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Current and predicted continued dramatic increases in international migration and ethnocultural diversity of older adult cohorts pose challenges for health care services. Review studies on ethnoculturally diverse older adults and health care show a lack of focus on their service use experiences. This study aims to report a meta-ethnography that addresses this knowledge gap through answering the review question: How do ethnoculturally diverse older adults who are immigrants experience health careservices?

The authors applied a seven-phase method of meta-ethnography to guide the review. The authors conducted two literature searches (April 2018 and June 2020) in MEDLINE, CINAHL, Embase, Sociological Abstracts and Abstracts in Social Gerontology that yielded 17 papers eligible for review.

“There’s always something positive and something negative” is the overarching metaphor for answering the review question. Findings highlight positive and negative tensions within ethnoculturally diverse older adults’ health care use experiences of understanding and being understood, having trust in providers and the health care system, having needs, preferences and resources met and desire for self-care over dependency. The majority of experiences were negative. Tipping points towards negative experiences included language, fear, provider attitudes and behaviours, service flexibility, attitudes towards Western and traditional health care and having knowledge and resources.

The authors propose concrete actions to mitigate the tipping points. The authors discuss policy recommendations for health care system changes at the micro, meso and macro service levels to promote positive experiences and address mainstream service policy inequities.

The demand for long-term home care services has been increasing in Taiwan due to the significant growth of the older population. In order to understand the crucial roles that language and communication play in providing better long-term home care services in Taiwan, this study aims to adopt a gerontological sociolinguistic perspective to investigate how professional care workers communicate with older people in this context.

Interviews were conducted with 58 long-term home care workers to identify their communication accommodation strategies for older people, considering their health conditions (dementia), personalities (grumpiness), living status (loneliness) and general principles of long-term home care communication.

The study's findings provide practical insights for long-term home care workers to enhance their communication skills while interacting with older people.

The results could contribute to improving the quality of care services provided to older people and address their specific communication needs.

To the best of the author’s knowledge, this paper is the first attempt to identify contextually specific communication accommodations to older people in existing literature of gerontological sociolinguistics that addresses language, communication and older age. The salience of the findings in this study can be further enhanced if they were applied in the development of training programs for future Taiwanese long-term home care workers.

The purpose of this study is to explore the lived experiences of the constraints of older adult family caregivers with chronic diseases in caring for and accessing health services during the COVID-19 pandemic.

This study used the descriptive phenomenology qualitative method. The sampling method was purposive sampling involving 16 older adult family caregivers.

The results of this study showed three themes such as difficulties in health services in hospitals during the COVID-19 pandemic (complaints of services provided by doctors, older adult treatment control problems and difficulty getting to hospital health facilities); difficulties accompanying taking older adult medicine (older adult non-compliance response to taking medication and older adult medicine assistance); and psychosocial complaints caring for and accompanying the older adult (negative emotions for the older adult, difficulty interacting with the older adult and the economic burden of caring for the older adult).

Barriers to family caregivers in caring for older adults with chronic diseases can help health-care service providers understand and support families caring for and assisting older adults, which may contribute to the quality of life and care for both family caregivers and older adults.

This study showed that Indonesian family caregivers faced difficulties caring for and living with older adults with chronic diseases during the pandemic. Family caregivers’ experiences are essential when developing an intervention to support and manage health care for older adults with chronic illnesses.

Many countries around the world are facing great challenges from their ageing population with shrinking workforce, this will put more pressure on their financial system and will increase the public spending on care costs provided to older people. Egypt is in the phase of establishing a new law for older people care's rights, a law that will organise how older people in need for care would benefit from access to government financial support and how will families support their older relatives financially and how the care costs will be shared between the older people, their families and the government.

The paper examines the suitability two cost-sharing methods and applying them to assess the effect on the individuals and families' income strain.

The preferred approach can be used for sharing costs as it applies a gradual funding withdrawal by the government and provide more fairness and flexibility for application in different regions. Besides, the parameters of this approach can be used by policy makers to control the levels of funding.

The paper will be the first to discuss the intergenerational fairness from a financial perspective in Egypt to avoid forcing older people into poverty or resorting to poverty trade-off.

Performance measures are an important mediating mechanism that influences the design and delivery of care. Unfortunately, it is still commonly the case that acute care indicators are employed to assess the efficacy of integrated care. This hinders the ability to accurately assess and continuously improve integrated care efforts for priority populations, including older persons who live with complex health and social care requirements. A core set of indicators is needed from which to assess the quality and impact of integrated care on these older persons and care partners.

A modified Delphi process was employed that comprised of the following steps: (1) selection of an indicator inventory (2) defining criteria for ranking and achieving consensus, (3) recruiting participants, (4) iterative voting rounds and analysis and (5) selection of a core indicator set.

The study produced a core set of 16 indicators of integrated care that pertain to older persons who live with health and social care requirements. The set can be applied by health and social care organizations and systems to assess the quality and impact of integrated care for this population across the continuum of care.

Although the gap in the availability of relevant indicators was the impetus for the study, this also meant there was a dearth of validated indicators to draw from. There are significant gaps in commonly used data sets with respect to indicators of integrated care as it relates to older persons and care partner.

The indicator set is intended to follow the older person and care partner throughout their health journey, enabling a whole systems view of their care. The set can be used in full or in part by health and social care systems and organizations across various primary, acute, rehabilitative and community settings for program development and evaluation purposes.

The core set of indicators that emerged out of this study is a first step toward ensuring that older persons who live with complex health and social care requirements and their care partners receive quality integrated care across the continuum of care.

The findings are informed by the perspectives of older persons, care partners and healthcare professionals. Future research is needed to test, validate and potentially expand the indicator set.

Providing high-quality and cost-efficient care of older people is an important development priority for many health and social care systems in the world. This paper suggests a shift from acute, episodic and reactive hospital-centered care toward longitudinal, person-centered and proactive home-centered care. The purpose of this paper is to contribute to the knowledge of a comprehensive development strategy for designing and providing home-centered care of older people.

The study design is based on qualitative research with an inductive approach. The authors study development initiatives at the national, regional and local levels of the Swedish health and social care system. The data collection methods included interviews (n = 54), meeting observations (n = 25) and document studies (n = 59).

The authors describe findings related to policy actions and system changes, attempts to achieve collaboration, integration and coordination, new forms of care offerings, characteristics of work settings at home and differences in patients' roles and participation at home and in the hospital.

The authors suggest home-centered care as a solution for providing person-centered and integrated care of older people and give examples of how this can be achieved.

The authors outline five propositions for research and development related to national policies, service modularity as a solution for customized and coordinated care, developing human resources and infrastructure for home settings, expanding services that enable older people living at home and patient co-creation.

As employed carers tend to experience work interruptions and conflict between work and care, especially women, this paper aims to assess the availability and accessibility of carer-friendly workplace policies (CFWPs) in Quebec workplaces.

An online survey was distributed to members of the Association of Human Resources Management Counsellors in Quebec. The authors used a validating quantitative data design. The data was collected between October 2019 and the end of February 2020 and the questionnaire yielded 122 valid responses.

Adult/elder care responsibilities remain systematically perceived less important than childcare or general work-life balance needs. The current distribution of CFWPs within Quebec workplaces is unlikely to ensure carers sufficient support to prevent or significantly mitigate negative repercussions. Notable differences were found between organization type and size.

There is a need for expanding CFWPs through increased support services, educational workshops, broader access to flexible work arrangements and manager training.

The results support recent research findings pointing that women with caring responsibilities face important opportunity costs and risk falling in precariousness. Carers should be able to maintain a social income from other sources to compensate a reduced activity on the labor market.

By investigating the availability of CFWPs in Quebec workplaces, this paper adds insights regarding the availability and access to CFWPs regionally and in small and medium size workplaces, rather than identifying best practice from workplaces across the globe. Workplace policies are analyzed for adult/elder care specifically.

This paper aims to offer a profile of domestic abuse of older women and its impact on their health and well-being; explore some of the conceptual tensions that exist in this field; and discuss current policy and practice responses to this group of victim-survivors.

It is a review paper drawing on material from a range of sources; it has policy, practice and research implications.

Although there is growing recognition that older women are victims of domestic abuse, it tends to be regarded as a “younger women’s issue” and to be subsumed under the umbrella of elder abuse. This not only removes the gendered element, but it also uncouples it from the lifecourse where, for many, its roots lie. It also tends to foreground “old age” as the primary dimension of risk. There is a tension between the justice-oriented approach of the domestic abuse system and the welfarist approach that imbues the safeguarding system. There is a need for integration between the two systems. Also, for the health and care system to be more alert to the needs of older women at risk, we need to achieve a more effective balance between protection and justice, accord a greater level of agency to older victim-survivors and ensure they have access to domestic abuse law, policy and appropriate support services.

More research is needed with older victim-survivors: listening to their lived experiences, coping strategies and pathways out of abuse. The issue also needs to be more visible.

Developing appropriate domestic abuse services for older women is critical. Practice lessons can be learnt too: especially greater integration of the safeguarding system with the domestic abuse system. Training is needed too for frontline health and social care staff about the distinctive nature of domestic abuse of older women.

Domestic abuse of older women needs to be spoken about and made more visible in society and inside services, including older people’s third sector services.

This paper adopts a critical lens and makes a number of new arguments.

Mobile technology and applications offer a new approach to personalised care for older people. Hear Me Now (HMN), developed by Maldaba Ltd, is an application for smartphones and tablets. Although originally conceived and co-produced by individuals with learning disabilities and their supporters, anecdotal evidence from specialist practitioners indicated that older people with chronic health conditions and frailty might also benefit from use of the HMN app. This feasibility study sought to explore whether older people could use the HMN app and examine their usage. The aim of this feasibility study was to explore whether older people could use HMN and to examine their usage of this application.

A purposive sample of six individuals (M = 4; F = 2) aged between 65 and 90 years was recruited for the study. Following training, the participants used HMN at home for different purposes over three months. Concurrently, the participants took part in an online interview every three weeks (N = 5 interviews). They also completed the Task Load Index (NASA-TLX) questionnaire during Weeks 1 and 12 and the system usability scale during Week 12 to assess usability of HMN.

The participants used the HMN app for a range of purposes and indicated that their confidence and skills increased when using HMN. Though the participants reported diverse experiences of using HMN for different purposes, it was clear the majority considered this app helpful in managing daily life and their health conditions; however, they also experienced barriers in its use such as dexterity and visual problems.

This is a small feasibility study that was restricted to older people using the HMN app. Though valuable insights were obtained from the participants, the evidence that older people could use HMN to support their personal activities and to self-manage health conditions remains anecdotal. Further research is therefore warranted following adaptation of HMN for use by older people.

This study indicates that patient self-management apps such as HMN have the potential to enable older adults with long-term health conditions to play an active role in managing their condition.