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Deliberate self-harm in older adults: a review of the literature from 1995 to 2004
- Authors:
- CHAN Jenifer, DRAPER Brian, BANERJEE Sube
- Journal article citation:
- International Journal of Geriatric Psychiatry, 22(8), August 2007, pp.720-732.
- Publisher:
- Wiley
In 1996 Draper reviewed critically the evidence on attempted suicide in old age in the 10 years between 1985 and 1994. The review highlighted a need for prospective controlled studies in older people with more representative samples as well as studies examining the interaction of risk factors, precipitants, motivations, psychopathology and response to treatment. The aim of this paper is to update this review and to summarise the advances in our understanding of DSH in later life. Relevant studies published between 1995 and 2004 are critically reviewed to summarise advances in the understanding of factors associated with deliberate self-harm in later life. The main advances in understanding have been to clarify the effect of personality and cultural factors, service utilisation pre and post attempt, and the (lesser) impact of socio-economic status and physical illness. Methodological weaknesses continue to include inadequate sample sizes performed on highly selected populations, inconsistent age criteria and lack of informant data on studies relating to role of personality. The authors conclude that future studies should include prospective, cross-cultural research with adequate sample sizes and which are population-based. Such approaches might confirm or refute the results generated to date and improve knowledge on factors such as the biological correlates of deliberate self-harm, service utilisation, costs and barriers to health care, and the interaction of these factors. Intervention studies to elucidate the impact of modifying these factors and of specific treatment packages are also needed.
Readmissions - an evaluation of reasons for unplanned readmissions of older people: a United Kingdom and international studies literature review
- Author:
- DOBRZANSKA Linda
- Journal article citation:
- Quality in Ageing, 5(4), December 2004, pp.20-28.
- Publisher:
- Pier Professional
- Place of publication:
- Brighton
A literature review study used to research the causes for unplanned readmissions of older patients. The evidence was produced using a wide geographic of sources from electronic databases dated 1990-2003. In total, 92 articles were identified. From these, 83 papers were selected which met the inclusion criteria and corresponded to the aims of the review. The author found that many international studies were inconsistent in their approach to defining terms. Yet despite this, in the United Kingdom researchers generally agreed that the reason for the majority of readmissions was a result of a relapse or complication of an initial illness. Furthermore, Amercian studies reveal that the readmission of older patients is caused by a specific disease and the antecedent care process.
Post-hospital falls incidence and risk factors among older adults: a systematic review and meta-analysis
- Authors:
- QIAN Xing Xing, et al
- Journal article citation:
- Age and Ageing, 51(1), 2022, p.afab209.
- Publisher:
- Oxford University Press
Background: Post-hospital falls constitute a significant health concern for older adults who have been recently discharged from the hospital. Objectives: To systematically summarise existing evidence on the incidence and risk factors for post-hospital falls among older adults. Methods: A systematic review and meta-analysis was conducted. Six electronic databases were searched to identify cohort studies investigating the incidence and risk factors for post-hospital falls in older adults. The incidence and risk factors for post-hospital falls were extracted. The meta-analysis was used to calculate pooled incidences and 95% confidence intervals (CI). The meta-regression and subgroup meta-analysis were conducted to explore sources of heterogeneity in incidence proportions across the eligible studies. A qualitative synthesis was performed for the post-hospital falls risk factors. Results: Eighteen studies from eight countries (n = 9,080,568) were included. The pooled incidence proportion of any and recurrent post-hospital falls was 14% (95% CI: 13%-15%) and 10% (95% CI: 5%-14%), respectively. Follow-up period, study quality, study country, setting, percentage of female subjects, percentage of subjects with previous falls and the primary data collection method for falls significantly contributed to the 64.8% of the heterogeneity in incidence proportions. Twenty-six risk factors for post-hospital falls were identified in the eligible studies, where biological factors were the most commonly identified factors. The highest risks were reported for previous falls, previous fractures, delirium and neurological diseases. Conclusion: The findings of this study suggested future post-hospital falls prevention should prioritise the needs of older adults with the dominant risk factors. Further investigations into the period-specific incidence and socioeconomic and environmental risk factors for post-hospital falls are also required. (Edited publisher abstract)
Improving the assessment of risk for imminent aggression in older adults in residential facilities
- Authors:
- ROBERTON Terri, DAFFERN Michael
- Journal article citation:
- Aggression and Violent Behavior, 51, 2020, p.101364.
- Publisher:
- Elsevier
Aggressive behaviour by older adults living in residential facilities occurs commonly, and negatively impacts caregivers, other residents, and sometimes visitors. A precondition of aggression prevention efforts is accurate identification of high-risk individuals and interactions. To this end, elucidation of early warning signs and specification of proximal causes, processes and high-risk interactions is critical. Structured risk assessment instruments have been shown to improve prediction of imminent aggression in inpatient mental health care settings, and these instruments have been applied to various other populations and settings; however, there is little evidence regarding their validity in older adult populations. This paper reviews literature that has sought to identify the proximal causes and processes associated with aggressive behaviour in older adults; this includes premorbid personality, cognitive impairment, language impairment, social functioning, mental health, functional dependency, sensory impairments, and pain. Given that the proximate causes and processes leading to aggression in older adults seem to differ in subtle ways from acute mental health inpatients, further examination (and possible modification) of existing risk assessment instruments for use in older adults is warranted. This paper identifies six factors that may improve utility and predictive validity when applying extant risk assessment instruments with older adults in residential facilities: confusion/disorientation, resistiveness to care, social disengagement, fear, symptoms of depression, and uncontrolled pain or discomfort. (Edited publisher abstract)
The relation between social isolation and increasing suicide rates in the elderly
- Authors:
- HEUSER Christoph, HOWE Jurgen
- Journal article citation:
- Quality in Ageing and Older Adults, 20(1), 2019, pp.2-9.
- Publisher:
- Emerald
Purpose: Suicidal attempts and thoughts are particularly relevant to the health of the elderly and can impact not only the individual, but family, friends and spouses as well. This topic is important for the gerontological research community, particularly as it relates to social isolation and the feeling of loneliness, common in this population group. The purpose of this paper is to investigate new knowledge about the relationship between an increased risk of suicide in the elderly and social isolation or loneliness. Design/methodology/approach: An extensive search was conducted to find relevant studies to answer the research question. Database research was done in PubMed and PsycINFO for relevant studies within the last 10 years. The title and abstract of relevant articles were screened before the full-text was acquired. Findings: In PubMed 163 studies were identified, and in PsycINFO 66 studies were identified. After a thorough screening, nine studies were found to be appropriate for this study. Originality/value: It is not clear which risk factor leads to an increase in suicidal thoughts and attempts, however most studies contemplated loneliness and isolation as a covariant. A causal link between the concepts is not simple. Nevertheless, loneliness and isolation seem to be relevant factors for suicidal ideations. (Edited publisher abstract)
Elder mistreatment in South Asian communities: a review of the literature
- Authors:
- TALPUR Ashfaque Ahmed, et al
- Journal article citation:
- Journal of Adult Protection, 20(5/6), 2018, pp.193-206.
- Publisher:
- Emerald
Purpose: The purpose of this paper is to perform a review of the literature of empirical studies on elder mistreatment (EM) in South Asians, and to discuss key implications for policy, practice and research. Design/methodology/approach: For this review, multiple electronic databases in the international health and social science were searched and supplemented by grey literature and cross-references. Quality of papers was assessed by two authors against the standard checklists. Findings: In total, 16 studies met the inclusion criteria of this review, of which 11 were cross-sectional design, and only six of them used standard instruments to measure EM. The prevalence estimates of overall EM retrieved from general population-based studies ranged from 9.3 per cent in India to 49.1 per cent in Nepal. Age, gender, residential settings, socioeconomic status, health, education, and social structures and processes were key risk factors for EM in South Asian communities. Reporting and action taking were culturally rooted. Originality/value: While the review is not systematic, there are limitations associated with the paper in covering the diverse range of databases and studies. However, this review provides a valuable synthesis of the empirical papers on the incidence, culturally specific risk factors and reporting trends of EM in South Asians. Additionally, the review presents the papers evaluated for a quality to ensure the validity of empirical data. Finally, the review includes several implications for policy, practice and future research on EM which may ultimately contribute in improving the health and wellbeing of elder South Asians. (Publisher abstract)
Suicide in later life: public health and practitioner perspectives
- Authors:
- MANTHORPE Jill, ILIFFE Steve
- Journal article citation:
- International Journal of Geriatric Psychiatry, 25(12), December 2010, pp.1230-1238.
- Publisher:
- Wiley
A selective review of English language literature focusing on the epidemiology of suicide among older people was conducted. Papers were selected for their ability to shed light on the potential for prevention and practice from public health perspectives. The study found that whilst the majority of older people who commit suicide have major depression, suicide seems to be due to a combination of personality factors and co-morbidities, including chronic pain and disablement. It also found that there is little information about the involvement of older people in risk reduction or about harm minimisation approaches at patient and public participation levels. The authors conclude that practitioners need to be aware of risk factors for suicide in later life, and that public health approaches combined with practitioners' experiences of older people at risk may help minimise the risks of suicide in later life.
Elder abuse risk indicators and screening questions: results from a literature search and a panel of experts from developed and developing countries
- Authors:
- ERLINGSSON Christen L., CARLSON Sharon L., SAVEMAN Britt-Inger
- Journal article citation:
- Journal of Elder Abuse and Neglect, 15(3/4), 2003, pp.185-203.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
In order to examine and compare expert opinions from elder abuse literature on risk indicators and screening questions to perspectives of experts from both developed and developing countries, a literature search was combined with a modified Delphi process involving 17 panel members. Each method resulted in a consensus on 48 risk indicators. These shared only 35% content. Each method also resulted in a consensus on screening questions: Thirteen questions for the literature search and nine for the Delphi panel. There were divergences between Delphi panel participants' responses from developed and developing countries indicating that more research is needed in developing countries. (Copies of this article are available from: Haworth Document Delivery Centre, Haworth Press Inc., 10 Alice Street, Binghamton, NY 13904-1580)
Risk factors for falls: a central role in prevention
- Authors:
- RUBENSTIEN Laurence Z., JOSEPHSON Karen R.
- Journal article citation:
- Generations, 26(4), Winter 2002, pp.15-21.
- Publisher:
- American Society on Aging
This American article reviews the risk factors for falls, highlighting the findings of relevant research. Goes on to discusses how identification of these risk factors is the core of a multidimensional fall evaluation.
- article
Risk factors for social isolation among older adults in long term care: a scoping review
- Authors:
- BOAMAH Sheila A., et al
- Publisher:
- Multidisciplinary Digital Publishing Institute
- Publication year:
- 2020
Objectives: A wealth of literature has established risk factors for social isolation among older people, however much of this research has focused on community-dwelling populations. Relatively little is known about how risk of social isolation is experienced among those living in long-term care (LTC) homes. We conducted a scoping review to identify possible risk factors for social isolation among older adults living in LTC homes. Methods: A systematic search of five online databases retrieved 1535 unique articles. Eight studies met the inclusion criteria. Results: Thematic analyses revealed that possible risk factors exist at three levels: individual (e.g., communication barriers), systems (e.g., location of LTC facility), and structural factors (e.g., discrimination). Discussion: Our review identified several risk factors for social isolation that have been previously documented in literature, in addition to several risks that may be unique to those living in LTC homes. Results highlight several scholarly and practical implications [Note: this is a preprint, not peer-reviewed] (Edited publisher abstract)