scholarly journals ENGAGING AFRICAN AMERICAN FAMILIES IN END OF LIFE DISCUSSIONS: CHALLENGES AND FACILITATORS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S950-S950
Author(s):  
Pamela Z Cacchione ◽  
Le'Roi L Gill ◽  
Justine Sefcik
Keyword(s):  
Older Adults ◽  
Health Care ◽  
African American ◽  
End Of Life ◽  
Health Care Providers ◽  
Descriptive Study ◽  
African American Families ◽  
Care Providers ◽  
Qualitative Descriptive ◽  
American Families

Abstract Our previous study, African American Preferences Around End of Life, identified that AA Elders wanted to talk to their family about their preferences, but their family tended to avoid discussing end of life topics. We found that African American families often have a difficult time broaching the subject of end of life for a variety of emotional, cultural and religious reasons. Therefore, the purpose of this qualitative descriptive study was: To better understand the challenges and facilitators that influenced end of life conversations within the African American family. Methods: In this qualitative descriptive study, we interviewed 15 AA family caregivers of older adults. Participants were family members of older adults enrolled in an urban Program of All-inclusive Care for the Elderly. Individual interviews lasted on average 50 minutes. Data analysis was completed using conventional content analysis. Results: The majority of participants were between 55 - 65 years of age and adult children of the AA older adult. Two themes emerged for challenges: I’m not comfortable and We just don’t talk about it. For facilitators again, two themes emerged: Another person took the initiative (e.g. health care provider led the conversation) and participants’ previous experience with death led them to initiate EOL conversations. In addition, three participants reported that after participating in the interview they planned to talk to their loved one to find out their end of life preferences. The results of this study provide insight into how health care providers can facilitate these important end of life preferences conversations.

scholarly journals Sexual Minority Women’s Sexual and Reproductive Health Literacy: A Qualitative Descriptive Study

2020 ◽  
Vol 47 (5) ◽  
pp. 728-739
Author(s):  
Margaret M. Paschen-Wolff ◽  
Madelyne Z. Greene ◽  
Tonda L. Hughes
Keyword(s):  
Health Care ◽  
Health Literacy ◽  
Reproductive Health ◽  
Health Care Providers ◽  
Sexual Minority ◽  
Sexual And Reproductive Health ◽  
Descriptive Study ◽  
Access To Information ◽  
Care Providers ◽  
Qualitative Descriptive

Although sexual minority women (SMW) are at risk for cervical cancer and sexually transmitted infections (STIs), they may not seek preventative sexual and reproductive health care at the same rates as their heterosexual peers. We conducted a qualitative descriptive study of 22 adult SMW, a subsample of participants enrolled in the Chicago Health and Life Experiences of Women study. The aim was to describe the sexual and reproductive health literacy of this community sample based on qualitative themes, using an integrated model of health literacy. This model considers not only access to information but also understanding, appraisal, and application of information. We found that family of origin, health care providers, and school-based sexual education were the most important sources of sexual and reproductive health information. Participants described their understanding, appraisal, and application of sexual and reproductive health information as interdependent concepts. Pap test literacy and decision making were strongly independent, with SMW seeking various sources of information, or were driven by health care providers, with SMW following instructions and trusting provider advice. STI-related literacy hinged on whether the participant perceived SMW as at risk for STIs. Our findings reinforce that simply having access to information is insufficient to enact health behaviors that reflect full literacy. Findings have implications for health care providers, who should provide evidence-based recommendations for their SMW clients, and for public health practitioners and educators, who could make sexual health education more inclusive of and specific to the needs of SMW.

scholarly journals HEALTHCARE ACCESS AND SOCIAL ENGAGEMENT OF OLDER MINORITY ADULTS: EXPERIENCES NAVIGATING TRANSPORTATION BARRIERS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S902-S903
Author(s):  
December Maxwell ◽  
Rebecca L Mauldin ◽  
Dennis Kao
Keyword(s):  
Older Adults ◽  
Health Care ◽  
African American ◽  
Health Care Providers ◽  
Social Engagement ◽  
Healthcare Access ◽  
Well Being ◽  
Spatial Accessibility ◽  
Care Providers ◽  
Health And Well Being

Abstract Transportation is vital in the daily lives of older adults and provides access to health care services and health enhancing activities, such as social engagement. Disparities in mobility exist for older African American and Hispanic adults compared to non-Hispanic Whites, including higher likelihood of driving cessation at an earlier age and having a higher risk for reduced life space. This poster presents findings from a qualitative analysis of data from the Using Geo-Ethnography to Explore the Spatial Accessibility of Health Services for Aging Minorities Study (GeoSAS), a mixed methods study of older minority adults in Houston, TX. Using interpretive phenomenological analysis, the transcripts of semistructured interviews with 23 older adults (13 African American and 10 Hispanic; 17 female; mean age = 71.3 yrs, SD = 6.3 years) were analyzed to address the research question: What are the mobility experiences and perceptions of minority older adults regarding healthcare access and social engagement? Based on an ecological systems theoretical framework, we found reciprocal influences of (1) healthcare systems and transportation utilization and (2) participants’ health and well-being, mobility, and social engagement. Support from family members and financial capacity were critical for participants’ mobility. Implications of this research include educating health care providers about patients’ transportation experiences and barriers, optimizing social support to increase mobility, and addressing systematic disparities in transportation access to enhance health and well-being for older minority adults.

Interdisciplinary Therapy Assessments for the Older Adult

2012 ◽  
Vol 17 (1) ◽  
pp. 11-16
Author(s):  
Lynn Chatfield ◽  
Sandra Christos ◽  
Michael McGregor
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Standardized Testing ◽  
Health Care Providers ◽  
Outcome Measurement ◽  
Care Providers ◽  
Patient Centered ◽  
Screening Process ◽  
Evidenced Based ◽  
Changing Economy

In a changing economy and a changing industry, health care providers need to complete thorough, comprehensive, and efficient assessments that provide both an accurate depiction of the patient's deficits and a blueprint to the path of treatment for older adults. Through standardized testing and observations as well as the goals and evidenced-based treatment plans we have devised, health care providers can maximize outcomes and the functional levels of patients. In this article, we review an interdisciplinary assessment that involves speech-language pathology, occupational therapy, physical therapy, and respiratory therapy to work with older adults in health care settings. Using the approach, we will examine the benefits of collaboration between disciplines, an interdisciplinary screening process, and the importance of sharing information from comprehensive discipline-specific evaluations. We also will discuss the importance of having an understanding of the varied scopes of practice, the utilization of outcome measurement tools, and a patient-centered assessment approach to care.

Pandemic Visitation Restrictions at the End of Life

2021 ◽  
Vol 46 (11) ◽  
pp. 3-4
Author(s):  
Molly Antone ◽  
Keyword(s):  
Health Care ◽  
End Of Life ◽  
Health Care Providers ◽  
Treatment Options ◽  
Care Providers ◽  
Medical Practices ◽  
Whole Person ◽  
Catholic Health Care

Dying today looks dramatically different than it did a century ago, largely due to wider treatment options and more specialized medical practices. Often missing from these advancements is the focus on factors relative to a patient’s total circumstances. Especially in light of the recent pandemic, it is incumbent upon Catholic health care providers to treat who whole person rather than simply focus on more utilitarian philosophies of care.

On the Margins of Death: A Scoping Review on Palliative Care and Schizophrenia

2018 ◽  
Vol 34 (1) ◽  
pp. 62-69 ◽  
Author(s):  
Erin Relyea ◽  
Brooke MacDonald ◽  
Christina Cattaruzza ◽  
Denise Marshall
Keyword(s):  
Health Care ◽  
Palliative Care ◽  
Access To Care ◽  
End Of Life ◽  
Health Care Providers ◽  
Scoping Review ◽  
End Of Life Care ◽  
Psychosocial Interventions ◽  
Life Care ◽  
Care Providers

Schizophrenia is a serious chronic mental illness that results in marginalization and stigma for sufferers. It is the seventh leading cause for disability worldwide. The symptoms of the illness, including hallucinations, delusions, and extremely disordered thinking and behavior, may also introduce barriers to accessing treatment, education, housing, and employment. Little is known about end-of-life care for individuals with schizophrenia. To address this gap, a scoping review was conducted to enhance understanding of hospice and palliative care for patients with schizophrenia. From this scoping review, 342 unique titles and abstracts were identified through a search of 20 databases, including 11 social science databases, 6 medical databases, and 3 gray literature databases. A total of 32 articles met the inclusion criteria and the following 4 themes were identified: Stigma affecting quality of care and access to care; Issues related to consent and capacity for the patient’s end-of-life care decisions and to appoint substitute decision makers; Best practices for psychosocial interventions, pharmacology, family and health-care collaborations, goals of care, setting, and smoking; and Barriers to care, including setting, communication, provider education, and access to care. The review suggests the importance of mandatory interdisciplinary training practices and policy standards outlining cooperative communication across health-care providers. It highlights gaps in evidence-based research on psychosocial interventions and collaborative frameworks to enable the provision of quality end-of-life care for individuals with schizophrenia.

scholarly journals New Syphilis Cases in Older Adults, 2004–2019: An Analysis of Surveillance Data From South China

2021 ◽  
Vol 8 ◽  
Author(s):  
Cheng Wang ◽  
Peizhen Zhao ◽  
Mingzhou Xiong ◽  
Joseph D. Tucker ◽  
Jason J. Ong ◽  
...  
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Health Care Providers ◽  
Temporal Trends ◽  
Health Concern ◽  
Targeted Prevention ◽  
Care Providers ◽  
Annual Percent Change ◽  
Syphilis Infection ◽  
Over Time

Background: Sexual health among older adults is a major public health concern globally. The syphilis burden is increasing in older adults in China. This study aimed to describe factors associated with syphilis infection and diagnosis among older adults in China during a 16 year period.Methods: Using 16 years of data (2004–2019) from the syphilis case report system of Guangdong, China, we compared data from older adults (aged ≥50 years) with those from younger people (aged 15–49 years). We compared the two age group with the Chi-square test for difference, and Joinpoint regression models to assess the temporal trends.Results: During the study period, 242,115 new syphilis diagnoses were reported in older adults. The mean notification rate of new diagnoses was 64.1 per 100,000 population across the entire 16-year period, which significantly increased over time (average annual percent change [AAPC] 16.2%, 95% CI 13.7–18.7). Syphilis diagnoses increased significantly over time among less developed cities and older women. In 2019, compared with younger adults, newly diagnosed older adults were more likely to be male, native to reporting city, had unknown transmission routes, and were diagnosed late.Conclusion: Our findings call for an urgent need to deliver more targeted prevention interventions for older adults, such as strengthen awareness among health care providers, and integration of syphilis services and primary health care for older adults.

It’s Complicated: Improving Undergraduate Nursing Students’ Understanding Family and Care of LGBTQ Older Adults

2019 ◽  
Vol 25 (4) ◽  
pp. 506-532 ◽  
Author(s):  
Nadine Henriquez ◽  
Kathryn Hyndman ◽  
Kathryn Chachula
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Nursing Students ◽  
Health Care Providers ◽  
Social Issues ◽  
Care Providers ◽  
Undergraduate Nursing Students ◽  
Case Study Methodology ◽  
Undergraduate Nursing

Research has identified the need for improved cultural competence of health care providers regarding the lesbian, gay, bisexual, transgender, and queer (LGBTQ) community’s needs. This article articulates the teaching approach and methodology of an unfolding LGBTQ family case study for undergraduate nursing students. This method provided a forum for exploration of personal biases and gender-affirming techniques, and addressed the challenges of aging for a transgender woman and family within the context of societal stigma and discrimination. Students gained knowledge concerning shifts in family structures and understanding of the nurses’ role encouraging inclusiveness and equitable access in health care settings, advocating for vulnerable populations, and addressing specific health concerns for transgender older adults. Student responses demonstrated increased knowledge of family diversity, and critical thought regarding the intersectionality of discrimination and aging. The findings revealed the case study methodology facilitated student understanding of the unique health and social issues for LGBTQ older adults within a family context.

scholarly journals A FRAMEWORK FOR CARE TRANSITIONS FOR OLDER ADULTS WITH COMPLEX HEALTH CONDITIONS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S687-S687
Author(s):  
Paul Stolee ◽  
Jacobi B Elliott ◽  
Kerry Byrne ◽  
Joanie Sims-Gould ◽  
Catherine Tong ◽  
...  
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Health Care Providers ◽  
Service Use ◽  
Care Transitions ◽  
Ethnographic Study ◽  
System Level ◽  
Health Conditions ◽  
Care Providers ◽  
Framework Analysis

Abstract For older adults with complex health conditions, transitions between care settings are common and a major risk to quality of care and patient safety. Care transition interventions have shown positive impacts on continuity of care and health service use, however, most require additional human resources (e.g., transition coach), focus on one transition or “handoff”, and provide support for individual patients without addressing underlying challenges of health system integration. We sought to develop a framework for system-level enhancements to care transitions for older adults. We report a secondary framework analysis of an ethnographic investigation (the “InfoRehab” project) of care transitions for older persons who had experienced a hip fracture. The ethnographic study involved interviews, observations, and document reviews for 23 patients, 19 family caregivers, and 92 health care providers. Data were collected at each transition point (1-4/patient) along the care continuum, at three Canadian sites (large urban, mid-size urban, rural). Our framework analysis followed the approach described by Gale et al. (2013), using as cases 12 peer-reviewed papers which had reported InfoRehab results. Two researchers coded findings from each paper, then developed an analytical framework of eight themes by consensus; these include: patient involvement and choice, family caregiver involvement, patient complexity, health care provider coordination, information sharing, documentation, system constraints, and relationships. NVivo 11 was used to index findings into these themes and to generate a matrix. We are working with system stakeholders, including patients and caregivers, to apply this framework in the development of improved systems for care transitions.

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