Cohousing communities and social determinants of health in later life: a scoping review protocol.

OBJECTIVE: The objective of this scoping review is to chart the extent and type of literature available worldwide on cohousing communities and older adults' social determinants of health, to identify and categorize key evidence on this topic, and to highlight gaps to guide further research. INTRODUCTION: The rapidly aging population in many industrialized countries has precipitated the development of housing alternatives, such as cohousing communities, to better address older adults' housing and social needs. There is mounting evidence that living in a cohousing community has many positive outcomes for this population; however, the scope and size of this body of research are unknown. INCLUSION CRITERIA: This review will assess studies conducted in all countries and territories focusing on people aged 60 and older living in cohousing communities. It will include quantitative, qualitative, and mixed method studies published from 1960 to 2022. METHODS: The databases to be searched are APA PsycArticles (EBSCO), Cairn.info, Campbell Collaboration, CINAHL (EBSCO), Érudit, Google Scholar, JBI, PubMed, SAGE Journals Online, Scopus, Science Direct (Elsevier), Sociological Abstracts (ProQuest), and ProQuest Dissertations and Theses Global (ProQuest). Two independent reviewers will review the titles and abstracts of potential studies against the inclusion criteria for the review followed by an assessment of the full text of selected citations. Data will then be extracted using a data extraction tool developed by the reviewers. The findings will be presented graphically and include tables with a narrative summary organized by relevant geographic areas.

Dignity in Older Adults With Schizophrenia Residing in Assisted Living Facilities.

There is a lack of nursing literature on older adults' perceptions of dignity, specifically those of older adults with schizophrenia. With the aging population, mental health services and support for older adults with schizophrenia will become a greater priority. The purpose of the current descriptive phenomenological study was to describe the meaning of the lived experience of dignity for older adults with schizophrenia residing in assisted living facilities. A purposive sample of eight older adults with schizophrenia residing in assisted living facilities participated in semi-structured interviews following the descriptive phenomenological psychological method. Five intertwined constituents were identified: (1) dignity is an intrinsic or self-regarding experience; (2) dignity is an experience that is reciprocal, extrinsic, and regards others, and is embedded in social relationships; (3) dignity can be eroded by ageism, stigma, discrimination, and alienation; (4) dignity can be interrupted when positive and negative symptoms of schizophrenia are present and misunderstood by others; and (5) dignity can be enhanced when oneself and others embrace a recovery-focused relationship. Implications for mental health nursing are provided. [Journal of Psychosocial Nursing and Mental Health Services, 56(2), 20-28.].

Insights Into Roles for Health-Care Professionals in Meeting the Needs of Older Adults and Unpaid Caregivers During Health-Care Transitions.

We provided insights from older adults, their unpaid caregivers, and health-care professionals into specific roles for professionals within the health system to better meet the needs of community-dwelling older adults and their unpaid caregivers experiencing transitions between health services. We used a qualitative approach to collect data within one Canadian province from older adults and unpaid caregivers of older adults who participated in focus groups ( n = 98) and professionals working in the health system who participated in an online survey ( n = 52). Questions included experiences with health service transitions, strengths, challenges, and suggestions to improve transitions. Thematic analysis resulted in identifying seven specific roles for professionals in supporting health-care transitions: information and education, planning for future health needs, supporting the acceptance of necessary care, facilitating access to the right services at the right time, facilitating communication between services, facilitating the discharge planning process and advocacy for older adults and unpaid caregivers. Our results based on evidence from older adults, unpaid caregivers, and health-care professionals will inform future research and further development of the instrumental and relational roles for professionals supporting older adults and their caregivers experiencing health-care transitions.

Achieving Excellence Through Contemporary and Relevant Psychiatric-Mental Health Nursing Standards of Practice.

Standards of practice (SOPs) comprise competency statements, which are grounded in current knowledge and research, and provide foundations for performance that support professional accountability. The nursing profession, and specifically the psychiatric-mental health specialty of nursing practice in Canada, develops and revises practice standards regularly. The current article describes the collaborative, evidence-informed journey of the Canadian Federation of Mental Health Nurses during its fourth revision of the Canadian Psychiatric-Mental Health Nursing SOPs. An intraprofessional team of psychiatric-mental health nurses from the clinical, academic, research, and policy areas developed and nurtured collaborative processes that emphasize collegial and authentic relationships. Effective communication and a respectful learning environment supported the process for all members of the team. The current article provides recommendations for other professional organizations considering developing and/or revising SOPs.

Interprofessional collaboration-in-practice: the contested place of ethics.

The main question examined is: How do nurses and other healthcare professionals ensure ethical interprofessional collaboration-in-practice as an everyday practice actuality? Ethical interprofessional collaboration becomes especially relevant and necessary when interprofessional practice decisions are contested. To illustrate, two healthcare scenarios are analyzed through three ethics lenses. Biomedical ethics, relational ethics, and virtue ethics provide different ways of knowing how to be ethical and to act ethically as healthcare professionals. Biomedical ethics focuses on situated, reflective, and nonabsolute principled justification, all things considered; relational ethics on intersubjective, professional, and institutional relations; and virtue ethics on prephilosophical tradition and what it means to be good and to be human embedded in social and political community. Analysis suggests that interprofessional collaboration-in-practice may be more rhetoric than actuality. Key challenges of interprofessional collaboration-in-practice and specific conditions perpetuating dissension and conflict are outlined with specific education and policy recommendations included.

Age and gender differences in emotional and informational social support insufficiency for older adults in Atlantic Canada.

It is well documented that nursing is concerned about the social support needs of older adults and the effects of those needs on health and well-being. Using survey data from the Atlantic Seniors Housing Research Alliance, the authors explore the emotional and informational social support needs of community-dwelling Canadians aged 65 and older living in the Atlantic provinces. The results indicate that these needs are not being met fully and that they increase with age. Also, men and women report different insufficiencies for specific needs; more men than women report having no support across all items. Nurses should be sensitive to specific age and gender support needs of older adults. They should also increase their social assessments and promote healthy social networks, especially for those 80 years and older. Further nursing research is recommended.

End-of-life healthcare decision-making: the intermediary role of the ethicist in supporting family caregivers and health professionals.

OBJECTIVE: Family support in end-of-life decision-making is critical, yet this issue receives little attention. The purpose of this research is to provide insight into how the clinical ethicist can effectively support family caregivers when making end-of-life healthcare decisions. It further suggests how the clinical ethicist can provide support to other healthcare professionals who work with family caregivers in making end-of-life healthcare decisions. PARTICIPANTS AND METHODS: Using a grounded theory approach, a theoretical sampling of 20 family caregivers previously involved in end-of-life decision-making were interviewed. Semi-structured in-depth interviews were audiotaped, and transcribed. RESULTS: Interviews were analyzed using a constant comparative approach. The analysis resulted in the identification of three categories related to the experience of decision-making: the impact of healthcare decision-making on individual and family well-being, the effectiveness of healthcare professionals in supporting families, and the role of the ethicist. CONCLUSIONS: The results demonstrated the challenges that family members encounter when faced with end-of-life decision-making. The participants identified the importance of having access to a clinical ethicist who, with objectivity and specific training, can better meet the needs of family caregivers and improve the process of decision-making at the end-of-life.