Arts-based interventions for person's with dementia and their caregivers represent an inexpensive... more Arts-based interventions for person's with dementia and their caregivers represent an inexpensive, non-invasive, and non-pharmacological intervention with the potential to improve psychological function as well as reduce healthcare costs. The paper presents an overview of Voices in Motion (ViM), and the impact of this social-cognitive intervention on changes in psychological function for those with dementia and their caregivers (current n=26 dyads). Choir rehearsals were held on a weekly basis, and included a social discussion component. A range of outcomes (neuropsychological and physiological function, neural activation) were assessed using an intensive repeated measures design that facilitates both between-and within-person analyses, including nuanced evaluation of whether psychological function improves post intervention relative to an individual's personal average, yielding a conservative within-person test of the benefits of intervention. Discussion focuses on the promise of such interventions for mitigating dementia symptoms and facilitating the psychological health of caregivers.
Arts-based interventions for person's with dementia and their caregivers represent an inexpensive... more Arts-based interventions for person's with dementia and their caregivers represent an inexpensive, non-invasive, and non-pharmacological intervention with the potential to improve psychological function as well as reduce healthcare costs. The paper presents an overview of Voices in Motion (ViM), and the impact of this social-cognitive intervention on changes in psychological function for those with dementia and their caregivers (current n=26 dyads). Choir rehearsals were held on a weekly basis, and included a social discussion component. A range of outcomes (neuropsychological and physiological function, neural activation) were assessed using an intensive repeated measures design that facilitates both between-and within-person analyses, including nuanced evaluation of whether psychological function improves post intervention relative to an individual's personal average, yielding a conservative within-person test of the benefits of intervention. Discussion focuses on the promise of such interventions for mitigating dementia symptoms and facilitating the psychological health of caregivers.
Canadian Journal of Nursing Research Archive, Dec 1, 2013
An aging population is driving increased demand for health services and a shift in care from hosp... more An aging population is driving increased demand for health services and a shift in care from hospital to home. Concerns about the high costs of acute care and the realization that hospitals are "bad places" (e.g., nosocomial infections, functional loss) for old, frail people have focused attention on treating people in their homes, which is for the most part where they prefer to be. Fortunately, technology has the potential to reduce health-care costs, enhance access to services, and improve management of chronic diseases (Center for Aging and Health, 2013). Home telehealth programs have documented positive outcomes, including reduced health-care costs, fewer hospitalizations and readmissions, improved quality of care, and better chronic disease management (Broderick & Lindeman, 2013; Chetney, 2008). A study of home telehealth implemented in several regional health-care systems in the United States found that health-care utilization decreased 20% for diabetes, 30.3% for hypertension, and 25.9% for congestive heart failure (Broderick & Lindeman, 2013). Another study demonstrated a 50% reduction in hospital readmissions related to heart failure and a total net savings of $8,155 per patient (Broderick, 2013); the findings indicate high levels of patient satisfaction, reduced hospitalization and readmission, decreased length of hospital stay, and decreased emergency department visits. What, then, is holding back the wider adoption of home telehealth? Most of the home telehealth programs brought to scale have required development of software unique to each health-care organization, which limits access to data across levels of care (e.g., acute care, home care, primary care). The home health consumer market has seen a proliferation of standalone devices that address specific needs (e.g., personal medical alert systems, medication dispensing devices, blood glucose meters). Home activity sensors (e.g., Lively) that "learn" personal routines and use built-in wireless service to alert caregivers when help may be needed are the latest product to enter the market. However, the usefulness of these
F oundations, including those that fund in the field of aging, are facing challenging times as a ... more F oundations, including those that fund in the field of aging, are facing challenging times as a result of the economic downturn. This article discusses recent factors affecting foundations, examines their responses to the recession, and highlights foundation efforts to address aging issues in three areas: (1) research that identifies salient financial problems, (2) programs that help older Americans address or prevent financial vulnerability, and (3) advocacy that addresses such problems.
Meaning-management theory (MMT) suggests living a meaningful life leads to higher death acceptanc... more Meaning-management theory (MMT) suggests living a meaningful life leads to higher death acceptance. This paper investigates how generativity, i.e. the intention to bring benefits to the next generation, can affect death acceptance through achieving meaning in life (MIL). 343 participants in Hong Kong (aged 18-90) filled in a questionnaire as part of "Age(ing) as Future" project. Generativity positively correlates with death acceptance. MIL fully mediates the effect of generativity on death acceptance (r(343)=.132, p=.014). The effect of generativity on MIL might differ by age and perceived influences of generative acts. As speculated, the mediation is moderated by Age and Transformational Future Time Perspective (TFTP; generative impact that expands future time perspective). In older adults with lower TFTP, generativity no longer predicts MIL and the mediation was nonsignificant. The results provide empirical support to MMT and emphasise the importance of perceived impact and the needs in different developmental stage.
This descriptive qualitative study explores the key characteristics, benefits, and lessons learne... more This descriptive qualitative study explores the key characteristics, benefits, and lessons learned from community-based choirs consisting of persons with dementia (PwD) and their caregivers based on reports from choir administrators and directors. Although there is growing interest in choirs for PwD, there has been no synthesis of information on these choirs. Semi-structured interviews were conducted between December 2016 and February 2017 with six administrators and/or directors of community-based choirs for PwD and their caregivers. The interviews were audio-recorded and transcribed. Content analyses indicated that choirs had many similarities in membership (e.g., early to mid-stage dementia), establishing formal sections and harmonies (e.g., soprano, alto, tenor, bass), administration (e.g., leadership, fees), and music programming (e.g., public performance, duration, and length of practice sessions). Benefits of the choir include enjoyment, sense of purpose, empowerment, caregiver support and respite, and increased awareness of dementia by others. In conclusion, this descriptive study suggests that community-based choirs are a cost effective and valuable program that improve quality of life for PwD and caregivers.
We Built It, But They Are Not Coming: Exploring Deterrents to Consumer Medication Information Use
PubMed, Aug 9, 2019
Given the prevalence of prescription medication use, it is important that consumers are aware of ... more Given the prevalence of prescription medication use, it is important that consumers are aware of the benefits and risks of taking their prescribed medications. One approach to informing consumers in North America is to provide them with Consumer Medication Information (CMI), the paper leaflets given to consumers when they fill a prescription for the first time. Unfortunately, reported use rates of written medication information are quite low. As part of a broader study investigating memory, perceptions, preferences and information needs around CMI, this study specifically examined reported deterrents to CMI use. Findings from this study revealed three areas that appear to influence CMI use: 1) Documentation, how CMI is designed and what it contains; 2) Provision, how and when CMI is given to consumers; and 3) Context, what the individual's characteristics and experiences are. These three factors warrant further investigation to reveal more of their unique facets and their relative influences on CMI use. That is, some aspects may be more influential than others.
Disability has become normative in old age, for the greater numbers of 1) persons with disability... more Disability has become normative in old age, for the greater numbers of 1) persons with disability now living long enough to experience the problems of aging and 2) older adults living long enough to experience the problems of disability. Regardless of the cause of disability, assistive technology (AT) has a major impact on the lives of older adults and its use has escalated. Federal and state policy makers have enacted legislation that encourages the use of AT devices and environmental changes in residences (i.e., home modification [HM]). Attention, however, has been focused on national policies such as the State Tech Act despite the presence of many stateinitiated actions. This article first presents a brief rationale for studying state-level AT/HM efforts. It then summarizes and critiques earlier studies before describing the methods and results of two studies of four different agencies with some responsibility for AT and/or HM for elders. A final section discusses the limitations and implications of these research projects, with reference to AT/HM policies and practices in the future.
Are Health Literacy and eHealth Literacy the Same or Different?
PubMed, 2017
Many researchers assume that there is a relationship between health literacy and eHealth literacy... more Many researchers assume that there is a relationship between health literacy and eHealth literacy, yet it is not clear whether the literature supports this assumption. The purpose of this study was to determine if there was a relationship between health and eHealth literacy. To this end, participants' (n = 36) scores on the Newest Vital Sign (NVS, a health literacy measure) were correlated with the eHealth Literacy Scale (eHEALS, an eHealth literacy measure). This analysis revealed no relationship (r = -.041, p = .81) between the two variables. This finding suggests that eHealth Literacy and health literacy are dissimilar. Several possible explanations of the pattern of results are proposed. Currently, it does not seem prudent to use the eHEALS as the sole measure of eHealth literacy, but rather researchers should continue to complement it with a validated health literacy screening tool.
... of long-term care (Ansello, 2004; Putnam, 2004). How this will play out remains to be seen, b... more ... of long-term care (Ansello, 2004; Putnam, 2004). How this will play out remains to be seen, but there are some promising forces furthering efforts to bring the two service spheres together. Improvements in the service systems will do much to counter the effects of ageism on ...
Bullet points: ï‚· We reviewed current literature on care of older adults in Emergency Departments ... more Bullet points: ï‚· We reviewed current literature on care of older adults in Emergency Departments (ED's) and assessed organizational culture in ED's using a framework developed by Edgar Schein. ï‚· We found that artifacts such as building design and the physical organization of the ED department focused on ease of monitoring of patients' status and facilitating patients' movement through the department negatively impact care of older adults. ï‚· Values and beliefs held by ED staff members, including that the ED was for urgent cases and that old people with non-urgent needs did not count in the department impact the respect older adults is given by staff members and the care they receive.
A national survey of the aging network-State Units on Aging (n = 42) and Area Agencies on Aging (... more A national survey of the aging network-State Units on Aging (n = 42) and Area Agencies on Aging (n = 342)-was conducted to examine their activities to address the assistive technology (AT) and home modifications (HM) needs of older adults. The study contrasts the awareness of and importance placed on AT /HM programs and services by state and local administrators of aging agencies; describes interagency activities; identifies challenges in service delivery; and discusses several innovative sevice models. These findings indicate that although state-level collaboration between the aging network and the rehabilitation system is on the rise, there has been little measurable impact on service delivery at the local level where the needs of elders with disabilities are addressed.
... Springer Publishing Company, Inc. 11 West 42nd Street, 15th Floor New York, NY 10036-8002 Acq... more ... Springer Publishing Company, Inc. 11 West 42nd Street, 15th Floor New York, NY 10036-8002 Acquisitions Editor: Helvi Gold Production Editor: Print Matters, Inc. Cover Design: Mimi Flow Composition: Compset, Inc. Library ...
Canada shares many similarities with other industrialized countries around the world, including a... more Canada shares many similarities with other industrialized countries around the world, including a rapidly aging population. What sets Canada uniquely apart is the collaborative approach that has been enacted in the health care system and the aging research initiatives. Canada has tremendous pride in its publicly funded health care system that guarantees universal coverage for health care services on the basis of need, rather than ability to pay. It is also distinguished as a multicultural society that is officially bilingual. Aging research has developed rapidly over the past decade. In particular, the Canadian Longitudinal Study on Aging is one of the most comprehensive research platforms of its kind and is expected to change the landscape of aging research.
Arts-based interventions for person's with dementia and their caregivers represent an inexpensive... more Arts-based interventions for person's with dementia and their caregivers represent an inexpensive, non-invasive, and non-pharmacological intervention with the potential to improve psychological function as well as reduce healthcare costs. The paper presents an overview of Voices in Motion (ViM), and the impact of this social-cognitive intervention on changes in psychological function for those with dementia and their caregivers (current n=26 dyads). Choir rehearsals were held on a weekly basis, and included a social discussion component. A range of outcomes (neuropsychological and physiological function, neural activation) were assessed using an intensive repeated measures design that facilitates both between-and within-person analyses, including nuanced evaluation of whether psychological function improves post intervention relative to an individual's personal average, yielding a conservative within-person test of the benefits of intervention. Discussion focuses on the promise of such interventions for mitigating dementia symptoms and facilitating the psychological health of caregivers.
Arts-based interventions for person's with dementia and their caregivers represent an inexpensive... more Arts-based interventions for person's with dementia and their caregivers represent an inexpensive, non-invasive, and non-pharmacological intervention with the potential to improve psychological function as well as reduce healthcare costs. The paper presents an overview of Voices in Motion (ViM), and the impact of this social-cognitive intervention on changes in psychological function for those with dementia and their caregivers (current n=26 dyads). Choir rehearsals were held on a weekly basis, and included a social discussion component. A range of outcomes (neuropsychological and physiological function, neural activation) were assessed using an intensive repeated measures design that facilitates both between-and within-person analyses, including nuanced evaluation of whether psychological function improves post intervention relative to an individual's personal average, yielding a conservative within-person test of the benefits of intervention. Discussion focuses on the promise of such interventions for mitigating dementia symptoms and facilitating the psychological health of caregivers.
Canadian Journal of Nursing Research Archive, Dec 1, 2013
An aging population is driving increased demand for health services and a shift in care from hosp... more An aging population is driving increased demand for health services and a shift in care from hospital to home. Concerns about the high costs of acute care and the realization that hospitals are "bad places" (e.g., nosocomial infections, functional loss) for old, frail people have focused attention on treating people in their homes, which is for the most part where they prefer to be. Fortunately, technology has the potential to reduce health-care costs, enhance access to services, and improve management of chronic diseases (Center for Aging and Health, 2013). Home telehealth programs have documented positive outcomes, including reduced health-care costs, fewer hospitalizations and readmissions, improved quality of care, and better chronic disease management (Broderick & Lindeman, 2013; Chetney, 2008). A study of home telehealth implemented in several regional health-care systems in the United States found that health-care utilization decreased 20% for diabetes, 30.3% for hypertension, and 25.9% for congestive heart failure (Broderick & Lindeman, 2013). Another study demonstrated a 50% reduction in hospital readmissions related to heart failure and a total net savings of $8,155 per patient (Broderick, 2013); the findings indicate high levels of patient satisfaction, reduced hospitalization and readmission, decreased length of hospital stay, and decreased emergency department visits. What, then, is holding back the wider adoption of home telehealth? Most of the home telehealth programs brought to scale have required development of software unique to each health-care organization, which limits access to data across levels of care (e.g., acute care, home care, primary care). The home health consumer market has seen a proliferation of standalone devices that address specific needs (e.g., personal medical alert systems, medication dispensing devices, blood glucose meters). Home activity sensors (e.g., Lively) that "learn" personal routines and use built-in wireless service to alert caregivers when help may be needed are the latest product to enter the market. However, the usefulness of these
F oundations, including those that fund in the field of aging, are facing challenging times as a ... more F oundations, including those that fund in the field of aging, are facing challenging times as a result of the economic downturn. This article discusses recent factors affecting foundations, examines their responses to the recession, and highlights foundation efforts to address aging issues in three areas: (1) research that identifies salient financial problems, (2) programs that help older Americans address or prevent financial vulnerability, and (3) advocacy that addresses such problems.
Meaning-management theory (MMT) suggests living a meaningful life leads to higher death acceptanc... more Meaning-management theory (MMT) suggests living a meaningful life leads to higher death acceptance. This paper investigates how generativity, i.e. the intention to bring benefits to the next generation, can affect death acceptance through achieving meaning in life (MIL). 343 participants in Hong Kong (aged 18-90) filled in a questionnaire as part of "Age(ing) as Future" project. Generativity positively correlates with death acceptance. MIL fully mediates the effect of generativity on death acceptance (r(343)=.132, p=.014). The effect of generativity on MIL might differ by age and perceived influences of generative acts. As speculated, the mediation is moderated by Age and Transformational Future Time Perspective (TFTP; generative impact that expands future time perspective). In older adults with lower TFTP, generativity no longer predicts MIL and the mediation was nonsignificant. The results provide empirical support to MMT and emphasise the importance of perceived impact and the needs in different developmental stage.
This descriptive qualitative study explores the key characteristics, benefits, and lessons learne... more This descriptive qualitative study explores the key characteristics, benefits, and lessons learned from community-based choirs consisting of persons with dementia (PwD) and their caregivers based on reports from choir administrators and directors. Although there is growing interest in choirs for PwD, there has been no synthesis of information on these choirs. Semi-structured interviews were conducted between December 2016 and February 2017 with six administrators and/or directors of community-based choirs for PwD and their caregivers. The interviews were audio-recorded and transcribed. Content analyses indicated that choirs had many similarities in membership (e.g., early to mid-stage dementia), establishing formal sections and harmonies (e.g., soprano, alto, tenor, bass), administration (e.g., leadership, fees), and music programming (e.g., public performance, duration, and length of practice sessions). Benefits of the choir include enjoyment, sense of purpose, empowerment, caregiver support and respite, and increased awareness of dementia by others. In conclusion, this descriptive study suggests that community-based choirs are a cost effective and valuable program that improve quality of life for PwD and caregivers.
We Built It, But They Are Not Coming: Exploring Deterrents to Consumer Medication Information Use
PubMed, Aug 9, 2019
Given the prevalence of prescription medication use, it is important that consumers are aware of ... more Given the prevalence of prescription medication use, it is important that consumers are aware of the benefits and risks of taking their prescribed medications. One approach to informing consumers in North America is to provide them with Consumer Medication Information (CMI), the paper leaflets given to consumers when they fill a prescription for the first time. Unfortunately, reported use rates of written medication information are quite low. As part of a broader study investigating memory, perceptions, preferences and information needs around CMI, this study specifically examined reported deterrents to CMI use. Findings from this study revealed three areas that appear to influence CMI use: 1) Documentation, how CMI is designed and what it contains; 2) Provision, how and when CMI is given to consumers; and 3) Context, what the individual's characteristics and experiences are. These three factors warrant further investigation to reveal more of their unique facets and their relative influences on CMI use. That is, some aspects may be more influential than others.
Disability has become normative in old age, for the greater numbers of 1) persons with disability... more Disability has become normative in old age, for the greater numbers of 1) persons with disability now living long enough to experience the problems of aging and 2) older adults living long enough to experience the problems of disability. Regardless of the cause of disability, assistive technology (AT) has a major impact on the lives of older adults and its use has escalated. Federal and state policy makers have enacted legislation that encourages the use of AT devices and environmental changes in residences (i.e., home modification [HM]). Attention, however, has been focused on national policies such as the State Tech Act despite the presence of many stateinitiated actions. This article first presents a brief rationale for studying state-level AT/HM efforts. It then summarizes and critiques earlier studies before describing the methods and results of two studies of four different agencies with some responsibility for AT and/or HM for elders. A final section discusses the limitations and implications of these research projects, with reference to AT/HM policies and practices in the future.
Are Health Literacy and eHealth Literacy the Same or Different?
PubMed, 2017
Many researchers assume that there is a relationship between health literacy and eHealth literacy... more Many researchers assume that there is a relationship between health literacy and eHealth literacy, yet it is not clear whether the literature supports this assumption. The purpose of this study was to determine if there was a relationship between health and eHealth literacy. To this end, participants' (n = 36) scores on the Newest Vital Sign (NVS, a health literacy measure) were correlated with the eHealth Literacy Scale (eHEALS, an eHealth literacy measure). This analysis revealed no relationship (r = -.041, p = .81) between the two variables. This finding suggests that eHealth Literacy and health literacy are dissimilar. Several possible explanations of the pattern of results are proposed. Currently, it does not seem prudent to use the eHEALS as the sole measure of eHealth literacy, but rather researchers should continue to complement it with a validated health literacy screening tool.
... of long-term care (Ansello, 2004; Putnam, 2004). How this will play out remains to be seen, b... more ... of long-term care (Ansello, 2004; Putnam, 2004). How this will play out remains to be seen, but there are some promising forces furthering efforts to bring the two service spheres together. Improvements in the service systems will do much to counter the effects of ageism on ...
Bullet points: ï‚· We reviewed current literature on care of older adults in Emergency Departments ... more Bullet points: ï‚· We reviewed current literature on care of older adults in Emergency Departments (ED's) and assessed organizational culture in ED's using a framework developed by Edgar Schein. ï‚· We found that artifacts such as building design and the physical organization of the ED department focused on ease of monitoring of patients' status and facilitating patients' movement through the department negatively impact care of older adults. ï‚· Values and beliefs held by ED staff members, including that the ED was for urgent cases and that old people with non-urgent needs did not count in the department impact the respect older adults is given by staff members and the care they receive.
A national survey of the aging network-State Units on Aging (n = 42) and Area Agencies on Aging (... more A national survey of the aging network-State Units on Aging (n = 42) and Area Agencies on Aging (n = 342)-was conducted to examine their activities to address the assistive technology (AT) and home modifications (HM) needs of older adults. The study contrasts the awareness of and importance placed on AT /HM programs and services by state and local administrators of aging agencies; describes interagency activities; identifies challenges in service delivery; and discusses several innovative sevice models. These findings indicate that although state-level collaboration between the aging network and the rehabilitation system is on the rise, there has been little measurable impact on service delivery at the local level where the needs of elders with disabilities are addressed.
... Springer Publishing Company, Inc. 11 West 42nd Street, 15th Floor New York, NY 10036-8002 Acq... more ... Springer Publishing Company, Inc. 11 West 42nd Street, 15th Floor New York, NY 10036-8002 Acquisitions Editor: Helvi Gold Production Editor: Print Matters, Inc. Cover Design: Mimi Flow Composition: Compset, Inc. Library ...
Canada shares many similarities with other industrialized countries around the world, including a... more Canada shares many similarities with other industrialized countries around the world, including a rapidly aging population. What sets Canada uniquely apart is the collaborative approach that has been enacted in the health care system and the aging research initiatives. Canada has tremendous pride in its publicly funded health care system that guarantees universal coverage for health care services on the basis of need, rather than ability to pay. It is also distinguished as a multicultural society that is officially bilingual. Aging research has developed rapidly over the past decade. In particular, the Canadian Longitudinal Study on Aging is one of the most comprehensive research platforms of its kind and is expected to change the landscape of aging research.
Uploads
Papers by Debra Sheets