Understanding Of Older People Research Articles

Three Philosophies of Person‐Centred Care, From the Perspectives of Care Workers and Managers Supporting Older People

ABSTRACTThe prominence of person‐centred care has been widely recognised in recent decades. In England, care governance frameworks prioritise the views and wishes of individual people receiving support. Despite workforce development initiatives linked to this agenda, there remains no consensus on the meaning of person‐centred care in the English care sector. An actor‐centred study explored understandings of person‐centred care from the perspective of care workers and managers working with older people in residential and community care. Analysis of interviews with 20 participants led to development of a typology based on the beliefs, values and practices of the interviewees. The three typological groups interpreted person‐centred care within their own distinctive philosophies: Nurturing Mental Health, Nurturing Agency and Nurturing Intimacy. The findings offer fresh insight into the ways an abstract concept is understood within the context of day‐to‐day practice with older people. Existing workforce development guidance encourages professionals to understand person‐centred care by enacting a series of wide‐ranging, desirable outcomes, which is potentially confusing for those working on the front line. This study shows, instead of trying to be all things to all people, staff emphasise a few specific outcomes and values in enacting person‐centred care, reflecting nuances in their overall understanding of older people's well‐being.

Food insecurity: The resilient, but “silent poverty” perspectives of older ethnic minority individuals within UK communities

AbstractFood insecurity is acknowledged as a key social determinant of health among older adults. Despite recording significantly higher levels of poverty in comparison to white ethnic groups, older individuals from ethnic minorities are under‐represented as recipients of food aid. Thus, there are knowledge gaps in our understanding of older people and their experiences of food insecurity within ethnic minority communities. Through the theoretical lens of Individual and Community Resilience, we empirically advance our understanding of food security and resilience within South Asian communities via in‐depth interviews with community stakeholders and older individuals from Bangladeshi and Pakistani communities across the Greater Manchester region. Our findings reveal that the integration of temporal, environmental and social constructs within a resilience framework reveals significant potential for further negative social, cultural and economic impact on older ethnic minorities in the future, especially as current food support services do not appear to cater for ethnic dietary preferences, language accessibility and/or cultural norms regarding asking for help/charity outside the home. We predict therefore, in combination with the identified persistent stressors, that food insecurity issues within older ethnic minority communities are likely to get much worse, resulting in the need for extensive resilient capacities to cope with future cost‐of‐living challenges. In acknowledging previous limitations within previous resilience frameworks, we propose an incremental contribution to theory and conclude by identifying culturally and operationally appropriate food support system approaches, which can be used to address the increasing prevalence of “silent poverty” within ethnic minority communities.

Managing the Last Move: Older People’s Practical, Relational, and Emotional Work throughout the Transition from Home to a Nursing Home

Moving into a nursing home is a significant transition for older people which can be emotional and stressful. The literature on the decision to move and subsequent residential stress focuses on the time after admission; however, there is less understanding of older people’s management of the process. To fully understand and possibly reduce negative consequences and health-related risks, the aim of this article is to explore how older people manage the transition from home to nursing home. The study is based on 21 longitudinal interviews with seven older people during the process of moving. Following Dorothy Smith’s theory of work, the analysis finds three types of work—practical, relational, and emotional—that older people engage in during the transition process. The results highlight the importance of considering the entire transition process, not only experiences before or after, if we are to reduce the negative, stress-related consequences of relocations of this kind. The findings have practical implications for professionals in health and social care and point to the need to develop practical, relational, and emotional support for older people throughout the transition process.

Forced to live in the present: older people's temporal experiences of the lockdown during the COVID-19 pandemic

Abstract This article explores the temporalities experienced by persons aged 70 years and over during the first months of the COVID-19 pandemic in Finland. Although the temporalities of the pandemic have been analysed from multiple perspectives, we contribute to this line of research in two ways. First, we show how deeply the pandemic affected older people's experiences of temporality. Second, we further develop the concept of forced present to highlight the consequences that the restriction measures had on older persons’ situations and perceptions of temporality. More specifically, we asked the following question: How did older people perceive time (past, present and future) during the pandemic? We used thematic analysis to examine a dataset consisting of written letters (N = 77) collected between April and June 2020. The findings showed that social isolation forced older people to live in the present without being able to plan their near future because they had no knowledge of when they would be ‘free’ again, which made some participants feel anxious and depressed. Furthermore, we found that the present became intertwined with the personal past as well as with the collective past, as evidenced by participants’ descriptions of war, previous pandemics and hardships. This article deepens our understanding of older people's everyday lives during the pandemic and highlights the problematic nature of social isolation of older people as a safety measure. Overall, this article reveals the particularity of older people's experiences in unequal pandemic times and the ageism inherent in the restriction measures.

233 Residents’ experiences of COVID-19 pandemic in a Long-Term Care Facility in Ireland: a qualitative study

Abstract Background COVID-19 fundamentally impacted Long-Term Care Facilities (LTCFs) in Ireland and worldwide. The pandemic resulted in a series of restrictions and limited older people in LTCFs in their daily lives. Learning and understanding the impact COVID-19 had on older people in LTCFs is crucial for future care delivery planning, as those in LTCFs are some of the frailest in society. This study aimed to provide a perspective of that understanding. Methods The study’s objective was to capture a description of the residents’ in-depth experience of COVID-19 in a communal long-term care facility for older people. Individual semi-structured interviews with residents who could consent were held between September to November 2021. Results Ten residents participated in the interview study. Their average stay in the LTC facility at the time of the interview was 3.25 years, with the shortest stay being 1.5 years and the longest being seven years. The gender distribution was 50/50 among the ten residents interviewed. Four main themes were concluded from the transcriptions; coping, loss & grief, resilience and social activities. The themes are interlinked and provide insight into residents’ ability to adapt to critical changes in the LTC facility in an extremely challenging period. Conclusion Although residents mentioned loss, not only about people but also the loss in doing activities, being active within the LTC facilities was essential and helped with coping with COVID-19 restrictions. Understanding residents’ experiences of COVID-19 in nursing homes is crucial to implement improvements as well as acknowledging the impact of COVID-19. Older people in LTCFs are already marginalised by their need for care. Further understanding of older people in LTC experience of a pandemic such as COVID-19 is required. This requires innovative solutions to capture the experience of all living in LTC facilities.

Implementasi Efektifitas Pelvic Floor Exercise Untuk Menurunkan Frekuensi Berkemih Pada Lansia

Pelvic floor exercise in the elderly plays a crucial role as a simple intervention that can be independently performed at home, aiming to address the issue of increased urinary frequency due to the decline in musculoskeletal and urinary physiological functions caused by the weakening of the sphincter muscles. In this effort, the activity aims to raise awareness about the importance of pelvic floor muscle exercises to reduce urinary frequency and the risk of urinary incontinence in the elderly. The implementation of this activity focuses on the area of the Healthy Elderly Integrated Service Post (Posyandu Lansia Sehat), with the goal of directly involving the elderly in maintaining their health quality. Community service projects employ a participatory approach through lectures, debates, demonstrations, and direct re-demonstrations to expand older people's understanding of pelvic floor exercises. One method for analyzing and assessing the degree of knowledge among older people is questionnaires. Conclusion community service activities carried out in the Jelidro community regarding pelvic floor exercise to reduce urinary frequency in older people can be understood by the percentage of 74% of questionnaire results. It can be done independently at home to maintain the physiological function of the pelvic muscle.

Existential Loneliness Among Older People from the Perspective of Health Care Professionals: A European Multicenter Study.

Health care professionals (HCPs) encounter different forms of loneliness in their work. It is essential that they have the courage, skills, and tools to deal with loneliness, in particular with existential loneliness (EL) which relates to meaning in life and the fundamentals of living and dying. The aim of this study was to investigate HCPs' views on loneliness among older people and their understanding, perception, and professional experience of EL in older people. In all, 139 HCPs from five European countries participated in audio-recorded focus group and individual interviews. The transcribed materials were locally analyzed using a predefined template. The participating countries' results were then translated, merged, and inductively analyzed using conventional content analysis. Participants described different forms of loneliness - a negative form that is unwanted and causes suffering, and a positive form where solitude is desired and sought. The results showed that the HCPs' knowledge and understanding of EL varied. The HCPs mainly related EL to different types of loss, eg loss of autonomy, independence, hope, and faith, and to concern alienation, guilt, regret and remorse, and concerns about the future. The HCPs expressed a need to improve their sensitivity and self-confidence to engage in existential conversations. They also stated the need to increase their knowledge and understanding of aging, death, and dying. Based on these results, a training program aimed to increase knowledge and understanding of older people's situation has been developed. The program includes practical training in conversations about emotional and existential aspects, based on recurrent reflections on the topics presented. The program is available at: www.aloneproject.eu.

Improving practicing nurses' knowledge andperceptions of older people: a quasi-experimental study.

This study aimed to determine if an e-learning module about understanding and communicating with older people can improve practicing nurses' ageist perceptions about older people. We used a quasi-experimental pre-post-test design. Participants completed a 13-item Ambivalent Ageism Scale before and after completing the Understanding and Communicating with Older People e-learning module as well as a Likert-style feedback survey with the option for written feedback on an open-ended question. Pre-post-test comparisons indicated a statistically significant decrease in ageist attitudes and self-reported increases in knowledge and confidence in working with older people. Qualitative analysis of written feedback revealed that most participants felt the module enhanced their understanding of older people. The e-learning activity has the potential to improve practicing nurses' knowledge and perceptions about working with older people and is likely to be associated with better patient-level outcomes.

Longer working lives – what do they mean in practice – a case of the Baltic countries

PurposeThe article seeks to contribute to a better understanding of older people's situation in the labour market in three Baltic countries – Estonia, Latvia and Lithuania. Three Nordic countries are taken as a reference point to compare the countries in order to better understand the situation from a comparative point of view. The article asks the questions: Does a longer working life for older people contribute to their better economic situation? How satisfied are they with a longer working life and their working conditions? Do they experience any discrimination in the labour market because of their age?Design/methodology/approachIn order to understand the situation of older people in the labour market, the authors employ welfare state models and the Active Ageing Index. The welfare state models help us to understand the context in which the working life of older people is taking place. The Active Ageing Index helps to gain a better understanding of the employment domain of active ageing. The analysis is based on several Europe-wide data sources: statistics on earnings from Eurostat database, information on income, job prospects, occupational safety and health, training, working life perspectives from the European Working Conditions Survey as well as a special survey, conducted by the authors, of Lithuanian, Latvian and Estonian residents aged 50 years and older.FindingsAnalysis conducted reveals that in the Baltic countries older employees, although actively participating in the labour market, face unfavourable material, physical and psychological situation in the labour market more frequently than their younger colleagues. The findings show that the most important factors influencing older employees' decision to stay longer in the labour market in the Baltic countries are linked mostly to welfare state-related issues, i.e. financial benefits, healthcare, possibility to reconcile work and family obligations. These welfare state-related issues are even more important for those who are going to stay longer in the labour market after reaching the retirement age.Originality/valueThis article contributes to a better understanding of older (50+) people's situation in the labour market. It suggests that, while the increasing employment of older people increases the Active Ageing Index and is generally viewed positively, in some countries with less developed welfare states high employment rates of older employees, although providing them with an additional means of livelihood, do not ensure a higher quality of life and, on the contrary, act as a factor reducing the quality of work and, at the same time, the quality of life.

Validation of the Stolwijk and Tanabe Human Thermoregulation Models for Predicting Local Skin Temperatures of Older People under Thermal Transient Conditions

Human thermoregulation models can predict human thermal responses to evaluate thermal comfort and help create a healthy environment, while their applicability to older people has not been sufficiently validated. This study aimed to evaluate the performance of the Stolwijk model and the Tanabe model for predicting older people’s mean and local skin temperatures under thermal transient conditions. Eighteen healthy older people were recruited and exposed to transient environments including neutral (26 °C), low-temperature (23 and 21 °C), and high-temperature (29 and 32 °C) conditions. The local skin temperatures of the subjects were measured and compared to predictions of the Stolwijk model and the Tanabe model. The results revealed that the Stolwijk model and the Tanabe model could accurately predict the mean skin temperature of older people under neutral and high-temperature conditions, while their predictive accuracy declined under low-temperature conditions. Increased deviations were observed in the predictions of local skin temperatures for all conditions. This work attempted to provide an understanding of older people’s thermal response characteristics under transient conditions and to inspire the improvement of thermoregulation models for older people.

Older workers: Past, present and future

In this article, we focus on the ever-growing numbers of older workers and considerations for workplace practices and policies that make the most from the qualities older workers bring. To begin, we explore the socio-political context examining employment trends for older workers and highlight policies and trends that inform workforce planning. We then extend the discussion of older workers from the perspective of person–environment (P-E) fit, entrepreneurship, resilience and cognitive functioning. Each of these perspectives have received increased research and practitioner attention over the past two decades. They present opportunities to increase our understanding of older people in a workplace context and how to support older workers in a socio-political environment focused on career longevity. We argue that a new national strategy is needed to guide future initiatives and policy development. We propose future research directions and practitioner intervention prospects. JEL Classification: M54

Media education for older people - views of stakeholders

ABSTRACTThis study is a part of an ongoing design-based research (DBR) project aimed at designing, piloting, and assessing a digital study module focused on older people’s media education. In order to gain a better understanding of older people’s media literacy and develop the teaching of adult educators, participatory creative workshops for a total of thirty-one stakeholders (older people and professionals who work with them) were conducted. Research data was collected from these workshops through a case exercise from stakeholders and a questionnaire from older people during the year 2019. According to the stakeholders, older people need more training in all the dimensions of media literacy, which is understood as competence in accessing, using, understanding, creating, and critically analyzing different media texts. However, use dimension was the most featured dimension in the data. In addition, older people are a heterogeneous group and it is essential that media education is tailored to meet the current needs of older people. The results indicate that media education should be designed especially to address the needs and individuality of older people.

The Role of Sexual Activity from the Perspective of Older Adults: A Qualitative Study.

Despite a growing amount of literature on aging and sexual activity, there are still a limited number of studies that capture older people's understanding of sexuality in later life. This study explored the meanings that older people ascribe to sexual activity and how these meanings relate to the continuation, the decline, and the complete cessation of sexual activity. Thirty in-depth semi-structured interviews were conducted with Czechs aged 50-75 years (13 men) who were recruited through a preventive cognitive health program offered at a hospital. The analysis was carried out with a grounded theory approach and the principles of consensual qualitative research. The study identified three dominant understandings of sexual activity in later life that emerged as a reflection of the aging process. The first was sexual activity within a relationship that represented proof of being with someone and where sexual inactivity was linked to the threat of loneliness. The second concerned sexual pleasure and its continuity in later life, while its loss gave room for affliction and the emergence of ageist beliefs. The third linked sexual activity with the connotations of self-identifying as young versus being self-perceived as really old. The study findings suggest that the understanding of sexual activity in later life is ambivalent. Its continuity is viewed as an instrument for mitigating the markers of getting old, while the threat of its decline may activate older people's desire for asexual aging and negative views on aging.

Kdo by měl dělat výzkum mezi seniory a seniorkami? Vliv charakteristik tazatele a respondenta ve výzkumech stárnutí a stáří

Who Should Interview Older People? The Effect of Interviewer and Interviewee Characteristics in Surveys of Older People and Aging Topics. Objectives: Aging of the population has increased the need to gain a better understanding of older people’s experiences, especially by collecting their views on various issues and quantitative surveys are frequently used methods. Methods: Five hypotheses are presented on assumption that the characteristics of the respondent and the characteristics of the interviewer (age and gender) significantly affect the interviewer's perceived difficulty in conducting the interview with respondents in higher age on aging related topics. Pooled data from seven quantitative surveys are used to test these hypotheses with multi-level linear regression. Results: Results show that age of interviewers increases the perceived difficulty only slightly if we control for the influence of the gender of the interviewer and the respondent's age and education. Also, more positively aging respondents make the interviews about aging topic easier for interviewers. These influences vary in each of the survey projects and topic. Discussion: Age- and gender-sensitive training and supervision when age/gender sensitive topics are to be surveyed is, according to our results here, strongly advisable.

Understanding functional ability: Perspectives of nurses and older people living in long-term care

The functional ability of older people has come to play a significant role in their care. Policies and public debate promote active aging and the need to maintain functioning in old age, including among older people living in long-term care. This study explores the meanings given to functional ability in the interview talk of long-term care nurses (n=24) and older people living in long-term care (n=16). The study is based on discourse analysis and positioning theory.In this study, accounts of functioning differed between nurses and older residents. For the nurses, functional ability was about the basic functions of everyday life, and they often used formal and theoretical language, whereas for older long-term care residents, functional ability was a more versatile concept. Being active was promoted, particularly in the nurses' talk but also sometimes in residents' talk, thereby reflecting the public discourse about functioning. In their talk, the nurses positioned themselves in relation to functional ability as competent professionals and active caregivers. In residents' talk, we found three positions: an active individual taking care of him or herself, a recipient of help, and a burden to nurses. To move in a direction that promotes activity and rehabilitative care, a better understanding of older people's individual needs and their own views of functional ability is needed.

"Holding on to What I Do": Experiences of Older Slovenians Moving into a Care Home.

This qualitative study explored Slovenian older people's experiences of transition into a care home and the influence on their everyday engagement in meaningful occupations. A longitudinal, phenomenological approach was employed. Semistructured interviews with six Slovenian older adults were conducted at three time intervals: before the relocation, 1 month after, and 6 months after the relocation into a care home. Interpretative Phenomenological Analysis was used for the study design and analysis. One overarching theme from the research findings Holding on to what I do is presented in depth. Although the participants' everyday occupations were challenged throughout the transition, they tried to maintain their most meaningful occupations that were an important part of their identity. Three superordinate themes underpinned this overarching theme: This is who I am, Adjusting my daily occupations, and The value of health. The study indicated the need to develop programs and services for older adults transitioning from home into a care home environment. Focusing on enabling older people to maintain their engagement in meaningful occupations as an important part of their identity is imperative. This study brings a better understanding of older people's experiences of transition into a care home from an occupational perspective. It has the potential to influence how elder care is planned and implemented in Slovenia and further afield.

Perceived autonomy support, psychological needs satisfaction, depressive symptoms and apathy in French hospitalized older people

Based on the self-determination theory, the aim of the present study was (1) to provide a better understanding of older people’s psychological needs satisfaction in geriatric care units, then to link this information with depressive symptoms and apathy; (2) to examine whether the perceived autonomy support from health care professionals differs between needs satisfaction profiles; and (3) to investigate for all participants how each need satisfaction was related to depressive symptoms and apathy. Participants (N=100; Mage=83.33years, SD=7.78, 61% female) completed the measures of psychological needs satisfaction, perceived autonomy support, geriatric depression and apathy. Sociodemographic data were also collected. Cluster analyses showed three distinct profiles: one profile with low-moderate need satisfaction, one profile with high-moderate need satisfaction and one profile with high need satisfaction. These profiles are distinct, and did not differ in terms of participants' characteristics, except gender. Multivariate analysis of covariance (MANCOVA) revealed that participants with low-moderate need satisfaction profile have significantly higher level of depressive symptoms and apathy, and lower levels of perceived autonomy support than participants of the two other profiles. Moreover, for all participants, regression analyses revealed that both competence and relatedness needs satisfaction significantly and negatively explained 28% of the variance in depressive symptoms score and 44% of the variance in apathy score. Our results highlight the interest to examine more thoroughly the variables fostering autonomy-supportive environment in geriatric care units, and to deepen the relationship between competence and relatedness needs satisfaction and depressive symptoms and apathy.

Experience, knowledge and attitudes: Are paramedic students prepared to care for older patients?

ABSTRACTAs the population ages, so does the number of older patients encountered by paramedics. It is vital that paramedics are adequately prepared to meet the unique and growing needs of these patients. Experience and education play key roles in the formation of attitudes that impact behavior, and ultimately patient care. The aim of this study was to determine the level of student paramedic experience with knowledge of, and attitudes toward, older adults and to examine the relationship between these factors. This was a cross-sectional study utilizing three paper-based questionnaires; Experience with Older Adults Questionnaire, Australian Facts on Aging Quiz 2 (FAQ2), and Aging Semantic Differential (ASD). Of the 871 paramedic student participants, 79% had an oldest living grandparent 65 years old or above, and 63% had encountered older adults on clinical placement. The mean (SD) score for the FAQ2 was 12.7 (3.0) out of a possible 25, indicating a low level of knowledge about older people. The mean (SD) score for the ASD was 120.3 (17.77), indicating slightly positive attitudes toward older adults. Knowledge (β = −0.06; p = .058) and experience (β = −0.06; p = .058) had weak associations with attitudes. Student paramedics have some prior experience with older adults, relatively low knowledge and generally positive attitudes. There is some association between these factors; however, the impact on patient care requires further investigation. Paramedic educators should strive to provide students with broad quality experiences and education that increases awareness and understanding of older people.

Technology and trust: older people's perspectives of a home monitoring system

ABSTRACTWith demographic changes and the growing numbers of older people living alone, concerns have been raised about the care of the ageing population. Increasingly, developments in technology are being seen as the solution to these concerns. For those who do not see themselves as old or frail enough to require personal care provision, and who prefer to maintain their identity as autonomous and independent individuals, the development of assistive technologies such as ambient home monitoring systems is one answer. However, this involves careful negotiations with older people's understandings of safety and privacy, and their experiences and relationships with technology, their carers and relevant service-providers. In two trials of a home monitoring system funded by the United Kingdom Technology Strategy Board, older people were interviewed pre-trial and post-trial about their perspectives on these issues. This paper presents a conceptual analysis of the qualitative data using a sociological framework of trust that considers habitual action, and relationships with kin and with wider institutions. The research found that older people's habits and norms do not need to be disrupted by the ambient system. What was of more importance was relationships between the older person and her or his ‘monitor’ based on trust, as well as institutional providers who need to instil or earn trust.

Choice and control for older people using home care services: how far have council-managed personal budgets helped?

Purpose– The purpose of this paper is to report the experiences of older people who use council-managed personal budgets (PBs) to fund home care services and their satisfaction with the level of choice and control they are able to exercise.Design/methodology/approach– Data were collected from 18 older people from eight home care agencies across three councils in England. All interviews were semi-structured and face-to-face.Findings– Despite some optimism about improvements in choice and flexibility experienced by older people using home care services, the findings from this small study suggest that the gap between the “ideal” of user choice and the “reality” of practice continues to be significant. The level of choice and control older people felt able to exercise to tailor home care services to their personal needs and preferences was restricted to low level choices. Other choices were constrained by the low levels of older people's PBs and council restrictions on what PBs can be spent on. Older people's understanding of limitations in public funding/pressures on agencies and their reluctance to play an active consumer role including willingness to “exit” from unsatisfactory care arrangements appeared to further challenge the potential for achieving greater choice and control through council-managed PBs.Originality/value– The English government's policy emphasis on personalisation of care and support and new organisational arrangements for managed PBs aim to promote user choice and control. This is the first study to report the experiences of older people using managed PBs under these new arrangements. The paper highlights areas of interests and concerns that social care staff, support planners and commissioners may need to consider.