A Theoretical Framework for the Development of Views of One’s Own Aging

Abstract Senior mentoring programs have been established that provide medical students exposure to a community-dwelling older adult mentor. The goal of these programs is to expose students to healthy older adults, increase knowledge of geriatrics, and prepare them to care for an aging population. However, even while participating in a senior mentoring program, health professions students still demonstrate some discriminatory language towards older adults (e.g., Gendron, Inker, & Welleford, 2018). In fact, research suggests ageist practices occur, intentionally or not, among all health professions and within assisted living and long-term care facilities (e.g., Bowling, 1999; Dobbs et al., 2008; Kane & Kane, 2005). There is reason to believe that how we feel about other older adults is a reflection of how we feel about ourselves as aging individuals. As part of an evaluation of a Senior Mentoring program, we found that students’ attitudes towards older adults were not significantly improved (t (92) = .38, p = .70). To further explore this, we collected subsequent qualitative data. Specifically, we asked students to respond to the open-ended prompt before and after completing their senior mentoring program: How do you feel about your own aging? Our findings have revealed just how complex students’ views towards aging and elderhood are, pointing to a need to develop a theoretical framework for how these views are formed. Thus, the results of this qualitative grounded theory study illustrate the stages of development medical students’ progress through as they come to accept themselves as aging humans.

Download Full-text

KNOWLEDGE OF AGEISM AND ATTITUDES ABOUT AGING AS A CORE COMPETENCY FOR HEALTH PROFESSIONALS

Innovation in Aging ◽

10.1093/geroni/igz038.3067 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S832-S833

Author(s):

Sarah Marrs ◽

Tracey Gendron ◽

Leland Waters ◽

Jenny Inker ◽

Maddie McIntyre

Keyword(s):

Older Adults ◽

Medical Students ◽

Older Adult ◽

Medical Training ◽

Qualitative Content Analysis ◽

Health Professions ◽

Community Dwelling ◽

Mentoring Program ◽

Term Care ◽

The Impact

Abstract Senior mentoring programs have been established that provide medical students exposure to a community-dwelling older adult mentor with whom they meet multiple times throughout the program. The goal of these programs is to expose students to healthy older adults, increase knowledge of geriatrics, and prepare them to care for an aging population. However, even while participating in a senior mentoring program, health professions students still demonstrate some discriminatory language towards older adults (e.g., Gendron, Inker, & Welleford, 2018). In fact, research suggests ageist practices occur, intentionally or not, among health professions in disciplines such as medicine, nursing, and social work and even within assisted and long-term care facilities (e.g., Bowling, 1999; Dobbs et al., 2008; Kane & Kane, 2005). We evaluated a senior mentoring program to gauge the impact of a new pedagogical approach and to gain a deeper understanding of the learning gained in relation to ageism and elderhood. This qualitative content analysis explored first-year medical students’ opinions of their own aging and attitudes towards caring for older adults. Students (n = 216) participating in a brief curriculum model of a senior mentoring program responded to the following open-ended prompts before and after the program: 1) How do you feel about your own aging?; 2) How do you feel about working with older adult patients after you complete your medical training? Responses suggest that students’ views of their own aging and views towards towards working with older patients are positively impacted by their experiences in the senior mentoring program.

Download Full-text

Effects of participation in an aging game simulation activity on the attitudes of allied health students toward older adults

Internet Journal of Allied Health Sciences and Practice ◽

10.46743/1540-580x/2007.1166 ◽

2007 ◽

Author(s):

Beverly Henry ◽

Carolinda Douglass ◽

Irene Kostiwa

Keyword(s):

Older Adults ◽

Allied Health ◽

Negative Attitude ◽

Term Care ◽

Allied Health Students ◽

Attitudes Toward Older Adults ◽

Before And After ◽

Students Attitudes ◽

Game Simulation ◽

The Impact

The Aging Game simulation activity was designed to improve medical students’ attitudes toward older adults. This study was conducted to determine if the Aging Game, adapted for use with allied health students, could yield positive results in the students’ levels of anxiety about aging and attitudes toward aging. The modified Aging Game was implemented at a large Midwestern university with 156 students from three allied health areas – nutrition and dietetics, physical therapy, and long-term care administration. All students actively engaged in the simulation activity and completed pre- and posttest questionnaires containing the Anxiety about Aging Scale (AAS) and the Aging Semantic Differential (ASD) measures. Results indicated most students had low anxiety about aging and positive attitudes toward older adults both before and after the Aging Game activity. Changes in the students’ pre- and posttest scores on AAS and/or ASD measures were mixed, with small differences in average scores. The demographics of the sample group for this study may partially explain the effects the simulation experience had on these allied health students. That some students took on a more negative attitude toward older adults after the simulation could be attributed to a more realistic view of the difficulties and challenges of aging. Also, the shortened timeframe of the Aging Game simulation may have affected the students’ reactions to the activity. Future activities to complement the simulation, such as reflective writing and interaction with older adults, may improve the impact of the Aging Game on the attitudes of allied health students.

Download Full-text

My Heart Has Always Been Set on Pediatrics, and Other Insights From First-Year Medical Students

Innovation in Aging ◽

10.1093/geroni/igaa057.002 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 1-1

Author(s):

Jennifer Inker ◽

Sarah Marrs ◽

Madeline McIntyre ◽

Leland Waters ◽

Tracey Gendron

Keyword(s):

Older Adults ◽

Medical Students ◽

Older Patients ◽

Qualitative Content Analysis ◽

Community Dwelling ◽

Mentoring Programs ◽

First Year ◽

Shortage Of Doctors ◽

Students Attitudes ◽

First Year Medical Students

Abstract Senior mentoring programs provide medical students exposure to a community-dwelling older adult mentor with whom they meet multiple times throughout the program. The goal of these programs is to expose students to healthy older adults, increase their knowledge of topics in geriatrics and aging, and increase the likelihood that students will pursue geriatric specialties. Though research findings show that senior mentoring programs have the potential to increase medical students’ attitudes towards older adults (Samra et al., 2013) and their willingness to consider working with older patients in the future (McManus et al., 2017), a critical shortage of doctors who specialize in geriatrics still exists. Moreover, the demand for geriatrically-trained physicians is expected to continue to increase (American Geriatrics Society, 2018). In order to develop avenues for successfully fostering interest in and pursuit of geriatrics specialties, we need to fully understand students’ perceptions of working with older adults. The purpose of this qualitative content analysis was to explore first-year medical students’ (n = 216) perceptions of working with older adults. We asked students to respond to the following reflection at the beginning and end of their Senior Mentoring program: How do you feel about working with older patients after you complete your training? Our findings suggest that while students feel more comfortable with and open to caring for older adults, they do not feel compelled to pursue geriatrics. Themes and sub-categories emerging from the data provide insight into why students continue to dismiss pursuing geriatrics.

Download Full-text

Vulnerable Older Adults in Disasters: Effects of Hurricane Irma on Nursing Homes and Assisted Living

Innovation in Aging ◽

10.1093/geroni/igaa057.2607 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 733-734

Author(s):

Lindsay Peterson ◽

David Dosa ◽

Patricia D’Antonio

Keyword(s):

Older Adults ◽

Assisted Living ◽

Gulf Coast ◽

Secondary Data ◽

Morbidity And Mortality ◽

Term Care ◽

The Face ◽

Qualitative Methodologies ◽

Hurricane Irma

Abstract Preparedness of residents in long-term care (LTC) in the face of hurricane emergencies is a contested and largely unanswered question. Our prior work involving the U.S. Gulf Coast hurricanes of 2005-08 showed that exposure to various storms on nursing home (NH) residents resulted in significantly more deaths than reported by health care officials. This work also highlighted that evacuation of NH residents, compared to sheltering in place, was independently associated with morbidity and mortality. Hurricane Irma struck Florida on Sept. 10, 2017, prompting the evacuation of thousands of NH and assisted living community (ALC) residents. This symposium will discuss the effects of Hurricane Irma on vulnerable older adults residing in NHs and ALCs using mixed quantitative and qualitative methodologies. The first presentation will discuss morbidity and mortality of NH residents exposed to Hurricane Irma and will stratify by long stay/short stay status and hospice enrollment. The second presentation will discuss improvements and continued barriers to NH preparedness based on interviews with 30 administrators following Hurricane Irma. Using a novel methodology to identify residents of ALCs using secondary data sources, the third presentation will document AL resident morbidity and mortality risk following Hurricane Irma. The final presentation will highlight results of interviews with 70 stakeholders from small and large ALCs concerning the hurricane experiences of residents, including those with dementia. This symposium offers a multi-faceted view of a disaster’s effects on LTC residents across Florida, including novel data from the NH environment and lesser-examined ALCs.

Download Full-text

Student-Led Fall Prevention Care Management Reduced Fall Risks at Assisted Living Facilities

Innovation in Aging ◽

10.1093/geroni/igaa057.767 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 238-238

Author(s):

Hiroko Kiyoshi-Teo ◽

Claire McKinley-Yoder ◽

Erin Lemon ◽

Olivia Ochoa

Keyword(s):

Older Adults ◽

Assisted Living ◽

Fall Prevention ◽

Fall Risk ◽

Care Management ◽

Assisted Living Facilities ◽

Care Needs ◽

Term Care ◽

Fall Risks ◽

The Impact

Abstract Older adults in residential care settings are four times more likely than those not living in care facilities to experience falls. Yet, fall prevention efforts at long-term care settings are under-resourced, under-regulated, and under-studied. To address this gap, we developed and studied the impact of a specialty clinical, Fall Prevention Care Management (FPCM), for nursing students to decrease older adults’ fall risks. We enrolled assisted living residents that facility liaison identified as being high fall risk (fall rates or fall risk were not tracked at the study sites) and MOCA ≥15, in 2 assisted living facilities in Northwest USA. Participants received weekly, 1-hour, individual, semi-structured, Motivational Interviewing-based care management visits by same students over 6 visits. Changes in fall risks were measured by the CDC STEADI assessment (unsteadiness & worry), Falls Self-Efficacy Scale International-Short (FESI-S), and Falls Behavioral Scale (FAB). Twenty-five residents completed the study. Students addressed the following (multiple responses possible): emotional needs (n=23), improved motivation to prevent falls (n=21), and individualized education/coaching (i.e., exercise, mobility aids) (n=10-17). FESI-S score improved from 16.0 to 14.4 (p=.001; decreased fear. FAB score improved from 2.94 to 3.10 (p=.05; more frequent fall prevention behaviors). Frequency of those who felt steady while standing or walking increased (24% to 40%, p=.07) and those who did not worry about falling increased (20% to 36%, p=.08). FPCM clinical offered valuable opportunity to address unmet care needs of older adults to reduce fall risks.

Download Full-text

Enhancing Our Understanding of Transitional Care Programs

Innovation in Aging ◽

10.1093/geroni/igaa057.448 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 136-137

Author(s):

Katherine McGilton ◽

Shirin Vellani ◽

Alexandra Krassikova ◽

Alexia Cumal ◽

Sheryl Robertson ◽

...

Keyword(s):

Older Adults ◽

Transitional Care ◽

Discharge Planning ◽

Grey Literature ◽

Occupational Therapists ◽

Community Dwelling ◽

Bibliographic Databases ◽

Multidisciplinary Teams ◽

Term Care ◽

Hospitalized Older Adults

Abstract Many hospitalized older adults experience delayed discharge. Transitional care programs (TCPs) provide short-term care to these patients to prepare them for transfer to nursing homes or back to the community. There are knowledge gaps related to the processes and outcomes of TCPs. We conducted a scoping review following Arksey & O’Malley’s framework to identify the: 1) characteristics of older patients served by TCPs, 2) services provided within TCPs, and 3) outcomes used to evaluate TCPs. We searched bibliographic databases and grey literature. We included papers and reports involving community-dwelling older adults aged ≥ 65 years and examined the processes and/or outcomes of TCPs. The search retrieved 4828 references; 38 studies and 2 reports met the inclusion criteria. Most studies were conducted in Europe (n=19) and America (n=13). Patients admitted to TCPs were 59-86 years old, had 2-10 chronic conditions, 26-74% lived alone, the majority were functionally dependent and had mild cognitive impairment. Most TCPs were staffed by nurses, physiotherapists, occupational therapists, social workers and physicians, and support staff. The TCPs provided 5 major types of services: assessment, care planning, treatment, evaluation/care monitoring and discharge planning. The outcomes most frequently assessed were discharge destination, mortality, hospital readmission, length of stay, cost and functional status. TCPs that reported significant improvement in older adults’ functions (which was the main goal of the TCPs) included multiple services delivered by multidisciplinary teams. There is a wide variation in the operationalization of TCPs within and between countries.

Download Full-text

Impact of the COVID-19 Pandemic on Self-Perception of Aging Among Older Adults

Gerontology and Geriatric Medicine ◽

10.1177/2333721421999320 ◽

2021 ◽

Vol 7 ◽

pp. 233372142199932

Author(s):

Alexander Seifert

Keyword(s):

Older Adults ◽

Multivariate Analysis ◽

Data Collection ◽

Descriptive Analysis ◽

Community Dwelling ◽

Living Alone ◽

Self Perception ◽

Before And After ◽

Subjective Views ◽

Community Dwelling Older Adults

The COVID-19 pandemic has created a pattern of physical distancing worldwide, particularly for adults aged 65+. Such distancing can evoke subjective feelings of negative self-perception of aging (SPA) among older adults, but how this pandemic has influenced such SPA is not yet known. This study, therefore, explored SPA at different time phases of the COVID-19 pandemic to explain the pandemic’s impact on SPA among older adults. The analysis employed a sample of 1,990 community-dwelling older adults aged 65 to 95 (mean age = 72.74 years; 43% female) in Switzerland. Data collection from different older adults within one study occurred both before and after Switzerland’s first confirmed COVID-19 case. The descriptive analysis revealed that negative SPA increased, and positive SPA decreased, after the Swiss government recommended physical distancing. After the Federal Council decided to ease these measures, negative SPA slightly decreased and positive SPA increased. According to the multivariate analysis, individuals interviewed after the lockdown were more likely to report greater levels of negative SPA and lower levels of positive SPA. Age, income, and living alone also correlated with SPA. The results suggest that the pandemic has affected older adults’ subjective views of their own aging, and these findings help illustrate the pandemic’s outcomes.

Download Full-text

Prevalence and Risk Factors of Postprandial Hypotension Among Japanese Older Adults in a Facility

Innovation in Aging ◽

10.1093/geroni/igaa057.716 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 222-222

Author(s):

Noriko Suzuki ◽

Masahiko Hashizume ◽

Hideyuki Shiotani

Keyword(s):

Risk Factors ◽

Blood Pressure ◽

Older Adults ◽

Older People ◽

Future Research ◽

Baseline Body Mass Index ◽

Term Care ◽

Postprandial Hypotension ◽

Before And After ◽

Japanese Older Adults

Abstract Postprandial hypotension (PPH) is an unrecognized sudden drop of blood pressure (BP) after meals and a hidden problem among older people including those living in long-term care facilities (LTCFs). Though PPH causes dizziness, falls, and syncope, it has received little attention from¬¬¬ healthcare workers (HCW) including caregivers, nurses and physicians, and risk factors of PPH should be carefully assessed to improve quality of life. Therefore, we aimed to examine the prevalence and risk factors of PPH in a LTCF in Japan. Participants were 114 older adults living in a LTCF in Japan (mean age 85.9 years old; 85 female (74%)). To examine PPH, blood pressure (BP) was measured before and after lunch. BP after meal was measured four times every 30 minutes. PPH is defined as a BP drop of 20 mmHg or more and we also defined a BP drop within a range of 19 to 15 mmHg as potential-PPH. As risk factors, we compared systolic and diastolic BP at baseline, body mass index, pulse rate, disease and complications between groups with/without PPH. The prevalence of PPH was 41% (47/114) and 52% with potential-PPH; 11% (13/114) added. Among risk factors, systolic BP was significantly higher in those with PPH (142.6 vs 123.5 mmHg, p <0.001). This study revealed that PPH & potential-PPH occurred in half of the subjects in a LTCF in Japan. HCW need to focus on high systolic BP to predict PPH and future research is necessary to prevent and cope with PPH for older people.

Download Full-text