Atiya Mahmood

A photovoice documentation of the role of neighborhood physical and social environments in older adults’ physical activity in two metropolitan areas in North America

A substantial body of evidence indicates that regular engagement in moderate-intensity physical activity on most days of the week is sufficient for older adults to achieve positive health outcomes. Although there is a growing body of literature that examines the affect of neighborhood environment on physical activity in older adults, the research tends to overlook social aspects that potentially shape the relationship between physical environment and physical activity. This article presents qualitative themes related to the role of the physical and social environments in influencing physical activity among older adults as identified through the photovoice method with sixty-six older adults in eight neighborhoods in metropolitan Vancouver, British Columbia, Canada and Greater Portland, Oregon, USA. The photovoice data generated seven themes: being safe and feeling secure, getting there, comfort in movement, diversity of destinations, community-based programs, peer support and intergenerational/volunteer activities. Although the majority of these themes have explicit or implicit physical and social aspects, certain themes are primarily based on physical environmental aspects (e.g., safe and feeling secure, comfort in movement), while a few themes are more oriented to social context (e.g., peer support, intergenerational activity/volunteering). The themes are discussed with a focus on how the neighborhood physical and social environmental aspects interplay to foster or hinder older adults in staying active in both everyday activities and intentional physical activities. Policy implications of the findings are discussed.

Use of a Systematic Observational Measure to Assess and Compare Walkability for Older Adults in Vancouver, British Columbia and Portland, Oregon Neighbourhoods

This study assessed neighbourhood walkability for older adults in eight neighbourhoods of Vancouver, British Columbia and Portland Oregon, utilizing the newly developed environmental audit tool ‘SWEAT-R’. The discrete variable based data are complemented with qualitative observation data. Findings indicate that the audit tool has a 95% or higher inter-rater reliability for more than 80% of the items. Neighbourhood environmental data suggest that neighbourhoods in Vancouver region have more urban design features supportive of walking behaviour. Sidewalk and street life environmental features were relatively similar across all four Portland neighbourhoods, however, there were notable differences in sidewalk characteristics among the four Vancouver neighbourhoods. The audit tool is useful in documenting walkable features in urban and suburban neighbourhoods with particular relevance to older adults’ needs.

Long‐term care physical environments – effect on medication errors

PURPOSE Few studies examine physical environmental factors and their effects on staff health, effectiveness, work errors and job satisfaction. To address this gap, this study aims to examine environmental features and their role in medication and nursing errors in long-term care facilities. DESIGN/METHODOLOGY/APPROACH A mixed methodological strategy was used. Data were collected via focus groups, observing medication preparation and administration, and a nursing staff survey in four facilities. FINDINGS The paper reveals that, during the medication preparation phase, physical design, such as medication room layout, is a major source of potential errors. During medication administration, social environment is more likely to contribute to errors. Interruptions, noise and staff shortages were particular problems. RESEARCH LIMITATIONS/IMPLICATIONS The surveys relatively small sample size needs to be considered when interpreting the findings. Also, actual error data could not be included as existing records were incomplete. PRACTICAL IMPLICATIONS The study offers several relatively low-cost recommendations to help staff reduce medication errors. Physical environmental factors are important when addressing measures to reduce errors. ORIGINALITY/VALUE The findings of this study underscore the fact that the physical environments influence on the possibility of medication errors is often neglected. This study contributes to the scarce empirical literature examining the relationship between physical design and patient safety.

'Til Divorce Do Us Part: Marriage Dissolution in Later Life

Late-life divorce—commonly referred to as gray divorce—is a rising trend that parallels the growth of the older adult population. We sought to gain an in-depth understanding of the experience of marriage dissolution, the divorce process, and life following divorce in a sample of older adults who divorced after more than 20 years of marriage. Qualitative data were collected from 10 divorcees (7 women and 3 men; M age = 63.5) and analyzed to understand the gray divorce experience; that is, factors that determined or delayed the decision to divorce and divorcees’ coping during and after divorce. Participants’ stories demonstrate that marriages endure despite problems because relationships are complex, and good experiences mix with bad ones. Outcomes of late-life divorce have significant health and financial implications for both individuals and society.

Personal theories of substance use among middle-aged and older adults with bipolar disorder

ABSTRACT Objectives: Most persons with bipolar disorder (BD) misuse alcohol and/or illicit drugs at some point, yet research specific to older adults with BD is nascent. The current study sought an in-depth understanding of the experiences and meanings of substance use in a sample of adults who self-reported substance misuse. Methods: Semi-structured interviews were conducted and thematically analyzed to understand the personal theories of substance use by 12 adults (9 women and 3 men; M = 49 years old) who self-reported diagnoses of BD and regular alcohol or illicit drug use. Results: Findings provide an in-depth picture of the theories middle-aged and older adults with BD have developed to explain their substance use. Participants’ theories suggest multiple reasons for substance use, including self-medication; increased confidence with substance use; rejection of prescribed medications; easy access to alcohol; early social exposure/use as facilitator; and living in a culture of substance use. Conclusion: Findings suggest multiple theories for the comorbid link between BD and substance use, primarily that persons with BD use drugs and/or alcohol to relieve stress or manage symptoms. It is clinically relevant to incorporate personal reasons for actively and regularly using substances as part of personalized substance treatment and BD symptom management.

Quality of Life for Diverse Older Adults in Assisted Living: The Centrality of Control.

ABSTRACT This pilot project asked: How do ethnically diverse older adult residents of assisted living (AL) facilities in British Columbia (BC) experience quality of life? And, what role, if any, do organizational and physical environmental features play in influencing how quality of life is experienced? The study was conducted at three AL sites in BC: two ethnoculturally targeted and one nontargeted. Environmental audits at each site captured descriptive data on policies, fees, rules, staffing, meals, and activities, and the built environment of the AL building and neighborhood. Using a framework that understands the quality of life of older adults to be contingent on their capability to pursue 5 conceptual attributes—attachment, role, enjoyment, security, and control—we conducted 3 focus groups with residents (1 per site) and 6 interviews with staff (2 per site). Attributes were linked to the environmental features captured in the audits. All dimensions of the environment, especially organizational, influence tenants’ capability to attain the attributes of quality of life, most importantly control. Although many tenants accept the trade-off between increased safety and diminished control that accompanies a move into AL, more could be done to minimize that loss. Social workers can advocate for the necessary multi-sectoral changes.

The use of Personas in gerontological education

ABSTRACT Using mechanisms of active learning, we developed a Persona project for our undergraduate Introduction to Gerontology course. We conceive of Personas as fictional characters that are created through the amalgamation of physical, social, and psychological traits and have unique lived experiences. This article details the development of this innovative pedagogical tool and describes how Personas are used as part of an experiential learning assignment over the course of a semester. Student-generated Personas act to contextualize the broad course material, ranging from physical and mental health to environments and financial well-being in later life. Student feedback of the Persona project highlights what they learned, how this project was helpful for them, and suggestions for enhancing the experience for students in subsequent semesters. We conclude by recommending that other gerontological and social science educators incorporate Personas into their coursework to provide students an interactive tool to apply information learned through class lectures and readings.

The role of neighborhood physical environment on mobility and social participation among people using mobility assistive technology

Abstract This paper presents a systematic literature review on the impact of the neighborhood physical environment on mobility and social participation among people using mobility assistive technology (MAT). Peer-reviewed articles from eight databases published in French or English from 1990 to 2016 were searched. Thirty studies were included in this review. Factors related to neighborhood environmental features, mobility in transit, and accessibility of homes and public buildings influenced mobility and social participation of MAT users. The majority of reviewed studies combined different types of MAT, which made the interpretation of the results challenging. Few studies included walker, cane, and crutch users. Definitions of mobility and social participation lacked consistency and were often simplistic. Future empirical research needs to examine the impact of neighborhood physical environment factors separately for different MAT users. Causality and links between mobility and social participation of different MAT users at the neighborhood level should be further explored.