scholarly journals Preparing for the New Normal: Chronicling the Impact of COVID-19 on Older Adults and Providers

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 585-585
Author(s):  
Rose Ann DiMaria-Ghalili ◽  
Justine Sefcik
Keyword(s):  
Older Adults ◽  
Health Care Providers ◽  
Healthcare Delivery ◽  
Community Dwelling ◽  
Retirement Community ◽  
Continuing Care ◽  
Care Providers ◽  
New Normal ◽  
Continuing Care Retirement Community ◽  
The Impact

Abstract COVID-19 and social distancing heralded an unprecedented change in the way older adults and health care providers live, work, socialize and manage their health. Early “calls-to-action” included the call for researchers to chronicle the impact of the COVID-19 pandemic on care of older adults to inform models of care and best practices in the new normal. This symposium explores the impact of COVID-19 on the health of older adults across the care continuum and healthcare delivery augmented by technology. The perspectives of older adults living in the community and providers who care for this population are highlighted. Additionally, there is a focus on the most vulnerable, those living in skilled care facilities and continuing care retirement communities. Fisher analyzes the key themes in 37 COVID-19 video communiques over 11 months at a continuing care retirement community. Sefcik explores coping strategies including outdoor activities among community-dwelling older adults. DiMaria-Ghalili examined patterns of physical and mental health, technology usage and loneliness in older adults, including those living in the community and a continuing care retirement community. Using longitudinal data and COVID-19 supplemental survey data from the National Health and Aging Trends Study, Huh-Yoo discusses disparities in online patient-provider communication and implications for the Post-COVID era. Coates discusses the facilitators and barriers perceived by interdisciplinary providers deploying telehealth during the COVID-19 pandemic and implications for healthcare delivery in older adults. The symposium will conclude with a discussion by Dr. Sefcik on the implications for research, practice and policy in the post COVID-19 era.

End-of-Life Treatment Preferences Among Older Adults

2001 ◽  
Vol 8 (6) ◽  
pp. 533-543 ◽  
Author(s):  
Eun-Shim Nahm ◽  
Barbara Resnick
Keyword(s):  
Older Adults ◽  
End Of Life ◽  
Health Care Providers ◽  
Retirement Community ◽  
Treatment Preferences ◽  
Continuing Care ◽  
Care Providers ◽  
Aggressive Interventions ◽  
To Receive ◽  
End Of Life Treatment

With the advancement of medical technology, various life-sustaining treatments are available at the end of life. Older adults should be encouraged to establish their end-of-life treatment preferences (ELTP) while they are physically and mentally able to do so. The purpose of this study was to explore ELTP among older adults and to compare those preferences in a subset of individuals who had reported their ELTP in a survey completed the previous year. This was a descriptive study of 191 older adults living in a continuing care retirement community. Approximately half of the participants did not want cardiopulmonary resuscitation, to be put on a respirator, or to receive dialysis. The findings in this study suggest that many older adults do not want aggressive interventions at the end of life, but choose rather those measures that will keep them comfortable. Moreover, treatment choices may change over time. Health care providers should initiate discussions about ELTP at regular intervals (yearly) to assist older adults in dictating their end-of-life care.

scholarly journals A Pilot Study to Test the Feasibility of a Home Mobility Monitoring System in Community-Dwelling Older Adults

2019 ◽  
Vol 16 (9) ◽  
pp. 1512 ◽  
Author(s):  
Heesook Son ◽  
Hyerang Kim
Keyword(s):  
Older Adults ◽  
Monitoring System ◽  
Health Care Providers ◽  
Community Dwelling ◽  
Care Providers ◽  
Remote Communication ◽  
Baseline Activity ◽  
Home Based ◽  
Health Related ◽  
Community Dwelling Older Adults

Technology enables home-based personalized care through continuous, automated, real-time monitoring of a participant’s health condition and remote communication between health care providers and participants. Technology has been implemented in a variety of nursing practices. However, little is known about the use of home mobility monitoring systems in visiting nursing practice. Therefore, the current study tested the feasibility of a home mobility monitoring system as a supportive tool for monitoring daily activities in community-dwelling older adults. Daily mobility data were collected for 15 months via home-based mobility monitoring sensors among eight older adults living alone. Indoor sensor outputs were categorized into sleeping, indoor activities, and going out. Atypical patterns were identified with reference to baseline activity. Daily indoor activities were clearly differentiated by sensor outputs and sensor outputs discriminated atypical activity patterns. During the year of monitoring, a health-related issue was identified in a participant. Our findings indicate the feasibility of a home mobility monitoring system for remote, continuous, and automated assessment of a participant’s health-related mobility patterns. Such a system could be used as a supportive tool to detect and intervene in the case of problematic health issues.

Transition and Adaptation to the Continuing Care Retirement Community From a Life Course Perspective: Something Old, Something New, and Something Borrowed

2016 ◽  
Vol 37 (3) ◽  
pp. 267-288 ◽  
Author(s):  
Liat Ayalon
Keyword(s):  
Older Adults ◽  
Life Course ◽  
Thematic Analysis ◽  
Adult Children ◽  
Life Course Perspective ◽  
Retirement Community ◽  
Continuing Care ◽  
Future Expectations ◽  
Linked Lives ◽  
Continuing Care Retirement Community

The study examined the accounts of older adults and their adult children concerning the transition to the continuing care retirement community (CCRC) and the adjustment to it, using a life course perspective. Up to three waves of interviews, consisting of a total of 187 interviews with older adults and their adult children, were conducted between 6 months and 6 years from the transition to the CCRC. Thematic analysis was employed using comparisons across groups of interviewees (older adults and adult children) and waves of interviews (up to three waves) to identify core categories of meaning. Time perception was an organizing principle across interviews. Both older adults and their adult children perceived themselves as moving forward and backward in time following the transition to the CCRC and future expectations for deterioration. The study emphasizes the linked-lives of older adults and their adult children.

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 Prevalence of older adults with low muscle mass living in a residential continuing care retirement community in Florida

2018 ◽  
Vol 7 (1) ◽  
pp. 83 ◽  
Author(s):  
Dennis Hunt ◽  
Sareen S. Gropper ◽  
Kelly A. Miller ◽  
Barbara Tymczyszyn ◽  
Deborah Chapa
Keyword(s):  
Older Adults ◽  
Skeletal Muscle ◽  
Muscle Mass ◽  
Nurse Practitioners ◽  
Oldest Old ◽  
Bioelectrical Impedance ◽  
Retirement Community ◽  
Continuing Care ◽  
Skeletal Muscle Index ◽  
Continuing Care Retirement Community

Muscle mass, strength, and function have been shown to decline with aging, and if of sufficient magnitude can result in sarcopenia. This study’s objective was to determine the prevalence of low muscle mass in a group of adults living in a “premier” Florida residential continuing care retirement community. The sample consisted of 80 older adults, ranging from young old (65-74 years) to the oldest old (85+ years) with the oldest participant being 94 years. Skeletal muscle mass was assessed via bioelectrical impedance analysis. Skeletal muscle index values were calculated and compared with established cut-off values to classify each individual’s muscle mass as normal or low (sarcopenic). The prevalence of sarcopenia among the males was 66% and among females was 73%. When examined by age, 56% of those in their 70s, 73% of those in their 80s, and 79% of adults in their 90s had low muscle mass indicative of sarcopenia. This study found a higher prevalence for sarcopenia in females and males, especially among the oldest groups, than previously reported in a nationally representative sample of adults. This study’s findings also suggest the need for further studies examining whether the prevalence of low muscle mass among adults in either classification varies with socioeconomic status and ethnicity. Continuing care retirement communities may provide excellent environments for the screening, diagnosis, and implementation of exercise and nutritional programs for residents to help prevent or attenuate sarcopenia’s deleterious effects. Nurse practitioners must incorporate screening for sarcopenia in their wellness package for their patients. Screening, nutritional education and support and exercise prescriptions are vital to prevent associated decline from sarcopenia.

Factors influencing older adults to complete advance directives

2010 ◽  
Vol 8 (3) ◽  
pp. 267-275 ◽  
Author(s):  
Gloria J. Alano ◽  
Renee Pekmezaris ◽  
Julia Y. Tai ◽  
Mohammed J. Hussain ◽  
Jose Jeune ◽  
...  
Keyword(s):  
Older Adults ◽  
New York ◽  
Health Care Providers ◽  
Female Gender ◽  
Community Dwelling ◽  
Major Surgery ◽  
Care Providers ◽  
Media Campaigns ◽  
Tertiary Teaching ◽  
Relief Of Suffering

AbstractObjective:The purpose of this study was to determine the factors which influence advance directive (AD) completion among older adults.Method:Direct interviews of hospitalized and community-dwelling cognitively intact patients >65 years of age were conducted in three tertiary teaching settings in New York. Analysis of AD completion focused on its correlation with demographics, personal beliefs, knowledge, attitudes, and exposure to educational media initiatives. We identified five variables with loadings of at least 0.30 in absolute value, along with five demographic variables (significant in the univariate analyses) for multiple logistic regression. The backward elimination method was used to select the final set of jointly significant predictor variables.Results:Of the 200 subjects consenting to an interview, 125 subjects (63%) had completed ADs. In comparing groups with and without ADs, gender (p < 0.0002), age (p < 0.0161), race (p < 0.0001), education (p < 0.0039), and religion (p < 0.0104) were significantly associated with having an AD. Factors predicting AD completion are: thinking an AD will help in the relief of suffering at the end of life, (OR 76.3,p < 0.0001), being asked to complete ADs/ or receiving explanation about ADs (OR 55.2,p < 0.0001), having undergone major surgery (OR 6.3,p < 0.0017), female gender (OR 11.1,p < 0.0001) and increasing age (76–85vs.59–75: OR 3.4,p < 0.0543; <85vs. 59–75: OR 6.3,p < 0.0263).Significance of results:This study suggests that among older adults, the probability of completing ADs is related to personal requests by health care providers, educational level, and exposure to advance care planning media campaigns.

Arthritis, Depression, and Falls Among Community-Dwelling Older Adults: Evidence From the Health and Retirement Study

2016 ◽  
Vol 37 (9) ◽  
pp. 1133-1149 ◽  
Author(s):  
Lien T. Quach ◽  
Jeffrey A. Burr
Keyword(s):  
Older Adults ◽  
Health Care Providers ◽  
Community Dwelling ◽  
Health And Retirement Study ◽  
Depression Symptoms ◽  
Care Providers ◽  
Significant Depression ◽  
Nationally Representative ◽  
Clinically Significant ◽  
Retirement Study

The aims of this study were to examine the association between different types of arthritis and falls and to investigate whether clinically significant depression symptoms (CSDS) moderate these relationships. The study used nationally representative data from the 2008 Health and Retirement Study ( n = 7,715, M age = 75, 62% female, and 90% White). Among the respondents, 42% experienced at least one fall during the previous 2 years. About one third had some form of arthritis: 22% osteoarthritis (OA), 4.8% rheumatoid arthritis (RA), 2.3% both OA and RA, and 7.9% with other arthritis types. About one fifth of respondents had CSDS. OA and CSDS are associated with the odds of falling (17% and 29%, respectively), adjusting for socio-demographic characteristics, lifestyle, health conditions, and psychiatric medications. There was no statistically significant interaction between types of arthritis and CSDS. Health care providers should pay attention to managing arthritis, especially OA, and CSDS to prevent falls among older adults.

scholarly journals THE IMPACT OF AN EDUCATION INTERVENTION: IMPROVING COMMUNICATION BETWEEN OLDER ADULTS AND HEALTH CARE PROVIDERS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S909-S909
Author(s):  
Janna Heyman ◽  
Linda White-Ryan ◽  
Peggy Kelly
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Health Care Providers ◽  
Educational Intervention ◽  
Prescription Drugs ◽  
Medication Use ◽  
Care Providers ◽  
Over The Counter ◽  
Medical Needs ◽  
The Impact

Abstract As people age, ensuing physical and psychological problems can increase, which makes it paramount to be comfortable discussing medical needs with health care professionals, particularly in light of the danger associated with misunderstanding medication use and combining alcohol with prescriptions and/or over the counter medications (National Institute on Aging, 2018). National studies found that about 40 percent of adults ages 65 and older drink alcohol and often do not understand the dangers of combining alcohol with medications (National Institute for Alcohol and Alcohol Abuse, 2008). An educational intervention was developed with a team of expert physicians, nurses, pharmacists and social workers who work in gerontology to focus on improving communication and addressing alcohol and medication use for older adults. A randomized controlled trial was conducted to assess whether the educational intervention improved older adults’ comfort in communicating with their health care providers, as well as their knowledge of the concomitant use of alcohol and prescription and over-the-counter (OTC) medications. Results of a MANCOVA showed that those in the intervention group showed larger increases in scores on communication with their health providers and knowledge about the implications of combining alcohol with prescription drugs than those in the control group (Wilks’ Lamda=.808, F(3,76)=6.039, p=.001&lt;.05). In addition, linear regression models showed that the intervention was significantly associated with participants’ knowledge of the implications of combining alcohol with prescription drugs. The coefficient across models was approximately 1.00, which represented a substantial increase given the average score of 6.5.

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