scholarly journals Loneliness and Purpose in Life Are Important Predictors for Future Care Planning

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 320-320
Author(s):  
Wingyun Mak ◽  
Silvia Sörensen
Keyword(s):  
Vision Loss ◽  
Purpose In Life ◽  
Later Life ◽  
Demographic Variables ◽  
Care Planning ◽  
Life Outcomes ◽  
Care Needs ◽  
Risk Of Mortality ◽  
Future Care

Abstract Experiencing purpose and social connection in later life is associated with better quality of life, better cognition, less morbidity, and lower risk of mortality. People who experience less purpose in life are more likely to report loneliness (Neville et al., 2018), and those with vision impairment are at greater risk for loneliness than the general population (Brunes et al., 2019). Planning for future care may be one way to enhance late life outcomes, but it is unclear how loneliness and purpose in life are related to planning behaviors in older people with vision loss. Using a sample of 200 older adults who were diagnosed with macular degeneration, this study explored the association of loneliness and purpose in life on future care planning variables after controlling for basic health and demographic variables. Hierarchical regressions showed that 1) people who are lonelier (β=.26, p<.05) but report greater purpose in life (β=.19, p<.05) are more aware of future care needs (ΔR2= .14, p<.001); 2) people who are lonelier (β=-.16, p<.05) but report greater purpose in life (β=-.46, p<.001) are less avoidant of planning (ΔR2= .14, p<.001); and 3) people who report greater purpose in life are more likely to gather information (β=.24, p<.05; ΔR2= .04, p<.05) and establish concrete plans related to planning for future care (β=.25, p<.05; ΔR2= .06, p<.001). These results suggest that having purpose in later life may boost planning behaviors, while those who are lonely may need help translating their awareness of future care needs into planning behaviors.

scholarly journals Preventing unwanted situations and gaining trust: a qualitative study of older people and families’ experiences with advance care planning in the daily practice of primary care

2019 ◽  
Vol 37 (4) ◽  
pp. 519-524
Author(s):  
Jolien J Glaudemans ◽  
Dick L Willems ◽  
Jan Wind ◽  
Bregje D Onwuteaka Philipsen
Keyword(s):  
Primary Care ◽  
Older People ◽  
Advance Care Planning ◽  
Daily Practice ◽  
Care Planning ◽  
Theory Approach ◽  
Face To Face ◽  
Future Care ◽  
Advance Care

Abstract Background Using advance care planning (ACP) to anticipate future decisions can increase compliance with people’s end-of-life wishes, decrease inappropriate life-sustaining treatment and reduce stress, anxiety and depression. Despite this, only a minority of older people engage in ACP, partly because care professionals lack knowledge of approaches towards ACP with older people and their families. Objective To explore older people’s and their families’ experiences with ACP in primary care. Methods We conducted qualitative, semi-structured, face-to-face interviews with 22 older people (aged >70 years, v/m: 11/11), with experience in ACP, and eight of their family members (aged 40–79 years, f/m: 7/1). Transcripts were inductively analysed using a grounded theory approach. Results We distinguished three main themes. (i) Openness and trust: Respondents were more open to ACP if they wanted to prevent specific future situations and less open if they lacked trust or had negative thoughts regarding general practitioners’ (GPs’) time for and interest in ACP. Engaging in ACP appeared to increase trust. (ii) Timing and topics: ACP was not initiated too early. Quality of ACP seemed to improve if respondents’ views on their current life and future, a few specific future care scenarios and expectations and responsibilities regarding ACP were discussed. (iii) Roles of family: Quality of ACP appeared to improve if family was involved in ACP. Conclusions Quality and accessibility of ACP may improve if GPs and nurses involve family, explain GPs’ interest in ACP and discuss future situations older people may want to prevent, and views on their current life and future.

scholarly journals Trans-ophthalmic Arterial Ethanol Embolotherapy for Arteriovenous Malformations: A Single Centre Experience

2021 ◽  
Author(s):  
Xin-yu Li ◽  
Xi-tao Yang
Keyword(s):  
Visual Acuity ◽  
Visual Field ◽  
Vision Loss ◽  
Visual Field Defects ◽  
Complete Relief ◽  
Life Outcomes ◽  
Single Centre ◽  
Permanent Disability ◽  
Single Centre Experience

Abstract Background and purposeArteriovenous malformations (AVMs) derived ophthalmic artery (OphA) branches are not common, however, their management is very challenging. We aimed at evaluating the safety and efficacy of Trans OphA ethanol embolotherapy for these lesions.Materials and methodsWe retrospectively reviewed 26 patients with AVMs fed by OphA, who underwent transOphA embolization using ethanol from February, 2015 to December, 2019. Sixty-six transOphA embolotherapy procedures (range, 1-4 procedures; mean, 2.5 procedures) were performed. Degree of devascularization, visual field, visual acuity, and quality-of-life outcomes were compared and analyzed at follow ups (mean, 32.6 months; month range 10-60). Complications were recorded.ResultsTwenty of the 26 patients (77%) reported complete or >90% AVM devascularization while six patients (23%) showed >70% devascularization. Eleven patients (42%) presented with visual acuity impairments with 4 complete relief, 6 improvements. Eight patients (42%) presented visual field defects with 4 complete relief, 3 with improvements. Ten patients (38.4%) presented with diplopia and exophthalmos with 2 complete relief, 6 major improvements. Bleeding was controlled in all cases (100%). All patients (100%) exhibited cosmetic deformities with 17 being completely relieved. Moreover, all patients (100%) exhibited impaired daily life, which was resolved in 21 patients with 5 patients reporting major improvements. No vision loss, death, or permanent disability in all patients.ConclusionsTransOphA ethanol embolotherapy was found to be efficacious, safe and it achieved symptomatic resolution or improvement of AVMs fed by OphA with acceptable complications without the risk of visual impairment.

scholarly journals Patterns of Intergenerational Care Planning Among Chinese Aging Families in Hong Kong

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 530-530
Author(s):  
Xue Bai ◽  
Chang Liu ◽  
Tongling Xu
Keyword(s):  
Hong Kong ◽  
Latent Profile Analysis ◽  
Service Providers ◽  
Profile Analysis ◽  
Care Transitions ◽  
Care Planning ◽  
Care Needs ◽  
Aging Parents ◽  
Future Care ◽  
Intergenerational Care

Abstract Care planning before the onset of intensive care needs can increase families’ ability to manage caregiving crises and cope with care transitions. However, future care planning has not been substantially examined in a family context. Drawing on the model of Preparation for Future Care Needs and a family systems perspective, this study investigated patterns of intergenerational care planning across multiple planning domains (awareness, avoidance, information gathering, decision making, and concrete planning) among Chinese intergenerational pairs. Quantitative data of 213 pairs of aging parents and adult children were collected in Hong Kong. Latent Profile Analysis was conducted to examine typological structure underlying care planning patterns. Three patterns were discovered: filial-maximal, dyadic-moderate, and filial-minimal. Profile 1 contained approximately 9.9% of pairs, which demonstrated a relatively higher level of avoidance on considering the need of care preparation and engaged less in concrete planning activities. Profile 2 contained 68.5% of intergenerational pairs that had a moderate preparation level. Profile 3 contained 21.6% of intergenerational pairs that were comparatively active in care planning. The findings also indicated that although older adults across three groups demonstrated a similar level of awareness to prepare for future care, their engagement in the concrete planning activities may be driven by their children’s awareness and preparation toward future care. The findings will enhance professionals’ and service providers’ awareness of diverse care planning patterns among Asian aging families, and inform targeted policies and programmes to alleviate unpreparedness for eldercare through intergenerational care planning which can be more effective than unilateral preparation.

scholarly journals Advance care planning: A systematic review about experiences of patients with a life-threatening or life-limiting illness

2018 ◽  
Vol 32 (8) ◽  
pp. 1305-1321 ◽  
Author(s):  
M Zwakman ◽  
LJ Jabbarian ◽  
JJM van Delden ◽  
A van der Heide ◽  
IJ Korfage ◽  
...  
Keyword(s):  
Advance Care Planning ◽  
Care Planning ◽  
Iterative Search ◽  
Future Care ◽  
Life Threatening ◽  
Research Findings ◽  
Advance Care ◽  
The Individual ◽  
End Of Life Communication

Background: Advance care planning is seen as an important strategy to improve end-of-life communication and the quality of life of patients and their relatives. However, the frequency of advance care planning conversations in practice remains low. In-depth understanding of patients’ experiences with advance care planning might provide clues to optimise its value to patients and improve implementation. Aim: To synthesise and describe the research findings on the experiences with advance care planning of patients with a life-threatening or life-limiting illness. Design: A systematic literature review, using an iterative search strategy. A thematic synthesis was conducted and was supported by NVivo 11. Data sources: The search was performed in MEDLINE, Embase, PsycINFO and CINAHL on 7 November 2016. Results: Of the 3555 articles found, 20 were included. We identified three themes in patients’ experiences with advance care planning. ‘Ambivalence’ refers to patients simultaneously experiencing benefits from advance care planning as well as unpleasant feelings. ‘Readiness’ for advance care planning is a necessary prerequisite for taking up its benefits but can also be promoted by the process of advance care planning itself. ‘Openness’ refers to patients’ need to feel comfortable in being open about their preferences for future care towards relevant others. Conclusion: Although participation in advance care planning can be accompanied by unpleasant feelings, many patients reported benefits of advance care planning as well. This suggests a need for advance care planning to be personalised in a form which is both feasible and relevant at moments suitable for the individual patient.

scholarly journals On the Quantity and Quality of Girls: Fertility, Parental Investments, and Mortality*

2021 ◽  
Author(s):  
S Anukriti ◽  
Sonia Bhalotra ◽  
Eddy H F Tam
Keyword(s):  
Gender Gap ◽  
Later Life ◽  
Life Outcomes ◽  
Gender Gaps ◽  
Parental Investments ◽  
Detection Technology ◽  
Lower Status

Abstract Access to prenatal sex-detection technology in India has led to a phenomenal increase in abortion of girls. We find that it has also narrowed the gender gap in under-5 mortality, consistent with surviving girls being more wanted than aborted girls. For every three aborted girls, one additional girl survived to age five. Mechanisms include moderation of son-biased fertility stopping and narrowing of gender gaps in parental investments. However, surviving girls are more likely to be born in lower status families. Our findings have implications not only for counts of missing girls but also for the later life outcomes of girls.

scholarly journals The HOPE Project (Helping Older People Engage): Relevance to Upstream Suicide Prevention

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 622-622
Author(s):  
Kim Van Orden ◽  
Yeates Conwell ◽  
Ben Chapman ◽  
Geoff Williams ◽  
Siilvia Sörensen ◽  
...  
Keyword(s):  
Suicide Prevention ◽  
Suicide Ideation ◽  
Later Life ◽  
Demographic Characteristics ◽  
Life Outcomes ◽  
T Score ◽  
Wide Variability ◽  
Baseline Characteristics ◽  
Score Range

Abstract The HOPE Project is an ongoing RCT testing whether Senior Corps volunteering for lonely older adults (age 60+) leads to reduced loneliness and improved quality of life—outcomes associated with suicide in later life. We have randomly assigned 130 participants to 12-months of volunteering or active control. We will describe the trial as well as baseline characteristics of participants that may predict non-compliance with volunteering/control. We found no difference between conditions nor demographic characteristics (age, gender) on non-compliance. Participants demonstrated wide variability in depression at baseline (PROMIS t-score range 38.9 to 71.4) and 18% reported suicide ideation; neither were associated with compliance (p>.20). These preliminary findings indicate that those with more severe mental health symptoms were equally willing/able to engage in volunteering as those without depression and suicide ideation. Volunteering is a highly scalable intervention (given nationwide Senior Corps infrastructure) that may function as upstream suicide prevention.

Height and quality of life among older adults (50+) in India: a cross-sectional study

2021 ◽  
pp. 1-26
Author(s):  
Y. Selvamani ◽  
P. Arokiasamy
Keyword(s):  
Quality Of Life ◽  
Older Adults ◽  
Handgrip Strength ◽  
Later Life ◽  
Poor Quality ◽  
World Health ◽  
Life Outcomes ◽  
Cross Sectional ◽  
Quality Of Life Outcomes

Abstract Adult height is a summary measure of health and net nutrition in early childhood. This study examines the association between height and quality-of-life outcomes in older adults (50+) in India. Cross-sectional data from Wave 1 of the World Health Organization (WHO) Study on global AGEing and adult health (SAGE) conducted in 2007 were analysed. The association between height and quality of life was assessed using bivariate and multivariate logistic and linear regression models. The mean WHO quality-of-life score (WHO-QoL) increased from 45.2 among the older adults in the lowest height quintile to 53.2 for those in the highest height quintile. However, the prevalence of self-rated poor quality of life declined from 16.4% in the lowest height quintile to 6.1% in the highest height quintile. In the fully adjusted regression model, height was found to be positively associated with quality-of-life outcomes among both men and women, independent of socioeconomic and physical health confounders. The association was particularly strong for women. Women in the highest height quintile had a 2.65 point higher WHO-QoL score than those in the lowest height quintile. Similarly, the likelihood of reporting a poor quality of life was lower among women in the highest height quintile. Furthermore, measures of economic status, handgrip strength, cognitive ability and poor self-rated health were significantly associated with WHO-QoL and self-rated poor quality of life. Overall, this study revealed a significant association between height and quality of life among older adults in India, suggesting a significant role of childhood circumstances in quality of life in later life.

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