scholarly journals Perceptions and Understandings of Frailty Language: A Scoping Review

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 177-177
Author(s):  
Mariko Sakamoto ◽  
Pamela Durepos ◽  
Kyla Alsbury ◽  
Patricia Hewston ◽  
Alyson Takaoka ◽  
...  
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Scoping Review ◽  
Health Care Professionals ◽  
Health Care Systems ◽  
Community Dwelling ◽  
Critical Examination ◽  
Primary Research ◽  
Care Systems ◽  
Research Studies

Abstract Diagnosing and responding to frailty in older adult populations is of growing interest for health care professionals, researchers and policymakers. Preventing frailty has the potential to improve health outcomes for older adults, which in turn has significant implications for health care systems. However, little is known about how older people understand and perceive the term “frailty”, and what it means for them to be designated as frail. To address this concern, a scoping review was undertaken to map the breadth of primary research studies that focus on community-dwelling older adults’ perceptions and understanding of frailty language, as well as explore the potential implications of being classified as frail. Searches were conducted in MEDLINE, Ageline, PsychInfo, CINAHL and EMBASE databases for articles published between January 1994 and February 2019. 4639 articles were screened and ten articles met the inclusion criteria, detailing eight primary research studies. Using content analysis, three core themes were identified across the included studies. These themes included: 1) understanding frailty as a multi-dimensional concept and inevitable consequence of aging, 2) perceiving frailty as a generalizing and harmful label; and 3) resisting and responding to frailty. Recommendations stemming from this review include the need for health care professionals to use person-centered language with older adults, discuss the term frailty with caution, and be aware of the potential consequences of labeling a person as frail. Importantly, this review demonstrates that for frailty interventions to be successful and meaningful for older adults, ongoing and critical examination of frailty language is necessary.

Mediators of marginalisation in discharge planning with older adults

2016 ◽  
Vol 37 (9) ◽  
pp. 1747-1769 ◽  
Author(s):  
EVELYNE DUROCHER ◽  
BARBARA E. GIBSON ◽  
SUSAN RAPPOLT
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Older Adult ◽  
Health Care Professionals ◽  
Health Care Services ◽  
Discharge Planning ◽  
Health Care Systems ◽  
Urban Setting ◽  
Care Services ◽  
Care Systems

ABSTRACTReturning home or moving to a more supportive setting upon discharge from inpatient health-care services can have a tremendous impact on the lives of older adults and their families. Institutional concerns with patient safety and expedience can overshadow health-care professionals' commitments to collaborative discharge planning. In light of many competing demands and agendas, it can be unclear what is driving discharge-planning processes and outcomes. This paper presents the results of a study examining discharge planning in an older adult rehabilitation unit in a Canadian urban setting. Using microethnographic case studies, we explored the perspectives of older adults, family members and health-care professionals. Drawing on concepts of relational autonomy to guide the analysis, we found that discourses of ageing-as-decline, beliefs privileging health-care professionals' expertise and conventions guiding discharge planning intersected to marginalise older adult patients in discharge-planning decision making. Discharge planning in the research setting was driven by norms of ‘protecting physical safety’ at the expense of older adults’ self-declared interests and values. Such practices resulted in frequent recommendations of 24-hour care, which have significant personal, social and financial implications for older adults and their families, and ultimately might undermine clients' or health-care systems' aims. The analysis revealed social, political and institutional biases that diminish the rights and autonomy of older adults.

Gender Differences in Older Adults’ Perceptions of Falls and Fall Prevention

2021 ◽  
pp. 152483992110097
Author(s):  
Susan Patton ◽  
Jennifer Vincenzo ◽  
Leanne Lefler
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Gender Differences ◽  
Fall Prevention ◽  
Health Care Professionals ◽  
Health Care Systems ◽  
Secondary Data ◽  
Traditional Role ◽  
Men And Women ◽  
Care Systems

Aim To explore gender differences in older adults’ perceptions about preventing falls. Background Falls are a major problem for older adults and health care systems and a challenge to the aging population. Consideration of older adults’ perceptions of fall prevention is needed to increase their engagement in evidence-based prevention strategies. Method A qualitative analysis of secondary data was performed. Results Three major themes emerged: We’ve Seen It, Women Are Caregivers, and Men Are Analyzing Risks and Modifying Behaviors. The men and women in this study shared information about falls and fall prevention in alignment with traditional role expectations. The women learned about falling through their roles as caregivers and prevented falls by controlling extrinsic risk factors indoors such as holding onto handrails on stairs or making home modifications. The men demonstrated an analytical approach to reducing risk such as employing improved safety measures during outdoors activities as a responsibility to maintain independence. Implications The different perceptions of men and women influence what they do to engage in fall prevention. Health care professionals need to consider gender differences and take an individualized approach that includes allowing older adults to share their experiences, acknowledging their successful fall prevention behaviors, and validating and addressing their concerns.

Older Adults’ Perceptions of Frailty Language: A Scoping Review

2021 ◽  
pp. 1-10
Author(s):  
Pamela Durepos ◽  
Mariko Sakamoto ◽  
Kyla Alsbury ◽  
Patricia Hewston ◽  
Julia Borges ◽  
...  
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Scoping Review ◽  
Health Care Professionals ◽  
First Language ◽  
Community Dwelling ◽  
Care Utilization ◽  
Holistic View ◽  
Age Related ◽  
Multiple Domains

Abstract There is growing interest in conceptualizing and diagnosing frailty. Less is understood, however, about older adults’ perceptions of the term “frail”, and the implications of being classified as “frail”. The purpose of this scoping review was to map the breadth of primary studies; and describe the meaning, perceptions, and perceived implications of frailty language amongst community-dwelling older adults. Eight studies were included in the review and three core themes were identified: (1) understanding frailty as inevitable age-related decline in multiple domains, (2) perceiving frailty as a generalizing label, and (3) perceiving impacts of language on health and health care utilization. Clinical practice recommendations for health care professionals working with individuals with frailty include: (1) maintaining a holistic view of frailty that extends beyond physical function to include psychosocial and environmental constructs, (2) using person-first language, and (3) using a strengths-based approach to discuss aspects of frailty.

scholarly journals Patient Rounds With Video-Consulted Relatives: Qualitative Study on Possibilities and Barriers From the Perspective of Healthcare Providers (Preprint)

2018 ◽  
Author(s):  
Christina Østervang ◽  
Lene Vedel Vestergaard ◽  
Karin Brochstedt Dieperink ◽  
Dorthe Boe Danbjørg
Keyword(s):  
Health Care ◽  
Focus Group ◽  
Health Care Professionals ◽  
Health Care Systems ◽  
New Technology ◽  
Work And Family ◽  
Focus Group Interviews ◽  
Work Routines ◽  
Care Systems ◽  
Group Interviews

BACKGROUND In cancer settings, relatives are often seen as a resource as they are able to support the patient and remember information during hospitalization. However, geographic distance to hospitals, work, and family obligations are reasons that may cause difficulties for relatives’ physical participation during hospitalization. This provided inspiration to uncover the possibility of telehealth care in connection with enabling participation by relatives during patient rounds. Telehealth is used advantageously in health care systems but is also at risk of failing during the implementation process because of, for instance, health care professionals’ resistance to change. Research on the implications for health care professionals in involving relatives’ participation through virtual presence during patient rounds is limited. OBJECTIVE This study aimed to investigate health care professionals’ experiences in using and implementing technology to involve relatives during video-consulted patient rounds. METHODS The design was a qualitative approach. Methods used were focus group interviews, short open interviews, and field observations of health care professionals working at a cancer department. The text material was analyzed using interpretative phenomenological analysis. RESULTS Field observational studies were conducted for 15 days, yielding 75 hours of observation. A total of 14 sessions of video-consulted patient rounds were observed and 15 pages of field notes written, along with 8 short open interviews with physicians, nurses, and staff from management. Moreover, 2 focus group interviews with 9 health care professionals were conducted. Health care professionals experienced the use of technology as a way to facilitate involvement of the patient’s relatives, without them being physically present. Moreover, it raised questions about whether this way of conducting patient rounds could address the needs of both the patients and the relatives. Time, culture, and change of work routines were found to be the major barriers when implementing new technology involving relatives. CONCLUSIONS This study identified a double change by introducing both new technology and virtual participation by relatives at the same time. The change had consequences on health care professionals’ work routines with regard to work load, culture, and organization because of the complexity in health care systems.

scholarly journals Forum: equity in access to health care. Introduction

2008 ◽  
Vol 24 (5) ◽  
pp. 1159-1161 ◽  
Author(s):  
Claudia Travassos
Keyword(s):  
Health Care ◽  
Health Care Access ◽  
Health Care Professionals ◽  
Access To Health Care ◽  
Health Care Systems ◽  
Care Access ◽  
Unethical Practices ◽  
Access To Health ◽  
Care Systems ◽  
Equity In Access

The Introduction outlines this issue's special Forum on equity in access to health care, including three Articles and a Postscript. The Forum represents a continuation of the debates raised during a seminar organized by the Oswaldo Cruz Foundation in the city of Rio de Janeiro, Brazil, in 2006, in collaboration with UNICEF, UNDP, World Bank, the WHO Special Program for Research and Training in Tropical Diseases, and the United Nations Research Institute for Social Development. The authors approach health care access and equity from a comprehensive and contemporaneous perspective, introducing a new conceptual framework for access, in which information plays a central role. Trust is proposed as an important value for an equitable health care system. Unethical practices by health administrators and health care professionals are highlighted as hidden critical aspects of inequities in health care. As a whole, the articles represent a renewed contribution for understating inequalities in access, and for building socially just health care systems.

scholarly journals MP34: Elder abuse in the emergency department: a systematic scoping review

CJEM ◽  
2019 ◽  
Vol 21 (S1) ◽  
pp. S54-S55
Author(s):  
E. Mercier ◽  
A. Nadeau ◽  
A. Brousseau ◽  
M. Emond ◽  
J. Lowthian ◽  
...  
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Emergency Department ◽  
Physical Abuse ◽  
Health Care Providers ◽  
Scoping Review ◽  
Elder Abuse ◽  
Community Dwelling ◽  
Screening Tools ◽  
Care Providers

Introduction: This systematic scoping review aims to synthetize the available evidence on the epidemiology, risk factors, clinical characteristics, screening tools, prevention strategies, interventions and knowledge of health care providers regarding elder abuse in the emergency department (ED). Methods: A systematic literature search was performed using three databases (Medline, Embase and Cochrane Library). Grey literature was scrutinized. Studies were considered eligible when they were observational studies or randomized control trials reporting on elder abuse in the prehospital and/or ED setting. Data extraction was performed independently by two researchers and a qualitative approach was used to synthetize the findings. Results: A total of 443 citations were retrieved from which 58 studies published between 1988 and 2018 were finally included. Prevalence of elder abuse following an ED visit varied between 0.01% and 0.03%. Reporting of elder abuse to proper law authorities by ED physicians varied between 2% to 50% of suspected cases. The most common reported type of elder abuse detected was neglect followed by physical abuse. Female gender was the most consistent factor associated with elder abuse. Cognitive impairment, behavioral problems and psychiatric disorder of the patient or the caregiver were also associated with physical abuse and neglect as well as more frequent ED consultations. Several screening tools have been proposed, but ED-based validation is lacking. Literature on prehospital- or ED-initiated prevention and interventions was scarce without any controlled trial. Health care providers were poorly trained to detect and care for older adults who are suspected of being a victim of elder abuse. Conclusion: Elder abuse in the ED is an understudied topic. It remains underrecognized and underreported with ED prevalence rates lower than those in community-dwelling older adults. Health care providers reported lacking appropriate training and knowledge with regards to elder abuse. Dedicated ED studies are required.

scholarly journals The Invisibility of Spiritual Nursing Care in Clinical Practice

2019 ◽  
Vol 38 (1) ◽  
pp. 147-155 ◽  
Author(s):  
Dawn M. Hawthorne ◽  
Shirley C. Gordon
Keyword(s):  
Health Care ◽  
Nursing Education ◽  
Nursing Care ◽  
Health Care Professionals ◽  
Nursing Practice ◽  
Health Care Systems ◽  
Spiritual Needs ◽  
Central Component ◽  
Nursing Curricula ◽  
Care Systems

Background and Purpose: Spirituality has been identified as the essence of being human and is recognized, by many health care professionals, as a central component in health and healing. Scholars have identified spiritual nursing care as essential to nursing practice and include caring for the human spirit through the development of relationships and interconnectedness between the nurse and the patient. However, despite the recognition of spiritual practices as important to health, little attention has been given to spirituality in nursing practice and education in the literature. The purpose of this article is to explore factors contributing to the invisibility of spiritual nursing care practices (SNCP), recognition and offer strategies to enhance the visibility of SNCP. Two major factors that reduce visibility of SNCP are conceptual confusion differentiating between spirituality and religion and limited education in the area of spirituality including nursing curricula and organizations. Strategies to enhance visibility of SNCP include educational approaches in nursing curricula and health care organizations. to influence nurses’ perceptions about spirituality and creation of a culture of spiritual care. Conclusion: Holistic nursing includes assessing and responding to the spiritual needs of patients. Changes in nursing education and health care systems are needed to increase the visibility of SNCP.

scholarly journals Assessing health systems’ preparedness for providing care for refugees, asylum seekers and migrants: a scoping review

2020 ◽  
Vol 30 (6) ◽  
pp. 1157-1163
Author(s):  
Ewa Kocot ◽  
Anna Szetela
Keyword(s):  
Health Care ◽  
Scoping Review ◽  
Asylum Seekers ◽  
Health Care Systems ◽  
Legal Aspects ◽  
Validity And Reliability ◽  
Care Systems ◽  
System Requirements ◽  
Health Care Usage ◽  
Special Health

Abstract Background Health care systems and care professionals often face the challenge of providing adequate health care for migrant groups. The objective of this study is to answer the question of whether and how meeting the special health system requirements regarding refugees (R), asylum seekers (AS) and migrants (M) (RASM) is checked and evaluated. Methods A scoping review was used as a methodology of the research, with four electronic databases, websites of relevant organizations and European projects searched, using a strictly defined search strategy. Finally, 66 studies were included in the analysis. Results The included studies presented assessment of different types, aspects and facilities of health care, as well as various methods of analysis. In the vast majority of the studies (n = 52, 78%) interviews or questionnaires were used to collect data. The studies were mostly declared to be qualitative. The main issues assessed in the studies can be categorized into three groups: (i) legal aspects, (ii) before receiving health care and (iii) during health care usage. Conclusions RASM inflow is a big challenge for health care system in many countries. The first step to guarantee adequate health care for RASM is assessing how the system is functioning. This makes it possible to find gaps, indicate the directions of activities needed and monitor progress. Further work on the development of a comprehensive tool, checked in terms of validity and reliability assessment, and enabling examination of many aspects of health care for RASM should be carried out.

scholarly journals USING COMMUNITY-BASED MODELS TO PROVIDE INTEGRATED CARE FOR RURAL OLDER ADULTS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S553-S553
Author(s):  
Martha R Crowther ◽  
Cassandra D Ford
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Rural Communities ◽  
Mental Health Problems ◽  
Health Care Systems ◽  
Physical And Mental Health ◽  
Community Based ◽  
Psychosocial Services ◽  
Care Systems ◽  
Rural Older Adults

Abstract Rural elders are one of the most at-risk populations for experiencing physical and mental health problems. In many rural communities, there are no psychosocial services available to meet the needs of the rural elderly. To provide rural older adults with integrated healthcare, we build upon our existing community-based infrastructure that has fostered community capacity for active engagement in clinical activities and has served as a catalyst to increase participation of rural older adults in clinical services. Our rural community model draws upon the role of culture in promoting health among rural older adults to provide rural service delivery. This model is built upon our network of partnerships with surrounding communities, including potential research participants, community-based organizations, community leaders, and community health-care systems and providers. By engaging the community we can create a sustainable system that will encourage rural older adults to utilize the health care system at a higher rate.

scholarly journals Out-of-Pocket Expenses Related to Aging in Place for Older People Experiencing Frailty: A Scoping Review

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 875-875
Author(s):  
Elaine Moody ◽  
Rebecca Ganann ◽  
Marilyn Macdonald ◽  
Lori Weeks ◽  
Liz Orr ◽  
...  
Keyword(s):  
Health Care ◽  
Older People ◽  
Scoping Review ◽  
Health Care Systems ◽  
Aging In Place ◽  
Community Dwelling ◽  
The Body ◽  
Cross Sectional ◽  
Functional Changes ◽  
Out Of Pocket Expenses

Abstract Supporting older people to live in the community as they experience health and functional changes has become a priority for policy makers, health system leaders and community members, including many older people themselves. Aging-in-place has been promoted as a way to support the sustainability of health care systems and limit health care and societal costs. However, the expenses borne by individuals and caregivers to support older people to age-in-place when experiencing changes in health and functional ability are often not considered in health care literature and policy. We conducted a scoping review using Joanna Briggs Institute methodology to explore the out-of-pocket expenses for people with frailty living in the community. We included research and policy papers on community-dwelling people over 60 and experiencing frailty. Findings about financial out-of-pocket expenses were extracted. A total of 9669 sources were screened by two reviewers and 42 sources were included. The sources were from 17 countries, most from the US, and had various designs, including 14 qualitative designs, 15 cross sectional, 11 other quantitative and 2 policy discussions. The sources most often reported expenses related to home care (16), medication (12), housekeeping (10), transportation (8), and medical equipment (6). Gaps in the body of literature include lack of a consistent measure of out-of-pocket expenses and cost considerations of co-housing programs. The context—including policy, community and personal—was particularly important to the experience of out-of-pocket expenses for people with frailty, and further research is needed to expand on this knowledge.

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