Geriatrics

Research

18 pages, 2665 KiB

Open AccessArticle

Virtual Dementia-Friendly Communities (Verily Connect) Stepped-Wedge Cluster-Randomised Controlled Trial: Improving Dementia Caregiver Wellbeing in Rural Australia

by Irene Blackberry, Tshepo Rasekaba, Debra Morgan, Kayla Royals, Jennene Greenhill, David Perkins, Megan O’Connell, Mohammad Hamiduzzaman, Margaret Winbolt, Ainsley Robinson, Hilary Davis and Clare Wilding

Geriatrics 2023, 8(5), 85; https://doi.org/10.3390/geriatrics8050085 - 25 Aug 2023

Viewed by 2066

Abstract

Caring for people living with dementia often leads to social isolation and decreased support for caregivers. This study investigated the effect of a Virtual Dementia-Friendly Rural Communities (Verily Connect) model on social support and demand for caregivers of people living with dementia. The [...] Read more.

Caring for people living with dementia often leads to social isolation and decreased support for caregivers. This study investigated the effect of a Virtual Dementia-Friendly Rural Communities (Verily Connect) model on social support and demand for caregivers of people living with dementia. The co-designed intervention entailed an integrated website and mobile application, peer-support videoconference, and technology learning hubs. This mixed-methods, stepped-wedge, cluster-randomised controlled trial was conducted with 113 participants from 12 rural communities in Australia. Caregiver data were collected using MOS-SSS and ZBI between 2018 and 2020. The relationship between post-intervention social support with age, years of caring, years since diagnosis, and duration of intervention were explored through correlation analysis and thin plate regression. Google Analytics were analysed for levels of engagement, and cost analysis was performed for implementation. Results showed that caregivers’ perception of social support (MOS-SSS) increased over 32 weeks (p = 0.003) and there was a marginal trend of less care demand (ZBI) among caregivers. Better social support was observed with increasing caregiver age until 55 years. Younger caregivers (aged <55 years) experienced the greatest post-intervention improvement. The greatest engagement occurred early in the trial, declining sharply thereafter. The Verily Connect model improved caregivers’ social support and appeared to ease caregiver demand. Full article

(This article belongs to the Special Issue Age-Friendly Ecosystems: Voices from around the World)

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9 pages, 208 KiB

Open AccessCommunication

Lessons Learned from Age-Friendly, Team-Based Training

by Sara C. Murphy, Jennifer J. Severance, Kathlene Camp, Janice A. Knebl, Thomas J. Fairchild and Isabel Soto

Geriatrics 2023, 8(4), 78; https://doi.org/10.3390/geriatrics8040078 - 28 Jul 2023

Viewed by 1226

Abstract

According to the Institute of Medicine, immediate steps must be taken across the United States to educate and train the healthcare workforce to work collaboratively to address the needs of the growing older adult population. The Geriatric Practice Leadership Institute (GPLI) was designed [...] Read more.

According to the Institute of Medicine, immediate steps must be taken across the United States to educate and train the healthcare workforce to work collaboratively to address the needs of the growing older adult population. The Geriatric Practice Leadership Institute (GPLI) was designed to support professional teams working in acute and post-acute care in transforming their organization into a designated Age-Friendly Health System. The program was built around the Institute for Healthcare Improvement’s Age-Friendly Health Systems 4Ms framework. This framework focuses on What Matters, Medication, Mentation, and Mobility (the 4Ms) in supporting care for older adults. The GPLI program is an online, seven-month team-based program with four to seven participants from one organization per team. Additionally, each team selected, developed, and completed a quality improvement project based on Age-Friendly Health Systems 4Ms. The curriculum also includes organizational culture, leadership, and interprofessional team-building modules. Using a post-completion survey, the experiences of 41 participants in the GPLI program were assessed. All respondents found the information in the program ‘very’ or ‘extremely’ valuable, and their executive sponsor ‘very’ or ‘extremely’ valuable in supporting their team’s involvement and project. The GPLI program has trained over 200 healthcare professionals and teams that have successfully implemented projects across their organizations. Full article

(This article belongs to the Special Issue Age-Friendly Ecosystems: Voices from around the World)

11 pages, 375 KiB

Open AccessArticle

Guiding Post-Hospital Recovery by ‘What Matters:’ Implementation of Patient Priorities Identification in a VA Community Living Center

by Katherine C. Ritchey, Laurence M. Solberg, Sandra Wolfe Citty, Lea Kiefer, Erica Martinez, Caroline Gray and Aanand D. Naik

Geriatrics 2023, 8(4), 74; https://doi.org/10.3390/geriatrics8040074 - 04 Jul 2023

Viewed by 1652

Abstract

Background: Patient priorities care (PPC) is an effective age-friendly health systems (AFHS) approach to aligning care with goals derived from ‘what matters’. The purpose of this quality improvement program was to evaluate the fidelity and feasibility of the health priorities identification (HPI) process [...] Read more.

Background: Patient priorities care (PPC) is an effective age-friendly health systems (AFHS) approach to aligning care with goals derived from ‘what matters’. The purpose of this quality improvement program was to evaluate the fidelity and feasibility of the health priorities identification (HPI) process in VA Community Living Centers (CLC). Methods: PPC experts worked with local CLC staff to guide the integration of HPI into the CLC and utilized a Plan–Do–Study–Act (PDSA) model for this quality improvement project. PPC experts reviewed health priorities identification (HPI) encounters and interdisciplinary team (IDT) meetings for fidelity to the HPI process of PPC. Qualitative interviews with local CLC staff determined the appropriateness of the health priorities identification process in the CLC. Results: Over 8 months, nine facilitators completed twenty HPI encounters. Development of a Patient Health Priorities note template, staff education and PPC facilitator training improved fidelity and documentation of HPI encounters in the electronic health record. Facilitator interviews suggested that PPC is appropriate in this setting, not burdensome to staff and fostered a person-centered approach to AFHS. Conclusions: The HPI process is an acceptable and feasible approach to ask the ‘what matters’ component of AFHS in a CLC setting. Full article

(This article belongs to the Special Issue Age-Friendly Ecosystems: Voices from around the World)

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16 pages, 1673 KiB

Open AccessArticle

Awareness and Perceptions of “Age-Friendly”: Analyzing Survey Results from Voices in the United States

by Lauren Dunning, Diane Ty, Priyanka Shah and Mac McDermott

Geriatrics 2023, 8(3), 58; https://doi.org/10.3390/geriatrics8030058 - 28 May 2023

Cited by 2 | Viewed by 2031

Abstract

The term “age-friendly” is widely used to describe cities, communities, health systems, and other environments. However, little is known about how this is interpreted or what the term means to the public. To investigate the public’s familiarity with the term and gain insights [...] Read more.

The term “age-friendly” is widely used to describe cities, communities, health systems, and other environments. However, little is known about how this is interpreted or what the term means to the public. To investigate the public’s familiarity with the term and gain insights into its relevance to older adults, we utilized data generated by a survey of 1000+ adults aged 40 and above. We employed a 10-question survey, distributed online in the US from 8 to 17 March 2023 via a third-party vendor, that captured awareness and perceptions of age-friendly designations by exploring awareness of the term, contextual understanding, and influence on decision making. The resultant aggregate data was analyzed using Microsoft Excel and straightforward summary statistical analyses. The majority of respondents (81%) were aware of the term “age-friendly.” Older adults (ages 65+) lagged in the self-described extreme or moderate level of awareness compared to adults aged 40–64. In the surveyed population, the term “age-friendly” was most often understood to apply to communities (57%), followed by health systems (41%) and cities (25%). Most people believed “age-friendly” refers to all ages, even though age-friendly health systems are designed to meet the unique needs of older adults. These survey results provide the age-friendly ecosystem field with insights into the awareness and perceptions of the term “age-friendly,” highlighting opportunities to bolster understanding. Full article

(This article belongs to the Special Issue Age-Friendly Ecosystems: Voices from around the World)

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11 pages, 493 KiB

Open AccessArticle

Age-Friendly Cities in Latin America: A Human Ecological Framework

by Jonathan R. Guillemot and Mildred E. Warner

Geriatrics 2023, 8(3), 46; https://doi.org/10.3390/geriatrics8030046 - 25 Apr 2023

Cited by 2 | Viewed by 2301

Abstract

Despite the demographic aging of Latin America, the uptake of the WHO’s Age-Friendly Cities Framework remains extremely low, with the notable exceptions of Chile, Mexico and Brazil. We argue for a broader human ecological framework, which focuses on the macro, meso and micro [...] Read more.

Despite the demographic aging of Latin America, the uptake of the WHO’s Age-Friendly Cities Framework remains extremely low, with the notable exceptions of Chile, Mexico and Brazil. We argue for a broader human ecological framework, which focuses on the macro, meso and micro levels, to better address the context, challenges and opportunities for age-friendly cities in the Latin American region. The WHO’s age-friendly city domains are primarily at the meso (community) scale, with a focus on built environment, services and participation. We call for more attention to be paid to the macro policy scale to address concerns regarding migration, demography and social policy context. More attention also should be given to the micro scale to recognize the critical role of family and informal care supports. It is possible that the WHO domains are the result of a design bias, with Global North settings in mind for their development. We find the domains of UNICEF’s Child-Friendly Cities Initiative, which give more attention to the realities of the Global South, helpful to broaden the WHO’s Age-Friendly Cities Framework. Full article

(This article belongs to the Special Issue Age-Friendly Ecosystems: Voices from around the World)

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14 pages, 285 KiB

Open AccessArticle

Variation in Implementing Dementia-Friendly Community Initiatives: Advancing Theory for Social Change

by Clara J. Scher and Emily A. Greenfield

Geriatrics 2023, 8(2), 45; https://doi.org/10.3390/geriatrics8020045 - 21 Apr 2023

Viewed by 1937

Abstract

Dementia-friendly communities (DFC) have emerged as a global movement to make communities more supportive and inclusive of people living with dementia (PLWD) and their care partners. This study contributes to a nascent body of research on DFC initiatives by building theory on their [...] Read more.

Dementia-friendly communities (DFC) have emerged as a global movement to make communities more supportive and inclusive of people living with dementia (PLWD) and their care partners. This study contributes to a nascent body of research on DFC initiatives by building theory on their local implementation. Based on an analysis of data from semi-structured interviews with 23 leaders of initiatives in Massachusetts (United States), we aimed to identify key dimensions of variation in the implementation of DFC initiatives. We found that all initiatives engaged in a common set of activities, such as the facilitation of training about dementia and improving services for PLWD. Although initiatives mostly engaged in these activities in ways that targeted the community at large, in some instances, they concentrated their efforts on enhancing the dementia-friendliness of their own organizations. We describe ways in which financial, social, and human capital operate as key factors that influence the initiatives’ primary focus (i.e., the community at large or their own organization). Our findings suggest the importance of helping DFC initiative leaders more explicitly specify the focal ecological level of their efforts throughout the trajectory of their work, especially in the context of resource considerations. Results also indicate ways in which DFC initiative efforts at one systems level can support those at other levels over time. Full article

(This article belongs to the Special Issue Age-Friendly Ecosystems: Voices from around the World)

Review

Jump to: Research, Other

24 pages, 983 KiB

Open AccessReview

Active Aging and Smart Public Parks

by João Boavida, Hande Ayanoglu, Cristóvão Valente Pereira and Rodrigo Hernandez-Ramirez

Geriatrics 2023, 8(5), 94; https://doi.org/10.3390/geriatrics8050094 - 22 Sep 2023

Viewed by 2244

Abstract

The global population is aging, with the percentage of people over 60 expected to rise from 12% to 22% and 33% residing in developed countries. However, most cities lack the appropriate infrastructure to support aging citizens in active aging and traversing the urban [...] Read more.

The global population is aging, with the percentage of people over 60 expected to rise from 12% to 22% and 33% residing in developed countries. However, most cities lack the appropriate infrastructure to support aging citizens in active aging and traversing the urban landscape, negatively impacting their quality of life. Studies have shown that public parks and green spaces can contribute to a higher quality of life and wellbeing. Also, smart cities are intended to improve the wellbeing and health of their inhabitants. However, most solutions are typically implemented indoors and tend to overlook the needs of older adults. A smart city should consider the increasing rate of aging and give more importance to outdoor environments as a key aspect of quality of life. The article’s main purpose is to provide a comprehensive background to understand the current knowledge on smart public parks and highlight the significance of new research in the field to promote active aging. The article is expected to inspire new research ideas by identifying gaps in knowledge. Open and challenging issues in emerging smart park solutions are proposed for further work. Full article

(This article belongs to the Special Issue Age-Friendly Ecosystems: Voices from around the World)

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21 pages, 689 KiB

Open AccessReview

Enhancing Community Participation through Age-Friendly Ecosystems: A Rapid Realist Review

by Judith Sixsmith, Meiko Makita, Deborah Menezes, Marianne Cranwell, Isaac Chau, Mark Smith, Susan Levy, Pat Scrutton and Mei Lan Fang

Geriatrics 2023, 8(3), 52; https://doi.org/10.3390/geriatrics8030052 - 11 May 2023

Cited by 4 | Viewed by 2537

Abstract

This rapid realist review explored the key components of age-friendly ecosystems that promote community participation among older adults. The study (undertaken in 2021 and updated in 2023) synthesized evidence from 10 peer-reviewed and grey literature databases to identify the underlying mechanisms and contextual [...] Read more.

This rapid realist review explored the key components of age-friendly ecosystems that promote community participation among older adults. The study (undertaken in 2021 and updated in 2023) synthesized evidence from 10 peer-reviewed and grey literature databases to identify the underlying mechanisms and contextual factors that shape why, under what circumstances, and for whom an age-friendly ecosystems might be effective as well as the intervention outcomes. A total of 2823 records were initially identified after deduplication. Title and abstract screening produced a potential dataset of 126 articles, reducing to 14 articles after full text screening. Data extraction focused on the contexts, mechanisms, and outcomes of ecosystems for older adults’ community participation. Analysis suggested that age-friendly ecosystems that aim to promote community participation are characterized by the provision of accessible and inclusive physical environments, the availability of supportive social networks and services, and the creation of opportunities for meaningful engagement in community life. The review also highlighted the importance of recognizing the diverse needs and preferences of older adults and involving them in the design and implementation of age-friendly ecosystems. Overall, the study has provided valuable insights into the mechanisms and contextual factors that contribute to the success of age-friendly ecosystems. Ecosystem outcomes were not well discussed in the literature. The analysis has important implications for policy and practice, emphasizing the need to develop interventions that are tailored to the specific needs and contexts of older adults, and that promote community participation as a means of enhancing health, wellbeing, and quality of life in later life. Full article

(This article belongs to the Special Issue Age-Friendly Ecosystems: Voices from around the World)

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Other

Jump to: Research, Review

13 pages, 8296 KiB

Open AccessPerspective

Age-Friendly Ecosystems: Expert Voices from the Field

by Terry Fulmer, Kim Dash, Jody Shue, JiHo Chang, Jessica Huang and Abby Maglich

Geriatrics 2023, 8(4), 68; https://doi.org/10.3390/geriatrics8040068 - 21 Jun 2023

Cited by 1 | Viewed by 1785

Abstract

(1) Background: With the growth of the age-friendly movement, age-friendly ecosystems (AFE) garnered more attention. The successful development of an AFE is contingent on unified efforts across different stakeholders; however, limited efforts were made to help create a common understanding of the necessary [...] Read more.

(1) Background: With the growth of the age-friendly movement, age-friendly ecosystems (AFE) garnered more attention. The successful development of an AFE is contingent on unified efforts across different stakeholders; however, limited efforts were made to help create a common understanding of the necessary components of an AFE. (2) Methodology: In response, The John A. Hartford Foundation and The Age-Friendly Institute hosted a series of convenings of international experts to identify a working definition of the characteristics composing an AFE. The goal of these convenings was to provide a foundation on which to unite cross-sector age-friendly work. (3) Results: This paper discussed the findings of the convenings and provided a framework from which future age-friendly work must draw upon. (4) Conclusions: This paper presented a necessary change in how we conceive AFEs. Full article

(This article belongs to the Special Issue Age-Friendly Ecosystems: Voices from around the World)

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8 pages, 493 KiB

Open AccessCommentary

The Value of Age-Friendly Public Health Systems in the Age-Friendly Ecosystem

by Megan Wolfe and J. Nadine Gracia

Geriatrics 2023, 8(3), 63; https://doi.org/10.3390/geriatrics8030063 - 02 Jun 2023

Cited by 1 | Viewed by 2273

Abstract

The United States population is living longer and healthier than ever. This enables our communities—and our society—to continue to benefit from our knowledge, experience, and energy as we age. The public health system is foundational for increasing life expectancy, and now it has [...] Read more.

The United States population is living longer and healthier than ever. This enables our communities—and our society—to continue to benefit from our knowledge, experience, and energy as we age. The public health system is foundational for increasing life expectancy, and now it has the opportunity to further support older adult health and well-being. Trust for America’s Health (TFAH), in partnership with The John A. Hartford Foundation, launched the age-friendly public health systems initiative in 2017 with the goal of raising awareness within the public health sector of its many potential roles in healthy aging. TFAH has worked with state and local departments of health to build capacity and expertise in older adult health and has provided guidance and technical assistance to expand this work across the U.S. TFAH now envisions a public health system that has healthy aging as a core function. This paper aims to describe why the public health sector should adopt healthy aging policies and practices, how this is being operationalized at the state and local levels, and the value of age-friendly public health systems within the age-friendly ecosystem. Full article

(This article belongs to the Special Issue Age-Friendly Ecosystems: Voices from around the World)

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