Search results for ‘Subject term:"older people"’ Sort:
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A scoping review of treatments for older adults with substance use problems
- Authors:
- MOWBRAY Orion, QUINN Adam
- Journal article citation:
- Research on Social Work Practice, 26(1), 2016, pp.74-87.
- Publisher:
- Sage
Objectives: To identify effective treatment services for older, substance-using adults, an examination of the evidence associated with interventions for this group is presented. Methods: Using explicit, validated criteria to identify effective interventions, 22 publications were included in a review and were subject to a critical appraisal of study methodology. Results: The review identified four types of substance use treatment service settings for older adults, with mixed efficacy. These settings included (1) primary care settings or health clinics, (2) combined individual and group-based settings, (3) individual-based treatment settings, and (4) multiple treatment/multisite settings. Conclusion: Analyses of these publications revealed primary care settings or health clinic settings offered the most evidence of effective interventions, with noticeable gaps in research on interventions within other settings. Implications for social work practice and research are discussed. (Publisher abstract)
Associations between physical function, dual-task performance and cognition in patients with mild Alzheimer's disease
- Authors:
- AUE SOBOL Nanna, et al
- Journal article citation:
- Aging and Mental Health, 20(11), 2016, pp.1139-1146.
- Publisher:
- Taylor and Francis
Objective: Alzheimer's disease (AD) causes a gradual decline in cognition, limitations of dual-tasking and physical function leading to total dependence. Hence, information about the interaction between physical function, dual-task performance and cognition may lead to new treatment strategies with the purpose of preserving function and quality of life. The objective of this study was to investigate the associations between physical function, dual-task performance and cognition in community-dwelling patients with mild AD. Methods: Baseline results from 185 participants (50–90 years old) in the single blinded multicenter RCT ‘ADEX’ (Alzheimer's disease: the effect of physical exercise) were used. Assessments included tests of physical function: 400-m walk test, 10-m walk test, Timed Up and Go test and 30-s chair stand test; dual-task performance, i.e., 10-m walk while counting backwards from 50 or naming the months backwards; and cognition, i.e., Mini Mental State Examination, Symbol Digit Modalities Test, the Stroop Color and Word Test, and Lexical verbal fluency test. Results: Results in the 30-s chair stand test correlated significantly with all tests of cognition (r = .208–.242) while the other physical function tests only randomly correlated with tests of cognition. Results in the dual-task counting backwards correlated significantly with results in all tests of cognition (r = .259–.388), which accounted for 7%–15% of the variation indicating that a faster time to complete dual-task performance was associated with better cognitive performance. Conclusion: The evidence of the associations between physical function, dual-task performance and cognition is important when creating new rehabilitation interventions to patients with mild AD. (Publisher abstract)
A pilot randomized controlled trial of mindfulness-based stress reduction for caregivers of family members with dementia
- Authors:
- BROWN Kirk Warren, COOGLE Constance L., WEGELIN Jacob
- Journal article citation:
- Aging and Mental Health, 20(11), 2016, pp.1157-1166.
- Publisher:
- Taylor and Francis
Objectives: The majority of care for those with Alzheimer's disease and other age-related dementias is provided in the home by family members. To date, there is no consistently effective intervention for reducing the significant stress burden of many family caregivers. The present pilot randomised controlled trial tested the efficacy of an adapted, eight-week mindfulness-based stress reduction (MBSR) programme, relative to a near structurally equivalent, standard social support (SS) control condition for reducing caregiver stress and enhancing the care giver–recipient relationship. Method: Thirty-eight family caregivers were randomised to MBSR or SS, with measures of diurnal salivary cortisol, and perceived stress, mental health, experiential avoidance, caregiver burden, and relationship quality collected pre- and post-intervention and at three-month follow-up. Results: MBSR participants reported significantly lower levels of perceived stress and mood disturbance at post-intervention relative to SS participants. At three-month follow-up, participants in both treatment conditions reported improvements on several psychosocial outcomes. At follow-up, there were no condition differences on these outcomes, nor did MBSR and SS participants differ in diurnal cortisol response change over the course of the study. Conclusion: Both MBSR and SS showed stress reduction effects, and MBSR showed no sustained neuroendocrine and psychosocial advantages over SS. The lack of treatment condition differences could be attributable to active ingredients in both interventions, and to population-specific and design factors. (Edited publisher abstract)
Safeness and treatment mitigate the effect of loneliness on satisfaction with elderly care
- Authors:
- KAJONIUS Petri J., KAZEMI Ali
- Journal article citation:
- Gerontologist, 56(5), 2016, pp.928-936.
- Publisher:
- Oxford University Press
Maximising satisfaction among the older persons is the goal of modern individualised elderly care and how to best achieve this is of relevance for people involved in planning and providing elderly care services. Purpose of the Study: What predicts satisfaction with care among older persons can be conceived as a function of process (how care is performed) and the older person. Inspired by the long-standing person versus situation debate, the present research investigated the interplay between person- and process-related factors in predicting satisfaction with elderly care. Design and Methods: A nationwide sample was analysed, based on a questionnaire with 95,000 individuals using elderly care services. Results: The results showed that person-related factors (i.e., anxiety, health, and loneliness) were significant predictors of satisfaction with care, although less strongly than process-related factors (i.e., treatment, safeness, and perceived staff and time availability). Among the person-related factors, loneliness was the strongest predictor of satisfaction among older persons in nursing homes. Interestingly, a path analysis revealed that safeness and treatment function as mediators in linking loneliness to satisfaction. Implications: The results based on a large national sample demonstrate that the individual ageing condition to a significant degree can be countered by a well-functioning care process, resulting in higher satisfaction with care among older persons. (Edited publisher abstract)
Delivery characteristics, acceptability, and depression outcomes of a home-based depression intervention for older African Americans: the Get Busy Get Better Program
- Authors:
- GITLIN Laura N., et al
- Journal article citation:
- Gerontologist, 56(5), 2016, pp.956-965.
- Publisher:
- Oxford University Press
Purpose of the Study: To facilitate replication, the authors examined delivery characteristics, acceptability, and depression outcomes of a home-based intervention, Get Busy Get Better, Helping Older Adults Beat the Blues (GBGB). GBGB, previously tested in a randomised trial, reduced depressive symptoms and enhanced quality of life in African Americans. Design and Methods: A total of 208 African Americans aged above 55 years with Patient Health Questionnaire (PHQ-9) scores ≥5 on two subsequent screenings were randomised to receive GBGB immediately or 4 months later. GBGB involves up to 10 home sessions consisting of care management, referral/linkage, depression education/symptom recognition, stress reduction, and behavioural activation. Interventionists recorded delivery characteristics (dose, intensity) and perceived acceptability of sessions. Baseline and post-tests were used to characterise participants and examine associations between dose/intensity and depression scores. Participant satisfaction and perceived benefits were examined at 8 momths. Results: Of 208 participants, 181 (87%, mean age = 69.6) had treatment data. Of these, 165 (91.2%) had ≥3 treatment sessions (minimal dose). Participants had on average 8.1 sessions (SD = 2.6) for an average of 65.4min (SD = 18.3) each. Behavioural activation and care management were provided the most (average of six sessions for average duration = 17.9 and 22.2min per session respectively), although all participants received each treatment component. GBGB was perceived as highly acceptable and beneficial by interventionists and participants. More sessions and time in programme were associated with greater symptom reduction. Implications: GBGB treatment components were highly acceptable to participants. Future implementation and sustainability challenges include staffing, training requirements, reimbursement limitations, competing agency programmatic priorities, and generalisability to other groups. (Edited publisher abstract)
Advance care planning in South Korea: Social work perspective
- Authors:
- KWON Sung Ae, KOLOMER Stacey
- Journal article citation:
- Social Work in Health Care, 55(7), 2016, pp.545-558.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
As ethical issues arise concerning the continuation of futile medical treatment for dying patients in Korean society, advance directive planning initiatives have been put into place to guide practice. This article describes the awareness and attitudes of social workers in Korea regarding advance care planning and related factors. A total of 246 gerontological/geriatric social workers completed a mailed or in-person survey regarding awareness and attitudes toward advance care planning. Seventy-three percent (n = 180) of the participants reported no knowledge of advance directives. Social workers who emphasised self-determination as a professional value, professed a preference for hospice care, and who were comfortable discussing death were more likely to have a positive attitudes toward advance care planning. This study reinforces the need for the infusion of advance care planning and end-of-life training in social work education in Korea. (Publisher abstract)
Guided self-help for generalized anxiety disorder in older adults
- Authors:
- LANDREVILLE Philippe, et al
- Journal article citation:
- Aging and Mental Health, 20(10), 2016, pp.1070-1083.
- Publisher:
- Taylor and Francis
Objective: The main objective of this study was to examine the efficacy of a guided self-help treatment based on cognitive behavioural principles (CBT-GSH) for generalised anxiety disorder (GAD) in older adults. Methods: Three older adults aged from 66 to 70 and diagnosed with GAD were included in a single-case experimental multiple-baseline protocol. Data were collected using daily self-monitoring, standardised clinician ratings, and self-report questionnaires at pretest, posttest, and 6-month and 12-month follow-ups. Treatment consisted of awareness training, worry interventions, relaxation training, pleasant activities scheduling, and relapse prevention. Participants used a manual presenting weekly readings and at-home practice exercises. They also received weekly supportive phone calls from a therapist. Results: At posttest, participants showed improvement on worries and GAD severity, on psychological process variables targeted by treatment (intolerance of uncertainty, negative problem orientation, cognitive avoidance, and perceived usefulness of worry), and on secondary variables associated with GAD (anxiety, depression, sleep difficulties, cognitive functioning, and disability). These results were generally maintained at 12 months after the end of treatment. Participants had favourable opinions toward the treatment. Conclusion: The results of this study suggest that CBT-GSH is both feasible and effective for the treatment of GAD in older adults. (Edited publisher abstract)
Does targeted cognitive training reduce educational disparities in cognitive function among cognitively normal older adults?
- Authors:
- CLARK Daniel O., et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 31(7), 2016, pp.809-817.
- Publisher:
- Wiley
Objective: The aim of this study was to investigate educational differences in treatment responses to memory, reasoning, and speed of processing cognitive training relative to no-contact control. Methods: Secondary analyses of the Advanced Cognitive Training for Independent and Vital Elderly trial were conducted. Two thousand eight hundred older adults were randomized to memory, reasoning, or speed of processing training or no-contact control. A repeated-measures mixed-effects model was used to investigate immediate post-training and 1-year outcomes with sensitivity analyses out to 10 years. Outcomes were as follows: (1) memory composite of Hopkins Verbal Learning Test, Rey Auditory Verbal Learning Test, and Rivermead Behavioral Memory Test; (2) reasoning composite of letter series, letter sets, and word series; and (3) speed of processing measured using three trials of useful field of view and the digit symbol substitution test. Results: The effects of reasoning and memory training did not differ by educational attainment. The effect of speed of processing training did. Those with fewer than 12 years of education experienced a 50% greater effect on the useful field of view test compared with those with 16 or more years of education. The training advantage for those with fewer than 12 years of education was maintained to 3 years post-training. Conclusion: Older adults with less than a secondary education are at elevated risk of dementia, including Alzheimer's disease. The analyses here indicate that speed of processing training is effective in older adults with low educational attainment. (Publisher abstract)
Changing our view of older people's continence care
- Author:
- DENNIS Jacqueline
- Journal article citation:
- Nursing Times, 112(20), 2016, pp.12-14.
- Publisher:
- Nursing Times
An assumption is often made that incontinence is inevitable in older people, or those with dementia or other long-term conditions. However, research has highlighted strategies that can help them to remain continent. A working group was established to develop a resource to promote continence for people with dementia and long-term conditions. This article explores the resources's key messages, as well as the importance of changing how incontinence is viewed, and what health professionals and the public expect of continence services. (Publisher abstract)
Identifying the causes, prevention and management of crises in dementia. an online survey of stakeholders
- Authors:
- LEDGERD Ritchard, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 31(6), 2016, p.638–647.
- Publisher:
- Wiley
Background: Crisis situations in dementia can lead to hospital admission or institutionalisation. Offering immediate interventions may help avoid admission, whilst stabilising measures can help prevent future crises. Objective: The objective was to identify the main causes of crisis and interventions to treat or prevent crisis in persons with dementia based on different stakeholder perspectives. Methods: An online questionnaire was developed to identify the causes of crisis and appropriate interventions in a crisis. Participants included people with dementia, family carers and staff working in health and social care, including emergency and voluntary sectors, and academia. Results: The results ranked the main causes of crisis, interventions that can prevent a crisis and interventions that can be useful in a crisis. Wandering, falls and infection were highly rated as risk factors for crises across all stakeholder groups. Consumers rated aggression as less important but severity of memory impairment as much more important than the other groups did. Education and support for family carers and home care staff were highly valued for preventing crises. Well-trained home care staff, communication equipment, emergency contacts and access to respite were highly valued for managing crises. Conclusions: The authors identified triggers and interventions that different stakeholders see as important for crisis in dementia. Recognition of these may be critical to planning effective and accepted support and care for people with dementia (Edited publisher abstract)