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Purpose: This paper aims to provide a response to the previously published paper on "Gerontocracy". Design/methodology/approach: This paper views care services through the lens of safeguarding, risks and responsibility in contradistinction from the largely economic and cost relevant argument put forward in the original paper. Findings: This paper articulates the contribution of informal carers to integrated care solutions solely from an economic perspective overlooks the wider human and social dimensions of care provision in society. Originality/value: Engaging in the wider debate about the status, contribution of informal carers to care solutions highlights the complexity of the carers' role in society which should evoke a more holistic debate of this important topic. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to emphasize the need for holistic geriatric health care in rural India. Many older people in Indian villages suffer from chronic ailments without any relief or intervention because of inaccessible and unaffordable health-care services. This paper explores how holistic health care can be assured for older people in Indian villages. Design/methodology/approach: This paper is based on reflections of the authors who have had experiences as caregivers to older persons within their respective families rooted in the Indian villages. Besides, they interacted with 30 older persons (18 males and 12 females in the age group of 60–80 years) living in the villages in three states of India, namely, Haryana, Rajasthan and Madhya Pradesh to develop a comprehensive viewpoint on the need of geriatric health care in rural India. Relevant reports, newspaper articles and research papers were also reviewed while developing viewpoints on such an important topic. Findings: Geriatric health-care facilities in rural India are abysmal. The older people in the villages cannot leverage health-care facilities that are generally inaccessible, inadequate and unaffordable. Even the government support for medical treatment is minuscule. Furthermore, there is lack of trained health-care professionals at all levels, namely, doctors, nurses and paramedic personnel. Training opportunities in geriatrics are also negligible. The scenario vis-à-vis geriatric health care in rural India can be upturned by increasing public spending on health-care infrastructure, increasing numbers of health-care professionals and expanding training programmes in geriatrics. Originality/value: This paper is based on the critical reflections of the authors as well as their informal interactions with some of the older people in the Indian villages. [ABSTRACT FROM AUTHOR]

Purpose: The goal of integrated, multidisciplinary and person-centered care is on the welfare policy agenda in many countries, but how about integrated service delivery in action? This paper describes a three-year service journey of an elderly person from home to a nursing home through home care, specialized hospital and inpatient care. The aim of this viewpoint paper is to consider how customer orientation and integration are realized when an older lady living an active life becomes seriously ill and loses the ability to conduct daily functions. Design/methodology/approach: The service path will be described from the perspective of a relative. Findings: The paper raises questions related to governance as well as multidisciplinary and customer orientation in integrated care. Originality/value: The paper discusses a real-life experience of an elderly care journey from active senior life to a nursing home in Finland. When making visible an elderly care journey, this gives real-life information about the challenges and the needs for development. Better practical understanding helps to remove inter-organizational barriers toward more integrated and patient safe care. [ABSTRACT FROM AUTHOR]

Purpose: The digital age requires people of all ages to communicate and organise their lives through digital technologies. The project EQualCare investigates how the growing population of older people living alone is managing this transition, how it shapes their (non-)digital social networks and what changes on a local level need to be brought about. This paper aims to give insight into the process of participatory action research (PAR) with older people in the community across four countries and reflects on experiences made by academic and co-researchers. Design/methodology/approach: Following the emancipatory underpinnings of PAR, which aims to reduce inequalities through collaboration and co-design, EQualCare involved nine teams of co-researchers across Finland, Germany, Latvia and Sweden making older people the centre of policy development. Co-researchers were involved in formulating research aims, collecting data, reflecting on data, formulating and disseminating recommendations for local policy stakeholders. Findings: Co-researchers' motivation to invest considerable time and effort was driven by a desire to create a more equal future for older people living alone. Moreover, they were keen to involve marginalised older people and became frustrated when this proved difficult. Power dynamics played a role throughout the process but became productive as roles and responsibilities were renegotiated. Doing PAR with older people can be emotionally challenging for co-researchers when negative feelings around ageing are encountered. Originality/value: The paper advances understanding on the process of PAR in ageing research by reflecting on the social, cultural and political contexts of doing PAR with diverse sets of older people. [ABSTRACT FROM AUTHOR]

Purpose: Despite continuing workforce challenges over the last decade, the social care system is considered a key enabler in keeping older people out of hospital. In response to the workforce challenges, White Paper was released, which acknowledged the opportunities afforded by digital technology to assist older people ageing at home, often supported by informal caregivers. Given the policy emphasis on digital-enabled care, the most appropriate methods for evaluating its impact on social care outcomes have yet to be determined. The purpose this study was to review the current literature using a systematic approach to understand the methodological limitations to inform more robust evaluations in their use in future research. Design/methodology/approach: This scoping review used a systematic approach adopting the framework of Arksey and O'Malley to examine studies examining the adoption of digital technologies to assist in older people's ability to age in place. Findings: The 21 relevant studies identified on digital technology to assist ageing-in-place are evolving. To date, it has focused on the efficacy and usability of the digital technologies themselves rather than investigating the impact of such technologies on re/enablement outcomes for older people. To rebalance this emphasis, there needs to be more research investigating the factors that enhance useability of digital technologies by older people and exploiting narrative data gained from qualitative research as they can provide valuable insights. Originality/value: To the best of the authors' knowledge, this is the first scoping review to consider qualitative methodological approaches for exploring ageing in place. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to critique and evaluate need-driven dementia compromised behavior theory and the health behavioral model using Meleis' (2010) criteria of theory evaluation. Design/methodology/approach: Theory critique using Meleis' (2010) criteria of theory evaluation. Findings: This paper provides a conclusion about each theory in terms of agitation in the elderly. Meleis's (2010) criteria will be used for both theories to evaluate different components such as the relationship between structure and function, diagram of the theory, circle of the contagiousness, usefulness and external components. Originality/value: The critique of the two theories broadened the nurses' understanding of the connection between the NDB model and the behavior symptoms, including agitation and its related issues. Further studies need to be conducted to shed light on the other aspects of the behavioral symptoms in elderly with dementia that supports the results of this study, like its specific causes, trigger factors and other intervention strategies. Nurses should be able not only to understand the patient's behavior symptoms but also to decode them into communication signals to meet their needs in a more effective way. [ABSTRACT FROM AUTHOR]

Purpose: Demand for care at home is growing because of the increase in life expectancy, an ageing population and the chronic conditions that often accompany longevity. Daytime care at home services have been widely reported on, but less is known about overnight care at home. This paper aims to gather evidence about overnight social care for older adults in their homes. Design/methodology/approach: Recent studies were identified through searches in three electronic databases. Studies published in English between January 2016 and June 2022 exploring overnight care at home for older adults were eligible for inclusion. An additional Google search identified home care services within the UK currently providing overnight support. Findings: The review retrieved five relevant papers, highlighting the paucity of research in this area. A narrative review of the literature identified common themes that suggested domiciliary night care staff play an integral role in meeting the overnight care and support needs of older adults who wish to be cared for at home. Despite the limited evidence base in this area, the Google search for UK domiciliary services who provide overnight support identified several active programmes. Originality/value: To the best of our knowledge, this is the first scoping review exploring the provision of overnight social care to older adults in their own homes. The review highlights the need for further research to inform commissioning and practice development. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper is to examine how external change agents (ECAs) engaged to disseminate a national quality register (NQR) called Senior alert nationwide in the Swedish health care and elderly care sectors interpret their work. To study this, sensemaking theories are used.Design/methodology/approach This is a qualitative inductive interview study including eight ECAs. To analyze the data, a thematic analysis is carried out.Findings Well-disseminated NQRs support health care organizations’ possibility to work with quality improvement and to improve care for patient groups. NQRs function as artifacts that can influence how health care professionals make sense of their work. In this paper, a typology depicting how the ECAs make sense of their dissemination work has been developed. The ECAs are engaged in prospective sensemaking. They describe their work as being about creating future good results, both for patients and affiliated organizations, and they can balance different quality aspects.Originality/value The number of NQRs increased markedly in Sweden and elsewhere, but there are few reports on how health care professionals working with the registers interpret their work. The use of ECAs to disseminate NQRs is a novel approach. This paper describes how the ECAs are engaged in prospective sensemaking – an under-researched perspective of the sensemaking theory. [ABSTRACT FROM AUTHOR]

Purpose: The demand for long-term home care services has been increasing in Taiwan due to the significant growth of the older population. In order to understand the crucial roles that language and communication play in providing better long-term home care services in Taiwan, this study aims to adopt a gerontological sociolinguistic perspective to investigate how professional care workers communicate with older people in this context. Design/methodology/approach: Interviews were conducted with 58 long-term home care workers to identify their communication accommodation strategies for older people, considering their health conditions (dementia), personalities (grumpiness), living status (loneliness) and general principles of long-term home care communication. Findings: The study's findings provide practical insights for long-term home care workers to enhance their communication skills while interacting with older people. Research limitations/implications: The results could contribute to improving the quality of care services provided to older people and address their specific communication needs. Originality/value: To the best of the author's knowledge, this paper is the first attempt to identify contextually specific communication accommodations to older people in existing literature of gerontological sociolinguistics that addresses language, communication and older age. The salience of the findings in this study can be further enhanced if they were applied in the development of training programs for future Taiwanese long-term home care workers. [ABSTRACT FROM AUTHOR]

Purpose: Perceptions of ageing towards the self and towards others can positively and negatively impact an older adult's mental wellbeing. This paper aims to consolidate literature examining the relationship between perceptions of ageing and depression in older adults to inform both practice and policy for older adult mental health services. Design/methodology/approach: Quantitative research articles examining perceptions of ageing and depression in older adults were identified through searches on three electronical databases, alongside forward and backwards citation searches. A total of 14 articles involving 31,211 participants were identified. Findings: Greater negative attitudes towards ageing were associated with higher levels of depressive symptoms and greater positive attitudes towards ageing were associated with lower levels of depressive symptoms or higher levels of happiness. However, the causal direction of this relationship could not be determined. Studies demonstrated that perceptions of ageing also act as a moderator in the relationship between depression and health status, hopelessness and personality traits. Future research should attempt to examine the relationship between perceptions of ageing and depression in older adults to attempt to identify the causal direction of this relationship. Originality/value: This is the only systematic review the authors are aware of consolidating literature which explores the relationship between older adults' perceptions of ageing and depression. It is hoped that these findings will be able to inform both policy and practice to improve older adults' care and support for depression. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to describe the perceptions that older people in Argentina have about the use of cell phones and to analyze their influence on user behavior. At the same time, it was intended to analyze whether sociodemographic factors influence these perceptions. Design/methodology/approach: The authors conducted a study with a non-experimental, cross-sectional and cross-correlational design; a non-probabilistic sample of 138 intentionally selected older people was chosen. Findings: The frequency and years of cell phone use, as well as the applications used, are influenced by the perceptions that older people have about cell phone use. In addition, it was found that age, gender and socio-educational level determine the perceptions that older people have about cell phone use. Originality/value: This research has implications for interventions aimed at improving older people's functional health. Understanding the perceptions of older people in relation to technology will enable the enhancement of its utility to foster an autonomous lifestyle and social integration in old age. [ABSTRACT FROM AUTHOR]

Purpose: Japan, the world's "oldest" society, has adopted intergenerational care programmes as one solution to the challenges of caring for its growing population of people living with dementia. Many countries are drawing inspiration from these intergenerational programmes, but research exploring factors influencing intergenerational care practice and how far these programmes can be translated in other countries is more limited. This paper aims to explore how environmental design features are used to support intergenerational initiatives in Japan. By examining four case studies, the paper illustrates how intergenerational engagement can be enabled and supported through environmental design. Design/methodology/approach: The research adopts a qualitative methodology, using observations, workshops and photographic elicitations within four case study sites: two residential care facilities, a community centre and supported housing scheme and a restaurant staffed by people with dementia. Findings: Two key themes emerge: encouraging community engagement through intergenerational shared spaces, and the role of intergenerationality in supporting social and economic participation. The paper concludes with a discussion of some of the key principles through which other countries can translate lessons gained from the Japanese experience of intergenerational programmes into their own health and social care systems. Originality/value: This paper provides international evidence of the role environmental design plays in supporting the development of intergenerational relationships among people with dementia and the wider community. Intergenerational engagement is community engagement; therefore, promoting community engagement is essential to promoting intergenerational care practice. Environmental design can play a key role in providing affordances through which such relationships can develop. [ABSTRACT FROM AUTHOR]

Purpose: This paper aims to highlight current finding issues relating to the provision of hospice care services which are largely provided by the independent sector and heavily reliant on charitable fund raising. The primary focus is on the UK, but it is an issue of relevance to many other countries around the world. Design/methodology/approach: The paper is an opinion piece informed by contemporary reports, official publications and research findings, as well as the author's own work within the hospice sector. Findings: As with many other countries around the world, the bulk of hospice funding in the UK comes from charitable donations of various kinds. However, the impact of COVID-19 highlighted both the fragility of this funding model and the precarious nature of hospice sector finances currently. Practical implications: This is an issue of growing importance that affects older people and their families not only in the UK but in all countries with ageing populations. Hospices play an important role in providing end-of-life care and, with demand for services steadily rising due to demographic trends, there are important questions about the sustainability of the current hospice funding model. Social implications: Issues of funding require a much higher level of engagement from policymakers if hospice care is going to continue to play a significant part in achieving a good death for people from all sections of society. Originality/value: Although hotly debated within the hospice sector and in official reports, this issue has yet to be properly examined within academic circles. [ABSTRACT FROM AUTHOR]

Purpose: As employed carers tend to experience work interruptions and conflict between work and care, especially women, this paper aims to assess the availability and accessibility of carer-friendly workplace policies (CFWPs) in Quebec workplaces. Design/methodology/approach: An online survey was distributed to members of the Association of Human Resources Management Counsellors in Quebec. The authors used a validating quantitative data design. The data was collected between October 2019 and the end of February 2020 and the questionnaire yielded 122 valid responses. Findings: Adult/elder care responsibilities remain systematically perceived less important than childcare or general work-life balance needs. The current distribution of CFWPs within Quebec workplaces is unlikely to ensure carers sufficient support to prevent or significantly mitigate negative repercussions. Notable differences were found between organization type and size. Practical implications: There is a need for expanding CFWPs through increased support services, educational workshops, broader access to flexible work arrangements and manager training. Social implications: The results support recent research findings pointing that women with caring responsibilities face important opportunity costs and risk falling in precariousness. Carers should be able to maintain a social income from other sources to compensate a reduced activity on the labor market. Originality/value: By investigating the availability of CFWPs in Quebec workplaces, this paper adds insights regarding the availability and access to CFWPs regionally and in small and medium size workplaces, rather than identifying best practice from workplaces across the globe. Workplace policies are analyzed for adult/elder care specifically. [ABSTRACT FROM AUTHOR]

Purpose: Education and training is vital in improving age-related care provisions. However, a lack of awareness and understanding of dementia could be a factor in meeting the age-related needs of people. This paper aims to examine the impact dementia education has on caregivers' confidence to provide person-centred care for people with intellectual disability and identifies additional training needs. Design/methodology/approach: A systematic scoping review was completed using preferred reporting items for systematic reviews and meta-analyses to guide the process of mapping existing evidence of dementia education and training programmes available to caregivers of people with intellectual disability. Findings: A search of five electronic databases identified 11 articles that reported on the role of dementia education in improving the knowledge of caregivers in effectively delivering the age-related care. Findings suggest that improved training provision is needed to support early diagnosis and increase caregivers' confidence in meeting the physical and psychological needs of older adults with intellectual disability. Originality/value: This review contributes to the literature by identifying the value of and need for continued development in dementia education and training to improve person-centred dementia care. [ABSTRACT FROM AUTHOR]

Purpose: This paper aims to provide an overview of the emerging AgeTech sector and highlight key areas for research and development that have emerged under COVID-19, as well as some of the challenges to real-world implementation. Design/methodology/approach: The paper is a commentary on emerging issues in the AgeTech sector, with particular reference to COVID-19. Information used in this paper is drawn from the Canadian AGE-WELL network. Findings: The COVID-19 pandemic has particularly impacted older adults. Technology has increasingly been seen as a solution to support older adults during this time. AgeTech refers to the use of existing and emerging advanced technologies, such as digital media, information and communication technologies (ICTs), mobile technologies, wearables and smart home systems, to help keep older adults connected and to deliver health and community services. Research limitations/implications: Despite the potential of AgeTech, key challenges remain such as structural barriers to larger-scale implementation, the need to focus on quality of service rather than crisis management and addressing the digital divide. Practical implications: AgeTech helps older adults to stay healthy and active, increases their safety and security, supports independent living and reduces isolation. In particular, technology can support older adults and caregivers in their own homes and communities and meet the desire of most older adults to age in place. Social implications: AgeTech is helpful in assisting older adults to stay connected. The COVID-19 pandemic has shown the importance of the informal social connections and supports within families, communities and voluntary organizations. Originality/value: The last months have seen a huge upsurge in COVID-19-related research and development, as funding organizations, research institutions and companies pivot to meet the challenges thrown up by the pandemic. This paper looks at the potential role of technology to support older adults and caregivers. [ABSTRACT FROM AUTHOR]

Purpose: Older people living in nursing homes have complex care needs and frequently need specialists' advice and support that can be challenging to deliver in a rural setting. The aim of this paper is to describe a model of integrated care in a rural area supported by a nurse case manager. Design/methodology/approach: A real-world evidence study of people living in Ribes de Freser nursing home, was conducted between specific timeframes in 2019 and 2022, comparing the casemix and outcomes of a traditional care model with the integrated interdisciplinary model. Findings: The integrated care model led to a significant reduction in transfers to the emergency department, hospitalisations, outpatient medical visits and a reduction in the number of medicines. In addition, the number of residents receiving end-of-life care at the nursing home showed a substantial increase. Originality/value: This case study contributes valuable evidence supporting the implementation of an integrated model of nurse case manager support in nursing homes, particularly in the rural contexts, where access to specialist medical staff may be limited. The findings highlight the potential benefits of person-centred integrated care for older adults, addressing their complex needs and improving end-of-life care in nursing home settings. [ABSTRACT FROM AUTHOR]

Purpose One may categorize assistive technologies for aged care into two types, namely, supportive (helping the elderly with their everyday activities) and empowering (obtaining physical or educational training to help seniors to maintain their capabilities). This paper looks at the impact of this perspective in the adoption of technologies that are used to aid already declined functions in comparison with technologies that are used to empower an elderly person’s capabilities. The purpose of this paper is to extract the factors that influence adoption of assistive technologies among seniors and the theories used in this context.Design/methodology/approach A systematic literature review was conducted on relevant peer reviewed papers. A preliminary exploratory search was conducted to identify keywords and online databases for the search. A total of 104 papers published since 2000 were analyzed after title, abstract and full text filtering.Findings The study summarizes and categorizes the factors impacting the adoption of assistive technologies among seniors. The paper analyses the theoretical support utilized by literature and maps the empirical evidence for supportive and empowering technologies.Research limitations/implications This research like any other literature review is limited to the search keys. However, the keys have brought to this work from a preliminary search.Practical implications The work informs nursing professionals on the process to adopt technologies among seniors. The paper also helps technology developers to design technological products that are easier to adopt for older adults.Originality/value It was found that existing adoption theories are able to handle supportive technology adoption mainly because of the direct link between usage and improved functionalities. However due to the indirect effect of empowering technologies, elderlies lag in benefit realization for empowering technologies. This opens avenues of research and requires future work and utilization of new theoretical approaches in this area. The paper indicates propositions, claims and suggested questions for future research in both supportive and empowering technologies. [ABSTRACT FROM AUTHOR]

Purpose: The independence and well-being of people with dementia can be significantly influenced by the design of the physical environments around them. Several assessment tools exist to evaluate the dementia design quality of existing residential aged care facilities but, to date, none have been formally identified as suitable for use during the design process. This paper aims to examine the feasibility of re-purposing existing post-occupancy tools for use during the design process, while mapping the influence of design stages on resulting dementia design quality. Design/methodology/approach: Literature searches identified audit tools for residential aged care settings. After reliability screening, three tools were analysed in-depth, mapping their suitability for use during the design process. Findings: The study confirmed that existing tools can be re-purposed for design stage use and identified that early design stages have a larger influence on overall dementia design quality than previously thought. Research limitations/implications: Non-English language publications were not reviewed. Searches may not have identified other existing audit tools for residential care environments. Practical implications: The ability to assess proposals at key stages of design may help improve the dementia design quality of future residential aged care environments – potentially enhancing the lives of ever-larger numbers of people with dementia. Originality/value: According to the authors' knowledge, this is the first known paper to consider formal design-stage evaluation of dementia design quality and the first to identify the relative influence of key stages of design on the resulting dementia design quality. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to describe family caregivers' experiences of providing care for older people with a tracheostomy during hospitalization. Design/methodology/approach: A descriptive phenomenological approach was used in this study. A total of 40 family caregivers were interviewed face-to-face in medical-surgical wards. Data was analyzed using Giorgi's phenomenological method. Findings: Family caregivers described meanings of providing care, learning how to provide care, caring activities, impacts of caregiving, support needs and qualities of being a caregiver. Meanings included filial responsibility, spousal attachment and end of life care. Caring activities were varied. Impacts experienced were reported as physical, psychological, social and financial. Caregivers expressed the need for information from the nursing team and assistance from their relatives. Positive caregiver qualities that were described included loving to provide care for older people and confidence and sincerity in caregiving. Practical implications: Although caring for older people with a tracheostomy was difficult and came with challenging impacts, family caregivers were willing to support their loved ones due to feelings of family responsibility. Originality/value: The paper addresses family participation in providing care for people with a tracheostomy. They experience physical, psychological, social and financial consequences of caregiving. Therefore, health-care professionals should support family caregivers with education, training and awareness of supports and resources for dealing with problematic impacts and other expressed needs. [ABSTRACT FROM AUTHOR]

Purpose: This paper aims to present the feasibility study findings from a four-year project funded by the European Union Commission (the SAIL project, Staying Active and Independent for Longer). The funding stream was Interreg 2Seas which offers opportunities for coastal areas on both sides of the English Channel to work together on complex practical issues. The project focused on enabling older people to stay active and independent for longer using social innovation (co-production) approaches. Design/methodology/approach: Ten pilot projects were developed, and each of the pilots worked with an academic partner to undertake a feasibility study that included 10 pilots across the four countries involved, France, Belgium, Holland and England. Findings: This paper presents barriers and facilitators (using logic models) to the social innovation process with older people, which has wider relevance in terms of social innovation and its application. Research limitations/implications: The findings which inform this paper are extensive, and this is a longitudinal qualitative study with much of the data collection being done using an online wiki (complemented by interviews and documentary analysis) which is a relatively new method for data collection. However, the consistency of the findings when analysed by three researchers was clear and pragmatically this complex method was required to examine complexity in the process of implementing social innovation in practice. Practical implications: This project has enabled greater understanding of how social innovation can be applied and has highlighted contextual issues that can undermine or enable attempts to adopt the approach. Social implications: For the 10 pilot projects generated, there were obviously important cultural and geographical differences in terms of engagement and practical implementation of social innovation. Some of which, as mentioned in this paper, are very important for the successful implementation of social innovation in a particular setting and indeed may be a strength or a barrier in terms of engaging with local people and agencies. Originality/value: The development of logic models is a useful approach when the topic under study is complex and likely to produce a diverse set of process outcomes. The logic model focuses upon the relationships between the resources that are used to create the intervention and what is produced in terms of outcomes. Ultimately, this enables the identification of the factors that contribute to a successful intervention. Thus, in relation to this study, logic models have helped to provide an evidence-based framework that can support decision-making regarding the most effective use of limited resources to support successful social innovation processes in the future. The logic model for each area of the findings presented here can in the future be used to help implement social innovation; also, to consider how it can be improved in future research. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to identify the difficulties and overload/burden experienced by family caregivers of older dependent people during the COVID-19 outbreak. Design/methodology/approach: A descriptive and cross-sectional study was conducted. This work was guided according to the Guideline strengthenin the reporting of observational studies in epidemiology (EQUATOR checklist). The study included 65 family caregivers of older people with physical or mental dependence. Caregivers were selected by convenience sampling through a national association of informal caregivers. Participants responded to an online questionnaire, which aimed to assess difficulties and burdens experienced during the pandemic. Ethical principles were followed throughout the research. Findings: The participants were mostly women, with an average age of 53 years, teleworking and cohabiting with the dependent elderly. Most caregivers reported that the pandemic has led to an increase in daily difficulties and associated burden. There was a statistically significant increase in hours devoted to care during the pandemic. Also, caregivers reported less time to take care of themselves and greater fatigue during this period. Research limitations/implications: This study had some limitations. For example, the small sample size. The sample was collected through an online version, and many caregivers did not have the digital skills needed to complete the questionnaires, and most of them were busy (divided between teleworking and household responsibilities). Another limitation was related to the perceived priority of caregivers because the majority of them considered this was a time-consuming study and saw no immediate benefits. Furthermore, they considered that this study has taken their time to manage all the provision of care to the elder relative and other activities related to their children who were also in quarantine. Finally, to date, there is no sufficient evidence to compare our results with other national and international studies. Further research is needed to allow the scalability of results and to apply the best available knowledge to mitigate the known and potential effects of this pandemic. Practical implications: This study highlighted that frontline caregivers suffered a negative impact on their physical and mental health, in addition to a significant economic burden during the pandemic outbreak. More research in this field is needed to plan, train and manage large-scale public health emergencies. Social implications: The COVID-19 pandemic imposed physical distancing, which profoundly affected the physical and mental health of community-dwelling older people and their family caregivers. Because of the confinement and closure of some social support institutions, family caregivers found themselves in a complex situation, having to reconcile care and teleworking. Therefore, it is important to identify the impact of the COVID-19 pandemic on the difficulties and burden of these caregivers to implement and develop social and health support measures. Originality/value: This paper addresses an increasingly important issue – the burden and difficulties of family caregivers, in the light of a new reality – the Covid-19 pandemic, which has brought new difficulties for this population. [ABSTRACT FROM AUTHOR]

Purpose: The impact of COVID-19 has most dramatically affected the older population, and nursing homes have become infection hotspots. As a response, governments have ordered isolation of older adults in geriatric institutions owing to the high risk of critical illness and mortality. The purpose of this paper is to discuss the potential impact of current policies on nursing homes and community-based care and provide suggestions for improvement in care. Design/methodology/approach: Taking the situation in Israel as an example, the author discussed major systemic problems pertaining to long-term care facilities and to community based care; the neglect of mental health; systemic deficiencies in end of life care; and the need to revise communications concerning COVID-19. Findings: Within each of the identified areas, recommended changes in strategy, policy and practice can help mitigate the dramatic impact of COVID-19 on the living experience of the older population. Originality/value: Drawing on the Israeli experience, this paper presents current shortcomings in the policy response to COVID-19 regarding nursing homes and community-based care and provides recommendations that are applicable to other contexts as well. Although some of these have been suggested or even practiced in some locations, many continue to be neglected and have not been discussed even as COVID-19 continues to infect societies around the globe. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to highlight some of the work with/for/about older people being undertaken by museums during the coronavirus disease (COVID-19) pandemic, thinking of museums as caregivers. Design/methodology/approach: This paper reviews the responses from museums which work with older adults, in times of pandemic. It reviews how museums have addressed older people during the COVID-19 outbreak in the UK and Portugal. Two Portuguese maritime museums which have older adults as strategic audiences are selected and their Facebook webpage during the lockdown is analyzed. Findings: Museums were committed to delivering online the work they have been doing offline, not without limitations. The digital turn in times of pandemic draw attention to inequalities regarding visitors who has access and literacy to engage with the digital museum as well as museums themselves. Unlike in the UK, in the two maritime museums, there were no specific programmes targeting older people – except for COVID-19 messages. However, older adults are presented online as active and as experts on maritime issues, representing empowering versions of ageing, either online or offline. Originality/value: This paper reviewed and illustrated with empirical examples from the UK and Portugal how museums are addressing older adults during the COVID-19 pandemic, contributing to the wider debate on the role of arts, culture and cultural heritage for the well-being of older adults. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to report on a scoping review of the advantages and challenges of extra care housing (ECH) provision in the UK for people living with dementia. Access to suitable housing is a fundamental right for people living with dementia and can enable people to live as well as possible (Twyford and Porteus, 2021). Understanding the advantages and disadvantages of different models of housing with care has been identified as a research priority by people living with dementia (Barrett et al., 2016) but "there is no current consensus on the best model of specialist housing for people with dementia" (Twyford and Porteus, 2021, p. 29). Design/methodology/approach: This scoping review identifies the advantages and disadvantages of living in ECH for people with dementia. It is the preliminary stage of a study that seeks to develop knowledge about different models of ECH for people living with dementia (Atkinson et al., 2021). Findings: Advantages include the promotion of independence, flexible staffing, safety and security, social inclusion, physical design and integrated service provision. Disadvantages include barriers to entry, tensions between independence and support, managing advanced dementia, resourcing flexible care, managing social exclusion, loneliness and stigma and a disabling environment. Research limitations/implications: The scoping review reinforces the need for further research into different models of ECH provision in the UK for people living with dementia. The review provides insight that is of benefit to all stakeholders involved in ECH and contributes to the development of evidence-based provision called for in the recent All Party Parliamentary Group inquiry (Twyford and Porteus, 2021). Originality/value: This scoping review summarises the current position for people living with dementia in ECH. [ABSTRACT FROM AUTHOR]

Purpose: International attention is increasingly turning to the challenge of creating age-friendly environments. This study aims to examine the application of asset-based approaches in undertaking community development projects with older people. The paper intends to share the learning that may be useful when designing community development projects for older people in the future. Design/methodology/approach: This study followed a multiple project case study design, with a focus on project delivery practices. It was undertaken as a co-production exercise involving university researchers and trained older volunteer community researchers (CRs). Over 18–24 months of qualitative research was conducted in relation to six area-based urban projects between 2018 and 2020. Findings: There were five leading themes as follows: mapping and building on assets in highly localised settings; creating governance and direction through steering groups; developing activities with diverse groups of older people; reaching isolated and lonely older people; building local capacity to embed sustainability. Practical implications: The effectiveness of assets-based approaches in promoting age-friendly agendas appears to be contingent on the values, skills, capacity and resourcing of delivery agencies, alongside wider public sector investment in communities. Diversity and inequalities amongst older people need to be taken into account and community development that specifically focuses on older people needs to be balanced with the whole population and intergenerational practice. Originality/value: This paper provides an empirical account of the practical application of assets practices specifically in the context of the age-friendly community agenda. The co-production method brings together insights from academic and volunteer older CRs. [ABSTRACT FROM AUTHOR]

Purpose: This paper aims to describe a literature review and online survey to explore the provisions and support for people living with dementia in housing with care (HwC) settings within England. Design/methodology/approach: An initial scoping literature review was conducted to synthesise the evidence relating to residents living with dementia in HwC settings and informed the development of an online survey distributed to HwC housing managers to explore the provisions, policies, procedures and support services relating to people living with dementia in HwC settings. Findings: The findings provided a picture of HwC settings in England and the residents, particularly those living with dementia, in terms of policies and procedures, reasons for moving into HwC, reasons for denying entry, reasons for leaving, positive outcomes, staff knowledge and training, environmental design, challenges and successes. Research limitations/implications: The survey responses were from a self-selected sample of HwC providers and scheme/village managers; thus, it may be the case that the settings involved were doing more to support residents living with dementia. It should also be appreciated that the responses were based on the perceptions of the individual staff members completing the survey, not those of the HwC residents. Originality/value: This study presented a picture of the current state of provisions and support for people with dementia within HwC settings in England, providing an essential platform from which to undertake targeted research to help shape future provision and enabling housing providers to assess their current schemes within the wider context. [ABSTRACT FROM AUTHOR]

Purpose: The Cameos of Care Homes project is an opportunity to use the medium of film to showcase the experiences and reflections of frontline care home staff whose employers participated in the National Health Service (NHS) England Vanguard programme. Reflecting on their involvement in one of the Enhanced Health in Care Homes Vanguards, 12 staff describe, in front of the camera, the impact on themselves and their colleagues, on their care for their older residents, and on the wider culture of the care home. The paper aims to discuss this initiative. Design/methodology/approach: The paper reports the experiences of care home staff that were purposefully recorded on film about their participation in a care home Vanguard. The recruitment of the care homes and staff is described, as are the development of interview questions and approaches needed when filming is considered as a research method. Findings: Participating care home staff reported that their involvement in the Vanguard programme had improved knowledge, confidence, morale, communication skills and the homes' learning cultures. They were enthusiastic about reporting their experiences on film. Examples were given of proactive early support from local NHS staff leading to improvements in care, thereby reducing demand on the NHS. However, participation was resource intensive for care homes. Care home staff hoped the support that accompanied the Vanguard programme would continue but were uncertain to what degree this would happen once the Vanguard programme ceased. Research limitations/implications: The interviews were undertaken with a self-selecting group of care home staff from two care homes operating in one of the six Vanguard sites in England. By their very nature, interviews for a public film cannot provide anonymity. Practical implications: Researchers seeking the views of care home staff may wish to consider filming interviews and presenting the film as a research output that is engaging and informative for care home and wider audiences. Originality/value: The paper presents an analysis of filmed interviews with care home managers and care workers working with older people. Their views on the Vanguard initiative have not been widely considered, in contrast to the sizeable literature relating to NHS activity and expenditure. [ABSTRACT FROM AUTHOR]

Purpose Academic researchers are increasingly required, and rightly so, to demonstrate the impact of their work beyond the gates of the university. This has led to an increasing focus, especially in response to funded calls, on developing research partnerships that cross disciplines, sectors and borders to help address our grand societal challenges. The purpose of this paper is to set out learning from the work of the organisation the Centre for Ageing Research and Development in Ireland (CARDI) and reflections on how to bring forward effective research partnerships involving users.Design/methodology/approach This paper is based on reflections and learning from the organisation CARDI which delivered a highly successful programme of interdisciplinary, cross-sectoral and cross-country research partnerships in both rural and urban areas between 2007 and 2015, across the island of Ireland.Findings Research partnerships that wish to involve users require time, commitment, support, understanding and a willingness to change and be challenged. This paper highlights that there are methodological, philosophical, moral, economic and of course, practical aspects to be considered.Research limitations/implications This reflective paper is based on a case study from the island of Ireland during the period 2007–2015 working in the area of ageing and older people.Practical implications The author emphasises that for research partnerships involving users to be successful, they need to not only consider the most effective research methods but also focus on the overarching purpose of the work and adopt an ethos and practice that maximises each partner's knowledge and expertise to their full potential.Social implications This reflective paper focused on the characteristics associated with partnership success, i.e. communication style, values, philosophy and practice and argues that establishing effective and inclusive partnerships requires time, the appropriate framework and reviewing the process on an ongoing basis.Originality/value The issue of user involvement in research partnerships requires much more consideration. Researchers, government, funders, businesses and service providers are increasingly recognising the benefits of "user" involvement to help design programmes and services that are most effective. Nowhere is this more important than in planning and delivering services, policy and programmes for our ageing population. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to explore the terms used in the Macmillan Dictionary and the Oxford English Dictionary to identify the people who are paid to provide care to the elderly and check their presence in a corpus – professional home care (PHC) – of three UK-based specialised websites. Design/methodology/approach: This study is based on the frameworks and methods of corpus-assisted Discourse Analysis (Baker, 2006). The terms were extracted from a corpus of British websites of companies providing PHC services. Findings: This study highlights that in the PHC corpus, the words "caregiver" and "carer" are used as synonyms at the level of popular communication, whereas "care assistant" and "care worker" are used for intra-specialistic communication. The analysis also points out the variations in terminology observed in the corpora that are intended for different communication contexts, e.g. how professionals define themselves compared to how external actors identify them. Originality/value: This paper provides insight into the terminological aspects of caregiving in the professional field through a corpus-based study on specialised terminology integrating lexicographic considerations. This methodological framework can capture the sociolinguistic attitudes of speakers. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to identify the range, type and outcomes of technological innovations aimed at supporting older people to maintain their independence within the context of integrated care at home. We also discuss key emergent themes relevant to the use of person-centred technology for older people in integrated care and propose recommendations for policy and practice. Design/methodology/approach: An integrative review methodology was used to identify and describe recent scientific publications in four stages: problem identification, literature search, data evaluation and data analysis. Findings: Twelve studies were included in the review. Three studies described remote consultations, particularly telemedicine; five studies described tools to support self-management; three studies described the use of healthcare management tools, and one study described both remote consultation and self-care management. Emergent themes were: acceptability, accessibility and use of digital technologies; co-ordination and integration of services; the implementation of digital technologies; and safety and governance. Several recommendations are proposed relevant to integrated care teams, technology developers and researchers. Originality/value: This review uniquely considers the extent to which novel digital technologies used in integrated care for older people are person-centred. [ABSTRACT FROM AUTHOR]

Purpose: This paper aims to explore the content of Safeguarding Adult Reviews (SARs) from older adult care homes to understand how safety is understood and might be measured in practice. Design/methodology/approach: SARs relevant to older adult care homes from 2015 onwards were identified via the Social Care Institute of Excellence SARs library. Using thematic analysis, initial inductive coding was mapped to a health-derived safety framework, the Safety Measurement and Monitoring Framework (SMMF). Findings: The content of the SARs reflected the dimensions of the SMMF but gaining a deeper understanding of safety in older adult care homes requires additional understanding of how this unique context interacts with these dimensions to create and prevent risks and harms. This review identified the importance of external factors in care home safety. Originality/value: This study provides an insight into the scope of safety issues within care homes using the SARs content, and in doing so improves understanding of how it might be measured. The measurement of safety in care homes needs to acknowledge that there are factors external to care homes that a home may have little knowledge of and no ability to control. [ABSTRACT FROM AUTHOR]

Purpose: This paper aims to assess the face validity to inform content validity of the Quality of Life – Aged Care Consumers (QOL-ACC), a new measure for quality assessment and economic evaluation in aged care. Design/methodology/approach: Semi-structured interviews were conducted with older adults (66–100 years) receiving aged care services at home (n = 31) and in residential care (n = 28). Participants provided feedback on draft items to take forward to the next stage of psychometric assessment. Items were removed according to several decision criteria: ambiguity, sensitive wording, not easy to answer and/or least preferred by participants. Findings: The initial candidate set was reduced from 34 items to 15 items to include in the next stage of the QOL-ACC development alongside the preferred response category. The reduced set reflected the views of older adults, increasing the measure's acceptability, reliability and relevance. Originality/value: Quality of life is a key person-centred quality indicator recommended by the recent Royal Commission into Aged Care Quality and Safety. Responding to this policy reform objective, this study documents a key stage in the development of the QOL-ACC measure, a new measure designed to assess aged care specific quality of life. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper is to promote discussion about, and the development of the evidence-base underpinning integrated working for intergenerational working. It discusses perspectives on intergenerational work in general and specifically draws on case experiences of the use of intergenerational reminiscence based on sporting memories to highlight issues pertaining to integrated working.Design/methodology/approach The paper presents a general discussion of issues of intergenerational projects and integrated working, with case discussions of the use of sporting memories as an intervention for focusing intergenerational contact.Findings It is concluded that intergenerational work has much to offer but that it is far from clear how best to organise integrated working for this type of work. There are interesting lessons to be drawn for intergenerational interventions and integrated working from the case study discussions.Research limitations/implications Although case studies can provide crucial in-depth knowledge they can be limited in developing evidence we can be sure is more generalisable across contexts. Hence, further research is required into the impact of intergenerational projects, and how best to maximise this through effective integrated working.Practical implications The discussion and case study materials suggest there is much potential in using intergenerational projects to achieve a range of possible outcomes but it is not clear how integrated working is best operationalised in such work. Care is required about clarity concerning the aims of specific projects, but practitioners and others should be encouraged to carefully explore this area of work.Social implications The challenges of an ageing society are significant, as is the need to maintain intergenerational contact, mutuality and the implicit social contract across generations. Specifically developing opportunities for such contact may help achieve this and a range of other positive outcomes.Originality/value This paper brings together a discussion of intergenerational projects with consideration of the challenges of integrated working, and adds specific case study lessons from the use of sports-based reminiscence. [ABSTRACT FROM AUTHOR]

Purpose Current debates surrounding the NHS contract in England are suggesting that it is in need of change to support an integrated health and social care transformation agenda that meets the needs of an ageing chronically ill population. The purpose of this paper is to describe a three-phase project in England that sought to develop and validate a whole systems contracting model for integrated health and social care focusing on older people with long-term conditions, and based on joint outcomes.Design/methodology/approach A participative mixed-method approach for the development of the contracting model was used; this consisted of a literature review, a design phase drawing on consensus method through stakeholder discussions and an international validation phase.Findings The final contracting model consists of four overarching and interrelated core elements: outcomes; partnership, collaboration and leadership; financial: incentives and risk; and legal criteria. Each core element has a series of more detailed contracting criteria, followed by further specifications attached to each criteria.Research limitations/implications While the policy environment appears to be conducive to change and encourages the adoption of new ways of thinking, there are difficulties with the implementation of new innovative models that challenge the status quo, and this is discussed.Practical implications The paper concludes with reflections on the way forward for local development and implementation.Originality/value There is currently much discussion for the need to realign contracting for integrated care that has a better fit for the transformation agenda, but until now, there have been no attempts to develop a whole systems approach that focusses on joint outcomes. This research bridges the gap but recognizes the challenges to implementation. [ABSTRACT FROM AUTHOR]

Purpose: As the aging population increases steadily, the demands for specialized nurses and geriatricians willing to work in geriatric settings will probably explode. Accordingly, the medical sciences students' attitude toward older adults and their willingness to work with them must be determined. This study aims to determine the medical sciences students' attitude toward older people and its relationship with their willingness to work with this population. In addition, it sought to determine the variables that could predict students' attitudes toward the elderly. Design/methodology/approach: A cross-sectional design using a stratified random sampling method was used to recruit a sample of 305 Iranian medical sciences students with a response rate of 97.4%. The instruments for data collection were composed of three parts: socio-demographic characteristics of participants, Kogan's Attitudes toward Old People Scale and the Willingness to Work with Elderly People Scale (WEPS). Data were analyzed in SPSS version 23 (IBM SPSS statistics 23.0). Findings: The participants' mean (SD) age was 22.95 (2.53). Most of them (69%) were women, and 51% were nursing students. The findings showed that 70% of students had a slightly positive attitude toward the elderly and only 12.8% of them declared geriatric setting as their workplace preference in the future. Experience of volunteering activities with elders, WEPS score, workplace preference after graduation and gender were the predictors of medical science students' attitudes toward the elderly. Originality/value: This paper further develops previous research on the attitudes of Iranian medical sciences students toward older adults. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to describe the design and development of the digital platform for the development and monitoring of care plans for older adults with complex care needs who are users of a home care service. Design/methodology/approach: Case study. The authors conducted an iterative process of design adapted to the environment and user-centred, agile development and research methodologies and a framework of complex interventions. They followed a four-step process: (1) conceptualization: analysis and design; (2) usability and high-fidelity prototyping; (3) software development; and (4) field testing in usual care. Older adults, informal caregivers, professional caregivers, and healthcare and social workers identified specific requirements and participated continuously through interviews, focus groups and consensus. Findings: In the conceptualization phase, the theory, context and requirements were identified, and the content and prototypes were developed. In the usability phase, the design was validated. The approach employed resulted in a digital technology that supports a person-centred care model in a home care company. In the conceptualization phase, the theory, context and requirements were identified, and the content and prototypes were developed. In the usability phase, the design was validated. The approach employed resulted in a digital technology that supports a person-centred care model in a home care company. Originality/value: The methodology employed has allowed the development of a platform based on theory, user needs and context. This could increase the possibilities of use and implementation of the technology and inspire other developers. [ABSTRACT FROM AUTHOR]

Purpose – The purpose of this paper is to understand the nature of support that helps older people continue living in their own homes for as long as they wish to. Design/methodology/approach – The research made use of a participatory approach in which service users, service providers and commissioners were involved in the design of the approach in addition to contributing to the research as participants in their own right. Findings – This paper presents analysis from the research which focuses on the importance of caring relationships for providing a support mechanism. The authors question whether budget cuts and efficiency drives within statutory care providers preclude the notion of caring relationships. Practical implications – The authors suggest, in the light of the evidence presented, that statutory service providers should acknowledge the role that caring relationships play in providing support for older people. Whilst budget cuts make providing support for caring relationships more challenging, the authors suggest that there is scope for delivering services and support in ways which promote the types of interactions which better support older people living independently. Originality/value – The analysis presented here provides a distinctive, timely and thoughtful insight into support for older people at a time when public sector budgets are under increasing pressure. [ABSTRACT FROM AUTHOR]

Purpose -- Re-abling care of frail older people is highly on the agenda in several countries. The purpose of this paper is to have a closer look at the argumentation used for its establishment by local policy actors in the field and the kind of expectations towards the behaviour of frail older people it entails. Design/methodology/approach -- The empirical material consists of qualitative interviews with 17 local policy actors in two Danish municipalities. The interviews have been analysed with the help of argumentative discourse analysis. Findings -- The most important argument for re-abling care appears to be grounded in economic reasons. However, a second, moral argument was found revolving around the older peoples' activity, which contributes to the establishment of moral expectations towards frail older people to be active. Research limitations/implications -- As the goal of the study was to analyse understandings and values of key local actors, the implementation of re-ablement programmes and the users' perspective were not studied. Originality/value -- The paper contributes to the investigation of the shift from universal entitlement as a right to towards market rationalities in Danish elder care. [ABSTRACT FROM AUTHOR]

Purpose: This paper aims to discuss and urge further deliberation on possible strategies to help geriatric and special needs patients to receive dental care during the pandemic. Design/methodology/approach: This paper contains literature review of published research articles related to past epidemics, COVID-19 and older persons. Findings: Accurate prediction of adverse outcomes, detection of unidentified problems, improved estimation of residual life expectancy and appropriate use of geriatric interventions is required to understand the necessity of the treatment and effect of possible COVID-19 contraction during the treatment. Research limitations/implications: The authors reviewed the only published literature and collated the lessons learnt from past epidemics, as the natural history of the COVID-19 is not known. Practical implications: Future dentists must be trained in crisis management to deal with pandemics more effectively. The dental fraternity should be equipped to provide some sort of "psychological counseling and reassurance" prior to dental care to vulnerable individuals with comorbidities and special needs. Originality/value: There are very few published articles focused on unique dental care plans for geriatric and special needs patients. [ABSTRACT FROM AUTHOR]

Purpose: On March 21, 2020, the Turkish Government imposed a curfew for citizens 65 years old and over and ordered them to stay at home as a measure to protect them against the COVID-19 outbreak. The curfew ended on June 10, 2020, having lasted 82 days. The purpose of this paper is to examine the significant emotional burden on the elderly, as they felt excluded and battled with despair during the lockdown. Design/methodology/approach: This reflective paper shares the COVID-19 lockdown experiences of the author with a group of elderly residents of a small community in Ankara, Turkey. Through semi-structured interviews and analysis, three overarching themes of the residents' experience were identified: vulnerability, social isolation/loneliness and ageism. Findings: The elderly in the community are individuals who get their social interaction outside the home. As a result of the nearly three months of social isolation, they have experienced social disconnection and health problems, Originality/value: To the best of the author's knowledge, this is the first attempt to give voice to the silenced group of elderly and share their thoughts and feelings during this difficult COVID-19 lockdown in Turkey. [ABSTRACT FROM AUTHOR]