Fictive Carers Perceptions of the Impact of Outcome-Focused Homecare with Older People Living Alone

Information support robots (ISRs) have the potential to assist older people living alone to have an independent life. However, the effects of ISRs on the daily activity, especially the sleep patterns, of older people have not been clarified; moreover, it is unclear whether the effects of ISRs depend on the levels of cognitive function. To investigate these effects, we introduced an ISR into the actual living environment and then quantified induced changes according to the levels of cognitive function. Older people who maintained their cognitive function demonstrated the following behavioral changes after using the ISR: faster wake-up times, reduced sleep duration, and increased amount of activity in the daytime (p < 0.05, r = 0.77; p < 0.05, r = 0.89, and p < 0.1, r = 0.70, respectively). The results suggest that the ISR is beneficial in supporting the independence of older people living alone since living alone is associated with disturbed sleep patterns and low physical activity. The impact of the ISR on daily activity was more remarkable in the subjects with high cognitive function than in those with low cognitive function. These findings suggest that cognitive function is useful information in the ISR adaptation process. The present study has more solid external validity than that of a controlled environment study since it was done in a personal residential space.

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The impact of adult mortality on the living arrangements of older people in rural South Africa

Ageing and Society ◽

10.1017/s0144686x0500365x ◽

2005 ◽

Vol 25 (6) ◽

pp. 431-444 ◽

Cited By ~ 21

Author(s):

VICTORIA HOSEGOOD ◽

IAN M. TIMÆUS

Keyword(s):

South Africa ◽

Older People ◽

Living Arrangements ◽

Adult Mortality ◽

Living Alone ◽

Rural South ◽

Kwazulu Natal ◽

The Impact ◽

Quality Infrastructure ◽

Rural South Africa

This paper examines changes in households with older people in a northern rural area of KwaZulu Natal province, South Africa, between January 2000 and January 2002. The focus is the impact of adult deaths, especially those from AIDS, on the living arrangements of older people. The longitudinal data are from the Africa Centre Demographic Information System. In 2000, 3,657 older people (women aged 60 years or older, men 65 years or older) were resident in the area, and 3,124 households had at least one older member. The majority (87%) of older people lived in three-generation households. Households with older people were significantly poorer, more likely to be headed by a woman, and in homesteads with poorer quality infrastructure than households without older members. By January 2002, 316 (8%) of the older people in the sample had died. Of all the households with an older person, 12 per cent experienced at least one adult death from AIDS. The paper shows that older people, particularly those living alone or with children in the absence of other adults, were living in the poorest households. They were also coping with an increasing burden of young adult deaths, the majority of which were attributable to AIDS.

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Shutting Down Sex

Anthropology in Action ◽

10.3167/aia.2020.270302 ◽

2020 ◽

Vol 27 (3) ◽

pp. 9-13

Author(s):

Lara McKenzie

Keyword(s):

Older People ◽

Social Life ◽

Living Alone ◽

Global Context ◽

Global North ◽

The Impact

This article examines the transformation of singledom during the COVID-19 pandemic, scrutinising the impact of rules and regulations governing proximity, touch and sex. I focus on government responses in Australia, situating the nation’s experience in a global context. National discussions were strangely sexless, presuming widespread coupledom and emphasising the lost, non-sexual intimacies of families and older people. I contrast this to broader theoretical claims of a ‘transformation of intimacy’ that posit a move to atomised relations across the Global North, including a growing tendency towards singledom. Yet assumptions of coupledom clearly persist in Australian policy and social life. I reflect on transformations of singledom and living alone during and prior to the pandemic, exposing tensions between theorisations, local realities, and the governance of sex and singledom.

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PP12 An evaluation of the role of SCAS in the attendance to call-outs and the transport to hospital of older people with dementia

Emergency Medicine Journal ◽

10.1136/emermed-2019-999abs.12 ◽

2019 ◽

Vol 36 (10) ◽

pp. e6.2-e6

Author(s):

Chloe Lofthouse-Jones ◽

Helen Pocock ◽

Phil King ◽

Patryk Jadzinski ◽

Ed England ◽

...

Keyword(s):

Older People ◽

Social Care ◽

Research Literature ◽

Living Alone ◽

Electronic Records ◽

Care Provision ◽

Out Of Hours ◽

People With Dementia ◽

Care Package ◽

The Impact

BackgroundOur previous work has shown that 35% of ambulance attendances by SCAS are to people aged 75 and over; 17% of these have dementia. The research literature suggests that older people with cognitive impairment/dementia experience longer stays, or die, in hospital. It is unclear whether factors such as call time or availability of social care impact conveyance rates. The aim of this study was to explore the impact of out-of-hours call-outs and social care provision on ambulance conveyance rates for people aged ≥75 years, including patients with dementia.MethodsFor this service evaluation, electronic records for patients aged ≥75 years attended by SCAS were extracted over one year. The proportion of conveyed patients according to a dementia record, out-of-hours call, time of year, triage grade, social care provision and indices of deprivation were calculated. Univariate and multivariate analyses identified factors which may influence conveyance.ResultsA total of 111,548 electronic records were included, 16.5% with dementia. 63.7% of calls resulted in conveyance (59.1% with dementia). Conveyances reduced in out-of-hours periods for all patients. 13.6% more patients living alone and 16.5% more patients living with family were conveyed to hospital if there was no care package in place. Adjusted for other factors, having a care package reduced the risk of conveyance in older people living alone by 36% (Odds ratio 0.64, 95% Confidence interval 0.62–0.67).ConclusionsAvailability of social care and time of call appear to be important determinants of conveyance in older people, both in those with and without dementia. More research is needed to improve needs assessments and local referral services and pathways.

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Under reconstruction: the impact of COVID-19 policies on the lives and support networks of older people living alone

International Journal of Care and Caring ◽

10.1332/239788221x16308602886127 ◽

2022 ◽

Author(s):

Johanna Pfabigan ◽

Paulina Wosko ◽

Barbara Pichler ◽

Elisabeth Reitinger ◽

Sabine Pleschberger

Keyword(s):

Older People ◽

Everyday Life ◽

Support Networks ◽

Living Alone ◽

Telephone Interviews ◽

The Impact

In the spring of 2020, the Austrian government introduced COVID-19 containment policies that had various impacts on older people living alone and their care arrangements. Seven qualitative telephone interviews with older people living alone were conducted to explore how they were affected by these policies. The findings show that the management of everyday life and support was challenging for older people living alone, even though they did not perceive the pandemic as a threat. To better address the needs of older people living alone, it would be important to actively negotiate single measures in the area of conflict between protection, safety and assurance of autonomy.

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Familial perceptions of the impact of outcome-focused homecare with older people experiencing dementia and living alone

Working with Older People ◽

10.1108/wwop-12-2013-0031 ◽

2014 ◽

Vol 18 (2) ◽

pp. 90-96 ◽

Cited By ~ 5

Author(s):

Stephen Gethin-Jones

Keyword(s):

Older People ◽

Intervention Strategy ◽

Well Being ◽

Living Alone ◽

Subjective Well Being ◽

Structured Interviews ◽

Content Type ◽

People With Dementia ◽

Potential Alternative ◽

The Impact

Purpose – The purpose of this paper is to discuss whether the use of outcome-focused homecare improves the subjective well-being of the familial carers of older people with dementia. It also discusses familial carers’ perception of whether this intervention has improved the well-being of their relative. Design/methodology/approach – This qualitative study followed the familial carers of 20 service users suffering from dementia over a six-month period. Semi-structured interviews were undertaken at three intervals during the six months. The carers were asked to assess their subjective well-being at the start, middle and end of the study. Findings – The key findings were that all 20 familial carers expressed an improvement in their subjective well-being and that of their older family member, who appeared more settled as a result of this model of care. Practical implications – The need to consider the use of outcome-focused care as an intervention strategy for older people living alone in the community. The need to provide supportive environments for the carers of older people with dementia to limit their sense of isolation. The prioritising of outcome-focused care in the most complex and chaotic cases. Originality/value – This study provides an insight into the effectiveness of outcome-focused homecare with older people experiencing dementia as perceived by their familial carers. Previously, research has established that outcome-focused care increased the subjective well-being of non-dementia sufferers. This study dovetails neatly with this in demonstrating the same effect on dementia sufferers as perceived by their familial carers. Additionally, this study also demonstrated that this model of outcome-focused care also improved the subjective well-being of the familial carers themselves. These finding will help practitioners consider the use of this model of homecare as a potential alternative or a delaying strategy to residential care.

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The Impact of Intersectional Identities on Older People With HIV

Innovation in Aging ◽

10.1093/geroni/igaa057.2560 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 723-723

Author(s):

Mark Brennan-Ing ◽

Charles Emlet

Keyword(s):

Older People ◽

African American Women ◽

Well Being ◽

Hiv Stigma ◽

Neurocognitive Functioning ◽

Bisexual Men ◽

And Bisexual ◽

And Gender ◽

The Impact ◽

Racial Ethnic

Abstract Kimberlé Crenshaw introduced the term “intersectionality” in the late 1980s to highlight the experience discrimination and marginalization of Black and African-American women originating from the confluence of their racial/ethnic and gender identities. Since that time the focus on intersectionality has broadened to consider other communities and individuals who may have multiple stigmatized and discredited identities, including older people with HIV (PWH). For example, Porter and Brennan-Ing described the “Five Corners” model as the intersection of ageism, racism, classism, sexism, and HIV stigma for older transgender and gender non-conforming PWH. HIV disproportionately affects marginalized communities (e.g., racial/ethnic and sexual minorities). Thus, for older PWH it is important to consider how HIV stigma may intersect with other marginalized identities and impact physical and psychological well-being. The first paper in this session examines how the intersection of HIV serostatus, gay identity, and age complicates identity disclosure, leading to social isolation and interference with care planning. The second paper describes how intersectional identities among older PWH interfere with access to mental health services in a population that is disproportionately affected by depression and PTSD. Our third paper examines the role of race, education, and behavioral health in neurocognitive functioning among a diverse sample of older HIV+ gay and bisexual men. Our last paper examines neurocognitive functioning among older Latinx PWH, finding that sexual and gender minorities were at greater risk for impairment. Implications of these findings for research and programming that accounts for the effects of intersectionality among older PWH will be discussed.

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Understanding the Link between Family Caregiver Quality of Life and the Care Provided to Older People With Dementia

Innovation in Aging ◽

10.1093/geroni/igaa057.500 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 153-154

Author(s):

Afeez Hazzan

Keyword(s):

Quality Of Life ◽

Quality Of Care ◽

Older People ◽

Family Caregivers ◽

Family Caregiver ◽

Well Being ◽

The United States ◽

People With Dementia ◽

The Impact

Abstract Dementia is one of the most rapidly growing diseases in the United States. In 2018, the direct costs to American society of caring for older people with dementia was approximately $277 billion. Primary informal caregivers are mainly responsible for the care of older people with dementia including Alzheimer’s disease. Caregivers perform a myriad of duties ranging from shopping for their loved ones’ groceries, helping with medications, and managing finances. The caregiving role becomes more demanding as the disease progresses over time, and studies have shown that the quality-of-life (QoL) experienced by caregivers of older adults who have dementia is lower than the QoL of caregivers for older people who do not have dementia. To the best of our knowledge, there has been no research conducted to investigate whether lower caregiver QoL affects the level or quality of care that caregivers provide to persons with dementia. In the current study, we interviewed family caregivers living in Rochester, New York to inquire about their quality of life and the care provided to older people living with dementia. Further, caregivers completed the 36-item Short Form Health Survey (SF-36) as well as a draft questionnaire for measuring the quality of care provided to older people living with dementia. Both quantitative and qualitative findings from this study reveals important relationships between family caregiver QoL and the care provided, including the impact of social support and financial well-being. The study findings could have significant impact, particularly for the provision of much needed support for family caregivers.

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The impact of living arrangements and intergenerational support on the health status of older people in China: are rural residents disadvantaged compared to urban residents?

Ageing and Society ◽

10.1017/s0144686x21000702 ◽

2021 ◽

pp. 1-26

Author(s):

Yazhen Yang ◽

Maria Evandrou ◽

Athina Vlachantoni

Keyword(s):

Life Satisfaction ◽

Older People ◽

Adult Children ◽

Rural Areas ◽

Living Arrangements ◽

Psychological Wellbeing ◽

Urban Residents ◽

Intergenerational Support ◽

Rural Residents ◽

The Impact

Abstract Research to-date has examined the impact of intergenerational support in terms of isolated types of support, or at one point in time, failing to provide strong evidence of the complex effect of support on older persons’ wellbeing. Using the Harmonised China Health and Retirement Longitudinal Study (2011, 2013 and 2015), this paper investigates the impact of older people's living arrangements and intergenerational support provision/receipt on their physical and psychological wellbeing, focusing on rural–urban differences. The results show that receiving economic support from one's adult children was a stronger predictor for higher life satisfaction among rural residents compared to urban residents, while grandchild care provision was an important determinant for poor life satisfaction only for urban residents. Having weekly in-person and distant contact with one's adult children reduced the risk of depression in both rural and urban residents. Older women were more likely than men to receive support and to have contact with adult children, but also to report poor functional status and depression. The paper shows that it is important to improve the level of public economic transfers and public social care towards vulnerable older people in rural areas, and more emphasis should be placed on improving the psychological wellbeing of urban older residents, such as with the early diagnosis of depression.

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Impact of an integrated community-based model of care for older people with complex conditions on hospital emergency presentations and admissions: a step-wedged cluster randomized trial

BMC Health Services Research ◽

10.1186/s12913-021-06668-x ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Jennifer Mann ◽

Fintan Thompson ◽

Robyn McDermott ◽

A. Esterman ◽

Edward Strivens

Keyword(s):

Older People ◽

Older Persons ◽

Hospital Admissions ◽

Community Dwelling ◽

Trial Registration ◽

Significant Finding ◽

Complex Needs ◽

Primary Practice ◽

The Impact ◽

Open Arch

Abstract Background Health systems must reorient towards preventative and co-ordinated care to reduce hospital demand and achieve positive and fiscally responsible outcomes for older persons with complex needs. Integrated care models can improve outcomes by aligning primary practice with the specialist health and social services required to manage complex needs. This paper describes the impact of a community-facing program that integrates care at the primary-secondary interface on the rate of Emergency Department (ED) presentation and hospital admissions among older people with complex needs. Methods The Older Persons Enablement and Rehabilitation for Complex Health Conditions (OPEN ARCH) study is a multicentre randomised controlled trial with a stepped wedge cluster design. General practitioners (GPs; n = 14) in primary practice within the Cairns region are considered ‘clusters’ each comprising a mixed number of participants. 80 community-dwelling persons over 70 years of age if non-Indigenous and over 50 years of age if Indigenous were included at baseline with no new participants added during the study. Clusters were randomly assigned to one of three steps that represent the time at which they would commence the OPEN ARCH intervention, and the subsequent intervention duration (3, 6, or 9 months). Each participant was its own control. GPs and participants were not blinded. The primary outcomes were ED presentations and hospital admissions. Data were collected from Queensland Health Casemix data and analysed with multilevel mixed-effects Poisson regression modelling to estimate the effectiveness of the OPEN ARCH intervention. Data were analysed at the cluster and participant levels. Results Five clusters were randomised to steps 1 and 2, and 4 clusters randomised to step 3. All clusters (n = 14) completed the trial accounting for 80 participants. An effect size of 9% in service use (95% CI) was expected. The OPEN ARCH intervention was found to not make a statistically significant difference to ED presentations or admissions. However, a stabilising of ED presentations and a trend toward lower hospitalisation rates over time was observed. Conclusions While this study detected no statistically significant change in ED presentations or hospital admissions, a plateauing of ED presentation and admission rates is a clinically significant finding for older persons with complex needs. Multi-sectoral integrated programs of care require an adequate preparation period and sufficient duration of intervention for effectiveness to be measured. Trial registration The OPEN ARCH study received ethical approval from the Far North Queensland Human Research Ethics Committee, HREC/17/QCH/104–1174 and is registered on the Australian and New Zealand Trials Registry, ACTRN12617000198325p.

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