Digital communication between a patient and their clinician offers the potential for improved patient care, particularly for young people with long term conditions who are at risk of service disengagement. However, its use raises a number of ethical questions which have not been explored in empirical studies. The objective of this study was to examine, from the patient and clinician perspective, the ethical implications of the use of digital clinical communication in the context of young people living with long-term conditions. (...) A total of 129 semi-structured interviews, 59 with young people and 70 with healthcare professionals, from 20 United Kingdom -based specialist clinics were conducted as part of the LYNC study. Transcripts from five sites were read by a core team to identify explicit and implicit ethical issues and develop descriptive ethical codes. Our subsequent thematic analysis was developed iteratively with reference to professional and ethical norms. Clinician participants saw digital clinical communication as potentially increasing patient empowerment and autonomy; improving trust between patient and healthcare professional; and reducing harm because of rapid access to clinical advice. However, they also described ethical challenges, including: difficulty with defining and maintaining boundaries of confidentiality; uncertainty regarding the level of consent required; and blurring of the limits of a clinician’s duty of care when unlimited access is possible. Paradoxically, the use of digital clinical communication can create dependence rather than promote autonomy in some patients. Patient participants varied in their understanding of, and concern about, confidentiality in the context of digital communication. An overarching theme emerging from the data was a shifting of the boundaries of the patient-clinician relationship and the professional duty of care in the context of use of clinical digital communication. The ethical implications of clinical digital communication are complex and go beyond concerns about confidentiality and consent. Any development of this form of communication should consider its impact on the patient-clinician-relationship, and include appropriate safeguards to ensure that professional ethical obligations are adhered to. (shrink)

Abstract The infantilization of older adults seems morally deplorable whereas very young children are appropriate recipients of such treatment. Children, we argue, are not mentally capable of acting autonomously and reasoning clearly. However, we have difficulty reconciling this justification with the fact that many of the elders whom we respect are mentally deficient in those very same ways. In this paper, I try to make sense of this asymmetry between our justifications for infantilizing the young and our conviction that our (...) elders ought to be respected. I argue that our intuitions against adult infantilization are non-consequentialist (i.e., deontic). I consider several candidates for the deontic factor that might explain the asymmetry of our judgments and practices. I argue that a very specific kind of dignity (one that is socially constructed and reified) grounds our disparate judgments and treatments of very young and very old persons with similar needs. (shrink)

After four decades of China’s family planning policy, the shrinking family size and increasing life expectancy pose special challenges for the one-child generation in terms of providing care for aging parents. The current study explored young adults’ responses to such pressure by examining their concerns about elder care, attitudes toward nursing homes, and living arrangement after marriage in a sample of 473 Chinese working young adults from six cities in China. Results showed that although most of the young adults reported (...) to have thought about the issue of parents’ elder care, the majority did not worry a lot about it. Only children expressed similar levels of worrying as those with siblings did. However, educational level, rather than sibling status, was systematically related to concerns about parents’ elder care and attitudes toward nursing homes. People with higher education tended to worry less about elder care, and were less likely to consider placing parents in nursing homes as a violation of filial piety. Analyses of the married sub-sample revealed that only children were more likely to co-reside with parents after marriage than those with siblings. And the main reason for co-residence was that the younger generation needed their parents’ help for childcare, rather than to better take care of their parents. Implications for parents’ elder care among Chinese only children were discussed. (shrink)

Technological advances in the information and knowledge society have influenced and transformed economic, social and educational dynamics. Currently there are many digital gaps related to the access to technology, lack of digital literacy and social use. These gaps vary based on the population ages and become more notorious in elders. This digital illiteracy is making all technological developments of the XXI Century to be underused, not making possible to take advantage of all the possibilities that they offer to our society, (...) in this case, to Colombia. This study aims at analyzing the penetration level and use of handheld digital devices, especially the cellular phone, in adult population, based on the 2016 national survey of life quality in Colombia, elaborated by Departamento Administrativo Nacional de Estadística-DANE, specifically on the module of ownership and use of ICT goods. Results of four age groups are compared: 32 years or under, from 33 to 45, from 46 to 59, and over 60. The total sample is 37047 inhabitants of the Colombian territory, grouped by regions (Antioquia, Bogota, Caribbean, Eastern Central, Orinoquia, Amazonia, Pacific, San Andres, and Valle del Cauca). Data have been analyzed by using descriptive and inferential statistical procedures, contingency tables analysis, and logistic regression, in order to identify and know the effect of age on the level of penetration and use of handheld digital devices when comparing results in young adults and older ones. Findings show that young adults use these technologies in a greater proportion when comparing to older adults, showing a significant correlation between age and the increase of the digital gaps of access and social use of handheld digital devices. Even when characteristics like country regions, level of education, and the urban or rural setting are taking into account, the probability of obtaining penetration and use of handheld digital devices decreases significantly when attaining old age. (shrink)

A growing phenomenon in contemporary society is adult children caring for their elderly parents. Although some interest has been directed to the question of filial piety in general, surprisingly, scant attention has been focused on the ethical dimensions of caring for elderly parents. This article explores the contribution that Aquinas’s theory of the virtues of filial piety and prudence can make to the ethical dilemmas of elder care. In examining Aquinas’s theory, I explicate the relationship between moral (...) agency and prudence, with a special emphasis on the relationship between the integral parts of prudence and the exercise of moral virtue. In doing so, I suggest how Aquinas’s theory can shape and guide contemporary filial piety in order to advance quality elder care. (shrink)

This essay investigates the demands on adult children to provide care for their elderly/ill parents from a socio-moral perspective. In order to narrow the examination, the question pursued here is agent-relative: What social and moral complexities are involved for the adult child when her parent(s) need care? First, this article examines our society’s expectation that adult children are morally obligated to provide care for their parents. Second, the essay articulates how transgressing against this normative expectation can (...) inure significant moral criticism. The final sections present these tensions within the context of disability. (shrink)

The concept of guardianship, its associated principles, distinctions, and articulation of the legal needs of the elderly are introduced via a review of well-canvassed criticisms of Canadian guardianship legislation. Claims that the reformed legislation of Alberta, Quebec, and British Columbia represent models of adequate adult guardianship compared with traditional (archaic lunacy) law are examined. This paper argues that these renovated models exhibit a dubious normative advance over traditional legislation. Specifically, the normative presuppositions of the reformed legislation, such as, (...) restriction to an autonomy-paternalism framework, and the norms of the liberal individual and state, obscure important issues in at least two key areas which challenge the models' assumptions; namely, assessment and legal competence and assessment and need. The development of guardianship laws and of social arrangements that are more responsive to the life experiences of the elderly requires critical re-articulation of the nature of individuals and their communities. (shrink)

One question of applied ethics is the status and proper treatment of marginal cases, i.e., of people who are not yet or not anymore in full possession of their rational capacities, such as elderly demented people. Does one belittle them if one does not treat them like normal human adults, or would it be disrespectful and demanding too much if one did? Are elderly demented even the proper object of respect? In this paper I explore what Kant would (...) say about these questions if he had addressed them. I look at what Kantian respect is, how he justifies the requirement to respect others, and what it demands more specifically. My claim is that Kant conceives of respect as a maxim of not exalting oneself above others. One should adopt this attitude independently of what the other is like. Differences between normal human adults and marginal cases are important for how one should treat them, but ultimately not for the question of why one should treat them with respect. Accordingly, elderly demented people should be respected, and it depends on the individual case what kind of actions this implies. (shrink)

A continuing need for care for elderly, combined with looser family structures prompt the question what filial obligations are. Do adult children of elderly have a duty to care? Several theories of filial obligation are reviewed. The reciprocity argument is not sensitive to the parent–child relationship after childhood. A theory of friendship does not offer a correct parallel for the relationship between adult child and elderly parent. Arguments based on need or vulnerability run the risk (...) of being unjust to those on whom a needs-based claim is laid. To compare filial obligations with promises makes too much of parents’ expectations, however reasonable they may be. The good of being in an unchosen relationship seems the best basis for filial obligations, with an according duty to maintain the relationship when possible. We suggest this relationship should be maintained even if one of the parties is no longer capable of consciously contributing to it. We argue that this entails a duty to care about one’s parents, not for one’s parents. This implies that care for the elderly is not in the first place a task for adult children. (shrink)

A continuing need for care for elderly, combined with looser family structures prompt the question what filial obligations are. Do adult children of elderly have a duty to care? Several theories of filial obligation are reviewed. The reciprocity argument is not sensitive to the parent–child relationship after childhood. A theory of friendship does not offer a correct parallel for the relationship between adult child and elderly parent. Arguments based on need or vulnerability run the risk (...) of being unjust to those on whom a needs-based claim is laid. To compare filial obligations with promises makes too much of parents’ expectations, however reasonable they may be. The good of being in an unchosen relationship seems the best basis for filial obligations, with an according duty to maintain the relationship when possible. We suggest this relationship should be maintained even if one of the parties is no longer capable of consciously contributing to it. We argue that this entails a duty to care about one’s parents, not for one’s parents. This implies that care for the elderly is not in the first place a task for adult children. (shrink)

The aim of this article is to investigate whether choosing the appropriate referring expression requires taking into account the hearer’s perspective, as is predicted under some versions of bidirectional Optimality Theory but is unexpected under other versions. We did this by comparing the results of 25 young and 25 elderly adults on an elicitation task based on eight different picture stories, and a comprehension task based on eight similar written stories. With respect to the elicitation task, we found that (...) elderly adults produce pronouns significantly more often than young adults when referring to the old topic in the presence of a new topic. With respect to the comprehension task, no significant differences were found between elderly and young adults. These results support the hypothesis that speakers optimize bidirectionally and take into account hearers when selecting a referring expression. If the use of a pronoun will lead to an unintended interpretation by the hearer, the speaker will use an unambiguous definite noun phrase instead. Because elderly adults are more limited in their processing capacities, as is indicated by their smaller working memory capacity, as speakers they will not always be able to reason about the hearer’s choices. As a result, they frequently produce non-recoverable pronouns. (shrink)

RESUMEN El artículo constituye una propuesta encaminada a dar respuesta a la necesidad social de la superación del profesor de Educación Física del Centro de Experiencia del Adulto Mayor. Se propone como objetivo fundamentar la estrategia para la superación del profesor de Educación Física dirigida a la rehabilitación acuática de los adultos mayores con limitaciones articulares, desde una visión de ciencia, tecnología y sociedad. Se reconoce la oportunidad que representa el empleo de las nuevas tecnologías como elemento que contribuye a (...) la mejora de la calidad de vida de las personas mayores. La magnitud del reto exige la puesta en acción de todos los resortes con los que la sociedad cuenta, para la atención al envejecimiento, mediante diversos programas, cuya significación contribuye a fortalecer la identidad nacional, y a elevar la cultura general integral de los profesores hacia los adultos mayores lo cual repercutirá en la formación de una conciencia social, política y cultural. ABSTRACT The article constitutes a proposal directed to give answer to the social need for the self-improvement of the teacher of Physical Education of the Center of Experience of the Elder Adult. It proposes as objective: to base the strategy for the self-improvement of the teacher of Physical Education directed to the aquatic rehabilitation of the elderly with articular limitations, from a vision of science, technology and society. It is recognized the opportunity that represents the employment of the new technologies as element that contributes to the progress of the quality of life of the elderly. The magnitude of the challenge demands the putting in action of all the springs with which the society is provided, for the attention to the aging, by means of diverse programs, which significance helps to strengthen the national identity, and to raise the integral general culture of the teachers towards the elderly which will reverberate in the formation of a social, political and cultural conscience. (shrink)

Background Few empirical studies have been found that explore ethical challenges among persons in high public positions that are responsible for elder care. The aim of this paper was to illuminate the meaning of being in ethically difficult situations related to elder care as experienced by high level decision-makers. Methods A phenomenological-hermeneutic method was used to analyse the eighteen interviews conducted with political and civil servant high level decision-makers at the municipality and county council level from two counties in Sweden. (...) The participants worked at a planning and control as well as executive level and had both budget and quality of elder care responsibilities. Results Both ethical dilemmas and the meaning of being in ethically difficult situations related to elder care were revealed. No differences were seen between the politicians and the civil servants. The ethical dilemmas mostly concerned dealings with extensive care needs and working with a limited budget. The dilemmas were associated with a lack of good care and a lack of agreement concerning care such as vulnerable patients in inappropriate care settings, weaknesses in medical support, dissimilar focuses between the caring systems, justness in the distribution of care and deficient information. Being in ethically difficult situations was challenging. Associated with them were experiences of being exposed, having to be strategic and living with feelings such as aloneness and loneliness, uncertainty, lack of confirmation, the risk of being threatened or becoming a scapegoat and difficult decision avoidance. Conclusion Our paper provides further insight into the ethical dilemmas and ethical challenges met by high level decision-makers', which is important since the overall responsibility for elder care that is also ethically defensible rests with them. They have power and their decisions affect many stakeholders in elder care. Our results can be used to stimulate discussions between high level decision-makers and health care professionals concerning ways of dealing with ethical issues and the necessity of structures that facilitate dealing with them. Even if the high level decision-makers have learned to live with the ethical challenges that confronted them, it was obvious that they were not free from feelings of uncertainty, frustration and loneliness. Vulnerability was revealed regarding themselves and others. Their feelings of failure indicated that they felt something was at stake for the older adults in elder care and for themselves as well, in that there was the risk that important needs would go unmet. (shrink)

This article assesses the possible impact of the Care Act 2014 on the provision of social care for elderly and disabled adults in England, focusing particularly on the balance between ensuring adequate care and affecting the property rights of the recipients of social care, their families, and others who might have legal or moral claims to their property. The article uses the European Convention on Human Rights to measure the Act’s implications, arguing that normative problems remain despite the Act’s (...) general compatibility with the Convention. (shrink)

The authors explore the changing dynamics of gendered familial caregiving in urban China within the context of economic reforms and the continued cultural influence of xiao. Data collected in China through interviews with 110 familial caregivers were used to examine cultural and structural influences on the caregiving behavior of adult children. Results from multiple regression analyses provide evidence of a gendered division of parental care tasks, a decline in the patrilocal tradition of caregiving, and a strong social pressure that (...) influences caregiving behavior. Structural factors linked to caregiving performance included family size, lack of pensions for elders, and caregivers’ employment status and income. Findings portend deleterious effects for the women who are now caregivers as they are likely to live longer but be more financially dependent and have fewer children available to help them. (shrink)

This research topic (RT) focused on the impact of fitness on cognitive function and development in adolescents and elderly adults from the standpoint of lifespan neuroscience. Adolescent brain development is characterized by multimodal integration of brain anatomical features and function, according to accumulating evidence. The elderly, on the other hand, suffer from age-related cognitive deterioration. Fitness may be a major factor influencing brain growth and cognitive performance throughout these two critical times for neurological development. It is a multidimensional (...) notion that includes cardiovascular fitness, muscular strength and endurance, flexibility, and body composition, as well as motor fitness (balance, agility, speed, power, and coordination). Adolescents and older people may be responsive to intervention trials aimed at improving fitness levels, such as outdoor activities, cardiovascular exercise, and mind-body practice since brain network integration and neural efficiency are rapidly altered during this period. This RT investigates how fitness influences structural and functional brain development, particularly cognitive functions, and emotional health in adolescents and elderly people, as well as training strategies that may assist cognitive progress throughout this time. It includes a clinical trial (1) and original research papers (4) on the influence of fitness on cognitive function and development in adolescents and elderly adults from a lifespan neu... (shrink)

In Europe the elderly population is projected to increase from 18.5% (93.9 million) in 2014 to 28.7% (149.1 million) by 2080. In the USA it is estimated that by the year 2030 more than 20% of the population will be aged 65 years or over. This specific population is at high risk of unrecognised or untreated psychiatric illnesses and suicide. It is well known that completed suicide rate increases with age in both men and women. Although elderly people (...) attempt suicide less often than other age groups, they show a higher completion rate. Generally the methods chosen by elderly are more lethal, the intent is more serious, they are more determined and they show fewer warning sign than the younger population. A recent systematic review and meta-analysis of psychosocial intervention following self-harm in adults found that cognitive behavioural therapy was the most effective in these patients. Unfortunately there have been few reported trials of other potentially effective interventions. Because the scientific literature on psychosocial suicide prevention interventions in the elderly is still scant we decided to conduct a mini-review in order to take stock of the situation. Studies were identified through electronic searches of the Cochrane library, MEDLINE, Scopus and Web of Science databases. PRISMA guidelines were followed and only 7 articles met the inclusion criteria. No firm conclusions can be drawn about this topic because there is still little data and studies used inconsistent outcome measures and designs. Nonetheless, the existing data suggests that psychosocial interventions are promising. (shrink)

The world’s elderly population is growing, and in Chile they represent 16.2% of the total population. In Chile, old age is marked by retirement, with a dramatic decrease in income that brings precariousness. Older adults are economically, socially, and psychologically vulnerable populations. This condition increases their likelihood of disengaging from their usual social environment, facilitating their isolation, sadness, and discomfort. From the perspective of social identity, well-being can be explained by two principles: social groups’ importance for health and people’s (...) psychological identification with those groups. This study analyzes the relationships between belonging to the neighborhood and extra-neighborhood groups and neighborhood social identification with WB. Urban or rural location and gender are measured, and the sample is 1,475 older Chilean adults of both sexes. The results show that the majority are not members of social groups, and the remaining 48% are members of one or two groups or organizations. Only 4.47% belong to three groups or organizations. Those who belong to groups obtain higher scores, emotional–mental WB, and positive emotions than older adults who do not belong to any organization. Urban and rural older adults have the same level of WB. Membership in close social organizations or distant ones causes different WB associations. Membership in neighborhood councils reduces gender differences in self-assessment of health. This result supports the idea that participation in heterogeneous groups with a shared sense of belonging to the neighborhood is associated with higher WB and lower perceived loneliness. Social identification with the neighborhood, rather than belonging to the group, had the most widespread impact on WB and health indicators. The variable social identification with the neighborhood was consistently associated with indicators of hedonic WB. (shrink)

The public debate on voluntary termination of life by elderly people, which has been an intensely controversial subject in the Netherlands for some time, has centered around the issue of “completed life” in recent years. In 2016, an ad hoc governmental advisory committee concluded that the already existing Euthanasia Act provided sufficient scope to resolve most of the problems related to the issue. Most of the older adults who feel they no longer have anything to look forward to in (...) their lives and who have developed a wish to die as a result would be able to invoke this Act. Partly for this reason, the committee considered broadening the legal options relating to assisted suicide undesirable. Analysis of the assessment practice of the regional euthanasia review committees reveals that the room for interpretation offered by the Euthanasia Act is indeed considerable. (shrink)

As intergenerational interactions increase due to an ageing population, the study of emotion-related responses to the elderly is increasingly relevant. Previous research found mixed results regarding affective mimicry – a measure related to liking and affiliation. In the current study, we investigated emotional mimicry to younger and older actors following an encounter with a younger and older player in a Cyberball game. In a complete exclusion condition, in which both younger and older players excluded the participant, we expected emotional (...) mimicry to be stronger for younger vs. older actors. In a partial inclusion condition, in which the younger player excluded while the older player included the participant, we predicted that the difference in player behaviour would lead to a difference in liking. This increased liking of the older interaction partner should reduce the difference in emotional mimicry towards the two different age groups. Results revealed more mimicry for older actors following partial inclusion especially for negative emotions, suggesting inclusive behaviour by an older person in an interaction as a possible means to increase mimicry and affiliation to the elderly. (shrink)

Genetic research into ageing, longevity and late-onset disease is becoming increasingly common. Yet, there is a paucity of knowledge related to clinical actionability and the return of pathogenic variants to otherwise healthy elderly individuals. Whether or not genetic research in the elderly should be managed differently from standard practices adapted for younger populations has not yet been defined. In this article, we provide an overview of ethical and practical challenges in preparing for a genetic study of over 14 (...) 000 healthy Australians aged 70 years or older enrolled in the ASPirin in Reducing Events in the Elderly Healthy Ageing Biobank. At the time of consent, all participants in this study were free of life-threatening illness, cardiovascular disease or cognitive impairment. ASPREE is thus a cohort of healthy elderly individuals with seemingly minimal burden of genetic disease recruited without ascertainment bias. The cohort presents a unique opportunity to address the penetrance of known pathogenic variants in a population without disease symptoms; however, it also raises a number of ethical concerns regarding the interpretation and disclosure of variants with known clinical actionability. Some of the challenges include how to manage the interpretation, disclosure and actioning of pathogenic variants found in otherwise healthy elderly adults without disease symptoms, whether or not to disclose findings for the benefit of family members rather than elderly consented donors themselves, how to manage the return of genetic findings to the elderly individuals who are now in severe cognitive decline or terminal illness, how to ensure quality of information and clinical service upon disclosure of results to this demographic and how to prepare for the insurance implications of disclosing genetic information under Australian law. We discuss these and other dilemmas and propose a defensible plan of management. Trial registration number ISRCTN83772183. (shrink)

ObjectiveNoisy galvanic vestibular stimulation (nGVS) is often used to improve postural stability in disorders, such as neurorehabilitation montage. For the safe use of nGVS, we investigated whether arterial pressure (AP) and heart rate vary during static supine and slow whole-body tilt with random nGVS (0.4 mA, 0.1–640 Hz, gaussian distribution) in a healthy elderly population.MethodsThis study was conducted with a double-blind, sham-controlled, cross-over design. Seventeen healthy older adults were recruited. They were asked to maintain a static supine position on (...) a bed for 10 min, and the bed was tilted up (TU) to 70 degrees within 30 s. After maintaining this position for 3 min, the bed was passively tilted down (TD) within 30 s. Real-nGVS or sham-nGVS was applied from 4 to 15 min. The time course of mean arterial pressure (MAP) and RR interval variability (RRIV) were analyzed to estimate the autonomic nervous activity.ResultnGVS and/or time, including pre-/post-event (nGVS-start, TU, and TD), had no impact on MAP and RRIV-related parameters. Further, there was no evidence supporting the argument that nGVS induces pain, vertigo/dizziness, and uncomfortable feeling.ConclusionnGVS may not affect the AP and RRIV during static position and whole-body tilting or cause pain, vertigo/dizziness, and discomfort in the elderly. (shrink)

The three dialogues in this contribution concern 21st century application of life‐like robots in the care of older adults. They depict conversations set in the near future, involving a philosopher (Dr Phonius) and a nurse (Dr Myloss) who manages care at a large facility for assisted living. In their first dialogue, the speakers discover that their quite different attitudes towards human‐robot interaction parallel fundamental differences separating their respective concepts of consciousness. The second dialogue similarly uncovers deeply contrasting notions of personhood (...) that appear to be associated with respective communities of nursing and robotics. The additional key awareness that arises in their final dialogue links applications of life‐like robots in the care of older adults with potential transformations in our understandings of ourselves – indeed, in our understandings of the nature of our own humanity. This series of dialogues, therefore, appears to address a topic in nursing philosophy that merits our careful attention. (shrink)

The Supreme Court of California held, in Delaney v. Baker, 82 Cal. Rptr. 2d 610, that the heightened remedies available under the Elder Abuse Act, Cal. Welf. & Inst. Code, §§ 15657,15657.2, apply to health care providers who engage in reckless neglect of an elder adult. The court interpreted two sections of the Act: section 15657, which provides for enhanced remedies for reckless neglect; and section 15657.2, which limits recovery for actions based on “professional negligence.” The court held that (...) reckless neglect is distinct from professional negligence and therefore the restrictions on remedies against health care providers for professional negligence are inapplicable.Kay Delaney sued Meadowood, a skilled nursing facility, after a resident, her mother, died. Evidence at trial indicated that Rose Wallien, the decedent, was left lying in her own urine and feces for extended periods of time and had stage I11 and IV pressure sores on her ankles, feet, and buttocks at the time of her death. (shrink)

As an independent researcher, registered social worker and erstwhile long-term, long-distance carer, the care of older people and protection of elders from abuse had been constant professional and personal foci for me for many years. Commissioned to review a case involving the serious abuse of an elder where official safeguarding procedures had not been used, I puzzled why this had been managed ?informally? by social services and partner agencies (i.e. outside adult safeguarding procedures), with vague unspecified ?monitoring? (AEA 2006). (...) Why was there this apparent gap between policy intention and implementation? That question led to research on which this essay is based. (shrink)

Applied Theatre is an inclusive term used to host a variety of powerful, community-based participatory processes and educational practices. Historically, Applied Theatre practices include Theatre-in-Education, Theatre-in-Health Education, Theatre for Development, prison theatre, community theatre, theatre for conflict resolution/reconciliation, reminiscence theatre with elderly people, theatre in museums, galleries and heritage centres, theatre at historic sites, and more recently, theatre in hospitals. In this paper we are positioning the application of recreational dramatic activities with older adults under Applied Theatre and we (...) are exploring the benefits they offer to the participants. We are concerned that their health and wellbeing in western societies is not prioritized and it is clear that loneliness in particular is a current and ongoing issue. We will present research results from a drama dissertation study that took place in a community hall in the South East England where drama is placed at the core of their practice with old populations. Data was collected by a mixed method and was critically discussed amongst the authors to conclude that attending recreational drama classes brings a certain degree of happiness, social belonging and improvement of interaction with others to old people’s lives. (shrink)

This article asks how people come to interpret themselves and others as autonomous given their multiple dependencies. We draw on a cross-case comparison of ethnographic studies with two populations for whom autonomy is both central and problematic: elderly patients in post-acute care, and young adults with disabilities in an independent living program. Analyzing the institutional efforts to make their clients “as independent as possible,” we find that staff members at each organization formulate autonomy as a temporal project through an (...) ongoing calibration of open futures, ideal pasts, and situational competence. Constantly adjusting and fine-tuning where in time autonomy “really” is, workers arrange present dependence so that the contours of the future remain open for their clients. In other words, they make use of temporal markers to produce recognizable autonomous subjects whose dependencies are momentary. Theorizing this temporal project enables us to see more clearly how all of us engage in the constant business of “doing” autonomy, and to better understand the role of institutions in producing autonomous selves. (shrink)

IntroductionIncorporating technology in cognitive interventions represents an innovation, making them more accessible, flexible, and cost-effective. This will not be feasible without adequate user-technology fit. Bearing in mind the importance of developing cognitive interventions whose technology is appropriate for elderly people with cognitive impairment, the objective of this systematic review was to find evidence about usability and user experience measurements and features of stimulation, training, and cognitive rehabilitation technologies for older adults with mild cognitive impairment or dementia.MethodThe Medline, PubMed, Scopus, (...) ScienceDirect, and PsycINFO databases were searched for literature published in the last 10 years, and three researchers independently reviewed potentially eligible studies, following specific inclusion criteria. A systematic review of the studies was conducted, presenting a qualitative synthesis of usability and UX measures with their outcomes, study characteristics and features of the cognitive intervention technologies.ResultsTen studies were selected: five were cognitive stimulation and five were cognitive training. Most of them were computer-based programs with a serious game format. Efficiency and effectiveness were the most frequent measurements used for collecting objective usability data, showing that elderly people with cognitive impairment require more time and help but can complete tasks. Regarding UX or subjective usability data, questionnaires and scales were the most used methods, reporting positive experience despite certain difficulties with the interface in five studies.ConclusionMeasuring usability and UX in cognitive intervention technologies for older adults with MCI or dementia provides an integrated view that can contribute to their development according to the needs and characteristics of the target population. More research is required to include this population group in usability and UX studies, as well as standardized tools and consensus on the relationship of these terms to guarantee the future effectiveness of cognitive intervention technologies.Review registrationThis review was registered in the PROSPERO International Register of Systematic Review Protocols. (shrink)

The number of older adults incarcerated in prisons is growing significantly, and there is a great need for legal authority, processes, and resources to mitigate individual and social burdens of elder neglect and abuse within these settings. Older adults in prison may be particularly vulnerable to abuse, neglect, or exploitation. They are dependent on the carceral system for basic resources, are at risk for retaliatory actions for reporting mistreatment, and bear disproportionately high health burdens. This essay first considers standards and (...) resources for mitigating elder mistreatment in the community and residential‐care settings in contrast to the available resources in prisons. Arguing that a conceptual model of elder abuse tailored to the prison population is needed, the essay proposes a research agenda through which such a model could be developed. The model could then be used in the creation of policy for detecting and mitigating elder mistreatment of incarcerated people. The essay concludes with a call to action to address the rift in legal protections and processes that leave older adults in prison at increased risk of abuse and neglect without a clear pathway for recourse. (shrink)

This study analyzes the most important predictors of acceptance of social network sites in a sample of Chilean elder people. We employ a novelty procedure to explore this phenomenon. This procedure performs apriori segmentation based on gender and generation. It then applies the deep learning technique to identify the predictors by segments. The predictor variables were taken from the literature on the use of social network sites, and an empirical study was carried out by quota sampling with a sample size (...) of 395 older people. The results show different predictors of social network sites considering all the samples, baby boomer males and females, silent males and females. The high heterogeneity among older people is confirmed; this means that dealing with older adults as a uniform set of users of social network sites is a mistake. This study demonstrates that the four segments behave differently, and many diverse variables influence the acceptance of social network sites. (shrink)

This study employs fMRI to examine the neural substrates of response to cognitive training in healthy old adults. Twenty Japanese healthy elders participated in a 4-week program and practiced a verbal articulation task on a daily basis. Functional connectivity analysis revealed that in comparison to age- and education-matched controls, elders who received the cognitive training demonstrated increased connectivity in the frontotemporal regions related with language and memory functions and showed significant correlations between the behavioral change in a linguistic task and (...) connectivity in regions for goal-oriented persistence and lexical processing. The increased hippocampal connectivity was consistent with previous research showing efficacious memory improvement and change in hippocampal functioning. Moreover, the increased intra-network connectivity following cognitive training suggested an improved neural differentiation, in contrast to the inter-network activation pattern typical in the aging brain. This research not only validates the relationship of functional change in the frontal and temporal lobes to age-associated cognitive decline but also shows promise in turning neural change toward the right direction by cognitive training. (shrink)

A central feature of Confucianism is the doctrine that an adult child has, for want of a better word, the ‘duty’ to care for his elderly parents1. Whether this doctrine should be framed in terms of an ethic of duties as opposed to an ethic of virtues is a vexed question. It might be argued that the doctrine is best framed in terms of the behaviour and dispositions appropriate to an agent who is, within the Confucian moral vision, (...) good. Nonetheless, in both popular discourse and in much the secondary literature, the doctrine is characterized in terms of a moral ‘ought’. We will adopt this perspective, and talk of the ‘filial duty of care’. We investigate the empirical question of whether Chinese communities still have a strong sense of this duty. We conclude that although there is a widespread perception among Chinese communities that their sense of filial duty of care has been eroded, in fact the adherence to it remains robust. (shrink)

Background Healthy aging is one of the essential aspects of a health promotion program in the elderly. Aim Exploring ethical challenges in healthy elderly care from the perspective of nurses, older adults, and families in the Iranian context. Research Design This qualitative study was conducted using a content analysis approach in 4 health centers in northeastern Iran from 2017 to 2019. Semi-structured interviews, observation, review of elderly files, and focus groups were used to collect data. Ethical considerations (...) The ethics committee of the university approved this study in Iran. This study adhered to the principles of the Helsinki Declaration. Ethical principles autonomy, confidentiality, and anonymity were considered for the participants. Participants were informed about the purpose of the study and submitted written informed consent regarding their participation. Findings The central theme was: An unfair approach to caring for healthy older adults. The three categories were as follows: Forgotten human care, disrespect, and lack of a meaningful and trustworthy relationship. The 14 subcategories highlighted the ethical challenges of healthy aging care in health centers. Discussion The findings showed that due to nurses’ unfamiliarity with the concept of healthy aging, older adults are discriminated against in care centers. Creating a standard care program for healthy older adults ensures that ethical principles are followed for these clients. Conclusion Various individual and organizational factors lead to an unfair approach to caring for healthy elderly in health centers. The following factors can help improve the care of healthy aging and reduce ethical challenges in this area: Introducing nurses to the concept of healthy old age and its dimensions, creating a community-based approach in health centers, prioritizing health issues over health issues, Involvement of families and older adults in needs assessment-goal setting-implementation and evaluation of health services, and design of home visit programs to provide services to healthy elderly. (shrink)

Background: Falls in older adults are a major public health problem. White matter hyperintensities are highly prevalent in older adults and are a risk factor for falls. In the absence of a cure for WMHs, identifying potential strategies to counteract the risk of WMHs on falls are of great importance. Physical activity is a promising countermeasure to reduce both WMHs and falls risk. However, no study has yet investigated whether PA attenuates the association of WMHs with falls risk. We hypothesized (...) that PA moderates the association between WMHs and falls risk.Methods: Seventy-six community-dwelling older adults aged 70–80 years old were included in this cross-sectional study. We indexed PA using the Physical Activity Score for the Elderly Questionnaire. Falls risk was assessed using the Physiological Profile Assessment, and WMH volume was determined by an experienced radiologist on T2-weighted and PD-weighted MRI scans. We first examined the independent associations of WMH volume and PASE score with PPA. Subsequently, we examined whether PASE moderated the relationship between WMH volume and PPA. We plotted simple slopes to interpret the interaction effects. Age, sex, and Montreal Cognitive Assessment score were included as covariates in all models.Results: Participants had a mean age of 74 years and 54 were female. Forty-nine participants had a Fazekas score of 1, 19 had a score of 2, and 6 a score of 3. Both PASE and WMH volume were each independently associated with PPA score. The interaction model indicated that PASE score moderated the association between WMH volume and PPA, whereby higher PASE score attenuated the association between WMHs and falls risk.Conclusion: PA is an important moderator of falls risk. Importantly, older adults with WMH can reduce their risk of falls by increasing their PA. (shrink)

The purpose of this mini-review is to investigate if there are any cognitive benefits of computer-based foreign language training for healthy older individuals aged 55+ years. The author conducted a literature search of peer-reviewed English written research articles found in Pub Med, Web of Science and Scopus. The findings of this mini-review reveal that the research on the cognitive benefits of computer-based foreign language training for healthy older individuals is small-scale. The limited research findings of only three relevant studies indicate (...) that these computer-based foreign language training programs may bring cognitive benefits for healthy elderly people, especially as far as the enhancement of their cognitive functions such as working memory are concerned. In addition, the authors of these studies suggest that foreign language learning is a useful activity for healthy older adults since it has the benefits of being meaningful and provides the chance for acquiring important skills that can benefit other aspects of life, such as travel or communication. In conclusion, the author of this mini-review also provides several implications for practice and future research. (shrink)

Internet addiction among older adults is a new problem in many countries. However, previous studies on excessive Internet use have focused more on young people, and only few studies have focused on Internet addiction in older adults. There is a need to continue to expand research on Internet addiction in older adults. This paper aimed to fill the gap in exiting literature. We adopted a self-reported questionnaire to assess the elderly’s interaction with children, loneliness, life satisfaction and Internet addiction (...) among old adults. A total of 241 old people were obtained from data collection in China via online survey with the help of a professional research company. We used OLS regression analysis and bootstrap method to test the hypothesis. The results of the empirical analysis indicated that interaction with children was significantly negatively associated with the Internet addiction of old people; loneliness mediated the relationship between interaction with children and old adults’ Internet addiction; and life satisfaction moderated the effect of interaction with children, and the indirect effect between interaction with children and old adults’ addiction via loneliness was stronger for those with low life satisfaction. Finally, we discussed the theoretical significance, practical implications, limitation of this research. Interventions to improve family function systems especially for older people with low life satisfaction can help prevent the development of Internet addiction. (shrink)

The growing number of older adults in America will result in an increasing demand for psychotherapists familiar with their psychological needs. To treat this population in an ethical manner, practitioners need to be aware of the unique characteristics of the aging process, especially in regards to age-related vulnerabilities, such as cognitive decline. Unfortunately, recent research has shown that those currently in practice do not have sufficient knowledge of the aging process and age specific issues of older adults. To address these (...) deficits the American Psychological Association published a report outlining six general concepts: attitudes, general knowledge about adult development, clinical issues, assessment, intervention, and education. These concepts are described. Furthermore, this article extends the current thinking on ethical issues regarding older adults by addressing their vulnerabilities. In addition, ethical issues such as informed consent, confidentiality, and elder abuse are addressed as they apply to both clinical and research situations. In addition, methods of resolving these important issues are suggested throughout the article. A depiction of the ethical issues of psychologists working with older adults is provided and practical procedures to help psychologists perform with high ethical standards of care for this age group are offered. (shrink)

As a global public health concern, elder abuse negatively affects health, psychosocial wellbeing, and mortality among elders. Research and practice efforts made to explore effective prevention and intervention strategies are growing. Despite the growing number of intervention studies on elder abuse, research synthesis on the empirical literature seems lacking. This study aims to identify the pooled effect size of prevention and interventions targeted ultimate and intermediate outcomes for elder abuse that occurred in community settings. Following the Cochrane guideline, our team (...) searched across eight electronic databases and manually searched reference lists of eligible studies and existing systematic reviews for all potentially eligible studies. A random-effects model of 51 effect size estimates reported an overall positive and statistically significant treatment effect of psychosocial interventions for elder abuse, d = 0.63, p < 0.05. The overall treatment effect was approaching statistical significance at 0.1 level for ultimate outcomes, d = 0.32, p = 0.09, and intermediate outcomes, d = 0.75, p = 0.1. An overall significant effect size was found among family-based interventions, d = 0.59, p < 0.05, and interventions targeting older adults and their caregivers, d = 0.45, p < 0.05. Existing evidence supports an overall significant effect for psychosocial interventions for elder abuse. Interventions that used a family-based model, combined education and supportive services, and targeted both caregivers and elders, showed significant effect size, suggesting such features being considered in elder abuse intervention design. Future intervention research is needed to shed light on the link between intervention activities and ultimate change in elder abuse behaviors. (shrink)

While cognitive changes in aging and neurodegenerative disease have been widely studied, language changes in these populations are less well understood. Inflecting novel words in a language with complex inflectional paradigms provides a good opportunity to observe how language processes change in normal and abnormal aging. Studies of language acquisition suggest that children inflect novel words based on their phonological similarity to real words they already know. It is unclear whether speakers continue to use the same strategy when encountering novel (...) words throughout the lifespan or whether adult speakers apply symbolic rules. We administered a simple speech elicitation task involving Finnish‐conforming pseudo‐words and real Finnish words to healthy older adults, individuals with mild cognitive impairment, and individuals with Alzheimer's disease (AD) to investigate inflectional choices in these groups and how linguistic variables and disease severity predict inflection patterns. Phonological resemblance of novel words to both a regular and an irregular inflectional type, as well as bigram frequency of the novel words, significantly influenced participants' inflectional choices for novel words among the healthy elderly group and people with AD. The results support theories of inflection by phonological analogy (single‐route models) and contradict theories advocating for formal symbolic rules (dual‐route models). (shrink)