Social Support and Social Satisfaction for Older Adults in Online Virtual Communities

We argue that older adults experience psychological changes based on significant events in their lives, and that their usage of online virtual communities (VCs) is driven by their varying needs for social support and social satisfaction. We propose that socioemotional choices they make, particularly their use of online VCs, are driven by a combination of need for social support and social satisfaction. We use survey data collected from older adults participating in three online VCs focused on retirement life in China. We expect our study to fill the gap in the literature on online VCs by providing insights into the motivation and satisfaction of older users in using online VCs, which can help in designing online virtual communities that can better cater to the psychological needs of older people

A UK survey of COVID‐19 related social support closures and their effects on older people, people with dementia, and carers

Abstract Objectives The aim of this national survey was to explore the impact of COVID‐19 public health measures on access to social support services and the effects of closures of services on the mental well‐being of older people and those affected by dementia. Methods A UK‐wide online and telephone survey was conducted with older adults, people with dementia, and carers between April and May 2020.The survey captured demographic and postcode data, social support service usage before and after COVID‐19 public health measures, current quality of life, depression, and anxiety. Multiple linear regression analysis was used to explore the relationship between social support service variations and anxiety and well‐being. Results 569 participants completed the survey (61 people with dementia, 285 unpaid carers, and 223 older adults). Paired samples t‐tests and X2‐tests showed that the mean hour of weekly social support service usage and the number of people having accessed various services was significantly reduced post COVID‐19. Multiple regression analyses showed that higher variations in social support service hours significantly predicted increased levels of anxiety in people with dementia and older adults, and lower levels of mental well‐being in unpaid carers and older adults. Conclusions Being unable to access social support services due to COVID contributed to worse quality of life and anxiety in those affected by dementia and older adults across the UK. Social support services need to be enabled to continue providing support in adapted formats, especially in light of continued public health restrictions for the foreseeable future. This article is protected by copyright. All rights reserved

Falling Off the Bandwagon? Exploring the Challenges to Sustained Digital Engagement by Older People

Objectives: This study examines older people’s use of information and communication technologies (ICTs) and identifies the factors which can prevent or promote their sustained use. Methods: A mixed methods approach was adopted. Quantitative and qualitative data were collected by a survey of 323 older ICT users (aged 50+) between 2011 and 2012. These data were supplemented by qualitative data obtained through in-depth interviews, focus groups,and story-telling. Quantitative data were analysed using PASW including bivariate and multivariate analyses. Qualitative data were analysed using an inductive, thematic approach. Results: The findings show that, contrary to some stereotypes, many older people are enthusiastic, competent and confident users of ICTs. However they report a range of challenges in reaching and maintaining this situation. These include technological complexity and change, age-related capability changes and a lack of learning and support mechanisms. Intrinsic motivation and social support are important in enabling older people to overcome these challenges. Discussion: Getting older people online has been a high priority in many countries over the past decade. However, little attention has been paid to whether and how their usage can be sustained over time. We discuss the implications of the findings for policy and practice

Asset rich cash poor in the economic downturn: the financial challenges facing retired older people

Older people are thought to be particularly vulnerable during times of economic downturn. Little is currently understood of the impact of the current economic downturn on the financial circumstances and wellbeing of retired people and the nature of the services and support needed to enable them to cope financially and maintain their wellbeing and quality of life. Retired people are not a homogenous group. Therefore, this study explores the impact of the downturn on a specific group: house owners over the age of 65, not in receipt of means tested state benefits and living on modest incomes. This group may be described as “asset rich cash poor” (ARCPs). It is thought that this group is particularly vulnerable as they are not eligible for state support but are insufficiently well off to be living comfortably. Findings from this research, although focused on retired people with specific circumstances, may have wider relevance in relation to retired people with different financial circumstances. The purpose of this study is to investigate the experiences of asset rich cash poor older people in the economic downturn, in order to establish: • how they manage their financial circumstances in these times; • the impact of the downturn on their wellbeing and quality of life; and • whether services and support available to this group and other older people could be improved. The study comprised two phases. In phase one, the perspectives of older people were explored by carrying out 28 semi-structured interviews with older people in the asset rich cash poor category, permanently resident in Dorset, some of whom lived in a conurbation and others in rural areas. In phase two, the study explored perspectives of key financial advice/information/service providers through four focus groups comprising: health and social care professionals; financial advisors from the private sector; and professionals from the third (not for profit) sector. 6 ASSET RICH CASH POOR IN THE ECONOMIC DOWNTURN The study has shown that the economic downturn is having a marked impact on the financial, social, mental and physical wellbeing of this sample of asset rich cash poor older people in Dorset. For many, the level of income that they had expected when planning for retirement had not come to fruition and they feel poor in relation to their previous lifestyle and retirement expectations. The key findings and policy implications of the study are: Key finding 1: Many ARCP older people particularly women, had done little retirement planning. Many ARCP older people had insufficiently planned for their retirement. In particular some women had relied on their husbands to manage all finances and had not provided for their own pensions. This reflects the findings of earlier studies on the older generation. Policy implications The independent Money Advice Service (formerly the FSA Consumer Financial Education Board) should commit greater financial resource to the awareness raising and skill development of future generations to help people plan more carefully for their retirement. Although the findings of this study show a widespread need among older people for information and advice, resources should be targeted particularly at women, especially those who have had extended periods out of workplace. Private, public and voluntary sector services should respond to this increased investment through developing and testing out models of financial capability training, with an emphasis on financial planning, as well as its mode of delivery. There may be potential in raising awareness of the need for retirement planning and associated training to non-working women through health visiting or child care services. For older people who have planned ahead, pensions and savings have been traditionally seen as a key way to plan responsibly for one’s retirement future. But these are not risk free as has been played out in the recent years of economic downturn, with the associated low interest rates and return on investment. People planning ahead for retirement need to be reminded of the impact of any future recession and the risks of this if it coincides with their planned retirement date. ASSET RICH CASH POOR IN THE ECONOMIC DOWNTURN 7 Key finding 2: Older people, in the ARCP category, tended to manage the money they had very carefully, despite the economic downturn, and had an aversion to debt. This finding mirrors the quantitative study of Atkinson et al. (2006) who found older people to be better at managing money than the younger generations. In discussion of the financial pressures placed upon them in term of escalating essential and non-essential expenditure, no interviewees referred to having resorted to unsecured debt. Policy implications Managing money is identified in this study and earlier studies as a strength within older people. Therefore, financial capability training for this age group should focus on the other dimensions of financial capability where older people are less skilled, for example choosing financial products and staying informed. Older people should be considered an asset in society and their strong skills in managing money should be utilised. Those organisations wishing to develop and deliver financial capability curricula for younger people could consider intergenerational programmes in which older people participate as guest speakers, sharing their experiences in managing money with younger generations. These educators could be encouraged to work together with the Money Advice Service and the Department of Health and financial advice and information providers to bring various age groups together. Key finding 3: The combination of reduced income from investments, increases in pensions which do not keep pace with inflation, combined with increases in costs for essential and non-essential expenditure, is having an impact on social, physical and mental wellbeing and is causing noticeable life style changes. The effects of the economic downturn on ARCP older people’s wellbeing was highlighted by both older people themselves and service providers. In both phases of the research, reference is made to feelings of anxiety, worry, fear, depression and concern. 8 ASSET RICH CASH POOR IN THE ECONOMIC DOWNTURN Policy implications Reduced wellbeing during the economic downturn in this age group is likely to put an increased demand on health and social care services. Policy makers in the Department of Health have a vested interest therefore in developing strategies to counter this negative impact. One recommendation to enhance social wellbeing is that the Money Advice Service, the Department of Health and local councils fund national and local initiatives to further support and develop social clubs or other groups for older people, with an emphasis on financial planning and management. This would help sustain wellbeing and provide a network of peers with whom older people might exchange financial experiences and information. Third and private sector organisations such as care homes and age related charities are well-placed to contribute to the development of these programmes. Key finding 4: The economic downturn is impacting on older people indirectly though cuts to public and third sector services. The economic downturn has been associated with cuts in funding to many services previously relied on by older people for their physical, social and mental wellbeing. Library closures were a cause of concern and a particular worry was the risk of withdrawal of bus passes. Policy implications Private sector service providers will need to fill the gap in services that currently support the health and wellbeing of older people, a gap left by the increased withdrawal of public and third sector services. A reduction of these services in particular will have a strong impact on the social, mental and physical wellbeing of older people. Key finding 5: Older people, in the ARCP category, do not always access enough or appropriate financial information. Many choose to seek financial information from trusted health and social care providers, their family and/or friends rather than from financial professionals. Older people, and professionals that support them, reported that older people are not always accessing the sound financial information which they may need, whether it be on financial products, forward financial planning or how to obtain the benefits they are entitled to. Lack of trust in financial advisors was widespread. Independent financial advisors indicated that older people on lower incomes were using their services less frequently. Some were either self-reliant by researching ASSET RICH CASH POOR IN THE ECONOMIC DOWNTURN 9 on the internet or using the media, or tapped into sources of social capital found within their social networks. Policy implications More effort and resource needs to be put in place to address these very serious concerns about access to advice and support by older people. Older people are approaching health professionals for financial advice, despite the fact that these professionals may not be best placed to provide this. Health professionals need to be able to direct these queries to trained financial service providers. Financial services within the private sector should therefore form interagency partnerships with more trusted public and third sector services in order to improve access to the services they provide. There is a very significant concern about lack of trust in advisors and banks. The need to rebuild reputation must be addressed by regulators, the advisors and banks themselves, with an increased emphasis being placed on the value systems of financial services and the role they can play in promoting community and individual wellbeing. The strength of the social networks of older people should also be harnessed, suggesting again that there is potential in targeting or developing social clubs for older people as locations to enhance financial capability. Key finding 6: In order to make ends meet, some older people in the ARCP category may take greater financial risks or be more vulnerable to abuse in an economic downturn. The professionals that support older people expressed concerns that the economic downturn may push older people towards riskier behaviours without them fully understanding the implications of the risks. There is also a risk of older people becoming more vulnerable to financial abuse. Policy implications Policy makers need to ensure that older people are made aware of the risks of financial abuse. As older people are often turning to more trusted health and social care providers for advice on financial matters, health/social care providers as well as financial service providers should both develop means to keep their older clients regularly informed of potential financial risk within the current economic climate. As financial support is not the remit of many of the health care providers and financial services is a regulated activity, it is advisable they form partnerships with the finance sector, in order to better inform their patients/clients of current financial risks or to be able to refer them on to qualified support. Service providers may also 10 ASSET RICH CASH POOR IN THE ECONOMIC DOWNTURN offer a helpline in which older people feel safe to disclose, anonymously if need be, any concerns of financial abuse they may be exposed to. Charities already offering these services (e.g. Age UK and Action on Elder Abuse-AEA) should be supported in these endeavours through encouraging partnerships between financial service providers on the one hand and health/social care providers on the other in order that the latter can provide accurate and up to date information on financial risk to its partners. A recent partnership between local financial advisors and the charity Age UK is an excellent example of this (Age UK, 2012). It is also essential that the Money Advice Service raises awareness of this risk. As the provision of financial services is a regulated activity, it is important to ensure that any activities undertaken by health/social care providers are not in breach of financial services regulations. Key finding 7: Older people made no reference to the Money Advice Service or the Financial Services Authority (FSA) as a source of help or advice. At the time of this study none of the interviewees of the focus groups made any reference to the role of the Financial Service Authority (FSA) or the Money Advice Service in providing information or advice about financial matters to older people. Policy implications Although the Money Advice Service is now independent of the FSA, and is endeavoring to target a wider population, it is not clear why our interviewees never referred to it. It may either be due to a lack of awareness of the service, a serious indictment of the outreach of the FSA, or alternatively a lack of IT expertise in older people, demonstrated also by their very limited use of online banking. In either event, older people may be denied access to key forms of help and advice on financial matters. Resources need to be devoted to either increasing IT literacy among older people, or alternatively providing help and support using traditional forms of communication and/or increasing the reach of the Money Advice Service by targeting this age group specifically. In conclusion, therefore, older people in this study reported being affected markedly by the current economic downturn. Members of the financial sector, including accountants, and the Money Advice Service have a responsibility to support older people during this and future downturns. They must reflect on ways in which they might tailor their support towards this group. One way of doing so is by actively seeking collaborative interagency partnerships with third and public sector health and social care professionals to improve their access and understanding of older ASSET RICH CASH POOR IN THE ECONOMIC DOWNTURN 11 clients. These more trusted professionals will be able to direct financial enquiries to accountants and financial advisors who older people may otherwise not have had the confidence, knowledge or trust to approach directly. Accountants and other financial services should also be aware of the particular challenges facing asset rich but cash older people and adapt their advice accordingly when dealing with this group. They should reflect in their consultations that many older people are fully capable of managing their money but are in greater need of advice on how to invest their money and plan ahead for their future. They should also think outside of the box in providing support, considering ways, for example, in which the power of existing social networks might be harnessed. 12 ASSET RICH CASH POOR IN THE ECONOMIC DOWNTUR

The role of age and digital competence on the use of online health and social care services : A cross-sectional population-based survey

Objective Online health and social care services are getting widespread which increases the risk that less advantaged groups may not be able to access these services resulting in digital exclusion. We examined the combined effects of age and digital competence on the use of online health and social care services. Methods We used a large representative population-based sample of 4495 respondents from Finland. Paper-based self-assessment questionnaire with an online response option was mailed to participants. The associations were analyzed using survey weighted logistic regression, exploring potential non-linear effects of age and controlling for potential sex differences. Results Higher age, starting from around the age of 60 was associated with a lower likelihood of using online services for receiving test results, renewing prescriptions and scheduling appointments. Good digital competence was able to hinder the age-related decline in online services use, but only up to around the age of 80. Conclusions Our results suggest that older adults are at risk of digital exclusion, and not even good digital competence alleviates this risk among the oldest. We suggest that health and social care providers should consider older users' needs and abilities more thoroughly and offer easy to use online services. More digital support and training possibilities should be provided for older people. It is equally important that face-to-face and telephone services will be continued to be provided for those older people who are not able to use online services even when supported.Peer reviewe

Self-Disclosure and Social Media Use among Younger and Older People with Dementia: An Internet-Mediated Mixed-Methods Study

Social media can facilitate self-disclosure of a stigmatized identity. This mixed-methods study explores self-disclosure by people with dementia on social media, comparing patterns and purpose of use by those aged 65 and above versus those aged under 65. Of 143 internet-using respondents of an online survey, 77 (aged between 44 and 88 years) were users of social media. Facebook was the most commonly used platform (95%), followed by Twitter, Instagram, LinkedIn, YouTube, and TikTok. People with dementia aged under 65 used more platforms and used social media more frequently than older counterparts [χ2 = 5.58, p = .031]. Content analysis of open-ended questions, validated and extended through qualitative interview data, showed younger users shared dementia-related information for purposes of advocacy and awareness whereas older users prioritized the dementia journey. Social media gives people with dementia a voice to share their experiences, raise awareness, and support themselves and other individuals affected by the condition

Gender equity in disaster early warning systems

Capacities of societies, communities and individuals or a social-ecological system to deal with adverse consequences and the impacts of hazard events define the resilience. New and innovative Emergency Communications, Warning Systems (ECWS) technologies and solutions improve resilience of the nations. Research shows that different types of systems (e.g. decision support, resource management, early warning, communications, and inter-agency) are highly valued in emergency and disaster events reducing live losses. As many individuals have online access today and young women have increased their online communication and young men tend to explore technology resources, the potential of using user friendly third revolution digital technology such as semantic features and devices (e.g. SMART phones) have the potential to improve the access to early warning/risk in-formation supporting community decision making saving lives. These personal and social relations that reflect gender dimensions can certainly be examined improving resilience making communities more prepared for disasters with proactive decision making for early warning. Fostering awareness about gender equity which is the recognition of women and men as active participants in development can tailor made within the context of resilience and more specifically within early warning systems saving lives of the people at immediate risk including the dependence of mother’s care (children and older people). In this context, this paper attempts to synthesis literature on the topic of gender equity within disaster early warning systems

Identifying and Managing Frailty: A Survey of UK Healthcare Professionals

Frailty is a common condition that leads to multiple adverse outcomes. Frailty should be identified and managed in a holistic, evidence-based and patient-centered way. We aimed to understand how UK healthcare professionals (HCPs) identify and manage frailty in comparison with UK Fit for Frailty guidelines, their frailty training, their confidence in providing support and organizational pathways for this. An online mixed-methods survey was distributed to UK HCPs supporting older people through professional bodies, special interest groups, key contacts, and social media. From 137 responses, HCPs valued frailty assessment but used a mixture of tools that varied by profession. HCPs felt confident managing frailty and referred older people to a wide range of supportive services, but acknowledged a lack of formalized training opportunities, systems, and pathways for frailty management. Clearer pathways, more training, and stronger interprofessional communication, appropriate to each setting, may further support HCPs in frailty management

Choice in the context of informal care-giving

Extending choice and control for social care service users is a central feature of current English policies. However, these have comparatively little to say about choice in relation to the informal carers of relatives, friends or older people who are disabled or sick. To explore the realities of choice as experienced by carers, the present paper reviews research published in English since 1985 about three situations in which carers are likely to face choices: receiving social services; the entry of an older person to long-term care; and combining paid work and care. Thirteen electronic databases were searched, covering both the health and social care fields. Databases included: ASSIA; IBSS; Social Care Online; ISI Web of Knowledge; Medline; HMIC Sociological Abstracts; INGENTA; ZETOC; and the National Research Register. The search strategy combined terms that: (1) identified individuals with care-giving responsibilities; (2) identified people receiving help and support; and (3) described the process of interest (e.g. choice, decision-making and self-determination). The search identified comparatively few relevant studies, and so was supplemented by the findings from another recent review of empirical research on carers' choices about combining work and care. The research evidence suggests that carers' choices are shaped by two sets of factors: one relates to the nature of the care-giving relationship; and the second consists of wider organisational factors. A number of reasons may explain the invisibility of choice for carers in current policy proposals for increasing choice. In particular, it is suggested that underpinning conceptual models of the relationship between carers and formal service providers shape the extent to which carers can be offered choice and control on similar terms to service users. In particular, the exercise of choice by carers is likely to be highly problematic if it involves relinquishing some unpaid care-giving activities

BEING ME: Project report on best practices in learning and education to support LGBT ageing care and wellbeing

This report is based on our experiences of using a collaborative approach to identifying best practices for those involved in professional, vocational and community-based education and learning, in order to facilitate improved support for Lesbian, Gay, Bisexual and Transgender (LGBT) older people in health and social care. The best practices discussed here on learning and teaching, emerged from cross national collaboration and intercultural dialogue with a variety of stakeholders, including older LGBT people, educators, practitioners and learners using the World Café method. As one of the workstreams within the BEING ME European Project funded by EU Erasmus Plus (https://www.beingme.eu/), we aimed to promote and support the social inclusion of LGBT older people through positive interaction with educational institutions that prepare future professionals to work with older people. The best practices described here include a) identifying pedagogic approaches (the method and practice of teaching) b) generating examples of tailored educational resources c) recommendations on how to improve the knowledge and capabilities of future care professionals in the area of LGBT affirmative practices. Through a process of learning and exchange during two World Cafés, these areas were able to be more clearly articulated and should be read in conjunction with the BEING ME ‘Best Practice principles’ (https://beingme.eu/public/application/downloads/resources/being-me-best-practice-principles-20190212.pdf) which underpin good practice in the area of LGBT ageing care. Giving specific attention to identify ways of enhancing the skills, knowledge and capabilities of practitioners through education, should place them in a better position to develop a culture of support, openness and respect for LGBT identities which in turn are essential to LGBT older people's inclusiveness in care environments. The Best Practices Report provides the foundation for the development of the BEING ME educators online ‘toolkit’ aimed at both formal and informal learning settings and to a range of disciplines professions and vocations in health and social care