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The relationship between self-reported health and mental health problems among older adults in New Zealand: experiential avoidance as a moderator
- Authors:
- ANDREW D. H., DULIN P. L.
- Journal article citation:
- Aging and Mental Health, 11(5), September 2007, pp.596-603.
- Publisher:
- Taylor and Francis
This study sought to examine the influence of experiential avoidance (EA) as a moderating variable between reported physical health problems and anxiety and depression among older adults. Experiential avoidance has been found in previous studies to be strongly associated with a number of psychological disorders in younger adults but has received minimal attention in older populations. Two-hundred-and-eight individuals from New Zealand between the ages of 70 and 92 years old participated in this study. The Geriatric Anxiety Inventory, the Geriatric Depression Scale and the Acceptance and Action Questionnaire were used to measure anxiety, depression and EA, respectively. It was hypothesized that self-reported health (SRH) and EA would be associated with depression and anxiety at the zero order level. It was also hypothesized that EA would be a unique predictor of depression and anxiety and would moderate the relationships between SRH and both depression and anxiety. Multiple regression analyses indicated that EA explained 8% of the unique variance in depression, 20% in anxiety and moderated the relationships between SRH and both depression and anxiety. This study also found that the relationships involving EA were more pronounced with anxiety as compared with depression in this elderly sample. The theoretical and practical applications of these findings are discussed.
Commissioning services for older people and mental health problems: is there a shared vision?
- Authors:
- TUCKER Sue, et al
- Journal article citation:
- Journal of Integrated Care, 15(2), April 2007, pp.3-12.
- Publisher:
- Emerald
UK policy seeks to shift commissioning of services 'closer to people' with a view to establishing shared visions of local care services grounded in the opinions and priorities of the public. But the participation of older people with mental health problems and their carers in the strategic planning process has been patchy. This article compares practitioner and public perspectives of the services that should be provided for older people with mental health problems in an area of North West England. Significant differences were found in the services the various stakeholder groups prioritised for development, and in their views on how they should be organised. The implications for commissioning are discussed.
Promoting mental health and well-being in later life: a first report from the UK Inquiry into Mental Health and Well-Being in Later Life
- Author:
- LEE Michele
- Publishers:
- Alcohol Concern, Mental Health Foundation
- Publication year:
- 2006
- Pagination:
- 81p., bibliog.
- Place of publication:
- London
The report draws on the views of nearly 900 older people and highlights discrimination, participation, relationships, physical health and poverty as key factors impacting on mental health and well-being in later life. It is often assumed that mental health problems are an inevitable part of growing older. This is not the case. There is much we can do to promote good mental health and well-being in later life. This report shows us what can be done. The report makes recommendations to national and local government, voluntary organisations, community groups, businesses, the media and others. Action is needed at the local and community levels. Local government has a key role to play.
Mental health and social care needs of older people with intellectual disabilities
- Authors:
- STRYDOM Andre, HASSIOTIS Angela, LIVINGSTON Gill
- Journal article citation:
- Journal of Applied Research in Intellectual Disabilities, 18(3), September 2005, pp.229-235.
- Publisher:
- Wiley
In this study all adults with intellectual disabilities (ID) without Down syndrome (DS) aged 65+ living in the London boroughs of Camden and Islington were identified. The Psychiatric Assessment Schedule for Adults with a Developmental Disability (PASADD) checklist was used to detect psychiatric disorder, the Vineland behaviour scale (maladaptive domain) for problem behaviours and the Dementia Questionnaire for persons with Mental Retardation (DMR) to screen for dementia. Carers reported health problems and disability. Needs were measured with the Camberwell Assessment of Need for adults with Intellectual Disabilities (CANDID-S). A total of 23 older people with ID (13 had mild ID and nine more severe ID) and their carers participated in the survey. In which, 74% had one or more psychiatric symptoms; 30% were previously known with a diagnosis of mental illness. One-third of the older people screened positive for dementia. Three quarters of the group had physical health problems, 74% had poor sight, 22% had hearing loss and 30% had mobility problems. Carers rated unmet needs for accommodation (22%), day activities, and eyesight and hearing. The people with ID rated unmet needs to be social relationships (44%), information and physical health. The authors conclude that older people with ID without DS have considerable prevalence of health problems and psychiatric disorders, including symptoms of functional decline and dementia. Such symptoms are often not recognised and further research into their needs is a priority.
Depression and dementia: coexistence and differentiation
- Author:
- WARRINGTON Jill
- Publisher:
- University of Stirling. Dementia Services Development Centre
- Publication year:
- 1996
- Pagination:
- 37p.,bibliog.
- Place of publication:
- Stirling
This report reviews the complex relationship between these two conditions and gives guidance on the recognition and management of depression in older people. Contents include: defining depression and dementia; how common are depression and dementia in the elderly?; what causes depression; how do depression and dementia relate to each other?; depressive dementia (pseudodementia); depression as a secondary condition to dementia.
A longitudinal study of chronic disease and depressive symptoms in a community sample of older people
- Authors:
- DENT O.F., et al
- Journal article citation:
- Aging and Mental Health, 3(4), November 1999, pp.351-357.
- Publisher:
- Taylor and Francis
Previous research on the association between illness and depression in older people has relied on self-reported diagnoses with their inherent limitations in scope and reliability. This Australian longitudinal study examined the association between depressive symptoms and medically-diagnosed chronic physical and neurodegenerative disease and disability in community-living older people.
Enabling older people with mental health needs to engage with community social care: a scoping review to inform a theory of change
- Authors:
- NEWBOULD Louise, TUCKER Susan, WILBERFORCE Mark
- Journal article citation:
- Health and Social Care in the Community, 30(4), 2022, pp.1286-1306.
- Publisher:
- Wiley
Despite apparent need, many older people with cognitive impairment and/or mental health needs do not fully engage with social care. This can manifest in different ways, including passive or aggressive attempts to avoid or repel care workers. However, little is known about how to support such individuals in their own homes and deliver effective care. Against this background, the researchers undertook a scoping review with a view to developing a preliminary theory of change suggesting how care might be modified to engage this client group. The most recent search was conducted on 21/04/21. Papers were included if they (i) focused on older people (65+) living at home with social care needs and (ii) described difficulties/problems with the provision/receipt of social care associated with individuals’ mental health needs. Twenty-six citations were identified through electronic database searches and reference screening, and the results were charted according to key theory of change concepts (long-term outcomes, preconditions, interventions, rationale and assumptions). All the included papers were related to people with dementia. Four subgroups of papers were identified. The first highlights those external conditions that make it more likely an intervention will be successful; the second describes specific interventions to engage older people who by virtue of their mental health needs have not engaged with social care; the third explores what services can be done to increase service uptake by older people with mental health needs and their caregivers more generally; and the fourth details theoretical approaches to explaining the behaviour of people with dementia. Each provides information that could be used to inform care delivery and the development of interventions to improve engagement with health and social care for these individuals. The study concludes that different framing of engagement difficulties, such as that offered through positioning theory, may assist in future service design. (Edited publisher abstract)
Characteristics of double care demanding patients in a mental health care setting and a nursing home setting: results from the SpeCIMeN study
- Authors:
- COLLET Janine, et al
- Journal article citation:
- Aging and Mental Health, 22(1), 2018, pp.333-39.
- Publisher:
- Taylor and Francis
Background: Older patients suffering from a combination of psychiatric disorders and physical illnesses and/or dementia are called Double Care Demanding patients (DCDs). Special wards for DCDs within Dutch nursing homes (NHs) and mental health care institutions (MHCIs) offer a unique opportunity to obtain insight into the characteristics and needs of this challenging population. Methods: This observational cross-sectional study collected data from 163 DCDs admitted to either a NH or a MHCI providing specialised care for DCDs. Similarities and differences between both DCD groups are described. Results: Neuropsychiatric symptoms were highly prevalent in all DCDs but significantly more in MHCI-DCDs. Cognitive disorders were far more present in NH-DCDs, while MHCI-DCDs often suffered from multiple psychiatric disorders. The severity of comorbidities and care dependency were equally high among all DCDs. NH-DCDs expressed more satisfaction in overall quality of life. Conclusions: The institutionalised elderly DCD population is very heterogeneous. Specific care arrangements are necessary because the severity of a patient's physical illness and the level of functional impairment seem to be equally important as the patient's behavioural, psychiatric and social problems. Further research should assess the adequacy of the setting assignment and the professional skills needed to provide adequate care for elderly DCDs. (Publisher abstract)
Successful strategies for discharging Medicaid nursing home residents with mental health diagnoses to the community
- Authors:
- LEEDAHL Skye N., et al
- Journal article citation:
- Journal of Social Service Research, 41(2), 2015, pp.172-192.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
To examine the effectiveness of discharge strategies targeted to residents' diverse needs this exploratory, mixed-methods study utilized the Minimum Data Set to describe demographics, health characteristics, and transition patterns of Kansas Medicaid residents with mental health diagnoses who were discharged from nursing homes from 2005 to 2008. Discharged residents (n = 720) had multiple comorbidities, and more than half remained in the community following their first nursing home event. In-depth interviews with nursing home staff (n = 11) explored successful discharge strategies. Successful strategies support an ecological approach to meeting individual, family, organizational, and community needs. This includes creating/sustaining a culture of discharge, encompassing informal and formal community supports in the discharge process, proactively addressing physical environment needs, and assisting individuals and their family members in managing physical and mental health conditions. Findings suggest that policies in the areas of preadmission screening, caregiver support, and revised Medicaid reimbursement are needed to better support continuity of care and promote discharge for nursing home residents with complex care needs. Future research could examine individual and family perspectives on the discharge process and track outcomes when transitioning between settings. (Edited publisher abstract)
Why is it important to consider so-called 'invisible' older people in UK healthcare?
- Authors:
- TINKER Anthea, et al
- Journal article citation:
- Quality in Ageing and Older Adults, 15(4), 2014, pp.187-196.
- Publisher:
- Emerald
Design/methodology/approach: Using information obtained from academic literature, government statistics and other publications from relevant organisations, this paper discusses older people who are in groups that are not readily visible to policy makers and practitioners. The authors investigated one 'invisible' group each and comparisons and conclusions were then made collaboratively. The six underserved populations covered were older people with physical disabilities, learning disabilities, those from LGBT communities, older prisoners, older people with chronic long-term mental health problems (in particular depression and dementia) and those who are homeless. The issues of health needs, access to health care and provision of services are discussed. Findings: Many groups of older people seem to be absent from statistics and from policy making. The paper suggests that there needs to be more research to identify the scale of any problems and how they may be solved. Practical implications: There are practical implications for health and social care professionals if they do not recognise that there are groups in society about whom little is known. Lack of knowledge and empathy may affect their approach to these groups. (Edited publisher abstract)