Poster Session
Location: Top Floor mezzanine
Social Model Hospice Homes: An Untapped Resource for Reducing EOL Disparities and Training Community Caregivers
Poster Session Kelly Melekis, Carol Weisse
The provision of equitable care at the end-of-life, especially for marginalized populations, is a serious public health issue requiring community action and involvement. To address the challenging barriers to end-of-life care, communities across the U.S. have been opening non-medical, residential care homes (RCHs) that employ a social model of hospice care where members of the community volunteer to serve as surrogate family so that individuals can access hospice services in a home setting. These homes strive to address the critical gap in case for individuals who are eligible for hospice but who are unable to access these services due to housing and/or caregiver insecurity. In this paper, we share data on the characteristics of social model hospice homes and their residents, based on a retrospective chart review of 500 residents, and highlight the potential of these community-run RCHs to promote well-being for both the dying and their caregivers. We also share data on an experiential training model for interprofessional education in end-of-life care that combines online learning, weekly seminars, and the provision of bedside care in a social model hospice home. Implications for building capacity for research and training at social model hospice homes is discussed.
Older People as the Main Character: Representation of Ageism and Sexism in Film
Poster Session Jill Chonody
Social beliefs are reflected in media portrayals of older adults, and this in turn, intersects with the presentation of gender. This study examines ageism when an older person is the main character, a novel approach to studying ageism in cinema, during a twenty-year time frame. Films were identified by employing Google searches of “films with an older adult(s) as the main character” and list was compiled. Searches continued until saturation was achieved, and then each film was examined to determine if it met inclusion criteria. Forty-six characters were analyzed from 28 US and UK films utilizing an author-created screening tool based on five ageism scales. Analysis reveals that ageist content remained about the same and was moderate across this timeframe. Results also indicate that positive stereotypes were found more often, particularly for female leads, while male leads more often embodied negative depictions. This suggests some shift from the stereotype of an older woman who is warm and positive with others. Nonetheless, if prevailing narratives - however benign or malevolent – are not consistently challenged, wider society will be resistant to change, too. As many countries experience an aging of the population, pressure from the “silver economy” may challenge ageist presentations in film, including the double standard of aging, and create a shift in representation. Given that we all likely want to be a part of this demographic, greater social pressure for content that presents a balanced and more nuanced picture of older adulthood will be needed.
Increased Odds of Hospital Long-stay Delayed Discharge in Senior Patients View Digital Media
Poster Session Brent E. Faught
The objective of this study is to determine the factors that increase the odds of long-stay delayed discharge in alternate level of care (ALC) patients using data collected from the Ontario Wait Time Information System (WTIS) database. Retrospective cohort study utilizing data from Niagara Health’s WTIS database. WTIS includes individuals admitted to any of the Niagara Health sites that have been designated as ALC. The sample consisted of 16,429 ALC senior patients who received care in Niagara Health hospitals and were recorded in the WTIS database. ALC designation of 30 or more days was used as the threshold for a long-stay delayed discharge. This study used binary logistic regression modeling to analyze sex, age, admission source, and discharge destination as well needs/barriers requirements to assess the likelihood of a long-stay delayed discharge among acute care (AC) and post-acute care (PAC) patients given the presence of each variable. Overall, 10.2% of the sample were considered long-stay ALC patients. Both AC and PAC long-stay ALC patients were more likely to be male [OR=1.23, (1.06-1.43); OR=1.28, (1.03-1.60)] and have a discharge destination of a long-term care bed [OR=28.68, (22.83-36.04); OR=6.22, (4.75-8.15)]. AC patients had bariatric [OR=7.16, (3.45-14.83)], behavioral [OR=1.89, (1.22-2.91)], infection (isolation) [OR=2.31, (1.63-3.28)], and feeding [OR=6.38, (1.82-22.30)] barriers hindering discharge. PAC patients had no significant barriers hindering patient discharge. Understanding the importance of specialized patient requirements in addition to clinical factors can help hospitals become more prepared in preventing delayed discharges.
Supporting Community Organizations to Promote a Meaningful Life in Retirement: Ideas and Reflections
Poster Session Couture Laurence, Valérie Poulin
With an aging population, a large number of people are currently making the transition to retirement. This can affect well-being, while developing and maintaining meaningful reference points in one's life can be a challenge during this transition. At present, retirement preparation programs focus mainly on the financial aspects of retirement, with little attention paid to the diverse backgrounds and needs of seniors. This study aims to develop a tool to support community organizations wishing to accompany seniors in addressing engagement and meaning in their services offered with regard to the transition to retirement. A review of the literature and an expert committee made up of agency managers and researchers in the field of aging were carried out. The preliminary version of the tool is based on the "Do live well" model, which reinforces the principles of prevention to promote the well-being of people, in relation to their life courses and desires. This tool deconstructs the vision of retirement as a challenge and instead positions this life transition as an opportunity to engage in meaningful activities. The presentation includes examples of the themes addressed in the tool. It is an opportunity to reflect with participants on the different ways of approaching retirement, and to raise awareness of the importance of supporting organizations that work with seniors from this perspective.
Population and Global Health Nursing: Community Programming to Promote Aging in Place and Social Wellbeing for Older Adults
Poster Session Courtney Reinisch
Community programs are needed to promote social wellbeing, physical health, and maintenance of cognition for older adults. An innovative approach to address these needs for the aging population may lie with leveraging of nursing students and partnering with community agencies. This study describes the experience of involving nursing students in health promotion for older adults by partnering with senior services of a local health department. Social isolation and loneliness are at epidemic proportions in the United States as noted by the Surgeon General (2023). These conditions are highly prevalent in older adults and can result in physical and mental health deterioration. Public health policy and programs are needed to allow older adults opportunity for civic engagement, continued learning, and promoting diversity. Nursing students are a valuable resource where teaching and learning is reciprocal. Nursing students prepared engaging informational sessions for older adults living in one suburban community. The settings were community rooms of three different public housing apartments, a community center, and a long-term care facility. Students taught older adults about dehydration, blood pressure management, stress management, and the importance of physical exercise. Students led the residents in chair yoga sessions and strength exercises. The cognitive, social, and physical activities promote social wellbeing and decrease the feelings of loneliness many older adults experience. While the older adults benefit from the learning and social engagement, nursing students demonstrate cultural humility and practice communication skills. Students learn about loss and witness the effects of social determinants on health of aging populations.
Community Nursing Education Innovation Using Cardiac Risk Assessment
Poster Session Mary Elzabeth Duffy, Courtney Reinisch
Heart disease is the leading cause of death globally. A cardiac risk assessment is needed. Community programs for maintaining older adults' physical, mental, and social well-being are needed for aging populations globally. This abstract explains the experience of teaching cardiac risk assessment to nursing students to allow them to conduct assessments in the community with partner organizations. The Healthcare Foundation of New Jersey funded this innovation. Nurses play a crucial role in health promotion and primary prevention of disease. Students in a population and global health course are provided with the information, skills, and necessary materials to perform comprehensive cardiac risk assessments. They first learn the steps and practice the skills in the clinical laboratory setting. They take their hands-on learning and practice the skills in various community-based settings, from campus to local high schools to church basements. Nursing students develop communication skills to inform and empower populations about lifestyle choices regarding smoking cessation, dietary enhancements, exercise, and stress management. Nursing students see firsthand the impacts of social determinants of health, the importance of cultural humility, and practice counseling skills with participants in the CV risk assessment. Nursing students develop communication skills to inform and empower populations about lifestyle choices regarding smoking cessation, dietary enhancements, exercise, and stress management. Preparing nursing students to conduct comprehensive assessments with cultural humility while engaging with the community is an innovative approach to addressing the morbidity and mortality associated with heart disease. This program promotes healthy physical and social aging into older adulthood.
Implementing Food Shaping Methods in Aged Care: A Policy Review to Guide Organizational Innovation
Poster Session Lily Chen, Deborah Debono, Bronwyn Hemsley
Food shaping methods (e.g., food molds) can improve nutrition for older people, particularly those with dysphagia (swallowing difficulty) who require texture-modified foods. Improved aged care quality and safety standards are expected to drive improvements in food and nutrition. However, little is known about how far current policies cover dysphagia, nutrition, texture modification, and food shaping. This policy review analyzes the information content of Australian aged care policies on nutrition for content relating to nutrition, dysphagia, food textures, and food shaping to guide aged care services in meeting quality and safety standards. We reviewed 13 relevant publicly available policies on nutrition in aged care, including 54 documents, produced by Australian national, state and territory health and ageing departments. Data was extracted from the policies and analyzed for informational content relating to dysphagia, texture-modified foods, nutrition, and food shaping. While all 13 of the policies provided statements on nutrition for older people, only 3 provided statements, limited in detail, relating to dysphagia, nutrition, texture-modified foods, and food shaping. Detailed results are presented and discussed in relation to future policy directions to support implementation of food shaping techniques in aged care. Current nutrition and aged care policy is lacking guidance and direction on how aged care service providers are to implement food shaping methods to improve the nutrition of older people with dysphagia. Further research is needed to identify barriers and facilitators to implementing a range of food-shaping methods in aged care to improve nutrition.
Minority Language Seniors: What Are Their Issues, Needs and Priorities for Maintaining Their Well-being and Health?
Poster Session Marie-Michèle Lord, Helene Carbonneau, Joanie Theriault, Galaad Lefay
Seniors from linguistic minorities make up a significant proportion of Canada's population, as in other countries, in both urban and rural areas. Evidence shows that these people face challenges in accessing health care and social services, particularly in terms of being able to explain their health problems in their language of origin. While this is an important finding, the other issues involved in maintaining health and well-being are poorly documented, and the voice of seniors themselves is little heard when it comes to their priorities. A research project was carried out in 2024 with the following objectives: 1) to identify the issues experienced by English-speaking seniors in Quebec (Canada's French-speaking province) when taking action to maintain their health and well-being; 2) to enable these people to target priorities for action to foster a health and social services system that enables them to adequately support their health and well-being. This project used a mixed design combining an online questionnaire (n= 545) with three focus groups (urban, rural, and remote). Results: This presentation will focus on the results of the online questionnaire. The analyses identified issues related directly to language, but also to stigmatization (e.g. feeling of having to go to a different province to access respectful care due to belonging to a linguistic minority) and issues of intersectionality (e.g. ageism and capcitism). A better understanding of these issues as experienced and reported by seniors themselves offers valuable avenues for improving health and social services practices for this population.
Comparison of Two Pilot Project Proposals to Manage Oral Health Care Needs in Missouri
Poster Session Julie Sutton
In Missouri, 18% of the population is aged over 65 years and 14.2% of the same population reports total extraction of their teeth. Nearly 85,000 people who are elderly, and differently abled receive institutionalized care. Missouri ranks below the national average for quality of care provided in nursing homes, and maintains a low status for institutionalized and noninstitutionalized access to oral health care. The reasons for this are myriad, however, one prevailing reason is oral healthcare provider shortage in the form of dentists, dental hygienists, and dental assistants. As of 2023, 338 Dental Care healthcare provider shortage areas were designated in Missouri leaving more than two million people without access. In 2022, the Missouri Dental Board in collaboration with the Missouri Department of Health and Senior Services Office of Dental Health released pilot project proposals to better meet the oral health needs of underserved populations in Missouri, especially the aging and institutionalized population. One such project leverages and expands the collaboration of dental professionals (Nursing Home Pilot Project with Telehealth), and one elevates the Dental Assistant to alleviate the impact of shortages among Dental Hygienists (EFDA-Oral Preventive Assistant (OPA) Pilot Program). This poster compares and contrasts the two pilots and predicts impacts with the intent to guide other states and regions in their management of reduced access to oral healthcare among the aging population.
The Aging and Sustainability of Villages in Depopulated Areas in Japan
Poster Session Masami Nakata, Tomoo Nakata
This study examines the impact of aging on small villages in depopulated areas in Japan. In response to the decline caused by aging, some Japanese villages received support from local governments through substantial subsidies and the deployment of personnel to the communities. In this research, two small villages in A Prefecture were analyzed to identify their commonalities and differences and elucidate the effects of aging. The two villages in A Prefecture (B Village and C Village) were compared and studied. Since 2014, field visits have been made several times to conduct interviews and observations, with the most recent visit being in February 2023. Both villages created essential facilities, such as shops, through community funding around 2000. Their differences included the location of the villages and their acceptance of new residents. In 2014, the leaders were confident in the sustainability of their organizations. Regarding the changes up to 2023, both villages experienced a reduction in services and a decrease in the number of people involved. Notably, neither village had found a promising successor. However, B Village was seeking cooperation with other organizations within the town. The changes observed were; 1) Due to regional aging and population decline, the scope of activities and maintenance of shops have become unsustainable. 2) The absence of successors was making sustainability difficult. This was attributed to the younger generation not sharing a sense of urgency. In this way, the sustainability of the villages was related to the issue of aging in two ways.
How to Think about Space to Make It Enabling for Elder People
Poster Session Pierre Yves Therriault, Galaad Lefay
Faced aging populations, public policies align with the desire of the elderly to remain at home and maintain autonomy. However, few theoretical and practical tools are currently available to support this desire. To this end, the concept of “enabling space” was proposed, aiming to create environments allowing elderly people to live independently while being integrated into their community. We discuss the development of concept of enabling space through an analysis of different cases aiming to operationalize it and determine its contribution to a plural aging population (inclusion, fulfillment, and community engagement). The objective is to show how these environments can improve the quality of life for elderly by encouraging their active participation in society. The concept analysis method was used for development; this involves the use of case studies. This helps to understand different dimensions of the concept and identify key elements for implementation. This approach also allows for analyzing the challenges and opportunities related to creating enabling spaces. Three cases (typical, opposite, and borderline) helped identify and categorize the six central attributes and the factors facilitating or hindering the establishment of enabling environment. Examples will present these dimensions and the associated issues, particularly in anticipating the evolution of the elderly and a plural aging process. The development of living environments capable of responding to the plurality of aging must be supported by interdisciplinary and intersectoral reflection. The concept of an enabling environment is discussed in relation to the goal of empowering the elderly in their choice of living environment.
