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Despite the existence of substantial research on physical environment of long-term care facilities, there is a scarcity of empirical research on the physical environment of community-based programs such as adult day centres. In particular, there is limited evidence on the role of environmental design of those settings in supporting (or hindering) the needs of older persons with dementia. This study explores the effect of physical and social environments of adult day program setting on clients’ activities and well-being in the context of purpose-built versus non-purpose-built facilities. A mixed-method approach was used that included: physical environmental assessment, in-depth interviews with staff members and ethnographic observations. Four themes emerged: ‘Design Matters’, ‘Social Connectedness’, ‘Staying Active’, and, ‘Community-based Health Services’. The findings demonstrate the need for adult day programs’ integrated and restorative services, which provide appropriate care and social contact for frail older adults, thereby fostering independence and healthy living.
This capstone project presents a critical synthesis of recent literature (2000 to 2013) focused on three types of innovative housing and/or service models and aging in place to address housing needs for older adults. The inquiry reviews and synthesizes literature across multidisciplinary field related to psychology, sociology, gerontology and architecture. By comparative analysis of their differences and similarities, opportunities and challenges are identified for Villages, NORCs and Cohousing. Findings affirm the potential of these innovative housing and/or service models to support aging in place. Through planned empowerment programs, sociocultural activities, enhanced health/social services and accessible built environment, older adults can remain autonomous and independent living in safe and comfortable surroundings. Organizational strategies include shared leadership, effective communication processes, co-location of services and relationships. Villages, NORCs and Cohousing’s distinct effectiveness stem from their identification, contextualization and strategic allocation of external and internal resources. Their challenge to sustain comes from membership recruitment and funding limitations. This comparative study and analysis will advance research, practice and policy on housing for aging in place.
Currently there are no instruments measuring communication about end-of-life (EOL) issues in families not involved in palliative care. The purpose of the study was the development and initial validation of a new quantitative instrument, the Marital End-of-Life Communication Scale (MELCS), to measure EOL communication in married/partnered adults. After initial item development and validation in married/partnered adults (age 45 years old and older, N=101), six items, scored by 5-point Likert-type response options, were chosen for the final version of the scale. Factor analyses confirmed the theorized single-factor structure. The MELCS demonstrated excellent reliability (CR=0.892) as well as good content, convergent (AVE=0.587), discriminant, construct, and criterion-related validity. In addition, the scale was invariant across age, gender, and level of death anxiety. Analyses of the nomological network showed that marital EOL communication positively related with general marital communication (R=0.53), and negatively related with death anxiety (R=–0.47) and self-rated health status (R=–0.44).
It is understood that regular physical activity (PA) plays a critical role in improving and maintaining a person’s health and well-being, especially as one grows older. Such benefits include preventing or controlling obesity, arthritis, hypertension, diabetes, cardiovascular disease including stroke, depression, cognitive disorders, certain cancers, and improving strength, flexibility and function. Regular PA can also stave off premature mortality. Despite these benefits of PA, older adults are becoming less active as they age. This capstone addresses two objectives: 1) to systematically and methodologically review and analyze cross-sectional and longitudinal associations between PA and health outcomes from the older adult general population living in the community or in institutional care aged 50 years and older and 2) to compare the results cross-sectionally and longitudinally. Results indicated that both cross-sectionally and longitudinally there were weak to moderate associations between PA and health outcomes such as emotional well-being, cognitive function, physical function, mortality, depression, chronic disease, quality of life and successful aging. Demonstrating a positive association between PA and health outcomes among older adults could have considerable public health implications in designing interventions to promote participation in PA.
The ability to live and age well is a common goal across the lifespan. For older adults with multiple chronic conditions, this goal frequently poses a challenge. A central process by which individuals face these challenges, or adversities, and regain a sense of wellness in their lives is a complex, dynamic phenomenon termed resilience. Cultivating resilience is therefore important for those with multiple chronic conditions, since they face daily stressors and long-lasting adversity. However, the concept of resilience has not been well developed in relation to chronic adversity or aging, and although it is a well-used term, it remains a challenging concept for researchers to engage with. Therefore, this research project conducted a conceptual and theoretical review of resilience in the context of aging with multiple chronic conditions. In addition, a lifespan model of resilience was developed, and an agenda for future research was outlined.
Smartphone applications have the capacity to support many of the needs specific to older adults with mild impairments in cognition. This capstone examines characteristics and diagnostic terminology used to encompass various forms of mild impairments in cognition, the unmet needs of those with these conditions, smartphone applications that have the potential to address these needs, and technology adoption considerations. User personas based on the literature review provide examples of how smartphone applications can be incorporated to meet the needs of this population. Findings from the literature review indicate that certain smartphone applications match with the needs of this population and could be utilized if technology adoption barriers are addressed. Given these findings, a research proposal is made for a feasibility study investigating a peer-led smartphone application training program to facilitate goal achievement for older adults with mild impairments in cognition.
The aim of this thesis was to explore potential differences in yoga practices between middle-aged (40 to 54) and older adult yoga students (55+). A social learning/health belief model was used to frame this research. A mixed methods approach was used. For the quantitative analyses, a convenience sample, of 452 participants, was collected through an on-line questionnaire. For the qualitative analyses, face-to-face interviews were conducted with 20 of the participants. Results of the mixed methods approach showed several unique differences between the age groups in terms of motivations and barriers, but not pathways. Implications for health promotion programs that target older adults were discussed.
Older adults have been described as experiencing irrational fear of crime with debilitating effects on the quality of their lives. Recent research suggests fear of crime by older adults may have been over-stated due to conceptual, methodological, and theoretical weaknesses. It has been argued that fear of crime has a “murky history,” “shaky foundations,” and “a constructed, contingent, and ultimately contestable” nature. A metanarrative review of the literature was completed in order to identify where the “fear of crime debate has been, where it presently sits, and where it might travel in the future.” The review utilized nine electronic data bases up to 2013 including Ageline, PsychInfo, Wiley Library, PsychArticles, Avery Index, Cochrane Central, ProQuest Dissertations, Web of Science, and SFU Library. Articles addressing definitional, conceptual, measurement and theoretical issues are included. The results strongly suggest that irrational fear of crime is a very limited experience for older adults.
The purpose of this meta-ethnography was to synthesize qualitative studies on the unique care giving contexts of South Asian and Chinese caregivers and care receivers, and to gain an understanding of the systemic factors that influence their care giving contexts. A broad search of the literature on South Asian and Chinese caregivers and care receivers was conducted and 22 journal articles were selected which met the inclusion criteria for the meta-ethnography. The systematic synthesis of the literature according to the Meta-Ethnography procedures laid out by Noblit and Hare (1988) revealed two dominant themes: (1) The Personal is Political and (2) Becoming an Ally. These interpretations illuminate the care giving contexts under discussion. They are especially beneficial for understanding the challenges and systemic issues which contribute to the care giving contexts of South Asian and Chinese groups.
This capstone project presents a critical synthesis of recent literature (2000-2013) related to aging in place in the urban environment. Definitions across multiple disciplines including geography, gerontology, sociology, and psychology are reviewed and inform the development of a proposed holistic definition of optimal aging in place. The literature is then reviewed and synthesised for social and built environment barriers and facilitators to aging in place, along with two key theoretical models and the World Health Organizations Age Friendly Cities framework leading to a conceptual framework for optimal aging in place. It is proposed that this theoretically grounded framework of optimal aging in place will help guide future work in the area of aging in place in the urban neighbourhood. It was found that the intersectionality of multiple factors affects each individual differently depending on their current level of competence leading to a unique combination of factors involved in optimal aging in place.
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