Search

In the development and deployment of health and ageing innovations, underlying values such as privacy or quality of life are often seen as a relatively stable starting point, if considered at all. However, values are neither stable nor singular. This paper introduces a valuation framework to explore the co-constitution of values and technological innovations. A careful and ongoing reflection on values and valuation, in particular in innovation practices targeted at older people, is crucial when aiming to increase sustainable innovations. Therefore, we include a Social Sciences and Humanities (SSH) perspective to technological development and innovation, to understand better the construction and co-constitution of ageing-in-place technologies. This framework is developed following a review of literature on values and valuation in the broad field of SSH. The proposed valuation framework consists of three core elements: (a) value multiplicity, (b) value dynamism, and (c) valuation implications. To demonstrate potential applicability of the framework, we conducted a thought experiment on values and valuation practices related to the development and potential further deployment of a COVID-19 health app in the Netherlands. This experiment pays special attention to multiple values at stake and implications for older adults who age in place. We argue this valuation framework provokes reflection on dynamic and multiple values underlying technology use and non-use, and contributes to responsible health and ageing innovations. [ABSTRACT FROM AUTHOR]

Discourses on later-life housing and care are polarised. Ageing in place – typically in one's long-term dwelling – is often presented as the most desirable living arrangement, while moving to a congregate environment tends to be regarded as a last resort. Such polarised discourses obscure older people's experiences as they contemplate needs for housing, health and social care. To expand current understandings of mobility intentions, this paper examines 'time work' – or actions undertaken to exert some agency over time – as older people with chronic health conditions and disabilities navigate present and future support arrangements. Based on an interpretive analysis of qualitative interviews with 22 older persons receiving home care in Ontario, Canada, I identify three themes that highlight the temporal aspects of mobility intentions: (a) maintaining continuity with the past and present, (b) constructing alternative futures and (c) facing precarity. Focusing on time work shows how people make sense of ageing in place and/or relocating not only in relation to their physical, social and psychological capacities, but also in relation to perceptions of the past, present and future. Time work, moreover, has implications for feelings of security in the present and a sense of control over the future. Based on these findings, I make suggestions for developing a comprehensive continuum of supports, so all older people can make meaningful choices concerning housing and care. [ABSTRACT FROM AUTHOR]

During the period of economic and political transformations in Poland, considerable changes occurred in large housing estates, while demographic transformation and housing-stock ageing starting to aggravate social and spatial problems. The serious issue currently dominating such estates concerns the process of natural ageing of the housing stock and residential ageing which is associated with the reduction of residential mobility and demographic ageing of people living in the large housing estates. This paper intends to identify ageing of the estates' population in the context of the evaluation of residential life quality. The authors concentrated on analysis of 2002 and 2011 statistical data, as well as data collected during their field surveys conducted in 2010–2012. Detailed studies were carried out on seven estates in five cities and towns in Poland (Kraków, Poznań, Tarnów, Żyrardów and Dzierżoniów). To identify the residential standard and quality of life, surveys were conducted on housing estates which allowed the researchers to establish the essential factors which determined the level of satisfaction of older people with regard to their place of residence. The authors also determined the course of changes in the perception of particular aspects of life quality in the process of residents' ageing in the selected places of residence. [ABSTRACT FROM AUTHOR]

Ageing in place has been promoted by policy makers as the optimal residential solution for later life, premised on older people's reluctance to contemplate relocation, their declining residential mobility and high levels of residential satisfaction. This paper takes a critical perspective to the notion of ageing in place by examining older people's dislikes about, rather than levels of satisfaction with their home and neighbourhood environments, and establishing whether such dislikes influence a desire to move. Analysis of the 2004 Living in Wales Survey shows that despite high levels of residential satisfaction, a significant proportion of older people do wish to move. Logistic regression results indicate this desire is strongly associated with dislikes about their immediate home environment, more than neighbourhood factors. Contemplating a move in later life may be shaped more by a desire to ‘attach’ to people, than to remain in situ to preserve an attachment to place. [ABSTRACT FROM PUBLISHER]

Limited research has been conducted about ageing in place among older parents who co-habit with their ageing offspring with intellectual disability (ID). This study aims to explore which older parents would choose ageing in place together with their ageing offspring with ID instead of moving and what factors are associated with this choice. A face-to-face interview was conducted using the 'housing pathways' framework with older parents (⩾60 years) co-habiting with their ageing offspring with ID (⩾40 years) from two local authorities in Taiwan. In total, 237 families completed our census survey between June and September 2015. The results showed that 61.6 per cent of the participants would choose ageing in place with their ageing offspring with ID, while 38.4 per cent of the participants would stay in their previous place without their disabled children, move in with their other children or move to a nursing home. Logistic regression analyses revealed that parents who preferred ageing in place together with their offspring with ID were more likely to own a house ('personal control'), have higher levels of life satisfaction ('self-esteem') and satisfaction with their current community ('self-identity'), and have a lower level of social support than parents who chose another option. To meet the needs of older parents and their ageing offspring with ID, care and housing transitions should be considered as part of long-term care policy. [ABSTRACT FROM AUTHOR]

The global population is ageing and the likelihood of living alone increases with age. Services are necessary to help older people living alone to optimise health and wellbeing. This systematic review aimed to summarise the effectiveness and accessibility of interventions to improve the health and wellbeing of older people living alone. Relevant electronic databases (CINAHL, MEDLINE, PsycINFO and Scopus) were searched for all years up to August 2018. Studies were included if they involved older people (aged ⩾55 years) living alone, and an intervention with measured health and wellbeing outcomes. All study types were included. The Theory of Access was used to assess interventions across dimensions of accessibility, availability, acceptability, affordability, adequacy and awareness. Twenty-eight studies met the eligibility criteria; 17 studies focused on ageing safely in place and 11 on psychological and social wellbeing. Studies comprised quantitative (N = 19), qualitative (N = 4) and mixed-methods (N = 5) approaches. Dimensions from the Theory of Access were poorly addressed in the studies, particularly those of higher-quality methodology. Studies were heterogeneous, preliminary in scope and lacked consistent study design, methodology or measurement. Services that do not address user accessibility in design or evaluation may be limited in their uptake and impact. It is recommended that dimensions of access and co-creation principles be integrated into service design processes and be evaluated alongside clinical effectiveness. [ABSTRACT FROM AUTHOR]

As consumer-directed care programmes become increasingly common in aged care provision, there is a heightened requirement for literature summarising the experience and perspectives of recipients. We conducted rapid evidence reviews on two components of consumer experience of home- and community-based aged care: (a) drivers of choice when looking for a service (Question 1 (Q1)); and (b) perceptions of quality of services (Question 2 (Q2)). We systematically searched MEDLINE and EMBASE databases, and conducted manual (non-systematic) searches of primary and grey literature (e.g. government reports) across CINAHL, Scopus, PsychINFO, and Web of Science, Trove and OpenGrey databases. Articles deemed eligible after abstract/full-text screening subsequently underwent risk-of-bias assessment to ensure their quality. The final included studies (Q1: N = 21; Q2: N = 19) comprised both quantitative and qualitative articles, which highlighted that consumer choices of services are driven by a combination of: desire for flexibility in service provision; optimising mobility; need for personal assistance, security and safety, interaction, and social/leisure activities; and to target and address previously unmet needs. Similarly, consumer perspectives of quality include control and autonomy, interpersonal interactions, flexibility of choice, and safety and affordability. Our reviews suggest that future model development should take into account consumers' freedom to choose services in a flexible manner, and the value they place on interpersonal relationships and social interaction. [ABSTRACT FROM AUTHOR]

The tremendous growth in the ageing population over the past two decades has compelled the Hong Kong government to reformulate its housing policy by redeveloping and incorporating certain age-friendly housing design elements and facilities into the public housing schemes built in the post-war period. This research investigates whether these introduced design elements and facilities satisfy the numerous special needs of the seniors in line with the concept of 'ageing in place'. Data were collected from 224 seniors through a comprehensive questionnaire survey in four large-scale redeveloped public rental housing estates. Using three designated built environment dimensions, namely micro, meso and macro, the results revealed that senior tenants were generally satisfied with the present living environments (in all the three scales) in the estates. At the micro-scale, seniors were satisfied with the level of privacy and sense of autonomy derived from the present design features in their homes. For the meso-scale, the study revealed that the seniors were particularly satisfied with the design elements such as convenient transportation and accessibility, including convenient walkways. At the macro-scale, the community care service is deemed important for seniors' wellbeing. However, more attention is needed on safety measures in interior and shower areas, public seating in common areas and provision of sufficient community care services. This study provides insights for policy makers and development authorities on elderly housing provision. [ABSTRACT FROM AUTHOR]

What constitutes a 'good place to grow old'? This study aimed to characterise salient features of built and social environments that are essential to support low-income ageing residents. Seated and mobile interviews were conducted with community-dwelling older participants (aged 55–92, mean = 71 years) in three distinct socio-economic and geographic samples of the Minneapolis (Minnesota, United States of America) metropolitan area. The interviews prompted participants to evaluate their homes and neighbourhoods, and probed for particular socio-spatial characteristics that impact residential wellbeing. Qualitative thematic analyses focused on 38 individuals living in subsidised housing and homeless shelters. Four interrelated themes encompassed essential residential qualities: (a) safety and comfort, (b) service access, (c) social connection, and (d) stimulation. These broad ideals, when achieved, enabled participants to cultivate residential wellbeing and fulfilling place attachment. Analyses of the empirical data complicate theoretical assumptions by recognising unequal access to, irregular opportunities for and potential dangers of place attachment. Rich descriptions of participant homelessness, health hazards, crime, lack of supportive infrastructure and social isolation illustrate how place attachment is not inherently positive or necessarily attainable; rather, it is problematic and can involve risk. This article extends geographical gerontology's address of socio-spatial inequalities by focusing on disadvantaged ageing individuals. [ABSTRACT FROM AUTHOR]

Faced with the dramatic pace of population ageing, the Shanghai municipal government launched a pilot programme in 2013 designed to address this and to strengthen ageing-in-place arrangements by providing basic in-home medical services for residents above the age of 80. Yet after a two-year trial run, the 'Home-Based Medical Care Scheme for the Oldest-Old' (HBMCSOO) policy remained significantly under-utilised despite the increasing demand for medical services. Our multi-disciplinary research team of social workers and anthropologists identified two key factors impeding the implementation of home-based medical care services: (a) the distortion of policy implementation and (b) the inadequate professionalisation of community-based elder-care workers. Based on our evaluation of the pilot programme, the Shanghai municipal government made several practical adjustments to improve the subsequent city-wide policy implemented in 2016. While these changes mostly focused on minor adjustments to improve in-home medical services for the oldest-old, they represent an encouraging first step towards our call for a holistic integrated care system whose design and delivery takes into account local political and social contexts, including existing institutional infrastructure and cultural expectations about care-giving responsibilities. The challenges of implementing Shanghai's HBMCSOO policy ultimately provide instructive lessons on best practices for integrating medical and social services in order to improve ageing-in-place measures in diverse local settings around the world. [ABSTRACT FROM AUTHOR]

The preference of older people when it comes to ageing in place may be modified by levels of frailty. The aim of this research is to characterise the relationship between frailty and ageing in place, and to identify differences in neighbourhood characteristics supporting ageing in place missed by frail and non-frail older people. A concurrent nested mixed-methods approach was used. For quantitative evaluation, a sample of 945 independently living older adults residing in four districts of Rotterdam were asked to complete a questionnaire in 2013 (response rate = 62%; N = 558). In addition, 32 interviews were conducted with frail and non-frail older people. Results showed that gender, age and especially frailty were related to missed neighbourhood characteristics. People displayed awareness of their increasing frailty and often acknowledged that it increased the need for neighbourhood characteristics enabling them to age in place. We can conclude that dependence on neighbourhoods varies with frailty status. This relationship is dynamic; with frailty, older people become more dependent on their neighbourhood. However, expectations regarding neighbourhood characteristics seem to dissipate with advanced age and increasing frailty. [ABSTRACT FROM AUTHOR]

The Active Ageing Framework has been adapted as a global strategy in ageing policies, practices and research over the last decade. Lifelong learning, however, has not been fully integrated into this discourse. Using survey data provided by 416 adults (aged 60 years and above) enrolled in non-formal general-interest courses in a public continuing education programme in Canada, this study examined the association between older adults’ duration of participation in the courses and their level of psychological wellbeing, while taking their age, gender, self-rated health and vulnerability level into consideration. An analytical framework was developed based on the literature of old-age vulnerabilities and the benefits of lifelong learning. Two logistic regression and trend analyses were conducted. The results indicate that older adults’ participation is independently and positively associated with their psychological wellbeing, even among those typically classified as ‘vulnerable’. This result provides additional evidence that suggests the continuous participation in non-formal lifelong learning may help sustain older adults’ psychological wellbeing. It provides older learners, even those who are most vulnerable, with a compensatory strategy to strengthen their reserve capacities, allowing them to be autonomous and fulfilled in their everyday life. The result of this study highlights the value of the strategic and unequivocal promotion of community-based non-formal lifelong learning opportunities for developing inclusive, equitable and caring active ageing societies. [ABSTRACT FROM AUTHOR]

By 2050, the number of people in Australia aged over 85 is expected to quadruple. Yet, from a socio-psychological research perspective, little is known about the experiences of people who continue to live at home during late old age (85 years and over), a period when challenging problems associated with ageing escalate and threaten to compromise independence. Utilising a qualitative methodology, the subjective lived experience of 23 very old adults (19 women, four men, with a mean age of 90.7 years, range 85–101 years) who live independently in rural Australia were elicited. The aims of the research were to understand their thoughts and feelings about ageing in place at home, and what psychological, social and practical adaptive strategies they employ to cope with difficulties encountered during very old age. In-depth interviews were analysed in an interpretive phenomenological tradition of thematic analysis, interpretation of paradigm cases and interpretation of exemplars. Participants described how historical, cultural and environmental contexts shaped their everyday thoughts, activities and what was meaningful for them. The findings add to our understanding of the largely unnarrated lives of the very old, suggest a need for person-centred home-care assessment processes and aid significant others (family, friends and neighbours) to understand better what very old adults need to live independently. [ABSTRACT FROM PUBLISHER]

Due to demographic changes and a widely supported policy of ageing in place, the number of community-dwelling older people will increase immensely. Thus, supportive neighbourhoods enabling older people to age in place successfully are required. Using Q-methodology, we examined older people's perceptions of the comparative importance of neighbourhood characteristics for ageing in place. Based on the World Health Organization's Global Age-friendly Cities guide, we developed 26 statements about physical and social neighbourhood characteristics. Thirty-two older people in Rotterdam, half of whom were frail, rank-ordered these statements. Q-factor analysis revealed three distinct viewpoints each among frail and non-frail older people. Comparisons within and between groups are discussed. Although both frail and non-frail older people strongly desired a neighbourhood enabling them to age in place, they have divergent views on such a neighbourhood. Older people's dependence on the neighbourhood seems to be dynamic, affected by changing social and physical conditions and levels of frailty. [ABSTRACT FROM PUBLISHER]