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To understand the impact of memory loss on aging in place, this paper investigated dyads where one spouse had been diagnosed with memory loss. In-depth qualitative interviews were conducted with ten couples (N = 20). Grounded theory methods were used to collect, code, and analyze data into themes. Data revealed consensus among and between dyads that it was best to focus on living, rather than what had been or might someday be lost. Nonetheless, differences according to gender and cognitive status (e.g., diagnosed or spouse) were reported. Given population aging, identifying the impact of gender roles and social norms on the potential for aging in place with memory loss is critical. Community services and care practices must be sensitive to the ways that couples prioritized and organized their relationship prior to diagnosis in order to encourage positive patterns of care between couples, foster successful adaptation to changing needs, and support in-home arrangements as long as possible. [ABSTRACT FROM AUTHOR]

The quality of life (QOL) of the approximately 1.5 million nursing facility (NF) residents in the US is undoubtedly lower than desired by residents, families, providers, and policy makers. Although there have been important advances in defining and measuring QOL for this population, there is a need for interventions that are tied to standardized measurement and quality improvement programs. This paper describes the development and testing of a structured, tailored assessment and care planning process for improving the QOL of nursing home residents. The Quality of Life Structured Resident Interview and Care Plan (QOL.SRI/CP) builds on a decade of research on measuring QOL and is designed to be easily implemented in any US nursing home. The approach was developed through extensive and iterative pilot testing and then tested in a randomized controlled trial in three nursing homes. Residents were randomly assigned to receive the assessment alone or both the assessment and an individualized QOL care plan task. The results show that residents assigned to the intervention group experienced improved QOL at 90- and 180-day follow-up, while QOL of residents in the control group was unchanged. [ABSTRACT FROM AUTHOR]

Background. The aim of the study was to describe home-living elderly people's views on the importance of food and meals. Methods. Semistructured interviews with twelve elderly people. The interviews were analysed using qualitative content analysis. Results. Respondents described how their past influenced their present experiences and views on food and meals. Increased reliance on and need of support with food and meals frequently arose in connection with major changes in their life situations. Sudden events meant a breaking point with a transition from independence to dependence and a need for assistance from relatives and/or the community. With the perspective from the past and in the context of dependency, respondents described meals during the day, quality of food, buying, transporting, cooking, and eating food. Conclusions. Meeting the need for optimal nutritional status for older people living at home requires knowledge of individual preferences and habits, from both their earlier and current lives. It is important to pay attention to risk factors that could compromise an individual's ability to independently manage their diet, such as major life events and hospitalisation. Individual needs for self-determination and involvement should be considered in planning and development efforts for elderly people related to food and meals. [ABSTRACT FROM AUTHOR]

Background. Action-oriented study circles (AOSC) have been found to improve nutrition in 24 nursing homes in Sweden. Little, however, is known about the conceptual use of knowledge (changes in staffs' knowledge and behaviours). Methods. Qualitative and quantitative methods, structured questionnaires for evaluating participants' (working in nursing homes) experiences from study circles (n = 592, 71 AOSC) and for comparisons between AOSC participants (n = 74) and nonparticipants (n = 115). Finally, a focus group interview was conducted with AOSC participants (in total n = 12). Statistical, conventional, and directed content analyses were used. Results. Participants experienced a statistically significant increase in their knowledge about eating and nutrition, when retrospectively comparing before participating and after, as well as in comparison to non-participants, and they felt that the management was engaged in and took care of ideas regarding food and mealtimes to a significantly greater extent than non-participants. The use of AOSC was successful judging from how staff members had changed their attitudes and behaviours toward feeding residents. Conclusions. AOSC facilitates professional development, better system performance, and, as shown in previous studies, better patient outcome. Based on a collaborative learning perspective, AOSC manages to integrate evidence, context, and facilitation in the efforts to achieve knowledge translation in a learning organisation. This study has implications also for other care settings implementing AOSC. [ABSTRACT FROM AUTHOR]

With the number of people living with dementia expected to more than double within the next 25 years, the demand for dementia home care services will increase. In this critical ethnographic study, we drew upon interview and participant data with persons with dementia, family caregivers, in-home providers, and case managers in nine dementia care networks to examine the management of dementia home care resources. Three interrelated, dialectical themes were identified: (1) finite formal care-inexhaustible familial care, (2) accessible resources rhetoric-Iinaccessible resources reality, and (3) diminishing care resources-increasing care needs. The development of policies and practices that provide available, accessible, and appropriate resources, ensuring equitable, not necessarily equal, distribution of dementia care resources is required if we are to meet the goal of aging in place now and in the future. [ABSTRACT FROM AUTHOR]

Building on earlier quantitative work where we showed that lone senior households reliant on public pensions in Nova Scotia (NS), Canada lacked the necessary funds for a basic nutritious diet, here we present findings from a qualitative study involving in-depth interviews with eight low-income lone senior women living in an urban area of NS. Using a phenomenological inquiry approach, in-depth interviews were used to explore lone senior women's experiences accessing food with limited financial resources. Drawing upon Bronfenbrenner's Ecological Systems Theory, we explored their perceived ability to access a nutritionally adequate and personally acceptable diet, and the barriers and enablers to do so; as well in light of our previous quantitative research, we explored their perceptions related to adequacy of income, essential expenses, and their strategies to manage personal finances. Seven key themes emerged: world view, income adequacy, transportation, health/health problems, community program use, availability of family and friends, and personal food management strategies. World view exerted the largest influence on seniors' personal perception of food security status. The implications of the findings and policy recommendations to reduce the nutritional health inequities among this vulnerable subset of the senior population are considered. [ABSTRACT FROM AUTHOR]

Objectives. Community processes are key determinants of older adults' ability to age in place, but existing scales measuring these constructs may not provide accurate, unbiased measurements among older adults because they were designed with the concerns of child-rearing respondents in mind. This study examines the properties of a new theory-based measure of collective efficacy (CE) that accounts for the perspectives of older residents. Methods. Data come from the population-based Chicago Neighborhood Organization, Aging and Health study (N = 1,151), which surveyed adults aged 65 to 95. Using descriptive statistics, correlations, and factor analysis, we explored the acceptability, reliability, and validity of the new measure. Results. Principal component analysis indicated that the new scale measures a single latent factor. It had good internal consistency reliability, was highly correlated with the original scale, and was similarly associated with neighborhood exchange and disorder, self-rated health, mobility, and loneliness. The new scale also showed less age-differentiated nonresponse compared to the original scale. Discussion. The older adult CE scale has reliability and validity equivalent to that of the existing measure but benefits from a more developed theoretical grounding and reduced likelihood of age-related differential nonresponse. [ABSTRACT FROM AUTHOR]

We examined where midlife and older adults with a mobility disability accessed food outside the home in King County, Washington, USA, how they travelled to these food destinations, and facilitators and barriers to food access using qualitative interviews. Thirty-five adults aged ≥50 years with a mobility disability (defined as use of an assistive device for mobility) were interviewed. Supplemental objective information was obtained from a Global Positioning System device worn by participants for 3 days. Participants primarily accessed food at grocery stores, restaurants, and coffee shops/cafés. The most common transportation modes were walking, obtaining a ride from friends, motorized chair/scooter, and public transit. Location and proximity of food destinations were factors affecting participants' ability to access these destinations. Adequate space, ease of entry, available amenities such as restrooms, and helpful people were facilitators for participants to access food outside the home. [ABSTRACT FROM AUTHOR]