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Driving forces for home-based reablement; a qualitative study of older adults’ experiences
- Authors:
- HJELLE Kari Margrete, et al
- Journal article citation:
- Health and Social Care in the Community, 25(5), 2017, pp.1581-1589.
- Publisher:
- Wiley
Reablement is an early and time-limited home-based intervention with emphasis on intensive, goal-oriented and interdisciplinary rehabilitation for older adults in need of rehabilitation or at risk of functional decline. The aim of this qualitative study was to describe how older adults experienced participation in reablement. Eight older adults participated in semi-structured interviews. A qualitative content analysis was used as the analysis strategy. Four main themes emerged from the participants’ experiences of participating in reablement: ‘My willpower is needed’, ‘Being with my stuff and my people’, ‘The home-trainers are essential’, and ‘Training is physical exercises, not everyday activities’. The first three themes in particular reflected the participants’ driving forces in the reablement process. Driving forces are intrinsic motivation in interaction with extrinsic motivation. Intrinsic motivation was based on the person's willpower and responsibility, and extrinsic motivation was expressed to be strengthened by being in one's home environment with ‘own’ people, as well as by the co-operation with the reablement team. The reablement team encouraged and supported the older adults to regain confidence in performing everyday activities as well as participating in the society. The findings contributing to an understanding of how intrinsic and extrinsic motivation influence reablement. Some persons need apparently more extrinsic motivational support also after the time-limited reablement period is completed. The municipal health and care services need to consider individualised follow-up programmes after the intensive reablement period in order to maintain the achieved skills to perform everyday activities and participate in society. (Edited publisher abstract)
A critical review of research on hospitalization from nursing homes; what is missing?
- Authors:
- AGOTNES Gudmund, et al
- Journal article citation:
- Ageing International, 41(1), 2016, pp.3-16.
- Publisher:
- Springer
- Place of publication:
- New York
In this paper the authors seek to summarise research literature on hospitalisation from nursing homes, to identify shared themes, findings and approaches, and to analyse strengths and weaknesses of the literature. The main aim of the article is to critically review current research on the topic of hospitalisation from nursing homes, based on a variety of original research articles and literature overviews. First, the authors examine why studies of hospitalisation from nursing homes are considered to be important in the literature, focusing on what is described as large variation in rates of hospitalisation between institutions and geographical areas as well as the occurrence of unwanted and avoidable hospitalisations. Second, the authors present studies on reasons for rates of hospitalisations of nursing home patients based on patient characteristics. Third, studies that have focused on institutional characteristics that may explain rates of hospitalisations are presented. Fourth, the authors examine factors and conditions highlighted in parts of the literature on hospitalisation, more closely than others connected to practice and decision making. Finally, some of the weaknesses of these hospitalisation studies are discussed and areas for future research studies are discussed. (Edited publisher abstract)
Depression in older cat and dog owners: the Nord-Trøndelag Health Study (HUNT)-3
- Authors:
- ENMARKER Ingela, et al
- Journal article citation:
- Aging and Mental Health, 19(4), 2015, pp.347-352.
- Publisher:
- Taylor and Francis
Objective: Previous studies have shown that mental health among older people who live with animals could be improved, but contrary results exist as well. This study compared the self-rated depression symptoms of both female and male non-pet owners, cat owners, and dog owners. Method: Participants included 12,093 people between the ages of 65 and 101 in Norway. One thousand and eighty three participants owned cats and 814 participants owned dogs. Self-rated depression symptoms were measured using HADS-D, the scale of self-administered depression symptoms in HADS (Hospital Anxiety and Depression Scale). Results: The main results showed higher mean values on the HADS-D for cat owners than for both dog and non-pet owners. The latter group rated their depression symptoms the lowest. When dividing the ratings into low- and high-depression symptoms, the logistic regression analysis showed that it was more likely that males who owned cats perceived lower depression symptoms than females who owned cats. No interactions were recognised between pet ownership and subjective general health status, loneliness, or marital status. Conclusions: Results provide a window into the differences in health factors between older females and males who own cats and dogs in rural areas. Results from population studies like ours might increase the available knowledge base when using cats and dogs in clinical environments such as nursing homes. (Edited publisher abstract)
Elderly people who committed suicide – their contact with the health service. What did they expect, and what did they get?
- Authors:
- KJOLSETH Ildri, EKEBERG Oivind, STEIHAUG Sissel
- Journal article citation:
- Aging and Mental Health, 14(8), November 2010, pp.938-946.
- Publisher:
- Taylor and Francis
Contact between elderly patients and healthcare professionals may be crucial for suicide prevention. This study investigated how elderly suicide cases had perceived the health service and what characterised their contact with it. The article describes a psychological autopsy study based on qualitative interviews. A psychological autopsy reconstructs the suicide through interviews with informants who knew the deceased well. The aim was to have two or three informants for each of 23 suicide cases aged over 65. The 63 informants were relatives, general practitioners, and home-based care workers. The systematic text condensation method was applied to analyse the interviews. The results indicated that many of the elderly expressed distrust of health service once their functional decline began. They feared losing their autonomy if they became dependent on help, and many therefore refused health service provisions. Communication between them and helpers failed. As they gradually became more dependent on medical care, many experienced that they were not given the desired help, which confirmed their distrust. The article concludes that contact between these people and the health service must inspire confidence for it to prevent suicide. Elderly people at risk of suicide are vulnerable and feel degraded if their autonomy is threatened by health personnel. The structure and organisation of the health service, and each worker's contact with the elderly, must preserve their dignity.
The relationship between coping, self-esteem and health on outdoor walking ability among older adults in Norway
- Authors:
- BERGLAND Astrid, THORSEN Kirsten, LOLAND Nina Waaler
- Journal article citation:
- Ageing and Society, 30(6), August 2010, pp.949-963.
- Publisher:
- Cambridge University Press
Walking is an essential component of outdoor mobility, and recognised as one of the best forms of physical activity for older adults. The purpose of this study was to examine the relationships between socio-demographic factors, coping resources, self-esteem and health status with the outdoor walking ability of people aged 55–79 years living in the community. The hypothesis was that there is a positive association between outdoor walking ability and coping, self-esteem and health status. A nationally-representative sample of women and men were initially contacted by telephone and then mailed questionnaires to ask questions regarding socio-demographic attributes, coping resources, self-esteem, health status and outdoor walking ability. This paper concentrates on the 3,069 respondents aged 55-79 years who completed both the telephone interview and the questionnaire. Around one-half of the participants were women, and around one-half were aged 65 or more years. Regarding outdoor walking ability, only 0.7 per cent of the respondents were not able to walk at all, and 80.8 per cent could walk at least one kilometre without a pause. Binary logistic multivariate regression analyses showed that those who had good outdoor walking ability (one kilometre or more) were significantly younger than those who did not, and that they were predominantly men, partnered or married, not in paid work, experienced significantly little pain, had better self-reported health and higher perceived coping.
Factor analysis of the Montgomery Aasberg depression rating scale in an elderly stroke population
- Authors:
- FARNER Lasse, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 24(11), November 2009, pp.1209-1216.
- Publisher:
- Wiley
The Montgomery Aasberg Depression Rating Scale (MADRS) is a widely used instrument for the measurement of change in depressive symptoms. This study aimed to explore the construct validity of the MADRS using factor analysis and to examine whether symptom clusters of depression after stroke are associated with any patient characteristics. A sample of 163 stroke patients was assessed, with information collected from patients’ records. Factor analysis identified three distinct factors: anhedonia, consisting of items associated with loss of interest, emotional withdrawal, suicidal thoughts and loss of appetite; sadness, consisting of items associated with observed and self-rated sadness and pessimism; agitation, consisting of inner tension, lack of concentration and loss of sleep. The study concluded that anhedonia is related to cognitive impairment, sadness to neurological impairment due to the stroke, and agitation is probably an indifferent factor that could be related to anxiety in combination with a variety of physical health problems.
‘I am not that old’: inter-personal experiences of thriving and threats at a senior centre
- Authors:
- LUND Anne, ENGLESRUD Gunn
- Journal article citation:
- Ageing and Society, 28(5), July 2008, pp.675-692.
- Publisher:
- Cambridge University Press
The high cultural valuation of youthfulness and fitness in the mass media and more generally in western consumer society is the contextual frame for this study. It examines older people's attitudes towards their own ageing and towards people who are older or frailer than themselves. Participant observation was conducted of the attitudes, actions and interactions of the users of a senior centre in Norway. The users held two sets of attitudes that led to quite different activities and actions at the centre. On the one hand, they saw the centre as helping them ‘thrive’, which was associated with involvement in the community and participation in the structured daily activities to promote the senses of belonging and being useful. On the other hand, some perceived the centre and particularly the other users as ‘threats’ – as reminding them that they were getting old and increasingly vulnerable to sickness and disability. To some, the centre was for old people with disabilities, and they used subtle strategies to distance themselves from this group. Some users' attitudes and behaviour were in tension: they wished to participate in the valued activities but also to distance themselves from frailer users, while not denying their own ageing. The distancing strategies and behaviour amounted to age discrimination in interpersonal relations and interactions at the centre. This behaviour accepts rather than challenges the cultural valuation of youthfulness and the negative representation of old age.
Marital history and intergenerational solidarity: the impact of divorce and unmarried cohabitation
- Author:
- DAATLAND Svein Olav
- Journal article citation:
- Journal of Social Issues, 63(4), 2007, pp.809-825.
- Publisher:
- Wiley
Among the more recent challenges for the family are the increasing divorce rates and the decline in marriages. This article examines the possible consequences of these trends for intergenerational family relationships. How does divorce in the parent generation, and the shift from marriage to unmarried cohabitation among adult children, affect intergenerational solidarity? These questions are explored with data from the Norwegian Life Course, Ageing and Generation Study (NorLAG, n = 5,589, age 40–79). Scandinavian countries have high divorce and cohabitation rates and may therefore be of interest as comparative cases for countries where these events are less institutionalized. The findings suggest, however, that Norway accommodates to the general norm in the sense that divorce among parents is associated with lower solidarity with adult children on most solidarity dimensions. This is more true for fathers than for mothers. There is, on the other hand, no difference in solidarity between married and cohabitating children vis à vis the parent generation. The explanations and implications of these findings are discussed.
The prevalence of psychiatric symptoms and behavioural disturbances and the use of psychotropic drugs in Norwegian nursing homes
- Authors:
- SALBAEK Geir, KIRKEVOLD Oyvind, ENGEDAL Knut
- Journal article citation:
- International Journal of Geriatric Psychiatry, 22(9), September 2007, pp.843-849.
- Publisher:
- Wiley
Psychiatric and behavioural symptoms in dementia are associated with a range of negative outcomes, including institutional placement and the widespread use of psychotropic drugs in spite of limited evidence for their efficacy. The aim was to determine the prevalence of psychiatric and behavioural symptoms and the pattern of psychotropic drug prescription in patients with various degrees of dementia. A sample of 1,163 non-selected nursing home patients were assessed by means of the Neuropsychiatric Inventory, the Clinical Dementia Rating scale and Lawton's activities of daily living scale. In addition, information was collected from the patients' records. Dementia was found in 81% of the patients and 72% of them had clinically significant psychiatric and behavioural symptoms. The frequencies of symptoms increased with the severity of the dementia. Psychotropic medication was being prescribed to 75% of patients with dementia. There was a significant relationship between the type of drug and the symptom for which it had been dispensed. Psychiatric and behavioural symptoms are frequent in nursing homes and the rate increases with the progression of the dementia. Systematic programmes are needed for disseminating skills and providing guidance regarding the evaluation and treatment of these symptoms in nursing homes.
Seven minute screen performance in a normal elderly sample
- Authors:
- SKJERVE Arvid, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 22(8), August 2007, pp.764-769.
- Publisher:
- Wiley
The Seven Minute Screen (7MS) is a brief cognitive case-finding instrument for dementia. The test is composed of four subtests that assess performance with regard to orientation, memory, visuospatial ability and language. The objective of this study was to describe 7MS performance in a normal sample of Norwegian people aged 65 years and older. The subjects were 66 Norwegian community-dwellers who met selection criteria modified from the Mayo Older American Normative Studies standard. Mean age was 73.2 years, age range was 65-93 years, and mean Mini-Mental State Examination score was 29.06, range 26-30. Analysis of the 7MS subtests revealed relatively modest influence of age, education and gender on test performance. The composite 7MS performance scores were associated with education. Normal performance was expressed as means, standard deviations and percentile values for the age groups 65-74 years and 75 + years. 7MS performance is described for a normal sample. These data have the potential to increase the clinicians' ability to interpret 7MS test results.