Medical Cannabis Use: Exploring the Perceptions and Experiences of Older Adults with Chronic Conditions.

Objectives: Although the rate of cannabis use by older adults is increasing more quickly than all other age groups, little is known about the reasons older adults use cannabis and the outcomes they experience. With this research, we investigated older adults' perceptions and experiences of medical cannabis use to treat and/or manage chronic conditions, specifically as a substitute for prescription drugs. Methods: Researchers relied on qualitative inquiry in the form of semi-structured, one-on-one interviewing to investigate the phenomenon of medical cannabis use for the management of chronic conditions. Results: Our findings suggest that older adults are open to medical cannabis as an alternative to pharmaceutical drugs, hopeful with regard to the management of symptoms and pain, and aware of and astute at managing issues related to stigma both from their physicians and family and friends. Furthermore, older adults describe the frustrations with education, awareness, and lack of support with dosing. Conclusions: Participations found medical cannabis use to be beneficial in managing chronic conditions and alleviating symptoms such as chronic pain. Findings are presented as an interpretation of the participants' perceptions of their medical cannabis use. Implications for putting medical cannabis use into everyday practice as well as policy implications are considered. Clinical Implications: This information will help clinicians better support older adults desiring to use medical cannabis. This research will help clinicians learn more about factors impacting medical cannabis use, and the types of information and assistance that may aid older adults in their health and well-being with the use of medical cannabis to treat chronic conditions.

Encounters with adversity: A framework for understanding resilience in later life.

Background and objectives: We explore the internal and external resources that older adults use to negotiate adversity and related to later life. We investigated the experiences older adults had with adversity and explored the factors that promote and protect resilience and the how these factors shaped the process of managing adversity related to aging.Research design and methods: Semi-structured interviews were conducted with 64 resilient adults ranging in age from 53 to 94 years of age, with an average of 71. Participants were defined as resilient on the basis of their willingness to identify as such. Grounded Theory coding techniques were applied to identify themes reflecting distinct ways in which participants dealt with what they indicated were the most significant hardships and adversities in their lives.Results: What emerged from the narratives about resilience and adversity were accounts of expressions of resilience that reflected the importance in having a resilient identity. Three major themes reflecting psychological and behavioral factors were derived from the data: 1. having vital components of resilience, or behaviors and beliefs in place, that encompass resilience as a way of being; 2. a broad but articulate set of strategies that participants actively engaged with to manage adversity, and 3. a set of protective practices used to prevent risk and prevail in the face of hardship.Discussion and implications: Findings suggest that dealing with adversity in later life requires the use of substantial internal and external resources in what can characterized as a proactive fashion. The results are presented as an interpretation of the participants' perceptions of their resilience and the role it plays in self-concept, strategic planning, and proactive practices. Implications for helping to put resilience into everyday practice are considered.

Spiritual resilience: Understanding the protection and promotion of well-being in the later life.

Spirituality is important to a large percentage of the older adult population and serves as a key factor of resilience. Using qualitative research, we conducted and analyzed interviews with 64 participants willing to discuss their experiences with adversity; ranged in age from 52 to 93 with a mean age of 74. For the purposes of this study, we analyzed 46 of the 64 interviews selecting participants who indicated that spirituality was an important resource for managing hardship. The researchers examined the connections between spirituality and resilience. Using in-depth interviews, we explored the interplay between spirituality and resilience and the importance spirituality plays in dealing with adversity and hardship. A grounded theory analysis of the 46 interviews was performed. Major findings include participants' use of spirituality as a tool to promote and maintain resilience in late life in five key domains: reliance on relationships, spiritual transformation, spiritual coping, power of belief, and commitment to spiritual values and practices. Results are presented as an interpretation of the participants' perceptions of their spirituality, and indicate their reliance on spirituality to overcome hardship. In addition, we discuss the connections between spirituality and resilience and how these connections play out in the lives of older adults when considering their generational and cohort status. The roles these two constructs play in the lives of older adults are considered.

Aging Audiences: Association of Live Performance Attendance and Cognitive Decline in a Biracial Sample.

OBJECTIVES: To examine if attendance in live performances was associated with change in cognition among African Americans (AAs) and European Americans (EAs). METHOD: The study consisted of 5,567 older adults with at least follow-up interview and analyzed using a linear mixed effects regression model adjusting for demographic and health variables. RESULTS: We found that frequent performance attendance was associated with slower decline in composite cognitive function among older AAs and EAs. Attending 10 or more performances per year was associated with 23% slower cognitive decline among AAs and 31% slower cognitive decline among EAs compared with those who never attend any performance. However, this difference was not significant ( p = .56). Attending live performances was also associated with slower decline in individual tests of perceptual speed, episodic memory, and mini-mental state exam (MMSE). DISCUSSION: Our findings suggest that live performances form a valuable component of arts engagement and should be encouraged for potential cognitive benefits.

Examining the Effects of Religious Attendance on Resilience for Older Adults.

Growing older often brings hardship, adversity, and even trauma. Resilience is a broad term used to describe flourishing despite adversity. To date, resilience and the connections to religion have not been well studied, despite compelling evidence that religious practice can promote psychological health. This research examines the role that religion plays in promoting resilience among older adults. Research questions include: (a) What is the relationship between religion and trait resilience? and (b) Does religion promote resilient reintegration following traumatic life events? Results indicate that religious service attendance is tied to higher levels of trait resilience and that both service attendance and trait resilience directly predict lower levels of depression and higher rates of resilient reintegration following traumatic life events. Findings suggest that religious service attendance has protective properties that are worthy of consideration when investigating resilience.

Do Higher Levels of Resilience Buffer the Deleterious Impact of Chronic Illness on Disability in Later Life?

PURPOSE OF THE STUDY: In examining the ability of resilience, or the ability to navigate adversity in a manner that protects well-being, to buffer the impact of chronic disease onset on disability in later life, the authors tested 2 hypotheses: (a) People with greater levels of resilience will have lower levels of disability and (b) resilience will moderate the association between the onset of a new chronic condition and subsequent disability. DESIGN AND METHODS: This study used a sample of 10,753 Americans between the ages of 51 and 98, derived from 3 waves of the Health and Retirement Study (2006-2010). Ordinary least squares regression was used to estimate the impact of resilience on changes in disability (measured as difficulty with activities of daily living [ADLs] and instrumental activities of daily living [IADLs]) over a 2-year period using a simplified resilience score. RESULTS: Resilience protects against increases in ADL and IADL limitations that are often associated with aging. Resilience mitigates a considerable amount of the deleterious consequences related to the onset of chronic illness and subsequent disability. IMPLICATIONS: Our results support our hypotheses and are consistent with claims that high levels of resilience can protect against the negative impact of disability in later life.

The Role of Spirituality in the Lives of Mothers of Breast Cancer Survivors.

Breast cancer impacts an entire family system. A cancer diagnosis embeds the patient/survivor and their loved ones in the illness process. The mothers of breast cancer patients are likely impacted in a variety of ways by their daughters' diagnoses. To date, few researchers have investigated the experiences and perspectives of this population. In the present study, authors explored how mothers of breast cancer survivors managed adversities associated with this disease and illness. Using secondary data and narrative analysis, investigators analyzed data gathered from 30 mothers. Findings indicate that participants relied on their spirituality for the management of stress and hardship related to having a loved one with breast cancer. This research has implications for family health and well-being.

What can I do with a doctoral degree in gerontology? Expanding your options.

An endless number of career trajectories are possible for gerontologists. With a growing aging population, our skills and areas of expertise are of high value to numerous industries. The purpose of this study is to describe the professional development and career trajectories of alumni of U.S. doctoral gerontology programs obtained through the Gerontology Education Longitudinal Study (GELS). Specifically, the authors examine how professional identification, doctoral program career preparation, and perception of job prospects affect alumni decisions to pursue "traditional" (i.e., academic) versus "nontraditional" (i.e., non-academic) careers. Results from the GELS revealed a fairly even split in the alumni sample of careers in traditional and nontraditional settings. The decision to pursue a traditional versus nontraditional career was not significantly associated with personal identification, doctoral program career preparation, or perception of employment options. These results suggest that the skill set obtained in doctoral gerontology programs is useful and is in demand in a variety of careers; therefore, doctoral programs may want to consider tailoring training to meet students' future career goals in both academic and non-academic settings.

Enduring as lived experience: exploring the essence of spiritual resilience for women in late life.

The purpose of this study was to explore spirituality and its relationship to resilience for women in late life. Over thirty interviews with six women aged 80 and older provide a dataset allowing for the phenomenological investigation of spiritual resilience. Themes emerged illustrating the components of spiritual resilience. The components of spiritual resilience are having divine support, maintaining purpose, and expressing gratitude. These factors are essential to the women's resilience and act as mechanisms that promote high levels of subjective well-being and an overall good quality of life. Essentially, participants articulate how their experiences of enduring hardships are informed by spiritual resilience.

Navigating hardships in old age: exploring the relationship between spirituality and resilience in later life.

Research suggests that spirituality is important to a large percentage of the older adult population and serves as a promoter of healthy aging. In this qualitative research I conducted and analyzed multiple interviews with 6 women aged 80 and older. Using multiple in-depth interviews I explored the interplay between spirituality and resilience over the life course. A grounded theory analysis of the 30 interviews was performed. The major finding is that participants used their spirituality as a tool to promote and maintain resilience in later life. I present the results as an interpretation of the participants' perceptions of their spirituality, and indicate their reliance on spirituality to overcome hardship over the life course. In addition, I discuss the connections between spirituality and resilience. The roles these two constructs play in the lives of older adults are considered.

Spirituality as a lived experience: exploring the essence of spirituality for women in late life.

Against the backdrop of a dramatic increase in the number of individuals living longer, particularly older women, it is vital that researchers explore the intersection of spirituality, gender, and aging. In this qualitative study of six women aged 80 and older, I explore, using, multiple, in-depth interviews, the experiences of spirituality over the life course. A hermeneutic phenomenological analysis of the interviews was performed and provided insights into the nature of their "lived experience" allowing for the understanding of the essence of their spirituality. The results are presented as an interpretation of the participants' perceptions of their spirituality and spiritual experiences. For the women in this study, the essence of their spirituality lies in: being profoundly grateful; engaging in complete acceptance; and having a strong sense of assuredness, while stressing the linkages and importance of spirituality. Implications for understanding spirituality for older adults are considered.

Making Sense of Extreme Longevity: Explorations Into the Spiritual Lives of Centenarians.

As the population grows older and more individuals live into advanced age the oldest-old segment will continue to increase in size. This qualitative study analyzes data gathered using in-depth interviewing and explores the spiritual saliency for sixteen centenarians. Results illustrate the importance spirituality has for older adults over the lifecourse, particularly those in advanced age. Our findings indicate that spirituality is key factor of support, an important resource in late life, and maintains continuity over the lifecourse for the centenarians. Additionally, spirituality serves as critical component in the everyday lives of the participants and provide a framework for helping older adults make sense of having lived a very long life. The findings reported here support the need for researchers and practitioners to consider the importance of spirituality in late life, particularly for those in their last decades.

Globalization of gerontology education: current practices and perceptions for graduate gerontology education in the United States.

The purpose of this study is to document current practices and understandings about globalization of gerontology education in the United States. Better understanding of aging requires international perspectives in global communities. However, little is known about how globalization of gerontology education is practiced in U.S. graduate-level degree programs. The authors conducted qualitative interviews with representatives of the Association for Gerontology in Higher Education, the major national organization supporting higher education in gerontology, graduate program directors, and students. Although all respondents expressed their interest in globalizing gerontology education, actual practices are diverse. The authors discuss suggested conceptualization and strategies for globalizing gerontology education.

Articulating the Ineffable: Explorations into the Spiritual Lives of Old Women.

Research suggests that spirituality is important to a large percentage of the older adult population. Against the backdrop of a dramatic increase in the number of individuals living longer, particularly older women, it is vital that researchers explore the intersection of spirituality, gender, and aging. In this qualitative study of 16 women aged 82 and older, I explore using in-depth interviews experiences of spirituality over the lifecourse. A narrative analysis of the interviews was performed and provided insights into the nature of their spiritual experiences. The results are presented as an interpretation of the participants' perceptions of their spirituality and spiritual experiences. Additionally, a narrative analysis is used for the interpretation of the difficulty in describing these experiences and the opportunities and challenges the term "spirituality" provides for older adults and researchers. Five types of narratives that emerged from data are discussed. These common narratives include the narrative of: conflation, continuity, confidence, connection, and caring. Implications for understanding spirituality and the role it plays in the lives of older adults are considered.

Experiences from Pagan Women: A Closer Look at Croning Rituals.

In this qualitative study I explore how Pagan women conceptualize aging, more specifically social aging, through the ritual process of being a Pagan and becoming a Crone. The central question of this research revolves around how older women who identify as Pagan experience, understand, and conceptualize their social aging and their role as aging women in American society. Semi-structured interviews were used to collect data and explore the meaning of aging for women identifying as Pagan. Major emergent themes within the data demonstrate that the croning ritual, a central aspect of Paganism, affirms these women in their process of aging. These women, through the ritual of croning, are able to understand their aging as celebration, maintain a positive sense of self while aging, and reclaim visibility as aging women. These women were able to embed their experiences of aging within a unique and specific cultural framework, a spiritual and foundational framework cultivating a spiritual connection with nature.

Gender and religious differences associated with volunteering in later life.

The purpose of this study is to use a nationally representative sample of older adults in the United States to investigate the effect gender and religiosity has on volunteer behavior in later life. This study looks specifically at the gender and religious differences associated with volunteering in later life. Accounting for gender and religious differences, more specifically, this study examines the assumption that older women are more likely to volunteer in later life as opposed to men, and that gender is a better predictor than being religious for the likelihood of occupying a volunteer role in later life. This study poses questions about the differences in gender and religiosity associated with volunteering in later life; the results indicate there is more work to be done as we conduct research that is clearer about how volunteerism and religiosity are measured in relation to gender, and the overall impact these differences have for older women and their respective communities.

Silver alerts and the problem of missing adults with dementia.

In the months following the introduction of the National AMBER (America's Missing: Broadcast Emergency Response) Alert plan used to locate missing and abducted children, Silver Alert programs began to emerge. These programs use the same infrastructure and approach to find a different missing population, cognitively impaired older adults. By late 2008, 17 states had enacted Silver Alert policies, and several more planned to take advantage of National Silver Alert grant funding to initiate policies in 2009. To date, however, no research has examined the efficacy of such programs, which have widely varying parameters and criteria to initiate the alerts. In this study, we empirically examine the 17 existing state Silver Alert and related policies. The analysis includes an examination of the varieties of programs: dementia related and AMBER extension, the dates of enactment, the criteria for activation, and the process of activation. We conclude with two salient questions that emerged from the analysis. We examine these questions and make recommendations for future research, including examining whether Silver Alerts are an appropriate response to address the problem of missing adults with dementia or cognitive impairments and examining the costs and benefits of the programs including determining how best to balance efforts to keep cognitively impaired elders safe while keeping their basic human rights of autonomy and empowerment intact.

Staff assignment practices in nursing homes: review of the literature.

Consistent assignment, whereby nursing home staff members, particularly certified nurse aides, are assigned to the same residents on most shifts, is increasingly viewed as a cornerstone of culture change in nursing homes. It has been advocated as a best-care model that increases residents' quality of life while contributing to a more stable frontline staff. Given these potential benefits, consistent assignment is now widely viewed as superior to rotating assignment, an alternative staffing model that aims to distribute care burden more fairly among staff and ensure that workers are familiar with most residents. Despite favorable anecdotal reports about the benefits of consistent assignment, the research literature reports mixed and sometimes contradictory findings for this staffing practice. This article reviews the research pertaining to staff assignment practices in nursing homes. Reviewed here are 13 reports on experimental trials (6 reports), evaluation research (4 reports), and nursing home surveys (3 reports). The review reveals broad diversity in staffing practices and raises questions that challenge popular assumptions about consistent assignment. The article closes with a discussion of the research, policy, and practice implications of the research findings.

"When I am an old woman, I shall wear purple": Red Hatters cope with getting old.

This ethnographic study examined women's friendships in Red Hat Society (RHS) chapters. Qualitative data included in-depth interviews (n = 25), a focus group interview (n = 7), participant observation, and examination of RHS publications. Results suggest that participation in the RHS (1) aids in developing and enhancing positive attitudes about self and aging that contribute to overall well-being, (2) offers the opportunity to obtain instrumental and emotional support, and (3) provides social connections that prevent feelings of social isolation. Collectively, these findings highlight the potential buffering role of RHS participation in women's lives.