Aim 1b: Explore how older adults perceive the concept of planning for aging and frailty and identify facilitators and barriers involved in the planning process. This instrument measures willingness to participate in planning for aging and frailty through the stages of the TTM they include. This variable was measured using survey questions to assess personal experiences (7 items) and experiences/exposures with others including family/friends (7 items) in five areas of planning for aging and frailty.
The distribution of stages of change in readiness across the domains of planning for aging and frailty is shown in Figure 1. Personal experiences and experiences with others across the five domains of planning for aging and frailty with age ratings. This planning for domains of aging and vulnerability includes: (1) communication/socialization, (2) environment, (3) financial, (4) physical care, and (5) cognitive status.
Researching aging and frailty planning using qualitative methodology is essential to capture the voices of older adults, given the dearth of research. The categories captured the main patterns that emerged from the interviews regarding planning for aging and frailty. Participants shared their sense of individuality, motivation, and personal characteristics that influence their perceptions of aging planning and frailty.
Interview Guide
Codebook Perceptions
I said, “we have the medical power of attorney” and the different end-of-life things, whatever. And I said, I want you to know where they are” (P149). 34;We have certainly already started thinking about what steps we will have to take to maintain a healthy and independent lifestyle ourselves” (P33) “Myself, my sister and a few other friends, we have been talking about this for the past year topic spoken” (P27) . P189) Experiences self-codes that refer to the. I think our generation is kind of in the middle, like oh my God, this meant a lot to my parents, it means nothing to my kids, what am I going to do with it? (P189) “Nobody talked about it when I was growing up.
Codes relating to society's readiness to plan for aging and frailty: “we don't teach young people about aging in this country” and “I just don't know anyone who talks about it with their kids. ". It's like a domino effect and a lot of things doctors just can't do because there's nothing left to work with.” (P16). 34;I took the lessons I learned that helped me go through this journey with my mom" (P131) "My experience with other people who are old and infirm (as a home helper) gave me something insight into what is involved in recruiting carers, help when to recognize it.
I pay a lot of attention to like the AARP magazines and the newsletters that come out, and I've given prescriptions in the past” (P34) “I've had both knees replaced and the physical therapist that came out helped me with a lot of things, not just the knee recovery, but talking to me about things as I get older and things to do to help me later” (P34) “Go to this Medicare meeting” (P131) “We need more people Education, even realtors. It's certainly not going to be a time when I can't drive." So I don't plan for that because I just don't believe that would be my reality" (P5) "My reluctance to accept that I'm getting old" (P189 ).So my focus in life now is to eat healthier.” (P24) “And now I sometimes feel pain in my knees.
You have to be able to do the stairs if you are going to see anything. I'll take care of you." And after putting up with my husband, I would never do that to him. I think because I've always been on a tight budget and felt like I didn't have the money to pay him back. . for planning and I work for the state, so I felt, "I'm going to have a good retirement with my retirement plan and I don't really need it because I have a retirement plan." (P71) "Plus, I didn't feel like I had money to pay them back.
It's about not feeling like I have the money to put back and thinking about my retirement plan, that's the big thing, thinking, "Oh, I have a retirement plan." So you think, "I'm fine." No, planning for your old age must be completely different from your pension plan” (P71) “My financial situation and the denial of thinking that I didn't need it because I had a good pension.
Table of Participant number and characteristics Participant
Examines contextual factors associated with stages of change for readiness to plan for aging and frailty. Given our desire to evaluate additional processes that may influence successful aging among older adults, the terminology and concept of planning for aging and frailty was used. Planning for aging and frailty incorporates the complex nature of aging and inevitable changes across comprehensive domains, including: (1) communication/socialization, (2) environment (living arrangements and transportation), (3) financial, (4) physical care (dependency) and caregiver), and (5) cognitive status.
The survey survey included measures of demographic characteristics, functional status, frailty, health status, social support, and stages of change for aging and frailty planning. Stages of Change for Aging and Frailty Planning is a seven-item survey that measures planning behavior using the transtheoretical model (precontemplation [no intention to change], contemplation [thinking about changing behavior in the near future], preparation [commitment to change behavior soon], action [recent change] and maintenance [ongoing behavior change] in five domains. Descriptive statistics were used to describe participant characteristics and summarize the distributions of stage of change across the planning of aging and frailty domains.
In contrast, the memory loss planning domain had the highest percentage of participants in the initial stages of planning. Finally, in the physical caregiving/caregiver domain, contextual factors associated with increased planning for aging and frailty were the same as those in the domain. The purpose of this study was to examine the relationships between contextual factors influencing older adults' willingness to participate in aging and frailty planning and TTM.
First, social support is strongly associated with activation of planning for aging and frailty across all domains except physical care/need for caregiver. Within the planning for aging and frailty paradigm, increased social support can help mitigate losses associated with aging, such as smaller social networks, impaired function, death of friends or spouses, and difficulty engaging in activities (Cornwell et al., 2008) and contribute to greater well-being. The concept of planning for aging and frailty is ripe for future research within the life course perspective.
Using the more global concept of planning for aging and frailty offers the opportunity to normalize life transitions and encourage recognition that these transitions are inevitable stages of the human lifespan, encompassing social, physical and cultural changes (Liveng et al ., 2017). what planning is needed. Developing and testing interventions to help people view planning for aging and frailty as a positive endeavor is warranted. A final implication of our study is that it highlights the importance of social support in planning for aging and frailty.
Future research is needed at the individual and societal levels to advance planning for aging and frailty and to optimize factors associated with increasing frailty.
Conclusion
Our findings support the need for triggers, resources and interventions to help people overcome these barriers and encourage people to think seriously about the need to plan. Finally, in Objective 2 (Chapter Four), we examined the associations between contextual factors and stages of change for readiness to plan for aging and frailty. This is perhaps related to the presence of family/friends in one's life can lead one to assume that the need for a caregiver is already in place, negating the need to plan.
The results of our study were consistent with existing research showing that future care planning rates are lower among community-dwelling African Americans than among White older adults ( Kahana et al., 2019 ), and higher as education levels and income increase ( Prenda & Lachman). 2001). Second, we explored participants' perceptions, facilitators, and barriers to planning, providing a rich description of older adults' experiences. Third, the COVID-19 pandemic has had a major impact on the communication/socialization domain, which may have contributed to a greater degree of willingness to make plans given the exposure to quarantine isolation and the increased use of technology to maintain social connectedness.
First, normalizing the aging process through the concept of planning for aging and frailty can help older adults, health care systems, and society engage with the aging process through awareness, education, and proactive planning. Second, there is a natural progression from planning for aging and frailty to serve as an upstream initiative to prepare the way for advanced care planning. Third, clinicians can practice patient- and family-centered care by recognizing the influence of life experiences on one's perception of planning.
Planning for aging and frailty as significant implications from a policy perspective considering the multidimensional aging process and the impact of aging on all sectors of life. Social determinants of health and socio-economic structuring of individuals' ability to plan must also be investigated further. Planning for aging and frailty is an innovative concept that has potential for future research within the life course perspective.
Furthermore, further research is warranted to develop interventions to help older adults recognize and actively plan for aging, and address barriers to planning. Preparing for aging: Development, feasibility, and preliminary results of an educational program for middle age and older based on proactive coping theory.
