended it be integrated into curricula in public schools, higher education institutions, and libraries (McGuire, 2017). At the 1971 WHCoA it was noted that such educational efforts were indeed rare and again recommended that aging and life cycle education be mandatory at all levels of education, programs be developed to train teachers about aging, and older citizens be used as school volunteers (McGuire, 2017). Since then, aging curricula and intergenerational programming have made their way slowly and insufficiently into education at both the pk-12 and college levels. Interestingly, more recently, it seems more for-profit organizations are investing in aging education and training versus educational institutions to educate their workforce to better meet the needs of their older consumer base to increase their profit margins. Beyond profit margins, what is the heuristic value of aging education and why is it increasingly important and needed not only in the United States, but worldwide? This paper will kick off the symposium and set the stage with a retrospective account of what factors have propelled aging education in the United States and what we have learned to move aging education forward at both the pk-12 and higher education levels.

Autocratic Power and Older Citizens: The Political Subjectification of Retirees in Belarus

This article contributes to research on everyday resistance as a means of citizens’ political subjectification in autocracies and advances the literature on the manipulation of news. Through analysis of state-controlled media and individual interviews, it traces how older people in Belarus engage in anti-authoritarian protests by relying on pre-existing patterns of interactions with the state. My analysis demonstrates that to promote its legitimacy, the paternalist regime cultivates dependence in older citizens and represents itself as the primary solution to problems associated with old-age vulnerability. In response to their systemic marginalisation in the job market, urban development and public health policies, older people claim their equal rights by resisting old-age vulnerability or performing it to challenge the system. The article argues that by practising low-key acts of insubordination, older Belarusians acquire the collective self-awareness and cultural competence that allowed them to engage in the 2020 protests as a distinct political subject.

Abolishing the Act on System of Choice in Swedish eldercare: on arguments and replacements in the municipalities

PurposeSince 2009 Swedish municipalities may apply the Act on System of Choice (LOV) in, among other things, eldercare. About half of the 290 Swedish municipalities have chosen this within home-care services for older citizens, thus creating conditions for a welfare mix where private and public providers compete. Some of these municipalities later made decisions to abolish LOV. This article aims to analyse the arguments put forward by municipal politicians to abolish LOV and discusses if the case of abandoning LOV represents a case of re-municipalization.Design/methodology/approachQualitative method was used to analyse decision protocols and media materials from 20 Swedish municipalities that had abolished LOV in home-care services.FindingsThe article shows that politics and ideology seem to have only a limited significance in abolishing LOV. The most important arguments found in the empirical materials were instead pragmatic and related to the transaction costs: in smaller municipalities about the weak position of private providers and in larger municipalities about reported cases of welfare crime and extensive needs to control and review. In smaller municipalities, LOV was replaced by public monopoly and in larger municipalities by other types of procurements.Originality/valueWith its focus on eldercare in party-dominated municipalities, the article adds knowledge to the literature on drivers of re-municipalization but also discusses possible delimitations of the concept of re-municipalization.

Evaluating the impact of engaging older adults and service providers as research partners in the co-design of a community mobility-promoting program: a mixed methods developmental evaluation study

BackgroundIncreasingly researchers are partnering with citizens and communities in research; less is known about research impacts of this engagement. EMBOLDEN is an evidence-informed, mobility-promoting intervention for older adults co-designed by a 26-person Strategic Guiding Council (SGC) of health/social service providers and older adult citizens. This study evaluated research partners’ perceptions of engagement strategies, the engagement context, strengths, areas for improvement, as well as the impacts of the guiding council on older-adult identified priority areas.MethodsThis study was guided by developmental evaluation, working in partnership with four older adult SGC members who helped to set evaluation priorities, decide methods, and adapt patient-centred evaluation tools. Data sources included a questionnaire, focus groups and document analysis of meeting notes from 16 SGC meetings that took place between December 2019 and February 2022. A thematic approach to analysis guided the coding of focus group transcripts and SGC meeting notes. Convergent mixed methods guided the integration and presentation of qualitative and quantitative data sources in a joint display of evaluation results.ResultsOf 26 SGC members, nine completed the evaluation squestionnaire, and five participated in focus groups. Around two thirds of the SGC commonly attended each meeting. EMBOLDEN’s SGC was structured to include a diverse group (across gender, ethnicity and discipline) of older adults and service providers, which was perceived as a strength. Engagement processes were perceived as inclusive and well-facilitated, which stimulated discussion at meetings. Advantages and disadvantages of engaging with the SGC virtually, as compared to in-person (as was the case for the first 3 SGC meetings) were also discussed. Impacts of the SGC were identified across preparatory, execution phase and translational stages of research. Impacts of SGC involvement on members were also described.ConclusionOlder adult research partners played an important role designing, implementing, and evaluating co-design approaches in this study. Older adults and service providers can make important contributions to the design, delivery and sharing results of health research through their lived expertise and connections to community. This project contributes to the growing field of citizen and community engagement in research by offering a participatory approach to engagement evaluation that considers diversity, satisfaction, and impact.

A multi-year quantitative study of the experienced age-friendliness in The Hague: A tale of four personas

As an active member of the Global Network for Age-Friendly Cities and Communities, The Hague has been monitoring the progress over the years. In 2022, a second cross-sectional survey based on the Age Friendly Cities and Communities Questionnaire (AFCCQ) was conducted among 396 community-dwelling older citizens in the municipality. During times of the pandemic, scores for Social Participation went notably down, and scores for Respect and Social Inclusion increased. For the first time, based on survey data, four personas were found through cluster analysis. These personas ranged from the precariat and people with personal health issues with lower scores, to the silent majority without the limitations of health problems, and the upper echelon who score positively in all domains. Age-friendly policies in The Hague should focus particularly on the first two clusters through dedicated action plans, which would help steer efforts towards those most in need for support. This would help The Hague to become an age-friendly city for all, and not only for those living in good health and with sufficient financial means.