scholarly journals Refining a Taxonomy of Goals for Older Adults With Functional Limitations and Their Caregivers to Inform Care Planning

2020 ◽  
pp. 073346482094432
Author(s):  
Catherine A. Clair ◽  
Maureen Henry ◽  
Lee A. Jennings ◽  
David B. Reuben ◽  
Shana F. Sandberg ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Older Adults ◽  
Daily Living ◽  
Functional Limitations ◽  
Complex Needs ◽  
Social And Emotional ◽  
Caregiver Needs ◽  
New Codes ◽  
Services And Supports

Purpose: The purpose of the study is to capture goals expressed by older adults with functional limitations and their caregivers. Methods: Through focus groups and interviews, 76 older adults with ≥1 activity of daily living limitation and 28 family/friend caregivers were asked about what mattered most to them and their goals for care. Transcripts were coded using an existing taxonomy. Goals that did not fit the taxonomy were assigned new codes. Results: We identified more than 50 goals in eight domains. Domains included (a) Medical Care; (b) Quality of Life: Physical; (c) Quality of Life: Social and Emotional; (d) Access to Services and Supports; (e) Caregiver Needs and Concerns; (f) End of Life; (g) Independence; and (h) Acceptable Housing. Conclusion: While there is overlap between identified goals and the existing taxonomy, new goals emerged. The goal domains identified could serve as a framework to improve and measure the quality of goal-oriented care for older adults with complex needs.

scholarly journals Predictors of change over time in subjective daytime sleepiness among older adult recipients of long-term services and supports

2020 ◽  
Vol 32 (7) ◽  
pp. 849-861
Author(s):  
Darina V. Petrovsky ◽  
Karen B. Hirschman ◽  
Miranda Varrasse McPhillips ◽  
Justine S. Sefcik ◽  
Alexandra L. Hanlon ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Social Support ◽  
Older Adults ◽  
Depressive Symptoms ◽  
Daytime Sleepiness ◽  
Daily Living ◽  
Services And Supports ◽  
Over Time

ABSTRACTObjectives:Daytime sleepiness is associated with multiple negative outcomes in older adults receiving long-term services and supports (LTSS) including reduced cognitive performance, need for greater assistance with activities of daily living and decreased social engagement. The purpose of this study was to identify predictors of change in subjective daytime sleepiness among older adults during their first 2 years of receiving LTSS.Design and Setting:Secondary analysis of data from a prospective longitudinal study of older adults who received LTSS in their homes, assisted living communities or nursing homes interviewed at baseline and every 3 months for 24 months.Participants:470 older adults (60 years and older) newly enrolled in LTSS (mean = 81, SD = 8.7; range 60–98; 71% women).Measurements:Subjective daytime sleepiness was assessed every 3 months through 2 years using the Epworth Sleepiness Scale. Multiple validated measures were used to capture health-related quality of life characteristics of enrollees and their environment, including symptom status (Symptom Bother Scale), cognition (Mini Mental Status Exam), physical function (Basic Activities of Daily Living), physical and mental general health, quality of life (Dementia Quality of Life, D-QoL), depressive symptoms (Geriatric Depression Scale) and social support (Medical Outcomes Survey-Social Support).Results:Longitudinal mixed effects modeling was used to examine the relationship between independent variables and continuous measure of daytime sleepiness. Increased feelings of belonging, subscale of the D-QoL (effect size = −0.006, 95% CI: −0.013 to −0.0001, p = 0.045) and higher number of depressive symptoms (effect size = −0.002, 95% CI: −0.004 to −0.001, p = 0.001) at baseline were associated with slower rates of increase in daytime sleepiness over time.Conclusions:Comprehensive baseline and longitudinal screening for changes in daytime sleepiness along with depression and perceived quality of life should be used to inform interventions aimed at reducing daytime sleepiness among older adults receiving LTSS.

scholarly journals Gaming Technology to Support Leisure Activities Among Older Adults

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 559-559
Author(s):  
Walter Boot
Keyword(s):  
Quality Of Life ◽  
Older Adults ◽  
Digital Divide ◽  
Daily Living ◽  
Leisure Activities ◽  
Well Being ◽  
Age Related ◽  
Gaming Technology ◽  
Research And Education

Abstract There has been a great deal of research on technology to support older adults in their performance of Activities and Instrumental Activities of Daily Living. There has been substantially less research, however, on exploring technology solutions that support hobbies and leisure. This is unfortunate, as quality of life and well-being are determined by more than just one’s ability to manage everyday tasks. An overview will be presented of research the Center for Research and Education on Aging and Technology Enhancement (CREATE) has conducted over two decades with the goals of understanding and supporting older adults’ performance of technology-based leisure activities. Many of these studies have involved videogaming, where there exists a substantial age-related digital divide. CREATE has evaluated older adults’ attitudes and game experiences through survey and research studies and has even recorded longitudinal gameplay. How these findings can be applied to support technology-based leisure activities will be expanded upon. Part of a symposium sponsored by Technology and Aging Interest Group.

Evaluation of a geriatric day rehabilitation centre: subjective and objective outcomes in community-dwelling older adults

2009 ◽  
Vol 15 (2) ◽  
pp. 117 ◽  
Author(s):  
A. Foley ◽  
S. Hillier ◽  
R. Barnard
Keyword(s):  
Quality Of Life ◽  
Older Adults ◽  
Lower Limb ◽  
Daily Living ◽  
Community Dwelling ◽  
Rehabilitation Centre ◽  
Lower Limb Strength ◽  
The Mean ◽  
Community Dwelling Older Adults

Pre and post testing were conducted on community-dwelling older adults referred to a geriatric day rehabilitation centre (DRC). Consecutive DRC clients were screened for inclusion over a 16-month period and were eligible if: aged 60+ years; cognitively intact; and reason for referral involved spinal or lower limb musculoskeletal impairment, disability or surgery, and/or reduced functional mobility or falls. Clients were excluded if they had a neurological disorder, or did not complete the program. Outcome measures included: lower limb strength; balance; mobility; self-reported pain; activities of daily living; and quality of life. Data were summarised using descriptive statistics and analysed using paired t-tests. Of the 137 participants recruited, 110 were female and the mean age was 79.5 ± 7.3 years. In total, 106 participants completed the DRC program and were assessed at baseline and re-assessed at discharge. The mean length of stay was 12.4 ± 2.9 weeks, with 21.4 ± 5.4 attendances. From baseline to discharge, statistically significant differences were found for all objective measures of physical functioning, balance, and for all lower limb strength tests (P < 0.0001). Glasgow Pain Questionnaire scores demonstrated statistically significant improvements in all five domains of the scale (P < 0.0001). The Barthel Index and Multi-dimensional Functional Assessment Questionnaire both showed a statistically significant improvement in the level of independence in activities of daily living (ADL) (P < 0.05). The Assessment of Quality of Life Questionnaire showed a statistically significant improvement (P = 0.027). The Exercise Benefits/Barriers Scale also showed a statistically significant improvement over DRC attendance (P = 0.005). The Falls Efficacy Scale showed a positive change, but the improvement was not statistically significant (P = 0.80). The study’s results indicate that community-dwelling older adults with physical disabilities and multiple comorbidities who attended the interdisciplinary geriatric DRC, significantly improved their lower limb strength, balance and physical function, and also showed significant decreases in self-reported pain, and improvements in independence in ADL and quality of life. Given the limitations of the current study, further research, in the form of high quality studies with larger sample sizes that involve direct comparisons with other forms of care or against a control group, is needed to determine whether day rehabilitation centre programs provide the optimum mode of rehabilitation for this population in the most cost effective manner.

scholarly journals Obesity in older adults: epidemiology and implications for disability and disease

2011 ◽  
Vol 22 (1) ◽  
pp. 10-34 ◽  
Author(s):  
Rafael Samper-Ternent ◽  
Soham Al Snih
Keyword(s):  
Public Health ◽  
Quality Of Life ◽  
Older Adults ◽  
Functional Limitations ◽  
Public Health Care ◽  
Economic Implications ◽  
Obesity Epidemic ◽  
All Cause Mortality ◽  
Care Costs

SummaryObesity is a worldwide problem with increasing prevalence and incidence in both developed and developing countries. In older adults, excess weight is associated with a higher prevalence of cardiovascular disease, metabolic disease, several important cancers, and numerous other medical conditions. Obesity has also been associated with increased functional limitations, disability, and poorer quality of life. Additionally, obesity has been independently associated with all-cause mortality. The obesity epidemic has important social and economic implications, representing an important source of increased public health care costs. The aim of this review is to report the epidemiology of obesity worldwide, and the implications of obesity on disability and chronic diseases in older adults.

The association of polypharmacy with functional status impairment, frailty, and health-related quality of life in older adults with gastrointestinal malignancy: Results from the Cancer and Aging Resilience Evaluation (CARE) registry.

2020 ◽  
Vol 38 (29_suppl) ◽  
pp. 118-118
Author(s):  
Darryl Alan Outlaw ◽  
Chen Dai ◽  
Mustafa Al-Obaidi ◽  
Smith Giri ◽  
Smita Bhatia ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Older Adults ◽  
Activities Of Daily Living ◽  
Functional Status ◽  
Daily Living ◽  
Cancer Type ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related

118 Background: The majority of new cancer diagnoses occur in adults greater than 65 years of age. Polypharmacy is a common and potentially devastating problem amongst older adults; however, its prevalence and impact in older adults with gastrointestinal (GI) malignancy is poorly understood. Our objective was to examine the prevalence of polypharmacy and its association with functional status impairments, frailty, and health-related quality of life (HRQoL) in older adults with GI malignancy. Methods: The Cancer and Aging Resilience Evaluation (CARE) registry at the University of Alabama at Birmingham (UAB) is an ongoing prospective cohort study that uses a brief geriatric assessment (CARE survey) in older adults with cancer. We evaluated older adults diagnosed with GI malignancy prior to starting cancer therapy. Our primary outcomes of interest were functional status impairments, including dependence in activities of daily living (ADL) and instrumental activities of daily living (IADL), frailty (as defined by a frailty index derived using the principles of deficit accumulation), and HRQoL (assessed via PROMIS 10 global that includes physical and mental scores). Patients were dichotomized into those taking ≥9 vs. < 9 medications. Multivariable analyses examined associations between polypharmacy and the above-listed outcomes, adjusted for age, sex, race, cancer type, cancer stage, and comorbidities. Results: Overall, 357 patients met eligibility criteria; mean age: 70.1 years; primary diagnoses: colorectal (33.6%), pancreatic (24.6%), hepatobiliary (16.2%), gastroesophageal (10.9%), other (14.6%). Patients reported taking a mean of 6.2 medications: 27.7% with 0-3 medications, 48.2% with 4-8 medications, and 24.1% with ≥ 9 medications. Patients taking ≥ 9 medications were more likely to report limitations in ADL (adjusted odds ratio [aOR] 3.29, 95% CI 1.72-6.29) and IADL (aOR 2.86, 95% CI 1.59-5.14). Polypharmacy was also associated with frailty (aOR 3.06, 95% CI 1.73-5.41) and lower physical (aOR 2.82, 95% CI 1.70-4.69) and mental (aOR 1.73, 95% CI 1.03-2.91) HRQoL. Conclusions: Independent of comorbid conditions, polypharmacy was associated with functional status limitations, frailty, and reduced HRQoL in older adults with GI malignancy. Further study of specific medications and interactions is warranted in order to reduce the negative consequences of polypharmacy in this growing and vulnerable population.

scholarly journals Health-related Quality of Life: Expanding a Conceptual Framework to Include Older Adults Who Receive Long-term Services and Supports

2012 ◽  
Vol 53 (2) ◽  
pp. 205-210 ◽  
Author(s):  
C. Zubritsky ◽  
K. M. Abbott ◽  
K. B. Hirschman ◽  
K. H. Bowles ◽  
J. B. Foust ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Older Adults ◽  
Conceptual Framework ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related ◽  
Services And Supports

scholarly journals Health-Related Quality of Life Among Older Adults With and Without Functional Limitations

2012 ◽  
Vol 102 (3) ◽  
pp. 496-502 ◽  
Author(s):  
William W. Thompson ◽  
Matthew M. Zack ◽  
Gloria L. Krahn ◽  
Elena M. Andresen ◽  
John P. Barile
Keyword(s):  
Quality Of Life ◽  
Older Adults ◽  
Functional Limitations ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related

scholarly journals Satisfaction With Outdoor Activities Over Time Among Long-Term Services and Supports Recipients

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 189-190
Author(s):  
Justine Sefcik ◽  
Karen Hirschman ◽  
Darina Petrovsky ◽  
Liming Huang ◽  
Nancy Hodgson ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Older Adults ◽  
Assisted Living ◽  
Term Care ◽  
Chronic Health ◽  
Outdoor Activities ◽  
Services And Supports ◽  
Over Time

Abstract Approximately 85% of older adults have at least one chronic health condition. The onset of chronic health conditions and mobility issues can constrain activities, including outdoor recreation. There is limited knowledge of older adults receiving long-term services and supports (LTSS) and their satisfaction with outdoor activities over time after enrolling in services. This study examined predictors of change in ratings of satisfaction with outdoor activities. A secondary analysis was conducted of data involving structured interviews with older adults (N=470) over the first two years of receiving LTSS (Health-Related Quality of Life: Elders in Long-Term Care; R01AG025524). Participants lived in assisted living communities, nursing homes, or their home. A single item on satisfaction with outdoor activities (assessed using a 5-point Likert scale: not at all to extremely satisfied) was the primary outcome. Mixed effects linear regression modeling using a backward elimination process was used for building a final multivariable model. In the final model, older age (p&lt;0.001) and higher overall quality of life ratings (p&lt;0.001) at baseline were associated with slower rates of increase in outdoor satisfaction over time. Higher education level (p=0.035) at baseline was associated with a faster rate of increase in outdoor satisfaction over time. Additionally, those who moved into an assisted living community (p=0.024) or nursing home (p=0.016) at baseline were associated with faster rates of increase in outdoor satisfaction over time compared to those in the home. Knowledge of factors influencing satisfaction with outdoor activities can assist interdisciplinary teams implement interventions for individual or organizational changes.

scholarly journals A Comprehensive Overview of Mobility and Aging in the Year 2020 (and beyond)

2020 ◽  
Author(s):  
Melissa Lunsman O’Connor
Keyword(s):  
Quality Of Life ◽  
Older Adults ◽  
Activities Of Daily Living ◽  
Daily Living ◽  
Motor Vehicle ◽  
Motor Vehicle Crashes ◽  
Mobility Limitations ◽  
Comprehensive Overview

Mobility can be defined as the ability to move effectively and purposefully though the environment in order to accomplish goals. Mobility can be conceptualized and measured in four broad ways. First, the speed, success, and quality of specific movements can be measured, such as gait and balance. Second, one can assess a person’s ability to complete activities of daily living (ADLs) and instrumental activities of daily living (IADLs) that involve movement. Third, the occurrence of adverse events, such as falls and motor vehicle crashes, can be measured. Finally, the range of a person’s movement inside and outside the home can be assessed. Regardless of how it is conceptualized, mobility is one of the most important determinants of quality of life and independence in adulthood. Unfortunately, the prevalence of mobility limitations increases with age. This book chapter will provide a comprehensive overview of mobility among older adults.

scholarly journals Prognostic Factors for Mortality, Activity of Daily Living and Quality of Life in Taiwanese Older Patients within 1 Year following Hip Fracture Surgery

2022 ◽  
Vol 12 (1) ◽  
pp. 102
Author(s):  
Ming-Hsiu Chiang ◽  
Yu-Yun Huang ◽  
Yi-Jie Kuo ◽  
Shu-Wei Huang ◽  
Yeu-Chai Jang ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Older Adults ◽  
Hip Fracture ◽  
Daily Living ◽  
Estimating Equation ◽  
Generalized Estimating Equation ◽  
Hip Fracture Surgery ◽  
Fracture Surgery

Background. Hip fractures among older adults are a major public health concern worldwide. This study investigated the potential clinical factors that predict postoperative 1-year activities of daily living (ADL), quality of life (QoL), and mortality in Taiwanese older adults following hip fracture. Methods. This is a prospective cohort study enrolling older adults (≥60 years) who had undergone hip fracture surgery in a single medical center. The comprehensive clinical history of each patient was examined. QoL, ADL, and mortality events were recorded consecutively at 3, 6, and 12 months after operation. The multiple logistic regression model and the generalized estimating equation (GEE) were adopted to identify contributing factors for mortality and postoperative ADL and QoL prognosis, respectively. Results. Among 377 participants with hip fracture, 48 died within 1 year of the index operation. ADL and QoL considerably decreased at 3 months following hip surgery. Old age, high Charlson Comorbidity Index, and American Society of Anesthesiologists grading were crucial predictors for mortality at the 1-year follow-up. The generalized estimating equation analysis indicated that the length of postoperative follow-up time, serum albumin level, patient cognitive status, and handgrip strength were considerably associated with QoL and ADL recovery prognosis in the Taiwanese older adults following hip fracture. Conclusions. Hip fractures have long-lasting effects on the older adults. Our data imply several prognosis predicting parameters that may assist clinicians in accounting for an individual’s personalized risks in order to improve functional outcomes and reduce mortality.

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