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During the pandemic, many older adults felt out of place in their home, work, and community spaces with potentially long-term consequences for health and wellbeing. Using national data from the COVID-19 Coping Study, thematic analysis of online long-answer responses (n = 1171; mean age 68 years; 71% female; 93% non-Hispanic White; 86% with at least a 4-year college degree; data collected April-June 2022) identified four themes regarding why particular places are challenging since the pandemic onset: (1) viral exposure fears, (2) frustrating regulations, (3) uncomfortable and hostile social dynamics, and (4) out of place negative emotions. Participants also shared how they continuously address or adapt to place-based challenges through lifestyle adjustments and coping strategies. Novel findings may inform multi-scalar policymaking and interventions to support wellbeing in later life in times of stress and instability.

At-home respite services seem too rigid to meet the needs of older adults and their caregivers. It is critical to develop service flexibility, as it allows for personalized care, adapted to health conditions, preferences, and evolving needs. While no prior studies used coconstruction methods to increase flexibility, this study could offer a better understanding of flexible respite for stakeholders. Using a living lab approach, this article aimed to (1) empirically determine the characteristics of this type of respite model and (2) document the levers and obstacles to consider for its implementation. Starting from a pre-existing flexible respite model named ANAAIS, the research team led workshops and interviews. First, the team carried out 2 workshops (TRIAGE and persona-scenario) with a total of 3 caregivers and 8 homecare professionals or managers. Second, a team member conducted interviews with 3 caregivers and 6 homecare professionals or managers. Content analysis was used on the data. The stakeholders coconstructed a Québec version of ANAAIS, a web application allowing caregivers to request an affordable respite, at the time wanted, and offered by a qualified care worker, through a simple application. Levers and barriers to its deployment are linked to the model's characteristics as well as its internal and external context. For example, relations and connexions were perceived as a lever to deployment, while the lack of resources was considered an obstacle. This living lab project showed the feasibility and pragmatism of coconstructing a flexible and applicable respite service model. [ABSTRACT FROM AUTHOR]

Home and community-based services (HCBS) enable frail patients to remain at home. We examined whether there were neighborhood-deprivation, racial, or rural disparities in HCBS utilization provided to Veterans by the Department of Veterans Affairs (VA) or Medicare by comparing the adjusted utilization rate of a historically disadvantaged group with the predicted utilization rate had it been treated as the historically dominant group. Among the 2.7 million VA patients over 66 years old in 2019, 11.0% were Black, 39.2% lived in rural settings, 15.3%/29.2%/30.9%/24.7% lived in least/mild/moderate/most-deprived neighborhoods. On average, 11.2% received VA or Medicare HCBS. Veterans residing in more deprived neighborhoods had 0.11–0.95% higher adjusted probability of receiving HCBS than expected had they resided in the least deprived neighborhoods. Veterans residing in rural areas had 0–0.7% lower HCBS rates than expected had they been treated like urban Veterans. Black Veterans were 0.8–1.2% more likely to receive HCBS than expected had they been treated like White Veterans. Findings indicate that VA resources were equitably employed, aligning with probable HCBS needs, suggesting that VA’s substantial and long-standing investment in HCBS for care of frail Veterans could serve as a model for other payers and providers in the U.S. [ABSTRACT FROM AUTHOR]

Aging in place has become a popularly accepted logic and practice in both the academic and policy domains. Older adults' preferred facilities and social networks, however, might not always be situated in the residential neighborhoods where their homes are located. While recognizing the value of aging in place, this article argues that geographical proximity should not be conflated with aging well, nor should a spatially delimited place be the only locus of "community." We propose the concept of aging in networks to capture a range of social networks in the life-worlds of older adults, including those that extend beyond their neighborhoods. We combine qualitative and geographic information systems (GIS) methods (i.e., qualitative GIS) to analyze three types of activity spaces observed among older adults in Singapore. Our analysis elicits the reasons why older adults use facilities and cultivate social networks both within and beyond their neighborhoods. This approach highlights the importance of studying and supporting both the local and extralocal ties of older adults. The article draws on qualitative GIS research (interviews and Global Positioning System tracking) with fifty older adults in two neighborhoods in Singapore (from a wider survey with 1,199 older adults). [ABSTRACT FROM AUTHOR]

Few studies have investigated how older people's daily activities and characteristics of the surrounding urban environment affect their emotions and daily satisfaction. This study fills the research gap by using a paper-based survey and a smartphone ecological momentary assessment (EMA) application (with GPS tracking and pop-up surveys about activities) to study older people's well-being in Hong Kong. Three hundred and two older adults completed the paper survey and forty-two of them further completed a six- to seven-day EMA survey. Based on a total of 1,530 activity episodes, generalized estimating equation models were developed to examine the relationship between older people's socioeconomic background, activity participation, urban environment characteristics, and their feelings of happiness and calmness. Results show that older people's daily life satisfaction is affected by the emotions they experienced throughout the day. In particular, a higher level of happiness was associated with socializing, leisure, and recreation activities taking place outside of the immediate neighborhood, and calmness was best achieved during passive relaxation and resting activities within the residential neighborhood. Furthermore, characteristics of the environment at activity locations are statistically significant in explaining momentary well-being. The findings support the planning for age-friendly cities and communities through encouraging older people to engage in activities outside their residential neighborhoods and designing activity locations with more leisure facilities, lower road density, and higher exposure to water bodies. [ABSTRACT FROM AUTHOR]

This paper explores LGBT retirees as agents of change who are renegotiating the terms of healthy aging in place and expanding our understanding of lifestyle and retirement migration. For the first time in history, a generation of self-identified lesbians, gay men, bisexuals, and transgender individuals have entered retirement. However, their subjective experiences have largely been glossed over in popular discourses of successful aging and migration in heteronormative society. This article explores why and how older LGBT people are choosing housing options to age "out of place" in order to support their sexual lives and identities. Examining the everyday experiences of these seniors—members of a double minority, both aged and LGBT—allows us to disrupt the idea of what healthy "aging in place" means and when it might actually be unhealthy. Employing standpoint theory pushes the analysis of marginalized voices to the fore and allows us to ask about these seniors' subjective realities. What results is a reimagining of the aging landscape. Interview data from LGBT seniors who have migrated to LGBT naturally occurring retirement communities or LGBT-focused housing complexes in France, Sweden, and Germany are used to stretch our notions of wellbeing and aging in place for these diverse retirees. One finding is that for these LGBT seniors, disrupting social norms by aging out of place is not escapist or amenity-seeking, but is key to honoring their sexuality and aging process in a safe and supportive environment. [ABSTRACT FROM AUTHOR]

The rapid pace of ageing raises concerns regarding financial security, health and long-term care and place for older people to live as they age. This paper examined the factors associated with preference to age in place (AIP) among 2231 respondents aged 60 and older from the Malaysia Ageing and Retirement Survey (MARS). The Categorical Principal Component Analysis (CATPCA) was utilized to identify variables that represent family supports, social connectedness and social participation. 75% of the respondents indicated that they would like to age in place with the binary logistic regression showing a greater likelihood among respondents with strong family and social connectedness, having a spouse, being non-Chinese and being in a good health condition. Urban respondents, with a high individual capacity and social participation, are less likely to age in place. There is a need to strengthen the family institutions and communities, providing incentives and support to promote ageing in place and empower them to remain sustainable for future generations. [ABSTRACT FROM AUTHOR]

The article discusses the safe and effective usage of community paramedicine to provide health and medical assistance to older adults in 2024. Topics covered include community paramedics' additional training as emergency medical services (EMS) providers, and the bridging of the care gap between EMS-based care and clinic-based care and home-based care. Also noted are barriers that limit the expansion of community paramedicine.

Copyright of European Journal of Social Work is the property of Routledge and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Abstract The Medicaid Aging Waiver program (MAW) subsidizes the cost of long-term care (LTC) at home or in communities to satisfy older people’s increasing desire to age in place. The MAW program might be health improving for older people by allowing them to age at home. However, less quality and quantity of home-based care comparing to nursing home care could offset some of the potential benefits. I use policy expenditure across states over time linked with detailed health information from the Health and Retirement Study (HRS) to identify the associated effects of MAWs on health outcomes of older adults who are at risk of needing LTC and who are resources constrained to be potentially eligible for Medicaid. Overall, the findings suggest that the MAW program is beneficial to health: a $1,000 increase in MAW spending for each older person results is associated with a 1.4 percent improvement in self-reported health status, a 1.5 percent reduction in functional mobility limitations, a 1.6 percent decrease in Instrumental Activities of Daily Living (IADL) limitations, and a 1.7 percent improvement in negative psychological feelings. For older people who are most likely not eligible for MAWs, such as those who are wealthy or in good health and do not require LTC, these health-improving effects have not been observed.

This study undertakes a systematic literature review, framed by eight research questions, and an exploration into the state-of-the-art concerning smart home innovations for care of older adults, ethical, security, and privacy considerations in smart home deployment, integration of technology, user interaction and experience, and smart home design and accessibility. The review evaluates the role of smart home technologies (SHTs) in enhancing the lives of older adults, focusing on their cost-effectiveness, ease of use, and overall utility. The inquiry aims to outline both the advantages these technologies offer in supporting care for older adults and the obstacles that impede their widespread adoption. Throughout the investigation, 58 studies were analyzed, selected for their relevance to the discourse on smart home applications in care for older adults. This selection came from a search of literature published between 2010 and 2023, ensuring an up-to-date understanding of the field. The findings highlight the potential of SHTs to improve various aspects of daily living for older adults, including safety, health monitoring, and social interaction. However, the research also identifies several challenges, including the high costs associated with these technologies, their complex nature, and ethical concerns surrounding privacy and autonomy. To address these challenges, the study presents recommendations to increase the accessibility and user-friendliness of SHTs for older adults. Among these, educational initiatives for older adults are emphasized as a strategy to improve technology acceptance, along with suggestions for design optimizations in wearable devices to enhance comfort and adaptability. The implications of this study are significant, offering insights for researchers, practitioners, developers, and policymakers engaged in creating and implementing smart home solutions for care of older adults. By offering an understanding of both the opportunities and barriers associated with SHTs, this research supports future efforts to create more inclusive, practical, and supportive environments for aging populations.

Home and community-based services are key to an aging society and the aging in place strategies that are preferred by older adults as well as policymakers. But the provision of these kinds of services is often inadequate in territorial terms, raising the question of how to increase their reach and efficiency. This article analyzes the spatial coverage of home support services in the Aveiro Region of Portugal, considering the distribution of their target population and identifying network configurations which would provide these services more efficiently, through a location analysis that minimizes the distance to potential users of these services. This approach showed that, in the Aveiro Region, the spatial coverage of these services is highly uneven and insufficient, considering that the population with difficulties in performing daily tasks exceeds the population benefiting from these services and that the level of coverage differs greatly between territories. It also showed that significant efficiency and equity gains are possible by optimizing the service providers’ location at the supra-municipal scale, decreasing the distances to be covered and reducing territorial inequalities. [ABSTRACT FROM AUTHOR]

ABSTRACT Understanding the interactions between older adults and their living spaces is an important research topic within the human dynamics of geographical scholarship because of their implications on the quality of aging. The prevailing theory of aging tends to stress aging in place which associates aging well with the home and community, thus inadvertently privileging residential neighborhoods as the focal point where older adults spend most of their time. Recent studies have, however, suggested that older adults also age in (social) networks that extend beyond their neighborhoods' physical locations. The need to incorporate perspectives on aging in networks has challenged the prioritization and the enforcement of absolute (or physical) space in GIS software. This study investigates the potential for integrating four top‐level spaces (absolute, relative, relational, and mental) to capture different dimensions of older adults' everyday lives. By leveraging on a dataset of older adults in Singapore, this study demonstrates how the four spaces combined facilitates understanding of aging, specifically their activity spaces, that would otherwise be achieved in a fragmented manner. [ABSTRACT FROM AUTHOR]

Background Methods Results Conclusions Promoting options for aging in place (AIP) has broad appeal to policymakers and professionals providing services to persons living with dementia (PWD). However, the benefits or burdens of AIP likely vary among individuals and families. We sought to describe factors influencing decision‐making to age in place versus seek a higher level of residential care for PWD.A qualitative study was undertaken as part of a larger mixed‐methods study utilizing semi‐structured interviews with PWD, family care partners, and dementia clinicians. Interview transcripts were analyzed using qualitative content analysis with constant comparison. Sample size was determined by thematic saturation within subgroups.We conducted 74 interviews among 14 PWD, 36 care partners, and 24 clinicians. Preferences for AIP were driven by (1) desire to preserve independence, (2) a sense that the “best care” is delivered by loved ones and in a familiar environment, (3) distrust and fear of care facilities, and (4) caregiver guilt. PWD and care partners frequently considered moving from home as a “last resort” and wanted to avoid planning for future care needs. Many decisions to move were reactive and triggered by patient safety events, physical dependency, or the loss of caregiver. Proactive decision‐making was facilitated by (1) prior experience witnessing the challenges of caring for a person with advanced dementia in the home; and (2) having substantial financial resources such that participants could seek major home adaptations or avoid “lower quality” institutions.Decisions regarding care setting for PWD frequently do not feel like a choice and are made under imperfect conditions. Programs using AIP as an outcome measure should recognize the various patient‐centered and non‐patient‐centered factors that influence such choices, and interventions should be designed to promote more informed and equitable decision‐making for care setting in dementia. [ABSTRACT FROM AUTHOR]

The Medicaid Aging Waiver program (MAW) subsidizes the cost of long-term care (LTC) at home or in communities to satisfy older people's increasing desire to age in place. The MAW program might be health improving for older people by allowing them to age at home. However, less quality and quantity of home-based care comparing to nursing home care could offset some of the potential benefits. I use policy expenditure across states over time linked with detailed health information from the Health and Retirement Study (HRS) to identify the associated effects of MAWs on health outcomes of older adults who are at risk of needing LTC and who are resources constrained to be potentially eligible for Medicaid. Overall, the findings suggest that the MAW program is beneficial to health: a $1,000 increase in MAW spending for each older person results is associated with a 1.4 percent improvement in self-reported health status, a 1.5 percent reduction in functional mobility limitations, a 1.6 percent decrease in Instrumental Activities of Daily Living (IADL) limitations, and a 1.7 percent improvement in negative psychological feelings. For older people who are most likely not eligible for MAWs, such as those who are wealthy or in good health and do not require LTC, these health-improving effects have not been observed. [ABSTRACT FROM AUTHOR]

In 2020, the Covid-19 pandemic led to a public health emergency and dramatic physical and social lockdown for many of society's most vulnerable people. This mixed methods study examined the feasibility and value of delivering health promotion occupational therapy through an online video platform to community dwelling seniors over the age of 65. Four stand-alone sessions were designed to introduce health promotion and aging in place to 10 community dwelling seniors. The sessions were designed to allow seniors to engage in informative, interactive activities offering a chance to share their lived experiences. Seniors embraced new technology and benefited from therapeutic recommendations in their homes. Qualitative and quantitative results support the adaptation of telehealth as a permanent benefit for community dwelling seniors and offers the potential to reach a broader audience, reduce barriers to access care, and optimize safety in the home. [ABSTRACT FROM AUTHOR]

Background Most older adults wish to remain in their homes and communities as they age. Despite this widespread preference, disparities in health outcomes and access to healthcare and social support may create inequities in the ability to age in place. Our objectives were to synthesise evidence of social inequity in ageing in place among older adults using an intersectional lens and to evaluate the methods used to define and measure inequities. Methods We conducted a mixed studies systematic review. We searched MEDLINE, EMBASE, PsycINFO, CINAHL and AgeLine for quantitative or qualitative literature that examined social inequities in ageing in place among adults aged 65 and older in Organisation for Economic Co-operation and Development (OECD) member countries. Results of included studies were synthesised using qualitative content analysis guided by the PROGRESS-Plus framework. Results Of 4874 identified records, 55 studies were included. Rural residents, racial/ethnic minorities, immigrants and those with higher socioeconomic position and greater social resources are more likely to age in place. Women and those with higher educational attainment appear less likely to age in place. The influence of socioeconomic position, education and social resources differs by gender and race/ethnicity, indicating intersectional effects across social dimensions. Conclusions Social dimensions influence the ability to age in place in OECD settings, likely due to health inequalities across the lifespan, disparities in access to healthcare and support services, and different preferences regarding ageing in place. Our results can inform the development of policies and programmes to equitably support ageing in place in diverse populations. [ABSTRACT FROM AUTHOR]

Objectives This study aimed to examine the meaning of home for persons with dementia and the role of the physical environment during their meaning-making process. In response to a growing number of persons with dementia, there has been a strong advocacy for prioritizing the development of dementia-friendly environments within design practice and research agendas, for which "home" has become one of the important loci. However, of the limited studies on the meaning of home from the perspective of those individuals who continue to live in their own homes after developing dementia, even fewer addressed this issue within the Chinese context. Methods Five dyads, persons with dementia and their family caregivers, participated in the qualitative phenomenology study. Ten home visits–2 visits per dyad–were conducted, during which interview data, photographs, and field notes were collected. Phenomenological analysis was applied within and across the data sets. Results Three key themes emerged—"Three Dimensions of Home" revealed that "home" goes beyond physical residence and immediate family connections, including meaningful objects and places, enduring relationships, self-identity, and lived experiences.; "The Impact of Physical Environment" and "The Impact of Cognitive Impairment" showed the complex interactions between the environment, cognitive impairment, and meaning-making. Discussion An exploration of the essence of meaning of home within the Chinese context, in person–environment relationships with dementia progression, and implications for future research and practice on dementia-related environments and care were further discussed. This study contributes insights into enhancing the well-being of persons with dementia and benefiting their caregivers. [ABSTRACT FROM AUTHOR]

Background and Objectives A better understanding of factors associated with assisted living admission and discharge practices can help identify communities that are more likely to allow residents to age in place. This study examined how state regulations and assisted living organizational characteristics related to community admission and discharge practices for bathing, getting out of bed, and feeding. Research Design and Methods Using data from a representative sample of 250 assisted living communities in seven states and a database of assisted living state regulations, we employed multilevel logistic regression models to examine regulatory and organizational correlates of assisted living community admission and discharge practices for 3 activities of daily living (bathing, getting out of bed, and feeding). Results States' regulations were not associated with assisted living community admission and discharge practices. However, assisted living communities above the median in the number of personal care staff members per resident were 17% (95% confidence interval [CI]: 6.5%, 27.1%) more likely to admit residents who needed assistance with feeding and 25.4% (95% CI: −37.7, −13.2) less likely to discharge these residents. For-profit communities were more likely to admit residents with bathing and feeding limitations. Discussion and Implications Organizational characteristics (e.g. for-profit affiliation, staffing levels) may, in part, drive admission and discharge practices, especially related to different care needs. The ability to house residents with advanced care needs may be influenced more by the organizational resources available to care for these residents than by states' admission and discharge regulations. [ABSTRACT FROM AUTHOR]

Background and Objectives Volunteers are the foundation of social service agencies in rural communities, yet limited research exists on their needs and challenges. Motivated by the multidimensional older voluntarism sustainability framework, this study aims to understand (1) the characteristics of volunteers, (2) the relationships between volunteers' sense of community and their own aging and volunteer retention, and (3) the unique challenges faced by volunteers and volunteer-based agencies. Research Design and Methods This study uses a mixed-methods design. Data were gathered via telephone interviews (n = 76) and in-person focus groups (n = 14) from the volunteer pool of a nonprofit organization in rural Michigan. Descriptive and regression analyses were conducted to understand the characteristics of the volunteers. Thematic analysis was conducted to identify unique challenges faced by rural agencies and volunteers. Results Findings show that most volunteers were over 70, women, married, volunteered weekly or more, and were affiliated with multiple agencies. Volunteers with a stronger attachment to the community and higher self-perceptions of aging were likelier to continue and increase volunteering commitments. Due to the low population density in rural areas, volunteers were concerned about the heavy burden of volunteering, the lack of social connections with fellow volunteers, and the lack of active involvement in shaping the organization. Discussion and Implications Results from the study shed light on the urgent need for creative and engaging volunteer recruitment and retention strategies to sustain older adults, service agencies, and communities in rural areas. [ABSTRACT FROM AUTHOR]

Can assistive technologies (ATs) support aging in place for people with dementia and disability? In seeking to go beyond the persistent institutional care delivery paradigm, this proof-of-concept study tested the feasibility of home care delivery using sensors and remote communication devices. This article reports the collaborative efforts among care professionals, care recipients and family caregivers in their private home environment and the impact of in-home passive remote monitoring (PRM) system on the users. The purpose of this study was to investigate the usability and impact of a PRM system combining in-house passive remote monitoring and an interactive communication function. In order to realize AT-supported, person-centered aging in place, a new care delivery model was designed, developed and tested for the duration of 12 weeks. The study was conducted with 5 older people (1 with severe disability and 4 with dementia), their primary family carers with 15 care professionals as users. The findings indicate that there were some technical issues. However, the overall assessment of the system performance was positive, and the users expressed favorable views regarding its preventive and interactive nature. The importance of team-based care delivery, adjusted to fit the PRM equipment, was also highlighted. Faced with the challenge of meeting the increasing demand for person-centered care with limited resources, there will be a greater need for better integration of improved ATs. The study indicates ATs' potential for enhancing the quality of life for those involved in caregiving, while stressing the significance of stakeholders' engagement, skills and teamwork. This proof-of-concept study tested the feasibility of a home care delivery system using sensors and remote communication device for those with dementia and disabilities. A home care delivery system was successfully created for 12 weeks by collaborative efforts among care professionals, care recipients and family caregivers in their private home environment. The introduction of in-home passive remote monitoring system increased the possibility of the older adults being able to live independently, and enabled rehabilitation at home. The users had favourable views regarding the system's preventive and interactive nature and highlighted a greater need for better integration of improved assistive technology in long-term care and rehabilitation. [ABSTRACT FROM AUTHOR]

Population aging is an important and increasingly relevant area of study for demographers. A growing body of research seeks to determine how long-term changes in births, mortality, and migration—the three drivers of any demographic process—have shaped the present aging situation. Using variable-r decomposition and cohort data, this research note presents a formula for the change in the old-age dependency ratio to determine the extent to which relative changes in births, as well as in mortality and migration rates, contribute to aging. This perspective provides a careful and in-depth picture of aging and contributes to the debate concerning whether changes in births or mortality have had the strongest effect on population aging. When applied to Australia, the United States, and several European populations, the decomposition of the old-age dependency ratio shows that aging occurred in all populations and that changes in both births and mortality contributed to this aging. Analysis of these populations demonstrates that although they differed regarding which of these factors contributed more, changes in births prevailed as the more significant factor. In nearly all populations, migration decreased the rate of population aging. [ABSTRACT FROM AUTHOR]

This paper examines moral dilemmas faced by family caregivers of older adults who employ live-in migrant care workers. Being both a family caregiver as well as an employer of a live-in migrant care worker often puts family members at a crossroad, where moral decisions must be made. Lacking a formal role, family members do not have a professional code of ethics or other clear rules that can guide their actions, and their choices are rooted in cultural, community, familial, and personal values. This paper discusses moral dilemmas that result from family caregivers' dual commitment, to the wellbeing of their older sick relative who is the recipient of care, and to the wellbeing of the live-in care worker whom they employ. The paper uses relational ethics as a theoretical framework to discuss three cases that involve complex moral decision making in real life. [ABSTRACT FROM AUTHOR]

As policymakers globally recognize aging in place as the preferred option for most adults, there is a growing need to supplement family or informal caregiving for frail older adults with formal homecare services, particularly for those who require 24/7 care due to significant physical and/or cognitive impairment. The core objective of this qualitative study was to explore family members' experiences in employing live-in care workers, particularly the nature of their engagement and the quality of their relationships with these care workers. Our analysis of semi-structured interviews with 35 family caregivers revealed four themes: 1) challenges in acquiring support and developing dependency; 2) negotiation of roles, responsibilities, and moral dilemmas; 3) shifting emotions between trust and suspicion; and 4) role confusion, expectations, and disappointments. The study suggests that families might benefit from formal guidance regarding fostering and maintaining positive relationships in the homecare environment. This paper provides nuanced knowledge that may inform the development of such interventions. [ABSTRACT FROM AUTHOR]

People in need of care and support do not always find appropriate services. This paper aims to explore the content and added value of monthly follow-up telephone calls after preventive home visits. We used both monitoring data and qualitative semi-structured interviews (with older adults, formal and informal caregivers). Results indicate that a majority of older adults (N = 95) received a regular follow-up of four telephone calls. Social connection and involvement were mentioned by all three groups as positive aspects of the program. Although time-consuming, this paper draws attention to the added value of follow-up telephone calls after preventive home visits. [ABSTRACT FROM AUTHOR]

The possible decline of cognitive functions with age has been in the focus of cognitive research in the last decades. The present study investigated effects of aging on conflict processing in a big dataset of a Stroop-inspired online training task. We focused on the temporal dynamics of conflict processing in the light of task practice by means of inspecting delta plots and Lorenz-interference curves to gain insights on a process level. The results indicate a relatively constant increase of cognitive conflict over the course of adulthood and a decrease with practice. Furthermore, the latency of the automatic processing of conflicting information relative to the controlled processing of task-relevant information decreases relatively constantly with age. This effect is moderated by practice, that is, the relative latency of the automatic processing decreases less with age at high practice levels. As such, practice seems to be able to partially counteract age-related differences in conflict processing, on a process level. [ABSTRACT FROM AUTHOR]

Background and Objectives Community support has a profound positive impact on older people's health and plays a crucial role in facilitating aging in place. This impact is particularly significant in the Chinese context, where community support can alleviate the pressure on traditional family caregiving. This study translated, adapted, and validated the perceived community support questionnaire (PCSQ) for use with older Chinese. Research Design and Methods Data for this validation study were collected from a cross-sectional survey of 1,064 Chinese aged 65 years and above. Following the cultural adaptation of the PCSQ-14, confirmatory factor analysis (CFA) was conducted to examine its factor structure. Criterion validity, convergent and discriminant validity, internal consistency reliability, and test–retest reliability of the scale were also assessed. Results Based on the CFA results, the adapted PCSQ-14 was found to have a 3-factor solution for community integration, community participation, and community organizations. The criterion-related validity was supported by its significant correlation with depression. Convergent and discriminant validity were established, with the internal consistency of the scale being 0.90. The test–retest reliability intraclass correlation coefficient for the scale was 0.78. Discussion and Implications The adapted version of the PCSQ-14 demonstrated promising psychometric properties in assessing perceived community support in older Chinese. The adapted PCSQ-14 could assist researchers in determining older Chinese adults' perceptions of community support, and could also assist practitioners and policymakers in developing targeted services for older people and allocating resources more effectively. [ABSTRACT FROM AUTHOR]

Background and Objectives Approximately 60% of people living with dementia at home are unable to routinely participate in mealtime activities (e.g. eating, safe food preparation), warranting assistance to ensure people with dementia meet their health and nutritional needs. The purpose of this study was to characterize these barriers to mealtime participation and identify potential caregiver-led strategies to enhance mealtime activities. Research Design and Methods We used a qualitative descriptive approach and obtained semistructured interview data from (a) allied health professionals and (b) community-based nutrition program providers who frequently serve people with dementia. Interview data were examined by means of directed content analysis and framework methodology until data saturation was reached. Codes from our analysis were categorized according to constructs drawn from the Socio-Ecological Model for Developing and Implementing Comprehensive Dementia Care. Results Data were obtained from 20 participants who attributed common mealtime participation barriers to: impairments in functional status, cognitive status deficits, a lack of caregiver knowledge and skills, and unsafe living conditions. Caregiver-led strategies to overcome these barriers included: reducing auditory and visual distractions, providing written cues to perform mealtime activities, eliminating clutter and fall risk hazards, and leveraging community-based nutrition program providers (e.g. home-delivered meal providers). Discussion and Implications People with dementia face several eating and mealtime participation obstacles. Caregiver-led strategies implemented by family, friends, or community-based nutrition program providers may enhance mealtime activities at home. Findings point to opportunities to develop decision-making tools and resources for caregivers to optimize the health and nutrition of people with dementia. [ABSTRACT FROM AUTHOR]

As we age, the ability to move is foundational to health. Life space is one measure of a person's ability to move and engage in activity beyond the home. A separate but related concept is activity space, a measurement of a person's spatial behaviors and visited locations that include social networks, neighborhoods, and institutions. In this article, we integrate the literature on life space and activity space, discussing how physical function is not only determined by individual capabilities, but also by the surrounding social and environmental factors, which may limit their agency. We show how structural racism contributes to inequities within this paradigm linking related concepts of movement, agency, belonging, and timing. We also explore implications for research and theory for mobility, social connection, and activity. [ABSTRACT FROM AUTHOR]

Copyright of Turkiye Klinikleri Journal of Health Sciences / Türkiye Klinikleri Sağlık Bilimleri Dergisi is the property of Turkiye Klinikleri and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Most older individuals prefer to age in place during their later years; however, achieving this aspiration presents significant challenges. Naturally Occurring Retirement Communities (NORCs) represent a potential option for promoting healthy aging, both from the perspective of meeting seniors' real needs and cost-effectiveness. This article aims to analyze the distribution of NORCs in Australia and compares census data from 2011 to 2021 to understand the overall distribution patterns and changes across the nation, by providing a localized analysis of the hotspot distribution of NORCs in eight Greater Capital Cities. The study employs methods of geovisualization, Global Moran's I, and Getis-Ord Gi* analysis to examine the spatial correlations and clustering effects of NORCs. The results indicate that NORCs are rapidly growing in Australia, with their distribution primarily influenced by sea change and urbanization. Understanding the trends in NORC distribution can assist the government in developing effective and localized policies and interventions to help older Australians to better age in place. [ABSTRACT FROM AUTHOR]

Purpose: This study aims to explore how social support has reshaped the care of older adults living alone in northeast Thailand during the COVID-19 pandemic. Design/methodology/approach: This study used a qualitative method using a narrative gerontological perspective with a descriptive design. Purposive sampling was conducted from 20 in-depth narrative interviews between November 2021 and February 2022 in Maha Sarakham province, northeast Thailand. Data transcriptions were performed using a narrative analytical process. Findings: The in-depth narrative interviews indicated that older adults living alone during the coronavirus pandemic valued a comfortable life, a sense of place, favourable living arrangements, self-reliance, life goals and meaningful life. The gerontological analysis showed that social support for older adults living alone included a social safety net, networking, supporting needs, physical care and mental health responses to the COVID-19 pandemic. Originality/value: To the best of the authors' knowledge, this is the first qualitative narrative gerontological study to explore how social support reshaped the care of older adults living alone during the COVID-19 pandemic in northeast Thailand. [ABSTRACT FROM AUTHOR]

This study uses mixed methodologies to reveal how structural and cultural changes are changing the connotations of home and aging in rural China. Based on surveys (n = 830) and 33 intensive interviews with older migrant workers, this study found that having rural public pensions, adult children living nearby, and owning land in their hometowns were associated with the respondents' desire for aging in place (AIP). Moreover, although the image of the rural home is idyllic, the reality is difficult. Aging migrant workers are gaining a strong sense of financial independence and their children's lack of parental care. The authors argue that having no social-care services, while adult children are rarely available for old-age care, is changing the connotations of AIP in rural China. These social and cultural transformations are making AIP more of a romantic ideal than a practical reality for migrant workers. [ABSTRACT FROM AUTHOR]

Older adults prefer ageing in place (AIP) rather than institutionalized facilities. Although its advantages, AIP can be challenging when communities are unable to meet residents' needs. This study aims to identify the relationship between the level of age-friendliness of community and AIP. We used AARP Age-friendly Community Survey data with 6670 older adults in the USA. We used responses from 63 items assessing various aspects of a community's age-friendliness to identify different types of age-friendly communities (AFCs) through latent profile analysis (LPA). We then ran multinomial logistic regression to examine whether the types of AFC were associated with AIP. LPA revealed three types of AFC: Underdeveloped, developing, and developed. Regression results showed older adults living in underdeveloped and developing communities are less likely to AIP compared to those in the developed community. These results show a positive impact of AFC on intention to AIP. Policymakers should consider expanding AFC initiatives for the growing number of older adults. [ABSTRACT FROM AUTHOR]

Objective: Through interviews with older adults and professionals in Chongqing, China, this paper explores the challenges and opportunities faced by smart cities that undertake to better support ageing‐in‐place. Methods: We undertook a qualitative multi‐methods approach, engaging 46 professional stakeholders and 64 older people to examine the role of smart cities in enabling older people to age‐in‐place in Chongqing, China. Results: With the development of smart cities, technology has the potential to facilitate ageing‐in‐place by creating opportunities for heathy and active ageing. This study identified specific priorities in delivering age‐friendly smart cities, including the following: shaping smart environments around the everyday lives of older people, designing inclusive and equitable smart cities and ensuring strong forms of institutional governance, trust and relationship building with older people. Conclusions: The age‐friendly city and communities movement (AFCC) and smart city policy instruments have potential for realising active ageing by supporting mobility, access to services and civic participation. However, there exists a disconnect between smart city policy and practice in delivering tangible well‐being outcomes for older people. Addressing this requires greater cross‐sectoral working, reconciling smart city policy priorities with AFCC domains and creating the institutional and governance framework to enable socially sustainable cities to support ageing‐in‐place. [ABSTRACT FROM AUTHOR]

Objective: This study examines the impacts of urbanisation‐induced displacement on rural older villagers and the issues of rebuilding ageing in place in Suzhou Municipality in China's Jiangsu Province. Methods: The study employed a qualitative research method involving three measures of data collection, including 20 older‐adult interviews, 14 key informant interviews (with street and community administrators, managers of service companies, managers of nursing homes and community doctor) and participant observation of older villagers' daily life in urban resettlement communities. Results: The displacement and resettlement of villagers for urbanisation had serious negative impacts on older villagers, including financial insecurity, relative deprivation and radical changes to the living environment. The community services were limited and insufficient, but the resettlement of the whole village in the same place enabled the village community to maintain social and cultural continuities, which facilitated older villagers' adaptation to the new urban place. Filial piety, though weakened and transformed, continued to play an important role in regulating old‐age support, but descending familism reduced family resources for old‐age support. Conclusions: This study highlights the importance of examining the impacts of external social and economic forces, such urbanisation in China, on ageing in place. We draw three conclusions based on empirical research in Suzhou: (1) the resettlement of older villagers in urban areas did not significantly narrow the rural–urban gap in old‐age support in Suzhou; (2) urbanisation‐induced displacement in China affected older residents differently from gentrification in Western countries, due to different processes of compensation and resettlement as well as China's rural–urban welfare gap; and (3) community services for displaced older villagers are limited, but social and cultural continuities before and after resettlement have helped older villagers adapt to the new urban place. [ABSTRACT FROM AUTHOR]

Objectives: This paper has two objectives. First, it assesses whether the existing informal care provided by adult children has an impact on older people's propensity to demand community care services. Second, it compares the different statuses of sons and daughters in the formal/informal support trade‐off. Methods: The paper is based on an analysis of data from the 2018 wave of the China Longitudinal Ageing Social Survey, within the framework of a revised version of Andersen's model, and applies multilevel models to analyse the effects of adult children's gender, numbers and the quality of their support, on older people's willingness to purchase community care services. Results: Older people who had sons as well as daughters demanded fewer services, while the number of sons increased service demand. Regarding sons, community care services compensated for economic support, daily life care and spiritual consolation, but did so only in respect of daily life care from daughters. Conclusions: Many families have only one son or one daughter as a result of the one‐child policy and therefore often require support from formal care services. Moreover, there is a distinct gender division and an influential filial culture governing the impact of services on the support provided by adult children. Because ageing in place depends on both informal family support and formal services, this key policy goal is at risk if the latter provides insufficient support to the former. [ABSTRACT FROM AUTHOR]

IntroductionRelocation after a disaster often has negative health effects on vulnerable people, particularly older adults. However, little is known about the number of repeated evacuations and relocations after disasters among those experienced disaster-related deaths. This case series aimed to summarize the secondary problems and mortality risks in patients involved in relocation after disasters.MethodsWe analyzed and summarized the data on 520 disaster-related deaths in Minamisoma City, a municipality near the Fukushima Daiichi Nuclear Power Plant, focusing on the number of relocations. Herein, we describe the cases of three individuals over 80 years old, who died after eight or more relocations, which were certified as disaster-related deaths.ResultsWe discuss following three cases, which are (1) a female patient in her 90s who had a stroke and was completely disabled, (2) a female patient in her 80s whose cancer was detected later due to her failing to see her family doctor, and (3) a male patient in his 80s whose regular postoperative treatment was disrupted following cancer recurrence.DiscussionOur findings indicate that evacuation led to the worsening of chronic diseases and eventually to post-disaster death. Prolonged wide-area evacuation and repeated relocation likely interrupted the continuum of care and led to the failure of adequate care provision. To reduce the loss of human life, it is necessary to review the number of wide-area evacuations and relocations over the medium to long term after large-scale disasters, including nuclear disasters, which may occur in the future. Simultaneously, it is important to establish a medical system at the evacuation site so that disaster victims can continue to receive medical care even after evacuation or relocation.

The pandemic has reinforced older adults' reliance on their homes and the concept of “aging in place”. Changes like reduced physical strength and cognitive deficit, however, have heightened the challenge of simple tasks like obstacle crossing among older adults, let alone when older adults cannot perceive the surroundings well during the nighttime. The study is, therefore, to evaluate the impact of lighting on older adults' obstacle-crossing behavior during the nighttime. Twenty-seven older adults (81 ± 6 yrs., 171 ± 12 cm, 75 ± 20 kg, 14 females) were recruited. Participants were asked to cross over the obstacle in a dark residential environment under point or line light. We found that the line light tended to (1) induce more external rotation of the trailing hip (p = 0.037) and more internal rotation of the leading ankle (p