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How does social support affect functional impairment in late life? Findings of a multicenter prospective cohort study in Germany
- Authors:
- HAJEK Andre, et al
- Journal article citation:
- Age and Ageing, 46(5), 2017, pp.813-820.
- Publisher:
- Oxford University Press
Objective: To investigate how social support affects functional impairment (FI) in late life in a longitudinal approach. Methods: in a multicenter prospective cohort study, subjects in old age (≥75 years at baseline) were interviewed every 1.5 years. Social support was quantified in the follow-up (FU) Waves 2 and 4 (FU Wave 2: n = 2,349; FU Wave 4: n = 1,484). FI was assessed by using the Lawton and Brody Instrumental Activities of Daily Living scale. Results: Fixed effects regressions showed that a decrease in social support is associated with FI in the total sample and in both sexes. The effect on FI was most pronounced with the dimension social integration, whereas changes in practical support only affected FI in the total sample and changes in emotional support only affected FI in men. Conclusions: The findings emphasise the importance of social support for functional status in late life. Thus, strengthening social support in old age might be effective in maintaining functional abilities. (Edited publisher abstract)
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)
Creating a positive dining experience for care home residents
- Author:
- WALES. Welsh Government
- Publisher:
- Welsh Government
- Publication year:
- 2017
- Pagination:
- 6
- Place of publication:
- Cardiff
This document provides advice to help care homes make the most of meal times for their residence. It looks at ways of ensuring that mealtimes are an enjoyable experience for older people living in a care home, that offer more choice and an opportunity for involvement and social interaction. (Edited publisher abstract)
‘The nourishing soil of the soul’: the role of horticultural therapy in promoting well-being in community-dwelling people with dementia
- Authors:
- NOONE Sarah, et al
- Journal article citation:
- Dementia: the International Journal of Social Research and Practice, 16(7), 2017, pp.897-910.
- Publisher:
- Sage
Two-thirds of people with dementia reside in their own homes; however, support for community-dwelling people with dementia to continue to participate in everyday activities is often lacking, resulting in feelings of depression and isolation among people living with the condition. Engagement in outdoor activities such as gardening can potentially counteract these negative experiences by enabling people with dementia to interact with nature, helping to improve their physical and psychological well-being. Additionally, the collaborative nature of community gardening may encourage the development of a sense of community, thereby enhancing social integration. Despite increasing evidence supporting its therapeutic value for people with dementia in residential care, the benefits of horticultural therapy have yet to be transposed into a community setting. This paper will examine the theoretical support for the application of horticultural therapy in dementia care, before exploring the potential of horticultural therapy as a means of facilitating improved physical and psychological well-being and social integration for people living with dementia within the community. (Publisher abstract)
Interventions to reduce dependency in bathing in community dwelling older adults: a systematic review
- Authors:
- GOLDING-DAY Miriam, et al
- Journal article citation:
- Systematic reviews, 6(1), 2017, Online only
- Publisher:
- BioMed Central
Background: The onset of bathing disability for older adults has been found to be an indicator and potential precursor of further disability. Thus interventions targeting bathing may prevent or delay further disability and the use of health and social care services. The aim of this systematic review was to identify interventions targeted at reducing dependency in bathing for community dwelling older adults, and determine their content and effectiveness in maintaining or improving function and quality of life. Methods: The authors conducted a systematic search of electronic databases including: The Cochrane Central Register of Controlled Trials (CENTRAL); MEDLINE; EMBASE; AMED; CINAHL; PsycINFO and OTSeeker. The search took place on 18 October 2016. The review included randomised controlled trials, nonrandomised controlled trials, and controlled before and after studies that evaluated an intervention designed to reduce dependency in bathing. Articles were screened for inclusion by two independent reviewers; risk of bias was assessed using quality assessment tools; and data extracted using pre-prepared forms. Disagreements were resolved by discussion and inclusion of a third reviewer. Results: The search process identified one study for inclusion in the review. This study evaluated a bathing intervention delivered by an occupational therapist following discharge from hospital. Overall, the findings suggest modest improvements in functional ability in favour of the intervention group although the results should be interpreted with caution. Conclusion: Despite evidence suggesting the importance of addressing bathing difficulties as a means of possible prevention of disability in the ageing process, there is a dearth of evaluative or interventional research studies. Further robust research is warranted, including studies of randomised and controlled design. (Edited publisher abstract)
Home and community-based occupational therapy improves functioning in frail older people: a systematic review
- Authors:
- DE CONINCK Leen, et al
- Journal article citation:
- Journal of the American Geriatrics Society, 65(8), 2017, pp.1863-1869.
- Publisher:
- Blackwells Publishing
Objectives: The objective is to assess the effectiveness of occupational therapy to improve performance in daily living activities in community-dwelling physically frail older people. Design: The authors conducted a systematic review and meta-analysis. It included randomized controlled trials reporting on occupational therapy as intervention, or as part of a multidisciplinary approach. This systematic review was carried out in accordance with the Cochrane methods of systematic reviews of interventions. Measurements: Meta-analyses were performed to pool results across studies using the standardized mean difference. The primary outcome measures were mobility, functioning in daily living activities, and social participation. Secondary outcome measures were fear of falling, cognition, disability, and number of falling persons. Results: Nine studies met the inclusion criteria. Overall, the studies were of reasonable quality with low risk of bias. There was a significant increase in all primary outcomes. The pooled result for functioning in daily living activities was a standardized mean difference of −0.30 and for mobility −0.45. All secondary outcomes showed positive trends, with fear of falling being significant. No adverse effects of occupational therapy were found. Conclusion: There is strong evidence that occupational therapy improves functioning in community-dwelling physically frail older people. (Edited publisher abstract)
Disability in prison activities of daily living and likelihood of depression and suicidal ideation in older prisoners
- Authors:
- BARRY Lisa C., et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 32(10), 2017, pp.1141-1149.
- Publisher:
- Wiley
Objective: The study objective was to determine if disability in activities of daily living specific to prison, prison activities of daily living (PADLs), is associated with depression and severity of suicidal ideation (SI) in older prisoners, a rapidly growing population at high risk of suicide. Methods: Cross-sectional design using data from a study of prisoners age ≥50 years (N = 167). Depression was operationalized as a score of ≥15 on the 9-item Physician Health Questionnaire (PHQ-9). SI severity was assessed using the Geriatric Suicide Ideation Scale (GSIS). Participants were considered to have PADL disability if they reported any of the following as “very difficult” or “cannot do:” dropping to the floor for alarms, climbing on/off the top bunk, hearing orders, walking while wearing handcuffs, standing in line for medications, and walking to chow. Associations were examined with bivariate tests and with multivariable logistic and linear regression models, and the interaction term gender × PADL disability was tested. Results: PADL disability was associated with depression and SI severity. There was no main effect of gender on either depression or SI, yet the association between PADL disability and depression was considerably stronger in male than in female older prisoners. Conclusions: Identifying older prisoners who have difficulty performing PADLs may help distinguish prisoners who may also be likely to be depressed or experience more severe SI. Furthermore, the association between PADL disability and depression may be particularly salient in older male prisoners. Longitudinal studies are needed as causal inferences are limited by the cross-sectional design. (Publisher abstract)
Exploring the relation between positive emotions and the functional status of older adults living independently: a systematic review
- Authors:
- CABRITA Miriam, et al
- Journal article citation:
- Aging and Mental Health, 21(11), 2017, pp.1121-1128.
- Publisher:
- Taylor and Francis
Objectives: Literature suggests that positive emotions positively influence physiological parameters but their relation to functioning in the daily life of older adults living independently remains unclear. The present work aims to investigate the relation between positive emotions and functional status in daily life of older people living independently. Method: A systematic literature review was conducted using the PubMed, PsycINFO and Scopus electronic databases. Included works were peer-reviewed empirical studies that analysed the relation between positive emotions and ability to perform activities of daily living with older adults living independently. Results: After removal of duplicates, 10 out of 963 papers met the inclusion criteria. Cross-sectional studies (n = 6) provided limited evidence about a relation between positive emotions and functioning in daily life. However, longitudinal studies (n = 4) provide significant evidence for an interaction between the two factors, suggesting that time influences this interaction. Conclusion: The variety on the design and samples of the studies included in this review does not allow a cohesive conclusion of the results. Nevertheless, limited evidence suggests that higher frequency in the experience of positive emotions might be associated with lower functional limitations. The issue of causality in emotions-functioning remains unclear from the review. Further observational studies are highly recommended, supported by innovative technologies. (Publisher abstract)
Identifying frailty risk profiles of home-dwelling older people: focus on sociodemographic and socioeconomic characteristics
- Authors:
- DURY Sarah, et al
- Journal article citation:
- Aging and Mental Health, 21(10), 2017, pp.1031-1039.
- Publisher:
- Taylor and Francis
Objectives: This paper investigates risk profiles of frailty among older people, as these are essential for detecting those individuals at risk for adverse outcomes and to undertake specific preventive actions. Frailty is not only a physical problem, but also refers to emotional, social, and environmental hazards. Methods: Using data generated from the Belgian Ageing Studies, a cross-sectional study (n = 28,049), we tested a multivariate regression model that included sociodemographic and socioeconomic indicators as well as four dimensions of frailty, for men and women separately. Results: The findings indicated that for both men and women, increased age, having no partner, having moved house in the previous 10 years, having a lower educational level and having a lower household income are risk characteristics for frailty. Moreover, when looking at the different frailty domains, different risk profiles arose, and gender-specific risk characteristics were detected. Discussion: This paper elaborates on practical implications, and formulates a number of future research recommendations to tackle frailty in an ageing society. The conclusion demonstrates the necessity for a thorough knowledge of risk profiles of frailty, as this will save both time and money and permit preventive actions to be more individually tailored. (Edited publisher abstract)
Community-based services and depression from person-environment fit perspective: focusing on functional impairments and living alone
- Authors:
- KIM BoRin, et al
- Journal article citation:
- Journal of Gerontological Social Work, 60(4), 2017, pp.270-285.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
Guided by the Person-Environment Fit perspective, the authors investigated the extent to which personal and environmental factors influence depression among community-dwelling adults. The data came from the special section about community-based service utilisation in the 2012 Health and Retirement Study (N=1,710). Although community-based service was not significantly associated with depression after controlling for covariates, respondents with functional limitations and living alone were less likely to be depressed when using community-based services. This study demonstrates the different associations between community-based services and depression depending on personal needs. It discusses the importance of community-based services for ageng-in-place policy, particularly among vulnerable populations. (Edited publisher abstract)