Older Adults Using Technology for Meaningful Activities During COVID-19: An Analysis Through the Lens of Self-Determination Theory

Restrictions during the COVID-19 pandemic significantly affected people's opportunities to engage in activities that are meaningful to their lives. In response to these constraints, many people, including older adults, turned to digital technologies as alternative ways to pursue meaningful activities. These technology-mediated activities, however, presented new challenges for older adults' everyday use of technology. In this paper, we investigate how older adults used digital technologies for meaningful activities during COVID-19 restrictions. We conducted in-depth interviews with 40 older adults and analyzed the interview data through the lens of self-determination theory (SDT). Our analysis shows that using digital technologies for meaningful activities can both support and undermine older people's three basic psychological needs for autonomy, competence, and relatedness. We argue that future technologies should be designed to empower older adults' content creation, engagement in personal interests, exploration of technology, effortful communication, and participation in beneficent activities. © 2023 ACM.

NOT ALONE IN YOUR HOME: LIBRARY SERVICES IN HOMES FOR THE OLDER ADULTS IN ZAGREB DURING THE COVID-19 PANDEMIC

Goal. The goal of the paper is to show the implementation of library services in the homes for older adults in the city of Zagreb during the COVID-19 pandemic from March 2020 to June 2022. Approach/methodology/design. Library services in homes for the older adults in the city of Zagreb are implemented within the Books at your door programme of the 65 plus project at the Zagreb City Libraries. The COVID-19 pandemic and related restrictions have made it difficult to design and implement library services for older people in libraries. Due to the protection of health, particularly large restrictions have been placed on contacts with elderly people in homes for the older adults. As a result of this challenge, the librarians have devised ways to stay in touch and provide library services to the home users during periods of greater and lesser restrictions on access to the homes. Results. The paper describes in detail the implementation and the results of the Books at your door programme from March 2020 to June 2022. Library services and various cultural programs that were carried out during the pandemic in homes for the older adults, organized by the Zagreb City Libraries, are presented and described. The results are based on and supported by the statistical data from the annual reports of the 65 plus project. Originality/value. The cultural activities that are carried out for the older adults by the libraries, sometimes in difficult business circumstances, are examples of good practice aimed at sensitizing the public and increasing care for the well-being of the elderly people. The experiences gained during the implementation of the Books at your door programme in difficult conditions during the pandemic can help experts and practitioners in designing library services in times of crisis. The data recorded in this paper also represent a kind of public archive on the cooperation between libraries and homes for the older adults in the Zagreb area during the COVID-19 pandemic. © 2023, Hrvatsko Knjiznicarsko Drustvo. All rights reserved.

Engagement during post-acute care transition: Perceptions and experiences of family caregivers of older adults with dementia

Older adults with dementia experience hospitalizations and post-acute care transitions more than people without dementia and rely on family caregivers for support. Family caregivers of older adults with dementia, therefore, play a crucial role during care transitions, and caregiver engagement is acknowledged as a critical factor in promoting quality of care. Despite this, "engagement" has been exclusively defined from the perspective of clinical care providers in other settings, and little is known about the post-acute care experiences and perceptions of family caregivers. The purpose of this dissertation was to describe the meaning of engagement to family caregivers navigating post-acute care transition, to elucidate their perspectives on barriers and facilitators of engagement, and to explore their support needs.Following an interpretive descriptive approach and guided by Meleis's Middle Range transition theory, semi-structured interviews were conducted with a purposive sample of 15 family caregivers of older adults with dementia. Using an inductive coding process, similar codes were categorized by grouping codes that describe similar concepts related to the caregiver experiences and perceptions. The process helped to develop themes from the categories and a conceptual framework that described the meaning of engagement.Thematic findings revealed family caregivers' descriptions of the meaning of engagement during post-acute care transitions is linked to being there, having meaningful connection with professional care providers, and having communication with the person with dementia. Limited communication and not being able to be there were seen as barriers to engagement. Nine family caregivers' level of engagement was impacted by the COVID-19 pandemic new visitation policies. Facilitator to engagement were linked to having good communication with professional care providers and having past post-acute care transition experience. The support needs of family caregivers were also related to their relationship with healthcare providers and receiving support from family and friends. The study supports highlighting communication as an integral part of transition and makes an argument to expanding the Meleis's Middle Range transition theory. Findings of the study contribute to the dementia caregiving literature and make an appeal to healthcare providers and policymakers to include family caregivers as part of the care team. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Stress and coping among elderly during the COVID-19 pandemic in Sulaimanya city in Kurdistan region of Iraq

This study aimed to find out the level of stress and coping methods among elderly in Sulaimanya city during the pandemic COVID-19. Through the snowballing sampling method, 394 elders were included to this study. After validation, two scales were used in this study;stress subscale from Depression, Anxiety and Stress Scale (DASS-21) and a culture-bound scale for determining coping methods. The results of this study showed that participants experienced a mild level of stress. Male participants, elders who live with their family, unvaccinated elders, physically passive elders have had higher stress level than female, elderly home, vaccinated, physical active elders. The findings also indicated that spiritual connection was the most common coping method used by the sample. Results of this study are the first and foremost way to share elder's unexpressed messages;it also can be a way for verbalizing their unspoken feelings. These results may also inform the elder's caregivers that elder's stress level and illness anxiety was not very high, strengthening their social support and spiritual connection may help them to reduce their distress into a lesser degree.

COVID-19 and the ageing immune system in an elderly patient: a case report

Background: The severity of COVID-19 infection has an increasing trend in the elderly, which contributes to the high morbidity and mortality rates in this population. Aging itself is a prominent risk factor for severe disease and death from COVID-19. Case Description: This case report a 71-year-old woman who complained of shortness of breath for 3 days before being admitted to the hospital. Bilateral consolidation and increased bronchovascular pattern were found on chest radiograph, and a positive SARS-COV2 nasopharyngeal swab PCR test result was noted. This patient was diagnosed with confirmed severe manifestation of COVID-19, community-acquired pneumonia and type 1 respiratory failure, as well as type II diabetes mellitus and suspicion of acute gastritis. The results of the geriatric status assessment were moderate functional status, risk of malnutrition, and moderate risk of deep vein thrombosis (DVT). This patient underwent treatment in accordance with the COVID-19 protocol along with management for geriatric status improvement. The patient was given permission to return home after 14 days of treatment, during which time her health had improved and her functional status had changed to moderate dependency. During follow-up, the patient continued to receive therapy. She is still being observed and future evaluations will be conducted. Conclusion: The increased susceptibility of the elderly to COVID-19 infection is caused by various factors. A burden of death and long-term disability brought on by this pandemic may be lessened by new or modified therapies that target aging-associated mechanisms. Therefore, COVID-19 case management in this population should be done with a comprehensive approach.

Psychiatric disorders in older adults

With an aging population, health professionals will face a growing cohort of older patients presenting with neurological and psychiatric disorders. The aging process is associated with an increase in chronic medical conditions, sensory impairments, cognitive and functional decline, and bereavement, all of which can impact psychological wellbeing. The COVID-19 pandemic has presented further, unique challenges for vulnerable older people, although preliminary findings have indicated that older adults have actually been more resilient than younger people in terms of developing mental health conditions during the pandemic. In the present chapter, an overview of common psychiatric disorders in late adulthood is provided, in addition to recommendations for assessment and treatment planning. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Loneliness Decreased for Older Adults Using Telephone and Video Communications

AimsTo study feasibility and impact of telephone and video communication on perceptions of loneliness and social isolation in community-dwelling older adults.MethodsPurposive flyer distribution to communities, area agencies on aging, meals on wheels, and snowball sampling. Sixteen people met inclusion criteria. Pre- and post-intervention data were collected: UCLA-3, UCLA20, FRAIL Scale, and Social Frailty Scale. Participants were allocated to either telephone or video communication groups, completing 8 weeks of one time per week 45-60-minute conversations.ResultsUCLA-20 demonstrated statistical significance (p = .017) for the full cohort with large effect size (Hedges' g = 1.273). UCLA-3, SFS-8, and FRAIL Scale did not demonstrate statistically significant pre-post differences. No statistically significant differences (p > .05) were identified between the telephone and video communication groups.ConclusionRemote communication may have a positive impact on perceptions of loneliness that appear to be independent of the communication modality utilized. Randomized controlled trials are required to determine if either modality is more effective.

Social Support Among Older South Africans During COVID-19

COVID-19 had a significant impact on older South Africans' experience of social support. This cross-sectional study explored possible risk and protective factors of social support among community-dwelling older adults (N = 118). Social support pre- to during COVID-19 decreased significantly;however, overall social support was greater for those who were older, had more face-to-face contact, and had a greater number of friends or relatives. From a socio-ecological perspective on resilience, greater opportunities for older adults to create connections, such as classes or community events, are recommended to facilitate desired social supports, which in turn supports greater health and well-being.

Low back pain, lower physical activity, and loneliness associated with decreased frequency of going out during COVID-19 in Japanese older adults

Background: This study investigated the association of frequency of going out with physical activity, low back pain, and loneliness among urban Japanese community-dwelling older adults affected by the coronavirus disease 2019 pandemic. Methods: This cross-sectional study recruited older adults aged 65 and over residing in apartment buildings in an urban area of Japan as participants. The questionnaire comprised items on participants' frequency of going out, musculoskeletal pain, physical activity, mobility, loneliness, and sociodemographic characteristics. Multiple logistic regression analysis was performed to explore the associations of decreased frequency of going out (less than once a week) during the pandemic with musculoskeletal pain, physical activity, and loneliness after controlling for age, sex, living alone, comorbidity, and social activity as confounding factors. Results: This study analyzed 236 older adults (mean age: 75.5 years;females 54.2%) whowent out more than two to three days a week before the pandemic. Participants who went out less than once a week during the pandemic (14%) had more arthritis than those who went out more. They also had a higher prevalence of reduced physical activity, low back pain, gait disability, and loneliness. Additionally, decreased frequency of going out was associated with lower physical activity [adjusted odds ratio (OR) = 3.91, 95% confidence interval (CI): 1.78-8.61], low back pain (OR = 2.79, 95% CI: 1.08-7.24), and loneliness (OR = 1.50, 95% CI: 1.14-1.98). Conclusions: This study indicated that reduced physical activity, loneliness, and low back pain are associated with a decreased frequency of going out during the pandemic among older adults.

Impact of infodemic on older people mental health during the COVID-19 pandemic

Background: The COVID-19 pandemic has had a significant impact on the mental health of older people. One concern is the exposure to a lot of pandemic-related information without any evidence-based background through the media and social networks. This study aimed to examine the effect of exposure to such information on the mental health of older people. Methods: The study is a cross-sectional correlational study. Sampling was focused on selecting older people through a systematic sample according to a random starting point and with a fixed, periodic interval, between late 2020 and early 2021, with a total of 200 participants age above 60 considered as older people. Results: We found that a significant percentage of older people had a high level of clinical symptoms/distress, according to the General Health Questionnaire (GHQ) scales. These results show that being exposed COVID-19 information from the media during the pandemic is a risk predictor for mental health/distress, GHQ-28 scores, (OR ExpB = 2.11, p =0.001). Similar results were found for Media Info (OR ExpB = 1.37, p =0.008). For each point increase in media information, the risk for general mental health problems increases 1.37 times. Conclusion: Through the results it was clear that older people are at risk of mental health problems, and being exposed to the infodemic increased this risk significantly, as well as being exposed to media where elevated risk of death from SARS-CoV-2 for older people was reported.

(Re)designing the continuum of care for older adults: The future of long-term care settings

This book broadens the visioning on new care environments that are designed to be inclusive, progressive, and convergent with the needs of an aging population. The contents cover a range of long-term care (LTC) settings in a single collection to address the needs of a wide audience. Due to the recent COVID-19 pandemic, rethinking the spatial design of care facilities in order to prepare for future respiratory and contagious pathogens is one of the prime concerns across the globe, along with social connectedness and autonomy in care settings. This book contributes to the next generation of knowledge and understanding of the growing field of the design of technology, programs, and environments for LTC that are more effective in infection prevention and control as well as social connectedness. To address these issues, the chapters are organized in four sections: Part I: Home- and community-based care;Part II: Facility-based care;Part III: Memory care and end-of-life care;and Part IV: Evidence-based applied projects and next steps. (Re)designing the Continuum of Care for Older Adults is an essential resource for researchers, practitioners, educators, policymakers, and students associated with LTC home and healthcare settings. With diverse topics in theory, substantive issues, and methods, the contributions from notable researchers and scholars cover a range of innovative programming, environments, and technologies which can impact the changing needs and support for older adults and their families across the continuum of care. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

iAssist: An online wellness platform to elevate the physical and mental health of the elderly

The physical and mental health of older adults is a critical issue that is often overlooked. With the recent increase in the number of people infected with the new variants of coronavirus, we are facing several problems, including a dearth of high-quality medical care. iAssist aims to be a platform that primarily focuses on the social benefit of promptly delivering medical aid to the elderly in our nation. It enables a variety of functions, such as doctor appointments, medicine orders, and lab appointments under one roof, with the goal of assisting caregivers, such as family members and healthcare professionals. Additionally, it offers a chatbot component that uses a social media messaging service, to inform users of new developments and assist in swiftly answering user questions. The technology stack used in iAssist makes the platform efficient and user-friendly for everyone involved. © 2022 IEEE.

Death risk among COVID-19 patients with diabetes mellitus

Deaths from COVID-19 are increasing in patients with comorbidities. One of the most common comorbidities is diabetes mellitus. The researchers wanted to see how having diabetes affected the mortality rate of COVID-19 participants. This investigation is a case control observational analytical study. Different types of people, called "cases", and "controls", complete the research sample. Each group had 68 responders, for a grand total of 136. Medical records from COVID-19 patients treated at Airlangga University Hospital, Surabaya, between March 2020 and September 2021 serve as the study's secondary data source. The purpose of this study's data analysis is to calculate an odds ratio. Patients with COVID-19 with concomitant diabetes mellitus had an increased risk of death, and this risk increased with age, gender, and COVID-19 symptoms. In contrast, education, occupation, and laboratory results were not significantly related to mortality among COVID-19 individuals with concomitant diabetes mellitus (GDA status). The results of this study show that COVID-19 patients with concomitant diabetes mellitus are at a higher risk of death if they are over the age of 65, if they are male, and if they have severe symptoms.

Gratitude and well-being in older adults with chronic pain: A brief gratitude intervention feasibility study

Chronic pain is a health problem that disproportionately affects older adults and negatively impacts quality of life. Gratitude interventions have emerged as a promising approach to ameliorate the negative impact of pain and enhance well-being. Despite the high prevalence of older adults with chronic pain, there are no gratitude interventions among older adults with chronic pain. The current study utilized a two-week gratitude daily diary intervention in a sample of 38 older adults (M = 67.53 years) with chronic knee or hip pain to evaluate the effects of gratitude on well-being (Aim 1) and the effects of the intervention on changes in well-being (Aim 2) across the study. Participants were randomly assigned to either the gratitude group (n = 21) or the attention-matched control group (n = 17). Participants in the gratitude group wrote three things they were grateful for each day, while the attention-matched control did not journal. All participants completed pre- and post-intervention interviews and received 14 nightly phone calls, which allowed for "global" analyses using pre-and post-intervention data and "daily" analyses using nightly phone call data. The results of Aim 1 revealed that trait and state gratitude were significantly related to physical and mental well-being, controlling for age and income level. In Aim 2, no significant effects emerged for treatment group on global or daily changes in well-being in Aim 2. However, significant main effects emerged for time on global and daily well-being outcomes, indicating improvements in well-being across time, regardless of treatment condition. The impact of small sample size, COVID-19, and methodological limitations are discussed, and clinical implications and future directions for gratitude interventions focused on improving the well-being of older adults with chronic pain are provided. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Space-time risk clusters of COVID-19 in a tourism area in the northeastern Brazil: an epidemiological overview after two years of pandemic

The world is facing a serious viral infection caused by the new Severe Acute Respiratory Syndrome Coronavirus 2. We aimed to evaluate and map the high-risk clusters of COVID-19 in the State of Alagoas, a touristic area in northeastern Brazil, after two years of pandemic by a population-based ecological study, using COVID-19 cases reported in the State of Alagoas, between March, 2020 and April, 2022. We performed a descriptive and statistical analysis of epidemiological data. We then map high-risk areas for COVID-19, using spatial analysis, considering the incidence rate by municipality. 297,972 positive cases were registered;56.9% were female and 42.7% aged between 20 and 39 years old. Men (OR = 1.59) and older than 60 years old (OR = 29.64) had a higher risk of death, while the highest incidence rates of the disease occurred in the metropolitan region. Our data demonstrate the impact of COVID-19 in the State of Alagoas, through the two years of pandemic. Although the number of cases were greater among women and young adults, the chance of death was greater among men and older adults. High-risk clusters of the disease initially occur in metropolitan cities and tourist areas.

Effects of Covid-19 on Mental Health of Older Adults: A Study Based on Perceptions and Experiences of older adults suffered from Covid-19

Aim: The objective of this conceptual study was to know the effects of COVID-19 on mental health of older adults. Study design: This qualitative study was conducted in October-December 2022 in District Sargodha. Twenty (20) older adults who have been suffered from COVID-19 were taken as respondents selected through snowball-purposive sampling technique. A semi-structured interview protocol was used to collect data through in-depth interviews from the respondents. Thematic analysis method of qualitative methodology of research was used to analyze the data to find the results. Result(s): The study found that older adults experienced severe mental health issues during COVID-19 period due to loneliness, isolation, anxiety and fear of disease and death. During the quarantine period and hospitalization, loneliness and social isolation affected the mental health of the older adults. Fear of disease & death and losing the loved ones negatively affected the older adults psychologically to great extent. However, respondents who were educated and well aware of causes and consequences of the disease;used this information and awareness as coping strategy and such respondents had less adverse affects on their mental health. Conclusion(s): COVID-19 virus affected the well-being of older people with regard to mental and emotional. Social isolation and loneliness have been observed as main factors affecting the mental condition of older adults during the pandemic. They experienced grave psychological issues due to loneliness and fear of disease & death during the quarantine/ hospitalization period.Copyright © 2023 Lahore Medical And Dental College. All rights reserved.

Death Anxiety among Older Adults during the COVID-19 Pandemic: Implications for Nursing Practice

Death anxiety is a worldwide phenomenon among diverse populations, including older adults. However, few studies were located in a literature review that examined how the Covid-19 pandemic influenced the perception of death anxiety among the older adult population. Therefore, the purpose of this scoping review article is two-fold: (1) to provide an introductory discussion, based on the literature, regarding how the Covid-19 pandemic and its precautionary measurements provoke death anxiety, including its sub-category of predatory death anxiety, among older adults;and (2) to identify non-pharmacological interventions specific to death anxiety management for gerontological nurses to use during the Covid-19 pandemic or similar pandemics in the future. An intended outcome of this discussion paper is an enhanced understanding of ways to provide effective psychological care to older adults. The focus of discussion includes: the role of sociocultural factors, predatory death anxiety and Terror Management Theory, salient nursing assessment parameters and non-pharmacological interventions to address death anxiety among this population of older adults. In conclusion, gerontological nurses need to demonstrate evidence-based practice taking into consideration their own definition and perceptions of death, the reasons for their beliefs, and the cultural, situational, and spiritual context, in which they practice. © 2023 Horizon Research Publishing. All rights reserved.

Use of Digital Health Technology Among Older Adults With Cancer in the United States: Findings From a National Longitudinal Cohort Study (2015-2021).

BACKGROUND: Despite the benefits of digital health technology use, older adults with cancer (ie, aged 65 years) have reported challenges to technology adoption. However, there has been a lack of a good understanding of their digital health technology use patterns and the associated influential factors in the past few years. OBJECTIVE: This study aimed to examine the trends in and factors associated with digital health technology use among older adults with cancer. METHODS: The National Health and Aging Trends Study (NHATS) data set is a national longitudinal cohort study with annual survey waves of Medicare beneficiaries 65 years and older. Participants were community-dwelling older adults who self-reported previous or current cancer diagnoses in each round. The study sample size of each round ranged from 1996 (2015) to 1131 (2021). Digital health technology use was defined as using the internet or online in the last month to order or refill prescriptions, contact medical providers, handle Medicare or other insurance matters, or get information about their health conditions. The association of sociodemographics, clinical factors (self-rated health, chronic conditions, difficulties in activities of daily living, dementia, anxiety, and depression), and physical function (Short Physical Performance Battery and grip strength) with digital health technology use was examined using design-based logistic regression. All statistical analyses accounted for the complex sample design. RESULTS: The prevalence of any digital health technology use increased from 36% in 2015 to 45% in 2019. In 2020-2021, which was amid the COVID-19 pandemic, it ranged from 51% to 52%. In terms of each digital health technology use behavior, in 2015, overall, 28% of older cancer survivors used digital health technology to obtain health information, followed by contacting clinicians (19%), filling prescriptions (14%), and handling insurance (11%). Greater use of digital health technology was associated with younger age, being White, having a college or higher education, having a higher income, having more comorbidities, nondementia, and having a higher gait speed. CONCLUSIONS: Digital health technology use in older adults with cancer has gradually increased, particularly during the COVID-19 pandemic. However, socioeconomic and racial disparities have remained in older cancer survivors. Additionally, older adults with cancer may have some unique features associated with digital health technology use; for example, their use of digital health may be increased by their comorbidities (ie, health care needs) and reduced by their frailty.

Falls Among Older Adults During the COVID-19 Pandemic Compared to a Pre-pandemic Period: A Case-Control Study.

BACKGROUND: Little is known about how the COVID-19 pandemic impacted older adults admitted to the hospital with fall-related injuries. This research sought to determine if there was a difference in patient characteristics and hospital outcomes among older adults with fall-related injuries during the COVID-19 pandemic compared to a non-pandemic period. METHODS: A retrospective chart review of patients 65 years or older admitted for traumatic falls before and during COVID-19 was undertaken. Data abstracted included demographics, fall details, injury data, and hospital course. RESULTS: Of 1598 patients, 50.5% presented during COVID-19 (cases), and 49.5% presented pre-pandemic (controls). Fewer cases fell in rural areas (28.6% vs 34.1%, P = .018) and were transferred from outside hospitals (32.1% vs 38.2%, P = .011). More cases experienced alcohol (4.6% vs 2.4%, P = .017) and substance use disorders (1.4% vs .4%, P = .029). Fewer cases had subdural hemorrhages (11.8% vs 16.4%, P = .007), and more had pneumothoraxes (3.5% vs 1.8%, P = .032). More patients admitted during COVID-19 experienced acute respiratory failure (2.0% vs .0%, P < .001), hypoxia (1.5% vs .3%, P = .005), and delirium (6.3% vs 1.0%, P < .001). Fewer cases were discharged to skilled nursing facilities (50.8% vs 57.3%, P = .009) and more to home with services (13.1% vs 8.3%, P = .002). DISCUSSION: This study suggested there was a similar frequency of presentation for falls among older adults during the two study periods. Older adults with fall-related injuries experienced differences in presenting comorbidities, injury patterns, complications, and discharge locations during the study periods.

Impact of COVID-19 on Lifestyle: A Sample of Iranian Older Adults.

The COVID-19 pandemic and prolonged quarantine affect the health behaviors of older adults. We investigated the changes in older adults' lifestyles during the pandemic in a sample of 1020 people aged 60 years old and over in Tehran. The results revealed that the COVID-19 pandemic had a positive impact on nutritional behaviors and social support while having a negative impact on physical activity and anxiety in older adults. Due to the greater deterioration of health behaviors among unmarried older adults, low socio-economic status, and COVID-19 inpatients, policymakers must pay attention to interventions to promote healthy lifestyles.