Working with Older People

Richardson, Heather; Payne, Angela; Richardson, Emily; Oo, Myint; Weir, Mandy; Byrne, Amy-Louise; Le Lagadec, Danielle; Hayman, Melanie

doi: 10.1108/wwop-09-2024-0060pmid: N/A

Residential Medication Management Reviews (RMMR) are a key component of safe, high-quality aged care service delivery. The RMMR is an interdisciplinary approach to medication management that relies on collaboration, communication and integration of systems. Acting as an improvement opportunity, the purpose of this paper is to present findings from a regional study, aimed at assessing the impact of RMMR on falls and hospital admissions and identifies barriers to impactful research in this area.Design/methodology/approachA three-year retrospective quantitative longitudinal practice audit was conducted in a regional state-managed high-care residential facility in Queensland, Australia. Data was collected pre-RMMR and six months post-RMMR.FindingsThe data collected was insufficient to achieve statistical significance or demonstrate the impact of RMMR on health outcomes. Factors impeding the research included limited ability to collect the data due to the lack of integration of information systems and limited stakeholder engagement resulting in poor recruitment. This highlights the need for improvement in RMMR processes and practices, and indeed wider research collaboration in the aged care sector.Research limitations/implicationsThís paper acts as a call to action to improve research and interprofessional collaboration in Australian aged care.Originality/valueThe aged care industry needs high-quality research to drive practice improvement and collaborative care and service delivery. This paper advocates for improvements in the aged care sector with respect to research engagement and communication pathways between service providers. Advancement in systems integration for information sharing, recruitment of participants and stakeholder engagement will support evidence-based practice and process change.

Chari, Damodar; Sawhney, Ina; Mukaetova-Ladinska, Elizabeta; Beishon, Lucy; Subramaniam, Hari

doi: 10.1108/wwop-06-2024-0031pmid: N/A

This study aims to establish if risk factors for venous thromboembolism (VTE) in older hospitalized psychiatric patients differ from geriatric inpatients and if the current risk assessment tools being used are suitable.Design/methodology/approachThe authors undertook a single centre retrospective review of 75 records for presence of predetermined risk factors. In total, 55 discharged patients with thrombotic events within geriatric settings were compared with 20 from mental health settings. Differences in risk factors were determined using t-test and Fisher’s exact test.FindingsVTE patients in geriatric units were older and had reduced mobility. Psychiatric patients were more likely to be dehydrated and treated with psychotropics. Whilst rates of VTE screening were comparable in both settings, geriatric inpatients were more frequently prescribed thromboprophylaxis.Research limitations/implicationsOlder psychiatric inpatients differ from those in medical/surgical settings in their profiles and risk factors for VTE. Approaches for VTE risk management also differed.Practical implicationsThe study suggests the need for VTE screening tools and treatment protocols specific to older psychiatric settings.Social implicationsTargeted approaches may improve outcomes specific to each group.Originality/valueTo the best of the authors’ knowledge, this is the first attempt in comparing VTE risk factors across acute physical health care and mental health settings.

Alhroub, Nisser; Al-Sarairhe, Ishraq; Alkhawaldeh, Abdullah; ALBashtawy, Mohammed; Al Omari, Omar; Salameh, Basma; Batran, Ahmad; Ayed, Ahmad; Ababneh, Anas; Abdalrahim, Asem; ALBashtawy, Zaid

doi: 10.1108/wwop-04-2024-0019

Abdalrahim, Asem

doi: 10.1108/wwop-11-2024-0080pmid: N/A

This study aims to validate and adapt the Health-Related Quality of Life (HRQoL) scale for use among elderly patients in Arabic-speaking care homes.Design/methodology/approachA total of 210 participants completed the Arabic-translated HRQoL scale to assess its reliability, validity and cultural adaptation. Internal consistency, test–retest reliability, exploratory factor analysis and content validity were examined.FindingsResults demonstrated high internal consistency (Cronbach’s alpha = 0.85–0.90), robust test–retest reliability (intraclass correlation coefficient = 0.91) and strong construct validityOriginality/valueThis study provides a culturally adapted and psychometrically validated HRQoL scale tailored for Arabic-speaking elderly care home residents. It addresses a significant gap in the availability of reliable tools to assess HRQoL in this population. By ensuring linguistic and cultural relevance, this study offers a robust instrument for evaluating quality of life, guiding interventions and improving care practices. The findings contribute to advancing evidence-based geriatric care in Arabic-speaking contexts, with implications for broader application in similar cultural settings. This work supports efforts to enhance the well-being and dignity of elderly individuals in care homes.

Abdalrahim, Asem

doi: 10.1108/wwop-11-2024-0078pmid: N/A

This study aims to explore the feasibility and acceptability of digital reminiscence therapy (RT) using touchscreen technology for people with dementia (PwD) in Jordanian care homes.Design/methodology/approachSemi-structured interviews were conducted with 14 residents and 7 care home staff.FindingsThematic analysis revealed four key themes: ease of use, supportive environment, engaging content and perceived positive impacts on quality of life (QoL). Participants highlighted enhanced communication, improved cognitive abilities and psychological well-being as primary benefits.Research limitations/implicationsThese findings underscore the potential of digital RT to improve dementia care while adapting interventions to sociocultural contexts.Originality/valueThis study offers original insights into the feasibility and acceptability of digital RT in a Middle Eastern context, focusing on PwD in Jordanian care homes. By addressing the unique cultural and resource limitations of low- and middle-income countries, the study highlights the potential of culturally adapted, technology-enabled interventions to enhance QoL, communication and emotional well-being for PwD. The findings provide valuable guidance for practitioners and policymakers on integrating digital RT into dementia care practices, making a significant contribution to the global discourse on innovative, non-pharmacological approaches for older populations.

Chong Espino, Yamisel; Sampaio, Daniel; Cardoso, Susana

doi: 10.1108/wwop-12-2024-0083pmid: N/A

This study aims to analyze the psychological benefits of digital and paper-based cognitive training in users with a lack of technological knowledge and a low level of education.Design/methodology/approachIn total, 60 individuals (Mage = 78.38; SDage = 9.15) attending a day center were recruited to complete a cognitive training program, 30 of them in digital format. They were all assessed on cognitive skills, technological knowledge and depressive symptomatology before and after the training. Regardless of age, education and technological knowledge, all participants completed the respective cognitive training program.FindingsThe results of this study indicate that it is feasible to use both digital and paper-based tasks in cognitive training for individuals aged over 60, with low levels of education and digital literacy. Although different, in both cases it will be possible to obtain cognitive benefits.Research limitations/implicationsCognitive training with digital or paper-based material can facilitate visual mnesic processing. Both visual and verbal skills can be trained through other non-digital materials.Originality/valueThis study contributes to understanding the benefits of both types of materials used in working with older people.

Guerra, Sara; Tavares, João; Casado, Tatiana; Sousa, Liliana

doi: 10.1108/wwop-07-2024-0044pmid: N/A

Maria (pseudonym) is a transgender woman born and raised in Portugal during the Estado Novo, a repressive regime that harshly discriminated against LGBTQIA+ people. Maria is currently 65 years old and started her transition in her early 50 s. This study aims to examine Maria’s life trajectory and how she accomplished her (late) coming out and (happy) transition.Design/methodology/approachThe authors adopted McAdams’ (1985) methodology for analyzing life stories, which divides a person’s life into chapters.FindingsMaria identified four chapters in her life trajectory: (a) “‘Who am I?’ A childhood and adolescence of secrecy and self-doubt”; (b) “Finding comfort in conforming to cis/heteronormativity”; (c) “Coming out: A sense of relief and authenticity”; and (d) “‘Finally being who I am’—a woman respected and satisfied with life.” Maria’s awareness of her “finite lifespan” and “time left” influenced her coming out and transition. Her constraints earlier in life heightened the significance and immediacy of time horizons and the opportunity to experience an authentic gender identity before she dies.Originality/valueThis study uniquely highlights age as a privilege in the transgender transition process, showing how awareness of a finite lifespan can drive late-life coming out and transition. Maria’s story challenges traditional aging narratives, demonstrating resilience and the potential for finding meaning and purpose, despite lifelong adversity.

Burton, Amy E.; Sale, Olivia; Higton, Rebecca; Buckley, Emily J.; Taylor, Jennifer

doi: 10.1108/wwop-10-2024-0064pmid: N/A

The purpose of this paper is to report on two research studies that explored how older adult residents in assisted living facilities in the United Kingdom (UK) experienced changes to their social activity and well-being during the Covid-19 pandemic restrictions.Design/methodology/approachA qualitative design was used and combined interview data from 13 residents across five assisted living facilities in the UK. Data were analysed using reflexive thematic analysis.FindingsFour themes were developed. The first theme “being locked in” explores the reduction in social contact and feelings of imprisonment experienced by assisted living residents. The second theme “keeping everyone safe” discusses the ways in which isolation was rationalised by older adults through drawing on narratives around safety and protection of others. The third theme “finding new ways to connect” illustrates how learning new skills enabled assisted living residents to maintain connections with others and highlights the novel opportunities for connection presented by communal living. The final theme “keeping a positive outlook” underlines how positive thinking and hope for the future enabled residents to cope with isolation.Originality/valueThe findings from this study present a novel insight into the experience of assisted living residents during Covid-19 restrictions. While it is known that isolation during lockdowns had negative well-being implications for community-dwelling older adults, this study highlights some of the ways that communal living was protective for assisted living resident well-being.

Straughair, Collette; Hodgson, Philip; Gates, Jessica; Johnson, Amy; Pryor, Claire; Cook, Glenda

doi: 10.1108/wwop-11-2024-0077pmid: N/A

Evidence-based hydration care for older people is essential to health and wellbeing. However, practices vary, leading to negative outcomes for older people, particularly in relation to increased incidence of morbidity and mortality. As a discrete work package situated within a larger study to enhance hydration care for older people in care homes, the purpose of this part of the study was to develop a hydration competency framework to support an evidence-based approach to practice.Design/methodology/approachAn overview of the literature informing hydration care was undertaken to establish best practice, resulting in the generation of a series of competency statements. Using a co-production approach, these statements were reviewed and assimilated into a hydration competency framework that was piloted across two care home sites. Revision and refinement of the framework was undertaken in response to feedback from the co-production group, until consensus was reached to agree the final iteration.FindingsThe hydration competency framework has three core domains relating to: understanding the individual daily hydration requirements of older people; assessing the individual daily hydration requirements of older people; implementing person-centred care to maintain and monitor the daily hydration requirement needs of older people. Each domain is comprised of competency statements that reflect the current evidence base informing best practice for hydration care for older people.Originality/valueThe hydration competency framework provides an innovative tool that can be used to support care home staff to deliver evidence-based hydration practices and positively enhance care outcomes for older people.