scholarly journals Physical Activity, Outcome Expectations, and Social Support in Dyads of Frail Older Adults and Their Home Care Aides

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 404-404
Author(s):  
Lijuan Yin ◽  
Naoko Muramatsu
Keyword(s):  
Physical Activity ◽  
Social Support ◽  
Older Adults ◽  
Home Care ◽  
Qualitative Data ◽  
Outcome Expectations ◽  
Community Dwelling ◽  
Care Recipients ◽  
Care Aides ◽  
Home Care Aides

Abstract Frail community-dwelling older adults increasingly receive home care and continue to face barriers to participating in physical activity (PA) that could help maintain their function. Home care aides (HCAs) are well-positioned to promoting PA among older home care recipients because of their established relationship and regular interpersonal exchanges; yet, the role of HCAs in promoting and supporting PA in home care settings is seldomly studied. Using the quantitative and qualitative data from a 4-month home-based gentle PA intervention delivered by HCAs to their clients in a Medicaid-funded home care setting, the current study examined whether outcome expectations for exercise (OEE) held by HCAs led to client PA outcomes (i.e. functional limitations and physical performance) through social support for exercise (SSE) provided by HCAs. Longitudinal mediation analysis of 46 HCA-client dyads showed that higher baseline OEE held by HCAs were related to greater SSE reported by clients after the intervention (p<.05; bootstrapped standard errors), controlling for client-level covariates, including baseline OEE, age, gender, comorbidity, and whether HCA was client’s family member. Unexpectedly, SSE did not have significant association with client PA outcomes nor mediated the relationship between OEE held by HCAs and client PA outcomes. Qualitative data suggested alternative factors may explain the results, such as clients’ family beliefs in the intervention and clients’ participation experiences (such as expectation fulfillment). Future research should consider older home care clients’ family contexts to enhance our understanding of HCAs’ roles in preserving the function of growing numbers of older home care recipients.

scholarly journals Physical Activity Level Following Resistance Training in Community-Dwelling Older Adults Receiving Home Care: Results from a Cluster-Randomized Controlled Trial

2021 ◽  
Vol 18 (13) ◽  
pp. 6682
Author(s):  
Hilde Bremseth Bårdstu ◽  
Vidar Andersen ◽  
Marius Steiro Fimland ◽  
Lene Aasdahl ◽  
Hilde Lohne-Seiler ◽  
...  
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Resistance Training ◽  
Home Care ◽  
Community Dwelling ◽  
Activity Level ◽  
Group Differences ◽  
Control Group ◽  
Cluster Randomized ◽  
Community Dwelling Older Adults

Older adults’ physical activity (PA) is low. We examined whether eight months of resistance training increased PA level in community-dwelling older adults receiving home care. A two-armed cluster-randomized trial using parallel groups was conducted. The included participants were >70 years and received home care. The resistance training group performed resistance training using body weight, elastic bands, and water canes twice per week for eight months. The control group was informed about the national PA guidelines and received motivational talks. The ActiGraph GT3X+ accelerometer was used to estimate PA. Outcomes included total PA (counts per minute), sedentary behavior (min/day), light PA (min/day), moderate-to-vigorous PA (min/day), and steps (mean/day). Between-group differences were analyzed using multilevel linear mixed models. Twelve clusters were randomized to either resistance training (7 clusters, 60 participants) or the control group (5 clusters, 44 participants). A total of 101 participants (median age 86.0 (interquartile range 80–90) years) had valid accelerometer data and were included in the analysis. There were no statistically significant between-group differences for any of the PA outcomes after four or eight months. This study offers no evidence of increased PA level following resistance training in older adults with home care.

scholarly journals Home Care Resiliency during the COVID-19 Pandemic: Older Adult-Home Care Aide Dyads’ Perspectives

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 721-721
Author(s):  
Naoko Muramatsu ◽  
Lijuan Yin ◽  
Maria Caceres ◽  
Jordan Skowronski
Keyword(s):  
Older Adults ◽  
Home Care ◽  
Healthcare Providers ◽  
Community Dwelling ◽  
Care Recipient ◽  
Work Related ◽  
Care Recipients ◽  
Acute And Chronic Stress ◽  
Home Based ◽  
Related Stress

Abstract Homecare has increased its value as an alternative to nursing homes and adapted to evolving COVID-19 challenges. However, little is known about how COVID-19 has impacted community-dwelling older adults who need assistance with daily activities, including dressing, cooking, and shopping. Guided by the stress process framework, this mixed-method study examined how older homecare recipients experienced the acute and chronic stress during the first eight months of the pandemic, focusing on the role of home care aides (HCAs) in the context of Medicaid-funded in-home services. Thirty-five dyads of care recipients and HCAs participated in a COVID telephone survey as part of a larger study. Care recipients were typically older minority (40% African American, 31% Latinx) women (77%). Their COVID-related anxiety level, assessed by a 6-item Spielberger State Anxiety Inventory (1 “not at all” to 4 “very much”), was 2.2 (SD=0.9). While COVID-19 drastically reduced contacts with family members and healthcare providers, HCAs continued to provide care in person. One care recipient said, “Fortunately, I still have my HCA come and that keeps me sane.” HCAs showed resilience while facing their own family- and work-related stress: “I have followed the rules and just adapted. (COVID) did not affect the activities for my client.” Some dyads, however, experienced care disruptions because of COVID infection or fear in one or both parties. COVID-19 has demonstrated homecare resilience at the person-, dyad-, and organization-levels, calling for equitable, sustainable home-based care for a growing number of older adults who desire to stay in the home.

scholarly journals Effectiveness of a resistance training program on physical function, muscle strength, and body composition in community-dwelling older adults receiving home care: a cluster-randomized controlled trial

2020 ◽  
Vol 17 (1) ◽  
Author(s):  
Hilde Bremseth Bårdstu ◽  
Vidar Andersen ◽  
Marius Steiro Fimland ◽  
Lene Aasdahl ◽  
Truls Raastad ◽  
...  
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Body Composition ◽  
Resistance Training ◽  
Home Care ◽  
Physical Function ◽  
Low Cost ◽  
Community Dwelling ◽  
Cluster Randomized ◽  
Community Dwelling Older Adults

Abstract Background Aging is associated with reduced muscle mass and strength leading to impaired physical function. Resistance training programs incorporated into older adults’ real-life settings may have the potential to counteract these changes. We evaluated the effectiveness of 8 months resistance training using easily available, low cost equipment compared to physical activity counselling on physical function, muscle strength, and body composition in community-dwelling older adults receiving home care. Methods This open label, two-armed, parallel group, cluster randomized trial recruited older adults above 70 years (median age 86.0 (Interquartile range 80–90) years) receiving home care. Participants were randomized at cluster level to the resistance training group (RTG) or the control group (CG). The RTG trained twice a week while the CG were informed about the national recommendations for physical activity and received a motivational talk every 6th week. Outcomes were assessed at participant level at baseline, after four, and 8 months and included tests of physical function (chair rise, 8 ft-up-and-go, preferred- and maximal gait speed, and stair climb), maximal strength, rate of force development, and body composition. Results Twelve clusters were allocated to RTG (7 clusters, 60 participants) or CG (5 clusters, 44 participants). The number of participants analyzed was 56–64 (6–7 clusters) in RTG and 20–42 (5 clusters) in CG. After 8 months, multilevel linear mixed models showed that RTG improved in all tests of physical function and maximal leg strength (9–24%, p = 0.01–0.03) compared to CG. No effects were seen for rate of force development or body composition. Conclusion This study show that resistance training using easily available, low cost equipment is more effective than physical activity counselling for improving physical function and maximal strength in community-dwelling older adults receiving home care. Trial registration ISRCTN1067873

scholarly journals How Do Older Adults Respond to Active Australia Physical Activity Questions? Lessons From Cognitive Interviews

2014 ◽  
Vol 22 (1) ◽  
pp. 74-86 ◽  
Author(s):  
Kristiann C. Heesch ◽  
Jannique van Uffelen ◽  
Wendy J. Brown
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Qualitative Data ◽  
Time Frame ◽  
Community Dwelling ◽  
Cognitive Interviews ◽  
Face To Face ◽  
Validated Questionnaire ◽  
Semistructured Interviews ◽  
Interviewing Techniques

The aim of this study was to examine older adults’ understanding and interpretation of a validated questionnaire for physical activity surveillance, the Active Australia Survey (AAS). To address this aim, cognitive interviewing techniques were used during face-to-face semistructured interviews with 44 adults age 65–89 years. Qualitative data analysis revealed that participants were confused with questionnaire phrasing, misunderstood the scope of activities to include in answers, and misunderstood the time frame of activities to report. They also struggled to accurately estimate the frequency and duration of their activities. Our findings suggest that AAS questions may be interpreted differently by older adults than intended by survey developers. Findings also suggest that older adults use a range of methods for calculating PA frequency and duration. The issues revealed in this study may be useful for adapting AAS for use in older community-dwelling adults.

Older Adults’ Perceived Physical Activity Enablers and Barriers: A Multicultural Perspective

2010 ◽  
Vol 18 (2) ◽  
pp. 119-140 ◽  
Author(s):  
Anna E. Mathews ◽  
Sarah B. Laditka ◽  
James N. Laditka ◽  
Sara Wilcox ◽  
Sara J. Corwin ◽  
...  
Keyword(s):  
Physical Activity ◽  
Social Support ◽  
Older Adults ◽  
American Indians ◽  
Fear Of Falling ◽  
Outcome Expectations ◽  
Positive Outcome ◽  
Diverse Group ◽  
Common Barriers ◽  
Multicultural Perspective

This study identified perceived physical activity (PA) enablers and barriers among a racially/ethnically and geographically diverse group of older adults. Data were from 42 focus groups conducted with African Americans, American Indians, Latinos, Chinese, Vietnamese, and non-Hispanic Whites (hereafter Whites). Constant-comparison methods were used to analyze the data. Common barriers were health problems, fear of falling, and inconvenience. Common enablers were positive outcome expectations, social support, and PA program access. American Indians mentioned the built environment and lack of knowledge about PA as barriers and health benefits as an enabler more than participants in other groups. Whites and American Indians emphasized the importance of PA programs specifically designed for older adults. Findings suggest several ways to promote PA among older people, including developing exercise programs designed for older adults and health messages promoting existing places and programs older adults can use to engage in PA.

scholarly journals 173 A Qualitative Study Exploring Facilitators and Barriers to Engagement in Physical Activity Among Older Irish and French Adults

2019 ◽  
Vol 48 (Supplement_3) ◽  
pp. iii17-iii65
Author(s):  
Fintan Sheerin ◽  
Aileen Lynch ◽  
Sean Kilroy ◽  
Monique Epstein ◽  
Ariane Girault ◽  
...  
Keyword(s):  
Physical Activity ◽  
Social Support ◽  
Older Adults ◽  
Environmental Factors ◽  
Qualitative Study ◽  
Psychological Health ◽  
Health Benefits ◽  
Community Dwelling ◽  
Moderate Intensity ◽  
Facilitators And Barriers

Abstract Background The physical and mental health benefits of physical activity (PA) in older adults have been well-documented. However, a large proportion of older adults worldwide fail to meet the internationally recommended guidelines of 150 minutes of moderate intensity PA per week. Factors associated with engagement in PA among older adults are complex, interacting and wide-reaching, involving individual, social, physical and environmental factors. Thus, to develop preventive lifestyle interventions it is necessary to carefully explore these factors. Methods This qualitative study (as part of a larger funded study to develop a PA-intervention) sought to identify and explore facilitators and barriers to PA in community dwelling older adults (≥65). Focus groups were conducted in Ireland (one) and France (two) and findings were analysed using thematic analysis. Results The main facilitators that emerged from focus group participants (n=33) were: availability of resources; tailored classes facilitated by staff knowledgeable of older adults’ needs; activities that facilitated social support and connectedness; perceived physical and psychological health benefits. Similar factors also influence continued participation in PA, as well as feelings of wellbeing and enjoyment, family support and motivation, although it was noted that it did sometimes require considerable effort. Barriers to engagement in PA included: lack of social support and resources; environmental factors, whether built, social, location or weather-related. Barriers of a more personal nature also emerged and included fear, loss of confidence due to functional changes, and lack of opportunity. Conclusion PA guidelines are but the first step. There is a need to develop implementation strategies at all levels: personal; interpersonal; organisational; community; and public policy, specifically for older adults, that will incorporate the above facilitators and address the above barriers to optimize engagement and maintenance in PA among older adults.

scholarly journals Are Home Care Aides Interested in Helping Clients Do Physical Activity?

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 443-443
Author(s):  
Naoko Muramatsu ◽  
Lijuan Yin ◽  
Maria Caceres
Keyword(s):  
Physical Activity ◽  
Home Care ◽  
Family Members ◽  
Care Program ◽  
Logit Analysis ◽  
Ordered Logit ◽  
Care Experience ◽  
Care Aides ◽  
Home Care Aides ◽  
Interest Levels

Abstract The current home care paradigm dictates home care aides (HCAs) provide prescribed help with activities of daily living, rather than stimulating older adults’ reserves to maintain independence. Little is known about whether HCAs are interested in expanding their role to promote their clients’ health. This study examined HCAs’ interest in helping clients do physical activity among workers who care for their family members or clients assigned by home care agencies in a Medicaid-funded home care program. Data came from brief surveys completed by HCAs at state-mandated in-service training sessions (N=602; 42% caring for non-family clients only, 38% family clients only, 20% both family and non-family clients). Ordered logit analysis was conducted to examine whether HCAs caring for family clients differ from those caring for non-family clients in levels of interest in helping clients do safe physical activity as part of home care work, controlling for HCAs’ age, gender, language (English/Spanish), and years of home care experience. HCAs’ interest levels were high (62% very, 21% somewhat, 8% slightly, 9% not at all interested). Ordered logit analysis indicated that HCAs caring for family members had significantly higher interest levels than those caring for non-family clients only (83% higher among HCAs caring for both family and non-family clients, 30% higher among HCAs caring for family clients only). To reflect HCAs’ interests and to maintain clients’ independence, home care workforce training should direct its attention to empower HCAs to assume health-promoting roles.

Risk of Psychological Distress Among Community-Dwelling Older Adults Experiencing Spousal Loss in Ghana

2019 ◽  
Vol 60 (3) ◽  
pp. 416-427 ◽  
Author(s):  
Razak M Gyasi ◽  
David R Phillips
Keyword(s):  
Mental Health ◽  
Physical Activity ◽  
Social Support ◽  
Older Adults ◽  
Psychological Distress ◽  
Older Persons ◽  
Well Being ◽  
Community Dwelling ◽  
Full Sample ◽  
Spousal Loss

Abstract Background Spousal loss, common in older age, has been linked to negative mental health outcomes and well-being, yet the mechanisms linking spousal loss and mental health are still unclear. Objective To investigate whether physical activity, social support, and gender modify the psychological distress effects of marital loss among community-dwelling older persons in Ghana. Methods Data from a 2016/2017 Ageing, Health, Psychological Well-being, and Health-seeking Behavior Study (N = 1,200) were examined. OLS regression models examined associations between spousal loss and psychological distress outcomes and interaction terms. Results Spousal loss (widowhood and divorce/separation) was associated with psychological distress (measured by the Kessler Psychological Distress Scale [KPDS-10]) for the full sample (β = .798, p < .001), women (β = .831, p < .001) and for men (β = .533, p < .05). After adjusting for potential confounders, the associations between spousal loss and psychological distress persisted for the full sample (β = .727, p < .001) and females only (β = .730, p < .001). In particular, when experiencing spousal loss, those with meaningful social support (β = −.856, p < .005) and engaged in physical activity (β = −.258, p < .001) were less likely to be psychologically distressed. Conclusions Spousal loss precipitates an independent risk of psychological distress in older age particularly among women, but social support and physical activity engagements moderate the relationship. These findings support the premise that providing opportunities to improve social support and regular physical activity may buffer the effects of psychological distress among older persons experiencing spousal loss. Providing support for older adults in times of divorce and widowhood, and working towards changes in social attitudes towards divorce are important considerations.

scholarly journals The Perceived Importance of Physical Activity: Associations With Psychosocial and Health-Related Outcomes

2013 ◽  
Vol 10 (3) ◽  
pp. 343-349 ◽  
Author(s):  
Thomas R. Wójcicki ◽  
Amanda N. Szabo ◽  
Siobhan M. White ◽  
Emily L. Mailey ◽  
Arthur F. Kramer ◽  
...  
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Psychological Health ◽  
Exercise Program ◽  
Outcome Expectations ◽  
Community Dwelling ◽  
Cognitive Assessments ◽  
Exercise Condition ◽  
Perceived Importance ◽  
Health Related

Background:The purpose of this study was to assess the extent to which participation in a 12-month exercise program changed the degree of importance that older adults attached to physical activity. In addition, associations among changes in physical activity importance and health-related and psychosocial outcomes were examined.Methods:Community-dwelling older adults (N = 179) were recruited to participate in a 12-month exercise trial examining the association between changes in physical activity and fitness with changes in brain structure and psychological health. Participants were randomly assigned to a walking condition or a flexibility, toning, and balance condition. Physical, psychological, and cognitive assessments were taken at months 0, 6, and 12.Results:Involvement in a 12-month exercise program increased the importance that participants placed on physical activity; this positive change was similar across exercise condition and sex. Changes in importance, however, were only associated with changes in physical health status and outcome expectations for exercise midway through the intervention. There were no significant associations at the end of the program.Conclusions:Regular participation in physical activity can positively influence the perceived importance of the behavior itself. Yet, the implications of such changes on physical activity-related outcomes remain equivocal and warrant further investigation.

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