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Attitudes towards seeking mental health services among older adults: personal and contextual correlates
- Authors:
- KESSLER Eva-Marie, AGINES Sabrina, BOWEN Catherine E.
- Journal article citation:
- Aging and Mental Health, 19(2), 2014, pp.182-191.
- Publisher:
- Taylor and Francis
This study investigates a wide range of contextual (e.g. physical access, residence) and personal (e.g. perceived social support, life satisfaction, openness to experience) predictors of attitudes towards seeking mental health services (ATSMHS) in a sample of 156 older community-dwelling adults in Germany. It was predicted that representations of old age as well as perceptions of (younger) psychotherapists would be uniquely important for determining ATSMHS. Method: Participants completed questionnaire measures which were analysed using hierarchical linear regression analyses to identify predictors of ATSMHS. Results: In the final saturated model, female gender, urban residence, personal and vicarious experience with psychotherapy, and higher perceived social support were each associated with more positive ATSMHS. In addition, more positive representations of old age and less negative perceptions of (younger) psychotherapists explained unique variance in ATSMHS over and above the other predictors. The overall model was significant and explained 49% of the variance in ATSMHS. Conclusion: The findings can be used to inform interventions to improve older adults’ ATSMHS. Interventions that seek to improve older adults’ representations of their own ageing as well as of psychotherapists may be useful for reducing the treatment gap. (Edited publisher abstract)
Social counselling for older people—between advice and therapy
- Authors:
- POHLMANN Stefan, HEINECKER Paula, LEOPOLD Christian
- Journal article citation:
- European Journal of Social Work, 17(3), 2014, pp.415-432.
- Publisher:
- Taylor and Francis
In Europe, social counselling services increasingly follow the guiding principle active ageing. Active ageing policies help people recognise and use their physical, social and mental potential in order to participate in society according to their individual needs and capacities. Counselling the heterogeneous target group—‘older people’—implies that services should be prepared to address individual risks and resources. This article discusses the largely unclear position of social counselling for older people within social work in Europe. An empirical perspective is established with a German online survey, conducted among social counselling professionals nationwide (N = 1050). Their services were studied in terms of service provision, target groups, counsellor qualification and applied methods. The aim was to describe and classify the existing counselling provision. The study revealed that social counselling is located somewhere between advice and psychotherapy, and as such primarily focused on helping with age-related deficits and problems. A considerable proportion of client contacts results from acute crises. Still, only a third of the respondents followed a specific, defined concept in their work, and even fewer stated having gerontological qualification. Primary achievements of the study were to help classify existing social counselling services for older people and to develop basic gerontological training for counsellors. (Publisher abstract)
How much does it hurt to be lonely? Mental and physical differences between older men and women in the KORA-Age Study
- Authors:
- ZEBHAUSER A., et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 29(3), 2014, pp.245-252.
- Publisher:
- Wiley
Objective: Loneliness has a deep impact on quality of life in older people. This study compared the intensity of and factors associated with loneliness between men and women. Methods: Analyses are based on the 2008/2009 data of the KORA-Age Study, comprising 4127 participants in the age range of 64–94 years. An age-stratified random subsample of 1079 subjects participated in a face-to-face interview. Loneliness was measured by using a short German version of the UCLA-Loneliness-Scale (12 items, Likert scaled, ranging from 0 to 36 points). Multiple logistic regression analysis was conducted to analyze the associations of socio-demographic, physical, and psychological factors with loneliness. Results: The mean level of loneliness did not significantly differ between men and women. However, among the oldest old (those of 85 years and older), loneliness was higher in women. Depression, low satisfaction with life, and low resilience were associated significantly with loneliness, which was more pronounced in men. Living alone was not associated with loneliness, whereas lower social network was associated with a three time higher risk for feeling lonely in both men and women. Conclusions: The extent of loneliness was equally distributed between men and women, although women were more disadvantaged regarding living arrangements as well as physical and mental health. However, loneliness was stronger associated with adverse mental health conditions in men. These findings should be considered when developing intervention strategies to reduce loneliness. (Edited publisher abstract)
Analysing equity in the use of long-term care in Europe
- Authors:
- RODRIGUES Ricardo, ILINCA Stefania, SCHMIDT Andrea
- Publisher:
- European Commission
- Publication year:
- 2014
- Pagination:
- 39
- Place of publication:
- Brussels
There are significant differences across social protection systems in Europe in the scope, breadth and depth of coverage of the risk to need long-term care in old-age. Together with other factors, such as education, household structure or societal values regarding care for frail older people, these differences can have a significant impact on the use of long-term care. Using SHARE data, this Research Note compares differences between European countries in the use of long-term care across income groups, for older people living at home. It analyses not only inequalities in the use of long-term care, but also differences in use that persist after differences in need have been taken into consideration, i.e. horizontal inequity. For this purpose, concentration indices, concentration curves and horizontal inequity indices are estimated for home care services and informal care. The countries analysed here are Austria, Germany, Sweden, the Netherlands, Spain, Italy, France, Denmark, Greece, Belgium and Czech Republic. The findings suggest that differences in use of home care services across income groups mostly reflect differences in need between those same groups. For informal care, the differences in use persist even after accounting for needs, and less affluent individuals are much more likely to use informal care. Some possible causes for these differences and policy implications are considered.
Regulating long-term care quality: an international comparison
- Editors:
- MOR Vincent, LEONE Tiziana, MARESSO Anna
- Publisher:
- Cambridge University Press
- Publication year:
- 2014
- Pagination:
- 519
- Place of publication:
- Cambridge
This edited book provides a comprehensive international survey of long-term care provision and regulation, built around a series of case studies from Europe, North America and Asia. The analytical framework allows the different approaches that countries have adopted to be compared side by side and readers are encouraged to consider which quality assurance approaches might best meet their own country's needs. Wider issues underpinning the need to regulate the quality of long-term care are also discussed. The book is aimed at policymakers working in the health care sector, researchers and students taking graduate courses on health policy and management. (Edited publisher abstract)
Negotiating the demands of active ageing: longitudinal findings from Germany
- Authors:
- TOMASIK Martin J., SILBEREISEN Rainer K.
- Journal article citation:
- Ageing and Society, 34(5), 2014, pp.790-819.
- Publisher:
- Cambridge University Press
The challenges of population ageing and globalisation have been addressed by many welfare states in terms of active ageing policies, which in turn confront individuals with new demands such as keeping up to date with technological developments. This paper analyses how individuals negotiate the demands of active ageing. The outcome variable was change in primary and secondary control strategies with regard to demands of active ageing over the course of one year. In a German sample of N = 602 men and women aged 55–75 years,a strong preference was found for engagement with these demands and a low preference for disengagement. A higher load of demands of active ageing was associated with an increase in engagement with these demands. However, when people perceived their everyday surroundings as unfavourable, their disengagement with demands of active ageing increased. Higher internal control beliefs concerning demands of active ageing were associated with an increase in engagement and a decrease in disengagement. The study concludes that individuals strengthen their efforts to master demands of active ageing when they believe that they can control them. When the everyday ecology seems unfavourable, though, strategies are preferred that enable people to avoid a presumably lost case. (Edited publisher abstract)
European healthcare: care homes report 2014
- Author:
- KNIGHT FRANK
- Publisher:
- Knight Frank
- Publication year:
- 2014
- Pagination:
- 12
- Place of publication:
- London
This report explores the market composition, structure and context of continental Europe’s four largest care home markets: France, Germany, Spain and Italy. Demand for elderly care is expected to rise significantly, as decreasing fertility rates, coupled with increasing overall life expectancy, are driving up the share of elderly in the population. The growing number of elderly will impact on future demand for long-term care (LTC) services. However, while all types of LTC services are set to increase, they will not do so uniformly. Homecare, the preferred service line for most European countries in recent years, will prove to be inefficient given the rising share of patients with specialised medical needs. Additionally, societal changes, including declining family size, increasing childlessness and rising non-traditional living arrangements, mean that care homes will play a crucial role in caring for the increasing elderly population. The report shows that the somewhat restrictive domestic care home market has driven French-based operators towards further expansion abroad and a greater diversification of services. In Germany, while there remains an acute shortage of beds, the market has experienced an increased level of consolidation in recent years, as well as a string of acquisitions by foreign operators and private equity firms. The recent economic revitalisation has brought greater investor interest in Spain while the Italian care home market remains ripe for new development and investment. The relatively small size of the Italian industry, coupled with the considerable level of market fragmentation, means there is substantial room for new entrants and potentially greater consolidation of private and non-profit homes. (Edited publisher abstract)
Suitability of the 6CIT as a screening test for dementia in primary care patients
- Authors:
- HESSLER Johannes, et al
- Journal article citation:
- Aging and Mental Health, 18,(4) 2014, pp.515-520.
- Publisher:
- Taylor and Francis
Objectives: To map the suitability of the Six Item Cognitive Impairment Test's (6CIT) as a screening instrument for dementia in primary care and to assess its feasibility, reliability, and validity in a real-world setting.Method: The present study was part of a population-based prospective trial aimed at reducing the incidence of stroke and dementia. The 6CIT was administered by general practitioners (GPs) at routine examinations every two years. Incidence of dementia was obtained from health insurance records. Psychometric qualities of the 6CIT were evaluated for two different cut-offs.Results: At baseline, 72 GPs examined 3908 patients. In total, 528 patients were diagnosed with new dementia. Less than 1% of the tests were not completed. Internal consistency (Cronbach's alpha), stability over time (Pearson's r), and the agreement between successive tests (Cohen's kappa) reached values of 0.58, 0.62, and 0.45, respectively. Sensitivity and specificity reached values of 0.49 and 0.92 at the 7/8 cut-off and of 0.32 and 0.98 at the 10/11 cut-off, respectively. Patients with dementia had significantly higher mean error scores than patients without dementia. High scores at baseline posed a more than fourfold risk of being diagnosed with dementia.Conclusion: The 6CIT's psychometric properties in a real-world setting suggest that the test is not suited as a routine screening instrument. Factors inherent to screening in primary care likely contributed to its low reliability and validity. This highlights the need for training GPs in the conduct of cognitive screening before such procedures can be implemented on a routine basis. (Publisher abstract)