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Supporting frail older people with depression and anxiety: a qualitative study
- Authors:
- FROST Rachael, et al
- Journal article citation:
- Aging and Mental Health, 24(12), 2020, pp.1977-1984.
- Publisher:
- Taylor and Francis
Objectives: Depression and anxiety are common in later life, particularly when people are frail. This leads to reduced quality of life, faster decline in physical health and increased health/social care use. Available treatments are commonly not tailored to people with frailty. We explored frail older peoples’ experiences of depression and/or anxiety and how services could be adapted to their needs. Methods: Semi-structured interviews with 28 older people in the UK purposively sampled for practice location and severity of frailty and anxiety/depression. We asked about symptoms, interactions with physical health, help-seeking, treatments and what might help in future. We audio-recorded and transcribed interviews, using thematic analysis to inductively derive themes. Results: Frail older people had low expectations of their wellbeing at this point in life due to multiple physical health issues and so anxiety and mild depressive symptoms were normalised. There was a particular reluctance and uncertainty regarding help-seeking for anxiety. Treatments were considered appropriate where they aligned with coping skills developed over their lifetime, and facilitated independence and problem-solving skills. Most older people felt their knowledge of mental health was limited and relied upon information about and endorsement of therapies from an expert. This was usually their GP, but access was often problematic. Online methods of accessing information and therapies were not popular. (Edited publisher abstract)
Purchasing power: getting the best for older people
- Authors:
- MANTHORPE Jill, ILIFFE Steve
- Journal article citation:
- Mental Health Today, November 2008, pp.26-29.
- Publisher:
- Pavilion
- Place of publication:
- Hove
The authors discuss some of the challenges facing commissioners who are purchasing mental health services for older people. They briefly highlight some of the main complexities which include: the complexity of older people's identities; the make up of workforces; the difficult nature of work with older people; and the multiple agencies involved in working with older people. It is argued that consistent application of a long-term strategy, which allows the accumulation of small changes across agencies and disciplines, is likely to be the key to success. It sets out the issues that need to be addressed, the pitfalls to avoid, and examines a series of objectives for commissioners.
Mental health in later life, a neglected area of policy and research allocation: summary of the UK Inquiry into Mental Health in Later Life
- Authors:
- HURST Philip, MINTER Jane
- Journal article citation:
- Housing Care and Support, 10(3), December 2007, pp.17-20.
- Publisher:
- Emerald
This article summarises the issues identified in the UK Inquiry report on Mental Health in Later Life. It looks at how the Inquiry undertook its work, how older people with mental health problems are often overlooked and what their views and experiences are of accessing services, what actions are proposed for the housing, health and care sectors, and key issues and recommendations.
Improving mental health services for older people
- Author:
- HARION Nerys
- Journal article citation:
- Nursing Times, 21.08.07, 2007, pp.21-22.
- Publisher:
- Nursing Times
The UK Inquiry into Mental Health and Well-Being in later life has revealed that the care of older people with mental health problems is inadequate. The author outlines the some of the recommendations of the report and the five main priority areas for action.
Individual standards for intermediate care for older people with mental health difficulties
- Author:
- HEALTH AND SOCIAL CARE ADVISORY SERVICE
- Publisher:
- Health and Social Care Advisory Service
- Publication year:
- 2006
- Pagination:
- 17p.
- Place of publication:
- London
This paper presents the standards and the early findings from the Department of Health funded national project on Intermediate Care for Older People with Mental Health difficulties. The project benchmarked the intermediate care service provision in seven sites across England during March and April 2006 against best practice standards developed by HASCAS. An overarching view is that is that there is often poor integration and understanding between mainstream older peoples intermediate care services and older peoples mental health services and that this results in sub optimal care.
Securing better mental health for older adults
- Authors:
- PHILP Ian, APPLEBY Louis
- Publisher:
- Great Britain. Department of Health
- Publication year:
- 2005
- Pagination:
- 8p.
- Place of publication:
- London
This document marks the start of a new initiative and provides a vision for how all mainstream and specialist health and social care services should work together to secure better mental health services for older people.This is the first time that the mental health and older people's divisions have adopted such a strategic approach in order to influence change and improve services for older people with mental illness.
The practice of geriatric psychiatry in three countries: observations of an American in the British Isles
- Author:
- REIFLER B.V.
- Journal article citation:
- International Journal of Geriatric Psychiatry, 12(8), August 1997, pp.795-807.
- Publisher:
- Wiley
The author compares the practice of geriatric psychiatry among the three countries: Ireland, the United Kingdom and the United States. Reviews how the practice of geriatric psychiatry is carried out, and the mental health services available in each country, including organisational characteristics. Findings suggest the USA is the most entrepreneurial of the three, Britain's greatest strength is the uniformity and comprehensiveness of its services, and Ireland provides an excellent model for nations of comparable size. Also found that considerable change is occurring in all three countries.
The assessment of pain in older people: UK national guidelines
- Author:
- SCHOFIELD Pat
- Journal article citation:
- Age and Ageing, 47(suppl 1), 2018, p.i1–i22.
- Publisher:
- Oxford University Press
This guidance highlights the problems in assessing and managing pain in an ever increasing older population. This brings an anticipated increase in the prevalence of chronic pain and with this comes the challenge of assessment of pain in many varied settings. The first iteration of this guideline was published in 2007. But there has been a proliferation of literature and research since then, so this is a a revised set of guidelines based on a systematic review to examine the evidence for the effectiveness of pain assessment strategies in older people with or without cognitive function. The objectives of the review included: exploring the attitudes and beliefs of older people with pain about the assessment of their pain and interactions with carers; evaluating the effectiveness of the assessment of function as a measure of pain in older people; evaluating the effectiveness of self-assessment to quantify pain in older people and determining if changes in pain assessment strategy are required for people with cognitive impairment, mental health or psychological problems. These guidelines provide a range of tools which demonstrate good validity and reliability for clinical practice in assessing pain in older people. (Original abstract)
Seasonality of depression referrals in older people
- Authors:
- HOLLOWAY Lucy Elizabeth, EVANS Sandra
- Journal article citation:
- Community Mental Health Journal, 50(3), 2014, pp.336-338.
- Publisher:
- Springer
Seasonal affective disorder is becoming more widely recognised as a prevalent mood disorder in the adult population. However, few studies have investigated the link between sunlight exposure and mood in the elderly. Referrals to the community Mental Health Care for Older People (MHCOP) in the Hackney and City area, were screened for the number of patients referred with depression in three separate years (2007, 2009 and 2011) in order to determine whether more referrals were made to the service during darker months of the year (October to March) than in the lighter months of the year (April to September). When data from the three years was combined, we found no significant increase in the number of referrals to the MHCOP in the darker months (Chi squared value 1.375, p value (2 tailed) 0.2409). Theauthors observed no statistically significant seasonal pattern of referrals, this suggests that depression in older people is not more prevalent in darker months of the year. (Edited publisher abstract)
The relationship between mental wellbeing and financial management among older people: an analysis using the third wave of Understanding Society
- Authors:
- HAYES David, UNIVERSITY OF BRISTOL. Personal Finance Research Centre, INTERNATIONAL LONGEVITY CENTRE UK
- Publisher:
- International Longevity Centre UK
- Publication year:
- 2014
- Pagination:
- 8
- Place of publication:
- London
This new analysis shows statistically significant relationships between age and both increased levels of mental wellbeing and people reporting they are managing their financial situation more comfortably. It corroborates previous research (C Fitch et al, in Mental Health Review Journal, 2011) suggesting that one in four people with mental health problems are in debt, while one in two people in debt have a mental health problem. This analysis also suggests that after controlling for a range of demographic and socio-economic characteristics, older people who are struggling to manage their finances have eight times the odds of having reduced levels of mental wellbeing. Fitch et al suggested that debt may be both a cause and consequence of mental health problems. This work supports the assertion that poor mental health is exacerbated by financial problems and, though questions of causality remain, indicates that mental wellbeing and financial management are inextricably intertwined. This working paper is published by the Personal Finance Research Centre (PFRC) at the University of Bristol and the International Longevity Centre UK (ILC-UK). The research has been produced as part of the ILC-UK and PFRC project on “financial wellbeing in older age” funded by the ESRC’s Secondary Data Analysis Initiative. It looks at the relationship between mental wellbeing and self-reported financial management among those aged 50 and over in the United Kingdom.1 These findings are drawn from the third wave (2011) of Understanding Society, a large social survey begun in 2009, which captures information on the social and economic circumstances, attitudes, and health, of the inhabitants of 40,000 households each year. This paper begins by examining how mental wellbeing among the over-50s varies with increasing age. It looks at self-reported financial management among the same age group, and explores the relationship between mental wellbeing and how well people feel they are managing their household’s financial situation. Finally, the researchers use regression analysis to assess the independent predictors of mental wellbeing; and the findings suggest a strong relationship between mental wellbeing and financial management. (Edited publisher abstract)