The Experience of Participating in Remotely Delivered Online Exercise Classes During the COVID-19 Pandemic Among Community-Dwelling Older Adults and Its Postpandemic Implications.

The COVID-19 pandemic has accelerated the use of videoconferencing-delivered online exercise classes among community-dwelling older adults. This phenomenon is new, and no research has investigated older adults' relevant experiences and postpandemic perspectives. This study is situated in a naturalistic paradigm and adopted a descriptive qualitative methodology to understand the phenomenon. In-depth interviews were conducted with 23 older adults (aged 55-89 years) who have participated in videoconferencing-delivered online exercise since the COVID-19 pandemic. Utilizing thematic analysis, eight key themes were identified. Older adults experienced convenience, exercise regularity, technological transformation, and motivation when using this new form of exercise delivery. At the same time, they also experienced certain technological barriers and compromised quality of instructor supervision. Looking forward, older adults welcomed the increased opportunity for supervised exercise due to increased virtual capacity. They also envisaged that mobility-restricted groups such as frail older adults and caregivers would benefit from this form of exercise delivery.

A Dyadic Pain Management Program for Community-Dwelling Older Adults with Chronic Pain: Study Protocol for a Cluster Randomized Controlled Trial.

Community-dwelling older adults suffer from chronic pain. Pain negatively affects their physical and psychosocial wellbeing. The majority of pain management education and programs focus only on older adults. Their informal caregivers should be involved in pain management. A dyadic pain management program for reducing pain and psychological health symptoms, and improving pain self-efficacy, quality of life, and physical function in older adults is proposed for evaluation of its effectiveness. This will be a cluster randomized controlled trial. Community-dwelling older adults aged 60 or above and their informal caregivers will be recruited. The dyadic pain management program will be an eight-week group-based program. The participants in the experimental group will receive four weeks of center-based, face-to-face activities and four weeks of digital-based activities via a WhatsApp group. The control group will receive the usual care and a pain management pamphlet. Data will be collected at baseline, and at the eighth-week and sixteenth-week follow-up session. The outcome measurements will include pain intensity, pain self-efficacy, perceived quality of life, depression, anxiety, and stress levels. Data on the caregiver burden will be collected from the informal caregivers. Because of the COVID-19 pandemic, all social activities have been suspended. In the near future, as the pandemic subsides, the dyadic pain management program will be launched to benefit community-dwelling older adults and informal caregivers and to reduce their pain and the care burden, respectively.

The deprived or the devil? A content analysis of the media representation of older adults under COVID-19 in Hong Kong

Older adults have been statistically proved to be at a higher risk of getting severely infected by the coronavirus COVID-19, evoking sweeping narratives of compassionate ageism surrounding them in different discourses. By analysing the media content, scholars from different areas have alerted us about the amplified ageism aroused by the pandemic crisis. However, we are still short of empirical evidence to learn how ageism is constructed in diverse sociocultural contexts in the wake of this global pandemic crisis. This study provides the case of Hong Kong to reflect on how ageism, as a set of social inequalities, is constructed. By examining 814 articles collected from the three most popular newspapers with different political orientations in Hong Kong, this study uses quantitative and qualitative content analysis to examine how older people have been generally represented. Then it further compares how these representations have been influenced by the media's liberal or conservative preferences. Third, it examines the relationship between the political orientation of newspapers and how different forms of ageism are constructed. The findings indicate that despite the liberal or conservative inclination of the three newspapers, they portray the older population as frail, dependent and deprived not only at the biomedical level but in all aspects of life. This study also reveals that the newspapers with a populist inclination in both camps have shown more hostile attitudes in representing compassionate ageism. In contrast, liberal and conservative-leaning media affirmed the government's dominant role in taking full responsibility for caring for the older population. The findings indicate that the polarised ageism frame cannot fully explain the underpinnings of ageism and implied policy processing in different contexts.

A Path Analysis of the Effect of Neighborhood Built Environment on Public Health of Older Adults: A Hong Kong Study.

Introduction: Health deterioration among frail older adults is a public health concern. Among the multi-dimensional factors, the neighborhood built environment is crucial for one's health. Although the relationship between the built environment and health in the general population has been thoroughly investigated, it has been ignored in the case of frail older adults, who may have difficulties in their daily basic living skills. A path analysis is constructed to model the proposed theoretical framework involving the neighborhood built environment and health among frail older adults. This study thus aims to investigate the environmental influences on health, and to validate the theoretical framework proposed for health and social services. Methods: This study used secondary data collected in Hong Kong. A sample of 969 older community dwellers aged 60 or above were frail with at least one activity of daily living. Demographic information, neighborhood built environment data, service utilization, and health conditions were collected from these participants and their caregivers. A path analysis was performed to examine the proposed theoretical framework. Results: The health condition was of general concern, including frailty and incapacities in daily activities in frail older adults. Besides psychosocial factors, service use, and caregivers' care quality, the built environment had a significant impact on the health of older adults as well. Specifically, more facilities offering services and groceries, a shorter distance to the nearest metro station, and more greenery exposure are associated with a better-expected health condition among frail older adults. Discussion: The proposed theoretical framework successfully supplements past negligence on the relationship between the built environment and the health of frail older adults. The findings further imply that policymakers should promote the usability of transit and greenery in neighborhoods and communities. In addition, service utilization should be improved to meet the basic needs of frail older adults in the communities.

COVID-19 pandemic: impacts and controversies

Coronavirus disease 2019 (COVID-19) refers to the pneumonia caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).1 On 11 March 2020, the World Health Organization declared COVID-19 a worldwide pandemic. Clinical presentations of organ damage and a higher risk have been reported in older adults who rate their health as poor or fair or have four or more chronic conditions or comorbidities;an increased rate of suicide among this population has been estimated.1,5-8 The whole world has been shaken and is now in risk-management mode, as countries experience second and third waves of breakouts. At the global, regional, local and family levels, how should we communicate the risks of this disease? (3) How can we balance economic impacts and outbreak prevention? and (4) What optimal measures in regard to testing, diagnosing, treating, and social distancing could be sensitive to diversified communities?

Qualitative Study of Chinese Stroke Caregivers' Caregiving Experience During the COVID-19 Pandemic.

BACKGROUND AND PURPOSE: The coronavirus disease 2019 (COVID-19) outbreak has led to disruptions in health care service delivery worldwide, inevitably affecting stroke survivors requiring ongoing rehabilitation and chronic illness management. To date, no published research has been found on stroke caregiving during the COVID-19 pandemic. This study aimed to explore Hong Kong stroke caregivers' caregiving experiences in the midst of this difficult time. METHODS: Individual semistructured interviews were conducted with 25 Chinese adult primary stroke caregivers from May to June 2020 via telephone. Interviews were transcribed verbatim and analyzed using an interpretive description approach and constant comparison strategy. RESULTS: Five themes of the stroke caregiving experience during the COVID-19 pandemic emerged: care service adversities, additional caregiving workload and strain, threatened relationship between caregiver and stroke survivors, threats to caregivers' physical and psychological well-being, and needs for continuing caregiving roles. Our findings suggested that caregivers have worsened physical and psychological well-being because of increases in care burden with simultaneously reduced formal and informal support. The relationship between caregiver and stroke survivor was subsequently affected, placing some survivors at heightened risk of abuse. CONCLUSIONS: Our study provides valuable findings about stroke caregiving experiences and needs during the pandemic. Delivery of psychological support, telemedicine, and household hygiene resources would be useful to mitigate caregivers' psychological distress during the COVID-19 pandemic.