scholarly journals We Should Have Talked About Hospice: Transforming Communication With Bereaved LGB Aging Women

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 530-531
Author(s):  
Korijna Valenti ◽  
Leah Janssen
Keyword(s):  
Older Adults ◽  
Communication Research ◽  
Policy And Practice ◽  
Communication Behaviors ◽  
Serious Illness ◽  
Meaningful Information ◽  
Dyadic Communication ◽  
Aging Women ◽  
Bisexual And Transgender ◽  
Eol Care

Abstract Because of historical discrimination, discomfort disclosing information, and differing definitions of family, lesbian, gay, bisexual, and transgender (LGBT) older adults with serious illness need both improved palliative and end-of-life (EOL) care communication with clinicians and recognized inclusion of spouses/partners. Communicating about palliative and EOL care may improve the care goals and emotional trajectory for patients and significant others. Using a descriptive qualitative approach, this study’s aim was to analyze the communication experiences during a spouse’s/partner’s EOL care for bereaved LGB women (n=16) 60 and older. Drawing on queer gerontology, issues relating to access to resources and information and the systemic silencing of older LGB women illuminate areas where policy and practice may be improved. Semi-structured, one-on-one interviews were used to provide deep and meaningful information about palliative and EOL care communication between participants, their spouse or partner, and clinicians. While results reflect certain outcomes found in prior studies with non-LGBT adults, thematic analysis revealed three main findings with evidence specific to this population: 1) avoiding deep discussions about EOL; 2) lack of understanding about palliative or EOL care; and 3) limited communication with clinicians. Findings illuminate the need for better understanding among clinicians regarding palliative and EOL communication with LGBT dyads as well as communication strategies based on recognition and acceptance. Further dyadic communication research may improve care goals for LGBT older adults. Understanding couples’ interactions and examining different communication behaviors may lead to improved palliative and EOL care goals for older LGBT adults with serious illness and their spouses/partners.

scholarly journals Change of Health and Change of Preferences on Life-Sustaining Treatment: Evidence From a Longitudinal Study

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 19-20
Author(s):  
Yifan Lou ◽  
Mercedes Bern-Klug ◽  
Jinyu Liu
Keyword(s):  
Older Adults ◽  
Health Status ◽  
Activities Of Daily Living ◽  
Daily Living ◽  
Living Will ◽  
Socioeconomic Background ◽  
Policy And Practice ◽  
Logistic Regression Models ◽  
Perceived Change ◽  
Eol Care

Abstract Background Decision-making for end-of-life (EoL) care is not a one-off choice. Older adults may change their preferences for life-sustaining treatments along their health continuum. Guided by prospect theory, we hypothesize that perceived change in health status is a driver behind preference changes. Method: Health and Retirement Study Wave 2012 to 2018 data. Sample is limited to 5,646 older adults who reported whether they requested to limit treatment in living will during two waves of data. Two possible preference changes were tested: from limited to default care and from default to limited care. Change in health status was indicated by changes (1=same, 2=improve, 3=decline) in physical pain, general health, activities of daily living, instrumental activities of daily living (IADL), and number of diagnoses. Multilevel logistic regression models were used to understand how change of health status was related to changes in EoL preferences. Results 700 older adults changed their preferences some time in 8 years. Those who changed their preferences are more likely to be older and not married, and to have lower socioeconomic background. Older adults who experienced deteriorated pain levels were more likely to change their preferences from default to limited care (OR=3.77, p<.05) and less likely to change from limited to default care (OR=0.63, p<.05). Change in IADL is also a significant predictor of change of preferences. Implication: The findings highlight the importance of periodic reassessment of EoL care preferences with older adults. We discuss policy and practice implications regarding health changes as underlying mechanisms of preference changes.

scholarly journals Medically Treated Opioid Overdoses Among the U.S. Elderly: Trends and Correlates

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 54-54
Author(s):  
Peter Treitler ◽  
Stephen Crystal ◽  
Richard Hermida ◽  
Jennifer Miles
Keyword(s):  
Older Adults ◽  
Pain Management ◽  
The Elderly ◽  
Opioid Use Disorder ◽  
Chronic Obstructive ◽  
Medicare Beneficiaries ◽  
Older Individuals ◽  
Opioid Use ◽  
Policy And Practice ◽  
Obstructive Pulmonary Disease

Abstract High rates of opioid prescribing and comorbid medical conditions increase risk of overdose among older adults. As the US population ages and the rates of opioid use disorder (OUD) increase in the elderly population, there is a need to characterize trends and correlates of overdose in order to more effectively target policy and practice. Using a ~40% random sample of 2015-2017 Medicare beneficiaries ages 65 and older with Part D pharmacy coverage, this study examined medically treated opioid overdoses among US older adults. The sample included 13-14 million beneficiaries per year. The rate of medically treated opioid overdoses among elderly Medicare beneficiaries increased by 15% from 6 per 10,000 in 2015 to 6.9 per 10,000 in 2017. Those with overdose were disproportionately female (63%), non-Hispanic white (83%), with diagnoses of pain conditions (96%), with diagnoses of major depression (63%), and with high rates of conditions that decrease respiratory reserve such as chronic obstructive pulmonary disease. 13% had co-occurring diagnosed alcohol use disorder, 36% were diagnosed with opioid dependence or abuse, and 12% were diagnosed with hepatitis C. Older individuals with overdose represent a complex mix of risk factors; identifying those most at risk (as well as those who have very low risk, whose pain management may be compromised by overly-rigid interpretation of opioid use guidelines) is key in order to address multiple risks, balancing risk reduction with appropriate pain management.

scholarly journals Older Adults as Citizen Scientists and Policy and Planning Voices in Higher Education

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 547-547
Author(s):  
Lenard Kaye ◽  
Sarah Burby
Keyword(s):  
Older Adults ◽  
Older Adult ◽  
Academic Research ◽  
Community Based Participatory Research ◽  
Retirement Communities ◽  
Policy And Practice ◽  
University Policy ◽  
Adult Participation ◽  
Life Education ◽  
Older Citizens

Abstract The University of Maine is embarking on achieving AFU status. In addition to maximizing older adult participation in all facets of campus life (education, recreation, culture, etc.), their presence in nontraditional sectors of university activity will be emphasized. Building on the principles of community-based, participatory research, focal points of UMaine’s AFU strategy will be to ensure that age-specific, engagement mechanisms are created and maintained that ensure older citizens play an influential role in guiding and interpreting academic research and development and curricula innovation across multiple professions and disciplines. Using a state-wide, older adult research registry, and co-design, community test-beds in partnership with continuing care retirement communities, older adults will serve as citizen scientists. Other empowerment strategies for maximizing elder voice include expanding the number of departments that incorporate life span perspectives in their mission statements and expanding the number of older adult advisory bodies that inform university policy and practice.

scholarly journals Transforming Cultural Ideas of Aging and Disability to Improve Policy and Practice

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 645-645
Author(s):  
Anne Ordway
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Recent Work ◽  
Interest Group ◽  
Quality Of Health Care ◽  
Real World ◽  
People With Disabilities ◽  
Policy And Practice ◽  
Full Participation

Abstract Aging and disability are normative processes that extend across the lifespan. However, ageism and ableism are incorporated into many of our practices, programs, and policies—devaluing the lives of older adults and people aging with disabilities and ultimately preventing their full participation in society. Ageism and ableism are closely connected. For example, both systems identify impairment as an individual and social liability. As recent studies have demonstrated, this has real world implications for the quantity and quality of health care requested, delivered, and received by both older adults and people with disabilities. In this session, we discuss the connections between these two forms of oppression and present recent work by researchers in both fields and the FrameWorks Institute that shows how to transform our cultural ideas of aging and disability and development more inclusive policies and services. Part of a symposium sponsored by the Lifelong Disabilities Interest Group.

scholarly journals Understanding immunesenescence

2018 ◽  
pp. 107-130
Author(s):  
Anna C. Whittaker ◽  
Jane Upton ◽  
Niharika Arora Duggal ◽  
Chadni Deb ◽  
Charanjit Randhawa ◽  
...  
Keyword(s):  
Older Adults ◽  
Hip Fracture ◽  
Health Service ◽  
Physical Function ◽  
Illness Perceptions ◽  
Stress Hormones ◽  
Policy And Practice ◽  
Factors Affecting ◽  
Rehabilitation Facilities ◽  
The Impact

This chapter discusses the impact of hip fracture in older age and in particular factors affecting recovery of physical function and wellbeing. It focuses particularly on a study of the impact of depression following hip fracture in older adults, and the influence of this depression on a range of outcomes including immune function, stress hormones, illness perceptions, physical function, and length of stay in health service and rehabilitation facilities. It shows that depression is common following hip fracture among older people, and is the biggest predictor of a slower recovery and poorer function in terms of immunity, wellbeing and physical ability. A pilot study associated with this research showed that illness perceptions following hip fracture did not differ between UK and Punjabi older adults, but that Punjabi speakers in India had greater levels of distress. Implications for health service policy and practice resulting from this research are discussed in this chapter, including potential intervention strategies to improve outcomes after hip fracture.

Call the Rezadora: Aiding Latino Families at the End of Life

2021 ◽  
pp. 154041532110289
Author(s):  
Kim L. Larson ◽  
Graziella D. Jewell ◽  
Maria Fernanda Maldonado ◽  
Morgan E. Braxton ◽  
Lee Ann Johnson
Keyword(s):  
End Of Life ◽  
Single Case ◽  
The United States ◽  
Latino Families ◽  
Holistic View ◽  
Serious Illness ◽  
Care Services ◽  
Palliative Care Teams ◽  
Eol Care

Introduction: The rezadora, a lay spiritual leader, provides support to Latino families as they provide end-of-life (EOL) care for loved ones. The purpose of this study was to learn about the work of the rezadora in Guatemala as a resource for Latinos with serious illness in the United States. Methods: An ethnographic exploratory case study was conducted during summer 2018 in rural Guatemala. We interviewed three rezadoras who resided in two villages. The study yielded two cases, the single case and the paired case, which allowed for a holistic view of how the rezadora serves the community. Results: Content and thematic analysis led to two themes: Essence of being called and Power of prayerful song. Essence of being called was represented by the prominence of the rezadora and their perpetual faith work. Power of prayerful song was characterized through the mission, customs, and the presence of the rezadora. A good death was aided by the rezadora in this context. Conclusions: As the Latino population ages in place, the need for palliative and EOL care services will increase. Lay spiritual leaders could enhance the palliative care teams in these communities and improve the quality of life for Latinos with serious illness.

scholarly journals Lesbian, Gay, Bisexual, and Trans Aging in a U.K. Context: Critical Observations of Recent Research Literature

2019 ◽  
Vol 89 (1) ◽  
pp. 93-107 ◽  
Author(s):  
Kathryn Almack ◽  
Andrew King
Keyword(s):  
Older Adults ◽  
Empirical Research ◽  
Evidence Base ◽  
Research Literature ◽  
Future Research ◽  
Policy And Practice ◽  
International Evidence ◽  
Care Systems ◽  
The Impact ◽  
People’S Perceptions

In this article, we provide critical observations of empirical research from leading U.K. researchers relating to the lives of lesbian, gay, bisexual, and trans older adults. We suggest learning that may be applied in differing global contexts as well as contributing to the development of an international evidence base. We illustrate the importance of paying attention to distinct health and care systems and legislation, which present global differences as well as similarities in terms of lesbian, gay, bisexual, and trans people’s perceptions and access to resources. With this contextual background, we then discuss the cutting-edge U.K. research in this field from 2010 onward. We identify key strengths including the contribution our evidence has made to policy and practice and the development of theoretical insights such as the impact of intersectionality. The article concludes with a discussion of future research in this field which has relevance at national and international levels.

scholarly journals The Role of Immigration in the Health of Lesbian, Gay, Bisexual, and Transgender Older Adults in the United States

2019 ◽  
Vol 89 (1) ◽  
pp. 3-21
Author(s):  
Jane J. Lee ◽  
Hyun-Jun Kim ◽  
Karen Fredriksen Goldsen
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Health Behaviors ◽  
Health Outcomes ◽  
Health Care Access ◽  
Well Being ◽  
The United States ◽  
Foreign Born ◽  
Care Access ◽  
Bisexual And Transgender

Lesbian, gay, bisexual, and transgender (LGBT) aging research is growing around the globe. Yet, few studies have examined the interconnectedness of different populations and cultures. This study examines whether LGBT foreign-born older adults experience greater health disparities than their U.S.-born counterparts. We conducted a cross-sectional analysis of the National Health, Aging, and Sexuality/Gender Study: Aging with Pride from 2014, which assessed measures of health and well-being among LGBT adults aged 50 years and older ( n = 2,441). We compared sociodemographic characteristics, health-care access, health behaviors, and health outcomes between foreign-born and U.S.-born participants. Foreign-born LGBT older adults reported greater socioeconomic disadvantage and higher levels of experiencing barriers to health-care access than U.S.-born LGBT older adults. Groups did not significantly differ in health behaviors and health outcomes when controlling for sociodemographic factors. Greater understanding of the mechanisms that shape the relationship between migration and health among the LGBT population is warranted.

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