Challenges to Aging in Place: Understanding Home Maintenance Difficulties

Age-related declines in capabilities may compromise older adults’ ability to maintain their homes, threatening successful aging in place. Structured interviews were conducted with 44 independently living older adults (mean age = 76.1, standard deviation = 4.7) to discuss difficult home maintenance tasks and how they managed those tasks. Solutions to managing difficulties were categorized as person-related or environment-related. The majority (85%) of responses were person-related solutions. An understanding of the specific challenges that older adults face in maintaining their homes can guide redesign efforts and interventions to effectively support older adults’ desire to age in place.     

The Role of the Environment in Sedentary Behavior in Community-Dwelling Older Adults

To compare amounts of sedentary behavior and physical activity in adults residing in planned group residential settings to those residing in private homes, this study recruited 31 older adults who resided in planned group residential settings (n = 13) and in private homes (n = 18). Daily activities were measured using the SenseWear Armband for 7 days. Estimates of the duration of daily activities performed across sedentary, light, and moderate-to-vigorous intensities were captured. It was found that participants in planned group residential settings were older (age 85.9 ± 3.5 vs. 78.3 ± 7.2; p = 0.001) and spent more time in sedentary behaviors (12.7 ± 1.5 vs. 11.3 ± 1.6; p = 0.02) than participants in private homes. The difference was attenuated slightly after controlling for age and wear time (adjusted difference 1.2 ± 0.6 hours, p = 0.06). Thus, adults residing in planned group residential settings, which provide supportive services, were more sedentary than adults residing in private homes. The environment in which older adults live may contribute to sedentary behavior.     

Quality of life of older people in Israel: a comparison between older people living at home who are members of a ‘supportive community’ and nursing home residents

The supportive community is a program that was developed in Israel for older people who live at home. The program provides its members with a service package that includes medical and social services, emergency call-button, cultural activities, and a ‘community parent’ who is responsible for the members. Using quantitative method, this study compared the level of quality of life between 55 older people living in their homes who are members of a supportive community (average age = 74.7) and 60 elderly people living in nursing homes (average age = 75.8). As expected, results indicate that quality of life among the older people living at their homes who are members of a supportive community was higher than among the older people living in a nursing home. In addition, the quality of life of married, educated, functionally independent older people in good health and with a good economic situation was higher. Predictor variables of quality of life were: the place of residence, health status, and age. In light of increased life expectancy and the growing need to care for the older population, the practical application of the study focused on a recommendation for the social services to continue the support community development program.     

Leadership in physical activity groups for older adults: a qualitative analysis

The purpose of this study was to determine whether a theory-based framework could be used to deductively identify and understand the characteristics of motivational leaders of physical activity groups for older adults. Participants were 23 older adults (mean age = 78.5 +/- 8.0 years, 65% women). An interview-guide approach was employed to elicit older adults' thoughts on important characteristics of physical activity group leaders. The data suggested that effective leaders are those whom the participants feel are properly qualified, are able to develop a personal bond with participants, and can use their knowledge and the group to demonstrate collective accomplishments. It was concluded that the findings could be used to extend the leadership activities beyond the traditional technical performance and individual feedback to include activities of social integration. Furthermore, the conceptual framework identified can serve as a valuable tool in guiding future researchers in their examination of leadership in physical activity groups for older adults.     

Meaning of Home in Later Life as a Concept to Understand Older Adults’ Housing Needs: Results from the 7 Age-Friendly Cities Pilot Project in Québec

To support older adults’ desire to age in place, their housing needs must be well understood. However, little research has explored housing needs from older adults’ point of view. This article, based on the results of 49 focus groups (n = 392) and one case study from the Age-Friendly Cities Project in Québec, Canada, uses the concept of meaning of home in later life to explore older adults’ housing needs. An overview presents how older adults express meaning of home and what their needs are regarding housing and relocation. Finally, the implications for decision makers and stakeholders are discussed.     

Age Similarities in Interpersonal Perception and Conversation Ability

Older adults tend to perform worse on emotion perception tasks compared to younger adults. How this age difference relates to other interpersonal perception tasks and conversation ability remains an open question. In the present study, we assessed 32 younger and 30 older adults’ accuracy when perceiving (1) static facial expressions, (2) emotions, attitudes, and intentions from videos, (3) and interpersonal constructs (e.g., kinship). Participants’ conversation ability was rated by coders from a videotaped, dyadic problem-solving task. Younger adults were more accurate than older adults perceiving some but not all emotions. No age differences in accuracy were found on any perception task or in conversation ability. Some but not all of the interpersonal perception tasks were related. None of the perception tasks predicted conversation ability. Thus, although the literature suggests a robust age difference in emotion perception accuracy, this difference does not seem to transfer to other interpersonal perception tasks or interpersonal outcomes.     

Vulnerable African American Seniors: The Challenges of Aging in Place

American Community Survey data are used to develop typologies of the generational dynamics and living arrangements of the estimated 1.6 million African American older adult households who will likely encounter the most difficulty aging in place. Policy recommendations and strategies are offered to address the specific barriers and challenges that must be overcome in order for these older adults to successfully live out their lives in their homes and community.     

Synergistic effect of social support and self-efficacy on physical exercise in older adults

The purpose of the current study was to examine whether the effects of social support on physical exercise in older adults depend on individual perceptions of self-efficacy. Three hundred nine older German adults (age 65-85) were assessed at 3 points in time (3 months apart). In hierarchical-regression analyses, support received from friends and exercise self-efficacy were specified as predictors of exercise frequency while baseline exercise, sex, age, and physical functioning were controlled for. Besides main effects of self-efficacy and social support, an interaction between social support and self-efficacy emerged. People with low self-efficacy were less likely to be active in spite of having social support. People with low support were less likely to be active even if they were high in self-efficacy. This points to the importance of both social support and self-efficacy and implies that these resources could be targets of interventions to increase older adults' exercise.     

Sustainability Processes among Naturally Occurring Retirement Community Supportive Service Programs

ABSTRACT

Sustainability remains a concern for community models to better support older adults’ aging in place in their own homes and communities. Based on qualitative data from leaders of 53 Naturally Occurring Retirement Community (NORC) Supportive Service Programs, which is among the most prominent community practice models in aging, we aimed to develop an empirically-grounded framework on sustainability processes. Results indicated that programs use funding, staff members, interorganizational partnerships, and volunteers to offer services to attract older adults, and that older adults’ participation, in turn, is perceived as influencing the accrual of additional resources. Across themes, respondents discussed the importance of being responsive to the community and facilitating consumer participation.     

Barriers to exercise behavior among older adults: a focus-group study

Longer life expectancy, rapid population growth, and low exercise-participation rates of adults 65 and older justify the need for better understanding of older adults' exercise behavior. The objectives of this focus-group study were to determine barriers to the exercise behavior of older adults. Six focus groups, three with exercisers and three with nonexercisers, were conducted at various sites throughout Rhode Island. The majority (n = 57) of the 66 individuals who participated were women, and all stated that they were 65 and older. Results from the focus-group data identified 13 barriers to exercise behavior. The most significant barriers mentioned by nonexercisers were fear of falling, inertia, and negative affect. Exercisers identified inertia, time constraints, and physical ailments as being the most significant barriers to exercise. Implications from these focus-group data can be useful in the development of exercise interventions for older adults, which could increase exercise participation.     

A city within a city: A “snapshot” of aging in a HUD 202 in Detroit, Michigan

Because of a recent surge of aging in place literature, we know a considerable amount about how older adults wish to remain in long lived-in homes and communities. However, there are still gaps in our knowledge. What happens when older adults live in a community that does not support their everyday needs? This paper represents an initial attempt to explore how one group of poor, non-white, central city residents in Detroit, Michigan make sense of and organize a new age-segregated home. Findings presented in this article are based on 30 in depth and photographic elicitation interviews with African American, low-income, older adults living in one Housing and Urban Development 202 (HUD 202). Findings suggest that participants in this sample cultivated a new urban space within the facility to compensate for the deficiencies of a deteriorated inner-city neighborhood. I use these findings to encourage broader conceptualizations and consideration for the aging in place model to be more inclusive to the lived experiences of older adults who occupy oppressed places.     

Family Members' Reports of Abuse in Michigan Nursing Homes

The objective of this article is to describe abuse and neglect of adults age 65 and older in Michigan nursing homes, as reported by members of their families. Using list-assisted random-digit dialing, data on abuse and neglect for a 12-month period were collected from individuals who had a relative age 65 or older in a Michigan nursing home. Of the nursing home residents represented in this analysis, the majority were female, Caucasian, and widowed. Neglect and caretaking mistreatment were the most frequent types of abuse reported. Comparison of these data with data from the National Ombudsman Reporting System suggests that family members constitute a sensitive source of data on abuse in nursing homes.     

Computer acceptance of older adults

Even though computers play a massive role in everyday life of modern societies, older adults, and especially older women, are less likely to use a computer, and they perform fewer activities on it than younger adults. To get a better understanding of the factors affecting older adults' intention towards and usage of computers, the Unified Theory of Acceptance and Usage of Technology (UTAUT) was applied as part of a more extensive study with 52 users and non-users of computers, ranging in age from 50 to 90 years. The model covers various aspects of computer usage in old age via four key constructs, namely performance expectancy, effort expectancy, social influences, and facilitating conditions, as well as the variables gender, age, experience, and voluntariness it. Interestingly, next to performance expectancy, facilitating conditions showed the strongest correlation with use as well as with intention. Effort expectancy showed no significant correlation with the intention of older adults to use a computer.     

Older adults' exercise behavior: roles of selected constructs of social-cognitive theory

Exercise is consistently related to physical and psychological health benefits in older adults. Bandura's social-cognitive theory (SCT) is one theoretical perspective on understanding and predicting exercise behavior. Thus, the authors examined whether three SCT variables-self-efficacy, self-regulation, and outcome-expectancy value-predicted older adults' (N = 98) exercise behavior. Bivariate analyses revealed that regular exercise was associated with being male, White, and married; having higher income, education, and self-efficacy; using self-regulation skills; and having favorable outcome-expectancy values (p < .05). In a simultaneous multivariate model, however, self-regulation (p = .0097) was the only variable independently associated with regular exercise. Thus, exercise interventions targeting older adults should include components aimed at increasing the use of self-regulation strategies.     

Testing the efficacy of the theory of planned behavior to explain strength training in older adults

The purpose of this study was to use the constructs of the theory of planned behavior (TPB) to gain a better understanding of the factors influencing older adults' participation in strength training. Two hundred men and women age 55 years and older were purposely sampled from seniors' centers in Ontario Canada. Participants completed a TPB questionnaire and reported their current physical activity participation. It was hypothesized that perceived behavioral control followed by attitude would be the strongest determinants of strength-training intentions and that intention would be the strongest determinant of strength-training behavior. Regression analyses revealed that subjective norm and perceived behavioral control explained 42% of the variance in intention and intention explained 40% of the variance in behavior. Gender and current strength-training participation did not significantly moderate the relationship between the TPB variables. The results suggest that interventions targeting subjective norm and perceived control might be helpful in promoting strength-training behavior among older adults.     

Meeting communication needs: topics of talk in the nursing home

Nursing home residents primarily rely on staff for communication and interpersonal relationships. Challenged by staffing shortages and increasingly complex care, staff who provide the most communication with residents lack awareness and skills to effectively communicate with older adults. This study, a secondary analysis of staff-resident interactions from one nursing home, explores communication topics and the effects of an intervention. Staff from one unit were recorded during 2 hours of caregiving to provide a representative sample of their communication with residents. Staff then attended an educational program targeting improved awareness of communication needs and reducing "elderspeak". Recording was repeated post-intervention. Baseline conversations focused on activities of daily living (ADLs), personal-social, technical care, and health assessment. Post-intervention ADL talk decreased in staff-resident interactions, while personal-social topics increased. These findings suggest that residents' limited opportunities for communication with staff are primarily focused on care tasks. With increased communication awareness, staff can learn to modify conversational topics to better meet older adults' psychosocial needs.     

Environmental Evaluations and Modifications to Support Aging at Home With a Developmental Disability

ABSTRACT

Increasing numbers of people with developmental disabilities are living into old age and are now residing in community-based housing, largely due to the deinstitutionalization movement. The overlay of age-related impairments onto pre-existing, lifelong disabilities puts this population at a magnified risk for premature behavioral limitations and loss of independence. This article describes a demonstration project designed to enable people with developmental disabilities to age in place. Interviews and observational assessments with 45 older adults with developmental disabilities were conducted in their community-based homes to identify potential barriers to aging in place. An Individualized Environmental Intervention Plan was developed for each study participant, recommending ways to solve problems and eliminate potential barriers. Individualized Environmental Intervention Plans were implemented to the extent possible through home modifications and assistive technology. Pre- and post-modification task performance and self-report revealed the positive impact that home modifications and assistive technology can have. The study demonstrates the need for ongoing evaluation and assessment sensitive to the needs of people with developmental disabilities and the unique characteristics of supported living settings.     

Motivational factors and physician advice for physical activity in older urban adults

This study aimed to ascertain by means of a new scale older adults' motives for engaging in physical activity, in a probability and representative sample of an older urban population. The sample size was 630 older adults, ranging from 65 to 94 years in age, randomly selected using multistage sampling. The participants completed a 17-item questionnaire, as well as answering questions on demographic variables, type of demand for physical activity, and physician's recommendation. A principal-component analysis was performed. The relationships among the four factors (physical health, social relationships, competence, and physician's advice) show a clearly motivational structure. Significant relationships have also been found between physician's recommendation and type of demand. The findings suggest that programs promoting physical activity in older adults should have different characteristics from those aimed at general adult populations.     

Aging and the Effects of Facial and Prosodic Cues on Emotional Intensity Ratings and Memory Reconstructions

Young (M = 23 years) and older (M = 77 years) adults' interpretation and memory for the emotional content of spoken discourse was examined in an experiment using short, videotaped scenes of two young actresses talking to each other about emotionally-laden events. Emotional nonverbal information (prosody or facial expressions) was conveyed at the end of each scene at low, medium, and high intensities. Nonverbal information indicating anger, happiness, or fear, conflicted with the verbal information. Older adults' ability to differentiate levels of emotional intensity was not as strong (for happiness and anger) compared to younger adults. An incidental memory task revealed that older adults, more often than younger adults, reconstruct what people state verbally to coincide with the meaning of the nonverbal content, if the nonverbal content is conveyed through facial expressions. A second experiment with older participants showed that the high level of memory reconstructions favoring the nonverbal interpretation was maintained when the ages of the participants and actresses were matched, and when the nonverbal content was conveyed both through prosody and facial expressions.