Identifying sources of strength: resilience from the perspective of older people receiving long-term community care

This study seeks to explore the sources of strength giving rise to resilience among older people. Twenty-nine in-depth interviews were conducted with older people who receive long-term community care. The interviews were subjected to a thematic content analysis. The findings suggest that the main sources of strength identified among older people were constituted on three domains of analysis; the individual-, interactional and contextual domain. The individual domain refers to the qualities within older people and comprises of three sub-domains, namely beliefs about one’s competence, efforts to exert control and the capacity to analyse and understand ones situation. Within these subdomains a variety of sources of strength were found like pride about ones personality, acceptance and openness about ones vulnerability, the anticipation on future losses, mastery by practising skills, the acceptance of help and support, having a balanced vision on life, not adapting the role of a victim and carpe-diem. The interactional domain is defined as the way older people cooperate and interact with others to achieve their personal goals. Sources of strength on this domain were empowering (in)formal relationships and the power of giving. Lastly, the contextual domain refers to a broader political-societal level and includes sources of strength like the accessibility of care, the availability of material resources and social policy. The three domains were found to be inherently linked to each other. The results can be used for the development of positive, proactive interventions aimed at helping older people build on the positive aspects of their lives

Centenarians' End-of-Life Thoughts and Plans: Is Their Social Network on the Same Page?

To explore how centenarians think about and plan for the end of life (EOL) and to what extent their primary contacts (proxy informants) are aware of these thoughts. Population-based study with semistructured in-person interviews. Defined geographical region approximately 60 km around Heidelberg, Germany. Subsample drawn from the larger study of centenarians (N = 78) with data on centenarians' EOL thoughts from the centenarian and the proxy informant. Centenarians reported on their thoughts about the EOL, perception of the EOL as threatening, longing for death, engagement in any EOL planning, and type of EOL plan (will, living will, healthcare surrogate) in place. Proxy respondents answered the same set of questions based on what they thought the centenarians' perspective was. In nearly half of cases, proxies misjudged whether the centenarian thought about EOL. Although only few centenarians perceived the EOL as threatening, and approximately one-quarter reported longing for death, proxies overestimated centenarians' reports on the former and underestimated the latter. Proxies reported more centenarian EOL planning than centenarians themselves. Even though enrolled proxies were mostly persons very close to the centenarian, many of them did not seem to be well informed about the centenarians' thoughts and plans regarding the EOL, suggesting a lack of communication between centenarians and social network members in this respect. Healthcare professionals should be aware that, even for very old adults approaching the end of their lives, discussions about EOL and EOL planning may need to be actively encouraged and supported

Falls and fear of falling in a sample of centenarians: the role of multimorbidity, pain and anxiety

Background: To explore the recent history of falls and the existence of fear of falling in a sample of centenarians, and to identify factors associated with both conditions. Methods: The sample included 109 centenarians from two Portuguese studies. The two main outcomes of this study are fear of falling and history of fall(s). Results: Results revealed that more than a half (51.4%) of the participants had fallen in the last 5 years and that the percentage of fear of falling was 78.9%. No association was found between the two conditions. The factors associated with each one were found to be different: number of health con- ditions for history of falls, and pain frequency and anxiety for fear of falling. Conclusions: The relationship between anxiety and fear of falling reinforces the importance of screening both conditions as it can improve their detec- tion and treatment. The established relationship between a high number of health conditions (common at very advanced ages) and falls demands greater attention in fall prevention initiatives specifically targeted to the extremely elderly.info:eu-repo/semantics/publishedVersio