Abstract
Background and Objectives
With the global population aging, there is a demand for older adults to age in place, that is, to live and age well in their home and community with some level of ...independence. Community-based housing models exist and may support this process. This scoping review aimed to describe and synthesize the ways in which community-based housing models relate to older adults’ aging in place and identify strengths and gaps in the literature.
Research Design and Methods
The housing models explored were villages, naturally occurring retirement communities, congregate housing and cohousing, sheltered housing, and continuing care retirement communities. This exploratory scoping review examined international peer-reviewed literature published from 2004 to 2019. Six databases were searched using terms related to housing models and older adults. Forty-six articles met the inclusion criteria. Descriptive numerical summary and thematic analysis were used to synthesize study characteristics and findings.
Results
Our analysis revealed 4 themes relating to aging in place in the housing models: Social Relations, Health and Well-being, Sense of Self and Autonomy, and Activity Participation. Further analysis identified housing-specific characteristics that appeared to pose barriers to, or enable, aging in place.
Discussion and Implications
To best support aging in place, the findings of the review suggest multiple characteristics worth considering when developing or relocating to a community-based housing model. Further research is required to understand how facilitating characteristics can promote aging in place for community-dwelling older adults.
The U.S. population over 65 years of age is increasing. Most older adults prefer to age in place, and technologies, including Internet of things (IoT), Ambient/Active Assisted Living (AAL) robots and ...other artificial intelligence (AI), can support independent living. However, a top-down design process creates mismatches between technologies and older adults' needs. A user-centered design approach was used to identify older adults' perspectives regarding AAL and AI technologies and gauge interest in participating in a co-design process. A survey was used to obtain demographic characteristics and assess privacy perspectives. A convenience sample of 31 retirement community residents participated in one of two 90-min focus group sessions. The semi-structured group interview solicited barriers and facilitators to technology adoption, privacy attitudes, and interest in project co-design participation to inform technology development. Focus group sessions were audiotaped and professionally transcribed. Transcripts were reviewed and coded to identify themes and patterns. Descriptive statistics were applied to the quantitative data. Identified barriers to technology use included low technology literacy, including lack of familiarity with terminology, and physical challenges, which can make adoption difficult. Facilitators included an eagerness to learn, interest in co-design, and a desire to understand and control their data. Most participants identified as privacy pragmatics and fundamentalists, indicating that privacy is important to older adults. At the same time, they also reported a willingness to contribute to the design of technologies that would facilitate aging independently. There is a need to increase technology literacy of older adults along with aging literacy of technologists.
Both urban and housing plans should be devoted to the effectiveness of the right to decent housing, according to the Constitution. Nevertheless, the disparity of their competences, terms of validity ...and technical measures provoked that they turned away and became uncoordinated. This study analyzes those problems and makes some proposals to overcome them. Tanto los planes urbanísticos como los de vivienda deberían procurar la efectividad del derecho a disfrutar de una vivienda digna y adecuada, por imperativo constitucional. Sin embargo, la disparidad de las competencias para aprobarlos y de sus plazos de vigencia han contribuido a que se dieran la espalda históricamente, así como a la descoordinación de las técnicas de las que se sirven. En este estudio se analizan estos problemas y se formulan algunas propuestas para superarlos.
Abstract
Moving to a continuing care retirement community (CCRC) and living apart together (LAT) as a repartnering form represent new late-life beginnings. A large study on LAT relationships ...constructed in CCRCs identified envy and jealousy, yet they were not examined in-depth. Envy is wanting something we lack, whereas jealousy is fear of losing something that is ours to another. These emotions are rarely explored in the context of older adults’ relationships. Using Goffman’s framework of (semi)-totalitarian institutions, our aim is to heuristically examine experiences of envy and jealousy from the perspective of residents and staff. In total, thirty semi-structured interviews were conducted in three CCRCs in Israel with ten LAT residents, ten non-LAT residents and ten CCRC staff members, including social workers. Findings refer to kinds of envy, ignoring envy and the development and consequences of LAT-related jealousy and/or envy in CCRCs. The discussion and conclusions address how semi-totalitarian CCRC features influence envy and jealousy experiences. They include implications for social work practice with older adults and their family members regarding adjustment to life in the CCRC and may assist CCRC management and social workers in addressing possible consequences of envy and jealousy.
Background: The COVID-19 third wave in Ontario from April to June 2021 led to a province-wide cancellation of elective surgeries and the development of policies to minimize in-person patient ...encounters. We aimed to assess the educational impact of the third wave on the orthopedic surgical trainees in a competency-based program. Methods: Qualitative post-third-wave surveys were distributed to residents in postgraduate years (PGY) 1-4 in a competency-based orthopedic training program in Ontario (n = 48). Results: Thirty-one residents (64.5%) responded to the survey. Overall average work hours per week were reduced from 79.3 to 73.3 hours among the junior residents (n = 16) and from 79.7 to 72.5 hours among the senior residents (n = 15). More than half of the residents saw their overall patient encounter volume either decrease or significantly decrease. More senior residents (66.7%, n = 10) reported significant decreases in their operating volume than the junior residents (43.8%, n = 7). Five senior residents (33.3%) and 6 junior residents (37.5%) did not receive credits for their rotation. Of those residents, 4 senior residents (80%) and 2 junior residents (33.3%) perceived that they achieved all expected competencies to pass the rotation. Conclusion: Several residents, especially residents in PGY3 and PGY4, perceived that they achieved the necessary competencies to progress to the next level of training despite seeing reduced work hours, decreased patient encounters, and reduced operating volume during the COVID-19 third wave in Ontario. Further studies on identifying and managing discrepancies pertaining to assessment of residents' performance and faculty's perception of their competence in orthopedic surgery training may be warranted.
Purpose
China’s population is ageing. Continuing care retirement communities (CCRCs) are an emerging living arrangement of older Chinese. Incorporating social sustainability features into CCRCs helps ...to create age-friendly residential environments for residents. However, it is still unclear what kinds of social sustainability features are incorporated into the residential environments of CCRCs in China. Therefore, this study aims to address this research gap.
Design/methodology/approach
Qualitative content analysis is adopted to analyse the retrieved business information of representative CCRC developers in China.
Findings
This study revealed 36 social sustainability features in CCRCs, with the top-ranked ones being health care and management, social connection and engagement, high-quality and diverse services and daily life support and assistance. Additionally, a preliminary social sustainability framework of CCRCs was proposed, and this framework includes the five components of care and health, environment and management, service and facility, age-friendly life philosophy and social support and inclusion.
Originality/value
In theory, this research’s findings clarify the meaning of social sustainability within the context of CCRCs, which supports future relevant explorations in the CCRC research community. In practice, these findings enhance stakeholders’ understanding of the social sustainability in CCRCs, which promotes the development of age-friendly living environments for older people in an ageing society.
Background
Most dementia care occurs in the community with support from informal caregivers who are often distressed. Dementia caregiver distress is known to be hazardous to the caregiver's health, ...but the impact on the dementia care recipient is not well known.
Methods
We searched the Medline, Embase, PsycINFO, CINAHL, and Cochrane databases from inception until June 2017 for studies investigating the association of informal caregiver distress with health outcomes of community‐dwelling dementia care recipients. The search results were screened and then data ed, and the risk of bias was appraised independently by pairs of reviewers.
Results
We included 81 original investigations (n = 43 761 caregivers and dementia care recipients). Sixty‐six studies (81.5%) were observational or cross‐sectional in design, and 47 studies (58%) had a low risk of bias. There was considerable clinical and methodological heterogeneity precluding quantitative synthesis. Dementia care recipients (n = 21 881) had a mean age of 78.2 years (SD ± 3.8 y), half (50.0%) were women, and two‐thirds (66.1%) had Alzheimer's disease. The dementia caregivers (n = 21 880) had a mean age of 62.5 years (SD ± 23.3), three‐quarters (74.1%) were women, and one‐half (50.5%) were spouses of the dementia care recipient. Twenty‐two unique dementia care recipient outcomes were studied including cognition, mood, quality of life, function, healthcare utilization, and costs. Overall, informal caregiver distress is commonly associated with the institutionalization of the dementia care recipient, worsening behavioral and psychological symptoms of dementia, and experiencing elder abuse.
Conclusion
Informal caregiving is a cornerstone of dementia care, and distress related to this role is associated with worsening of several dementia care recipient health outcomes. It is important that clinicians and researchers worldwide consider the broader consequences of caregiver distress. J Am Geriatr Soc 67:609–617, 2019.
Background and objectives
during the coronavirus disease 2019 pandemic in Israel, people residing in continuing care retirement communities (CCRC) found themselves under strict instructions to ...self-isolate, imposed by the CCRC managements before, during and after the nationwide lockdown. The present study explored the personal experiences of CCRC residents during the lockdown.
Research design and methods
in-depth interviews were conducted with 24 CCRC residents from 13 different CCRCs. Authors performed a thematic analysis of interview transcripts, using constant comparisons and contrasts.
Results
three major themes were identified: (i) ‘Us vs. them: Others are worse off’. Older residents engaged in constant attempts to compare their situation to that of others. The overall message behind these downward comparisons was that the situation is not so bad, as others are in a worse predicament; (ii) ‘Us vs. them: Power imbalance’. This comparison emphasised the unbalanced power-relations between older adults and the staff and management in the setting and (iii) ‘We have become prisoners of our own age’. Interviewees described strong emotions of despair, depression and anger, which were intensified when the rest of society returned back to a new routine, whilst they were still under lockdown.
Discussion and implications
the measures imposed on residents by managements of CCRCs during the lockdown, and the emotional responses of distress among some of the residents, revealed that CCRCs have components of total institutions, not normally evident. This underscores the hidden emotional costs of the lockdown among those whose autonomy was compromised.
Dementia is a leading cause of disability, and the prevalence of dementia is steadily increasing. Although people with dementia are living longer lives in the community, without adequate support for ...their declining physical and psychological needs, the majority of these individuals end up in nursing homes. With no cure in sight, and in the context of population ageing, we must consider how to care for these individuals in the future. Technologies that augment existing care can maintain a person comfortably in their community, maximize individual autonomy and promote social participation. However, to date, such technologies have rarely been used in dementia care. This Perspectives article highlights the need for affordable and appropriate technologies to assist future dementia care, outlines some of the technologies currently available and describes the many challenges to integration of such technologies. Finally, guidelines are suggested for the development and implementation of new technologies in dementia care.
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