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A preference-based model of care: an integrative theoretical model of the role of preferences in person-centered care
- Authors:
- HAITSMA Kimberly Van, et al
- Journal article citation:
- Gerontologist, 60(3), 2020, pp.376-384.
- Publisher:
- Oxford University Press
Knowledge of individuals’ everyday preferences is a cornerstone of person-centered care (PCC). Initial evidence demonstrates the positive impact of honoring preferences in care for older adults receiving long-term services and supports (LTSS). Yet, the mechanisms through which preference-based care affects individual well-being remain poorly understood. This article proposes a theoretical model of PCC entitled the Preference-Based Model of Care that integrates the Theory of Human Motivation, Self-determination Theory, the Competence-Press Model of person and environment fit, the Living Systems Framework, and the Broaden-and-Build theory of positive emotions to deepen our understanding of the processes through which preference-based care affects well-being among older adults receiving LTSS. The Preference-Based Model of Care illustrates how goal-directed behaviors facilitate need fulfillment through the expression of individual preferences and how these behaviors mediate the relationship between person–environment fit and affect balance within a particular social, cultural, and political context. The Preference-Based Model of Care can advance research on PCC in LTSS and can inform LTSS clinical practice guidelines for older adults, regardless of functional or cognitive capacity. (Publisher abstract)
Direct and indirect influences of socio-economic position on the wellbeing of older adults: a structural equation model using data from the first wave of the Irish longitudinal study on ageing
- Authors:
- PRATSCHKE Jonathan, HAASE Trutz, MCKEOWN Kieran
- Journal article citation:
- Ageing and Society, 37(9), 2017, pp.1770-1797.
- Publisher:
- Cambridge University Press
The authors use Structural Equation Modelling techniques to analyse the determinants of wellbeing amongst older adults using data from the first wave of the Irish Longitudinal Study on Ageing (TILDA), a rich source of data on people aged over 50 and living in private households. The analysis uses a two-group linear statistical model to explore the influence of socio-economic position on the wellbeing of men and women, with Full Information Maximum Likelihood estimation to handle missing data. The fit indices for the final model are highly satisfactory and the measurement structure is invariant by gender and age. The results indicate that socio-economic position has a significant direct influence on wellbeing and a strong indirect influence which is mediated by health status and lifestyle. The total standardised effect of Socio-economic Position on Socio-emotional Wellbeing is statistically significant (p ⩽ 0.05) and equal to 0.32 (men) and 0.43 (women), a very strong influence which risks being underestimated in standard multivariate models. The authors conclude that health, cognitive functioning and wellbeing reflect not just the ageing process, but also the impact of social inequalities across the lifecourse and how they are transmitted across different life spheres. These results can help to orient future research on factors which mediate between socio-economic position and wellbeing, an important policy-related issue. (Publisher abstract)
Developing a relational model of care for older people: creating environments for shared living
- Authors:
- WOODWARD James, KARTUPELIS Jenny
- Publisher:
- Jessica Kingsley
- Publication year:
- 2018
- Pagination:
- 168
- Place of publication:
- London
Care of older people is a major issue in the UK, crossing the boundaries between emotion, practical issues and economics. Drawing on recent research, the book looks at the nature of interpersonal relationships, their critical effect and the factors which affect their formation. The authors, who have worked extensively in the field of promoting the spiritual wellbeing of older people in the UK, argue for a new approach to the care of older people based on interpersonal relationships. (Edited publisher abstract)
A community hub approach to older people’s housing
- Authors:
- EVANS Simon, et al
- Journal article citation:
- Quality in Ageing and Older Adults, 18(1), 2017, pp.20-31.
- Publisher:
- Emerald
Purpose: The purpose of this paper is to explore the potential of housing with care schemes to act as community hubs. The analysis highlights a range of benefits, barriers and facilitators. Design/methodology/approach: Data are presented from the Adult Social Services Environments and Settings project which used a mixed methods approach including a review of the literature, surveys and in-depth case study interviews. Findings: Most housing with care schemes have a restaurant or café, communal lounge, garden, hairdresser, activity room and laundrette, while many also have a library, gym, computer access and a shop. Many of these facilities are open not just to residents but also to the wider community, reflecting a more integrated approach to community health and adult social care, by sharing access to primary health care and social services between people living in the scheme and those living nearby. Potential benefits of this approach include the integration of older people’s housing, reduced isolation and increased cost effectiveness of local services through economies of scale and by maximising preventative approaches to health and wellbeing. Successful implementation of the model depends on a range of criteria including being located within or close to a residential area and having on-site facilities that are accessible to the public. Originality/value: This paper is part of a very new literature on community hub models of housing with care in the UK. In the light of new requirements under the Care Act to better coordinate community services, it provides insights into how this approach can work and offers an analysis of the benefits and challenges that will be of interest to commissioners and providers as well as planners. This was a small scale research project based on four case studies. Caution should be taken when considering the findings in different settings. (Publisher abstract)
Delineating the third age: joint models of older people's quality of life and attrition in Britain 2002–2010
- Author:
- TAMPUBOLON Gindo
- Journal article citation:
- Aging and Mental Health, 19(7), 2015, pp.576-583.
- Publisher:
- Taylor and Francis
Objectives: In the public mind, later life is being transformed by the emerging possibility of a flourishing third age with sustained quality of life. The authors draw trajectories of life quality measured using CASP-19 over eight years. They refine these trajectories by jointly modelling attrition, since older people tend to leave longitudinal studies (attrite) not at random. Methods: Growth curve models are applied to the English Longitudinal Study of Ageing waves 1 to 5. Then joint model is estimated where attrition is considered. Extensive predictors are entered including demographic attributes, social and economic status, health conditions, and behaviours. Results: Strong non-linear age trajectory of life quality is revealed by the growth curve models where the peak is achieved in the late 60s. Then the joint model uncovers the peak somewhat later in time, and also reveals secular improvement in life quality experienced by recent cohorts. Sharp estimates for many predictors of higher levels of life quality are also found. Conclusion: For the first time, the trajectories of life quality in the third age are drawn and improvement across cohorts is demonstrated. The contributions are estimated for predictors amenable to intervention such as social capital. This can help in policy discussion on improving the lives of older people in the third age. (Edited publisher abstract)
Successful aging and its discontents: a systematic review of the social gerontology literature
- Authors:
- MARTINSON Marty, BERRIDGE Clara
- Journal article citation:
- Gerontologist, 55(1), 2015, pp.58-69.
- Publisher:
- Oxford University Press
Purpose of the Study: The purpose of this study was to analyse the range of critiques of successful ageing models and the suggestions for improvement as expressed in the social gerontology literature. Design and Methods: The authors conducted a systematic literature review using the following criteria: journal articles retrieved in the Abstracts in Social Gerontology, published 1987–2013, successful aging/ageing in the title or text (n = 453), a critique of successful ageing models as a key component of the article. Sixty-seven articles met the criteria. Qualitative methods were used to identify key themes and inductively configure meanings across the range of critiques. Results: The critiques and remedies fell into 4 categories. The Add and Stir group suggested a multidimensional expansion of successful ageing criteria and offered an array of additions. The Missing Voices group advocated for adding older adults’ subjective meanings of successful ageing to established objective measures. The Hard Hitting Critiques group called for more just and inclusive frameworks that embrace diversity, avoid stigma and discrimination, and intervene at structural contexts of ageing. The New Frames and Names group presented alternative ideal models often grounded in Eastern philosophies. Implications: The vast array of criteria that gerontologists collectively offered to expand Rowe and Kahn’s original successful model is symptomatic of the problem that a normative model is by definition exclusionary. Greater reflexivity about gerontology’s use of “successful ageing” and other normative models is needed. (Edited publisher abstract)
Defining successful aging: a tangible or elusive concept?
- Authors:
- MARTIN Peter, et al
- Journal article citation:
- Gerontologist, 55(1), 2015, pp.14-25.
- Publisher:
- Oxford University Press
Purpose of the Study: Everyone wants to age successfully; however, the definition and criteria of successful ageing remain vague for laypersons, researchers, and policymakers in spite of decades of research on the topic. This paper highlights work of scholars who made significant theoretical contributions to the topic. Design and Methods: A thorough review and evaluation of the literature on successful ageing was undertaken. Results: The review includes early gerontological definitions of successful ageing and related concepts. Historical perspectives reach back to philosophical and religious texts, and more recent approaches have focused on both process- and outcome-oriented models of successful ageing. The authors elaborate a number of perspectives on successful ageing. Additional views on successful ageing emphasise subjective versus objective perceptions of successful ageing and relate successful ageing to studies on healthy and exceptional longevity. Implications: Additional theoretical work is needed to better understand successful ageing, including the way it can encompass disability and death and dying. The extent of rapid social and technological change influencing views on successful ageing also deserves more consideration. (Edited publisher abstract)
"Successful aging," gerontological theory and neoliberalism:a qualitative critique
- Authors:
- RUBINSTEIN Robert L., DE MEDEIROS Kate
- Journal article citation:
- Gerontologist, 55(1), 2015, pp.34-42.
- Publisher:
- Oxford University Press
This article is a critique of the successful ageing (SA) paradigm as described in the Rowe and Kahn book, Successful Aging (1998). The major point of this article is that two key ideas in the book may be understood as consonant with neoliberalism, a social perspective that came into international prominence at the same time the SA paradigm was initially promoted. These two key ideas are (a) the emphasis on individual social action applied to the nature of the ageing experience and (b) the failure to provide a detailed policy agenda for the social and cultural change being promoted and, particularly, for older adults who may be left behind by the approach to change the book suggests. The article provides no evidence for a direct connection between SA and neoliberalism, but rather shows how similarities in their approaches to social change characterise both of them. In sum, the article shows (a) how the implicit social theory developed in the book, in a manner similar to neoliberalism, elevates the individual as the main source of any changes that must accompany the SA paradigm and (b) the focus on SA as individual action does not provide for those older adults who do not or will not age "successfully." This, the authors conclude, implicitly sets up a two-class system of older adults, which may not be an optimal means of addressing the needs of all older adults. The article also reviews a number of studies about SA and shows how these, too, may emphasise its similarities to neoliberalism and other issues that the SA paradigm does not adequately address. (Edited publisher abstract)
Do past stressful life events and personal control beliefs predict subjective wellbeing in old age? Evidence from a Spanish nationwide representative sample
- Authors:
- RUBIO Laura, DUMITRACHE Cristina G., CORDON-POZO Eulogio
- Journal article citation:
- Ageing and Society, 38(12), 2018, pp.2519-2540.
- Publisher:
- Cambridge University Press
It has been widely corroborated that recent stressful life events could impact wellbeing; nevertheless, it is not clear whether stressful situations experienced in the past and the individual resources used to deal with them influence older adults’ wellbeing. This study aims to analyse the influence of stressful past events and personal control beliefs, or the extent to which people believe they can control or influence their environment in order to achieve desired outcomes, on negative affect and domain-specific life satisfaction in a cross-sectional sample of 1,177 Spanish people age 50 years and older. For this purpose, the measurement of ten stressful past events, perceived control beliefs, negative affect and life satisfaction were obtained. Preliminary analyses showed that domain-specific life satisfaction grouped into two factors: internal and external life satisfaction. The results of the partial least squares structural equation model indicated that stressful events and control beliefs have an impact on both negative affect and life satisfaction in old age. Stressful past events had a negative effect on life satisfaction, while control beliefs were positively associated with negative affect. The model was able to predict the variance of internal life satisfaction at 37.5 per cent.
The silent impact of hearing loss: using longitudinal data to explore the effects on depression and social activity restriction among older people
- Authors:
- ANDRADE Claudia Campos, PEREIRA Cicero Roberto, Da SILVA Pedro Alcantara
- Journal article citation:
- Ageing and Society, 38(12), 2018, pp.2468-2489.
- Publisher:
- Cambridge University Press
Hearing loss is frequent in old age and has been associated with fewer social activities and depression. However, hearing problems have also been associated with other comorbidities, which prevent more definitive conclusions about the unique role on older people's wellbeing. Moreover, little attention has been paid to the psychological processes through which this relationship occurs. This study aims to investigate the effect of hearing loss on older adults’ wellbeing from a longitudinal perspective. Using data from three points in time, the authors investigated the mutual relationship between hearing loss, depression and social activities. Based on longitudinal data of the Survey of Health, Ageing and Retirement in Europe (SHARE) from ten European countries, they conducted the test of competing auto-regressive cross-lagged theoretical models. Results show that hearing loss reduces social activity, which is mediated by depression. The adequacy of this model (versus a model proposing that social activity restriction mediates the relationship between hearing loss and depression) was supported in each of the countries of the sample. Findings showing that hearing loss can contribute to depression and, subsequently, to restriction in social activities have implications for early detection and clinical interventions on hearing loss. (Edited publisher abstract)