"How are You Doing?" on the Healthy Aging of the Community-Dwelling Oldest-Old in the Shadow of the COVID-19 Pandemic.

OBJECTIVE: Globally, the oldest-old population is growing rapidly. Little is known about the perceived well-being of the community-dwelling oldest-old, especially during the COVID-19 pandemic. This study examined the oldest-old's perceptions of aging well and the COVID-related impacts on them. METHODS: Semi-structured in-depth interviews with 22 adults aged 85 or above were conducted with purposive sampling methods. Transcripts were analyzed using thematic analysis. RESULTS: Four main themes emerged: 1) sustaining functional ability; 2) staying active with a positive attitude; 3) feeling grateful for support from society and family; 4) COVID-19-related anxieties and policies destabilizing their well-being. DISCUSSION: This study provides direct evidence from the oldest-old on how they maintained their well-being. While they valued support from society and family, COVID-19-related measures disturbed their routines and prevented them from self-attaining well-being. The findings should be considered when developing interventions for this vulnerable group.

Effects of horticultural therapy: Perspectives of frail and pre-frail older nursing home residents.

AIM: The aim of the study was to explore the perceptions and experiences of a group of frail and/or pre-frail older nursing home residents in relation to horticultural therapy. METHOD: A total of 22 frail/pre-frail residents were interviewed. A qualitative content analysis approach was adopted to interpret the data from four nursing homes. RESULTS: Four main themes were identified: (a) "Horticultural therapy is an enjoyable activity and a good pastime in nursing home life"; (b) "Joining the programme made me happier"; (c) "Horticultural activities facilitated socialization among the residents"; and (4) "Not much mention was made of the programme by the staff outside the sessions." CONCLUSION AND IMPLICATION FOR PRACTICE: The findings provide evidence of the positive effects of horticultural therapy on perceived well-being among frail nursing home residents and expand the existing state of knowledge on the use of horticultural therapy in long-term residential care. Among others nursing implications, they are also important to develop appropriate and meaningful nursing practice to improve frail residents' perceived quality of life in the institution they now call "home."

Frailty and its association with the Mediterranean diet, life-space, and social participation in community-dwelling older people.

Frailty is a common and vulnerable state in older people, which leads to a higher risk of adverse health outcomes. This cross-sectional study examined the association between frailty and its phenotypic components with the Mediterranean diet, life-space, and social participation in community-dwelling older people. 263 community-dwelling older people recruited from three community centers in Hong Kong completed the study (robust = 85, pre-frail = 120, frail = 58). The results showed that the Mediterranean diet (OR = 0.29), life-space (OR = 0.32), and social participation (OR = 0.31) were associated with frailty. All factors were preferentially associated with slowness. The Mediterranean diet and social participation were additionally associated with weakness and low activity, respectively. To reduce the risk of frailty among diverse populations of older people in community settings, eliminating foods considered detrimental in the Mediterranean diet is advocated. Older people's satisfaction with social participation should be taken into consideration. Environmental designs should accommodate slow-walking older people to maximize their life-space.

Effects of Horticulture on Frail and Prefrail Nursing Home Residents: A Randomized Controlled Trial.

OBJECTIVE: Frail nursing home residents face multiple health challenges as a result of their frail status. The aim of this study was to examine the effects of HT on the psychosocial well-being of frail and prefrail nursing home residents. DESIGN: Randomized controlled trial. SETTING: Nursing homes. PARTICIPANTS: One hundred eleven participants were randomly allocated into the intervention [horticultural therapy (HT)] and control (social activities) conditions. INTERVENTION: HT group participants attended a weekly 60-minute session for 8 consecutive weeks. Control group activities were social in nature, without any horticulture components. MEASUREMENTS: The outcome measures include happiness, depressive symptoms, self-efficacy, well-being, social network, and social engagement. The time points of measurement were at baseline (T0), immediately postintervention (T1), and 12 weeks postintervention (T2). A modified intention-to-treat approach was adopted. A multivariate general estimating equation was used to analyze the data. RESULTS: Forty-six and 50 participants received at least 1 session of the intervention and control condition protocol, respectively. A significant interaction effect between group and time was observed only on the happiness scale (ß = 1.457, P = .036), but not on other outcome variables. In a follow-up cluster analysis of those who received HT, a greater effect on subjective happiness (mean difference = 6.23, P < .001) was observed for participants who were happier at baseline. CONCLUSION: HT was found to be effective in promoting subjective happiness for frail and prefrail nursing home residents. Its favorable effect suggests that HT should be used to promote the psychosocial well-being of those who are frail.