scholarly journals HOME AND COMMUNITY HEALTHCARE FOR FRAIL OLDER ADULTS: A PATIENT, CAREGIVER, AND PRACTITIONER PERSPECTIVE

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S691-S691
Author(s):  
Andrew McDonald ◽  
Rowena Rizzotti ◽  
Joanna Rivera ◽  
Grace Park ◽  
Antonina Garm ◽  
...  
Keyword(s):  
Older Adults ◽  
Independent Living ◽  
Healthcare Providers ◽  
Community Dwelling ◽  
Community Healthcare ◽  
Use Of Technology ◽  
Age Related ◽  
Group Members ◽  
Tracking Devices ◽  
At Home

Abstract Frailty and the decline in ability to maintain independent living may be forestalled through discussions with healthcare providers and seniors about managing health at home. In addition, the use of technology in supplementing doctors’ visits to assess frailty progression may be easily adopted by some but not others. We conducted this qualitative study to elucidate the context in which seniors access care at home and current barriers to independent living, from the perspectives of both seniors and practitioners. Pre-approved discussion questions were administered to two audio-recorded focus group sessions of 14 participants. The first group were community-dwelling older adults and informal caregivers, while the second consisted of healthcare practitioners. Group members were sampled to include a range of health backgrounds and levels of technological expertise. Thematic analysis with NVivo Software was used to parse out key discussion topics from the audio transcripts. The caregiver/patient group emphasized the stigma of frailty and age-related isolation, desiring transparency and advocacy from care teams. Practitioners/researchers discussed the importance of a holistic biopsychosocial approach to frailty management and the need for standardized frailty measurement. Patients/caregivers used health-tracking devices at home and were more optimistic about telehealth/video-conferencing than practitioners. Awareness of contextual factors surrounding “aging in place” and what aspects of care are valued by patients and practitioners is key to advancing home health and paving the way for new evidence-based services in the home.

scholarly journals Age-Related Differences in Home Experiences and Worries During COVID-19

2020 ◽  
Author(s):  
Amanda Hunsaker ◽  
Eszter Hargittai
Keyword(s):  
Older Adults ◽  
Age Groups ◽  
Personal Space ◽  
Community Dwelling ◽  
Living Alone ◽  
Supportive Services ◽  
Age Related ◽  
Home Based ◽  
Single Person ◽  
At Home

The Coronavirus pandemic differentially impacted older adults in comparison to other age groups, creating extended time at home and even limiting interaction with others. In order to understand how individuals are coping with extensive time at home, we used a representative sample of community-dwelling adults to examine how home experiences and personal worries during the COVID-19 pandemic may differ across age groups, including among older adults. Overall, we find fewer older adults experienced home-based stressors (e.g. household conflict, lack of personal space) and fewer worries (e.g. related to finances or boredom) that may arise during a disease outbreak with lockdown measures. Those ages 70+ who were living alone also faced fewer negative home experiences and worries than individuals 60-69 years old living in single-person households. Supportive services to manage such home stressors and worries might benefit all age groups.

scholarly journals Technology Used to Recognize Activities of Daily Living in Community-Dwelling Older Adults

2020 ◽  
Vol 18 (1) ◽  
pp. 163
Author(s):  
Nicola Camp ◽  
Martin Lewis ◽  
Kirsty Hunter ◽  
Julie Johnston ◽  
Massimiliano Zecca ◽  
...  
Keyword(s):  
Older Adults ◽  
Activities Of Daily Living ◽  
Daily Living ◽  
Wearable Technology ◽  
Community Dwelling ◽  
Use Of Technology ◽  
Key Stakeholders ◽  
Environmental Technologies ◽  
Current Monitoring ◽  
Future Work

The use of technology has been suggested as a means of allowing continued autonomous living for older adults, while reducing the burden on caregivers and aiding decision-making relating to healthcare. However, more clarity is needed relating to the Activities of Daily Living (ADL) recognised, and the types of technology included within current monitoring approaches. This review aims to identify these differences and highlight the current gaps in these systems. A scoping review was conducted in accordance with PRISMA-ScR, drawing on PubMed, Scopus, and Google Scholar. Articles and commercially available systems were selected if they focused on ADL recognition of older adults within their home environment. Thirty-nine ADL recognition systems were identified, nine of which were commercially available. One system incorporated environmental and wearable technology, two used only wearable technology, and 34 used only environmental technologies. Overall, 14 ADL were identified but there was variation in the specific ADL recognised by each system. Although the use of technology to monitor ADL of older adults is becoming more prevalent, there is a large variation in the ADL recognised, how ADL are defined, and the types of technology used within monitoring systems. Key stakeholders, such as older adults and healthcare workers, should be consulted in future work to ensure that future developments are functional and useable.

scholarly journals Physical Restraint of Older Adults at Home: Preliminary Analysis of a Prospective Cohort Study

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 683-683
Author(s):  
Asa Inagaki ◽  
Ayumi Igarashi ◽  
Maiko Noguchi-Watanabe ◽  
Mariko Sakka ◽  
Chie Fukui ◽  
...  
Keyword(s):  
Older Adults ◽  
Online Survey ◽  
Physical Restraint ◽  
Community Dwelling ◽  
Physical Restraints ◽  
Care Nurse ◽  
Factors Associated ◽  
Home Care Nurse ◽  
Community Dwelling Older Adults ◽  
At Home

Abstract Our study aimed to explore the prevalence and factors of physical restraints among frail to dependent older adults living at home. We conducted an online survey to ask about the physical/mental conditions, demographics, service utilization, and physical restraints of community-dwelling older adults. Either home care nurse or care managers who were responsible for the older adult answered the survey that were conducted at baseline and one month later. We obtained data from 1,278 individuals. Physical restraint was reported for 53 (4.1%) participants. Multiple logistic regression revealed the factors associated with physical restraints at home: having been restrained at baseline, having pneumonia or heart failure, receiving home bathing, or using rental assistive devices were associated with physical restraints at one month. The findings could be used to promote discussion about which services prevent physical restraints and what we should do to support clients and their family to stay at home safely.

scholarly journals Process evaluation of a reablement training program for homecare staff to encourage independence in community-dwelling older adults

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Teuni H. Rooijackers ◽  
G. A. Rixt Zijlstra ◽  
Erik van Rossum ◽  
Ruth G. M. Vogel ◽  
Marja Y. Veenstra ◽  
...  
Keyword(s):  
Older Adults ◽  
Training Program ◽  
Process Evaluation ◽  
Community Dwelling ◽  
Team Approach ◽  
Staff Members ◽  
Care Plans ◽  
Lump Sum ◽  
Community Dwelling Older Adults ◽  
At Home

Abstract Background Many community-dwelling older adults experience limitations in (instrumental) activities of daily living, resulting in the need for homecare services. Whereas services should ideally aim at maintaining independence, homecare staff often take over activities, thereby undermining older adults’ self-care skills and jeopardizing their ability to continue living at home. Reablement is an innovative care approach aimed at optimizing independence. The reablement training program ‘Stay Active at Home’ for homecare staff was designed to support the implementation of reablement in the delivery of homecare services. This study evaluated the implementation, mechanisms of impact and context of the program. Methods We conducted a process evaluation alongside a 12-month cluster randomized controlled trial, using an embedded mixed-methods design. One hundred fifty-four homecare staff members (23 nurses, 34 nurse assistants, 8 nurse aides and 89 domestic workers) from five working areas received the program. Data on the implementation (reach, dose, fidelity, adaptations and acceptability), possible mechanisms of impact (homecare staff's knowledge, attitude, skills and support) and context were collected using logbooks, registration forms, checklists, log data and focus group interviews with homecare staff (n = 23) and program trainers (n = 4). Results The program was largely implemented as intended. Homecare staff's average compliance to the program meetings was 73.4%; staff members accepted the program, and particularly valued its practical elements and team approach. They experienced positive changes in their knowledge, attitude and skills about reablement, and perceived social and organizational support from colleagues and team managers to implement reablement. However, the extent to which homecare staff implemented reablement in practice, varied. Perceived facilitators included digital care plans, the organization’s lump sum funding and newly referred clients. Perceived barriers included resistance to change from clients or their social network, complex care situations, time pressure and staff shortages. Conclusions The program was feasible to implement in the Dutch homecare setting, and was perceived as useful in daily practice. Nevertheless, integrating reablement into homecare staff's working practices remained challenging due to various personal and contextual factors. Future implementation of the program may benefit from minor program adaptations and a more stimulating work environment. Trial registration ClinicalTrials.gov (Identifier NCT03293303). Registered 26 September 2017.

scholarly journals Harnessing Stakeholder Perspectives and Experience to Address Nutrition Risk in Community-Dwelling Older Adults

Healthcare ◽  
2021 ◽  
Vol 9 (4) ◽  
pp. 477
Author(s):  
Catherine B. Chan ◽  
Naomi Popeski ◽  
Leah Gramlich ◽  
Marlis Atkins ◽  
Carlota Basualdo-Hammond ◽  
...  
Keyword(s):  
Older Adults ◽  
Design Thinking ◽  
Healthcare Providers ◽  
Community Organizations ◽  
Community Dwelling ◽  
Nutrition Risk ◽  
Intersectoral Cooperation ◽  
Stakeholder Perspectives ◽  
Patient Representatives ◽  
Community Dwelling Older Adults

Community-dwelling, older adults have a high prevalence of nutrition risk but strategies to mitigate this risk are not routinely implemented. Our objective was to identify opportunities for the healthcare system and community organizations to combat nutrition risk in this population in the jurisdiction of Alberta, Canada. An intersectoral stakeholder group that included patient representatives was convened to share perspectives and experiences and to identify problems in need of solutions using a design thinking approach. Results: Two main themes emerged from the workshop: (1) lack of awareness and poor communication of the importance of nutrition risk between healthcare providers and from healthcare providers to patients and (2) the necessity to work in partnerships comprised of patients, community organizations, healthcare providers and the health system. Conclusion: Improving awareness, prevention and treatment of malnutrition in community-dwelling older adults requires intersectoral cooperation between patients, healthcare providers and community-based organizations.

EFFECTS OF COMPUTERIZED COGNITIVE TRAINING ON GAIT SPEED IN COMMUNITY DWELLING OLDER ADULTS, A PILOT STUDY

2016 ◽  
pp. 1-6
Author(s):  
J. Blackwood ◽  
T. Houston
Keyword(s):  
Older Adults ◽  
Cognitive Training ◽  
Gait Speed ◽  
Independent Living ◽  
Functional Decline ◽  
Community Dwelling ◽  
Computerized Cognitive Training ◽  
Home Based ◽  
Improved Function ◽  
Community Dwelling Older Adults

Background: In older adults declines in gait speed have been identified as predictors of functional decline and have been found in those with cognitive dysfunction. Cognitive training interventions that emphasize addressing executive function (EF) have resulted in a transfer effect from training cognitive processes into improved function. However research examining the effects of an EF specific computerized cognitive training (CCT) program on gait speed (GS) is limited. Objectives: To compare the effects of a six week EF specific CCT program on GS in community dwelling older adults using a pretest/posttest experimental design with subgroup comparisons based on a cutoff GS of 1.0m/s. Setting: Home based Participants: Forty independent living older adults (>65 years) without diagnosed cognitive impairment participated in either the intervention or control groups. Intervention: A six week long progressively challenging EF focused CCT program was performed at home. Measurements: Demographic variables, cognitive function (Trail-Making Test Part B) and GS were measured at baseline at week 7. Between group comparisons were completed for the whole sample initially with subgroup comparisons performed based on participants’ initial GS (Slow walkers: GS<1.0m/s; Fast Walkers: GS>1.0m/s). Results: No differences in GS were found for the whole population, but subgroup analyses restricted to slow walkers demonstrated a statistically significant improvement in GS after 6 weeks of CCT (µ =0.33 m/s, p = 0.03). Other outcomes measures were not statistically different at posttest. Conclusions: Older adults who walk at speeds <1.0m/s may benefit from a progressively challenging CCT program when self-administered in the home.

scholarly journals What influences diet quality in older people? A qualitative study among community-dwelling older adults from the Hertfordshire Cohort Study, UK

2017 ◽  
Vol 20 (15) ◽  
pp. 2685-2693 ◽  
Author(s):  
Ilse Bloom ◽  
Wendy Lawrence ◽  
Mary Barker ◽  
Janis Baird ◽  
Elaine Dennison ◽  
...  
Keyword(s):  
Older Adults ◽  
Cohort Study ◽  
Older People ◽  
Social Engagement ◽  
Community Dwelling ◽  
Related Factors ◽  
Age Related ◽  
Hertfordshire Cohort Study ◽  
The Uk ◽  
Community Dwelling Older Adults

AbstractObjectiveTo explore influences on diet in a group of community-dwelling older adults in the UK.DesignData were collected through focus group discussions with older people; discussions were audio-recorded, transcribed verbatim and transcripts analysed thematically.SettingHertfordshire, UK.SubjectsParticipants were sampled purposively from the Hertfordshire Cohort Study, focusing on those whose diets had been assessed at two time points: 1998–2001 and 2011.ResultsNinety-two adults participated (47 % women; 74–83 years) and eleven focus groups were held. A number of age-related factors were identified that were linked to food choices, including lifelong food experiences, retirement, bereavement and medical conditions, as well as environmental factors (such as transport). There appeared to be variability in how individuals responded to these influences, indicating that other underlying factors may mediate the effects of age-related factors on diet. Discussions about ‘keeping going’, being motivated to ‘not give up’, not wanting to be perceived as ‘old’, as well as examples of resilience and coping strategies, suggest the importance of mediating psychological factors. In addition, discussion about social activities and isolation, community spirit and loneliness, indicated the importance of social engagement as an influence on diet.ConclusionsInterventions to promote healthier diets in older age should take account of underlying psychological and social factors that influence diet, which may mediate the effects of age-related factors.

scholarly journals Effects of Reallocating Time Spent in Different Physical Activity Intensities on Sarcopenia Risk in Older Adults: An Isotemporal Substitution Analysis

Biology ◽  
2022 ◽  
Vol 11 (1) ◽  
pp. 111
Author(s):  
Jort Veen ◽  
Diego Montiel-Rojas ◽  
Fawzi Kadi ◽  
Andreas Nilsson
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Protein Intake ◽  
Handgrip Strength ◽  
Community Dwelling ◽  
Self Report ◽  
Linear Regression Models ◽  
Age Related ◽  
Muscle Health ◽  
The Impact

The role of daily time spent sedentary and in different intensities of physical activity (PA) for the maintenance of muscle health currently remains unclear. Therefore, we investigated the impact of reallocating time spent in different PA intensities on sarcopenia risk in older adults, while considering PA type (muscle strengthening activities, MSA) and protein intake. In a sample of 235 community-dwelling older adults (65–70 years), a sarcopenia risk score (SRS) was created based on muscle mass assessed by bioimpedance, together with handgrip strength and performance on the five times sit-to-stand (5-STS) test assessed by standardized procedures. Time spent in light-intensity PA (LPA), moderate-to-vigorous PA (MVPA), and being sedentary was assessed by accelerometry, and PA type (MSA) by self-report. Linear regression models based on isotemporal substitution were employed. Reallocating sedentary time to at least LPA was significantly (p < 0.05) related to a lower SRS, which remained evident after adjustment by PA type (MSA) and protein intake. Similarly, reallocating time in LPA by MVPA was related to a significantly (p < 0.05) lower SRS. Our results emphasize the importance of displacing sedentary behaviours for more active pursuits, where PA of even light intensities may alleviate age-related deteriorations of muscle health in older adults.

scholarly journals Reactive Postural Responses to Continuous Yaw Perturbations in Healthy Humans: The Effect of Aging

Sensors ◽  
2019 ◽  
Vol 20 (1) ◽  
pp. 63 ◽  
Author(s):  
Ilaria Mileti ◽  
Juri Taborri ◽  
Stefano Rossi ◽  
Zaccaria Del Prete ◽  
Marco Paoloni ◽  
...  
Keyword(s):  
Older Adults ◽  
Balance Control ◽  
Center Of Mass ◽  
Community Dwelling ◽  
Body Segments ◽  
Healthy Humans ◽  
Eyes Closed ◽  
Age Related ◽  
Postural Responses ◽  
Mass Displacement

Maintaining balance stability while turning in a quasi-static stance and/or in dynamic motion requires proper recovery mechanisms to manage sudden center-of-mass displacement. Furthermore, falls during turning are among the main concerns of community-dwelling elderly population. This study investigates the effect of aging on reactive postural responses to continuous yaw perturbations on a cohort of 10 young adults (mean age 28 ± 3 years old) and 10 older adults (mean age 61 ± 4 years old). Subjects underwent external continuous yaw perturbations provided by the RotoBit1D platform. Different conditions of visual feedback (eyes opened and eyes closed) and perturbation intensity, i.e., sinusoidal rotations on the horizontal plane at different frequencies (0.2 Hz and 0.3 Hz), were applied. Kinematics of axial body segments was gathered using three inertial measurement units. In order to measure reactive postural responses, we measured body-absolute and joint absolute rotations, center-of-mass displacement, body sway, and inter-joint coordination. Older adults showed significant reduction in horizontal rotations of body segments and joints, as well as in center-of-mass displacement. Furthermore, older adults manifested a greater variability in reactive postural responses than younger adults. The abnormal reactive postural responses observed in older adults might contribute to the well-known age-related difficulty in dealing with balance control during turning.

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