scholarly journals A Preference-Based Model of Care: An Integrative Theoretical Model of the Role of Preferences in Person-Centered Care

2019 ◽  
Vol 60 (3) ◽  
pp. 376-384 ◽  
Author(s):  
Kimberly Van Haitsma ◽  
Katherine M Abbott ◽  
Annabelle Arbogast ◽  
Lauren R Bangerter ◽  
Allison R Heid ◽  
...  
Keyword(s):  
Older Adults ◽  
Theoretical Model ◽  
Positive Emotions ◽  
Positive Impact ◽  
Well Being ◽  
Cognitive Capacity ◽  
Model Of Care ◽  
Person Centered Care ◽  
Centered Care ◽  
Services And Supports

Abstract Knowledge of individuals’ everyday preferences is a cornerstone of person-centered care (PCC). Initial evidence demonstrates the positive impact of honoring preferences in care for older adults receiving long-term services and supports (LTSS). Yet, the mechanisms through which preference-based care affects individual well-being remain poorly understood. This article proposes a theoretical model of PCC entitled the Preference-Based Model of Care that integrates the Theory of Human Motivation, Self-determination Theory, the Competence-Press Model of person and environment fit, the Living Systems Framework, and the Broaden-and-Build theory of positive emotions to deepen our understanding of the processes through which preference-based care affects well-being among older adults receiving LTSS. The Preference-Based Model of Care illustrates how goal-directed behaviors facilitate need fulfillment through the expression of individual preferences and how these behaviors mediate the relationship between person–environment fit and affect balance within a particular social, cultural, and political context. The Preference-Based Model of Care can advance research on PCC in LTSS and can inform LTSS clinical practice guidelines for older adults, regardless of functional or cognitive capacity.

scholarly journals Living With Cognitive Impairment in China: Exploring Dyadic Experiences Through a Person-Centered Care Lens

2020 ◽  
pp. 016402752093559
Author(s):  
Jing Wang ◽  
Kirsten N. Corazzini ◽  
Eleanor S. McConnell ◽  
Ding Ding ◽  
Hanzhang Xu ◽  
...  
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Cultural Context ◽  
Unmet Needs ◽  
Well Being ◽  
Barriers And Facilitators ◽  
Person Centered Care ◽  
Care Partners ◽  
Centered Care ◽  
Successes And Challenges

China has experienced a substantial increase in the number of older adults with dementia and milder forms of cognitive impairment. Being spouses of Persons with cognitive impairment (PWCI) and living with them for several decades does not necessarily mean that it is easier for them to provide person-centered care and maintain a valued and healthy relationship. The current study explored how elements of PCC, as operationalized by the Senses Framework, operate or fail to operate in the dyadic experiences of PWCI and their spousal care partners within the socio-cultural context of China. Our findings suggest that PWCI and their spouses experience the six senses through the person-centeredness in their daily interactions with each other. It also indicated successes and challenges to being person-centered early in the disease and identified their unmet needs as well as barriers and facilitators to improve their well-being.

scholarly journals FOLLOWING IN THE FOOTSTEPS OF A GREAT APPLIED GERONTOLOGIST (WHILE SIMULTANEOUSLY FORGING YOUR OWN PATH)

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S427-S428
Author(s):  
Carol Whitlatch
Keyword(s):  
Older Adults ◽  
Quality Of Care ◽  
Best Practices ◽  
Early Stage ◽  
Well Being ◽  
Model Of Care ◽  
Physical Discomfort ◽  
Centered Care ◽  
Family Centered

Abstract Dr. M. Powell Lawton was an inspirational and productive scholar whose work had application for improving personal care and well-being for older adults and their families. He held strong to the principles of Person- and Family-Centered Care long before this terminology and model of care was commonly practiced. He was a living example of PFCC always wearing comfortable clothes and shoes to ensure his unique creativity was not obstructed by physical discomfort. Dr. Lawton’s work has inspired countless gerontologists who have taken the next steps towards ensuring quality of care by understanding personal preferences, activities, and care values. Dr. Whitlatch will discuss Dr. Lawton’s ongoing influence on care and best practices focusing on her own research that gives voice to the care values, preferences, and activities of families facing early-stage dementia. Dr. Whitlatch encourages attendees to wear their most comfortable shoes to the lecture in honor of Dr. Lawton.

PERSON-CENTERED CARE PLANNING AND SHARED DECISION MAKING FOR MENTAL AND COMORBID CONDITIONS

2020 ◽  
Author(s):  
Helen Millar ◽  
Ihsan M Salloum
Keyword(s):  
Mental Health ◽  
Life Expectancy ◽  
Mental Health Problems ◽  
Well Being ◽  
Care Planning ◽  
Shared Decision ◽  
Coordinated Care ◽  
Model Of Care ◽  
Person Centered Care ◽  
Centered Care

Developments in person-centered coordinated care are essential given the challenges of the growing epidemic of physical comorbidity in the mentally ill population. Excessive deaths due to comorbidity, especially cardiovascular disease, continue to contribute to the significant reduction in life expectancy in people with mental health problems. Contemporary and proposed models are now available to provide evidence for a way forward in this field. Practical guidance on implementation using person-centered care planning has now been developed to promote a more collaborative and integrated approach as a solution to the current single disease focused model of care, which is failing this patient group. The WHO perspective supports this strategy with the recent global objectives outlining proactive and preventative strategies and interventions to tackle comorbidity. The emphasis is on a transformation of current systems using evidence-based approaches for more integration to support the delivery of more effective and efficient care for those with mental disorders and other comorbid chronic diseases. Coordinated, collaborative, system-wide strategies encompass transparent shared decision making in prevention, early intervention, treatment options, lifestyle management and pharmacological rationalization. Hence urgent action is required to help create the conditions to enable the delivery of person-centered coordinated care in health care systems by involving commissioning bodies, clinicians, patient groups along with voluntary and other community providers. Contemporary models of care for comorbidity emphasize the importance of coordination in the management of physical well-being from the onset of treatment of people with mental health problems in order to ensure better outcomes, improved overall well-being, and a longer life expectancy. Illustratively, no further funds are available to implement this shift in the model of care in the United Kingdom, so redesign and redistribution of current resources will be key to promote this more seamless coordinated system of care to improve the quality of life and life expectancy for this population.

Servicing the Senior Swallow: A Family-Centered Private Practice Model of Service Delivery

2020 ◽  
pp. 1-4 ◽  
Author(s):  
Yvette M. McCoy
Keyword(s):  
Older Adults ◽  
Medical Model ◽  
Recovery Process ◽  
Swallowing Disorders ◽  
Current Evidence ◽  
Care Needs ◽  
Skilled Nursing ◽  
Person Centered Care ◽  
Centered Care ◽  
Traditional Medical Model

Purpose Person-centered care shifts the focus of treatment away from the traditional medical model and moves toward personal choice and autonomy for people receiving health services. Older adults remain a priority for person-centered care because they are more likely to have complex care needs than younger individuals. Even more specifically, the assessment and treatment of swallowing disorders are often thought of in terms of setting-specific (i.e., acute care, skilled nursing, home health, etc.), but the management of dysphagia in older adults should be considered as a continuum of care from the intensive care unit to the outpatient multidisciplinary clinic. In order to establish a framework for the management of swallowing in older adults, clinicians must work collaboratively with a multidisciplinary team using current evidence to guide clinical practice. Private practitioners must think critically not only about the interplay between the components of the evidence-based practice treatment triad but also about the broader impact of dysphagia on caregivers and families. The physical health and quality of life of both the caregiver and the person receiving care are interdependent. Conclusion Effective treatment includes consideration of not only the patient but also others, as caregivers play an important role in the recovery process of the patient with swallowing disorders.

scholarly journals Last Place of Care and End-of-Life Quality of Life in the United States: Evidence From a National Representative Data Set

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 17-17
Author(s):  
Yifan Lou ◽  
Nan Jiang ◽  
Katherine Ornstein
Keyword(s):  
Quality Of Life ◽  
Older Adults ◽  
End Of Life ◽  
End Of Life Care ◽  
The United States ◽  
Life Care ◽  
Person Centered Care ◽  
Centered Care ◽  
The Relationship

Abstract Background: Quality of life (QoL) during last stage of life has raised expanded interests as an important aspect of person-centered care. Last place of care (LPC), refer to the last place decedents received their formal end-of-life care (EOLC), has been identified as a key indicator of older adults’ end-of-life QoL, but the relationship was understudied. This study explores the association between LPC and end-of-life QoL among American older adults. Methods: Data used seven waves of Last Month of Life data with a total sample of 3068 Medicare decedents in NHATS. Outcome is end-of-life QoL assessed by eleven measures on four domains: pain and symptoms management (SP), quality of healthcare encounter (HE), person-centered care (PC), and overall quality of care (QC). LPC was categorized into home, hospital, nursing home, and residential hospice. Multivariate logistic regression analyses were used to examine the relationship with covariates. Results: LPC varied by most demographic characteristics, except immigration status and education. Older adults whose LPC is hospital, compared to those who had home-care, were less likely to have great experiences on HE, PC, and QC. People dying at nursing homes are more likely to receive care meeting their dyspnea and spiritual needs. Residential hospice is negatively related to respected care, clear coordination, and keeping family informed, but are more likely to provide PS and spiritual care. Discussion: Home-based end-of-life care has certain advantages but still has room to improve on SP and religious concerns. Hospitals should keep reforming their service delivery structure to improve patients’ QoL.

scholarly journals The Translation and Cross-Cultural Adaptation of an Arabic Version of the Reminiscence Functions Scale

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 343-343
Author(s):  
Abdallah Abu Khait ◽  
Juliette Shellman
Keyword(s):  
Mental Health ◽  
Older Adults ◽  
Positive Impact ◽  
Well Being ◽  
Arab Countries ◽  
Lessons Learned ◽  
Arabic Version ◽  
Harmonization Process ◽  
Back Translation ◽  
Target Culture

Abstract The Reminiscence Functions Scale (RFS), a 43 item reliable and valid scale, measures eight specific reasons as to why individuals reminisce: (a) identity (b) death preparation; (c) problem-solving; (d) bitterness revival; (e) boredom reduction; (f) intimacy maintenance; (g) conversation; and (h) teach/Inform others. Research indicates that certain reminiscence functions have a positive impact on the mental-health and well-being of older adults. However, no known studies have been conducted in Arab countries examining the relationship between reminiscence functions and mental health outcomes due to the lack of an Arabic version of the RFS. The purpose of this study was to translate the RFS from English to Arabic (Modern Standard Arabic), back-translate from Arabic to English, and compare the two English versions for equivalence and accuracy through a multi-step translation method. A team of bilingual, bicultural, Arabic speaking experts assembled to conduct the forward, back translation and harmonization process. In the next step, professionals with expertise in linguistics communication sciences and disorders, Arabic literature, geriatric nursing, and medicine reviewed the translated documents to assess the content (relevant to the target culture) and semantic equivalencies (similarity of meaning in the target culture). Challenges that occurred during the study included finding nuanced translation equivalences for Likert scale responses, translation of idioms such as “when time is heavy on my hands”, and logistical issues such as coordinating virtual meetings for the team of experts. Lessons learned during the translation process and implications for use of the RFS-Arabic version with Jordanian older adults will be presented.

scholarly journals A Tale of Two Emotions: The Diverging Salience and Health Consequences of Calmness and Excitement in Old Age

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 626-627
Author(s):  
Jeremy Hamm ◽  
Carsten Wrosch ◽  
Meaghan Barlow ◽  
Ute Kunzmann
Keyword(s):  
Older Adults ◽  
Old Age ◽  
Perceived Control ◽  
Positive Emotions ◽  
Multilevel Models ◽  
Growth Models ◽  
Well Being ◽  
Physical Symptoms ◽  
Health Consequences ◽  
Younger Adults

Abstract Using two studies, we examined the late life prevalence and health consequences of discrete positive emotions posited to motivate rest and recovery (calmness) or pursuit of novelty and stimulation (excitement). Study 1 assessed the salience of these discrete emotions in older adults (n=73, Mage=73) relative to younger adults (n=73, Mage=23) over a one-week period. Multilevel models showed that older (vs. younger) adults reported higher calmness and lower excitement. Study 2 examined the longitudinal health consequences of calmness and excitement in old age (n=336, Mage=75), as moderated by perceived control. Multilevel growth models showed that calmness, but not excitement, buffered against 10-year declines in psychological well-being (perceived stress, depressive symptoms) and physical health (physical symptoms, chronic conditions) for older adults with low perceived control. Results suggest that positive emotions with disparate motivational functions become more (calmness) or less (excitement) salient and have diverging implications for health in old age.

scholarly journals Comparing the Protective Value of Human and Pet Social Support on Well-Being of Older Adults During COVID-19

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 936-936
Author(s):  
Juliet Sobering ◽  
Lisa Brown
Keyword(s):  
Social Support ◽  
Older Adults ◽  
Positive Emotions ◽  
Protective Factor ◽  
Behavioral Activation ◽  
Well Being ◽  
Psychological Benefits ◽  
Beneficial Effects ◽  
Age Related ◽  
Media Reports

Abstract Older adults are vulnerable to particular risk factors that contribute to lower well-being and poorer functioning. With the COVID-19 pandemic, the importance of social support has been highlighted in media reports because of its well-known beneficial effects on overall well-being. However, as adults age, social networks, contacts, and activities naturally decrease. These age-related losses are often difficult, if not impossible, to replace. Pets have recently been recognized as a valuable source of social support for many older adults, providing both physical and psychological benefits through mutual connection and behavioral activation. Previous studies have examined how human social support or pet social support enhance older adults’ well-being (i.e., positive emotions, engagement, relationships, accomplishment, and meaning). However, there is a gap in our scientific knowledge as previous research has not evaluated if pet social support can serve as a protective factor in the absence of adequate human social support. Current analyses, with 141 older adult participants, suggests that pet owners with a positive attachment to their pet experience higher well-being as pets serve as a coping resource that protects against common life stressors. Similar to human social support, pet social support appears to be a protective factor that also promotes and fosters a sense of well-being in older adults. Support in late life is especially important for families and agencies to be attuned to, especially during a global pandemic.

scholarly journals The COVID-19 Pandemic Reignites the Need for Person-Centered Gerontological Approach

2021 ◽  
Vol 7 ◽  
pp. 233372142110418
Author(s):  
Pamela A. Saunders ◽  
Tara McMullen ◽  
Sonya Barsness ◽  
Andrew Carle ◽  
Gay Powell Hanna
Keyword(s):  
Older Adults ◽  
Policy Development ◽  
Geriatric Medicine ◽  
Adverse Outcomes ◽  
Call To Action ◽  
Person Centered Care ◽  
People With Dementia ◽  
Care Partners ◽  
National Response ◽  
Centered Care

The national response to the COVID-19 pandemic pressed gerontologists to reflect, redesign, and reform services supporting older adults. Efforts to isolate a peer cohort to stabilize and maintain a standard of health had adverse outcomes and added pressure conflicting with autonomy and individual desires. In this, person-centered care emerges as a meaningful archetype to address dignity and independence. This article presents views from academics and practitioners across an interdisciplinary spectrum, arising from a webinar hosted by Georgetown University Program in Aging & Health. A description of personhood as an extension of the humanities is followed by a robust discussion of safety and autonomy for older adults during the COVID-19 pandemic. We examine the necessary commute between critical gerontological theory and the practice of humanistic gerontology. Further, this article disentangles humanism and person-centered care to balance autonomy and safety for older adults in congregate living situations and focuses on specific populations: people with dementia and their care partners. Discussion on the importance of person-centered policy development in a public health pandemic is also explored. The article concludes with a call to action for the adoption of a comprehensive person-centered care model across the fields of gerontology and geriatric medicine.

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