Support For Older Adults Research Articles

Psycho-Social Factors in Older Adults’ Mental Health: A Narrative Review

Health promotion is a top priority worldwide. This includes mental health in older adults, who are at risk due to the ageing process, associated with deteriorating health status. Notwithstanding the importance of the topic, psycho-social factors are often neglected in the implementation or formulation of advanced age health promotion programs. In this context, it is imperative to reach a better understanding of the main psycho-social aspects involved in mental health promotion in older adults. The main objective of this narrative review was to identify documents that made a core contribution to the understanding of psycho-social factors related to mental health in community-dwelling older adults. To achieve this, a narrative review was carried out that included a total of 40 articles published between 2018 and 2022. This review was performed through an interpretive stance. Ethical approval was not required for this review. Three main categories were derived from thematic analysis: (i) mental health interventions; (ii) mental health and frailty in older adults, and (iii) social support in older adults. To conclude, understanding the main protective psycho-social factors involved in mental health in community-dwelling older adults is of paramount importance. Identifying the implications of the psycho-social factors in this population is vital to elaborate specific interventions, therefore enhancing their mental health.

Mental health status and factors related on mental health status of the older adults living alone

Purpose This study aims to describe the mental health status and factors related to the mental health status of older adults living alone. Design/methodology/approach This is a descriptive correlational study. Older adults living alone from the urban area of the Northeast of Thailand were recruited randomly from within a stratified sampling frame and received a questionnaire. Data were collected using a demographic form, way of coping, social support, family relationship, and Thai Mental Health Indicator-15 (TMHI-15). Data were analysed using descriptive statistics, Spearman's rank correlation coefficient, and Chi-square test. Findings The mental health status related to personal factors at p < 0.05 including gender, education level, income, health status, coping strategies, social support and family relationship are related to mental health status. Research limitations/implications This study provides further empirical support for older adults who are living alone, especially females who have low income and have a disease. Consequently, policy on social support in older adults should be directed to developing a range of divergent intervention strategies. Practical implications This study requires some form of long-term care as well as utilization of treatment and support services, enhanced quality of life for older adults living alone. Social implications This study requires some form of long-term care as well as utilization of treatment and support services, enhanced quality of life for older adults living alone. Originality/value This study provides further empirical support for older adults who are living alone.

When Harry Met Sally: Older Adult Spouses' First Encounter Reminiscing and Well-Being.

Interest in reminiscence activities for older adults has grown in recent years, but the benefits of co-reminiscence are not well-known. Drawing from a narrative identity framework, this study examined older adult spouses' co-reminiscence about their first encounters. We hypothesized that perceived closeness and support increase when spouses co-reminisce and that greater perceptions of closeness and support after reminiscing relate to lower depressive symptoms and greater marital satisfaction in daily life. One hundred and one couples completed questionnaires measuring marital satisfaction and depressive symptoms at home and then participated in a laboratory session in which they co-reminisced about their first encounters. Self-reported perceived support and relationship closeness were obtained before and after reminiscence. t Tests and the Actor Partner Interdependence Model were used to examine hypotheses. As hypothesized, closeness and perceived support increased from pre- to postreminiscence for husbands and wives. In addition, one's own relationship closeness after reminiscence was positively associated with own marital satisfaction (actor effect). One's perceived support after reminiscence was positively related to spouse's marital satisfaction and negatively associated with their spouse's depressive symptoms (partner effects). Findings suggest that co-reminiscence about early relationship development can boost feelings of closeness and support for older adults. Benefiting from co-reminiscence in this way also appears to indicate broader relationship and individual well-being. Brief co-reminiscence activities may nurture late-life relational well-being.

Direct and Indirect Income Support and Their Determinants: Developing an Income Profile for Older Adults in Sri Lanka

Given the rapid increase in population aging and older population dependency rates, a sound understanding of old-age income support systems is vital for formulating effective policy responses. This research studies old-age income sources to develop an income profile for older adults in Sri Lanka, measuring direct and indirect income sources using nationally representative survey data from Household Income and Expenditure Surveys 1995/1996 and 2016. In the absence of direct information on intergenerational transfers, we investigate the material support older adults receive from their families, an essential source of income in many developing countries. We found that while indirect income support, cash transfers, and employment are vital sources of old-age income, there have been significant changes in the composition of old-age income over time. Indirect income support is becoming less important, and income from employment and formal cash transfers is becoming more prominent. These results highlight potential avenues to improve the economic well-being of older adults, such as increasing the mandatory retirement age and taking measures to provide decent employment opportunities for older adults while also expanding pension coverage to all types of workers and access to social security for vulnerable groups such as women or the poor.

Community Volunteers and Primary Care Providers Supporting Older Adults in System Navigation: A Mixed Methods Study.

Introduction:Primary care providers and community volunteers have important roles in supporting patient system navigation and utilization of community-based health and social services (CBHSS). This study aimed to explore the experiences and impacts of system navigation in a complex intervention supporting older adults.Methods:We used a convergent mixed methods design. Participants included primary care team members (n = 67), community volunteers (n = 38), and programme clients (n = 128) across six communities in Ontario, Canada. Data sources included focus groups, interviews, system navigation function survey for volunteers, CBHSS use survey for clients, and implementation data on CBHSS recommended by providers and volunteers and used by clients.Results:Results showed the different patterns of how CBHSS categories were recommended and ultimately used. Exercise-related CBHSS were both recommended and used, independence-related CBHSS were mostly only recommended with less uptake, and chronic health condition and diet/nutrition CBHSS were most often used by clients.Discussion:Primary care teams’ practice of system navigation was impacted by programme participation, including through learning about local CBHSS. However, volunteers felt more confident in tasks that did not include connecting to CBHSS. The programme did seem to result in many referrals, though the actual client uptake tended to be to more clinical rather than healthy lifestyle resources.

SEE-Diabetes, a patient-centered diabetes self-management education and support for older adults: Findings and information needs from patients’ perspectives

AimsThis study identified the information needs of people with diabetes aged 65 and older through surveys and focus groups to inform the development of a patient-centered educational decision aid for diabetes care, SEE-Diabetes (Support-Engage-Empower-Diabetes). MethodsWe conducted survey (N = 37) and three focus groups (N = 9). The survey collected demographics, diabetes duration, insulin usage, and clinic notes accessibility through a patient portal. In focus groups, participants evaluated the Assessment and Plan section of three selected deidentified clinic notes to assess readability and helpfulness for diabetes care. ResultsThe mean age of participants was 66 (24–82, SD = 12), and 22 were female (60%). The mean diabetes duration was 20.9 years (1–63, SD=15). Most participants (80%) read their clinical notes via patient portal. In the focus groups, the readability of clinic notes was noted as a primary concern because of medical abbreviations and poor formatting. Participants found the helpfulness of clinic notes was negatively impacted by vague or insufficient self-care information. ConclusionsWe found the high use of patient portal for reading clinic notes, which offers a use case opportunity for the proposed SEE-Diabetes educational aid. Feedback about the readability and helpfulness of clinic notes will be considered during the design process.

The Small House Model to Support Older Adults in Long-Term Care


 The small house model of long-term care (LTC) is identified internationally by several model names. Although some differences exist between the characteristics of these models (e.g., number of residents, degree of resident freedom, facility design), there are 3 recurring components: functional units with a small group of residents, replication of familiar domestic routines, and some form of decentralized staff.
 The key philosophic difference between the small house model and the traditional LTC model is the heavy focus on person-centred care. This approach to care in the small house model is firmly rooted in freedom of choice and autonomy for the residents.
 Small house models eliminate the strict delineation of roles; staff at all levels are included in the decision-making process. Self-managed and universal work teams are prominent features of the small house model. Frontline staff with strong interpersonal skills are essential for successful implementation.
 No strong trend emerges from the literature with respect to the impact of the small house model on resident-centred outcomes compared with more traditional models of LTC. This is likely due to lack of consistency in the outcomes that are measured and variability among the different small house models. This finding is consistent with other reviews on the topic.
 Literature exploring the Canadian experience with small house models is limited. The majority of identified studies used data from the US or European jurisdictions, which potentially limits its generalizability to the Canadian context.

Situated Scaffolding for Sustainable Participatory Design

An extensive literature on participatory design with older adults has, thus far, little to say about the support older adults need when involved in online activities. Our research suggests that to empower older adults in participatory design, scaffolding work has to be done. Scaffolding interactions - creating temporary instructional support to help the learning of participants - is a common approach in participatory design. Yet, when applied in online participatory design with older adults, the traditional understanding of the concept does not match the way older adults' learn. Hence, we argue for a new understanding of this term, which we call situated scaffolding. We illustrate our argument with a case where older adults collaborate online as part of a participatory design project. We unpack the different dimensions of situated scaffolding and discuss how this novel understanding can be used to further inform sustainable participatory design for and with older adults.

Neuropsychiatric Disorders and Frailty in Older Adults over the Spectrum of Cancer: A Narrative Review.

Simple SummaryReceiving a diagnosis of cancer in older adults supersizes the coexisting multimorbidity and frailty of the single individual. The multidimensional nature of this diagnosis needs to be appropriately targeted in the realm of the entire spectrum of cancer care, including the survivorship phase and the continuum of supportive care. The identification of late-life symptoms, syndromes, and the trajectory of frailty throughout the cancer course hold promise to better capture the clinical complexity of old-age patients and deliver targeted new pathways of care. In particular, neuropsychiatric disorders, beyond dementia, given their intrinsic association with frailty, need to be further explored to understand their impact on cancer disease course. Starting from this background, we aimed to assess the presence of neuropsychiatric conditions, including depression, sleep disturbances, anxiety, behavioral disturbances, attitude, motivation, and support in older adults receiving a diagnosis of cancer in order to understand the magnitude of the problem that may serve as a platform for future multidisciplinary studies and target interventions.Background: The interplay between different neuropsychiatric conditions, beyond dementia, in the presence of a diagnosis of cancer in older adults may mediate patients’ fitness and cancer-related outcomes. Here, we aimed to investigate the presence of depression, sleep disturbances, anxiety, attitude, motivation, and support in older adults receiving a diagnosis of cancer and the dimension of frailty in order to understand the magnitude of the problem. Methods: This review provides an update of the state of the art based on references from searches of PubMed between 2000 and June 2021. Results: The evidence obtained underscored the tight association between frailty and unfavorable clinical outcomes in older adults with cancer. Given the intrinsic correlation of neuropsychiatric disorders with frailty in the realm of cancer survivorship, the evidence showed they might have a correlation with unfavorable clinical outcomes, late-life geriatric syndromes and higher degree of frailty. Conclusions: The identification of common vulnerabilities among neuropsychiatric disorders, frailty, and cancer may hold promise to unmask similar shared pathways, potentially intercepting targeted new interventions over the spectrum of cancer with the delivery of better pathways of care for older adults with cancer.

HIV-related Stigma, Personal Mastery, Mindfulness, and Social Support in Older Adults Living with HIV in Coachella Valley, California

HIV-related Stigma, Personal Mastery, Mindfulness, and Social Support in Older Adults Living with HIV in Coachella Valley, California

A cross-sectional study of prevalence and correlates of self-harm and suicidal ideation in older adults with dual sensory loss.

Loss of vision and hearing (dual sensory loss: DSL) presents risk factors for self-harm and/or suicidal ideation, although this has rarely been examined for older adults. This study estimated the prevalence of thoughts about self-harm and suicide ideation in a national sample of adults with DSL in Denmark. All 513 people aged 50 years or older who were registered with the national provider of service for people with DSL in Denmark were eligible to participate. Surveys were returned by 290 participants. Participants were mostly female (70%) and aged 50-100 years (M=81). Surveys contained questions related to thoughts of self-harm and suicide as well as physical, mental, and social wellbeing. In total, 17% of participants reported thoughts of self-harm and/or suicide in the past two weeks. Not participating in social activities, poorer self-rated health, and presence of more depressive symptoms were associated with self-harm and suicidal ideation. Factors that were associated with self-harm and suicidal ideation were lower levels of emotional support, non-participation in social activities, and symptoms of depression. These finding highlight the importance of ongoing mental health screening and support for older adults with DSL, especially in ensuring accessible mental health services.

Quality of life related to functional dependence, family functioning and social support in older adults.

to determine the relationship between quality of life and functional dependence, family functioning and social support in older adults in northeastern Mexico. this is a quantitative, descriptive and analytical study, with 205 older adults. The Barthel Index, Lawton and Brody Scale, APGAR test, Multidimensional Scale of Perceived Social Support and WHOQOL-BREF were applied. the physical, psychological and social dimensions of quality of life are related to functional capacity, family functioning and social support (p< 0.05). Functional capacity and social support predict physical and psychological quality of life. Basic activities, family function and social support predict social quality of life. Instrumental activities and social support predict environmental quality of life. quality of life depends on functional independence, family function and positive perceived health. Independence in basic activities and adequate social support improve physical quality of life. Being independent in basic activities and social support improve psychological quality of life. When presenting a decrease in independence in instrumental activities, perceived quality of life decreases.

Barriers to the Prevalence of Dentistry to Improve the Quality of Medical Treatment in Acute Care Hospitals Supporting Older Adults

Barriers to the Prevalence of Dentistry to Improve the Quality of Medical Treatment in Acute Care Hospitals Supporting Older Adults

Perspectives on How Fall Prevention Technologies Can Support Older Adults’ Self-Monitoring Processes

Fall risk increases as older adults lose the functional resources necessary to maintain balance while completing everyday activities. As functional resources often decline gradually with age, momentary deficits may not be apparent until after a fall occurs. Mobile fall prevention technologies could support older adults in self-monitoring their ability to safely navigate their environments. In this paper we present perspectives on self-monitoring and feedback in a sample of older adults (n = 20, 50% female, age 65+) who had self-assessed their balance via a smartphone for 30 consecutive days. Thematic analysis of semi-structured interviews showed that fall history differentiated a) participants’ awareness of day-to-day variation in functional ability; b) trust in the accuracy of self-monitoring; and c) imaginations of what types of feedback a mobile fall prevention technology should provide. Insight on older adults’ internal self-monitoring processes and guidelines for feedback design are discussed.

Older Americans With Disability Are Vulnerable to Economic and Food Insecurity During COVID-19

This study investigated whether older Americans with physical disability were vulnerable to three types of economic insecurity (difficulty paying regular bills, difficulty paying medical bills, income loss) and two types of food insecurity (economic obstacles, logistical obstacles) during the early months of the COVID-19 pandemic. We evaluated the extent to which associations are moderated by three personal characteristics (age, sex, race/ethnicity) and two pandemic-specific risk factors (job loss, COVID-19 diagnosis). Data were from a random 25 percent subsample of the Health and Retirement Study participants who completed a COVID-19 module administered in 2020. Our analytic sample included 3,166 adults aged 51 and older. We estimated logistic regression models to document the odds of experiencing each hardship. Persons with three or more functional limitations reported significantly higher odds of both types of food insecurity, and difficulty paying regular and medical bills, relative to those with no limitations. After controlling for health conditions, effects were no longer significant for paying medical bills, and attenuated yet remained statistically significant for other outcomes. Patterns did not differ significantly on the basis of the moderator variables. Older adults with more functional limitations are vulnerable to economic and food insecurity during the pandemic, potentially exacerbating the physical and emotional health threats imposed by the pandemic. Our findings reveal an urgent need to promote policies and procedures to protect older adults with disability from economic and food insecurity. Supports for older adults with disability should focus on logistical as well as financial support for ensuring food security.

Employers’ Support of Older Adults Facing Ageism in the Workplace: A Scoping Review of the Literature

Abstract As the Canadian population continues to age rapidly, addressing the social structures that negatively impact older adults is of increasing importance. The most prominent of these social structures is the workplace, which can be a potential source of age discrimination. The goal of this scoping review was to analyze the literature that addresses strategies for employers to support older workers experiencing ageism, in order to answer the research question: How can employers support older adults (50+) facing ageism in the workplace? Following Arksey and O’Malley’s five-step framework, an electronic database and grey literature search was conducted between September and December 2020. Thematic content analysis was performed to establish key themes. The search revealed 3,635 peer-reviewed and grey literature sources that were evaluated by three investigators. Thirty-six articles, published between 2006 and 2020, met inclusion criteria and examined various support strategies for employers. Five major emerging themes were identified from the literature: (1) Recruitment practices, (2) Training opportunities, (3) Education for managers, leaders, and employees in the workplace, (4) Flexible employment opportunities, and (5) Methods to change the psycho-social environment of the workplace. Implementation of these interventions is required to support older adults who may be experiencing workplace ageism. Longitudinal research of these interventions is required to determine the lasting effects of these strategies; however, the existing literature supports the implementation of these supportive actions, which is vital to ensuring that older adults are able to attain and maintain valuable work, in healthy environments, now and into the future.

Determinants of Intention to Use Digital Technology for Older Adults by Environmental Dimensions

Due to the COVID-19 pandemic, it is common to hear news of older adults being socially isolated due to difficulties in purchasing or accessing online services and in interacting with family or friends through video calling apps. Despite an increasing ease of access to digital devices, such access far from universal. Thus, digital inequality has become a serious problem for older adults. To understand why digital inequality issues are so relevant for older adults, we must understand older adults' entire life contexts and the potential of digital technologies in their lives. With these understandings, the purpose of this study was to explore the technology acceptance process and identify key precursors to acceptance of digital technology using the Technology Acceptance Model (TAM) 3 as a framework. This study used data from the 2018 Digital Divide Survey of the Ministry of Science and ICT. A total of 1,662 older adults (aged 55+) were analyzed using structural equation modeling with bootstrap sampling. Model fit indices (CFI = .928; SRMR = .074; RMSEA = .044) suggested an acceptable fit. Results indicated that two environmental dimensions, personal environment (self-efficacy and value recognition) and social environment (social norms and social support systems), had a significant impact on the intention to use technology both directly and indirectly. Furthermore, perceived usefulness and perceived ease of use mediated between environmental domains and the intention. This study indicates that providing appropriate digital support for older adults is important to achieve greater digital inclusion.

Carer Café in Taiwan: An Innovative Model Providing Caregiver Support for Older Adults

Physical places and environments play critical roles in shaping how people interact. This paper introduces an innovative Carer Café model in Taiwan with social infrastructure support and services for family caregivers caring for older adults. Carer cafés are community-based initiatives of Taiwan Association of Family Caregivers (TAFC), aiming to help carers recognizing their own needs and increase awareness of long-term care resources available. Through partnerships with local coffee shops, respite-focused services are provided. The “free coffee for two” campaign encourages family members and friends taking a caregiver out for a “respite coffee”. Carer Café has also become an important “third place” hosting respite programs and the “a shop within a shop” style creating designated space to build a sense of community. Pilot survey (n=375) showed 77% perceived reduced stress, 83% appreciated services provided, and 250% increased referrals within one year. Implications on impact and future opportunities will be discussed.

The Association Between Online Social Network Support and Fear of COVID-19 Among Older Adults

Public health concerns related to the COVID-19 health crisis are particularly salient among older adults. Fear surrounding COVID-19 has also been associated with increased spread, morbidity, and mortality of the disease. Prior to the pandemic, loneliness and social isolation were already a concern for older adults, and the pandemic further constrained how older adults may socially connect with others because of public health safety precautions. Social networks are a valuable form of support for older adults, and to our knowledge limited prior research has addressed whether social networks are associated with fear of COVID-19. Thus, the purpose of this study is to examine the association between social network and fear of COVID-19 among older adults. A convenience sample (n = 239) of adults 60+ years of age in the U.S. completed a 20-minute survey online or by phone. The independent variable was social network support measured by six items which asked about in-person and virtual contacts with members of the same and other generations. The dependent variable was measured by the Fear of COVID-19 scale (seven items). Results of ordinary least squares regression show that increased social network support was significantly associated with decreased fear of COVID-19 (p < 0.05), while holding constant age, sex, race, marital status, education, whether a respondent lives alone, and self-rated health. Findings highlight the importance of social networks for older adults during the COVID-19 crisis. Existing social networks which engage older adults should be expanded, with the knowledge that such efforts may also help reduce fear of COVID-19 for older adults.

Developing Educational Materials to Support Older Adults With Hypertension Management

A comprehensive approach to hypertension management requires medication adherence as well as more general health behavior changes. Our primary objective is to provide evidence-based and tailored education about hypertension, medications, and health self-management strategies with consideration for different stages of behavior change, health literacy, education, disease knowledge, and experience. To facilitate health behavior change, enable information seeking, and increase engagement, the educational materials provide different layers of information, including tips and information in the MEDSReM app, as well as more detailed educational content on the web portal. We will present examples of the materials in different formats to show how they are tailored to ease comprehension, support adherence, and influence behavior change. These educational materials will have broad utility outside of the MEDSReM system, and will also serve as the education-only comparison condition for the randomized controlled trial.