scholarly journals A Web-Based Intervention to Help Caregivers of Older Adults With Dementia and Multiple Chronic Conditions: Qualitative Study (Preprint)

2017 ◽  
Author(s):  
Jenny Ploeg ◽  
Carrie McAiney ◽  
Wendy Duggleby ◽  
Tracey Chambers ◽  
Annie Lam ◽  
...  
Keyword(s):  
Older Adults ◽  
Alzheimer Disease ◽  
Chronic Conditions ◽  
Emotional Health ◽  
Community Dwelling ◽  
Multiple Chronic Conditions ◽  
Web Based ◽  
Roles And Responsibilities ◽  
Study Results ◽  
Caregiving Roles

BACKGROUND Caregivers (ie, family members and friends) play a vital role in the ongoing care and well-being of community-living older persons with Alzheimer disease and related dementia in combination with multiple chronic conditions. However, they often do so to the detriment of their own physical, mental, and emotional health. Caregivers often experience multiple challenges in their caregiving roles and responsibilities. Recent evidence suggests that Web-based interventions have the potential to support caregivers by decreasing caregiver stress and burden. However, we know little about how Web-based supports help caregivers. OBJECTIVE The objectives of this paper were to describe (1) how the use of a self-administered, psychosocial, supportive, Web-based Transition Toolkit, My Tools 4 Care (MT4C), designed by atmist, Edmonton, Alberta, Canada, helped caregivers of older adults with Alzheimer disease and related dementia and multiple chronic conditions; (2) which features of MT4C caregivers found most and least beneficial; and (3) what changes would they would recommend making to MT4C. METHODS This study was part of a larger multisite mixed-methods pragmatic randomized controlled trial. The qualitative portion of the study and the focus of this paper used a qualitative descriptive design. Data collectors conducted semistructured, open-ended, telephone interviews with study participants who were randomly allocated to use MT4C for 3 months. All interviews were audio-taped and ranged from 20 to 40 min. Interviews were conducted at 1 and 3 months following a baseline interview. Qualitative content analysis was used to analyze collected data. RESULTS Fifty-six caregivers from Alberta and Ontario, Canada, participated in either one or both of the follow-up interviews (89 interviews in total). Caregivers explained that using MT4C (1) encouraged reflection; (2) encouraged sharing of caregiving experiences; (3) provided a source of information and education; (4) provided affirmation; and for some participants (5) did not help. Caregivers also described features of MT4C that they found most and least beneficial and changes they would recommend making to MT4C. CONCLUSIONS Study results indicate that a self-administered psychosocial supportive Web-based resource helps caregivers of community-dwelling older adults with Alzheimer disease and related dementia and multiple chronic conditions with their complex caregiving roles and responsibilities. The use of MT4C also helped caregivers in identifying supports for caring, caring for self, and planning for future caregiving roles and responsibilities. Caregivers shared important recommendations for future development of Web-based supports.

scholarly journals Association between patterns of multiple chronic conditions and cognitive impairment in community‐dwelling older adults in Taiwan

2021 ◽  
Vol 17 (S10) ◽  
Author(s):  
Pei‐Iun Hsieh ◽  
Yen‐Ching Chen ◽  
Jeng‐Min Chiou ◽  
Ta‐Fu Chen ◽  
Su‐Ling Yeh ◽  
...  
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Chronic Conditions ◽  
Community Dwelling ◽  
Multiple Chronic Conditions ◽  
Community Dwelling Older Adults

scholarly journals A Web-Based Intervention to Help Caregivers of Older Adults With Dementia and Multiple Chronic Conditions: Qualitative Study

JMIR Aging ◽  
2018 ◽  
Vol 1 (1) ◽  
pp. e2 ◽  
Author(s):  
Jenny Ploeg ◽  
Carrie McAiney ◽  
Wendy Duggleby ◽  
Tracey Chambers ◽  
Annie Lam ◽  
...  
Keyword(s):  
Older Adults ◽  
Qualitative Study ◽  
Chronic Conditions ◽  
Multiple Chronic Conditions ◽  
Web Based

scholarly journals Illness perceptions and health outcomes among community-dwelling older adults with multiple chronic conditions

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 615-616
Author(s):  
Ayo Bankole
Keyword(s):  
Older Adults ◽  
Health Outcomes ◽  
Chronic Conditions ◽  
Illness Perceptions ◽  
Community Dwelling ◽  
Multiple Chronic Conditions ◽  
Targeted Interventions ◽  
Self Rated Health ◽  
The Past ◽  
The Relationship

Abstract Illness perceptions (IP) has been associated with self-management and health outcomes in individuals with chronic diseases such as heart disease and diabetes; however, there is less research on the relationship between IP and health outcomes in individuals with multiple chronic conditions (MCC). Older adults with MCC are more likely to experience poor outcomes such as hospitalizations and poor self-rated health yet, there is less understanding of the processes associated with these outcomes. The purpose of this study was to (1) explore the relationship between IP and self-rated health among older adults with MCC (2) explore the relationship between IP and the number of hospitalization within the past year among older adults with MCC. Understanding these relationships may be instrumental to designing targeted interventions to improve health outcomes for this population. 116 participants (ages 65-90) completed the illness perception of multimorbidity scale, modified general health subscale of the SF-36 questionnaire, and self-reported number of hospitalizations within the past year. Ordinal logistic regression was used for analysis. Older adults who reported negative IP were likely to report worse self-rated health and this relationship remained significant after controlling for age and number of chronic conditions {-0.032 (95% CI (-0.050 to 0.014) p< 0.05}. There was no significant relationship between IP and the number of hospitalization within the past year. The study results study suggest that IP is associated with self-rated health in older adults with MCC. IP may be useful to design targeted interventions to improve self-rated health in this population.

scholarly journals Self-Management of Multiple Chronic Conditions by Community-Dwelling Older Adults: A Concept Analysis

2018 ◽  
Vol 4 ◽  
pp. 237796081775247 ◽  
Author(s):  
Anna Garnett ◽  
Jenny Ploeg ◽  
Maureen Markle-Reid ◽  
Patricia H. Strachan
Keyword(s):  
Older Adults ◽  
Disease Management ◽  
Chronic Conditions ◽  
Concept Analysis ◽  
Community Dwelling ◽  
Self Management ◽  
Multiple Chronic Conditions ◽  
Complex Process ◽  
Health And Disease ◽  
Community Dwelling Older Adults

The proportion of the aging population living with multiple chronic conditions (MCC) is increasing. Self-management is valuable in helping individuals manage MCC. The purpose of this study was to conduct a concept analysis of self-management in community-dwelling older adults with MCC using Walker and Avant’s method. The review included 30 articles published between 2000 and 2017. The following attributes were identified: (a) using financial resources for chronic disease management, (b) acquiring health- and disease-related education, (c) making use of ongoing social supports, (d) responding positively to health changes, (e) ongoing engagement with the health system, and (f) actively participating in sustained disease management. Self-management is a complex process; the presence of these attributes increases the likelihood that an older adult will be successful in managing the symptoms of MCC.

scholarly journals Women’s Caregiving Experience of Older Persons Living With Alzheimer Disease and Related Dementias and Multiple Chronic Conditions: Using Wuest’s Theory

2020 ◽  
Vol 6 ◽  
pp. 237796082097481
Author(s):  
Shelley Peacock ◽  
Melanie Bayly ◽  
Wendy Duggleby ◽  
Jenny Ploeg ◽  
Lori Pollard ◽  
...  
Keyword(s):  
Alzheimer Disease ◽  
Health Care Providers ◽  
Chronic Conditions ◽  
Active Role ◽  
Qualitative Description ◽  
Control Group ◽  
Multiple Chronic Conditions ◽  
Care Providers ◽  
Web Based

Introduction Care of persons living with chronic conditions rests heavily on women within the context of the family. Research demonstrates that women experience more caregiving strain compared to men, yet less is known about the differences in experiences between women carers: namely, wives and daughters. Objective The purpose of this study was to examine and compare the experiences of wife and daughter carers of older adults living with Alzheimer disease and related dementias, plus at least two other chronic conditions. Methods Using qualitative description with Wuest’s feminist caring theory of precarious ordering as an analytic framework, interview transcripts of women carer participants who were from the control group of a larger multi-site mixed methods study evaluating the web-based intervention My Tools 4 Care were analyzed. Findings Both wives and daughters experienced daily struggles, altered prospects, and ambivalent feelings around their caring role. Negotiating the role of professional carer was an important part of balancing caring demands and anticipating the future, and women took an active role in trying to harness caring resources. Findings indicated wives and daughters were generally similar in how they described their caregiving, although daughters reported more shared caring and decision-making, and needed to balance paid employment with caregiving. Conclusion Wives and daughters face similar challenges caring for persons with a dementia and multiple chronic conditions, and actively engage in strategies to manage caring demands. The findings illuminate the importance of accessible, appropriate support from professional carers/health care providers, and suggest that assistance navigating such supports would benefit women carers.

scholarly journals The Acceptability of Technology in Health Care Among Older Korean Adults With Multiple Chronic Conditions

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 223-223
Author(s):  
Ji Yeon Ha ◽  
Hyeyoung Park
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Technology Acceptance ◽  
Cognitive Ability ◽  
Self Efficacy ◽  
Chronic Conditions ◽  
Community Dwelling ◽  
Multiple Chronic Conditions ◽  
Korean Adults ◽  
Facilitating Conditions

Abstract Background: Although there are benefits in utilizing ICT in health care, older adults have challenges in employ technologies in their health care management due to the changes in cognitive and physical functions, low motivation to use technology, and low computer/internet literacy (Adebayo et al, 2017; Wildenbos et al, 2018). The purpose of this study is to investigate the acceptance of technology among older Korean adults with multiple chronic conditions and examine factors associating with the acceptance of the technology. Method: The participants were 226 community-dwelling older adults who have more than two chronic conditions. Directed by the senior technology acceptance model (Chen & Chan, 2014), demographics, gerontechnology self-efficacy, gerontechnology anxiety, facilitating conditions, self-reported health conditions, cognitive ability, social relationship, attitude to life and satisfaction, physical functioning, and acceptance of technology were surveyed using a self-reported questionnaire. Findings: Older Korean adults with multiple chronic conditions showed a moderately high technology acceptance score (M = 25.35, SD = 5.28). There were significant differences in the acceptance of technology depending on age (r=-0.241, p<.01), cognitive ability (r=0.225, p<.01), gerontechnology self-efficacy (r=0.323, p<.0001), and facilitating conditions (r=0.288, p<.0001). Conclusion: While older age were associated to the acceptance of technology, gerontechnology self-efficacy which is one’s judgment of their ability to perform a task successfully using gerontechnology and facilitating conditions which are environmental factors that help older adults use gerontechnology easier were positively associated with the acceptance of technology among older Korean adults with multiple chronic conditions.

scholarly journals Feasibility and preliminary effects of an integrated hospital-to-home transitional care intervention for older adults with stroke and multimorbidity: A study protocol

2019 ◽  
Vol 9 ◽  
pp. 2235042X1982824 ◽  
Author(s):  
Maureen Markle-Reid ◽  
Ruta Valaitis ◽  
Amy Bartholomew ◽  
Kathryn Fisher ◽  
Rebecca Fleck ◽  
...  
Keyword(s):  
Older Adults ◽  
Transitional Care ◽  
Pragmatic Trial ◽  
Community Dwelling ◽  
Multiple Chronic Conditions ◽  
Rehabilitation Centre ◽  
Major Life ◽  
Web Based ◽  
Care Intervention ◽  
Hospital To Home

Background: Stroke is a major life-altering event and the leading cause of death and disability in Canada. Most older adults who have suffered a stroke will return home and require ongoing rehabilitation in the community. Transitioning from hospital to home is reportedly very stressful and challenging, particularly if stroke survivors have multiple chronic conditions. New interventions are needed to improve the quality of transitions from hospital to home for this vulnerable population. Objectives: The primary objective of this study is to examine the feasibility of implementing a new 6-month transitional care intervention supported by a web-based app. The secondary objective is to explore its preliminary effects. Design: A single arm, pre/post, pragmatic feasibility study of 20–40 participants in Ontario, Canada. Participants will be community-dwelling older adults (≥55 years) with a confirmed stroke diagnosis, ≥2 co-morbid conditions, and referred to a hospital-based outpatient stroke rehabilitation centre. The 6-month transitional care intervention will be delivered by an interprofessional (IP) team and involve care coordination/system navigation, self-management education and support, home visits, telephone contacts, IP team meetings and a web-based app. Primary evaluation of the intervention will be based on feasibility outcomes (e.g. acceptability, fidelity). Preliminary intervention effects will be based on 6-month changes in health outcomes, patient experience, provider experience and cost. Conclusions: Information on the feasibility and preliminary effects of this newly-developed intervention will be used to optimize the design and methods for a future pragmatic trial to test the effectiveness and implementation of the intervention in other contexts and settings.

scholarly journals Characteristics of Older Adults who Receive Assistance with Management of Multidrug Regimens

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 754-755
Author(s):  
Rachel O'Conor ◽  
Julia Yoshino Benavente ◽  
Mogan Eifler ◽  
Lauren Opsasnick ◽  
Laura Curtis ◽  
...  
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Health Literacy ◽  
Cognitive Aging ◽  
Chronic Conditions ◽  
Clinical Care ◽  
Medication Management ◽  
Patient Activation ◽  
Community Dwelling ◽  
Multiple Chronic Conditions

Abstract Many older adults manage multiple chronic conditions requiring adherence to multidrug regimens, yet half are non-adherent, increasing their risk of hospitalization for poorly controlled chronic conditions. Few studies have investigated whether caregivers support medication-related behaviors of community-dwelling older adults. We interviewed 97 patient-caregiver dyads participating in a cognitive aging cohort study to identify factors associated with caregiver assistance in managing multidrug regimens. Patients completed a neuropsychological battery covering five cognitive domains. Health literacy and patient activation were measured using the Newest Vital Sign and Consumer Health Activation Index, respectively. Caregivers reported their medication-related involvement. Predictors of involvement in medication-related tasks were examined using logistic regression models. Patients were on average 71 years old, managing 4 comorbidities and prescribed 5 medications. The majority were female (73%) and identified as Black (46%) or White (47%). Caregivers’ mean age was 65 years; half were female (53%), were predominantly spouses (57%) or children (26%), and lived with the patient (61%). 31% of caregivers ordered patients’ prescribed medications, 40% helped manage their medications, and 50% spoke with the patient’s clinician about their clinical care. Cognitive impairment (OR 2.60, 95% CI 1.08-6.25), limited health literacy (OR 2.97, 95% CI 1.26-6.97), and ≥3 comorbidities (OR 2.14, 95% CI 1.06-9.30) were associated with medication management assistance. Patient activation, gender, cohabitation, or relationship were not associated. These findings suggest that caregivers are assisting with older adults’ medication management and should be included in clinical discussions about medication management, especially among patients with cognitive impairment, low health literacy or multimorbidities.

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 Experiences of community-dwelling older adults living with multiple chronic conditions: a qualitative study

BMJ Open ◽  
2019 ◽  
Vol 9 (3) ◽  
pp. e023345 ◽  
Author(s):  
Jenny Ploeg ◽  
Marta Canesi ◽  
Kimberly D Fraser ◽  
Carrie McAiney ◽  
Sharon Kaasalainen ◽  
...  
Keyword(s):  
Older Adults ◽  
Qualitative Study ◽  
Social Services ◽  
Chronic Conditions ◽  
Healthcare Services ◽  
Community Dwelling ◽  
Community Living ◽  
Multiple Chronic Conditions ◽  
Interpretive Description ◽  
Management Options

ObjectivesThe aim of the study was to understand the experiences of living with multiple chronic conditions (MCC) from the perspective of community-living older adults with MCC.DesignA qualitative study using an interpretive description approach.SettingParticipants were recruited from southern Ontario, Canada.Participants21 community-living, older adults (≥65 years) with an average of 7.4 chronic conditions including one of diabetes, dementia or stroke.MethodsData were collected through digitally-recorded, in-depth, semi-structured in-person interviews. Interview transcripts were analysed and coded using Thorne’s interpretive description approach.ResultsFive themes were identified representing older adults' experiences of living with MCC: (a) trying to stay healthy while living with MCC, (b) depending on family caregivers for support with just about everything, (c) paying the high costs of living with MCC, (d) making healthcare decisions by proxy and (e) receiving healthcare services that do not address the complex needs of persons living with MCC.ConclusionsThe experience of living with MCC in the community was complex and multi-faceted. The need for a person-centred and family-centred approach to care in the community, which includes the coordination of health and social services that are tailored to the needs of older adults and their informal caregivers, was underscored. Such an approach would facilitate improved information-sharing and discussion of care management options between health professionals and their patients, enable older adults with MCC to actively engage in priority-setting and decision-making and may result in improved health and quality of life for older adults with MCC.

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