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Being occupied: supporting ‘meaningful activity’ in care homes for older people in England
- Authors:
- SMITH Nick, et al
- Journal article citation:
- Ageing and Society, 38(11), 2018, pp.2218-2240.
- Publisher:
- Cambridge University Press
The benefits of meaningful activity in later life are well documented. Studies show that being occupied contributes to both physical and mental health as well as quality of life. Research also suggests that activity may be beneficial to people residing in care homes, including people living with dementia. This paper presents findings from a study which used the Adult Social Care Outcomes Toolkit (ASCOT) to measure quality of life in six care homes located in the south-east of England. The study found, like previous ones, that care home residents’ days were characterised by a lack of activity. Drawing on observations, interviews and focus groups with residents and staff from these homes, this paper attempts to understand why care home residents do not engage in meaningful activities. The authors reject the idea that these low levels of activity are a natural part of the ageing process or that they can be explained by notions of resident choice. Instead, the findings point to both insufficient funding and working practices within care homes as more substantive explanations. These explanations inform a discussion of how the low levels of engagement in meaningful activity could be addressed and residents’ quality of life improved. (Edited publisher abstract)
Fear of falling and activities of daily living function: mediation effect of dual-task ability
- Authors:
- BRUSTIO Paolo R., et al
- Journal article citation:
- Aging and Mental Health, 22(6), 2018, pp.856-861.
- Publisher:
- Taylor and Francis
Objective: The aim of the study was to explore the association between fear of falling (FOF), dual-task ability during a mobility task, and the activities of daily living (ADL) in a sample of older adults. Methods: Seventy-six older adults (mean age M = 70.87 ± 5.16 years) participated in the study. Data on FOF (using the Falls Self-Efficacy Scale-International), walking ability during both single- and dual-task performances and ADL were collected. Results: Mediation analysis demonstrated the mediation effect of dual-task ability between FOF and ADL level. Moreover, significantly lower performances were observed during dual-task condition, and lower ADL levels were also found in older adults with. Conclusion: The study underlines the relationship between FOF, dual-task ability and ADL level. These results could be used to develop specific intervention programmes for successful ageing. (Edited publisher abstract)
The everyday lives of older adults with visual impairment: an occupational perspective
- Author:
- NASTASI Julie Ann
- Journal article citation:
- British Journal of Occupational Therapy, 81(5), 2018, pp.266-275.
- Publisher:
- Sage
Introduction: In order to live in a world created for the sighted, older adults with visual impairment must adapt to complete vision-dependent activities that require reading, writing, and object identification. The objective of this study was to explore the occupational lives of three older adults with visual impairment. Method: A qualitative study with four interviews each and two observation sessions each was conducted with older adults with visual impairment. Data were analysed by participant and across participants using open, axial, and selective coding. Codes were refined throughout the process yielding the themes of the study. Results: Three themes emerged from the analysis: an occupational life of doing, an occupational life rich with well-being, and an occupational life filled with motivation for independence. Participants were highly motivated to complete their occupations and activities independently. Participation in activities in the home and community environments provided participants with life satisfaction and happiness. Through problem-solving skills, adaptations, and support of family and friends, participants successfully completed their desired occupations. Conclusion: This study highlights the importance of motivation and support to facilitate participation in occupations in the home and community environments. (Edited publisher abstract)
Utility of functioning measures in the prediction of independent living status in older adults with serious mental illness
- Authors:
- FORTUNA Karen L., et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 33(2), 2018, pp.423-431.
- Publisher:
- Wiley
Objective: The objective of the study was to compare the predictive utility of three commonly used functioning measures for people with serious mental illness in the prediction of independent living status. Methods: The authors conducted a secondary data analysis from the Helping Older People Experience Success study with adults aged 50 years and older with a diagnosis of bipolar disorder, schizoaffective disorder, schizophrenia, or major depressive disorder (N = 183). Results: Total scores for the Independent Living Skills Survey, Multnomah Community Ability Scale, and UCSD Performance-Based Skills Assessment were modestly inter-correlated. For the overall sample, greater independent living status at baseline and 1-year follow-up was predicted by higher baseline functioning scores on both the self-reported Independent Living Skills Survey and the UCSD Performance-Based Skills Assessment. However, by diagnostic subgroup, independent living status at 1-year follow-up was only predicted by the Independent Living Skills Survey for affective disorders and by the UCSD Performance-Based Skills Assessment for schizophrenia-spectrum disorders. For the total sample, the Independent Living Skills Survey was associated with self-efficacy and employment status. Neither the Independent Living Skills Survey nor UCSD Performance-Based Skills Assessment was associated with medical or psychiatric hospitalisations or with subjective physical or mental health status. Conclusions: These commonly used functioning measures for people with serious mental illness examine different aspects of functioning. The choice of functional measurement should be based on the population under study and intervention goals. (Edited publisher abstract)
Multiple influences on participating in physical activity in older age: developing a social ecological approach
- Authors:
- BOULTON Elisabeth R., HORNE Maria, TODD Chris
- Journal article citation:
- Health Expectations, 21(1), 2018, pp.239-248. Online only
- Publisher:
- Wiley
Background: Evidence of the benefits of engaging in physical activity (PA) is strong, yet the number of older adults meeting the recommended 150 min/wk is low. Policy to increase uptake and adherence has focussed on the health benefits of PA, but may not be the most successful approach. Objective: This qualitative study sought to ask older adults what the components of a successful intervention to promote PA would be, by asking active older adults what motivated them to be active and asking inactive older adults what might encourage them to change. Design, setting and participants: Focus groups and semi-structured interviews were held with 60 community-dwelling older adults, aged 50-87 years. Framework analysis was used to analyse the data, and themes congruent with a social ecological model of behaviour change were developed. Findings: Five themes emerged that influenced PA engagement at multiple levels: individual; interpersonal; perceived environment; community or organizational; and policy. PA engagement was determined by attitude or health status for some participants, but for the majority, PA being enjoyable, sociable, affordable, accessible, flexible and seasonal were more important than the health benefits. Discussion and conclusions: A social ecological model is presented, highlighting the fact that both motivated and unmotivated older adults need to have a range of appropriately labelled, appealing and accessible activities to choose from when thinking about engaging in PA. Policymakers and practitioners need to ensure that their offers of activity sessions are easy to access and easy to remain involved in. (Publisher abstract)
Receipt of formal and informal help with specific care tasks among older people living in their own home. National trends over two decades
- Authors:
- DAHLBERG Lena, et al
- Journal article citation:
- Social Policy and Administration, 52(1), 2018, pp.91-110.
- Publisher:
- Wiley
Sweden is seen as a typical example of a social democratic welfare regime, with universal and generous welfare policies. However, in the last decades, there have been substantial reductions in the Swedish provision of care for older people. This study aimed to examine trends in sources of care-receipt in older people (77+) living in their own home and with a perceived need for help with two specific tasks: house cleaning and/or food shopping. Trends in care-receipt were examined in relation to gender, living alone, having children and socio-economic position. Data from the 1992, 2002 and 2011 data collection waves of the national study, Swedish Panel Study of Living Conditions of the Oldest Old (SWEOLD), were used. Response rates varied between 86 and 95 per cent, and the sample represents the population well. Trends and differences between groups were explored in bivariate and logistic regression analyses. There was a reduction in formal care-receipt regarding house cleaning and food shopping over the study period. It was more common for women than men to receive formal care, and more common for men than women to receive informal care. Reductions in formal care have affected older women more than older men. Still, living alone was the most influential factor in care-receipt, associated with a greater likelihood of formal care-receipt and a lower likelihood of informal care-receipt. It can be concluded that public responsibility for care is becoming more narrowly defined in Sweden, and that more responsibility for care is placed on persons in need of care and their families. (Publisher abstract)
Occupational therapy interventions to improve performance of instrumental activities of daily living for community-dwelling older adults: a systematic review
- Authors:
- HUNTER Elizabeth G., KEARNEY Pamalyn J.
- Journal article citation:
- The American Journal of Occupational Therapy, 72(4), 2018,
- Publisher:
- AOTA Press
- Place of publication:
- Bethesda, MD
OBJECTIVE: This study examined the effectiveness of interventions within the scope of occupational therapy to improve the performance of instrumental activities of daily living (IADLs) for community-dwelling older adults. METHOD: This study searched and examined the literature (2008 through 2016) using four electronic databases. Fourteen studies met the inclusion criteria and were critically appraised and synthesized. RESULTS: Analysis revealed four thematic areas: cognitive, self-management, prevention, and home-based multidisciplinary rehabilitation interventions. Strong evidence supports the use of tailored, multidisciplinary, home-based care programs to support older adults to maintain IADL improvements over time and the use of cognitive interventions to improve memory, executive function, functional status, and everyday problem solving. In addition, strong evidence indicates that tailored home-based preventive sessions were beneficial to mediate functional disability and satisfaction with performance. CONCLUSION: Evidence supports tailored interventions designed to enhance IADL performance. More studies are needed that focus on IADLs specifically and that use IADLs in their interventions. (Edited publisher abstract)
Towards co‐designing active ageing strategies: a qualitative study to develop a meaningful physical activity typology for later life
- Authors:
- GUELL Cornelia, et al
- Journal article citation:
- Health Expectations, 21(5), 2018, pp.919-926. Online only
- Publisher:
- Wiley
Background: Physical activity levels decline in later life despite the known benefits for physical, cognitive and mental health. Older people find it difficult to meet activity targets; therefore, more realistic and meaningful strategies are needed. The authors aimed to develop a typology of older people's motivations and lifelong habits of being active as a starting point to co‐designing active ageing strategies in a workshop. Methods: Semi‐structured interviews with 27 participants aged 65‐80 in Norfolk, UK were conducted, and participant observation with 17 of them. At a workshop with 13 study participants and 6 government and civil society representatives, the authors invited reflections on preliminary findings. Results: Three types were developed. “Exercisers” had engaged in sport and exercise throughout their life but experienced physical ill health and limitations as barriers. “Out‐and‐about‐ers” pursued social engagement and a variety of interests but experienced biographical disruption through retirement and loss of companions that limited social activities in later life. A final type characterized people who preferred “sedentary/solitary” activities. A workshop elicited suggestions for new strategies relating to these types that addressed people's specific motivations. An example was to combine social engagement and physical activity in “dog‐parent”‐walking schemes to link people through shared responsibility for a dog. Conclusions: The authors suggest that these potential strategies map more closely onto the everyday life‐worlds in which public health might seek to intervene than common physical activity interventions. Most notably, this means a more differentiated understanding of barriers, and acknowledging that intellectual, social or solitary pursuits can include incidental physical activity. (Edited publisher abstract)
Can technology-assisted toilets improve hygiene and independence in geriatric rehabilitation? A cohort study
- Authors:
- YACHNIN David, et al
- Journal article citation:
- Disability and Rehabilitation: Assistive Technology, 13(7), 2018, pp.626-633.
- Publisher:
- Taylor and Francis
- Place of publication:
- London
Purpose: To investigate whether technology-assisted toilets (TATs) could be used to improve toileting hygiene and independence for geriatric rehabilitation patients. TATs are commercially available toilet seats that use a stream of warm water to clean the user, have a fan for drying and are operated by a remote control. Materials and methods: Twenty-five geriatric rehabilitation in-patients were recruited, six completed the study, and seven partially completed the study. Each participant had two trial bowel movements. One trial involved cleaning themselves with toilet paper; the other involved cleaning themselves with the TAT functions. After each trial, participants received a visual inspection for cleanliness and answered the Psychosocial Impact of Assistive Devices Scale (PIADS), a validated scale, to assess their sense of competence, adaptability and self-esteem in the bathroom. A toileting cleanliness scale, designed for this study, was completed by a nurse after TAT usage. Participants received a score from 1 (completely clean) to 4 (completely soiled) based on a visual inspection after cleaning. Results: TAT and toileting cleanliness scores were similar. PIADS scores showed a trend towards higher scores when using the TAT, but results were not statistically significant. Conclusions: TATs cleaned as well as standard toileting in geriatric rehabilitation inpatients. Participants indicated that TATs improved their sense of competence, adaptability and self-esteem. Geriatricians and rehabilitation professionals should consider prescribing TATs in their practice as an assistive device in order to promote patient independence and dignity and reduce the burden of care for patients requiring toileting assistance. (Edited publisher abstract)
The association of mobility limitation and social networks in relation to late-life activity
- Authors:
- LITWIN Howard, LEVINSON Maayan
- Journal article citation:
- Ageing and Society, 38(9), 2018, pp.1771-1790.
- Publisher:
- Cambridge University Press
The current study examines the interaction between mobility limitations and social networks in relation to activity in later life. Although the importance of activity participation to successful ageing has been well established, it is still unclear what contributes to higher levels of activity. This research addresses this issue, using data from the Survey of Health, Ageing and Retirement in Europe. The analysis focuses on a sub-sample of respondents aged 60 and older, from 13 countries, who participated in two specific waves, in 2011 and 2013. Multivariate analysis of the longitudinal data was conducted using hierarchical generalised Poisson regression and incorporating a new comprehensive social network scale. The inquiry found that having multiple mobility limitations is associated with less activity and that having a resourceful social network contributes to more activity. The research further revealed that social network is particularly beneficial to those with multiple mobility limitations because it mitigates the negative association with activity. This conclusion furthers the understanding of the relationship between different key dimensions in the successful ageing paradigm. Specifically, the findings imply the significance of having a social network among those who are functionally challenged. This finding has important implications for active ageing policies. (Edited publisher abstract)