Entering into a system of care: A qualitative study of carers of older community‐dwelling Australians

ObjectivesTo determine the impact of COVID-19 pandemic social restriction measures on people with rheumatic and musculoskeletal diseases (RMDs) and to explore how people adapted to these measures over time.DesignMixed-methods investigation comprising a national online longitudinal survey and embedded qualitative study.SettingUK online survey and interviews with community-dwelling individuals in the East of England.ParticipantsPeople in the UK with RMDs were invited to participate in an online survey. A subsection of respondents were invited to participate in the embedded qualitative study.Primary and secondary outcome measuresThe online survey, completed fortnightly over 10 weeks from April 2020 to August 2020, investigated changes in symptoms, social isolation and loneliness, resilience and optimism. Qualitative interviews were undertaken assessing participant’s perspectives on changes in symptoms, exercising, managing instrumental tasks such a shopping, medication and treatment regimens and how they experienced changes in their social networks.Results703 people with RMDs completed the online survey. These people frequently reported a deterioration in symptoms as a result of COVID-19 pandemic social restrictions (52% reported increase vs 6% reported a decrease). This was significantly worse for those aged 18–60 years compared with older participants (p=0.017). The qualitative findings from 26 individuals with RMDs suggest that the greatest change in daily life was experienced by those in employment. Although some retired people reported reduced opportunity for exercise outside their homes, they did not face the many competing demands experienced by employed people and people with children at home.ConclusionsPeople with RMDs reported a deterioration in symptoms when COVID-19 pandemic social restriction measures were enforced. This was worse for working-aged people. Consideration of this at-risk group, specifically for the promotion of physical activity, changing home-working practices and awareness of healthcare provision is important, as social restrictions continue in the UK.

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Experience of family caregivers of community-dwelling stroke survivors and risk of elder abuse: a qualitative study

The Journal of Adult Protection ◽

10.1108/jap-03-2014-0007 ◽

2014 ◽

Vol 16 (5) ◽

pp. 276-293 ◽

Cited By ~ 7

Author(s):

Celia Chow ◽

Agnes Tiwari

Keyword(s):

Qualitative Study ◽

Family Caregivers ◽

Local Community ◽

Service Providers ◽

Elder Abuse ◽

Community Dwelling ◽

Stroke Survivors ◽

Content Type ◽

The Disabled ◽

Personal Resilience

Purpose – The purpose of this paper is to explore the following questions. First, what are the experiences of family caregivers in caring for community-dwelling stroke survivors? Second, what services help or do not help the caregivers in managing their caregiving role? Design/methodology/approach – A qualitative study was conducted with a total of six focus group interviews with 29 stroke caregivers selected using convenience sampling in a local community centre. All interviews were recorded and transcribed for content analysis. Findings – The results pointed to three main themes working together to facilitate desirable outcomes in caregiving and prevent elder abuse: factors contributing to caregiver stress and factors that have a buffering effect on caregiver stress and unmet needs identified from caregivers’ experiences. Research limitations/implications – The authors found that there were a number of factors contributing to caregiver stress. The findings matched with the concept that caregiver stress should not be considered as the primary cause of elder abuse. Findings provided information for further research to investigate positive coping and adjustment for stroke survivors, caregivers and their families. Practical implications – Policy makers and service providers may consider specific policies and tailor-made services to enhance the effectiveness of current practice. The themes emerging from the study could be further reviewed in a longitudinal way to explore the cost-effectiveness, the outcomes and trajectory of interventional programmes. Social implications – Education would be essential to let the public understand caregivers’ difficulties and needs. Prevention of elder abuse may be approached with a range of risk factors for both perpetrating and being elder abuse victim. Originality/value – From the findings of the study, the authors found that there were service gaps within policy and interventions. Concrete suggestions for improving the public's attitude and public facilities/transport for the disabled were captured in the study. In addition to personal resilience, caregivers had a strong wish for a supportive environment and services that would facilitate a better caregiving outcome.

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The Informal Caregivers’ Viewpoint About Care Inhibitors for Community-Dwelling Elderly in an Iranian Context: A Qualitative Study

Iranian Rehabilitation Journal ◽

10.18869/nrip.irj.14.3.185 ◽

2016 ◽

Vol 14 (3) ◽

pp. 185-196

Author(s):

Samaneh Pourhadi ◽

Hamid Reza Khankeh ◽

Reza Fadayevatan ◽

Robab Sahaf ◽

◽

...

Keyword(s):

Qualitative Study ◽

Informal Caregivers ◽

Community Dwelling ◽

Iranian Context

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Cardiovascular disease risk prediction in older people: a qualitative study

British Journal of General Practice ◽

10.3399/bjgp.2020.1038 ◽

2021 ◽

pp. BJGP.2020.1038

Author(s):

Denise Ann Taylor ◽

Katharine Wallis ◽

Sione Feki ◽

Sione Segili Moala ◽

Manusiu He-Naua Esther Latu ◽

...

Keyword(s):

Cardiovascular Disease ◽

Risk Assessment ◽

Qualitative Study ◽

Older People ◽

Focus Groups ◽

Risk Prediction ◽

Heart Attack ◽

Clinical Decision Making ◽

Community Dwelling ◽

Cvd Risk

Background: Despite cardiovascular disease (CVD) risk prediction equations becoming more widely available for people aged 75 years and over, views of older people on CVD risk assessment are unknown. Aim: To explore older people’s views on CVD risk prediction and its assessment. Design and Setting: Qualitative study of community dwelling older New Zealanders. Methods: We purposively recruited a diverse group of older people. Semi-structured interviews and focus groups were conducted, transcribed verbatim and thematically analysed. Results: Thirty-nine participants (mean age 74 years) of Māori, Pacific, South Asian and European ethnicities participated in one of 26 interviews or three focus groups. Three key themes emerged, (1) Poor knowledge and understanding of cardiovascular disease and its risk assessment, (2) Acceptability and perceived benefit of knowing and receiving advice on managing personal cardiovascular risk; and (3) Distinguishing between CVD outcomes; stroke and heart attack are not the same. Most participants did not understand CVD terms but were familiar with ‘heart attack,’ ‘stroke’ and understood lifestyle risk factors for these events. Participants valued CVD outcomes differently, fearing stroke and disability which might adversely affect independence and quality of life, but being less concerned about a heart attack, perceived as causing less disability and swifter death. These findings and preferences were similar across ethnic groups. Conclusion: Older people want to know their CVD risk and how to manage it, but distinguish between CVD outcomes. To inform clinical decision making for older people, risk prediction tools should provide separate event types rather than just composite outcomes.

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Recipient and instructor perspectives of an adapted exercise-based fall prevention programme for adults aged 50+ years with vision impairment: a qualitative study nested within a randomised controlled trial

BMJ Open ◽

10.1136/bmjopen-2020-038386 ◽

2020 ◽

Vol 10 (9) ◽

pp. e038386

Author(s):

Lisa Dillon ◽

Lindy Clemson ◽

Helen Nguyen ◽

Kirsten Bonrud Jakobsen ◽

Jodi Martin ◽

...

Keyword(s):

Older Adults ◽

Randomised Controlled Trial ◽

Qualitative Study ◽

Fall Prevention ◽

Controlled Trial ◽

Community Dwelling ◽

Vision Impairment ◽

Prevention Programme ◽

Randomised Controlled ◽

Fall Prevention Programme

ObjectiveOlder adults with vision impairment currently have no access to tailored fall prevention programmes. Therefore, the purpose of this study, nested within an ongoing randomised controlled trial (RCT), is to document the adaptation of an existing fall prevention programme and investigate the perspectives of instructors involved in delivery and the older adults with vision impairment receiving the programme (recipients).DesignWe documented programme adaptations and training requirements, and conducted semistructured, individual interviews with both the instructors and the recipients of the programme from 2017 to 2019. The content of each interview was analysed using behaviour change theory through deductive qualitative analysis.SettingNew South Wales and Australian Capital Territory, Australia.ParticipantsThe 11 trained instructors interviewed were employees of a vision rehabilitation organisation and had delivered at least one programme session as part of the RCT. The 154 recipients interviewed were community-dwelling adults aged ≥50 years with vision impairment and no diagnosis of dementia, and had completed their participation in the programme as part of the intervention group of the RCT.ResultsSix key themes were identified relating to recipient (delivery aptitude, social norms, habit formation) and instructor (individualised adaptation, complimentary to scope of practice, challenges to delivery) perspectives. With initial training, instructors required minimal ongoing support to deliver the programme and made dynamic adaptations to suit the individual circumstances of each recipient, but cited challenges delivering the number of programme activities required. Recipient perspectives varied; however, most appreciated the delivery of the programme by instructors who understood the impact of vision impairment.Conclusions and implicationsThis novel qualitative study demonstrates that the adapted programme, delivered by instructors, who already have expertise delivering individualised programmes to older people with vision impairment, may fill the gap for a fall prevention programme in this population.Trial registration numberACTRN12616001186448.

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‘I’ve never drunk very much water and I still don’t, and I see no reason to do so’: a qualitative study of the views of community-dwelling older people and carers on hydration in later life

Age and Ageing ◽

10.1093/ageing/afz141 ◽

2019 ◽

Vol 49 (1) ◽

pp. 111-118 ◽

Cited By ~ 5

Author(s):

Cini Bhanu ◽

Christina Avgerinou ◽

Kalpa Kharicha ◽

Yehudit Bauernfreund ◽

Helen Croker ◽

...

Keyword(s):

Qualitative Study ◽

Older People ◽

Later Life ◽

Adverse Outcomes ◽

Community Dwelling ◽

Drinking Patterns ◽

Adequate Hydration ◽

Perceived Importance ◽

Community Dwelling Older People ◽

Informal Carers

Abstract Background dehydration is associated with significant adverse outcomes in older people despite being largely preventable and treatable. Little research has focused on the views of community-dwelling older people on hydration, healthy drinking and the perceived importance of drinking well in later life. Objectives to understand community-dwelling older people and informal carers’ views on hydration in later life and how older people can be supported to drink well. Methods qualitative study using interviews and a focus group exploring hydration and nutrition in later life (24 older people at risk of malnutrition and dehydration, 9 informal carers) and thematic analysis. Results this article presents the findings on hydration alone. Four themes are presented: perceptions of healthy drinking, barriers to and facilitators of drinking in later life and supporting older people to drink well. The perceived importance of adequate hydration in later life was polarised. Concerns about urinary incontinence and knowledge gaps were significant barriers. Consideration of individual taste preference and functional capacity acted as facilitators. Distinct habitual drinking patterns with medications and meals exist within individuals. Many relied on thirst at other times or when fluid demands are greater (such as hot weather), a known unreliable prompt in later life. Conclusions older people could be supported to drink well by building upon existing habitual drinking patterns. Primary care and public health should consider individual barriers, facilitators and tailored education. A multidisciplinary approach to promote hydration should be incorporated into care for older people with more complex needs.

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EXPLORING FACTORS THAT CONTRIBUTE TO JOINING AND REGULARLY PRACTICING IN COGNITIVE TRAINING AMONG HEALTHY OLDER ADULTS: A ONE-YEAR FOLLOW-UP QUALITATIVE STUDY

Journal of Prevention of Alzheimer's Disease ◽

10.14283/jpad.2020.14 ◽

2020 ◽

pp. 1-7

Author(s):

P. Srisuwan ◽

D. Nakawiro ◽

S. Chansirikarnjana ◽

O. Kuha ◽

S. Kengpanich ◽

...

Keyword(s):

Older Adults ◽

Qualitative Study ◽

Cognitive Training ◽

Individual Characteristics ◽

Community Dwelling ◽

Notification System ◽

Healthy Older Adults ◽

Effective Program ◽

One Year ◽

At Home

BACKGROUND: Cognitive interventions have the potential to enhance cognition among healthy older adults. However, little is known of the factors associated with the joining and participating of older people in group-based multicomponent cognitive training (CT). OBJECTIVES: To explore factors that contribute to joining and regularly practicing CT over 1 year among healthy older adults. DESIGN: A qualitative study. SETTING: Geriatric clinic in Bangkok, Thailand. PARTICIPANTS: 40 nondemented community-dwelling older adults INTERVENTION: The CT of executive functions, attention, memory and visuospatial functions (TEAM-V) program was conducted over 5 sessions, with a 2-week interval between each session. MEASUREMENTS: An inductive qualitative approach, based on semi-structure interviews with 40 healthy older adults, was employed. The interviews explored factors of joining CT at baseline, factors of regularly participating in class at 6 months and at home at 1 year. Data were coded and analyzed using and the thematic analysis approach. RESULTS: After analyzing factors concerning joining CT, 3 core themes emerged: (1) individual characteristics with 3 subthemes of “health status”, “time arrangement”, and “financial status”; (2) individual perceptions with 2 subthemes of “perceived susceptibility to dementia” and “perceived severity of dementia” and (3) encouragement from families and friends. After analyzing factors of practicing CT in class, 3 core themes emerged: (1) program with 3 subthemes of “session”, “group facilitators” and “notification before class”; (2) accessibility with 2 subthemes of “distance” and “transportation” and (3) encouragement from families and friends. After analyzing factors of practicing CT at home, 2 core themes emerged: (1) contents of the training program and (2) encouragement from families and friends. CONCLUSIONS: Increased awareness of holistic factors including older adults’ characteristic and perceptions, support from families and friends and accessibility should be emphasized in planning CT. Designing the content of CT that could be applied or adapted in daily living and effective program components such as a notification system could increase practicing.

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