Nonkin Carers' Roles and Contributions to the Support of Older People Living Alone: An Analysis of Qualitative Data.

OBJECTIVES: In the Global North, the number of older people living alone who have little or no support from family members is increasing. However, little is known about older people living alone who have basic needs for support but do not have kin living nearby or a sustainable relationship to a relative they can rely on. Thus, this paper focuses on the role of nonkin carers and their contribution to the support arrangements of older people living alone. METHODS: We conducted semistructured interviews with 32 older people living alone aged between 67 and 99 (Ø 84.2 years) in Austria, 23 women, and 9 men. The interviews were analyzed by applying a coding strategy based on grounded theory. In addition, sociograms were created to illustrate relevant relations in each support arrangement. RESULTS: We identified and characterized 3 groups of nonkins involved in the support arrangements of older people living alone based on the origins of the relationships: (1) friends, (2) neighbors, and (3) acquaintances like members of various communities. The arrangements were classified according to the amount and quality of involvement of nonkin carers, namely manifold, scattered, and little nonkin involvement. DISCUSSION: Our study highlights the diversity of nonkin support in the support arrangements of older people living alone. This heterogeneity should be considered by policy-makers when promoting informal care and designing policy measures.

Under Reconstruction: The Impact of COVID-19 Policies on the Lives and Support Networks of Older People Living Alone.

The Austrian government introduced in spring 2020 COVID-19 containment policies that had various impacts on older people living alone (OPLA) and their care arrangements. Seven qualitative telephone interviews with OPLA were conducted to explore how they were affected by these policies. The findings show that the management of everyday life and support was challenging for OPLA even though they did not perceive the pandemic as a threat. To better address the needs of OPLA, it would be important to actively negotiate single measures in the area of conflict between protection, safety and assurance of autonomy.

Developing dementia-friendly pharmacies in Austria: a health promotion approach.

The need for integrated, accessible and person-centred care for people with dementia to foster quality of life and facilitate life in the community has been voiced by health policy. Pharmacies have the potential to provide easily accessible information and support for people with dementia, caregivers and the public. The 'Dementia-friendly Pharmacy' programme aimed at re-orienting community pharmacy in Austria, focusing on stronger inclusion of professional counselling into core services. It followed principles of health promotion and person-centred care, aiming at empowering all actors involved, and at fostering quality of life. Methodologically, the programme was based on participatory health research, thus involving all relevant actors and consolidating their perspectives on issues related to dementia care. In the course of the programme, a workshop series covering topics relevant for dementia care in community pharmacy, as well as prototypes for small-scale projects were developed, and measures were taken for securing sustainability. Findings related to programme development and implementation encompass pharmacy staff's motivation to participate in the programme, counselling knowledge and skills development, experience with building community partnerships and cross-organizational development and sustainability. Furthermore, effectiveness of the programme has been established. These findings are discussed against the background of re-orienting pharmacies.

Challenges and strategies in communication with people with dementia and their informal caregivers in community pharmacies - a narrative approach.

BACKGROUND: People with dementia and their informal caregivers get in touch with the healthcare system predominantly via contacts with primary care providers. Among these, community pharmacists have been denominated as the health professionals most accessible to the public. Communication with and counselling people with dementia and their informal caregivers present particular challenges to pharmacists. AIM: This study aims to research the challenges faced and strategies used by community pharmacists who deal with people living with dementia and their informal caregivers. METHODS: Within the context of two workshops with 74 participants, 15 small groups were formed, each of which generated and discussed a small story. Fourteen of those narratives were reported, tape recorded and transcribed. In these 14 narratives, community pharmacists reflected on their experiences with people with dementia or their informal caregivers. The narratives were systematically analysed and interpreted. FINDINGS: Among the main challenges reported by the workshop participants are the difficulty of identifying a person with dementia; the question of what appropriate communication is; the only partially successful networking with doctors, nursing personnel and support institutions; unsuccessful counselling; and the tension between the economic situation and the care for people with dementia and their informal caregivers. In general, strategies for dealing with people with dementia are characterised by uncertainty whereas communication with informal caregivers is well rehearsed and effective. CONCLUSIONS: Community pharmacies require possibilities to retreat for counselling as well as the possibility for pharmacists to take time for people with dementia and their informal caregivers in everyday pharmacy life. Reflective spaces for narrations about difficult situations provide relief for staff in community pharmacies.

["Doing gender" in a nursing home for the elderly : Perspectives of staff and management]. / "Doing Gender" im Altenpflegeheim : Perspektiven von Mitarbeitenden und Führungskräften.

BACKGROUND: "Doing gender" plays an important role in nursing interactions in long-term care settings. AIM: The aim of this article is to focus on the experiences of staff and management in a long-term care setting on the social categorization of gender and to reflect and discuss these findings against already existing research. MATERIAL AND METHODS: Within a qualitative study, one to one interviews and group discussions with a total of 28 participants were conducted. RESULTS AND CONCLUSION: The results show how "doing gender" as a social practice effects interactions with residents, within the working team and in the context of management and hierarchy in the long-term care setting. In interactions with residents, gender-specific behavior can be observed. Within the working team gender-specific differences with respect to division of labor and working hours are reported. Concerning management and hierarchy it can be observed that male executives react more strongly in correspondence with the expectations of their gender role whereas female executives show more discrepancies between the expectations towards their position and gender role.

Organic Acid Excretion in Penicillium ochrochloron Increases with Ambient pH.

Despite being of high biotechnological relevance, many aspects of organic acid excretion in filamentous fungi like the influence of ambient pH are still insufficiently understood. While the excretion of an individual organic acid may peak at a certain pH value, the few available studies investigating a broader range of organic acids indicate that total organic acid excretion rises with increasing external pH. We hypothesized that this phenomenon might be a general response of filamentous fungi to increased ambient pH. If this is the case, the observation should be widely independent of the organism, growth conditions, or experimental design and might therefore be a crucial key point in understanding the function and mechanisms of organic acid excretion in filamentous fungi. In this study we explored this hypothesis using ammonium-limited chemostat cultivations (pH 2-7), and ammonium or phosphate-limited bioreactor batch cultivations (pH 5 and 7). Two strains of Penicillium ochrochloron were investigated differing in the spectrum of excreted organic acids. Confirming our hypothesis, the main result demonstrated that organic acid excretion in P. ochrochloron was enhanced at high external pH levels compared to low pH levels independent of the tested strain, nutrient limitation, and cultivation method. We discuss these findings against the background of three hypotheses explaining organic acid excretion in filamentous fungi, i.e., overflow metabolism, charge balance, and aggressive acidification hypothesis.