As the world population ages and older adults comprise a growing proportion of current and potential Internet users, understanding the state of Internet use among older adults as well as the ways ...their use has evolved may clarify how best to support digital media use within this population. This article synthesizes the quantitative literature on Internet use among older adults, including trends in access, skills, and types of use, while exploring social inequalities in relation to each domain. We also review work on the relationship between health and Internet use, particularly relevant for older adults. We close with specific recommendations for future work, including a call for studies better representing the diversity of older adulthood and greater standardization of question design.
Governments and public health institutions across the globe have set social distancing and stay-at-home guidelines to battle the COVID-19 pandemic. With reduced opportunities to spend time together ...in person come new challenges to remain socially connected. This essay addresses how the pandemic has changed people’s use of digital communication methods, and how inequalities in the use of these methods may arise. We draw on data collected from 1,374 American adults between 4 and 8 April 2020, about two weeks after lockdown measures were introduced in various parts of the United States. We first address whether people changed their digital media use to reach out to friends and family, looking into voice calls, video calls, text messaging, social media, and online games. Then, we show how age, gender, living alone, concerns about Internet access, and Internet skills relate to changes in social contact during the pandemic. We discuss how the use of digital media for social connection during a global public health crisis may be unequally distributed among citizens and may continue to shape inequalities even after the pandemic is over. Such insights are important considering the possible impact of the COVID-19 pandemic on people’s social wellbeing. We also discuss how changes in digital media use might outlast the pandemic, and what this means for future communication and media research.
The increased use of PET amyloid imaging in clinical research has sparked numerous concerns about whether and how to return such research test results to study participants. Chief among these is the ...question of how best to disclose amyloid imaging research results to individuals who have cognitive symptoms that could impede comprehension of the information conveyed. We systematically developed and evaluated informational materials for use in pre-test counseling and post-test disclosures of amyloid imaging research results in mild cognitive impairment (MCI). Using simulated sessions, persons with MCI and their family care partners (N = 10 dyads) received fictitious but realistic information regarding brain amyloid status, followed by an explanation of how results impact Alzheimer's disease risk. Satisfaction surveys, comprehension assessments, and focus group data were analyzed to evaluate the materials developed. The majority of persons with MCI and their care partners comprehended and were highly satisfied with the information presented. Focus group data reinforced findings of high satisfaction and included 6 recommendations for practice: 1) offer pre-test counseling, 2) use clear graphics, 3) review participants' own brain images during disclosures, 4) offer take-home materials, 5) call participants post-disclosure to address emerging questions, and 6) communicate seamlessly with primary care providers. Further analysis of focus group data revealed that participants understood the limitations of amyloid imaging, but nevertheless viewed the prospect of learning one's amyloid status as valuable and empowering.
The current exploratory investigation aims to establish the reliability and validity of a hope measure, the Herth Hope Index, among families impacted by early cognitive impairment (N = 96). ...Exploratory factor analysis was used to examine the dimensionality of the measure. Bivariate analyses were used to examine construct validity. The sample had moderately high hope scores. A two-factor structure emerged from the factor analysis, explaining 51.44% of the variance. Both factors exhibited strong internal consistency (Cronbach’s alphas ranged from .83 to .86). Satisfaction with social support was positively associated with hope, supporting convergent validity. Neurocognitive status, illness insight, and depression were not associated with hope, indicating discriminant validity. Families impacted by cognitive impairment may maintain hope in the face of a potentially progressive illness, regardless of cognitive status. The Herth Hope Index can be utilized as a reliable and valid measure of hope by practitioners providing support to families impacted by cognitive impairment.
Advance directives (ADs) provide a way to express medical care preferences at the end of life, yet they are underutilized. This article analyzes the effect of the Patient Self-Determination Act and ...presents recommendations for the improvement of AD legislation. Although the Patient Self-Determination Act was intended to educate patients, clinicians, and the public about ADs, more work is needed to improve involvement in end-of-life care decision making for individuals who may be disenfranchised in this process.
In March 2020, like much of the rest of the world, we went into lockdown. A week into our new reality, we decided to do a survey study about how people were experiencing the COVID-19 pandemic. In ...this piece, we describe what motivated us to do the study, how we went about it, and what others can learn from our experiences.
Family caregivers of individuals with dementia typically have limited opportunity during brief clinical encounters to describe the dementia-related behaviors and interactions they find difficult to ...handle. Lack of objective data depicting the nature, intensity, and impact of these manifestations of the underlying disease further constrains the extent to which strategies recommended by nurses or other health care providers can be tailored to the situation. The current article describes a prototype wearable camera system used to gather image and voice data from the caregiver's perspective in a pilot feasibility intervention study conducted with 18 caregiving dyads. Several scenarios are presented that include salient events (i.e., behaviors or interactions deemed difficult by the caregiver or identified as concerning by the research team during screening) captured in the resulting video. The current authors anticipate future wearable camera systems and software will automate screening for salient events, providing new tools for assessment and intervention by nurses.
Background:
People with a diagnosis of mild cognitive impairment (MCI) often struggle with uncertainty and fear when learning of and coping with their diagnosis. However, little is known about their ...experiences and perspectives, and those of their care partners, when seeking out and undergoing a diagnostic evaluation for their cognitive symptoms.
Method:
This study is a secondary analysis of a focus group discussion that was initially conducted to learn the perspectives and experiences of participants and their care partners during a mock disclosure session of brain scan results. Participant’s broader views on their experience of completing a cognitive evaluation resulting in an MCI diagnosis were evaluated in this study. Analysis used qualitative content methodology and line-by-line coding which generated categories and themes.
Results:
The (1) “presence of a threat” and (2) attempts to “minimize the threat” emerged as overarching themes driving the process of seeking out a diagnostic evaluation for cognitive symptoms. Subthemes that highlight the complexity of the presence of a threat included the “fear of stigma,” and the “emotional reactions” related to an MCI diagnosis. Three additional subthemes represented approaches that participants and their care partners used to minimize threat of MCI: “use of language” to minimize the threat; “information sharing and withholding”; and the “use of social support to legitimize personal experiences.”
Conclusion:
These findings add to the literature by elucidating the uncertainty, fears, and coping strategies that accompany a diagnostic evaluation of MCI.
Stroke victims are at relatively high risk for injurious falls. The purpose of this study was to document longitudinal fall patterns following inpatient rehabilitation for first-time stroke ...survivors.
Participants (n = 231) were recruited at the end of their rehab stay and interviewed monthly via telephone for 1 to 32 months regarding fall incidents. Analyses were conducted on: total reports of falls by month over time for first-time and repeat fallers, the incidence of falling in any given month; and factors differing between fallers and non fallers.
The largest percentage of participants (14%) reported falling in the first month post-discharge. After month five, less than 10% of the sample reported falling, bar months 15 (10.4%) and 23 (13.2%). From months one to nine, the percentage of those reporting one fall with and without a prior fall were similar. After month nine, the number of individuals who reported a single fall with a fall history was twice as high compared to those without a prior fall who reported falling. In both cases the percentages were small. A very small subset of the population emerged who fell multiple times each month, most of whom had a prior fall history. At least a third of the sample reported a loss of balance each month. Few factors differed significantly between fallers and non-fallers in months one to six.
Longitudinal data suggest that falls most likely linked to first time strokes occur in the first six months post discharge, particularly month one. Data routinely available at discharge does not distinguish fallers from non-fallers. Once a fall incident has occurred however, preventive intervention is warranted.
Theoretical and empirical work on digital media use and social connectedness has often considered face-to-face communication to be an available option. But how do various digital media uses relate to ...social connectedness when face-to-face communication is not, or much less, possible? Drawing on survey data from 2925 US adults during the early months of the COVID-19 pandemic, we find that different digital communication methods display different relationships with social connectedness under stay-at-home circumstances with limited in-person interactions outside the home. Overall, digital communication relates to lower social connectedness. In line with notions from social presence theory, especially digital media lower in social presence (e.g. email, social media, and online games, and to some extent text messaging) relate negatively to social connectedness, while this is not the case for higher social presence media (e.g. voice and video calls). Our study has implications for theorizing about digital media use and social connectedness in times when face-to-face communication is less available.
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