The Gerontologist
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All individuals deserve an equitable opportunity to achieve a good death. Unfortunately, access to end-of-life care and services is largely unequal on the basis of race, gender, class, and other social identities. We need to understand how individuals with multiple marginalized identities face different access in attaining a good death and use this knowledge to bring equity to end-of- life care. ⋯ This argument sheds light on the relationship between intersectionality and a good death, demonstrated by a case vignette, and suggests that the more marginalized social identities one has, the more difficult their access to a good death. Because it is particularly important to both recognize and actively combat these inequities, I offer three practical strategies for end-of-life researchers and practitioners. For the sake of our increasingly diverse population, advancements in end-of-life care must be made to facilitate a good death for all.
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Our aim was to create a "storyline" that provides empirical explanation of stakeholders' perspectives underlying the use of patient- and family-reported outcome and experience measures to inform continuity across transitions in care for frail older adults and their family caregivers living at home. ⋯ The motivations underlying stakeholders' use of these tools were distinct, yet synergistic between the goals of person/family-centered care and healthcare system-level goals aimed at efficient use of health services. There is a missed opportunity here for PROMs and PREMs to be used together to inform continuity across transitions of care.
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The Coronavirus Disease 2019 (COVID-19) pandemic has highlighted the pervasive ageism that exists in our society. Although instances of negative or hostile ageism have been identified, critical attention to the nuances of ageism throughout the pandemic, such as the prevalence and implications of positive or compassionate ageism, has lagged in comparison. This commentary uses stereotype content theory to extend the conversation regarding COVID-19 and ageism to include compassionate ageism. ⋯ The implications of compassionate ageism that have and continue to occur during the pandemic are discussed using stereotype embodiment theory. Future actions that focus on shifting attention from the intent of ageist actions and beliefs to the outcomes for those experiencing them are needed. Further, seeking older individuals' consent when help is offered, recognizing the diversity of aging experiences, and thinking critically about ageism in its multiple and varied forms are all required.
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Older adults with multiple comorbidities experience high rates of hospitalization and poor outcomes from Coronavirus Disease 2019 (COVID-19). Changes in care utilization by persons in advanced illness management (AIM) programs during the COVID-19 pandemic are not well known. The purpose of this study was to describe changes in care utilization by homebound AIM patients in an epicenter of the COVID-19 pandemic before and during the pandemic. ⋯ Our results demonstrate decreased acute and post-acute utilization, while maintaining high levels of connectedness to the AIM program, among a cohort of homebound older adults during the COVID-19 pandemic compared with 1 year prior. While further study is needed, our results suggest that AIM programs can provide support to this population in the home setting during a pandemic.
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Benevolent and hostile ageism are subtypes of ageism that characterize older adults as incompetent. With benevolent ageism, older adults are also viewed as warm. The coronavirus disease 2019 (COVID-19) pandemic has strained resources and prompted debates about priority for older adults versus other groups. ⋯ These findings replicate and extend past work. As the COVID-19 pandemic continues to wreak havoc on health care and employment resources, this study sheds light on one factor-benevolent and hostile ageism-that contributes to a greater understanding of prioritization views toward a vulnerable segment of the population.