Editorial

Citation

Iphofen, R. (2012), "Editorial", Quality in Ageing and Older Adults, Vol. 13 No. 2. https://doi.org/10.1108/qaoa.2012.55913baa.001

Editorial

Article Type: Editorial From: Quality in Ageing and Older Adults, Volume 13, Issue 2

We have not before published anything about hospital visiting and, indeed, there seems little literature on the topic particularly on visiting by older people. Yet with an increasingly active and engaged ageing population, this is clearly an area that deserves further attention. I particularly liked the approach taken in our first article – “Not just grapes and flowers” – since we are also increasingly receiving work based on participatory methods: research on, by and with older people. There are acknowledged limitations to participatory approaches, but there are also clear gains from access to insight and practical recommendations that could make a big difference to what older people experience during a hospital stay. Researchers wishing to conduct similar work can learn some useful lessons from this paper and hospital management can learn even more about enhancing the patient experience.

The paper from Frances Wilby and Cathy Chambless is a more formal study of provision for adults over 65 who seek support services in a state in western USA. If services are to meet the needs of a target population effectively then their specific characteristics need to be carefully understood. In the USA as elsewhere in the developed world the recognition that institutional care is unlikely to be able to meet the requirements of our current ageing population means that home and community-based services must grow in effectiveness and focus. Methodologically this paper also provides a contrast to the primary research of our first paper in that it represents an excellent example of secondary research – utilizing existing data sets to offer additional insights to those the data originally sought to represent. While participatory research can be innovative and challenging, it requires great time and energy commitments; secondary research can certainly reduce the “nuisance factor” of over-researching a target population. Once again this suits some categories of older research subject who might not wish to devote the time and energy to another’s project. Additionally, this work offers a model for researchers into ageing who are keen to minimize intrusion into their subjects’ lives while still producing useful data for policy and practice.

No one doubts the central importance of food and eating behaviour in human life. The ceremony, the ritual and the social relationships engendered in how and when we eat are vital to the quality of our lives. One of the dangers confronting us when we are older and perhaps have less energy is that food becomes merely functional. That can become even more the case in formal care situations. Hence the importance of the study we publish here from Andrea Kenkmann and Lee Hooper. They explored the complex needs of a varied residential home population and show just how difficult it can be to get this right. Thus, some residents might enjoy the flexibility of a “restaurant” style provision while others prefer something more stable that resembles the family home. Clearly simply establishing a restaurant provision within a care home is as complex as finding the perfect restaurant experience has always been throughout our lives. What matters is that more thought is given to the dining experience in residential homes since it affects our emotions, our memories and our relationships with others.

In light of all too frequent scandals concerning the care of the elderly by health professionals it was interesting to see the research from Issi Doron and colleagues in Israel. They explored physical therapists’ attitudes to the worthiness of treating persistent vegetative state patients of different ages. Fundamentally, this was a study to see if health professionals held ageist perspectives which could affect the nature of the treatment they would give. Sadly, they discovered this to be the case. Perhaps this is less surprising in an “end-of-life” situation, but the concern is that such views might carry over into other treatment settings leading to lower quality of care for older patients. This article suggests creating opportunities for further ethical reflection by health professionals on the implications for care of their inherent prejudices.

As if to demonstrate the breadth of methodological range available to social gerontology the next paper in this issue – from Deb Hearle, Val Rees and Jane Prince in South Wales – represents an excellent example of non-intrusive observational methods. They were concerned to examine just how much “purposeful activity” was engaged in one residential care home over a specified period of time. Sadly, it appears there was very little constructive “occupied” activity provided for. While single case studies have their limitations, they can provide a proving ground for suitable less intrusive research methods and forestall unanticipated errors in investigative procedures. Of course “caring for” the residents is a priority for staff, but useful occupied time remains an unmet need and is just as vital for the physical and psychological health of the residents. Care staff and management need to be supported in considering ways in which this gap in provision can be filled.

Ava Lorenc and colleagues used a series of focus groups to explore older peoples’ decision making with regard to accessing treatment from a range of complementary and alternative medicine (CAM) approaches. Rarely discussing their alternative choices with their orthodox practitioners the older people in this sample exploited CAM as a form of maintenance therapy. They reported perceptions of improved well-being across the various mental and physical therapies chosen. What is interesting about these choices is that they appear to be made on the basis of little solid evidence but a willingness to take some degree of responsibility for their own care. Clearly health professionals need to learn more about these active choices and consider how best to incorporate the provision of alternatives within a holistic care plan.

Finally, as if to complete a full range of age-appropriate research methodologies, we report the results of a telephone survey conducted by Ulrike Schultz and her colleagues at the University of Iowa on the nutrition needs of older adults. In similar vein to the previous CAM study, the respondents’ interest in healthy eating was primarily to maintain their health status and prevent disease and disability. Most made their food selections in terms of taste and feeling better rather than cost, convenience, losing weight, and better appearance. And again the respondents seem to have more self-reliance in terms of the compilation of useful nutritional information. This work could help guide health promotion professionals in assessing the nutritional needs of older adults and how best to enhance their knowledge and improve their healthy eating behaviour.

Ron Iphofen