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The relationship between rural community type and attachment to place for older people living in North Wales, UK.

ABSTRACT: This paper explores the relationship between rural community type and attachment to place for 387 older people aged 70 and over. Six rural settlements in North Wales are characterised according to certain statistics (e.g. age structure, in-migration, strength of local culture, and multiple deprivation) to provide distinct community profiles. It is hypothesised that community type is characterised by particular types of attachment, which are dependent on life course trajectories and changes or stability in the environment. Using a sevenfold classification of attachment to place, the paper tests seven hypotheses. The results support four of the seven hypotheses. Older people living in a retirement destination are more likely to report aesthetic qualities and the appropriateness of the environment. People living in native areas with a strong culture and local language are more likely to note the importance of historical attachment and social integration into the community. Three hypotheses are rejected: older people living in a retirement destination are not less likely to report social support, or a historical perspective in attachment to place, and older people living in areas with high levels of multiple deprivation are not more likely to encounter relocation restraints than are others. Overall, the findings suggest that the taxonomy of attachment to place provides a flexible framework for differentiation by community. The paper concludes that communities are not merely settings-they play a significant role in self-identity and are a vital source of emotional and experiential meaning for the inhabitant.

SUBMITTER: Burholt V

PROVIDER: S-EPMC5547680 | biostudies-other | 2005 Jun

REPOSITORIES: biostudies-other

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Project description:BACKGROUND:Considering the real-world experiences of those with cognitive impairments is important in building a positive community for older people. Community-based participatory research is an important methodology for investigators focused on improving community health. The aim of this study was to 1) investigate factors associated with the continuation of community dwelling among high-risk older people and 2) to create a model of an inclusive community space for older people in the largest housing complex district in Tokyo. METHODS:From 198 residents who completed all three steps (mail, face-to-face, and home-visit) of a previous large-scale epidemiological survey, we identified 66 residents who were at high-risk of moving out of the community. These participants underwent 6 months of regular assessments by experienced researchers to identify the factors associated with continuing to live in the community. We also employed a community action approach to develop a community space for residents in the study district where more than two researchers who were medical professionals served as staff. The services offered by the space were continuously improved according to user feedback. The function of this center was evaluated during interdisciplinary research meetings. RESULTS:After 6 months, among the 66 high-risk residents, 49 people were living in the community and 12 people had moved out of the community. Those who could not continue to live in the community had greater unmet needs in terms of social support, especially daily living support and housing support. In addition, their families perceived a heavier burden of care. Interestingly, dementia diagnosis via the DSM-5, clinical dementia rating, physical health, mental health, and long-term care usage did not predict the outcome. Through discussions with guests, we equipped the space with various services such as coordination of community care and networking with existing organizations. CONCLUSIONS:Merely providing healthcare and long-term care might not be sufficient to support community living in people with cognitive impairments. Daily living support and housing support should be provided in the context of a broad health services package. For this purpose, creating a comfortable community space for residents and community workers is essential.

Project description:BACKGROUND:Falls in community-dwelling older people have been recognised as a significant public health issue in China given the rapidly growing aged population. Although there are several reviews documenting falls prevention programs for community-dwelling older adults, no systematic reviews of the scope and quality of falls prevention interventions in Mainland China exist. Therefore, the aim of this study was to systematically review falls prevention interventions for community-dwelling older people living in Mainland China. METHODS:We systematically reviewed literature from Chinese and English databases. All types of randomised controlled trials (RCTs) and quasi-experimental studies published from 1st January 1990 to 30th September 2019 were included. Observational studies and studies in care facilities and hospitals were excluded. Narrative synthesis was performed to summarise the key features of all included studies. Quality assessment was conducted using the Cochrane Risk of Bias Tool and ROBINS-I tool for randomised and non-randomised studies respectively. RESULTS:A total of 1020 studies were found, and 101 studies were included in the analysis. Overall, very few high quality studies were identified, and there was insufficient rigor to generate reliable evidence on the effectiveness of interventions or their scalability. Most interventions were multiple component interventions, and most studies focused on outcomes such as self-reported falls incidence or awareness of falls prevention. CONCLUSION:There is an opportunity to undertake an evaluation of a rigorously-designed, large-scale falls prevention program for community-dwelling older people in Mainland China. To help mitigate the rising burden of falls in Mainland China, recommendations for future falls prevention interventions have been made. These include: (1) target disadvantaged populations; (2) incorporate personalised interventions; and (3) investigate the effectiveness of those under-explored interventions, such as psychological, social environment, management of urinary incontinence, fluid or nutrition therapy and surgery. The study results will also potentially provide a useful evidence base for other low-and-middle income countries in a similar situation.

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The relationship between rural community type and attachment to place for older people living in North Wales, UK.

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