Possibilities, Patience, and Perseverance: A Preliminary Analysis of the Needs and Experiences of Ten Older Adults Regarding Their Use of Digital Health Technology.

The COVID-19 pandemic created the need to use digital health resources (DR), as they sometimes were the only option to receive healthcare or social interaction. The aim of this research is to provide insight into the experiences during the lockdown of older people using DR for health in general and the points of improvement they see. A qualitative study was carried out using semi-structured interviews with older persons by telephone. A total of 10 older adults participated, with a median age of 78 years, the majority having a chronic disease. The most important themes for motivation to use health-related DR were 'urgency' and 'usefulness'. Experiences with DR were related to the themes 'human contact' and 'communication', which were experienced by respondents as facilitated by DR, and 'time and energy', which was two-sided. Additionally, most older persons worried about accessibility of DR by all older persons and the support needed. In conclusion, older persons are convinced of the urgency and the usefulness of digital technology for health and healthcare. Time and energy constraints can be alleviated by using DR on the one hand, but this can also be challenging if older persons are less digitally skilled or lack digital literacy. Good and sustained human support is therefore mandatory.

Making Chile More Pedestrian-Friendly for Older Persons: Expert Perspectives.

Walking provides numerous benefits to older persons, but its practice is hindered by social factors and the built environment. This article aims to understand the factors that encourage or discourage older people's walking behaviors, as well as the policies influencing those factors in Chile. It does so by reporting the analysis of twenty-five semi-structured interviews with Chilean policymakers and local leaders. The experts consistently represented walking as a beneficial activity for older persons that, nonetheless, occurs in adverse built environments. They asserted that the absence of older people in the public discussion and a top-down policy-making structure hamper its promotion.

HIV and AIDS prevention: knowledge, attitudes, practices and health literacy of older persons in the Western Cape and KwaZulu-Natal Provinces, South Africa and in Lesotho.

BACKGROUND: Population ageing and access to anti-retroviral therapies in South Africa have resulted in ageing of the HIV/AIDS epidemic, which has implications for policy, planning and practice. Impactful interventions on HIV/AIDS for older persons require knowledge on effects of the pandemic on this population. A study was undertaken to assess knowledge, attitudes, and practices (KAP) of HIV/AIDS, as well as health literacy (HL) level of a population aged ≥ 50 years. METHODS: A cross-sectional survey was conducted at three sites in South Africa and two sites in Lesotho with an educational intervention at the South African sites. At baseline, data were collected for assessment of KAP of HIV/AIDS and HL levels. The pre- and post-intervention comprised participants at South African sites being familiarised with the contents of a specially constructed HIV/AIDS educational booklet. Participants' KAP was reassessed six weeks later. A composite score of ≥ 75% was considered adequate KAP and an adequate HL level. RESULTS: The baseline survey comprised 1163 participants. The median age was 63 years (range 50-98 years); 70% were female, and 69% had ≤ 8 years' education. HL was inadequate in 56% and the KAP score was inadequate in 64%. A high KAP score was associated with female gender (AOR = 1.6, 95% CI = 1.2-2.1), age < 65 years (AOR = 1.9, 95% CI = 1.5-2.5) and education level (Primary school: AOR = 2.2; 95% CI = 1.4-3.4); (High school: AOR = 4.4; 95% CI = 2.7-7.0); (University/college: AOR = 9.6; 95% CI = 4.7-19.7). HL was positively associated with education but no association with age or gender. The educational intervention comprised 614 (69%) participants. KAP scores increased post intervention: 65.2% of participants had adequate knowledge, versus 36% pre-intervention. Overall, younger age, being female and higher education level were associated with having adequate knowledge about HIV/AIDS, both pre- and post-intervention. CONCLUSIONS: The study population had low HL, and KAP scores regarding HIV/AIDS were poor but improved following an educational intervention. A tailored educational programme can place older people centrally in the fight against the epidemic, even in the presence of low HL. Policy and educational programmes are indicated to meet the information needs of older persons, which are commensurate with the low HL level of a large section of that population.

Human Rights of Older Persons in States of Emergency: Approach of the Council of Europe

The objective of this paper is to evaluate the law of the Council of Europe (CoE) regarding protection of the human rights of elderly in crisis situations using the examples of the armed conflict in Ukraine and COVID-19. Given this, the paper is divided into two main parts. The first part analyses the response of the Council of Europe bodies to the measures influencing the rights of elderly introduced by the governments of the CoE member states in relation to COVID-19. The second part is devoted to the specifics of the legal regulation of the human rights of the elderly during armed conflicts, applying the example of the war in Ukraine. The Conclusions focus on the comparison of the protection of older people in the two mentioned crisis situations, i.e. with regard to the war in Ukraine and in connection with COVID-19. The author is of opinion that the rights of older persons received more attention in times of the health crisis than during the armed conflict. © 2023 The Author.

Protecting the Right to Social Participation of Older Persons in Long-Term Care under Article 19 of the United Nations Convention on the Rights of Persons with Disabilities

The COVID-19 pandemic has drawn public attention to the long-standing issues of social isolation and loneliness of older persons living in residential long-term care (LTC) and has increased awareness of the importance of social participation. This article aims to contribute towards a shift in the understanding of how the United Nations Convention on the Rights of Persons with Disabilities (CRPD) may be applied in aged-care. It argues that the CRPD, in particular Article 19 (Living independently and being included in the community), has considerable potential to protect the right to social participation. It is also argued that changes in LTC settings and support may assist in protecting this right. Furthermore, the participation of older persons in this process and cultural change within LTC provider organizations and the general community is crucial. However, applying the Convention in the aged-care context raises challenges that require further consideration by human rights mechanisms.

The Demographic Challenge Facing the EU: Roads to Sustainability in an Ageing Europe

The pandemic put all underlying structural problems about the living conditions of older persons in Europe on display. The inadequate protection afforded to older persons during this crisis reflects the weak position of this group. Additionally, the growing ageing population in EU entails an urgent challenge to the union. In this chapter, I argue for what policies the EU needs to implement to ensure an equitable society for all ages, both in times of crisis and otherwise. Three different recommendations are also provided;(1) establish commissions for the rights of older persons that implement the evidence-based knowledge that already exists about older persons' conditions, (2) contribute to the jurisprudence instituting the rights for the older persons, including codifying these rights in an international convention, and (3) give special priority to its work for advancing a social market economy by implementing the EU Charter of Fundamental Rights as a central element in EU law and policy for older persons. © The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Switzerland AG 2022, corrected publication 2022.

Ordinary care in extraordinary times.

The Coronavirus Disease 2019 (COVID-19) has accounted for more than 25 000 cases in Ireland with approximately 28% of the clusters in nursing homes as of June 2020. The older population is the most vulnerable to serious complications from this illness and over 90% of deaths due to COVID-19 to date have been in patients over the age of 65. Continuing to provide routine care within nursing homes in these challenging times is an essential part of ensuring that presentations to hospitals for non-essential reasons are minimized. In this article, we describe a project being undertaken by a rural Psychiatry of Old Age Service in the northwest of Ireland. We aim to provide ordinary care in extraordinary times by using mobile tablets within the nursing homes and long-stay facilities in our region for remote video consultations during the COVID-19 crisis.

Mortality in COVID-19 older patients hospitalized in a geriatric ward: Is obesity protective?

BACKGROUNDS: To investigate the relationship between obesity and 30-day mortality in a cohort of older hospitalized COVID-19 inpatients. METHODS: Included patients were aged 70 years or more; hospitalized in acute geriatric wards between March and December 2020; with a positive PCR for COVID-19; not candidate to intensive care unit admission. Clinical data were collected from patients electronic medical records. Data on 30-day mortality were retrieved from the hospital administrative database. RESULTS: Patients included (N = 294) were on average 83.4 ± 6.7 years old, 50.7% were women, and 21.7% were obese (BMI > 30 kg/m2). At 30-day, 85 (28.9%) patients were deceased. Compared to survivors in bivariable analysis, deceased patients were older (84.6 ± 7.6 vs 83.0 ± 6.3 years), more frequently with very complex health status (63.5% vs 39.7%, P < .001), but less frequently obese (13.4% vs 24.9%, P = .033) at admission. Over their stay, deceased patients more frequently (all P < .001) developed radiologic signs of COVID-19 (84.7% vs 58.9%), anorexia (84.7% vs 59.8%), hypernatremia (40.0% vs 10.5%), delirium (74.1% vs 30.1%), and need for oxygen (87.1% vs 46.4%) compared to survivors. In multivariable analysis that controlled for all markers of poor prognosis identified in bivariable analysis, obese patients remain with 64% (adjOR 0.36, 95%CI 0.14-0.95, P = .038) lower odds to be deceased at 30-day than non-obese patients. CONCLUSIONS: In this population of older COVID-19 inpatients, an inverse association between obesity and 30-day mortality was observed even after adjusting for all already-known markers of poor prognosis. This result challenges previous observations in younger cohorts and would need to be replicated.

Trends in elder abuse and age discrimination during the COVID-19 pandemic in Hong Kong: Findings from a two-wave representative telephone survey study.

OBJECTIVES: Empirical evidence about the heightened risks of elder abuse and age discrimination during the COVID-19 pandemic is scarce. This study aimed to track the changes in rates of both, and investigated their associated factors in the community-dwelling older population in Hong Kong. METHODS: In this two-wave, cross-sectional telephone survey, we interviewed a population-based sample of individuals (≥55 years), and captured the situation of elder abuse and age discrimination before the COVID-19 outbreak (n = 1209, Wave 1: October-December 2019) and during the pandemic (n = 891, Wave 2: December 2020-January 2021). Participants reported their experiences of different types of abuse and discrimination, financial health, subjective well-being, satisfaction with environment, health and social services, and resilience. RESULTS: Abuse was reported by 20.2% of the sample before the outbreak and 17.8% during the pandemic; while discrimination was reported by 24.6% and 29.8% at the two time points, respectively. A drop in physical abuse was observed, but it was accompanied by a rise in discrimination in the form of harassment or refusal of services. Findings of logistic regression analysis show that abuse during the pandemic was associated with younger age, poorer subjective well-being, and lower resilience; while discrimination was associated with female gender, being married, and poorer subjective well-being. CONCLUSIONS: Elder abuse and discrimination were prevalent across time points. The pandemic has highlighted the marginalization of older persons in our communities. There is an urgent need for development of effective interventions to end abuse and discrimination.

Residential Environments for Older Persons: A Comprehensive Literature Review (2005-2022).

BACKGROUND: Independent noninstitutional and institutional residential long-term care environments for older persons have been the subject of significant empirical and qualitative research in the 2005-2022 period. A comprehensive review of this literature is reported, summarizing recent advancements in this rapidly expanding body of knowledge. PURPOSE AND AIM: This comprehensive review conceptually structures the recent literature on environment and aging to provide conceptual clarity and identify current and future trends. METHOD AND RESULT: Each source reviewed was classified as one of the five types-opinion piece/essay, cross-sectional empirical investigation, nonrandomized comparative investigation, randomized study, and policy review essay-within eight content categories: community-based aging in place; residentialism; nature, landscape, and biophilia; dementia special care units; voluntary/involuntary relocation; infection control/COVID-19, safety/environmental stress; ecological and cost-effective best practices; and recent design trends and prognostications. CONCLUSIONS: Among the findings embodied in the 204 literature sources reviewed, all-private room long-term care residential units are generally safer and provide greater privacy and personal autonomy to residents, the deleterious impacts of involuntary relocation continue, family engagement in policy making and daily routines has increased, multigenerational independent living alternatives are increasing, the therapeutic role of nature and landscape is increasingly well-documented, ecological sustainability has increased in priority, and infection control measures are of high priority in the wake of the coronavirus pandemic. Discussion of the results of this comprehensive review sets the stage for further research and design advancements on this subject in light of the rapid aging of societies around the globe.

Qualitative Analysis of Coping Strategies Among Older Persons During COVID-19 Lockdown in Nigeria: Considerations for Community Health Promotion.

Background: The challenge of COVID-19 and the disease control restrictions in Nigeria directly affected social life. Older adults were disproportionately affected because of social vulnerabilities, socio-economic dependency, and the high risk of COVID-19 infectious disease in the population.Purpose: To this end, the study explored the instrumental coping strategies of older adults duirng the COVID-19 lockdown in Nigeria.Research Design: An exploratory research design using qualitative approach based on in-depth interviews was adopted.Study Sample: Twenty-seven (27) older adults aged 60 years and more in Ibadan, Nigeria were purposively selected for participation in the research.Data Collection and/or Analysis: Community living older adults participated in in-depth telephone interviews during the COVID-19 restrictions. Using Atlas ti 8.4, the 27 transcripts were analyzed and validated through content analysis.Results: Older adults coped with fear, anxiety, depression, and other health challenges, and three major themes emerged as problem-focused coping strategies. Older adults explored spirituality, engaged in their social networks through telephones, and focused on a healthy diet and physical activities.Conclusions: Community health promotion strategies for older adults should explore the identified problem-focused coping strategies to optimize the health and wellbeing of older adults.

International human rights law and the intangible face of ageism

PurposeThe purpose of this paper is to show the potential of international human rights law to raise awareness of the international community about ageism and its three aspects – old age discrimination, stereotyping and prejudices against older persons. The author evaluates the ability of international human rights law to encourage states to take action against these phenomena and looks for new solutions. The author also intends to examine if there are international law instruments compelling states to reject stereotypes and prejudices on older persons if there is no treaty devoted to them.Design/methodology/approachThe author applies methods relevant to legal science. The core human rights treaties, soft law documents and activities of human rights bodies are selected, analysed and interpreted.FindingsThe core human rights treaties require going beyond their literal interpretation to observe older persons' rights. States should interpret them in good faith, relying on the ageing mainstreaming approach. Instruction to states on how to do so lies in the soft law and output of the international human rights bodies. However, there is also room for improvement. Therefore, the author proposes adopting a targeted resolution on counteracting ageism and its components, updating positions by international treaty bodies, and involving various human rights procedures and specialised agencies in the fight against intangible dimensions of ageism.Originality/valueIt is the first study analysing awareness about stereotyping and prejudices against older persons from international human rights law. The author indicates untapped possibilities of the fight against ageism and its intangible dimensions under international law.

Universal human rights instruments and digital literacy of older persons

The clash of global ageing with the ICT development appears a new challenge to the international community. Transferring many life activities to the global network during the 2020 pandemic has clearly proved that low digital literacy may result in social exclusion and limit enjoying various human rights. Therefore, the author of this study examines the universal human rights instruments' capability to compel States to take steps towards the inclusion of older generations into the information society, mainly through improving their digital skills. Since a worldwide convention protecting older persons' rights is still in pre – negotiations on the UN forum, she picks out provisions scattered among human rights treaties, potentially referring to digital literacy in older adults, and tries to establish their contemporary interpretation and effectiveness. The author takes the view that international human rights law and its mechanisms have the potential to affect the so-called grey digital divide. However, the provisions adopted in previous decades require a modern and inclusive interpretation corresponding to the contemporary demographic situation and the 'digital reality'. The States' obligations to respect, protect and fulfil the rights to education, information, access to scientific achievements, and an adequate standard of living need to be overhauled and updated. [ABSTRACT FROM AUTHOR] Copyright of International Journal of Human Rights is the property of Routledge and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Older People, Loneliness, Social Isolation and Technological Mitigations: Utilising Experiences of the Covid-19 Pandemic as we Move Forward

In this article, the effects of social isolation which can lead to increasing feelings of loneliness and abandonment for some are examined. The article analyses findings which emerged from a qualitative study carried out with older people in three distinct areas in Scotland (city, rural and urban) who were shielding during Covid-19. It focuses on the ways in which social isolation affected them and the extent to which information and communication technology (ICT) and telecare technologies served to mitigate key aspects. The key themes which emerged from the research included loneliness as 'multi-layered', with these layers including 'disconnections between loneliness and social isolation';'well-being reversals';'neighbours as strangers';'disjointed communities and co-production' and 'service abandonment'. Additional themes which emerged focused on 'ICT rebounds and evolvement' and 'hope, buoyancy and reciprocity'. These layers and themes can be seen to have longer term significance with regard to the implications for social work and social care planning as we move forward. They also emphasise the need for greater cohesiveness between health, telecare and social care services.

Age-based triage and human rights

The article provides the first comprehensive assessment of age-based triage from the perspective of human rights. Triage, that is the sorting of patients into categories of priority of treatment, has been known for decades. It has however got larger prominence during the Covid-19 crisis. The crisis has exposed healthcare systems in many countries to a critical shortage of resources, forcing them to consider resorting to triage. The absence of legal rules has been compensated by non-binding triage guidelines, adopted by professional medical and ethical associations. This article analyses 11 guidelines, showing that none of them is truly age neutral. Some use allocation criteria that entail disparate treatment of older persons, consisting of their de-prioritization or exclusion from access to life-saving treatment on account of their age. Others rely on allocation criteria whose application has disparate effects on older persons. The article argues that whereas the latter approach could be compatible with human rights standards, the former entails violations of the principle of non-discrimination and of several other human rights (the right to life, the prohibition of inhuman and degrading treatment, the right to private life, and the right to health). © The Author(s) 2023.

The psychological impact of the COVID-19 pandemic in the elderly in southwest China: A longitudinal study based on generalized estimating equations.

The objectives of this study were to assess the trends in anxiety and depression levels in older adults nearly 10 months after the outbreak of coronavirus disease 2019 (COVID-19) and explore its determinants. A longitudinal study was performed between October 2019 and December 2020. The Patient Health Questionnaire 9-Item Scale and the Generalized Anxiety Disorder 7-Item Scale were used to assess depression and anxiety. Data were collected before (wave 1), during (wave 2), and 10 months after the COVID-19 outbreak (wave 3). The prevalence of depressive symptoms in the elderly was found to be 18.9%, 28.1%, and 35.9% at wave 1, wave 2, and wave 3 respectively. The prevalence of depressive symptoms at wave 1 was lower than that at wave 2 (χ 2  = 15.544, P < 0.001) and wave 3 (χ 2 = 44.878, P < 0.001). There was no significant change in the prevalence of anxious symptoms (wave 1, 28.5%, wave 2, 30.3%, and wave 3, 30.3%). Older adults who were single/divorced/widowed had higher levels of anxiety compared with those who were married (OR = 2.306 95%CI 1.358-3.914, P = 0.002). The pandemic appeared to be associated with increases in depressive symptoms in older persons. Targeted interventions could be carried out among those with higher risk of maladjustment.

Infectious diseases and cognition: do we have to worry?

OBJECTIVES: Age-related physiological changes, particularly immune system decline, may contribute to greater vulnerability to infectious diseases in older individuals. A growing body of evidence shows that both, acute, and chronic infections may be accompanied by cognitive disturbances as part of their manifestations. Given the importance of cognition in aging trajectories, the objective of this article was to review current knowledge on cognitive outcomes of infectious diseases in older adults, and to emphasize the importance of considering cognition as a domain of interest in its own rights in these diseases. METHODS: A MEDLINE/PubMed database search was conducted to identify articles reporting cognitive impairment associated with various severe acute infections and specific chronic infectious conditions such as human immune deficiency virus, the herpes virus family, hepatitis C virus, Lyme borreliosis, Helicobacter pylori, periodontitis, and emerging pathogens like SARS-CoV-2, as well as potentially preventive strategies like vaccination. RESULTS/ CONCLUSIONS: Taken together, the studies examined in the present review emphasize that numerous acute and chronic infectious diseases share mechanisms that, when added to specific risk factors frequently found in older persons, contribute to considerably increase the risk of cognitive outcomes such as cognitive decline and dementia. This review may help to appreciate the role that infectious diseases play in cognitive trajectories and thus promote further investigation on the topic.

INTERNATIONAL LAW AND THE FIGHT AGAINST AGEISM AND FOR THE PROTECTION OF ELDERLY: TAKING STOCK OF THE SITUATION AFTER COVID-19 PANDEMIC

The ageism that harms older persons manifests itself in many ways in our societies and needs to be combated more effectively through international law. The existing mechanisms at the international and regional levels and developments in the field of soft law are analyzed here under the premise that it is necessary to continue working to strengthen and improve them, in order to continue preparing the ground for the adoption of a specific convention of universal scope on the rights of older persons. The COVID 19 pandemic has revealed, in a terrible way. the deficiencies in the models of assistance and care for the older persons and the gaps in the international mechanisms for the protection of human rights. © 2022 by the Author(s).

Covid-19 in Brazil: Who Could the Older persons Count on?

Brazil was one of the three countries in the world most affected by the Covid-19 pandemic in terms of the total and relative number of deaths. With an increasingly aging population, 75.1% of deaths from the virus at one point in time were of elderly people. This article discusses the impact of Brazilian President Jair Bolsonaro's negative stance toward the country's vulnerable situation and, above all, toward the elderly population. Without state protection, the elderly could only count on civil society action to mitigate the effects of the pandemic. © Caisse nationale d'assurance vieillesse. Tous droits réservés pour tous pays.