Aging in the Social Space

A publication called Aging in the Social Space is a compilation of studies, which deal with theoretical understanding and empirical solutions, learning about problem spheres, specifying content parallels of social, legal, economic, moral and ethical views on senior issues in society, which are closely related to each other and are interconnected. This publication focus on the case study of Poland. It is supposed to provide a multidimensional view of old age issues and issues related to aging and care for old people in society. We believe that it is natural also to name individual spheres, in which society has some eff ect, either direct or indirect, within issues concerning seniors. Learning about these spheres is the primary prerequisite for successful use of social help to seniors in society

Dissertation: Examining and investigating home modifications and smart home technologies to reduce fall injury among older adults.

Nearly one in six U.S. residents are over the age of 65. The proportion of older adults in the U.S. is anticipated to grow to 22.1% of the total population by 2050. The cost of treating age related conditions and injuries is expensive, government programs including Medicaid paid over $550 Billion in 2017, and makes up between 14-16% of the federal budget each year. With the high cost of treating age related conditions and injuries, and the proportion of older adults continuing to increase every year, it is imperative that researchers and government entities find and invest in preventative measures in order to reduce injury and related healthcare costs. Among the many age-related injuries older adults suffer, falls are arguably the most important to address. It is estimated that one in three older adults has a fall every year. In 2016, falls were the seventh leading cause of death among older adults. Approximately one third of all fallers require medical attention after experiencing a fall. Over 800,000 older adults are hospitalized each year due to fall related injuries. Injuries sustained as a result of a serious fall include various fractures, traumatic brain injuries, and other cuts and bruises.Home modifications, and more recently smart home technologies, can help increase the safety of older adults living in the community. With older adults wanting to “age in place”, installing these modifications and technologies before an accident happens may lower rates of injury. Today, dozens of companies sell various smart home devices for the consumer market. Bud despite the high demand for these technologies by the American consumer, the ability of these devices to keep older adults safe, and how older adults value these technologies, remains uncertain. These home technologies may be particularly beneficial to older adults living in rural areas due to the increased isolation and limited access to healthcare resources. Previous research indicates rural populations have a greater proportion of older adults compared to urban areas, yet lack the infrastructure to provide specialty care to this population. It is estimated that more than 60 million family members provide some sort of informal care to an older adult relative. Of all of these family members, nearly 40% report spending 20 or more hours a week providing this unpaid care. Previous research has failed to examine how these family members feel about home modifications and technologies for their older adult relative. Finding ways to ease the burden of caring for older family members will significantly better the situations of many family relatives.This dissertation aims to cover three areas. 1. Identify people at risk of suffering subsequent fall injuries. Find the average time between an initial fall injury and a subsequent fall injury, and find average time between an initial fall injury and death.2. Examine the preferences of older adults living in a rural area towards various smart home technologies and home modifications.3. Examine the preferences of family members of older adults regarding smart home technologies and home modifications

Comparing palliative care in care homes across Europe (PACE) : protocol of a cross-sectional study of deceased residents in 6 EU countries

Objectives: Although a growing number of older people are dying in care homes, palliative care has developed in these settings only recently. Cross-country representative comparative research hardly exists in this area. As part of a large EU-funded project, we aim to undertake representative comparative research in care homes in Europe, to describe and compare 6 countries in terms of (1) resident outcomes, quality and costs of palliative and end-of-life care; and (2) palliative care structures and staff knowledge and attitudes toward palliative care. We also aim to explore country, facility, staff, patient, and care characteristics related to better outcomes at resident level. Design and Methods: To obtain a representative nationwide sample, we will conduct a large-scale cross-sectional study of deceased residents in care homes in Belgium, Finland, Italy, the Netherlands, Poland, and the United Kingdom, using proportional stratified random sampling (taking into account region, facility type and bed capacity). In each country, all participating care homes retrospectively report all deaths of residents in and outside the facilities over the previous 3-month period. For each case, structured questionnaires, including validated instruments, are sent to (1) the administrator/manager, (2) staff member most involved in care, (3) treating physician (general practitioner or elderly care physician), and (4) a closely involved relative. It is estimated that, per country, 50 care homes are needed on average to obtain a minimum of 200 deceased residents. Collected data include clinical and socio-demographic characteristics, quality of dying, quality and costs of palliative care and end-of-life care, and palliative care structures at the facility level and country level. To obtain a representative view of staff knowledge and attitudes regarding palliative care, PACE will conduct a cross-sectional study of staff working in the participating care homes. Conclusion: Considering the growing challenges associated with aging in all European countries, there is an urgent need to build a robust international comparative evidence base that can inform the development of policies to target improved palliative care in care homes. By describing this research protocol, we hope to inform international research in care homes on how to perform representative end-of-life care research in these settings and better understand which systems are associated with better outcomes

Meaningful Self-Reporting Of Quality Of Life In People Living With Dementia

The aim of this research study is to investigate the hypothesis that people living with dementia can comment meaningfully on their quality of life. A careful literature review revealed that “while it is generally agreed that any appraisal of quality of life should as far as possible rely on the individual’s own perspective, having people with dementia evaluate their own quality of life remains a much-debated issue” although the findings of many recent studies support the theory that people with dementia can evaluate their own quality of life (Cahill et al., 2004, p. 313). A 32-question questionnaire adapted from the Dementia Quality of Life scale (Brod, Stewart, Sands, & Walton, 1999) was administered to nine elder participants with dementia. A family caregiver and a professional caregiver also completed the Quality of Life Scale to reflect how they thought the elder with dementia experienced quality of life. Analysis indicated high inter-item consistency across all items and respondents on the Quality of Life Scale (α = 0.957). Correlations between respondents (participants and informal and formal caregivers) on most subscales were high (τ = .040 to .717) (although correlations often did not reach statistical significance with N = 9), further affirming that the ratings of Quality of Life by participants with dementia were as valid as the ratings of those who knew them and their lives best. The findings provide evidence that comments about quality of life made by people living with dementia can be regarded as meaningful, indicating that this population deserves greater respect regarding their ability to be included in decisions regarding their well-being and quality of life

Transportation for an Aging Population: Promoting Mobility and Equity for Low-Income Seniors

This study explores the travel patterns, needs, and mobility problems faced by diverse low-income, inner-city older adults in Los Angeles in order to identify solutions to their mobility challenges. The study draws information from: (1) a systematic literature review of the travel patterns of older adults; (2) a review of municipal policies and services geared toward older adult mobility in six cities; (3) a quantitative analysis of the mobility patterns of older adults in California using the California Household Travel Survey; and (4) empirical work with 81 older adults residing in and around Los Angeles’ inner-city Westlake neighborhood, who participated in focus groups, interviews, and walkabouts around their neighborhood

Beliefs in advance care planning among Chinese Americans: Similarities and differences between the younger and older generations

The purpose of this research is to explore behavioral, normative, and control beliefs in the discussion of advance care planning (ACP) among older and younger Chinese Americans. Ethnic minority groups have been identified as less engaged in ACP and this represents an ethnic and cultural gap. Older Chinese American adults often have different beliefs and values compared to the younger generation who are more acculturated to American mainstream culture. These differences may hinder the discussion of ACP with Chinese older adults. A qualitative design was used. The Theory of Planned Behavior guided the development of the interview guide. We recruited 60 Chinese Americans. Prior experience was identified as a theme that influenced attitudes about ACP. We found that older and younger Chinese participants had different beliefs in the norm and control related to ACP discussions, but not in the belief of attitudes about ACP discussions. Both younger and older Chinese American participants believed that ACP was important and necessary. Participants in both clusters expressed that they were ready and willing to engage in ACP discussions with their family members but hesitant to initiate these discussions. The reluctance in discussing ACP with Chinese older adults may be related to the expectations and obligations of Xiao (filial piety) in Chinese culture. This study describes the similarities and differences of beliefs in ACP between older and younger Chinese Americans. We identified barriers and facilitators in behavioral, normative, and control beliefs that can be used to promote ACP for Chinese Americans

Collaborating to Create Elder Friendly Communities in New Hampshire: A Scan of the Current Landscape

The fact that the population of the United States is aging is no surprise; the demographic projections are well documented. There have never been as many older adults living as there are today, and this number will only increase. Northern New England is aging more rapidly than the rest of the country, with Vermont, Maine, and New Hampshire having the oldest populations in term of median age (U.S. Census, 2014). New Hampshire is expected to be the fastest aging state in New England through 2030, with nearly one-third of its population being over the age of 65 (Norton, 2011). This phenomenon is anticipated to place substantial pressure on publicly-funded health programs and long-term services and supports in the Granite State. But the story of the aging of the population is not only about increased numbers. As longevity increases, the average age of the older population will see a dramatic increase. The number of persons over the age of 85 in the United States is expected to increase five-fold by 2040. As the possibility for functional limitations and disability increases with age, the need for long-term, formal, and informal supports is expected to increase as the number of older adults, particularly those over the age of 85 increases. In addition, women continue to live longer than men; on average, life expectancy for women is three years longer than for men. These factors create a complex picture of aging, which includes a growing population of older adults, a majority of whom will be women; and a growing number of those over the age of 85, who are more likely to require some type of assistance as they age. It is a mistake to look at our aging population in a singular way. Although we tend to make generalizations about older adults, as a group, they are more physiologically and socially diverse than any other age group (Brummel-Smith & Mosqueda, 2003). As we age, we become more and more diverse, as there are no two people who have had the same life experiences, shaping who we are over our lifetimes. The baby boomers (those born between 1946 and 1964) are likely to be the most diverse cohort of older adults we have seen to date, and it is likely that they will redefine our conception of age and aging. Older adults bring a diverse set of skills, talents, and knowledge that should be tapped as a significant natural resource to support a new and exciting vision of aging

Surveying Persons with Disabilities: A Source Guide (Version 1)

As a collaborator with the Cornell Rehabilitation Research and Training Center on Disability Demographics and Statistics, Mathematica Policy Research, Inc. has been working on a project that identifies the strengths and limitations in existing disability data collection in both content and data collection methodology. The intended outcomes of this project include expanding and synthesizing knowledge of best practices and the extent existing data use those practices, informing the development of data enhancement options, and contributing to a more informed use of existing data. In an effort to provide the public with an up-to-date and easily accessible source of research on the methodological issues associated with surveying persons with disabilities, MPR has prepared a Source Guide of material related to this topic. The Source Guide contains 150 abstracts, summaries, and references, followed by a Subject Index, which cross references the sources from the Reference List under various subjects. The Source Guide is viewed as a “living document,” and will be periodically updated

Perceived Social Support among Chinese American Hemodialysis Patients

Social support is linked to improved health outcomes both in Western and Asian societies and is a vital factor in a patient\u27s adjustment to end-stage renal disease and its treatment regimen. This study explored perceived social support among 46 Chinese American hemodialysis patients in San Francisco\u27s Chinatown using the Norbeck Social Support Questionnaire plus open-ended questions. Findings unexpectedly revealed low levels of perceived social support and lack of tangible support especially in elder patients. We can no longer assume that traditional family cultural values are providing adequate social support for this population