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The purpose of this paper is to explore the relationship of self-determination with degree of dependence in daily activities among community-dwelling persons aged 80 years and older.

This cross-sectional study focused on community-dwelling people 80 years or older with varied degree of dependence in daily activities. Self-determination in daily life was assessed with the statements from the Impact on Participation and Autonomy-Older persons (IPA-O), and degree of dependence in daily activities was assessed with the activities of daily living (ADL) staircase. Data were analysed using Fisher’s exact test, and the relative risk with a 95 per cent confidence interval was used to explore the risk of perceiving reduced self-determination in daily life.

Compared to the independent persons, the perceived self-determination was significantly lower among persons dependent in instrumental activities of daily living (I-ADL), and persons dependent in personal activities of daily living (P-ADL). Reduced self-determination was most pronounced in persons requiring help with P-ADL.

Following key features could be applied to strengthen the community-dwelling older people’s self-determination; incorporating a dialogue where self-determined questions are raised; adopting a person-centred approach between the persons involved; acknowledging older people’s capabilities – what they are able to do and to be, and what they value.

This study highlights the need of integrating a self-determined dialogue into healthcare where the older person and the professional focus on self-determined questions.

The purpose of this study is to explore social barriers affecting participation in chosen instrumental activities of daily living (IADL) among community-dwelling persons with schizophrenia in Rwanda.

A qualitative study used an embedded single case study design and constructivist epistemology paradigm. Purposive sampling and semistructured interviews of 10 persons with schizophrenia and their 10 caregivers were conducted. Data analysis was done thematically using an inductive analysis approach, following within-case and cross-case analysis.

The hindrances to participation and community negative attitudes were explored as the two themes. This study focuses on the community negative attitudes including family exclusion and stigmatization, which hinder the participation of persons with schizophrenia in their chosen IADLs.

This study highlights the need for psychoeducation about mental illness for the caregivers of the persons with schizophrenia, community outreach activities for sensitizing about mental illness to address stigma toward persons with mental illness and strengthening the activities which promote the social interaction and sense of belonging of persons with mental illness.

Persons with schizophrenia are facing maltreatment and stigma from the community members while participating in their chosen IADLs. Awareness raising of the support needs of persons living with schizophrenia will contribute to relevant stakeholders advocating for inclusion into families and communities.

How people spend their time is an indicator of how they live their lives, with time use over the life course conditioned both by age and by participation in age-graded institutions. This chapter uses nationally representative data from the pooled 2008–2020 American Time Use Survey (ATUS) to evaluate how time use in 12 activity categories varies by age, gender, and disability status among 137,266 respondents aged 15 and older. By doing so, we quantify the “disability gap” in time use between men and women with and without disabilities, identifying at what age and by how much people with disabilities experience time differentials in activities of daily living (ADLs), instrumental activities of daily living (IADLs), and other indicators of social participation. Results indicate that – at many ages – patterns of time use for people with disabilities deviate from those of people without disabilities, with more pronounced differences in midlife. Further, the magnitude of women's disability gaps equals or exceeds men's for sleeping, and nearly all ADLs and IADLs, indicating that disability gaps are also gendered.

This book is a policy proposal aimed at the democratic left. It is concerned with gradual but radical reform of the socio‐economic system. An integrated policy of industrial and economic democracy, which centres around the establishment of a new sector of employee‐controlled enterprises, is presented. The proposal would retain the mix‐ed economy, but transform it into a much better “mixture”, with increased employee‐power in all sectors. While there is much of enduring value in our liberal western way of life, gross inequalities of wealth and power persist in our society.

Normal aging changes, acute and chronic illness, and the long stay in the hospital made the decline in elderly physical and mental abilities in non-instrumental and Instrumental Activities Daily Livings (IADL). This paper aims to determine the validity and reliability of Lawton IADL in the Iranian elderly community relevancy to physical, mental and cognitive measurements.

A cross-sectional study with 422 participants, age 60 years old and over selected by face-to-face interviewing from the geriatric clinic, Tehran medical university from January to June 2019.

Of 422 participants referring to outpatient clinics the majority were male (62.8%); with an average of 66.9 ± 5.95 years old. Reliability was significantly high (Cronbach’s alpha = 0.96, p < 0.001). There was a significant relationship between IADL with Short-Form Health Survey36-Mental Component Score (SF36-MCS), with p < 0.01. Reliability was significantly high (Cronbach’s alpha = 0.96, p < 0.001). In the factor analysis with eigenvalues more than one, two components were found; that the first factor named as observational daily activities, whereas the second factor named “advanced daily activities”.

The limitation of this study was the low number of similar studies to compare the results and the stronger discussion.

Determining IADL's dependency in the community elderly is important to maintain their self-care manages. More studies are needed to manifest the relationship between mental health and IADL's independence. Therefore, validation in different settings is important in planning for the geriatrics team.

This paper investigates the mechanics of multimedia tie maintenance, with a particular emphasis upon social network sites (SNSs) and their uses and gratifications. We present results from a national sample of American adults (N = 571) of all ages, investigating the associations of several attitudinal and social variables with multimedia tie maintenance. We find that Facebook is used to maintain social ties at rates comparable to other media and is increasingly used to connect with close ties, contrary to previous literature. We also uncover highly significant patterns of “expressive” and “instrumental” engagement, isolating distinct expressive/instrumental orientations toward digital media in general and Facebook specifically. Respondents who displayed an expressive pattern of engagement with Facebook did not use non-SNS media to maintain ties any less frequently than those who do not use Facebook expressively. Respondents who displayed an instrumental pattern of engagement with Facebook meanwhile, supplemented their lack of SNS use to maintain ties by using other media more frequently for this purpose. This paper contributes to the literatures of media multiplexity, networked individualism, uses and gratifications theory, and social capital through SNSs. It makes a significant contribution to understanding the psychological and social gratifications of digital media, and their relationship to patterns of multimedia tie maintenance.

This paper aims to discuss an online sensor-based support system which is believed to be useful for persons with a cognitive impairment, such as those with Alzheimer’s disease, suffering from deficiencies in cognitive skills which reduce their independence. Such patients can benefit from the provision of further assistance such as reminders for carrying out instrumental activities of daily living (iADLs).

The system proposed processes data from a network of sensors that have the capability of sensing user interactions and ongoing iADLs in the living environment itself. A probabilistic learning model is built that computes joint probability distributions over different activities representing users’ behavioural patterns in performing activities. This probability model can underpin an intervention framework that prompts the user with the next step in the iADL when inactivity is being observed. This prompt for the next step is inferred from the conditional probability, taking into consideration the iADL steps that have already been completed, in addition to contextual information relating to the time of day and the amount of time already spent on the activity. The originality of the work lies in combining partially observed sensor sequences and duration data associated with the iADLs. The prediction of the next step is then adjusted as further steps are completed and more time is spent towards the completion of the activity; thus, updating the confidence that the prediction is correct. A reminder is only issued when there has been sufficient inactivity on the part of the patient and the confidence is high that the prediction is correct.

The results verify that by including duration information, the prediction accuracy of the model is increased, and the confidence level for the next step in the iADL is also increased. As such, there is approximately a 10 per cent rise in the prediction performance in the case of single-sensor activation in comparison to an alternative approach which did not consider activity durations. Thus, it is concluded that incorporating progressive duration information into partially observed sensor sequences of iADLs has the potential to increase performance of a reminder system for patients with a cognitive impairment, such as Alzheimer’s disease.

Activity duration information can be a potential feature in measuring the performance of a user and distinguishing different activities. The results verify that by including duration information, the prediction accuracy of the model is increased, and the confidence level for the next step in the activity is also increased. The use of duration information in online prediction of activities can also be associated to monitoring the deterioration in cognitive abilities and in making a decision about the level of assistance required. Such improvements have significance in building more accurate reminder systems that precisely predict activities and assist its users, thus, improving the overall support provided for living independently.

Research on women’s health has increased substantially in the past decade, but this has not been paralleled in the area of developmental disabilities. In developmental disabilities research, there has been little attempt to disentangle the impact of age, intellectual disabilities, and other developmental disabilities on women’s health. The 1994–1995 Disability Supplement to the National Health Interview Survey, administered to a representative sample of the U.S. population, was used to describe the aging process in the community for women age 30 and older with mental retardation (MR), developmental disabilities (DD) or both (MR/DD). Definitions of MR and DD consistent with professional and legal standards were developed and adapted to the NHIS-D questions. Approximately 77 million civilian, non-institutionalized women in the United States were age 30 and older at the time of the survey. Among these women an estimated 0.56% have mental retardation or developmental disability. Compared with women in general, women with these disabilities were disproportionately absent in the community, had negative perceptions of their health status, and their health indicators tended to support these perceptions. Most women with these disabilities were independent in activities of daily living (ADL), but instrumental activities of daily living (IADLs) posed more of a challenge, and limitations in major activities were common. Limitations in mobility were common among women with DD.