Search results for ‘Subject term:"older people"’ Sort:
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The transition to living alone and psychological distress in later life
- Authors:
- STONE Juliet, EVANDROU Maria, FALKINGHAM Jane
- Journal article citation:
- Age and Ageing, 42(3), 2013, pp.366-372.
- Publisher:
- Oxford University Press
Background: Living alone in later life has been linked to psychological distress but less is known about the role of the transition into living alone and the role of social and material resources. Methods: A total of 21,535 person-years of data from 4,587 participants of the British Household Panel Survey aged 65+ are analysed. Participants provide a maximum 6 years' data (t0−t5), with trajectories of living arrangements classified as: consistently partnered/ with children/alone; transition from partnered to alone/with children to alone. General Health Questionnaire (GHQ)-12 caseness (score >3) is investigated using multi-level logistic regression, controlling for sex, age, activities of daily living, social and material resources. Results: After a transition from partnered at t0 to alone at t1, the odds for GHQ-12 caseness increased substantially, but by t3 returned to baseline levels. The odds for caseness at t0 were highest for those changing from living with a child at t0 to living alone at t1 but declined following the transition to living alone. None of the covariates explained these associations. Living consistently alone did confer increased odds for caseness. Conclusions: Living alone in later life is not in itself a strong risk factor for psychological distress. The effects of transitions to living alone are dependent on the preceding living arrangement and are independent of social and material resources. This advocates a longitudinal approach, allowing identification of respondents' location along trajectories of living arrangements. (Publisher abstract)
Ageing and lesbian, gay and bisexual relationships
- Authors:
- KNEALE Dylan, et al
- Journal article citation:
- Working with Older People, 18(3), 2014, pp.142-151.
- Publisher:
- Emerald
Purpose: The purpose of this paper is to explore how minority stress and the experience of societal level hostility towards lesbian, gay and bisexual (LGB) people and their relationships may have impacted upon their relationships and relationship histories. Design/methodology/approach: This paper introduced the minority stress framework and examines the relationship histories of a small cohort aged 50 at the last sweep of data collection. Findings: The minority stress framework states that societal level hostility will lead to unequal treatment and psychological distress among minority groups, which could impact on their relationships histories. In these data, those people we identify as being LGB were significantly more likely to have had a higher number of cohabiting partnerships, were less likely to have had longer-term cohabiting relationships, and were less likely to be in a relationship at age 50. This is despite LGB people placing an equal importance on partnership and marriage. These results are accompanied by caveats, but the authors conclude that if minority stress does impact upon relationships, it is upon the stability and length of relationships. Practical implications: Compared to older LGB couples, opposite sex couples, are more likely to have been in receipt of peer and especially familial support for their relationship, particularly around times of relationship crisis. Additionally, for those same sex couples that did approach professional sources of support, such as couple counselling, heteronormative and even hostile attitudes from counselling providers may have meant that experienced and informed support was not available when needed. The findings therefore pose a challenge to service providers to ensure that relationship support and allied services are available and adapted to meet the needs of older LGB people, whose previous contacts with these service providers may have been substantially less than positive, and whose need for relationship support may be greater. Originality/value: The needs of older LGB people and their relationships are often overlooked. The use of a small sample of cohort data to examine these issues provides new insight into the way in which older LGB people may age differently to non-LGB people. (Publisher abstract)
A grounded theory longitudinal study of carers’ experiences of caring for people with dementia
- Authors:
- LIN Mei-Chun, MACMILLAN Maureen, BROWN Norrie
- Journal article citation:
- Dementia: the International Journal of Social Research and Practice, 11(2), March 2012, pp.181-197.
- Publisher:
- Sage
Provision of care for older people with dementia in the UK is shifting from institutions to the community. This, coupled with increased longevity, is increasing the burden on, and reducing the autonomy of, those who care for these individuals. This longitudinal, grounded approach study sought to identify, describe and explore the changes in the carers’ experiences, autonomy and health over time. Six spouses (mean age 69 years, 6-10 years caring since diagnosis) were interviewed at the beginning, at six months and at eighteen months. Four themes emerged; my life changed, commitment, responsibility and duty, and support. The core category “my life changed” represented the beginning of the caregiving journey and the learning from experience that occurred as a consequence. “Commitment” referred to a deepened and sustained element. “Responsibility and duty” increased over time and “support” reflected the fluctuating nature of help provided by formal and informal sources. All participants experienced changes on their caregiving journey but the degree and nature of necessary adaptations varied. The authors conclude that a theory of caring emerged, but the changes did not appear to conform to any fixed pattern. All carers learned by experience to manage their situations. Autonomy and health was challenged in every case.
Mindfulness and older people: a small study
- Authors:
- MARTIN Marion, DOSWELL Sinikka
- Journal article citation:
- British Journal of Occupational Therapy, 75(1), January 2012, pp.36-41.
- Publisher:
- Sage
There is a growing body of evidence that mindfulness can improve health and wellbeing. However there is relatively little research examining how older people respond to mindfulness-based therapy and few papers on the subject published by occupational therapists. This small research study was carried out with four older people who attended mindfulness classes run by an occupational therapist for Age UK. Focus groups took place during the classes, and follow-up interviews were carried out a year later. Interpretative qualitative analysis was used to analyse the data. All four participants readily accepted this approach, believing it was especially suited to their age group. Although they all reported positive experiences during the classes, one year on they were either too ill to be interviewed or found that distracting life events had prevented them from continuing to be mindful. As a group older people may find informal mediation during everyday activities easier than formal mediation. The authors conclude that mindfulness-based therapy with older people may have some benefits but more research is needed in this area.
Do improvements in emotional distress correlate with becoming more mindful? A study of older adults
- Authors:
- SPLEVINS Kate, SMITH Alistair, SIMPSON Jane
- Journal article citation:
- Aging and Mental Health, 13(3), May 2009, pp.328-335.
- Publisher:
- Taylor and Francis
The study aimed (1) to investigate changes in older adults' emotional wellbeing (specifically depression, anxiety and stress levels) and mindful ability following a mindfulness-based cognitive therapy (MBCT) course; (2) to explore correlations between mindfulness (measured as an overall ability and as individual components; observe, describe, act with awareness and accept without judgement) and changes in depression, anxiety and stress levels. Twenty-two participants took an eight-week MBCT course. Levels of depression, anxiety and stress were recorded pre- and post-intervention, as was mindfulness ability (measured both as an overall ability and as individual components). Significant improvements in emotional wellbeing and mindfulness were reported post-MBCT, with large to moderate effect sizes. Increased mindfulness was moderately and significantly associated with improved emotional wellbeing. Increases on all four components of mindfulness were positively associated with greater emotional wellbeing, however only act with awareness and accept without judgement were significantly correlated (with reduced depression). Older adults in the sample reported higher scores on observe and act with awareness than other populations.
Specialist clinical assessment of vulnerable older people: outcomes for carers from a randomised controlled trial
- Author:
- VENABLES Dan
- Journal article citation:
- Ageing and Society, 26(6), November 2006, pp.867-882.
- Publisher:
- Cambridge University Press
'Caring for carers’ is high on the United Kingdom policy agenda for community care. Although recent policy advocates the provision of services directly to the carer, research suggests that an alternative way of helping carers is through targeting enhanced services towards the cared-for person. This paper reports a randomised controlled trial of the effects on carer distress of an additional specialist clinical assessment for vulnerable older people at risk of residential or nursing home placement. The sample was composed of 142 informal carers of older people, randomly assigned to receive either the additional specialist assessment or the usual social services assessment. Carers were assessed using the modified Social Behaviour Assessment Schedule (SBAS), and data were also collected on older peoples' service use throughout the study period. Regression analyses indicated that changes in older peoples' behaviour, as opposed to carer or service-related factors, predicted changes in carer distress, and that the carers of the older people who experienced depressive symptoms received the greatest benefit from the specialist assessment. The study suggests that an effective means of improving outcomes for carers may be to target services towards the distressing behaviours of the person for whom they care, with symptoms of depression being particularly important.
Psychosocial benefits of solitary reminiscence writing: an exploratory study
- Authors:
- ELFORD H., et al
- Journal article citation:
- Aging and Mental Health, 9(4), July 2005, pp.305-314.
- Publisher:
- Taylor and Francis
Claims have been made that reminiscence has benefits for older people's psychological well-being, and that writing memories may be a therapeutic process. This paper describes an exploratory study in which five nursing home residents engaged in a process of writing their memories by themselves, in a series of booklets containing memory prompts and photographs, over a period of four weeks. Each completed booklet was typed up by researchers and returned to participants the following week, with a bound copy provided to participants at the end of the study period. Analysis focuses on two sets of data: an in-depth case study of one participant, and a thematic analysis of field notes, researcher reflections, and the written material produced by the other study participants. The case study revealed three main themes: views on the past; sharing the past; and confidence in writing about the past. The field note analysis indicated the presence of four themes: proof and maintenance of skills; psychological or internal processes; social contact; and pleasure in reminiscence. The writing was seen as cathartic and provided a meaningful purpose, an opportunity to exercise writing skills and memory, and a focus for participants to share key stories with others. This exploratory study suggests that there is potential in using solitary writing within a reminiscence framework to improve psychological well-being in older people. However, caution should be exercised when encouraging older people to write their stories. Issues of confidentiality, audience, support, and appropriateness of the activity for the individual need consideration.
Burnout in UK care home staff and its effect on staff turnover: MARQUE English national care home longitudinal survey
- Authors:
- COSTELLO Harry, et al
- Journal article citation:
- Age and Ageing, 49(1), 2020, p.74–81.
- Publisher:
- Oxford University Press
Background: staff burnout and turnover lead to care home residents receiving poorer quality care. Burnout is thought to cause turnover, but this has never been investigated. We know little about which care home staffs are burnt out. Aims: to explore burnout’s relationship with staff turnover and prevalence and predictors of burnout. Method: this study calculated the relationship between Maslach Burnout Inventory scores and future staff turnover (12-month number of staff leaving/number employed). This study explored staff, resident and care home predictors of burnout, measured as emotional exhaustion (EE), depersonalisation (DP) and personal accomplishment (PA). Results: two-thousand sixty-two care staff in 97 care home units participated. Median yearly staff turnover was 22.7%, interquartile range (IQR) 14.0–37.7%. Care staff recorded low median burnout (median EE: 14, IQR: 7–22; DP: 1, IQR: 0–5; PA 42, IQR: 36–45). This study found no association between staff burnout and turnover rate. Younger staff age was associated with higher burnout (EE coefficient − 0.09; 95% confidence interval (CI): −0.13, −0.05; DP −0.02; 95% CI: −0.04, −0.01; PA 0.05; 95% CI: 0.02, 0.08). Speaking English as a second language predicted higher EE (1.59; 95% CI: 0.32, 2.85), males had higher DP (0.02; 95% CI: 0.01, 0.04) and staff working only night shifts lower PA (−2.08; 95% CI: −4.05, −1.30). Conclusions: this study found no association between care homes staff burnout level and staff turnover rates. It is a myth that burnout levels are high. Interventions for burnout could focus on at-risk groups. Future studies could consider turnover at an individual level. (Edited publisher abstract)
Practitioners' understanding of barriers to accessing specialist support by family carers of people with dementia in distress
- Authors:
- MANTHORPE Jill, et al
- Journal article citation:
- International Journal of Care and Caring, 2(1), 2018, pp.109-123.
- Publisher:
- Policy Press
Distressing symptoms in dementia are hard to manage for many family carers. This article explores practitioners' perceptions of the barriers to accessing skilled behaviour management support encountered by carers. A survey of cases referred to the English National Health Service (n = 5,360) was followed by in-depth group discussions and practitioner interviews. Data revealed that practitioners focused on care home residents or older people with mental health problems other than dementia, rather than community-dwelling people with dementia and families. Barriers to access included misperceptions about the nature of distressing behaviour affecting carers and structural limitations in the capacity of specialist services to respond to carers. (Publisher abstract)
Carers for older people with co-morbid cognitive impairment in general hospital: characteristics and psychological well-being
- Authors:
- BRADSHAW Lucy E., et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 28(7), 2013, pp.681-690.
- Publisher:
- Wiley
To describe the characteristics and well-being of carers of older people with mental health problems admitted to a general hospital, patients aged 70 years or older with unplanned admission to an acute general teaching hospital in the UK were screened for mental health problems. Those screened positive, together with a carer, were invited to undergo further assessment with a battery of health status measurements. Carers were interviewed to ascertain strain (caregiver strain index (CSI)), psychological distress (12-item General Health Questionnaire) and quality of life (EQ-5D). Two hundred and fifty patients were recruited to the study, of whom 180 were cognitively impaired and had carers willing to take part. After 6 months, 57 patients (32%) had died, and follow up was completed on 100 carers. Carers' own health, in terms of mobility, usual activities, and anxiety, was poor in a third of cases. At the time of admission, high carer strain was common, particularly among co-resident carers. High levels of behavioural and psychiatric symptoms at baseline were associated with more carer strain and distress. At follow-up, carer strain and distress had reduced only slightly, with no difference in outcomes for carers of patients who moved from the community to a care home. The authors conclude that hospital staff should be alert to sources of carer strain and offer carers practical advice and emotional support. Interventions are required to prevent and manage behavioural and psychiatric symptoms at the time of acute physical illness or to alleviate their effects on carers. (Edited publisher abstract)