scholarly journals The case for involving adult children outside of the household in the self-management support of older adults with chronic illnesses

2010 ◽  
Vol 6 (1) ◽  
pp. 34-45 ◽  
Author(s):  
John D. Piette ◽  
Ann Marie Rosland ◽  
Maria Silveira ◽  
Mohammed Kabeto ◽  
Kenneth M. Langa
Keyword(s):  
Older Adults ◽  
Chronic Diseases ◽  
Adult Children ◽  
Self Care ◽  
Chronically Ill ◽  
Community Dwelling ◽  
Management Support ◽  
Telephone Contact ◽  
Multiple Chronic Diseases ◽  
Care Support

Objectives: This study sought to (1) identify barriers to spousal support for chronic illness self-care among community-dwelling older adults; and (2) describe the potential availability of self-care support from adult children living outside of the household. Methods: Nationally representative US sample of chronically ill adults aged 51+ were interviewed as part of the Health and Retirement Study (N = 14,862). Both participants and their spouses (when available) reported information about their health and functioning. Participants also reported information about their contact with adult children and the quality of those relationships. Results: More than one-third (38%) of chronically ill older adults in the US are unmarried; and when spouses are available, the majority of them have multiple chronic diseases and functional limitations. However, the vast majority of chronically ill older adults (93%, representing roughly 60 million Americans) have adult children, with half having children living over 10 miles away. Most respondents with children (78%) reported at least weekly telephone contact and that these relationships were positive. Roughly 19 million older chronically ill Americans have adult children living at a distance but none nearby; these children are in frequent telephone contact and respondents (including those with multiple chronic diseases) report that the relationships are positive. Discussion: As the gap between available health services for disease management and the need among community-dwelling patients continues to grow, adult children—including those living at a distance—represent an important resource for improving self-care support for people with chronic diseases.

scholarly journals Development & Testing of a Comprehensive Digital Self-Care Support System for Older Adults With Chronic Conditions

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 633-633
Author(s):  
Priya Nambisan ◽  
Kurt Stange ◽  
Kalle Lyytinen ◽  
Eva Kahana ◽  
Edmund Duthie ◽  
...  
Keyword(s):  
Older Adults ◽  
Support System ◽  
Low Income ◽  
Chronic Conditions ◽  
Self Care ◽  
Community Dwelling ◽  
Multiple Chronic Conditions ◽  
Phase 3 ◽  
Phase Study ◽  
Care Support

Abstract This 3-phase study involves the conceptualization and design, development and usability testing of a Comprehensive Digital Self-care Support System (CDSSS) named myHESTIA for older adults with multiple chronic conditions (MCC). The objective of this study was to test whether a CDSSS can be developed for those who are dealing with MCC and whether such a system that is specifically developed for older adult patients will enable daily capture of self-care data. Participants for this 3-phase study included: 10 older adults (age>60) and 10 caregivers in Phase 1; 15 Geriatrics clinicians and 25 community-dwelling low-income older adults in Phase 2; and, 10 older adults (age>60) with MCC in Phase 3. Agile method of system development was used for the design and development of the system. The first two phases involved collecting data for designing and developing myHESTIA. The third phase involved small group usability and feasibility testing, in which the participants used myHESTIA trackers for 4 weeks. Results from phase 3 shows daily inputs were possible and the self-reported data shows that it was not at all difficult for older adults to track their symptoms daily. User experience data (n=10) shows overall positive experience along pragmatic (5.8 out of 7), hedonic (4.6 out of 7), sociability (5.5 out of 7) and usability (6.3 out of 7) experience dimensions. Finally, all the participants (n=10) who completed the phase 3 study reported intention to continue using myHESTIA. Results indicate that it is feasible to design a CDSSS for older adults with MCC.

scholarly journals Source of Purchased Medications and Its Impact on Medication Mistakes and Hospitalizations: The NHATS 2017

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 793-793
Author(s):  
Martha Coates ◽  
Janeway Granche ◽  
Rose Ann DiMaria-Ghalili
Keyword(s):  
Older Adults ◽  
Hospital Stay ◽  
Chronic Diseases ◽  
Community Dwelling ◽  
Hospital Stays ◽  
Related Harm

Abstract Older adults self-administer prescribed medication regimens to treat chronic diseases which can lead to mismanagement, medication related harm and hospitalizations. We examined the extent to which source of purchased medications influenced the occurrence of self-reported medication mistakes and hospitalizations in community-dwelling participants who managed medications independently (N= 3899). The majority (65%) picked-up medications, 18% had medications delivered, and 17% used both (picked-up and delivery). Compared to those picking up their medications, those using delivery only were less likely to have a hospital stay (OR=0.691 [95% CI 0.507-0.943]) and no difference in odds of medication mistakes (OR=1.051 [95% CI 0.764-1.445]), while those using both methods were more likely to report hospital stays (OR=1.429 [95% CI 1.106-1.846]) and medication mistakes (OR = 1.576[95% CI 1.078-2.304]). Older adults who picked-up medications from a local pharmacy and had medications delivered were more likely to report medication mistakes and hospitalizations.

Modeling Personas for Older Adults with Heart Failure

2018 ◽  
Vol 62 (1) ◽  
pp. 1072-1076 ◽  
Author(s):  
Richard J. Holden ◽  
Pushkar Joshi ◽  
Kartik Rao ◽  
Anagha Varrier ◽  
Carly N. Daley ◽  
...  
Keyword(s):  
Heart Failure ◽  
Older Adults ◽  
Information Needs ◽  
Self Care ◽  
Chronically Ill ◽  
User Centered Design ◽  
Future Design ◽  
Patients With Heart Failure ◽  
Design Activities ◽  
Key Dimensions

In the early stages of the design process, designers often benefit from the use of personas, or archetypes of target users presented in a vivid way to highlight design-relevant characteristics. In the growing efforts to create health information technology (HIT) for older adults, empirically derived personas could help orchestrate more user-centered design activities. However, there is a lack of ready-to-use personas for older adult HIT users and more so for those designing in specific domains such as heart failure self-care. This paper presents personas of older adults derived from qualitative analysis of interviews with 24 older patients with heart failure. Analyses unearthed key dimensions distinguishing patients based on their dispositions towards the self-management of their chronic condition, including locus of control, relationship with the health/support system, information needs, and activities of self-care. Two personas are presented: Direction Follower and Researcher, with subtypes for the latter codified as Investigator and Explorer. Our work contributes to future design of systems including HIT to support chronically ill older adults.

scholarly journals Trajectories of self-rated health in an older general population and their determinants: the Lifelines Cohort Study

BMJ Open ◽  
2020 ◽  
Vol 10 (2) ◽  
pp. e035012
Author(s):  
Marlies Feenstra ◽  
Barbara C van Munster ◽  
Janet L MacNeil Vroomen ◽  
Sophia E de Rooij ◽  
Nynke Smidt
Keyword(s):  
Older Adults ◽  
Cohort Study ◽  
General Population ◽  
Health Risk ◽  
Chronic Diseases ◽  
Community Dwelling ◽  
Endocrine Function ◽  
Self Rated Health ◽  
Physiological Markers ◽  
Community Dwelling Older Adults

ObjectivesPoor self-rated health (SRH) is a strong predictor of premature mortality in older adults. Trajectories of poor SRH are associated with multimorbidity and unhealthy behaviours. Whether trajectories of SRH are associated with deviating physiological markers is unclear. This study identified trajectories of SRH and investigated the associations of trajectory membership with chronic diseases, health risk behaviours and physiological markers in community-dwelling older adults.Study design and settingProspective general population cohort.ParticipantsTrajectories of SRH over 5 years were identified using data of 11 600 participants aged 65 years and older of the Lifelines Cohort Study.Outcome measuresTrajectories of SRH were the main outcome. Covariates included demographics (age, gender, education), chronic diseases, health-risk behaviour (physical activity, smoking, drinking) and physiological markers (body mass index, cardiovascular function, lung function, glucose metabolism, haematological condition, endocrine function, renal function, liver function and cognitive function).ResultsFour stable trajectories were identified, including excellent (n=607, 6%), good (n=2111, 19%), moderate (n=7677, 65%) and poor SRH (n=1205, 10%). Being women (OR: 1.4; 95% CI: 1.0 to 1.9), low education (OR: 2.1; 95% CI: 1.5 to 3.0), one (OR: 10.4; 95% CI: 7.4 to 14.7) or multiple chronic diseases (OR: 37.8; 95% CI: 22.4 to 71.8), smoking (OR: 1.8; 95% CI: 1.0 to 3.2), physical inactivity (OR: 3.1; 95% CI: 1.8 to 5.2), alcohol abstinence (OR: 2.2; 95% CI: 1.4 to 3.2) and deviating physiological markers (OR: 1.5; 95% CI: 1.1 to 2.0) increase the odds for a higher probability of poor SRH trajectory membership compared with excellent SRH trajectory membership.ConclusionSRH of community-dwelling older adults is stable over time with the majority (65%) having moderate SRH. Older adults with higher probabilities of poor SRH often have unfavourable health status.

scholarly journals Effects of Self-Care for Older PErsons (SCOPE) on Functional and Physiological Measures: A Cluster Randomized Controlled Trial

2020 ◽  
Vol 9 (3) ◽  
pp. 885
Author(s):  
Ted Kheng Siang Ng ◽  
David Bruce Matchar ◽  
Rehena Sultana ◽  
Angelique Chan
Keyword(s):  
Older Adults ◽  
Older Persons ◽  
Primary Outcome ◽  
Controlled Trial ◽  
Self Care ◽  
Community Dwelling ◽  
Physiological Measures ◽  
Randomized Controlled ◽  
Cluster Randomized ◽  
Community Dwelling Older Adults

Background: Population aging poses unprecedented demands on the healthcare system. There is also a scarcity of evidence on self-care intervention to improve objective measures of morbidity and aging-associated functional and physiological measures in a low-income multi-ethnic population setting. Methods: We conducted a cluster randomized controlled trial (ClinicalTrials.gov Identifier: NCT01672177) to examine the effects of the Self-Care for Older PErsons (SCOPE) program. We randomized 14 Senior Activity Centers and randomly selected older adults within these centers. Functional and physiological measurements were performed at baseline, 10-month, and 18-month periods. The primary outcome was a composite of three morbidity-specific measures, which include hemoglobin A1c (HbA1C), peak expiratory flow, and systolic blood pressure. Aging-associated functional and physiological measures were examined as secondary outcomes. Repeated-measure mixed models were employed to examine the effects of SCOPE on these measures. Results: 378 community-dwelling older adults participated in either the treatment (n= 164) or the control arm (n = 214). The primary outcome was not significantly improved. For the secondary outcomes, SCOPE participants demonstrated slower oxygen desaturation at an 18-month period (p = 0.001), improved time to complete the chair-stand test (p < 0.001) at a 10-month period with the effect persisting at the 18-month period (p < 0.001). SCOPE participants also had significantly improved vitamin B12 levels at the 18-month period (p < 0.001), increased hemoglobin concentration (p < 0.001), decreased mean corpuscular volume (p = 0.001), and decreased creatinine (p = 0.002) at the 10-month period. Conclusions: SCOPE did not improve morbidity-specific measures. However, it improved several aging-associated measures implicated in geriatric syndromes. This study highlights the potential of a self-care program in the prevention of geriatric syndromes in community-dwelling older adults, while emphasizing self-management to manage existing morbidities.

scholarly journals Synergistic effects of hip/knee osteoarthritis and comorbidities on mobility and self-care limitations among older adults: Cross-sectional analysis of the Oxford pain, Activity and Lifestyle study

2020 ◽  
Vol 10 ◽  
pp. 2235042X2097452
Author(s):  
Philippa JA Nicolson ◽  
Esther Williamson ◽  
Hopin Lee ◽  
Alana Morris ◽  
Angela Garrett ◽  
...  
Keyword(s):  
Older Adults ◽  
Depressive Symptoms ◽  
Knee Osteoarthritis ◽  
Synergistic Effects ◽  
Self Care ◽  
Postal Questionnaire ◽  
Community Dwelling ◽  
Mobility Limitations ◽  
Cross Sectional ◽  
Knee Oa

Objective: To estimate synergistic effects of hip/knee osteoarthritis (OA) and comorbidities on mobility or self-care limitations among older adults. Methods: We used baseline, cross-sectional data from the Oxford Pain, Activity and Lifestyle (OPAL) study. Participants were community-dwelling adults aged 65 years or older who completed a postal questionnaire. Participants reported demographic information, hip/knee OA, comorbidities and mobility and self-care limitations. We used modified Poisson regression models to estimate the independent and combined relative risks (RR) of mobility or self-care limitations, the relative excess risk due to interaction (RERI) between hip/knee OA and comorbidities, attributable proportion of the risk due to the interaction and the ratio of the combined effect and the sum of the individual effects, known as the synergy index. Results: Of the 4,972 participants included, 1,532 (30.8%) had hip/knee OA, and of them 42.9% reported mobility limitations and 8.4% reported self-care limitations. Synergistic effects impacting self-care limitations were observed between hip/knee OA and anxiety (RR: 3.09, 95% Confidence Interval (CI): 2.00 to 4.78; RERI: 0.93, 95% CI: 0.01 to 1.90), and between hip/knee OA and depressive symptoms (RR: 2.71, 95% CI: 1.75 to 4.20; RERI: 0.58, 95% CI: 0.03 to 1.48). The portion of the total RR attributable to this synergism was 30% and 22% respectively. Conclusions: This study demonstrates that synergism between hip/knee OA and anxiety or depressive symptoms contribute to self-care limitations. These findings highlight the importance of assessing and addressing anxiety or depressive symptoms when managing older adults with hip/knee OA to minimize self-care limitations.

Predictors of satisfaction with life among older adults

2017 ◽  
Vol 41 (S1) ◽  
pp. S177-S178
Author(s):  
S. Von Humboldt ◽  
I. Leal
Keyword(s):  
Older Adults ◽  
Sex Education ◽  
Adult Children ◽  
Sense Of Coherence ◽  
Structural Equation ◽  
Structural Model ◽  
Satisfaction With Life ◽  
Community Dwelling ◽  
Equation Modeling ◽  
Health Related

IntroductionIncreasing longevity brings challenges for older adults’ satisfaction with life (SWL).AimsThis study aims at exploring a structural model of predictors of SWL in a cross-national sample of older adults.MethodsA community-dwelling sample of 1234 older adults was assessed regarding SWL, sense of coherence (SOC) and socio-demographic, lifestyle and health-related characteristics. Structural equation modeling was used to investigate a structural model of the self-reported SWL, comprising SOC, socio-demographic characteristics (age, sex, education, marital and professional status, household, adult children, income, living setting and religion), lifestyle and health-related characteristics (physical activity, recent disease and medication).ResultsSignificant predictors are SOC (β = .733; P < .001), religion (β = .725; P < .001), income (β = .551; P < .001), adult children (β = .546; P < .001), education (β = –.403; P < .001), living setting (β = –.292; P < .001) and medication (β = –.197; P < .001). The variables accounted for 24.8% of the variability of SWL. Moreover, differences between the four nationality groups (F(3, 671) = 3.671, P = .066) were not found concerning SWL.ConclusionsSense of coherence is the strongest predictor of self-reported SWL. Other predictors are religion, income, adult children, education, living setting and medication. The four nationalities did not present significant differences, concerning SWL. This study highlights the factors that influence older adults’ SWL, namely, SOC, religion and income, as promoters of aging well, within a salutogenic model of health for older populations.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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