Graphic Novela: Mexican American Families’ Use of Community Services for Older Adults

2021 ◽  
pp. 105477382110570
Author(s):  
Lori Martin-Plank ◽  
Mary P. Davis ◽  
Deborah K. Williams ◽  
Jennifer T. May ◽  
Evangeline M. Ortiz-Dowling ◽  
...  
Keyword(s):  
Older Adults ◽  
Older Adult ◽  
Support Services ◽  
Mexican American ◽  
Community Services ◽  
Qualitative Description ◽  
Advisory Council ◽  
Structural Barriers ◽  
Mexican American Families

Knowledge gaps exist about how to help Mexican American (MA) families seek assistance when their capacity to assist older family members is challenged. MA families may resist confronting unpleasant but real situations with the older adult, for example, the need to access long term support services (LTSS), because of cultural and structural barriers. The purpose was to describe stakeholders’ reactions to a culturally focused graphic novela created in partnership with a community advisory council. Qualitative description with content analysis of a focus group’s reactions to the graphic novela was used. Results included positive reactions as well as suggestions for improvement and dissemination. Graphic novelas can be an effective medium for modeling conversations about older adults’ needing additional care, and demonstrating how to identify and access available LTSS or other services. Included is a description of the researchers’ process of partnering with diverse stakeholders, which is essential for creating new solutions.

scholarly journals Housing, Affordability, and Community-Based Aging

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 690-691
Author(s):  
Samara Scheckler
Keyword(s):  
Older Adults ◽  
Older Adult ◽  
Long Term Care ◽  
Housing Tenure ◽  
Policy Implications ◽  
Housing Cost ◽  
Home Equity ◽  
Community Based ◽  
Term Care

Abstract The house acts as both an environment of care and a vehicle to financially potentiate long-term community-based support. While housing can empower a diverse set of options for a person-centered aging process, inadequate housing can also impede healthy aging in the community. This symposium teases out the nodes where housing acts to benefit or limit safe community-based aging. The first paper in this symposium, Homeownership Among Older Adults, describes typologies of older adult homeownership and sensitively highlights trends, disparities and important considerations of homeownership in later life. The next two papers take these older adults and explores situations where their housing acts as an asset or as a burden. Identifying Cost Burdened Older Adults acknowledges that housing cost burdens look different for older adults than younger cohorts. A more precise definition of older adult housing cost burden is proposed to help researchers and policymakers better synthesize the complex relationships between older adult housing and their long-term care decisions. The Long-Term Care Financing Challenge then explores the role of home equity in expanding the community-based long-term care choice set for older adults. This paper demonstrates benefits (both realized and unrealized) in home equity and suggests policy implications moving forward. Finally, Cardiometabolic Risk Among Older Renters and Homeowners disentangles the relationship between housing and health by demonstrating health disparities that are associated with housing tenure, conditions and affordability. Taken together, this symposium explores the complex and multidirectional relationships between housing, long-term care and older adult health.

scholarly journals Hospital to Home: Supporting the Transition From Hospital to Home for Older Adults

2021 ◽  
pp. 084456212110443
Author(s):  
Brittany Barber ◽  
Lori Weeks ◽  
Lexie Steeves-Dorey ◽  
Wendy McVeigh ◽  
Susan Stevens ◽  
...  
Keyword(s):  
Older Adults ◽  
Home Care ◽  
Family Caregivers ◽  
Older Adult ◽  
Long Term Care ◽  
Home Care Services ◽  
Term Care ◽  
Care Services ◽  
Hospital To Home

Background An increasing proportion of older adults experience avoidable hospitalizations, and some are potentially entering long-term care homes earlier and often unnecessarily. Older adults often lack adequate support to transition from hospital to home, without access to appropriate health services when they are needed in the community and resources to live safely at home. Purpose This study collaborated with an existing enhanced home care program called Home Again in Nova Scotia, to identify factors that contribute to older adult patients being assessed as requiring long-term care when they could potentially return home with enhanced supports. Methods Using a case study design, this study examined in-depth experiences of multiple stakeholders, from December 2019 to February 2020, through analysis of nine interviews for three focal patient cases including older adult patients, their family or friend caregivers, and healthcare professionals. Results Findings indicate home care services for older adults are being sought too late, after hospital readmission, or a rapid decline in health status when family caregivers are already experiencing caregiver burnout. Limitations in home care services led to barriers preventing family caregivers from continuing to care for older adults at home. Conclusions This study contributes knowledge about gaps within home care and transitional care services, highlighting the importance of investing in additional home care services for rehabilitation and prevention of rapidly deteriorating health.

scholarly journals Dual Trajectories of Dementia and Social Support in the Mexican-Origin Population

2020 ◽  
Author(s):  
Sunshine M Rote ◽  
Jacqueline L Angel ◽  
Jiwon Kim ◽  
Kyriakos S Markides
Keyword(s):  
Social Support ◽  
Mexican American ◽  
The Elderly ◽  
Epidemiologic Studies ◽  
Living Alone ◽  
Instrumental Support ◽  
Latent Classes ◽  
Mexican American Families ◽  
High Support

Abstract Background and Objectives In the next few decades, the number of Mexican American older adults with Alzheimer’s disease and related disorders will increase dramatically. Given that this population underutilizes formal care services, the degree of care responsibilities in Mexican American families is likely to increase at the same time. However, little is known about the changing need for assistance with instrumental day-to-day activities and emotional support by long-term patterns of cognitive impairment. Research Design and Methods We use 7 waves of the Hispanic Established Populations for the Epidemiologic Studies of the Elderly (1992/1993–2010/2011) and trajectory modeling to describe long-term patterns of perceived emotional and instrumental support, and dementia. Results Results revealed 2 latent classes of both emotional and instrumental support trajectories: low and high support. Specifically, those living alone were more likely to belong to the group with low support than to that with high support. Three latent classes for likely dementia were also revealed: likely dementia, increasing impairment, and no impairment. Those living alone were more likely to belong to the increasing impairment and likely dementia groups. The dual trajectory of emotional and instrumental support with likely dementia revealed that the probability of belonging to the low-support group was highest for those with increasing impairment. Discussion and Implications These findings highlight the risk and vulnerability of those who live alone concerning perceived social support and dementia. Implications of the findings for the potential dependency burden on Latino caregivers are discussed.

scholarly journals Barriers to Engage Low-Skilled Adults in Educational Opportunities: A Global Perspective

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 64-64
Author(s):  
Abigail Helsinger ◽  
Nytasia Hicks ◽  
Meghan Young ◽  
Oksana Dikhtyar ◽  
Phyllis Cummins ◽  
...  
Keyword(s):  
Older Adults ◽  
Older Adult ◽  
Learning Opportunities ◽  
Global Perspective ◽  
Middle Aged ◽  
Structured Interviews ◽  
Key Informants ◽  
Program Costs

Abstract The demand for adult education and training (AET) opportunities is substantial as older adults are remaining in the labor force at older ages, and are facing substantial technological changes in the workplace. Strategies to engage middle-aged and older adult workers in AET often exclude low-skilled and sub-populations. The engagement of these sub-populations in AET is challenging as access, awareness, and program costs associated with AET opportunities often target highly skilled populations. The inequality in AET participation warrants specific programs and strategies to address challenges low-skilled adult workers face in pursuing AET. The purpose of this study is to identify AET opportunities for low-skilled middle-aged and older adults, as well as highlight major barriers to engage and retain these sub-population in AET. Data were collected from 36 key informants through semi-structured interviews and through document reviews. Key informants represented Australia, Canada, Italy, Norway, the Netherlands, the U.K., and the U.S. Descriptive methods were used to identify barriers in recruiting and retaining low-skilled middle-aged and older adults. We particularly focused on the barriers related to cost, language, access, and awareness. Results highlighted opportunities tailored to support adult workers in the pursuit of adult learning opportunities both domestically and internationally. Barriers including learning histories, lack of long-term person-centered support, as well as the role of multiple forms of learning, such as formal and informal learning, were identified. Last, we provide recommendations for recruiting and retaining middle-aged and older adult workers in AET programs.

scholarly journals 62 Engaging Older Adults in Co-Creating a Virtual Coaching Assistant (CAPTAIN) to Support Independent Living at Home

2019 ◽  
Vol 48 (Supplement_3) ◽  
pp. iii1-iii16
Author(s):  
Joanne Carroll ◽  
Louise Hopper
Keyword(s):  
Older Adults ◽  
Older Adult ◽  
Independent Living ◽  
Design Thinking ◽  
Cognitive Activity ◽  
Self Report ◽  
Technology System ◽  
Production Cycles ◽  
System Requirements

Abstract Background As population age increases (CSO, 2016), the CAPTAIN project aims to prevent premature or unnecessary transfer to long-term residential care by offering a safe environment where older adults can retain their autonomy, dignity and independence. CAPTAIN (Coach Assistant via Projected and Tangible Interface) will develop a virtual eCoaching assistant to facilitate independence in the home using augmented reality projections, voice and speech recognition, artificial intelligence and a user interface designed by older adults with their peers in mind. Methods Using Design Thinking and participatory research principles, older adults (n=10), caregivers (n=3) and healthcare professionals (HCPs) (n=2) co-create the CAPTAIN system with the research team. Co-creation occurs in cycles. Two co-design cycles use participatory workshops to identify older adults’ needs through discussion of typical older adult ‘personas’, examine how technology can support these needs and translate these outputs into system requirements. Four co-production cycles will evaluate CAPTAIN prototypes (hardware and software) to determine the effectiveness of personalised recommendations, usability and acceptability. The evaluation (involves additional caregivers, HCPs and stakeholder groups) combines observed CAPTAIN use, system-generated data, self-report measures, participatory group workshops and one-to-one interviews. Results Participants found the personas helpful in terms of generating conversation in the co-design sessions. They confidently described older adult needs, suggested where technology could provide useful support, and features they thought CAPTAIN should offer. Requirements across seven thematic areas (health, nutrition, physical and cognitive activity, accessibility, social interaction, education and safety) have now been sent to technical developers. Data from each cycle will continue to inform the development of CAPTAIN until system completion. Conclusion Participant contributions have ensured the continued development of an accessible, easy-to-use assistive technology system that will facilitate independent living and support older adults “…to do the things they want to do, when they want to do them”.

Older Adult Strategies for Community Wayfinding

2016 ◽  
Vol 36 (2) ◽  
pp. 213-233 ◽  
Author(s):  
David X. Marquez ◽  
Rebecca H. Hunter ◽  
Michelle H. Griffith ◽  
Lucinda L. Bryant ◽  
Sarah J. Janicek ◽  
...  
Keyword(s):  
Older Adults ◽  
Data Collection ◽  
Older Adult ◽  
Exploratory Study ◽  
Information Sources ◽  
Route Planning ◽  
Ethnically Diverse ◽  
Primary Method ◽  
Drawing Task

Community wayfinding becomes more challenging with age and decrements in functioning. Given the growth in numbers of older adults, we need to understand features that facilitate or inhibit wayfinding in outdoor settings to enhance mobility and community engagement. This exploratory study of 35 short- ( n = 14) and long-term ( n = 21) residents in an ethnically diverse neighborhood identified relevant wayfinding factors. Data collection included an interview, map-drawing task, and walk along a previously audited, prescribed route to identify key wayfinding strategies. Most participants sought information from other people as a primary method of route planning. Street signs and landmarks were overwhelming favorites as helpful wayfinding features. When asked to recall the route following the walk, only half of participants gave completely correct directions. Findings reinforce the importance of landmarks and legible, systematic, and consistently available signage, as well as trustworthy person-to-person information sources. Findings also underscore the need for wayfinding research in diverse environments.

scholarly journals Hospital to Home: Supporting the Transition from Hospital to Home for Older Adults

2021 ◽  
Author(s):  
Brittany Barber ◽  
Lori Weeks ◽  
Lexie Steeves-Dorey ◽  
Wendy McVeigh ◽  
Susan Stevens ◽  
...  
Keyword(s):  
Older Adults ◽  
Home Care ◽  
Older Adult ◽  
Long Term Care ◽  
Home Care Services ◽  
Adult Patients ◽  
Term Care ◽  
Care Services ◽  
Hospital To Home

Abstract Background: An increasing proportion of older adults experience avoidable hospitalizations, and some are potentially entering long-term care homes earlier and often unnecessarily. Within Canada, approximately 10 percent of newly admitted long-term care residents could have potentially been cared for at home. Without adequate support from health care services to transition older adults from hospital to home, they often lack access to appropriate services when they are needed in the community thus making them more vulnerable to avoidable hospital visits, rapid deterioration of health, and earlier and unnecessary placement into residential long-term care. The purpose of this study was to collaborate with an existing enhanced home care program called Home Again in Halifax, Nova Scotia, to identify factors that contribute to older adult patients being assessed as requiring long-term care when they could potentially return home with enhanced supports. Methods: Through a retrospective case study design, we analyzed nine interviews for three focal patient cases including older adult patients, their family or friend caregivers, and healthcare professionals. Results: Findings indicate home care services for older adults are being sought too late, after hospital re-admission, or a rapid decline in health status when family caregivers are already experiencing caregiver burnout. Limitations in home care services ultimately led to barriers preventing family caregivers from continuing to care for older adults at home, such as absence of overnight services, a lack of information about home care services, and a lack of knowledge to navigate resources available. Conclusion: This study contributes knowledge about gaps within home care and transitional care services, highlighting the significance of investing in additional home care services for rehabilitation and the prevention of rapidly deteriorating health when older adults are discharged home after their first hospital visit. By understanding experiences and challenges of patients, family or friend caregivers, and healthcare professionals, we identified ways to reduce healthcare costs and improve the delivery and quality of home care services to better support older adult patients and their family or friend caregivers and to ensure hospitalized older adults are not unnecessarily admitted to nursing homes.

Benzodiazepines and Other Sedative-Hypnotics in the Older Adult

2016 ◽  
Author(s):  
Arthur Robin Williams ◽  
Olivera J. Bogunovic
Keyword(s):  
Older Adults ◽  
Older Adult ◽  
Cognitive Deficits ◽  
The Elderly ◽  
The United States ◽  
Active Management ◽  
Pharmacokinetics And Pharmacodynamics ◽  
Rebound Effects ◽  
Sedative Hypnotics

Sedative-hypnotic-use disorder is a serious problem in the elderly and is a growing concern in the United States. The American Geriatrics Society’s “Choosing Wisely” initiative cautions against the use of any benzodiazepines or other sedative-hypnotics as initial treatment in older adults, yet benzodiazepines are the most frequently prescribed drugs in the elderly for both insomnia and anxiety. Other classes of medication (e.g., serotoninergic antidepressants) may be substituted for benzodiazepines based on diagnosis. With advancing age, the elderly are more sensitive to the potential side effects of benzodiazepines because of altered pharmacokinetics and pharmacodynamics Increasingly, studies have indicated that older patients disproportionately experience adverse events with benzodiazepines such as falls and cognitive deficits and have difficulty reducing or stopping long-term use without experiencing rebound effects such as anxiety and insomnia. Sedative-hypnotic-use disorders among older adults are increasing in prevalence and warrant heightened clinical attention, thoughtful assessment, and active management.

scholarly journals Real-World Effectiveness of Smoking Cessation Strategies for Young and Older Adults: Findings From a Nationally Representative Cohort

2019 ◽  
Vol 22 (9) ◽  
pp. 1560-1568 ◽  
Author(s):  
Shannon Lea Watkins ◽  
Johannes Thrul ◽  
Wendy Max ◽  
Pamela M Ling
Keyword(s):  
Older Adults ◽  
Smoking Cessation ◽  
Young Adults ◽  
Logistic Regression ◽  
Older Adult ◽  
Evidence Based ◽  
Product Substitution ◽  
Short Term ◽  
Behavioral Support

Abstract Introduction Young adults have high combustible cigarette and e-cigarette use rates, and low utilization of evidence-based smoking cessation strategies compared to older adults. It is unknown whether young adults who try to quit smoking without assistance, with evidence-based strategies, or with e-cigarettes, are equally successful compared to older adults. Aims and Methods This analysis used a population-based sample from the Population Assessment of Tobacco and Health study of young adult (aged 18–24, n = 745) and older adult (aged 25–64, n = 2057) established cigarette smokers at Wave 1 (2013–2014) who reported having made a quit attempt at Wave 2 (2014–2015). Cessation strategies were: behavioral therapy, pharmacotherapy, product substitution, 2+ strategies, and unassisted. Logistic regression estimated associations between cessation strategy and short-term cessation status at Wave 2 (quit, no quit); multinomial logistic regression predicted long-term cessation patterns at Waves 2 and 3 (sustained quit, temporary quit, delayed quit, no quit). Results No cessation strategy (ref: unassisted) significantly predicted short-term cessation. No cessation strategy (ref: unassisted) significantly predicted long-term cessation patterns for young adults. Substitution with e-cigarettes predicted short-term cessation for older daily smokers of ≥5 cigarettes/day (adjusted odds ratio [AOR]: 1.70; 95% confidence interval: 1.08, 2.67) but did not predict long-term cessation patterns. Conclusions Despite differences in cessation strategy use between young and older adult smokers, strategy effectiveness largely did not differ by age group. No strategy examined, including e-cigarettes, was significantly associated with successful cessation for young adults. More work is needed to identify effective interventions that help young adult smokers quit. Implications (1) Neither behavioral support, pharmacotherapy, nor product substitution was associated with short-term cessation for young or older adults compared to quitting unassisted. (2) Neither behavioral support, pharmacotherapy, nor product substitution was associated with longer-term cessation for young or older adults compared to quitting unassisted. (3) Substitution with e-cigarettes predicted short-term cessation for older daily smokers of ≥5 cigarettes/day but was not associated with longer-term cessation.

A Consideration of Love Labour in Informal Caring: Family Caring in Ireland

2010 ◽  
Vol 18 (1) ◽  
pp. 82-99
Author(s):  
Jacqui O'Riordan ◽  
Féilim O'Hadhmaill ◽  
Helen Duggan
Keyword(s):  
Support Services ◽  
Extended Family ◽  
Family Members ◽  
Community Support ◽  
Community Services ◽  
Family Carers ◽  
Theoretical Perspectives ◽  
Community Support Services ◽  
Close Relatives

This paper is drawn from research on family carers1 that was carried out in the Cork area of Ireland in 2007–08. The research itself focused on the experiences of family carers and their access to support services in the locality. Key findings indicate that individuals are often caring for family members over the long term, often with minimal access to discretionary community support services. The assumption made by the Irish State, by community services, by carers themselves and by extended family members and friends, is that the onus is and should be on close relatives, and particularly women, to take the major responsibility for caring, when this care takes place in the home (Timonen and McMenamin 2002). This also contributes to the invisibility and undervaluation of family carers (Baker et al. 2004; Lynch 2007). The development of theoretical perspectives on caring can contribute to highlighting the manner in which assumptions about family, domesticity, gender roles and household continue to disadvantage those located primarily within the private sphere.

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