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Effects of reminiscing about nostalgic smells on the physiological and psychological responses of older people in long-term care facilities
- Authors:
- FU Sin Rou, LEE Mei Fen, OU Sheng Jung
- Journal article citation:
- Ageing and Society, 40(3), 2020, pp.501-511.
- Publisher:
- Cambridge University Press
This study adopted mixed-methods research to explore the effects of reminiscing about nostalgic smells on the physiological and psychological responses of older people in long-term care facilities. A total of 60 participants were randomly divided into two groups and each participant was either interviewed regarding their reminiscence about nostalgic smells (experimental group) or were engaged in daily conversation (control group). The results indicated that anxiety and depression symptoms were more effectively relieved in the experimental group than in the control group. Moreover, most of the nostalgic smells recalled by the experimental group were associated with naturally occurring smells. Regarding heart rate variability, the normalised low-frequency of the experimental group decreased significantly. The results verified the utility of using reminiscence about olfactory memories in reminiscence therapy as this can calm anxiety and lessen depression, which can be very important for older adults living in long-term care facilities. (Edited publisher abstract)
A pilot trial of acceptance and commitment therapy for symptoms of depression and anxiety in older adults residing in long-term care facilities
- Author:
- DAVISON Tanya E.
- Journal article citation:
- Aging and Mental Health, 21(7), 2017, pp.766-773.
- Publisher:
- Taylor and Francis
Objectives: The aim of this study was to evaluate the efficacy and acceptability of a psychological intervention based on acceptance and commitment therapy (ACT) to improve symptoms of depression and anxiety among older adults living in long-term care. Method: Forty one residents aged between 63 and 97 years (M = 85.3 years) participated in this study. Residents were allocated to receive either a 12 session ACT intervention implemented by trainee psychology therapists or a wait-list control group. Measures of depression and anxiety were collected at baseline and 8 week post-intervention, and residents who received the intervention were tracked for three months. A treatment satisfaction questionnaire was administered to residents who received the intervention and a sample of 10 facility staff members. Results: Using an intention to treat approach and controlling for baseline scores, scores on depression measures were significantly lower after the ACT intervention than after the wait-list control. These outcomes were maintained at three-month follow-up. Treatment satisfaction was rated highly by both residents and their care staff. Conclusion: This preliminary trial suggests that ACT shows promise as a therapeutic approach to address symptoms of depression in long-term care. (Publisher abstract)
Suicide attempts and completions in Veterans Affairs nursing home care units and long-term care facilities: a review of root-cause analysis reports
- Authors:
- MILLS Peter D., et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 31(5), 2016, pp.518-52.
- Publisher:
- Wiley
Objective: Suicide was the 10th leading cause of death for Americans in 2010. The suicide rate is highest among men who are aged 75 and older. The prevalence of suicidal behavior in nursing homes and long-term care (LTC) facilities was estimated to be 1%. This study describes the systemic vulnerabilities found after suicidal behaviour in LTC facilities in the United States as well as steps to decrease or mitigate the risk. Method: This is a retrospective review of root-cause analysis (RCA) reports of suicide attempts and completions between 1 January 2000 and 31 December 2013 in the Veterans Health Administration LTC and nursing home care units. The RCA reports of suicide attempts and completions were coded for patient demographics, method of attempt or completion, root causes, and actions developed to address the root cause. Results: Thirty-five RCA reports were identified. The average age was 65 years, 11 had a previous suicide attempt, and the primary mental health diagnoses were depression, posttraumatic stress disorder, and schizophrenia. The primary methods of self-harm were cutting with a sharp object, overdose, and strangulation. Conclusions: It is recommended that all staff members are aware of the signs and risk factors for depression and suicide in this population and should systematically assess and treat mental disorders. In addition, LTC facilities should have a standard protocol for evaluating the environment for suicide hazards and use interdisciplinary teams to promote good communication about risk factors identified among patients. Finally, staff should go beyond staff education and policy to make clinical changes at the bedside. Published 2015. This article is a U.S. Government work and is in the public domain in the USA. (Publisher abstract)
The emotional wellbeing of older carers
- Authors:
- SCRUTTON Jonathan, CREIGHTON Helen, INTERNATIONAL LONGEVITY CENTRE UK
- Publisher:
- University College London
- Publication year:
- 2015
- Pagination:
- 20
- Place of publication:
- London
This report, the second in a two part series summarising research from the Department of Epidemiology and Public Health at University College London (UCL), focuses on the subjective wellbeing of older carers. The research finds that: long term caregiving was associated with declines in quality of life and life satisfaction for carers, and an increased risk of depression; and giving up caregiving was associated with increased depression amongst both male and female carers. The report addresses the wider context of these findings, highlighting how the ageing population could potentially lead to large increases in the number of older carers, with the number of carers over 65 already having risen by 35 per cent since 2001. It also highlights the day-to-day realities faced by many older carers, including a high risk of emotional distress; the loss of friends, either because of a lack of time to socialise or because friends were unable to properly understand the constraints and strains of caring; and potential health risks. The report explores the policy implications of the research, highlighting that few policies and support services are aimed at older carers specifically. The report suggests that more could be done to protect the emotional wellbeing and mental health of older carers, through appropriate support being provided at all stages of the caregiving cycle. (Edited publisher abstract)
Facility organizational and facility resident characteristics in nursing homes serving residents with a mental health history
- Authors:
- FRAHM Kathryn, et al
- Journal article citation:
- Journal of Social Service Research, 37(1), January 2011, pp.61-72.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
Nursing homes have been identified as the primary source of institutional care for older adults with a mental health history, and to have a higher prevalence of mental health disorders among their residents compared to older people in the community. The purpose of this study was to identify characteristics among nursing homes serving residents with a mental health history, and to examine the characteristics of the facilities that serve this population. A retrospective, cross-sectional design was conducted using the 2003 national Online Survey, Certification, and Reporting facility data merged with the resident-level Minimum Data Set resulting in 2,499 nursing homes. Across these facilities, 22% of the total residents had a diagnosis of a mental disorder not including any form of dementia. Among those with a mental health history, 53% of facility residents had depression, 37% had schizophrenia, 19% had anxiety disorder, and 15% had manic depression. Nursing homes serving people with a mental health history are more likely to be for profit, have a greater number of beds, have lower occupancy rates, and have more residents with Medicaid as the primary payer. This information can be used to inform nursing home practice and policy to ensure adequate mental health care provision.
Suicidal ideation and its correlates among elderly in residential care homes
- Authors:
- MALFENT Daniela, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 25(8), August 2010, pp.843-849.
- Publisher:
- Wiley
Studies have shown that the highest suicide rates are found among the elderly, with suicidal ideation prevalent in long-term care facilities. Despite these facts most residents show no signs of suicidal ideation. However, there is a lack of information on which factors protect against suicidal thoughts among the elderly. This study aimed to assess the prevalence and correlates of suicidal ideation with risk and protective factors among older residential care home residents in Vienna. Participants included 129 residents, aged 60 and older, from 15 Viennese residential care homes, who completed a self-report questionnaire containing socio-demographic factors, physical health, mental health, and protective factors like self-efficacy, and internal locus of control as well as satisfaction with life. They were also asked about active and passive suicidal thoughts. Results indicated active suicidal ideation during the last month in 7% of the elderly, 11% reported active suicidal ideation during the past year. Depressive symptoms and current psychotherapeutic treatment were important predictors. In conclusion, the authors suggest that research and prevention strategies could not only target risk, but also include protective factors.
Differentiation of the pattern of cognitive impairment between depressed and non-depressed patients with dementia living in long-term care facilities
- Authors:
- HUDON Carol, et al
- Journal article citation:
- Aging and Mental Health, 14(3), April 2010, pp.293-302.
- Publisher:
- Taylor and Francis
The principal objective of this study was to examine the cognitive profile of patients with dementia plus concomitant depression (D+) and without concomitant depression (D-). Patients were recruited from long-term care facilities, and their depression status was determined using the Cornell Scale for Depression in Dementia. From this, 61 patients were assigned to the D+ group and 89 patients were assigned to the D- group. Cognitive functioning was assessed using the Hierarchic Dementia Scale (HDS). Analyses first indicated that on the total HDS score, patients of the D+ group exhibited more severe cognitive impairment compared to those of the D- group. Further analyses revealed that the difference between groups pertained to perception, attention/memory, calculation, and language functions. Moreover, secondary analyses revealed that the cognitive deficits of the D+ group were associated with behavioural (agitation and retardation, in particular), but not with mood-related, symptoms of depression. Ideational symptoms of depression (suicide and self-depreciation, in particular) were positively correlated with cognitive impairment. The article concludes that these findings add to those of previous studies showing that D+ and D- patients differ not only regarding the presence or absence of depressive symptoms, but also regarding cognitive manifestations. This study thus reinforces the need to detect and treat accurately depression in dementia.
Notation of depression in case records of older adults in community long-term care
- Author:
- PROCTOR Enola K.
- Journal article citation:
- Social Work: A journal of the National Association of Social Workers (NASW), 53(3), July 2008, pp.243-253.
- Publisher:
- Oxford University Press
Although significant numbers of social service clients experience mental health problems, virtually no research has examined the responsiveness of social service agencies to mental disorder. This article examines the extent to which client depression is reflected in records of a public social service agency, community long-term care (CLTC) in the United States. Researchers assessed new, consenting CLTC clients for depression using standardized research criteria in a telephone interview. Agency case records were abstracted to determine the extent to which client depression was noted. Sensitivity and specificity of depression notation were 25.21 percent and 92.80 percent, respectively, indicating that agency records reflected depression for about one in four clients meeting depression criteria. Factors associated with accurate depression notation included cognitive impairments, low social support, psychotropic medications, and mental health treatment. The depression notation rates found are comparable to those in medical settings. Structured screening and assessment might enhance detection of mental disorder for social service clients.
Evaluating the effect of COVID-19 pandemic lockdown on long-term care residents’ mental health: a data-driven approach in New Brunswick
- Authors:
- MCARTHUR Caitlin, et al
- Journal article citation:
- Journal of the American Medical Directors Association, 22(1), 2021, pp.187-192.
- Publisher:
- Elsevier (for the American Medical Directors Association)
Long-term care (LTC) residents, isolated because of the COVID-19 pandemic, are at increased risk for negative mental health outcomes. The purpose of this article is to demonstrate how the interRAI LTC facility (LTCF) assessment can inform clinical care and evaluate the effect of strategies to mitigate worsening mental health outcomes during the COVID-19 pandemic. We present a supporting analysis of the effects of lockdown in homes without COVID-19 outbreaks on depression, delirium, and behavior problems in a network of 7 LTC homes in New Brunswick, Canada, where mitigative strategies were deployed to minimize poor mental health outcomes (eg, virtual visits and increased student volunteers). This network meets regularly to review performance on risk-adjusted quality of care indicators from the interRAI LTCF and share learning through a community of practice model. This study included 4209 assessments from 765 LTC residents between January 2017 to June 2020 and modeled the change within and between residents for depression, delirium, and behavioral problems over time with longitudinal generalized estimating equations. Though the number of residents who had in-person visits with family decreased from 73.2% before to 17.9% during lockdown (chi square, P < .001), the number of residents experiencing delirium (4.5%-3.5%, P = .51) and behavioral problems (35.5%-30.2%, P = .19) did not change. The proportion of residents with indications of depression decreased from 19.9% before to 11.5% during lockdown (P < .002). The final multivariate models indicate that the effect of lockdown was not statistically significant on depression, delirium, or behavioral problems. This analyses demonstrate that poor mental health outcomes associated with lockdown can be mitigated with thoughtful intervention and ongoing evaluation with clinical information systems. Policy makers can use outputs to guide resource deployment, and researchers can examine the data to identify better management strategies for when pandemic strikes again. (Edited publisher abstract)
Positive effects of art therapy on depression and self-esteem of older adults in nursing homes
- Authors:
- CHING-TENG Yao, YA-PING Yang, YU-CHIA Chen
- Journal article citation:
- Social Work in Health Care, 58(3), 2019, pp.324-338.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
Depression and self‐esteem affects the health and quality of life of older adults who live in nursing homes. This study tested the effectiveness of art therapy activities on reducing the depression and improving the self-esteem of elderly living in long‐term care institutes. This was a quasi‐experimental study. A purposive sampling strategy was used to select 55 subjects who were aged 65 and above with intact mental functions and depression tendencies and currently residing in nursing homes in Kaohsiung, Taiwan. 29 subjects who participated in a selection of 12 artistic activities were assigned to the experimental group and 26 subjects who adhered to their ordinary activities were allocated to the control group. Structured questionnaires of the artistic group were used for data collection. The art therapy programmes showed promising effects in improving the depression and self‐esteem of older adults living in nursing homes. Art therapy activities benefit the mental health of older adults. Incorporating artistic activities into social work care may help develop long‐term care into a more diverse, unique, and innovative direction. (Publisher abstract)