Redesigning Health Care for an Older America

With the goal of creating a new vision of health care for an older America, the International Longevity Center assembled a Health Care Task Force, a cadre of specialists in the fields of economics, social work, political science, and medicine. Its mandate is to focus on the development of an intergenerational life-span perspective of disease prevention and health maintenance, built on a strong foundation of structural reform medical care, by showing how strategies that enhance healthy aging can save money as well as improve quality of life. Midway into this ambitious four-year project, and with the hope of contributing to the national debate on health care, the Task Force established a list of guiding principles, with the belief that the longevity and healthy aging of today's older adults, the aging baby boomer generation and the generations that will follow, depend upon the health care decisions that are made today

From positive youth development to youth’s engagement : the dream teens

In addition to the empirical validation of ‘health and happiness’ determinants, theoretical models suggesting where to ground actions are necessary. In the beginning of the twentieth century, intervention models focused on evaluation and empirical validation were only concerned about overt behaviours (verbal and non-verbal) and covert behaviours (cognitions and emotions). Later on in the middle of the century, there was a shift from treating the problems to a positive approach, focused on promoting assets and individual strengths. Thus, the role of social competences, self-regulation and resilience became salient. Researchers also highlighted the importance of social cohesion and social support, as active health and wellbeing facilitators. More recently, in the twentyfirst century, the population’s engagement (positive engagement) has become crucial. This paper presents the evolution of this theoretical and scientific path, using Portugal as a case study, where early interventions focused on the positive aspects of both covert and overt behaviours, while more recent interventions included explicitly the perspective of youth engagement and participation, as is the case of the Dream Teens Project. It is expected that the political and professional understanding of this trajectory will allow professionals to provide better health and educational services, improving young people’s engagement, quality of life, health and wellbeingpeer-reviewe

Towards Age-Friendly Work in Europe: A Life-Course Perspective on Work and Ageing from EU Agencies

[Excerpt] The European population is ageing owing to decreasing birth rates and increasing longevity. Population ageing is associated with a decrease in the size and ageing of the workforce. The majority of the EU Member States have reacted to this development by, among other measures, increasing retirement ages and limiting early access to pensions. Nevertheless, a large percentage of workers in the EU do not stay in employment until the official retirement age. The reasons for this are diverse, and will be examined in more detail in this report. Policy-makers are faced with the challenge of addressing this demographic change and its implications for employment, working conditions, living standards and the sustainability of welfare states. The working conditions of older workers and their participation in the labour market are affected by various policy areas (see also Table 1). This report aims to outline various aspects of the working conditions of the ageing workforce and related policies

Credibility of Health Information and Digital Media: New Perspectives and Implications for Youth

Part of the Volume on Digital Media, Youth, and Credibility. This chapter considers the role of Web technologies on the availability and consumption of health information. It argues that young people are largely unfamiliar with trusted health sources online, making credibility particularly germane when considering this type of information. The author suggests that networked digital media allow for humans and technologies act as "apomediaries" that can be used to steer consumers to high quality health information, thereby empowering health information seekers of all ages

Exercise-based interventions to enhance long-term sustainability of physical activity in older adults: a systematic review and meta-analysis of randomized clinical trials

Older adults; Physical activity; AdherenceAdultos mayores; Actividad física; AdherenciaAdults majors; Activitat física; AdherènciaExercise is a form of physical activity (PA). PA is an important marker of health and quality of life in older adults. The purpose of this study was to conduct a systematic review of the literature to assess the effect of exercise-based interventions on an at least six-month follow up PA measure, and to describe the specific strategies implemented during the intervention to strengthen the sustainability of PA in community-dwelling 65+ year-old adults. We registered and conducted a systematic review and meta-analysis (PROSPERO: CRD42017070892) of randomized clinical trials (RCT). We searched three electronic databases during January 2018 to identify RCT assessing any type of exercise-based intervention. Studies had to report a pre-, post-, and at least 6-month post-intervention follow-up. To be included, at least one PA outcome had to be assessed. The effect of exercise-based interventions was assessed compared to active (e.g., a low-intensity type of exercise, such as stretching or toning activities) and non-active (e.g., usual care) control interventions at several time points. Secondary analyses were conducted, restricted to studies that reported specific strategies to enhance the sustainability of PA. The intervention effect was measured on self-reported and objective measures of time spent in PA, by means of standardized mean differences. Standardized mean differences of PA level were pooled. Pooled estimates of effect were computed with the DerSimonian–Laird method, applying a random effects model. The risk of bias was also assessed. We included 12 studies, comparing 18 exercise intervention groups to four active and nine non-active control groups. Nine studies reported specific strategies to enhance the long-term sustainability of PA. The strategies were mostly related to the self-efficacy, self-control, and behavior capability principles based on the social cognitive theory. Exercise interventions compared to active control showed inconclusive and heterogeneous results. When compared to non-active control, exercise interventions improved PA time at the six-months follow up (standardized mean difference (SMD) 0.30; 95%CI 0.15 to 0.44; four studies; 724 participants; I2 0%), but not at the one- or two-years follow-ups. No data were available on the mid- and long-term effect of adding strategies to enhance the sustainability of PA. Exercise interventions have small clinical benefits on PA levels in community-dwelling older adults, with a decline in the observed improvement after six months of the intervention cessation.The present study was funded by United States Department of Health & Human Services National Institutes of Health (NIH), USA, and NIH National Institute on Aging (NIA), USA, (K24 AG057728)

Older people maintaining mental health well-being through resilience : an appreciative inquiry study in four countries

Aim. To explore the experience and strategies of mental health well-being through resilience in older people across the four participating countries. Background. While there is increasing evidence of the way older people maintain physical well-being, there has not been the same emphasis when examining the ways in which older people enhance their resilience and so promote mental health well-being. Design. An Appreciative Inquiry approach was used. Method. A convenience sample of 58 people over the age of 65 years from Australia, UK, Germany, and South Africa were interviewed. Data were analysed using thematic analysis. Results. Participants described their experiences of mental health well-being in relation to: social isolation and loneliness; social worth; self-determination; and security. Strategies utilised include promoting resilience by maintaining community connections and relationships, keeping active, and emotional, practical and spiritual coping. Conclusion. The findings highlight the importance of maintaining mental health well-being through resilience. Although there were some variations between countries, these strategies for maintaining well-being transcended culture and nation. Relevance to clinical practice. Listening to older people through research such as the current study will help to determine what help is needed and how healthcare and policy makers can assist

Healthy ageing and home: The perspectives of very old people in five European countries

This paper reports on in-depth research, using a grounded theory approach, to examine the ways in which very old people perceive healthy ageing in the context of living alone at home within urban settings in five European countries. This qualitative study was part of a cross-national project entitled ENABLE-AGE which examined the relationship between home and healthy ageing. Interviews explored the notion of healthy ageing, the meaning and importance of home, conceptualisations of independence and autonomy and links between healthy ageing and home. Data analysis identified five ways in which older people constructed healthy ageing: home and keeping active; managing lifestyles, health and illness; balancing social life; and balancing material and financial circumstances. Older people reflected on their everyday lives at home in terms of being engaged in purposeful, meaningful action and evaluated healthy ageing in relation to the symbolic and practical affordances of the home, contextualised within constructions of their national context. The research suggests that older people perceive healthy ageing as an active achievement, created through individual, personal effort and supported through social ties despite the health, financial and social decline associated with growing older. The physicality and spatiality of home provided the context for establishing and evaluating the notion of healthy ageing, whilst the experienced relationship between home, life history and identity created a meaningful space within which healthy ageing was negotiated