The lived experience of patients suffering from stroke and their perception of palliative care needs: a literature review

Purpose This study aims to review the lived experience of patients suffering from stroke and describe their perception of palliative care needs. Design/methodology/approach A literature review search was conducted. Web of Sciences, SAGE, CINAHL, PubMed and Jordanian Database for Nursing Research databases were used to search the literature. Findings The findings of 37 articles were address palliative care approaches for patients with stroke, lived experiences of patients suffering from stroke and the experience, barriers and facilitators related to health-care service for stroke survivors. Originality/value This review indicated the importance of recognizing palliative care needs among patients suffering from stroke to improve post-stroke recovery. This study recommends further research, especially in low- and middle-income countries, to understand patients’ experiences and recognize the main palliative care needs that can be incorporated into interventions designed to improve the quality of life among them.

Risk factors for depression in older adults in Bogotá, Colombia

Purpose This paper aims to identify psychosocial, demographic and health risk factors associated with depression in older people. Design/methodology/approach A correlational study with 281 independent and autonomous persons of the community over 60 years old from Bogotá was conducted. The three instruments used to measure the variables included in the data analyses were Demographic and Health Data Questionnaire, Short version of 15 items of Geriatric Depression Scale (GDS) and Montreal Cognitive Assessment Test (MoCA). Findings Fifteen percent of the participants presented depression. Depression was associated with different demographic, low social support and health factors in this population group and was particularly high in women. Being a woman with poor social support networks and a previous history of depressive episodes should be considered as determining factors within a clinical risk profile for depression in older adulthood. It is essential to design prevention strategies focused on women and on the development of better social support in old age. Originality/value Depression is a prevalent and highly disabling disease, when it is suffered by an older person it is associated with higher mortality, functional dependence, poor physical health, worse quality of life indicators and psychological well-being. In the elderly, the clinical diagnosis of depression is difficult, as it has a high comorbidity and is often confused with other health conditions prevalent during older adulthood.

What do knee OA patients perceive about their disorder? A qualitative study

Purpose The purpose of this study was to explore patient’s perception of their disorder. Design/methodology/approach This study used a phenomenographical approach within a qualitative research paradigm. A total of 21 patients with knee osteoarthritis (OA) were recruited for the study, and data were collected through open-ended face-to-face interviews. The interviews were transcribed and thematically analyzed. The transcribed verbatim was analyzed for themes. Findings The themes developed reflected the patients’ perceptions about the disease process. Thematic analysis revealed three themes: Knee OA is a degenerative disease, Knee OA is an age-related disease and Knee OA is caused by certain activities of daily living. The patient’s information varied and was limited to what had been provided by the health-care practitioner. The knowledge was more biomedical in orientation and was limited and not supported by the evidence. Research limitations/implications There is a need to provide evidence-based information that the patient must understand. Health-care providers must use a biopsychosocial framework to discuss the disease knowledge with patients. Practical implications This study helps us in identifying disease perceptions that can be used to design education programs for knee OA patients. It also highlights the need for delivering educational programs to knee OA patients. Originality/value This study lays a foundation for further research. To the author’s best knowledge, this is the first study to explore disease perceptions using a qualitative approach conducted among patients from a lower middle-income country.

Elderly smallholder farmers’ perceptions of and adaptation to climate variability and change in rural Ghana

Purpose This paper aims to examine elderly smallholder farmers’ perceptions of and adaptation to climate variability and change in the Offinso Municipality, Ghana. Design/methodology/approach This paper used quantitative and qualitative methods. Quantitative data were analyzed with frequencies and chi-square tests, whereas qualitative data were thematically analyzed. Findings The results showed that elderly smallholder farmers’ knowledge of climate variability and climate change were based on their sex, level of formal education and experience in farming. Elderly smallholder farmers adopted both on-farm and off-farm strategies to cope with climate change and variability. The vulnerability of elderly smallholder farmers to climate change calls for social protection mechanisms such as a pension scheme that guarantees access to monthly cash transfers. Such a scheme will ease constraints to livelihood and ensure improved well-being. Originality/value Elderly smallholder farmers have remained invisible in discourses on perceptions and adaptation to climate change despite the surge in number of this category of farmers. This paper therefore represents an attempt to highlight the experiences of elderly smallholder farmers with climate variability and change.

Designing inclusive environments for people living with dementia: how much do we really know?

Purpose Recent years have seen a growing interest in and awareness of the importance of environmental design to the well-being of people living with dementia, in terms of both policy and practice. This trend has been accompanied by a plethora of advice, guidance and tools that aim to encourage and promote the development of inclusive environments. Not all of these are evidence-based, and even those that claim to be so are limited by a paucity of good quality, comprehensive research studies. This paper aims to consider the current state of knowledge in the field of dementia-friendly design and describes a project that refreshed and updated the suite of Environmental Assessment Tools originally developed by The Kings Fund and now managed by the Association for Dementia Studies. Design/methodology/approach The mixed methods project reported on in this paper comprised a review of the literature, a survey of people who have used the five design assessment tools and an iterative process of updating the tools to make them as evidence-based and user-friendly as possible. Findings The suite of five assessment tools was refreshed and updated to reflect the latest evidence and the views of professionals and others who use the tools. The authors conclude that while a focus on dementia-friendly design is to be welcomed, there remains a need for relevant high-quality evidence to inform such work. In particular, there is a lack of research within people’s own homes and studies that include the perspectives of people living with dementia. Originality/value Few assessment tools and guidelines for dementia-friendly environments are truly evidence-based. This paper reports on a project that combined a comprehensive literature review with the views of practitioners to update a widely used suite of tools that aim to make a range of settings more suitable for people living with dementia.

Nature-based activities for people living with dementia: A nice day out or a matter of human rights?

Purpose There is growing interest in and evidence for the benefits of connecting with nature for people living with dementia, sometimes known as “green care”, including reduced stress, improved sleeping and even enhanced cognition. However, many people living with dementia are denied such opportunities, often because of practitioner perceptions of risk and poor design of outdoor spaces. This paper reports on the evaluation of a project that worked with national providers to give people living with dementia opportunities and support to access the natural environment. Design/methodology/approach The evaluation adopted a mixed-methods approach, using a combination of bespoke and commonly used tools and in-depth case study work to identify the facilitators and challenges to delivering the project and explore the experiences of activity participants. Findings Qualitative measures indicated a significant improvement in mental well-being for participants with dementia and family carers following attendance at activity sessions. Research interviews indicated that participants enjoyed activities based on connecting with nature. Being outdoors was a major factor in the experience, along with taking part in activities that were meaningful and opportunities for social interaction. Originality/value This paper provides evidence for the benefits of connecting with nature for people living with dementia. This paper concludes that access to the outdoors is not a luxury, it is a basic human right and one which has become increasingly important in light of restrictions that have emerged as a result of the COVID19 pandemic.

Female spouses lived experiences of living with a husband with dementia: a qualitative study on changes in everyday life

Purpose The purpose of this study is to gain a deeper understanding of female spouses’ lived experiences of changes in everyday life while living with a husband with dementia. Design/methodology/approach Nine individual interviews of female spouses were conducted in 2017. A phenomenological narrative approach was applied during data collection, and the analysis was inspired by Amedeo Giorgi’s analytic steps. Findings Female spouses experienced changes in their marital relationships, and found ways of managing these changes, although they realized life was marked by loneliness and distress. The identified themes reveal how female spouses experienced changes in everyday life as the disease progressed. Everyday routines gradually changed and they actively sought ways to uphold everyday life and a marital relationship. Research limitations/implications Research should focus on developing supportive interventions, where the people with the lived experiences in relation to dementia are involved in the research process, to better target the needs for support, when developing interventions. Practical implications Insight into everyday life can help health-care service providers to better the support to female spouses and contribute with more individualized support, which may contribute to the quality of care. Originality/value In this study, the authors disclose the envisible and silent work that takes place in an everyday life, when living with a husband with dementia during the time span of caregiving. Spouses’ experiences are important to include, when developing intervention to support spouses to better tailor the interventions.

Assets-based approaches to developing age friendly communities: learning from the bristol ageing better programme

Purpose International attention is increasingly turning to the challenge of creating age-friendly environments. This study aims to examine the application of asset-based approaches in undertaking community development projects with older people. The paper intends to share the learning that may be useful when designing community development projects for older people in the future. Design/methodology/approach This study followed a multiple project case study design, with a focus on project delivery practices. It was undertaken as a co-production exercise involving university researchers and trained older volunteer community researchers (CRs). Over 18–24 months of qualitative research was conducted in relation to six area-based urban projects between 2018 and 2020. Findings There were five leading themes as follows: mapping and building on assets in highly localised settings; creating governance and direction through steering groups; developing activities with diverse groups of older people; reaching isolated and lonely older people; building local capacity to embed sustainability. Practical implications The effectiveness of assets-based approaches in promoting age-friendly agendas appears to be contingent on the values, skills, capacity and resourcing of delivery agencies, alongside wider public sector investment in communities. Diversity and inequalities amongst older people need to be taken into account and community development that specifically focuses on older people needs to be balanced with the whole population and intergenerational practice. Originality/value This paper provides an empirical account of the practical application of assets practices specifically in the context of the age-friendly community agenda. The co-production method brings together insights from academic and volunteer older CRs.

Dispossessed, without place and face. The plight of elders

Purpose Have we grown closer and closer apart? Imagine the plight of our elders. Their history is linked with their geography, where they lived, loved and labored. The purpose of this paper is to explore how, though they have earned their “place” in the world, a world now under the hegemony of accelerated time and blurring of distance, many of them feel displaced, “unseen” and irrelevant. Design/methodology/approach The paper’s methodology is in narrative structure, at times referring to contemporary philosophical and art sources. The author’s commentary addresses this loss of place and face for today’s elders within the context of our failure, in the USA and much of the West, to construct a consistent, coherent philosophy of life stages. Put simply, the thoroughly pragmatic and future-driven culture of youth and productivity assigns no intrinsic value to getting old. Findings Place unfolds in particularities – my place, our home, etc. – and is critically distinct from space. As we squeeze together time and space through worldviews and technologies, we have erased the importance of place. This poses unique problems for elders for whom place, in particular home, carries special meaning involving time and relationships. Originality/value For elders, in particular, meaning comes through lived, embodied experiences. The author argued that our embodied encounters enable moral meaningfulness, and that it is the face which is the centerpiece of such engagement. Face reveals a moral invitation to authentic person-to-person communication. And in light of this communication, understanding the importance of place and need for face-to-face interaction helps to ground us in our conversations with elders. With our seniors, for whom the greatest gift is our time and attention, it is not only what we say, but how we are with them, through our presence, that matters.