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The longitudinal relationship between mental health disorders and chronic disease for older adults: a population-based study
- Authors:
- CHEN Chun-Min, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 32(9), 2017, pp.1017-1026.
- Publisher:
- Wiley
Objective: Although mental health disorders in older adults are common, their relationship with chronic disease and the influence of chronic disease on the development of mental health disorders over time is not well understood. This longitudinal study investigated the change in status of mental health disorders and chronic disease, as well as their interrelationships, over time. Methods: Participants included community-dwelling older adults living in Taiwan, aged 65 years or older, who completed six waves of survey interviews. Mental health disorders were scored using the Short Psychiatric Evaluation Schedule, and chronic disease(s) status was recorded during consecutive biennial data collection waves. The autoregressive latent trajectory model and parallel latent growth curve model were used for data analysis. Results: The study findings suggest that in older people pre-existing mental health disorders and/or chronic disease(s) will predispose them to developing significantly more mental health disorders and/or chronic diseases respectively. The study findings also suggest that pre-existing mental health disorders can significantly contribute to the development of chronic disease over time, and that pre-existing chronic disease(s) significantly can contribute to the development of mental health disorders over time, indicating a reciprocal interrelationship. Conclusions: The authors' findings suggest that it in addition to monitoring and treating chronic disease(s) in older people, it is also important to monitor and treat their mental health disorders. Doing so will result in overall better health outcomes and will facilitate a better quality of life as they age. (Publisher abstract)
‘I'm happy in my life now, I'm a positive person’: approaches to successful ageing in older adults living with HIV in Ontario, Canada
- Authors:
- EMLET Charles A., et al
- Journal article citation:
- Ageing and Society, 37(10), 2017, pp.2128-2151.
- Publisher:
- Cambridge University Press
Worldwide approximately 3.6 million people aged 50 and older are living and ageing with the human immunodeficiency virus (HIV). Few studies have explored successful ageing from the insider perspective of those living well and ageing with HIV. This study draws upon the lived experience and wisdom of older, HIV-positive adults living in Ontario, Canada in order to understand their views and strategies for successful ageing. This qualitative study involved semi-structured interviews with 30 individuals age 50 years and older who are HIV-positive. Purposive sampling techniques were used to recruit individuals who shared their experiences of successful ageing. Constructivist grounded theory coding techniques were used for analysis. Themes related to successful ageing included resilience strategies and challenges, social support and environmental context. Stigma and struggles to maintain health were identified as impediments to successful ageing. Models of successful ageing must take into account the potential for a subjective appraisal of success in populations suffering from chronic and life-threatening illnesses including HIV. Practitioners can draw upon organically existent strengths in this population in order to provide intervention development for older adults around the world who are struggling to manage their HIV. (Publisher abstract)
"Living in fear": experiences of older private-renters in London
- Author:
- AGE UK LONDON
- Publisher:
- Age UK London
- Publication year:
- 2017
- Pagination:
- 48
- Place of publication:
- London
This report looks at older people’s experience of private renting, the factors that contribute to older people having negative experiences of private-renting and their increased risk ‘vulnerability’ in relation to these factors. The research involved five focus groups with a total of 25 older private-renters, six additional interviews older private-renters and four interviews with a landlord and professionals. Issues of particular relevance to older private-renters in London include: security of tenure; rent and other costs; repairs and maintenance; the impact of poor housing on health conditions combined with difficulties of moving due to lack of affordable alternatives, and moving home. The report also highlights that the amount these issues affect older people can depend on their backgrounds or circumstances, which may make them more vulnerable. The research goes on to define 'vulnerability' on the grounds of insecure tenancy, health; and affordability. It concludes by making 11 recommendations to help reduce the vulnerabilities of the increasing numbers of older people who are privately renting in London. (Edited publisher abstract)
Visitors and resident autonomy: spoken and unspoken rules in assisted living
- Authors:
- BENNETT Colleen R., et al
- Journal article citation:
- Gerontologist, 57(2), 2017, pp.252-260.
- Publisher:
- Oxford University Press
Purpose of the Study: This article explores resident autonomy in assisted living (AL) and the effects that visitors and visiting the AL have on that autonomy. It examines formal and informal policies that govern visiting in AL, stakeholders’ views and enforcement of these policies, and the complex arrangements that visiting often entails in everyday life in the setting. Design and Methods: Data are drawn from a multiyear ethnographic study of autonomy in AL. Research from multiple sites included participant observation, informal and in-depth, open-ended interviews of various stakeholders, and the writing of field notes. Research team biweekly discussions and the Atlas.ti software program facilitated coding and analysis of interview transcripts and fieldnotes. Results: The ethnographic data highlight complicated factors related to visitors and visiting in AL. The article discusses two important aspects of visiting: (a) formal and informal policies at each setting; and (b) how resident autonomy is expressed or suppressed through rules about visiting in AL. Implications: The data underscores the importance of resident autonomy and quality of care in relation to visitors and visiting, especially how this relationship is affected by inconsistent and confusing formal and informal visiting policies in AL. (Publisher abstract)
Walking, sustainability and health: findings from a study of a walking for health group
- Authors:
- GRANT Gordon, et al
- Journal article citation:
- Health and Social Care in the Community, 25(3), 2017, pp.1218-1226.
- Publisher:
- Wiley
Not only is it tacitly understood that walking is good for health and well-being but there is also now robust evidence to support this link. There is also growing evidence that regular short walks can be a protective factor for a range of long-term health conditions. Walking in the countryside can bring additional benefits, but access to the countryside brings complexities, especially for people with poorer material resources and from different ethnic communities. Reasons for people taking up walking as a physical activity are reasonably well understood, but factors linked to sustained walking, and therefore sustained benefit, are not. Based on an ethnographic study of a Walking for Health group in Lincolnshire, UK, this paper considers the motivations and rewards of group walks for older people. Nineteen members of the walking group, almost all with long-term conditions, took part in tape-recorded interviews about the personal benefits of walking. The paper provides insights into the links between walking as a sustainable activity and health, and why a combination of personal adaptive capacities, design elements of the walks and relational achievements of the walking group are important to this understanding. The paper concludes with some observations about the need to reframe conventional thinking about adherence to physical activity programmes. (Publisher abstract)
Can videoconferencing affect older people's engagement and perception of their social support in long-term conditions management: a social network analysis from the Telehealth Literacy Project
- Authors:
- BANBURY Annie, et al
- Journal article citation:
- Health and Social Care in the Community, 25(3), 2017, pp.938-950.
- Publisher:
- Wiley
Social support is a key component in managing long-term conditions. As people age in their homes, there is a greater risk of social isolation, which can be ameliorated by informal support networks. This study examined the relationship between changes in social support networks for older people living in a regional area following weekly videoconference groups delivered to the home. Between February and June 2014, we delivered 44 weekly group meetings via videoconference to participants in a regional town in Australia. The meetings provided participants with education and an opportunity to discuss health issues and connect with others in similar circumstances. An uncontrolled, pre-post-test methodology was employed. A social network tool was completed by 45 (87%) participants either pre- or post-intervention, of which 24 (46%) participants completed the tool pre- and post-intervention. In addition, 14 semi-structured interviews and 4 focus groups were conducted. Following the intervention, participants identified increased membership of their social networks, although they did not identify individuals from the weekly videoconference groups. The most important social support networks remained the same pre- and post-intervention namely, health professionals, close family and partners. However, post-intervention participants identified friends and wider family as more important to managing their chronic condition compared to pre-intervention. Participants derived social support, in particular, companionship, emotional and informational support as well as feeling more engaged with life, from the weekly videoconference meetings. Videoconference education groups delivered into the home can provide social support and enhance self-management for older people with chronic conditions. They provide the opportunity to develop a virtual social support network containing new and diverse social connections. (Publisher abstract)
Self-management abilities and quality of life among frail community-dwelling individuals: the role of community nurses in the Netherlands
- Authors:
- CRAMM Jane-Murray, NIEBOER Anna Petra
- Journal article citation:
- Health and Social Care in the Community, 25(2), 2017, pp.394-401.
- Publisher:
- Wiley
The objective of the study was to determine whether community nurses in the Netherlands improve self-management abilities and quality of life of frail community-dwelling people. This longitudinal study was performed in the context of a larger evaluation study of the ‘Zichtbare Schakels’(Visible Link) programme, conducted to determine the quality of care provided by community nurses to community-dwelling frail people in Rotterdam, the Netherlands. For the current study, clients seen by community workers in Rotterdam between July 2013 and November 2014 participated. Data were gathered via personal interviews by the community nurses as part of care delivery at the start (T0; n = 220) and end of care delivery (T1; n = 111 – the remaining 109 clients were still receiving care) to evaluate and improve quality of care. The study measured client's quality of life (using the EQ5D), self-management abilities (using the Self-Management Ability Scale) and background characteristics. Results showed that clients seen by the community nurses especially experience problems when it comes to usual activities and pain/discomfort. Furthermore, quality of life was much worse among clients of the community nurses than among frail older (aged ≥70 years) people in Rotterdam, Dutch patients with chronic illnesses or diabetes and older (aged ≥65 years) people who had recently been hospitalised. Significant improvements were seen in client's self-management and quality of life over time. Self-management abilities at T0 and changes in self-management abilities (T1 – T0) clearly predicted quality of life at T1. Investing in community health nurses may be beneficial for the improvement of self-management abilities and quality of life among very frail people in the community. (Edited publisher abstract)
The association of physical illness and self-harm resulting in hospitalisation among older people in a population-based study
- Authors:
- MITCHELL Rebecca, et al
- Journal article citation:
- Aging and Mental Health, 21(3), 2017, pp.279-288.
- Publisher:
- Taylor and Francis
Objectives: This research aims to identify the association of physical illness with hospitalisations following self-harm compared to non-self-harm injury among older people. Method: A population-based cohort study of individuals aged 50+ years admitted to hospital either for a self-harm or a non-self-harm injury using linked hospital admission and mortality records during 2003–2012 in New South Wales, Australia was conducted. Logistic regression and survival plots were used to examine the association of 21 physical illnesses and mortality at 12 months by injury intent, respectively. Age-adjusted health outcomes, including length of stay, readmission and mortality were examined by injury intent. Results: There were 12,111 hospitalisations as a result of self-harm and 474,158 hospitalisations as a result of non-self-harm injury. Self-harm compared to non-self-harm hospitalised injury was associated with higher odds of mental health conditions (i.e. depression, schizophrenia, bipolar and anxiety disorders), neurological disorders (excluding dementia), other disorders of the nervous system, diabetes, chronic lower respiratory disease, liver disease, tinnitus and pain. Tinnitus, pain, malignancies and diabetes all had a higher likelihood of occurrence for self-harm compared to non-self-harm hospitalisations even after adjusting for mental health conditions, number of comorbidities and alcohol and drug dependency. Conclusion: Older people who are experiencing chronic health conditions, particularly tinnitus, malignancies, diabetes and chronic pain may be at risk of self-harm. Targeted screening may assist in identifying older people at risk of self-harm. (Edited publisher abstract)
Comprehensive assessment when older people are in hospital improves their chances of getting home and living independently
- Author:
- NATIONAL INSTITUTE FOR HEALTH RESEARCH. Dissemination Centre
- Publisher:
- National Institute for Health Research
- Publication year:
- 2017
- Place of publication:
- London
This NIHR Signal looks at the findings of an updated Cochrane review which compared the effectiveness of comprehensive geriatric assessment by a multidisciplinary specialist team with routine care for people over 65, excluding those with stroke and orthopaedic conditions. The findings show that older people who received comprehensive geriatric assessment when in hospital were slightly more likely to be living in their own homes one year later. People who received comprehensive geriatric assessment were also 20 percent less likely to be in a nursing home after three months or more. It concluded that comprehensive geriatric assessment may save NHS resources, but the quality of evidence was too low to assess this reliably. NIHR Signals highlight examples of important research and explain why the study was needed, what the study found and the implications of the findings. They include commentary from experts, researchers and those working in practice. (Edited publisher abstract)
State of the nation: older people and malnutrition in the UK today
- Author:
- MALNUTRITION TASK FORCE
- Publisher:
- Malnutrition Task Force
- Publication year:
- 2017
- Pagination:
- 27
- Place of publication:
- London
Brings together information, statistics and evidence from across the health and social care system to provide a picture of what is happening to older people who are malnourished or at risk of malnutrition in England. It examines the causes and consequences of malnutrition in the UK. It discusses risk factors in three categories: medical and disease-related factors which are directly related to another on-going health condition, such as dementia; physical risk factors, which may be related to underlying health problems, such as mobility or sensory loss; and social factors, such as income and loneliness. The report shows that the prevalence of these risk factors is widespread and likely to increase as the population ages. It looks at older people at risk of malnutrition in hospitals and living in the community, and the support that could prevent malnutrition. The report also looks at economic costs and pressures, and whether the NHS and social care services are currently able to support older people at risk. The final section summarises existing good practice guidance and highlights the need for increasing public awareness, professional training, and an integrated system of health and social care in order to prevent and treat malnutrition. (Edited publisher abstract)