Relocation to ordinary or special housing in very old age: aspects of housing and health.
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ABSTRACT:
SUBMITTER: Granbom M
PROVIDER: S-EPMC5549188 | biostudies-other | 2014 Mar
REPOSITORIES: biostudies-other
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Project description:The aim of this study was to explore how very old people consider and arrive at decisions on relocation, with specific attention to housing and health relationships during the process of ageing. The sample included 13 very old participants of an 11-year longitudinal study of relationships between housing and health. Applying a mixed-methods approach, data from qualitative interviews and quantitative survey data from three data collection waves were utilised. The quantitative data were interwoven with the qualitative findings into a coherent body of text. The core theme "Negotiating and effectuating relocation is a long process" indicates a non-linear process consisting of five phases constituting the main categories of our findings. In the first phase, some informants considered relocation while others avoided thinking about it. Next, relations between health and home changed and led to turning points triggering relocation, i.e. when dependence in everyday activities reached critical points or when sudden illness forced an involuntary move. In the third phase, once the decision to relocate was made it was set in stone by the individual, but often questioned by the authorities, leading to a situation causing much frustration. While waiting for the relocation, doubts as well as expectations about the new home were expressed. Finally, even though the actual move caused different feelings, it was most often a positive experience and resulted in subjective health improvement and increased social contacts. The results can be used for the development of positive, proactive strategies for improved housing provision along the ageing process.
| S-EPMC5547368 | biostudies-other
Project description:This study examined whether relocating from a high-poverty neighborhood to a lower poverty neighborhood as part of a federal housing relocation program (HOPE VI; Housing Opportunities for People Everywhere) had effects on adolescent mental and behavioral health compared to adolescents consistently living in lower poverty neighborhoods.Sociodemographic, risk behavior, and neighborhood data were collected from 592 low-income, primarily African-American adolescents and their primary caregivers. Structured psychiatric interviews were conducted with adolescents. Prerelocation neighborhood, demographic, and risk behavior data were also included. Hierarchical Linear Modeling (HLM) was used to test associations between neighborhood variables and risk outcomes. HLM was used to test whether the effect of neighborhood relocation and neighborhood characteristics might explain differences in sexual risk taking, substance use, and mental health outcomes.Adolescents who relocated of HOPE VI neighborhoods (n = 158) fared worse than control group participants (n = 429) on most self-reported mental health outcomes. The addition of subjective neighborhood measures generally did not substantively change these results.Our findings suggest that moving from a high-poverty neighborhood to a somewhat lower poverty neighborhood is not associated with better mental health and risk behavior outcomes in adolescents. The continued effects of having grown up in a high-poverty neighborhood, the small improvements in their new neighborhoods, the comparatively short length of time they lived in their new neighborhood, and/or the stress of moving appears to worsen most of the mental health outcomes of HOPE VI compared to control group participants who consistently lived in the lower poverty neighborhoods.
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Project description:Increasing age is associated with deficits in a wide range of cognitive domains as well as with structural brain changes. Recent studies using diffusion tensor imaging (DTI) have shown that microstructural integrity of white matter is associated with cognitive performance in elderly persons, especially on tests that rely on perceptual speed. We used structural equation modeling to investigate associations between white matter microstructure and cognitive functions in a population-based sample of elderly persons (age ? 60 years), free of dementia, stroke, and neurological disorders (n = 253). Participants underwent a magnetic resonance imaging scan, from which mean fractional anisotropy (FA) and mean diffusivity (MD) of seven white matter tracts were quantified. Cognitive functioning was analyzed according to performance in five task domains (perceptual speed, episodic memory, semantic memory, letter fluency, and category fluency). After controlling for age, FA and MD were exclusively related to perceptual speed. When further stratifying the sample into two age groups, the associations were reliable in the old-old (? 78 years) only. This relationship between white matter microstructure and perceptual speed remained significant after excluding persons in a preclinical dementia phase. The observed pattern of results suggests that microstructural white matter integrity may be especially important to perceptual speed among very old adults.
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Project description:Background: In different parts of the world new models of senior housing have rapidly appeared, which indicates that existing housing and care models are not fulfilling the hopes and needs of current and new generations of older people. Material and Methods: This qualitative study focuses on one type of communal senior housing complex located in a mid-sized town in Central Finland. The complex was designed to have accessible low-maintenance apartments and common spaces, and to be near easily accessible green spaces, amenities, services, and public transport. The complex has a part-time community coordinator. The minimum age limit is set at 55 years. The data consists of 36 qualitative interviews with residents (21 women, 15 men) aged 66-93, conducted between November 2018 and February 2019. The semi-structured interviews were recorded and transcribed. The data analysis focused on how different aspects of the manmade, natural, and social environment were portrayed in residents' descriptions of day-to-day life. Theoretical framework adopted for the study draws from the ideas of environmental and geographic gerontology. The data was analyzed using positioning analysis which is one form of discourse analysis. Results: The senior housing in this study fulfilled its promise of providing accessible a physical and social environment which encourages and enables residents to be physically active and independent, yet which also provides social activities and feeling safe. In this respect, the senior housing complex offered an environment which supports well-being and healthy aging. However, the residents' interpretations of what the senior housing complex represented varied. For some of the residents it was first and foremost a social place, which provided opportunities for social contacts and social activities. For some of the residents the most important were maintenance-free apartments and outdoor areas. The question remains as to how social practices, in the form of government policies and market systems can support the development of different kinds of senior housing which are affordable and accessible for all.
| S-EPMC7890193 | biostudies-literature
Project description:In this paper, we present empirical results for the very old (75+) concerning transitions between independent living in ordinary home without public support, independent living in ordinary home or special accommodations with home help and home health care, and living in around the clock care. We investigate the role of age and gender, dependency in activities of daily living (ADL) and the informal support from a partner. We also study mortality conditional on the above-mentioned variables and on the mode of old age care. The results show that the propensity to move to a more intensive mode of care is less for males, higher with more limitations in personal ADL and increasing with age. There is also a stabilizing effect of the availability of informal care support, as measured by marriage or cohabitation, as it makes it less likely to move from the current care mode. In the case of mortality, the observed relations pointed in the expected directions-mortality increasing with increasing PADL-limitations and age and being higher for men than for women. The age relation, however, does not hold in the same way in around the clock care. The estimated relationships are used as input in a micro-simulation model intended for analysis of the effect of population aging on the needs and resource requirements for old age care in Sweden.
| S-EPMC5547298 | biostudies-other
Project description:Objectives: To synthesize the evidence on the relationships between physical housing characteristics or housing accessibility and different aspects of health among community-dwelling people 60 years and older. Methods: A systematic review of recent evidence with a narrative synthesis was conducted. Results: We included 15 studies and found three themes covering physical housing characteristics or housing accessibility that are associated with aspects of health among community-dwelling older adults: (1) interventions by home modifications targeting housing features both at entrances and indoors; (2) non-interventions targeting indoor features; (3) non-interventions targeting entrance features, that is, the presence of an elevator or stairs at the entrance. The overall quality of evidence across studies was assessed as very low. Discussion: The findings highlight the need for studies with a stronger research design and higher methodological quality that address the physical housing environment in relation to health among older adults to strengthen the body of evidence.
| S-EPMC10693737 | biostudies-literature
Project description:Although research on the association between subjective views of aging (VOA) and survival is scarce, more negative VOA have been found to be associated with increased all-cause mortality, even after controlling for possible confounders. Longitudinal studies on the predictive association of VOA with survival in individuals aged 80 years or older are, however, very limited. Thus, the aim of this study was to link adults' awareness of age-related change (AARC), a multidimensional measure of adults' subjective VOA, to survival time across a 3.5-year observation interval in advanced old age. To put the AARC construct in context, the study also considered related psychosocial concepts (i.e., perceived control and appraisal of life) essential for coping with late-life challenges as potential behavioral predictors of longevity. Data came from a representative panel study that included persons living in community and institutional settings. A total of 1,863 interviews were conducted at wave 1. This study used meta-data from wave 2 fieldwork 2 years after the initial assessment and death records obtained during panel maintenance after 3.5 years to estimate determinants of survival. Results showed that loss-related VOA indicated increased risk to survival, whereas gain-related VOA were predictive of longer survival. Both perceived age-related losses and perceived age-related gains exerted a significant independent effect on late-life mortality over and above socio-demographic background characteristics, perceived control, engagement with life, as well as health status. These findings suggest that the multidimensional examination of very old adults' VOA may help to better understand successful longevity in the Fourth Age.
| S-EPMC8505719 | biostudies-literature
Project description:BACKGROUND:Despite the growing epidemic of heart failure (HF), there is limited data available to systematically compare non-cardiac comorbidities in the young-old, old-old, and oldest-old patients hospitalized for HF. The precise differences will add valuable information for better management of HF in elderly patients. METHODS:A total of 1053 patients aged 65 years or older hospitalized with HF were included in this study. Patients were compared among three age groups: (1) young-old: 65 to 74 years, (2) old-old: 75 to 84 years, and (3) oldest-old: ?85 years. Clinical details of presentation, comorbidities, and prescribed medications were recorded. RESULTS:The mean age was 76.7 years and 12.7% were 85 years or older. Most elderly patients with HF (97.5%) had at least one of the non-cardiac comorbidities. The patterns of common non-cardiac comorbidities were different between the young-old and oldest-old group. The three most common non-cardiac comorbidities were anemia (53.6%), hyperlipidemia (45.9%), and diabetes (42.4%) in the young-old group, while anemia (73.1%), infection (58.2%), and chronic kidney disease (44.0%) in the oldest-old group. Polypharmacy was observed in 93.0% elderly patients with HF. Additionally, 29.2% patients were diagnosed with infection, and 67.0% patients were prescribed antibiotics. However, 60.4% patients were diagnosed with anemia with only 8.9% of them receiving iron repletion. CONCLUSIONS:Non-cardiac comorbidities are nearly universal in three groups but obviously differ by age, and inappropriate medications are very common in elderly patients with HF. Further treatment strategies should be focused on providing optimal medications for age-specific non-cardiac conditions.
| S-EPMC6964950 | biostudies-literature
Project description:Background and Objectives:Older people are likely to transition to a new home closer to family who can provide assistance or to long-term residential care as their health declines and their care needs increase. A minority choose to move to "age-friendly" housing before the onset of disability, but the majority prefer to "age in place" and defer moving until health crises compel a transition. Older people living with dementia are likely to move into residential care, but not much is known about the role they play in decision making around these moves. This qualitative study addresses this gap in knowledge by examining how a rare cohort of "older old" people, most with some level of cognitive impairment, were involved in decisions surrounding assistance seeking and moving to a care home. Research Design and Methods:Thematic analysis of qualitative interview data from Cambridge City over-75s Cohort (CC75C) study participants aged 95 years and older, who had moved in later life, and their proxy informants (n = 26). Results:Moves at such an old age were made due to a complexity of push and pull factors which had layered dynamics of decision making. In most cases (n = 22), decision making involved other people with varying degrees of decision ownership. Only four older people, who moved voluntarily, had full ownership of the decision to move. Many relatives reported being traumatized by events leading up to the move. Discussion and Implications:"Older old" people are sometimes unable to make their own decisions about moving due to the urgency of health crisis and cognitive decline. There is a need to support relatives to discuss moving and housing options at timely junctures before health crises intervene in an effort to optimize older people's participation in decision making.
| S-EPMC7127322 | biostudies-literature
Project description:BackgroundIt can be challenging for general practitioners to support their oldest old patients through the complex process of relocation.ObjectiveTo provide a typology of the experiences of moving in very old age that is clinically useful for practitioners navigating very old people's relocation.MethodsQualitative analysis of data from a mixed-methods UK population-based longitudinal study, Cambridge City over-75s Cohort (CC75C), from Year 21 follow-up onwards. Interviews with participants aged ?95 years old and proxy informants (Year 21: 44/48, 92%, subsequent attrition all deaths). Thematic analysis of qualitative data available from 26/32 participants who moved before they died.ResultsIndividuals who moved voluntarily in with family experienced gratitude, and those who moved into sheltered house or care homes voluntarily had no regrets. One voluntary move into care was experienced with regret, loss and increased isolation as it severed life-long community ties. Regret and loss were key experiences for those making involuntary moves into care, but acceptance, relief and appreciation of increased company were also observed. The key experience of family members was trauma. Establishing connections with people or place ahead of moving, for example through previous respite care, eased moving. A checklist for practitioners based on the resulting typology of relocation is proposed.ConclusionsMost of the sample moved into residential care. This study highlights the importance of connections to locality, people and place along with good family relationships as the key facilitators of a healthy transition into care for the oldest old. The proposed checklist may have clinical utility.
| S-EPMC6859521 | biostudies-literature