scholarly journals A Mixed-Methods Analysis of Care Arrangements of Older People with Limited Physical Abilities Living Alone in Italy

2021 ◽  
Vol 18 (24) ◽  
pp. 12996
Author(s):  
Maria Gabriella Melchiorre ◽  
Sabrina Quattrini ◽  
Giovanni Lamura ◽  
Marco Socci
Keyword(s):  
Mixed Methods ◽  
Older People ◽  
Functional Limitations ◽  
Qualitative Interviews ◽  
Family Members ◽  
Ageing In Place ◽  
Home Help ◽  
Italian Regions ◽  
Territorial Differentiation ◽  
Physical Abilities

Older people with limited physical abilities, who live alone without cohabiting family members, need support ageing in place and to perform daily living activities. In this respect, both the available informal and formal care seem crucial. The present study aimed to explore the current role of the care arrangements of older people, especially if they have functional limitations. Qualitative interviews were carried out in 2019 within the “Inclusive ageing in place” (IN-AGE) research project, involving 120 older people who lived at home, alone, or with a private personal care assistant (PCA) in three Italian regions (Lombardy, Marche, and Calabria). A mixed-methods analysis was conducted. Results showed that support networks are still mainly made up of family members, but also of domestic home help (DHH) and PCAs, friends/neighbours, and public services, albeit the latter provide support in a residual way, while the former is not as intensive as it was in the past. Frequency and geographical/living proximity of help play a role, emerging also as a territorial differentiation. The paucity or absence of support, especially from the family, risks compromising the ability of ageing in place. It seems, thus, necessary to innovate and improve, in particular, home services, also through real formal and informal care integration.

scholarly journals The stability of care preferences following acute illness: a mixed methods prospective cohort study of frail older people

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
S. N. Etkind ◽  
N. Lovell ◽  
A. E. Bone ◽  
P. Guo ◽  
C. Nicholson ◽  
...  
Keyword(s):  
Cohort Study ◽  
Mixed Methods ◽  
Older People ◽  
Family Support ◽  
Prospective Cohort ◽  
Qualitative Interviews ◽  
Acute Illness ◽  
Frail Older People ◽  
Preference Stability ◽  
The Stability

Abstract Background Patient preferences are integral to person-centred care, but preference stability is poorly understood in older people, who may experience fluctuant illness trajectories with episodes of acute illness. We aimed to describe, and explore influences on the stability of care preferences in frail older people following recent acute illness. Methods Mixed-methods prospective cohort study with dominant qualitative component, parallel data collection and six-month follow up. Study population: age ≥ 65, Rockwood Clinical Frailty score ≥ 5, recent acute illness requiring acute assessment/hospitalisation. Participants rated the importance of six preferences (to extend life, improve quality of life, remain independent, be comfortable, support ‘those close to me’, and stay out of hospital) at baseline, 12 and 24 weeks using a 0–4 scale, and ranked the most important. A maximum-variation sub-sample additionally contributed serial in-depth qualitative interviews. We described preference stability using frequencies and proportions, and undertook thematic analysis to explore influences on preference stability. Results 90/192 (45%) of potential participants consented. 82/90 (91%) answered the baseline questionnaire; median age 84, 63% female. Seventeen undertook qualitative interviews. Most participants consistently rated five of the six preferences as important (range 68–89%). ‘Extend life’ was rated important by fewer participants (32–43%). Importance ratings were stable in 61–86% of cases. The preference ranked most important was unstable in 82% of participants. Preference stability was supported by five influences: the presence of family support; both positive or negative care experiences; preferences being concordant with underlying values; where there was slowness of recovery from illness; and when preferences linked to long term goals. Preference change was related to changes in health awareness, or life events; if preferences were specific to a particular context, or multiple concurrent preferences existed, these were also more liable to change. Conclusions Preferences were largely stable following acute illness. Stability was reinforced by care experiences and the presence of family support. Where preferences were unstable, this usually related to changing health awareness. Consideration of these influences during preference elicitation or advance care planning will support delivery of responsive care to meet preferences. Obtaining longer-term data across diverse ethnic groups is needed in future research.

scholarly journals Mixed-methods quantitative–qualitative study of 29 nonagenarians and centenarians in rural Southern Italy: focus on positive psychological traits

2017 ◽  
Vol 30 (1) ◽  
pp. 31-38 ◽  
Author(s):  
Anna Scelzo ◽  
Salvatore Di Somma ◽  
Paola Antonini ◽  
Lori P. Montross ◽  
Nicholas Schork ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Rating Scales ◽  
Southern Italy ◽  
Oldest Old ◽  
Qualitative Interviews ◽  
Personal Narratives ◽  
Family Members ◽  
Well Being ◽  
Psychological Traits ◽  
Mental Well Being

ABSTRACTObjective:This was a study of positive psychological traits in a group of rural Italians aged 90 to 101 years, and their children or other family members.Design:Mixed-methods quantitative (standardized rating scales) and qualitative (semi-structured interviews) study.Setting:Study participants’ homes in nine villages in the Cilento region of southern Italy.Participants:Twenty-nine nonagenarians and centenarians and 51 family members aged 51–75 years, selected by their general practitioners as a part of a larger study called CIAO (Cilento Initiative on Aging Outcomes).Methods:We used published rating scales of mental and physical well-being, resilience, optimism, anxiety, depression, and perceived stress. Qualitative interviews gathered personal narratives of the oldest-old individuals, including migrations, traumatic events, and beliefs. Family members described their impressions about the personality traits of their older relative.Results:Participants age ≥90 years had worse physical health but better mental well-being than their younger family members. Mental well-being correlated negatively with levels of depression and anxiety in both the groups. The main themes that emerged from qualitative interviews included positivity (resilience and optimism), working hard, and bond with family and religion, as described in previously published studies of the oldest old, but also a need for control and love of the land, which appeared to be unique features of this rural population.Conclusions:Exceptional longevity was characterized by a balance between acceptance of and grit to overcome adversities along with a positive attitude and close ties to family, religion, and land, providing purpose in life.

scholarly journals Insights From The Frontline of COVID-19 in Residential Care Settings for Older People in The Republic of Ireland: A Mixed Methods Study

2021 ◽  
Author(s):  
Mary Rose Sweeney ◽  
Andrew Boilson ◽  
Ciara White ◽  
Mary Nevin ◽  
Briege Casey ◽  
...  
Keyword(s):  
Health Care ◽  
Mixed Methods ◽  
Infection Control ◽  
Older People ◽  
Residential Care ◽  
Family Members ◽  
Care Provision ◽  
Front Line ◽  
Staff Members ◽  
The Republic

Abstract Background The COVID-19 pandemic had a disproportionate effect among residents, family members and staff in residential care settings for older people in Ireland relative to other health care settings, particularly in wave one of the virus. The purpose of this study was to explore the COVID-19 pandemic as it was experienced by people on the front line of the virus - residents, family members and staff in residential care settings for older people in the Republic of Ireland (ROI). Method A 2-phased mixed methods cross-sectional study was conducted. This consisted of a survey administered anonymously online shortly after the 1st wave of the virus (June - August 2020), via our nursing and health care networks, advocacy organisations for older people and on social media targeting - staff, residents and family members. Family members who took part in the survey were invited to take part in phase 2 - qualitative one-to-one interviews which were conducted shortly after wave 2 of the virus (November - December 2020). ResultsSeventy-six staff members completed the survey as well as 28 family members and 2 residents. Eleven family members took part in the qualitative interviews. Good infection control protocols, good governance/management structures, being prepared and agile responses were important factors in determining better outcomes. Isolation, loss of connectedness (to family, staff members and other residents) as well as a reduction in the level/quality of care provision led to significant adverse impacts for both residents and their families. Staff reported high levels of stress, trauma and burnout. A strong theme emerging from the qualitative element was the important role that family members typically have in supplementing care provision which suddenly and completely ceased during the pandemic. This caused huge distress amongst family members and physical decline and mental anguish amongst residents. ConclusionsThis is the first research study to explore the experiences of residents, family members and staff who were at the front line of the pandemic in residential care settings in ROI when the pandemic struck. This study provides valuable insights which could be used by staff in residential care settings, policy makers/implementers in further waves of the pandemic or in future communicable disease outbreaks. The rights and needs of residents must be carefully balanced with infection control and prevention measures. Strategies to ensure that residents and staff are appropriately supported during future waves of the pandemic should now be implemented.

scholarly journals Ambivalence among staff regarding ageing with intellectual disabilities: Experiences and reflections

2019 ◽  
pp. 174462951987499 ◽  
Author(s):  
Åsa Alftberg ◽  
Maria Johansson ◽  
Gerd Ahlström
Keyword(s):  
Older People ◽  
Intellectual Disabilities ◽  
Qualitative Interviews ◽  
Group Homes ◽  
Theoretical Concept ◽  
Assistive Devices ◽  
Active Lifestyle ◽  
Ageing In Place ◽  
Staff Members ◽  
People With Intellectual Disabilities

This study explores the experiences and reflections of staff in intellectual disability (ID) services concerning ageing with ID. Qualitative interviews were conducted with 24 staff members in group homes and daily activity centres. The findings showed that the staff were uncertain about the signs of ageing in people with intellectual disabilities; they compared the life conditions of these people with conditions in older people without intellectual disabilities. Their emphasis on an active lifestyle was very strong. The staff members also mentioned uncertainty about how to facilitate assistive devices and whether ‘ageing in place’ was the best solution. The overall theme was manifested as ambivalence where notions of older people with intellectual disabilities seemed incompatible with notions of old age in general and could be explained by the theoretical concept of age coding. The findings of this study indicate the need to provide education about ageing to staff working in ID services.

scholarly journals TALKING ABOUT LONELINESS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S374-S374
Author(s):  
Michael Thomas
Keyword(s):  
Mixed Methods ◽  
Older People ◽  
Personal Experience ◽  
Qualitative Interviews ◽  
Temporal Variations ◽  
Mixed Methods Study ◽  
Alternative Strategies ◽  
Research Interviews ◽  
Complicating Factors ◽  
Data Point

Abstract his paper draws on insights from a mixed methods study on temporal variations in loneliness among older people (aged 50 years plus) in England. The paper highlights alternative strategies available to participants in research interviews, including engaging with personal experience of loneliness or avoidant tactics such as digression, projection onto others or claiming ignorance of the topic. The data point towards complicating factors including a reluctance to disclose loneliness as a socially undesirable phenomenon, as well as difficulties in articulating the complexities of this topic. These considerations remind researchers of the need for reflection on the use of qualitative interviews when investigating loneliness and other difficult aspects of personal experience.

Beyond the Patient: A Mixed-Methods Inquiry Into Family Members' Involvement in the Treatment of Parkinson's Disease to Target Third-Party Disability

2020 ◽  
pp. 1-17
Author(s):  
Helen Mach ◽  
Carolyn Baylor ◽  
Rebecca Hunting Pompon ◽  
Kathryn Yorkston
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Mixed Methods ◽  
Phase 1 ◽  
Qualitative Interviews ◽  
Family Members ◽  
Communication Disorders ◽  
Third Party ◽  
Future Research ◽  
Clinical Practices

Purpose Family members of people with Parkinson's disease (PD) may experience third-party disability, manifesting as difficulty managing communication breakdowns and changed relationships influenced by communication disorders. This study examined family involvement in therapy to address third-party disability from the perspective of family members of people with PD and speech-language pathologists (SLPs). Method A mixed-methods design was used with two phases of data collection. In Phase 1 qualitative interviews, nine family members shared their perspectives about their involvement in therapy. In Phase 2, a survey was developed from Phase 1 data to gather data from SLPs ( N = 110) on their clinical practices involving family members. Results Family members and SLPs agreed that when family were involved in therapy, it was primarily to support therapy exercises for the person with PD. Many SLPs reported providing supportive activities for family members. However, qualitative data from family members suggested that the limited involvement they had in therapy did not sufficiently meet their unique needs resulting from communication changes with the person with PD and other related challenges. Constraints influencing family member involvement included insurance billing regulations, privacy laws for patients, and family members' availability. Conclusions While some families and SLPs reported efforts to specifically include families and address their needs in therapy, these practices were inconsistent and, from families' perspectives, insufficient to meet their own needs. Future research should consider family-centered approaches that involve family members in speech-language therapy to enhance their daily lives, along with persons with PD.

scholarly journals Nurses' Perceptions of Their Relationships with Informal Carers in Institutional Respite Care for Older People

2013 ◽  
Vol 2013 ◽  
pp. 1-9 ◽  
Author(s):  
Sirpa Salin ◽  
Marja Kaunonen ◽  
Päivi Åstedt-Kurki
Keyword(s):  
Older People ◽  
Qualitative Interviews ◽  
Family Members ◽  
The Elderly ◽  
Respite Care ◽  
Informal Carer ◽  
Primary Nursing ◽  
Care For The Elderly ◽  
Nurses Perceptions ◽  
At Home

The purpose of this study was to describe nurses' experiences of their collaboration and relationships with family members in institutional respite care for the elderly. The family has a particularly important role in respite care, which is an extension of care provided at home. However no published studies were found on this subject. The data were collected through qualitative interviews (N=22). Content analysis of the nurses’ descriptions of their collaboration with family members yielded four main categories as follows: (1) conscious ignoring, (2) attempting to understand the family’s situation, (3) hinting at private family matters, and (4) being a friend. The results lend support to earlier findings which emphasize the complexity of relationships between nurses and family carers. A novel finding here is that these relationships may also develop into friendships. Greater emphasis must be placed on primary nursing so that the nurse and informal carer can build up a genuine relationship of trust. If periods of respite care are to help older people and their families to manage independently, it is imperative that nurses have the opportunity to visit their patients at home.

The temporal aspects of mobility intentions: older people's reflections on present and future support arrangements

2019 ◽  
pp. 1-21
Author(s):  
Rachel Barken
Keyword(s):  
Older People ◽  
Living Arrangement ◽  
Qualitative Interviews ◽  
Later Life ◽  
Ageing In Place ◽  
The Past ◽  
Interpretive Analysis ◽  
Health And Social Care ◽  
Temporal Aspects ◽  
Time Work

AbstractDiscourses on later-life housing and care are polarised. Ageing in place – typically in one's long-term dwelling – is often presented as the most desirable living arrangement, while moving to a congregate environment tends to be regarded as a last resort. Such polarised discourses obscure older people's experiences as they contemplate needs for housing, health and social care. To expand current understandings of mobility intentions, this paper examines ‘time work’ – or actions undertaken to exert some agency over time – as older people with chronic health conditions and disabilities navigate present and future support arrangements. Based on an interpretive analysis of qualitative interviews with 22 older persons receiving home care in Ontario, Canada, I identify three themes that highlight the temporal aspects of mobility intentions: (a) maintaining continuity with the past and present, (b) constructing alternative futures and (c) facing precarity. Focusing on time work shows how people make sense of ageing in place and/or relocating not only in relation to their physical, social and psychological capacities, but also in relation to perceptions of the past, present and future. Time work, moreover, has implications for feelings of security in the present and a sense of control over the future. Based on these findings, I make suggestions for developing a comprehensive continuum of supports, so all older people can make meaningful choices concerning housing and care.

Management of e-resources in academic libraries in Ghana: Copyright implications

IFLA Journal ◽  
2021 ◽  
pp. 034003522110271
Author(s):  
Theresa L Adu ◽  
Thomas B van der Walt
Keyword(s):  
Distance Education ◽  
Mixed Methods ◽  
Distance Learning ◽  
Academic Libraries ◽  
Online Courses ◽  
Qualitative Interviews ◽  
Digital Resources ◽  
Mixed Methods Approach ◽  
Sequential Mixed Methods ◽  
Library Staff

This study investigated the copyright issues surrounding the management of e-resources in academic libraries in Ghana. Forty-seven library staff and head librarians from four academic libraries were engaged using questionnaires and qualitative interviews in a sequential mixed-methods approach to generate data for this study. The findings indicate that in all four institutions copyright issues arose with the provision of distance learning, online courses and e-reserves services. All the respondents stated that they or their colleagues had had faculty ask questions on copyright issues. However, the professional librarians indicated that the library was not consulted and the instructors for online courses or distance education programmes did not cooperate with librarians; rather, the department posting the materials made the decisions on copyright regarding the usage of digital resources for distance learning, online courses or e-reserves. This does not augur well for the management of copyright of e-resources in academic libraries in Ghana.

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