Andrea Petriwskyj

Volunteering as a Productive Aging Activity: Incentives and Barriers to Volunteering by Australian Seniors

Recent research demonstrates that involvement in productive activities, particularly volunteering, has important societal and individual benefits in the contemporary aging environment. However, less attention has been paid to the structural dimension of volunteering or what encourages or discourages older people regarding volunteering. The authors present the findings from a two-phase Australian case study that explores the incentives and barriers to volunteering by those aged 50 and older, all members of a national seniors organization. Results suggest that governments and organizations need to consider many issues if more seniors are to be attracted to volunteering. Ensuring appropriate incentives to encourage volunteering was viewed as particularly important, with incentives including the need for more training, more flexible and diverse options, and more opportunities for intergenerational volunteering. Potential barriers included negative perceptions of volunteer activities, fear of encountering ageism, and concerns about the increasingly regulatory organizational environment.

Assessment of insight and self-awareness in older drivers

Abstract Older drivers, particularly those with cognitive deficits related to dementia, are at increased risk of motor vehicle accidents. With the numbers of older drivers and potentially older drivers with early dementia rising worldwide, it is important to delineate factors which may put these groups at increased risk of an accident while driving. One such factor is a lack of insight into their deficits often found in drivers with cognitive impairment. Intact insight and self-monitoring skills are important prerequisites for safe driving; loss of these abilities may signal the need to curtail or cease driving. There are several measures that attempt to assess the construct of insight; however, few have been used with older drivers. We review the issues of self-awareness and driving, discuss characteristics of a selection of such measures potentially appropriate for older adults, and detail potential avenues for future research on insight inventories and driving. Use of such measures suggested in studies of driving in older populations may assist in identifying the drivers at increased risk for a motor vehicle accident.

A qualitative metasynthesis: family involvement in decision making for people with dementia in residential aged care

Aim:Involving people in decisions about their care is good practice and ensures optimal outcomes. Despite considerable research, in practice family involvement in decision making can be challenging for both care staff and families. The aim of this review was to identify and appraise existing knowledge about family involvement in decision making for people with dementia living in residential aged care. Methods:The present Joanna Briggs Institute meta-synthesis considered studies that investigate involvement of family members in decision making for people with dementia in residential aged care settings. While quantitative and qualitative studies were included in the review, this article presents the qualitative findings. A comprehensive search of studies was conducted in 15 electronic databases. The search was limited to papers published in English, from 1990 to 2013. Twenty-six studies were identified as relevant for this review; 16 were qualitative papers reporting on 15 studies. Two independent reviewers assessed the studies for methodological validity and extracted the data using the standardized Joanna Briggs Institute Qualitative Assessment and Review Instrument (JBI-QARI). The findings were synthesized using JBI-QARI. Results:The findings related to the decisions encountered and made by family surrogates, family perceptions of, and preferences for, their role/s, factors regarding treatment decisions and the collaborative decision-making process, and outcomes for family decision makers. Conclusion:Results indicate varied and complex experiences and multiple factors influencing decision making. Communication and contacts between staff and families and the support available for families should be addressed, as well as the role of different stakeholders in decisions.

Seniors’ motivations for participation in local governance: evidence from an Australian study

Increasing expectations of citizen involvement as well as demographic changes brought by population ageing make evidence about the factors impacting on seniors’ participation increasingly important for local governments. In particular, knowledge about motivations for involvement can assist local governments in attempting to attract input from more than just the usual suspects, and to determine whose interests are represented. This article reports on an Australian study exploring seniors’ motivations for participation in governance processes, using a two-phase mixed method approach. Findings from this study suggested that seniors’ participation was motivated by both self- and other-directed, and both practical and abstract factors. Comparison of the sources highlighted nuances in the data which reflect questions about representation, representativeness and inclusion. Findings are discussed in relation to these questions, and implications for local government engagement practices are addressed.

Staff members' negotiation of power in client engagement: analysis of practice within an Australian aged care service.

With increasing focus on client control and active client roles in aged care service provision, client engagement is highlighted as fundamental to contemporary care practice. Client engagement itself, however, is complex and is impacted by a range of issues including the relationships and power dynamics inherent in the care context. These dynamics do not simply reflect the roles that are available to or taken up by clients; just as important are the roles and positions that staff of aged care services are offered, and take up, in client engagement. This paper presents the findings of a study that explored client engagement practice within a large Australian service provider. Analysis of interview and focus group discussions addressed the ways in which staff were positioned - by both themselves and by clients - in terms of the roles that they hold within engagement practice and the power relations inherent within these. Analysis of power from the dominant policy perspective of choice and control, and the alternative perspective of an ethic of care suggests that power relations within the care context are dynamic, complex and involve on-going negotiation and regulation by clients and staff members in aged care. The use of these two contrasting perspectives reveals a more dynamic and complex understanding of power in care practice than dominant uni-dimensional approaches to critique suggest.

Family involvement in decision making for people with dementia in residential aged care: a systematic review of quantitative literature

Aim:Ensuring older adults’ involvement in their care is accepted as good practice and is vital, particularly for people with dementia, whose care and treatment needs change considerably over the course of the illness. However, involving family members in decision making on peoples behalf is still practically difficult for staff and family. The aim of this review was to identify and appraise the existing quantitative evidence about family involvement in decision making for people with dementia living in residential aged care. Methods:The present Joanna Briggs Institute (JBI) metasynthesis assessed studies that investigated involvement of family members in decision making for people with dementia in residential aged care settings. While quantitative and qualitative studies were included in the review, this paper presents the quantitative findings. A comprehensive search of 15 electronic databases was performed. The search was limited to papers published in English, from 1990 to 2013. Twenty-six studies were identified as being relevant; 10 were quantitative, with 1 mixed method study. Two independent reviewers assessed the studies for methodological validity and extracted the data using the JBI Meta Analysis of Statistics Assessment and Review Instrument (JBI-MAStARI). The findings were synthesized and presented in narrative form. Results:The findings related to decisions encountered and made by family surrogates, variables associated with decisions, surrogates’ perceptions of, and preferences for, their roles, as well as outcomes for people with dementia and their families. Conclusions:The results identified patterns within, and variables associated with, surrogate decision making, all of which highlight the complexity and variation regarding family involvement. Attention needs to be paid to supporting family members in decision making in collaboration with staff.

Barriers to the retention of older participants in political organisations: evidence from Spain

ABSTRACT It has been argued that older peoples civic engagement has benefits for both individuals themselves and the community more broadly. Removing barriers to participation is, therefore, essential. However, the multi-dimensional nature of civic participation, as well as the different issues raised by recruitment and retention, complicate this. This study explores the barriers to retention of Spanish older people in political organisations, as one important type of participation that has received little attention in the literature to date. A total of 192 people aged 65 and over and actively engaged in three kinds of political organisation participated in this study. Participants answered an open-ended question regarding perceived barriers to continued involvement. Results show a range of reasons for potential future disengagement from political organisations. These barriers fit into three overarching categories related to changes in means, motives or the opportunity context for participation. Means-related barriers were by far the most frequently identified type of barrier. Both the type of organisation and some socio-demographic and participatory characteristics have an impact on the reasons respondents indicated they may potentially stop participating in future. Results suggest the necessity of a more nuanced and multi-faceted approach to understanding barriers to participation. Particularly, the development of retention strategies by political organisations should take into account the specific characteristics of the individuals and organisations they are targeting.

Interventions to build resilience in family caregivers of people living with dementia: a comprehensive systematic review.

BackgroundRecent studies have indicated that family caregivers of people with dementia have higher rates of depression, anxiety and hopelessness, as well as higher levels of burden, stress and distress. Not all caregivers, however, succumb to the negative effects of caring. Caregivers who are able to recover from, resist or adapt to the physical and psychological demands of caring can be considered “resilient”. ObjectivesThe objective of this review was to examine the existing evidence regarding interventions for building resilience in family caregivers of people living with dementia. Inclusion criteria Types of participantsThis review considered studies that included family caregivers of people with dementia. Types of intervention(s)/phenomena of interestStudies investigating interventions to build resilience in family caregivers were considered by the review. For qualitative studies, the phenomena of interest were family caregivers’ experiences of the interventions including factors affecting implementation and their subjective experience of outcomes. ContextStudies conducted in any cultural or geographical context and any settings including participants’ homes in the community, residential aged care or hospital, medical or allied health practice were considered for inclusion. Types of studiesQuantitative studies incorporating experimental and descriptive study designs and qualitative studies, including, but not limited to, phenomenology, grounded theory, ethnography, action research and feminist research were considered for inclusion. OutcomesQuantitative studies were included that contained either objective or subjective outcome measures (or a combination of both). In cases in which proxy measures of resilience were used, only those papers that explicitly related the aims of the intervention and the measurement of outcomes to resilience itself were considered for inclusion. Proxies could include, but were not limited to, self-efficacy, locus of control, perceived burden, psychological wellbeing, strength, coping, positive adjustment and resourcefulness. Qualitative studies were similarly considered for inclusion if they explicitly related the aims of the intervention to resilience. Search strategyEleven electronic databases were searched for research studies published in English in or after 1990. Methodological qualityQuantitative and qualitative studies selected for retrieval were assessed by two independent reviewers for methodological validity using standardized critical appraisal instruments from the Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument (JBI-MAStARI) and Joanna Briggs Institute Qualitative Assessment and Review Instrument (JBI-QARI). Data extractionQuantitative and qualitative data were extracted from publications included in the review using the standardized data extraction tools from JBI-MAStARI and JBI-QARI. Data synthesisIt was not possible to pool quantitative findings for statistical meta-analysis using JBI-MAStARI. Qualitative research findings were too limited to be pooled using the JBI-QARI. The findings are presented in narrative form. ResultsThe review included three publications reporting one quantitative intervention study and one mixed-method intervention study. There was a lack of available studies and, of the two intervention studies that were identified, neither found any statistically significant change in quantitative measures of resilience. Qualitative data suggested positive impacts of a poetry writing intervention and a positive experience of the intervention. Conclusion Implications for practiceThe studies differed in both the nature of the intervention and the way resilience was conceptualized and operationalized. Consequently, it was not possible to offer any recommendations for practice. Implications for researchImplications for research relate to the development of a more comprehensive theory of resilience in family caregivers that can be used to develop and rigorously evaluate reliable and valid measures of resilience in line with that theory. Further, well-designed, sufficiently powered intervention studies informed by theory are needed.

Learning Through Political Participation A Case Study of Spanish Elders Involved in Political Organizations

Older people’s civic participation contributes to community development while at the same time providing opportunities for personal growth in later life. One important dimension of civic participation that has been largely underexplored is informal learning. The aim of this study is to explore the learnings experienced by Spanish older people through their participation in political organizations as one important type of participation that has received little attention in the literature to date. A total of 192 people aged 65 years and older and actively engaged in three kinds of political organizations participated in the study. Participants answered an open-ended question regarding learnings through political participation. Results show a range of informal learnings, relating to social, political, or instrumental domains. Both the type of organization and some sociodemographic and participatory characteristics are associated with the type of learnings experienced by participants. Implications for political organizations are discussed.

'We're in the sandwich': Aged care staff members' negotiation of constraints and the role of the organisation in enacting and supporting an ethic of care.

Aged care staff are often seen as holding power in care relationships, particularly in client engagement. Such a perception, however, may limit our understanding and analysis of the dynamics and politics within care spaces. This paper uses interview and focus group data from both staff and clients of an Australian aged care provider to identify the positions given to, and taken up by, staff in client engagement. Focusing on one of these positions, in which staff are seen as managing and negotiating constraints, the paper uses an ethic of care lens to examine the context in which engagement - and this position taking - occurs. Findings reflect the importance of the organisational and systemic context to the practice of care ethics and the potential vulnerability and disempowerment of care giving staff. Implications for the support of staff in client engagement and the role of care organisations beyond structures and processes to an active participant in an ethic of care are discussed.