|Thursday, June 25|
An analysis of relationship between introverted and extroverted behavior and space environment of pension institutions
* Yawen Lu, Dalian University of Technology , China
Bo Zhou, Dalian University of Technology , China
Based on the theory of environment behavior,the behavior of the elderly in pension institutions can be divided into two types according to the behavior characteristics of the elderly: extroverted behavior and introverted behavior. The author believes that there is a close relationship between extroverted and introverted behavior and space environment of the pension institutions. Through field research, questionnaire interview, moving line observation and fixed-point observation, this paper analyzes the space environment of various activities, studies the relationship between old people's behavior and the environment, records the location and content of old people's activities in different periods, analyzes the relationship between the choice of places of activities and the space environment of pension institutions, and extroverted and introverted behavior of the elderly. The purpose of this paper is to summarize how to further meet the needs of the elderly and improve the living environment of the elderly through scientific research and analysis, so as to provide reference proposals for improving the living quality and management construction of pension institutions.
Supporting aging in place for older adults with long-term mobility disability: A person-environment approach
* Widya A. Ramadhani, University of Illinois at Urbana Champaign, United States
Wendy A. Rogers, University of Illinois at Urbana Champaign, United States
Aging in place at home is the more preferred living option because it allows older adults to maintain independence in their familiar environment. Despite its benefits, aging at home is not exempt from challenges. The challenges can come from the intra-individual factors (i.e., functional limitations) and extra-individual factors (i.e., physical environment barriers). Lawton and Nahemow's ecological theory of aging emphasizes the transaction of these factors to allow successful adaptation. Adapting to changes within the body and the residential settings are both important in maintaining older adults' behavior and activity engagement. This study aimed to develop a fundamental understanding of the specific needs of older adults with long-term mobility disability who are aging in their homes. Their aging in place experience may be different from the general population because their age-related changes are secondary to their primary disability. This study analyzed the qualitative data from 60 in-depth structured interviews that were part of the Aging Concerns, Challenges, and Everyday Solution Strategies (ACCESS) study. The interview was conducted with older adults who have a mobility disability prior to the age of 50 years old. The analysis focused on the basic daily activities (ADLs) conducted within the home environment, which are: (1) bathing, showering, and grooming, (2) dressing, (3) eating or feeding self, (4) moving around the home, (5) toileting, and (6) transferring. Through the analysis, we found that the activities of daily living challenges are tied to personal and environmental factors, such as physical access, general health limitations, physical strength, and transferring. There are opportunities for the built environmental design to fill in the gap between person competence and environmental press. Understanding the experience of basic activities engagement in the home is an important step to develop better home design research and design strategies for older adults with long-term mobility disability.
Implementing shared decision-making in interprofessional home care teams supporting frail elderly facing housing decisions: a stepped wedge cluster randomised trial
* France Légaré, Université Laval, Canada
* Lionel Adisso, Université Laval, Canada
Nathalie Brière, CIUSSS de la Capitale-Nationale, Canada
Dawn Stacey, University of Ottawa, Canada
Guy Lacroix, Université Laval, Canada
Sophie Desroches, Université Laval, Canada
Serge Dumont, École de service social, Université Laval, Canada
Kimberly Fraser, University of Alberta, Canada
Louis-Paul Rivest, Université Laval, Canada
Monica Taljaard, University of Ottawa, Canada
Pierre J. Durand, Université Laval, Canada
Henriette Bourassa, Université Laval, Canada
Lise Roy, Université Laval, Canada
One of the toughest decisions faced by frail elderly is whether to stay at home or move to a care facility. This study seeks to scale up and evaluate the implementation of shared decision-making (SDM) in interprofessional (IP) home care teams supporting frail elderly facing housing decisions. A stepped wedge cluster randomised trial involving nine Integrated (University) Health and Social Service Centers (CISSS/CIUSSS) in the province of Quebec was conducted with IP home care teams. Participants were CISSS/CIUSSS, clients and caregivers. Participating CIUSSS/CISSS were randomised to one of four intervention periods. Clients were eligible if they (1) were aged ≥65; (2) were receiving care from the IP home care team; (3) had made a decision about whether to stay at home or move to another location; (4) are able to read, understand and write French or English; (5) were able to provide informed consent. If clients were not able to provide informed consent, their primary caregiver became the eligible participant. The intervention, targeted at IP home care teams, consisted of a 1.5-hour online tutorial and a 3.5-hour skills building workshop in IP SDM. The comparator was a decision guide distributed at the beginning of the project. The primary outcome was whether clients and caregivers assumed an active role in decision-making. Zip codes were used to identify rural or urban living environment. A generalized mixed linear model based on the approach suggested by Kasza et al. was used. A binomial distribution with a log link was used to model prevalence ratio. Results are in process: Analyses will take into account the influence of rural/urban living environment by evaluating confusion and effect modification (subgroup analyses). Innovative practices will allow the optimization of housing decisions faced by frail elders living in rural/urban environment.