Care for older people in multigenerational families: a life course analysis across four generations

Internationally, the implementation of care pathways is a common strategy for making transitional care for older people more effective and patient-centered. Previous research highlights inherent tensions in care pathways, particularly in relation to their patient-centered aspects, which may cause dilemmas for health care providers. Health care providers’ understandings and experiences of this, however, remain unclear. Our aim was to explore health care providers’ experiences and understandings of implementing a care pathway to improve transitional care for older people. We conducted semistructured interviews with 20 health care providers and three key persons, along with participant observations of 22 meetings, in a Norwegian quality improvement collaborative. Through a thematic analysis, we identified an understanding of the care pathway as both patient flow and the patient’s journey and a dilemma between the two, and we discuss how the negotiation of conflicting institutional logics is a central part of care pathway implementation.

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Positive Subjective Health of Older Homeless and Older Irish Travelers: a Participant-Led Approach

Innovation in Aging ◽

10.1093/geroni/igaa057.353 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 107-107

Author(s):

Bridin Carroll ◽

Kieran Walsh

Keyword(s):

Older People ◽

Life Course ◽

Community Care ◽

Well Being ◽

Subjective Health ◽

Social Connections ◽

Structural Determinants ◽

Care Models ◽

Nuanced Understanding ◽

Positive Ageing

Abstract Older people experiencing homelessness and older Irish Travellers (OTOH) are both over-represented in the cohort who use acute health services. Impending health care reform in Ireland will be based on primary care models, meaning home and community care will be, for the first time, underpinned by a regulatory framework. For these reasons, this study aims to gain a nuanced understanding of how OTOH, as marginalised older people, might be best served by new home care and community care models. Using a qualitative, voice-led approach, a life course and structural determinants lens is employed to probe the health conditions, experiences and expectations of OTOH, as well as their perceptions and values around the concept of ‘home’. The research processes and outcomes of one of five phases of research are presented in this paper: participant-led research. In this phase, five OTOH were trained and assisted to complete a short research project which fed into the goals of the wider study. Emergent findings suggest that social connections underpin health and well-being for OTOH, throughout the life course, and presently. This was also seen as a fundamental element for healthy and positive ageing. In addition, ‘home’ was defined with reference to the presence (or absence) of familial or other social connections. This study represents an important contribution to scholarship on old age social exclusion. It is entirely novel in its approach to focusing on OTOH health and wellbeing. The outputs of this study also have important implications for upcoming health reform policies in Ireland.

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The importance of addressing ageism in Swedish healthcare

Nordic Journal of Nursing Research ◽

10.1177/2057158520929348 ◽

2020 ◽

Vol 40 (3) ◽

pp. 113-115

Author(s):

Katarina Sjögren Forss

Keyword(s):

Older People ◽

Health Inequalities ◽

European Countries ◽

Or Groups ◽

Significant Class ◽

Care For Older People

Ageism is discrimination against individuals or groups based on their age. In the Swedish healthcare context, the term is uncommon, despite the fact that older people are a significant class of users. One of every five individuals in Sweden is 65 years of age or older, and the proportion of older people in the population is rising. Therefore, ageism in healthcare warrants more awareness and focus. In three recent articles that we have published relating to nutritional, depression and continence care for older people, we found indications of ageism even though we did not aim to study it. There is a need to identify the manifestations of ageism and label them, and to become alert to both the visible and invisible expressions of ageism. This will help in the development of interventions and policies to eliminate ageism in healthcare. With health inequalities growing and seemingly becoming the norm rather than the exception in Sweden and other European countries, it has become imperative to address and eliminate health inequalities through a range of initiatives and mechanisms. Fighting ageism in different settings must be a part of this larger goal.

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