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Journal article

Buddhism-as-a-meaning-system for coping with late-life stress: a conceptual framework

Author:
XU Jianbin
Journal article citation:
Aging and Mental Health, 22(1), 2018, pp.100-108.
Publisher:
Taylor and Francis

Objectives: Religion is increasingly conceptualised as a meaning system for adjustment and coping. Most of the conceptualisations are grounded in the Judeo-Christian tradition. They may thus not be applicable to Buddhism, which provides a distinct tenor of meaning for coping. This article seeks to construct a conceptual framework of Buddhism-as-a-meaning-system for coping with late-life stress. Method: Literature review and conceptualisation were employed. Results: Under this framework, Buddhism functions as a meaning system involving existential meaning, cognitive meaning, and behavioural meaning. Conclusion: There is reason to believe that this framework promises to offer a holistic conceptual map of Buddhist coping in late life. Thus, it could serve as a guide for further empirical and theoretical exploration in the uncharted terrains of Buddhist coping in old age. In addition, gerontological practitioners could use this framework as a frame of reference when working with elderly Buddhist clients who are in stressful circumstances. (Publisher abstract)

Journal article

Promoting supported ambulation in persons with advanced Alzheimer’s disease: a pilot study

Authors:
LANCIONI Giulio E., et al
Journal article citation:
Disability and Rehabilitation: Assistive Technology, 13(1), 2018, pp.101-106.
Publisher:
Informa Healthcare
Place of publication:
London

Purpose: This study assessed the effects of an intervention programme, which combined the use of a walker with assistive technology, on the ambulation and indices of positive involvement of persons with advanced Alzheimer’s disease. A social validation assessment of the programme was also carried out. Method: The study included 10 participants with moderate to severe Alzheimer’s disease and inability to walk independently. During baseline, the participants sat in their chair or were provided with a walker. During the intervention, the participants were provided with the walker and assistive technology, which delivered (a) preferred stimulation contingent on step responses and (b) encouragements to ambulate if needed. Results: The participants’ mean step frequencies were between 17 and 45 per session during the baseline and between 83 and 127 per session during the intervention. Sessions lasted 3 min. Most participants also had an increase in indices of positive involvement during the intervention sessions, thus showing an interest in those sessions. The social validation assessment showed that staff personnel rated the programme favourably. Conclusions: A programme combining the use of a walker with assistive technology may be a practical resource for improving ambulation and positive involvement of persons with advanced Alzheimer’s disease. Implications for rehabilitation: 1) A programme based on relatively simple technology combined to a walker device may support ambulation in participants with advanced Alzheimer’s disease who are no longer able to walk independently; 2) The same programme may also help increase the indices of positive involvement (i.e., improve the general attention/activity and mood) of most participant; 3) The staff’s positive ratings of the program suggest that there may be a favorable attitude toward the acceptance and application of the programme in daily contexts. (Edited publisher abstract)

Journal article

How nursing home residents with dementia respond to the interactive art installation ‘VENSTER’: a pilot study

Authors:
LUYTEN Tom, et al
Journal article citation:
Disability and Rehabilitation: Assistive Technology, 13(1), 2018, pp.87-94.
Publisher:
Informa Healthcare
Place of publication:
London

The goal of this study was (1) to determine whether and how nursing home residents with dementia respond to the interactive art installation in general and (2) to identify whether responses change when the content type and, therefore, the nature of the interaction with the artwork changes. The interactive art installation ‘VENSTER’ evokes responses in nursing home residents with dementia, illustrating the potential of interactive artworks in the nursing home environment. Frequently observed responses were naming, recognising or asking questions about depicted content and how the installation worked, physically gesturing towards or tapping on the screen and tapping or singing along to the music. It seemed content matters a lot. When VENSTER is to be used in routine care, the choice of a type of content is critical to the intended experience/usage in practice. In this study, recognition seemed to trigger memory and (in most cases) a verbal reaction, while indistinctness led to asking for more information. When (initially) coached by a care provider, residents actively engaged physically with the screen. Responses differed between content types, which makes it important to further explore different types of content and content as an interface to provide meaningful experiences for nursing home residents. Implications for rehabilitation: 1) VENSTER can facilitate different types of responses ranging from verbal reactions to active physical engagement. The choice of a type of content is critical to the intended experience/usage in practice; 2) Activating content seems suitable for use as a meaningful experience during the spare time in between existing activities or therapy; 3) Sessions with interactive content are short (avg. 30 mins) and intense and can therefore potentially be used as an activating therapy, activity or exercise; 4) In order to actively engage residents with dementia, the role of the care provider seems very important. (Edited publisher abstract)

Journal article

Psychiatric disorders among older prisoners: a systematic review and comparison study against older people in the community

Authors:
DI LORITO Claudio, VOLLM Birgit, DENING Tom
Journal article citation:
Aging and Mental Health, 22(1), 2018, pp.1-10.
Publisher:
Taylor and Francis

Objectives: Despite emerging evidence that older prisoners experience poor mental health, literature in this area is still limited. In the present systematic review and meta-analysis, the authors report on the prevalence of psychiatric disorders among older prisoners and compare their findings against community studies on older people. Methods:The authors searched on Assia, PsycInfo, MedLine, Embase, Web of Science, Google and Gov.uk. They carried out bias assessments, rated studies for quality and ran a heterogeneity test. They meta-analysed prevalence rates of psychiatric disorders through an aggregate weighted mean and calculated relative risk (RR) and statistical significance against community studies. Sensitivity analyses were further performed. Results: They reviewed nine studies and obtained the following prevalence: ‘Any psychiatric disorder’ 38.4%, depression 28.3%, schizophrenia/psychoses 5.5%, bipolar disorder 4.5%, dementia 3.3%, cognitive impairment 11.8%, personality disorder 22.9%, alcohol abuse 15.9%, anxiety disorders 14.2%, PTSD 6.2%. Older prisoners were found to have higher RR for every single psychiatric disorder against older people in the community, with the sole exception of alcohol abuse (RR = 1) and dementia (RR = .75). The prevalence rates were statistically significantly higher (p < .05) among the prisoners for ‘Any psychiatric disorder’, depression and personality disorder. Overall, the sensitivity analyses confirmed our original results. Conclusion: The findings point at a high prevalence of every single psychiatric disorder among older prisoners, who also experience rates of dementia and alcohol abuse comparable to those reported in the community. The results have relevant implications for policy and practice in this area. Further research is crucial to confirm findings from this study. (Edited publisher abstract)

Journal article

Cognitive functioning, cognitive reserve, and residential care placement in patients with Alzheimer's and related dementias

Authors:
KADLEC Helena, et al
Journal article citation:
Aging and Mental Health, 22(1), 2018, pp.19-25.
Publisher:
Taylor and Francis

Objective: To test the hypothesis that patients with mild to moderate dementia with higher initial cognitive reserve (higher education levels exhibit faster cognitive decline at later stages of disease progression as they approach residential care (RC) placement. Method: Two provincial administrative databases were used. One contained individuals' scores of cognitive functioning (assessed at 6- to 12-month intervals using the Standardized Mini-Mental State Examination, SMMSE, 2007–2014) and education level; the second (BC Ministry of Health Home and Community Care database, 2001–2014) contained individuals' RC placement; N = 10531. Results: During 2.5–0.5 years prior to placement, SMMSE scores of patients with 0–8 years of education dropped slightly (M D 20.6 to 20.0), while patients with 9–12 years and 13+ years of education started higher (M D 21.8 and 21.4), but decreased faster and ended up lower (M D 19.5 and 18.8). Six-months prior to placement, SMMSE scores of all groups dropped almost 2 points. Conclusions: Once cognitive reserve of more highly educated dementia patients is depleted and they approach RC placement, their cognitive functioning deteriorates faster. Finding effective interventions that maintain or enhance cognitive reserve may increase the time in the community for dementia patients. (Publisher abstract)

Journal article

The differences between sex offenders who victimise older women and sex offenders who offend against children

Authors:
BROWNE K.D., HINES Morag, TULLY Ruth J.
Journal article citation:
Aging and Mental Health, 22(1), 2018, pp.11-18.
Publisher:
Taylor and Francis

Objectives: Within the literature on sex offending, much attention is paid to the distinction between those sex offenders who offend against adults and those who offend against children. In contrast, there is a paucity of research into sex offenders who offend specifically against elderly or older victims. Method: A detailed interview and psychometric tests were conducted with a sample of 28 sex offenders who had been convicted of a sexually motivated offence against an older female. These data were compared to a sample of 23 child sex offenders. Results: Results indicate that amongst other significant differences between these sub-groups, men who offend against older women are generally younger, are more violent, and are more likely to use a weapon and cause injury and death compared to child sex offenders. The men who offended against children were more likely to think about and plan their offending, spend more time with the victim pre and post offence, admit sexual arousal during the offence, and admit to a sexual motivation for the offence. Conclusions: This study suggests that men who sexually offend against older women and men who sexually offend against children are distinct groups. Treatment and risk management strategies should take this into account. Further exploration of this sub-group of offenders is recommended to help inform treatment and risk management strategies for sex offenders who offend against older people. (Publisher abstract)

Journal article Full text available online for free

The relation between mood, activity, and interaction in long-term dementia care

Authors:
BEERENS Hanneke C., et al
Journal article citation:
Aging and Mental Health, 22(1), 2018, pp.26-32.
Publisher:
Taylor and Francis

Objective: The aim of the study is to identify the degree of association between mood, activity engagement, activity location, and social interaction during everyday life of people with dementia (PwD) living in long-term care facilities. Method: An observational study using momentary assessments was conducted. For all 115 participants, 84 momentary assessments of mood, engagement in activity, location during activity, and social interaction were carried out by a researcher using the tablet-based Maastricht Electronic Daily Life Observation-tool. Results: A total of 9660 momentary assessments were completed. The mean age of the 115 participants was 84 and most (75%) were women. A negative, neutral, or positive mood was recorded during 2%, 25%, and 73% of the observations, respectively. Positive mood was associated with engagement in activities, doing activities outside, and social interaction. The type of activity was less important for mood than the fact that PwD were engaged in an activity. Low mood was evident when PwD attempted to have social interaction but received no response. Conclusion: Fulfilling PwD's need for occupation and social interaction is consistent with a person-centred dementia care focus and should have priority in dementia care. (Publisher abstract)

Journal article

Characteristics of double care demanding patients in a mental health care setting and a nursing home setting: results from the SpeCIMeN study

Authors:
COLLET Janine, et al
Journal article citation:
Aging and Mental Health, 22(1), 2018, pp.333-39.
Publisher:
Taylor and Francis

Background: Older patients suffering from a combination of psychiatric disorders and physical illnesses and/or dementia are called Double Care Demanding patients (DCDs). Special wards for DCDs within Dutch nursing homes (NHs) and mental health care institutions (MHCIs) offer a unique opportunity to obtain insight into the characteristics and needs of this challenging population. Methods: This observational cross-sectional study collected data from 163 DCDs admitted to either a NH or a MHCI providing specialised care for DCDs. Similarities and differences between both DCD groups are described. Results: Neuropsychiatric symptoms were highly prevalent in all DCDs but significantly more in MHCI-DCDs. Cognitive disorders were far more present in NH-DCDs, while MHCI-DCDs often suffered from multiple psychiatric disorders. The severity of comorbidities and care dependency were equally high among all DCDs. NH-DCDs expressed more satisfaction in overall quality of life. Conclusions: The institutionalised elderly DCD population is very heterogeneous. Specific care arrangements are necessary because the severity of a patient's physical illness and the level of functional impairment seem to be equally important as the patient's behavioural, psychiatric and social problems. Further research should assess the adequacy of the setting assignment and the professional skills needed to provide adequate care for elderly DCDs. (Publisher abstract)

Journal article

Respite service use among caregivers of older people: comparative analysis of family dementia caregivers with musculoskeletal and circulatory system disorder caregivers

Authors:
VECCHIO Nerina, et al
Journal article citation:
Aging and Mental Health, 22(1), 2018, pp.92-99.
Publisher:
Taylor and Francis

Objectives: To identify the main drivers of the use of respite services and the need for respite services among caregivers of people experiencing dementia relative to family caregivers of people with other health conditions. Method: Based on nationally representative secondary data regression analysis was used to test the association between selected health conditions and the utilisation of and need for respite services. Results: For a person living with dementia the odds of using respite care are higher than for a person with either a musculoskeletal or circulatory condition. Family caregivers of people living with dementia report the odds of the need for more respite as 5.3 times higher than for family caregivers of people with musculoskeletal conditions and 7.7 times higher than for family caregivers of people with circulatory conditions. The main reason for never using respite services is largely driven by the type of health condition, age of care recipient, existence of a spouse, and level of disability. Conclusions: Respite services that cater to the specific needs of families experiencing dementia at home should become a higher priority within the aged care sector. Alternative models of respite care that focus on prevention and early intervention would be cost effective. (Publisher abstract)

Journal article

Loneliness and depressive symptoms: the moderating role of the transition into retirement

Authors:
SEGEL-KARPAS Dikla, AYALON Liat, LACHMAN Margie E.
Journal article citation:
Aging and Mental Health, 22(1), 2018, pp.135-140 |.
Publisher:
Taylor and Francis

Objectives: The transition to retirement implies significant changes in daily routine and in the social environment. More specifically, it requires more self-directed efforts in order to stay socially engaged. Hence, for those who suffer from loneliness, the transition to retirement could result in increased depressive symptoms due to the lack of structured daily routine. Methods: The authors used two waves of the Health and Retirement Study, and tested whether the transition to retirement between the two waves moderates the effects of loneliness on depressive symptoms. Results: The transition to retirement moderated the effect of loneliness in wave 1 on depressive symptoms in wave 2, such that for those who retired, the effect was stronger in comparison to those who stayed employed. Conclusions: Although many manage to easily transition into retirement, lonely older workers are at increased risk for maladjustment and the experience of depressive symptoms following retirement. This group could perhaps benefit from interventions aimed at increasing daily social interactions and establishing a socially satisfying routine (Edited publisher abstract)

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