On the political and policy front, interest has increased in making communities more "age-friendly", an ongoing trend since the World Health Organization launched its global Age-Friendly Cities project. We conceptualize age-friendly communities by building on the WHO framework and applying an ecological perspective. We thereby aim to make explicit key assumptions of the interplay between the person and the environment to advance research or policy decisions in this area. Ecological premises (e.g., there must be a fit between the older adult and environmental conditions) suggest the need for a holistic and interdisciplinary research approach. Such an approach is needed because age-friendly domains (the physical environment, housing, the social environment, opportunities for participation, informal and formal community supports and health services, transportation, communication, and information) cannot be treated in isolation from intrapersonal factors, such as age, gender, income, and functional status, and other levels of influence, including the policy environment.
The literature on age-friendly communities is predominantly focused on a model of urban aging, thereby failing to reflect the diversity of rural communities. In this article, we address that gap by focusing on the concept of community in a rural context and asking what makes a good fi t between older people and their environment. We do this through (a) autobiographical and biographical accounts of two very different geographical living environments: bucolic and bypassed communities; and through (b) analysis of the different needs and resources of two groups of people: marginalized and community-active older adults, who live in those two different rural communities. We argue that the original 2007 Health Organization definition of age friendly should be reconceptualized to explicitly accommodate different community needs and resources, to be more inclusive as well as more interactive and dynamic, incorporating changes that have occurred over time in people and place.
More than 30 years ago, Elder theorised multiple life-course trajectories in domains such as family and work, punctuated by transitions that create the structure and rhythm of individual lives. We argue that in the context of population ageing, family care should be added as a life-course domain. We conceptualise life courses of family care with core elements of ‘care as doing’ and ‘care as being in relationship’, creating hypothetical family care trajectories to illustrate the diversity of life-course patterns of care. The framework provides a basis for considering influences of care on cumulative advantage/disadvantage for family carers.
Although some studies have confirmed positive associations between social engagement and well-being in later life, this study aimed to understand why some seniors cannot be engaged. The authors analyzed the lived experiences of 89 seniors in three rural communities in Canada, from semi-structured interviews and using the constant comparison method. Five factors make choices for social engagement in later life unequal among older adults who differ by gender, class, age, and health status. Profound engagement in care work, compulsory altruism, personal resources, objectively perceived and subjectively available engagement opportunities, and ageist barriers around paid work constrain choices for seniors who lack privilege in the context of a market economy, particularly for low-income older women. To avoid stigmatizing vulnerable older persons, societal barriers to meaningful activities must be addressed - for example, through provision of income security or by reversing inter- and intragenerational ageism in access to the labor market.
The power of social connections is a contemporary focus of research across world regions. Yet, evidence of challenges to carers’ social relationships remains fragmented and underexplored. We conducted a scoping review of 66 articles to create a state-of-knowledge review of the social consequences of caring. Findings indicate evidence of consequences for relationships with care receivers, with other family members and with broader social networks. Knowledge gaps include changes in relationships across time and in understanding diversity in the types and extent of consequences. Evidence challenges assumptions related to caregiving families and to the sustainability of family care.
In the midst of a 'care crisis', attention has turned again to families who are viewed both as untapped care resources and as disappearing ones. Within this apparent policy/demographic impasse, we test empirically theorised trajectories of family care, creating evidence of diverse patterns of care across the lifecourse. The study sample, drawn from a Statistics Canada national survey of family care, comprised all Canadians aged 65 and older who had ever provided care (N = 3,299). Latent Profile Analysis yielded five distinct care trajectories: compressed generational, broad generational, intensive parent care, career care and serial care. They differed in age of first care experience, number of care episodes, total years of care and amount of overlap among episodes. Trajectories generally corresponded to previously hypothesised patterns but with additional characteristics that added to our understanding of diversity in lifecourse patterns of care. The five trajectories identified provide the basis for further understanding how time and events unfold in various ways across lifecourses of care. A gap remains in understanding how relationships with family and social network members evolve in the context of care. A challenge is presented to policy makers to temper a 'families by stealth' policy approach with one that supports family carers who are integral to health and social care systems.
The philosophy concerning long-term care for frail seniors has shifted from a provider-driven, medical model toward a more client-centred, social model. While this philosophy emphasises the decision-making abilities of clients and respect for their values and preferences, evidence suggests that there are difficulties in understanding and implementing the philosophy. Qualitative in-depth interviews were conducted with residents of adult family living and assisted living programmes in western Canada to better understand the elements that residents themselves felt were integral to client-centred care.Three main themes emerged from the data analysis: (1) the physical setting, people within the setting, and the community were important areas of expression of residents' values and preferences; (2) the decision about where to live influenced whether the residential care environment was congruent with residents' values and preferences; (3) contentment resulted when there was a good fit between preferences and experiences, reflecting the essence of residents' perspective of client-centred care. Choices among models of care, appropriate staffing levels and training, and recognition of family contributions may improve the practice of client-centred care.
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