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BACKGROUND: Most older adults wish to remain in their homes and communities as they age. Despite this widespread preference, disparities in health outcomes and access to healthcare and social support may create inequities in the ability to age in place. Our objectives were to synthesise evidence of social inequity in ageing in place among older adults using an intersectional lens and to evaluate the methods used to define and measure inequities. METHODS: We conducted a mixed studies systematic review. We searched MEDLINE, EMBASE, PsycINFO, CINAHL and AgeLine for quantitative or qualitative literature that examined social inequities in ageing in place among adults aged 65 and older in Organisation for Economic Co-operation and Development (OECD) member countries. Results of included studies were synthesised using qualitative content analysis guided by the PROGRESS-Plus framework. RESULTS: Of 4874 identified records, 55 studies were included. Rural residents, racial/ethnic minorities, immigrants and those with higher socioeconomic position and greater social resources are more likely to age in place. Women and those with higher educational attainment appear less likely to age in place. The influence of socioeconomic position, education and social resources differs by gender and race/ethnicity, indicating intersectional effects across social dimensions. CONCLUSIONS: Social dimensions influence the ability to age in place in OECD settings, likely due to health inequalities across the lifespan, disparities in access to healthcare and support services, and different preferences regarding ageing in place. Our results can inform the development of policies and programmes to equitably support ageing in place in diverse populations.
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Vida Independente , Fatores Socioeconômicos , Humanos , Idoso , Feminino , Masculino , Envelhecimento/psicologia , Fatores Etários , Idoso de 80 Anos ou mais , Apoio Social , Disparidades em Assistência à Saúde , Determinantes Sociais da Saúde , Disparidades nos Níveis de Saúde , Países DesenvolvidosRESUMO
BACKGROUND: Ageing in place is a common desire among older adults and people in need of care. Accessible housing and ambient assisted living (AAL) technologies can help to live independently at home. However, they cannot replace the human support network of informal caregivers, healthcare professionals and social workers. The needs of these stakeholders should be considered and analysed in order to develop user-friendly and acceptable (digital) solutions for ageing in place while supporting human support networks in fulfilling their roles. This paper presents the first step for a comprehensive multi-level needs analysis within the framework of an user-centered design thinking approach. METHODS: Guideline-based interviews were conducted with healthcare professionals, social workers and an informal caregiver to collect data about the needs of older adults as well as people in need of care, and their human support networks. RESULTS: The call for more information that is easier to find is a common desire of the three groups. There is agreement on system-based communication and orientation problems, the existence of physical and psychological stress exacerbated by a lack of human resources, the desire for personalised care, the need to feel safe and supported in emergencies, and the need for advice and help with administrative tasks. Overall, the needs of one group are closely linked to those of the other. CONCLUSION: Stakeholder selection and diversity are decisive for findings about ageing in place. The overlaps between the stakeholders' needs offer chances and challenges at the same time for the development of user-friendly, acceptable (digital) solutions and products that support ageing in place.
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Envelhecimento , Vida Independente , Humanos , Idoso , Avaliação das Necessidades , Cuidadores/psicologia , Pesquisa QualitativaRESUMO
BACKGROUND: Most people want to remain at home as they age. Ageing in place - remaining at home and connected to the community - is a national and international policy priority; however, to better understand how policy might be implemented, a more nuanced understanding is required about older adults' lived experiences of ageing in place, especially the experiences of those aged 80 and above. OBJECTIVE: To describe and explore the social processes which enable ageing in place from the perspective of community-dwelling older people (80+). METHODS: Forty-six respondents (80-100+ years) participated in the first wave of a longitudinal qualitative study set in North East England. Semi-structured interviews were conducted in participants' homes between June 2022 and January 2023. Interviews were analysed using reflexive thematic analysis. RESULTS: Participants positioned their homes as a place of freedom and as the antithesis of a 'care home'. Remaining in place was important for all participants; a key priority for them was to remain physically active to enable this. However, many participants faced significant hurdles to remaining in place. These were primarily related to health and mobility issues. Some participants were able to overcome such barriers by drawing on financial resources and available social networks. CONCLUSION: The home is central to understanding older peoples' (80+) experiences of ageing. In a socio-political context which promotes ageing in place, the social factors shaping experiences of ageing in place must be considered. This involves attending to the challenges of later life, particularly health and especially mobility and physical function. Currently, those with resources (social and economic) are better equipped to respond to such challenges, thus potentially exacerbating widening inequalities in ageing. By foregrounding the perspectives of those ageing in place alongside social factors shaping their experiences, our study has important implications for policy and health and social care. We show that a more equitable allocation of resources is vital to fulfil the ageing in place policy agenda. Furthermore, we highlight a need to recognise commitments to ageing in place displayed by people aged 80 and above, especially when remaining in place becomes difficult to achieve.
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Vida Independente , Pesquisa Qualitativa , Humanos , Estudos Longitudinais , Idoso de 80 Anos ou mais , Masculino , Feminino , Vida Independente/psicologia , Inglaterra/epidemiologia , Envelhecimento/psicologia , Envelhecimento/fisiologiaRESUMO
Assistive robots have the potential to support independence, enhance safety, and lower healthcare costs for older adults, as well as alleviate the demands of their care partners. However, ensuring that these robots will effectively and reliably address end-user needs in the long term requires user-specific design factors to be considered during the robot development process. To identify these design factors, we embedded Stretch, a mobile manipulator created by Hello Robot Inc., in the home of an older adult with motor impairments and his care partner for four weeks to support them with everyday activities. An occupational therapist and a robotics engineer lived with them during this period, employing an immersive participatory design approach to co-design and customise the robot with them. We highlight the benefits of this immersive participatory design experience and provide insights into robot design that can be applied broadly to other assistive technologies.
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Desenho de Equipamento , Robótica , Tecnologia Assistiva , Humanos , Idoso , Masculino , Design Centrado no Usuário , Atividades Cotidianas , FemininoRESUMO
Many older adults with complex care needs live at home due to ageing-in-place policies. This study explored homecare workers' experiences and suggestions for improvements of care. Twelve semi-structured interviews were analyzed thematically, and revealed pride, capability, and satisfaction in their work, yet they feel undervalued and lack support. They advocate for integrated care models, recognition of their competence, flexible work approaches, and committed leadership. This would enhance patient care and address their own working conditions, addressing concerns from being relegated to the bottom of the hierarchy. They emphasize the need for comprehensive approaches, spanning from housekeeping to end-of-life palliative care.
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Visitadores Domiciliares , Pacientes Domiciliares , Pesquisa Qualitativa , Humanos , Masculino , Feminino , Pacientes Domiciliares/psicologia , Pessoa de Meia-Idade , Visitadores Domiciliares/psicologia , Idoso , Serviços de Assistência Domiciliar , Adulto , Entrevistas como AssuntoRESUMO
OBJECTIVES: This paper considers home from the perspective of people living with dementia supporting ongoing discourse around ageing in place and the significance of creating more inclusive communities. METHODS: Forty-six home tour interviews led by people living with dementia were conducted in England and Scotland to better understand the connectivity between home and neighbourhood for people living with dementia. These interviews used a range of participatory and creative approaches including video, photographic images and in situ interviews. Data were analysed via reflexive thematic analysis. RESULTS: Three themes were identified in data analysis. 1. Connected home and neighbourhood, where participants revealed the dynamic relationship between home and neighbourhood; 2. Practices of home, where participants discussed the everyday nature of their homes and routines; and 3. Displaying home and family, which reflected participant's biographical homes in the context of living with dementia. DISCUSSION: The findings show that home holds multiple meanings for people living with dementia. For example, home is understood as a part of the neighbourhood and an extension of the home space into gardens and backyards, thus extending existing discourses that solely focus on the inside of people's homes. For people living with dementia, homes are also sites of negotiation and renegotiation where new meanings are created to reflect the changing nature and context of the home. There is not one fixed solution to these issues. Support and understanding for people living with dementia will need to evolve to adapt to the shifting dynamics and multiple meanings of home.
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Demência , Vida Independente , Humanos , Idoso , Envelhecimento , InglaterraRESUMO
BACKGROUND: Swedish social policy enables ageing in place with support from home-based care services despite high age and/or declining health. AIM: This study aims to describe the daily life experiences behind the decision to apply for a nursing home placement in older adults ageing in place. MATERIALS AND METHODS: A qualitative design was chosen, and 11 semi-structured interviews were conducted and analysed using inductive qualitative content analysis. RESULTS: The participants described a feeling of dependence in which they had to ignore their personal privacy when receiving home-based care. They reached a turning point when ageing in place was, for several reasons, no longer considered an acceptable option. This influenced their choice to apply to a nursing home where they expected that they could maintain control over their lives. DISCUSSION AND CONCLUSION: The results indicate that when enhancing ageing in place it is important to enable older adults to receive support to maintain autonomy in daily activities and to have the opportunity to age in the right place.
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Serviços de Assistência Domiciliar , Acontecimentos que Mudam a Vida , Humanos , Idoso , Suécia , Vida Independente , Casas de Saúde , Pesquisa QualitativaRESUMO
Older adults prefer ageing in place (AIP) rather than institutionalized facilities. Although its advantages, AIP can be challenging when communities are unable to meet residents' needs. This study aims to identify the relationship between the level of age-friendliness of community and AIP. We used AARP Age-friendly Community Survey data with 6670 older adults in the USA. We used responses from 63 items assessing various aspects of a community's age-friendliness to identify different types of age-friendly communities (AFCs) through latent profile analysis (LPA). We then ran multinomial logistic regression to examine whether the types of AFC were associated with AIP. LPA revealed three types of AFC: Underdeveloped, developing, and developed. Regression results showed older adults living in underdeveloped and developing communities are less likely to AIP compared to those in the developed community. These results show a positive impact of AFC on intention to AIP. Policymakers should consider expanding AFC initiatives for the growing number of older adults.
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BACKGROUND: The number of older adults in need of care and living at home is increasing in Europe. At the same time, the number of professional caregivers is decreasing. This development reinforces the need for assistive technology to support care recipients in their own homes and promote their independence. One of the main challenges of independent living is the preparation of food. Interactive robots could assist older adults with difficulties performing physically demanding tasks. Within the project AuRorA (full German project title: Wiederverwendbare, interaktive Verhalten für proaktive Roboter im Smart Home), an interactive voice-controlled robot arm was developed as an assistance system in the kitchen. OBJECTIVE: The aim of the study was to assess how older adults evaluate the AuRorA system and to collect data on actual willingness to use the technology. Older adults were asked to evaluate the system in terms of usefulness, usability, accessibility and intention to use. MATERIAL AND METHODS: Due to the ongoing coronavirus disease 2019 (COVID-19) pandemic, the older adults evaluated the system via an online survey. The validated questionnaire Technology Usage Inventory (short: TUI) was used in conjunction with self-developed questionnaires to collect data on study population characteristics. RESULTS: A total of 106 participants were included in the analysis. The acceptance, usability and usefulness of the system were rated as medium, while the intention to use was rated as low. A significant strong correlation was found between the TUI subscales intention to use and usefulness. CONCLUSION: It can be assumed that the actual need of the individual participant for such a robotic assistive system had an influence on the evaluation of the system. The perceived usefulness may have been a crucial influence on the intention to use and the overall assessment of the system.
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BACKGROUND: Most persons with dementia live at home and want to stay there as long as possible. In most cases, informal carers such as spouses or children care for them. Together with other family members and professional carers, they form care arrangements to address the complex needs of persons with dementia. One major aim of informal carers is to keep the care arrangement stable. The middle-range theory of 'stability of home-based care arrangements for people living with dementia' (SoCA-Dem theory) offers a theory to understand what constitutes and influences the stability of home-based care arrangements. Based on this theory, the aim of this study was to (1) uncover the underlying structures of differences and commonalities of home-based care arrangements for persons living with dementia, (2) construct types of these care arrangements, and (3) compare these types with regard to their stability. METHOD: This is a secondary analysis of data from a convenience sample of n = 320 care arrangements for persons with dementia obtained in the observational DemNet-D study. Data were analysed using multiple correspondence analysis and hierarchical cluster analysis. Sociodemographic data and variables related to the structure of the care arrangement (D-IVA), burden of the informal carer (BICS-D), dementia severity (FAST), and quality of life of the person with dementia (QOL-AD) were included. RESULTS: The multiple correspondence analysis identified 27 axes that explained the entire variance between all care arrangements. The two axes 'dementia and care trajectory' and 'structure of the dyadic relationship' best distinguished care arrangements from each other and together explained 27.10% of the variance. The subsequent cluster analysis identified four types of care arrangements. Two types included spouse-centred care arrangements, and two types included child-centred care arrangements at different phases of the dementia and care trajectory. The types differ with regard to their stability. CONCLUSION: The results highlight the heterogeneity and commonality of care arrangements for persons living with dementia. They contribute to a better understanding of informal dementia home care. Furthermore, the results can guide the development of tailored support for persons living with dementia and their caring families.
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Demência , Serviços de Assistência Domiciliar , Cuidadores , Análise por Conglomerados , Demência/diagnóstico , Demência/epidemiologia , Demência/terapia , Alemanha/epidemiologia , Humanos , Qualidade de VidaRESUMO
Due to social, political, and demographic developments in Dutch healthcare, the pressure on informal carers of vulnerable, senior citizens living at home continues to increase. To relieve this pressure, people in the senior citizens' social network are looking for ways to share care tasks with others. However, many informal caregivers seem to experience a threshold in this respect. This pilot study focuses on understanding the considerations involved in sharing caregiving tasks with others. Therefore, semi-structured interviews were conducted with six informal caregivers of single, senior citizens living at home. This study shows that these considerations are characterised by a relationship between informal caregivers' workload, their shyness to ask others for help, and the perception of care recipients' demand, combined with informal caregivers' natural inclination to do it themselves. Feelings of being responsible for the care and behaviour of care recipients, and the choices that must be made for them seem to play an additional role. To develop adequate solutions that lead to sharing informal care with others, and relieving the pressure on informal caregivers, more insight into the (personal) mechanisms behind this sense of responsibility seems necessary.
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Cuidadores , Assistência ao Paciente , Humanos , Projetos Piloto , Atenção à Saúde , EmoçõesRESUMO
In Japan, the ageing population is increasing, and the issue of "the declining birthrate and increasing ageing population", "population declining", and "extending healthy life expectancy" have been taken up in various academic fields, but they are still unsolved in the term of effective methods. Currently, in each region of Japan unlike big cities such as Tokyo and Osaka, there is the shortage of medical doctors, hospitals, living supportive infrastructure of roads, communications, public transportation, banks, post offices, and supermarkets, etc. All the necessary infrastructure is collapsing, and the current situation is becoming apparent in population declining villages of Japan. Will our country become more concentrated in big cities in the future? In particular, it is the elderly living in the community who are directly affected by these factors. In this article, we would like to introduce the history and recent activities of "Age-friendly cities and communities (AFCC)" led by the World Health Organization (WHO), and also introduce the efforts of "The Ageing in Place in Cities" project by Manchester Urban Ageing Research Group, the University of Manchester, UK, Akita City Hall, and Advanced Research Center for Geriatric and Gerontology (ARGG), Akita University, Japan.
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Geriatria , Vida Independente , Idoso , Envelhecimento , Cidades , Humanos , Japão , Reino Unido , UniversidadesRESUMO
BACKGROUND: Older adults prefer to age in place. Social network change and health decline challenge ageing in place, as stressors that make age-related advantages disappear. The aim of this study was to explore social network change and health decline and its impact on older adults who are ageing in place. METHOD: In-depth interviews (n = 16) were conducted with older adults who were ageing in place and who were experiencing health decline and social network change. Procedures for grounded theory building were followed to analyse the interviews with respondents who were discharged from the hospital less than 4 months ago (n = 7). Narrative analysis was conducted to reach a deeper understanding of the expected complexity of experiences of this targeted sample. RESULTS: Results encompass a typology with four types of impact: A. Sneak preview of old age, B. Disruptive transition into old age, C. Drastically ageing, and D. Steadily ageing. Additionally, indications were found that older adults should be able to move along the four types of impact and ideally could end up in quartile D, experiencing little or no impact at all (anymore). CONCLUSION: The results present an optimistic view on the possibilities of older adults to continue ageing in place despite experiencing unavoidable and uncontrollable stressors in life. Also, the results provide leads for practice, to develop an action perspective for home care nurses and gerontological social workers to determine and reduce the impact of social network change and health decline on older adults who are ageing in place. Suggestions for further research would be to unravel how to detect temporal setbacks in successful ageing in place.
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Serviços de Assistência Domiciliar , Vida Independente , Idoso , Envelhecimento , Humanos , Pesquisa Qualitativa , Rede SocialRESUMO
BACKGROUND: Informal caregiving for people with dementia can negatively impact caregivers' health. In Asia-Pacific regions, growing dementia incidence has made caregiver burnout a pressing public health issue. A cross-sectional study with a representative sample helps to understand how caregivers experience burnout throughout this region. We explored the prevalence and contributing factors of burnout of caregivers of community-dwelling older people with dementia in Hong Kong (HK), China, and New Zealand (NZ) in this study. METHODS: Analysis of interRAI Home Care Assessment data for care-recipients (aged ≥65 with Alzheimer's disease/other dementia) who had applied for government-funded community services and their caregivers was conducted. The sample comprised 9976 predominately Chinese in HK and 16,725 predominantly European in NZ from 2013 to 2016. Caregiver burnout rates for HK and NZ were calculated. Logistic regression was used to determine the adjusted odds ratio (AOR) of the significant factors associated with caregiver burnout in both regions. RESULTS: Caregiver burnout was present in 15.5 and 13.9% of the sample in HK and NZ respectively. Cross-regional differences in contributing factors to burnout were found. Care-recipients' ADL dependency, fall history, and cohabitation with primary caregiver were significant contributing factors in NZ, while primary caregiver being child was found to be significant in HK. Some common contributing factors were observed in both regions, including care-recipients having behavioural problem, primary caregiver being spouse, providing activities-of-daily-living (ADL) care, and delivering more than 21 h of care every week. In HK, allied-health services (physiotherapy, occupational therapy and speech therapy) protected caregiver from burnout. Interaction analysis showed that allied-health service attenuates the risk of burnout contributed by care-recipient's older age (85+), cohabitation with child, ADL dependency, mood problem, and ADL care provision by caregivers. CONCLUSIONS: This study highlights differences in service delivery models, family structures and cultural values that may explain the cross-regional differences in dementia caregiving experience in NZ and HK. Characteristics of caregiving dyads and their allied-health service utilization are important contributing factors to caregiver burnout. A standardized needs assessment for caregivers could help policymakers and healthcare practitioners to identify caregiving dyads who are at risk of burnout and provide early intervention.
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Cuidadores , Vida Independente , Idoso , Idoso de 80 Anos ou mais , Esgotamento Psicológico/epidemiologia , China , Estudos Transversais , Hong Kong/epidemiologia , Humanos , Nova ZelândiaRESUMO
BACKGROUND: Among older adults, living alone is often associated with higher risk of Emergency Department (ED) admissions. However, older adults living alone are very heterogeneous in terms of health. As more older adults choose to live independently, it remains unclear if the association between living alone and ED admissions is moderated by health status. We studied the association between living alone and ED admission outcomes (number of admissions, inpatient days and inpatient costs) among older adults with and without multimorbidity. METHODS: We used data from 16,785 individuals of the third follow-up of the Singapore Chinese Health Study, a population-based cohort of older Singapore Chinese (mean age: 73(61-96) years). Participants were interviewed face-to-face from 2014 to 2016 for sociodemographic/health factors and followed-up for one year on ED admission outcomes using Singapore Ministry of Health's Mediclaim Database. We first applied multivariable logistic regression and two-part models to test if living alone is a risk factor for ED admission outcomes. We then ran stratified and joint effect analysis to examine if the associations between living alone and ED admission outcomes were moderated by multimorbidity. RESULTS: Compared to living with others, living alone was associated with higher odds of ED admission [Odds Ratio (OR) 1.28, 95 % Confidence Interval(CI) 1.08-1.51)], longer inpatient days (+0.61, 95 %CI 0.25-0.97) and higher inpatient costs (+322 USD, 95 %CI 54-591). The interaction effects of living arrangement and multimorbidity on ED admissions and inpatient costs were not statistically different, whereas the interaction between living arrangements and multimorbidity on inpatient days was borderline significant (p-value for interaction=0.050). Compared to those living with others and without multimorbidity, the relative mean increase was 1.13 inpatient days (95 %CI 0.39-1.86) for those living alone without multimorbidity, and 0.73 inpatient days ( 95 %CI 0.29-1.17) for those living alone with multimorbidity. CONCLUSIONS: Older adults living alone were at higher risk of ED admission and higher inpatient costs regardless of multimorbidity, while those living alone without multimorbidity had the longest average inpatient days. To enable aging in place while avoiding ED admissions, interventions could provide instrumental support and regular health monitoring to older adults living alone, regardless of their health status.
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Serviço Hospitalar de Emergência , Vida Independente , Idoso , Hospitalização , Hospitais , Humanos , MultimorbidadeRESUMO
AIMS: To explore reasons, thoughts, motives, and influencing factors regarding the use or non-use of Personal Safety Alerting Devices (PSADs) in the daily lives of community-dwelling older persons. DESIGN: A qualitative descriptive study design was used. METHODS: Six focus groups were conducted with a total of 32 older persons between February-August 2016. Data analysis followed the Qualitative Analysis Guide of Leuven. RESULTS: The participants described the use or non-use of PSADs as a decision resulting from a "legitimation process". This process implies that a person needs to perceive the necessity for a PSAD and then determine the right moment at which to start using it. During this process, each person weighs her or his "ageing self" and "perception of technology" then decides whether to start using a device or to delay its use. "Critical events" initiate this process, compelling the person to consider their own safety and their possible need for assistance. CONCLUSION: The legitimation process suggests that the initiation of PSAD use represents a turning point in life. Using a PSAD is not simply a matter of obtaining one. It is a complex decision-making process establishing legitimation for its use, which is interwoven with one's individual ageing, self-perception, and the meaning attributed to the device. IMPACT: Older persons need to be supported; in particular, they require time to go through the legitimation process for PSAD use. Nurses can empower them in this process, such that they perceive using a PSAD as a means to restore their frailty balance and feel enabled to (re)gain control over their own life and thus to preserve their independence.
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Fragilidade , Vida Independente , Idoso , Idoso de 80 Anos ou mais , Feminino , Grupos Focais , Humanos , Motivação , Pesquisa QualitativaRESUMO
BACKGROUND: The majority of people with dementia prefer to live independently and safely in their own home cared for by their family members. Much effort has been invested in the development of technology, such as sensor-based networks. Many challenges remain, in particular gaining more knowledge about their experiences and perceived benefits. This study aimed to explore experiences, needs and benefits with using sensor-based technology for safety and independence in the homes of people with dementia and their family members. METHODS: This study is part of the TECH@HOME project, aiming to evaluate the effects of sensor-based technology on independence among people with dementia and caregiver stress among their family members. This study applied an inductive, qualitative approach with semi-structured interviews of people with dementia (n = 9) and family members (n = 21). The participants were interviewed between June and September 2018 after using the technology for at least 6 months. The interviews were analysed with manifest content analysis. RESULTS: Our findings highlighted that technology was considered as a precaution and a safety measure that could provide a sense of having control of the everyday life of the person with dementia. Understanding and acceptance of the technology were as important, together with the reliability of the technology. Ethical dilemmas related to the monitoring of the person with dementia in the home were also raised. CONCLUSION: This study provides insights into how people with dementia and family members experience and benefit from using sensor-based technology in their own homes. The knowledge generated is essential for healthcare professionals and policymakers developing and implementing care and service systems including technology, as well as for the industry.
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Monitoramento Biológico/instrumentação , Monitoramento Biológico/métodos , Cuidadores/psicologia , Família/psicologia , Pessoal de Saúde/psicologia , Segurança do Paciente , Tecnologia de Sensoriamento Remoto , Adulto , Idoso , Idoso de 80 Anos ou mais , Atitude Frente aos Computadores , Demência , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pesquisa Qualitativa , Reprodutibilidade dos TestesRESUMO
BACKGROUND: Meaning in life (MiL) is considered to be an important part of health and is associated with many positive outcomes in older adults, such as quality of life and longevity. As health promotors, nurses may take patients' MiL into account in the care process. There is a knowledge gap in terms of what constitutes good care in relation to older patients' MiL, and what the benefits may be for patients when nursing is attuned to this aspect. The purpose of this study was to explore the experiences of home nursing older adults in relation to nurses' attunement to MiL. METHODS: Gadamerian hermeneutic phenomenological design with semi-structured interviews. Participants were 24 aged home nursing patients. A framework of care ethical evaluation was used in the analysis. Multiple dialogues enhanced understanding. RESULTS: Patients did not expect nurses' regard for their MiL. They rather expected 'normal contact' and adequate physical care. Nurses showed that they were open to patients' MiL by being interested in the patient as a person and by being attentive to specific and hidden needs. Participants explained that the nurse's behaviour upon arrival set the tone: they knew immediately if there was room for MiL or not. All participants had positive and negative experiences with nurses' behaviour in relation to MiL. Valued nursing care included maintaining a long, kind and reciprocal relationship; doing what was needed; and skilled personalised care. Participants mentioned 'special ones': nurses who attuned to them in a special way and did more than expected. Benefits of care that was attuned to patients' MiL were: experiencing a cheerful moment, feeling secure, feeling like a valuable person and having a good day. Older adults also stressed that consideration for MiL helps identify what is important in healthcare. CONCLUSION: Aged homecare patients value nurses' attunement to their MiL positively. Although patients regard MiL mostly as their own quest, nurses play a modest yet important role. Managers and educators should support nurses' investment in reciprocal nurse-patient relationships.
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Although technology has the potential to promote aging in place among community-living older adults with dementia, the use remains scarce. In this literature study we provide an overview of perspectives (i.e., needs, wishes, attitudes, possibilities, and difficulties) of different stakeholders on technology use in the care for community-living older adults with dementia. After selection, 46 studies were included. We mainly found perspectives of informal caregivers and, to a lesser extent, of persons with dementia and formal caregivers. Shared perspectives were, among other things, ease of use, stability and ï¬exibility of technology, importance of privacy, and conï¬dentiality. Among older adults, fun and pleasure, in addition to enhancing freedom and independence, facilitates technology use. Informal caregivers' peace of mind and relief of burden also appeared to be important in using technologies. Formal caregivers value the potential of technologies to improve monitoring and communication. Insight in perspectives of stakeholders are essential to enhance the use of technology in the care for community-living older adults with dementia.
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Demência , Vida Independente , Tecnologia Assistiva , Idoso , Cuidadores , Comunicação , Demência/terapia , HumanosRESUMO
BACKGROUND: With the increase in longevity in the world, successful ageing has become an important issue. This study aims to investigate the relationship between ageing in place and successful ageing in elderlies. METHODS: This study, which utilised a descriptive and relational-screening model, was conducted with the participation of 370 individuals aged 65 and over who were registered in Family Health Centres in a city centre located in the eastern part of Turkey. RESULTS: The participating elderlies' Successful Ageing Scale mean score was 54.16 ± 11.32, and the Ageing in Place Scale mean score was 54.24 ± 12.88. While there was a positive, statistically significant relationship between the Successful Ageing Scale total score, the Ageing in Place Scale total score, and living in the same environment, there was a negative, significant relationship between age and the Successful Ageing Scale total score. CONCLUSION: Elderlies' successful ageing processes are affected positively by the increase in the duration of living in the same environment and satisfaction level about the place they lived in. Successful ageing is negatively affected by the increase in age. It is recommended that elderly people's living environments should not be changed and their social support networks should be strengthened as much as possible so they can have a successful ageing process.