Qualitative Analysis of Cannabis Use Among Older Adults in Colorado.

BACKGROUND: Although the rate of cannabis use by older adults is increasing more quickly than all other age groups, little is known about the reasons why older adults use cannabis and the outcomes they experience. OBJECTIVE: The objective of this study was to identify the most salient themes concerning the use of medical and recreational cannabis by older adults living in Colorado. Specifically, we sought to (1) characterize perceptions of cannabis use by users and non-users, (2) determine how older adults access cannabis, and (3) explicate both positive and negative outcomes associated with cannabis use. METHODS: Between June and November 2017, we conducted 17 focus groups in senior centers, health clinics, and cannabis dispensaries in 15 Colorado cities. Participants included 136 persons aged over 60 years who were both users and non-users of cannabis. We coded and analyzed session transcripts using thematic analysis with NVivo software. RESULTS: We identified 16 codes from which five main themes emerged. These themes included: a lack of education and research about cannabis, a lack of provider communication, access to medical cannabis, the outcomes of cannabis use, and a reluctance to discuss cannabis use. CONCLUSIONS: Older adults want more information about cannabis and desire to communicate with their healthcare providers. Older adults who used cannabis for medical purposes reported positive outcomes but highlighted difficulties in accessing medical cannabis. Older adults in Colorado also revealed how a stigma continues to be attached to using cannabis.

Grupo de convivência para idosos na atenção primária à saúde: contribuições para o envelhecimento ativo / Conviviality groups for elderly people in primary health care: contributions to active aging / Grupo de convivencia para ancianos en la atención primaria a la salud: contribuciones para el envejecimiento activo

Objetivo: Analisar as contribuições do grupo de convivência de idosos para o envelhecimento ativo na perspectiva de seus participantes.Método:Estudo qualitativo, exploratório-descritivo, realizado com 14 idosos participantes de um grupo de convivência de uma Unidade Básica de Saúde. Os dados foram coletados por meio de entrevistas semi estruturadas, submetidas à análise de conteúdo de Bardin e analisadas à luz da Política de Envelhecimento Ativo. Resultados: Emergiram três categorias temáticas:"Grupo de convivência como oportunidade de lazer socializante para idosos"; "Grupo de Convivência como espaço de aprendizagem para os idosos"; "A importância do Grupo de Convivência no processo de promoção da saúde e envelhecimento ativo dos idosos".Conclusão: A percepção dos idosos frente a participação no grupo de convivência remeteu a momentos de lazer, socialização, aprendizado e melhora da saúde física e mental, contribuindo para ampliar a qualidade de vida enquanto envelhecimento ativo

Objective: To analyze the contributions of the elderly conviviality groups to active aging from the perspective of their participants. Methodology: A qualitative study, exploratory-descriptive, carried out with 14 elderly people from a conviviality groups of a Basic Health Unit. Data were collected through semi-structured interviews, submitted to content analysis and analyzed in light of the Active Aging Policy And World Aging and Health Report. Results: Three thematic categories emerged: "Conviviality groups as a socializing leisure opportunity for the elderly""; "Conviviality groups as a learning space for the elderly"; "The importance of the conviviality groups in the process of health promotion and active aging of the elderly". Conclusion: It was analyzed that the perception of the elderly regarding the participation in the conviviality groups referred to moments of leisure, socialization, learning and improvement of physical and mental health, contributing to increase the quality of life as an active aging

Objetivo: Analizar las contribuciones del grupo de convivencia de ancianos para el envejecimiento activo en la perspectiva de sus participantes.Metodología: Estudio cualitativo, exploratorio-descriptivo, realizado con 14 ancianos participantes de un grupo de convivencia de una Unidad Básica de Salud. Los datos fueron recolectados por medio de entrevistas semiestructuradas, sometidas a análisis de contenido y analizadas a la luz de la Política de Envejecimiento Activo E Informe Mundial del Envejecimiento y Salud. Resultados: emergieron tres categorías temáticas: "Grupo de convivencia como oportunidad de ocio socializante para ancianos"; "Grupo de Convivencia como espacio de aprendizaje para los ancianos"; "La importancia del Grupo de Convivencia en el proceso de promoción de la salud y envejecimiento activo de los ancianos". Conclusión: Se analizó que la percepción de los ancianos frente a la participación en el grupo de convivencia remitió a momentos de ocio, socialización, aprendizaje y mejora de la salud física y mental, contribuyendo a ampliar la calidad de vida como envejecimiento activo

Sintomas depressivos em grupos de terceira idade / Depressive symptoms in elderly people / Los síntomas depresivos en los terceros grupos de edad

Objective: The study's goal has been to identify depressive symptoms in elderly people living in communities or groups in the municipality of Petrolina, Pernambuco State, Brazil, through the Geriatric Depression Scale. Methods: It is a cross-sectional study that was carried out with 185 elderly people. Three structured and semistructured instruments were applied, including the Geriatric Depression Scale. Descriptive statistics and the logit model with Odds Ratio (OR) were used. The Kruskal Wallis and Mann Whitney tests were applied in order to evaluate the scale score. A significance level of 5% and a confidence interval of 95% were used. Results: The active elderly showed 36.2% of depressive symptoms. The multivariate model presented the gender (for men OR=0.31; p-value=0.043) and the health perception (OR=10.27 and p-value=0.001) as depression associated factors. Conclusion: There is a need for implementing strategies aiming to prevent depressive symptoms in elderly people, and also taking into consideration the factors associated with its occurrence

Objetivo: Identificar a ocorrência de sintomas depressivos a partir da Escala de Depressão Geriátrica em idosos participantes de centros e grupos de convivência de idosos no município de Petrolina-Pernambuco. Métodos: Estudo transversal com 185 idosos. Aplicaram-se três instrumentos estruturados e semiestruturados, incluindo a Escala de Depressão Geriátrica. Utilizou-se a estatística descritiva e o modelo logit com apresentação do odds ratio. Os testes de Kruskal Wallis e Mann Whitney foram aplicadas para avaliação do escore da escala. Adotou-se nível de significância de 5% e intervalo de confiança de 95%. Resultados: Observou-se ocorrência de 36,2% de sintomas depressivos nos idosos ativos. O modelo multivariado apresentou o sexo (homens OR=0,31; p-valor=0,043) e a percepção de saúde (ruim OR=10,27; p-valor=0,001) como fatores associados à depressão. Conclusão: Há necessidade da implantação de estratégias de prevenção para enfrentamento de depressão na pessoa idosa nos fatores que estiveram associados à sua ocorrência

Objetivo: Identificar la aparición de los síntomas depresivos en la Escala de Depresión Geriátrica en ancianos que participan de los centros y grupos de convivencia de ancianos en la ciudad de Petrolina, Pernambuco. Métodos: Estudio transversal con 185 ancianos. Se aplicaron tres instrumentos estructurados y semi-estructurados, incluyendo la Escala de Depresión Geriátrica. Se utilizó la estadística descriptiva y el modelo logit con presentación odds ratio. Las pruebas de Kruskal Wallis y Mann-Whitney se aplicaron para evaluar la puntuación de la escala. Se adoptó un nivel de significación de 5% y un intervalo de confianza de 95%. Resultados: Se ha observado una ocurrencia 36,2% de los síntomas depresivos en los ancianos activos. El modelo multivariado mostró sexo (hombres OR = 0,31 ; valor de p = 0,043) y percepción de la salud (OR = 10,27; p-valor = 0,001) como factores asociados a la depresión. Conclusión: Hay necesidad de implementar estrategias de prevención para hacer frente a la depresión en los ancianos en los factores que se asociaron con su ocurrencia

Service Use, Participation, Experiences, and Outcomes Among Older Adult Immigrants in American Adult Day Service Centers: An Integrative Review of the Literature.

Older adult immigrants are often socially isolated and vulnerable to poor health. Adult day service (ADS) centers could potentially facilitate social integration and address their long-term health care needs. The current review (a) identifies barriers to and facilitators of ADS use among immigrants, (b) explores how ADS programs impact older adult immigrants' health and well-being, and (c) isolates the most effective culturally based components of ADS programs. An integrative review was conducted using Whittemore and Knafl's methodology. Four databases were searched. Articles were critically appraised and data were organized within an ADS-specific framework. Functional impairment, race, gender, and degree of loneliness were all predictors of ADS use. ADS enhanced immigrants' quality of life and provided fulfillment. Transportation, bilingual nurses, peer support, and cultural activities were deemed essential by participants. ADS can provide support to older adult immigrants by adding cultural elements to existing services and using nurses as cultural liaisons. More research is needed to assess the impact of ADS on disease outcomes, including dementia, and on immigrants in multi-ethnic settings. [Res Gerontol Nurs. 2018; 11(6):317-328.].

Loneliness in senior housing communities.

There are many studies on loneliness among community-dwelling older adults; however, there is limited research examining the extent and correlates of loneliness among older adults who reside in senior housing communities. This study examines the extent and correlates of loneliness in three public senior housing communities in the St. Louis area. Data for this project was collected with survey questionnaires with a total sample size of 148 respondents. Loneliness was measured using the Hughes 3-item loneliness scale. Additionally, the questionnaire contained measures on socio-demographics, health/mental health, social engagement, and social support. Missing data for the hierarchical multivariate regression models were imputed using multiple imputation methods. Results showed approximately 30.8% of the sample was not lonely, 42.7% was moderately lonely, and 26.6% was severely lonely. In the multivariate analyses, loneliness was primarily associated with depressive symptoms. Contrary to popular opinion, our study found the prevalence of loneliness was high in senior housing communities. Nevertheless, senior housing communities could be ideal locations for reducing loneliness among older adults. Interventions should focus on concomitantly addressing both an individual's loneliness and mental health.

Motivation to volunteer among senior center participants.

Senior centers in the United States play a vital role in the aging continuum of care as the focal points of a community-based system of services targeting independent older adults to promote their social integration and civically engagement. Although several studies have evaluated the diversity of senior center programs, demographic characteristics of participants, and benefits of participation, very few have explored motivations to volunteer among participants. Many senior centers rely on a cadre of participants who volunteer there to assist with programs and meal services. However, a systematic examination of volunteering interests and the rationale for volunteering among senior center participants has been missing from the literature. This mixed-methods study, conducted at a large suburban senior center, explores the interests and motivations of volunteerism among the participants. The study found that there was limited interest in volunteering among senior center participants. Those who were motivated to volunteer wanted to do so in order to stay connected with their community. There was strong interest in volunteering for single events or projects rather than a long-term commitment. Implications for senior centers are discussed.

Adult Day Center Programs and Their Associated Outcomes on Clients, Caregivers, and the Health System: A Scoping Review.

Purpose of the Study: Adult day centers (ADCs) offer a heterogeneous group of services that provide for the daily living, care, nutritional, and social needs of older adults. We sought to conceptually map and identify key gaps and findings from literature focused on ADCs, including the types of programs that exist and their associated outcomes on improving health and strengthening health systems. Design and Methods: We conducted a scoping review by searching 5 databases for studies evaluating the outcomes of ADCs specifically for community-dwelling older adults. Included studies were conceptually mapped according to the methods used, type of outcome(s) assessed, study population, disease focus, service focus, and health system considerations. The mapping was used to derive descriptive analyses to profile the available literature in the area. Results: ADC use has positive health-related, social, psychological, and behavioral outcomes for care recipients and caregivers. There is a substantial amount of literature available on some ADC use outcomes, such as health-related, satisfaction-related and psychological and behavioral outcomes, while less research exists on issues of accessibility and cost-effectiveness. Implications: As the population ages, policymakers must carefully consider how ADCs can best serve each user and their caregivers with their unique circumstances. ADCs have the potential to help shape health system interventions, especially those targeting caregivers and people requiring long-term care support. Due to the variation among types of ADC programs, future research on ADCs should consider different characteristics of ADC programs to better contextualize their results.

Home and community-based service and other senior service use: Prevalence and characteristics in a national sample.

We report on the use of home and community-based services (HCBS) and other senior services and factors affecting utilization of both among Americans over age 60 in the Health and Retirement Study (HRS). Those using HCBS were more likely to be older, single, Black, lower income, receiving Medicaid, and in worse health. Past use of less traditional senior services, such as exercise classes and help with tax preparation, were found to be associated with current use of HCBS. These findings suggest use of less traditional senior services may serve as a "gateway" to HCBS that can help keep older adults living in the community.

The Effect of Adult Day Program Attendance on Emergency Room Registrations, Hospital Admissions, and Days in Hospital: A Propensity-Matching Study.

Purpose of the Study: This study is an investigation of the effect of adult day program attendance by home care clients 65 years of age and older on numbers and rates of emergency room registrations, hospital admissions, and days in hospital. Design and Methods: Each adult day program attendee was matched to a single unique nonattendee (n = 812) on the basis of similar propensity scores which had been estimated from 19 demographic, psychosocial, clinical, and functional covariates. Evaluation of the propensity-matching procedure indicated that balance had been achieved on the covariates. Results: Subsequent analyses revealed significantly lower mean 100-day rates of emergency room registrations, hospital admissions, and days in hospitals for attendees, compared to matched nonattendees. Although lower rates were largely attributable to longer stays in the home care program for attendees, attendees' mean number of days in hospital was still significantly lower compared to nonattendees. Implications: Findings replicate and extend results from previous research that reported a decreased reliance on costly health care services by seniors who attend adult day programs.

Disaster preparedness: Assessment of older adults living in the NYC rockaways.

OBJECTIVE: To determine if there has been a measureable improvement in disaster preparedness among older adults affected by Hurricane Sandy in the NYC Rockaways and to identify if there are any characteristics among this sample that might be factors for vulnerability. DESIGN: A 16-item self-reported survey compromised of demographics and needs assessment questions. SUBJECTS: Senior citizens who are members of a local senior center and live in the Rockaways. MAIN OUTCOME MEASURES: Three hypotheses were tested. (1) H1: That there is a positive difference in level of the Pre- and Post- Sandy Storm Preparedness. (2) H0: That the level of Storm Preparedness is not related to relative advanced age factor in older adults. (3) H0: That the level of Storm Preparedness is not related to living arrangement, income level, and/or access to transportation RESULTS: The alternative hypothesis was accepted for hypothesis one. The null hypotheses were accepted for hypotheses two and three. CONCLUSIONS: It was found that the level of disaster preparedness has significantly improved. The age of the participants when analyzed as two groups, those under and those over age 70, is not related to storm preparedness. Also, demographic factors are not significantly related to disaster preparedness. These findings may be a result of older adult psychological development as discussed by Erikson or the participants may be homogeneous due to their shared traumatic experience of Hurricane Sandy.

Oral Health Status of Older Adults Attending Senior Centers and Congregate Meal Sites in New Hampshire.

PURPOSE: This study assessed the oral health status of older adults in randomly selected New Hampshire senior centers and congregate meal sites for the purpose of future planning, implementation and evaluation of targeted public health programs. METHODS: A cross-sectional surveillance project was developed. Registered dental hygienists visually assessed denture use, number of natural teeth, teeth mobility, untreated caries, root fragments, gingivitis, need for care and treatment urgency among randomly selected active older adults living within New Hampshire communities. RESULTS: Altogether, 610 adults 60 years old and older attending 25 senior centers and congregate meal sites participated. Sixteen percent were edentulous and 42% reported having a removable upper or lower denture. Among edentulous adults, 5% had no dentures at all. Among 513 dentate participants, 22% had untreated caries, 14% had root fragments, 9% had gingivitis and 7% presented with obviously mobile teeth. Overall, 19% required early or urgent dental care. Differences were detected by sex, age group, urban versus rural location of the site and by the participation in a federal nutritional program for older adults. CONCLUSION: Baseline information about oral health needs of older adults in New Hampshire was gathered. Overall needs as well as existing oral health disparities will be addressed through the collaboration of public and private partners.

S4AC Case Study: Enhancing Underserved Seniors' Access to Health Promotion Programs.

The Seniors Support Services for South Asian Community (S4AC) project was developed in response to the underutilization of available recreation and seniors' facilities by South Asian seniors who were especially numerous in a suburban neighbourhood in British Columbia. Addressing the problem required the collaboration of the municipality and a registered non-profit agency offering a wide range of services and programs to immigrant and refugee communities. Through creative outreach and accommodation, the project has engaged more than 100 Punjabi-speaking seniors annually in diverse exercise activities. Case study research methods with staff and current and former senior participants of S4AC include participant observation, individual interviews, and focus groups. Viewed through the critical interpretive lens of the "candidacy framework", findings reveal the myriad ways in which access to health promotion and physical activity for immigrant older adults is a complex iterative process of negotiation at multiple levels.

Capacidade de execução das atividades instrumentais de vida diária em idosos: Etnoenfermagem / Execution capacity of instrumental activities of daily living in elderly: Ethnonursing

Objetivo: Analisar as intervenções de saúde e enfermagem propostas em grupos de convivência para idosos. Métodos: Estudo de abordagem qualitativa, do tipo etnoenfermagem. Participaram do estudo 35 idosos que faziam parte de um projeto de extensão universitária. A coleta de dados foi pautada pelo modelo Observação-Participação-Reflexão, diário de campo e entrevista. A análise dos dados seguiu quatro fases. Resultados: As oficinas foram contextualizadas conforme as necessidades dos idosos para realização das atividades diárias. A autonomia e a independência emergiram como preditores de saúde. O grupo de convivência foi referido como promotor da cultura do envelhecimento ativo e saudável. Conclusão: Os grupos são espaços para possíveis problematizações das demandas dos idosos, em relação à execução das atividades de vida diária. Capacidade funcional, autonomia e independência foram fatores determinantes para a saúde e o bem-estar dos idosos, devendo ser focos da intervenção de enfermagem.

Predictors of senior center use among older adults in New York City public housing.

Despite agreement among stakeholders that senior centers can promote physical and mental health, research on senior center use in urban populations is limited. Our objective was to describe demographic and health factors associated with senior center use among urban, low-income older adults in order to inform programming and outreach efforts. We used data from a 2009 telephone survey of 1036 adults randomly selected from rosters of New York City public housing residents aged 65 and older. We analyzed senior center use by race/ethnicity, age, gender, health, housing type, and income, and used a forward selection approach to build best-fit models predicting senior center use. Older adults of all ages and of both genders reported substantial use of senior centers, with nearly one third (31.3%) reporting use. Older adults living alone, at risk of depression, or living in specialized senior housing had the greatest use of centers. Senior center use varied by race/ethnicity, and English-speaking Hispanics had a higher prevalence of use than Spanish-speaking Hispanics (adjusted prevalence ratio [PR]=1.69, 95% CI: 1.11-2.59). Spanish-speaking communities and older adults living in non-senior congregate housing are appropriate targets for increased senior center outreach efforts.

Older adults are mobile too!Identifying the barriers and facilitators to older adults' use of mHealth for pain management.

BACKGROUND: Mobile health (mHealth) is a rapidly emerging field with the potential to assist older adults in the management of chronic pain (CP) through enhanced communication with providers, monitoring treatment-related side effects and pain levels, and increased access to pain care resources. Little is currently known, however, about older adults' attitudes and perceptions of mHealth or perceived barriers and facilitators to using mHealth tools to improve pain management. METHODS: We conducted six focus groups comprised of 41 diverse older adults (≥60 years of age) with CP. Participants were recruited from one primary care practice and two multiservice senior community day-visit centers located in New York City that serve older adults in their surrounding neighborhoods. Focus group discussions were recorded and transcribed, and transcriptions were analyzed using direct content analysis to identify and quantify themes. RESULTS: Focus group discussions generated 38 individual themes pertaining to the use of mHealth to help manage pain and pain medications. Participants had low prior use of mHealth (5% of participants), but the vast majority (85%) were highly willing to try the devices. Participants reported that mHealth devices might help them reach their healthcare provider more expeditiously (27%), as well as help to monitor for falls and other adverse events in the home (15%). Barriers to device use included concerns about the cost (42%) and a lack of familiarity with the technology (32%). Facilitators to device use included training prior to device use (61%) and tailoring devices to the functional needs of older adults (34%). CONCLUSIONS: This study suggests that older adults with CP are interested and willing to use mHealth to assist in the management of pain. Participants in our study reported important barriers that medical professionals, researchers, and mHealth developers should address to help facilitate the development and evaluation of age-appropriate, and function-appropriate, mHealth devices for older persons with CP.