Support For Older People Research Articles

Age‘n’dem, Age and Dementia Friendly Streetscapes Toolkit, Walking Environments to Support Older People to Walk More and for Longer ( breakout presentation )

Age’n’dem was developed as a participatory design process with many older residents of Moonee Valley to: inform streetscape design, ensure access for older people including people with dementia, and be mindful of other special needs of community members ensuring measures were inclusive. Age’n’dem was delivered as a component of the Victorian State Dementia Plan Underlying Age’n’dem was a desire to change outcomes for older residents. The existing streetscape palette was tired. The experiential learning process informed redesign of Union Road streetscape in Ascot Vale, Victoria as it: operated as an intact and attractive environment for shopping, was surrounded by the highest density of older people in the municipality, particularly older women, shops played an important role in supporting people to age in place, and offered a complete range: newsagents, small supermarket, hardware, butchers, bakers and the deli, cake and coffee. Shopkeepers played an informal role: looking out for regulars, helping out when and if something happened. Residents knew, understood and relied on it. Walking up to the street, passing the time in a familiar place and dropping in on shopkeepers had become part of a daily ritual for many locals over time. What the shopkeepers did informally, helping older residents age in place was better than any response any community service could offer. Our role became one of supporting a natural and organic response by listening, watching and learning. We wanted to encourage this to happen, more often and for longer. We knew: If we made the street more comfortable we could sustain older residents’ interest as they age; If the environment was increasingly supportive it could continue to provide this function, enabling residents to age in place for as long as possible, and; Walking plays a key role in dementia prevention. Moonee Valley had budget for streetscape redesign and remediation and were funded through the Municipal Association of Victoria (MAV) and Department of Health and Human Services for Age’n’dem development. Investing in local’s knowledge was important. Process is everything. Our most articulate supporters are the older residents themselves talking on national radio, and statewide press.

On-line health seeking activity of older adults: an integrative review of the literature

The internet is increasingly used to provide health information. Supporting older people to access on-line health information requires understanding their current usage and possible barriers and facilitators. Methods involved searching three databases. Inclusion criteria were: (i) articles published within 10 years; (ii) people aged >65; (iii) explored reasons for older people accessing on-line health information and (iv) in English. Eight articles met these criteria. Older people use on-line health information to learn about a disease, medication, treatment, or healthy living. Factors influencing usefulness of on-line health information included demographics, health status, trust in the information, lack of skills using the internet and attitudes of health professionals. Findings indicate that while older people access on-line health information there are barriers: Low trust, financial barriers, lack of familiarity with the internet and low health literacy levels. Implications for nursing include working in partnership with older people to assist them to identify appropriate on-line information.

The Living Arrangements of Older People in the 1851 and 1891 Census Enumerators' Books for Hertfordshire

This article examines the living arrangements of older people through digitised transcripts of the 1851 and 1891 census enumerators' books for eight Hertfordshire communities. The percentages of older people living with their offspring were higher than expected, especially in rural parishes. However, relationships between older people and their offspring were recorded in urban society through family business and strong ties to local industry. By 1891, co-residence between older people and their offspring generally declined when the older people migrated inwards to suburban and urban parishes and the offspring left parishes suffering from agricultural depression. The argument that familial support was more directed towards older women in the nineteenth century is not confirmed. The proportions of older men and women co-residing with offspring were found in 1851 and 1891 to be roughly in equal measure, and the proportions of older men co-residing with offspring increased by 1891. Even when adjustments were made to exclude almshouse residence and incorporate those living with extended kin only, a bias of familial support towards women was not universally reflected across each parish. The differences in living arrangements by geography and by gender can be explained by occupational structure, almshouse accommodation, social welfare changes, widowhood, and migratory habits, which reinforce the importance of familial support for older people in nineteenth century society.

Competences for working with older people: The development and verification of the European core competence framework for health and social care professionals working with older people

ABSTRACTUniversities of applied sciences in Europe face the challenge of preparing students in health and social care for working with older people and contributing to the innovations needed in light of the ageing of society, along with changes in the health and social care systems in many countries. Dealing with the special needs of older people and the increasing burden of chronic diseases requires specific competencies for health and social care professionals, as well as an integrated approach to health and social care. Research has found that many educational programs lack adequate preparation for students in health and social care when it comes to the correct competences. To identify the competences needed for all health and social care professionals in Europe, who work with older people, the European Later Life Active Network (ELLAN) has conducted research and developed a verified competence framework. This “European core competences framework for health and social care professionals working with older people” describes roles and competences that students in health and social care programs need to learn in order to provide good care and support for older people. Within the ELLAN consortium, 26 universities of applied sciences from 25 European countries collaborated in this research and development process. The framework has been verified by two Delphi rounds among a group of 21 experts and a group of 21 researchers from 19 countries. The framework includes awareness of diversity and different cultural backgrounds. This makes it a useful document for educational purposes all over Europe.

Extroversion, social support and life satisfaction in old age: a mediation model

ABSTRACTObjectives: The aim of this study was twofold: on the one hand to analyze whether extroversion predicts social support in older people, and on the other hand to determine if different types of social support mediate the effect that extroversion has on older people's life satisfaction. Method: The sample comprised 406 community-dwelling older adults (M = 74.88, SD = 6.75) from urban areas of Granada, southern Spain. Results: Extroversion was positively correlated with emotional (r = .23) and with affectionate support (r = .30). Extroversion and all types of social support also positively correlated with life satisfaction. The multiple mediation analysis revealed that when age, gender, marital status and loneliness were controlled, extroversion predicted emotional (B = .008, p < .01) and affectionate support (B = .015, p < .01) and emotional and affectionate support mediated the association between extroversion and life satisfaction (total effect: B = .034, SE = .0024, p < .001, r2 = .295). Results from this study highlight the fact supportive social relations are crucial for older people's life satisfaction. Also emotional and affectionate support constitutes important explanatory mechanisms of the indirect effect of extroversion on life satisfaction.Conclusion: Personality traits should be considered when interventions aimed at promoting life satisfaction in old age and successful aging are designed.

Intergenerational care as a viable intervention strategy for children at risk of delinquency

AbstractLiterature has consistently cited early childhood interventions as an effective method for mitigating or preventing future delinquency in at‐risk children. In this manuscript, we propose an adapted model of Intergenerational Care presenting as a possible intervention strategy for children at risk of delinquency. This model of care draws from programmes that provide formal care and support for older people and young children, with a primary focus on intergenerational interactions that focus on respite day care, community engagement, educational pedagogy across generations and evaluation. Using a specific model of Intergenerational Care, we incorporated three components of existing childhood intervention strategies: preparing for school readiness, promoting social skills with elders and peers, and managing behaviour. While no intervention strategy targeting children at risk of delinquency has made use of intergenerational interactions, the adapted Intergenerational Care model that we propose, with these three components supported by the existing literature, offers a unique and promising approach for preventing future delinquent behaviour in children. Recommendations for longitudinal research are also proposed.

Meeting the health needs of older people with intellectual disabilities: exploring the experiences of residential social care staff.

Older people with intellectual disabilities often experience high levels of health needs and multiple morbidities but they may be supported by residential care staff with little or no previous experience of identifying and meeting health needs. Little is known regarding how they undertake this health-related role and this exploratory study seeks to address this gap. A purposive sample of 14 managers of supported living accommodation in Wales were interviewed in 2014 to determine their experiences of supporting tenants in relation to age-related health needs. The semi-structured interviews were transcribed and thematically analysed. Three of the emerging themes are reported in this paper: meeting health needs, the consequences of ageing and relationships. Findings indicate that residential care staff support older people with intellectual disabilities with complex and multiple health needs: they monitor health status, support access to healthcare, provide additional support arising from changing health needs and advocate for tenants in the context of healthcare. However, their role is often not understood by healthcare professionals. The importance of staff having a long-term relationship with those they support was identified as being important to identifying any health-related changes. The need to develop effective relationships with healthcare staff was also noted. It is concluded that there is a need for better understanding among health staff of the role of residential social care workers and for further research regarding health-related communication.

Best practice for providing social care and support to people living with concurrent sight loss and dementia: professional perspectives

Purpose – Approximately 100,000 people in the UK aged 75 and over have concurrent dementia and sight loss, but current understanding of their experiences, needs and preferences is limited. The purpose of this paper is to report on a research project that explored the provision of social care and support for older people with both conditions. Design/methodology/approach – The project was a collaboration between the universities of York, Worcester, Bournemouth and Cambridge, supported by the Thomas Pocklington Trust and the Housing and Dementia Research Consortium. Data for this paper were drawn from focus groups held in 2013 involving 47 professionals across the dementia, sight loss and housing sectors. Findings – Thematic analysis identified five main barriers to providing high-quality, cost-effective social care and support: time constraints; financial limitations; insufficient professional knowledge; a lack of joint working; and inconsistency of services. The requirements of dementia and sight loss often conflict, which can limit the usefulness of equipment, aids and adaptations. Support and information needs to address individual needs and preferences. Research limitations/implications – Unless professionals consider dementia and sight loss together, they are unlikely to think about the impact of both conditions and the potential of their own services to provide effective support for individuals and their informal carers. Failing to consider both conditions together can also limit the availability and accessibility of social care and support services. This paper is based on input from a small sample of self-selecting professionals across three geographical regions of England. More research is needed in this area. Practical implications – There are growing numbers of people living with concurrent dementia and sight loss, many of whom wish to remain living in their own homes. There is limited awareness of the experiences and needs of this group and limited provision of appropriate services aids/adaptations. A range of measures should be implemented in order to support independence and well-being for people living with both conditions and their family carers. These include increased awareness, improved assessment, more training and greater joint working. Social implications – People living with dementia or sight loss are at high risk of social isolation, increasingly so for those with both conditions. Services that take an inclusive approach to both conditions can provide crucial opportunities for social interaction. Extra care housing has the potential to provide a supportive, community-based environment that can help residents to maintain social contact. Originality/value – This paper adds much-needed evidence to the limited existing literature, and reflects the views of diverse professionals across housing, health and social care.

Supporting older people with cancer and life-limiting conditions dying at home: a qualitative study of patient and family caregiver experiences of Hospice at Home care.

To explore patients' and family caregivers' experiences and perceptions of Hospice at Home care. The public indicate a preference to be cared for and to die at home. This has inherent challenges, with a key factor being the family caregiver. Supporting end-of-life care at home has resulted in the expansion of Hospice at Home services. A wide configuration of services exists with a lack of robust evidence as to what is valued by recipients, particularly those who are older people. A prospective descriptive qualitative study. Recruitment was purposive. Eligible participants were in receipt of Hospice at Home service on at least three occasions and were deemed to have a life expectancy measured in weeks rather than days. Digitally recorded semistructured interviews with 41 participants (16 patients and 25 family caregivers) were undertaken between October 2014 - July 2015. Data were analysed and organized thematically. Several subthemes: 'Talking about'; 'Knowing and Doing'; 'Caring for the Caregivers'; and 'Promoting Choice' contributed to the overall theme of Embracing Holism. A positive impact on emotional, psychological, social and physical well-being was apparent. This study has provided additional insights as to the value of Hospice at Home care where Hospice Nurses are helping to bring Hospice care into the home. This is helping to support older people who are dying and their caregivers, to live as well as possible and facilitate their wish to be cared for and die in their own home.

Do computers increase older people’s inclusion and wellbeing?

Purpose – The purpose of this paper is to consider two recent studies on computer use by older people, who may become increasingly isolated due to infirmity and sensory impairments. Older people are less likely to use computer technology yet it has been suggested that it may help reduce isolation. These studies inquired into older people’s experience with computers. Design/methodology/approach – The first paper discussed here explored how a sample of older people in the USA acquired a computer and whether it contributed to their well-being. The second paper was about a similar study with a sample of older people in the UK. Findings – In the US sample, people who saw tablet computers being used by a friend were likely to purchase one. In the UK sample, people seemed to have had to overcome more fears of using computer technology, but in both samples, once initial difficulties were overcome, people were enthusiastic about using them. In both, people felt more able to keep up hobbies and interests through finding information or connecting with interest groups online, and able to keep connected with family members. Originality/value – In light of increasing migration of services and information to the internet, these studies explored the things that help and hinder older people in terms of using computers, in order to address the digital divide, whereby those unable to use them can be left isolated and with reduced information and support. These studies were able to explore personal meanings of computer use and specific fears and difficulties, which are important to understand in planning for training and support for older people who are not yet on line. They also demonstrated that, alongside face-to-face interaction, being online was experienced as reducing people’s isolation and enhancing their lives.

From Provider to Enabler of Care? Reconfiguring Local Authority Support for Older People and Carers in Leeds, 2008 to 2013

This article explores developments in the support available to older people and carers (i.e., caregivers) in the city of Leeds, United Kingdom, and examines provision changes during a period characterized by unprecedented resource constraint and new developments in national-local governance. Using documentary evidence, official statistics, and findings from recent studies led by the author, the effects of these changes on service planning and delivery and the approach taken by local actors to mitigate their impact are highlighted. The statistical data show a marked decline in some types of services for older people during a 5-year period during which the city council took steps to mobilize citizens and develop new services and system improvements. The analysis focuses on theories of social quality as a framework for analysis of the complex picture of change related to service provision. It concludes that although citizen involvement and consultations exerted a positive influence in delivering support to some older people and carers, research over a longer timescale is needed to show if these changes are adequate to protect older people and carers from the effects of ongoing budgetary constraints.

Supporting Older People with Cancer – Merging Geriatric and Oncological Knowledge

Cancer in old age means a complex situation that may differ depending on where in the aging process the person is. For the older patient it is a reminder of that life is going to its end. Cancer treatment is to be provided in addition to handling other health problems and the overall frailty that goes with old age. Comprehensive geriatric assessment and case management may be a way to handle the frailty and merging oncology and geriatric knowledge.

Older people coping with low mood: a qualitative study.

To gain new insight into support for older people with low mood, the perceptions, strategies, and needs of older people with depressive symptoms were explored. Two in-depth interviews were held with 38 participants (aged ≥77 years) who screened positive for depressive symptoms in general practice. To investigate the influence of the presence of complex health problems, 19 persons with and 19 without complex problems were included. Complex problems were defined as a combination of functional, somatic, psychological or social problems. All participants used several cognitive, social or practical coping strategies. Four patterns emerged: mastery, acceptance, ambivalence, and need for support. Most participants felt they could deal with their feelings sufficiently, whereas a few participants with complex problems expressed a need for professional support. Some participants, especially those with complex problems, were ambivalent about possible interventions mainly because they feared putting their fragile balance at risk due to changes instigated by an intervention. Most older participants with depressive symptoms perceived their coping strategies to be sufficient. The general practitioners (GPs) can support self-management by talking about the (effectiveness of) personal coping strategies, elaborating on perceptions of risks, providing information, and discussing alternative options with older persons.

Family structure and support for the oldest old: A cross-sectional study in Dujiangyan, China

Objective In China, adult children have traditionally provided support for their aged parents. This model of care is increasingly challenged by the decline of the extended family. Recently, China’s decades-long one-child policy has eased. We examine the association of family size and composition with family support for nonagenarians and centenarians. Methods Data were obtained through a questionnaire survey of 619 nonagenarians and centenarians in Dujiangyan and were analyzed by chi-square tests, Student t tests, and multivariate logistic regression models. Results This study revealed that an increased number of offspring might provide financial support for older people, but this does not necessarily translate into physical and emotional care. Conclusion It is clear that although alternative sources of support for older people are increasingly needed, in China the family will continue to play an important role in supporting older people.

Protocol for a mixed-methods longitudinal study to identify factors influencing return to work in the over 50s participating in the UK Work Programme: Supporting Older People into Employment (SOPIE)

IntroductionIncreasing employment among older workers is a policy priority given the increase in life expectancy and the drop in labour force participation after the age of 50. Reasons for this...

Intergenerational inequity arguments and the implications for state-funded financial support of older people

ABSTRACTAs population demographics shift towards an older population structure in the Western world, concerns about the future costs of pensions are apparent in politics, media and everyday conversations. In New Zealand, the universal state-funded pension paid to all citizens over the age of 65 years is often considered to be unsustainable in the context of population ageing. To examine the arguments surrounding universal superannuation, rhetorical analysis was undertaken on two New Zealand newspaper articles that discussed the future cost of pensions, and the 233 public responses these articles generated. The cost of superannuation was used to emphasise the different characteristics of each generational cohort and the ways that this produced inequity across generations. Claims of intergenerational inequity generated antagonism and widened divisions between generational groups. Foregrounding generational inequity in the discussion of superannuation has profound implications for state-funded income support for older people which relies upon widespread public support. Intergenerational inequity ignores the significant inequity in health and social circumstances in retirement among older New Zealanders and overlooks the significant impact of universal superannuation on protecting older New Zealanders from poverty in later life.

Supporting Older People with Learning Disabilities: a Toolkit for Health and Social Care CommissionersSueTurner &amp; CarolineBernard, 2014, pp. 1–40. British Institute of Learning Disabilities, Birmingham.

Supporting Older People with Learning Disabilities: a Toolkit for Health and Social Care CommissionersSueTurner &amp; CarolineBernard, 2014, pp. 1–40. British Institute of Learning Disabilities, Birmingham.

Consumer views about aging-in-place.

BackgroundSupporting older people’s choices to live safely and independently in the community (age-in-place) can maximize their quality of life and minimize unnecessary hospitalizations and residential care placement. Little is known of the views of older people about the aging-in-place process, and how they approach and prioritize the support they require to live in the community accommodation of their choice.PurposeTo explore and synthesize the experiences and perspectives of older people planning for and experiencing aging-in-place.MethodsTwo purposively sampled groups of community-dwelling people aged 65+ years were recruited for individual interviews or focus groups. The interviews were semistructured, audio-recorded, and transcribed. Themes were identified by three researchers working independently, then in consort, using a qualitative thematic analysis approach.ResultsForty-two participants provided a range of insights about, and strategies for, aging-in-place. Thematic saturation was reached before the final interviews. We identified personal characteristics (resilience, adaptability, and independence) and key elements of successful aging-in-place, summarized in the acronym HIPFACTS: health, information, practical assistance, finance, activity (physical and mental), company (family, friends, neighbors, pets), transport, and safety.DiscussionThis paper presents rich, and rarely heard, older people’s views about how they and their peers perceive, characterize, and address changes in their capacity to live independently and safely in the community. Participants identified relatively simple, low-cost, and effective supports to enable them to adapt to change, while retaining independence and resilience. The findings highlighted how successful aging-in-place requires integrated, responsive, and accessible primary health and community services.

Using Action Research and Action Learning (ARAL) to develop a response to the abuse of older people in a healthcare context

PurposeThe purpose of this paper is to describe Monash Health’s development of a Policy and Procedure on the abuse of older people in metropolitan Australia. Monash Health is a public healthcare network that consists of six public hospitals and over 40 community health care sites throughout the South East of Melbourne.Design/methodology/approachAn Action Research Action Learning approach was employed to develop a comprehensive set of policy and procedure documents to ensure that Monash Health became compliant with the State Government’s expectations around responding to the abuse of older people in a consistent manner.FindingsAlmost 90,000 Monash Health hospital admissions per year are older people aged over 65 years. Senior Monash Health management recognized that staff did not have adequate information, education and resources to consistently identify and respond to situations of elder abuse. What is more, the existing internal Monash Health document Supporting Older People at Risk did not meet obligations stated in the Victorian Government’s Elder Abuse Strategy (2009).Originality/valueThe project’s emphasis upon participatory action research, cooperative inquiry and action learning further resulted in the identification of an opportunity to develop a strategic response to violence and abuse for all patients of Monash Health, not just older people.

8.K. Round table: Themes for Integrated Study of Care Changes to Support Older People with Multiple Chronic Conditions&lt;subtitle&gt;Organised by: Loughborough University, UK&lt;/subtitle&gt;

8.K. Round table: Themes for Integrated Study of Care Changes to Support Older People with Multiple Chronic Conditions&lt;subtitle&gt;Organised by: Loughborough University, UK&lt;/subtitle&gt;