Older adults in the United States have been the age group hardest hit by the Covid pandemic. They have suffered a disproportionate number of deaths; Covid patients eighty years or older on ventilators had fatality rates higher than 90 percent. How could we have better protected older adults? Both the popular press and government entities blamed nursing homes, labeling them “snake pits” and imposing harsh fines and arduous new regulations. We argue that this approach is (...) unlikely to improve protections for older adults. Rather than focusing exclusively on acute and critical resources, including ventilators, a plan that respected the best interests of older adults would have also supported nursing homes, a critical part of the health care system. Better access to protective equipment for staff members, early testing of staff members and patients, and enhanced means of communication with families were what was needed. These preventive measures would have offered greater benefit to the oldest members of our population than the exclusive focus on acute care. (shrink)

Background Health ministries in Europe are investing increasingly in innovative digital technologies. Older adults, who have not grown up with digital innovation, are expected to keep up with technological shifts as much as other age groups. This is ethically challenging, as it may threaten a sense of dignity and well-being in older adults. Research objective To clarify the phenomenon of sense of dignity experienced in older adults, concerning how their expectations and needs are met (...) within the context of digitally led healthcare in Norway. Research design A Reflective Lifeworld Research design was chosen, and purposive, in-depth interviews were conducted. Participants and research context The participants were 13 adults 75 years and older from Northern Norway, living at home and not receiving consistent assistance. Ethical considerations Followed the principles of the Helsinki Declaration. This study was approved by the Social Science Data Services in Norway (project number 916119). Interviews were conducted carefully within a safe environment chosen by the participants. Findings Older adults experience that using new digital systems in healthcare makes them become dependent with experiences of helplessness. They feel an increased sense of dependency on other people, and that recognition can assail their experience of personal dignity. Older adults not only expect digitally led healthcare to give them a feeling of safety but also experience feeling insecure concerning privacy and loss of possibilities for dialogue with healthcare providers. They are met by demands from society, which they often struggle to achieve. Conclusion The phenomenon of sense of dignity experienced in older adults, concerning how their expectations and needs are met within digitally led healthcare, indicates a sense of feeling lost in the digital world. Further, innovative healthcare lacks focus on ethical performance. This impacts their perception of dignity, as loss of dignity is noticed especially in its rupture. (shrink)

The COVID-19 pandemic has exacerbated many social problems and put the already vulnerable, such as racial minorities, low-income communities, and older individuals, at an even greater risk than before. In this paper we focus on older adults’ well-being during the COVID-19 pandemic and show that the risk-mitigation measures presumed to protect them, alongside the generalization of an ageist public discourse, exacerbated the pre-existing marginalization of older adults, disproportionately affecting their well-being. This paper shows that states (...) have duties to adopt and put into practice redress measures to compensate for the negative consequences of COVID-19 public health policies on older adults’ overall well-being. These duties flow from the minimal ethical requirement of respect for persons. We show that respect is a morally basic attitude that presupposes taking the others’ interests into account, with the aim of advancing their well-being. This duty is not limited to kinship, relatives, and friends but it extends to states and the rest of the civil society. In the conclusion, we draw lessons from the COVID-19 pandemic and sketch some redress measures that could compensate for the decrease in older adults’ well-being as a result of the adoption of measures to contain the spread of the virus. (shrink)

Numerous studies have documented the detrimental impact of age-based stereotype threat on older adults' cognitive performance and especially on veridical memory. However, far fewer studies have investigated the impact of ABST on older adults' memory distortion. Here, we review the subset of research examining memory distortion and provide evidence for the role of stereotype threat as a powerful socio-emotional factor that impacts age-related susceptibility to memory distortion. In this review we define memory distortion as errors in (...) memory that are associated with gist-based errors or source misattributions. Whereas, some of the reviewed experiments support the conclusion that ABST should be considered in the context of age-related differences in memory distortion, others reported little or no impact of stereotype threat. These discrepancies suggest that the role of ABST, and socio-emotional processes generally, in age-related changes in memory distortion are less clear. In this review, we argue that ABST does play an important role in age-related changes in memory distortion. We present evidence suggesting that discrepancies in the reviewed literature may be reconciled when evaluated in the context of the leading theories about stereotype threat: the Executive Resource Depletion hypothesis and the Regulatory Focus theory. We also discuss how differences in methodology and participant characteristics can account for a priori contradictory results in the literature. Finally, we propose some recommendations for researchers and practitioners when assessing memory in older adults. (shrink)

BackgroundInformation and communication technology solutions have the potential to support active and healthy aging and improve monitoring and treatment outcomes. To make such solutions acceptable, all stakeholders must be involved in the requirements elicitation process. Due to the COVID-19 situation, alternative approaches to commonly used face-to-face methods must often be used. One aim of the current article is to share a unique experience from the Pharaon project where due to the COVID-19 outbreak alternative elicitation methods were used. In addition, an (...) overview of common functional, quality, and emotional goals identified by six pilot sites is presented to complement the knowledge about the needs of older adults.MethodsOriginally planned face-to-face co-creation seminars were impossible to carry out, and all pilot sites chose alternative requirements elicitation methods that were most suitable in their situation. The elicited requirements were presented in the form of goal models. In one summary goal model, we provide an overview of common functional, quality, and emotional goals.ResultsDifferent elicitation methods were combined based on the digital literacy of the target group and their access to digital tools. Methods applied without digital technologies were phone interviews, reviews of literature and previous projects, while by means of digital technologies online interviews, online questionnaires, and virtual co-creation seminars were conducted. The combination of the methods allowed to involve all planned stakeholders. Virtual and semi-virtual co-creation seminars created collaborative environment comparable to face-to-face situations, while online participation helped to save the time of the participants. The most prevalent functional goals elicited were “Monitor health,” “Receive advice,” “Receive information.” “Easy to use/comfortable,” “personalized/tailored,” “automatic/smart” were identified as most prevalent quality goals. Most frequently occurring emotional goals were “involved,” “empowered,” and “informed.”ConclusionThere are alternative methods to face-to-face co-creation seminars, which effectively involve older adults and other stakeholders in the requirements elicitation process. Despite the used elicitation method, the requirements can be easily transformed into goal models to present the results in a uniform way. The common requirements across different pilots provided a strong foundation for representing detailed requirements and input for further software development processes. (shrink)

Although there is a growing recognition that older adults and those with extensive comorbid conditions undergo cancer screening too frequently, there is little information about patients’ perceptions regarding cessation of cancer screening. Information on older adults’ views of screening cessation would be helpful both for clinicians and for those designing interventions to reduce overscreening.

This article reveals a 91-year-old cognitively intact man’s lived experiences of being cared for in a geriatric context in which the majority of the patients were cognitively impaired. A narrative patient story was analysed phenomenologically. The findings indicate that this patient’s basic needs for ethical care were not met. The staff did not see him as a unique individual with his own preferences, resources and abilities to master his life. In order to survive this lack of ethical care, he played (...) the role of an ‘old cognitively impaired man’, which provided him with at least the understanding and attention the cognitively impaired patients received from the staff. The findings also indicate that ethical care is independent of whether or not older cognitively intact and impaired patients stay or live in the same unit, but it is more dependent on a caregiver’s ability to respect and confirm each and every patient for who he or she is and would like to be. (shrink)

Eliciting negative stereotypes about ageing commonly results in worse performance on many physical, memory, and cognitive tasks in adults aged over 65. The current studies explored the potential effect of this “stereotype threat” phenomenon on older adults’ emotion recognition, a cognitive ability that has been demonstrated to decline with age. In Study 1, stereotypes about emotion recognition ability across the lifespan were established. In Study 2, these stereotypes were utilised in a stereotype threat manipulation that framed an (...) emotion recognition task as assessing either cognitive ability, social ability, or general abilities. Participants then completed an emotion recognition task in which they labelled dynamic expressions of negative and positive emotions. Self-reported threat concerns were also measured. Framing an emotion recognition task as assessing cognitive ability significantly heightened older adults’ reports of stereotype threat concerns. Despite this, older adults’ emotion recognition performance was unaffected. Unlike other cognitive abilities, recognising facially expressed emotions may be unaffected by stereotype threat, possibly because emotion recognition is automatic, making it less susceptible to the cognitive load that stereotype threat produces. (shrink)

Financial products and options are frequently complex and difficult for consumers to understand, which, alongside positively oriented sales pitches and predatory practices, may lead to uninformed and hazardous financial decisions. While several legal reforms have been implemented to improve consumers’ understanding of financial products, these modifications have only achieved mixed results. An ongoing challenge is the passive nature of such modifications, giving rise to confirmation bias—noticing the information which confirms one’s belief about a product, while ignoring or not paying enough (...) attention to the potential risks. The aim of this study was to test an implementable form of public policy to help older adults successfully navigate these financial decisions. We tested whether a self-evaluation worksheet, involving an active manipulation of financial content, would significantly impact older adult participants’ responses in an experimental reverse mortgage scenario. Forty community-dwelling, healthy older adults were randomized to one of two conditions: Control Condition and Manipulation Condition. In addition to completing a comprehensive neuropsychological examination, participants were administered the Reverse Mortgage Task. Results indicated that a simple yet active manipulation—imparting accurate and understandable information regarding a complex financial product that must be further manipulated—led to the following among participants in the Manipulation Condition: declines in mood; superior understanding of the financial product; and reduced intention of purchasing the financial product. In order for older adults to be well informed about reverse mortgages, policies must be put in place to ensure that adequate and accurate information has been not only provided but also actively processed by the individual. (shrink)

A large share of the available literature on television and ageing depicts old age as a life stage characterized by losses in which people use television as a substitute for decreased activities. The aim of the present study is to investigate how television viewing is part of both selection and compensation strategies. Based on a qualitative interview study among a diverse sample of older adults, we found three ways in which television viewing is part of selection strategies and (...) three ways in which it is part of compensation strategies. In contrast to the focus on compensation in previous research, we found that selection strategies appear to provide a better characterization of older people’s television viewing than compensation strategies. Moreover, particular television viewing behavior does not automatically signal whether television viewing is part of selection or compensation strategies. (shrink)

This book exploits the power of phenomenological methods to access and describe lived moral experiences of pain and suffering for patients, their families and the wider community. Creating new fields of communication for patients, their family members and health professionals in shared decision making processes, this book builds on knowledge about suffering to help and guide correct action in preventing and relieving chronic pain and improving systems of care. It offers a new phenomenology for understanding moral experience in serious illness (...) and suffering, and its implication for policy, practice and research. A series of applied chapters, looking at individual experiences of suffering and care experiences, present some areas of ethical inquiry, including: pain and suffering maternal care ethics evaluation and moral deliberation about treatment options decision-making and moral agency end-of-life experiences of care. Exploring how moral phenomenology could provide fruitful alternatives to traditional frameworks in bioethics, this is an important addition to the literature. It will be of interest to scholars and students of bioethics and phenomenological methods in the health and human services. (shrink)

In higher-level cognitive tasks, older compared to younger adults show a bias towards positive emotion information and away from negative information (a positivity effect). It is unclear whether this effect occurs in early perceptual processing. This issue is important for determining if the positivity effect is due to automatic rather than controlled processing. We tested this with older and younger adults on a positive/negative face emotion valence classification task using masked priming. Positive (happy) and negative (angry) (...) face targets were preceded by masked repetition or valence primes with neutral face baselines. In Experiment 1, 30 younger and 30 older adults were tested with 50 ms primes. Younger adults showed repetition priming for both positive and negative targets. Older adults showed repetition priming for positive but not negative targets. Neither group showed valence priming. In Experiment 2, 30 older and 29 younger adults were tested with longer duration primes. Younger adults showed repetition priming for both positive and negative emotions, and no valence priming. Older adults only showed repetition and valence priming for positive targets. We proposed older adults’ lack of angry face priming was due to an early attention orienting strategy favouring happy expressions at the expense of angry ones. (shrink)

Background: Family members are often required to act as substitute decision-makers when health care or research participation decisions must be made for an incapacitated relative. Yet most families are unable to accurately predict older adult preferences regarding future health care and willingness to engage in research studies. Discussion and documentation of preferences could improve proxies' abilities to decide for their loved ones. This trial assesses the efficacy of an advance planning intervention in improving the accuracy of substitute decision-making and (...) increasing the frequency of documented preferences for health care and research. It also investigates the financial impact on the healthcare system of improving substitute decision-making.Methods/DesignDyads (n = 240) comprising an older adult and his/her self-selected proxy are randomly allocated to the experimental or control group, after stratification for type of designated proxy and self-report of prior documentation of healthcare preferences. At baseline, clinical and research vignettes are used to elicit older adult preferences and assess the ability of their proxy to predict those preferences. Responses are elicited under four health states, ranging from the subject's current health state to severe dementia. For each state, we estimated the public costs of the healthcare services that would typically be provided to a patient under these scenarios. Experimental dyads are visited at home, twice, by a specially trained facilitator who communicates the dyad-specific results of the concordance assessment, helps older adults convey their wishes to their proxies, and offers assistance in completing a guide entitled My Preferences that we designed specifically for that purpose. In between these meetings, experimental dyads attend a group information session about My Preferences. Control dyads attend three monthly workshops aimed at promoting healthy behaviors. Concordance assessments are repeated at the end of the intervention and 6 months later to assess improvement in predictive accuracy and cost savings, if any. Copies of completed guides are made at the time of these assessments.DiscussionThis study will determine whether the tested intervention guides proxies in making decisions that concur with those of older adults, motivates the latter to record their wishes in writing, and yields savings for the healthcare system.Trial RegistrationISRCTN89993391. (shrink)

BackgroundHospitalized older adults frequently have impaired cognition and must rely on surrogates to make major medical decisions. Ethical standards for surrogate decision making are well delineated, but little is known about what factors surrogates actually consider when making decisions.ObjectivesTo determine factors surrogate decision makers consider when making major medical decisions for hospitalized older adults, and whether or not they adhere to established ethical standards.DesignSemi-structured interview study of the experience and process of decision making.SettingA public safety-net hospital (...) and a tertiary referral hospital in a large city in the Midwest United States.ParticipantsThe study included 35 surrogates with a recent decision-making experience for an inpatient aged 65 or older.MeasurementsThe key factors that surrogates considered when making decisions. Interview transcripts were coded and analyzed using the grounded theory method of qualitative analysis.ResultsSurrogates considered patient-centered factors and surrogate-centered factors. Patient-centered factors included: respecting the patient’s input, using past knowledge of the patient to infer the patient’s wishes, and consider ing what is in the patient’s best interests. Some surrogates expressed a desire for more information about the patient’s prior wishes. Surrogate-centered factors included: surrogate’s wishes as a guide, surrogate’s religious beliefs and/or spirituality, surrogate’s interests, and family consensus.ConclusionOur study indicates that surrogate decision making is more complex than the standard ethical models, which are limited to considerations of the patient’s autonomy and beneficence. Because surrogates also imagine what they would want under the circumstances and consider their own needs and preferences, models of surrogate decision making must account for these additional considerations. Surrogates’ desire for more information about patients’ preferences suggests a need for greater advance care planning. (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)

The study was conducted to unveil social connectedness of the older adults in non-urban societies in Ghana, and the ecological and social inclusion theories underpinned the study. The descriptive cross-sectional survey was undertaken based on the positivist school of thought. Older adults who were 60 years or more, participated in the study. Older Adults’ Social Connectedness Questionnaire was designed to gather data to answer the research questions and test the hypothesis. Frequency counts and percentages, (...) mean and standard deviation and independent samples t-test were the analytical tools employed for the data analysis. The study unveiled, inter alia, that the older adults tend to enjoy moderate level of social connectedness and the major groups of people they frequently socially interact with are relatives, religious group members, neighbours and friends. The study also unveiled that religious activities, phone calls, cultural and social activities are the principal conduits for the older adults’ social interaction with significant others. Finally, the study establ ished a difference in the level of social connectedness of the male and female older adults. It is reckoned that the older adults in the rural settings need more and intensive social interactions to serve as impetus for longevity. (shrink)

Determining whether and/or how to enable older persons with disabilities to engage in sex raises several ethical considerations. With the goal of enabling the sexual functioning of older adults with disabilities, Jecker argues that sex robots could be used as a helpful tool. In her article, ‘Nothing to be Ashamed of: Sex Robots for Older Adults with Disabilities’, Jecker acknowledges the importance of sexual functioning and the fact that ageist assumptions incorrectly classify older persons (...) as asexual. Additionally, older adults may experience disabilities that negatively influence their sexual functioning, which is problematic since sex may be linked to the following capabilities: developing a meaningful life narrative; being healthy; experiencing bodily integrity; feeling and communicating emotions; affiliating with others and reflecting on and choosing a life plan.1 In accordance with Nussbaum’s capabilities approach,2 Jecker says that society has a duty to support these capabilities at a minimal threshold. And insofar as sexual functioning may be relevant to the capabilities for older adults with disabilities, then we need to respond accordingly. One way of achieving this aim is by providing access to sex robots. I agree that sex robots ought to be made available for older adults with disabilities. Nevertheless, the article inspires several areas for further exploration. As Jecker rightfully mentions, older adults are often incorrectly labelled as non-sexual. For instance, in their analysis of older individuals’ views on sex and quality of life, Gott …. (shrink)

Background: The present study compared the effects of a traditional resistance training and resistance training combined with cognitive task on body composition, physical performance, cognitive function, and plasma brain-derived neurotrophic factor levels in older adults. Methods: Thirty community-dwelling older adults were randomized into TRT and RT+CT. Exercise groups performed a similar resistance training program, twice a week over 16 weeks. Cognitive Training involved performing verbal fluency simultaneously with RT. Exercise sessions were performed 2-3 sets, 8-15 repetitions (...) at 60-70% of 1-repetition maximum. Body composition, physical function, cognitive performance, and BDNF levels were assessed before and after intervention period. Results: The physical performance was similarly improved in response to both TRT and RT+CT. However, exclusive improvements on cognitive function and BDNF levels were observed only after RT+CT. Conclusion: The RT program associated with a cognitive task, improved physical and cognitive performance in healthy older adults. (shrink)

This paper describes the significance of key empirical findings from the recent and landmark study Caring and Aging with Pride: The National Health, Aging and Sexuality Study (with Karen I. Fredriksen‐Goldsen as the principal investigator), on lesbian, gay, bisexual, and transgender aging and health disparities. We will illustrate these findings with select quotations from study participants and show how nonconscious bias (i.e., activation of negative stereotypes outside conscious awareness) in the clinical encounter and health care setting can threaten shared decision‐making (...) and perpetuate health disparities among LGBT older adults. We recognize that clinical ethicists are not immune from nonconscious bias but maintain that they are well situated to recognize bias and resulting injustice by virtue of their training. Further, we discuss how clinical ethicists can influence the organization's ethical culture and environment to improve the quality and acceptability of health care for LGBT older adults. (shrink)

The development of neuropsychological assessment methods using virtual reality (VR) is a valid and promising option for the detection of cognitive impairment in the older people, focusing on activities composed of tasks of multiple demands. This study verified the association of age, schooling, and general cognitive status on the performance of neurologically healthy older adults in ECO-VR, a virtual reality task of multiple demands for neuropsychological assessment. A total of 111 older adults answered a sociodemographic (...) questionnaire, the Mini Mental State Examination, the Vocabulary subtest of the Wechsler Intelligence Scale for Adults (third edition), and the ECO-VR. Correlation analyses, multiple linear regression, and comparisons between groups (effects by age and schooling groups) were used to evaluate the results. The ECO-VR total score was significantly associated with age, years of education, MMSE, and Vocabulary subtest. The linear regression models identified that age was the main predictor for total score and rule breaking of ECO-VR. According to the univariate analysis, it was identified the main effect of age group and schooling group in the total ECO-VR score, but there was no interaction effect. The results are discussed in order to understand the role of sociodemographic characteristics in the performance of older adults in a virtual reality task of multiple demands. It was also verified the possibility use of virtual reality for neuropsychological assessment of older adults. (shrink)

Reasoning requires making inferences based on information gleaned from a set of relations. The relational complexity of a problem increases with the number of relations that must be considered simultaneously to make a correct inference. Previous work (Viskontas, Morrison, Holyoak, Hummel, & Knowlton, 2004) has shown that older adults have difficulty integrating multiple relations during analogical reasoning, especially when required to inhibit irrelevant information. We report two experiments that examined the ability to integrate multiple relations in younger, middle-aged, (...) and older adults performing two other reasoning tasks. These tasks systematically varied relational complexity, and required either inductive reasoning (a version of the Raven's Matrices Task) or transitive inference. Our results show that as people age they have increasing difficulty in solving problems that require them to integrate multiple relations. This difficulty may stem from a decrease in working memory capacity. (shrink)

In this article we examine the association between national welfare regime and the propensity of middle–aged and older individuals with adult children of their own to provide social support to aged parents. Using data from mature adults (50+) in 26 European countries, we examine whether older and younger generations compete for the time resources of the middle “sandwiched” generation, and whether national policy context shapes this competition. Contrary to expectations, we found that sandwich generation members were less (...) likely to provide support to their parents in Conservative–Mediterranean and East European regimes, but more likely to do so in universalistic Social–Democratic regimes. This evidence supports the hypothesis that well–developed welfare states “crowd–in” family support to older individuals. Middle generation members who provided social support to their adult children tended to provide to their older parents as well. This was particularly true in the two regimes where resources and public benefits tend to be more generous and may be interpreted as state benefits that reduce intergenerational competition. Findings are discussed in terms of the capacity of state policies to shape the allocation of family resources to older adults where extended family lineages have become the norm. (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)

In recent years, foreign language learning has been proposed as a possible cognitive intervention for older adults. However, the brain network and cognitive functions underlying FLL has remained largely unconfirmed in older adults. In particular, older and younger adults have markedly different cognitive profile—while older adults tend to exhibit decline in most cognitive domains, their semantic memory usually remains intact. As such, older adults may engage the semantic functions to a (...) larger extent than the other cognitive functions traditionally considered the most important. Using anatomical measurements and a cognitive test battery, the present study examined this hypothesis in twenty cognitively normal older adults, who participated in a two-month Italian learning programme. Results showed that the immediate learning success and long-term retention of Italian vocabularies were most consistently predicted by the anatomical measures of the left pars orbitalis and left caudal middle frontal cortex, which are implicated in semantic and episodic memory functions. Convergent evidence was also found based on the pattern of cognitive associations. Our results are consistent with a prominent role of semantic and episodic memory functions in vocabulary learning in older learners. (shrink)

Social technology can improve the quality of older adults' social lives and mitigate negative mental and physical health outcomes associated with loneliness, but it should be designed collaboratively with this population. In this paper, we used participatory design methods to investigate how robots might be used as social facilitators for middle-aged and older adults in both the US and Japan. We conducted PD workshops in the US and Japan because both countries are concerned about the social (...) isolation of these older adults due to their rapidly aging populations. We developed a novel approach to participatory design of future technologies that spends 2/3 of the PD session asking participants about their own life experiences as a foundation. This grounds the conversation in reality, creates rapport among the participants, and engages them in creative critical thinking. Then, we build upon this foundation, pose an abstract topic, and ask participants to brainstorm on the topic based on their previous discussion. In both countries, participants were eager to actively discuss design ideas for socially facilitative robots and imagine how they might improve their social lives. US participants suggested design ideas for telepresence robots, social distancing robots, and social skills artificial intelligence programs, while Japanese participants suggested ideas for pet robots, robots for sharing experiences, and easy-to-operate instructor robots. Comparing these two countries, we found that US participants saw robots as tools to help facilitate their social connections, while Japanese participants envisioned robots to function as surrogate companions for their parents and distract them from loneliness when they were unavailable. With this paper, we contribute to the literature in two main ways, presenting: A novel approach to participatory design of future technologies that grounds participants in their everyday experience, and Results of the study indicating how middle-aged and older adults from the US and Japan wanted technologies to improve their social lives. Although we conducted the workshops during the COVID-19 pandemic, many findings generalized to other situations related to social isolation, such as older adults living alone. (shrink)

Older adults with age-related hearing loss exhibit substantial individual differences in speech perception in adverse listening conditions. We propose that the ability to rapidly adapt to changes in the auditory environment is among the processes contributing to these individual differences, in addition to the cognitive and sensory processes that were explored in the past. Seventy older adults with age-related hearing loss participated in this study. We assessed the relative contribution of hearing acuity, cognitive factors, rapid perceptual (...) learning of time-compressed speech, and hearing aid use to the perception of speech presented at a natural fast rate, speech embedded in babble noise, and competing speech. Speech perception was modeled as a function of the other variables. For fast speech, age [odds ratio = 0.79], hearing acuity, pre-learning perception of time-compressed speech, and rapid perceptual learning were all significant predictors. For speech in noise, only hearing and pre-learning perception of time-compressed speech were significant predictors. Consistent with previous findings, the severity of hearing loss and auditory processing was strong contributors to individual differences in fast speech and speech in noise perception. Furthermore, older adults with good rapid perceptual learning can use this capacity to partially offset the effects of age and hearing loss on the perception of speech presented at fast conversational rates. Our results highlight the potential contribution of dynamic processes to speech perception. (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)

El presente trabajo tiene como objetivo determinar los tipos de actividades de reformulación conversacional que aparecen en conversaciones en adultos mayores con diferentes niveles de desempeño cognitivo: normales y trastorno cognitivo leve, a partir de una tarea de construcción de un discurso narrativo-argumentativo. Desde una perspectiva de investigación cualitativa, se obtuvo un corpus de 4 entrevistas, que fue codificado con la ayuda del software ATLAS.ti lo que permitió la generación de conceptos y el desarrollo de explicaciones a partir de los (...) datos, los que fueron contrastados con el marco teórico disponible. Los resultados indicaron que los hablantes realizaron actividades de auto-reformulación auto-iniciada, auto-reformulación iniciada por otro y hetero-reformulación derivada del auto-inicio. Las dos primeras se redujeron en los hablantes identificados con trastorno cognitivo leve, mientras que el último tipo de actividad fue el más frecuente y dominante en la conversación. Los hablantes con trastorno cognitivo leve realizaron reformulaciones que no corregían o adecuaban el discurso, por lo que no cumplieron con la finalidad de la reparación. This study aimed to determine the types of activities of conversational reformulation that occur during oral dialogues with older adults who have varying levels of cognitive performance. Study participants, who ranged between normal cognitive function and mild cognitive impairment, were given the task of constructing a narrative-argumentative dialogue. For qualitative investigation purposes, a corpus of four interviews was obtained. Each series of interviews were encoded using ATLAS.ti software which generated linked concepts and explanations from the data. Findings were then compared with the available theoretical framework. The results indicated that participants exhibited three modes of reformulation technique: self-initiated self-reformulation activities; self-reformulation started by another person; and hetero-reformulation derived from self-start. The first two were reduced in speakers exhibiting mild cognitive impairment, while the latter was the most frequent and dominant mode in the conversation. Speakers with mild cognitive impairment executed reformulations that did not correct or enhance the speech, and as such did not meet the purpose of reformulation. (shrink)

During normal aging there is a decline in cognitive functions that includes deficits in oral discourse production. A higher level of education and more frequent reading and writing habits might delay the onset of the cognitive decline during aging. This study aimed at investigating the effect of education and RWH on oral discourse production in older adults. Picture-based narratives were collected from 117 healthy adults, aged between 51 and 82 years with 0–20 years of formal education. Measures (...) of macro, microlinguistic and modalizations were computed and entered as dependent variables in hierarchical regression analyses that included age, education and RWH as regressors. Results revealed that higher education explained a better performance at the macrostructure and microstructure dimensions. Higher frequency of RWH explained the production of fewer modalizations. These results demonstrate the positive effect of education and RWH in oral discourse production in older adults. Therefore, higher attention should be given to these social factors. (shrink)

Background To investigate attitudes of staff, residents and family members in long-term care towards sex and intimacy among older adults, specifically the extent to which they conceptualise sex and intimacy as a need, a right, a privilege or as a component of overall well-being. Methods The present study was a part of a two-arm mixed-methods cross-sectional study using a concurrent triangulation design. A validated survey tool was developed; 433 staff surveys were collected from 35 facilities across the country. (...) Interviews were conducted with 75 staff, residents and family members. Results It was common for staff, residents and family members to talk about intimacy and sexuality in terms of rights and needs. As well as using the language of needs and rights, it was common for participants to use terms related to well-being, such as fun, happiness or being miserable. One participant in particular described receiving intimate touch as a ‘kind of care’—a particularly useful way of framing the conversation. Conclusion While staff, residents and family frequently used the familiar language of needs and rights to discuss access to intimate touch, they also used the language of well-being and care. Reframing the conversation in this way serves a useful purpose: it shifts the focus from simply meeting minimum obligations to a salutogenic approach—one that focuses on caring for the whole person in order to improve overall well-being and quality of life. No data are available. (shrink)

Classic feminist social theory highlights the exploitation of women’s labor in capitalist societies traditionally through an examination of how housework and childcare is perceived and organized, excluding an explicit analysis of older adult care work. In light of the surge in the demand for older adult caregiving over the last several decades, this paper uses older adult care work as a new lens to understand how gender, and its intersections with other critical identities such as race, ethnicity, (...) and nativity, are a basis for continued exploitation and marginalization in modern capitalist systems. Building on Marxist feminism and Sylvia Wynter’s work on social value and domination, I argue that women’s care labor, both paid and unpaid, is an instrument of capital accumulation that differentially exploits women based on key intersectional identities. An examination of the system of older adult care work in the United States allows us to see the multilayered and complex system of exploitation that creates and institutionalizes existing social hierarchies as capitalism seeks to expand. The paper ends with a discussion of two potential family care paths America could conceivably pursue in the coming years; one toward increased commodification of care work in line with neoliberal capitalism, and the other toward more comprehensive social welfare policies that alleviate women’s reproductive labor burden and begin to break down gendered and racialized hierarchies. (shrink)

Inadequate pain control, especially in older adults, remains a significant issue when caring for this population. Older adults, many of whom experience multiple acute and chronic conditions, are especially vulnerable to having their pain seriously underassessed and inadequately treated. Nurses have an ethical obligation to appropriately treat patients’ pain. To fulfill their ethical obligation to relieve pain in older patients, nurses often need to advocate on their behalf. This article provides an overview of the persistent (...) problem of undertreated pain in older adults and explores how nurses can meet this ethical duty through the application of Beauchamp and Childress’ three principles of beneficence. (shrink)

Depression experienced by older adults is proving an increasing global health burden, with rates generally 7% and as high as 27% in the USA. This is likely to significantly increase in coming years as the number and proportion of older adults in the population rises all around the world. Therefore, it is imperative that the effectiveness of approaches to the prevention and treatment of depression are understood. Creative arts interventions, including art, dance movement, drama and music (...) modalities, are utilised internationally to target depression and depressive symptoms in older adults. This includes interventions led by trained arts therapists as well as other health and arts professionals. However, to date there has not been a systematic review that reports effects and examines the processes (why) and mechanisms (how) of creative arts interventions are used to address depression in this older age group. This systematic review of studies on creative arts interventions for older adults experiencing depression examined: outcomes of four creative arts modalities (art, dance movement, drama, and music); with particular attention paid to processes documented as contributing to change in each modality; and mechanisms considered to result from these processes. Our analysis of 75 articles (17 art, 13 dance, 4 drama and 41 music) indicates mostly significant quantitative or positive qualitative findings, particularly for interventions led by creative arts therapists. Mechanisms of change gleaned from the studies that were common across modalities include physical (e.g. increased muscle strength; neurochemical effects, such as endorphin release), intra-personal (e.g. enhanced self-concept, strengthened agency and mastery; processing and communication of emotions), cultural (e.g. creative expression, aesthetic pleasure), cognitive (e.g. stimulation of memory) and social (e.g. increased social skills and connection), that were all considered to contribute to reduced depression and symptoms. Recommendations for future research include a stronger focus on testing of processes and mechanisms. (shrink)

Older people are an increasingly important consumer group and hence advertising target, yet relatively little research in the UK and in Europe has examined how older adults are portrayed in advertising. In this study, a sample of 221 magazine advertisements depicting older adults were coded for features such as the advertised products, setting, role prominence, rhetorical scheme, tone and type of portrayal. In a departure from previous studies, we devised a set of six descriptive ‘types’ (...) which encapsulate the way older people are portrayed in these advertisements. Also, and as the main focus of this paper, we compared a magazine designed for people over 50 to ten general readership magazines in order to investigate any differences in the portrayal of older adults in age-targeted vs. general readership advertising. Previous research on old age stereotyping, social identity theory and inter-group theory form the basis of our analysis. (shrink)