Aging, care and dependency in multimorbidity: how relationships affect elderly women’s homecare and health service use

Relationships are multidimensional, and we know little about the facets of relationships in the way elderly patients’ with multimorbidity utilise homecare and health services. Gerontology literatures emphasize the importance of place of care, inequalities, availability of health services and affordability. However, the diversity of relationships and associated dependency in elderly care remain underassessed. A qualitative study involving a demographic survey and interviews was conducted to explore relationship experiences of elderly women with multimorbidity in homecare and health services utilization. Civil Surgeon of Sylhet District in Bangladesh was contacted to recruit participants for the study, and this resulted in 33 interviews [11 staff and 22 elderly women with multimorbidity]. Three domains of Axel Honneth’s Theory of Recognition and Misrecognition [i.e. intimate, community and legal relationships] were used to underpin the study findings. Data was analysed using critical thematic discourse method. Four themes were emerged: nature of caregiving involved; intimate affairs [marital marginalization, and parent-children-in law dynamics]; alienation in peer-relationships and neighbourhood [siblings’ overlook, neighbourhood challenges, and gender inequality in interactions]; and legal connections [ignorance of rights, and missed communication]. A marginalization in family relationships, together with poor peer supports and a misrecognition from service providers, resulted in a lack of care for elderly women with multimorbidity. Understanding the complexities of elderly women’s relationships may assist in policy making with better attention to their health and well-being support needs. Staff training on building relationships, and counselling services for family and relatives are essential to improve the quality of care for the women.

Descriptors of living alone for elders: based on Turkey national data

Background The objective of this study is to analyze the data of the 2018 Turkey Demographic and Health Survey and determine personal and demographic factors associated with elderly who are 60 and older and living alone. Methods This cross-sectional study is the secondary analysis of the national data obtained with the 2018 Turkey Demographic and Health Survey. Logistic regression analysis was used to estimate differences in living alone based on gender, age, welfare status, region of residence, urban/rural residence, whether the person is working in a paid job and home ownership. Independent effect of every variable is observed in the first stage and then checked for all variables in the equation. Results There is a total of 37,897 participants’ data in the Turkey Demographic and Health Survey Database. In the study, there are 6244 (16.5%) older adults in 11,056 households and 9.79% of the elderly population is alone. The percentage of elderly women living alone is 13.62% while this percentage is 5.48% for elderly men (p < 0.001). The risk of living alone for elderly women is 2.74 times more than elderly men (95% Cl 2.28–3.31). Being poor increases the risk of living alone for elderly people 2.84 fold compared to being rich (95% Cl 2.17–3.71). Those who have high school and higher education level have 2.38 (95% Cl 1.73–3.29) fold higher risk of living alone than people with lower education. Older adults living in the Western region of the country have 3.18 (95% Cl 2.20–4.59) times higher risk of living alone than older adults living in the Eastern region of the country. The risk of living alone for older adults increases 1.90 fold (95% Cl 1.55–2.32) if the house they live in do not belong to a household member. Conclusion Based on these findings, needs of older adults under risk should be met to allow them to be healthy and live their lives in better social, economic and cultural conditions.

Social Interaction in Public Spaces and Well-Being among Elderly Women: Towards Age-Friendly Urban Environments

The world’s population is aging and becoming more urbanized. Public space in urban areas is vital for improving the health of the elderly by stimulating social interaction. Many urban design projects are advertised as age-friendly but ignore the real needs of the elderly, especially elderly women, for social interaction in urban public spaces. Insufficient attention is paid to the physical and psychological characteristics of elderly women when shaping public space. This analysis addresses the question: What are the qualities of urban spaces which facilitate health-improving social interaction for elderly women? Methods include a case study in Beijing, field investigation, mapping, and qualitative and quantitative analysis. The survey was carried out in April 2021, and concerned 240 women aged 55–75 years. Results indicate that the social interactions of older women relate to both their physical and psychological situations. Public spaces can positively impact the psychological well-being and social participation of elderly women. Conclusions include insights regarding the relationship between social interaction and well-being among elderly women, as well as proposing a series of principles for shaping public spaces for an age-friendly urban environment.

Construction of Progress Prediction Model of Urinary Incontinence in Elderly Women: Protocol for a Multi-Center, Prospective Cohort Study

Background: Urinary incontinence (UI) is a common health problem and seriously affects quality of life. Many women lack understanding of UI or are too ashamed to seek medical advice early, leading to a low treatment rate. The aim of this study is to establish an effective UI progress prediction model for elderly women with UI for earlier detection and better treatment. Methods: This study is conducted as a prospective, multi-center, cohort study, and recruits 800 women aged ≥60 with mild or moderate UI in China. Participants are divided into three groups: stress urinary incontinence group (SUI), urgency urinary incontinence group (UUI), and mixed urinary incontinence group (MUI). This study will investigate the general conditions of patients, after complete relevant pelvic floor function assessment, as well as after follow up at 6 months, 12 months, and 18 months by telephone. The primary endpoint is UI disease progress. Single factor and multi-factor Cox regression model analyses are undertaken to evaluate the associated risk factors affecting the progress of UI to establish a progress prediction model for elderly women. Discussion: This study will provide more predictive information for elderly women with UI, and new clinical references for the intervention and the treatment of UI for medical staff.

Deep Q-networks with web-based survey data for simulating lung cancer intervention prediction and assessment in the elderly: a quantitative study

Background Lung cancer screening and intervention might be important to help detect lung cancer early and reduce the mortality, but little was known about lung cancer intervention strategy associated with intervention effect for preventing lung cancer. We employed Deep Q-Networks (DQN) to respond to this gap. The aim was to quantitatively predict lung cancer optimal intervention strategy and assess intervention effect in aged 65 years and older (the elderly). Methods We screened lung cancer high risk with web-based survey data and conducted simulative intervention. DQN models were developed to predict optimal intervention strategies to prevent lung cancer in elderly men and elderly women separately. We assessed the intervention effects to evaluate the optimal intervention strategy. Results Proposed DQN models quantitatively predicted and assessed lung cancer intervention. DQN models performed well in five stratified groups (elderly men, elderly women, men, women and the whole population). Stopping smoking and extending quitting smoking time were optimal intervention strategies in elderly men. Extending quitting time and reducing smoked cigarettes number were optimal intervention strategies in elderly women. In elderly men and women, the maximal reductions of lung cancer incidence were 31.81% and 24.62% separately. Lung cancer incidence trend was deduced from the year of 1984 to 2050, which predicted that the difference of lung cancer incidence between elderly men and women might be significantly decreased after thirty years quitting time. Conclusions We quantitatively predicted optimal intervention strategy and assessed lung cancer intervention effect in the elderly through DQN models. Those might improve intervention effects and reasonably prevent lung cancer.