Search results for ‘Subject term:"older people"’ Sort:
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A typical week with mild cognitive impairment
- Authors:
- RENN Brenna N, WOOL Jenny L, BELZA Basia
- Journal article citation:
- Gerontologist, 61(7), 2021, pp.1095-1106.
- Publisher:
- Oxford University Press
Background and Objectives: Identifying the experience of people with mild cognitive impairment (MCI) may help develop research agendas, interventions, and other supports to better match individuals’ needs. The purpose of this study was to explore the subjective experience of a “typical week” living with MCI to document (a) important activities, (b) barriers to usual activities, and (c) facilitators and supports. Research Design and Methods: This study conducted remote individual photo-elicitation interviews with 11 community-dwelling adults aged 55 years or older with MCI. Participants each provided 5–10 photographs of daily life taken over 1 week to facilitate a semistructured qualitative interview. Interview transcriptions were coded in Dedoose software and analyzed using thematic analysis. Results: Participants shared photos and narratives highlighting the important activities in a typical week, in which physical activity, social engagement, spiritual and religious practice, hobbies, and cognitive stimulation were central. Many also shared disruptions to former routines and reduction of activities alongside increased use of new strategies and environmental supports (e.g., calendars, smartphones). Finally, emergent themes centered on disclosure of their diagnosis and reflections about the future. Discussion and Implications: Participant-generated images aided data collection and facilitated discussion of sensitive topics with individuals with MCI. Such narratives may illustrate the needs and opportunities to promote well-being in individuals with MCI, including engagement in meaningful and health-promoting activities, assessing barriers to important daily activities, and considering supports that match the experience and needs of those with MCI. (Edited publisher abstract)
Older adults’ perceived benefits of Equine-Assisted Psychotherapy: implications for social work
- Authors:
- LEE Kathy, et al
- Journal article citation:
- Research on Social Work Practice, 30(4), 2020, pp.399-407.
- Publisher:
- Sage
The purpose of this study was to explore participants’ perceived benefits of equine-assisted psychotherapy and to understand if older adults with functional or cognitive impairment found meaning and purpose in their interactions with horses. This study employed a mixed methods study design with a concurrent triangulation approach. The findings from this study suggest that those impacted with functional or cognitive impairment can meaningfully engage in EAGALA model of equine-assisted psychotherapy and demonstrate the ability to find purpose from their experience. Their perceived benefits were not limited to their interactions with horses but instead wide-ranging, including positive influences from their peers, the outdoor environment associated with equine-assisted activities, and the increased level of social interactions through reminiscence. Social workers can serve a vital role in the use of equine-assisted psychotherapy among older adults, and equine-assisted psychotherapy may hold less stigma than traditional talk therapy to the older adult population. (Edited publisher abstract)
Intelligent power wheelchair use in long-term care: potential users' experiences and perceptions
- Author:
- RUSHTON Paula W.
- Journal article citation:
- Disability and Rehabilitation: Assistive Technology, 12(7), 2017, pp.740-746.
- Publisher:
- Taylor and Francis
- Place of publication:
- London
Purpose: Long-term care (LTC) residents with cognitive impairments frequently experience limited mobility and participation in preferred activities. Although a power wheelchair could mitigate some of these mobility and participation challenges, this technology is often not prescribed for this population due to safety concerns. An intelligent power wheelchair (IPW) system represents a potential intervention that could help to overcome these concerns. The purpose of this study was to explore a) how residents experienced an IPW that used three different modes of control and b) what perceived effect the IPW would have on their daily lives. Materials and methods: The authors interviewed 10 LTC residents with mild or moderate cognitive impairment twice, once before and once after testing the IPW. Interviews were conducted using a semi-structured interview guide, audio recorded and transcribed verbatim for thematic analyses. Results: The analyses identified three overarching themes: (1) the difference an IPW would make, (2) the potential impact of the IPW on others and (3) IPW-related concerns. Conclusions: Findings from this study confirm the need for and potential benefits of IPW use in LTC. Future studies will involve testing IPW improvements based on feedback and insights from this study. (Edited publisher abstract)
Alternate housing models for older people with disabilities: their clientele, structures and resources in relation to the quality of and satisfaction with care delivery
- Authors:
- DUBUC Nicole, et al
- Journal article citation:
- Ageing and Society, 34(9), 2014, pp.1575-1600.
- Publisher:
- Cambridge University Press
This paper reports on the study of a subsidy programme that was established in Quebec for alternate housing models (AHMs), which allows private and community organisations to offer housing services within the framework of a partnership with public health-care services. The research objectives were: (a) to compare how facility characteristics and services provided by AHMs and nursing homes (NHs) differ; (b) to examine the personal characteristics of residents living in AHMs; and (c) to compare residents with similar characteristics within AHMs and NHs in terms of unmet needs, quality of care, satisfaction with care and services, and psycho-social adaptation to the residence. A cross-sectional study was undertaken with individually matched groups to assess whether AHMs meet the needs of elders in a way similar to NHs. Overall, residents in both groups had moderate to severe levels of disability and about 60 per cent had mild to severe cognitive problems. While their general features were heterogeneous, the AHMs were more comfortable and homelike than the NHs. The quality of and satisfaction with care was appropriate in both settings, although AHMs performed better. Only one-quarter of residents in both settings, however, evidenced a good level of psycho-social adaptation to their residence. This partnership approach is a good strategy to provide a useful range of housing types in communities that can respond to the needs of elders with moderate to severe disabilities. (Publisher abstract)
The transition from cognitive impairment to dementia: older people's experiences
- Authors:
- MANTHORPE Jill, et al
- Publisher:
- National Institute for Health Research
- Publication year:
- 2011
- Pagination:
- 119p.
- Place of publication:
- London
The aim of this study was to understand the experiences, expectations and service needs of the person who is becoming the person with dementia, from the perspectives of the older person and their supporter or carer. Separate interviews were carried out with 27 people with memory problems as well as 26 key supporters and carers, regarding their perceptions of expectations, experiences and perceptions of the process of assessment and diagnosis. The interviews were transcribed and analysed to generate themes and codes. Few of the participants experienced the system of memory assessment as patient-centred. Instead, they felt that they were kept waiting for long periods of time without knowing what was going on, and sometimes experienced tests and assessments as distressing in settings that could be alarming. Five transitions in the experience of the participants were identified: ‘internalising dialogue’; ‘confirming positions’; ‘seeking expert advice’; ‘being tested’; and ‘seeking understanding’. The findings suggest that transition is not a linear process. Professionals would be better able to provide tailored support to individuals and their carers at this uncertain time if they are informed of the ‘journey’ from the insights of those who have undertaken it. Recommendations are providing relating to: national issues; issues for commissioners and practitioners; and research questions.
Making sense of mild cognitive impairment: a qualitative exploration of the patient's experience
- Authors:
- LINGLER Jennifer Hagerty, et al
- Journal article citation:
- Gerontologist, 46(6), December 2006, pp.791-800.
- Publisher:
- Oxford University Press
The proposed dementia precursor state of mild cognitive impairment is emerging as a primary target of aging research. This study examines, from the patient's perspective, the experience of living with and making sense of the diagnosis pf mild cognitive impairment. Twelve older adults with amnestic or nonamnestic mild cognitive impairment from a university-based memory disorders clinic were recruited for the study. In-home, semi structured interviews were then conducted in order to elicit rich descriptions of the personal experience of having mild cognitive impairment. The qualitative method of grounded theory was used to analyze narrative data. The results found that understanding and coming to terms with the syndrome, or assigning meaning, constituted a fundamental aspect of living with a diagnosis of mild cognitive impairment. This process comprised interrelated emotional and cognitive dimensions. Participants employed a range of positive, neutral, and negative phrasing in order to depict their emotional reactions to receiving a diagnosis. Cognitive representations of mild cognitive impairment included both prognosis-focused and face-value appraisals. Expectations of normal aging, personal experience with dementia, and concurrent health problems were key contextual factors that provided the backdrop against which participants assigned meaning to a diagnosis of mild cognitive impairment. Clinicians who disclose diagnoses of mild cognitive impairment need to be mindful of the potential for varying interpretations of the information that is conveyed. Future research needs to include systematic, longitudinal investigations of illness representation and its impact on health behaviours among individuals with mild cognitive impairment.
Do older adults presenting with memory complaints wish to be told if later diagnosed with Alzheimer's disease?
- Author:
- ELSON Paul
- Journal article citation:
- International Journal of Geriatric Psychiatry, 21(5), May 2006, pp.419-425.
- Publisher:
- Wiley
Many patients with Alzheimer's disease are not told their diagnosis. Studies have shown that relatives possess mixed views regarding whether or not patients should be told while elderly peers favour disclosure. Recent studies have shown that patients with diagnosed dementia also favour being told. The present study sought the views of patients prior to diagnosis. Participants in this UK study were a consecutive sample of patients aged 65 and over suffering from memory complaints. They were asked what they considered to be causing their memory problems and whether or not they would want to know the cause. They were then specifically asked if they would want to know if diagnosed with Alzheimer's disease and what were their reasons for this. Two-thirds of patients were uncertain regarding the cause of their memory difficulties although the remainder did offer some valid explanations. Eighty-six per cent wanted to know the cause while 69% wanted to know if diagnosed with Alzheimer's disease and a variety of reasons were offered to support their preference. The majority of older adults presenting to services with memory complaints had little understanding of the potential cause of their problems. Most were nevertheless keen to know the cause, even if this transpired to be Alzheimer's disease. The clinical implications of the findings are discussed and suggestions made for future research.
Obtaining self-report data from cognitively impaired elders: methodological issues and clinical implications for nursing home pain assessment
- Authors:
- FISHER Susan E., et al
- Journal article citation:
- Gerontologist, 46(1), February 2006, pp.81-88.
- Publisher:
- Oxford University Press
The authors developed and evaluated an explicit procedure for obtaining self-report pain data from nursing home residents across a broad range of cognitive status, and we evaluated the consistency, stability, and concurrent validity of resident responses. Using a modification of the Geriatric Pain Measure (GPM-M2), 61 residents from two nursing homes were interviewed once a week for 4 consecutive weeks. The authors collected additional data by means of chart review, cognitive status assessments, and surveys of certified nursing assistants. The authors used descriptive and correlational analyses to address our primary aims. Eighty-nine percent of residents completed all four scheduled interviews. Cognitive status was not significantly correlated with number of nonresponses and prompts for yes–no questions, but it was significantly correlated with nonresponses and prompts for Likert-scale questions. Completion time for the 17-item pain measure was not predicted by cognitive status. Residents' scores on the GPM-M2 were significantly correlated with number of chronic pain-associated diagnoses, and internal consistency was excellent. Residents' GPM-M2 scores were stable over time for all comparisons. Using explicit protocols and reporting procedural data allows researchers and clinicians to better understand and apply results of self-report studies with cognitively impaired elders. Results suggest that many nursing home residents can provide consistent and reliable self-report pain data, given appropriate time and assistance.
Are persons with cognitive impairment able to state consistent choices?
- Authors:
- FEINBERG Lynn Friss, WHITLATCH Carol J.
- Journal article citation:
- Gerontologist, 41(3), June 2001, pp.374-382.
- Publisher:
- Oxford University Press
This American study examines the decision-making capacity of persons with cognitive impairment with respect to their everyday care preferences and choices. This is the first in a series of articles to report on findings from a larger study that examines choice, decision making, values, preferences, and practices in everyday care for community-dwelling persons with cognitive impairment and their family caregivers. Fifty-one people with cognitive impairment and their carers were interviewed. All persons with cognitive impairment were interviewed twice within a week using a parallel interview to determine stability and accuracy of responses. The family caregiver was interviewed once. Persons with mild to moderate cognitive impairment are able to respond consistently to questions about preferences, choices and their own involvement in decisions about daily living, and to provide accurate and reliable responses to questions about demographics. Concludes that including the perspective of persons with cognitive impairment in both research and practice has the potential to enhance their autonomy and improve their quality of life.
Older persons' and their caregivers' perspectives and experiences of research participation with impaired decision-making capacity: a scoping review
- Authors:
- HOSIE Annmarie, et al
- Journal article citation:
- Gerontologist, 62(2), 2022, pp.e112-e122.
- Publisher:
- Oxford University Press
Background and Objectives: Human research ethics statements support the equitable inclusion of diverse groups. Yet older people are underrepresented in clinical research, especially those with impaired decision-making capacity. The aim of this study was to identify the perspectives and experiences of older persons and their caregivers of research participation with impaired decision-making capacity. Research Design and Methods: Scoping review of the literature and online sources in January-February 2019 (updated June 2020) according to Joanna Briggs Institute methodology and PRISMA Extension for Scoping Reviews. English-language peer-reviewed research articles and Australian online narratives were included. Data were tabulated and narratively synthesized. Results: From 4,171 database records and 93 online resources, 22 articles (2000-2019, 82% United States, 16 first authors) and one YouTube webinar (2018) were initially included; updated searches yielded an additional article (2020) and YouTube webinar (2020). Studies were heterogeneous in terminology, methods, and foci, with hypothetical scenarios, quantitative analyses, and examination of proxy consent predominating. Participants (N = 7,331) were older persons (71%), caregivers of older persons with dementia/cognitive impairment (23%), and older persons with dementia/cognitive impairment (6%). Synthesis identified 2 themes: willingness to participate and decision-making approaches. Discussion and Implications: Research participation by older persons with dementia may be optimized through reducing risks and burdens and increasing benefits for participants, greater consumer input into study development, and shared and supported decision-making. Older persons' and caregivers' perspectives and experiences of research participation with impaired decision-making capacity require investigation in a greater range of countries and conditions other than dementia, and dissemination through more varied media. (Edited publisher abstract)