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Building on the benefits: assessing satisfaction and well-being in elder care
- Authors:
- JENSEN Christine J., FERRARI Michael, CAVANAUGH John C.
- Journal article citation:
- Ageing International, 29(1), Winter 2004, pp.88-110.
- Publisher:
- Springer
- Place of publication:
- New York
One hundred interviews were conducted with primary caregivers who completed the Caregiver Well-Being Scale (CWB), the Caregiving Uplifts Scale (CUPL), the Caregiving Satisfaction Scale (CSS), and the Center for Epidemiologic Studies Depression Scale. CWB, CUPL and CSS scores were significantly higher for caregivers for elders with a primarily physical (e.g. heart disease) rather than a primarily cognitive impairment (e.g. dementia), indicating greater perceived caregiver benefits based on type of care recipient impairment. Little evidence of depressive symptoms was found in either group. These findings advance previous research by indicating that caregivers experience satisfaction in their role and potential for personal fulfillment even when faced with challenging circumstances. Discusses validation of positive experiences and the impact of positive appraisals on depression levels.
Acceptability of a lay-delivered intervention for depression in senior centers
- Authors:
- RAUE Patrick J., et al
- Journal article citation:
- Aging and Mental Health, 25(3), 2021, pp.445-452.
- Publisher:
- Taylor and Francis
Objective: We examined: 1. depression rates among senior center clients; and 2. the acceptability of a lay-delivered intervention for depression (“Do More, Feel Better”) from the perspective of key stakeholders prior to its implementation. Method: We conducted cross-sectional surveys at four Seattle-area senior centers of 140 clients, 124 volunteers, and 12 administrators and staff. Client measures included the Patient Health Questionnaire-9 (PHQ-9) to determine depression severity, and items assessing depression treatment preferences. Following description of “Do More, Feel Better” as a lay-delivered intervention focused on increasing participation in rewarding activities, we used quantitative and qualitative items to assess acceptability to: 1. clients participating in; 2. volunteers administering; and 3. administrators and staff supporting the intervention. Results: 25% of senior center clients (35/140) endorsed elevated depressive symptoms (PHQ-9 ≥ 10). 81% of clients (114/140) reported that they would consider participating in “Do More, Feel Better,” and 59% percent of volunteers (73/123) expressed interest in learning how to assist others using the intervention. Administrators and staff reported high comfort levels with proposed volunteer training procedures, and they identified funding and staffing considerations as challenges to sustaining the intervention. Conclusion: Findings indicate high depression rates among senior center clients and support the acceptability of lay-delivered behavioral interventions for depression from a variety of stakeholders. Further investigation of the feasibility, effectiveness, and implementation of “Do More, Feel Better” is warranted, particularly in the context of a lack of health care professionals available to meet the mental health needs of older adults. (Edited publisher abstract)
Why may older people with depression not present to primary care? Messages from secondary analysis of qualitative data
- Authors:
- CHEW-GRAHAM Carolyn, et al
- Journal article citation:
- Health and Social Care in the Community, 20(1), January 2012, pp.52-60.
- Publisher:
- Wiley
Depression in older people is common, under-diagnosed and often undertreated. It has been thought that 10-15% of older people meet the clinical criteria for depression, but less than a third of these discuss their symptoms with their general practitioner (GP), and less than a half of these will be offered guideline-concordant treatment. The aim of this study was to explore the reasons why older people with depression may not present to primary care. Secondary analysis was carried out of qualitative data collected in 2 previous studies of older people with depression in North-West England. Data consisted of 19 transcripts of semi-structured, in-depth interviews. The findings show that older people are reluctant to recognise and name depression as a set of symptoms that legitimises attending their GP. They do not consider themselves candidates for help for their distress, partly due to perceptions of the role of the GP but also to previous negative experiences of help seeking. In addition, the treatments offered, which are predominantly biomedical, may not be acceptable to older people. The article concludes that interventions may need to encourage social engagement, such as befriending, and enhancement of creative, physical and social activity.
Promoting physical activity in the management of depression. The perspective of older people
- Authors:
- WRIGHT Alan, CATTAN Mima
- Journal article citation:
- Mental Health and Learning Disabilities Research and Practice, 6(1), April 2009, pp.53-67.
- Publisher:
- South West Yorkshire Mental Health NHS Trust and University of Huddersfield
While exercise has been widely proposed in the management of depression in older people, the subjective experiences of individuals participating in this intervention have been neglected. Similarly, little is known about the manner in which unsupervised physical activity is adopted by older people as they recover from an episode of depression. This qualitative study sought the views of 11 older people who had recently been admitted to hospital with depression and attended regular in-patient exercise groups. It was found that participants valued opportunities to exercise when in hospital and reported a range of benefits. Following discharge unsupervised physical activity played a crucial part in the recovery process and three typologies were defined which categorised participants’ motivation to be physically active. It was concluded that opportunities for older people to join exercise groups when hospitalised with depression are likely to be valued and that individual factors should be acknowledged when promoting post discharge physical activity.
Professional carers' knowledge and response to depression among their aged-care clients: the care recipients' perspective
- Authors:
- MELLOR David, et al
- Journal article citation:
- Aging and Mental Health, 12(3), May 2008, pp.389-399.
- Publisher:
- Taylor and Francis
Depression is an under-diagnosed disorder among the elderly, even in those who are in receipt of aged-care services. One factor associated with this under diagnosis has been identified as a reluctance amongst the elderly to discuss their mood and emotions with their medical practitioners. The current study focused on why depression is not recognised and acted on by those providing residential or home-based care to older people. This study interviewed 15 elderly people residing in high-level or low-level aged-care facilities, and three elderly people who were receiving personal care in their homes. All participants had been identified by their care agencies as depressed. Participants reported their perceptions of their personal carers' knowledge and practices in managing the residents' depression. Although the participants described their carers in positive terms, they were critical of their knowledge and skills in recognising depression, and indicated that the communication between personal carers and care recipients about depressive symptomatology was seriously flawed. Training for personal carers in these areas, and efforts to change organisational culture are recommended.
Long-term prescribing of antidepressants in the older population: a qualitative study
- Authors:
- DICKINSON Rebecca, et al
- Journal article citation:
- British Journal of General Practice, 60(573), April 2010, pp.257-259.
- Publisher:
- Royal College of General Practitioners
Previous work has reported high rates of long-term antidepressant prescribing in patients over 75 years in the UK. This study explored the attitudes of older patients and their GPs to taking long-term antidepressant therapy, and their accounts of the influences on long-term antidepressant use. Qualitative in-depth semi-structured interviews were conducted with 36 patients aged 75 years or over and 10 GPs from one primary care trust in North Bradford. Patients were sampled to ensure diversity in age, sex, antidepressant type, and home circumstances. Participants perceived significant benefits and expressed little apprehension about taking long-term antidepressants, despite being aware of the psychological and social factors involved in onset and persistence of depression. Barriers to discontinuation followed four themes: pessimism about the course and curability of depression; negative expectations and experiences of ageing; medicine discontinuation perceived by patients as a threat to stability; and passive (therapeutic momentum) and active (therapeutic maintenance) decisions to accept the continuing need for medication. The authors conclude that although there might be concern at a public health level about high rates of long-term antidepressant prescribing, no evidence was found of a drive for change from either the patients or their doctors. Any apprehension was more than balanced by attitudes and behaviours supporting continuation.
Older primary care patient views regarding antidepressants: a mixed methods approach
- Authors:
- BOGNER Hilary, et al
- Journal article citation:
- Journal of Mental Health, 18(1), February 2009, pp.57-64.
- Publisher:
- Taylor and Francis
- Place of publication:
- London
The authors aim to generate hypotheses regarding antidepressant use among older primary care patients. A mixed methods design was utilised that is both hypothesis-testing and hypothesis-generating. Adults aged 65 years and over were recruited from primary care practices in the Baltimore, Maryland area in the US and interviewed in their homes. Personal characteristics of older adults according to antidepressant use (hypothesis-testing) were then examined. Participants taking antidepressants and participants not taking antidepressants were asked open-ended questions about their views on treatment for depression. Themes related to use of antidepressants were examined (hypothesis-generating). Older adults taking antidepressants were more likely to be white and have more depression symptoms compared to older adults not taking antidepressants. Positive and negative themes emerged when participants discussed antidepressant use. The study linked quantitative data from the participants with the themes they endorsed to form an emerging theory about older adults' perceptions about antidepressant use. Few personal characteristics were associated with antidepressant use. An improved understanding of how older adults view antidepressant use, derived from multiple methods, may inform clinical practice.
To tell or not to tell: comparison of older patients' reaction to their diagnosis of dementia and depression
- Authors:
- JHA Arun, TABET Naji, ORRELL Martin
- Journal article citation:
- International Journal of Geriatric Psychiatry, 16(9), September 2001, pp.879-885.
- Publisher:
- Wiley
This study investigates the reaction of elderly patients to the disclosure of their diagnosis of dementia compared with depression. Elderly patients suffering from dementia and depression were asked to complete a questionnaire about the diagnosis and other aspects of their clinical summary sent to them by post. Demographic data included age, gender, marital status and occupation; degree of dementia or depression was established by administering the mini-mental state examination and the geriatric depression scale, respectively. Results showed most depressed and dementia patients liked the idea of reading their diagnosis but one quarter of dementia cases felt upset. Within the dementia group, the majority of patients with mild or severe dementia welcomed the idea of knowing their diagnosis; and 13 (100%) of the patients with vascular dementia wished to know (compared with 68% cases with Alzheimer's disease). Among dementia patients who also happened to be depressed, a higher proportion (60%) expressed an unfavourable view towards knowing their diagnosis, but only a minority (40%) of them were actually upset. Most older married females, especially those with depression and Alzheimer's disease, felt pessimistic afterwards. There was no significant difference between patients with dementia or depression in their wish to know their diagnosis. Patients with severe dementia, even if they felt upset, preferred to be told their diagnosis. Patients with vascular dementia tended to express a more favourable view.
Older people's sadness: a study of older people with depression
- Authors:
- CHESTER Rosie, SMITH Jef
- Publisher:
- Counsel and Care
- Publication year:
- 1995
- Pagination:
- 63p.,bibliog.
- Place of publication:
- London
Report challenging current thinking about the needs of depressed older people.
Only connect: the impact of Covid-19 on older LGBT+ people
- Author:
- OPENING DOORS LONDON
- Publisher:
- Opening Doors London
- Publication year:
- 2020
- Pagination:
- 8
- Place of publication:
- London
This report evaluates Opening Doors London’s (ODL) own response to the lockdown and explores the experiences and feelings of its members during this turbulent period. ODL provides information and support services specifically for Lesbian, Gay, Bisexual and Trans (LGBT+) people over 50 in the UK. The report is based on a survey of ODL members, with input from the staff and volunteers who swung into action to reconfigure the delivery of vital services in order to continue supporting some of the most vulnerable members of the LGBT+ community. The survey has evidenced the extent of loneliness and social isolation experienced by a group of older LGBT+ people living in London, which has been exacerbated by the Covid-19 lockdown and worsened both physical and mental health. It also evidenced that the recalibration of ODL services meant that we were able to continue support for this vulnerable population. Findings include: 50% of respondents reported a negative impact on their psychological wellbeing; 18% felt much more depressed than usual; 23% experienced worsened physical health during lockdown; 37% felt more lonely than usual; 27% hardly ever or never had someone to talk to. (Edited publisher abstract)