Women, Health and Aging: Building a Statewide Movement

Provides an overview of current policy and program environments that affect the state's most vulnerable elder population, and considers some effective strategies to address the growing needs of older persons in California

Managing behavioural and psychological symptoms in people with dementia and their carers living at home/community- A mixed methods evidence synthesis for non-pharmacological interventions

Plain English Summary Background Two-thirds of people with dementia live at home and many experience distressing symptoms such as aggression, wandering, agitation, emotional problems, known as behavioural and psychological symptoms of dementia (BPSD), which result in poor outcomes. We aimed to combine evidence from various sources to find out what types of non-drug based interventions might be helpful for people with dementia and their carers. We also conducted focus groups (FG) and interviews with service users and providers around managing BPSD

The Association of Depression, Respite Care, Socialization, and Self-Rated Health for African American Family Caregivers

Alzheimer’s disease is a brain disorder caused by nerve damage that slowly destroys memory and thinking skills, as well as the ability to carry out the simplest tasks. The burden of care often lies with family caregivers who are essential to healthcare providing care and support to over 6.5 million individuals suffering from Alzheimer’s dementia and related dementias, allowing them to thrive in familiar surroundings. For the family caregiver, the strain experienced can lead to stress and decreased quality of life, leading to a negative impact on health and well-being. The purpose of this study, using data from the 2017 National Health and Aging Trends Study/National Study of Caregiving (NHATS/NSOC) was to examine the association between the variables. The chi-square test was used to examine the associations between depression levels, age, gender, race, ethnicity, and the self-rated health of African American caregivers; between receiving respite help from family members to care for the subject person and self-rated health of the caregiver; and between participating in social activities with other people and the self-rated health of the caregiver. There were significant associations between depression levels, being female, being over 50 years old, participating in social activities, and the self-reported health of African American caregivers. African American caregivers are often overlooked in research, so this study was intended to generate provider and community support for caregivers and create solutions and resources to help to relieve their burden and health challenges

Usability and feasibility of consumer-facing technology to reduce unsafe medication use by older adults

Background Mobile health technology can improve medication safety for older adults, for instance, by educating patients about the risks associated with anticholinergic medication use. Objective This study's objective was to test the usability and feasibility of Brain Buddy, a consumer-facing mobile health technology designed to inform and empower older adults to consider the risks and benefits of anticholinergics. Methods Twenty-three primary care patients aged ≥60 years and using anticholinergic medications participated in summative, task-based usability testing of Brain Buddy. Self-report usability was assessed by the System Usability Scale and performance-based usability data were collected for each task through observation. A subset of 17 participants contributed data on feasibility, assessed by self-reported attitudes (feeling informed) and behaviors (speaking to a physician), with confirmation following a physician visit. Results Overall usability was acceptable or better, with 100% of participants completing each Brain Buddy task and a mean System Usability Scale score of 78.8, corresponding to “Good” to “Excellent” usability. Observed usability issues included higher rates of errors, hesitations, and need for assistance on three tasks, particularly those requiring data entry. Among participants contributing to feasibility data, 100% felt better informed after using Brain Buddy and 94% planned to speak to their physician about their anticholinergic related risk. On follow-up, 82% reported having spoken to their physician, a rate independently confirmed by physicians. Conclusion Consumer-facing technology can be a low-cost, scalable intervention to improve older adults’ medication safety, by informing and empowering patients. User-centered design and evaluation with demographically heterogeneous clinical samples uncovers correctable usability issues and confirms the value of interventions targeting consumers as agents in shared decision making and behavior change

A Story to Tell among Minority Alzheimer\u27s Patient Caregivers: A Phenomenological Study

The level of burden experienced by caregivers of patients diagnosed with Alzheimer\u27s disease is high. Studies that examine this burden by taking into account cultural and spiritual differences are limited, particularly with regard to minority populations. The purpose of this study was to investigate the burden and challenges faced by minority caregivers providing in-home care to Alzheimer\u27s patients. Guided by social support theory, a phenomenological study design was used with semi-structured interviews of 12 caregivers to examine their perspectives on the burden and challenges they face, including their lived experiences, cultural and spiritual values, and interaction with health professionals. Thematic analysis in an inductive way was used to analyze the collected qualitative data. The results of the analyses of the collected data showed that cultural and spiritual values are important in making decisions, as caregivers in minority populations face daily challenges in terms of limited social support and resources. The findings of this study suggest that public health interventions aimed at alleviating the burden on Alzheimer\u27s caregivers need to take into account differences in cultural and spiritual values. Findings also show that there is a need for social support programs that reduce the burden on caregivers in general and on the minority population in particular. The findings of this study may drive positive social change by helping public health workers design and implement programs that consider differences in the cultural and spiritual values of minority populations while garnering the resources to provide the needed social support and alleviate the burden faced by the family member caregivers

Access to Hospice Care: Expanding Boundaries, Overcoming Barriers

This report looks at issues of social justice, access, and public policy in hospice and palliative care. As it examines the issues from the perspectives of social justice and fairness, it also recommends ways in which the definition of hospice can be expanded to include more Americans for a longer period of time than simply the days or months shortly before death

Exploration of the Older Adult Informal Caregiver Self-Care Promoting Well-Being

abstract: ABSTRACT This qualitative descriptive study described caregiver recognition of personal and social contextual resources guiding purposeful participation in self-care and well-being. This research builds on health empowerment theory, which conceptualizes health empowerment as an inherent, relational and ongoing process, expressive of health patterning of well-being (Shearer, 2009). By 2060, Americans 65 years and older will number nearly 98 million, more than double that in 2013. The number of older adults aged 85 and older will double from 6 million in 2003, to 14.6 million by 2040 (Health & Human Services, 2014). Sixty-five million adults serve as informal caregivers, many themselves suffering from chronic conditions (National Alliance for Caregiving & AARP, 2009). Current research has examined the burden of caregiving, but little is known about caregiver strengths and resources that foster personal self-care and well-being. Twenty-one older adult informal caregivers participated in focus groups or individual interviews. Length of time as caregivers ranged from one year to more than ten years; 24% of the participants were men. Seventy-six percent of the participants reported having one or more chronic condition. Themes generated from qualitative content analysis provided a basis for validating and extending the health empowerment theory among older adult informal caregivers. Across participants, empowerment reflected recognition of strengths and resources, as well as growth consistent with valued goals facilitating new health patterns and well-being. The health empowerment theory perspective provided a relevant basis for theory-based intervention focused on promoting strengths, abilities and potential among older adults, limiting vulnerability to diminished health and well-being.Dissertation/ThesisDoctoral Dissertation Nursing and Healthcare Innovation 201

Exploring the Iranian-Canadian Family Experience of Dementia Caregiving: A Phenomenological Study

Presently in Canada, there are approximately 500,000 individuals living with dementia, which is expected to increase to over one million by 2038. With Canada’s minority elderly population growing, the number of Iranian-Canadian older adults living with dementia is expected to rise as well. Family caregivers are a significant source of help among Iranian-Canadians and the provision of informal care by adult children for parents with dementia in the Iranian culture is an expression of love and dedication. This study explored the meaning of the experience of Iranian adult children in Canada caring for a parent with Alzheimer’s disease, the values and attitudes they held in regards to their utilization and expectation from formal and informal care services, and the role of culture in shaping these experiences. A phenomenological study was used to investigate this phenomenon. In-depth, semi-structured interviews were held with four adult child caregivers and rich data were obtained. The research findings focused on the dual reality of dementia caregiving, the importance of fulfilling filial obligations, and the expression of preferences in formal dementia care. Key words: dementia, minority, Iranian-Canadian, family caregiver, informal care, culture, phenomenolog

Seeing the wood for the trees. Carer related research and knowledge: A scoping review

This NIHR-SSCR funded scoping review provides a comprehensive mapping of what is known about carers and caring, and aims to help inform policy, practice and research in relation to carers. The review was undertaken by searching 10 electronic bibliographic databases, supplemented by additional web searches to identify academic research, grey literature and wider knowledge. The analysis adopts a selective thematic approach covering: carer variables - the characteristics of different types of carer and different caring situations; types of care - the nature of needs of the cared for person and the features of the care situation; the impact of caring – resilience and coping, employment and health; and carer support and needs assessment. The final section highlights key messages identified from the review. It found that caring involves all sections and age groups of the population, with people are likely to experience one or more periods of caregiving over their lifetime. The uniqueness of each caring relationship is also highlighted. In relation to types of carers, knowledge about ‘hard to reach’ groups, such as BAME and LGBT carers, remains sparse. Older carers are also relatively invisible in policy and research terms. It found that much of the knowledge about carers identified in the review relates to their characteristics, their lived experience and the nature of their caregiving, with relatively less being known about the effectiveness of interventions to support them. The report concludes by offering suggestions for policy and practice. An appendix provides a bibliography of the 3,434 items identified in review, classified into 17 types of reference

The Healthy Brain Initiative : the public health road map for state and national partnerships, 2013\u20132018 : interim progress report

Formal recognition of Alzheimer\u2019s disease (AD) as a public health issue, and the genesis of the Centers for Disease Control and Prevention\u2019s (CDC) active involvement in this issue, dates back to 2005. Research over the previous decade had begun documenting the growing public health burden of AD and other dementias. AD is now the sixth leading cause of death for all ages; one out of every 3 older adults dies with dementia. Twice as many Americans fear the loss of mental capability more than they do diminished physical ability. In 2010, the total estimated cost of dementia was between $159 and$215 billion (Hurd, Martorell, Delavande, Mullen, & Langa, 2013).Concern for stemming this public health crisis spurred a series of collaborative national efforts among numerous private, non-profit, and governmental agencies (see Notable Milestones). One of the most recent was an 18-month strategic planning effort led by CDC and the Alzheimer\u2019s Association to delineate more clearly the role of public health in addressing and promoting cognitive function. The resulting report\u2014The Healthy Brain Initiative: The Public Health Road Map forState and National Partnerships, 2013-2018\u2014is the second in a series of road maps for cognitive health. Two years have passed since this second Road Map (2013) was finalized, affording an ideal opportunity to take stock of what has been accomplished and what challenges remain. Towards that end, we offer this progress report to:\u2022 Convey CDC\u2019s priorities for years 2013-2015 of the Healthy Brain Initiative to date\u2022 Highlight accomplishments and ongoing activity in these priority areas for 2013-2015\u2022 Share CDC\u2019s currently planned priorities for moving the Healthy Brain Initiative forward in 2016-2018\u2022 Reflect on opportunities for future progress while ensuring that the Healthy Brain Initiative remains flexible and responsive to new and emerging issues.Suggested citation: Centers for Disease Control and Prevention. The Healthy Brain Initiative: The Public Health Road Map for State and National Partnerships, 2013-2018, Interim Progress Report; Atlanta, GA: CDC, 2015.2013-healthy-brain-initiative-interim-report.pdfIntroduction -- Background -- Accomplishments--HBI Domain: Monitor and Evaluate: HBI Domain: Develop Policy and Mobilize Partnership; HBI Domain: Educate and Empower the Nation; HBI Domain: Assure a Competent Workforce -- Looking Ahead -- References. -- Acknowledgements -- Related Publications and Presentations.2015736