Exploring terms used for the oldest old in the gerontological literature.

In response to the global increasing age of the population, there is general agreement on the need to define what is meant by 'old.' Yet there is no consensus on age groups within the definition of old, which makes comparative studies of people of differing ages in advancing years impossible. Attempts to sub-categorize the 'old' also show little consensus. This article serves to open a dialogue, as an illustrative example of these inconsistencies. Specifically, the aim of this research was to examine definitions of the 'oldest old' and 'fourth age', in order to highlight such inconsistencies and the need for consistent age stratifications. The authors conducted a literature search from January 2003 to April 2015 using the six most highly-rated non-medical journals in gerontology; the search was conducted again in 2018–2019 for currency. Forty-nine articles in total were reviewed. The findings show little consensus on the age stratifications used to define the 'oldest old' and 'fourth age,' which ranged from seventy-five plus to ninety-two plus years. Dividing the 'old' population into the oldest old and/or fourth age still shows a lack of consensus, with some authors suggesting that such divisions have only served to move ageism into very old age. There are terms for ten-year cohorts, which - if universally used - will mean that comparative ageing studies are possible. This in turn will inform international and national strategy documents, policy initiatives, clinical guidelines, and service provision and design. Given the growth in the numbers of people classed as old and the time span being 'old' covers, there is a real need for consensus. Definite age groupings that define people as cohorts, with existing and agreed words — such as sexagenarians (60–69,) septuagenarians (70–79), octogenarians (80–89), etc. - will completely remove the need for the value-laden term 'old' (and all its derivatives) for this poorly-defined population

Izkušnje kronično obolelih pacientov s telemedicinsko obravnavo v ambulantah družinske medicine

Uvod: Telemedicinska obravnava stopa v ospredje kot strategija za obvladovanje kroničnih nenalezljivih bolezni,  ki v Sloveniji povzročijo visok delež smrti. Namen raziskave je bil preučiti, kakšne izkušnje imajo pacienti z diagnozo kronične bolezni tako z uporabo telemedicinske opreme kot s telemedicinsko obravnavo v ambulanti družinske medicine. Metode: Julija 2020 so bile v enem od slovenskih  zdravstvenih domov izvedene štiri fokusne skupine z 19 pacienti s sladkorno boleznijo tipa 2 in/ali visokim krvnim tlakom. Prepisi skupinskih pogovorov so bili analizirani po načelih induktivne tematske analize. Rezultati: S pomočjo induktivne tematske analize je bilo  oblikovanih sedem tem: prednosti in slabosti  telemedicinske obravnave, enostavnost uporabe telemedicinske opreme, dvosmerna komunikacija z zdravstvenim osebjem, učinki telemedicinske obravnave na zdravstveno stanje pacientov, želja po uporabi in dostopnosti telemedicinske obravnave, vpliv in opora  okolja ter skrb za lastno zdravje. Teme vsebujejo 10 podtem in 29 dejavnikov. Diskusija in zaključek: Na izvajanje telemedicinskih  meritev najbolj vplivajo zaznana potreba pacientov in navodila zdravstvenega osebja. Kljub pozitivni izkušnji pacientov z uporabo telemedicinske opreme je potrebna strokovna presoja primernosti tovrstne obravnave na individualni ravni, ki ne vključuje le zdravstvenega stanja pacientov, marveč tudi oceno njihovega odnosa do zdravja in digitalnih veščin

Achieving Prudent Dementia Care (Palliare): An International Policy and Practice Imperative

This paper examines the provision of integrated advanced dementia care within seven European countries and critically reviews the potential contribution of the Prudent Healthcare perspective as a starting point for reform. Progressive efforts to innovate, promote quality and integrate care are tempered with the reality of resource constraints. Some policy makers in Europe and North America have turned their attention to the principles of Prudent Healthcare as a potential mechanism to maximise benefits for patients within available resources. As dementia progresses, living well requires increasing levels of support and care, people living with advanced dementia have complex health and social care needs, are highly dependent on others but are not yet at the terminal end stage of the condition. People with advanced dementia can benefit from a dementia specific palliative approach to care (Palliare), that helps them to live the best life possible for the months and often years they live with advanced dementia. It is also highly desirable to align policy innovations with integrated palliative care practice models and the education of the dementia workforce to accelerate informed improvements in advanced dementia care. There may be some coherence, at least superficially between Prudent Healthcare and integrated palliative care models such as Palliare. It is argued that for successful implementation, both require practitioners to be equipped with knowledge and skills and be empowered to deliver high quality care often within impoverished care environments. Adoption of the prudent perspective will however require development of a repertoire of approaches to hear the voice or proxy voice of people living with advanced dementia and to commit to the development and implementation of new evidence for advanced dementia practice. Evidence informing this policy debate draws upon contemporary literature and policy and the findings from research activities undertaken by the Palliare project supported through the Erasmus+ K2 Strategic Partnerships funding programme.info:eu-repo/semantics/publishedVersio

Attitudes of nurses and student nurses towards working with older people and to gerontological nursing as a career in Germany, Scotland, Slovenia, Sweden, Japan and the United States.

The aim of this study was to describe attitudes towards caring for older people among nurses and student nurses in six participating countries. Working with older people has historically had a negative profile and, with a global rise in the numbers of older people and a global shortage of nurses, it is essential to recruit nurses into this area. This study gathered data from six countries to explore nurses' and student nurses' attitudes to nursing older people and to gerontological nursing as a career. A convenience sample of 1064 nursing students and 2585 nurses in six countries answered the Multifactorial Attitudes Questionnaire (MAQ), designed to elicit attitudes towards caring for older people and to the esteem that comes with working in this field. The MAQ consists of seven positive and thirteen negative statements, and uses a Likert scale. A higher total score indicates a more positive attitude. Differences in attitudes among the six counties was observed for both nursing students and for nurses ( < 0.001). Nursing students in Scotland and the USA had the highest mean scores, and Slovenia and Sweden were the countries with the lowest mean scores. The highest scores for nurses were reported in Scotland and Sweden, and the lowest scores in Germany and Japan. From the findings, it is suggested that formal nursing education to students between 18 and 29 years of age has high importance for positive attitudes towards working with older people

Acceptance of welfare technologies among nurses

V zdravstvu in sistemih dolgotrajne oskrbe postaja uporaba tehnologij blagostanja neizbežna. Mednje uvrščamo raznolike tehnološke rešitve za ohranjanje in krepitev zdravja ter večjo varnost in samostojnost uporabnikov, ki jim posledično olajšajo tudi vključevanje v družbo. Hkrati vplivajo tudi na prakso zdravstvene nege. Vendar pa je malo znanega o sprejemanju tovrstnih tehnologij med medicinskimi sestrami, ki delajo s starejšimi osebami izven kliničnega okolja. Cilj predstavljenega petstopenjskega pregleda literature je bil odpraviti to vrzel v znanju. Decembra 2022 smo izvedli obsežno iskanje po sedmih bibliografskih podatkovnih zbirkah (MEDLINE, CINAHL, PubMED, Scopus, Proquest Social Sciences Database, APA PsycArticles in SocINDEX) in sivi literaturi, na podlagi katerega smo po zastavljenih kriterijih izbrali 27 publikacij, objavljenih med letoma 2007 in 2022. Na podlagi vsebinske analize, ki smo jo izvedli s pomočjo programa ATLAS.ti 9, smo prepoznali pet kategorij dejavnikov sprejemanja: organizacijske dejavnike, dejavnike, vezane na medicinsko sestro, tehnološke dejavnike, socialni vpliv ter dejavnike, vezane na pacienta. Osredotočenost na pacienta je bila rdeča nit vseh skupin dejavnikov. V prihodnje bi bilo priporočljivo proučiti dejavnike, ki vplivajo na sprejemanje novih tehnologij s strani medicinskih sester, preden se jih začne uporabljati.Welfare technologies, which encompass a wide range of technologies used to maintain or improve individuals’ functioning, safety, participation or independence, are becoming inevitable for health care and long-term care. These technologies are also impacting nursing practice. However, little is known about their acceptance among nurses who work with older adults outside of the clinical setting. The goal of this five-stage scoping review was to address this knowledge gap. A comprehensive search of seven bibliographic databases (MEDLINE, CINAHL with full text, PubMED, Scopus, Proquest Social Sciences Database, APA PsycArticles, and SocINDEX with full text) and grey literature was conducted in December 2022. Based on the inclusion and exclusion criteria, 27 articles were selected. The content-based analysis conducted using ATLAS.ti 9 software identified five categories of acceptance factors: individual, organizational, patient-related and technological factors, and social influence. Notably, patient-centeredness was found to be represented in all five categories. In the future, the factors that influence nurses\u27 acceptance of new technologies should be researched before the technologies are put into use

Impact of using aging-in-place technologies on quality of life

Background: It is widely recognized that technologies have the potential to contribute to high-quality long-term care for older people at home. Evidence from past RCTs partly confirms the positive effects of technology use, although results are mixed and various questions remain unanswered. Objective: This study aimed to demonstrate the beneficial mid- and long-term effects of using aging-in-place technologies on quality of life (QoL) indicators like perceived safety, control, and participation (ATQoL scale) and other specific psychosocial outcomes (PI-ADS) as well as general health-related QoL (EQ-5D-5L Index value and Health today). Method: We conducted an RCT with 281 older people in Austria, Italy, the Netherlands, and Slovenia. Persons in the intervention group (n=143) obtained a bundle of smart home and assistive technologies which they used for 6 or 13 months in their private homes. Persons in the control group (n=138) received no intervention. Three hypotheses were tested with Generalized Linear Mixed Models. Results: We found slightly positive impacts of technology use on some of the specific QoL indicators for persons who used the technologies for 13 months and were relatively motivated and healthy. No, or even detrimental, effects emerged after 6 months. However, persons who used the emergency watch frequently perceived more favorable outcomes than those who used it rarely. Effects had small to medium standardized effect sizes. No effects emerged for the general health-related QoL measure. Conclusion: Despite study limitations (and the COVID-19 pandemic) we conclude that aging-in-place technologies can mitigate adverse age-related developments, and have stabilizing effects on the QoL of older persons. Our trial showed that outcome indicators that are closely related to technology use should be preferred to general indicators. Findings now have to be consolidated in meta-analyses to paint a clearer picture of the beneficial effects of technology use