Food waste is an increasingly important issue in all food-service establishments, including retirement living communities. With residents of these communities having faced food insecurity as children and young adults, they have unique and very strong feelings regarding this issue. We interviewed 16 Canadian residents and used manifest content analysis to gain an understanding of how their experiences, behaviors, and feelings toward food waste may impact their quality of life. The results of this study may have implications for how retirement living communities approach their food-service operations.
Housing adaptation aims to enable clients to live independently in their own homes. Studies focusing on participation in everyday life following a housing adaptation are lacking and needed. This study aimed to explore housing adaptation clients' experiences of participation in everyday life before and after a housing adaptation, through the lens of a housing adaptation, using a qualitative follow-up design, with 11 participants. It was found that when the housing adaptation met the participants' needs, performance of activities improved and the housing adaptation opened doors to engagement and participation in everyday life. Thus, focus on performance and engagement in everyday life at the onset of the housing adaptation process, combined with regular follow-ups, may enhance participation.
This article examines the extent to which a reverse mortgage may improve the income of an elderly household. This question is analyzed in the context of an aging society where the existing Confucian contract of filial piety has been eroding with the advent of economic and demographic transitions underway in contemporary China. We use data from a China Household Finance Survey that was administered in 2011 covering 949 elderly households from 22 provinces. We use models from the literature to calculate the incremental gains to income from the use of a reverse mortgage. The findings are revealing in terms of the potential gains from the use of reverse mortgages. On average, an elderly homeowner makes a monthly mortgage payment of RMB (sic)1,383; a reverse mortgage for the same household raises monthly income by RMB (sic)1,388 or 29%. The major beneficiaries of a reverse mortgage are single and elderly individuals possessing significant housing equity and living in the more developed regions. Overall, the reverse mortgage provides a means for society to allow the elderly access to income without being a burden on the state.
This study examined whether residents' level of resilience mediated the relationship between social support for exercise from staff and resident satisfaction in assisted living. This was a secondary data analysis using baseline data from a function-focused care intervention study including 171 residents from four assisted living facilities. Using structural equation modeling, we found that mood and social support for exercise from staff were the only variables associated with resilience. Mood, gender, cognition, and social support for exercise from staff directly influenced resident satisfaction and explained 31% of the variance in the model. Implications for future research and practice are discussed.
Residential care and assisted living services provide support to seniors who may not have the ability to live independently. However, East Asian residents often do not have sufficient access to culturally specific activities, which may result in psychosocial stress and isolation. This study presents a geographic analysis method to evaluate spatial distribution of culturally tailored senior care facilities in Metro Vancouver. We identify geographical disparities, indicating that many East Asian seniors have poor local access to a culturally tailored facility. We recommend the use of geographical analysis techniques to improve the analysis and planning for senior care in an increasingly diverse population.
Assisted living and similar residential care is an important source of care for elders, including those with dementia. Meaningful activities may help residents maintain function, improve self-esteem, and enhance quality of life. Using data from the 2010 Nation& Survey of Residential Care Facilities, this study identifies the extent of resident engagement in different types of activities; examines the extent to which cognitive status, other resident characteristics, and residential care community characteristics relate to activity engagement; and, among cognitively impaired residents, assesses whether being in dementia-specific settings is associated with activity engagement. Compared with persons without cognitive impairment, those with severe cognitive impairment are less likely to go on outings (79% versus 36%) and talk with family and friends (85% versus 72%). Residents with mild to severe cognitive impairment have higher participation in leisure activities than other residents if they live in dementia-specific settings (73% higher) than those who do not.
Enriched living environments that contain a wide array of personal memorabilia and memory-stimulating cues have the potential to support cognitive functioning. The purpose of this ethnographic research was to describe the care environments of older adults with cognitive impairment living in nursing homes (n = 42), to evaluate the degree to which these environments contained memory-stimulating cues, and to understand the extent to which these environments were cognitively stimulating for older adults with dementia. Results indicated varying levels of enrichment both within and between homes, with nearly a quarter of the residents living in environments that contained no memory-enhancing stimuli.
This project explored ways of enhancing the lighting of older adults with Age Related Visual Loss. The Visual Functioning Questionnaire (25) was administered at the start of the project and home assessments were carried out mid-way by occupational therapy students. Firstly, findings were analysed using Qualitative Data Analysis Software, and secondly by the Qualitative Analysis Guide of Leuven. Following this, each participant was provided with a lighting prescription devised by experts. Findings indicated that the participants were able to use both this information and that from the focus groups to meet their lighting needs, particularly drawing on LED technology.
The culture change movement has pushed for reform for more than two decades to align policy, the long-term care industry, and resident preferences with regard to care. Evidence from research indicates that culture change has the potential to improve quality in nursing homes. There is no one-size-fits-all way to implement culture change; however, there are key elements and associated concepts and models. A common thread is that they run counter to the medical model, typically found in nursing homes, where care is provided in a hospital-like setting according to the schedules and routines of physicians and staff with little resident input This qualitative study looks for evidence of culture change in a traditional model of care compared to a newer culture change model, by describing the differences in practices associated with the medical model, person-centered care, and person-directed care between the two settings. Our results indicate that there is evidence of person-directed care in one model of culture change-the Green House home-but not in the traditional nursing home. Future studies should examine other culture change models to compare the differences in the utilization of person-directed care. This information will help to clarify the definitions and concepts of culture change, along with developing best practices for future culture change models.
This study tested two new instruments, the Function Focused Environment Assessment (FF-EA) and the Function Focused Policy Assessment (FF-PA). The measures were developed for clinical evaluation of assisted living (AL) settings to help optimize function and physical activity among residents. In total, 106 AL settings and 242 residents were included. There was evidence of item reliability (0.92) and interrater reliability (kappa =0.40, p = .015; agreement 85%) of FF-EA and item reliability (0.89) and interrater reliability (kappa = 0.48, p = .001, agreement 82%) of the FF-PA, and support for validity of both measures based on INFIT and OUTFIT statistics and hypothesis testing.
Aging in place offers emotional and physical benefits; however, challenges associated with advanced age may make aging in place difficult. As communities across the country prepare for forecasted increases in the proportion of older residents, it is important to understand barriers that may prevent aging in place. Perceived barriers voiced by residents of a suburban county who completed an Aging in Place Needs Assessment Survey were categorized into four themes: need to downsize/home modification; need for assistance; family desire to reciprocate care; and isolation. A fifth group with no intent to relocate, but with concerns about having to, was also identified. Included among this group were persons with mental health or developmental disorders, such as anxiety and autism spectrum disorder. Results were examined through a person-centered lens to illustrate that aging in place may be the desired option even among residents who indicate that it is not. It is important that aging-in-place initiatives preserve identity by fostering a sense of autonomy, control, and well-being in older residents.
For older people using long-term care services, the conditions of their life-space may be critical. The relationships between the physical housing environment and aspects of health were examined among older people in Japan (aged 65+ years, N= 1,928) by multivariable logistic regression analysis, adjusting for sociodemographic characteristics. Lack of safety, low access to emergency assistance, low or high indoor temperature, poor sanitary conditions, and state of home disrepair were significantly associated with negative aspects of health among people with low activities of daily living (ADL) independence. Home care service providers and policymakers need to consider the importance of appropriate environmental conditions for the most vulnerable groups.
An increasing proportion of older people are unable to afford rental or purchase of age-appropriate residential accommodation in Australia. This article reports on a community-initiated research project investigating feasibility of affordable co-housing for older residents wishing to age in their community. Factors enabling successful co-housing for seniors were investigated through a systematic literature review. The multi-phase participatory research approach drew on the knowledge of local seniors, community support workers, and planning and design professionals through workshops and interviews in a regional community in southeast Queensland. The findings demonstrate interest in and barriers to senior co-housing. The research engagement approach enables tailored solutions for individual long-term security, relevant to small communities in Australia.
A continuing care retirement community (CCRC) represents a residential alternative for older adults. It offers a variety of social and health care services to meet older adults' needs and preferences. Using the theory of innovation as a theoretical basis, the overall goal of the study was to use the source of information about the CCRC as a potential predictor of the decision to move. In total, 76 older adults responded to a question about the source of information on the CCRC. Of these, 40 were CCRC residents and 36 were community dwellers, who expressed an interest in the CCRC but decided to remain in their community. Based on their responses, respondents were classified into one of five dusters (e.g., spouse, friends, children, nonhuman sources, mixed human and nonhuman sources). Those classified into the spouse or adult children as sources of information were more likely to live in a CCRC. Results show that information about the CCRC should be conveyed to additional members in the family, such as adult children, as they often take a major role in the decision to relocated. The findings have implications for administrators as they clearly point to potential sources of greater influence on older adults' decision to relocate.
This study aims to examine housing typologies for older adults in the light of three qualitatively examined exogenous factors: policy, societal developments, and technology. The developments in inpatient and assisted ambulatory housing facilities for older adults have been mapped from 1945 to 2016 using quantitative data. Using these data, five transition periods can be distinguished. Within the first transition periods, policy factors were tremendously important, while within the later ones, societal influence empowered by technological change became the primarily driving factor. This research shows that the classification of inpatient, assisted ambulatory housing, and outpatient housing may no longer be applicable in its current form.
Assisted living programs (ALPs) embed licensed assisted living services within independent housing. To advance nascent research on this type of housing plus services, this study aimed to develop empirically grounded program theory on the processes through which ALPs benefit residents within independent housing. Eighteen in-depth interviews were conducted with current and prospective consumers of an ALP in northern New Jersey, including residents and family caregivers. The setting for the ALP was a federally subsidized independent housing building, which had introduced the ALP approximately 1 year prior to the study. Themes emerging from an iterative coding process indicated the most valued aspects of the ALP’s service delivery, including the comprehensiveness of the service options, the flexible timing for their delivery, and the relational aspects of care. Participants further described the ways in which the structure of the ALP facilitated prevention, such as preventing the occurrence and escalation of adverse health events. The study concludes by presenting a program model that integrates these findings, which suggests that ALPs deliver care in ways that make long-term services and supports more accommodating and acceptable to consumers. This, in turn, can enhance their preventive value to facilitate aging in place among independent housing residents in clinical need of such supports.
Lighting plays an important role in daily life: It helps people perform daily activities independently and safely, and also benefits their health. This study assesses the research evidence of lighting's impacts on older adults in four domains: (a) performance of activities of daily living and instrumental activities of daily living; (b) circadian rhythm; (c) fall prevention and postural stability; and (d) sleep quality. A comprehensive review of lighting studies on older adults' visual and nonvisual performance was conducted using a modified PRISMA systematic review process. For the first domain, some older adults had difficulty in using the toilet, preparing meals, and doing laundry under lower illuminance. For the second domain, brighter and bluish lighting improved older adults' circadian rhythm. For the third domain, low-intensity LED lighting affixed on door frames can help older adults maintain postural stability and prevent falling during nighttime movement. Finally, some studies concluded that receiving outdoor daylight during exercise was beneficial to older adults' sleep quality. This study provides several methodological, theoretical, and collaborative suggestions for developing a more conclusive evidence base for lighting standards and strategies for older adults.
This small-scale, Welsh qualitative study explores how a new "moving on" service empowered older people to move voluntarily from their home to an extra-care facility. Eighteen older people were interviewed about their experiences of the service, which offered in-person, bespoke information, advice, financial, practical, brokerage, and emotional support about moving. Findings indicate three service use patterns: continuous, partial, and discontinued. It was instrumental in empowering clients to exercise decisional, executional, delegated, and/or consumer autonomies. Recommendations for future developments of a prototype "moving on" service include a multipartner approach and caseworker case management training modeled on social work practice.
An average of 26,560 UK excess winter deaths occur in people 65+ years old each winter, of which 30% are attributed to cold homes. Cold homes are known to exacerbate health problems prevalent in the 65+ demographic. Through conducting interviews in homes occupied by 65+-year-olds known to be achieving less than the World Health Organization (WHO) minimum recommended temperature (18 degrees C), this article highlights their struggles in maintaining health and managing their homes, with instances of extreme and potentially dangerous methods to achieve thermal comfort identified. Fairer energy provision, better targeted financial aid, and improved support networks are necessary to alleviate current problems.
