Dance wherever you are: the evolution of multi-modal delivery for social inclusion of rural older adults

Abstract Background and Objectives Older adult social inclusion involves meaningful participation that is increasingly mediated by information communication technology (ICT) and in rural areas requires understanding of older adults’ experiences in the context of the digital divide. This paper examines how the multi-modal streaming (live, pre-recorded, blended in-person) of the Sharing Dance Older Adults program developed by Canada's National Ballet School (NBS) and Baycrest, influenced social inclusion processes and outcomes in rural settings. Research Design and Methods Data were collected from on-site observations of dance sessions, research team reflections, focus groups and interviews with older adult participants and their carers in pilot studies in the Peterborough Region of Ontario, and the Westman Region of Manitoba, Canada (2017-2019). There were 289 participants including older adults, people living with dementia, family carers, long-term-care staff, community facilitators, and volunteers. Analytic themes were framed in the context of rural older adult social exclusion. Results Remote delivery addressed barriers of physical distance by providing access to the arts-based program and enhancing opportunities for participation. Constraints were introduced by the use of technology in rural areas and mitigated by in-person facilitators and different streaming options. Meaningful engagement in dynamic interactions in the dance was achieved by involving local staff and volunteers in facilitation of and feedback on the program and its delivery. Different streaming technologies influenced social inclusion in different ways: live-stream enhanced connectedness, but constrained technical challenges; pre-recorded was reliable, but less social; blended delivery provided options, but personalization was unsustainable. Discussion and Implications Understanding different participants’ experiences of different technologies will contribute to more effective remote delivery of arts-based programs with options to use technology in various contexts depending on individual and organizational capacities.

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Ageism and COVID-19: what does our society’s response say about us?

Age and Ageing ◽

10.1093/ageing/afaa097 ◽

2020 ◽

Vol 49 (5) ◽

pp. 692-695 ◽

Cited By ~ 30

Author(s):

Sarah Fraser ◽

Martine Lagacé ◽

Bienvenu Bongué ◽

Ndatté Ndeye ◽

Jessica Guyot ◽

...

Keyword(s):

Older Adults ◽

Older Adult ◽

Social Inclusion ◽

Public Discourse ◽

Long Term Care ◽

Intergenerational Solidarity ◽

Term Care ◽

The Public ◽

Initial Perception

Abstract The goal of this commentary is to highlight the ageism that has emerged during the COVID-19 pandemic. Over 20 international researchers in the field of ageing have contributed to this document. This commentary discusses how older people are misrepresented and undervalued in the current public discourse surrounding the pandemic. It points to issues in documenting the deaths of older adults, the lack of preparation for such a crisis in long-term care homes, how some ‘protective’ policies can be considered patronising and how the initial perception of the public was that the virus was really an older adult problem. This commentary also calls attention to important intergenerational solidarity that has occurred during this crisis to ensure support and social-inclusion of older adults, even at a distance. Our hope is that with this commentary we can contribute to the discourse on older adults during this pandemic and diminish the ageist attitudes that have circulated.

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Housing, Affordability, and Community-Based Aging

Innovation in Aging ◽

10.1093/geroni/igaa057.2415 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 690-691

Author(s):

Samara Scheckler

Keyword(s):

Older Adults ◽

Older Adult ◽

Long Term Care ◽

Housing Tenure ◽

Policy Implications ◽

Housing Cost ◽

Home Equity ◽

Community Based ◽

Term Care

Abstract The house acts as both an environment of care and a vehicle to financially potentiate long-term community-based support. While housing can empower a diverse set of options for a person-centered aging process, inadequate housing can also impede healthy aging in the community. This symposium teases out the nodes where housing acts to benefit or limit safe community-based aging. The first paper in this symposium, Homeownership Among Older Adults, describes typologies of older adult homeownership and sensitively highlights trends, disparities and important considerations of homeownership in later life. The next two papers take these older adults and explores situations where their housing acts as an asset or as a burden. Identifying Cost Burdened Older Adults acknowledges that housing cost burdens look different for older adults than younger cohorts. A more precise definition of older adult housing cost burden is proposed to help researchers and policymakers better synthesize the complex relationships between older adult housing and their long-term care decisions. The Long-Term Care Financing Challenge then explores the role of home equity in expanding the community-based long-term care choice set for older adults. This paper demonstrates benefits (both realized and unrealized) in home equity and suggests policy implications moving forward. Finally, Cardiometabolic Risk Among Older Renters and Homeowners disentangles the relationship between housing and health by demonstrating health disparities that are associated with housing tenure, conditions and affordability. Taken together, this symposium explores the complex and multidirectional relationships between housing, long-term care and older adult health.

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ThessAHALL—A Life-Long Learning Programme for the Social Inclusion of “Early-Stage” Older Adult Researchers

10.1007/978-3-030-78733-2_9 ◽

2021 ◽

pp. 89-97

Author(s):

Despoina Mantziari ◽

Evdokimos Konstantinidis ◽

Despoina Petsani ◽

Nikolaos Kyriakidis ◽

Vassiliki Zilidou ◽

...

Keyword(s):

Older Adults ◽

Social Exclusion ◽

Older Adult ◽

Social Inclusion ◽

Early Stage ◽

Open Science ◽

Ageing Population ◽

Life Long Learning ◽

The Social

AbstractAiming at limiting the risk of ageism & social exclusion of older adults in society, the Thess-AHALL looks at co-design and open science solutions for social inclusion for the ageing population.

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Hospital to Home: Supporting the Transition From Hospital to Home for Older Adults

Canadian Journal of Nursing Research ◽

10.1177/08445621211044333 ◽

2021 ◽

pp. 084456212110443

Author(s):

Brittany Barber ◽

Lori Weeks ◽

Lexie Steeves-Dorey ◽

Wendy McVeigh ◽

Susan Stevens ◽

...

Keyword(s):

Older Adults ◽

Home Care ◽

Family Caregivers ◽

Older Adult ◽

Long Term Care ◽

Home Care Services ◽

Term Care ◽

Care Services ◽

Hospital To Home

Background An increasing proportion of older adults experience avoidable hospitalizations, and some are potentially entering long-term care homes earlier and often unnecessarily. Older adults often lack adequate support to transition from hospital to home, without access to appropriate health services when they are needed in the community and resources to live safely at home. Purpose This study collaborated with an existing enhanced home care program called Home Again in Nova Scotia, to identify factors that contribute to older adult patients being assessed as requiring long-term care when they could potentially return home with enhanced supports. Methods Using a case study design, this study examined in-depth experiences of multiple stakeholders, from December 2019 to February 2020, through analysis of nine interviews for three focal patient cases including older adult patients, their family or friend caregivers, and healthcare professionals. Results Findings indicate home care services for older adults are being sought too late, after hospital readmission, or a rapid decline in health status when family caregivers are already experiencing caregiver burnout. Limitations in home care services led to barriers preventing family caregivers from continuing to care for older adults at home. Conclusions This study contributes knowledge about gaps within home care and transitional care services, highlighting the importance of investing in additional home care services for rehabilitation and prevention of rapidly deteriorating health.

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Current Status of the Long-term Care Security System for Older Adults in China

Research on Aging ◽

10.1177/0164027520949117 ◽

2020 ◽

pp. 016402752094911

Author(s):

Peng Du ◽

Tingyue Dong ◽

Jingyao Ji

Keyword(s):

Older Adults ◽

Rural Areas ◽

Service Provision ◽

Long Term Care ◽

Care Service ◽

Security System ◽

Current Status ◽

Term Care ◽

Insurance System

In response to the increasing care demand of older adults and their families, the construction of the long-term care (LTC) security system has been widely recognized by the government, society and families. This article discusses the socio-demographic background, current situation, achievements and issues of this system. The LTC security system in China has achieved considerable progress in enriched service provision and expanded social insurance system pilot programs. However, the issues of unbalanced service provision and the explorative design of the insurance system still need to be resolved. Our recommendations for the development of the LTC security system include comprehensively reviewing the integrated care service system in terms of placing “old adults at the center,” addressing the long-standing divisions between urban and rural areas in service provision and insurance design, advancing research and discussion concerning pilot experiences and improving the unified evaluation and financial planning systems.

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Willingness to live in eldercare institutions among older adults in urban and rural China: a nationwide study

Ageing and Society ◽

10.1017/s0144686x09990596 ◽

2009 ◽

Vol 30 (4) ◽

pp. 583-608 ◽

Cited By ~ 19

Author(s):

RITA JING-ANN CHOU

Keyword(s):

Older Adults ◽

Rural Areas ◽

Filial Piety ◽

Long Term Care ◽

Cultural Beliefs ◽

Institutional Care ◽

Policy Implications ◽

Care Needs ◽

Term Care

ABSTRACTRecent economic development and socio-cultural changes have made it increasingly difficult for Chinese families to provide eldercare. Consequently, institutional care has been strongly promoted to meet older adults' long-term care needs. Although it has been estimated that China needs more beds to meet such needs, unfilled beds have been reported nationwide. One reason for the low occupancy may be a lack of willingness among older adults to live in long-term care institutions. Based on a national survey of 20,255 older adults, this study examined the extent of willingness among older Chinese to live in eldercare institutions, and it was found that in urban and rural areas, only 20 and 17 per cent of older adults, respectively, were willing to do so. Using an integrated theoretical model and logistic regression analyses, this study shows that gender, perceived family harmony, perceived filial piety, socio-cultural beliefs and practices about raising children and eldercare, knowledge and opinion about eldercare institutions, and self-assessed economic status were associated with willingness to live in eldercare institutions for both urban and rural older adults, while other predictors of willingness had different effects. The paper concludes with a discussion of the substantive, theoretical and policy implications for long-term care in China.

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Age-Friendly Online Training Programs for Long-Term Services and Supports Staff to Improve Care for Older Adults

Innovation in Aging ◽

10.1093/geroni/igaa057.1719 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 532-532

Author(s):

Linda Edelman ◽

Kara Dassel

Keyword(s):

Older Adults ◽

Rural Communities ◽

Rural Areas ◽

Urban Areas ◽

Online Training ◽

Team Leadership ◽

Educational Opportunities ◽

Opioid Use ◽

Term Care

Abstract The purpose of our Geriatric Workforce Enhancement Program is to provide geriatric and primary care education and training to long-term care (LTC) providers and staff, health professions students and community members. Our LTC partners and the communities we serve are often very rural and travel to urban areas for training can be difficult. Therefore, we have developed four online training that are offered free to our partners and rural communities statewide. These programs are designed to integrate the aims of the Age-Friendly 4M’s model (i.e., What Matters, Mobility, Medication, Mentation). The LTC nurse residency program provides gerontological nursing and inter-professional leadership training (all 4M’s), in a synchronous online environment. The asynchronous Alzheimer’s Disease and Related Dementias training modules educate LTC staff and family caregivers about types, diagnosis and care of older adults with dementia (Mentation and Medication). The asynchronous Opioid Use in LTC modules were developed with partners to deliver live at LTC staff trainings about opioid stewardship (Medication). The LTC Learning Communities are monthly tele-health sessions for inter-professional LTC teams to discuss current issues and propose solutions (all 4M’s). We have successfully leveraged different synchronous and asynchronous online modalities to increase educational opportunities for formal and informal caregivers, including those in rural areas whose educational opportunities are geographically limited. To date our programs have reached over 500 individuals across our state, increasing knowledge about geriatric concepts, communication and team leadership. Moving forward, we will continue to develop and refine educational programs that promote the Age-Friendly geriatric-focused health care.

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Identifying roles in older adults’ emergency department transitions

Proceedings of the Human Factors and Ergonomics Society Annual Meeting ◽

10.1177/1071181320641159 ◽

2020 ◽

Vol 64 (1) ◽

pp. 685-689

Author(s):

Megan E. Salwei ◽

Hanna Barton ◽

Nicole E. Werner ◽

Rachel Rutkowski ◽

Peter L.T. Hoonakker ◽

...

Keyword(s):

Older Adults ◽

Emergency Department ◽

Older Adult ◽

Error Detection ◽

Care Transitions ◽

Care Facility ◽

Transitions Of Care ◽

Adult Care ◽

Term Care ◽

Long Term Care Facility

Older adults frequently visit the emergency department (ED) and participate in multiple transitions of care following an ED visit. These transitions of care, e.g. to hospital, long-term care facility or home, represent patient safety risks because of communication and coordination failures between the various roles involved, but also provide opportunities for error detection and recovery and, therefore, resilience. The objective of this study was to identify and describe the multiple roles involved in older adult care transitions during an ED visit. As part of a large research project, we conducted patient-centered observations and interviewed ED clinicians and hospital administrators. We identified 16 ED roles involved in older adult care transitions out of the ED, including 4 roles solely focused on coordinating transitions. By better understanding the roles involved in ED care transitions, we can improve the design of team processes and technologies to support care of older adults throughout their care transitions.

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Hospital to Home: Supporting the Transition from Hospital to Home for Older Adults

10.21203/rs.3.rs-275757/v1 ◽

2021 ◽

Author(s):

Brittany Barber ◽

Lori Weeks ◽

Lexie Steeves-Dorey ◽

Wendy McVeigh ◽

Susan Stevens ◽

...

Keyword(s):

Older Adults ◽

Home Care ◽

Older Adult ◽

Long Term Care ◽

Home Care Services ◽

Adult Patients ◽

Term Care ◽

Care Services ◽

Hospital To Home

Abstract Background: An increasing proportion of older adults experience avoidable hospitalizations, and some are potentially entering long-term care homes earlier and often unnecessarily. Within Canada, approximately 10 percent of newly admitted long-term care residents could have potentially been cared for at home. Without adequate support from health care services to transition older adults from hospital to home, they often lack access to appropriate services when they are needed in the community thus making them more vulnerable to avoidable hospital visits, rapid deterioration of health, and earlier and unnecessary placement into residential long-term care. The purpose of this study was to collaborate with an existing enhanced home care program called Home Again in Halifax, Nova Scotia, to identify factors that contribute to older adult patients being assessed as requiring long-term care when they could potentially return home with enhanced supports. Methods: Through a retrospective case study design, we analyzed nine interviews for three focal patient cases including older adult patients, their family or friend caregivers, and healthcare professionals. Results: Findings indicate home care services for older adults are being sought too late, after hospital re-admission, or a rapid decline in health status when family caregivers are already experiencing caregiver burnout. Limitations in home care services ultimately led to barriers preventing family caregivers from continuing to care for older adults at home, such as absence of overnight services, a lack of information about home care services, and a lack of knowledge to navigate resources available. Conclusion: This study contributes knowledge about gaps within home care and transitional care services, highlighting the significance of investing in additional home care services for rehabilitation and the prevention of rapidly deteriorating health when older adults are discharged home after their first hospital visit. By understanding experiences and challenges of patients, family or friend caregivers, and healthcare professionals, we identified ways to reduce healthcare costs and improve the delivery and quality of home care services to better support older adult patients and their family or friend caregivers and to ensure hospitalized older adults are not unnecessarily admitted to nursing homes.

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In the Eye of the COVID-19 Storm: An Ethical Analysis on Aging, End of Life, and Recovery

Medical Research Archives ◽

10.18103/mra.v9i5.2414 ◽

2021 ◽

Vol 9 (5) ◽

Author(s):

Al Giwa

Keyword(s):

Older Adults ◽

Older Adult ◽

Elder Abuse ◽

Adult Population ◽

Severe Disease ◽

Multiple Chronic Conditions ◽

Geriatric Population ◽

Term Care ◽

Medical Response ◽

Older Adult Population

Early into the COVID pandemic, epidemiologists and infectious disease experts warned that older adults were among those most vulnerable to the disease, as multiple studies from China, Italy, Washington State, and New York City showed that age greater than 65 significantly increased the risk of severe disease and/or death from the novel 2019 coronavirus. Centers for Disease Control data through June 2020 show that nearly 81% of deaths due to COVID-19 are of people 65 years of age and older. These breakdowns indicate that, primarily, persons with advanced age and most, often, those with multiple chronic conditions are those who have died. The effects of the virus led to public health measures aimed at reducing exposures of older people and other vulnerable populations. The disease was amplified in rehabilitation centers, skilled nursing facilities, assisted living centers, group homes, and other long-term care facilities serving a primarily geriatric population. Even as parts of the country are opening up, the death toll is still climbing and affecting the older adult population disproportionately. Duty to care, autonomy and self-determination, non-judgmental regard, justice, and futility are all significant ethical principles and constructs that have arisen in the intense and real-time application of healthcare as we continue to face the present global pandemic. We use an ethical lens to examine the medical response of the SARS-CoV-2 pandemic on the older adult population and explore if society is doing enough to protect older adults, or rather, engaging in and furthering collective and systematic elder abuse.

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