Technology for Healthy Aging: Use of Electronic Communication among Older Adults

Abstract In the digital era, many electronic platforms have been established to facilitate patient-provider communication, such as e-mail, text messaging, and patient portal. The use of these electronic platforms is termed as electronic-communication (e-communication). E-communication has a variety of personalized healthcare functions, such as exchanging information, reviewing lab results, and facilitating patient engagement. However, little is known about the actual use of e-communication among older adults who are potentially major users of e-communication considering their high-level health care needs. Understanding their use of e-communication is critical in improving the application of e-communication in older adults. Using data from American Health Information National Trends Survey (HINTS2019-Cycle3; n=1,961; meanage =74.10, range=65-98), we explored: 1) the prevalence of e-communication use among older adults, and 2) factors affecting their use of e-communication. Variables were measured by self-reports. Weighted logistic regression with replicate weights provided by the HINTS was performed for data analysis. We found that 50% older adults reported the use of e-communication in the last year. Factors associated with higher likelihood of older adults’ e-communication use included younger age (OR=09.96, 95%CI=0.93-0.98, p<0.001), higher education (OR=4.82, 95%CI=2.32-10.02, p<0.001 for college graduate or higher), higher income (OR=1.58, 95%CI=1.05-2.38, p=0.030), comorbid conditions (OR=1.64, 95%CI=1.02-2.64, p<0.001), and having a regular provider (OR=2.06, 95%CI=1.31-3.22, p=0.002). This study provided nationally representative results demonstrating a great potential use of e-communication in older adults. Special attention is needed to focus on socially vulnerable older adults (e.g., those with older age, lower education and income, and having comorbidity).

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Psychological Distress and Access to Care Among Midlife Women

Journal of Aging and Health ◽

10.1177/0898264318822367 ◽

2019 ◽

Vol 32 (5-6) ◽

pp. 317-327

Author(s):

Pamela Jo Johnson ◽

Judy Jou ◽

Dawn M. Upchurch

Keyword(s):

Health Care ◽

Psychological Distress ◽

Healthy Aging ◽

The United States ◽

Midlife Women ◽

Care Needs ◽

Interview Survey ◽

Unmet Health Care Needs ◽

Nationally Representative ◽

Using Data

Objective: The objective of this study is to examine unmet health care needs among midlife women (ages 50-64 years) in the United States by level of psychological distress. Method: Using data for a nationally representative sample of midlife women ( N = 8,838) from the 2015-2016 National Health Interview Survey, we estimated odds ratios of reasons for delayed care and types of care foregone by level of psychological distress—none, moderate (moderate psychological distress [MPD], and severe (severe psychological distress [SPD]). Findings: More than one in five midlife women had MPD (15.3%) or SPD (5.2%). Women with MPD or SPD had 2 to 5 times higher odds of delayed and 2 to 20 times higher odds of foregone care. Conclusions: Midlife women with psychological distress have poorer health than those with no distress, yet they are less likely to get needed health care. There is a missed window of opportunity to address mental health needs and manage comorbid chronic conditions to facilitate healthy aging.

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How Loneliness, Depressed Mood, and Diet Affect Eating Habits and Grocery Shopping

Innovation in Aging ◽

10.1093/geroni/igaa057.079 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 24-25

Author(s):

Erica Solway ◽

Dianne Singer ◽

Preeti Malani ◽

Jeffrey Kullgren ◽

Matthias Kirch ◽

...

Keyword(s):

Older Adults ◽

Healthy Aging ◽

Eating Habits ◽

Grocery Shopping ◽

Food Shopping ◽

National Poll ◽

Nationally Representative ◽

Using Data ◽

Fair Poor ◽

Sample Age

Abstract This study examined the prevalence of loneliness and relationship with cooking and eating habits among older adults using data collected in December 2019 from a nationally representative sample age 50-80 through the National Poll on Healthy Aging. Older adults who live alone were more likely those who lived with others (19% vs. 8%) and those with a high PHQ-2 score were more like than those with a low PHQ-2 score (20% vs. 11%) to report that they do not cook dinner most days (0-2 times/week). Those who rated their diet as fair/poor were more likely to indicate they cook few meals a week (0-2) compared to those who reported a good or very good/excellent diet (18% vs. 11 % vs 8%). Those with a high PHQ-2 score were less likely than those with a low PHQ-2 score to say they do major food shopping less than once a week (31% vs 47%). Those with a high PHQ-2 score were more likely to say that that always ate alone in the last week compared to those with a low PHQ-2 score (17% vs 7%). These findings demonstrate that older adults who lived alone, had a higher PHQ-2 score, and had a poorer diet were more likely to cook and do grocery shopping less often. Strategies and policies to support older adults to address depressive symptoms and to increase cooking and improve diet may have many health and social benefits and will be explored through this session.

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Policy Series: The Impact of Ageism on Health and Efforts to Address It Through Reframing Aging

Innovation in Aging ◽

10.1093/geroni/igaa057.2556 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 722-722

Author(s):

Erica Solway

Keyword(s):

Older Adults ◽

Healthy Aging ◽

Policy Implications ◽

Physical And Mental Health ◽

Negative Effects ◽

Research Education ◽

National Poll ◽

Nationally Representative ◽

Using Data ◽

The Impact

Abstract Ageism can manifest in a variety of ways including in institutional policies and practices, interpersonal interactions, older adults’ internalization of ageist stereotypes, and through the media. While major incidents of age-based discrimination and their negative effects on health are more recognized, older adults also experience less momentous, but still harmful ageism in their day-to-day lives. These types of everyday ageism are also harmful to health. This symposium will highlight recent research from the University of Michigan National Poll on Healthy Aging on self-reported experiences of everyday ageism among a nationally representative sample of U.S. adults age50-80 and its connections to physical and mental health outcomes. Next, another researcher also using data from the National Poll on Healthy Aging will explore the prevalence of positive attributes of aging, its relationships to health, and ways in which it may buffer older adults from the adverse health consequences of ageism. Then speakers will highlight the Reframing Aging initiative and the ways in which GSA and other organizations are leading a national effort to address ageism through education and dissemination of research-based resources. This session will feature research, education, and advocacy efforts and will focus on the policy implications of efforts to better understand the prevalence of and strategies to counter the effects of ageism.

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Understanding employee turnover in humanitarian organizations

Industrial and Commercial Training ◽

10.1108/ict-10-2015-0067 ◽

2016 ◽

Vol 48 (4) ◽

pp. 208-214 ◽

Cited By ~ 17

Author(s):

Rameshwar Dubey ◽

Angappa Gunasekaran ◽

Nezih Altay ◽

Stephen J Childe ◽

Thanos Papadopoulos

Keyword(s):

Employee Turnover ◽

Factor Loading ◽

Personal Factors ◽

Related Factors ◽

Content Type ◽

Factors Affecting ◽

Work Related ◽

Humanitarian Organizations ◽

Using Data ◽

High Level

Purpose – At a time when the number and seriousness of disasters seems to be increasing, humanitarian organizations find that besides their challenging work they are faced with problems caused by a high level of turnover of staff. The paper aims to discuss these issues. Design/methodology/approach – Based on the 24 variables leading to employee turnover identified by Cotton and Tuttle (1986) the authors analyse the work-related, external and personal factors affecting employee turnover in humanitarian organizations, using a survey of members of the Indian National Institute of Disaster Management. Findings – Results indicated that the three factors are present. Of the external factors, only employment perception had a factor loading over 0.7; of the work-related factors, all were significant; of the personal factors, biographical information, marital status, number of dependants, aptitude and ability and intelligence had the highest loadings. It was also shown that behavioural intentions and net expectation were not significant. Originality/value – Only a few studies reported on employee turnover and its reasons are not well understood in the context of humanitarian organizations. To address this need, the aim of this paper is to explore the personal reasons impacting employee turnover in humanitarian organizations. In the study the authors have adopted 24 variables used in Cotton and Tuttle (1986) and classified into constructs to explain turnover, and further tested the model using data gathered from humanitarian organizations.

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Child care needs of parents in paid work: An interpretation of findings from Australia's Welfare 1993: Services and Assistance

Children Australia ◽

10.1017/s1035077200004442 ◽

1995 ◽

Vol 20 (2) ◽

pp. 10-13

Author(s):

Graeme Vaughan

Keyword(s):

Child Care ◽

Informal Support ◽

Care Needs ◽

Work Arrangements ◽

Care Services ◽

Paid Employment ◽

Formal Services ◽

Using Data ◽

Australian Bureau Of Statistics ◽

High Level

The extent to which the child care needs of parents in paid employment are adequately met is an important matter. This paper examines the issue using data published in the recent report from the Australian Institute of Health and Welfare, Australia's Welfare 1993: Services and Assistance. Data from recent surveys by the Australian Bureau of Statistics are used to supplement the report's findings.While families with both parents or the sole parent in paid employment are the major users of formal child care services many of them continue to experience difficulties in obtaining child care that meets their needs. Many of these families need to arrange their domestic and working lives to care for children within the family or rely on informal support by other family members, friends and neighbours. Many adopt a mix of strategies-formal services, informal support and flexible work arrangements-to meet their child care needs. These families show a high level of unmet demand for formal services; mothers in these families experience difficulties in balancing the competing demands of caring for children and paid employment.

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Coprescribing of Benzodiazepines and Opioids in Older Adults: Rates, Correlates, and National Trends

The Journals of Gerontology Series A ◽

10.1093/gerona/gly283 ◽

2018 ◽

Vol 74 (12) ◽

pp. 1910-1915 ◽

Cited By ~ 8

Author(s):

Taeho Greg Rhee

Keyword(s):

Older Adults ◽

Future Research ◽

Physician Visits ◽

Prescribing Trends ◽

Clinical Diagnoses ◽

Nationally Representative ◽

Using Data ◽

National Trends ◽

Ambulatory Medical Care ◽

Over Time

Abstract Background To estimate prescribing trends of and correlates independently associated with coprescribing of benzodiazepines and opioids among adults aged 65 years or older in office-based outpatient visits. Methods I examined a nationally representative sample of office-based physician visits by older adults between 2006 and 2015 (n = 109,149 unweighted) using data from the National Ambulatory Medical Care Surveys (NAMCS). National rates and prescribing trends were estimated. Then, I used multivariable logistic regression analyses to identify demographic and clinical factors associated with coprescriptions of benzodiazepines and opioids. Results From 2006 to 2015, 15,954 (14.6%) out of 109,149 visits, representative of 39.3 million visits nationally, listed benzodiazepine, opioid, or both medications prescribed. The rate of prescription benzodiazepines only increased monotonically from 4.8% in 2006–2007 to 6.2% in 2014–2015 (p < .001), and the rate of prescription opioids only increased monotonically from 5.9% in 2006–2007 to 10.0% in 2014–2015 (p < .001). The coprescribing rate of benzodiazepines and opioids increased over time from 1.1% in 2006–2007 to 2.7% in 2014–2015 (p < .001). Correlates independently associated with a higher likelihood of both benzodiazepine and opioid prescriptions included: female sex, a visit for chronic care, receipt of six or more concomitantly prescribed medications, and clinical diagnoses of anxiety and pain (p < .01 for all). Conclusion The coprescribing rate of benzodiazepines and opioids increased monotonically over time in outpatient care settings. Because couse of benzodiazepines and opioids is associated with medication burdens and potential harms, future research is needed to address medication safety in these vulnerable populations.

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Exploring Community-Dwelling Older Adults’ Considerations About Values and Preferences for Future End-of-Life Care: A Study from Sweden

The Gerontologist ◽

10.1093/geront/gnaa012 ◽

2020 ◽

Vol 60 (7) ◽

pp. 1332-1342 ◽

Cited By ~ 1

Author(s):

Malin Eneslätt ◽

Gert Helgesson ◽

Carol Tishelman

Keyword(s):

Older Adults ◽

End Of Life ◽

Community Dwelling ◽

Participatory Action ◽

Action Research Project ◽

Care Needs ◽

Swedish Version ◽

Using Data ◽

Eol Care ◽

Community Dwelling Older Adults

Abstract Background and Objectives There is a substantial body of research on advance care planning (ACP), often originating from English-speaking countries and focused on health care settings. However, studies of content of ACP conversations in community settings remain scarce. We therefore explore community-dwelling, older adults’ reasoning about end-of-life (EoL) values and preferences in ACP conversations. Research Design and Methods In this participatory action research project, planned and conducted in collaboration with national community-based organizations, we interviewed 65 older adults without known EoL care needs, about their values and preferences for future EoL care. Conversations were stimulated by sorting and ranking statements in a Swedish version of GoWish cards, called the DöBra cards, and verbatim transcripts were analyzed inductively. Results While participants shared some common preferences about EoL care, there was great variation among individuals in how they reasoned. Although EoL preferences and prioritizations could be identical, different individuals explained these choices very differently. We exemplify this variation using data from four participants who discussed their respective EoL preferences by focusing on either physical, social, existential, or practical implications. Discussion and Implications A previously undocumented benefit of the GoWish/DöBra cards is how the flexibility of the card statements support substantial discussion of an individual’s EoL preferences and underlying values. Such in-depth descriptions of participants’ reasoning and considerations are important for understanding the very individual nature of prioritizing EoL preferences. We suggest future users of the DöBra/GoWish cards consider the underlying reasoning of individuals’ prioritizations to strengthen person-centeredness in EoL conversations and care provision.

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Determinants of long-term care insurance applications in South Korea

Journal of Public Health ◽

10.1093/pubmed/fdaa094 ◽

2020 ◽

Author(s):

Sunhee Park ◽

Heejung Kim ◽

Chang Gi Park

Keyword(s):

Older Adults ◽

South Korea ◽

Long Term Care ◽

Community Dwelling ◽

Care Needs ◽

Term Care ◽

Factors Affecting ◽

Long Term Care Insurance ◽

The Government

Abstract Background South Korea established universal long-term care insurance (LTCI) in 2008. However, actual requests for LTCI remain lower than government estimates because some eligible candidates never apply despite their strong care needs. This study aimed to examine factors affecting LTCI applications for older, community-dwelling Koreans. Methods Both individual- and community-level data were obtained from a national dataset from the Korea Health Panel Survey and the Korea National Statistical Office (N = 523). Data were analyzed using multilevel modeling. Results Only 16.4% of older adults in need of care applied for LTCI. Those who applied were more likely to be older, report poor self-rated health, receive care from non-family caregivers, and have caregivers experiencing high levels of caregiving burden. Regional differences in LTCI applications existed concerning the financial condition of one’s community. Conclusions Our study findings emphasize that Korean LTCI should implement both individual and community strategies to better assist older adults in properly acquiring LTCI. The government should make comprehensive efforts to increase access to LTCI in terms of availability, quality, cost, and information by collaborating with local centers.

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Functional Hearing Loss and Social Engagement Among Medicare Beneficiaries

The Journals of Gerontology Series B ◽

10.1093/geronb/gbz094 ◽

2019 ◽

Vol 76 (1) ◽

pp. 195-200 ◽

Cited By ~ 1

Author(s):

Aishwarya Shukla ◽

Thomas K M Cudjoe ◽

Frank R Lin ◽

Nicholas S Reed

Keyword(s):

Older Adults ◽

Hearing Loss ◽

Social Engagement ◽

Social Activity ◽

Medicare Beneficiaries ◽

Cross Sectional ◽

The Past ◽

Hearing Ability ◽

Nationally Representative ◽

Using Data

Abstract Objectives Hearing loss is common in older adults and limits communication. We investigated the independent association between functional hearing loss and social engagement in a nationally representative sample of older adults. Methods Using data from the 2015 Medicare Current Beneficiaries Survey, we modeled the cross-sectional association between self-reported hearing ability and limitation in social activity over the past month using multivariable logistic regression. Results The majority of the study population was female (54.8%) and non-Hispanic white (74.3%). Participants (40.4%) reported “a little trouble” hearing and 7.4% reported “a lot of trouble” hearing. Those who reported any trouble hearing had higher odds of limited social engagement in the past month. After adjustment for demographic, clinical, and functional covariates, those who reported “a lot of trouble” hearing had 37% higher odds of limited social activity in the past month compared to those with normal hearing. Discussion These results suggest that hearing loss may be an important risk factor for limited social engagement and downstream negative health consequences, independent of other disability and health conditions.

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NEIGHBORHOOD AGE COMPOSITION AND SELF-RATED HEALTH: FINDINGS FROM A NATIONALLY REPRESENTATIVE STUDY

Innovation in Aging ◽

10.1093/geroni/igz038.247 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S64-S64

Author(s):

Amanda Lehning ◽

Amanda J Lehning ◽

Nicole Mattocks ◽

Kyeongmo Kim ◽

Richard J Smith

Keyword(s):

Older Adults ◽

Regression Models ◽

Neighborhood Change ◽

Age Composition ◽

Logistic Regression Models ◽

Self Rated Health ◽

Representative Study ◽

Nationally Representative ◽

Using Data ◽

Conceptual Work

Abstract Neighborhood age composition is an understudied area. Furthermore, existing empirical and conceptual work is conflicting, with some indicating neighborhoods with more older adults are beneficial and other scholarship suggesting it can be detrimental. Using data from 7,197 older adults from the first wave (2011) of the National Health & Aging Trends Study combined with census tract data from the National Neighborhood Change Database, we examined the association between neighborhood age composition and self-rated health. Findings from logistic regression models indicate those living in neighborhoods with a growing concentration of older residents are significantly more likely to report lower self-rated health compared to those living in a neighborhood in which older adults overall are declining (β=1.51, p < .05) or are becoming diluted by younger residents (β=.66, p < .05). Results have implications for interventions promoting aging in place, particularly for those who may be stuck in place in age-concentrated neighborhoods.

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