Are older adults’ demographic characteristics social determinants of their perceived importance, desire, and ability to perform end‐of‐life self‐care actions?

Nursing Forum ◽  
2019 ◽  
Vol 54 (4) ◽  
pp. 565-574 ◽  
Author(s):  
Huey‐Ming Tzeng ◽  
Anne Barker ◽  
Yu (Sunny) Kang ◽  
Udoka Okpalauwaekwe ◽  
Chang‐Yi Yin
Keyword(s):  
Older Adults ◽  
End Of Life ◽  
Social Determinants ◽  
Self Care ◽  
Demographic Characteristics ◽  
Perceived Importance

scholarly journals Social determinants, multimorbidity, and patterns of end-of-life care in older adults dying from cancer

2017 ◽  
Vol 8 (2) ◽  
pp. 117-124 ◽  
Author(s):  
Siran M. Koroukian ◽  
Nicholas K. Schiltz ◽  
David F. Warner ◽  
Charles W. Given ◽  
Mark Schluchter ◽  
...  
Keyword(s):  
Older Adults ◽  
End Of Life ◽  
Social Determinants ◽  
End Of Life Care ◽  
Life Care

Spontaneous self-affirmation before and during COVID-19: Associations with information-seeking, worry and adherence

2020 ◽  
Author(s):  
Tracy Epton ◽  
Chris Keyworth ◽  
Chris Armitage
Keyword(s):  
Older Adults ◽  
Opposite Direction ◽  
Information Seeking ◽  
Demographic Characteristics ◽  
Brief Interventions ◽  
Adaptive Behaviors ◽  
Uk Government ◽  
Nationally Representative

Objective: To assess the extent of spontaneous self-affirmation pre COVID-19 and during COVID-19 pandemic to identify for whom self-affirmation interventions might be helpful; and the extent to which spontaneous self-affirmation is associated with increased information-seeking, worry and adherence to UK government instructions. Methods: Two large nationally-representative surveys of UK adults were conducted via YouGov in March 2019 (pre COVID-19; N = 10421) and April 2020 (during COVID-19; N = 2252); both surveys measured demographic characteristics and spontaneous self-affirmation. The latter survey included measures of time spent accessing COVID-19 related news, worry about COVID-19 related news and degree of adherence to UK government instructions. Results: Spontaneous self-affirmation was lower before COVID-19 (44%) than it was during the pandemic (57%), although the pattern was in the opposite direction among older adults. Older adults were more likely to spontaneously self-affirm during COVID-19 than pre COVID-19. Greater spontaneous self-affirmation was associated with more time spent accessing news, and greater adherence to UK government instructions, but not media-related worry. Conclusions: The threat of COVID-19 may have triggered greater levels of spontaneous self-affirmation, which could give people the resources they needed to allow them to seek COVID-19-related news and adhere to UK government instructions. Groups lower in spontaneous self-affirmation, such as younger people could be targeted with brief interventions to promote self-affirmation and encourage performance of adaptive behaviors.

scholarly journals Engagement in Advance Care Planning: The Association With Cognitive Impairment and Care Preferences

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 417-418
Author(s):  
Hyo Jung Lee ◽  
Giyeon Kim
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Relative Risk ◽  
End Of Life ◽  
Advance Care Planning ◽  
Multinomial Logistic Regression ◽  
Quality Care ◽  
Care Planning ◽  
Advance Care ◽  
Four Levels

Abstract Although there has been growing evidence that Advance care planning (ACP) benefits people with cognitive impairment nearing death, our understanding about this issue is still limited. This study examines whether cognitive impairment is associated with ACP engagement and end-of-life care preferences among older adults in the U.S. Using data from the 2012 National Health and Trends Study (n=1798, aged 65 to 101), we identified four levels of ACP engagement: None (28%), Informal ACP conversation only (12%), Formal ACP only (14%), and Both informal and formal ACP (46%). Older adults with None showed the highest prevalence of having cognitive impairment (17%), followed by those with Formal ACP only (15%) and the other two (6%, 6%). The results of Multinomial Logistic Regression showed that, compared to those without, respondents with cognitive impairment had 143% increased relative risk of having None (RR = 2.43, CI: 1.58-3.73) and 81% increased relative risk of completing Formal ACP only (RR = 1.81, CI: 1.11-2.95) relative to completing Both informal and formal ACP. In addition, respondents with None were more likely to prefer to receive all treatments available nearing death than those with any ACP engagement. Achieving high quality care at the end of life can be more challenging for older adults with cognitive impairment and their family caregivers due to the limited capacity. Although encouraged, informal ACP conversation with loved ones does not necessarily occur before the formal ACP, especially, for those with cognitive impairment. Therefore, they may merit more attention such as early ACP engagement.

scholarly journals Self-compassion as predictor of daily physical symptoms and chronic illness across older adulthood

2021 ◽  
pp. 135910532110023
Author(s):  
Heather Herriot ◽  
Carsten Wrosch
Keyword(s):  
Older Adults ◽  
Longitudinal Study ◽  
Chronic Illness ◽  
End Of Life ◽  
Old Age ◽  
Physical Symptoms ◽  
Older Adulthood ◽  
Self Compassion ◽  
Early Old Age

This study examined whether self-compassion could benefit daily physical symptoms and chronic illness in early and advanced old age. The hypotheses were evaluated in a 4-year longitudinal study of 264 older adults. Results showed that self-compassion predicted lower levels of daily physical symptoms across the study period in advanced, but not early, old age ( T-ratio = −1.93, p = 0.05). In addition, self-compassion was associated with fewer increases in chronic illness in advanced, but not early, old age ( T-ratio = − 2.45, p < 0.02). The results of this study suggest that self-compassion may be particularly adaptive towards the end of life.

Closing the Loop in Computer Agent/Patient Communication

2020 ◽  
Vol 64 (1) ◽  
pp. 711-715
Keyword(s):  
Older Adults ◽  
Best Practice ◽  
Self Care ◽  
Effective Teacher ◽  
Care Providers ◽  
Conversational Agents ◽  
Patient Centered ◽  
Face To Face ◽  
Communication Techniques ◽  
Improve Instruction

While patient-centered communication supports patient self-care, providers rarely have enough time to consistently use patient- centered communication techniques. Technology has potential to support patient-centered communication, but frequently older adults prefer face-to-face communication with providers. Conversational agents (CAs) may support provider communication with older adults by emulating best practices from face-to-face communication. We investigated older adults’ response to a prototype CA communication system that served as a virtual provider and presented medication instructions using teachback, a recommended best practice that involves asking patients questions to ‘close the communication loop’. Older adults were told how to take medications by a CA who used (or did not use) teachback, and then were interviewed. Older adults were open to interacting with the CA and thought it would help support self-care. They thought the CA was a more effective teacher when using teachback and that this interactive strategy helped them remember the instructions. However, teachback did not improve instruction memory.

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.

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