scholarly journals Material Disadvantage and Positive Subjective Health of Older Homeless and Older Irish Travelers

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 713-713
Author(s):  
Bridin Carroll ◽  
Kieran Walsh
Keyword(s):  
Home Care ◽  
Life Course ◽  
Care Delivery ◽  
Sense Of Self ◽  
Homeless People ◽  
Later Life ◽  
Subjective Health ◽  
Positive Health ◽  
Social Lives ◽  
Housing Deprivation

Abstract Focusing on older Irish Travellers and older homeless people (OTOH) as two marginalised sub-sections of the older population, this paper investigates life-course and structural forms of material disadvantage, and its implications for positive health and accessing community care in older age. With growing interest in strengthening home care structures for older people, it is critical to interrogate the relevance of these structures for those who experience environmental uncertainty in later life, and possess significant trajectories of disadvantage. The analysis draws on 50 life-course interviews with OTOH aged between 50-72 years. The findings illustrate significant life-course experiences of material and multi-faceted forms of disadvantage, including stigma and discrimination, with implications across health and social lives. Housing deprivation was a multi-factorial player, causing certain physical illnesses, hindering some health treatments, and contributing to precarious conditions and sense of self worth. Findings are discussed in relation to flexible models of home care delivery.

scholarly journals Older Adults’ Participation in Education and Successful Aging: Implications for University Continuing Education in Canada

2010 ◽  
Vol 36 (1) ◽  
Author(s):  
Atlanta Sloane-Seale ◽  
Bill Kops
Keyword(s):  
Older Adults ◽  
Continuing Education ◽  
Successful Aging ◽  
Sense Of Self ◽  
Later Life ◽  
Well Being ◽  
Positive Health ◽  
Educational Activities ◽  
Education Practice ◽  
Personal Renewal

Representatives from Manitoba seniors’ organizations and the University of Manitoba collaborated on a proposal to examine the participation of older adults in learning activities. The initiative led to a series of studies on this theme, including an exploration of participation at a seniors’ centre (Sloane-Seale & Kops, 2004), a comparison of participants and non-participants at three selected urban seniors’ centres (Sloane-Seale & Kops, 2007), and an analysis of participation at several urban and rural seniors’ centres, as well as participants’ perceptions of the characteristics of successful aging (Sloane-Seale & Kops, 2008). Building on these previous studies, the study described in this article examined the participation of older adults in Manitoba and how it links to successful aging. Key statistics relating to older adults’ participation, types of educational activities, learning in later life, and characteristics of successful aging were collected. The results suggest that such participation leads to a more inclusive and comprehensive understanding of successful aging; that educational activities positively influence mental and physical activity, which in turn result in more positive health and well- being; and that spirituality and life planning, including a positive sense of self, a focus on personal renewal and growth, a connection to the broader community, and setting life goals, contribute to successful aging. In light of Canada’s aging population, these findings have implications for educational gerontology, lifelong learning, and continuing education practice and research.

scholarly journals POSITIVE HEALTH AMONGST OLDER TRAVELLERS AND OLDER HOMELESS PEOPLE: LIFE-COURSE AND STRUCTURAL DETERMINANTS

2018 ◽  
Vol 2 (suppl_1) ◽  
pp. 629-629
Author(s):  
K Walsh ◽  
D O’Donovan ◽  
T Scharf ◽  
E O’Shea ◽  
A Macfarlane
Keyword(s):  
Life Course ◽  
Homeless People ◽  
Structural Determinants ◽  
Positive Health

scholarly journals Positive Subjective Health of Older Homeless and Older Irish Travelers: a Participant-Led Approach

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 107-107
Author(s):  
Bridin Carroll ◽  
Kieran Walsh
Keyword(s):  
Older People ◽  
Life Course ◽  
Community Care ◽  
Well Being ◽  
Subjective Health ◽  
Social Connections ◽  
Structural Determinants ◽  
Care Models ◽  
Nuanced Understanding ◽  
Positive Ageing

Abstract Older people experiencing homelessness and older Irish Travellers (OTOH) are both over-represented in the cohort who use acute health services. Impending health care reform in Ireland will be based on primary care models, meaning home and community care will be, for the first time, underpinned by a regulatory framework. For these reasons, this study aims to gain a nuanced understanding of how OTOH, as marginalised older people, might be best served by new home care and community care models. Using a qualitative, voice-led approach, a life course and structural determinants lens is employed to probe the health conditions, experiences and expectations of OTOH, as well as their perceptions and values around the concept of ‘home’. The research processes and outcomes of one of five phases of research are presented in this paper: participant-led research. In this phase, five OTOH were trained and assisted to complete a short research project which fed into the goals of the wider study. Emergent findings suggest that social connections underpin health and well-being for OTOH, throughout the life course, and presently. This was also seen as a fundamental element for healthy and positive ageing. In addition, ‘home’ was defined with reference to the presence (or absence) of familial or other social connections. This study represents an important contribution to scholarship on old age social exclusion. It is entirely novel in its approach to focusing on OTOH health and wellbeing. The outputs of this study also have important implications for upcoming health reform policies in Ireland.

Associations between life-course frailty and later-life heart size and function in the 1946 NSHD British birth cohort-an epidemiological study

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
C.C Topriceanu ◽  
J.C Moon ◽  
R Hardy ◽  
A.D Hughes ◽  
N Chaturvedi ◽  
...  
Keyword(s):  
Life Course ◽  
Birth Cohort ◽  
Frailty Index ◽  
Later Life ◽  
Left Ventricular ◽  
Step Change ◽  
Deficit Accumulation ◽  
Heart Size ◽  
And Function ◽  
The Life Course

Abstract Background Cardiovascular diseases are an important component of the multi-morbidity syndrome which is associated with negative health outcomes resulting in a major societal economic burden. An objective way to assess multi-morbidity is to calculate a frailty index based on medical deficit accumulation. Late-life frailty has been validated to predict mortality, but little is known about the association between life-course frailty and cardiovascular health in later-life. Purpose To study the association between life-course frailty and later-life heart size and function using data from the world's longest running birth cohort with continuous follow-up. Methods A 45-deficit frailty index (FI) was calculated at 4 age-intervals across the life-course (0 to 16 years old, 19 to 44 years old, 45 to 54 years old and 60 to 64 years old) in participants from the UK 1946 Medical Research Council (MRC) National Survey of Heath and Development (NSHD) birth cohort. The life-course frailty indices (FI0_16, FI19_44, FI45_54 and FI60_64) reflect the cumulative medical deficits at the corresponding age-intervals. They were used to derive FImean and FIsum reflecting overall-life frailty. The step change in deficit accumulation between age-intervals was also calculated (FI2-1, FI3-1, FI4-1, FI3-2, FI4-2, FI4-3). Echocardiographic data at 60–64 years provided: E/e' ratio, ejection fraction (EF), myocardial contraction fraction index (MCFi) and left ventricular mass index (LVmassi). Generalized linear mixed models with gamma distribution and log link assessed the association between FIs and echo parameters after adjustment for sex, socio-economic position and body mass index. Results 1.805 NSHD participants were included (834 male). Accumulation of a single deficit had a significant impact (p<0.0001 to p<0.049) on LVmassi and MCFi in all the life-course FIs and overall FIs. LVmassi increased by 0.89% to 1.42% for the life-course FIs and by 0.36%/1.82% for FIsum and FImean respectively. MCFi decreased by 0.62% to 1.02% for the life-course FIs and by 0.33%/ 1.04%. for FIsum and FImean respectively. One accumulated deficit translated into higher multiplicative odds (13.2 for FI60-64, 2.1 for FI4-1, 75.4 for FI4-2 and 78.5 for FI4-3) of elevated filling pressure (defined as E/e' ratio >13, p<0.0.005 to p<0.02).A unit increase in frailty decreased LV EF (%) by 11%/12% for FI45-54 and FI60-64 respectively, by 10% to 12% for FI2-1, FI3-1, FI4-1 and FI4-2, and 4%/15% for FIsum and FImean respectively (p<0.0014 to p<0.044). Conclusion Frailty during the life-course, overall life-frailty and the step change in deficit accumulation is associated with later-life cardiac dysfunction. Frailty strain appears to have its greatest impact on pathological myocardial hypertrophy (high LVmassi and low MCFi) potentially paving the way to later-life systolic or diastolic dysfunction in susceptible individuals. Funding Acknowledgement Type of funding source: None

The unique role of the social worker within the Hospital at Home care delivery team

2021 ◽  
pp. 1-15
Author(s):  
Helena Ross ◽  
Ryan Dritz ◽  
Barbara Morano ◽  
Sara Lubetsky ◽  
Pamela Saenger ◽  
...  
Keyword(s):  
Home Care ◽  
Social Worker ◽  
Care Delivery ◽  
Unique Role ◽  
The Social ◽  
Hospital At Home ◽  
At Home

scholarly journals Body size throughout the life-course and incident benign prostatic hyperplasia-related outcomes and nocturia

BMC Urology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Saira Khan ◽  
K. Y. Wolin ◽  
R. Pakpahan ◽  
R. L. Grubb ◽  
G. A. Colditz ◽  
...  
Keyword(s):  
Body Size ◽  
Benign Prostatic Hyperplasia ◽  
Life Course ◽  
Early Life ◽  
Prostate Volume ◽  
Late Life ◽  
Later Life ◽  
Normal Weight ◽  
Prostatic Hyperplasia ◽  
The Life Course

Abstract Background Existing evidence suggests that there is an association between body size and prevalent Benign Prostatic Hyperplasia (BPH)-related outcomes and nocturia. However, there is limited evidence on the association between body size throughout the life-course and incident BPH-related outcomes. Methods Our study population consisted of men without histories of prostate cancer, BPH-related outcomes, or nocturia in the intervention arm of the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial (PLCO) (n = 4710). Associations for body size in early- (age 20), mid- (age 50) and late-life (age ≥ 55, mean age 60.7 years) and weight change with incident BPH-related outcomes (including self-reported nocturia and physician diagnosis of BPH, digital rectal examination-estimated prostate volume ≥ 30 cc, and prostate-specific antigen [PSA] concentration > 1.4 ng/mL) were examined using Poisson regression with robust variance estimation. Results Men who were obese in late-life were 25% more likely to report nocturia (Relative Risk (RR): 1.25, 95% Confidence Interval (CI): 1.11–1.40; p-trendfor continuous BMI < 0.0001) and men who were either overweight or obese in late-life were more likely to report a prostate volume ≥ 30 cc (RRoverweight: 1.13, 95% CI 1.07–1.21; RRobese: 1.10, 95% CI 1.02–1.19; p-trendfor continuous BMI = 0.017) as compared to normal weight men. Obesity at ages 20 and 50 was similarly associated with both nocturia and prostate volume ≥ 30 cc. Considering trajectories of body size, men who were normal weight at age 20 and became overweight or obese by later-life had increased risks of nocturia (RRnormal to overweight: 1.09, 95% CI 0.98–1.22; RRnormal to obese: 1.28, 95% CI 1.10–1.47) and a prostate volume ≥ 30 cc (RRnormal to overweight: 1.12, 95% CI 1.05–1.20). Too few men were obese early in life to examine the independent effect of early-life body size. Later-life body size modified the association between physical activity and nocturia. Conclusions We found that later-life body size, independent of early-life body size, was associated with adverse BPH outcomes, suggesting that interventions to reduce body size even late in life can potentially reduce the burden of BPH-related outcomes and nocturia.

How can we ensure the success of specialised palliative home-care? A qualitative study (ELSAH) identifying key issues from the perspective of patients, relatives and health professionals

2021 ◽  
pp. 026921632110265
Author(s):  
Hannah Seipp ◽  
Jörg Haasenritter ◽  
Michaela Hach ◽  
Dorothée Becker ◽  
Lisa-R Ulrich ◽  
...  
Keyword(s):  
Home Care ◽  
Focus Groups ◽  
Health Professionals ◽  
Care Delivery ◽  
Death And Dying ◽  
Theory Approach ◽  
Palliative Home Care ◽  
Palliative Care Teams ◽  
Key Issues

Background: Specialised palliative home-care supports patients with life-limiting diseases in their familiar surroundings. The number of palliative care teams and patients being cared for is increasing worldwide. To assess and improve quality, it is needed to understand, how specialised palliative home-care can be provided successfully. For this purpose we examined the views of all involved stakeholders. Aim: To identify the issues that patients, their relatives and involved health professionals view as important in ensuring the success of specialised palliative home-care. Design: We used a qualitative design based on participant observations, interviews and focus groups following the principles of a Grounded Theory approach. Setting/participants: All specialised palliative home-care teams ( n = 22) caring for adults in Hesse, Germany, participated. We conducted participant observations ( n = 5), and interviewed patients ( n = 14), relatives ( n = 14) and health professionals working in or collaborating with specialised palliative home-care ( n = 30). We also conducted focus groups ( n = 4) with health professionals including a member check. Results: Successful specialised palliative home-care needs to treat complex symptoms, and provide comprehensive care including organisation of care, involving relatives and addressing issues of death and dying. Sense of security for patients and relatives is key to enable care at home. Care delivery preferences include a focus on the quality of relationships, respect for individuality and the facilitation of self-determination. Conclusions: Consideration of the identified key issues can help to ensure successful specialised palliative home-care. Knowledge of these should also be considered when researching and assessing quality of care. Trial registration: German Clinical Trials Register DRKS-ID: DRKS00012421; http://www.germanctr.de .

scholarly journals HEALTHCARE PROVIDERS’ EXPERIENCES IN CARING FOR OLDER ADULTS WITH MULTIPLE CHRONIC CONDITIONS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S317-S318
Author(s):  
Jenny Ploeg ◽  
Marie-Lee Yous ◽  
Kimberly Fraser ◽  
Sinéad Dufour ◽  
Sharon Kaasalainen ◽  
...  
Keyword(s):  
Older Adults ◽  
Primary Care ◽  
Home Care ◽  
Family Caregivers ◽  
Chronic Conditions ◽  
Care Delivery ◽  
Healthcare Providers ◽  
Multiple Chronic Conditions ◽  
Team Approach ◽  
Personal Support

Abstract The management of multiple chronic conditions (MCC) in older adults living in the community is complex. Little is known about the experiences of interdisciplinary primary care and home providers who care for this vulnerable group. The aim of this study was to explore the experiences of healthcare providers in managing the care of community-living older adults with MCC and to highlight their recommendations for improving care delivery for this group. A qualitative interpretive description design was used. A total of 42 healthcare providers from two provinces in Canada participated in semi-structured interviews. Participants represented diverse disciplines (e.g., physicians, nurses, social workers, personal support workers) and settings (e.g., primary care and home care). Thematic analysis was used to analyze interview data. The experiences of healthcare providers managing care for older adults with MCC were organized into six major themes: (1) managing complexity associated with MCC, (2) implementing person-centred care, (3), involving and supporting family caregivers, (4) using a team approach for holistic care delivery, (5) encountering rewards and challenges in caring for older adults with MCC, and (6) recommending ways to address the challenges of the healthcare system. Healthcare providers highlighted the need for a more comprehensive integrated system of care to improve care management for older adults with MCC and their family caregivers. Specifically, they suggested increased care coordination, more comprehensive primary care visits with an interprofessional team, and increased home care support.

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