Appreciating the Predicament of Housebound Older Adults with Arthritis: Portrait of a Population

2005 ◽  
Vol 24 (1) ◽  
pp. 57-69 ◽  
Author(s):  
Kareen Nour ◽  
Sophie Laforest ◽  
Monique Gignac ◽  
Lise Gauvin
Keyword(s):  
Rheumatoid Arthritis ◽  
Older Adults ◽  
Social Life ◽  
Health Behaviours ◽  
Population Data ◽  
Living Alone ◽  
Self Management ◽  
Home Based ◽  
Behavioural Profile ◽  
Low Levels

ABSTRACTThis paper draws a socio-demographic, physical, psychosocial, and behavioural profile of housebound older adults with arthritis and compares older adults with rheumatoid arthritis to those with osteoarthritis. Data from 125 housebound older adults with osteoarthritis (65%) or rheumatoid arthritis (35%) were compared to published samples and to population data using appropriate weighting. Respondents were mainly women, living alone, mean age 77 years (SD = 10.50). Symptoms of stiffness, fatigue, and pain intensity were moderate to severe, and a substantial proportion (51.4%) reported depression. Participants reported low levels of health behaviours such as exercise. Overall, older adults with rheumatoid arthritis were significantly younger, reported less pain and limitations, were more optimistic and satisfied with their social life, and had a higher self-efficacy than older adults with osteoarthritis. Home-based pain self-management programs should be constructed considering the unique profiles and needs of this population.

scholarly journals AB0894-HPR THE JOURNEY OF PATIENTS WITH RHEUMATOID ARTHRITIS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1470.2-1471
Author(s):  
M. Fusama ◽  
S. Oliver ◽  
H. Nakahara ◽  
Y. Van Eijk-Hustings ◽  
Y. Kuroe
Keyword(s):  
Rheumatoid Arthritis ◽  
Side Effects ◽  
Social Life ◽  
Life Story ◽  
Daily Life ◽  
Financial Burden ◽  
Psychological State ◽  
Self Management ◽  
Stable Phase ◽  
Management Skills

Background:The course of rheumatoid arthritis (RA) differs from patient to patient, and each patient has a unique story. The disease condition affects psychological and social aspects, greatly affecting the quality of life. The disease course is unpredictable, and each patient’s story can be seen as a lifelong journey, full of ups and downs. Therefore, it is crucial to know what kind of support is required during the course of their life.Objectives:The aim of this study is to examine the life story of patients with RA and clarify a common situation in their stories in order to consider what kind of support is needed.Methods:This is a qualitative study using life story interview for patients with RA in Japan. Interview included disease history, patients’ behaviors, effects on daily life, the patients’ perspectives regarding psychological considerations and useful support. Data were analyzed using content analysis. This study was approved by the ethics committee and informed consent was obtained.Results:Eight patients participated in this study. They were all females and the average age was 57 years old. As a result of the categorization, we extracted the following eight situations: (1) Emergence of symptom; patients thought joint pain would go away, however, the symptom did not improve and began to affect their daily life and work, (2) Choose a hospital to visit; pain and anxiety have continued and decided to visit a hospital, (3) Encounter with their doctors; patients expected their doctor to relieve their pain, while they were afraid of being told that they were suffering from a serious disease. (4) Diagnosis of RA; patients were shocked when diagnosed and anxious about what would happen and wondered why they had such a disease, (5) Choice of treatment; patients were afraid of the side effects. They wanted to make a decision discussing with their doctor, but they could not understand the explanation about drugs well and, therefore, followed the doctor’s opinion. (6) Change of treatment; a biological agent was often recommended. Patients were also worried about side effects and the financial burden. (7) Remission or stable phase; they felt better mentally too, however, they often felt anxiety about disease flare, side effect of drugs and financial burden, and (8) Flare and remission; patients felt shocked and disappointed when RA flared, and then, they noticed that patients with RA had alternating periods of relapse and remission and they had to live with RA.These interviews revealed repeated worsening and improvement of symptoms and many similar repeated psychological reactions such as anxiety, shock, denial, conflict, acceptance, giving up and relief. To cope with these fluctuating disease and mental conditions, patients were supported by educational and psychological assistance, timely consultations, social life help from nurses and support from their family. The patients considered a trusting relationship with their doctors is necessary. The patients had also realized through their experience the importance of enhancing their own abilities, such as decision-making, prevention of infections and self-management skills. Moreover, they noticed that it is important to have their own goals including hobbies and work.Conclusion:This study elucidated the common behaviors of patients with RA, the impact of RA on their psychological state and daily and social life, and the required support. The psychological condition and daily and social life also had a great influence on medical behavior. Therefore, psychosocial support and establishment of trust between healthcare professionals and patients are crucial. In addition, improving patients’ self-management skills including self-efficacy and empowerment is also necessary. As patients with RA often feel anxious in various situations and expect nurses’ support, nurses should listen to patients, pay attention to their concerns and anxieties, and show a solution-oriented attitude. In order for patients to feel at ease in their Patient Journey, nurses should sail with them while maintaining a patient-centered perspective.Disclosure of Interests:None declared

Timing of onset and self-management of multiple chronic conditions: A qualitative examination taking a lifespan perspective

2018 ◽  
Vol 16 (3) ◽  
pp. 173-189 ◽  
Author(s):  
Allison R Heid ◽  
Andrew R Gerber ◽  
David S Kim ◽  
Stefan Gillen ◽  
Seran Schug ◽  
...  
Keyword(s):  
Older Adults ◽  
Social Life ◽  
Chronic Conditions ◽  
Self Management ◽  
Multiple Chronic Conditions ◽  
Older Individuals ◽  
Structured Interviews ◽  
Targeted Interventions ◽  
Timing Of Onset ◽  
Management Behaviors

Objectives Over two-thirds of older individuals live with multiple chronic conditions, yet chronic diseases are often studied in silos. Taking a lifespan approach to understanding the development of multiple chronic conditions in the older population helps to further elucidate opportunities for targeted interventions that address the complexities of multiple chronic conditions. Methods Semi-structured interviews were conducted with 38 older adults (age 64+) diagnosed with at least two chronic health conditions. Content analysis was used to build understanding of how older adults discuss the timing of diagnoses and subsequent self-management of multiple chronic conditions. Results Findings highlight the complex process by which illnesses unfold in the context of individuals’ lives and the subsequent engagement and/or disengagement in self-management behaviors. Two primary themes were evident regarding timing of illnesses: illnesses were experienced within the context of social life events and/or health events, and illnesses were not predominantly seen as connected to one another by patients. Self-management behaviors were described in response to onset of each illness. Discussion Findings provide insight into how older adults understand their experience of multiple chronic conditions and change in self-management behaviors over time. In order for practitioners to ignite behavioral changes, a person’s history and life experiences must be considered.

scholarly journals Marriage and Mortality: The Importance of Non-Spousal Support for Never-Married Older Adults

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 347-347
Author(s):  
Adam Roth ◽  
Siyun Peng
Keyword(s):  
Older Adults ◽  
Social Life ◽  
Extended Family ◽  
Spousal Support ◽  
Social Needs ◽  
Never Married ◽  
Married Individuals ◽  
Low Levels ◽  
Nationally Representative ◽  
Levels Of Support

Abstract Married individuals have been shown to consistently outlive their unmarried peers. Although numerous factors contribute to such mortality disparities, spousal support serves as one of the most central marital resources that reduces mortality risk for married older adults. Unmarried older adults, who lack access to such support, tend to rely more heavily on extended family and friends for their social needs. Yet it is unclear whether support from these non-spousal sources can be successfully substituted for spousal support to provide unmarried older adults with similar protection against mortality. In the present study, we use nationally representative data from the National Social Life, Health, and Aging Project to assess whether support from family and friends reduces the mortality differences between married and unmarried older adults. Although we examine all forms of singlehood (i.e., divorce, widowhood, and never married), we pay primary attention to never married older adults in relatively to their married peers as they have been exposed to a lifetime without a spouse. We find that never married older adults are especially sensitive to non-spousal support. More specifically, never married respondents who reported low levels of support were far more likely to die than married respondents who had similar levels of non-spousal support. Yet when support was high, never married respondents were neither more nor less likely to die than their married peers.

scholarly journals Association of Loneliness With Falls: A Study of Older US Adults Using the National Social Life, Health, and Aging Project

2021 ◽  
Vol 7 ◽  
pp. 233372142198921
Author(s):  
Meltem Zeytinoglu ◽  
Kristen E. Wroblewski ◽  
Tamara J. Vokes ◽  
Megan Huisingh-Scheetz ◽  
Louise C. Hawkley ◽  
...  
Keyword(s):  
Older Adults ◽  
Multivariate Analysis ◽  
Social Life ◽  
Living Alone ◽  
Morbidity And Mortality ◽  
Loneliness Scale ◽  
Point Increase

Objectives: Falls represent a significant cause of morbidity and mortality in older adults, and are more common among those living alone. We aimed to determine if there is an association between loneliness and falls. Methods: Participants were surveyed in three waves separated by 5 years. We used the three-item UCLA Loneliness Scale to measure loneliness. Results: Data from 2337 respondents, with both loneliness and fall data in at least two consecutive waves, were included. Over three waves, 51% respondents reported a fall and 23% reported ≥ two falls. In multivariate analysis, the odds of having ≥ one fall 5 years later increased by a factor of 1.11 per one point increase on the loneliness scale (OR = 1.11, 95% CI 1.04, 1.19; p < .01). Discussion: Lonely older adults have increased odds of future falls. Strategies for combating loneliness in older adults may help reduce fall-related morbidity and mortality.

scholarly journals Age-Related Differences in Home Experiences and Worries During COVID-19

2020 ◽  
Author(s):  
Amanda Hunsaker ◽  
Eszter Hargittai
Keyword(s):  
Older Adults ◽  
Age Groups ◽  
Personal Space ◽  
Community Dwelling ◽  
Living Alone ◽  
Supportive Services ◽  
Age Related ◽  
Home Based ◽  
Single Person ◽  
At Home

The Coronavirus pandemic differentially impacted older adults in comparison to other age groups, creating extended time at home and even limiting interaction with others. In order to understand how individuals are coping with extensive time at home, we used a representative sample of community-dwelling adults to examine how home experiences and personal worries during the COVID-19 pandemic may differ across age groups, including among older adults. Overall, we find fewer older adults experienced home-based stressors (e.g. household conflict, lack of personal space) and fewer worries (e.g. related to finances or boredom) that may arise during a disease outbreak with lockdown measures. Those ages 70+ who were living alone also faced fewer negative home experiences and worries than individuals 60-69 years old living in single-person households. Supportive services to manage such home stressors and worries might benefit all age groups.

scholarly journals An integrated home-based self-management system to support the wellbeing of older adults

2014 ◽  
Vol 6 (4) ◽  
pp. 359-383 ◽  
Author(s):  
Julie Doyle ◽  
Andrea Kealy ◽  
John Loane ◽  
Lorcan Walsh ◽  
Brian O'Mullane ◽  
...  
Keyword(s):  
Older Adults ◽  
Management System ◽  
Self Management ◽  
Home Based

scholarly journals Changes in Modes of Social Contact and Their Links With Mental Health During the COVID-19 Pandemic

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 539-539
Author(s):  
Laura Finch ◽  
Louise Hawkley
Keyword(s):  
Mental Health ◽  
Older Adults ◽  
Health Risks ◽  
Social Life ◽  
Social Contact ◽  
Living Alone ◽  
Media Messages ◽  
Phone Calls ◽  
Frequency Of Contact ◽  
Using Data

Abstract Amid the COVID-19 pandemic, social distancing has been emphasized for older adults because of their greater physical health risks. Using data from the National Social Life, Health and Aging Project (NSHAP), we examined how older adults may have changed their frequency of contact with others via various modes (i.e., in-person, phone calls, messages, and video calls) since the pandemic started, and how these choices may be impacting their mental health. From September 2020 through January 2021, NSHAP respondents (N=2,554 age 50-94 with data from 2015-16) completed a survey via web, phone, or paper-and-pencil. Although some older adults reported reducing their in-person contact with out-of-household family (38%) and friends (40%) since the pandemic started, some also increased contact with them via remote modes such as phone calls (25% and 16% with family and friends respectively); emails, texts, or social media messages (26 and 21%); and video calls (24 and 18%). Net of demographics, living alone, survey mode, and 2015-16 levels of the respective mental health variables, those who decreased in-person contact with family were less happy (B=-0.12, SE=0.06, p=.035), had higher loneliness scores (B=0.23, SE=0.09, p=.011), and more frequently felt depressed (B=0.10, SE=0.05, p=.055). In the presence of decreased in-person contact, increases in remote modes of contact had no net remediating impact—a pattern also found when analyzing contact with friends. Results indicate a persistent adverse effect of reduced in-person contact on mental health despite increased contact with family and friends via remote means.

Saskatoon in motion: Class vs. home-based exercise intervention in older adults with chronic health conditions

2005 ◽  
Author(s):  
Bruce Reeder ◽  
Karen Chad ◽  
Liz Harrison ◽  
Nigel Ashworth ◽  
Suzanne Sheppard ◽  
...  
Keyword(s):  
Older Adults ◽  
Exercise Intervention ◽  
Chronic Health Conditions ◽  
Health Conditions ◽  
Chronic Health ◽  
Home Based

Moral accounts and membership categorization in primary care medical interviews

2012 ◽  
Vol 8 (3) ◽  
pp. 211-222 ◽  
Author(s):  
Patrick J. Dillon
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Social Identity ◽  
Social Life ◽  
Health Behaviours ◽  
Moral Knowledge ◽  
Membership Categorization ◽  
Medical Interviews

Although the link between health and morality has been well established, few studies have examined how issues of morality emerge and are addressed in primary care medical encounters. This paper addresses the need to examine morality as it is (re)constructed in everyday health care interactions. A Membership Categorisation Analysis of 96 medical interviews reveals how patients orient to particular membership categories and distance themselves from others as a means of accounting (Buttny 1993; Scott and Lyman 1968) for morally questionable health behaviours. More specifically, this paper examines how patients use membership categorisations in order to achieve specific social identity(ies) (Schubert et al. 2009) through two primary strategies: defensive detailing and prioritizing alternative membership categories. Thus, this analysis tracks the emergence of cultural and moral knowledge about social life as it takes place in primary care medical encounters.

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