Continuity in Socialization Styles: Typologies of Socialization in the Different Life Stages of Older People.

The purpose of this research was to identify the socialization styles of the older person (such as authoritative, indulgent, authoritarian, and negligent) in three different roles: (1) nowadays as a grandparent, (2) considering the style used to educate their own children in the past; and (3), considering the socialization style they received when they were children. The sample (317 people over 65 years old with at least one grandchild aged up to 16 years old participated) received the questionnaire on socialization styles in those roles. The results showed the predominance of the indulgent style in their role as grandparents. Almost 80% showed intergenerational continuity between at least two roles, with the exception of those with a neglectful style. Continuity in socialization style is crucial to understanding the dynamics within family relationships, which have highly durable intergenerational ties.

Resistance to Eating in People with Dementia Living in Long-term Care Facilities: Gaps between Common and Good Practices.

OBJECTIVES: The present study aims to explore the perception of common and best practices for dealing with resistance to eating of persons with dementia living in long-term care facilities. METHODS: Forty-two staff members working in long-term care facilities were interviewed. They worked in four Spanish long-term care facilities; 21 were nursing assistants and 21 technical staff. Participants heard a vignette in which person with dementia showed resistance to eating. Participants were asked how a situation like that is commonly managed by their workmates, and how the situation should be managed. Responses were content-analyzed. RESULTS: Strategies mentioned by participants were quite diverse and did not converge on common ground that harmonizes their responses. Less than half of the participants considered person-centered strategies as a best practice. Those strategies were lower on assistant carers, compared to technical staff. CONCLUSIONS: Resistance to eating is a common situation faced by professionals. Nonetheless, there is not a common procedure to deal with this situation. Resistance to eating was seen more as a problem to be eradicated than a behavior to be understood. CLINICAL IMPLICATIONS: Staff development initiatives are necessary in relation to mealtime situations. They should consider work position and competencies needed by assistant carers.

Exploring the Benefits of Proactive Participation among Adults and Older People by Writing Blogs.

The use of Information and Communication Technologies (ICTs) for information-seeking, social contact and leisure activities is increasing in adults and older people. However, little is known about adults and older people who are already actively using ICTs to write a blog. The aim of this paper is to describe the benefits adults and older people gain from having a blog. Twenty-three older adult bloggers (aged 60-83 years; most of them with college degrees and retired) from Spain who, at the time of the study had an active blog were interviewed. A thematic analysis identified four different benefits related to blogging: (1) a general sense of satisfaction from producing the blog; (2) relational benefits; (3) cognitive benefits; and (4) identity benefits. Results showed that adults and older people experienced a variety of benefits that broadens the distinction between personal and social benefits found in previous research. Blogging in later life challenges the traditional passive/consumer and online user experience view of adults and older people and seems to be a good example of proactive participation through websites.

Managing apathy among people with dementia living in institutional settings: Staff's perceived gap between common and best practices.

The aim of this study is to explore how staff manage apathy involving a person living with dementia (PLWD). Forty-two staff members working in four Spanish long-term care facilities were interviewed; 21 were nursing assistants and 21 technical staff. They read a vignette about a PLWD presenting apathy. Participants were asked (1) how a situation like that is commonly managed, and (2) how it should be managed. Responses were content-analyzed. Most participants (88.1%) mentioned having experienced a situation similar to the one described in the vignette. Behavior-focused strategies and person-centered strategies were the most frequently mentioned. As for best practices, person-centered strategies emerged as the preferred alternative, and technical staff mentioned them more frequently than assistant carers. Our findings stress the importance of organizational guidelines and staff development in the management of apathy in PLWD.

Sexual harassment from older residents at long-term care facilities: is it really part of the job?

OBJECTIVES: To explore the extent to which staff members in long-term care facilities (LTCF) have experienced situations of sexual harassment, how they commonly and ideally manage the situation, and how their work position influences their responses. DESIGN: Cross-sectional quantitative study, using the vignette technique. METHOD: A total of 2,196 staff-members who were currently working in Spanish LTCF participated in the study. Data were collected using a self-administered questionnaire. Questions regarding sexual harassment were analysed by a vignette that described a case of sexual harassment. Participants had to choose common and best practices for dealing with the case, and report the frequency with which they had experienced similar situations. RESULTS: The results indicate that 29.9% of participants had experienced an episode of sexual harassment in a LTCF similar to the one presented in the vignette. Responses to the situation were diverse and there were significant differences between common and perceived best practices. Differences were also found depending on the work position of the participant (manager, technical staff or nursing assistant). CONCLUSIONS: There is a need for a fuller recognition of the sexual needs of older people. However, the presence of inappropriate sexual behavior must also be acknowledged. The right of staff to work in an environment free of harassment must be respected. The need for explicit institutional guidelines and training opportunities is discussed.

Staff responses to residents exposing their genitals in public in long-term care settings: The gap between common and perceived best practices.

AIMS AND OBJECTIVES: To explore staff reactions to residents' behaviour consisting in exposing their genitals in public, and to differentiate between what is perceived as common practice (what most staff do) and best practice (the best possible approach). BACKGROUND: The presence of inappropriate sexual behaviours (ISBs) in long-term care facilities poses practical and ethical dilemmas since they may impinge on the rights of others (staff and residents) and thus need to be adequately monitored and managed. However, no studies have focused on how staff handle ISBs, and particularly exposing oneself in public. METHODS: A total of 2,175 people working in 152 Spanish LTC facilities participated in the study. They were presented with a vignette describing a resident exposing his/her genitals in public, and they were asked what they think most of their workmates would do and what they think should be done in that situation. The STROBE checklist was used to enhance the quality and transparency of the research. RESULTS: Approximately one-third of participants (32.4%) reported having experienced behaviours such as the one described in the vignette. Staff reactions underline the predominance of restrictive practices. However, if prompted to think in terms of best practice, supportive reactions increased in frequency. Finally, factors such as work position have an influence on perceived common and best practices, with care assistants generally holding more restrictive views than directors or technical staff. CONCLUSIONS: Around one-third of staff members, and particularly those in managerial or technical positions, had witnessed residents exposing their genitals in public. However, there is no common ground among staff regarding the best way to handle the situation. RELEVANCE TO CLINICAL PRACTICE: Our findings stress the importance of organisational policies and workplace training in the management of challenging behaviours such as exposing oneself.

Staff's reactions towards partnered sexual expressions involving people with dementia living in long-term care facilities.

AIMS: To explore staff responses, in terms of common practices, towards partnered sexual relationships in long-term care facilities where one or both people involved have dementia. It also tries to determine personal and institutional factors influencing these responses. BACKGROUND: Although some studies, mostly qualitative, have focused on reactions to residents' sexual expressions so far the issue has not been assessed in a study using large and diverse samples. DESIGN: Cross-sectional quantitative study using vignette technique. METHODS: Participants were 2,295 staff members at 152 Spanish long-term care facilities. Data were collected during 2016. A vignette describing sexual situations involving people with dementia was presented to participants. After the vignette, participants had to answer the question: "What do you think most of your colleagues would do in this situation?" with nine possible responses. RESULTS: Results showed that relationships involving persons with dementia were perceived as potentially problematic by staff. In both conditions, discussing the case with a colleague or supervisor was the most frequently chosen reaction. More restrictive reactions were mentioned when only one person with dementia was involved in the relationship. Factors such as participants" age and years of experience, professional post and commitment to person-centred care practices were related with the frequency of common restriction practices. CONCLUSION: Results highlight the importance of providing staff with clear guidelines regarding the management of specific sexual situations to avoid stereotyped restrictive reactions.

Involving institutionalised people with dementia in their care-planning meetings: lessons learnt by the staff.

BACKGROUND: Applying a person-centred care (PCC) approach is an aspiration for many services attending people with dementia (PwD). However, the implementation and assessment of PCC practices represent a challenge to health professionals. AIM: To evaluate the impact on staff of a programme aiming to involve people with dementia (PwD) in their individualised care-planning (ICP) meetings in long-term residential settings; specifically, to explore the lessons that staff perceived they had learned from the experience. METHODS: Twenty-one staff members working in residential facilities for older people were interviewed after the programme. Responses to two questions ('Do you think that your work has been affected in any way by the attendance of PwD at ICP meetings?' and 'Have you learnt something new as a result of these meetings?') were submitted to thematic analysis. RESULTS: Eighteen of the 21 participants identified at least one lesson they had learned from the experience. The lessons could be grouped under three main headings: (i) an increase in their understanding of PwD, (ii) questioning of their own care practices, and (iii) an improvement in teamwork. CONCLUSION: The involvement of PwD in ICP meetings had a positive impact on staff. They stated that the experience encouraged them to develop PCC-compatible attitudes and modify the way they treat PwD, thus improving the quality of care they deliver. The experience also seemed to empower staff (particularly the lesser trained members) and increase the cohesion of working teams.

Grandparent Visitation Rights in Spain: Which Psychosocial Arguments are Taken into Account to Grant or Deny Visits?

The purpose of this study was to assess reports by psychologists and social workers in lawsuits regarding grandparent visitation rights in Barcelona (Spain). Seventy-three reports written during a five-year period were analysed Sixty-three per cent of cases recommended grandparents being granted visitation rights. A content analysis of the reports revealed that they were more likely to contain negative rather than positive comments about a family member (especially grandparents). Finally, the analysis showed that aspects such as grandparent abilities and a hidden agenda on the part of grandparents were associated with a recommendation that a visitation schedule be denied, whereas the presence of a strong bond between grandparents and the grandchild was related to a favourable recommendation. The article discusses directions for further research and the potential value of drawing up guidelines to assess grandparent rights in the event of family conflict.

Staff members' perceived training needs regarding sexuality in residential aged care facilities.

The purpose of the article is to ascertain if staff members of residential aged care facilities (RACF) perceive the need for training regarding residents' sexuality, and what, if any, benefits from the training were perceived, and to compare perceived benefits of training between care assistants and professional/managerial staff. Interviews were conducted with 53 staff members of five different RACF in Spain. Their responses to two semistructured questions were transcribed verbatim and submitted to content analysis. Results show that most interviewees said they lacked training about sexuality and aging. Two potential highlighted benefits of the training are knowledge/attitudinal (countering negative attitudes regarding sexuality) and procedural (developing common protocols and tools to manage situations related to sexuality). Care assistants and professional staff agreed on the need for training, though the former emphasized the procedural impact and the latter the knowledge/attitudinal benefits. The results suggest that RACF staff should have an opportunity to receive training on residents' sexuality, as sexual interest and behavior is a key dimension of residents' lives.

Staff attitudes and reactions towards residents' masturbation in Spanish long-term care facilities.

AIMS AND OBJECTIVES: To explore staff attitudes and reactions towards masturbation in long-term care facilities. BACKGROUND: Staff attitudes and reactions towards the expression of sexuality in long-term care facilities may be influenced by the nature of the sexual behaviour being expressed. Staff attitudes towards masturbation, a common sexual behaviour in such settings, have gone largely unexplored so far. DESIGN: An exploratory, descriptive, qualitative research design. METHODS: Fifty-three staff members working in five different long-term care facilities participated in the study. They were asked about what they would think, how they would react, and what possible reactions they might expect from workmates if they entered a room and found a resident masturbating. RESULTS: The majority of participants considered that masturbation was acceptable and avoiding interference was by far the most common reaction, although other reactions also arose. When asked about reactions attributed to workmates, mentions to reprimanding the resident and gossiping/joking about the issue were more frequent than acceptance. CONCLUSIONS: The discrepancy between professionals' own reported attitudes and those attributed to workmates suggests the existence of widespread negative reactions towards sexual activity in later life. RELEVANCE TO CLINICAL PRACTICE: In the light of these results, we underline the necessity of developing explicit policies regarding sexual issues. Formal training offered to staff would also help to recognise and preserve resident's sexual rights and needs.

Staff attitudes towards sexual relationships among institutionalized people with dementia: does an extreme cautionary stance predominate?

BACKGROUND: This study explores whether staff perceptions and reactions to sexual situations involving one or two persons with dementia (PWD) reflect an extreme cautionary stance (an overprotective and paternalist style) or a person-centered model of care (focusing on understanding the residents' perspective and their rights). METHOD: Fifty-three staff members currently working in residential aged care facilities (RACFs) were purposively selected to participate in the study. Two vignettes describing sexual situations involving PWD were presented to participants. They were asked about their interpretation of the situation and how they would react. Data were analyzed using content analysis, aimed at identifying common themes in the responses. RESULTS: When the sexual relationship involved a PWD and a cognitively intact resident, participants tended to define the situation as real (54.7%) or possible (35.8%) abuse, whereas when both parties had dementia it was more frequently conceptualized as a possibly abusive (39.6%) or non-abusive (37.7%) situation. The most frequent reaction to both situations was seeking the advice of other professionals. CONCLUSION: The interpretation of the first situation is compatible with an extreme cautionary stance, whereas the second scenario is less clearly perceived as an example of abuse.

Barriers to sexual expression in residential aged care facilities (RACFs): comparison of staff and residents' views.

AIM: To explore and compare the views of both staff and residents about barriers to sexual expression in residential aged care facilities. BACKGROUND: Although remaining sexually active in older age helps to preserve and promote well-being, the percentage of sexually active persons living in residential aged care facilities is low. Previous research has identified several barriers to sexual expression in such settings. Most of this research has focused on staff perceptions, neglecting the residents' perspective. DESIGN: A qualitative descriptive study. METHODS: Fifty-three staff members and 47 older people living in five residential aged care facilities were interviewed. They were asked about barriers to sexual expression in residential settings. Data were analysed using content analysis, aimed at identifying common ideas in the responses. Data were collected over 7 months in 2012. RESULTS: About 40% of the residents subsample did not identify any barrier to sexual expression, although all other participants identified at least one. The most oft-cited barriers were lack of privacy, residents' attitudes and lack of communication about sexuality. CONCLUSION: A substantial number of residents were unable to identify or mention barriers to sexual expression. Generational factors and group pressure could affect residents' attitudes towards sexuality.

Tell me your life: including life stories in an adult development and aging course.

The goals of this study were to determine the learning impact of an assignment that consisted of interviewing and analyzing older people's life stories, and to explore how the assignment was evaluated by students. Participants in the study were 122 first-year social education students enrolled in an adult development and aging course. They evaluated the assignment using an eight-adjective questionnaire and were asked about the benefits of the task. Their answers to the questionnaire were then reviewed using content analysis. The results indicated that marks on the life story assignment predicted marks on an exam about basic course concepts. Students considered that the assignment was interesting, useful, and integrated into the course, although most of them also thought that it was very time-consuming. They identified benefits related to the explicit goals of the course (improvement in the learning of developmental concepts, the acquisition of research-related skills, and the deactivation of aging stereotypes) and personal, growth-related benefits. The authors discuss the difficulties posed by the assignment and its usefulness as a complement to more traditional, lecture-based teaching methods in adult development and aging courses.

The involvement of Spanish older people in nondegree educational programs: reasons for and barriers to participation.

This article examines the reasons older Spanish people participate in nondegree educational programs and the barriers they may face when they want to do so. Data were drawn from the 2007 Survey on Adults' Involvement in Learning Activities (Encuesta sobre la Participación de la Población Adulta en Actividades de Aprendizaje: EADA) and correspond to a nationally representative sample of Spanish people aged between 60 and 74 years old (n=4,559). Overall, only 8.7% of the sample participated in a nondegree educational program. Predictors of participation were being a woman, being younger, having a higher educational level, and being employed. The most frequent reason given for participation was of an intrinsic nature (e.g., interest in the topic), although instrumental motives (e.g., utility of the content for daily life) were more common than suggested by previous research. As for barriers to participation, the vast majority of older people (95.6% of those who did not participate) did not even express a desire to participate. The most frequent barriers were internal (e.g., age/health restrictions). This kind of barrier was ascribed a greater importance by older and less educated groups as well as by those who participate less in cultural activities. Policies to promote older people's participation in nonformal educational activities are discussed in light of the data.

"Now I Understand You": Changes in the Communication of Professionals in Nursing Homes After Receiving Training in the Validation Method.

Caring for older persons is a challenge for professionals who work in nursing homes. Problems in maintaining effective communication with a person with dementia in an effort to understand their needs is a major barrier to good care. Therefore, the main goals of this study were to explore communication barriers between professionals and people with dementia and to observe changes in communication patterns between them after completing Naomi Feil's introductory training in the bases of the validation method (BVM). The 11 professionals who worked in nursing homes attended a 16-hour introductory course on BVM. Participants were interviewed individually three times. The goal was to observe qualitatively the changes in relationships and communication patterns with people with dementia. The results were analyzed thematically. The professionals highlighted how, after the training, they had a different understanding of the person with dementia and a more humane perspective. These changes also reflected how the professionals experienced improvements in job satisfaction, security, and confidence. This study concluded that training nursing home staff in BVM for person-centered and human care has positive implications on how the professionals view their daily work and their way of interacting with older residents. [J Contin Educ Nurs. 2023;54(4):157-168.].

Grandchildren of grandparents with Alzheimer's disease: Exploratory study of the impact of the disease on their relationships.

The aim of this study was to describe the perception of changes that Alzheimer's disease in grandparents has made to the relationship with their grandchildren of between 6 and 13. Qualitative methodology was used. Semi-structured interviews were carried out with 25 grandchildren living in Catalonia, Spain. Participants reported a change in roles from being the care receiver to being the caregiver, changes in the activities that they did together and a positive impact on the grandparent's emotional wellbeing. In the physical sphere, sleeping problems were reported in grandchildren that cohabited with their grandparents. The feelings they described include fear of not being recognized by their grandparents and sadness, as well as satisfaction resulting from their affection and participating in caring. These findings suggest the need to provide information and resources for grandchildren and their families to enable them to deal with the disease.

Grandmothers offering regular auxiliary care for their grandchildren: an expression of generativity in later life?

The study explores the meaning that grandmothers who offer regular childcare attach to that experience and the extent to which the notion of generativity might explain the meaning of the experience of caring for a grandchild. Twenty-four Spanish grandmothers aged 60 and over who provided at least 12 hours a week of childcare were interviewed. Interviews were transcribed verbatim and qualitatively analyzed. The results suggest that grandmothers regard their childcare input as being part of their parental duty of helping in times of need. A range of consequences of caregiving were mentioned, generally positive and satisfactory. Our participants apparently began their caregiving task as an expression of parental generativity, although rewards associated with childcare are linked to grandparental generativity.

Long-term care staff 's positive experiences of caring for people living with dementia: Narratives' content and lessons learned.

Research on caregiving for persons with dementia has mainly focused on its negative impact on caregivers. However, while some studies have found that positive aspects of care can also be found among informal caregivers, little attention has been paid to these positive aspects among staff working in long-term care facilities. The aim of this is study is to explore what kind of positive stories of caring for a person living with dementia staff working in long-term care facilities recall, and what kind of lessons they extracted from these experiences. Forty-two staff members currently working in four Spanish long-term care facilities (21 nursing assistants; 21 technical staff) were interviewed. They were asked about positive stories related to caring for people living with dementia. Data were analyzed using content analysis, aimed at identifying common ideas in the responses. Results showed that the type of stories were quite diverse, but can be grouped into three main themes: attachment, awakening, and mastery. The stories imply different lessons learned, including the importance of individualized care, the value of persistence and patience, and the relevance of technical knowledge and strategies to provide good care. The articles discusses how recording, reflecting on and discussing positive experiences that care staff encounter in their daily practice, may be key to skill development, reinforce job satisfaction, and improve quality of care in a person-centered care direction.

Beyond Parenting Socialization Years: The Relationship between Parenting Dimensions and Grandparenting Functioning.

Parental socialization has been studied mainly when is in process, but less is known about its long-term impact on older adults, particularly on one of the most important developmental tasks in later life: being a grandparent. Participants were 313 Spanish grandparents. The present study examined the relationship between parenting and its impacts in the long term, when the child is a grandparent. The variables examined were parenting (parental warmth and parental strictness) and grandparenting functioning (satisfaction with life, meaning of life, parent-adult child relationship quality, emotional closeness with grandchildren, and role overload). The statistical analyses were a correlation analysis and multiple linear regression analyses. A constant pattern between parenting and grandparenting functioning has been found. Warmth was positively associated with grandparenting functioning, as opposed to strictness, which did not show benefits for grandparents and even showed a significant negative relationship with an indicator of grandparenting functioning. Present findings highlight that, during the socialization years, greater parental warmth but not parental strictness might be of benefit for children at the end of their life (i.e., when they are grandparents) but also for their descendants because they have a better relationship with the two following generations (i.e., adult children and grandchildren).