Understanding the Barriers to and Facilitators of Anxiety Management in Residents of Long-Term Care.

Older adults, 65 years of age and older, living in long-term care (LTC) commonly experience anxiety. This study aimed to understand care providers' perspectives on the barriers to and facilitators of managing anxiety in residents of LTC. Ten semi-structured interviews with care providers in LTC were completed. Framework analysis methods were used to code, thematically analyze, designate codes as barriers or facilitators, and map the codes to the Theoretical Domains Framework. Themes were categorized as acting at the resident, provider, or system level, and were labelled as either barriers to or facilitators of anxiety care. Key barriers to anxiety care at each level were resident cognitive impairment or co-morbidities; lack of staff education, staff treatment uptake and implementation; as well as the care delivery environment and access to resources. There is a need to prioritize measurement-based care for anxiety, have increased access to non-pharmacological treatments, and have a care delivery environment that supports anxiety management to improve the care for anxiety that is delivered to residents.

Social Supports and Barriers for Older Adults Not Participating in Group Physical Activity.

Group physical activity can provide physical and social benefits; however, social barriers or a lack of social support may affect participation. This study examined social-support needs and barriers among older adults who were not participating in group physical activities. Using interpretive description, semistructured interviews were conducted with 38 older adults (M = 70.9 years; 81.6% women). Themes were grouped into two categories. Category 1, expectations and initial impressions, consisted of the following: (a) Groups cannot meet everyone's expectations or interests, (b) groups are intimidating to join, and (c) the need for inclusive programming. Category 2, social processes within group physical activity, consisted of (a) modeling physical activity behaviors, (b) sharing information and suggestions about physical activity opportunities, and (c) encouragement and genuine interest. Outreach to this population should aim to address these barriers and utilize these supportive behaviors to reduce feelings of intimidation and promote participation among older adults.

Considering Cats, Dogs, and Contradictions: Pets and Their Relational Influence on Experiences of Aging in Place.

Relationships with companion animals, or "pets", may promote health and well-being for older adults as they age-in-place. Less is known, however, about ways that pet-related challenges may simultaneously influence aging-in-place experiences. This study explores the relational qualities of having pets later in life by considering qualitative accounts of older adults who are aging in the community. Semi-structured interviews with 14 socio-economically diverse, community-dwelling older adult pet-owners (≥ 60 years) living in Calgary, Alberta, Canada, were analyzed reflexively. Four recurring themes suggested that companion animal relationships were valued in older adults' lives and helped them cope with challenging circumstances, even when pets were central to these challenges. Findings also confirmed the relational nature of human-animal relationships as being shaped by both individual attributes and systemic factors. Methodological approaches to addressing these multifaceted complexities when studying pets and aging are considered. Enhanced cross-sectoral community and policy-level supports for aging-in-place with pets may have a population-level influence on health, well-being, and social justice across the socio-demographically diverse aging population.

Instructor Social Support in the Group Physical Activity Context: Older Participants' Perspectives.

Instructors in organized physical activity classes can be a source of social support through their relationships with participants, influence on participants' interactions with each other, and design of activities. Grounded in interpretive description, the objective of this study was to examine older adults' experiences of and their perspectives on group physical activity instructors' supportive behaviors. Observations of 16 group physical activity classes (N = 295) and focus groups or interviews with N = 38 class participants aged ≥ 55 (n = 29 women) were conducted at four municipal recreation facilities in a Canadian city. Five themes shed light on how instructors provided social support: (a) supporting autonomous engagement, (b) developing caring connections, (c) fostering trust through expert instruction, (d) managing conflict directly and effectively, and (e) creating a climate where people want to go. Instructor training should consider older adults' social support needs and help instructors embody behaviors that support continued physical activity participation, thereby contributing to healthy aging.

An environmental scan of methods for assessing age-friendliness in post-secondary institutions.

The University of Calgary joined the Age-Friendly University (AFU) Global Network in 2018. As part of our university's AFU action plan, a baseline assessment of the institution's age-friendliness will be conducted to identify areas of strength and growth. To inform our approach and that of other institutions undertaking this work, an environmental scan was performed to determine methods used by post-secondary institutions to date to assess age-friendliness. Both academic and grey literature published between 2012 and 2022 in the English language was searched using diverse keywords. The academic literature was identified from four databases (Abstracts in Social Gerontology, Academic Search Complete, Education Research Complete, Scopus) and the grey literature from 84 institutional websites of AFU Global Network members. Twelve academic sources and four grey sources were included in the analysis. Seven methods were used to assess age-friendliness, with the most common approaches being surveys, inventories, focus groups, interviews, and photovoice. The Age-Friendly Inventory and Campus Climate Survey (Silverstein et al., 2022) was selected to evaluate the University of Calgary's age-friendliness due to its alignment with all 10 AFU principles, comprehensiveness, and involvement of multiple stakeholders. Other post-secondary institutions should consider their context and resources when selecting an assessment method.

Non-pharmacologic and pharmacologic treatments for anxiety in long-term care: a systematic review and meta-analysis.

BACKGROUND: older adults living in long-term care (LTC) commonly suffer from anxiety symptoms and disorders. We completed a systematic review and meta-analysis to identify efficacious treatments for anxiety symptoms for older adults living in LTC. METHODS: we searched five electronic databases (MEDLINE, Embase, PsycINFO, Cochrane Database of Systematic Reviews and Cochrane Central Register of Controlled Trials) to identify treatments for anxiety that have been trialled in LTC. Included studies had to be randomised trials, include residents of LTC, and measure anxiety symptoms as an outcome. RESULTS: the electronic search returned 6,617 articles, 519 were reviewed in full text, and 80 were included in the descriptive synthesis. Limited studies were meta-analysed (n = 10) due to differences in described treatment and comparator conditions. Limited clinically relevant evidence supporting the use of pharmacologic treatments for symptoms of anxiety in LTC was identified. Of the treatments trialled, music compared with usual care (standardised mean difference, SMD: -0.82; 95% confidence interval (CI): -1.31, -0.34), music compared with social interaction (SMD: -0.41; 95% CI: -0.72, -0.10) and massage compared with usual care (SMD: -4.32; 95% CI: -7.44, -1.19) were found to improve anxiety symptoms, however, significant heterogeneity was detected in two comparisons. CONCLUSIONS: a range of non-pharmacologic treatments that improved anxiety symptoms were identified for use in LTC. Although limited evidence exists to support the use of particular treatments, most non-pharmacologic treatments were low-risk interventions that may be readily implemented. Further research is required to assess the treatment effect on residents of LTC with anxiety disorders or clinically relevant symptoms at baseline.

Leashes, Litterboxes, and Lifelines: Exploring Volunteer-Based Pet Care Assistance Programs for Older Adults.

At the convergence of population aging and pet-ownership, community stakeholders are well-positioned to support older adults' relationships with companion animals through age-related transitions in health and living arrangements. In this study's setting, a volunteer-based pet care assistance program launched in 2017 to provide practical assistance with pet care for socially disadvantaged, community-dwelling older adults. This case study explored the impacts and feasibility of this and similar programs via (i) an Internet-based environmental scan to compare similar programs and (ii) qualitative interviews with a sampling of diverse community stakeholders (n = 9). A small number of comparable international programs (n = 16) were found. Among these, programs were delivered using a range of funding models; fewer than half involved collaborations across human social services and animal welfare sectors; and none addressed all dimensions of support offered by our local program. Analysis of qualitative interviews highlighted five major themes confirming the value of the volunteer-based approach and the importance of cross-sectoral collaborations in addressing older adults' under-recognized pet care-related needs. Taken together, the findings confirmed the effectiveness of our local program model. Collaborative, cross-sectoral programs that target both human and companion animal well-being hold promise to reduce barriers to pet ownership that many disadvantaged older adults face. This unique approach leverages the health-promoting potential of human-animal relationships in ways that enhance quality of life for individuals, animal welfare, and age-friendliness of communities.

How Do Non-Catastrophic Natural Disasters Impact Middle-Aged-to-Older Persons? Using Baseline Canadian Longitudinal Study on Aging Data to Explore Psychological Outcomes Associated with the 2013 Calgary Flood.

The objective of this study was to identify group-level health outcomes associated with the 2013 Calgary flood on Calgary participants (45-85 years of age) in the Canadian Longitudinal Study on Aging (CLSA). We compared baseline CLSA data collected on Calgary participants during the 6 months prior to and following the flood. Logistic regression models were created to explore whether select psychological outcomes were associated with the flood for participants categorized by evacuation status. Participants living in evacuated communities pre-flood had significantly lower levels of a diagnosed anxiety disorder than non-evacuated communities, which disappeared post-flood. Participants with higher household income were less likely to have post-traumatic stress disorder symptoms, worse self-rated mental health, and lower life satisfaction post-flood. Living alone reduced and female gender increased levels of perceived functional social support post-flood. Although natural disasters can shape research findings, the scope of the data being collected and the representativeness of impacted groups may challenge the ability to detect subtle impacts.

Experiences With Social Participation in Group Physical Activity Programs for Older Adults.

Little is known about how social participation can be facilitated among older adults in group physical activity and its psychosocial benefits that contribute to successful aging. This study aimed to understand older adults' experiences with social participation in group physical activity programs. Using interpretive description methodology, 16 observations, eight focus groups, and two interviews with participants unable to attend focus groups were conducted with adults 55 years and older attending programs across four recreation facilities. Group programs were found to influence social participation through (a) a meaningful context for connecting and (b) instructors' expectations of social interaction. Social participation in these programs addressed psychosocial needs by (c) increasing social contact and interaction, (d) fostering social relationships and belonging, and (e) promoting regular engagement. Training for instructors should include balancing the physical aspects of program delivery with the social, while also considering older adults' diverse needs and preferences for social interaction.

Examining the municipal-level representativeness of the Canadian Longitudinal Study on Aging (CLSA) cohort: an analysis using Calgary participant baseline data. / Examen de la représentativité à l'échelle municipale de la cohorte de l'Étude longitudinale canadienne sur le vieillissement (ELCV) : une analyse des données de référence des participants de Calgary.

INTRODUCTION: The Canadian Longitudinal Study on Aging (CLSA) is a rich, nationally representative population-based resource that can be used for multiple purposes. Although municipalities may wish to use CLSA data to address local policy needs, how well localized CLSA cohorts reflect municipal populations is unknown. Because Calgary, Alberta, is home to one of 11 CLSA data collection sites, our objective was to explore how well the Calgary CLSA sample represented the general Calgary population on select sociodemographic variables. METHODS: Baseline characteristics (i.e. sex, marital status, ethnicity, education, retirement status, income, immigration, internal migration) of CLSA participants who visited the Calgary data collection site between 2011 and 2015 were compared to analogous profiles derived from the 2011 National Household Survey (NHS) and 2016 Census datasets, which spanned the years when data were collected on the CLSA participants. RESULTS: Calgary CLSA participants were representative of the Calgary population for age, sex and Indigenous identity. Discrepancies of over 5% with the NHS and/or 2016 Census were found for marital status, measures of ethnic diversity (i.e. immigrant status, place of birth, non-official language spoken at home), internal migration, income, retirement status and education. CONCLUSION: Voluntary studies face challenges in recruiting fully representative cohorts. Communities opting to use CLSA data at a municipal level, including the 10 other CLSA data collection sites, should exercise caution when interpreting the results of these analyses, as CLSA participants may not be fully representative of the local population on select characteristics of interest.

Disruptive Solidarity or Solidarity Disrupted? A Dialogical Narrative Analysis of Economically Vulnerable Older Adults' Efforts to Age in Place with Pets.

Over one-third of older adults in many countries have a companion animal, and pets may harbor health-promoting potential. Few studies have considered pet-ownership in relation to economic vulnerability, and pet-ownership has not been often considered within policy efforts to promote ageing-in-place. We conducted a mixed methods case study to understand perspectives of both community agencies that support ageing-in-place and older adults themselves. A shortage of affordable, appropriate pet-friendly housing emerged as a challenge, even when framed as a legitimate choice and preference for many older adults. In this manuscript, we share the trajectories of three economically vulnerable older adults whose affordable housing needs became entangled with commitments to pets. Guided by dialogical narrative methodology, we offer each narrative as a short vignette to (i) illustrate the extent to which older adults will practice 'more-than-human solidarity' for a pet, even when their own well-being is compromised as a result; and (ii) highlight incongruence between the underlying moral values that shape solidaristic practices of individuals versus solidaristic arrangements that shape affordable housing opportunities. We suggest that housing rules and legislation that disrupt, rather than confirm, more-than-human solidarity may render older adults susceptible to, rather than protected from, deteriorating physical, mental and social well-being. We propose that collective solidaristic practices must reflect and subsume the moral complexity of solidarity practiced by individuals, to enable fair and equitable ageing-in-place.

Pets, Social Participation, and Aging-in-Place: Findings from the Canadian Longitudinal Study on Aging.

ABSTRACTThe objective of this study was to assess whether pet ownership contributes to social participation and life satisfaction for older adults. We used baseline data from the Canadian Longitudinal Study on Aging (CLSA) for this purpose, and logistic regression models to estimate associations between social participation and life satisfaction for pet owners and non-owners. One third of all older adults (≥ 65 years, n = 7,474) in our sample reported pet ownership. Pet owners were less likely than non-pet owners to report life satisfaction and to participate frequently in social, recreational, or cultural activities, but pet owners were no less satisfied than were non-owners with their current levels of social participation. For pet owners experiencing barriers to social participation, pets appeared protective of life satisfaction in some circumstances. Both individual characteristics and structural factors linked to the World Health Organization's age-friendly communities framework were relevant to understanding these findings.

Supportive neighbourhood built characteristics and dog-walking in Canadian adults.

OBJECTIVES: Our study objectives were to: 1) estimate differences in perceptions of the neighbourhood built environment among non-dog-owners, owners who walk their dogs (dog-walkers) and owners who do not walk their dogs (non-dog-walkers), and 2) estimate associations between perceptions of the neighbourhood built environment and dog-walking frequency. METHOD: A random cross-section of Calgary adults completed telephone interviews during August-October 2007 (n = 2,199, response rate = 33.6%) or January-April 2008 (n = 2,223, response rate = 36.7%). Telephone interviews and a follow-up questionnaire captured physical activity, health and sociodemographic characteristics, dog-ownership, and perceived built environment characteristics. Using ANOVA, we compared the perceived built environment among non-dog-owners, non-dog-walkers and dog-walkers. For dog-owners only, logistic regression estimated associations (odds ratios: OR) between dog-walking participation and perceived built environment. Among dog-walkers, logistic regression estimated associations between dog-walking ≥4 times/week and perceived built environment. Furthermore, among dog-walkers, linear regression estimated associations (unstandardized ß) between dog-walking frequency and perceived built environment. RESULTS: Compared with dog-walkers, non-dog-owners reported more positive perceptions of neighbourhood street connectivity, pedestrian infrastructure, and walkability (p < 0.05). Among dog-walkers, aesthetics was positively associated (p < 0.05) with the likelihood of walking the dog ≥4 times in a usual week (covariate-adjusted-OR = 1.67) and dog-walking frequency (covariate-adjusted-ß = 0.15). Among dog-walkers, walkability was also positively associated (p < 0.05) with dog-walking ≥4 times in a usual week (covariate-adjusted-OR = 1.03) and dog-walking frequency (covariate-adjusted-ß = 0.05). CONCLUSION: Perceptions of the neighbourhood built environment appear to differ between non-dog-owners and dog-owners. While built environment improvements may not encourage owners to initiate dog-walking, creating attractive and walkable neighbourhoods may support regular dog-walking among owners already walking their dogs.

Unleashing their potential: a critical realist scoping review of the influence of dogs on physical activity for dog-owners and non-owners.

BACKGROUND: Dog-owners tend to be more physically active than non-owners; however, dogs have also been shown to inhibit physical activity for non-owners, under some circumstances. METHODS: We conducted a scoping review to identify studies pertaining to the influence of dogs on physical activity for both dog-owners and non-owners, and adopted a critical realist orientation to draw inferences about the positive and negative impact of dogs via their affect on physical and social environments. RESULTS: We identified 35 studies from disparate literatures for review. These studies confirm that dog and owner behaviors affect shared physical and social environments in ways that may influence physical activity patterns, not only among dog-owners but also among non-owners. The direction of influence appears to be most positive in neighborhoods exhibiting high levels of social cohesion, socioeconomic status, perceived safety, dominant culture, or all of these. In disadvantaged neighborhoods, the health of women as well as older adults may be disproportionately affected by dog and owner behavior. CONCLUSIONS: While dogs have the potential to increase physical activity for both dog-owners and non-owners, the presence or absence of dogs will not have a standard effect across the physical and social environments of all neighborhoods. Dogs' contributions to shared environments in ways that support physical activity for all must be leveraged. Thus, specific contextual factors must be considered in relation to dogs when planning neighborhood-level interventions designed to support physical activity. We suggest this population health topic merits further investigation.

Characteristics of urban parks associated with park use and physical activity: a review of qualitative research.

Given that recent literature reviews on physical activity in urban parks deliberately excluded qualitative findings, we reviewed qualitative research on this topic informed by a published classification scheme based on quantitative research. Twenty-one studies met our inclusion criteria. These studies relied mainly on semi-structured interviews with individuals or in focus groups; only five studies involved in situ observation. Our synthesis aligns with previous quantitative research showing that attributes including safety, aesthetics, amenities, maintenance, and proximity are important for encouraging park use. Furthermore, our synthesis of qualitative research suggests that perceptions of the social environment entwine inextricably with perceptions of the physical environment. If so, physical attributes of parks as well as perceptions of these attributes (formed in relation to broader social contexts) may influence physical activity patterns. Both qualitative and quantitative methods provide useful information for interpreting such patterns, and in particular, when designing and assessing interventions intended to improve the amount and intensity of physical activity.