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怀俄明州全人关怀老年计划(PACE)关闭:对社会隔离和孤独影响的定性分析。

The closure of Wyoming's Program of All-Inclusive Care for the Elderly (PACE): Qualitative analysis of the impact on social isolation and loneliness.

机构信息

Department of Psychology, College of Arts and Sciences, University of Wyoming, Laramie, WY, United States.

Cheyenne Regional Medical Center, Behavioral Health and Population Health Services, Cheyenne, WY, United States.

出版信息

Front Public Health. 2024 Nov 14;12:1426100. doi: 10.3389/fpubh.2024.1426100. eCollection 2024.

Abstract

INTRODUCTION

Social isolation and loneliness are global public health concerns experienced among older adults which are commonly associated with negative physical, psychological, and social outcomes. The healthcare system has an opportunity to identify and address social isolation and loneliness in older adults. The Program of All-Inclusive Care for the Elderly (PACE) was developed to serve comprehensive social needs along with medical and behavioral needs of older adults who qualify for long-term care while still living in the community. In 2021, due to state budget reductions, Wyoming's only PACE program (WY PACE) closed, resulting in the discharge of all participants and loss of social engagement opportunities provided by this program. The objectives of this evaluation were to (1) examine the impact of the WY PACE closure on isolation and loneliness, (2) identify how older adults adapted to the loss of services addressing isolation and loneliness, and (3) identify needs for future interventions to address isolation among clients who experienced loss of supportive programs.

METHODS

A mixed-methods design was used to facilitate understanding of qualitative findings while also conducting quantitative analyses to provide context for qualitative responses. Participants included 17 individuals who were either former PACE participants or their caregivers. Participants ( = 12;  = 74 years old) were predominantly non-Hispanic White ( = 8, 66%) and cisgender female ( = 7, 58%). Caregivers of participants ( = 5;  = 63 years old) were predominantly Hispanic, Latino, or of Spanish origin ( = 3, 60%) and cisgender female ( = 4, 80%).

RESULTS

A mixed-methods design was used to facilitate understanding of qualitative findings while also conducting quantitative analyses to provide context for qualitative responses. Participants included 17 individuals who were either former PACE participants or their caregivers. Participants ( = 12;  = 74 years old) were predominantly non-Hispanic White ( = 8, 66%) and cisgender female ( = 7, 58%). Caregivers of participants ( = 5;  = 63 years old) were predominantly Hispanic, Latino, or of Spanish origin ( = 3, 60%) and cisgender female ( = 4, 80%).

DISCUSSION

This evaluation provided preliminary insight into the impacts of the loss of programs like WY PACE on social isolation and loneliness. Creative solutions to maintain social engagement of this vulnerable population are needed.

摘要

简介

社会隔离和孤独是全球老年人面临的公共健康问题,通常与负面的身体、心理和社会后果有关。医疗保健系统有机会识别和解决老年人的社会隔离和孤独问题。老年人全面关怀计划(PACE)旨在满足符合长期护理条件的老年人的综合社会需求以及医疗和行为需求,同时让他们仍然生活在社区中。2021 年,由于州预算削减,怀俄明州唯一的 PACE 计划(WY PACE)关闭,导致所有参与者出院,该计划提供的社会参与机会丧失。本评估的目的是:(1)研究 WY PACE 关闭对隔离和孤独的影响;(2)确定老年人如何适应解决隔离和孤独的服务丧失;(3)确定为失去支持性项目的客户提供干预措施以解决隔离问题的需求。

方法

采用混合方法设计,以促进对定性研究结果的理解,同时进行定量分析,为定性反应提供背景。参与者包括 17 名前 PACE 参与者或其照顾者。参与者(n=12;年龄=74 岁)主要是非西班牙裔白人(n=8,66%)和跨性别女性(n=7,58%)。参与者的照顾者(n=5;年龄=63 岁)主要是西班牙裔、拉丁裔或西班牙语裔(n=3,60%)和跨性别女性(n=4,80%)。

结果

采用混合方法设计,以促进对定性研究结果的理解,同时进行定量分析,为定性反应提供背景。参与者包括 17 名前 PACE 参与者或其照顾者。参与者(n=12;年龄=74 岁)主要是非西班牙裔白人(n=8,66%)和跨性别女性(n=7,58%)。参与者的照顾者(n=5;年龄=63 岁)主要是西班牙裔、拉丁裔或西班牙语裔(n=3,60%)和跨性别女性(n=4,80%)。

讨论

本评估初步探讨了像 WY PACE 这样的项目丧失对社会隔离和孤独的影响。需要创造性的解决方案来维持这个弱势群体的社会参与。

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