Search results for ‘Subject term:"older people"’ Sort:
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Health and social care providers’ perspectives of older people’s drinking: a systematic review and thematic synthesis of qualitative studies
- Authors:
- BAREHAM Bethany Kate, et al
- Journal article citation:
- Age and Ageing, 49(3), 2020, p.453–467.
- Publisher:
- Oxford University Press
Background: alcohol may increase risks to late-life health, due to its impact on conditions or medication. Older adults must weigh up the potential risks of drinking against perceived benefits associated with positive roles of alcohol in their social lives. Health and social care workers are in a key position to support older people’s decisions about their alcohol use. Objective: to systematically review and synthesise qualitative studies exploring health and social care providers’ views and experiences of older people’s drinking and its management in care services. Method: a pre-specified search strategy was applied to five electronic databases from inception to June 2018. Grey literature, relevant journals, references and citations of included articles were searched. Two independent reviewers sifted and quality-appraised articles. Included study findings were analysed through thematic synthesis. Results: 18 unique studies were included. Four themes explained findings: uncertainty about drinking as a legitimate concern in care provision for older people; the impact of preconceptions on work with older adults; sensitivity surrounding alcohol use in later life; and negotiating responsibility for older adults’ alcohol use. Discipline- and country-specific patterns are highlighted. Conclusions: reservations about addressing alcohol could mean that service providers do not intervene with older adults. Judgements of whether older care recipients’ drinking warrants intervention are complex. Providers will need support and training to recognise and provide appropriate intervention for drinking amongst older care recipients. (Publisher abstract)
What do we know about the application of the Mental Capacity Act (2005) in healthcare practice regarding decision-making for frail and older people? A systematic literature review
- Authors:
- HINSLIFF-SMITH Kathryn, et al
- Journal article citation:
- Health and Social Care in the Community, 25(2), 2017, pp.295-308.
- Publisher:
- Wiley
In England and Wales, decision-making in cases of uncertain mental capacity is regulated by the Mental Capacity Act 2005. The Act provides a legal framework for decision-making for adults (16 and over) who are shown to lack capacity and where best interest decisions need to be made on their behalf. Frail older people with cognitive impairments represent a growing demographic sector across England and Wales for whom the protective principles of the Act have great relevance, as they become increasingly dependent on the care of others. However, while the Act articulates core principles, applying the Act in everyday healthcare contexts raises challenges for care providers in terms of interpretation and application. This paper presents a review of the published evidence documenting the use of the Act in healthcare practice, with particular reference to frail older people. The aim was to identify, review and critically evaluate published empirical studies concerned with the implementation and application of the Act in healthcare settings. A systematic approach was undertaken with pre-determined exclusion and inclusion criteria applied across five electronic bibliographic databases combined with a manual search of specific journals. This review reports on 38 empirical sources which met the inclusion criteria published between 2005 and 2013. From the 38 sources, three descriptive themes were identified: knowledge and understanding, implementation and tensions in applying the Act, and alternative perspectives of the Act. There is a need for improved knowledge and conceptualisation to enable successful incorporation of the Act into everyday care provision. Inconsistencies in the application of the Act are apparent across a variety of care settings. This review suggest staff need more opportunities to engage, learn and implement the Act, in order for it to have greater resonance to their individual practice and ultimately benefit patient care. (Publisher abstract)
Advance directive decision making among independent community-dwelling older adults
- Authors:
- SESSANNA Loralee, JEZEWSKI Mary A.
- Journal article citation:
- Journal of Applied Gerontology, 27(4), 2008, pp.486-510.
- Publisher:
- Sage
This review of US literature finds that advance directive decision making has predominantly been explore among Caucasian women aged 65 or older and possessing a high school level education who are living independently in the community. While generally willing to discuss the issues, numerous barriers to advance directive discussion and completion remain both among older adults themselves and their health care providers. Research gaps include a lack of studies of men, older people from minority ethnic and cultural groups, and older people with lower levels of education. Replication of existing studies is also needed to strengthen the evidence base in this area.
Staff-family relationships in the care of older people: a report on a systematic review
- Authors:
- HAESLER Emily, BAUER Michael, NAY Rhonda
- Journal article citation:
- Research in Nursing and Health, 30(4), August 2007, pp.385-398.
- Publisher:
- Wiley
This review considers staff-family relationships in acute, sub-acute, rehabilitation and long term health care settings. The research evidence, both quantitative and qualitative, points to the need to address power and control issues, communication and collaborative approaches to care. Interventions to promote staff-family relationships are more likely to succeed when implemented with accompanying information sharing, education and management support.
Health care professionals and care staff challenges and experiences of managing sexual expression among older adults ≥60 years in long-term care facilities: a qualitative review and meta-synthesis
- Authors:
- HO Pei Juan, GOH Yong Shian
- Journal article citation:
- Age and Ageing, 51(1), 2022, p.afab230.
- Publisher:
- Oxford University Press
Long-term care (LTC) facilities, in which older adults are institutionalised, have the responsibility to address their residents' rights, privacy and comfort in expressing themselves sexually in an acceptable manner. However, many older adults have reported barriers in their sexual expression, which is often a result of the care staff's attitudes in the facilities. This review synthesis evidence from qualitative studies on the challenges faced by care staff when supporting sexual expression of older residents in LTC facilities. The systematic review and meta-synthesis is reported according to the Enhanced Transparency in Reporting the Synthesis of Qualitative Research Statement. A systematic literature search for peer-reviewed studies was conducted on PubMed, Cochrane Library, EMBASE, Scopus, Web of Science, PsycINFO, CINAHL and ProQuest Theses and Dissertations from inception until December 2020. Sandelowski and Barroso's two-step approach was used to synthesise the evidence. Seventeen qualitative studies published between 2004 and 2020 were included. This review encapsulated the experiences and challenges of 4,387 care staff whose age ranged from 18 to 69 years. Through the meta-synthesis, four themes were identified: varying manifestations of sexual expression and situations encountered, a spectrum of care staff's attitudes, setting boundaries in dementia care and workplace support. Managing sexual expression can be challenging for the care staff, given the complex interplay between personal beliefs, social contexts, moral dilemmas, practical barriers and the lack of clear policies. This review highlighted the need to equip them with knowledge, skills and confidence in managing sexuality in LTC facilities. (Edited publisher abstract)
Supporting ex-service personnel moving to social care work with older people: a systematic rapid review of the role of education
- Authors:
- MANTHORPE Jill, BRAMLEY Stephanie
- Journal article citation:
- Working with Older People, 23(3), 2019, pp.127-141.
- Publisher:
- Emerald
Purpose: Motivation is central to the ongoing professional development, performance and retention of healthcare workers. Despite the increasing prevalence of people with dementia (PwD) and the associated demand for geriatric nurses, there exists a paradoxical shortage. The purpose of this paper is to explore the motivation and demotivation of healthcare professionals for working with older PwD, challenges faced, factors influencing intention to leave the field of work and methods to enhance staff motivation to continue working with this group. Design/methodology/approach: This grounded-theory study used thematic analysis to synthesise data from 13 semi-structured interviews relating to the motivating and demotivating factors of healthcare professionals (nurses and healthcare assistants) for working with older PwD in a hospital setting. Findings: Staff were motivated by previous personal experiences, personal characteristics and the fulfilment of the carer–patient relationship. Conversely, staff were mostly demotivated by organisational and working environment factors (e.g. poor leadership characteristics, inadequate staffing levels, lack of development opportunities), negatively influencing their intention to remain in employment. Research limitations/implications: The generalisability of the results is limited by the size of the sample. Different organisational strategies/interventions (i.e. support, training, recognition and rewards) are necessary to nurture staff motivation, improve retention, create positive working environments and enhance patient care. Originality/value: This study offers numerous ways in which to address factors contributing to demotivation in working with PwD, thereby helping to improve staff retention and support the needs of a growing population. (Edited publisher abstract)
Disclosing a diagnosis of dementia: a systematic review
- Authors:
- BAMFORD Claire, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 19(2), February 2004, pp.151-169.
- Publisher:
- Wiley
The issue of diagnostic disclosure in dementia has been debated extensively in professional journals, but empirical data concerning disclosure in dementia has not previously been systematically reviewed. Five electronic databases were searched up to September 2003 (Medline, Embase, Cinahl, Sociological Abstracts, Web of Science). Additional references were identified through hand searches of selected journals and bibliographies of relevant articles and books. The title and abstract of each identified paper were reviewed independently by two reviewers against pre-determined inclusion criteria: original data about disclosure were presented and the paper was in English. Any disagreements were resolved by discussion until consensus was reached. Data were extracted independently by two reviewers using a structured abstraction form. Data quality were not formally assessed although each study was critically reviewed in terms of methodology, sampling criteria, response rates and appropriateness of analysis. Fifty-nine papers met the inclusion criteria for detailed review. Many of the studies had methodological shortcomings. The studies reported wide variability in all areas of beliefs and attitudes to diagnostic disclosure and reported practice. Studies of the impact of disclosure indicate both negative and positive consequences of diagnostic disclosure for people with dementia and their carers. Existing evidence regarding diagnostic disclosure in dementia is both inconsistent and limited with the perspectives of people with dementia being largely neglected. This state of knowledge seems at variance with current guidance about disclosure.
Pedagogical principles and methods underpinning education of health and social care practitioners on experiences and needs of older LGBT+ people: findings from a systematic review
- Authors:
- HIGGINS Agnes, et al
- Journal article citation:
- Nurse Education in Practice, 40, 2019, p.102625.
- Publisher:
- Elsevier
BACKGROUND: There is a growing awareness of the need for LGBT + competency training to ensure that the health and social care services offered to older LGBT + people is affirmative and gender sensitive., OBJECTIVE: To conduct a synthesis of the literature that describes the pedagogical principles, curriculum content and methods (teaching and assessment) used to educate health and social care practitioners on the experiences and needs of older LGBT + people., DESIGN: Systematic thematic review of literature., DATA SOURCES: MEDLINE, CINAHL, PsycINFO, EMBASE, Web of Science, Social Sciences Index, ERIC., METHOD: In accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement, this review examined peer-reviewed papers published in English, prior to April 2018 that addressed pedagogical and curriculum issues on the inclusion of needs and experiences of older LGBT + people., RESULTS: The combined searches yielded 2214 papers of which 17 papers were eligible for inclusion, 10 discussion papers and 7 evaluation studies. Analysis identified the following themes: i) Acknowledging the wider historical context of older LGBT + people's lives; ii) Recognising that older LGBT + people are not a homogenous group; iii) Incorporating a multitude of theories and models from different perspectives; iv) Alerting practitioners to the health issues and disparities facing older LGBT + people; v) Including content that supports inclusive care for older LGBT + people; vi) Addressing barriers to older LGBT + people accessing health care; vii) Interactive activities are the preferred pedagogical strategy; viii) Involving older LGBT + people in curriculum development is a core principle; and ix) Mandatory education is not always the solution., CONCLUSION: As the field matures there is a need for more exploration of curriculum principles, assessment strategies and strategies to overcome barriers to the inclusion of issues experienced by older LGBT + people within curricula. (Edited publisher abstract)
Advance care planning for home health staff: a systematic review
- Authors:
- GLEESON Aoife, NOBLE Simon, MANN Mala
- Journal article citation:
- BMJ Supportive and Palliative Care, early cite 26 February 2019,
- Publisher:
- BMJ Publishing Group
Background Advance care planning (ACP) is a process where patients express their wishes regarding their future healthcare. Its importance has been increasingly recognised in the past decade. As increasing numbers of elderly people are living in care homes, the aim of this review was to identify the most effective ACP interventions to train/educate all levels of healthcare professionals working in care homes. Design A systematic review. Two independent reviewers undertook screening, data extraction and quality assessment. Data sources Searched from inception to June 2018: Ovid Medline, Ovid Medline in process, Ovid Embase, Cochrane Central Register of Controlled Trials, EBSCO Cinahl and Ovid PsycINFO. Results Six studies were included: three before and after studies, one cluster randomised controlled trial (RCT), one non-blinded RCT and one qualitative study. Five studies reported on ACP documentation, three on impact on ACP practice and three studies on healthcare-related outcomes. All quantitative studies reported an improvement in outcomes. In the three studies reporting on health-related outcomes, one showed significant reductions in hospitalisation rate, days and healthcare costs; one reported significant reductions in hospital deaths; and the third showed reductions in hospital days and deaths. A meta-analysis could not be performed due to the heterogeneity of the outcome measures. The included qualitative study highlighted perceived challenges to implementing an educational programme in the care home setting. Conclusion There is limited evidence for the effectiveness of ACP training for care home workers. More well-designed studies are needed. (Edited publisher abstract)
Management of depression and referral of older people to psychological therapies: a systematic review of qualitative studies
- Authors:
- FROST Rachael, et al
- Journal article citation:
- British Journal of General Practice, early cite 11 February 2019,
- Publisher:
- Royal College of General Practitioners
Background Depressive symptoms are common in later life and increase both the risk of functional and cognitive decline and the use of healthcare services. Despite older people expressing preferences for talking therapies, they are less likely to be referred than younger adults, particularly when aged ≥80 years. Aim To explore how healthcare professionals (HCPs) manage older people in relation to depression and referrals to psychological therapies. Design and setting Systematic review and thematic synthesis of qualitative studies. Method MEDLINE, Embase, PsycINFO, CINAHL, and the Social Sciences Citation Index (inception–March 2018) were searched for studies exploring HCPs’ views regarding management of late-life depression across all settings. Studies of older people’s views or depression management across all ages were excluded. Results In total, 27 studies, were included; these predominantly focused on the views of GPs and primary and community care nurses. Many HCPs felt that late-life depression was mainly attributable to social isolation and functional decline, but treatments appropriate for this were limited. Clinicians perceived depression to have associated stigma for older adults, which required time to negotiate. Limited time in consultations and the complexity of needs in later life meant physical health was often prioritised over mental health, particularly in people with frailty. Good management of late-life depression appeared to depend more on the skills and interest of individual GPs and nurses than on any structured approach. Conclusion Mental ill health needs to be a more-prominent concern in the care of older adults, with greater provision of psychological services tailored to later life. This may facilitate future identification and management of depression. (Edited publisher abstract)