A Scoping Review of Research on Older People and Intergenerational Relations in the Context of Climate Change.

BACKGROUND AND OBJECTIVES: In view of the inherited temporal dimension of climate change, this study aims to highlight diverse intergenerational effects and coping strategies by examining the state of literature on older people and intergenerational relations in the context of climate change. RESEARCH DESIGN AND METHODS: A scoping review of peer-reviewed scientific literature was conducted. We searched the following bibliographical data sets: PubMed, Web of Science, and APA PsycNet in addition to a snowballing search based on Google Scholar. The primary search was conducted between September 22, 2021 and September 26, 2021, using variations of the search terms: older people AND intergenerational AND climate change. Two independent raters classified the articles using prespecified inclusion and exclusion criteria. RESULTS: In total, 20 articles were maintained for data extraction. Articles reflect 2 poles in relation to older people and intergenerational relations in the context of climate change. The first emphasizes intergenerational conflicts and differences, whereas the second stresses solidarity and transmission of knowledge and practices between the generations. DISCUSSION AND IMPLICATIONS: Both older and younger people are affected by age-based discrimination in the context of climate change. Generational differences in energy consumption and attitudes toward climate change exist. Nonetheless, these can be overcome by stressing the solidarity between the generations and the ability of older people to contribute to the climate change movement as well as by the ability of both young and old to transmit knowledge and practices related to sustainability.

Toward healthy aging in Latin America and the Caribbean: leaving no one behind?

The framework of healthy aging has created a structure for research across the United Nations Decade of Healthy Aging (2021-2030) and for action to address the mission of the Sustain-able Development Goals “to leave no one behind”. Across the decade, researchers, governments and civil society are urged to develop strategies to identify and address inequities and to foster healthy aging. This agenda requires coordinated effort from researchers in Gerontology and Geriatrics to address the broad set of social and health issues in aging including functional status, social participation, and older adults’ needs in the context of social and health care systems.

Hacia el envejecimiento saludable en América Latina y el Caribe: ¿no dejar a nadie atrás?

El marco de envejecimiento saludable ha creado una estructura para la investigación a través de la Década del Envejecimiento Saludable de las Naciones Unidas (2021-2030), así como para la acción destinada a abordar la misión de los Objetivos de Desarrollo Sostenible de “no dejar a nadie atrás”. Se insta a los investigadores, los gobiernos y la sociedad civil a que, a lo largo de la década, elaboren estrategias que permitan detectar y abordar las desigualdades y fomentar el envejecimiento saludable. Este programa requiere el esfuerzo coordinado de los investigadores en gerontología y geriatría para afrontar la amplia variedad de problemas sociales y de salud que se producen en el envejecimiento, incluidos los que afectan la capacidad funcional, la participación social y las necesidades de las personas mayores en el contexto de los sistemas de atención social y de salud.

Climate Change and Mental Health of Older Persons: A Human Rights Imperative.

Climate change threatens the basic prerequisites for wellbeing, including clean air and water, food supply and the adequacy and security of shelter. Climate change is a powerful and ongoing presence in the lives of older persons, both creating and exacerbating vulnerabilities. The absence of a legally binding international instrument specifically protecting the human rights of older persons and minimal references to older persons in key international climate instruments attest to the lack of attention to and visibility of older persons in national and international law. There is a need to integrate the areas of older people and environmental sustainability to ensure that the rights of older people are preserved especially now, as the effects of the climate change crisis become more pronounced.

Neighborhood environments and intrinsic capacity interact to affect the health-related quality of life of older people in New Zealand.

OBJECTIVES: Following the WHO 2015 policy framework, we tested the effects of older people's intrinsic capacity and their perceptions of their neighborhood environments on mental and physical health-related quality of life (QoL) outcomes across two years. STUDY DESIGN: Participants (mean age = 66) were drawn from two waves of a longitudinal study of aging (n = 2910) in 2016 and 2018. Regression analyses tested the main and interaction effects of intrinsic capacity and neighborhood factors on health-related QoL at T2 (controlling for T1). MAIN OUTCOME MEASURES: Intrinsic capacity was assessed with number of chronic conditions. Neighborhood perceptions was assessed with measures of housing suitability, neighborhood satisfaction, and neighborhood social cohesion. Health-related QoL was assessed with SF12 physical and mental health component scores. RESULTS: Perceptions of greater neighborhood accessibility and more trust among neighbours were associated with better mental health-related QoL two years later, but not to changes in physical health-related QoL. A significant interaction between intrinsic capacity and neighborhood access to facilities on physical health-related QoL over time showed that those reporting lower neighborhood access experienced a stronger impact of intrinsic capacity on physical health-related QoL. CONCLUSIONS: The neighborhood environment is important to the wellbeing of older people and is amenable to policy interventions. We need more work on the aspects of the immediate environment that support QoL in older age. This study points to the need for accessible facilities and cohesive neighborhoods to support health.

Loneliness of older black South African women subjected to forcible relocation.

Background: A cohort of older black South African women, forcibly relocated during apartheid, has grown old in these places. Even after 50 years, residents in a rural township expressed no connection to place and ruptured intergenerational relations. Their sense of community was based almost exclusively on their links with others who shared their history of relocation. Objective: This article seeks to understand loneliness of a group of older women who have been rendered vulnerable by longstanding exclusion from community, services and material resources. We use loneliness as a metric for exclusion from social relations. Methods: Sixteen Setswana-speaking women in Ikageng, a township in North West Province of South Africa (age 61-73), participated in the Mmogo-method® and open-ended interviews. Textual data were analyzed using thematic analysis, visual data analysis of elements and symbolic representations of loneliness. Results: Loneliness is a powerfully unpleasant experience of not being able to interact with other people in general, or more specifically as a result of the loss of particular people (including spouses, parents and children) and isolation provoked by the impact of relational interactions and group dynamics. Loneliness was mitigated by socializing and gathering for traditional activities, performing spiritual rituals, and keeping busy individually or with others, thus reinforcing a core theme that any social interaction alleviates loneliness. Conclusions: Even though loneliness is powerfully unpleasant, it is an expression of the importance of social interactions formed in a particular context. In the face of longstanding societal exclusion and disconnection from community, social connections are central to identity and to survival.

Correction to: Social exclusion of older persons: a scoping review and conceptual framework.

[This corrects the article DOI: 10.1007/s10433-016-0398-8.].

An Intersectional Exploration: Experiences of Stroke Prevention in Middle-Aged and Older Arab Muslim Immigrant Women in Canada.

Background Arab immigrants have increasing rates of stroke and uncontrolled stroke risk factors coupled with minimal resources for stroke prevention. Purpose This article describes the results of an interpretive descriptive study about Arab immigrant women's experiences of practicing stroke prevention. We use an intersectionality approach to discuss some of the factors that influenced women's ability to manage their health. Methods Sixteen middle-aged and older Arab Muslim immigrant women were recruited between 2015 and 2016 from two religious centers in an urban Canadian center. Women were between the ages of 45 and 75 years, were living in the community, and had a combination of stroke risk factors. Semi-structured interviews lasting 2-3 h were conducted in Arabic by the primary bilingual researcher. Data analysis was completed in Arabic, with final themes and exemplars translated to English with the support of a certified translator. Results Study themes include relating life stressors to physical health, pursuing knowledge in the dark, negotiating medication and treatment options, making an effort to eat healthy and be active, and identifying triple ingredients for empowerment. Conclusion Economic status, access to transportation, language fluency, life stressors, and personal coping strategies influenced Arab women's ability to manage personal health.

The association of perceived conflict with sadness for long-term care residents with moderate and severe dementia.

Objectives Research into the lived experiences of long-term care residents with dementia has identified perceived conflict, and its impact on sadness, as priorities for quality of life from the perspectives of people with dementia. However, whether and to what extent perceived conflict and sadness are associated has not been previously tested in this population. This study tested the associations between perceived conflicts with staff, family or friends and co-residents and their experience of sadness, and whether cognitive impairment or functional dependence modified these associations. Methods The study design was cross-sectional, correlational retrospective. Participants were 5001 residents of 613 long-term care facilities in Ontario, Canada with moderate and severe dementia. Clinical administrative data collected from 2012 to 2013 using the Resident Assessment Instrument 2.0 were used to measure the person's perception of conflicts with family/friends, staff, or co-residents, as well as verbal and non-verbal indicators of sadness. Hypotheses were tested using logistic regression, with cluster correction. Results Sadness (adjusting for age, sex, family/friend contact, pain, cognitive impairment, and functional dependence) was positively associated with perceived conflicts with family or friends (OR 1.91; 95% CI 1.26-2.88; p = 0.002) and staff (OR 1.51; 95% CI 1.07-2.13; p = 0.020). These associations did not differ depending on the level of cognitive impairment or functional dependence. The association between co-resident conflict and sadness was statistically significant for people with moderate (OR 2.02; 95% CI 1.45-2.82; p < 0.001) but not for those with severe dementia (OR 1.18; 95% CI 0.72-1.91; p = 0.511). Conclusion Long-term care residents with dementia who perceive conflict with others require support to maintain high quality relationships, particularly with family and friends. Future research should rigorously assess the modifiability of perceived conflict for people with moderate and severe dementia, and whether interventions to ameliorate perceived conflict result in decreased sadness and improved quality of life.

Social dimensions of health across the life course: Narratives of Arab immigrant women ageing in Canada.

The increase in ethnically and linguistically diverse older adults in Canada necessitates attention to their experiences and needs for healthy ageing. Arab immigrant women often report challenges in maintaining health, but little is known about their ageing experiences. This interpretive descriptive study uses a transnational life course framework to understand Arab Muslim immigrant women's experiences of engaging in health-promoting practices as they age in Canada. Women's stories highlight social dimensions of health such social connectedness, social roles and social support that are constructed and maintained within different migration contexts across the life course. Barriers and facilitators to healthy ageing in this population centred around five themes: (i) the necessity of staying strong, (ii) caring for self while caring for others, (iii) double jeopardy of chronic illnesses and loneliness, (iv) inadequate support within large social networks and (v) navigating access to health-supporting resources. The findings point to transnational connections and post-migration social support as major influencers in creating facilitators and barriers to healthy ageing for Arab Muslim immigrant women.

Social exclusion of older persons: a scoping review and conceptual framework.

As a concept, social exclusion has considerable potential to explain and respond to disadvantage in later life. However, in the context of ageing populations, the construct remains ambiguous. A disjointed evidence-base, spread across disparate disciplines, compounds the challenge of developing a coherent understanding of exclusion in older age. This article addresses this research deficit by presenting the findings of a two-stage scoping review encompassing seven separate reviews of the international literature pertaining to old-age social exclusion. Stage one involved a review of conceptual frameworks on old-age exclusion, identifying conceptual understandings and key domains of later-life exclusion. Stage two involved scoping reviews on each domain (six in all). Stage one identified six conceptual frameworks on old-age exclusion and six common domains across these frameworks: neighbourhood and community; services, amenities and mobility; social relations; material and financial resources; socio-cultural aspects; and civic participation. International literature concentrated on the first four domains, but indicated a general lack of research knowledge and of theoretical development. Drawing on all seven scoping reviews and a knowledge synthesis, the article presents a new definition and conceptual framework relating to old-age exclusion.

The Impact of Eldercare on Adult Children's Health and Employment in Transitional China.

This paper explores the content and extent of the burden of caregiving for Chinese families in transition. It sets out to understand how Chinese families manage to balance family caregiving responsibilities with employment, the impact of the existing social institutions on family caregiving practices, and the risks that caregivers have to face. Data were collected from a sample of 214 workers from 14 manufacturing companies in an industrialized city in central China in 2013. Analysis revealed that common types of eldercare were assisting with activities of daily living and medical related care; middle aged employed respondents were most likely to be the caregivers to older family members; financial and time demands of care were challenging for caregivers, but women with more education and a secure job responded to the pressure of care giving better than those with less education and insecure jobs. An absence of workplace policies to support family caregivers was reported to create insecure employment conditions among middle aged workers. The findings imply an urgent need for legislative action and workplace policy that support family caregiving in China.

Staying married after stroke: a constructivist grounded theory qualitative study.

BACKGROUND: Marriages are one of the most powerful predictors of health and longevity, yet research in stroke has focused separately on survivors' experience of impairments and how spouses deal with caregiving. OBJECTIVES: The purpose of this constructivist grounded theory study was to understand the key themes related to reconstruction or breakdown of marriages after stroke. METHODS: In semi-structured interviews, 18 couples in long-term marriages discussed how their marriages were reconstructed or broke down after one member of the couple returned home after being hospitalized for a stroke. Constant comparison methods were used to compare the experiences of 12 couples in which both partners indicated their relationship was going well with 6 couples who either separated or remained in parallel marriages. RESULTS: Analysis revealed an overarching process of reconstructing compatible role-identities and three themes related to the reconstruction or breakdown of the marital identity: feeling overwhelmed, resolving conflict, and perceiving value in the marriage. CONCLUSIONS: Our findings highlight that marriages are contexts in which survivors and spouses can recalibrate their role-identities. Marriage relationships are not peripheral to survivors' and spouses' outcomes after stroke; rather, marriage is fundamental to the management of impairments and to the well-being of the couple.

Reconciling Marriage and Care after Stroke.

Most research on stroke's impact on couples has focused on the transition to caregiving/receiving. Despite considerable evidence that marriage is the primary source of support in the face of chronic conditions, little is known about what happens to marriage in the context of care after stroke. To address this gap, we undertook a qualitative grounded-theory study of 18 couples in which one partner had experienced a stroke. Findings revealed two interrelated themes of the couple processes: working out care, which involved discovering and addressing disruptions in day-to-day activities; and rethinking marriage, which involved determining the meaning of their relationship within the new context of care and disability. Three distinct types of marriages evolved from these processes: reconfirmed around their pre-stroke marriage; recalibrated around care; and a parallel relationship, "his" and "her" marriage. Our findings highlight the need to consider relationship dynamics in addition to knowledge about stroke and care.

A Bicultural Researcher's Reflections on Ethical Research Practices With Muslim Immigrant Women: Merging Boundaries and Challenging Binaries.

Bicultural researchers are well positioned to identify tensions, disrupt binaries of positions, and reconcile differences across cultural contexts to ensure ethical research practices. This article focuses on a bicultural researcher's experiences of ethically important moments in research activities with Muslim immigrant women. Three ethical principles of respect, justice, and concern for welfare are highlighted, revealing the implications of binary constructions of identity, the value of situated knowledge in creating ethical research practices, and the need to recognize agency as a counterforce to oppressive narratives about Muslim women.

Translating Knowledge: Promoting Health Through Intergenerational Community Arts Programming.

INTRODUCTION: Intergenerational programs have been touted to address the generation gaps and isolation of older adults. Mutual contact alone has produced mixed results, but attention to the intergenerational program content demonstrates well-being benefits. This practice-based article examines the benefits of creating and performing ensemble-created plays to older adults' and university students' well-being and the key processes that promote well-being. METHOD: This community participatory research project involved older adults as researchers as well as research subjects. Individual semistructured interviews were conducted by two trained interviewers with older adults (n = 15) and university students (n = 17). RESULTS: Professional dramaturgical processes of storytelling, reminiscence, and playfulness were key elements in participants' generative learning. They augmented older adults' and university students' ability to understand their situations and try innovative solutions. Skills such as openness, flexibility, and adaptation transferred into students' and older adults' daily lives. CONCLUSION: Participating in this intergenerational theatre group reduced ageism and improved intergenerational relationships. It increased older adults' and university students' well-being by building social networks, confidence, and self-esteem and developed a sense of social justice, empathy, and support for others.

Developing Navigation Competencies to Care for Older Rural Adults with Advanced Illness.

Navigators help rural older adults with advanced illness and their families connect to needed resources, information, and people to improve their quality of life. This article describes the process used to engage experts - in rural aging, rural palliative care, and navigation - as well as rural community stakeholders to develop a conceptual definition of navigation and delineate navigation competencies for the care of this population. A discussion paper on the important considerations for navigation in this population was developed followed by a four-phased Delphi process with 30 expert panel members. Study results culminated in five general navigation competencies for health care providers caring for older rural persons and their families at end of life: provide patient/family screening; advocate for the patient/family; facilitate community connections; coordinate access to services and resources; and promote active engagement. Specific competencies were also developed. These competencies provide the foundation for research and curriculum development in navigation.

Features of home and neighbourhood and the liveability of older South Africans.

While older people live in developing countries, little is known about the relative importance of features of their communities in influencing their liveability. We examine components of home and neighbourhood among older South Africans. Linear regression analyses revealed that features of home (basic amenities, household composition, financial status and safety) and neighbourhood (ability to shop for groceries, participate in organizations and feel safe from crime) are significantly associated with life satisfaction. Approaches to liveability that are person-centred and also set within contexts beyond home and neighbourhood are needed to address boundaries between home and neighbourhood; incorporate personal resources into liveability models and import broader environmental contexts such as health and social policy.