The role of social support in the health of older persons is well documented. This support is particularly important for isolated nursing home residents. The purpose of this study was to test the feasibility of using low-cost videophones to enhance communication between nursing home residents and their families. Ten pairs of residents and family members received videophones and engaged in regular televisits for six months. All participants completed brief survey instruments prior to and after the study period to determine the effects of the televisits on the frequency and quality of contacts. A post-study survey assessed ease and satisfaction with using videophones. Findings include identification of technical and design problems, possible solutions, factors affecting actual use of equipment, and conditions under which benefits of use may be optimal. Categories for estimating potential actual users are suggested. Importantly, the study demonstrates that videophones can be used successfully by a wide range of frail nursing home residents and can enhance social interactions, regardless of distance. Affordable videophone technology offers the potential for reduced isolation among institutionalized elders and others with distance and mobility barriers.
Lesbian, gay, bisexual, or transgender (LGBT) older adults are often unaware or fearful of aging services that contribute to greater vulnerability, isolation, and risk when services are needed. In addition, they may perceive or experience bias in health care encounters. Providers may not recognize their own biases or their impact on such encounters. In response, a group of LGBT community activists, aging professionals, researchers, and a theatre ensemble developed an interactive theatre experience, described herein, that portrays challenges faced by LGBT older adults needing services. Goals included raising awareness among LGBT older adults and providers about issues such as the limited legal rights of partners, limited family support, and fear of being mistreated as a result of homophobia. Evaluations and feedback reflected the potential of interactive theatre to engage people in sensitive discussions that can lead to increased awareness, reduced bias, practice change, and ultimately improved care for LGBT older adults.
Providers must place increased emphasis on the importance of cane/walker use for injury prevention through patient education to promote personal relevance, proper fitting, and training. New strategies are needed to improve device acceptability and accessibility.
It appears that medical education curriculum guidelines have insufficient content about families of people with mental illness. The educational experiences of psychiatrists and primary care physicians may not adequately prepare them for working with family members of their patients. It is recommended that medical education curriculum guidelines incorporate information about family stigma; family/caregiver burden; information exchange; family stress, coping, and adaptation; family support; crisis response; and multiple family group psychoeducation.
A 2008 Institute of Medicine (IoM) report outlined a vision for health care and a workforce capable of addressing health and extended care needs of our aging population. It highlighted dramatic shortages necessitating bold action and outlined recommendations aimed at building a sizable and qualified workforce. This study updates report findings and progress made on its recommendations. Through review of publicly accessible, internet-based literature and government and professional organization websites, current workforce data and recent policy changes are compared to the report’s statistics and recommendations. Direct comparisons are limited by changing definitions, context, and data collection and analyses methods. Future workforce need projections are estimated using reports from various sources. Inability to forecast medical advances, socio-economic changes, and world events impacts the accuracy of these projections. Nonetheless, clear conclusions emerge despite such limitations. Progress toward fulfilling the IoM goals is variable and insufficient. The current and projected numbers for all geriatric health providers remain inadequate compared to estimated 2030 demand. Challenges in meeting estimated needs persist essentially unchanged. The 2008 IoM framework and recommendations remain relevant and constitute an important roadmap to complete unfinished goals. Initial findings from this update provide a platform for developing practice and policy reforms.
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