Overcoming existential loneliness: a cross-cultural study

Abstract Background Moving into a long-term care facility (LTCF) can reduce the ability for older adults to engage in meaningful roles and activities and the size of their social network. These changes and losses can lead them to experience existential loneliness (EL)—the intolerable emptiness and lack of meaningful existence resulted from the losses they have experienced. While EL has often been understood as a universal human experience, it has primarily been studied in people from Western cultures; little is known about how EL may be experienced by and manifested in people from Eastern cultures. Hence, this qualitative study aimed to describe the experience and coping of EL in Hong Kong Chinese and Swedish older adults living in LTCFs. Methods A qualitative study using Thorne’s (2004) interpretive description was conducted. Thirteen Chinese and 9 Swedes living in LTCFs in Hong Kong, China and Malmo, Sweden, respectively were interviewed about their experience of EL in two series of semi-structured interviews. Data were analyzed using thematic analysis. Results The core theme of “overcoming EL” described the participants’ experience of EL, which came about through the combined process of “Feeling EL” and “Self-Regulating”. Both Chinese and Swedish participants had similar experience with EL. Realizing that they did not want to living with EL anymore, they coped by reframing their experience and identifying new meaning in their life. Conclusions The study findings suggested that early and clear counselling support that help older adults to define new meaning in life may help them cope. In addition, more opportunities should be available at the LTCFs to promote quality relationships, enable older adults to reflect on their lives with pride, and support their ability to do the things they enjoy.

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Overcoming existential loneliness: a cross cultural study

10.21203/rs.2.17403/v1 ◽

2019 ◽

Author(s):

Betty PM Chung ◽

Jonas Olofsson ◽

Frances KY Wong ◽

Margareta Ramgard

Keyword(s):

Older Adults ◽

Qualitative Study ◽

Sense Of Self ◽

Care Facility ◽

Human Condition ◽

Term Care ◽

Long Term Care Facility ◽

Existential Loneliness ◽

Meaningful Existence ◽

Meaningful Experiences

Abstract Moving into a long-term care facility (LTCF) can alter the way older adults see themselves and reduce their ability to engage in meaningful experiences and roles. They experience a shrinkage in their social network when they move away from home, a reduction in the frequency of their social contacts and the number of people from whom they receive emotional support. These changes and losses can lead to feelings of loneliness. However, the loneliness these older adults experience may be more than having the difficulty with expressing the feelings of loneliness or the loss of social roles, as common examined in the loneliness literature. Rather, this loneliness stemmed from the intolerable emptiness and lack of meaningful existence attributed to all the losses they have experienced (i.e., existential loneliness (EL). The aim of this qualitative study was to describe the experience of EL in older adults from Eastern and Western cultures who were living in LTCFs and how they dealt with the experience. Methods: Open interviews were conducted with 13 Chinese and 9 Swedes living in the LTCF about the experience of EL. A qualitative study using Thorne’s (2004) interpretive description (ID) was conducted and data were analysed using thematic analysis. Results: The core theme “overcoming EL’ captures the participants’ experience of EL. It describes a combined process of “feeling EL” and “self-regulating”. The study affirms that EL, was triggered as a common human condition in our study when the Chinese in Hong Kong, China and Swedes in Malmo, Sweden faced with life boundaries and crisis such as losses, frailty and mortality. Conclusions: EL is a very stress-inducing human phenomenon. Our study demonstrates that EL experience affects the fundamental structure of the ‘self’ unfolded by the experience of loss of control, isolation and meaningless in life. However, being EL allows the older adults of these two ethnics groups reaping the benefits that a ‘clearer’ sense of self provides, ranging from spirit of contentment to decreased distress. Thus, early and clear counselling support addressing the searching and meaning ascribed to EL should facilitate overcoming and better coping with the experience.

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The Association Between new Nurses’ Gerontological Education, Personal Attitudes Toward Older Adults, and Intentions to Work in Gerontological Care Settings in Ontario, Canada

Canadian Journal of Nursing Research ◽

10.1177/08445621211063702 ◽

2021 ◽

pp. 084456212110637

Author(s):

Jessica Smith ◽

Monakshi Sawhney ◽

Lenora Duhn ◽

Kevin Woo

Keyword(s):

Older Adults ◽

Nursing Education ◽

Care Setting ◽

Adult Population ◽

Care Facility ◽

Term Care ◽

Clinical Placements ◽

Long Term Care Facility ◽

Attitudes Toward Older Adults ◽

Personal Attitudes

Background The older adult population in Canada is increasing, and many will require care within an acute geriatric unit (AGU) or long-term care facility (LTCF). However, the nursing workforce is not growing at the same pace as the population is aging. New graduate nurses may be able to fill this gap; therefore, it is important to understand their intentions of working in gerontological care settings (i.e., AGU or LTCF). Aim To examine if nursing education and personal attitudes toward older adults influence newly registered nurses’(RNs) intentions to work in a gerontological care setting. Method Nurses (n= 1,103) who registered with the College of Nurses of Ontario for the first time in 2018 were invited to complete a questionnaire. Results The majority of participants (n = 181) reported a positive attitude toward older adults. However, only 14% reported an intention to work in a gerontological care setting. Participants who completed multiple geriatric focused clinical placements were more likely to report an intention to work in these settings. Conclusion This study provides some information regarding the attitudes and intentions of newly RNs toward a career in gerontological care settings. Further research is needed to understand nurses’ intentions regarding working in AGUs or LTCFs.

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Long-term care placement: The transitional support needs and preferences of spousal dementia caregivers

Dementia ◽

10.1177/14713012211056461 ◽

2021 ◽

pp. 147130122110564

Author(s):

Deborah Brooks ◽

Elizabeth Beattie ◽

Elaine Fielding ◽

Katy Wyles ◽

Helen Edwards

Keyword(s):

Long Term Care ◽

Intervention Development ◽

Care Facility ◽

Spousal Caregivers ◽

Support Needs ◽

Structured Interviews ◽

Term Care ◽

Long Term Care Facility ◽

Facility Staff

Background and objectives Many spousal caregivers experience stress, depression, loneliness, guilt and grief when placing a partner with dementia into long-term care. However, there is little research about their transitional support experiences, needs and preferences. This study aimed to gain a deeper understanding of these issues from spousal caregiver and long-term care facility staff perspectives, to inform subsequent support and intervention development. Research design and methods Semi-structured interviews and small group discussions were held separately with spousal caregivers ( n = 9) and care facility staff ( n = 11). Criterion and variation sampling aimed to ensure a range of experiences and perspectives. The ‘Framework’ approach was utilised for data analysis. Interpretation was with respect to underpinning models of stress-grief process in dementia caregiving. Findings A range of informational, psychoeducational and psychosocial supports were identified to help spousal caregivers cope better with the stressors and losses experienced throughout the transition from home to long-term care. Improved education about disease progression, information relating to long-term care provision, peer support and dementia-specific grief counselling were deemed important. Opportunities for better support within care facilities were also identified. Support should be tailored to individual needs and preferences. Discussion and implications The findings suggest a supportive care framework be developed, encompassing the trajectory from assessment for and admission into long-term care to end-of-life and post-bereavement support. Spousal caregivers should have their support needs assessed by trained health or social care professionals and be offered a range of support options as appropriate.

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Tackling Communication Barriers Between Long-Term Care Facility and Emergency Department Transfers to Improve Medication Safety in Older Adults

Journal of Gerontological Nursing ◽

10.3928/00989134-20150616-04 ◽

2015 ◽

Vol 41 (7) ◽

pp. 8-13 ◽

Cited By ~ 5

Author(s):

Stephanie M. Callinan ◽

Nicole J. Brandt

Keyword(s):

Older Adults ◽

Emergency Department ◽

Medication Safety ◽

Long Term Care ◽

Care Facility ◽

Communication Barriers ◽

Term Care ◽

Term Care Facility ◽

Long Term Care Facility

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Clinical features and risk factors for mortality among long-term care facility residents hospitalized due to COVID-19 in Spain

The Journals of Gerontology Series A ◽

10.1093/gerona/glab305 ◽

2021 ◽

Author(s):

José-Manuel Ramos-Rincón ◽

Máximo Bernabeu-Whittel ◽

Isabel Fiteni-Mera ◽

Almudena López-Sampalo ◽

Carmen López-Ríos ◽

...

Keyword(s):

Risk Factors ◽

Older Adults ◽

Long Term Care ◽

Functional Dependence ◽

Care Facility ◽

Community Dwelling ◽

Term Care ◽

Term Care Facility ◽

Long Term Care Facility

Abstract Background COVID-19 severely impacted older adults and long-term care facility (LTCF) residents. Our primary aim was to describe differences in clinical and epidemiological variables, in-hospital management, and outcomes between LTCF residents and community-dwelling older adults hospitalized with COVID-19. The secondary aim was to identify risk factors for mortality due to COVID-19 in hospitalized LTCF residents. Methods This is a cross-sectional analysis within a retrospective cohort of hospitalized patients≥75 years with confirmed COVID-19 admitted to 160 Spanish hospitals. Differences between groups and factors associated with mortality among LTCF residents were assessed through comparisons and logistic regression analysis. Results Of 6,189 patients≥75 years, 1,185 (19.1%) were LTCF residents and 4,548 (73.5%) were community-dwelling. LTCF residents were older (median: 87.4 vs. 82.1 years), mostly female (61.6% vs. 43.2%), had more severe functional dependence (47.0% vs 7.8%), more comorbidities (Charlson Comorbidity Index: 6 vs 5), had dementia more often (59.1% vs. 14.4%), and had shorter duration of symptoms (median: 3 vs 6 days) than community-dwelling patients (all, p<.001). Mortality risk factors in LTCF residents were severe functional dependence (aOR:1.79;95%CI:1.13-2.83;p=.012), dyspnea (1.66;1.16-2.39;p=.004), SatO2<94% (1.73;1.27-2.37;p=.001), temperature≥37.8ºC (1.62;1.11-2.38; p=.013); qSOFA index≥2 (1.62;1.11-2.38;p=.013), bilateral infiltrates (1.98;1.24-2.98;p<.001), and high C-reactive protein (1.005;1.003-1.007;p<.001). In-hospital mortality was initially higher among LTCF residents (43.3% vs 39.7%), but lower after adjusting for sex, age, functional dependence, and comorbidities (aOR:0.74,95%CI:0.62-0.87;p<.001). Conclusion Basal functional status and COVID-19 severity are risk factors of mortality in LTCF residents. The lower adjusted mortality rate in LTCF residents may be explained by earlier identification, treatment, and hospitalization for COVID-19.

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Cycling Without Age Program: The Impact for Residents in Long-Term Care

Western Journal of Nursing Research ◽

10.1177/0193945919885130 ◽

2019 ◽

Vol 42 (9) ◽

pp. 728-735 ◽

Cited By ~ 1

Author(s):

Paula McNiel ◽

Judith Westphal

Keyword(s):

Lived Experience ◽

Long Term Care ◽

Care Facility ◽

The United States ◽

Structured Interviews ◽

Term Care ◽

Long Term Care Facility ◽

Centered Care ◽

The Impact

Long-term care facilities seek ways to enhance the quality of life for residents. Cycling Without Age (CWA), a new international cycling program, is gaining momentum for older adults. This study explored resident riders’ and trishaw pilots’ lived experience of their participation in the CWA program using a qualitative approach at a long-term care facility in the United States. Researchers conducted 27 face-to-face, semi-structured interviews with riders and pilots. For resident riders, the three themes identified included (a) breath of fresh air; (b) wave, chat, and remember; and (c) sit back and relax. Two themes were identified for the pilots: (a) change in frame of mind, and (b) mental and physical rewards. CWA can be as a new strategy for person-centered care. The CWA program provides nursing an opportunity to advocate, recommend, and obtain an order for residents to participate in the program.

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Promoting Resident and Family Councils: a pilot evaluation

Working with Older People ◽

10.1108/wwop-11-2015-0029 ◽

2016 ◽

Vol 20 (2) ◽

pp. 101-109

Author(s):

Jamie Znidarsich ◽

Susan Davies ◽

Susan Mary Sullivan

Keyword(s):

Long Term Care ◽

Care Facility ◽

Original Research ◽

Structured Interviews ◽

Term Care ◽

Content Type ◽

Long Term Care Facility ◽

Care Facilities ◽

The Status

Purpose – The purpose of this paper is to evaluate the status and impact of a recently formed Resident and Family Council to determine whether the group was achieving the goals of improving long-term care facility relationships, enhancing communication and promoting positive change within the facility. Design/methodology/approach – The pilot evaluation was designed to develop recommendations for future sustainability, of the council, as well as providing wider lessons about the benefits and potential pitfalls of such groups. Data were gathered utilizing participatory qualitative research methods. Semi-structured interviews were conducted with nine council members, representing all groups within the Resident and Family Council. Documents relating to the work of the council and observational field notes maintained during meetings were also analyzed. Findings – A number of themes and dynamics were identified relating to communication, collaboration and future sustainability. Practical implications – Recommendations for initiating Resident and Family Councils should include surveying interest within long-term care facilities, involving the facility ombudsmen or volunteer coordinator, and assessing resources within the community, such as volunteer organizations or partnering with local education organizations. Originality/value – This original research can serve as a template for establishing Resident and Family Councils within long-term care facilities.

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Explain the ‘unexplainable’: A qualitative enquiry of the representations of the caregivers of brain-injured people

Journal of Health Psychology ◽

10.1177/1359105316642834 ◽

2016 ◽

Vol 23 (8) ◽

pp. 1050-1062 ◽

Cited By ~ 4

Author(s):

Magali Huet ◽

Lionel Dany ◽

Thémistoklis Apostolidis

Keyword(s):

Social Representations ◽

Care Facility ◽

Structured Interviews ◽

Term Care ◽

Long Term Care Facility ◽

Individualized Care ◽

Injured Person ◽

Brain Injured ◽

Traumatic Brain Injured

The aim of our research is to highlight the role of social representations of the traumatic brain-injured person in the adjustments made by caregivers in building and maintaining quality of care. Twenty-three semi-structured interviews were conducted with nursing assistants and medico-psychological assistants, working in a long-term care facility. The interviews were the subject of a thematic content analysis. The analysis shows the role of representations of the traumatic brain-injured person in the way caregivers explain behaviours and situations and in the orientation of their professional practices. In explaining the inexplicable, caregivers establish a more human relationship through individualized care.

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Identifying roles in older adults’ emergency department transitions

Proceedings of the Human Factors and Ergonomics Society Annual Meeting ◽

10.1177/1071181320641159 ◽

2020 ◽

Vol 64 (1) ◽

pp. 685-689

Author(s):

Megan E. Salwei ◽

Hanna Barton ◽

Nicole E. Werner ◽

Rachel Rutkowski ◽

Peter L.T. Hoonakker ◽

...

Keyword(s):

Older Adults ◽

Emergency Department ◽

Older Adult ◽

Error Detection ◽

Care Transitions ◽

Care Facility ◽

Transitions Of Care ◽

Adult Care ◽

Term Care ◽

Long Term Care Facility

Older adults frequently visit the emergency department (ED) and participate in multiple transitions of care following an ED visit. These transitions of care, e.g. to hospital, long-term care facility or home, represent patient safety risks because of communication and coordination failures between the various roles involved, but also provide opportunities for error detection and recovery and, therefore, resilience. The objective of this study was to identify and describe the multiple roles involved in older adult care transitions during an ED visit. As part of a large research project, we conducted patient-centered observations and interviewed ED clinicians and hospital administrators. We identified 16 ED roles involved in older adult care transitions out of the ED, including 4 roles solely focused on coordinating transitions. By better understanding the roles involved in ED care transitions, we can improve the design of team processes and technologies to support care of older adults throughout their care transitions.

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