scholarly journals There Is No Community Here: Living Alone, Place, and Older Peoples' Risk of Social Isolation

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 122-123
Author(s):  
Rachel Weldrick
Keyword(s):  
Risk Factors ◽  
Older People ◽  
Social Exclusion ◽  
Social Isolation ◽  
Significant Risk ◽  
Later Life ◽  
Community Dwelling ◽  
Living Alone ◽  
Future Research ◽  
Diverse Range

Abstract Existing research has identified significant risk factors for experiencing social isolation in later life including chronic health conditions, mobility impairments, and living alone among others. Although many older people who live alone maintain active social lives, living alone remains a top predictor of social isolation. Less is known about other types of risk factors, such as place-based risks and social exclusion. Despite calls to examine the role of place and social exclusion in social isolation risk, few studies have investigated the links. Models of isolation risk have often omitted place-based factors and social exclusion and focused largely on individual-level risks. In order to address these gaps, this paper presents the findings of 17 in-depth, qualitative interviews with community-dwelling older people who live alone (aged 65-93). Participants were recruited using a theoretical sampling strategy to ensure that a diverse range of neighbourhood types were represented among the participants (e.g., walkable vs. car-dependent neighbourhoods). Interview transcripts were analyzed using a constructivist grounded approach resulting in several major themes. Participants described aspects of their local environments as shaping their risk of isolation including infrastructure and amenities delivered in place, and neighbourhood makeup, among others. These themes are further examined through the lens of place-based exclusion and used to conceptualize how dimensions of both place and social exclusion fit into the model of known isolation risk factors. An adapted model of risk is presented to guide future research and intervention planning.

Understanding diversity in later life and a new culture of aging: Sociology of aging in Japan

2021 ◽  
pp. 026858092110053
Author(s):  
Daisuke Watanabe
Keyword(s):  
Social Science ◽  
Older People ◽  
Social Isolation ◽  
Social Problems ◽  
Family Care ◽  
Later Life ◽  
Social Disparities ◽  
Mutual Aid ◽  
Care Problems ◽  
Sociological Studies

This essay introduces sociological studies on aging and related topics in Japan since 2000. It argues the three following points. First, the results of sociological studies on aging, and those from related social science disciplines, have moved away from a uniform understanding of aging to reveal greater diversity in the process. Second, it has become apparent that older people face various social problems, such as social isolation, social disparities, and family care problems. Studies have argued that it is essential to support mutual aid in the community. Finally, the reflexivity of high modernity attempts to push the problem of aging towards autonomy, but a new culture of aging assumes that dependence has the potential to overcome this reflexivity.

scholarly journals Prevalence and Risk Factors of Postprandial Hypotension Among Japanese Older Adults in a Facility

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 222-222
Author(s):  
Noriko Suzuki ◽  
Masahiko Hashizume ◽  
Hideyuki Shiotani
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Older Adults ◽  
Older People ◽  
Future Research ◽  
Baseline Body Mass Index ◽  
Term Care ◽  
Postprandial Hypotension ◽  
Before And After ◽  
Japanese Older Adults

Abstract Postprandial hypotension (PPH) is an unrecognized sudden drop of blood pressure (BP) after meals and a hidden problem among older people including those living in long-term care facilities (LTCFs). Though PPH causes dizziness, falls, and syncope, it has received little attention from¬¬¬ healthcare workers (HCW) including caregivers, nurses and physicians, and risk factors of PPH should be carefully assessed to improve quality of life. Therefore, we aimed to examine the prevalence and risk factors of PPH in a LTCF in Japan. Participants were 114 older adults living in a LTCF in Japan (mean age 85.9 years old; 85 female (74%)). To examine PPH, blood pressure (BP) was measured before and after lunch. BP after meal was measured four times every 30 minutes. PPH is defined as a BP drop of 20 mmHg or more and we also defined a BP drop within a range of 19 to 15 mmHg as potential-PPH. As risk factors, we compared systolic and diastolic BP at baseline, body mass index, pulse rate, disease and complications between groups with/without PPH. The prevalence of PPH was 41% (47/114) and 52% with potential-PPH; 11% (13/114) added. Among risk factors, systolic BP was significantly higher in those with PPH (142.6 vs 123.5 mmHg, p <0.001). This study revealed that PPH & potential-PPH occurred in half of the subjects in a LTCF in Japan. HCW need to focus on high systolic BP to predict PPH and future research is necessary to prevent and cope with PPH for older people.

Preventing social isolation in later life: findings and insights from a pilot Queensland intervention study

2012 ◽  
Vol 33 (7) ◽  
pp. 1167-1189 ◽  
Author(s):  
HELEN BARTLETT ◽  
JENI WARBURTON ◽  
CHI-WAI LUI ◽  
LINDA PEACH ◽  
MATTHEW CARROLL
Keyword(s):  
Older People ◽  
Social Isolation ◽  
Later Life ◽  
Western Society ◽  
Community Based Interventions ◽  
Community Based ◽  
Rigorous Evaluation ◽  
Psychological Measures ◽  
Social Settings ◽  
Government Project

ABSTRACTThe isolation of older people is recognised as a major social problem in contemporary Western society. While the risk factors and social or health outcomes of isolation and loneliness in later life are well documented, evidence regarding the effectiveness of programmes aimed at reducing social isolation in older people remains inconclusive. This paper reports on the challenges of attempting to undertake a rigorous evaluation of three demonstration pilot projects targeting older people at risk of social isolation, conducted within different social settings in Queensland, Australia. The demonstration projects were part of the Queensland Cross-Government Project to Reduce Social Isolation in Older People (CGPRSIOP) led by the Office for Seniors within the Queensland Department of Communities. In the absence of good evaluation of programmes aimed at social isolation, this government-run programme incorporated validated psychological measures to evaluate the effectiveness of interventions. While use of these measures suggested some promising results, the focus of this paper is on the methodological and practical challenges associated with utilising evaluation measures in community-based interventions. The detailed consideration of the methodological issues involved in this programme highlights some key lessons and offers new insights into evaluating interventions for reducing social isolation.

Theorising Sleep Practices and Later Life: Moving to Sheltered Housing

2007 ◽  
Vol 12 (5) ◽  
pp. 214-224 ◽  
Author(s):  
Eileen Fairhurst
Keyword(s):  
Older People ◽  
Textual Analysis ◽  
Later Life ◽  
Original Data ◽  
Sheltered Housing ◽  
Future Research ◽  
Special Issue ◽  
Professional Discourse ◽  
Interesting Topic

This paper re-analyses data from a study of older people and sheltered housing which combined textual analysis of professional discourse with interviews. There were only two references salient to ‘sleep’ in that paper and I offered no analytic comment upon them. At that time, then, sleep as a sociologically interesting topic, was, for me a taken for granted matter. It is that taken for grantedness that is examined here. On being invited to contribute to this special issue, I went back to the original data and interrogated it for ‘sleep’. I realised that, with this different concern, the texts and interviews contained much more about the ‘doing’ of sleep in later life than I had appreciated, especially where, when and how sleeping practices occur. Sleeping ‘upstairs’ or ‘downstairs’, in a single- or double-bed and on which side of the bed were all matters of relevance when older people were considering a move to sheltered housing. Older people's own sleeping practices are contrasted with those offered in texts produced by architects designing sheltered housing. The paper concludes by considering the methodological implications of re-analysing research materials for emerging sociological topics and by giving pointers to future research on sleep practices in later life.

Medication Management for Community-dwelling Older People with Dementia and Chronic Illness

2008 ◽  
Vol 14 (1) ◽  
pp. 25 ◽  
Author(s):  
Debbie Kralik ◽  
Kate Visentin ◽  
Geoff March ◽  
Barbara Anderson ◽  
Andrew Gilbert ◽  
...  
Keyword(s):  
Chronic Illness ◽  
Older People ◽  
Medication Management ◽  
Community Dwelling ◽  
Consumer Involvement ◽  
Future Research ◽  
Coordination Of Care ◽  
Health Providers ◽  
People With Dementia ◽  
Community Dwelling Older People

The purpose of this paper is to report the findings of an integrative review of the literature on medication management for individuals who live in the community and have both chronic illness and mild to moderate dementia. The aim of the review was to summarise what is known about this topic, evaluate and compare previous research on the topic of medication management for people with dementia, and locate gaps in current work, thus pointing to directions for future research. Dementia is a national health priority for Australia. A significant component of community care for people with dementia is the management and administration of the medications required for other chronic conditions. Medication management is a broad term that encompasses several aspects, such as client-centred medication review, rational prescribing and support, repeat prescribing, client information/education, capacity to communicate with multiple health providers and having access to medicines. Cognitive impairment has been associated with medication management issues so it is important to ensure quality outcomes of medicine use by community-dwelling older people with dementia. The literature revealed a number of issues, such as the importance of person-centred care, the need for the coordination of care, and consumer partnerships in medication management. These are all important considerations in planning primary care services to support people with dementia and chronic illnesses. People with dementia who have chronic illness require coordinated, tailored, and flexible care processes in the community. There exists a range of services and programs such as home medicine reviews to support people living in the community with chronic illness and dementia; however, there is little coordination of care and evaluation of interventions is, at best, inconsistent. Currently, Australia lacks an integrative primary health care (PHC) framework, within which consumer involvement in decision-making and/or care planning is valued and sought. Current services are limited in the degree to which there is collaboration between key partners and Australian PHC initiatives are fragmented and have limited impact on service delivery.

scholarly journals Social Exclusion in Older-Age and the European Pillar of Social Rights

2021 ◽  
pp. 421-431
Author(s):  
Maciej Kucharczyk
Keyword(s):  
Older People ◽  
Labour Market ◽  
Social Exclusion ◽  
Working Conditions ◽  
Social Protection ◽  
Later Life ◽  
Social Rights ◽  
Term Care ◽  
Goods And Services

AbstractThe European Pillar of Social Rights is about delivering new and more effective rights for Europeans. It builds upon 20 key principles, structured around three categories: equal opportunities and access to the labour market; fair working conditions; and social protection and inclusion. Directly relevant to older people, the Pillar has the potential to address the multidimensionality of exclusion in later life from a rights-based perspective – for example, by enhancing the rights to quality and affordable health and long-term care, to adequate pensions to live in dignity, to age-friendly working conditions and an inclusive labour market, or to access goods and services. Despite these valuable elements, there remains significant uncertainly around how the Pillar will achieve this and what kind of implemental actions might emerge across member states. This chapter analyses the potential of the European Pillar to address social exclusion of older people in Europe, the challenges that might impede its efforts, and the measures necessary to overcome such challenges.

Gender Differences in Risk Factors for Depressive Symptoms in Patients with COPD: The 2014 and 2016 Korea National Health and Nutrition Examination Survey

2020 ◽  
Author(s):  
Ji Soo Choi ◽  
Se Hyun Kwak ◽  
San Lee ◽  
Eun Hye Lee
Keyword(s):  
Risk Factors ◽  
Gender Differences ◽  
Depressive Symptoms ◽  
National Health ◽  
Low Income ◽  
Significant Risk ◽  
Living Alone ◽  
Nutrition Examination Survey ◽  
Health And Nutrition ◽  
Low Bmi

Abstract Background: Although depression is a common comorbidity of chronic obstructive pulmonary disease (COPD), the role of gender remains unexplored. We evaluated gender differences of risk factors of depressive symptoms in adults with COPD. Methods: This was a population-based cross-sectional study using data from the 2014 and 2016 Korea National Health and Nutrition Examination Survey. Spirometry was used to identify patients with COPD, defined as a FEV1/FVC ratio <0.7. Presence of depressive symptoms was defined as a total score ≥5 on the Patient Health Questionnaire-9. Results: Overall, 17.8% of participants expressed depressive symptoms, with 13.1% being men and 29.6% being women. Multivariable regression analysis revealed that low BMI (adjusted OR, 2.62), female gender (adjusted OR, 3.48), living alone (adjusted OR, 1.75), currently smoking (adjusted OR, 2.52), and GOLD Stage III/IV (adjusted OR, 2.34) were significant risk factors for depressive symptoms. In a subgroup analysis, low BMI, low income, living alone, and multiple chronic disorders were risk factors of depressive symptoms in men, whereas low educational attainment, urban living, and currently smoking were risk factors in women.Conclusions: As risk factors of depressive symptoms in COPD patients vary according to gender, different approaches are needed to manage depression in men and women with COPD.

scholarly journals 347 Numeracy Performance and the Relationship to Age and Retirement among Community-Dwelling Adults

2019 ◽  
Vol 48 (Supplement_3) ◽  
pp. iii17-iii65
Author(s):  
Maureen Mickus ◽  
Craig Carpenter ◽  
Scott Loveridge
Keyword(s):  
Later Life ◽  
Well Being ◽  
Population Based ◽  
Community Dwelling ◽  
Future Research ◽  
Intellectual Stimulation ◽  
Telephone Surveys ◽  
Age Related ◽  
Financial Need ◽  
Alternative Choice

Abstract Background Remaining in the workforce in later life may be based on financial need, role fulfillment or opportunities for social participation. Employment can also provide intellectual stimulation, including the use of everyday math skills. Normal age-related decline in numeracy performance has been documented, but the role of retirement in the capacity to perform these functions is less understood. This research uses population-based telephone surveys to analyze whether the interaction of age and retirement influences the ability of community-dwelling adults to calculate simple math problems. Methods Data was drawn from three independently sampled surveys in 2006 (n=991), 2010 (n=1,023) and 2014 (n=997). In addition to standard demographic questions, the survey measured individuals’ ability to perform basic computations. Three questions were asked regarding temporal (now or 5 years later) preferences about jobs, a community bond, and an inheritance payout. Respondents were then asked to calculate the amount needed to select the other option instead. Deficient numeracy performance was defined as either no response or an irrational choice (e.g. a lesser amount of inheritance with the alternative choice.) Results Approximately 30% of persons age 65+ chose not to perform the follow-up calculations for these questions. Moreover, a 1% increase in age decreased the likelihood of rationally calculating the discount rate by between 0.15 and 0.25 percentage points, depending on the scenario. A sharp decline in numeracy was observed starting at age 66 with the addition of an age x retirement interaction, even when controlling for key variables such as education and income. Conclusion Retirement may reduce the opportunity for intellectual challenges afforded in the workplace and consequently, the ability to perform math calculations may decline. Alternatively, decisions to retire may be due to declining health, including cognitive impairments. The timing of retirement has major implications for public policy. Future research more deeply exploring the causal influence of retirement on health and well-being is warranted.

scholarly journals Nutritional Status and Risk Factors for Frailty in Community-Dwelling Older People: A Cross-Sectional Study

Nutrients ◽  
2020 ◽  
Vol 12 (4) ◽  
pp. 1041 ◽  
Author(s):  
Pilar Pérez-Ros ◽  
Rafael Vila-Candel ◽  
Lourdes López-Hernández ◽  
Francisco Miguel Martínez-Arnau
Keyword(s):  
Physical Activity ◽  
Risk Factors ◽  
Nutritional Status ◽  
Older People ◽  
Cross Sectional Study ◽  
Community Dwelling ◽  
Sectional Study ◽  
Cross Sectional ◽  
Community Dwelling Older People ◽  
The Relationship

Objective: This study aims to assess the relationship that frailty has with nutritional status and functional risk factors in community-dwelling older adults. Methods: Cross-sectional study in community-dwelling older people, independent for walking and without impaired cognition. Frailty was assessed by Fried criteria. Nutritional status was analyzed by the Mini Nutritional Assessment Short Form (MNA-SF), biochemical markers (albumin, total proteins, cholesterol, lymphocytes, and hemoglobin); and anthropometric parameters (body mass index [BMI], body fat percentage, handgrip, and perimeters). A comprehensive geriatric assessment analyzed other risk factors: functionality, cognition, falls, comorbidity, polypharmacy, physical activity, and quality of life (QoL). Results: We included 564 elderly people with a mean age of 76.05 (standard deviation 3.97) years; 63.1% (n = 356) were women, and 83.9% (n = 473) were prefrail, and frail. The sample presented high functionality and a nutritional status with a predominance of overweight and obesity. Factors associated with frailty (R2 = 0.43) were age over 75 years (odds ratio [OR] 3.31, 95% confidence interval [CI] 1.76, 6.21; p < 0.001), female gender (OR 2.37, 95% CI 1.24, 4.52; p = 0.009), anemia (OR 2.45, 95% CI 1.19, 5.02; p = 0.015), falls (OR 1.94, 95% CI 1.12, 3.25; p = 0.016) and the fear of falling (OR 4.01: 95% CI 1.76, 9.16; p = 0.001). Performing more than 3 weekly hours of physical activity was found to be a protective factor (OR 0.23, 95% CI 0.15, 0.35; p < 0.001). Conclusions: The relationship between frailty and malnutrition in functionally independent community-dwelling older people is unclear. More studies are needed to know what nutritional markers are related to frailty, cognition, and functionality in order to discriminate the risk factors for community-dwelling older people at risk of malnutrition and dependency.

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