Determining the role and responsibilities of the community epilepsy nurse in the management of epilepsy.

AIMS AND OBJECTIVES: The aim of this study is to enhance the understanding of the core elements and influencing factors on the community-based epilepsy nurse's role and responsibilities. BACKGROUND: Internationally, epilepsy nurse specialists play a key role in providing person-centred care and management of epilepsy but there is a gap in understanding of their role in the community. DESIGN: A national three-stage, mixed-method study was conducted. METHODS: One-on-one, in-depth semi-structured qualitative interviews were conducted online with 12 community-based epilepsy nurses (Stage 1); retrospective analysis of data collected from the National Epilepsy Line, a nurse-led community helpline (Stage 2); and focus group conducted with four epilepsy nurses, to delve further into emerging findings (Stage 3). A thematic analysis was conducted in Stages 1 and 3, and a descriptive statistical analysis of Stage 2 data. Consolidated Criteria for Reporting Qualitative studies checklist was followed for reporting. RESULTS: Three key themes emerged: (1) The epilepsy nurse career trajectory highlighted a lack of standardised qualifications, competencies, and career opportunities. (2) The key components of the epilepsy nurse role explored role diversity, responsibilities, and models of practice in the management of living with epilepsy, and experiences navigating complex fragmented systems and practices. (3) Shifting work practices detailed the adapting work practices, impacted by changing service demands, including COVID-19 pandemic experiences, role boundaries, funding, and resource availability. CONCLUSION: Community epilepsy nurses play a pivotal role in providing holistic, person-centred epilepsy management They contribute to identifying and addressing service gaps through innovating and implementing change in service design and delivery. RELEVANCE TO CLINICAL PRACTICE: Epilepsy nurses' person-centred approach to epilepsy management is influenced by the limited investment in epilepsy-specific integrated care initiatives, and their perceived value is impacted by the lack of national standardisation of their role and scope of practice. NO PATIENT OR PUBLIC CONTRIBUTION: Only epilepsy nurses' perspectives were sought.

Effectiveness of digital technologies to engage and support the wellbeing of people with dementia and family carers at home and in care homes: A scoping review.

Use of digital technologies to support meaningful engagement of people with dementia and carers increased during the COVID-19 pandemic. The purpose of this scoping review was to determine the effectiveness of digital technologies in supporting the engagement and wellbeing of people with dementia and family carers at home and in care homes. Studies published in peer reviewed literature were identified across four databases (CINAHL, Medline, PUBMED, PsychINFO). Sixteen studies met the inclusion criteria. Findings indicate that digital technologies can potentially support the wellbeing of people with dementia and family carers, although only a few studies had measured impact on wellbeing, as many were reporting on technology at proof-of-concept stage rather than commercially ready products. Moreover, current studies lacked meaningful involvement of people with dementia, family carers, and care professionals in the design of the technology. Future research should bring together people with dementia, family carers, care professionals and designers to coproduce digital technologies with researchers and evaluate them using robust methodologies. Codesign should start early in the intervention development phase and continue until implementation. There is a need for real world applications that nurture social relationships by focusing on how digital technologies can support more personalised, adaptive forms of care. Developing the evidence base to identify what makes digital technologies effective in supporting the wellbeing of people with dementia is crucial. Future interventions should therefore consider the needs and preferences of people with dementia, their families, and professional carers, as well as the suitability and sensitivity of wellbeing outcome measures.

The four domains of the person-centred practice framework from the perspective of critical care nurses in intensive care units during a pandemic.

OBJECTIVES: The aim was to describe the Person-Centred Practice Framework's four domains (prerequisites, care environment, person-centred processes, and person-centred outcomes) through the perspectives of critical care nurses working in intensive care units during the second year of the COVID-19 pandemic. Furthermore, the aim was to investigate the relationships between prerequisites, care environment, person-centred processes, and person-centred outcomes. DESIGN/METHODS: A cross-sectional study involving questionnaires. Prerequisites were measured using person-related conditions, the care environment by using the Person-Centred Climate Questionnaire-Staff version, the person-centred processes by using the Person-Centred Care Assessment Tool and person-centred outcomes were measured with one question about present health and well-being and by using Self-rated Exhaustion Disorder. Descriptive and analytic statistics were used. Data was collected from July 2021 to November 2021. SETTING: Critical care nurses (n = 217) working in 15 Swedish adult intensive care units. RESULTS: Participants' average length of experience in intensive care units was 14 years, and most participants experienced increased nursing care responsibilities. They perceived the climate as safe but had limitations in terms of its everydayness and community. Participants perceived the organisations both supported and hindered personalized care. Most participants experienced a variety of exhaustion symptoms, and their health had positive relationship with community. CONCLUSION: By showing how prerequisites, care environment, person-centred process influences critical care nurses' health and well-being, organisations might identify aspects in the work environment that require targeted interventions to reach healthy workplaces. IMPLICATIONS FOR CLINICAL PRACTICE: To preserve the health and well-being of critical care nurses and to flourish as humans in their professional roles, they need to interact with and form relationships with their colleagues, patients, and relatives. Organisations should have a person-centred approach for every individual in the workforce to harness each critical care nurses' knowledge and skills for individuals to growth in their roles.

Culture Change in Long-Term Care-Post COVID-19: Adapting to a New Reality Using Established Ideas and Systems.

The response to the COVID-19 pandemic in long-term care (LTC) has threatened to undo efforts to transform the culture of care from institutionalized to de-institutionalized models characterized by an orientation towards person- and relationship-centred care. Given the pandemic's persistence, the sustainability of culture-change efforts has come under scrutiny. Drawing on seven culture-change models implemented in Canada, we identify organizational prerequisites, facilitatory mechanisms, and frontline changes relevant to culture change that can strengthen the COVID-19 pandemic response in LTC homes. We contend that a reversal to institutionalized care models to achieve public health goals of limiting COVID-19 and other infectious disease outbreaks is detrimental to LTC residents, their families, and staff. Culture change and infection control need not be antithetical. Both strategies share common goals and approaches that can be integrated as LTC practitioners consider ongoing interventions to improve residents' quality of life, while ensuring the well-being of staff and residents' families.

Temporary suspension of visiting as experienced by non-covid-19 patients undergoing orthopaedic surgery, their relatives, and health professionals, a multimethod study

Background: Hospitals worldwide implemented visitor restrictions policies due to the SARS-CoV-2 pandemic. Aim: To investigate the impact of visitor restrictions experienced by non-Covid-19 orthopaedic patients, their relatives, and health professionals from a person-centred practice (PCP) perspective. Methods: Seventy-eight patients/relatives completed a self-reported survey. Template Analysis was conducted on twenty-five telephone interviews and one focus group interview. Findings: Despite accepting the restrictions for the country's good, we found a profound need for visits among the relatives. However, one-fifth of the patients were content, and one-third got more rest than earlier admissions. We uncovered a current readiness to develop an organisational PCP culture focused on the good of the patient. All stakeholders were attentive to the importance of the relatives' role, and the need for the involvement of relatives as team players became evident. Conclusion: The study emphasised the need for PCP strategies to involve relatives when visitor restrictions are necessary.

Ageing and Loneliness in Times of Pandemic: A Scoping Review.

Society is immersed in a process of demographic transformation of great relevance: the ageing of the population. During the ageing stage, relevant changes occur, such as age-related losses, lack of formal and informal support or changes in social roles, which can cause situations of isolation or loneliness in older people. After the Spanish government decreed a state of alarm throughout the national territory in response to the arrival of SARS-CoV2, the confinement of the entire population was established, and only essential services and authorized persons could continue to carry out their daily activities and professional tasks. In addition, since the beginning of the pandemic, older people were considered high-risk people, a circumstance that increased their isolation situation. OBJECTIVE: Understand, organize and systematically analyse the scientific evidence generated in relation to the impact that the COVID-19 pandemic has had on the processes and feelings of isolation and loneliness of the elderly population, from the beginning of the health crisis until the date of search. MATERIALS AND METHODS: a scoping review was conducted using the methodology of Arksey and O'Malley, which included a review of the studies available in the online databases Proquest, Scopus and WOS. From the search, information related to the isolation and collective of elderly people during the pandemic was extracted. RESULTS: a total of 32 articles were included, from which three fundamental areas of analysis emerged and three issues emerged: older people and institutionalisation during the pandemic, ageism and hospitalisation of the elderly during the pandemic, and loneliness and isolation of older people throughout the pandemic. DISCUSSION: the lack of material resources and infrastructures to be able to face the problem of isolation in institutions was evident. The importance of acquiring, on the part of the elderly, competences, knowledge and skills in new technologies in order to continue with contact with their peer group and family was also observed. CONCLUSIONS: this study identifies areas already understood, as well as knowledge gaps, that allow for determining opportunities for future research and thus the ability to improve in situations similar to the one that occurred.

The research experience of postgraduate students: a mixed-methods study

Research experience is widely used in quality assurance exercises to benchmark postgraduate education at the institutional level. However, individual differences in students' research experience have been largely neglected. Furthermore, little is known about how differences in students' research experience are associated with skill development and overall satisfaction. This study addressed these gaps using an explanatory sequential mixed-methods design. Study 1 was a quantitative study that involved surveying 590 research postgraduate students (i.e. 421 PhD and 168 MPhil students). A person-centered approach, specifically latent profile analysis, was used to analyze the data. Our findings revealed that students could be divided into three groups based on their research experience: rewarding, ordinary, and unsatisfactory. Those with a rewarding research experience experienced greater development in their skills and higher levels of satisfaction, while those in the unsatisfactory group demonstrated the worst outcomes. Study 2 was a qualitative study that involved interviews with 10 PhD students. The qualitative findings largely triangulated the quantitative results but also uncovered emerging themes, including the importance of student-supervisor misfit, publication pressure, and the COVID-19 pandemic context. Theoretical and practical implications of these findings are discussed.

Loneliness in Community-Dwelling, Older Adults: An Integrative Review

Loneliness is a major public health concern impacting the well-being of older adults. Loneliness increases older adults' risk of adverse health outcomes. Approximately 35% of adults over age 65 report frequent feelings of loneliness. A comprehensive search was performed of the literature published from 2011 to 2021. Primary studies that examined or described loneliness in the community-dwelling, older adult US population were included. The evidence was synthesized, and common themes were identified. Twenty-two studies were included. The University of California Los Angeles Loneliness Scale was the most frequently used measurement tool. Older adults experienced physical and psychological changes associated with loneliness. Common approaches to reduce loneliness included community-based, person-centered, and socialization approaches. Loneliness increases older adults' risk of adverse health outcomes. Future studies should consider the impact of loneliness on older adults across diverse backgrounds. The integration of loneliness screening tools may help promote targeted interventions and improve quality of care.

Exploring staff perspectives on caring for isolated hospitalised patients during the COVID-19 pandemic: a qualitative study.

BACKGROUND: Strict isolation of COVID-19 patients to prevent cross infection may inadvertently cause serious adverse outcomes including psychological harm, limitations to care, increased incidence of delirium, deconditioning and reduced quality of life. Previous research exploring the staff perspective of the effect of isolation on patients is limited. The aim of this study is to understand staff perceptions and interpretations of their experiences of the care and treatment of isolated patients and the impact of isolation on patients, families, and staff. METHOD: This qualitative, exploratory study is set in a major metropolitan, quaternary hospital in Melbourne, Australia. Data was collected in focus groups with clinical and non-clinical staff and analysed using content analysis. The hospital ethics committee granted approval. Each participant gave informed verbal consent. RESULTS: Participants included 58 nursing, medical, allied health, and non-clinical staff. Six main themes were identified: 1) Communication challenges during COVID-19; 2) Impact of isolation on family; 3) Challenges to patients' health and safety; 4) Impact on staff; 5) Challenging standards of care; 6) Contextual influences: policy, decision-makers and the environment. CONCLUSION: Isolating patients and restricting visitors resulted in good pandemic management, but staff perceived it came at considerable cost to staff and consumers. Innovative communication technology may facilitate improved connection between all parties. Mental health support is needed for patients, families, and staff. Further research using a co-design model with input from patients, families and staff is recommended to determine appropriate interventions to improve care. Preventing the spread of infection is essential for good pandemic management, but the cost to consumers and staff must be mitigated. Preparation for future pandemics must consider workforce preparedness, adapted models of care and workflow.

Putting nutrition education on the table: development of a curriculum to meet future doctors' needs.

COVID-19 has further exacerbated trends of widening health inequalities in the UK. Shockingly, the number of years of life lived in general good health differs by over 18 years between the most and least deprived areas of England. Poor diets and obesity are established major risk factors for chronic cardiometabolic diseases and cancer, as well as severe COVID-19. For doctors to provide the best care to their patients, there is an urgent need to improve nutrition education in undergraduate medical school training.With this imperative, the Association for Nutrition established an Interprofessional Working Group on Medical Education (AfN IPG) to develop a new, modern undergraduate nutrition curriculum for medical doctors. The AfN IPG brought together expertise from nutrition, dietetic and medical professionals, representing the National Health Service (NHS), royal colleges, medical schools and universities, government public health departments, learned societies, medical students, and nutrition educators. The curriculum was developed with the key objective of being implementable through integration with the current undergraduate training of medical doctors.Through an iterative and transparent consultative process, thirteen key nutritional competencies, to be achieved through mastery of eleven graduation fundamentals, were established. The curriculum to facilitate the achievement of these key competencies is divided into eight topic areas, each underpinned by a learning objective statement and teaching points detailing the knowledge and skills development required. The teaching points can be achieved through clinical teaching and a combination of facilitated learning activities and practical skill acquisition. Therefore, the nutrition curriculum enables mastery of these nutritional competencies in a way that will complement and strengthen medical students' achievement of the General Medical Council (GMC) Outcome for Graduates.As nutrition is an integrative science, the AfN IPG recommends that the curriculum is incorporated into initial undergraduate medical studies before specialist training. This will enable our future doctors to recognise how nutrition is related to multiple aspects of their training, from physiological systems to patient-centred care, and acquire a broad, inclusive understanding of health and disease. In addition, it will facilitate medical schools to embed nutrition learning opportunities within the core medical training, without the need to add in a large number of new components to an already crowded programme or with additional burden for teaching staff.The undergraduate nutrition curriculum for medical doctors is designed to support medical schools to create future doctors who will understand and recognise the role of nutrition in health. Moreover, it will equip frontline staff to feel empowered to raise nutrition-related issues with their patients as a fundamental part of enhanced care and to appropriately refer on for nutrition support with a registered associate nutritionist/registered nutritionist (ANutr/RNutr) or registered dietitian (RD) where this is likely to be beneficial.

Supporting the mental health of children and young people with learning disabilities during COVID-19

Why you should read this article:• To be aware of the effects of the COVID-19 pandemic on the mental and physical health of children and young people with learning disabilities• To learn about how one CAMHS learning disabilities team supported the mental health of children and young people during the COVID-19 pandemic• To recognise that innovative and flexible services are required to meet the complex needs of children and young people with learning disabilitiesThis article explores the authors' experiences of supporting the mental health of children and young people with learning disabilities during the coronavirus disease 2019 (COVID-19) pandemic. The article discusses the prevalence of and risk factors for the development of mental health issues in this group. It also describes some service improvement projects developed by a child and adolescent mental health service learning disabilities team to support the mental health needs of children and young people during the COVID-19 pandemic. The article includes a case study to illustrate how a flexible and person-centred approach can support the mental health of this population.

The value of community psychiatric services for the elderly's dementia caregiver group: Exploring the perspectives of participants

Community Psychiatric Services for the Elderly (CPSE) at a large teaching hospital in Toronto has offered a monthly support group for caregivers of persons with dementia for over 30 years. Participants were surveyed in January 2018 about group attendance, benefits of attending the group, and areas for improvement. Results are shared in this case study. A total of 8 participants responded to the survey with a response rate of 47%. The feedback was predominantly positive. The most prevailing theme that emerged from the survey responses was group members' appreciation for the opportunity to meet with one another to discuss relevant issues and gain support from the facilitator and each other. Feedback from the survey also revealed opportunities for improvement on how the group could be better facilitated to elicit more equal participation from all group members. Formally assessing the value of the group from the perspectives of participants confirmed that the group is a safe place for dementia caregivers to get support and a valuable way to access knowledge from dementia care experts. COVID-19 has fostered evolution of the group from in-person to virtual meeting, opening opportunities for more feedback from members to help create the future of the dementia caregiver support group. © The Author(s), 2021.

Nurses' experiences of person-centred care planning using video-conferencing.

AIM: The aim was to illuminate how nurses experience person-centred care planning using video conferencing upon hospital discharge of frail older persons. DESIGN: Care planning via video conferencing requires collaboration, communication and information transfer between involved parties, both with regard to preparing and conducting meetings. Participation of involved parties is required to achieve a collaborative effort, but the responsibilities and roles of the involved professions are unclear, despite the existence of regulations. METHOD: A qualitative content analysis was conducted based on 11 individual semi-structured interviews with nurses from hospitals, municipalities and primary care in Sweden. RESULTS: This study provides valuable insights into challenges associated with care planning via video conferencing. The meeting format, that is video conferencing, is perceived as a barrier that makes the interaction challenging. Shortcomings in video technology make a person-centred approach difficult. The person-centred approach is also difficult for nurses to maintain when the older person or relatives are not involved in the planning.

Protecting mental health in quarantine: Exploring lived experiences of healthcare in mandatory COVID-19 quarantine, New South Wales, Australia.

Objectives: In response to the COVID-19 pandemic, Australia implemented mandatory hotel quarantine for returned international travellers from March 2020-November 2021. Healthcare was rapidly transformed and scaled up to facilitate delivery of face-to-face and virtual healthcare within quarantine facilities. We sought to understand, from the patient perspective, what a virtual model of healthcare may need to be aware of to respond to, protect, and mitigate people's mental health within a 'public health protection' context of quarantine. Design: Qualitative study design using in-depth semi-structured interviews exploring experiences of the virtual model of healthcare in quarantine. Setting: Special Health Accommodation (SHA) quarantine facilities following Australian Federal and New South Wales (NSW) State quarantine policy, NSW, Australia. Participants: 25 returned international travellers aged 18 years or older of any COVID-19 status who quarantined within SHA between October 2020-March 2021. Results: Participants identified three broad areas of concern. Firstly, their potential to transmit COVID-19, that created anxiety for all participants. Secondly, the effects of losing personal freedoms in quarantine to protect the wider Australian community. Thirdly, many participants entered quarantine during intense biographical moments in their lives, compounding the stress of their experience. Participants felt lost within the 'faceless' quarantine administrative system they navigated prior to their actual arrival in Australia and during their mandated quarantine period. This cumulative experience compromised their expectations and experiences of person-centred care once in quarantine. Conclusions: Quarantine has been a critical public health measure for managing COVID-19 in Australia. The pandemic provides opportunities to learn from quarantine implementation. Participants struggled to separate healthcare provision from the broader quarantine systems and processes. Due to this confusion, blame was directed at healthcare providers for many, and in some cases all difficulties, including those encountered getting into and once within quarantine. Valuable lessons can be learnt from engaging with patients' perspectives to adapt and strengthen future quarantine to deliver responsive, person-centred healthcare.

Reaching out to those we teach about: a qualitative appreciative inquiry of older persons’ experience as mentors in a bachelor of nursing programme during the Covid-19 pandemic

Background: This article describes the development and refinement of a component of a first-year nursing course called ‘Theoretical perspectives in nursing care: complexities in seniors care’. Initially developed in 2020 in response to the pandemic restrictions and guided by the philosophy of person- centredness and person-centred practice, a senior mentorship programme called ‘Engaging with your senior mentor in the community’ has become an important element of the broader theoretical course. Aim: To report on the experiences of older persons living in the community who volunteered to be mentors to first-year bachelor of nursing students, and explain how their experiences informed person-centred quality improvements for future courses. Methods: Appreciative inquiry principles guided the study. Qualitative descriptive design methods – online surveys and focus groups – were employed to evaluate the senior mentorship initiative. Thematic analysis was performed to identify themes that described what the experience of participating in the initiative was like from the perspective of the senior mentors themselves. Findings: Our analysis identified five themes: (a) sharing;(b) contributing;(c) listening;(d) self-reflecting;and (e) communicating expectations. Conclusion: Sharing wisdom informed by lived experience can be a rewarding part of ageing. Senior mentors believed they had contributed in a meaningful way to the student nurses’ learning. Implications for practice: * This article reaffirms that older persons are keen to participate in education initiatives * Insights from the senior mentors will inform educators in health and social sciences who want to incorporate the voices of older persons in their classroom and practice teaching * Older persons should be considered potential partners who can help educators develop a culture of person-centredness to help students prepare to appreciate the older persons in their care

HIV care experiences and health priorities during the first wave of COVID-19: clients' perspectives - a qualitative study in Lusaka, Zambia.

BACKGROUND: The novel COVID-19 pandemic threatened to disrupt access to human immunodeficiency (HIV) treatment for persons living with HIV (PLHIV), two-thirds of whom live in sub-Saharan Africa. To inform a health system response supportive of continuity of care, we sought to understand clients' HIV care experiences and health priorities during the first wave of COVID-19 outbreak in Lusaka, Zambia. METHODS: Leveraging a study cohort of those who completed periodic SMS surveys on HIV care, we purposefully sampled 25 PLHIV after first confirmed COVID-19 case was reported in Zambia on 18th March 2020. We phone-interviewed participants, iteratively refining interview guide to capture emergent themes on COVID-19 awareness, health facility interactions, and social circumstances, which we analyzed using matrix analysis. RESULTS: All participants were aware of COVID-19, and HIV care experiences and health priorities of clients were affected by associated changes at health system, household, and individual level. The health system instituted early clinic visits to provide 6-months of antiretroviral therapy (ART) for stable patients and 3-months for unstable patients to reduce clinic visits and wait times. Most patients welcomed this long-desired extended appointment spacing. Some reported feeling respected and engaged when health care workers telephoned requesting their early clinic visit. However, others felt discouraged by an absence of physical distancing during their clinic visit due to 'severe acute respiratory syndrome coronavirus 2' (SARS-CoV-2) infection concerns. Several expressed a lack of clarity regarding next viral load monitoring date and means for receiving results. Patients suggested regular patient-facility communication by telephone and SMS. Patients emphasized that COVID-19 restrictions led to loss of employment and household income, exacerbating poverty and difficulties in taking ART. At individual level, most participants felt motivated to stay healthy during COVID-19 by ART adherence and regular laboratory monitoring. CONCLUSIONS: Clients' HIV care and health priorities during the first wave of COVID-19 in Lusaka province were varied with a combination of positive and negative experiences that occurred especially at health system and individual levels, while at household level, the experiences were all negative. More research is needed to understand how patients practice resiliency in the widespread context of socio-economic instability. Governments and patients must work together to find local, health systems solutions to support ART adherence and monitoring. Additionally, the health system should consider how to build on changes for long-term HIV management and service delivery.

Person-centred planning in education: an exploration of staff perceptions of using a person-centred framework in an alternative provision

Opportunities for children to be involved in the decisions made about them are part of current statutory educational legislation. Person-centred planning (PCP) has been proposed as an appropriate method of meeting statutory requirements to gather pupil views. However, young people within alternative provisions (APs) may lack opportunities to be heard. This paper reports on an action research project with staff from an AP for children at risk of exclusion. Participants opted to trial the use of the PCP approach 'Making Action Plans' ('MAPs';carried out virtually due to Covid19 restrictions) and evaluated the project through two focus groups. Findings indicate that (virtual) use of MAPs requires staff to carefully consider their setting's structure, needs, capacity and capabilities. Pre-meeting preparation and adapting the MAP process with technology improved engagement, access and alternative ways of working. The MAP process provided a range of positive outcomes as a by-product of its implementation.

An investigation of the level of burnout and resilience among hospital based nurse managers after COVID 19 - A cross-sectional questionnaire-based study.

AIM: We aim to investigate burnout and resilience among hospital based nurse managers post COVID-19 in order to suggest appropriate person-centred leadership support. BACKGROUND: Nurse leaders are central to establishing safe and caring environments for patients and staff. Therefore, their own wellbeing is crucial, particular in times of crisis where they must provide support and guidance. METHODS: Cross-sectional questionnaire included ward managers. Data collected were burnout inventory, brief resilience score and demographic data. To analyse data, we used descriptive statistics. RESULTS: 51.2% answered the questionnaire. Of those, 32.3% displayed symptoms of high personal burnout and 29% of work-related burnout. 6.5% showed signs of high employee-related burnout. As a group, ward managers showed moderate to high resilience. CONCLUSION: Personal and work-related burnout was highly prevalent among ward managers. Results suggest that the cause of their burnout symptoms cannot be attributed to low individual resilience. We thus suggest a shift in focus from strengthening individual leadership resilience to the establishment of healthful and resilient cultures in accordance with person-centred leadership. IMPLICATIONS FOR NURSING MANAGEMENT: Person-centred leadership has the potential to shift the focus from the resilience of individual leaders to that of collective responsibility for creating a healthful and resilient culture.

Aging all over the place: a multidisciplinary framework that considers place and life trajectories of older adults within their communities

Purpose>This conceptual paper aims to describe aging all over the place (AAOP), a federative framework for action, research and policy that considers older adults’ diverse experiences of place and life trajectories, along with person-centered care.Design/methodology/approach>The framework was developed through group discussions, followed by an appraisal of aging models and validation during workshops with experts, including older adults.Findings>Every residential setting and location where older adults go should be considered a “place,” flexible and adaptable enough so that aging in place becomes aging all over the place. Health-care professionals, policymakers and researchers are encouraged to collaborate around four axes: biopsychosocial health and empowerment;welcoming, caring, mobilized and supportive community;spatiotemporal life and care trajectories;and out-of-home care and services. When consulted, a Seniors Committee showed appreciation for flexible person-centered care, recognition of life transitions and care trajectories and meaningfulness of the name.Social implications>Population aging and the pandemic call for intersectoral actions and for stakeholders beyond health care to act as community leaders. AAOP provides opportunities to connect environmental determinants of health and person-centered care.Originality/value>Building on the introduction of an ecological experience of aging, AAOP broadens the concept of care as well as the political and research agenda by greater integration of community and clinical actions. AAOP also endeavors to avoid patronizing older adults and to engage society in strengthening circles of benevolence surrounding older adults, regardless of their residential setting. AAOP’s applicability is evidenced by existing projects that share its approach.