Caring for Community-Dwelling Older Adults With Diabetes: Perspectives From Health Care Providers and Caregivers

Technology enables home-based personalized care through continuous, automated, real-time monitoring of a participant’s health condition and remote communication between health care providers and participants. Technology has been implemented in a variety of nursing practices. However, little is known about the use of home mobility monitoring systems in visiting nursing practice. Therefore, the current study tested the feasibility of a home mobility monitoring system as a supportive tool for monitoring daily activities in community-dwelling older adults. Daily mobility data were collected for 15 months via home-based mobility monitoring sensors among eight older adults living alone. Indoor sensor outputs were categorized into sleeping, indoor activities, and going out. Atypical patterns were identified with reference to baseline activity. Daily indoor activities were clearly differentiated by sensor outputs and sensor outputs discriminated atypical activity patterns. During the year of monitoring, a health-related issue was identified in a participant. Our findings indicate the feasibility of a home mobility monitoring system for remote, continuous, and automated assessment of a participant’s health-related mobility patterns. Such a system could be used as a supportive tool to detect and intervene in the case of problematic health issues.

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MP34: Elder abuse in the emergency department: a systematic scoping review

CJEM ◽

10.1017/cem.2019.169 ◽

2019 ◽

Vol 21 (S1) ◽

pp. S54-S55

Author(s):

E. Mercier ◽

A. Nadeau ◽

A. Brousseau ◽

M. Emond ◽

J. Lowthian ◽

...

Keyword(s):

Older Adults ◽

Health Care ◽

Emergency Department ◽

Physical Abuse ◽

Health Care Providers ◽

Scoping Review ◽

Elder Abuse ◽

Community Dwelling ◽

Screening Tools ◽

Care Providers

Introduction: This systematic scoping review aims to synthetize the available evidence on the epidemiology, risk factors, clinical characteristics, screening tools, prevention strategies, interventions and knowledge of health care providers regarding elder abuse in the emergency department (ED). Methods: A systematic literature search was performed using three databases (Medline, Embase and Cochrane Library). Grey literature was scrutinized. Studies were considered eligible when they were observational studies or randomized control trials reporting on elder abuse in the prehospital and/or ED setting. Data extraction was performed independently by two researchers and a qualitative approach was used to synthetize the findings. Results: A total of 443 citations were retrieved from which 58 studies published between 1988 and 2018 were finally included. Prevalence of elder abuse following an ED visit varied between 0.01% and 0.03%. Reporting of elder abuse to proper law authorities by ED physicians varied between 2% to 50% of suspected cases. The most common reported type of elder abuse detected was neglect followed by physical abuse. Female gender was the most consistent factor associated with elder abuse. Cognitive impairment, behavioral problems and psychiatric disorder of the patient or the caregiver were also associated with physical abuse and neglect as well as more frequent ED consultations. Several screening tools have been proposed, but ED-based validation is lacking. Literature on prehospital- or ED-initiated prevention and interventions was scarce without any controlled trial. Health care providers were poorly trained to detect and care for older adults who are suspected of being a victim of elder abuse. Conclusion: Elder abuse in the ED is an understudied topic. It remains underrecognized and underreported with ED prevalence rates lower than those in community-dwelling older adults. Health care providers reported lacking appropriate training and knowledge with regards to elder abuse. Dedicated ED studies are required.

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Integration of physical activity in reablement for community dwelling older adults: a systematic scoping review

10.21203/rs.2.17945/v1 ◽

2019 ◽

Author(s):

Hanne Leirbekk Mjøsund ◽

Cathrine Fredriksen Moe ◽

Elissa Burton ◽

Lisbeth Uhrenfeldt

Keyword(s):

Physical Activity ◽

Older Adults ◽

Health Care Providers ◽

Data Extraction ◽

Community Dwelling ◽

Cochrane Central Register ◽

Care Providers ◽

Limited Evidence ◽

Individual Needs ◽

Community Dwelling Older Adults

Abstract Introduction: Reablement is a rehabilitative intervention provided to homecare receivers (mostly older adults) with the aim of improving function and independence. There is limited evidence of the effectiveness of reablement and the content of these interventions is variable. Physical activity (PA) is known to be important for improving and maintaining function among older adults, but it is unclear how PA is integrated in reablement.Objective: To map existing evidence of how PA strategies are integrated and explored in studies of reablement for community dwelling older adults and to identify knowledge gaps.Methods: An apriori protocol was published. Studies investigating or exploring time-limited (within 6 months), interdisciplinary reablement for community-dwelling older adults, published in English, Norwegian, Danish, Swedish and German were considered for inclusion. PubMed, Cochrane central register of controlled trials, Embase, PsycINFO, AMED, PEDro, CINAHL and Google Scholar were searched for studies published between 1996 and July 2019, in addition to reference and citation searches. Study selection and data extraction were made independently by two reviewers.Results: Forty-three studies were included. Exercise strategies and practice of daily activities were reported to be included in the majority of intervention studies, but in most cases, no information was provided about the degree or intensity of which PA was involved, or how PA interventions were targeted to individual needs. Interventions aiming to increase general PA levels or reduce sedentary behavior were rarely described. None of the studies explored older adults’, health care providers’ or family members’ experiences with PA in a reablement setting, but some of the studies touched upon themes related to PA experiences. Some studies reported outcomes of physical fitness, including mobility, strength and balance, but there was insufficient evidence for any synthesis of these results. None of the studies reported PA levels among older adults receiving reablement.Conclusion: There is limited evidence regarding how PA is integrated in reablement, including how PA strategies are targeted to older adults’ individual needs and preferences in a reablement setting. The feasibility, and effectiveness of PA interventions, as well as experiences or barriers related to PA in a reablement setting should be further investigated.

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Self-Reported Sleep Difficulties and Self-Care Strategies Among Rural Older Adults

Journal of Evidence-Based Complementary & Alternative Medicine ◽

10.1177/2156587213510005 ◽

2013 ◽

Vol 19 (1) ◽

pp. 36-42 ◽

Cited By ~ 4

Author(s):

Joanne C. Sandberg ◽

Cynthia K. Suerken ◽

Sara A. Quandt ◽

Kathryn P. Altizer ◽

Ronny A. Bell ◽

...

Keyword(s):

Older Adults ◽

Health Care Providers ◽

Sleep Problems ◽

Self Care ◽

Community Dwelling ◽

Use Of Self ◽

Care Providers ◽

Sleep Difficulty ◽

Supplement Use ◽

Community Dwelling Older Adults

This study examined the use of self-care strategies to address difficulty sleeping among community-dwelling older adults. Data were collected from a series of 18 questionnaires administered to 195 rural African American and white older adults in North Carolina. Participants reported whether they had experienced difficulty sleeping and strategies used to respond to the symptom. The most widely used strategies included ignoring the symptom, staying in bed or resting, and praying. Herb and supplement use were not reported. Ethnicity, income, and education were associated with use of specific self-care strategies for sleep. This variation suggests that older adults may draw on cultural understandings to interpret the significance of difficulty sleeping and influence their use of self-care strategies, including complementary and alternative medicine use. This information may enable health care providers to communicate with the older patients about sleep difficulty strategies to minimize sleep problems.

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Community-dwelling older adults' contextual experiencing of humour

Ageing and Society ◽

10.1017/s0144686x10000759 ◽

2010 ◽

Vol 31 (1) ◽

pp. 110-124 ◽

Cited By ~ 10

Author(s):

THECLA DAMIANAKIS ◽

ELSA MARZIALI

Keyword(s):

Older Adults ◽

Health Care Providers ◽

Sense Of Self ◽

Community Dwelling ◽

Ageing Process ◽

Social Connections ◽

Care Providers ◽

Institutional Settings ◽

Personal Context ◽

Community Dwelling Older Adults

ABSTRACTThe purpose of this exploratory study was to examine the contextual experiencing of humour by community-dwelling older adults. Data for this study consisted of audio-recorded, transcribed interviews with 20 older adults who had participated in a larger study of a number of dimensions associated with the process of ageing. Qualitative coding of the interview content was used to extract salient themes that identified types of humour experienced in different life contexts. The analysis of older adults' narratives about their day-to-day lives yielded four types of experienced humour: affiliative, self-enhancing, self-defeating, and authentic. Within an inter-personal context, expressing and appreciating humour contributed to sustaining positive social connections. The use of authentic humour and being able to laugh at one's self and life's uncontrollable circumstances appeared to support a positive sense of self and was adaptive for coping with the inevitable losses that accompany the ageing process, such as declining health status. The results of this study suggest that humour expression and appreciation may play an important role in managing the ageing process in ways that are adaptive especially in inter-personal contexts. Possibly health-care providers in both community and institutional settings need to be made aware of the benefits for older adults of experiencing humour in different life contexts.

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COVID-19 Vaccine Hesitancy Among Community-Dwelling Older Adults: The Role of Information Sources

Journal of Applied Gerontology ◽

10.1177/07334648211037507 ◽

2021 ◽

pp. 073346482110375

Author(s):

Divya Bhagianadh ◽

Kanika Arora

Keyword(s):

Older Adults ◽

Health Care Providers ◽

Information Sources ◽

Information Source ◽

Community Dwelling ◽

Vaccine Hesitancy ◽

Care Providers ◽

Logistic Regression Models ◽

Community Dwelling Older Adults

Despite high enthusiasm surrounding the rollout of the COVID-19 vaccine, some older adults continue to remain hesitant about its receipt. There is limited evidence on vaccine hesitancy among community-dwelling older adults. In this study, we examine the prevalence and predictors (particularly the role played by information sources) of vaccine hesitancy in this group. We use the Medicare Current Beneficiary Survey and employ multivariable logistic regression models to explore this. Relative to those relying on regular news, those depending on health care providers (HCPs), social media, other internet/webpages, and family/friends as the main information source on COVID-19 expressed higher negative vaccine intent. The high negative intent with HCPs as the main information source should be interpreted with caution. This could be reflective of the timing of the survey and changing attitude toward the vaccine among HCPs themselves.

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Psychometric Properties of the “Lasher and Faulkender Anxiety about Aging Scale” among Iranian older people

10.21203/rs.3.rs-75395/v1 ◽

2020 ◽

Author(s):

Amir Pakpour ◽

Shamsedin Namjoo ◽

Khadijeh Sabahiazar ◽

Mohammad Asghari Jafarabadi ◽

Vijay Kumar r Chattu ◽

...

Keyword(s):

Older Adults ◽

Health Care ◽

Psychometric Properties ◽

Health Care Providers ◽

Health Care Services ◽

Factor Model ◽

The Elderly ◽

Community Dwelling ◽

Care Providers ◽

Factors Affecting

Abstract BackgroundAssessing anxiety in the elderly and the factors affecting this phenomenon will help the health care providers to provide appropriate and effective support and health care services for older adults. The aim of the present study was to assess the psychometric properties of the Aging Scale (AAS) among Persian speaking older adults.Method:A sample of 703 community-dwelling older adults was recruited for the study. A 'forward-backward' translation procedure was conducted to develop the Iranian version of the AAS. Confirmatory factor analysis (CFA) and Rasch model were then used for construct validity, and GHQ-12 and MSPSS were utilized for assessing concurrent validity of the AAS.ResultThe study participants included 416 (59.2%) men and 287 (40.8%) women with an average age of 69.4 years (SD D 8.11). Cronbach’s alpha for Fear of Old People, Psychological Concerns, Physical Appearance, Fear of Losses and the overall score was 0.881, 0.705, 0.748, 0.768 and 0.77, respectively. Applying CFA, it was found that the four original factors model was the best solution with 0.55 of the total variance. The result of the CFA indicated that this four-factor model had a good fit to the data. The results were then confirmed by Rasch analysis. Moreover, the AAS was significantly correlated with MSPSS (r=-0.395, p < 0.001) and GHQ_12 (r = 0.238, p < 0.001).ConclusionThe Persian version of the AAS was found to be valid and reliable for measuring anxiety of ageing among Persian speaking elderly populations.

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Nurse Practitioners’ Experiences of Polypharmacy in Community-Dwelling Older Adults

Innovation in Aging ◽

10.1093/geroni/igaa057.670 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 207-207

Author(s):

Christine Pariseault ◽

Nancy Sharts-Hopko ◽

Elizabeth Blunt

Keyword(s):

Older Adults ◽

Health Care ◽

Older Adult ◽

Health Care Providers ◽

Nurse Practitioners ◽

Adult Population ◽

Medication Management ◽

Community Dwelling ◽

Care Providers ◽

Adequate Care

Abstract Numerous studies exist that define polypharmacy and its impact on health. Additionally, the literature is rich in studies documenting the benefits of care provided by nurse practitioners. A gap in research exists at the intersection of the value of nurse practitioners in caring for older adults and their management of polypharmacy. Coinciding with a growth of America’s older adult population and the need for adequate care, the purpose of this study was to explore the experiences of nurse practitioners caring for older adults experiencing polypharmacy. A qualitative descriptive study was conducted using a purposive sampling of nurse practitioners who care for older adults. Interviews were conducted and data was analyzed for themes. Four themes emerged: defining polypharmacy, communicating and collaborating, clinical judgement of nurse practitioners in relation to polypharmacy, and medication issues of older adults. Major themes emerged that depict the complexity of medication management in older adults as well as the important role of NPs in providing care to older adults. The significance of the study findings to future practice includes improving communication and collaboration of prescribing health care providers, better identification and management of polypharmacy, and improving the health care delivered to older adults. Safe and effective prescribing for older adults requires NPs consider the unique needs of each older adult while utilizing technology to support collaboration and decision making.

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Interdisciplinary Therapy Assessments for the Older Adult

Perspectives on Gerontology ◽

10.1044/gero17.1.11 ◽

2012 ◽

Vol 17 (1) ◽

pp. 11-16

Author(s):

Lynn Chatfield ◽

Sandra Christos ◽

Michael McGregor

Keyword(s):

Older Adults ◽

Health Care ◽

Standardized Testing ◽

Health Care Providers ◽

Outcome Measurement ◽

Care Providers ◽

Patient Centered ◽

Screening Process ◽

Evidenced Based ◽

Changing Economy

In a changing economy and a changing industry, health care providers need to complete thorough, comprehensive, and efficient assessments that provide both an accurate depiction of the patient's deficits and a blueprint to the path of treatment for older adults. Through standardized testing and observations as well as the goals and evidenced-based treatment plans we have devised, health care providers can maximize outcomes and the functional levels of patients. In this article, we review an interdisciplinary assessment that involves speech-language pathology, occupational therapy, physical therapy, and respiratory therapy to work with older adults in health care settings. Using the approach, we will examine the benefits of collaboration between disciplines, an interdisciplinary screening process, and the importance of sharing information from comprehensive discipline-specific evaluations. We also will discuss the importance of having an understanding of the varied scopes of practice, the utilization of outcome measurement tools, and a patient-centered assessment approach to care.

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New Syphilis Cases in Older Adults, 2004–2019: An Analysis of Surveillance Data From South China

Frontiers in Medicine ◽

10.3389/fmed.2021.781759 ◽

2021 ◽

Vol 8 ◽

Author(s):

Cheng Wang ◽

Peizhen Zhao ◽

Mingzhou Xiong ◽

Joseph D. Tucker ◽

Jason J. Ong ◽

...

Keyword(s):

Older Adults ◽

Health Care ◽

Health Care Providers ◽

Temporal Trends ◽

Health Concern ◽

Targeted Prevention ◽

Care Providers ◽

Annual Percent Change ◽

Syphilis Infection ◽

Over Time

Background: Sexual health among older adults is a major public health concern globally. The syphilis burden is increasing in older adults in China. This study aimed to describe factors associated with syphilis infection and diagnosis among older adults in China during a 16 year period.Methods: Using 16 years of data (2004–2019) from the syphilis case report system of Guangdong, China, we compared data from older adults (aged ≥50 years) with those from younger people (aged 15–49 years). We compared the two age group with the Chi-square test for difference, and Joinpoint regression models to assess the temporal trends.Results: During the study period, 242,115 new syphilis diagnoses were reported in older adults. The mean notification rate of new diagnoses was 64.1 per 100,000 population across the entire 16-year period, which significantly increased over time (average annual percent change [AAPC] 16.2%, 95% CI 13.7–18.7). Syphilis diagnoses increased significantly over time among less developed cities and older women. In 2019, compared with younger adults, newly diagnosed older adults were more likely to be male, native to reporting city, had unknown transmission routes, and were diagnosed late.Conclusion: Our findings call for an urgent need to deliver more targeted prevention interventions for older adults, such as strengthen awareness among health care providers, and integration of syphilis services and primary health care for older adults.

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