Adult Day Service (ADS) centers offer a variety of services to meet the needs of older adults and their caregivers. During the last decade, ADS has received increased attention due to shifts in policy toward home and community-based services for an aging population. This article reviews the effectiveness of ADS from 2000 to the present, with particular attention given to caregiver and participant outcomes, health care utilization, and future directions in ADS research. Multiple databases were searched to identify relevant research and 61 articles were selected for review based on inclusion criteria. The results of this review emphasize the need to implement and test more specific interventions targeting the needs of the ADS population.
The purpose of this study was to examine older adults' experiences and perspectives regarding transportation mobility. Using a community-based participatory research approach, residents of Arlington, Texas, age 55 and older, participated in individual interviews (N = 15) or one of six focus groups (N = 45) as part of an overall study about ageing well in a large ethnically diverse city in the United States of America. Thematic analysis was conducted using inductive and deductive qualitative methods and social equity as a sensitising concept. Findings indicate that older adults who are transportation-disadvantaged experience limited access to health care, goods and services and are isolated from familiar lifestyle habits and social networks. Access to affordable, adequate transportation is compromised through social and political forces, which marginalise historically disadvantaged populations. Implications for cross-disciplinary practice and future research on sustainable transportation and policy development are discussed within a social justice and social equity framework.
Reactions to early life trauma can reemerge or be exacerbated in later life as coping resources and abilities are compromised by age-related changes and declines in health. For newly admitted nursing home residents, this can impact their receptiveness to assistance with care and elicit challenging reactions to environmental and situational triggers. Unfortunately, current assessment tools fail to account for reactions to early-life trauma. In this article, we review existing literature on early-life trauma and aging and introduce a hypothetical case to illustrate the importance of identifying nursing home residents with past trauma experiences.
This study used an ethnocultural approach to explore how cultural factors influenced ethnically diverse dementia caregivers' experiences and use of services. A modified thematic analysis of in-depth interviews with 15 caregivers, ranging in age from 50 to 75 years, including spouses, daughters, sons, cousins, and a friend, from three minority groups-African American, Hispanic, and South Korean caregivers-was conducted by a team of multi-lingual researchers. Caregiver stress was pervasive across all subgroups. Several themes emerged that were qualitatively different across groups, including knowledge about dementia, language barriers, religion and spirituality, and cultural differences in attitudes about caring and formal services. A two-pronged intervention model that includes a generic intervention to reduce caregiver stress along with a culturally targeted intervention tailored to a family's language, food preferences, religious practices, gender norms, and other values was recommended to more successfully reach and support these caregivers.
To address the need for accessible, affordable, and sustainable Alzheimer's disease and related dementia caregiver interventions with minority populations, we developed the Senior Companion Program Plus, a three-phase pilot study that used a mixed methods experimental design. The intent was to determine if participation in a lay provider, peer-led psychoeducational intervention designed for African American Alzheimer's disease and related dementia caregivers ( N = 16) improved caregiver burden and/or stress, coping skills, and social support. Focus groups with Senior Companions informed the intervention design. Quantitative results indicated that caregivers experienced improvement in their overall level of social support and well-being in meeting basic needs. Qualitative findings suggested that caregivers experienced improvement in their knowledge about the disease, experienced increased coping with Alzheimer's disease and related dementia caregiving, and reported benefits of using a lay provider model. Overall, the data suggest that the Senior Companion Program Plus is a promising intervention for African American Alzheimer's disease and related dementia caregivers.
The decision to move into assisted living (AL) can be viewed as a life-changing process for older adults and their families; and each may possess differing views of this process. This qualitative study examined the AL decision-making process as described by twentytwo older adult and family member dyads. Participants described emotional and logistical components related to the AL moving decision. Further, fifteen of twenty-two dyads expressed conflicting or differing views of the AL moving decision. Our discussion examines the need for future studies to explore the impact of family and older adult disagreements on the older adult's AL adjustment; the necessity for community-based agencies and AL settings to provide social services over the duration of the decisionmaking process; and the importance of employing social workers skilled in family practice in the AL setting.
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