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Journal article

Assistive devices in context: cross-sectional association between challenges in the home environment and use of assistive devices for mobility

Authors:
SEPLAKI Christopher L., et al
Journal article citation:
Gerontologist, 54(4), 2014, pp.651-660.
Publisher:
Gerontological Society of America

Purpose: This study estimates the cross-sectional association between physical and social challenge in the home environment and use of assistive devices (AD) for mobility in the home, controlling for lower extremity physical performance (short physical performance battery [SPPB]) and other factors. Design and Methods: Data are from the Women’s Health and Aging Study I, a prospective study of the factors related to physical disability in a sample of moderately to severely disabled older women. The study describes these associations in the baseline sample overall and also within subsets who do and do not have both a baseline and a 3-year follow-up observation. Results: On average, physical challenge in the home environment is inversely associated with level of AD use in the overall sample, independent of SPPB, living alone, and other factors. No significant association was found between social challenge and the level of AD use in the overall sample. Findings by follow-up responder status were similar (with minor variability). Implications: Future cohorts who are better educated and more receptive to technology may confront challenges in the home environment that limit their ability to age in place. Findings suggest that the physical challenges of the home are significantly related to AD use. Future analyses that explore the mechanisms of the home environment as a source of challenges to independent functioning could help in the design of future interventions for these cohorts as they age. (Edited publisher abstract)

Journal article

Cycles of adaptive strategies over the life course

Authors:
COOPER Margaret, BIGBY Christine
Journal article citation:
Journal of Gerontological Social Work, 57(5), 2014, pp.421-437.
Publisher:
Taylor and Francis
Place of publication:
Philadelphia, USA

An increasing number of Australia’s ageing population are aging with long-term physical impairments. This study explored the life experiences of this group using a qualitative approach. In-depth interviews were conducted with 10 disabled Victorians, aged between 51 and 84 years, and an inductive thematic analysis undertaken. A relationship was found between the adaptive strategies that participants developed as they moved through life phases and the impairment stages. The implications of the emergence of a cyclical process of adaptation across the life course. and particularly in respect of aging, delivery of aged-care services and social workers in this sector are discussed. (Publisher abstract)

Journal article

Depression and frailty in later life: a synthetic review

Authors:
MEZUK Briana, et al
Journal article citation:
International Journal of Geriatric Psychiatry, 27(9), September 2012, pp.879-892.
Publisher:
Wiley-Blackwell

Frailty is defined as a state or indication of being vulnerable to declining health in later life. Depression in later life is predictive of many of the same kinds of outcomes as frailty, including cognitive impairment, disability, fracture, and mortality. The aim of this review was to explore the conceptual and empirical interrelationships between depression and frailty among older adults. A literature search was conducted using PubMed for publications through to 2010. Reviewers assessed the eligibility of each report and abstracted information on study design, sample characteristics, and key findings. Of these abstracted articles, 39 met the inclusion criteria. The findings from both cross-sectional and cohort studies indicated that frailty, its components, and functional impairment are risk factors for depression. Although cross-sectional studies indicated a positive association between depression and frailty, findings from cohort studies were less consistent. The majority of studies included only women and non-Hispanic Whites. None used diagnostic measures of depression or considered antidepressant use in the design or analysis of the studies.

Journal article

Declines in late-life disability: the role of early- and mid-life factors

Authors:
FREEDMAN Vicki A., et al
Journal article citation:
Social Science and Medicine, 66(7), April 2008, pp.1588-1602.
Publisher:
Elsevier

Investigations into the reasons for declines in late-life disability have largely focused on the role of contemporaneous factors. Adopting a life-course perspective as a backdrop, in this paper we ask whether there also has been a role for selected early- and mid-life factors in the decline, and if so whether these factors have been operating through changes in the risks of disability onset or recovery. Drawing on five waves from 1995 to 2004 of the U.S. Health and Retirement Study, we found for the 75 years and older population in the United States that the prevalence of difficulty with activities of daily living (ADL) declined from 30.2% in 1995 to 26.0% in 2004, whereas the trend in difficulty with instrumental activities of daily living (IADL) was flat. Onset of ADL limitations also was reduced during this period while recovery increased. Changes in the educational composition of the older population were linked to declines in the prevalence of ADL limitations, but there were also modest contributions of changes in mother's education, self-rated childhood health, and lifetime occupation. Declines in late-life vision impairments and increases in wealth also contributed substantially to the downward trend, and had chronic conditions not increased, it would have been even larger. Reductions in the onset of ADL limitations were partly driven by changes in educational attainment of respondents and their mothers and, in late-life, better vision and wealth. In contrast, the recovery trend was not accounted for by changes in early- or mid-life factors. We conclude that early- and mid-life factors have contributed along with late-life factors to U.S. late-life disability trends mainly through their influence on the onset of, rather than recovery from, limitations.

Journal article

Remembering with or without awareness through poetry to better understand aging and disability

Author:
MALEKOFF Andrew
Journal article citation:
Journal of Gerontological Social Work, 44(1/2), 2004, pp.255-264.
Publisher:
Taylor and Francis
Place of publication:
Philadelphia, USA

The author offers three poems that are evocative of his experience as a child with his grandfathers and their disabilities; and as an adult attempting to deal with the impending death of his father. The author aims that the first poem will reinforce the idea that connecting with personal memories of aged and disabled family members might support interactions with people who are aged and disabled in the here and now. The final two poems aim to encourage those working with family members of seriously ill aged people in a hospital setting to better understand the stress of decision-making and to consider devising short-term mutual aid groups to support them during a time for which no preparation exists.

Journal article Full text available online for free

Research into practice

Author:
WINGHAM Gaynor
Journal article citation:
Community Care, 4.4.02, 2002, p.41.
Publisher:
Reed Business Information

Looks at research in northern England that investigates the links between services for older people and disabled people.

Journal article

Exploratory study on challenges faced by ageing persons with physical disabilities

Author:
CHUNG Angela
Journal article citation:
Asia Pacific Journal of Social Work and Development, 21(1), June 2011, pp.89-96.
Publisher:
Taylor and Francis

As the population enjoys a longer life expectancy, persons with disabilities are also living longer. There is growing evidence that persons with physical disabilities may age in an accelerated way from their able-bodied counterparts, due to over-use of particular muscle groups to compensate for a lost function or to long-term complications resulting from the original impairments. This exploratory study sought to investigate whether older adults with lifelong physical disabilities are buffered with sufficient financial, familial, social, and spiritual resources to deal with this challenge. A total of 28 beneficiaries aged 50 years and above from a voluntary welfare organisation that supports persons with disabilities took part in an interviewer-administered survey. In addition, 6 respondents also took part in individual face-to-face interviews. The findings showed some level of perceived lack of financial and social resources, and a general sentiment of apprehension over financial needs and future care. The article concludes that more preparation should be done to educate and prepare ageing persons with disabilities to better plan for their old age.

Journal article

Does socio-economic advantage lead to a longer, healthier old age?

Authors:
MATTHEWS Ruth J., JAGGER Carol, HANCOCK Ruth M.
Journal article citation:
Social Science and Medicine, 62(10), May 2006, pp.2489-2499.
Publisher:
Elsevier

The effect of socio-economic disadvantage on mortality is well documented and differences exist even at older ages. However, whether this translates into differences in the quality of life lived at older ages is less well studied, and in particular in the proportion of remaining life spent without ill health (healthy life expectancy), a key UK Government target. Although there have been studies exploring socio-economic differences in disability-free life expectancy (DFLE) worldwide, these have tended to focus on a single measure of socio-economic advantage, for example, education, race, social class or income, with the majority based on cross-sectional data from younger populations. In this prospective study we examine differences in DFLE and total life expectancy (TLE) at older ages using a range of measures of socio-economic advantage. We use a longitudinal study of 1480 participants aged 75 years or over in 1988 registered with a UK primary care practice, who were followed up until 2003 with measurements at up to seven time points. Disability was defined as difficulty with any one of five activities of daily living. The largest differences in DFLE for both men and women were found for housing tenure. Women aged 75 years living in owned or mortgaged property could expect to live 1 year extra without disability compared with those living in rented accommodation, while for men the difference was almost 1.5 years. The effect of socio-economic advantage on disability-free and total life expectancies appeared to be larger for men than women. In women, socio-economic advantage had more effect on DFLE than total life expectancy for all indicators considered, thus the socio-economically advantaged experienced a compression of disability.

Journal article

Care of Europe's older people

Author:
DAYE Gertaud
Journal article citation:
Quality in Ageing, 6(2), July 2005, pp.21-24.
Publisher:
Pier Professional
Place of publication:
Brighton

This paper explores dignity from the viewpoint of older Europeans themselves.  General recommendations concerning policies for older persons are considered together with commitments included in action plans on aging, in relation to the questions of to what extent these texts can be seen as a means to guarantee the dignity of the older person?  The inter-relatedness of recommendations concerning health, labour market and those on social protection policies are stressed and the impact on the dignity of older citizens highlighted. The use of language is explored, as is the presentation of older persons in the media and advertising and the impact on dignity.  The paper also questions whether dignity, or rather the loss of dignity, is experienced similarly by all groups of older persons.  Is there a difference for men and women, for persons from ethnic minorities and for persons with a disability who are becoming old? Finally it considers what kind of care we want when we are old - how do we wish to be taken care of once we are no longer able to live fully independent lives in our own homes?

Book

Health expectancy: first workshop of the International Healthy Life Expectancy Network (REVES)

Editors:
ROBINE Jean-Marie, BLANCHET Madeleine, DOWD John
Publisher:
HMSO
Publication year:
1992
Pagination:
188p.,tables.
Place of publication:
London

Looks at various studies devoted to disability-free life expectancy. Part 1 contains papers on: expectation of life without disability measured from OPCS disability surveys; summary of results of calculation of life expectancy free of disability in the Netherlands 1981-85; Health expectancy in Quebec 1987; recent values of disability-free life expectancy in the United States; health expectancy in Canada; data from Switzerland. Part 2 contains papers on the different types of disability-free life expectancy and the methods of calculation. Part 3 examines the interpretation of these calculations and part 4 at the uses of disability-free life expectancy.

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