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Listening to older care-givers: research into aspirations for support
- Authors:
- SKELTON Judd, et al
- Publisher:
- Manchester Metropolitan University. Interpersonal and Organisational Development Research Group
- Publication year:
- 1997
- Pagination:
- 69p., bibliog.
- Place of publication:
- Manchester
There is a need to address the problems identified by the study through multi-sectoral policies and programmes to sustain the health of older care-givers and to maintain their ability to provide adequate care. The fact that older care givers on “24-hour call” are particularly prone to failing health comes as no surprise. Often, there is a combination of factors such as vulnerability, heavy physical demands of care and a sense of losing the quality of life. Other contributory factors are the lack of sleep and rest, the curtailment or suppression of periods of sickness and the inability of maintaining hobbies. The main indicators of negative health effects are depression, fear and a low assessment of one’s own health.
High score on the Relative Stress Scale, a marker of possible psychiatric disorder in family carers of patients with dementia
- Authors:
- ULSTEIN Ingun, WYLLER Torgier, ENGEDAL Knut
- Journal article citation:
- International Journal of Geriatric Psychiatry, 22(3), March 2007, pp.195-202.
- Publisher:
- Wiley
Compares the scores on the Relative Stress Scale (RSS) with those on the General Health Questionnaire (GHQ) and the Geriatric Depression Scale (GDS), and to establish a cut-off score for RSS in order to distinguish carers with symptoms of psychiatric disorders from those without. One hundred and ninety-four carers of 194 patients suffering from dementia according to ICD-10 were included in the study. Burden of care was assessed by the 15-items RSS, and psychiatric symptoms by means of the GHQ-30 and the 30-items GDS. A case score above 5 on GHQ and above 13 on GDS were used to define carers with probable psychiatric morbidity. Sensitivity (SS), specificity (SP), accuracy and likelihood ratio for a positive test (LR+) were calculated for different cut-points of the RSS. Fifty-six percent of the carers had a GHQ score above 5, and 22% had a GDS score above 13. A two-step cluster analysis using 192 of the 194 carers, identified three groups of carers; a low risk group for psychiatric morbidity (LRG), 82 carers with GHQ 5 and GDS 13; a medium risk group (MRG), 69 carers with GHQ > 5 and GDS 13; and a high-risk group (HRG), 40 carers with GHQ > 5 and GDS > 13. The optimal RSS cut-off to distinguish between the LRG and the others was > 23, whereas the optimal cut-off to separate the HRG from the others was >30. The RSS is a useful instrument to stratify carers according to their risk of psychiatric morbidity.
Older adults' health and changes in late-life drinking patterns
- Authors:
- MOOS R. H., et al
- Journal article citation:
- Aging and Mental Health, 9(1), January 2005, pp.49-59.
- Publisher:
- Taylor and Francis
This study focused on the prospective associations between older adults' health-related problems and their late-life alcohol consumption and drinking problems. A sample of 1,291 late-middle-aged community residents (55-65 years old at baseline) participated in a survey of health and alcohol consumption, and was followed one year, four years, and 10 years later. Health-related problems increased and alcohol consumption and drinking problems declined over the 10-year interval. Medical conditions, physical symptoms, medication use, and acute health events predicted a higher likelihood of abstinence and less frequent and lower alcohol consumption. However, overall health burden predicted more subsequent drinking problems, even after controlling for alcohol consumption and a history of heavy drinking and increased drinking in response to stressors. Among older adults, increased health problems predict reduced alcohol consumption but more drinking problems. Older adults with several health problems who consume more alcohol are at elevated risk for drinking problems and should be targeted for brief interventions to help them curtail their drinking.
Gender differences in the contributions of risk factors to depressive symptoms among the elderly persons dwelling in a community, Japan
- Authors:
- KATSUMATA Yuriko, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 20(11), November 2005, pp.1084-1089.
- Publisher:
- Wiley
The aim was to examine the relative importance of risk factors associated with depressive symptoms and gender differences in exposure to the risk factors among the elderly persons living in the community. The data came from the Minamifurano-town Aging Study, a community-based sample of non-institutionalized elderly persons aged 65 years or older. Of the 731 eligible subjects, 665 were assessed for four domains of the potential risk factors (demographic characteristics, health and disability, stress, and social networks) and depressive symptoms according to the 30-item Geriatric Depression Scale (GDS). The mean overall GDS-score was 10.9 (SD 6.2), 10.2 (SD 6.0) in men and 11.6 (SD 6.4) in women. The stress domain in men and the health and disability domain in women contributed most to the explanation of the variation in the GDS-score. Stress for men and health and disability status for women were important factors associated with depressive symptoms. Future studies should determine whether modification of these factors may prevent depression among the elderly persons living in the community.
Caregiver comorbidity and the ability to manage stress
- Authors:
- PARRISH Monique, ADAMS Sarah
- Journal article citation:
- Journal of Gerontological Social Work, 42(1), 2003, pp.41-57.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
This analysis evaluated the hypothesis that comorbidity, as a measure of physical health status, would negatively impact the stress management capability of caregivers. To examine this relationship, data from 3,112 caregivers participating in the Uniform Caregiver Assessment through California's Caregiver Resource Center System in 2000 were used. Results indicated that comorbidity was not a significant predictor of caregiver inability to manage stress; however, high depression scores, disruptive behavior by the care receiver, and reduced social support from family and friends were significantly associated. Implications for social workers in these areas are discussed. (Copies of this article are available from: Haworth Document Delivery Centre Haworth Press Inc., 10 Alice Street Binghamton, NY 13904-1580)
Self-efficacy, health locus of control, and psychological distress in elderly Chinese women with chronic illnesses
- Authors:
- WU A. M. S., YANG C.S. K., KWOK C. .
- Journal article citation:
- Aging and Mental Health, 8(1), January 2004, pp.21-28.
- Publisher:
- Taylor and Francis
This study examined the associations among self-efficacy, health locus of control, and psychological distress in 159 elderly Chinese women who had chronic physical illnesses. The present findings did not support the dual health control hypothesis that specifies the balance between internal and external health control beliefs is related to a low level of psychological distress. Correlation results showed that internal health locus of control was linked to general self-efficacy. Results from hierarchical regression analysis indicated that health control beliefs did not interact with general self-efficacy; instead, these two variables each exerted their main effects on participants' negative mental health status. It was found that psychological distress was best predicted by a low level of general self-efficacy as well as a high level of external health locus of control. Internal health control beliefs did not contribute to the prediction of distress. Implications and limitations of this study were also discussed.
Extending a helping hand
- Authors:
- SIMIC Paul, LAMBAT Ismail
- Journal article citation:
- Community Care, 2.10.97, 1997, p.23.
- Publisher:
- Reed Business Information
There is a popular misconception that Asian extended families always 'look after their own'. The authors describe a project which aims to support Asian families and prevent the abuse which can arise under stress.
Briefing: the health and care of older people in England 2015
- Authors:
- MORTIMER Jill, GREEN Marcus
- Publisher:
- Age UK
- Publication year:
- 2015
- Pagination:
- 59
- Place of publication:
- London
Briefing paper which presents the latest statistical data on older people's health and care needs and the provision of health and care services in England. It reports on an ageing population with a rising prevalence of people with long term conditions and multiple health conditions. It examines trends in health and social care funding and looks at the implications of cuts to social care on older people. It also looks at the use of health and care services to investigate whether the health and care system is meeting the needs of older people in England. It reports that unmet need is rising with over a million older people in England now have at least one unmet need for social care, compared to 800,000 in 2010. It also highlights the stresses that exist in the primary care, community care and acute sector. Data shows there is an increase in the number of emergency admissions and readmissions in hospitals and the pattern of demand on primary services has intensified, with the number of times an older person visits a GP practice has increased from seven to 13 on average in just 13 years. The briefing concludes that there is a need to change the funding of the health and social care system for older people if their needs to be met in the future. (Edited publisher abstract)
Midlife and older gay men living with HIV/AIDS: the influence of resiliency and psychosocial stress factors on health needs
- Authors:
- KING Shawn D., OREL Nancy
- Journal article citation:
- Journal of Gay and Lesbian Social Services, 24(4), October 2012, pp.346-370.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
HIV/AIDS research has mostly focused on younger gay men. However, the population of older gay men living with HIV/AIDS continues to increase at a rapid rate. The aim of this study was to investigate the physical and mental health outcomes for midlife and older gay men living with HIV/AIDS, and the influence that coping and psychosocial stress factors have on their utilisation of health and social services. This cross-sectional study originated from a larger study of 316 gay men aged 45 years and older and includes a subsample of 38 participants living with HIV/AIDS. An online survey questionnaire explored physical and mental health service utilisation rates, including physical and mental health status. Resiliency, internal health locus of control beliefs, and psychosocial stressors of age and sexual orientation discrimination, stigma, and internalised homophobia were also examined. The findings show that 65.8% of the HIV/AIDS participants had received no mental health services the past year, despite reporting higher mental health distress. Of those reporting an HIV status, 10.5% indicated having no health visits in the preceding year and more delays in seeking care when needed and unmet health needs for which services were not sought. Participants reporting higher resiliency indicated less mental health distress and better health access indicators. Stigma and internalised homophobia negatively affected resiliency. Implications for practitioners working with midlife and older gay men are discussed.
Effects of an automated telephone support system on caregiver burden and anxiety: findings from the REACH for TLC intervention study
- Authors:
- MAHONEY Diane Feeney, TARLOW Barbara J., JONES Richard N.
- Journal article citation:
- Gerontologist, 43(4), August 2003, pp.556-567.
- Publisher:
- Oxford University Press
The authors sought to determine the main outcome effects of a 12-month computer-mediated automated interactive voice response (IVR) intervention designed to assist family caregivers managing persons with disruptive behaviors related to Alzheimer's disease. Researchers conducted a randomized controlled study of 100 caregivers, 51 in the usual care control group and 49 in the technology intervention group, who received yearlong access to an IVR-mediated system. The system provided caregiver stress monitoring and counseling information, personal voice-mail linkage to AD experts, a voice-mail telephone support group, and a distraction call for care recipients. The authors conducted analyses by using a repeated measures approach for longitudinal data and an intention-to-treat analytic approach. Outcomes included the caregiver's appraisal of the bothersome nature of caregiving, anxiety, depression, and mastery at baseline, 6, 12, and 18 months. There was a significant intervention effect as hypothesized for participants with lower mastery at baseline on all three outcomes: bother (p =.04), anxiety (p =.01), and depression (p =.007). Additionally, wives exhibited a significant intervention effect in the reduction of the bothersome nature of caregiving (p =.02). Wives who exhibited low mastery and high anxiety benefited the most from the automated telecare intervention. Findings suggest that, to optimize outcome effects, similar interventions should be tailored to match the users' characteristics and preferences.