‘We’re not doing it to be nasty’: Caregivers’ ethical dilemmas in negotiating driving safety with older adults

2021 ◽  
pp. 1-8
Author(s):  
Michelle N. Lafrance ◽  
Elizabeth Dreise ◽  
Lynne Gouliquer ◽  
Carmen Poulin
Keyword(s):  
Older Adults ◽  
Older Adult ◽  
Thematic Analysis ◽  
Ethical Dilemmas ◽  
Informal Caregivers ◽  
Health Conditions ◽  
Driving Safety ◽  
Loved One ◽  
Study Participants ◽  
Ability To Drive

Abstract The purpose of this research was to investigate how informal caregivers of older adults cope with and negotiate driving safety when their loved one is no longer safe to drive. Fifteen informal caregivers of an older adult living at home took part in the present study. Participants cared for individuals with a range of health conditions that significantly impaired driving safety, including dementia, Parkinson’s disease, macular degeneration, and stroke. A thematic analysis of participants’ accounts identified the complex interpersonal, social, and organisational context they encountered when their loved one did not recognise or acknowledge limitations in their ability to drive. This analysis highlights the ethical dilemma at the heart of caregivers’ experiences and identifies stake and blame as key considerations in the development of sensitive and effective policies and practices.

scholarly journals Interviewing an Elder: Students’ Perceptions of Change in an Introduction to Gerontology Classroom

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 102-102
Author(s):  
Sarah Hahn
Keyword(s):  
Older Adults ◽  
Older Adult ◽  
Thematic Analysis ◽  
Qualitative Data ◽  
High Impact ◽  
High Impact Practices ◽  
Positive Attitudes ◽  
Attitudes Toward Older Adults

Abstract Within the gerontological classroom, high-impact practices and creative assignments have consistently shown to help engage students, optimize learning, and increase positive attitudes toward older adults and aging (e.g., Chonody, 2015; Yamashita, et al., 2018). One such creative assignment, interviewing an older adult, has been cited as both an influential and valuable experience to gerontology students (e.g., O’Hanlon & Brookover, 2002). Although this assignment has been popular in and out of gerontology courses, more data regarding this and student’s understanding is needed. As such, this presentation aims to 1) introduce and establish the value of using the written assignment, "Interview an Elder" in the gerontology classroom and 2) present preliminary qualitative data on how students’ perceptions of older adults changed after the assignment. Using thematic analysis, results suggest that students are not only surprised by what they learned, but have increased positive perceptions of older adults overall.

Driving, transportation, and mobility in the older adult

2017 ◽  
pp. 1303-1310
Author(s):  
Benjamin M. Shapiro ◽  
L. Jaime Fitten
Keyword(s):  
Older Adults ◽  
Older Adult ◽  
Well Being ◽  
Driving Safety ◽  
Crash Risk ◽  
Accident Risk ◽  
Healthy Older Adults ◽  
Crash Rates ◽  
Normal Ageing ◽  
The Impact

Older adults drive more miles than prior generations and have mobility and transportation needs that are central to independence and well-being. While older adult crash rates have decreased due to safety improvements, those aged 80 years and older have higher morbidity and mortality from crashes due to physical vulnerabilities. Normal ageing is associated with cognitive, motor, and sensory changes that prompt healthy older adults to modify their driving. Older adults use a wide range of potentially driver-impairing medications that increase accident risk. Glaucoma, visual field changes from strokes, and other impairments assessed in the Useful Field of View test can significantly increase crash risk. Moderate and advanced dementia results in unsafe driving due to the impact on ‘process skills’, resulting in the prevailing opinion that they should not drive. However, there is no appropriate screening instrument to assess driving safety among older adults.

Preventing Harm to Vulnerable Older Adults: A Social Justice Perspective

2021 ◽  
pp. 104973152110109
Author(s):  
Joan Braun
Keyword(s):  
Older Adults ◽  
Social Justice ◽  
Social Workers ◽  
Older Adult ◽  
Elder Abuse ◽  
Theory Method ◽  
Grounded Theory Method ◽  
Statutory Authority ◽  
Study Participants ◽  
Vulnerable Adults

This article presents the results from a qualitative study that explored how legislation in British Columbia, intended to protect vulnerable adults from harm, is implemented in practice. The legislation contains guiding principles that require the least restrictive and minimally intrusive form of support or intervention be used and that the adult’s wishes be respected. Sixteen professionals who work as elder abuse responders in British Columba participated in this study through interviews and a focus group. Fifteen of the study participants were social workers. Grounded theory method was used, and themes were identified. The first theme reveals that responders prefer to obtain older adult consent to service provider involvement, rather than forcing compliance by using statutory authority. The second theme reveals that responders may not be able to intervene in a minimally intrusive manner because of resource shortages and organizational structural issues. These findings have human rights and social justice implications.

scholarly journals Walking football initiation and maintenance in older adults: a mixed-methods investigation

2021 ◽  
Author(s):  
◽  
Rachel Catherine Cholerton
Keyword(s):  
Older Adults ◽  
Mixed Methods ◽  
Older Adult ◽  
Healthy Lifestyle ◽  
Health Conditions ◽  
Future Research ◽  
Complex Nature ◽  
The United Kingdom ◽  
Healthcare Needs ◽  
Intention To Continue

For older adults, physical activity (PA) is important to maintain a healthy lifestyle, and benefits include higher mobility and less healthcare needs (Age UK, 2018; Guzman-Castillo et al., 2017; Hambrook et al., 2020). Despite this, there are still a large number of older adults in the United Kingdom (UK) who are inactive (Sport England, 2020a), and research suggests few older adults maintain PA long-term (Kendrick et al., 2018; Van Der Deijl et al., 2014). Interventions to increase PA in older adults include sport, the benefits of which include managing mental health conditions, and reporting less sedentary behaviour in older adulthood (Eime et al., 2010; Gayman et al., 2017). Adapted sports such as walking football have also gained popularity (Lloyd, 2019), and understanding the experiences of those participating could inform design of accessible sport interventions to increase levels of older adult PA. A mixed-methods programme of research was undertaken. Studies one and two explored initiation and maintenance experiences of 55-75 year-old walking football players. Influences related to initiation of walking football included sporting identity, player values, and empowering players to cognitively and socially develop in older age. Influences related to maintenance of walking football included awareness of walking football benefits, positive walking football culture and availability of maintenance resources. Informed by study one and two findings, an empirically grounded survey was developed in study three to investigate differences in walking football initiation and maintenance influences, across key respondent characteristics in 50-75 year-old adults (chapter six). Further analysis investigated what characteristics and influences contribute to players returning to walking football after the Coronavirus-19 pandemic. Analysis found significant differences in social influences in initiation and maintenance across the number of health conditions. Regression analyses found walking football culture and maintenance resources (e.g. scheduling sessions) during maintenance contributed to the intention to continue playing after Coronavirus-19 pandemic restrictions were eased. Findings highlight the complex nature of older adult walking football participation, but show support for encouraging social interactions in those with health conditions, and creating a positive walking football culture and encouraging older adults to increase maintenance resources, in order to continue walking football play. The thesis provides club, coach and sporting body recommendations, and recommends that future research focuses on exploring the walking football culture in more detail, and the implementation of maintenance resources in aiding older adults to successfully maintain the sport.

scholarly journals National Profiles of Coronavirus Disease – 2019 Mortality Risks by Age Structure and Preexisting Health Conditions

2020 ◽  
Author(s):  
Ashton M Verdery ◽  
Lauren Newmyer ◽  
Brandon Wagner ◽  
Rachel Margolis
Keyword(s):  
Older Adults ◽  
Population Health ◽  
Older Adult ◽  
Age Structure ◽  
Adult Population ◽  
Health Conditions ◽  
Risk Profiles ◽  
Mortality Risks ◽  
Older Adult Population ◽  
Cross National

Abstract Background and Objectives Although individual age and preexisting health conditions are well-documented risk factors for Coronavirus Disease 2019 (COVID-19) mortality, it is unclear whether these two factors capture unique dimensions of risk for epidemic severity at the national level. In addition, no studies have examined whether national distributions of these factors are associated with epidemic experiences to date. Research Design and Methods Drawing on surveys of older adults from 42 countries and estimated case fatality ratios by age and preexisting health conditions, we document and compare national profiles of COVID-19 mortality risks among older adults. We develop two measures of national risk profiles: one based on age structures and another based on distributions of preexisting health conditions. Our analysis compares these constructs and documents their associations with national COVID-19 mortality rates. Results National profiles of COVID-19 mortality risk based on age structure and preexisting health conditions are moderately uncorrelated, capturing different aspects of risk. Both types of national risk profiles correlate meaningfully with countries’ COVID-19 mortality experiences to date. Discussion and Implications Measures of population age structure are readily available for every country in the world, while cross-national measures of older adult population health are more limited. In the COVID-19 crisis, these factors give different pictures of the countries with high and low risks of COVID-19 mortality. Moreover, our results suggest that both types of national risk profiles based on population health reflect current COVID-19 mortality severity in several countries, highlighting the need for more cross-national comparative data on older adult population health.

scholarly journals Lack of Diversity in Personal Health Record Evaluations with Older Adult Participants: A Systematic Review of Literature

2017 ◽  
Vol 23 (4) ◽  
pp. 789 ◽  
Author(s):  
Laura Kneale ◽  
George Demiris
Keyword(s):  
Older Adults ◽  
Older Adult ◽  
Evaluation Studies ◽  
Personal Health Record ◽  
The Body ◽  
Personal Health ◽  
Inclusion Criteria ◽  
Adult Participants ◽  
Full Text Review ◽  
Study Participants

Background: Older adults are not adopting personal health records (PHRs) at the same rates as other adult populations. Disparities in adoption rates are also reported in older adult subgroups. The variability in adoption may be because PHRs are not designed to meet older adult users.Objective: We analyzed PHR evaluation studies to examine the characteristics and perspectives of older adult study participants to identify their self-reported needs.Method: We searched Medline, CINAHL, PsycINFO, and Embase for PHR evaluation studies that involved older adult participants.Results: 1017 abstracts were identified, and 179 publications went through full text review. 10 publications met inclusion criteria. These publications described studies conducted in 3 countries, and evaluated 7 PHRs. Homogeneity was found in the study populations and participant opinions of the systems.Discussion: Many PHR evaluations do not include diverse older adult participants. This may lead to consistency in outcomes, but it also may create gaps in identifying user needs. Additional studies, specifically targeting diverse older adult participants, are needed to gain a more comprehensive understanding of the opinions of older adults on PHRs and how these systems could benefit older adult healthcare consumers.Conclusion: The body of research shows that older adults are highly satisfied using PHRs. These outcomes may be generalizable because most PHR evaluation studies do not include diverse older adult participants. This lack of participant diversity may be contributing to the disparities observed in PHR adoption rates.

scholarly journals A scoping review of age-related health conditions among geriatric populations in sub-Saharan Africa

2019 ◽  
Author(s):  
Keshena Naidoo ◽  
Jacqueline van Wyk
Keyword(s):  
Older Adults ◽  
Older Adult ◽  
Scoping Review ◽  
The Body ◽  
Health Needs ◽  
Sub Saharan Africa ◽  
Health Conditions ◽  
Age Related ◽  
Modifiable Factors ◽  
Sub Saharan

Abstract Background Globally people are living longer, resulting in an increased demand for primary care services to be responsive to geriatric health needs. There is however, little information on the nature and prevalence of age-related health conditions among older adults in the sub-Saharan African (SSA) region. This scoping review was undertaken to synthesise evidence on the scope and nature of age-related health needs among people aged 60 years and older in SSA. Methods We systematically searched five electronic databases for studies published prior to 30 June 2019. Using the keywords “Africa”, “older adult” or “geriatric”, and “health”, two independent reviewers used a set of eligibility criteria to extract and screen the abstracts and full-text publications. Particular focus was given to age-dependent disorders in people over 60 years such as dementia, disability and falls Results Sixty-four studies met the inclusion criteria. The review revealed a noticeable absence of studies from the majority of Sub-Saharan African countries. Publications included for review represent twelve countries from this region. The morbidities reported on included dementia, functional impairment, mental health, falls, sarcopenia and nutritional disorders, sensory impairment, frailty and musculoskeletal disorders. Many of these conditions co-existed among older adults, resulting in impaired quality of life and disability. Modifiable factors for geriatric morbidity such as hypertension, depression, cognitive and sensory impairments were under-diagnosed and often untreated. Low awareness and management of these conditions were noted among health providers and communities in SSA region. Conclusions The body of empiric research and evidence on age-related health conditions in geriatric people in SSA remains small. Further research is required on screening and management programs for age-related conditions in people over 60 years in SSA, and health professions training in the care of older adults. Ethics and dissemination : This study did not include human participants. Data was sourced from published literature. Keywords: older adult - geriatric - aged - health - Africa

scholarly journals Prevalence of stroke, risk factors, disability and care needs in older adults in Singapore: results from the WiSE study

BMJ Open ◽  
2018 ◽  
Vol 8 (3) ◽  
pp. e020285 ◽  
Author(s):  
Wen Lin Teh ◽  
Edimansyah Abdin ◽  
Janhavi Ajit Vaingankar ◽  
Esmond Seow ◽  
Vathsala Sagayadevan ◽  
...  
Keyword(s):  
Older Adults ◽  
Cognitive Functioning ◽  
Older Adult ◽  
Population Sample ◽  
Well Being ◽  
Self Report ◽  
Health Conditions ◽  
Secondary Outcome ◽  
Care Needs ◽  
Stroke Prevalence

ObjectivesThe aims of the present study were to establish the prevalence of stroke, and to explore the association between stroke prevalence and sociodemographic and health factors, disability, cognitive functioning and care needs among older adult residents in Singapore.SettingData were drawn from the Well-being of the Singapore Elderly study—a cross-sectional epidemiological survey conducted from 2012 to 2013 on older adults living in Singapore.ParticipantsParticipants were Singapore residents (citizens and permanent residents) 60 years and above who were living in Singapore during the survey period . Older adult residents who were institutionalised were also included in this study. Those who were not living in Singapore or who were not contactable were excluded from the study. The response rate was 65.6 % (2565/3913). A total population sample of 2562 participants completed the survey. Participants comprised 43.6% males and 56.4% females. The sample comprised 39.4% Chinese, 29.1% Malay, 30.1% Indian and 1.4% other ethnicities .Primary and secondary outcome measuresHistory of stroke, along with other health and mental health conditions, disability and cognitive functioning, were determined by self-report.ResultsWeighted stroke prevalence was 7.6% among older adults aged 60 and above. At a multivariate level, Malay ethnicity (OR 0.41, p=0.012, 95% CI 0.20 to 0.82), hypertension (OR 4.58, p=0.001, 95% CI 1.84 to 11.40), heart trouble (OR 2.45, p=0.006, 95% CI 1.30 to 4.63), diabetes (OR 2.60, p=0.001, 95% CI 1.49 to 4.53) and dementia (OR 3.57, p=0.002, 95% CI 1.57 to 8.12) were associated with stroke prevalence.ConclusionsSeveral findings of this study were consistent with previous reports. Given that Singapore’s population is ageing rapidly, our findings may indicate the need to review existing support services for stroke survivors and their caregivers. Future research could investigate the association between various sociodemographic and health conditions and stroke prevalence to confirm some of the findings of this study.

scholarly journals Certified Older Adult Peer Support Specialists' Use of Technology to Support Older Adults in the Community

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 128-129
Author(s):  
Karen Fortuna
Keyword(s):  
Mental Health ◽  
Older Adults ◽  
Mental Illness ◽  
Physical Health ◽  
Peer Support ◽  
Older Adult ◽  
Serious Mental Illness ◽  
Text Messaging ◽  
Health Conditions ◽  
Middle Aged

Abstract Middle-aged and older adults with mental health conditions have a high likelihood of experiencing comorbid physical health conditions, premature nursing home admissions, and early death compared with the general population of middle-aged and older adults. An emerging workforce of certified older adult peer support specialists aged 50 years or above is one of the fastest growing mental health workforces and may be a suitable community-based workforce to simultaneously support the mental health, physical health, and aging needs of middle-aged and older adults with a serious mental illness. Older adult peer support specialists are people with a lived experience of aging into middle age and older adulthood with a mental health condition. This presentation will present three single-arm pilot studies examining how certified older adult peer support specialists’ incorporate technology, including text messaging, ecological momentary assessments, and smartphone applications into practice and clinical outcomes among older adults with serious mental illness.

Integrating CBT and CFT within a case formulation approach to reduce depression and anxiety in an older adult with a complex mental and physical health history: a single case study

2020 ◽  
Vol 13 ◽  
Author(s):  
Nicola Birdsey
Keyword(s):  
Older Adults ◽  
Physical Health ◽  
Older Adult ◽  
Single Case ◽  
Health Conditions ◽  
Anxiety And Depression ◽  
Case Formulation ◽  
Depression And Anxiety ◽  
Health History ◽  
Mental And Physical Health

Abstract Depression and anxiety are major contributors to growing healthcare costs in the UK, particularly with an increasingly ageing population. However, identification of mental health needs in older adults has been overshadowed by a tendency to focus on physical health issues, despite the established co-morbidity of depression, anxiety and physical health conditions. When older adults seek psychological support, treatment options may vary and may be time limited, either because of protocol guidance or due to the resource constraints of psychology services. Time-limited treatment, common in many adult services, may not best meet the needs of older adults, whose physical, cognitive and emotional needs alter with age. It is, therefore, important to identify treatments that best meet the needs of older adults who seek psychological support, but who may arrive with complex mental and physical health histories. This paper aims to explore how a case formulation-driven approach that draws on the theoretical underpinnings of cognitive behavioural therapy (CBT) and compassion-focused therapy (CFT) can be used to reduce anxiety and depression in an older adult with a complex multi-morbid mental and physical health history. This study employs a single-case (A–B) experimental design [assessment (A), CBT and CFT intervention (B)] over 28 sessions. Results suggest the greatest reductions in depression and anxiety (as measured using PHQ-9 and GAD-7) occurred during the CFT phase of the intervention, although scores failed to drop below subclinical levels in any phase of the intervention. This case highlights the value of incorporating CFT with CBT in case formulation-driven interventions. Key learning aims (1) To consider the value of using case formulation approaches in older adult populations. (2) To demonstrate flexibility in balancing evidence-based interventions with service user needs by incorporating CBT and CFT to treat anxiety and depression in an older adult. (3) To present a clinical case to identify how assessment, formulation and treatment of anxiety and depression are adapted to best meet the needs of older adults with complex co-morbid mental and physical health conditions. (4) To appreciate the impact of contextual factors, such as austerity measures, on therapeutic work with individuals with long-standing mental and physical health difficulties.

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