Ethical issues related to the use of gerontechnology in older people care: A scoping review

2019 ◽  
Vol 27 (1) ◽  
pp. 88-103 ◽  
Author(s):  
Suvi Sundgren ◽  
Minna Stolt ◽  
Riitta Suhonen
Keyword(s):  
Older People ◽  
Scoping Review ◽  
Ethical Issues ◽  
Scientific Practice ◽  
Empirical Studies ◽  
Quality Care ◽  
Healthcare Services ◽  
Community Dwelling ◽  
Main Theme ◽  
Community Dwelling Older People

Background: Demographic trends indicate growth of population aged 65 and older in Western countries. One of the greatest challenges is to provide high-quality care for all. Technological solutions designed for older people, gerontechnology, can somewhat balance the gap between resources and the increasing demand of healthcare services. However, there are also ethical issues in the use of gerontechnology that need to be pointed out. Purpose: To describe what ethical issues are related to the use of gerontechnology in the care of community-dwelling older people. Methods: A scoping review was performed to identify and analyse studies concerning ethical issues when using gerontechnology in the home care of older people. The literature search was limited to studies published after 1990 and addressed to the electronic databases CINAHL, PubMed, Cochrane, Medic, IEEE Explore and Web of Science. The search was performed in July−August 2018. Data from empirical studies were analysed using thematic analysis. Ethical considerations: This scoping review was conducted in accordance with good scientific practice. The work of other researchers was respected and cited appropriately. Results: A total of 17 studies were identified. Two main themes were found. ‘Balancing between the benefits of using gerontechnology and the basic rights of older people’, consisted of the subthemes safety, privacy and autonomy. The other main theme, ‘Gerontechnology as a risk of insecurity for older people’, included the subthemes fear of losing human contact and concern and fear. Surveillance and monitoring technologies were mainly studied. Conclusion: These results suggest that there may be ethical issues related to the use of gerontechnology and they must therefore be taken into consideration when implementing technology in the care of community-dwelling older people.

scholarly journals Mapping instruments for assessing and stratifying frailty among community-dwelling older people: a scoping review

BMJ Open ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. e052301
Author(s):  
Luiz Eduardo Lima Andrade ◽  
Beatriz Souza de Albuquerque Caciqu New York ◽  
Rafaella Silva dos Santos Aguiar Gonçalves ◽  
Sabrina Gabrielle Gomes Fernandes ◽  
Álvaro Campos Cavalcanti Maciel
Keyword(s):  
Older People ◽  
Latin American ◽  
Scoping Review ◽  
Data Extraction ◽  
Grey Literature ◽  
Community Dwelling ◽  
Frailty Phenotype ◽  
Advantages And Disadvantages ◽  
Study Selection ◽  
Community Dwelling Older People

ObjectiveTo map in the current literature instruments for the assessment and stratification of frailty in community-dwelling older people, as well as to analyse them from the perspective of the Brazilian context.DesignScoping review.Study selectionThe selection of studies took place between March and April 2020. Includes electronic databases: Medline, Latin American and Caribbean Literature in Health Sciences, Scopus, Web of Science and Cumulative Index of Nursing and Literature Health Alliance, in addition to searching grey literature.Data extractionA data extraction spreadsheet was created to collect the main information from the studies involved, from the title to the type of assessment and stratification of frailty.ResultsIn summary, 17 frailty assessment and stratification instruments applicable to community-dwelling older people were identified. Among these, the frailty phenotype of Fried et al was the instrument most present in the studies (45.5%). The physical domain was present in all the instruments analysed, while the social, psychological and environmental domains were present in only 10 instruments.ConclusionsThis review serves as a guideline for primary healthcare professionals, showing 17 instruments applicable to the context of the community-dwelling older people, pointing out advantages and disadvantages that influence the decision of the instrument to be used. Furthermore, this scoping review was a guide for further studies carried out by the same authors, which aim to compare instruments.

scholarly journals Functional Independence in the Community Dwelling Older People: a Scoping Review

2020 ◽  
Author(s):  
E. A. L. M. Molenaar ◽  
J. A. Barten ◽  
S. te Velde ◽  
L. van der Schoot ◽  
N. Bleijenberg ◽  
...  
Keyword(s):  
Older People ◽  
Scoping Review ◽  
Functional Independence ◽  
Community Dwelling ◽  
Physical Factors ◽  
Contributing Factors ◽  
Holistic View ◽  
Stakeholder Consultation ◽  
Community Dwelling Older People ◽  
Definition Of

AbstractAgeing potentially poses a threat to independent functioning of older adults. Although clinicians commonly focus on physical factors limiting Functional Independence (FI), it is likely that personal and environmental interactions also seem important to maintain FI. Herewith, FI exceeds several professional borders and calls for a uniform, multidisciplinary interdisciplinary supported definition of FI. This study aims to provide such a definition of FI in community dwelling older people. A scoping review was performed. Pubmed/Medline, Psychinfo and CINAHL were searched for studies describing aspects of FI. A literature-based definition of FI was discussed by experts (n = 7), resulting in a formulated final definition of FI and insight into contributing factors to FI. A multidisciplinairy focusgroup a stakeholder consultation (n = 15) ensured clinical relevance for daily practice. Data from the focusgroup stakeholder consultation were analyzed by using Atlas.ti (version 8). Based on the literature search, 25 studies were included. FI was finally defined as “Functioning physically safely and independent from another person, within one’s own context”. The contributing factors of FI comprised physical capacity combined with coping, empowerment and health literacy. Moreover, the level of FI is influenced by someone’s own context. This study confirms the relevance of the physical aspect of FI, but additionally stresses the importance of psychological factors. In addition, this study shows that one’s context may affect the level of FI as well. This underlines the importance of a holistic view and calls for multidisciplinary interdisciplinary collaboration in community-dwelling older people.

Location monitoring of physical activity and participation in community dwelling older people: a scoping review

2019 ◽  
Vol 43 (2) ◽  
pp. 270-283 ◽  
Author(s):  
Claire Gough ◽  
Heather Weber ◽  
Stacey George ◽  
Anthony Maeder ◽  
Lucy Lewis
Keyword(s):  
Physical Activity ◽  
Older People ◽  
Scoping Review ◽  
Community Dwelling ◽  
Community Dwelling Older People

scholarly journals Unmet care needs of older people: A scoping review

2020 ◽  
pp. 096973302094811
Author(s):  
Dominika Kalánková ◽  
Minna Stolt ◽  
P Anne Scott ◽  
Evridiki Papastavrou ◽  
Riitta Suhonen
Keyword(s):  
Older People ◽  
Nursing Care ◽  
Scoping Review ◽  
Ethical Issues ◽  
Empirical Studies ◽  
Point Of View ◽  
World Health ◽  
Organizational Level ◽  
Care Needs ◽  
Complex Needs

The aim was to synthesize the findings of empirical research about the unmet nursing care needs of older people, mainly from their point of view, from all settings, focusing on (1) methodological approaches, (2) relevant concepts and terminology and (3) type, nature and ethical issues raised in the investigations. A scoping review after Arksey and O’Malley. Two electronic databases, MEDLINE/PubMed and CINAHL (from earliest to December 2019) were used. Systematic search protocol was developed using several terms for unmet care needs and missed care. Using a three-step retrieval process, peer-reviewed, empirical studies concerning the unmet care needs of older people in care settings, published in English were included. An inductive content analysis was used to analyse the results of the included studies (n = 53). The most frequently used investigation method was the questionnaire survey seeking the opinions of older people, informal caregivers or healthcare professionals. The unmet care needs identified using the World Health Organization classification were categorized as physical, psychosocial and spiritual, and mostly described individuals’ experiences, though some discussed unmet care needs at an organizational level. The ethical issues raised related to the clinical prioritization of tasks associated with failing to carry out nursing care activities needed. The unmet care needs highlighted in this review are related to poor patient outcomes. The needs of institutionalized older patients remain under-diagnosed and thus, untreated. Negative care outcomes generate a range of serious practical issues for older people in care institutions, which, in turn, raises ethical issues that need to be addressed. Unmet care needs may lead to marginalization, discrimination and inequality in care and service delivery. Further studies are required about patients’ expectations when they are admitted to hospital settings, or training of nurses in terms of understanding the complex needs of older persons.

Prioritization and management of calls from older people to GP out-of-hours services

2021 ◽  
Vol 33 (1) ◽  
Author(s):  
Suzanne Smith ◽  
Lucia Carragher
Keyword(s):  
Older People ◽  
Service Provision ◽  
Emergency Services ◽  
Oldest Old ◽  
Community Dwelling ◽  
Third Party ◽  
Older Person ◽  
Out Of Hours ◽  
Accident And Emergency ◽  
Community Dwelling Older People

Abstract Background Urgent out-of-hours medical care is necessary to ensure people can remain living at home into older age. However, older people experience multiple barriers to using out-of-hours services including poor awareness about the general practitioner (GP) out-of-hours (GPOOH) service and how to access it. In particular, older people are reluctant users of GPOOH services because they expect either their symptoms will not be taken seriously or they will simply be referred to hospital accident and emergency services. The aim of this study was to examine if this expectation was borne out in the manner of GPOOH service provision. Objective The objective was to establish the urgency categorization and management of calls to GPOOH , for community dwelling older people in Ireland. Methods An 8-week sample of 770 calls, for people over 65 years, to a GPOOH service in Ireland, was analysed using Excel and Nvivo software. Results Urgency categorization of older people shows 40% of calls categorized as urgent. Recognition of the severity of symptoms, prompting calls to the GPOOH service, is also reflected in a quarter of callers receiving a home visit by the GP and referral of a third of calls to emergency services. The findings also show widespread reliance on another person to negotiate the GPOOH system, with a third party making 70% of calls on behalf of the older person seeking care. Conclusion Older people are in urgent need of medical services when they contact GPOOH service, which plays an effective and patient-centred gatekeeping role, particularly directing the oldest old to the appropriate level of care outside GP office hours. The promotion of GPOOH services should be enhanced to ensure older people understand their role in supporting community living.

Ten‐year trends in lifestyle habits among community‐dwelling older people in Taiwan

2021 ◽  
Author(s):  
Hsiao‐Ting Tsou ◽  
Tai‐Yin Wu ◽  
Kuan‐Liang Kuo ◽  
Sheng‐Huang Hsiao ◽  
Sheng‐Jean Huang ◽  
...  
Keyword(s):  
Older People ◽  
Community Dwelling ◽  
Lifestyle Habits ◽  
Community Dwelling Older People

scholarly journals Frailty Status and All-Cause Mortality in the Community-Dwelling Older People: An Umbrella Review

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 488-489
Author(s):  
A R M Saifuddin Ekram ◽  
Joanne Ryan ◽  
Carlene Britt ◽  
Sara Espinoza ◽  
Robyn Woods
Keyword(s):  
Older People ◽  
Systematic Reviews ◽  
Community Dwelling ◽  
Umbrella Review ◽  
Frailty Phenotype ◽  
Frailty Status ◽  
Increased Risk ◽  
All Cause Mortality ◽  
Community Dwelling Older People ◽  
Meta Analyses

Abstract Frailty is increasingly recognised for its association with adverse health outcomes including mortality. However, various measures are used to assess frailty, and the strength of association could vary depending on the specific definition used. This umbrella review aimed to map which frailty scale could best predict the relationship between frailty and all-cause mortality among community-dwelling older people. According to the PRISMA guidelines, Medline, Embase, EBSCOhost and Web of Science databases were searched to identify eligible systematic reviews and meta-analyses which examined the association between frailty and all-cause mortality in the community-dwelling older people. Relevant data were extracted and summarised qualitatively. Methodological quality was assessed by AMSTAR-2 checklist. Five moderate-quality systematic reviews with a total of 374,529 participants were identified. Of these, two examined the frailty phenotype and its derivatives, two examined the cumulative deficit models and the other predominantly included studies assessing frailty with the FRAIL scale. All of the reviews found a significant association between frailty status and all-cause mortality. The magnitude of association varied between individual studies, with no consistent pattern related to the frailty measures that were used. In conclusion, regardless of the measure used to assess frailty status, it is associated with an increased risk of all-cause mortality.

scholarly journals The composition of the gut microbiome differs among community dwelling older people with good and poor appetite

2021 ◽  
Author(s):  
Natalie J. Cox ◽  
Ruth C.E. Bowyer ◽  
Mary Ni Lochlainn ◽  
Philippa M. Wells ◽  
Helen C. Roberts ◽  
...  
Keyword(s):  
Older People ◽  
Gut Microbiome ◽  
Community Dwelling ◽  
Poor Appetite ◽  
Community Dwelling Older People
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