With a policy shift towards personalisation of adult social care in England, much attention has focused on individualised support for older people with care needs. This article reports the findings of a scoping review of United Kingdom (UK) and non-UK literature, published in English from 2005 to 2017, about day centres for older people without dementia and highlights the gaps in evidence. This review, undertaken to inform new empirical research, covered the perceptions, benefits and purposes of day centres. Searches, undertaken in October/November 2014 and updated in August 2017, of electronic databases, libraries, websites, research repositories and journals, identified 77 relevant papers, mostly non-UK. Day centres were found to play a variety of roles for individuals and in care systems. The largest body of evidence concerned social and preventive outcomes. Centre attendance and participation in interventions within them impacted positively on older people's mental health, social contacts, physical function and quality of life. Evidence about outcomes is mainly non-UK. Day centres for older people without dementia are under-researched generally, particularly in the UK. In addition to not being studied as whole services, there are considerable evidence gaps about how day centres are perceived, their outcomes, what they offer, to whom and their wider stakeholders, including family carers, volunteers, staff and professionals who are funding, recommending or referring older people to them.
(Publisher abstract)
With a policy shift towards personalisation of adult social care in England, much attention has focused on individualised support for older people with care needs. This article reports the findings of a scoping review of United Kingdom (UK) and non-UK literature, published in English from 2005 to 2017, about day centres for older people without dementia and highlights the gaps in evidence. This review, undertaken to inform new empirical research, covered the perceptions, benefits and purposes of day centres. Searches, undertaken in October/November 2014 and updated in August 2017, of electronic databases, libraries, websites, research repositories and journals, identified 77 relevant papers, mostly non-UK. Day centres were found to play a variety of roles for individuals and in care systems. The largest body of evidence concerned social and preventive outcomes. Centre attendance and participation in interventions within them impacted positively on older people's mental health, social contacts, physical function and quality of life. Evidence about outcomes is mainly non-UK. Day centres for older people without dementia are under-researched generally, particularly in the UK. In addition to not being studied as whole services, there are considerable evidence gaps about how day centres are perceived, their outcomes, what they offer, to whom and their wider stakeholders, including family carers, volunteers, staff and professionals who are funding, recommending or referring older people to them.
(Publisher abstract)
Subject terms:
literature reviews, day centres, older people, dementia, outcomes;
Briefing paper which discusses the meaning of quality and draws together literature on older people's definition of quality services. Discusses various individual quality preferences, the contribution made by different services, the role of service delivery and how quality can be assessed and assured.
Briefing paper which discusses the meaning of quality and draws together literature on older people's definition of quality services. Discusses various individual quality preferences, the contribution made by different services, the role of service delivery and how quality can be assessed and assured.
Subject terms:
literature reviews, older people, outcomes, quality assurance, standards;
BELL Sue Anne, HOROWITZ Jennifer, IWASHYNA Theodore J.
Journal article citation:
Gerontologist, 60(7), 2020, pp.e535-e547.
Publisher:
Oxford University Press
This review synthesizes the current literature surrounding chronic disease outcomes after weather- and climate-related disasters among older adults. The associations between exposure of older adults to weather- and climate-related disasters and the primary outcomes of diabetes, end-stage renal disease (ESRD), congestive heart failure (CHF), and chronic obstructive pulmonary disease (COPD) were examined. Research Design and Methods: A systematic review of studies reporting on clinical outcomes of four chronic diseases after disaster exposure was performed. Under the direction of an informationist, the databases PubMed, Scopus, EMBASE, and Web of Science (Science and Social Science Citation Index) were searched from inception to July 2019. Results: Of 5,229 citations identified, 17 articles met the study criteria. Included articles were retrospective observational in nature and focused on earthquakes (24%, n = 4), hurricane (41%, n = 7), and wildfire (35%, n = 6) disasters. Outcome data by disease process included COPD (35%, n = 6), ESRD (41%, n = 7), CHF (24%, n = 4), and diabetes (29%, n = 5). Three main categories were identified: access to health care, postdisaster health care utilization, and study rigor. The age-stratified analyses reported in this review found multiple instances where disasters have limited or insignificant effects on older adults relative to younger populations. Discussion and Implications: Disaster research faces unique methodological challenges, and there remains a need for data-driven conclusions on how best to care for older adults before, during, and after disasters. To encourage consistent dialogue among studies, we advocate for the use of rigorous and standardized scientific methodology to examine the health impacts of disasters on adults with chronic disease.
(Edited publisher abstract)
This review synthesizes the current literature surrounding chronic disease outcomes after weather- and climate-related disasters among older adults. The associations between exposure of older adults to weather- and climate-related disasters and the primary outcomes of diabetes, end-stage renal disease (ESRD), congestive heart failure (CHF), and chronic obstructive pulmonary disease (COPD) were examined. Research Design and Methods: A systematic review of studies reporting on clinical outcomes of four chronic diseases after disaster exposure was performed. Under the direction of an informationist, the databases PubMed, Scopus, EMBASE, and Web of Science (Science and Social Science Citation Index) were searched from inception to July 2019. Results: Of 5,229 citations identified, 17 articles met the study criteria. Included articles were retrospective observational in nature and focused on earthquakes (24%, n = 4), hurricane (41%, n = 7), and wildfire (35%, n = 6) disasters. Outcome data by disease process included COPD (35%, n = 6), ESRD (41%, n = 7), CHF (24%, n = 4), and diabetes (29%, n = 5). Three main categories were identified: access to health care, postdisaster health care utilization, and study rigor. The age-stratified analyses reported in this review found multiple instances where disasters have limited or insignificant effects on older adults relative to younger populations. Discussion and Implications: Disaster research faces unique methodological challenges, and there remains a need for data-driven conclusions on how best to care for older adults before, during, and after disasters. To encourage consistent dialogue among studies, we advocate for the use of rigorous and standardized scientific methodology to examine the health impacts of disasters on adults with chronic disease.
(Edited publisher abstract)
Subject terms:
older people, long term conditions, systematic reviews, literature reviews, disasters, outcomes;
Disability and Rehabilitation: Assistive Technology, 15(4), 2020, pp.373-393.
Publisher:
Taylor and Francis
Place of publication:
London
Purpose: To conduct a systematic review of existing methods to evaluate the individual aspects of welfare technology from the perspectives of independence, safety, activity, and participation. Furthermore, the study aimed to describe outcomes that have been the focus of previous research to evaluate individual aspects of welfare technology in older persons living in ordinary housing. Materials and methods: A systematic literature review in PubMed, CINAHL Plus, PsycINFO, Scopus, and Web of Science. Studies selected were those that explored the use of assistive and welfare technology devices from older persons’ perspectives, and which considered the concepts of independence, safety, activity and participation, and quality of life. Results: A broad spectrum of instruments was applied in the studies. For independence, three questionnaires were used in the identified studies. For safety, one instrument was used in two versions. To study activity and participation as well as quality of life, several scales were used. Additionally, several studies included qualitative approaches for evaluation, such as interviews, or posed one or more questions regarding the effects of welfare technology. Conclusions: The integration of digital assistive and welfare technology should be based on the needs of older persons, and those needs must be assessed using reliable and relevant instruments. The heterogeneity of the target group, i.e., older persons, together with the fact that assessments must give consideration to identifying goals, obstacles, and risks as well as users’ preferences, implies a person-centred approach.
(Publisher abstract)
Purpose: To conduct a systematic review of existing methods to evaluate the individual aspects of welfare technology from the perspectives of independence, safety, activity, and participation. Furthermore, the study aimed to describe outcomes that have been the focus of previous research to evaluate individual aspects of welfare technology in older persons living in ordinary housing. Materials and methods: A systematic literature review in PubMed, CINAHL Plus, PsycINFO, Scopus, and Web of Science. Studies selected were those that explored the use of assistive and welfare technology devices from older persons’ perspectives, and which considered the concepts of independence, safety, activity and participation, and quality of life. Results: A broad spectrum of instruments was applied in the studies. For independence, three questionnaires were used in the identified studies. For safety, one instrument was used in two versions. To study activity and participation as well as quality of life, several scales were used. Additionally, several studies included qualitative approaches for evaluation, such as interviews, or posed one or more questions regarding the effects of welfare technology. Conclusions: The integration of digital assistive and welfare technology should be based on the needs of older persons, and those needs must be assessed using reliable and relevant instruments. The heterogeneity of the target group, i.e., older persons, together with the fact that assessments must give consideration to identifying goals, obstacles, and risks as well as users’ preferences, implies a person-centred approach.
(Publisher abstract)
Subject terms:
systematic reviews, literature reviews, older people, outcomes, assistive technology, quality of life;
International Journal of Geriatric Psychiatry, 23(8), August 2008, pp.773-781.
Publisher:
Wiley
This article reviews the literature regarding the naturalistic outcomes of minor and subsyndromal depression (Min/SSD) in older primary care patients, synthesizing and critiquing findings and discussing avenues for future research. The author obtained relevant articles from repeated computer-assisted literature searches over the past 15 years, and by reviewing the reference citations of the articles so obtained. A variety of relevant outcome domains were identified, as were important putative predictors, moderators, and mediators of outcome. In general, minor and subsyndromal depression each have comparable outcomes, outcomes that are clearly worse than non-depressed subjects, with substantially elevated risk of worsening into major depression, albeit not as poor as those with major depression. Min/SSD is common and of real clinical importance in primary care seniors. Several definitions of SSD may be used, each with overlapping but distinguishable utility in identifying patients. While the evidence base has expanded greatly in the past decade, considerable work remains to be done. Naturalistic studies of several outcome domains are needed, focusing on the predictive, moderating, and mediating roles of a wide range of psychopathological, medical, functional, and psychosocial factors. Such work will complement interventions and biomarker research approaches.
This article reviews the literature regarding the naturalistic outcomes of minor and subsyndromal depression (Min/SSD) in older primary care patients, synthesizing and critiquing findings and discussing avenues for future research. The author obtained relevant articles from repeated computer-assisted literature searches over the past 15 years, and by reviewing the reference citations of the articles so obtained. A variety of relevant outcome domains were identified, as were important putative predictors, moderators, and mediators of outcome. In general, minor and subsyndromal depression each have comparable outcomes, outcomes that are clearly worse than non-depressed subjects, with substantially elevated risk of worsening into major depression, albeit not as poor as those with major depression. Min/SSD is common and of real clinical importance in primary care seniors. Several definitions of SSD may be used, each with overlapping but distinguishable utility in identifying patients. While the evidence base has expanded greatly in the past decade, considerable work remains to be done. Naturalistic studies of several outcome domains are needed, focusing on the predictive, moderating, and mediating roles of a wide range of psychopathological, medical, functional, and psychosocial factors. Such work will complement interventions and biomarker research approaches.
Subject terms:
literature reviews, older people, outcomes, patients, primary care, depression;
Journal of Gerontological Social Work, 50(S1), 2008, pp.45-77.
Publisher:
Taylor and Francis
Place of publication:
Philadelphia, USA
As survival rates for various cancers improve, with some now being seen as chronic illnesses, cancer is an increasingly important topic within gerontology. Demand for psychosocial interventions to improve the health and quality of life of those with cancer is rising, and this systematically conducted review aims to identify evaluation studies that are evidence-based. The majority that are disease-specific relate to breast cancer (15), with a smaller number (3) covering prostate cancer. In addition, the review identifies eight studies of treatments directed at patients with a variety of diagnoses. In the case of breast cancer, most treatments are group-based and designed to promote mutual aid. The use of complementary therapies is also a common feature. All these studies reported at least some improvement in health-related quality of life. Other studies used psycho-educational interventions to improve disease awareness and these gave positive results for both patients and carers. The paper concludes with a ‘treatment resource appendix’ directed at US practitioners. (Copies of this article are available from: Haworth Document Delivery Centre, Haworth Press Inc., 10 Alice Street, Binghamton, NY 13904-1580).
As survival rates for various cancers improve, with some now being seen as chronic illnesses, cancer is an increasingly important topic within gerontology. Demand for psychosocial interventions to improve the health and quality of life of those with cancer is rising, and this systematically conducted review aims to identify evaluation studies that are evidence-based. The majority that are disease-specific relate to breast cancer (15), with a smaller number (3) covering prostate cancer. In addition, the review identifies eight studies of treatments directed at patients with a variety of diagnoses. In the case of breast cancer, most treatments are group-based and designed to promote mutual aid. The use of complementary therapies is also a common feature. All these studies reported at least some improvement in health-related quality of life. Other studies used psycho-educational interventions to improve disease awareness and these gave positive results for both patients and carers. The paper concludes with a ‘treatment resource appendix’ directed at US practitioners. (Copies of this article are available from: Haworth Document Delivery Centre, Haworth Press Inc., 10 Alice Street, Binghamton, NY 13904-1580).
Subject terms:
literature reviews, older people, outcomes, psychosocial intervention, quality of life, cancer, health;
Journal of Gerontological Social Work, 50(S1), 2008, pp.191-214.
Publisher:
Taylor and Francis
Place of publication:
Philadelphia, USA
The number of people with Alzheimer’s disease, or a related dementia, is growing at a significant rate and it is essential that social workers in geriatric setting are knowledgeable both about the disorder and appropriate interventions. This systematically conducted review examines psychosocial approaches to managing mood and behavioural changes, identifying those that can be administered in both individual and group formats. These include psychotherapy groups, wellness groups, life review treatment, reminiscence groups, cognitive-behavioural therapy, validation therapy, arousal or stimulation interventions, memory enhancement and simulated presence therapy. Results have been mixed, and the results of all studies need to be interpreted with caution because of methodological limitations. More and better conducted studies are needed. The paper concludes with a ‘treatment resource appendix’ directed at American social workers. (Copies of this article are available from: Haworth Document Delivery Centre, Haworth Press Inc., 10 Alice Street, Binghamton, NY 13904-1580).
The number of people with Alzheimer’s disease, or a related dementia, is growing at a significant rate and it is essential that social workers in geriatric setting are knowledgeable both about the disorder and appropriate interventions. This systematically conducted review examines psychosocial approaches to managing mood and behavioural changes, identifying those that can be administered in both individual and group formats. These include psychotherapy groups, wellness groups, life review treatment, reminiscence groups, cognitive-behavioural therapy, validation therapy, arousal or stimulation interventions, memory enhancement and simulated presence therapy. Results have been mixed, and the results of all studies need to be interpreted with caution because of methodological limitations. More and better conducted studies are needed. The paper concludes with a ‘treatment resource appendix’ directed at American social workers. (Copies of this article are available from: Haworth Document Delivery Centre, Haworth Press Inc., 10 Alice Street, Binghamton, NY 13904-1580).
Journal of Gerontological Social Work, 50(S1), 2008, pp.153-189.
Publisher:
Taylor and Francis
Place of publication:
Philadelphia, USA
Depression and anxiety and the most common mental health problems of later life, but relatively little is known about their unique manifestation in older adults. Moreover, much of the growing body of research on psychosocial interventions for this population has yet to be translated into practice. This systematically conducted review covers meta-analyses of interventions for late-life depression and anxiety; and primary research literature on the effectiveness of cognitive-behavioural therapy, interpersonal therapy and reminiscence therapy. The review also looks at combined (pharmacological/psychosocial) treatments and other non-pharmacological approaches (e.g. exercise), and at treatment resistance. Despite evidence of the effectiveness of psychosocial treatments, they are rarely implemented and future research needs to encompass not just the conditions and potentially effective interventions but also the barriers to evidence-based practice. The paper concludes with a ‘treatment resource appendix’ directed at American social workers. (Copies of this article are available from: Haworth Document Delivery Centre, Haworth Press Inc., 10 Alice Street, Binghamton, NY 13904-1580).
Depression and anxiety and the most common mental health problems of later life, but relatively little is known about their unique manifestation in older adults. Moreover, much of the growing body of research on psychosocial interventions for this population has yet to be translated into practice. This systematically conducted review covers meta-analyses of interventions for late-life depression and anxiety; and primary research literature on the effectiveness of cognitive-behavioural therapy, interpersonal therapy and reminiscence therapy. The review also looks at combined (pharmacological/psychosocial) treatments and other non-pharmacological approaches (e.g. exercise), and at treatment resistance. Despite evidence of the effectiveness of psychosocial treatments, they are rarely implemented and future research needs to encompass not just the conditions and potentially effective interventions but also the barriers to evidence-based practice. The paper concludes with a ‘treatment resource appendix’ directed at American social workers. (Copies of this article are available from: Haworth Document Delivery Centre, Haworth Press Inc., 10 Alice Street, Binghamton, NY 13904-1580).
Journal of Gerontological Social Work, 50(S1), 2008, pp.215-241.
Publisher:
Taylor and Francis
Place of publication:
Philadelphia, USA
Although the prevalence of alcohol abuse is generally less among older than younger people in the USA, it poses particular risks for increased morbidity and mortality among older people. It is also expected to increase as the population ages. However, little attention has been paid to the development and evaluation of interventions for this population. This systematically conducted review identifies nine outcome studies, finding that promising interventions include those that are age-specific, less confrontational and cognitive-behavioural in approach. The paper concludes with a ‘treatment resource appendix’ directed at American social workers. (Copies of this article are available from: Haworth Document Delivery Centre, Haworth Press Inc., 10 Alice Street, Binghamton, NY 13904-1580).
Although the prevalence of alcohol abuse is generally less among older than younger people in the USA, it poses particular risks for increased morbidity and mortality among older people. It is also expected to increase as the population ages. However, little attention has been paid to the development and evaluation of interventions for this population. This systematically conducted review identifies nine outcome studies, finding that promising interventions include those that are age-specific, less confrontational and cognitive-behavioural in approach. The paper concludes with a ‘treatment resource appendix’ directed at American social workers. (Copies of this article are available from: Haworth Document Delivery Centre, Haworth Press Inc., 10 Alice Street, Binghamton, NY 13904-1580).
CUMMINGS Sherry M., BRIDE Brian, RAWLINS-SHAW Ann M.
Journal article citation:
Journal of Evidence-Based Social Work, 3(1), 2006, pp.79-99.
Publisher:
Taylor and Francis
Place of publication:
Philadelphia, USA
The purpose of this article is to enhance social work practitioners and researchers' understanding of the nature of elder alcohol abuse, the needs of elders with alcohol abuse disorders, and the availability of effective treatment strategies by reviewing the epidemiological and outcomes research literatures related to alcohol abuse and the elderly. The few empirical studies that examine outcomes associated with the treatment of elderly substance abusers reveal positive outcomes, especially when “age-specific,” cognitive-behavioural, and less confrontational treatment approaches are employed. The authors highlight the need for further research concerning the nature of alcohol abuse among the elderly and the impact of specific alcohol treatment strategies on older adults. Such research should consider the needs and experiences of specific sub-populations of elders such as women, minorities, and those with late onset disorders. (Copies of this article are available from: Haworth Document Delivery Centre, Haworth Press Inc., 10 Alice Street, Binghamton, NY 13904-1580).
The purpose of this article is to enhance social work practitioners and researchers' understanding of the nature of elder alcohol abuse, the needs of elders with alcohol abuse disorders, and the availability of effective treatment strategies by reviewing the epidemiological and outcomes research literatures related to alcohol abuse and the elderly. The few empirical studies that examine outcomes associated with the treatment of elderly substance abusers reveal positive outcomes, especially when “age-specific,” cognitive-behavioural, and less confrontational treatment approaches are employed. The authors highlight the need for further research concerning the nature of alcohol abuse among the elderly and the impact of specific alcohol treatment strategies on older adults. Such research should consider the needs and experiences of specific sub-populations of elders such as women, minorities, and those with late onset disorders. (Copies of this article are available from: Haworth Document Delivery Centre, Haworth Press Inc., 10 Alice Street, Binghamton, NY 13904-1580).
Extended abstract:
Author
CUMMINGS Sherry M.; BRIDE Brian; RAWLINS-SHAW Ann M .;
Title
Alcohol abuse treatment for older adults: a review of recent empirical research.
Journal citation/publication details
Journal of Evidence-Based Social Work, 3(1), 2006, pp.79-99.
Summary
The seven outcome studies identified for the formal review reported in this paper reveal positive effects, especially when age-specific, cognitive-behavioural and less confrontational treatment approaches are used. However, the evidence base is extremely limited, and more research is needed on the nature of alcohol abuse among older people and the impact of treatment on specific sub-populations such as women and people from minority ethnic groups. All of the research reviewed appears to be from the USA .
Context
Social work practitioners will increasingly confront older people with alcohol disorders as the population ages and the aim of this paper is to enhance practitioners' understanding of these disorders and the availability of effective treatment strategies. It covers a considerable amount of literature in addition to the few studies that are formally reviewed, to provide an insight into the consequences of alcohol abuse for morbidity and mortality among older people, the prevalence of abuse and the kinds of treatment approaches that are in use.
Methods
What sources were used?
The following databases were searched: ETOH [the now archived Alcohol and Alcohol Problems Science Database, 1977-2003, produced by the US National Institute on Alcohol Abuse and Alcoholism]; PsycINFO; Sociofile [the former name of Sociological Abstracts]; PubMed; and AgeLine.
What search terms/strategies were used?
No details are given, apart from a date limitation to material from 1980 onwards.
What criteria were used to decide on which studies to include?
Eligible studies specifically addressed the outcomes of interventions for older adults with alcohol abuse or dependence disorders. No specific definition of 'older adult' was established, and studies that identified subjects as 'old' or 'older' were selected.
Who decided on their relevance and quality?
No details are given. The authors note that the vast majority of the studies they identified were descriptive and did not consider the outcomes of interventions.
How many studies were included and where were they from?
Seven studies were found, summarised in Table 2 which gives details of study populations, sample sizes (16-137 individuals), gender, race, treatment and outcomes. They all appear to be from the USA .
How were the study findings combined?
The synthesis is narrative in nature, with each study described in turn.
Findings of the review
On the basis of the very limited number of outcome studies identified, the authors find that interventions with older alcohol abusers produce positive outcomes including abstinence (four studies), a reduction in alcohol use (two studies) and improvements in general health (one study). Older people seem to do best when treated with a cognitive-behavioural approach (one study), are more likely to comply with treatment and have better outcomes when treated in an older person-specific programme (one study), and have better outcomes when treated in a more supportive, less confrontational environment (one study).
Authors' conclusions
While the number of studies identified in this review is very small, they 'offer important data suggesting the beneficial response of older persons to alcohol treatment programs'. More research, however, is needed to confirm the results of these studies, explore which components of interventions are essential to their success, and extend studies to cover women and those from minority ethnic groups. The adoption of clear definitions of 'abuse' and 'elderly' is also necessary. In the studies reviewed 'light' alcohol use was deemed acceptable by some researchers, while others defined any alcohol use as abuse. Participants ranged from 45 to 91, and people within this span of ages clearly have very different outlooks and face different kinds of challenge in their lives.
Implications for policy or practice
No specific implications are discussed.
Subject terms:
literature reviews, older people, outcomes, treatment, therapy and treatment, alcohol misuse;