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The heterogeneity of socially isolated older adults: a social isolation typology
- Author:
- MACHIELSE Anja
- Journal article citation:
- Journal of Gerontological Social Work, 58(4), 2015, pp.338-356.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
Recent statistics show a growing number of older adults who are living alone and are socially isolated. It is against this background that, in recent years, many interventions have been developed to address social isolation among the elderly. Evaluative studies show that most interventions are hardly effective, though. An important reason for this is the heterogeneity of the socially isolated. This article offers insight into this heterogeneity by presenting a typology with different profiles of socially isolated older adults and the intervention implications of this typology. The typology is derived from an extensive qualitative study on socially isolated elderly individuals in the Netherlands. The typology imposes some degree of order to a diversity of circumstances, ambitions, and possibilities of the socially isolated elderly, thereby deepening the understanding of the heterogeneity of this population. The definition of social isolation used in this study starts from a societal angle of incidence, namely the current policy context of Western European welfare states, in which governments emphasize the importance of independence and self-reliance of their citizens. Developed from that perspective, the typology provides a theoretical basis for applying interventions aimed at increasing self-reliance of social isolated elderly. This perspective on social isolation also has consequences for the way in which the effectiveness of interventions to alleviate social isolation is assessed. (Publisher abstract)
Do care homes increase risk of dehydration?
- Author:
- DIX Ann
- Journal article citation:
- Nursing Times, 111(34/35), 2015, p.15.
- Publisher:
- Nursing Times
This article summarises key findings from a recent study by A. Wolf published in the Journal of Royal Society of Medicine which compared dehydration levels of older hospital patients arriving from care homes with those living in their own homes. Laboratory data was used to assess whether patients were dehydrated on admission and whether they subsequently died in hospital. The results found that older people living in care home were 10 time more likely to be admitted to hospital with dehydration than patients who lived in their own homes. (Edited publisher abstract)
Detecting dehydration in older people: useful tests
- Authors:
- HOOPER Lee, BUNN Diane
- Journal article citation:
- Nursing Times, 111(32/33), 2015, pp.12-16.
- Publisher:
- Nursing Times
Dehydration is common in older people, leading to longer hospital stays and increased disability and mortality. This article looks at known risk factors, signs and screening and diagnostic tests that nurses can use to detect dehydration in older people. It also outlines evidence on how useful they have proven to be. The article concludes that there is limited evidence that any clinical, test or question is useful in screening for dehydration in older people, though knowledge of risk factors may be helpful in targeting more vulnerable groups. (Edited publisher abstract)
Completed suicide among nursing home residents: a systematic review
- Authors:
- MURPHY Briony J., et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 30(8), 2015, pp.802-814.
- Publisher:
- Wiley
Objective: This systematic review examines published research describing the frequency, nature, and contributing factors of completed suicides among nursing home residents. Methods: The review examined all original, peer-reviewed literature published in English between 1 January 1949 and 31 December 2013 describing completed suicides among nursing home residents. Information extracted for analysis included: study and population characteristics, method of suicide, potential risk factors, and interventions. Results: Eight studies were identified; the majority (n = 5) conducted in the United States of America. There were 113 suicides in nursing homes reported in the literature, 101 with detailed information available for aggregate analysis. The majority were male (n = 62, 61.4%), aged between 61 and 93 years. Suicide was most commonly by hanging (n = 27, 38.0%) or falling from a height (n = 27, 38.0%). Risk factors were considered in a proportion of studies. Depression was examined in 27 cases and present in 18 (67%). Duration of residence was examined in 25 cases, 13 (52%) of which had resided in the nursing home less than 12 months. Physical health was examined in 22 cases, 11 (50%) of whom were experiencing physical decline. Prior suicidal behaviour, cognitive function, and personal loss were also examined. Organizational risk factors and intervention strategies were rarely considered. Conclusions: There is a paucity of research describing completed suicide among nursing home residents. More large-scale research is required using standardised methods for reporting information to better understand and prevent completed suicides in this setting. (Edited publisher abstract)
Do prescribed medicines affect falls risk?
- Author:
- PARKIN Angela
- Journal article citation:
- Nursing Times, 111(25), 2015, p.25.
- Publisher:
- Nursing Times
Falls and fall related injuries are a common problem for older people. This article comments on evidence from a Swedish population-based, case-controlled study (See related link from the European Journal of Public Health), which has reconsidered the risk of falls associated with commonly prescribed medicines. (Edited publisher abstract)
Financial abuse: evidence review
- Authors:
- DAVIDSON Susan, ROSSALL Phil
- Publisher:
- Age UK
- Publication year:
- 2015
- Pagination:
- 31
- Place of publication:
- London
This report summarises what research says about the financial abuse of older people. It looks at who is at risk, who the perpetrators are, the impacts, and the barriers against recognition and action on financial abuse. It also looks at the problems faced by people with dementia and carers when managing money, and the impact of cultural values on determining behaviour. The challenges and possible preventative measures for professionals who work with older people, not only in financial institutions but also health and care staff, are also covered. The appendices list suggested measures for the prevention and detection of financial abuse (Edited publisher abstract)
Associations between falls and general health, nutrition, dental health and medication use in Swedish home-dwelling people aged 75 years and over
- Authors:
- FONAD Edit, et al
- Journal article citation:
- Health and Social Care in the Community, 23(6), 2015, p.594–604.
- Publisher:
- Wiley
The vast majority of elderly people in Sweden live in private homes in their communities for as long as possible. Poor health and a high risk of falls are very common among this group. This cross-sectional study investigates the association between falls and general health, appetite, dental health, and the use of multiple medications among home-dwelling men and women aged ≥75 years. Data were collected between October 2008 and March 2009 using a postal questionnaire. A total of 1243 people participated in the questionnaire survey (74% response rate), of which 1193 were included in the analysis. The majority of participants were women (n = 738, 62%). Falls in the previous 12-month period were reported by 434 (36%) participants. Most fallers (n = 276, 64%) were women. The majority of the fallers lived in a flat (n = 250, 58%). Poor health (aOR: 1.61; CI: 1.34–1.95), poor dental health (aOR: 1.22; CI: 1.07–1.39) and the use of four or more types of medication daily (aOR: 1.13; CI: 1.03–1.25) were significantly associated with falls in all participants. Poor dental health was found irrespectively of living in a flat (aOR: 1.23; CI: 1.04–1.46) or living in a house (aOR: 1.28; CI: 1.02–1.61), and both were significantly associated with falls. The use of more than four different types of medication daily (aOR: 1.25; CI: 1.11–1.41) was associated with falls for those living in a flat. The results highlight that falls are associated with poor general health, poor dental health and the use of four or more types of medication daily. Health professionals should provide health promotion education and investigate dental health and risk factors for oral disease. Likewise, medical and clinical practices of physicians and community care nurses should include assessing the risk of falling, and treatment that predisposes falls. (Publisher abstract)
The meaning of the experience of anticipating falling
- Authors:
- SHAW James A., CONNELLY Denise M., MCWILLIAM Carol L.
- Journal article citation:
- Ageing and Society, 35(9), 2015, pp.2011-2025.
- Publisher:
- Cambridge University Press
Falling in later life continues to be a critical issue in gerontology research, health professional practice and ageing health policy. However, much research in the area of fall risk and fall prevention neglects the meaning of the experiences of older people themselves. This humanistic interpretive phenomenological study explored the meaning of the experience of anticipating falling from the perspective of older people in order to foster a more person-focused approach to fall risk assessment and fall prevention. Individual semi-structured interviews were conducted with nine participants over the age of 65 living independently in the community. Follow-up interviews with two key informants were completed to inform the emerging interpretations. For older participants residing in the community, the experience of anticipating falling meant confronting their embodied lived-identity in the context of ageing. Experiential learning shaped how participants understood the meaning of falling, which constituted tacit, pathic knowledge of vulnerability and anxiety with respect to falling. Findings emphasise the importance of critically reflecting on the social experience of anticipating falling to develop effective and relevant fall prevention interventions, programmes and policies. A lifeworld-led approach to fall risk assessment and fall prevention resonates with these findings, and may encourage health-care providers to adopt a sustained focus on embodied lived-identity and quality of life when engaging older people in fall prevention activities. (Publisher abstract)
Changes in vision in older people: causes and impact
- Authors:
- NAZROO James, WHILLANS Jennifer, MATTHEWS Katey
- Publisher:
- Thomas Pocklington Trust
- Publication year:
- 2015
- Pagination:
- 7
- Place of publication:
- London
Summarises findings from research using data from the English Longitudinal Study of Ageing (ELSA) to look at the links between development of visual impairment and older peoples’ social and economic position, and the impact of both deteriorating and improving sight on key aspects of their lives. Findings are presented in the following areas: the relationship between self-reports and objective measures of vision; the relationship between wealth, social status and developing visual impairment; other risk factors for developing visual impairment; uptake of cataract surgery; and consequences of change in vision. The findings showed that older people in the poorest fifth of the population had an almost 80% higher risk of developing severe visual impairment than those from the wealthiest fifth. Deterioration in vision over a two year period was also related to decreases in income, quality of life and social activity. People whose vision deteriorated from good or very good to fair or poor were found to have levels of depression that increased by 29% and a fall in income levels of 19%, compared to the changes for those whose vision remained stable. (Edited publisher abstract)
A review of literature exploring the possible causes of abuse and neglect in adult residential care
- Authors:
- HUTCHISON Andrew, KROESE Biza Stenfert
- Journal article citation:
- Journal of Adult Protection, 17(4), 2015, pp.216-233.
- Publisher:
- Emerald
Purpose: The purpose of this paper is to present a systematic review of empirical research, which explores possible causal and risk factors linked to abuse or neglect in residential care facilities. Design/methodology/approach: Electronic database searches were conducted to identify and synthesise studies reporting on empirical research aimed at exploring causal and/or risk factors associated with abuse or neglect in adult residential care services. Sample characteristics, design characteristics and outcome data were extracted from each paper. This information was then collated and summarised. Each study was evaluated using Sale and Brazil’s (2004), cross-paradigm framework of trustworthiness and rigour. Findings: In all, 17 papers, reporting on 15 separate research studies, met the inclusion criteria for this review. Results revealed that research in this area has utilised a diverse range of methodological approaches to explore abuse and/or neglect within the context of residential services for older adults and adults with learning disabilities. Possible causal and risk factors identified were separated into those that operated at a cultural or organisational/environmental level and those that operated at an individual or interpersonal level. Originality/value: While there are limitations associated with presenting a review of such a diverse group of studies, this paper presents a valuable synthesis of the empirically derived causal and risk factors linked to the abuse and neglect of adults in care. Additionally, readers are able to obtain a comprehensive overview of the quality of empirical research in this area. Finally, a number of applied implications and future research directions are highlighted, which may contribute to the development of further research and ultimately to improvements in residential care standards and a reduction in future instances of abuse and neglect.