| 1. |
- Baxter, Rebecca, et al.
(author)
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Illuminating Meanings of Thriving for Persons Living in Nursing Homes
- 2020
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In: The Gerontologist. - : Oxford University Press (OUP). - 1758-5341 .- 0016-9013. ; 60:5, s. 859-867
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Journal article (peer-reviewed)abstract
- BACKGROUND AND OBJECTIVES: Thriving has been described as a multidimensional concept that can be used to explore place-related well-being; however, there has been limited research into the meaning of thriving in aged care. This study aimed to illuminate meanings of thriving as narrated by persons living in nursing homes. RESEARCH DESIGN AND METHODS: Narrative interviews were conducted with 21 persons residing in a rural Australian nursing home. The interviews were audio-recorded, transcribed, and interpreted using a phenomenological hermeneutic approach. RESULTS: Meanings of thriving could be understood as: Striving toward acceptance of being in a nursing home while maintaining a positive outlook; Feeling supported and cared for while maintaining a sense of independence; Balancing opportunities for solitude and company while living with others; and, Feeling a sense of home while residing in an institutional environment. The meanings of thriving, as presented through the interpretive lens of Gaston Bachelard's "Poetics of Space," encompassed having access to literal, metaphorical, and symbolic doors, as well as having the freedom to open, close, and use these doors however the person wishes. DISCUSSION: Exploring meanings of thriving in nursing homes could contribute towards understanding and implementing positive life-world constructs in research and practice. These findings could be used to inform and enhance person-centered care practices by maximizing opportunities for persons residing in nursing homes to have options and choices, and the agency to make decisions where possible, in relation to their everyday care and living environment. © The Author(s) 2019. Published by Oxford University Press on behalf of The Gerontological Society of America.
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| 2. |
- Eneslätt, Malin, et al.
(author)
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Exploring Community-Dwelling Older Adults’ Considerations About Values and Preferences for Future End-of-Life Care : A Study from Sweden
- 2020
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In: The Gerontologist. - : Oxford University Press. - 0016-9013 .- 1758-5341. ; 60:7, s. 1332-1342
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Journal article (peer-reviewed)abstract
- Background and ObjectivesThere is a substantial body of research on advance care planning (ACP), often originating from English-speaking countries and focused on health care settings. However, studies of content of ACP conversations in community settings remain scarce. We therefore explore community-dwelling, older adults’ reasoning about end-of-life (EoL) values and preferences in ACP conversations.Research Design and MethodsIn this participatory action research project, planned and conducted in collaboration with national community-based organizations, we interviewed 65 older adults without known EoL care needs, about their values and preferences for future EoL care. Conversations were stimulated by sorting and ranking statements in a Swedish version of GoWish cards, called the DöBra cards, and verbatim transcripts were analyzed inductively.ResultsWhile participants shared some common preferences about EoL care, there was great variation among individuals in how they reasoned. Although EoL preferences and prioritizations could be identical, different individuals explained these choices very differently. We exemplify this variation using data from four participants who discussed their respective EoL preferences by focusing on either physical, social, existential, or practical implications.Discussion and ImplicationsA previously undocumented benefit of the GoWish/DöBra cards is how the flexibility of the card statements support substantial discussion of an individual’s EoL preferences and underlying values. Such in-depth descriptions of participants’ reasoning and considerations are important for understanding the very individual nature of prioritizing EoL preferences. We suggest future users of the DöBra/GoWish cards consider the underlying reasoning of individuals’ prioritizations to strengthen person-centeredness in EoL conversations and care provision.
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| 3. |
- Fischer, Björn, et al.
(author)
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The Importance of User Involvement : A Systematic Review of Involving Older Users in Technology Design.
- 2020
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In: The Gerontologist. - : Oxford University Press (OUP). - 0016-9013 .- 1758-5341. ; 60:7, s. e513-e523
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Journal article (peer-reviewed)abstract
- BACKGROUND AND OBJECTIVES: There is a lack of understanding of how older adults' involvement and participation matters in actual design practice. This systematic literature review investigates existing empirical studies involving older users during the design of technologies and explores the nature and consequences of involving older people.RESEARCH DESIGN AND METHODS: Our literature review is informed by the guidelines of the PRISMA statement. We examined the included studies by means of thematic content analysis to identify the nature of older users' involvement and existing evidence on what consequences it has.RESULTS: In total, 40 empirical studies published in the period 2014-2018 are included in the review. Most empirical studies involve older people from local networks, with underlying stereotypical images and at lower levels of participation. The results reveal three main consequences of involving older users: learning, adjusted design, and an increased sense of participation. Furthermore, we found that user involvement is a structured process whose outcomes are contingent on a range of premises.DISCUSSION AND IMPLICATIONS: Synthesizing the results, we develop the concept of user involvement and present an analytical framework. Our results have implications for researchers and policy makers, since they throw into question the widely held assumption that involving older people inevitably yields beneficial outcomes.
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| 4. |
- Friedman, Barbara Bodorkos, et al.
(author)
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Are People Ready for Personalized Brain Health? Perspectives of Research Participants in the Lifebrain Consortium
- 2020
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In: The Gerontologist. - : Oxford University Press. - 0016-9013 .- 1758-5341. ; 60:6, s. E374-E383
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Journal article (peer-reviewed)abstract
- BACKGROUND AND OBJECTIVES: A healthy brain is central to physical and mental well-being. In this multi-site, qualitative study, we investigated views and attitudes of adult participants in brain research studies on the brain and personalized brain health as well as interest in maintaining a healthy brain.DESIGN AND METHODS: We conducted individual interviews with 44 adult participants in brain research cohorts of the Lifebrain consortium in Spain, Norway, Germany, and the United Kingdom. The interviews were audio recorded, transcribed, and coded using a cross-country codebook. The interview data were analyzed using qualitative content analysis.RESULTS: Most participants did not focus on their own brain health and expressed uncertainty regarding how to maintain it. Those actively focusing on brain health often picked one specific strategy like diet or memory training. The participants were interested in taking brain health tests to learn about their individual risk of developing brain diseases, and were willing to take measures to maintain their brain health if personalized follow-up was provided and the measures had proven impact. The participants were interested in more information on brain health. No differences in responses were identified between age groups, sex, or countries.DISCUSSION AND IMPLICATIONS: Concise, practical, personalized, and evidence-based information about the brain may promote brain health. Based on our findings, we have launched an ongoing global brain health survey to acquire more extensive, quantitative, and representative data on public perception of personalized brain health.
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| 5. |
- Henning, G., et al.
(author)
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Retirement and Sexual Satisfaction
- 2023
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In: Gerontologist. - : Oxford University Press (OUP). - 0016-9013. ; 63:2, s. 274-284
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Journal article (peer-reviewed)abstract
- Background and Objectives Although interest in sexuality in older age has increased over the last decades, few studies have focused on longitudinal change in sexual satisfaction around retirement age. In the present study, we studied change in sexual satisfaction across retirement in a sample of Swedish older adults with a partner. Research Design and Methods Our analyses were based on n = 759 participants (359 male, 400 female) from the longitudinal Health, Aging, and Retirement Transitions in Sweden study. For this study, we used 5 waves spanning over a period of 4 years. Results On average, sexual satisfaction did not change significantly before retirement, but decreased after retirement. Interestingly, women showed higher sexual satisfaction than men, as well as a more positive development of both pre- and postretirement sexual satisfaction. Individuals with higher relationship satisfaction had a higher sexual satisfaction until retirement, but their sexual satisfaction also decreased faster after retirement, whereas those with lower relationship satisfaction showed a stable but lower sexual satisfaction. Discussion and Implications Sexual satisfaction can change in the retirement transition in several important ways and further studies on the impact of retirement and other late-life stage transitions are warranted.
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| 6. |
- Lundin, Anette, 1982-, et al.
(author)
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Assistant Nurses' Positioned Accounts for Prioritizations in Residential Care for Older People
- 2021
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In: The Gerontologist. - : Oxford University Press. - 0016-9013 .- 1758-5341. ; 61:4, s. 573-581
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Journal article (peer-reviewed)abstract
- Background and Objectives: Swedish eldercare is strained by an increased administrative workload, which draws time away from individual care of and interaction with older people. This study explores how eldercare staff, working closely with residents in Swedish special housing (nursing homes), make accounts for how they prioritize work tasks.Research Design and Methods: Openly structured, thematic interviews were conducted with 12 permanently employed, female assistant nurses, including a group interview with 3 of them. Positioned accounts (small stories) concerning prioritizations due to insufficient resources were analyzed, using Bamberg's three-level positioning analysis.Results: The analysis shows that the staff take a favorable position toward the older people by distinguishing between care and "the other things."They also justify prioritizations at odds with their care values. The assistant nurses present themselves as doing the best they can in organizationally restricted situations. Organizational demands limit the space for care, giving rise to an idealization of "icing on the cake."Morale is complex in residential care. A narration of "the torn carer"was found as a co-constructed storyline explaining why the staff did not perform eldercare consistent their care values.Discussion and Implications: When ideals and practice differ, interaction in the peer group becomes important in order to maintain a positive professional identity. "The torn carer"is a way for the staff to escape blame for not living up to care values, but it also victimizes them. Staff could be empowered by a working environment characterized by a reflective practice.
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| 7. |
- Schick-Makaroff, K., et al.
(author)
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Using Patient- and Family-Reported Outcome and Experience Measures Across Transitions of Care for Frail Older Adults Living at Home: A Meta-Narrative Synthesis
- 2021
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In: Gerontologist. - : Oxford University Press (OUP). - 0016-9013. ; 61:3
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Journal article (peer-reviewed)abstract
- Background and Objectives: Our aim was to create a "storyline" that provides empirical explanation of stakeholders' perspectives underlying the use of patient- and family-reported outcome and experience measures to inform continuity across transitions in care for frail older adults and their family caregivers living at home. Research Design and Methods: We conducted a meta-narrative synthesis to explore stakeholder perspectives pertaining to use of patient-reported outcome and experience measures (PROMs and PREMs) across micro (patients, family caregivers, and healthcare providers), meso (organizational managers/executives/programs), and macro (decision-/policy-makers) levels in healthcare. Systematic searches identified 9,942 citations of which 40 were included based on full-text screening. Results: PROMs and PREMS (54 PROMs; 4 PREMs; 1 with PROM and PREM elements; 6 unspecified PROMs) were rarely used to inform continuity across transitions of care and were typically used independently, rarely together (n = 3). Two overarching traditions motivated stakeholders' use. The first significant motivation by diverse stakeholders to use PROMs and PREMs was the desire to restore/support independence and care at home, predominantly at a micro-level. The second motivation to using PROMs and PREMs was to evaluate health services, including cost-effectiveness of programs and hospital discharge (planning); this focus was rarely at a macro-level and more often split between micro- and meso-levels of healthcare. Discussion and Implications: The motivations underlying stakeholders' use of these tools were distinct, yet synergistic between the goals of person/family-centered care and healthcare system-level goals aimed at efficient use of health services. There is a missed opportunity here for PROMs and PREMs to be used together to inform continuity across transitions of care.
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| 8. |
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| 9. |
- Taei, Afsaneh, et al.
(author)
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Crime, disorder, and territorial stigmatization : Older adults living in deprived neighborhoods
- 2023
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In: The Gerontologist. - : Oxford University Press (OUP). - 1758-5341 .- 0016-9013. ; 63:5, s. 910-919
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Journal article (peer-reviewed)abstract
- BACKGROUND AND OBJECTIVES: The existence of social problems, crime, and a diminishing sense of community are acknowledged challenges to residents of deprived neighborhoods. In research on deprived neighborhoods in Sweden, the perspectives of young residents and adults of working age dominate. This study explores how older adults in deprived neighborhoods in Sweden experience crime and disorder, and how they adapt and respond to these problems and the neighborhood's poor reputation.RESEARCH DESIGN AND METHODS: Semi-structured interviews were conducted with 22 older adults who had lived five years or more in deprived areas of two cities in Sweden. Data were analyzed using Hirschman's theory of exit, voice, loyalty with a thematic analysis.RESULTS: Most residents had positive things to say about their homes and neighborhoods, even if criminal acts such as shootings, drug dealing, arson, burglary, and knife attacks were part of everyday life. The residents attempted to manage these events with various strategies. Exit strategies included relocation and forms of adaptation and detachment. They used several voice strategies to actively try to solve the problems and engage with the community. Loyalty strategies-and relativizing-were used to defend their neighborhood reputation.DISCUSSION AND IMPLICATIONS: The findings show we should move on from generalized notions of older adults as passive victims of their environment and highlight that some older adults are active agents in building communities in deprived neighborhoods. City improvement programs should extend support to older adults who wish to engage. Approaches are identified which may strengthen older adults' contributions in such neighborhoods.
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