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Comparison of access, outcomes and experiences of older adults and working age adults in psychological therapy
- Authors:
- CHAPLIN Robert, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 30(2), 2015, pp.178-184.
- Publisher:
- Wiley
Objective: This study aimed to evaluate the access, experiences and outcomes of older adults receiving psychological therapies in comparison with adults of working age Methods: Primary and secondary care providers of psychological therapy services participated in the National Audit of Psychological Therapies. The main standards of access, experience and outcomes were measured by retrospective case records audits of people who completed therapy and a service user questionnaire. Outcomes were measured pre-treatment and post-treatment on the PHQ-9 and GAD-7. Results: A total of 220 services across 97 organisations took part, 137 (62%) in primary care. Service user questionnaires were received from 14,425 (20%) respondents. A total of 122,740 records were audited, of whom 7794 (6.4%) were older adults. They were under represented as 13% of the sample would have been expected to be over 65 years according to age adjusted psychiatric morbidity figures. People over 75 years had the third expected referral rate. Significantly, more older adults than working age adults completed therapy (59.6% vs 48.6%) and were assessed as having 'recovered' post-treatment (58.5% vs 45.5%). Older adults were more satisfied with waiting times and numbers of sessions, but there were no differences in self-reported experience of therapy. Conclusion: Although older adults are less likely to gain access to psychological therapies, they appear to have better outcomes than working age adults. Further work is needed to improve access for older people. (Publisher abstract)
Emotional social support and access to care among older people living with HIV in rural China
- Authors:
- LIN Chunqing, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 30(10), 2015, pp.1041-1047.
- Publisher:
- Wiley
Objectives: Globally, the number of older people living with HIV (PLH) is growing. Additionally, older PLH are facing particular challenges related to accessing health care. The objective of this study is to investigate the older PLH's access to care and its relationship to emotional and tangible social support. Methods: A cross-sectional study was conducted among 225 PLH who were 50 years of age or older in Anhui, China. A computer-assisted personal interview was used to collect the participants' demographic characteristics, perceived health status, and access to care. The following two dimensions of social support were measured: emotional support and tangible support. The association between emotional/tangible support and access to care was calculated using Pearson's/point-biserial correlations and with multiple linear regression. Results: Higher tangible support was reported by the participants who were married or living with a partner, those who had higher annual income levels, and those with better perceived health status. Emotional support was correlated with higher education, higher income, and better perceived health status. Multiple regression analyses showed that access to care was significantly associated with emotional support but not with tangible support. Conclusions: The study findings point to the importance of providing emotional support for older PLH. It is suggested that emotional support should be provided for older PLH in addition to tangible assistance, in order to engage them in treatment and care. (Edited publisher abstract)
Proposals to extend age discrimination legislation (age goods, facilities and services): consultation document
- Author:
- NORTHERN IRELAND. Office of the First Minister and Deputy First Minister
- Publisher:
- Northern Ireland. Office of the First Minister and Deputy First Minister
- Publication year:
- 2015
- Pagination:
- 118
- Place of publication:
- Belfast
This consultation sets out policy proposals to protect adults and young people aged 16 years and over from discrimination on the basis of age in relation to goods, facilities and services, charities, premises, education, public functions, and private clubs and associations. The scope of the proposals is therefore broader than goods, facilities and services alone. The proposals also cover health and social care and financial services, setting out the evidence of current discriminatory practice, scope and exceptions of proposals and how these would work in practice. The consultation ends on 8 October 2015. (Edited publisher abstract)
The future of transport in an ageing society
- Authors:
- HOLLEY-MOORE George, CREIGHTON Helen
- Publisher:
- International Longevity Centre UK
- Publication year:
- 2015
- Pagination:
- 32
- Place of publication:
- London
Sets out the key transport challenges that are arising from the UK’s ageing population. Using analysis from the English Longitudinal Study of Ageing (ELSA), as well as evidence from transport experts at a stakeholder’s workshop, this report argues that the current transport system is failing to meet the needs of too many older people. Despite free bus travel, one third of over 65s in England never use public transport. And over half either never use public transport or use it less than once a month. Approximately 35,000 people aged 65-84 in England have difficulty walking even a short distance, but are restricted to using public transport making any journey difficult. 1.45 million over 65s find it quite difficult or very difficult to travel to a hospital, whilst 630,000 over 65s find it difficult or very difficult to travel to their GP. Furthermore, the report shows that it is the oldest old, those who are in poor health and those living in rural areas who are let down the most by the current public transport system: Among the over 80s less than 55 per cent report finding it easy to travel to a hospital, a supermarket or a post office. Among the over 65s who report that it is ‘Very Difficult’ for them to travel to see their GP, less than 30 per cent are in good health. Just 20 per cent of those aged 70-74 living in rural areas use public transport weekly, compared to 38 per cent of those who live in an urban setting. The report argues that with the start of the new Parliament it is time to embrace the opportunities for improvement. In particular, devolution of central Government powers to local communities could mean more flexible transport services which better reflect the needs of older people, while advances in technology, including driverless cars, could further expand older people’s transport options. (Edited publisher abstract)
Access to long-term care: perceptions and experiences of older Dutch people
- Authors:
- SCHIPPER Lisette, et al
- Journal article citation:
- Quality in Ageing and Older Adults, 16(2), 2015, pp.83-93.
- Publisher:
- Emerald
Purpose: Despite the current focus on demand-based care, little is known about what clients consider important when they have a request for formal long-term care services. The paper aims to discuss this issue. Design/methodology/approach: Questions about the access process to care services were added to the “Senior Barometer”, a Dutch web-based questionnaire that assesses the opinion of older people about different aspects in life. The questionnaire surveyed both people who already requested care services (“users”), and people that did not (“future clients”). Findings: The results show a significant difference in what people expect to be the first step from what users actually did, when requesting formal care services. In addition, there was a significant difference on how “users” and “future clients” rated several access service aspects. Research limitations/implications:The results give valuable information on how both “users” and “future clients” value the access process. The findings also provide valuable input for organisations providing long-term care for older clients about the important issues that have to be considered when organising the access process. Originality/value: This study shows what older people in the Netherlands find important during the access process to care and this has not been explored before. The difference between what “users” and “future clients” find of importance in the care access process suggests that it is difficult for people to foresee what will be important once the need for care arrives, or where they will turn to with a request for care services. (Edited publisher abstract)
"You don't stop the worrying": the difficulties of caring in later life
- Author:
- INDEPENDENT AGE
- Publisher:
- Independent Age
- Publication year:
- 2015
- Pagination:
- 40
- Place of publication:
- London
Drawing on findings from focus groups and interviews with older carers, this report explores their experience of caring, what issues most concern them, where they find support in their caring, and what more support is needed. Older carers agreed that caring took a heavy toll on them, and had multiple impacts on their quality of life. It was clear that carers perceived that some of the impacts of caring were exacerbated by their age. Particular impacts affecting older carers included: difficulties keeping up with family and friends; financial constraints; poor health; and stress. They identified a range of gaps in support available to them, problems accessing services and a lack of support from the wider community in their role as carers. ‘Former carers’ made clear that there were important differences between the experiences of those whose loved ones moved into residential care or supported / independent living, and those who were bereaved. The report sets out older carers’ priorities, which include: improving carers’ access to support, in particular by ensuring GPs play a part in identifying carers and signposting to support; addressing inadequacies in care and support services available to carers’ loved ones; developing a ‘carers’ friend’ service to provide one-to-one practical and emotional support for carers; and improving support for bereaved carers, offering them opportunities to find mutual support among those with similar experiences. (Edited publisher abstract)
Depression literacy among American Indian older adults
- Authors:
- ROH Soonhee, et al
- Journal article citation:
- Journal of Evidence-Informed Social Work, 12(6), 2015, pp.614-627.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
Older American Indians experience high rates of depression and other psychological disorders, yet little research exist on the depression literacy of this group. Depression literacy is fundamental for individuals seeking help for depression in a timely and appropriate manner. In the present study the authors examine levels and predictors of knowledge of depression symptoms in a sample of rural older American Indians (N = 227) living in the Midwestern United States. Data from self-administered questionnaires indicate limited knowledge of depression and negative attitudes toward seeking help for mental health problems. Additional findings and implications for social work practice and policy are discussed. (Publisher abstract)
Optimizing health promotion among ethnocultural minority older adults (EMOA)
- Authors:
- KHAN Mushira Mohsin, KOBAYSHI Karen
- Journal article citation:
- International Journal of Migration Health and Social Care, 11(4), 2015, pp.268-281.
- Publisher:
- Emerald
Purpose: This paper aims to identify barriers in the uptake and effective utilisation of health promotion interventions among ethnocultural minority older adults (EMOA). Design/methodology/approach: The paper draws on a literature review of 25 sources (peer-reviewed articles as well as documents from the grey literature). The search was primarily conducted in a database developed during a scoping review on the health and health care access and utilisation of EMOA. Emphasis was placed on older ethnocultural minorities in Canada; however examples from the UK (which has a comparable health care system) and the USA and Australia (which have large, ethnically diverse populations) were also selected. The Candidacy framework was used as an analytical lens in the review. Findings: Findings indicate that health promotion needs to be understood as comprehensive care, involving not only the provision of health care services, but also knowledge dissemination and the facilitation of access to these services. Limited health literacy, low levels of self-efficacy and autonomy, and diverse life course experiences, particularly in the case of immigrant older adults, give rise to issues around the identification of need and system navigation. Cultural beliefs on health and illness, particularly around diet and exercise, and a lack of trust in formal systems of health care, are barriers to the uptake of interventions. Similarly, service permeability is low when cultural competency is lacking. Practical implications: The recommendations include the need for collaborative engagement with stakeholders, including family, peers, community partners and health practitioners, and the development of concise, culturally, and linguistically appropriate tools of health promotion that are targeted toward the intersecting needs of individuals in this diverse population of older adults. (Edited publisher abstract)
Becoming a dementia-friendly arts venue: a practical guide
- Authors:
- ALLEN Penny, et al
- Publisher:
- Alzheimer's Society
- Publication year:
- 2015
- Pagination:
- 40
- Place of publication:
- London
A guide for arts venue managers and staff on how to make the environment, facilities and programming of arts venues accessible to people with dementia, their families and carers. The guide covers: community engagement and where to find information and support to engage with people living with dementia and their carers; accessibility and how to publicise a venue to people with dementia and making it a welcoming and safe space; how to programme events and activities that take people with dementia needs into account. This guide contains examples of successful initiatives around the country and a list of resources that provide more in-depth information about becoming dementia friendly. (Edited publisher abstract)
Mental health in later life: striving for equality
- Author:
- NATIONAL DEVELOPMENT TEAM FOR INCLUSION
- Publisher:
- National Development Team for Inclusion
- Publication year:
- 2015
- Pagination:
- 13
- Place of publication:
- Bath
The issue of older people’s mental health often receives a lower priority than that of children, young people and adults of ‘working’ age. This paper makes the case that equal attention needs to be paid to older people’s mental health, and the services and support they experience, need and want. Drawing on research undertaken by NDTi and others in the sector, this paper highlights the changes required to enable a shift in attitudes and approach in health and social care. It sets out the five key areas where it believes action needs to be taken: overcoming age discrimination in mental health services; increasing voice, visibility and influence of older people with mental health problems; focusing on the common mental health problems experienced by older people, such as depression and substance misuse; clarifying responsibility for commissioning of older people’s mental health services; and developing a coalition on older people’s mental health. It then identifies three priorities for change to help older people have better experiences and responsive and personalised services. The changes are: tackling the ‘double stigma’ of mental health and ageism; developing a shared vision and agenda for change for mental health in later life; and enabling equal access to a range of services, treatments and interventions. The paper aims to prompt for further debate and discussion. (Edited publisher abstract)