Active aging needs from the perspectives of older adults and geriatric experts: a qualitative study

Assessing the Needs of Elderly People in a Home Environment: Perspectives from Patients, Caregivers, and a Family Nurse

Background: Social demographic changes contribute to increased life expectancy and disability. The ability to maintain independence depends on receiving appropriate support. This study aimed to analyze the needs of individuals over 75 years of age living in a home environment. Methods: A cross-sectional study assessed support needs from the perspectives of the patient, caregiver, and researcher. The following research tools were used: Camberwell Assessment of Need for the Elderly (CANE), Mini-Mental State Examination (MMSE), Barthel Index, and Geriatric Depression Scale (GDS). Results: The average total number of needs reported by the patients was 5.0 ± 2.9, by caregivers 6.63 ± 2.98, and by researchers 5.76 ± 3.43. The most frequently reported unmet needs were related to Accommodation, Company, and Eyesight/Hearing/Communication. A higher number of met needs (p = 0.006) and total needs (p = 0.011) was observed in individuals aged 85 and older and in seniors who had a caregiver (p < 0.001). Lower functional ability was an indicator of a higher number of met needs (p < 0.001). Cognitive function did not affect the number of reported needs. A correlation was found between the number of needs and depressive symptoms. The total number of needs reported by patients was significantly lower than the number reported by healthcare personnel and caregivers. Conclusions: The CANE questionnaire enabled the identification of individual care needs in the elderly. Although unmet needs were in areas that could be easily addressed, elderly individuals did not receive adequate support. Researchers and caregivers identified more met and unmet needs than the elderly individuals themselves.

Management of care for hospitalized older persons - comfort as an essential outcome: a qualitative study

BACKGROUND

The global aging population highlights the need for accurate care management, tailored to their specific needs. This study investigated the production of comfort as a therapeutic outcome of nursing care management for hospitalized older persons.

METHODS

This exploratory descriptive research was conducted in 9 medical wards and 4 surgical wards of a university hospital in the state of Rio de Janeiro, Brazil, via a qualitative approach. Between May and June, 2022, the researchs collected data from 19 nurses in management positions. Semistructured interviews were conducted, and the researchers investigated the data thus collected via thematic-categorical content analysis on the basis of the approach developed by Bardin. The theoretical framework was based on Kolcaba's Comfort Theory.

RESULTS

Inadequate staffing was the main challenge among the forces (barriers) that were observed to obstruct the care management of hospitalized older persons, what lead to task prioritization that favored techinical over comfort-focued care. Additionally, the overload and stress faced by nurses created discomfort for the team, which was reflected in the care that they provided. The results also revealed that a lack of knowledge represented a significant challenge because professional insecurity led nurses to choose restrictive interventions; however, this approach ultimately sacrified comfort. Alongside with leadership, experience emerged as a primary facilitating force. The main risks faced by hospitalized older persons that were identified by nurses included falls, pressure injuries, delirium, pneumonia, and bronchoaspiration. The main nursing interventions used to ensure comfort and safety of hospitalized older persons pertained to the environment as well as to the need to encourage the presence of family members. However, intervening variables, beyond the professional's control, such as inapproprieted hospital infrastructure and the unavailability of family members, were not considered. As a result, the interventions proved to be ineffective since they did not address these factors that impacted patient's levels of comfort.

CONCLUSIONS

Analysis of the findings of this research revealed that although care management focused on promoting comfort, safety and autonomy among patients, nursing practices prioritized patient safety while sacrificing comfort and autonomy.

TRIAL REGISTRATION

This work was approved by the Ethics Committee - no. 57513722.0.0000.5282.

Unequal ageing: the quality of life of senior citizens in the EU before and after COVID-19. A multidimensional approach

Introduction

The ageing population presents a significant demographic and socio-economic challenge for the European Union (EU). Declining fertility rates, coupled with increasing life expectancy, have led to a growing proportion of older individuals within the population, raising concerns about their quality of life. This study aims to assess the quality of life for seniors across EU countries in the years 2015, 2019, and 2022, with a particular focus on the impact of the COVID-19 pandemic. The research seeks to answer the following question: How has the quality of life among seniors in the EU evolved over time, and how has the COVID-19 pandemic affected this trajectory? We hypothesize that the pandemic has exacerbated existing socio-economic inequalities, particularly affecting the most vulnerable older populations.

Methods

This study utilises the Synthetic Measure of Senior Quality of Life (SMSQoL) to evaluate the living conditions of seniors across four critical domains: health, finances, social relations, and environment. Data for the analysis were drawn from Eurostat and national statistical reports, complemented by pilot studies conducted in selected EU countries. The pilot studies focused on gathering qualitative data to supplement the quantitative measures, especially in areas where standardised data were incomplete or unavailable. The assessment spans three years: 2015 (pre-pandemic baseline), 2019 (immediate pre-pandemic), and 2022 (post-pandemic). The analysis includes 27 EU member states and uses both descriptive and inferential statistical methods to evaluate trends and disparities. Cross-sectional analysis was applied to examine the impact of differing social policies, levels of social security, access to healthcare, and economic strength across these countries.

Results

The analysis reveals significant disparities in the quality of life among seniors across EU countries, with pronounced differences between regions. In particular:Northern and Western Europe: seniors in these regions generally experienced improved overall life quality over the observed period. Countries such as Sweden and Germany reported gains in health, financial stability, and social relations, largely due to strong social policies and robust healthcare systems.Eastern Europe: Seniors in Eastern European countries, including Romania and Bulgaria, continued to face substantial challenges, with minimal improvements in quality of life. Economic instability, limited access to healthcare, and weaker social security systems were identified as key contributors to this stagnation.Impact of COVID-19: the pandemic exacerbated existing inequalities, particularly in the domains of social relations and finances. Seniors in economically vulnerable regions were disproportionately affected by social isolation and reduced income, intensifying the pre-existing challenges in their living conditions.Quantitative analysis confirmed that while some regions showed resilience, the most vulnerable populations experienced a sharp decline in their overall quality of life, particularly between 2019 and 2022.

Discussion

The findings from this study highlight the persistence of economic and social inequalities in the life conditions among seniors across the EU. While countries in Northern and Western Europe have made strides in improving senior living conditions, Eastern Europe continues to face significant challenges. The COVID-19 pandemic acted as a catalyst, exacerbating these inequalities, particularly in terms of social isolation and financial insecurity. These results align with previous studies that have highlighted the uneven impact of social policies and economic strength on senior well-being across Europe. The disparities underscore the need for more balanced and equitable policy interventions that can address the vulnerabilities of older populations, particularly in regions struggling with economic instability. Future research should focus on longitudinal studies that track the recovery trajectories of seniors post-pandemic and assess the effectiveness of policy measures aimed at mitigating these disparities.

Empowering the older people on self-care to improve self-efficacy based on Pender's health promotion model: A randomized controlled trial

BACKGROUND

Aging is a critical phase of human, necessitating focused attention on the unique issues, needs, and diseases that older adults face. Self-efficacy has been recognized as a fundamental prerequisite for behavior change in health promotion and health education. Therefore, the present study was aimed to empower older people to improve their self-efficacy based on Pender's health promotion model.

METHODS

His randomized clinical trial was conducted with 64 older adults (32 in the intervention group and 32 in the control group) who were referred to health centers in Kermanshah and selected by cluster sampling. Empowerment interventions were implemented over six sessions, each lasting 60 minutes, for the older adults, along with two additional sessions for their families. Training was conducted using various strategies aligned with the constructs of Pender's Health Promotion Model, including perceived barriers, perceived benefits, self-efficacy, activity-related affect, interpersonal influences, and situational influences. Data were collected at two time points: prior to the intervention and four weeks post-intervention, utilizing Sherer's General Self-Efficacy Scale and a demographic checklist. The data were analyzed using SPSS version 22.

RESULTS

The mean age of the older adults in the intervention group was 66.63±6.84 years, while in the control group, it was 65.25±7.07 years. Before the intervention, there was no significant difference in self-efficacy score between the groups (intervention: 53.09±16.18; control: 55.59±7.33; P>0.01). After the intervention, the intervention group's the self-efficacy score of the intervention group (68.87±10.27) was significantly higher than that of the control group (54.96±5.67; (P˂0.01).

CONCLUSION

Empowerment interventions based on the Pender's health promotion model significantly increased self-efficacy among older adults. Given the importance of self-efficacy in lifestyle changes, implementing these interventions in health centers, clinics, and nursing homes can effectively prevent future issues faced by older adults.

Unveiling the dynamics of social engagement and subjective health in older adults: A gendered perspective

OBJECTIVES

As populations age globally, understanding the dynamics that influence the well-being of older individuals become increasingly crucial. The research employs a comprehensive approach to unravel the multifaceted interplay between social engagements and subjective health perceptions of older Indians, with a special focus on gender differences.

SUBJECTS AND METHODS

This study used data from the Longitudinal Aging Study in India (LASI) wave 1, 2017-18 with a total sample of 30,533 older adults aged 60 years and above. Bivariate analysis, chi-square tests and unadjusted and adjusted average marginal effects from logistic regression models were used to assess the relationship between social engagements and subjective health among older adults, stratified by gender.

RESULTS

The prevalence of poor health status decreased with higher frequency of social networks among both men (pp. (percentage point) = 6.1; CI (Confidence Interval): 10.6, 1.6) and women (pp. = 9.2; CI: 14.9, 3.4). The adjusted average marginal effects demonstrate that with an increase in the overall score of social engagement, the likelihood of poor health is almost reduced by half. For men, the prevalence of poor health was 9.8 pp. (95 % CI: 13.7, 5.8), while for women, it was 9.3 pp. (95 % CI: 15.2, 3.1).

CONCLUSION

Gendered perspectives unveil unique patterns, highlighting how societal expectations and roles assigned to each gender may influence the subjective health perceptions of older individuals. This study adds to the expanding knowledge base to enhance the well-being and fulfillment of aging populations, considering the complex interplay of social dynamics and gendered perspectives.

Public perception on active aging after COVID-19: an unsupervised machine learning analysis of 44,343 posts

Introduction

To analyze public perceptions of active aging in China on mainstream social media platforms to determine whether the "14th Five Year Plan for the Development of the Aging Career and Older Adult Care System" issued by the CPC in 2022 has fully addressed public needs.

Methods

The original tweets posted on Weibo between January 1, 2020, and June 30, 2022, containing the words "aging" or "old age" were extracted. A bidirectional encoder representation from transformers (BERT)-based model was used to generate themes related to this perception. A qualitative thematic analysis and an independent review of the theme labels were conducted by the researchers.

Results

The findings indicate that public perceptions revolved around four themes: (1) health prevention and protection, (2) convenient living environments, (3) cognitive health and social integration, and (4) protecting the rights and interests of the older adult.

Discussion

Our study found that although the Plan aligns with most of these themes, it lacks clear planning for financial security and marital life.

Challenges and opportunities in the Polish healthcare sector from the implementation of telemedicine solutions in the field of gerontology and geriatric medicine: own experience

OBJECTIVE

Aim: To analyze and summarize the implementation of telemedical solutions in geriatrics and gerontology within the Polish healthcare sector, aiming to develop innovative strategies for improving elderly care through telemedical technologies.

PATIENTS AND METHODS

Materials and Methods: An interdisciplinary pilot project in geriatrics was implemented, focusing on health, organizational, and technological areas. The project involved continuous monitoring of health parameters, remote consultations, and the use of telemedical devices and platforms. Key data collection tools included digital clinimetric outcomes from the FRA-MNA-SARC model, with data transmitted to a telemedical platform.

RESULTS

Results: The pilot project demonstrated significant positive outcomes for senior participants. Continuous monitoring of health parameters allowed for early detection and timely intervention, leading to noticeable improvements in chronic disease management. This proactive approach reduced emergency hospital visits and enhanced overall health stability. The medication adherence support system, with automated reminders, ensured patients took their medications as prescribed, resulting in improved compliance and health outcomes. Telemedical solutions efficiently reduced the need for frequent in-person visits, allowing healthcare providers to monitor progress and adjust therapies in real-time. The project also effectively engaged patients and caregivers, increasing confidence in health management and providing valuable support and real-time information.

CONCLUSION

Conclusions: Implementing telemedical solutions in geriatrics within the Polish healthcare sector shows significant potential to improve elderly care. Telemedicine can effectively support chronic disease management, enhance seniors' quality of life through continuous health monitoring, and provide a practical framework for personalized and efficient healthcare delivery.