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Bakgrund: God hälsa omfattas av fysiskt, psykiskt och socialt välbefinnande. Att åldras innebär stora förändringar både fysiologiskt, socialt och psykologiskt. Den psykiska hälsan hos äldre kan präglas av upplevelser av ensamhet, immobilitet och en känsla av att sakna ett sammanhang. Det är ur ett vårdvetenskapligt perspektiv viktigt att förstå och medvetandegöra dessa dimensioner av åldrandet för att bättre kunna främja hälsa hos äldre personer. Att i egenskap av sjuksköterska eller annan vårdpersonal se värdet av att bryta mental och känslomässig isolering hos äldre men också rent fysiskt hitta sätt att motivera till aktiviteter som främjar välbefinnande. Det är viktigt att sjuksköterskan är medveten om och förstår husdjurs betydelse och hur de kan påverka äldres hälsa och livskvalitet. Syfte: Att beskriva hur närvaron av djur kan främja hälsa hos äldre personer. Metod: För litteraturöversikten användes Fribergs (2022) analysmodell och baserad på tio vetenskapliga artiklar. Sökningen utfördes i databaser som CINAHL Complete och PubMed. Studiernas kvalitet granskades utifrån fyra av Fribergs 13-14 frågor. Resultat: Resultatet visade att husdjur har en positiv inverkan på livskvaliteten hos äldre individer. Att äga ett husdjur kan förbättra den fysiska och psykiska hälsan, stärka sociala kontakter och minska känslor av ensamhet bland äldre. Detta ökar känslor av kärlek och stärker relationen mellan djurägaren och djuret. Litteraturöversikten belyste även utmaningar och risker, såsom oro för ekonomiska kostnader och svårigheter med att sköta om djuren på grund av stigande ålder och ökad fallrisk. Lösningar som anpassade boendemiljöer och förebyggande insatser i form av husdjursrelaterade aktiviteter kan vara till hjälp för både djur och deras ägare. Slutsats: Meningsfullhet spelar en viktig roll för äldre hälsa och i vissa fall kan motivation och meningsfullhet stärkas av samvaro med djur, vilket har en positiv påverkan på äldres hälsa och välbefinnande. Sjuksköterskor kan integrera husdjuren i aktiviteter och därigenom motivera äldre personer att främja egen hälsa och förebygga ohälsa. / Background: Good health includes physical, mental, and social well-being. To age is to be exposed to many changes both physiologically, socially and mentally. Mental health within older adults can be characterized by experiences of loneliness, immobility, a sense of lacking context. From a healthcare point of view, it is of importance to understand and raise awareness of these dimensions of getting older to better promote good health amongst elderly people. As a nurse or other healthcare staff see the value of breaking the mental and emotional isolation in older people but also, from a physiology standpoint, find ways to motivate elderly to do beneficial activities to promote health and well-being. It is important for nurses to be aware of and understand the significance of pets and how they can affect the health and quality of life of the elderly. Aim: To describe how the presence of animals can promote health in older people. Method: Literature overview Friberg's (2022) analysis model is used and based on ten scientific articles. The search was performed in databases such as CINAHL Complete and PubMed. Results: The result of the review showed that pets have a positive impact on the quality of life of older individuals. Owning a pet can improve physical and mental health, strengthen social connections, and reduce feelings of loneliness among the elderly. Despite this, the relationship and love between the pet owner and the animal increase. The study also highlighted challenges and risks, such as concerns about financial costs and difficulties in caring for pets due to the increasing age and higher risk of falls. Solutions such as adapted living environments and preventive measures in the form of pet- related activities can be helpful för both the animals and their owner. Conclusions: Meaningfulness play an important role in the health of the elderly, and in some cases, motivation and meaningfulness can be strengthened by spending time with animals, which has a positive impact on the health and well-being of older adults. Nurses can integrate pets into activities, thereby motivating elderly individuals to promote their own health and prevent illness.

The demography of the United States is in the midst of an unprecedented transition that will result in persons age 65 and over outnumbering children by the year 2030 (MacManus, 1995). This demographic shift has the potential to give elderly voters significant influence over public education funding (Poterba, 1997). The purpose of this study was to describe the phenomenon of elderly voter attitudes toward public education funding in a rural county. By engaging elderly voters in dialogue that captured the essence of their lived experiences in school and in the community, valuable information related to how those experiences had nurtured community loyalty or fostered rational self-interest was obtained. A phenomenological approach rooted in the tenets of narrative analysis was used as the framework for the research design in this study. The setting was a rural county in a mid-Atlantic state. Ten volunteers were solicited from among typical elderly voters in the county. Data were collected from personal interviews, field notes, interview notes and reflexive notes. Constant-comparative analysis was conducted in accordance with a three-iteration strategy to develop within and across-case analyses. Code-mapping was used to develop a visible audit trail. Personal narratives based on information obtained from the four data sources were written for each participant. The themes that resulted from an analysis of each narrative across all cases were applied to the economic theories of community loyalty and rational self-interest. The application of the emergent themes relative to each theory led to the conclusion that the lived experiences of the ten participants in school and in the community had impacted their attitudes toward public education funding. The identification of these experiences has implications for local education policy makers as they engage in strategic planning initiatives. / Ph. D.

Recently, technology and its impact on aging has become an expanding field of inquiry among marketers, designers, and housing professionals. A major reason for this interest is that the use of technology can help older people who experience deteriorating health to live independently. Another reason stems from an increase in the elderly population. The purpose of this study was to investigate older people's attitudes toward adopting technology as it relates to homes that could improve the quality of life and assist in aging in place. Attitudes were examined in terms of perception and acceptance of residential technology. Data for this study were gathered by an online survey. Online questionnaires were distributed to the potential sample of 9,789 e-mail addresses through the Virginia Tech alumni list serve on February 2004. The response rate was 15.8% with 1,546 eligible responses returned by February 27. The majority of the sample for this study can be described as Caucasian, married men, age 55 to 64 with good or excellent health and a post graduate college education living in owned single-family detached homes. Chi-square, ANOVA, Pearson's correlations, and path analysis were employed to test hypothesized relationships. Nine hypotheses were proposed to examine the relationships of variables based on the research framework. Results from this study cannot be generalized to a national population because of the limitations of the sampling frame. Results, however, are significant in terms of the investigation of early computer adopters who are age 55 and older living independently. Their desire to age in place was not very different from the national population. Findings about the attitudes toward computer and Internet technology indicated that respondents had surprisingly similar attitudes. Age was revealed as an important factor for both the desire to age in place and attitudes toward residential technology as a direct effect. Future research should include people with various demographic backgrounds. In addition, the results of this study imply that differentiated marketing strategies should be recommended to reach older consumers. / Ph. D.

Increasing physical activity among individuals in the U.S.A. is a primary health concern. Sedentary life-style is a risk factor for a number of diseases. Life expectancy in the U.S. has increased dramatically over the past several decades, yet frequently, few of these additional years remain disease free. It is now known that life-style factors, including exercise,. are important determinants of the number of healthy, functionally independent years remaining for older adults. Unfortunately, few older adults exercise regularly. Interventions aimed at ameliorating this problem are clearly needed. The Exercise and Older Adults study was designed to assess the effectiveness of an intervention to increase exercise among sedentary and lightly exercising adults ages 55 and older. Unlike other studies which typically involve a supervised aerobic program, this intervention involved the creation of individually tailored exercise programs which participants could maintain without the aid of the researchers. Social learning theory and behavioral principles led to the creation of an intervention combining information, peer modelling, personalized planning, and commitment-making. Subjects came to a single meeting following a three week period of exercise self-monitoring. During the meeting, experimental group subjects were given an exercise information packet, viewed two videotapes about older adults and exercise, created personal exercise plans involving several participation and relapse prevention strategies, and signed a commitment sheet stating that they would try to follow their new exercise plan. Control group subjects received the information packets only. Subjects continued to self-monitor their exercise for six weeks. Repeated Measures Analyses of Covariance did not support the hypothesis that the intervention received by the experimental group was more effective in increasing exercise than the minimal intervention received by the control group. Hierarchical Regression Analyses did not support the hypothesis that self -efficacy and outcome expectancy predict exercise changes. However, both groups in this study increased their exercise significantly and mean differences between groups at the three week follow-up point were significant for several exercise outcomes. Possible reasons for the failure to find statistical significance across time between groups is discussed and future research directions are outlined. / Ph. D.

The use of artificial means of nutrition and hydration for terminally ill patients is a controversial topic, involving medical, legal, social, and ethical issues. Often, the patient who is dying in the hospital and ceases to eat and drink receives tube feeding. In contrast, hospice patients are usually not given tube feeding, and emphasis is placed on palliative treatment. The purpose of the first project was to describe the dietary intake of twelve older adult cancer patients in home hospice care. The mean daily intakes of energy for males ranged from 657 to 2142 kcal per day, or from 28 to 93% of the recommended intake (RI). For females, the mean daily intakes of energy ranged from 358 to 1852 kcal per day or from 18 to 97% of the RI. Intakes for protein, carbohydrate, fat, and select vitamins and minerals were also highly variable. It was found that some patients survived for extended periods of time with very low intakes of food and fluids. Also, three patients who died during the study showed gradually declining intakes of food and fluids until death. In the second project, a structured interview was administered to 14 hospice patients and 18 family members to determine their knowledge, perceptions, attitudes, and wishes concerning tube feeding for seriously and terminally ill patients. Responses to the questions indicated that in general patients were less opposed to the use of aggressive means of nutrition support than were family members. Also, three of the patients, and only one family member indicated that they would want to receive tube feeding if they became unable to eat and drink by themselves. Both patients and family members mentioned circumstances related to patient autonomy and prognosis as reasons why it would be permissible to withhold tube feeding from a patient. The third project presents five case studies of hospice patients who died without receiving artificial nutrition or hydration. The patients' medical records were examined, and their nurses or family members were interviewed about their symptoms and conditions during the dying process. Results indicated that most of the patients experienced no anxiety or restlessness, no nausea or vomiting, and no additional pulmonary problems as death approached. In four patients, pain was either absent or under control. Although four patients stopped eating three to seven days before death, they did not appear to exhibit hunger or thirst during this time. All five patients were reported to have died peacefully. These case studies appear to support the position that terminal starvation and dehydration do not cause pain or discomfort to patients who die without tube feeding. In fact, such patients may experience relief from troublesome symptoms. / Ph. D.

Appropriate housing for the aging American population is a timely topic of research in both housing and gerontology. Universal design is an innovation in housing design that is gaining interest from both industries. This research examines the effectiveness of universal design features that have been identified by experts in the field of aging, housing, and universal design as important to resident and caregiver participants of the ECHO demonstration housing program. A national survey was conducted that included all available current residents of the HUD ECHO houses and their caregivers. The relationships between age, effectiveness of universal design features, health and dependency were investigated. Quantitative results include some confounding relationships, and plausible explanations. A qualitative analysis, based on on-site and telephone interviews, and tape recordings of those interviews with residents and their caregivers, as well as architectural drawings, observation, and photographs of the ECHO houses provided additional details. The qualitative approach indicated that many of the universal design features recommended by the experts consulted satisfactorily met the needs of residents and/or their caregivers. It also revealed, however that some features were not considered important by residents and caregivers, some were not reported as present (when they were documented by the researcher as present), and at least one HUD-specified universal design feature was not provided by ECHO houses. Another aspect of the qualitative perspective addressed the health of the residents. Health characteristics are presented in the context of their effect on dependency. Phase II dependency task information was compared to that reported in phase I, and improvement and decline was noted. Conclusions, and Implications that elaborate on findings, and future research is recommended for taking this research to the next level. / Ph. D.

Social media marketing is more prevalent than ever before, and Individual-based Marketing online, Cookies and various advertisements are becoming a part of daily life for many. At the same time the elderly population is ever increasing. The elderly are also one of the most misrepresented groups in our current society, it is an extremely generalised group, where market research is not often prevalent. This study therefore aims to increase understanding of how elderly view and interact with online Individual-based Marketing on Facebook, and what implications the answer to this question may bring for the future of marketing. The aim is answered by using literature reviews of past research, various theories, as well as a qualitative study. The qualitative study consists of semi structured interviews with stimuli. Ten Swedish pensioners were interviewed, and this resulted in a large variety of answers. The results conveyed that elderly are not homogenous in their view and use of social media, as well as most Individual-based Marketing, in this case on Facebook, were not well fitted to their interests, resulting in a need to improve segmentation in various ways.  Some of the elderly also had a difficult time understanding and trusting technology, such as clicking on advertisements, what they viewed to be trustworthy and what not. However, others seemed to have no issues regarding online behaviour as well as marketing, which further proves that pensioners are not a homogeneous group and that this needs to be understood to improve targeted marketing and segmentation.  Further research suggestions within the topic are to study different income classes, as well as a larger variety of elderly, from various communities. It could also be interesting to study elderly’s source criticism and how that affects their Cookies acceptance and further Individual-based Marketing.

No / to measure general practitioners' knowledge of, confidence with and attitudes to the diagnosis and management of dementia in primary care. Setting: 20 general practices of varying size and prior research experience in Central Scotland, and 16 similarly varied practices in north London. Participants: 127 general practitioners who had volunteered to join a randomised controlled trial of educational interventions about dementia diagnosis and management. Methods: self-completion questionnaires covering knowledge, confidence and attitudes were retrieved from practitioners prior to the educational interventions. Results: general practitioners' knowledge of dementia diagnosis and management is good, but poor awareness of its epidemiology leads to an over-estimate of caseload. Knowledge of local diagnostic and support services is less good, and one third of general practitioners expressed limited confidence in their diagnostic skills, whilst two-thirds lacked confidence in management of behaviour and other problems in dementia. The main difficulties identified by general practitioners were talking with patients about the diagnosis, responding to behaviour problems and coordinating support services. General practitioners perceived lack of time and lack of social services support as the major obstacles to good quality care more often than they identified their own unfamiliarity with current management or with local resources. Attitudes to the disclosure of the diagnosis, and to the potential for improving the quality of life of patients and carers varied, but a third of general practitioners believed that dementia care is within a specialist's domain, not that of general practice. More experienced and male general practitioners were more pessimistic about dementia care, as were general practitioners with lower knowledge about dementia. Those reporting greater difficulty with dementia diagnosis and management and those with lower knowledge scores were also less likely to express attitudes endorsing open communication with patient and carer. Conclusion: educational support for general practitioners should concentrate on epidemiological knowledge, disclosure of the diagnosis and management of behaviour problems in dementia. The availability and profile of support services, particularly social care, need to be enhanced, if earlier diagnosis is to be pursued as a policy objective in primary care.