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Background and Objectives The concept of aging in place is acknowledged as the preference of older adults, yet without consideration of the intersections of diversity in later life, it is critiqued as unattainable, unrealistic, or even undesirable. This gave rise to the exploration of what is needed to age in the right place (AIRP). Building on existing research, we examined the meaning of AIRP to older adults (aged 55+ years) who have experienced homelessness. Research Design and Methods We conducted photovoice interviews with 11 residents of a temporary housing program in Metro Vancouver (Canada). Results Using thematic analysis, we organized meanings of AIRP according to (1) Where one lives—the physical and social environment, (2) Where one goes and what one does, and (3) How one feels in "the right place." Discussion and Implications Participants meanings' of AIRP are applied to Maslow's hierarchy of needs. That is, when basic needs of shelter are met, participants' considerations of "the right place to age" extend beyond affordable housing to include feeling safe and comfortable in one's home and neighborhood and having access to meaningful engagement and activities—both in vibrant urban districts and naturescapes—enabled by affordable transportation. Our examination of what AIRP means to this group of older adults broadens current conceptualizations. Given the increase in homelessness among older adults, it is imperative that policymakers and practitioners are cognizant of meanings of AIRP so diverse older adults can not only age in place, but can thrive in the right place. [ABSTRACT FROM AUTHOR]

Older people with experiences of homelessness (OPEH) tend to experience more complex health, social, and psychological issues than people experiencing homelessness at younger ages. Simultaneously, many housing resources (e.g., shelters, temporary housing) are often ill equipped to meet the needs of OPEH. As such, OPEH are often unable to age in the right place (AIRP) -- that is, in a place that supports unique needs and vulnerabilities. However, several promising practices exist that deliver housing and services tailored to OPEH. To investigate the aspects of housing and shelter that both promote and impede AIRP for OPEH, this study examines the delivery of services in three such promising practices from the perspective of service providers. Findings from fifteen qualitative interviews revealed three overarching themes: 1) barriers to providing individualized support (e.g., staff turnover); 2) shifting contexts and structures (e.g., housing market changes); and 3) mechanisms of success (e.g., facilitating smooth transitions into permanent housing). These findings provide evidence to support the refinement of service delivery to promote AIRP for OPEH. In doing so, these insights can help to elevate promising practices to the level of best practice. [ABSTRACT FROM AUTHOR]

The physical, mental and social benefits for older adults who volunteer are well-documented. Absent from this area of research is an understanding of volunteer motivations among ethnoculturally diverse older adults. This paper addresses this research gap by examining motivations to volunteer related to cultural generativity among Jewish older adults, a group that remains underexplored in research. Cultural generativity is defined as an impulse to pass down one's culture to the next generation, and thus to outlive the self. The Jewish community is notable for possessing high levels of social capital, indicated by close community ties and the large number of faith and culturally based organisations, and therefore makes them an important ethnocultural group to study. Semi-structured qualitative interviews were conducted with 20 adult volunteers age 65 and over. The guiding research questions for this study are: What are the motivations to volunteer among older Jewish adults? and Do these motivations align with the concept of generativity applied to Jewish culture? Data analysis identified three themes related to cultural generativity: volunteering to preserve and pass down Jewish traditions and teachings; a Jewish ethic of giving back perceived as a duty; and experiences of anti-Semitism and discrimination motivating Jewish participants to volunteer. Findings suggest the ways in which cultural generativity may be expressed through volunteerism. [ABSTRACT FROM AUTHOR]

Despite steady increases in homelessness in the U.S., only recently has research on transportation needs and use for persons experiencing homelessness (PEH) been the focus of research endeavours. Moreover, limited research has identified how the geographic relocation of homeless community services and resources impacts the transportation needs of PEH and how this process affects access to health and social services. To fill this gap in the literature, using a community‐engaged research approach, we conducted a qualitative research study in which 24 professionals working in planning, transportation, local government, and the homelessness services sector were engaged in in‐depth, semi‐structured interviews. We examined participant perspectives on how PEH transportation needs and use changed after three new emergency shelters replaced a centralised one, and how access to health and social services was impacted. Data were organised into three overarching categories: (1) Changes in transportation need and use following decentralisation; (2) Impact of transportation changes on PEH access to services; and (3) Recommendations for improving transportation access. Findings suggest the need to offer PEH transportation on demand, provide education on transportation and system navigation, and increase transportation‐related funding for homeless service providers and PEH to ensure transportation costs are not a barrier to healthcare and social services. [ABSTRACT FROM AUTHOR]

Purpose: Medical respite provides postacute care to people experiencing homelessness upon hospital discharge if they are too sick to recover on the streets or in a traditional shelter. The current study examined the feasibility of conducting a study to test the effectiveness of a medical respite intervention for older people experiencing homelessness. Methods: Fifteen patient and 11 provider participants were interviewed between July and November 2018. Results: Participants' considerations for how to design a program of research included (1) desired qualities of researchers; (2) preferences for study design; (3) mechanisms for participant recruitment and retention; (4) what, where, and how to collect data; and (5) barriers and motivations to participation. Conclusions: Findings from this study build on an emerging research base on how to appropriately engage vulnerable patient groups, including older people experiencing homelessness, in trauma-informed research by including peer researchers on research teams to serve as advisors throughout the research process. [ABSTRACT FROM AUTHOR]

Although moving from institutional to home-like long-term care (LTC) settings can promote and sustain the health and wellbeing of older adults, there has been little research examining how home is perceived by older adults when moving between care settings. A qualitative study was conducted over a two-year period during the relocation of residents and staff from an institutional LTC home to a purpose-built LTC home in Western Canada. The study explored perceptions of home amongst residents, family members and staff. Accordingly, 210 semi-structured interviews were conducted at five time-points with 35 residents, 23 family members and 81 staff. Thematic analyses generated four superordinate themes that are suggestive of how to create and enhance a sense of home in LTC settings: (a) physical environment features; (b) privacy and personalisation; (c) autonomy, choice and flexibility; and (d) connectedness and togetherness. The findings reveal that the physical environment features are foundational for the emergence of social and personal meanings associated with a sense of home, and highlight the impact of care practices on the sense of home when the workplace becomes a home. In addition, tension that arises between providing care and creating a home-like environment in LTC settings is discussed. [ABSTRACT FROM AUTHOR]

Introduction Though hospitals are a common location where older adults experiencing homelessness receive health care, an understanding of the types of supports needed upon hospital discharge is limited. We examined the unique characteristics of older homeless adults and the health and psychosocial supports required upon hospital discharge. Design and Methods Guided by principles of community-based participatory research (CBPR), we conducted 20 in-depth, semi-structured interviews with shelter/housing and health care providers in Metro Vancouver. Results Thematic analyses revealed 6 themes: (a) older people experiencing homelessness have unique vulnerabilities upon hospital discharge; (b) following hospital discharge, general population shelters are inappropriate for older adults; (c) shelter/housing options for older adults who have complex health and social needs are limited; (d) shelter/housing for older adults who require medical stabilization and convalescence after hospital discharge is needed; (e) a range of senior-specific shelter/housing options are needed; and (f) unique community supports are needed for older adults upon hospital discharge. Discussion and Implications As the population of older adults increases across North America, there is a parallel trend in the increased numbers of older adults who are experiencing homelessness. Not only is there often a need for ongoing medical care and respite, but there is a need for both shelter and housing options that can appropriately support individual needs. [ABSTRACT FROM AUTHOR]

Objectives: Most persons with bipolar disorder (BD) misuse alcohol and/or illicit drugs at some point, yet research specific to older adults with BD is nascent. The current study sought an in-depth understanding of the experiences and meanings of substance use in a sample of adults who self-reported substance misuse. Methods: Semi-structured interviews were conducted and thematically analyzed to understand the personal theories of substance use by 12 adults (9 women and 3 men; M = 49 years old) who self-reported diagnoses of BD and regular alcohol or illicit drug use. Results: Findings provide an in-depth picture of the theories middle-aged and older adults with BD have developed to explain their substance use. Participants’ theories suggest multiple reasons for substance use, including self-medication; increased confidence with substance use; rejection of prescribed medications; easy access to alcohol; early social exposure/use as facilitator; and living in a culture of substance use. Conclusion: Findings suggest multiple theories for the comorbid link between BD and substance use, primarily that persons with BD use drugs and/or alcohol to relieve stress or manage symptoms. It is clinically relevant to incorporate personal reasons for actively and regularly using substances as part of personalized substance treatment and BD symptom management. [ABSTRACT FROM AUTHOR]

Abstract: High prevalence rates of alcohol and substance use disorders have been reported among persons with bipolar disorder (BD). In the present study, we explored the daily experiences of middle‐aged and older adults living with BD who reported regular substance use and the ways in which participants expressed ‘control’ in relation to their use of alcohol and other substances. Semistructured, in‐depth interviews were conducted with 12 participants (nine women and three men), aged 36–57 years of age (mean = 49 years). Thematic analyses identified emergent themes and patterns in participants’ life histories. The theme of ‘control’ emerged as central to participants’ reports, and was organized into four categories: (i) substance use to control BD symptoms; (ii) substance use provides a sense of being in control; (iii) methods of controlled substance use; and (iv) not having control: overreliance on substances. Implications of the present study include the need for nurses to openly discuss the use of alcohol and other drugs with persons with BD, provide health information and screening, and determine whether persons with BD feel they have control over their substance use. Several lines of research with persons who have BD and use substances are suggested. [ABSTRACT FROM AUTHOR]

Objective: Long-term care (LTC) facilities are increasingly intent on creating a “homelike” atmosphere for residents. Although residential staff are integral to the construction of a home within LTC settings, their perceptions have been relatively absent from the literature. Method: Thirty-two LTC staff participants were interviewed about their experiences and perceptions of the physical environment and conceptualizations of home, and thematic analyses were conducted. Results: An overarching category—interpersonal relationships—emerged from our analyses emphasizing the importance of relationships in creating a homelike environment within institutional settings. Sub-themes that inform our understanding include the following: (a) Staff members’ perceptions of home; (b) “Their second home”: Adjustment to and familiarity in LTC; and (c) “We become family”: Relationality makes a home. Discussion: The study provides evidence to inform current policies and practices in LTC. Specifically, enough time and space should be given to residents and staff to create and maintain personal relationships to make residential care homelike. [ABSTRACT FROM AUTHOR]

Sleep disturbances are common among older women; however, little is known about sleep experiences among chronic benzodiazepine users. The experience of sleep, sleep troubles, and management of sleep problems were explored through semistructured interviews with 12 women aged 65–92 who had used a benzodiazepine for three months or longer to treat a sleep disturbance. Themes that emerged from an interpretive phenomenological analysis included multiple reasons for sleep disruptions (health problems, mental disturbances, and sleeping arrangements), opposing effects of benzodiazepines on sleep (helps or does not work), and several supplemental sleep strategies (modification of the environment, distraction, and consumption). [ABSTRACT FROM AUTHOR]

Aim: We examined qualitative data from a larger study of benzodiazepine-using women older than 65 years, living in the United States, for subjective experiences of loneliness and social isolation. Method: Data from semistructured interviews with seven participants discussed aspects of social isolation or loneliness. Following a phenomenological design, data were coded and analysed for experiences. Results: Three themes emerged: 'Dislike being alone'; 'Loneliness and isolation'; and 'Social isolation causes negative feelings'. Conclusion: Social isolation and loneliness are negative aspects of the lived experience for older benzodiazepine-using women and the loss of companions and transportation is important to this experience. Being isolated can cause depression, fear and insecurity. Future research should consider the role psychotropic medications have in coping with social isolation and loneliness among older adults. Clinicians should be aware of social isolation and loneliness in late life and discuss non-pharmacologic treatment options with their ageing patients. [ABSTRACT FROM AUTHOR]

A phenomenological study explored whether older women who are chronic benzodiazepine users identified themselves as dependent, how dependence was perceived, and how meanings and understandings shaped experiences of benzodiazepine use. Self-reported benzodiazepine dependence was associated with being unable to reduce use or a desire to discontinue use and reliance on benzodiazepines to remain comfortable and able to handle daily life. Themes included: (a) benzodiazepine dependence is similar to dependence to diabetes or blood pressure medications; (b) dependence is distinctive from addiction/abuse; (c) addiction/abuse is perceived as worse than dependence; and (d) concerns of addiction/abuse result in low-dose benzodiazepine use. [ABSTRACT FROM AUTHOR]

Late-life divorce—commonly referred to as gray divorce—is a rising trend that parallels the growth of the older adult population. We sought to gain an in-depth understanding of the experience of marriage dissolution, the divorce process, and life following divorce in a sample of older adults who divorced after more than 20 years of marriage. Qualitative data were collected from 10 divorcees (7 women and 3 men; M age = 63.5) and analyzed to understand the gray divorce experience; that is, factors that determined or delayed the decision to divorce and divorcees’ coping during and after divorce. Participants’ stories demonstrate that marriages endure despite problems because relationships are complex, and good experiences mix with bad ones. Outcomes of late-life divorce have significant health and financial implications for both individuals and society. [ABSTRACT FROM PUBLISHER]