Gerontologist最新文献_第3页

"I Haven't Grieved Yet…": The Experiences of Older Homeless Persons Living in Long-Term Transitional Housing.

IF 4.6 2区医学

Gerontologist Pub Date : 2025-02-15 DOI: 10.1093/geront/gnaf064

Émilie Cormier, Tamara Sussman, Valérie Bourgeois-Guérin, Diandra Serrano, Michel Gauthier, Atiya Mahmood, Christine A Walsh, Sarah L Canham

{"title":"\"I Haven't Grieved Yet…\": The Experiences of Older Homeless Persons Living in Long-Term Transitional Housing.","authors":"Émilie Cormier, Tamara Sussman, Valérie Bourgeois-Guérin, Diandra Serrano, Michel Gauthier, Atiya Mahmood, Christine A Walsh, Sarah L Canham","doi":"10.1093/geront/gnaf064","DOIUrl":"https://doi.org/10.1093/geront/gnaf064","url":null,"abstract":"Background and objectives: Older homeless persons can experience relief when accessing housing. However, becoming housed can also elicit the (re)emergence of loss and grief. Building on the notion of disenfranchised grief, this study sought to better understand how grief works together with relief to shape older persons' experiences living in long-term transitional housing.Research design and methods: Eleven older persons with experience of homelessness participated in up to three photovoice interviews in Montreal, Canada. Informed by the principles of interpretative phenomenology, their accounts and photos were analyzed to capture the nuances and depth of their lived experiences.Results: Analysis showed that relocation to long-term transitional housing allows for the re-emergence of grief associated with past losses, while also provoking new forms of grief related to housing conditions and anticipated losses. Analysis further revealed that a failure to recognize these losses, alongside a lack of resources to support the grieving process, can result in an accumulation of losses that widens the gap between older homeless persons' experiences and the world around them.Discussion and implications: If left unattended, grief and loss can threaten older homeless persons' reaffiliation when relocating to transitional housing. Adopting a humanistic-existential grief perspective could go a long way in supporting the development of housing policies, programs and practices that nurture the time and space required to attend to grief and truly address precarity in the final stages of life.","PeriodicalId":51347,"journal":{"name":"Gerontologist","volume":" ","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143426675","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Social Pathologies and the Fear of Ageing in Houellebecq's Postmodern Narrative.

IF 4.6 2区医学

Gerontologist Pub Date : 2025-02-15 DOI: 10.1093/geront/gnaf069

Ieva Stončikaitė

{"title":"Social Pathologies and the Fear of Ageing in Houellebecq's Postmodern Narrative.","authors":"Ieva Stončikaitė","doi":"10.1093/geront/gnaf069","DOIUrl":"https://doi.org/10.1093/geront/gnaf069","url":null,"abstract":"In Michel Houellebecq's écriture grise, the decline of Western civilisation is intertwined with contemporary maladies and the fear of ageing. A bleak depiction of ageing bodies functions as an extended metaphor for broader social pathologies, including the decline of spirituality, community well-being, and traditional values. Recurring themes such as the obsession with sex and anti-ageing bodywork, the cult of youth, compulsive consumerism, and erotic hedonism reflect Houellebecq's critique of the transformations of the second half of the 20th century. Many of his protagonists, trapped in an existential midlife crisis and driven by anxieties related to intimate relationships and societal pressures to remain functional, youthful, and engaged, frequently resort to suicide. Using the framework of interdisciplinary age studies and the critical theory of social pathologies, this article discusses how Houellebecq's characters struggle to navigate the challenges within competitive neoliberal imperatives, libidinal economies, and the discourse of successful ageing. It also underscores how his oeuvre, often characterised as apocalyptic, dystopian, or neo-decadent, advocates for authentic connection, care, faith, and unconditional love as essential components of human existence and survival.","PeriodicalId":51347,"journal":{"name":"Gerontologist","volume":" ","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143425791","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Strengthening Connections Between the Aging and Disability Networks: Perspectives from the Field.

IF 4.6 2区医学

Gerontologist Pub Date : 2025-02-15 DOI: 10.1093/geront/gnaf068

Traci L Wilson, Beth Blair, Virginia Biggar, Deborah Stone-Walls, Sandy Markwood

{"title":"Strengthening Connections Between the Aging and Disability Networks: Perspectives from the Field.","authors":"Traci L Wilson, Beth Blair, Virginia Biggar, Deborah Stone-Walls, Sandy Markwood","doi":"10.1093/geront/gnaf068","DOIUrl":"https://doi.org/10.1093/geront/gnaf068","url":null,"abstract":"The aging and disability networks in the United States provide services and supports enabling millions of older adults, people with disabilities, and caregivers to live in the community settings of their choice. With increasing numbers of people with disabilities aging into older adulthood and older adults aging into disability, community living requires seamless and equitable access to services and supports across the aging and disability networks and the life course. This Forum article provides a brief overview of the aging and disability networks and describes successful national initiatives bridging aging and disability organizations such as USAging's Aging and Disability Vaccination Collaborative and the National Aging and Disability Transportation Center. State and local trends in disability and aging collaborations are described, including the growth of community care hubs that bring aging and disability organizations together in social care networks to serve these populations. This article will help researchers better understand the current initiatives connecting aging and disability organizations and identify opportunities for further research.","PeriodicalId":51347,"journal":{"name":"Gerontologist","volume":" ","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143426001","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Early Mortality and Medical Complexity Among Medicolegal Cardiovascular Disease Deaths: Comparing housed and unhoused decedents.

IF 4.6 2区医学

Gerontologist Pub Date : 2025-02-13 DOI: 10.1093/geront/gnaf056

Ben King, Shriya Swamy, Shaya Khorsandi

{"title":"Early Mortality and Medical Complexity Among Medicolegal Cardiovascular Disease Deaths: Comparing housed and unhoused decedents.","authors":"Ben King, Shriya Swamy, Shaya Khorsandi","doi":"10.1093/geront/gnaf056","DOIUrl":"https://doi.org/10.1093/geront/gnaf056","url":null,"abstract":"Background: There are extreme psychosocial, environmental, and behavioral risks to the health and well-being of persons experiencing homelessness . Within this complex and hazardous environment, there is an opportunity to gain clearer perspective into the role of accelerating cardiovascular disease (CVD) progression alongside the aging cohort effect in this population.Method: Utilizing 2021 and 2022 data from the Harris County Medical Examiner, investigators analyzed cardiovascular disease-associated deaths for excess mortality and impact of age-related factors specific to persons experiencing homelessness. All medicolegal deaths involving CVD were examined to determine relative frequencies of secondary causes of death and the influence of age between housed individuals and individuals experiencing homelessness.Results: The examination of the CVD mortality cases among persons experiencing homelessness in 2021 (n=52) and 2022 (n=71) revealed important trends. The mean age for CVD deaths for persons experiencing homelessness was 58.6 and 60.6 years in 2021 and 2022 respectively. Despite this slight, recent increase, the average age for CVD death among persons experiencing homelessness is dramatically lower than the housed, medicolegal CVD deaths and the general population. Top-associated conditions were hypertension and atherosclerosis, regardless of housing status. However, Chronic Obstructive Pulmonary Disease (COPD) and Congestive Heart Failure (CHF) were more common in CVD deaths of people experiencing homelessness.Discussion: These findings re-emphasize the uniqueness and complexity of the risks for premature mortality in people experiencing homelessness. This underscores the call for social services and healthcare systems to be more responsive to the challenges faced by persons experiencing homelessness, with more integrated and targeted health and aging care interventions to address the specific needs of these marginalized individuals.","PeriodicalId":51347,"journal":{"name":"Gerontologist","volume":" ","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143411515","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Caring for people with dementia: Mapping the experience and journey from diagnosis.

IF 4.6 2区医学

Gerontologist Pub Date : 2025-02-13 DOI: 10.1093/geront/gnaf053

Ruth Brookman, Ruby Lipson-Smith, Olivia Maurice, Nina Mcllwain, Lukas Hofstaetter, Michelle DiGiacomo, Danielle Ní Chróinín, Madeleine J Cannings, Celia B Harris

{"title":"Caring for people with dementia: Mapping the experience and journey from diagnosis.","authors":"Ruth Brookman, Ruby Lipson-Smith, Olivia Maurice, Nina Mcllwain, Lukas Hofstaetter, Michelle DiGiacomo, Danielle Ní Chróinín, Madeleine J Cannings, Celia B Harris","doi":"10.1093/geront/gnaf053","DOIUrl":"https://doi.org/10.1093/geront/gnaf053","url":null,"abstract":"Background and objectives: Family care partners of people with dementia are not typically the focus of healthcare and aged care providers. They experience unmet needs, missed opportunities for support, and barriers to wellbeing that impact the dyad. This longitudinal study aimed to understand the experience of care partners, mapping their journey as they navigated healthcare and aged care systems as well as other supports.Research design and methods: Fifteen family care partners participated in this longitudinal, qualitative study. For 6 months they recorded details (provider, date, purpose, outcome, and satisfaction rating) of interactions with health and aged care services. Monthly semi-structured interviews reviewed experiences, prompted by logbooks. Thematic analysis identified factors that influenced care partners' experiences and mapped the typical journey.Results: Data indicated that participants' needs fluctuated with three key time points of heightened need: dementia diagnosis, in-home care, and transition into residential care. Thematic analysis identified three corresponding themes of carer need and risk: 'psychological support/ distress', 'social connection/social isolation', and 'knowledge/disempowerment'.Discussion and implications: Findings suggest a critical role of time in dementia care journeys, impacting the support that care partners need from healthcare and aged care systems. The potentially foreseeable, time-based nature of unmet needs suggests that education and training can highlight needs for knowledge, support, and connection, and the importance of prioritising them differentially according to the stages of the carer journey.","PeriodicalId":51347,"journal":{"name":"Gerontologist","volume":" ","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143411514","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Healthcare and Community Organizations Implementing Evidence-Based Dementia Caregiving Programs: Findings from Best Programs for Caregiving.

IF 4.6 2区医学

Gerontologist Pub Date : 2025-02-13 DOI: 10.1093/geront/gnaf059

Rachel M Cannon, David M Bass, Sara M Powers, Morgan J Minyo, Zoe F Fete, Megan K Huth

{"title":"Healthcare and Community Organizations Implementing Evidence-Based Dementia Caregiving Programs: Findings from Best Programs for Caregiving.","authors":"Rachel M Cannon, David M Bass, Sara M Powers, Morgan J Minyo, Zoe F Fete, Megan K Huth","doi":"10.1093/geront/gnaf059","DOIUrl":"https://doi.org/10.1093/geront/gnaf059","url":null,"abstract":"Background and objectives: A major success in implementation science is the delivery of evidence-based dementia support programs for family/friend caregivers by service organizations. Best Programs for Caregiving (BPC) launched in 2020 as an online resource profiling 42 evidence-based programs being delivered as regular services. Data collected in 2018-2019 describes the number, characteristics, and experiences of organizations delivering BPC programs.Research and design methods: Data came from structured surveys of program developers and organizations delivering BPC programs. Descriptive analyses profile programs and organizations.Results: In 2018-2019, 350 organizations were reported as implementing 37 BPC programs, serving an estimated 40,000 caregivers and persons living with dementia. Most delivery organizations were healthcare systems (n = 77, 23.8%), AAAs (n = 77, 23.8%), or Alzheimer's/Dementia Associations (n = 39, 12.0%). Eighteen funding sources were used to cover program-delivery costs, which most commonly were the Older Americans Act Title III E (n = 60, 34.3%) and non-ACL grants (n = 49, 28.0%). The most common challenges with delivering programs were marketing (n = 124, 69.8%) and engaging caregivers (n = 118, 66.3%), despite high satisfaction with program training and support.Discussion and implications: More organizations than previously known were delivering evidence-based BPC programs. Delivery experiences varied widely, with top challenges highlighting the need to increase knowledge of the availability of dementia caregiving support programs. Findings offer benchmarks for assessing the future availability and reach of evidence-based dementia caregiving programs to meet the needs of the increasing number of families caring for individuals living with dementia.","PeriodicalId":51347,"journal":{"name":"Gerontologist","volume":" ","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143416148","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Differing Realties among Assisted Living Residents with Dementia: Understanding Care Partner Responses.

IF 4.6 2区医学

Gerontologist Pub Date : 2025-02-12 DOI: 10.1093/geront/gnaf061

Candace L Kemp, Emerald Anglin, Jennifer Craft Morgan, Molly M Perkins, Elisabeth O Burgess

{"title":"Differing Realties among Assisted Living Residents with Dementia: Understanding Care Partner Responses.","authors":"Candace L Kemp, Emerald Anglin, Jennifer Craft Morgan, Molly M Perkins, Elisabeth O Burgess","doi":"10.1093/geront/gnaf061","DOIUrl":"https://doi.org/10.1093/geront/gnaf061","url":null,"abstract":"Background and objectives: Persons living with dementia can experience confusion in terms of orientation to time, place, and scenario. The ways care partners respond are apt to shape quality of life and care experiences. With a focus on assisted living (AL) residents with dementia, we seek to: 1) examine differing realities and care partner responses and 2) identify influential resident and care partner factors, other contributing contextual conditions, and response outcomes.Research design and methods: We present analysis of qualitative data gathered from a grounded theory (GT) study involving eight diverse AL communities each studied for a one-year period between 2019 and 2023. Researchers followed 73 residents with dementia and 103 care partners (family, friends, AL staff, external workers, volunteers), conducting interviews (n=236) and participant observation (980 visits and 2,676 hours), and reviewing resident participants' AL records. Guided by principles of GT, analysis was iterative, involved initial, axial, and selective coding, and led to the identification of the core category, \"reality management.\"Results: Most residents experienced dementia-related confusion. In response, care partners engaged in a process of \"reality management,\" which involved strategies that invalidated or validated realities and emotions; these included: ignoring, dismissing, correcting, redirecting, and joining. The nature, types and expression of confusion, and resident and care partner characteristics and capacities, influenced responses and outcomes.Discussion and implications: Findings reinforce the value of person- and situation-specific responses and have implications for practice and underscore the need for additional research.","PeriodicalId":51347,"journal":{"name":"Gerontologist","volume":" ","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143400477","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

"Where it's okay if we die": exploring older Canadians' perspective on long-term care through found poetry.

IF 4.6 2区医学

Gerontologist Pub Date : 2025-02-11 DOI: 10.1093/geront/gnaf040

Camille Joanisse, Samantha A Oostlander, Michael S Mulvey, Linda Garcia, Sandra Harrisson, Martine Lagacé, Sarah Fraser, Annie Robitaille, Margaret Gillis, Jill Courtemanche, Tracey L O'Sullivan

{"title":"\"Where it's okay if we die\": exploring older Canadians' perspective on long-term care through found poetry.","authors":"Camille Joanisse, Samantha A Oostlander, Michael S Mulvey, Linda Garcia, Sandra Harrisson, Martine Lagacé, Sarah Fraser, Annie Robitaille, Margaret Gillis, Jill Courtemanche, Tracey L O'Sullivan","doi":"10.1093/geront/gnaf040","DOIUrl":"https://doi.org/10.1093/geront/gnaf040","url":null,"abstract":"The thought of living in a nursing home may be disheartening as long-term care establishments have been poorly perceived for decades. The government oversight for quality of care in long-term care homes (LTCH) has resulted in persistent shortcomings when it comes to residents' well-being and health. The COVID-19 pandemic both exacerbated and unveiled long-standing issues regarding the treatment of older adults. Public perceptions about quality of care provided in LTCH declined during the pandemic. With magnification focused on organizational issues in LTCH, future care receivers expressed firm reluctance to consider residence in such facilities. Understanding of older adults' perspectives on LTCH is essential for tailoring care practices and policies. In this study we conducted two rounds of interviews with community-dwelling older adults aged 65 or over to better understand their perceptions of LTCH. The narrative data were analyzed using found poetry as an artistic inquiry. Six poems were composed, combining participants' words into one poetic voice - addressing themes such as death, isolation, ongoing healthcare challenges and private care. Found poetry allowed for salient words to emerge, creating space for nuanced expression of emotions. The combination of multiple voices added to the depth of the poems, which were grounded in the participants' reality.","PeriodicalId":51347,"journal":{"name":"Gerontologist","volume":" ","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143392525","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Understanding factors influencing personal care workers intentions to leave: A systematic integrative review.

IF 4.6 2区医学

Gerontologist Pub Date : 2025-02-11 DOI: 10.1093/geront/gnaf055

Britt O'Keefe, Eva Yuen, Briony Dow, Susan Perlen, Alison M Hutchinson

{"title":"Understanding factors influencing personal care workers intentions to leave: A systematic integrative review.","authors":"Britt O'Keefe, Eva Yuen, Briony Dow, Susan Perlen, Alison M Hutchinson","doi":"10.1093/geront/gnaf055","DOIUrl":"https://doi.org/10.1093/geront/gnaf055","url":null,"abstract":"Background and objectives: The global need for older persons' care, driven by demographic shifts such as an aging population and increased life expectancy, is outpacing the available care workforce. Nursing home operators face complex workforce challenges, including high turnover and low retention, particularly among personal care workers (PCW). The objective of this review was to understand the factors influencing PCWs' intention to leave.Research design and methods: Following Whittemore and Knafl's methodology and adhering to Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines, an integrative review of peer-reviewed literature published between 1997 and 2024 was undertaken. A comprehensive search was conducted across several databases, including Business Source Complete, CINAHL Complete, Medline Complete, APA PsycINFO, and EMBASE. All studies underwent independent screening and quality assessment using the Mixed Methods Appraisal Tool.Results: Included were 21 articles reporting 20 studies using quantitative (n=17), qualitative (n=3), and mixed methods (n=1), which identified various factors influencing PCWs' intention to leave. These factors were categorized as individual, job and organizational, and socio-political-environmental. Demographic characteristics, employee satisfaction, health, career development, workplace conditions, leadership, empowerment, resident connections, and societal perceptions influenced personal care workers' intentions to leave.Discussion and implications: The findings of this review reveal opportunities for nursing home operators and policy-makers to implement strategies to mitigate the high rates of turnover through PCW role and organizational reforms. Further, the findings underscore the need for qualitative research exploring the perceptions and experiences shaping the employment intentions of current and former PCWs.","PeriodicalId":51347,"journal":{"name":"Gerontologist","volume":" ","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143392528","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Family Structure and Unmet Care Needs among Older Adults with and without Dementia in the U.S.

IF 4.6 2区医学

Gerontologist Pub Date : 2025-02-11 DOI: 10.1093/geront/gnaf062

Sarah E Patterson, Vicki A Freedman

{"title":"Family Structure and Unmet Care Needs among Older Adults with and without Dementia in the U.S.","authors":"Sarah E Patterson, Vicki A Freedman","doi":"10.1093/geront/gnaf062","DOIUrl":"https://doi.org/10.1093/geront/gnaf062","url":null,"abstract":"Background and objectives: Family members provide the bulk of assistance to older adults with care needs, but implications of family structure for unmet care needs-and differences when dementia is present-are less clear.Research design and methods: We use samples of older adults with care needs from the 2015 National Health and Aging Trends Study (NHATS) and the 2017 Panel Study of Income Dynamics (PSID). We examine two measures that indicate whether needs are being met for self-care and mobility activities: having unassisted difficulty with at least one activity (NHATS, PSID) and experiencing any adverse consequences related to a lack of help (NHATS). In NHATS we also combine these to identify individuals with met (no unassisted difficulty; no consequences), self-met (unassisted difficulty only), under-met (any consequence only), and unmet needs (unassisted difficulty, any consequence).Results: Adverse consequences were reported more often among those with dementia (43%) relative to those without (24%); in contrast, unassisted difficulty was reported by fewer older adults with dementia (68%, 70%) than without dementia (85%, 87%). Having more family members was positively associated (OR=1.039) and having a spouse or partner was inversely associated (OR=0.700) with experiencing adverse consequences. Having stepchildren was associated with lower odds of having unassisted difficulty (OR=0.228, 0.531), but greater odds of unmet (relative to met) needs (RRR=1.610). Most family associations were not moderated by dementia.Discussion and implications: Adverse consequences, unassisted difficulty, and unmet need are distinct concepts, and produce different estimates and distinctive relationships with dementia and family structure.","PeriodicalId":51347,"journal":{"name":"Gerontologist","volume":" ","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143392527","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0