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‘Meaning in life? Make it as bearable, enjoyable and good as possible!’: a qualitative study among community‐dwelling aged adults who receive home nursing in the Netherlands
- Authors:
- HUPKENS Susan, et al
- Journal article citation:
- Health and Social Care in the Community, 29(1), 2021, pp.78-90.
- Publisher:
- Wiley
The population of adults ageing in place and using home‐care services is growing rapidly worldwide. Meaning in life (MiL) of this group of clients is relevant for healthcare and social workers. MiL is associated with many positive outcomes, but can be challenging for aged persons. Objective of this study was to explore MiL in daily life of community‐dwelling aged persons who receive homecare. A hermeneutic phenomenological approach was followed. Three waves of semi‐structured interviews took place among 24 clients of a home‐care organisation in the Netherlands between November 2015 and July 2018. Photo‐elicitation was part of the interview procedure. Interpretative Phenomenological Analysis and dialogues enhanced understanding. Findings show that participants derived meaning from self, others, environment and living. The process of retaining MiL involved maintaining, adapting and discovering. We conclude that community‐dwelling aged adults can draw MiL from many sources. Retaining MiL is interwoven in everyday life and requires continuous adaptation to ever‐changing life conditions during later life. Although relevant general themes were sketched in this paper, the importance of each, and the connections between them, vary and come to light at the individual level. The themes in this paper and the cases in the appendices provide insights that may help professionals recognise MiL in their work. Besides listening to the stories of aged adults, person‐centred interventions should support aged adult's strategy to retain MiL. (Edited publisher abstract)
Bringing well-being and choice into everyday home care
- Author:
- PATMORE Charles
- Journal article citation:
- Working with Older People, 10(3), September 2006, pp.24-27.
- Publisher:
- Emerald
The author presents the findings of research which investigated what enables some home care services to give older people personalised extra help, which supports morale and well-being. For example why some services can take their clients shopping, provide companionship, or look after their pets, when others services say they cannot do this. The research was funded by the Department of Health and conducted at the Social Policy Research Unit. First, 23 home care providers in 12 localities were interviewed. Six providers were then picked for indepth study. The article highlights key findings, including ways of promoting well-being and choice for service users.
Home and community-based services and life satisfaction among homebound and poor older adults
- Authors:
- CHEN Qingru, et al
- Journal article citation:
- Journal of Gerontological Social Work, 62(7), 2019, pp.708-727.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
Guided by the personal-environment (P-E) fit perspective, this study aims to: (1) describe characteristics of older people with homebound and low-income status; (2) investigate how the combination of homebound and low-income status is associated with life satisfaction; and (3) examine whether Home and Community-Based Services (HCBS) utilization moderates the association between homebound and low-income status and life satisfaction. Data were drawn from the 2012 Health and Retirement Study, and the sample included respondents who were 51+ years who completed a questionnaire for HCBS utilization (n= 1,662). Results describe sociodemographic, health-related, and environmental characteristics of older adults. Combined homebound and low-income status was a significant predictor of lower life satisfaction, but better life satisfaction when they used HCBS. These findings suggest that promoting HCBS utilization is a promising strategy to enhance well-being among those homebound and poor. Further studies are needed to test the effectiveness of HCBS with longitudinal data and to investigate the details of effective HCBS utilization such as frequency of use and types of services. (Edited publisher abstract)
Meeting the needs of older people living at home with dementia who have problems with continence
- Authors:
- DRENNAN Vari M., MANTHORPE Jill, ILIFFE Steve
- Journal article citation:
- Quality in Ageing and Older Adults, 18(4), 2017, pp.246-253.
- Publisher:
- Emerald
Purpose: The purpose of this paper is to discuss the question of how to meet the needs of older people living at home with dementia who have problems with continence. The paper is focused on social care practice in community settings. Design/methodology/approach: This paper is practice focused and draws on the authors’ research and experiences in clinical care, workforce development and service improvement. Findings: This paper summarises research on incontinence and its negative effects on quality of life and care relationships. It describes the impact of incontinence in terms of social embarrassment, restricted social activity, extra work (such as laundry) and costs, but also distress. It links research with care practice, with a focus on people with dementia who may be at particular risk of both continence problems and of assumptions that nothing can be done to assist them. Social implications: This paper provides questions that could be addressed in commissioning and provision of services and argues that they need to be informed by care practitioners’ experiences. It provides details of sources of support that are available at national and local levels. Originality/value: This paper draws together research on continence and social care practice to provide a series of self-assessment questions for local services. It focuses on social care workers who are at the frontline of practice including personal assistants and carers. (Publisher abstract)
Psychological well-being over time among informal caregivers caring for persons with dementia living at home
- Authors:
- LETHIN Connie, et al
- Journal article citation:
- Aging and Mental Health, 21(11), 2017, pp.1138-1146.
- Publisher:
- Taylor and Francis
Objectives: To investigate informal caregivers’ psychological well-being and predicted increase in psychological well-being, when caring for persons with dementia (PwDs) living at home, related to caregiver, PwD and formal care (FC) factors. Method: A cohort study at baseline and 3 months’ follow-up in eight European countries. Caregivers included (n = 1223) were caring for PwDs aged ≥ 65 years at home. Data on caregivers, PwDs and FC were collected using standardised instruments. Regression analysis of factors associated with caregiver psychological well-being at baseline and 3 months later was performed. Results: Factors associated with caregiver psychological well-being at baseline were positive experience of caregiving, low caregiver burden, high quality of life (QoL) for caregivers, male gender of PwD, high QoL of PwD, few neuropsychiatric symptoms and depressive symptoms for the PwD. At follow-up, caregivers with increased psychological well-being experienced of quality of care (QoC) higher and were more often using dementia specific service. Predicting factors for caregivers’ increased psychological well-being were less caregiver burden, positive experience of caregiving, less supervision of the PwD and higher caregiver QoL, if PwD were male, had higher QoL and less neuropsychiatric symptoms. Furthermore, higher QoC predicted increased caregivers’ psychological well-being. Conclusion: Informal caregiving for PwDs living at home is a complex task. The authors' study shows that caregivers’ psychological well-being was associated with, among other things, less caregiver burden and higher QoL. Professionals should be aware of PwD neuropsychiatric symptoms that might affect caregivers’ psychological well-being, and provide proper care and treatment for caregivers and PwDs. (Edited publisher abstract)
The effect of telecare on the quality of life and psychological well-being of elderly recipients of social care over a 12-month period: the Whole Systems Demonstrator cluster randomised trial
- Authors:
- HIRANI Shashivadan Parbati, et al
- Journal article citation:
- Age and Ageing, 43(3), 2014, pp.334-341.
- Publisher:
- Oxford University Press
Background: Home-based telecare (TC) is utilised to manage risks of independent living and provide prompt emergency responses. This study examined the effect of TC on health-related quality of life (HRQoL), anxiety and depressive symptoms over 12 months in patients receiving social care. Design: A study of participant-reported outcomes [the Whole Systems Demonstrator (WSD) Telecare Questionnaire Study; baseline n = 1,189] was nested in a pragmatic cluster-randomised trial of TC (the WSD Telecare trial), held across three English Local Authorities. General practice (GP) was the unit of randomisation and TC was compared with usual care (UC). Methods: Participant-reported outcome measures were collected at baseline, short-term (4 months) and long-term (12 months) follow-up, assessing generic HRQoL, anxiety and depressive symptoms. Primary intention-to-treat analyses tested treatment effectiveness and were conducted using multilevel models to control for GP clustering and covariates for participants who completed questionnaire measures at baseline assessment plus at least one other assessment (n = 873). Results: Analyses found significant differences between TC and UC on Short Form-12 mental component scores (P < 0.05), with parameter estimates indicating being a member of the TC trial-arm increases mental component scores (UC-adjusted mean = 40.52; TC-adjusted mean = 43.69). Additional significant analyses revealed, time effects on EQ5D (decreasing over time) and depressive symptoms (increasing over time). Conclusions: TC potentially contributes to the amelioration in the decline in users’ mental HRQoL over a 12-month period. TC may not transform the lives of its users, but it may afford small relative benefits on some psychological and HRQOL outcomes relative to users who only receive UC. (Publisher abstract)
Impairments in life quality among clients in geriatric home care: associations with depressive and anxiety symptoms
- Authors:
- DIEFENBACH Gretchen J., TOLIN David F., GILLIAM Christina M.
- Journal article citation:
- International Journal of Geriatric Psychiatry, 27(8), August 2012, pp.828-835.
- Publisher:
- Wiley
This study examined the independent contributions of depressive and anxiety symptoms to quality of life among older adults who were in receipt of a home care program. Participants were 66 community-dwelling older adults (ages 65 years and older), living in the northwestern United States who were experiencing chronic medical illness and concomitant functional disability. They completed self-report measures of depression, anxiety, and health-related quality of life. Additional data on cognitive, health, and functional status were collected for use as covariates. The associations of depressive symptoms with quality of life impairments in home care were substantial and pervasive. Depressive symptoms were significantly associated with quality of life impairments in nearly all domains. After controlling for depressive symptoms, anxiety symptoms accounted for additional and statistically significant variance in impaired life quality in the domains of mental health, role emotional functioning, and bodily pain. The results show that depressive and anxiety symptoms have negative associations with life quality among older adults receiving home care. The authors highlight the importance of developing community-based programs to assess and treat depressive and anxiety symptoms among home care clients.
Enabling older people to stay at home: the costs of substituting and supplementing care with assistive technology
- Authors:
- GOODACRE Kate, et al
- Journal article citation:
- British Journal of Occupational Therapy, 71(4), April 2008, pp.130-140.
- Publisher:
- Sage
A wide-ranging multiprofessional research project explored issues relating to the introduction of assistive technology into the existing homes of older people in order to provide them with the opportunity to remain at home. The financial relationship between assistive technology and packages of formal care was also explored. The costs of residential care and those of a number of packages containing differing quantities of assistive technology, formal care and informal care were compared. The analyses provide a strong financial case for substituting and/or supplementing formal care with assistive technology, even for individuals with quite disabling conditions. Although needs and hence the cost of provision rise with an increasing level of disability, the savings in care costs accrue quickly. The consideration of a variety of users with different needs and informal care provision, and occupying a very wide range of housing, leads to the conclusion that in comparison with traditional care packages, at worst, incorporating significant amounts of assistive technology into care packages is cost neutral, but that with careful specification of assistive technology major savings are feasible.
ICT in the elderly and dementia
- Author:
- NUGENT I. C.
- Journal article citation:
- Aging and Mental Health, 11(5), September 2007, pp.473-476.
- Publisher:
- Taylor and Francis
The use of Information and Communication Technology (ICT) can be used in a number of ways to improve the living experience and quality of life of people within their home environment and beyond. It is perhaps possible to consider three distinct areas in which ICT may be successfully deployed. In the first instance ICT can be used to accommodate or support the ongoing needs of a person during their normal day-to-day activities, for example reminding systems for medication management. Alternatively, ICT can be used to provide access to information content on how to manage a specific medical problem. In the second instance ICT can be to used provide restoration or improvement of a given function, for example by motivating people to have increased levels of physical activity as a form of rehabilitation Thirdly and finally, ICT can be used as a preventative measure, for example, to detect the likely onset of a clinical condition and subsequently provide an increased amount of time to provide an intervention prior to exacerbation of a disease.
Older people
- Author:
- MANTHORPE Jill
- Journal article citation:
- Research Matters, 2005, pp.37-42.
- Publisher:
- Community Care
This article reports on studies from four continents into age discrimination in the workplace, home care support and mental health issues give valuable pointers for UK practice.