IntroductionIncreasingly, older adults are turning to emergency departments (EDs) to address healthcare needs. To achieve these research demands, infrastructure is needed to both generate evidence of intervention impact and advance the development of implementation science, pragmatic trials evaluation and dissemination of findings from studies addressing the emergency care needs of older adults. The Geriatric Emergency Care Applied Research Network (https://gearnetwork.org) has been created in response to these scientific needs—to build a transdisciplinary infrastructure to support the research that will optimise emergency care for older adults and persons living with dementia.Methods and analysisIn this paper, we describe our approach to developing the GEAR Network infrastructure, the scoping reviews to identify research and clinical gaps and its use of consensus-driven research priorities with a transdisciplinary taskforce of stakeholders that includes patients and care partners. We describe how priority topic areas are ascertained, the process of conducting scoping reviews with integrated academic librarians performing standardised searches and providing quality control on reviews, input and support from the taskforce and conducting a large-scale consensus workshop to prioritise future research topics. The GEAR Network approach provides a framework and systematic approach to develop a research agenda and support research in geriatric emergency care.Ethics and disseminationThis is a systematic review of previously conducted research; accordingly, it does not constitute human subjects research needing ethics review. These reviews will be prepared as manuscripts and submitted for publication to peer-reviewed journals, and the results will be presented at conferences.Open Science Framework registered DOI: 10.17605/OSF.IO/6QRYX, 10.17605/OSF.IO/AKVZ8, 10.17605/OSF.IO/EPVR5, 10.17605/OSF.IO/VXPRS.
The stressful nature of caring for an older adult with a chronic disease, such as Alzheimer’s disease (AD), can create barriers between the caregiver-care recipient, as they try to navigate their continuously changing social relationship. Interpersonal synchrony (i.e., matching or similarity of movement, emotions, hormones, or brain activity), is an innovative approach that could help to sustain caregiving relationship dynamics by promoting feelings of connection and empathy through shared behavior and experiences. This review investigates the current literature on interpersonal synchrony from an interdisciplinary perspective by examining interpersonal synchrony through psychological, neural, and hormonal measures across the adult lifespan. We then present a case for examining the degree to which interpersonal synchrony can be used to facilitate affiliation and well-being in the caregiver-care recipient relationship. We find that there is significant evidence in healthy adult populations that interpersonal synchrony can support affiliative feelings, prosocial behavior, and well-being. Characterizing the psychological, neural, and hormonal mechanisms of interpersonal synchrony is a first step towards laying the groundwork for the development of tools to support relational closeness and empathy in the caregiving context. Finally, we explore the strengths and limitations of using interpersonal synchrony to support relational well-being, and discuss possible avenues for future research.
The Family Caregiver Activation in Transitions (FCAT) tool in its current, non-scalar form is not pragmatic for clinical use as each item is scored and intended to be interpreted individually. The purpose of the current study was to create a scalar version of the FCAT to facilitate better care communications between hospital staff and family caregivers. We also assessed the scale's validity by comparing the scalar version of the measure against patient health measures. Data were collected from 463 family caregiver–patient dyads from January 2016 to July 2019. An exploratory factor analysis was performed on the 10-item FCAT, resulting in a statistically homogeneous six-item scale focused on current caregiving activation factors. The measure was then compared against patient health measures, with no significant biases found. The six-item scalar FCAT can provide hospital staff insight into the level of caregiver activation occurring in the patient's health care and help tailor care transition needs for family caregiver–patient dyads. [
Journal of Gerontological Nursing, 48
(12), 35–42.]
Purpose of Review
This narrative review highlights important factors contributing to loneliness in older adults prior to and during the COVID-19 pandemic and effects on brain health.
Recent Findings
We characterize risk factors for loneliness in older adulthood and the impact of COVID-19. Furthermore, we discuss the implications of loneliness for older adults’ brain health.
Summary
Understanding the multifactorial causes of loneliness in different subpopulations of older adults both before and during the COVID-19 pandemic will provide insights for the development of interventions targeted to reduce loneliness in older adults based on their specific risk factors.
In older adulthood, individuals may experience acute and chronic stressors, such as the loss of independence, mobility, or the experience of chronic diseases. Loneliness is also a concern in older adulthood as many experience the loss of close others and smaller social networks. Loneliness is well-established as being associated with higher stress levels in younger adults, but there are mixed findings on the impact in older adulthood. Furthermore, while older adults may engage in behaviors designed to reduce and manage stress, it is not known whether these behaviors modulate the relationship between loneliness and chronic stress. The current study examined the relationship between loneliness and stress in older adulthood and the degree to which stress-management moderated this relationship (note: data collected prior to COVID-19 pandemic). We hypothesized that loneliness and perceived stress would be positively associated, but that stress-management would moderate this relationship. Participants included 40 healthy older adults (Mage= 69.18, Range:55-86yrs; 29 females) who completed the UCLA-Loneliness Scale, the Perceived Stress Scale, the NEO-FFI (to assess neuroticism), and demographic information about participation in stress management activities. We found that loneliness was significantly associated with chronic stress, r(38) = .539, p < .001. Furthermore, loneliness and neuroticism were significant predictors of perceived stress, F(2, 37) = 10.657, p < .001, R2 = .366. These findings demonstrate that loneliness is a significant predictor of perceived stress in older adulthood and point to a need for further exploration of effective stress-management tools in later life.
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