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      The impact of the COVID-19 pandemic on frail older people ageing in place alone in two Italian cities: Functional limitations, care arrangements and available services

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          Abstract

          The study aimed to explore and compare effects of lockdown, due to the COVID-19 pandemic in 2020, on frail older people living alone at home in Brescia and Ancona, two urban cities located respectively in Northern and Central Italy. This country was the Western epicenter of the first wave of the pandemic (February-May 2020), which affected the two cities differently as for infections, with a more severe impact on the former. A follow-up study of the IN-AGE research project (2019) was carried out in July-September 2020, by means of telephone interviews, involving 41 respondents. Semi-structured questions focused on the effects of the first wave of the pandemic on their mobility and functional limitations, available care arrangements, and access to health services. The lockdown and social distancing measures overall negatively impacted on frail older people living alone, to a different extent in Ancona and Brescia, with a better resilience of home care services in Brescia, and a greater support from the family in Ancona, where however major problems in accessing health services also emerged. Even though the study was exploratory only, with a small sample that cannot be considered as representative of the population, and despite differences between the two cities, findings overall suggested that enhancing home care services, and supporting older people in accessing health services, could allow ageing in place, especially in emergency times.

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          Using the framework method for the analysis of qualitative data in multi-disciplinary health research

          Background The Framework Method is becoming an increasingly popular approach to the management and analysis of qualitative data in health research. However, there is confusion about its potential application and limitations. Discussion The article discusses when it is appropriate to adopt the Framework Method and explains the procedure for using it in multi-disciplinary health research teams, or those that involve clinicians, patients and lay people. The stages of the method are illustrated using examples from a published study. Summary Used effectively, with the leadership of an experienced qualitative researcher, the Framework Method is a systematic and flexible approach to analysing qualitative data and is appropriate for use in research teams even where not all members have previous experience of conducting qualitative research.
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            Frailty in elderly people

            Frailty is the most problematic expression of population ageing. It is a state of vulnerability to poor resolution of homoeostasis after a stressor event and is a consequence of cumulative decline in many physiological systems during a lifetime. This cumulative decline depletes homoeostatic reserves until minor stressor events trigger disproportionate changes in health status. In landmark studies, investigators have developed valid models of frailty and these models have allowed epidemiological investigations that show the association between frailty and adverse health outcomes. We need to develop more efficient methods to detect frailty and measure its severity in routine clinical practice, especially methods that are useful for primary care. Such progress would greatly inform the appropriate selection of elderly people for invasive procedures or drug treatments and would be the basis for a shift in the care of frail elderly people towards more appropriate goal-directed care. Copyright © 2013 Elsevier Ltd. All rights reserved.
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              Assessing self-maintenance: activities of daily living, mobility, and instrumental activities of daily living.

              S. Katz (1983)
              The aging of the population of the United States and a concern for the well-being of older people have hastened the emergence of measures of functional health. Among these, measures of basic activities of daily living, mobility, and instrumental activities of daily living have been particularly useful and are now widely available. Many are defined in similar terms and are built into available comprehensive instruments. Although studies of reliability and validity continue to be needed, especially of predictive validity, there is documented evidence that these measures of self-maintaining function can be reliably used in clinical evaluations as well as in program evaluations and in planning. Current scientific evidence indicates that evaluation by these measures helps to identify problems that require treatment or care. Such evaluation also produces useful information about prognosis and is important in monitoring the health and illness of elderly people.
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                Author and article information

                Contributors
                Role: ConceptualizationRole: Data curationRole: Formal analysisRole: Funding acquisitionRole: InvestigationRole: MethodologyRole: Project administrationRole: ResourcesRole: SoftwareRole: ValidationRole: Writing – original draftRole: Writing – review & editing
                Role: ConceptualizationRole: Data curationRole: Formal analysisRole: InvestigationRole: MethodologyRole: ResourcesRole: ValidationRole: Writing – original draftRole: Writing – review & editing
                Role: ResourcesRole: SoftwareRole: SupervisionRole: ValidationRole: VisualizationRole: Writing – review & editing
                Role: ConceptualizationRole: Data curationRole: Funding acquisitionRole: InvestigationRole: Project administrationRole: ResourcesRole: SoftwareRole: SupervisionRole: ValidationRole: VisualizationRole: Writing – review & editing
                Role: Editor
                Journal
                PLoS One
                PLoS One
                plos
                PLOS ONE
                Public Library of Science (San Francisco, CA USA )
                1932-6203
                15 March 2024
                2024
                : 19
                : 3
                : e0298074
                Affiliations
                [1 ] Centre for Socio-Economic Research on Ageing, IRCCS INRCA—National Institute of Health and Science on Ageing, Ancona, Italy
                [2 ] Social Policy Laboratory, Department of Architecture and Urban Studies, Polytechnic University of Milan, Milan, Italy
                University of Naples - Parthenope: Universita degli Studi di Napoli Parthenope, ITALY
                Author notes

                Competing Interests: The authors have declared that no competing interests exist.

                Author information
                https://orcid.org/0000-0002-4428-3749
                https://orcid.org/0000-0001-9093-2167
                Article
                PONE-D-23-11033
                10.1371/journal.pone.0298074
                10942073
                38489312
                3d522d9d-ec7d-42d8-834f-94933151f812
                © 2024 Melchiorre et al

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 29 May 2023
                : 18 January 2024
                Page count
                Figures: 0, Tables: 4, Pages: 25
                Funding
                Funded by: funder-id http://dx.doi.org/10.13039/501100002803, Fondazione Cariplo;
                Award ID: 2017-0941
                Award Recipient :
                The paper was produced within the framework of the IN-AGE project, funded by Fondazione Cariplo ( https://www.fondazionecariplo.it/it/index.html#), Grant N. 2017-0941. The Project was awarded to GL. This work has also partially been supported by the Ricerca Corrente funding from the Italian Ministry of Health to IRCCS INRCA. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
                Categories
                Research Article
                Medicine and Health Sciences
                Epidemiology
                Pandemics
                Medicine and Health Sciences
                Medical Conditions
                Infectious Diseases
                Viral Diseases
                Covid 19
                Earth Sciences
                Geography
                Human Geography
                Urban Geography
                Cities
                Social Sciences
                Human Geography
                Urban Geography
                Cities
                People and places
                Geographical locations
                Europe
                European Union
                Italy
                Biology and Life Sciences
                Developmental Biology
                Organism Development
                Aging
                Biology and Life Sciences
                Physiology
                Physiological Processes
                Aging
                Social Sciences
                Sociology
                Human Families
                Medicine and Health Sciences
                Critical Care and Emergency Medicine
                People and Places
                Population Groupings
                Ethnicities
                European People
                Italian People
                Custom metadata
                All relevant data supporting the findings are within the paper and its Supporting Information. Additionally, all relevant quantitative data are available in Mendeley Dataset at https://doi.org/10.17632/7g42mxdz4t.1.
                COVID-19

                Uncategorized
                Uncategorized

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