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At a time of increasing interest in mental health in later life, the role of public health approaches is potentially heightened. This paper draws on interview data with older people living in London to consider the interplay between personal and public approaches to health and well‐being. The interviews were under taken as part of the midpoint review of the UK government's 10‐year strategy for older people (Healthcare Commission et al, 2006) and the social characteristics of London are considered.

The purpose of this study is to highlight the experiences and issues of an overlooked demographic: older LGBTQ + adults in the US, in the context of the COVID-19 pandemic. This allows the authors to explore possible changes in policy and practice regarding the management of the pandemic with attention to elderly LGBTQ.

Building on the authors’ experience in disaster research and a study of older LGBTQ + adults in the San Francisco Bay Area, the authors analyze key trends in COVID-19 pandemic management while drawing lessons from the AIDS epidemic.

The authors have found that LGBTQ + people, especially older and transgender individuals, have unique experiences with hazards and public safety and healthcare professionals and organizations (e.g. heteronormative care, traumatic insensitivity, deprioritizing essential treatments as elective). Second, older LGBTQ + adults' perceptions of state responses to pandemics were heavily influenced by experiences with the HIV/AIDS pandemic. And third, experiences with the COVID-19 pandemic have important implications for preventing, responding to and recovering from future epidemics/pandemics.

The authors point to two parallel implications of this work. The first entails novel approaches to queering disaster prevention, response and recovery. And the second is to connect the management of the COVID-19 pandemic to the principles of harm reduction developed by grassroots organizations to suggest new ways to think about contagion and organize physical distancing, while still socializing to take care of people’s physical and mental health, especially the more marginalized like elderly LGBTQ + people.

The aim of this study is to describe the view of age‐related prioritisation in health care among physicians and healthcare politicians and to compare their views regarding gender and age.

Swedish physicians (n=390) and politicians (n=310), mean age 52 years, answered an electronic questionnaire concerning age‐related priority setting in healthcare. The questionnaire had fixed response alternatives with possibility of adding comments.

A majority of the participants thought that age should not influence prioritisation, although more physicians than politicians thought that younger patients should be prioritised. There were also significant differences concerning their views on lifestyle‐related diseases and on who should make decisions concerning both vertical and horizontal prioritisation. The comments indicated that the politicians referred to ethical principles as a basis for their standpoints while the physicians often referred to the importance of biological rather than chronological age.

Web‐based surveys as a method has its limitations as biased samples and biased returns could cause major problems, such as limited control over the drop‐outs. The sample in this study was, however, judged to be representative.

The results indicate that supplementary guiding principles concerning prioritisation in healthcare are needed in order to facilitate decision‐making concerning resource allocation on a local level.

This paper adds important knowledge about decision makers' views on age‐related priorities in healthcare, thus contributing to scientific base for prioritisation in healthcare and the ongoing debate in society.

Joint reviews are an approach to partnership working between those involved in inspection and regulation. They provide great opportunities and some challenges. This article describes a case study of the review of the National Service Framework for Older People. It discusses culture and commitment, organisational imperatives and governance.

This paper aims to examine the management strategies adopted by older people living with HIV/AIDS (PHAs) to conceal their positive status in healthcare settings, and their responses taken and means used to cope with the stigmatizing and exclusionary effects as a result of the disclosure of their status by/to healthcare workers.

Under the auspices of a local NGO in Hong Kong, a total of seven male older PHAs aged 55 or above from pre‐existing HIV/AIDS self‐help groups were recruited for two separate focus groups. A thematic approach was adopted for data analysis and specific themes identification.

An analysis of the data revealed that older PHAs did exercise their own agency in preventing against and managing stigma in their access to and use of health care services. Two more specific themes around “sign of disapproval” and “discriminatory practice” as barriers to access were also identified.

Because of the small sample size, the pattern of stigmatization experiences and coping strategies cannot claim to be representative of the complete picture of the stigma associated with HIV/AIDS.

This is the first exploratory study of the stigmatization and devaluation suffered by older PHAs in healthcare settings in the context of Hong Kong. It also explored in details the pros and cons of the stigma management strategies employed by this vulnerable group of patients. The implications for practice both on the side of healthcare workers and policy makers and that of PHAs were discussed.

This chapter explores age-based variations in the healthcare experiences of transgender people. Specifically, we outline how transgender people narrate their experiences with coming out and transition in later life as well as possibilities for future research and clinical practice concerning older transgender populations. To this end, we begin with a review of the limited literature on older transgender populations including the ways such findings converge and diverge from studies of younger transgender populations. Then, we analyze data gathered from older transgender people throughout the United States concerning their experiences with health events, healthcare providers, and healthcare settings. For this empirical analysis, we draw on over 250 qualitative responses from transgender people over the age of 40. The findings of this chapter demonstrate the importance of adjusting existing healthcare protocols to provide adequate care for aging transgender populations. Specifically, our analyses highlight gaps in access and quality of healthcare delivery as well as issues related to medical education, trans-inclusive protocols, and sex-gender segregated medical traditions. The implications of our work here reveal important possibilities for expanding transgender healthcare access as well as existing barriers to such access. We specifically utilize the case of our respondents and the existing literature to illuminate gaps in needs assessment and healthcare delivery concerning older transgender populations. We will conclude the chapter with recommendations for bridging such gaps in research, education, and system operation.

This paper synthesises the literature on the issues related to the older patient, health service quality and its measurement. It discusses the need to consider these perspectives in the definition and assessment of quality of a community‐focused aged healthcare programme, and critically examines the existing evaluation of quality in healthcare, contrasting the patient's role and impact on the quality of the service and its outcome. The paper then reviews the documented problems associated with using satisfaction as an indicator of the patient's view of quality. An alternate validated approach to measuring the patient's perception of the quality of the service is identified in the services literature; this multidimensional hierarchical tool and scale, which specifically measures the patient's view of quality, is presented. The tool covers nine sub‐dimensions, four dimensions and the global perspective of quality as perceived by the patient. An adaptation of this tool is presented to measure the patient's view of quality using the relatively new Transition Aged Care programme as an example, and make the argument for the holistic measurement of transitional aged care quality, using a validated and reliable patient‐specific tool. Importantly, the paper proposes that the identification of the patient view of service quality will offer information that could specifically assist with service improvement.

This chapter attempts to study the long-term determinants of public and private healthcare expenditure in Hong Kong, by employing time series data over the period from 1990 to 2017. We find that income is not a determinant of either public or private spending per capita on healthcare services. Rather, a higher proportion of elderly will raise public expenditure on health and private spending even more. The share of children within the population will conversely decrease both public and private spending. Results also show that the rising density of doctors decreases both public and private per capita healthcare spending, showing that the supplier-induced demand problem is not an issue in Hong Kong.

The purpose of this paper is to synthesise data from the existent literature on the experiences of non-western older migrants in Europe in accessing and using healthcare services.

In total, 1,606 records were reviewed and 12 studies were selected. A thematic synthesis using Thomas and Harden’s approach was conducted.

The findings resulted in the three overarching themes: traditional discourses under new circumstances; predisposed vulnerabilities of older migrants and the healthcare system; and the conceptualization of health and the roles of healthcare professionals. The authors found that older migrants’ experience of accessing healthcare is influenced by many factors, such as health literacy, differences in healthcare beliefs and language barriers, and is not limited to cultural and traditional discourses of care. Findings reveal that there is a limited body of knowledge on barriers experienced by older migrant women.

The geographical scope of the study and subsequent type of healthcare systems should be taken into account while understanding barriers to care. Another limitation is that although we studied different migrant groups, the authors synthesised barriers experienced by all. Future research could study migrants as separate groups to better understand how previous experiences with healthcare in their home country and specific social, cultural and economic circumstances shape them.

This paper provides a synthesis of the experiences of migrants from non-western countries who moved to a host country with a very different language, culture and healthcare system.