Engaging Older People in Age-Friendly Cities through Participatory Video Design.

Participatory video design is a novel approach to collect experiences and perceptions of older people about the age-friendliness of their city or neighborhood. In this article, we describe how this co-creative method can add to specific knowledge about the preferences and needs of older people about the improvement or preservation of their environment. We describe two examples of this approach in the cities of The Hague and Leiden, the Netherlands. Persons of 60 years and older were invited to participate in a "workshop" on filmmaking focusing on age-friendly cities. A professional filmmaker and a researcher of the University of Applied Sciences worked in co-creation with older people, to produce short films on the topics that were perceived as important from the perspective of the participants. The older people worked in couples to produce their short films about the city or their neighborhood. Topics of the films included communication and information, outdoor spaces, social relations, and community support. The use of participatory video design can foster empowerment and social interaction among older participants, and insight into the preferences and needs of older people regarding age-friendly cities.

Wishes and needs of community-dwelling older persons concerning general practice: A qualitative study.

INTRODUCTION: Community-dwelling older persons often experience hindering health complaints that disturb daily activities. If general practitioners (GPs) are unaware of such complaints, this could lead to a mismatch in provided care and needed or expected care. In this qualitative study with community-dwelling older persons we investigated how older persons experience hindering health complaints, how they deal with them, and what they expect from their GP. METHODS: Participants (aged ≥80 years) with pain and/or problems with walking/standing were invited to participate in a (group)interview about hindering health problems and expectations from general practice. Data were analysed using the framework method and results were discussed with a client panel. RESULTS: Participants experienced various hindering health complaints in addition to pain and/or problems with walking/standing. Complaints affecting social activities were experienced as the most hindering. Participants actively tried to remain independent and, to achieve this, GPs were expected to be involved and be easily accessible. However, they did not expect specific help from their GP for pain or problems with walking/standing. Suggestions for improvement of care from GPs included optimisation of accessibility (continuous availability by telephone), a yearly check including medication review, open communication, and empathy and support during major life events. CONCLUSIONS: According to older persons with hindering health complaints, GPs could improve their accessibility/relationship with patients by: 1) continuous telephonic availability, 2) initiating regular contact with medication reviews, and 3) initiating support during major life events. This might lower the reported barriers to contact the GP for hindering health complaints.

[Coping strategies of older people with low mood]. / Omgaan met somberheid op oudere leeftijd: een kwalitatieve studie.

BACKGROUND: To gain new insights for support for older people with low mood, we explored the perceptions of 'screenpositive' older people on underlying causes and possible solutions. DESIGN AND METHOD: We conducted two in-depth interviews with 38 participants (≥77 years) who screened positive for depressive symptoms in general practice. To investigate the influence of the presence of complex health problems, we included 19 persons with and 19 without complex problems. Complex problems were defined as a combination of functional, somatic, psychological or social problems. RESULTS: All participants used several cognitive, social or practical coping strategies. Four patterns emerged: mastery, acceptance, ambivalence, and need for support. Some participants, especially those with complex problems, were ambivalent about possible interventions. CONCLUSION: Most older participants perceived their coping strategies as sufficient. General practitioners can support self-management by exploring the (effectiveness of) personal coping strategies, providing information, elaborating on perceptions of risks and discussing alternative options with older persons.

Suicidality in Huntington's Disease: A Qualitative Study on Coping Styles and Support Strategies.

BACKGROUND: Huntington's disease (HD) mutation carriers are at increased risk of suicidal ideation, suicide attempts, and completed suicide. However, research is lacking on coping strategies and treatment options that can be offered to suicidal HD mutation carriers. OBJECTIVE: This study explores how individuals with pre-motor or motor symptomatic HD cope with suicidality, how their partners support them, and their ideas and wishes regarding how relatives and healthcare professionals can help them in coping with suicidality. METHODS: This qualitative study included 11 HD mutation carriers who experienced suicidal ideation or attempted suicide and 3 of their partners. They participated in a focus group discussion or an individual in-depth interview. Two independent researchers fragmented the transcribed interviews, coded these fragments, grouped them under themes, and structured the data. RESULTS: HD study participants used four main strategies to cope with suicidality, including talking about suicidality, employing self-management activities, using medication, and discussing end-of-life wishes. Partners, relatives, and healthcare professionals can support suicidal HD mutation carriers in each of those four strategies. CONCLUSIONS: Despite the absence of a turnkey solution for suicidality in HD, healthcare professionals can play an important role in supporting suicidal HD mutation carriers by providing an opportunity to talk about suicidality, providing psychoeducation on self-management, prescribing medication, and discussing end-of-life wishes. Future HD-specific intervention studies could investigate the effect of combining these treatment strategies into one holistic approach.

Older people coping with low mood: a qualitative study.

BACKGROUND: To gain new insight into support for older people with low mood, the perceptions, strategies, and needs of older people with depressive symptoms were explored. METHODS: Two in-depth interviews were held with 38 participants (aged ≥77 years) who screened positive for depressive symptoms in general practice. To investigate the influence of the presence of complex health problems, 19 persons with and 19 without complex problems were included. Complex problems were defined as a combination of functional, somatic, psychological or social problems. RESULTS: All participants used several cognitive, social or practical coping strategies. Four patterns emerged: mastery, acceptance, ambivalence, and need for support. Most participants felt they could deal with their feelings sufficiently, whereas a few participants with complex problems expressed a need for professional support. Some participants, especially those with complex problems, were ambivalent about possible interventions mainly because they feared putting their fragile balance at risk due to changes instigated by an intervention. CONCLUSION: Most older participants with depressive symptoms perceived their coping strategies to be sufficient. The general practitioners (GPs) can support self-management by talking about the (effectiveness of) personal coping strategies, elaborating on perceptions of risks, providing information, and discussing alternative options with older persons.