scholarly journals Care Poverty Within the Home Space: Exploring the Emotional Experiences of Unmet Care Needs

2021 ◽  
Vol 6 ◽  
Author(s):  
Tiina Sihto ◽  
Lina Van Aerschot
Keyword(s):  
Older Adults ◽  
Emotional Experience ◽  
Emotional Experiences ◽  
Structured Interviews ◽  
Care Needs ◽  
Outreach Work ◽  
Societal Level ◽  
Home Space ◽  
Scarcity Of Resources ◽  
Societal Inequality

Older adults face inequalities in care. The concept of care poverty has been developed to point out how unmet care needs are not just an individual issue but a phenomenon linked to social and economic disadvantage and societal inequality. In this paper, we approach the question of care poverty by focusing on its intertwinement with emotions and the home space. We analyze how the presence, or more commonly absence, of care shapes interviewees’ descriptions of emotional experiences tied to the home space. Our data consists of 12 semi-structured interviews conducted in 2019 and 2020 with customers of outreach work for older adults in Finland. These customers typically face a situation that can be characterized as care poverty: their care needs are not (or have not been) met by either the service system or informal sources. When analyzing the data, we followed the guidelines for thematic analysis proposed by Braun and Clarke. Our analysis shows how care and lack of care transform interviewees’ emotional connections with the home space, highlighting particularly three main themes: insecurity, isolation and belongingness. Our analysis reveals how lack of care can transform the home into an unsafe place; a space characterized by isolation, or a space where one sometimes ceases to feel at ease or “like oneself.” The emotional experience of home and being adequately cared for is also tied to the sense of (not) belonging to a place. Based on our analysis, we argue that as an experience, care poverty is not just about individual unmet needs and/or a scarcity of resources at the societal level; it should also be understood as deeply relational—born and shaped in interactions (or the lack of interactions) among people, and lived in and through relationships with others. Furthermore, we highlight the importance of a sense of belonging to the feeling of being adequately cared for.

scholarly journals A Small-Scale Qualitative Study of Early Comprehensive Patient Engagement in Acute Clinical Settings: Is It Feasible?

2020 ◽  
Author(s):  
Andrea Nedergaard Jensen ◽  
Ove Andersen ◽  
Hejdi Gamst-Jensen ◽  
Maria Kristiansen
Keyword(s):  
Older Adults ◽  
Qualitative Study ◽  
Patient Engagement ◽  
Participant Observation ◽  
Patient Flow ◽  
Time Constraints ◽  
Small Scale ◽  
User Engagement ◽  
Structured Interviews ◽  
Care Needs

Abstract Background: Patient-centered care (PCC) based on systematic and comprehensive patient engagement is important for patient satisfaction. However, ensuring PCC is difficult in emergency departments (ED) characterized by a high patient flow and a substantial proportion of older adults with multimorbidity and complex care needs. This small-scale qualitative study aimed to identify potentials and barriers for providing early PCC for older adults in Danish EDs using a novel user-engagement conversation tool.Methods: Participant observation, focus group interviews and individual semi-structured interviews with ED nurses and geriatric nurses were conducted between September and December 2019 in an ED at a hospital in the Capital Region of Denmark. Thematic network analysis with a focus on potentials and barriers for patient engagement was conducted.Results: Two key subthemes related to potentials emerged: 1) a positive attitude towards patient engagement in the context of PCC, and; 2) perceived benefits of PCC overall and the engagement tool in particular. Additionally, two key subthemes related to barriers emerged: 1) time constraints and; 2) concerns related to the importance of cross-sectoral care coordination.Conclusion: This study contributes to mounting evidence in support of policies and practices that encourage PCC as a driver of unpacking patients’ needs and values leading to targeted follow-up care. However, barriers such as time constraints, and lack of cross-sectoral care collaboration should be acknowledged if the potentials of PCC is to be fulfilled in ED settings.

scholarly journals Qualitative exploration of the experiences of informal care-givers for dependent older adults in Mexico City

2018 ◽  
Vol 39 (11) ◽  
pp. 2377-2396 ◽  
Author(s):  
Liliana Giraldo-Rodríguez ◽  
Nathalia Guevara-Jaramillo ◽  
Marcela Agudelo-Botero ◽  
Dolores Mino-León ◽  
Mariana López-Ortega
Keyword(s):  
Older Adults ◽  
Mexico City ◽  
Informal Care ◽  
Family Care ◽  
Structured Interviews ◽  
Care Needs ◽  
Cross Sectional ◽  
Term Care ◽  
Care Givers ◽  
Care Giving

AbstractPopulation ageing and increasing prevalence of chronic diseases and their consequences, changes in family structure and a decrease in the potential pool of family care, increase the need for formal long-term care for older adults in Mexico, and the need to understand the experiences of informal care-givers and how this impacts their social, family and personal conditions. This study investigates the experience of informal care-givers of dependent older adults using a cross-sectional qualitative study with an ethnographic focus. Thematic analysis was performed. The study comprised 48 semi-structured interviews with care-givers of dependent older adults who are beneficiaries of an in-home medical programme in Mexico City. The average age of care-givers was 54.7 years (standard deviation = 13.1, range = 24–86) and 75 per cent (36) were women. Results show care-giving experiences are diverse and complex, and profoundly affect the care-giver's life in terms of emotional burden, health deterioration and adverse life conditions due to economic deprivation. They also revealed key aspects such as the need to improve communication between care-givers and health-care personnel, the need for training about specific care needs and opportunity costs incurred. This information can serve as a basis for generating support strategies that may be integrated into the in-home programme. It is essential to promote actions that consider the ‘dependent older adult–informal care-giver’ dyad, and that aim to reduce the care-giving burden.

scholarly journals COVID-19-Related Lifestyle Changes among Community-Dwelling Older Adult Day-Care Users: A Qualitative Study

2021 ◽  
Vol 19 (1) ◽  
pp. 256
Author(s):  
Akira Teramura ◽  
Yumi Kimura ◽  
Kosuke Hamada ◽  
Yasuko Ishimoto ◽  
Masato Kawamori
Keyword(s):  
Older Adults ◽  
Day Care ◽  
Leisure Activities ◽  
Lifestyle Changes ◽  
Community Dwelling ◽  
Structured Interviews ◽  
Care Needs ◽  
Care Services ◽  
Before And After ◽  
Socially Isolated

In Japan, the community-based comprehensive care system is an important initiative. The purpose of this study was to understand COVID-19-related lifestyle changes experienced by older adults who lived in communities and used day-care services. Using a qualitative inductive research method, semi-structured interviews were conducted with 13 older adults who used day-care services in Kyoto City, which assessed lifestyle changes before and after the spread of COVID-19 during March–April 2021. The extracted lifestyle change codes were classified into six categories and 16 subcategories. The data revealed that older adults felt socially isolated and experienced multiple changes in their lives, including limited leisure activities, changes in roles, decreased interpersonal interaction with family and acquaintances, poor diet and sleep quality, and reduced attention to personal appearance and grooming. The findings suggest that during COVID-19, older adults had difficulty adapting to the various changes in their lives and showed a decline in physical and mental functioning. Thus, it is important for day-care facilities to create sustainable spaces in response to the various care needs of community-dwelling older adults whose lifestyles have changed as a result of the COVID-19 situation.

scholarly journals Closeness to friends explains age differences in positive emotional experience during the lockdown period of COVID-19 pandemic

2021 ◽  
Author(s):  
Elena Cavallini ◽  
Alessia Rosi ◽  
Floris Tijmen van Vugt ◽  
Irene Ceccato ◽  
Filippo Rapisarda ◽  
...  
Keyword(s):  
Older Adults ◽  
Age Differences ◽  
Online Survey ◽  
Emotional Experience ◽  
Daily Activities ◽  
Stressful Situation ◽  
Emotional Experiences ◽  
Emotional Wellbeing ◽  
Social Closeness ◽  
Age Related

Abstract Background Studies on age differences in emotional states during the COVID-19 pandemic showed that older adults experienced greater emotional wellbeing compared to younger adults. We hypothesized these age differences to be related to the perception of closeness to family/friends or the engagement in daily activities during the pandemic. Aim To investigate age differences in positive and negative emotional experiences and whether the perception of closeness to family/friends and the engagement in daily activities during pandemic explained such age-related differences. Methods Through a cross-sectional study, 1,457 adults aged 18–87 years old completed an online survey assessing positive and negative emotional experiences, the perception of more closeness to family/friends, and daily activities that participants started/re-started during the pandemic. Results Increasing age was associated with more positive and less negative emotional experiences. Age differences in positive emotional experience were explained by the perception of more closeness to friends and not by the engagement in daily activities. For negative emotional experience age, differences remained significant even after accounting for the perception of closeness to family/friends and engagements in daily activities. Discussion Older adults’ greater overall level of positive emotional experience was explained by their greater perception of more closeness to friends. We speculate that social closeness provides a coping mechanism to increase emotional wellbeing employed especially in older adults. Conclusion Our findings reinforce the link between perceived social closeness and emotional wellbeing especially in older adults. To cope with stressful situation, it is important to encourage older adults to increase the closeness to their social network.

scholarly journals Emotional earthquakes in the landscape of psychosis: an interpretative phenomenology

2016 ◽  
Vol 9 ◽  
Author(s):  
Jonathan Hutchins ◽  
John Rhodes ◽  
Saskia Keville
Keyword(s):  
Lived Experience ◽  
Interpretative Phenomenological Analysis ◽  
Emotional Experience ◽  
Psychotic Symptoms ◽  
Emotional Experiences ◽  
Structured Interviews ◽  
Psychotic Experience ◽  
Early Intervention In Psychosis ◽  
Onset Phase ◽  
Post Onset

AbstractTraditionally studies have neglected emotion in psychosis, possibly as a consequence of psychiatry's emphasis on psychotic symptoms rather than individuals’ lived experience of emotions before, during and after psychotic episodes. This study sought to investigate how individuals experienced their emotions and delusions in the context of psychosis. A qualitative Interpretative Phenomenological Analysis (IPA) research methodology was used. Semi-structured interviews were conducted with a purposively sampled group of eight participants recruited from a local Early Intervention in Psychosis service. Four themes were generated by the analysis. The first highlighted emotional experiences prior to the onset of psychosis: ‘struggling with life distress’. The second highlighted the intense emotional experience within psychotic experiences: ‘transformed world and intense emotion’. The third theme highlighted self-critical tendencies in the post-onset phase of psychosis: ‘blame and guilt after the breakdown’. The final theme highlighted a mixture of emotions in the post-onset phase: ‘confusion, despair and hope’. There were many clinical implications highlighted in the study including the value of normalizing participants’ emotional experiences in order to promote engagement in services and of assessing for self-criticism, despair and hope following the psychotic experience, alongside therapeutically addressing the varying levels of emotional experiences before, during and after a psychotic breakdown.

Servicing the Senior Swallow: A Family-Centered Private Practice Model of Service Delivery

2020 ◽  
pp. 1-4 ◽  
Author(s):  
Yvette M. McCoy
Keyword(s):  
Older Adults ◽  
Medical Model ◽  
Recovery Process ◽  
Swallowing Disorders ◽  
Current Evidence ◽  
Care Needs ◽  
Skilled Nursing ◽  
Person Centered Care ◽  
Centered Care ◽  
Traditional Medical Model

Purpose Person-centered care shifts the focus of treatment away from the traditional medical model and moves toward personal choice and autonomy for people receiving health services. Older adults remain a priority for person-centered care because they are more likely to have complex care needs than younger individuals. Even more specifically, the assessment and treatment of swallowing disorders are often thought of in terms of setting-specific (i.e., acute care, skilled nursing, home health, etc.), but the management of dysphagia in older adults should be considered as a continuum of care from the intensive care unit to the outpatient multidisciplinary clinic. In order to establish a framework for the management of swallowing in older adults, clinicians must work collaboratively with a multidisciplinary team using current evidence to guide clinical practice. Private practitioners must think critically not only about the interplay between the components of the evidence-based practice treatment triad but also about the broader impact of dysphagia on caregivers and families. The physical health and quality of life of both the caregiver and the person receiving care are interdependent. Conclusion Effective treatment includes consideration of not only the patient but also others, as caregivers play an important role in the recovery process of the patient with swallowing disorders.

Age Advantages of Emotional Experience during the COVID-19 Pandemic are Robust, but Diminished Compared to Pre-pandemic Conditions

2020 ◽  
Author(s):  
Rui Sun ◽  
Disa Sauter
Keyword(s):  
Older Adults ◽  
Large Scale ◽  
Negative Emotion ◽  
Emotional Experience ◽  
Negative Emotions ◽  
Older Individuals ◽  
Selection Strategies ◽  
Scale Test ◽  
Prolonged Stress

Getting old is generally seen as unappealing, yet aging confers considerable advantages in several psychological domains (North & Fiske, 2015). In particular, older adults are better off emotionally than younger adults, with aging associated with the so-called “age advantages,” that is, more positive and less negative emotional experiences (Carstensen et al., 2011). Although the age advantages are well established, it is less clear whether they occur under conditions of prolonged stress. In a recent study, Carstensen et al (2020) demonstrated that the age advantages persist during the COVID-19 pandemic, suggesting that older adults are able to utilise cognitive and behavioural strategies to ameliorate even sustained stress. Here, we build on Carstensen and colleagues’ work with two studies. In Study 1, we provide a large-scale test of the robustness of Carstensen and colleagues’ finding that older individuals experience more positive and less negative emotions during the COVID-19 pandemic. We measured positive and negative emotions along with age information in 23,629 participants in 63 countries in April-May 2020. In Study 2, we provide a comparison of the age advantages using representative samples collected before and during the COVID-19 pandemic. We demonstrate that older people experience less negative emotion than younger people during the prolonged stress of the COVID-19 pandemic. However, the advantage of older adults was diminished during the pandemic, pointing to a likely role of older adults use of situation selection strategies (Charles, 2010).

scholarly journals 346 How Do we Increase Adherence to Home Exercise Programmes? Interviews with Older Adults and Physiotherapists

2019 ◽  
Vol 48 (Supplement_3) ◽  
pp. iii17-iii65
Author(s):  
Siti Khalijah ◽  
Suzanne Timmons
Keyword(s):  
Older Adults ◽  
Cardiovascular Health ◽  
Home Exercise ◽  
Video Content ◽  
Structured Interviews ◽  
Timed Up And Go ◽  
Convenience Sample ◽  
Improve Compliance ◽  
Exercise Programmes ◽  
Purposive Sample

Abstract Background Regular exercise and physical activity can maintain function and cardiovascular health, and prevent cognitive decline, in older adults. However, studies show that there is often poor adherence to home exercise programmes (HEP). The purpose of this study was to explore how HEP are perceived by both older adults and physiotherapists. Methods A convenience sample of 28 older adults attending outpatient physiotherapy clinics were given an exercise journal to record their adherence to the HEP prescribed by their physiotherapists for six weeks. Subsequently, semi-structured interviews were conducted with a purposive sample, and the corresponding prescribing physiotherapists, to achieve maximal variation in terms of HEP adherence, age and sex. The interviews were audio recorded, transcribed, and simple content analysis performed. Results Fourteen participants returned their exercise journal. Median age was 80; half were female; median Berg Balance Score and Timed-up-and-Go-Test were 49 and 16 seconds respectively. Participants exercised a median 79.8% of the prescribed dose, or 5.6 days per week. Seven older adults were interviewed; about half had a positive attitude towards exercise. They were also moderately positive about their HEP (comments ranged from “doable” and “nothing bad about it” to “enjoyable”). Barriers included time, mood, boredom, remembering to do the HEP, and variable health status. Enablers included simple instructions and design, family encouragement, and sense of achievement. Physiotherapists (n=5) perceived that many older adults aren’t compliant with HEPs, but there was some therapeutic nihilism (“you can’t force them”). Their HEP instructions varied from verbal to written instructions/diagrams; one physiotherapist used individualised video content. Notably, participants with good adherence understood their HEP well in terms of content and purpose, although this may be cause or effect. Conclusion To improve compliance with HEP, healthcare professionals need to take time to motivate the recipient, simplify their instructions, and trouble-shoot potential barriers at the time of prescription.

scholarly journals POS0160-HPR THE CARE PROCESS OF HIP AND KNEE OSTEOARTHRITIS: GIVING AN ACCOUNT OF PATIENTS’ EXPERIENCE

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 292.2-293
Author(s):  
S. Battista ◽  
M. Manoni ◽  
A. Dell’isola ◽  
M. Englund ◽  
A. Palese ◽  
...  
Keyword(s):  
Knee Osteoarthritis ◽  
Health Professionals ◽  
Emotional Experience ◽  
Functional Limitations ◽  
Care Quality ◽  
Care Process ◽  
Exact Science ◽  
Structured Interviews ◽  
Patients Experience

Background:The care process is often a complex and intimate process experienced by patients. Osteoarthritis (OA) care is usually characterised by multimodal interventions that consider the broader array of symptoms and functional limitations and often require a high level of patients’ compliance. Despite efforts to improve the quality of care of patients suffering from OA, and the publication of state-of-the-art clinical practice guidelines [1], the quality of the care process, as experienced by patients, seems to be suboptimal [2]. Hence, it is essential to investigate how patients experience this process to highlight potential elements that can enhance or spoil it to optimise the care quality.Objectives:To explore the patients’ experience of the received OA care process.Methods:Qualitative study, 10 semi-structured interviews were performed. The interview guide was created by a pool of healthcare professionals (physiotherapists, psychologists, nurses) and expert patients. It investigated the emotional experience, beliefs, expectations, perceived barriers and facilitators towards conservative treatments perceived by patients suffering from OA. The interviews lasted approximately one hour, were transcribed verbatim and analysed independently by two authors, who labelled their core parts to find categories and subcategories. A theme-based analysis was performed following an ecological paradigm, naturalistic epistemology, philosophy of phenomenological research.Results:Our analysis revealed 7 main categories with several subcategories (Fig. 1). 1) Uncertainty as some patients perceived treatment choice not to be based on medical evidence “there is an almost religious way of thinking on how to deal with the pathology. It is not an exact science when you choose the physicians you choose the treatment”. 2) Relationship with the self and the others as some patients did not feel understood or even shameful and hopeless about their condition. 3) Patients’ and Health Professionals’ beliefs about the pathology management where common thoughts were the perceived (ab)use of passive therapies, the movement as something dangerous and that OA is “something that you try to resist to, but (surgery) is your destiny”. 4) facilitators and 5) barriers of the adherence to therapeutic exercise that revolve around the cost of the therapy, the time needed and the willingness to change life habits. 6) Patients’ attitudes towards pathology in which the oldest patients perceive OA as “something I have to accept since I am getting old” and the youngest as “Something I have to fight”. 7) Relationship with food in which diet is seen as something that “you force yourself to follow” which is useful only to lose weight and not to preserve a high health status and where overeating is used “to eat your feelings”.Figure 1.Categories and Subcategories stemmed from the analysis of the patients’ interviewsConclusion:Patients suffering from hip and knee OA seem to experience an uncertain care process. The lack of clear explanations and the attitude towards conservative treatment, which is considered as “a pastime while waiting for surgery,” fosters the importance of providing patients with adequate information about the treatment, to shift their beliefs and improve their awareness. This will enhance a patient-centred and shared decision-making treatments.References:[1]Fernandes L, Hagen KB, Bijlsma JWJ, et al. EULAR recommendations for the non-pharmacological core management of hip and knee osteoarthritis. Ann. Rheum. Dis. 2013;72:1125–35.[2]Basedow M, Esterman A. Assessing appropriateness of osteoarthritis care using quality indicators: a systematic review. J Eval Clin Pract 2015;21:782–9.Acknowledgements:This work is part of the project funded by EULAR Health Professionals Research Grant 2020.Disclosure of Interests:None declared

Perceived barriers and contributors to sense of purpose in life in retirement community residents

2020 ◽  
pp. 1-17
Author(s):  
Nathan A. Lewis ◽  
Naomi Reesor ◽  
Patrick L. Hill
Keyword(s):  
Older Adults ◽  
Purpose In Life ◽  
Retirement Community ◽  
Retirement Communities ◽  
Structured Interviews ◽  
Contributing Factors ◽  
Sense Of Purpose ◽  
The Social ◽  
Continuing Care Retirement Communities ◽  
Retirement Facilities

Abstract Despite the growing use of retirement communities and ageing care facilities, little is known about how residing in retirement residences may impact aspects of older adult wellbeing. Living in these communities may hold particular influence on residents’ sense of purpose, if they feel limited in their opportunities for individual action, or could serve to promote purposefulness depending on the social connections available. The current study sought to explore contributing factors as well as barriers to purpose in older adults living in three continuing care retirement communities. Using brief semi-structured interviews, 18 older adults were asked to describe their purpose in life, community-related activities and any perceived challenges limiting their ability to pursue this purpose. Thematic analysis was used to examine themes common across interviews. Interviews presented a mixed picture of the nature of purposefulness in retirement facilities. Residents espoused several benefits of community living such as social and leisure opportunities, while also noting several obstacles to their purpose, including health concerns and the belief that purpose in life was not relevant for older adults. These findings provide insight into how older adults can derive a sense of purpose from activities within their retirement community and how facilities can better tailor programmes to promote purposefulness and support personally valued roles for residents.

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