Place For Older Adults Research Articles

Engaging Stakeholders to Implement an Aging in Place Intervention through an Area Agency on Aging

Community Aging in Place, Advancing Better Living for Elders (CAPABLE) is an interdisciplinary evidence-based intervention for reducing disability, reducing cost, and promoting aging in place for older adults who qualify for Medicaid services. However, implementation of CAPABLE through existing community services and with different older adult populations may require adaptations based on stakeholder input. The purpose of this qualitative study was to adapt CAPABLE for implementation through an Area Agency on Aging (AAA) targeting older adults with disability but who do not meet thresholds for Medicaid services. Data collection occurred with stakeholders from a single AAA. Two, 60-minute focus groups were conducted with frontline providers (n=7) and administrators (n=7). Thematic analysis of the data were completed using NVivo 12 Pro. Stakeholders described three themes to consider for implementing CAPABLE in their AAA: screening and referral process, eligibility, and team meetings. Frontline providers recognized the need to allow care managers “to decide who would be most appropriate for the program because they have a better understanding of the person, their family, and home environment.” Administrators supported expanding eligibility requirements, “Could we offer the program to someone even if they were recently hospitalized?” All stakeholders expressed that an initial interdisciplinary team meeting could be beneficial for goal setting, “If the team and consumer could be together for the first meeting that could save time and help generate ideas for goals.” These perspectives affirm the importance of early stakeholder engagement in adapting to adopt evidence-based programs into “real-world” settings.

Age-Friendly Cities During a Global Pandemic.

Age-friendly cities optimize opportunities for health, participation, and security to enhance quality of life as people age. The Age-Friendly Cities framework evaluates eight evidence-based domains, including: outdoor spaces and buildings; transportation; housing; social participation; respect and social inclusion; civic participation and employment; communication and information; and community support and health services. The COVID-19 pandemic has impacted each of these domains, necessitating reconsideration of opportunities to promote safety, wellness, and empowerment for older adults and persons with disabilities in this new reality. This qualitative descriptive study provides perspectives of gerontologists, senior service providers, and diverse older adults. Participants identified emerging issues and concerns related to the eight age-friendly domains, as well as highlighted best practices and potential solutions. The findings provide direction for gerontological nurses in practice and research who aim to address social determinants of health while promoting aging in place for older adults. [Journal of Gerontological Nursing, 46(12), 7-13.].

CREATION OF A NEW AGING IN PLACE MEASURE

Aging in place and other “place” terms (such as stuck in place, aging in the right place, aging out of place, and age-friendliness) are often discussed in the gerontological literature. Yet, a validated measure that incorporates this new diversity of place definitions and person-environment fit does not exist. The creation of a more inclusive and comprehensive measure is crucial as the aging-in-place concept grows and expands to include the broader continuum of care. This study reports findings from steps in the process of developing a quantitative measure. Namely, we report findings from the first 4 steps of gerontologist Neal Kraus’ a 9-step Measurement Development model that we used to create a measure of aging in place for older adults. This process consisted of several steps and sources from: in-depth and focus group data, literature review, and selecting and testing items from existing comparable measures. Specifically, data analysis of 84 hours of in-depth interview narrative, from May 2017 to present, is discussed. Data arose from a combination of focus group and interview narrative. Initially, these data illustrate how the original conceptual domains were created. Then, we present examples of how the conceptual domain pool was further expanded through a systematic literature review and by review and assessment of comparable measures to develop our new aging in place questionnaire. Both this measure development process and findings are applicable to the creation of measures about other gerontological topics.

IMAGINING AND REALISING AN AGE-FRIENDLY UNIVERSITY

The number of people in Ireland aged over 65 is expected to double from 11% to 22% over the next twenty years. This cohort of the population has diverse educational needs which are currently inadequately provided for within higher education and the pressure to meet these needs will increase. In 2008 DCU engaged in a process which resulted in launching Ten Principles of an Age Friendly University. Our vision is to lead a global initiative to embrace the opportunities of an aging population by providing a place for older adults to learn, and where DCU will lead a centre of excellence (research, innovation, teaching, advocacy, engagement) with older adults, harnessing and developing areas of expertise. Opportunities to engage in authentic dialogue with older people also raise awareness within the traditional student cohort to embrace the longevity dividend and inform their own ageing process contributes to the transformational goals of DCU.

Factors Influencing Advance Care Planning Among Older Adults in Two Socioeconomically Diverse Living Communities.

Advance care planning (ACP) is an iterative, complex, and dynamic process of discussion, decision-making, and documentation about end-of-life care. The extent to which this process takes place in older adults in diverse socioeconomic settings is not well documented. The aim of this study was to assess the knowledge, attitudes, and beliefs about ACP among older adults in two socioeconomically diverse settings to identify the individual and contextual factors that influence behaviors regarding end-of-life care. A cross-sectional survey design was used. An affordable independent continuing care retirement community and a high-income eligible (HIE) independent continuing care retirement community. Individuals aged 55 years and older who resided in independent living. A 61-item survey was administered. Simple descriptive statistics were used to examine the responses, and inferential statistics were used to evaluate which items were associated with key outcomes between the 2 settings. Seventy-seven older adults completed the survey. Significant differences in familiarity of terminology and knowledge of ACP, as well as significant differences in completion of advance directives and communication, were found between the 2 communities. No differences were found in attitudes and beliefs about end-of-life issues. Higher levels of knowledge and engagement in ACP were reported at the HIE community as compared to the affordable housing community. These findings provide insight into the influence of the contextual forces that encourage and support ACP.

Executive function is necessary for the regulation of the stepping activity when stepping in place in older adults.

To determine the effect of age on stepping performance and to compare the cognitive demand required to regulate repetitive stepping between older and younger adults while performing a stepping in place task (SIP). Fourteen younger (25.4 ± 6.5) and 15 older adults (71.0 ± 9.0) participated in this study. They performed a seated category fluency task and Stroop test, followed by a 60 s SIP task. Following this, both the cognitive and motor tasks were performed simultaneously. We assessed cognitive performance, SIP cycle duration, asymmetry, and arrhythmicity. Compared to younger adults, older adults had larger SIP arrhythmicity both as a single task and when combined with the Category (p < 0.001) and Stroop (p < 0.01) tasks. Older adults also had larger arrhythmicity when dual tasking compared to SIP alone (p < 0.001). Older adults showed greater SIP asymmetry when combined with Category (p = 0.006) and Stroop (p = 0.06) tasks. Finally, they had lower cognitive performance than younger adults in both single and dual tasks (p < 0.01). Age and type of cognitive task performed with the motor task affected different components of stepping. While SIP arrhythmicity was larger for all conditions in older compared to younger adults, cycle duration was not different, and asymmetry tended to be larger during SIP when paired with a verbal fluency task. SIP does not require a high level of control for dynamic stability, therefore demonstrating that higher-level executive function is necessary for the regulation of stepping activity independently of the regulation of postural balance. Furthermore, older adults may lack the cognitive resources needed to adequately regulate stepping activity while performing a cognitive task relying on the executive function.

Older Adults with Hoarding Behaviour Aging in Place: Looking to a Collaborative Community-Based Planning Approach for Solutions

This paper reports on and synthesizes new research that examines how a collaborative community response can promote successful aging in place for older adults with hoarding behaviour. Through interviews with older adults with hoarding behaviour, who used a particular community support and a focus group interview with members of the community collaborative that directed supports for this population, our findings suggest that there were valuable outcomes for both groups. These older adults with hoarding behaviour were able to remain in their own homes, their safety was enhanced, their sense of isolation was minimized, empowerment was fostered, and they gained valuable insight into their behaviour. The members of the community collaborative were able to access the expertise of other professionals, maximize their own expertise, and they generated an enhanced understanding of the experience of older adults living with hoarding behaviour in Edmonton. This study is a significant addition to the much too sparse literature about the community planning needs of older adults with hoarding behaviour. It offers knowledge that is integral to theories and principles of better aging in place but attempts to translate this into practice.

Understanding Aging in Place for Older Adults: A Needs Analysis

Understanding Aging in Place for Older Adults: A Needs Analysis

Understanding Aging in Place for Older Adults: A Needs Analysis.

A goal of many older adults is to remain in their own homes as they age (Beyond 50.05 Survey, 2005). However, a detailed assessment is lacking of the needs of older adults as they age in place. Using focus groups, twenty-six independently living older adults (mean age 78.8 years) from the Atlanta metropolitan area were asked to describe the tasks they perform to maintain their homes, as well as any difficulties they have performing these tasks. Participants described performing a wide range of tasks and focused primarily on physical difficulties. However, participants also reported solutions to manage these difficulties that fell into three broad categories: "Cessation," "Perseverance," and "Compensation." These categories represent classes of opportunities for interventions that may help older adults remain independent in their homes longer. By understanding the nature of home maintenance problems older adults encounter while aging in place, interventions and redesign efforts can be more effective. These data suggest that interventions should start with answering physical issues.

A Study of Older Adults Attending a Program on Human Sexuality

This study attempted to ascertain if significant changes took place in older adults' knowledge and attitudes about human sexuality following a two-session course on the subject. Subjects were volunteers who attended a neighborhood center in Miami, Florida. Information was gathered immediately before the first session and after the second session by use of pencil-and-paper tests. Test items were adapted from the Sex Knowledge and Attitude Test and Attitude and Knowledge Assessment. At the first session, small-group discussions followed a large-group instruction period; the second session consisted of a 20-minute film on human sexuality, followed by group discussion. Of the 30 participants who took the pretest, only four completed the posttest, although most of the 30 attended the second session.