Development and Formative Evaluation of a Death Education Program for Community-Dwelling Chinese Older Adults

Abstract Planning for end-of-life (EOL) care in advance can enhance one’s quality of life at EOL. Culturally sensitive educational programs are needed in Chinese populations to enlighten the public and encourage advance planning due to a culture of death-denying and avoidance. This study describes the team’s efforts to develop and formatively evaluate a death education program designed for community-dwelling Chinese older adults. The program was designed based on the Knowledge-Attitude-Behavior Model, as a 2-session 3-hour program spreading over two days with 1.5 hours for each day. The content paid attention to discussing the importance of making plans for EOL in Chinese culture and discussing how to have death-related conversations with the family and health care professionals. In 2020, semi-structured interviews were conducted by phone with 12 health care professionals and researchers, and four Chinese older adults in China to obtain their feedback on program content and delivery. The directed content analysis method was used to analyze the data. Although they confirmed multiple challenges in conducting death education in China, such as family avoidance even if an older adult initiates the death-related conversation, health care professionals not feeling comfortable with such discussions, etc., they also felt the urgency and importance of delivering death education among older adults and in society as a whole. Detailed suggestions were categorized into relationship building, program preparation (e.g., setting, materials), multiple ways of recruitment, target population, length, various formats of content delivery, content (e.g., pay attention to spiritual care), and general support from the public.

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Perceptions and Understandings of Frailty Language: A Scoping Review

Innovation in Aging ◽

10.1093/geroni/igaa057.572 ◽

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.

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Psychiatric Illness in Relation to Frailty in Community-Dwelling Elderly People without Dementia: A Report from the Canadian Study of Health and Aging

Canadian Journal on Aging / La Revue canadienne du vieillissement ◽

10.3138/8774-758w-702q-2531 ◽

2007 ◽

Vol 26 (1) ◽

pp. 33-38 ◽

Cited By ~ 31

Author(s):

Melissa K. Andrew ◽

Kenneth Rockwood

Keyword(s):

Older Adults ◽

Health Care ◽

Elderly People ◽

Health Care Professionals ◽

Psychiatric Illness ◽

Frailty Index ◽

Community Dwelling ◽

Mental Illnesses ◽

Canadian Study ◽

Index Value

ABSTRACTWe investigated whether frailty, defined as the accumulation of multiple, interacting illnesses, impairments and disabilities, is associated with psychiatric illness in older adults. Five-thousand-six-hundred-and-seventy-six community dwellers without dementia were identified within the Canadian Study of Health and Aging, and self-reported psychiatric illness was compared by levels of frailty (defined by an index of deficits that excluded mental illnesses). People with psychiatric illness (12.6% of those surveyed, who chiefly reported depression) had a higher mean frailty index value than those who did not. Older age was not associated with higher odds of psychiatric illness. Taking sex, frailty, and education into account, the odds of psychiatric illness decreased with each increasing year of age (OR 0.95; 95% CI, 0.94–0.97). Frailty was associated with psychiatric illness; for each additional deficit-defining frailty, odds of psychiatric illness increased (OR 1.23; 95% CI, 1.19–1.26). Similarly, psychiatric illness was associated with much higher odds of being among the most frail. These findings lend support to a multidimensional conceptualization of frailty. Our data also suggest that health care professionals who work with older adults with psychiatric illness should expect frailty to be common, and that those working with frail seniors should consider the possible co-existence of depression and psychiatric illness.

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Malnutrition: A Misunderstood Diagnosis by Primary Care Health Care Professionals and Community-Dwelling Older Adults in Ireland

Journal of the Academy of Nutrition and Dietetics ◽

10.1016/j.jand.2021.05.021 ◽

2021 ◽

Author(s):

Aisling A. Geraghty ◽

Sarah Browne ◽

Ciara M.E. Reynolds ◽

Sharon Kennelly ◽

Lucy Kelly ◽

...

Keyword(s):

Older Adults ◽

Primary Care ◽

Health Care ◽

Health Care Professionals ◽

Community Dwelling ◽

Primary Care Health ◽

Care Health ◽

Community Dwelling Older Adults

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Older Adults’ Perceptions of Frailty Language: A Scoping Review

Canadian Journal on Aging / La Revue canadienne du vieillissement ◽

10.1017/s0714980821000180 ◽

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.

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Insights Into Roles for Health-Care Professionals in Meeting the Needs of Older Adults and Unpaid Caregivers During Health-Care Transitions

Canadian Journal of Nursing Research ◽

10.1177/0844562116676579 ◽

2016 ◽

Vol 48 (3-4) ◽

pp. 70-79 ◽

Cited By ~ 2

Author(s):

Lori E. Weeks ◽

Gloria McInnis-Perry ◽

Colleen MacQuarrie ◽

Sanja Jovanovic

Keyword(s):

Older Adults ◽

Health Care ◽

Health System ◽

Health Care Professionals ◽

Online Survey ◽

Care Transitions ◽

Community Dwelling ◽

Future Research ◽

The Right ◽

Health Care Transitions

We provided insights from older adults, their unpaid caregivers, and health-care professionals into specific roles for professionals within the health system to better meet the needs of community-dwelling older adults and their unpaid caregivers experiencing transitions between health services. We used a qualitative approach to collect data within one Canadian province from older adults and unpaid caregivers of older adults who participated in focus groups ( n = 98) and professionals working in the health system who participated in an online survey ( n = 52). Questions included experiences with health service transitions, strengths, challenges, and suggestions to improve transitions. Thematic analysis resulted in identifying seven specific roles for professionals in supporting health-care transitions: information and education, planning for future health needs, supporting the acceptance of necessary care, facilitating access to the right services at the right time, facilitating communication between services, facilitating the discharge planning process and advocacy for older adults and unpaid caregivers. Our results based on evidence from older adults, unpaid caregivers, and health-care professionals will inform future research and further development of the instrumental and relational roles for professionals supporting older adults and their caregivers experiencing health-care transitions.

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Improving Local Service Delivery to Prevent Falls in Community-Dwelling Older Adults: Translating Research to Practice

The Gerontologist ◽

10.1093/geront/gnaa121 ◽

2020 ◽

Author(s):

Travis M Gagen ◽

Maria T Bulzacchelli

Keyword(s):

Older Adults ◽

Health Care ◽

Fall Prevention ◽

Health Care Professionals ◽

Prevention Programs ◽

Community Dwelling ◽

Local Health ◽

Prevention Interventions ◽

Unintentional Falls ◽

Community Dwelling Older Adults

Abstract Unintentional falls are the leading cause of both fatal and nonfatal injuries among Americans 65 years of age and older and place an enormous burden on the health care system. As the population continues to age, preventing falls will be increasingly important for reducing morbidity, mortality, and medical costs. Evidence-based fall prevention interventions for older adults exist, but widespread adoption of these interventions is needed. Local health departments, Area Agencies on Aging, first responders, and health care professionals can all play important roles in implementing fall prevention programs. This article presents a conceptual model for local delivery of fall prevention programs for community-dwelling older adults. This model can serve as a guide for translating existing fall prevention research into practice.

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