To Plan or Not to Plan? Experiences and Challenges of Older Swiss Adults Facing End-of-Life Decisions.

End-of-life (EoL) planning and the drafting of advance care directives (ACD) are challenging for older adults. As part of a mixed study, the content of 18 semi-structured interviews with Swiss community-dwelling older adults was analyzed to investigate contextual and interactional aspects that might influence their choice to complete ACD. Results show that EoL planning vary greatly. Three types of planners were highlighted: the solo planners, the collaborative planners, and the delegators. Each represents a specific way of conceiving autonomy, the usefulness of ACD and of involving third parties in the decision-making process. Whereas for solo planners, ACD is a personal, rational affair, for collaborative planners and delegators, reflection and decisions on EoL issues are interactional and iterative processes. The results suggest that health and social care professionals would benefit from taking into consideration the various types of planning, in order to provide the best support to older adults for ACD completion.

Will they let me die? Perspectives of older Swiss adults on end-of-life issues.

This article contributes to scientific discussion with regard to the interplay of individual and social factors on end-of-life decisions. Semi-directed interviews (N = 18) with people over 65 years highlighted two different but articulated fears in relation to end-of-life care: on one hand, older adults fear not being allowed to die and being subjected to therapeutic obstinacy; on the other, they fear not being cared for properly, due to their age and a lack of financial resources in the health and social care system. Recommendations are given to assist professionals in discussing these fears with the people concerned and their families.

The association of educational attainment, cognitive level of job, and leisure activities during the course of adulthood with cognitive performance in old age: the role of openness to experience.

BACKGROUND: The relevance of mental health for everyday life functioning and well-being is crucial. In this context, higher educational attainment, higher cognitive level of one's occupation, and more engaging in stimulating leisure activities have been found to be associated with better cognitive functioning in old age. Yet, the detailed pattern of the potential interplay of such a cognitively engaged lifestyle with personality dimensions, such as openness to experience, in their relations to cognitive functioning remains unclear. METHODS: Two thousand eight hundred and twelve older adults served as sample for the present study. Psychometric tests on verbal abilities and processing speed were administered. In addition, individuals were retrospectively interviewed on their educational attainment, occupation, and regarding 18 leisure activities that had been carried out in mid-life. Moreover, openness to experience was assessed. RESULTS: We found that the effect of openness to experience on cognitive functioning was mediated by educational attainment, cognitive level of job, and engaging in different leisure activities. Data were not better described by alternative moderation models testing for interactive (i.e. dependent) effects of openness to experience and cognitively stimulating engagement. CONCLUSIONS: To explain interindividual differences in cognitive functioning in old age, present data are in line with a mechanism in which individuals with high openness to experience may have been more engaged in stimulating activities in early and mid-life. Possibly by increasing their cognitive reserve throughout adulthood, this may finally enhance their cognitive performance level later in old age.

Selective incivility: immigrant groups experience subtle workplace discrimination at different rates.

Immigrants play an increasingly important role in local labor markets. Not only do they grow steadily in number but also in cultural, educational, and skill diversity, underlining the necessity to distinguish between immigrant groups when studying discrimination against immigrants. We examined immigrant employees' subtle discrimination experiences in a representative sample in Switzerland, controlling for dispositional influences. Results showed that mainly members of highly competitive immigrant groups, from immediate neighbor countries, experienced workplace incivility and that these incivility experiences were related to higher likelihoods of perceived discrimination at work. This research confirms recent accounts that successful but disliked groups are particularly likely to experience subtle interpersonal discrimination.