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Alonso-Moreno FJ, Llisterri Caro JL, Martínez Altarriba MC, Segura-Fragoso A, Martín-Sánchez V, Miravet Jiménez S, Velilla Zancada S, Martínez García FV, Micó Pérez RM, Cinza Sanjurjo S, Sánchez Sánchez B. Prevalence of suspected abuse of non-institutionalized older people treated in primary care. PRESENCIA study. Semergen 2024; 50:102263. [PMID: 38838584 DOI: 10.1016/j.semerg.2024.102263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 03/04/2024] [Accepted: 03/06/2024] [Indexed: 06/07/2024]
Abstract
OBJECTIVES To determine the prevalence of suspected abuse of non-institutionalised elderly people and the associated variables. PATIENTS AND METHOD Observational, descriptive, cross-sectional, multicentre study in patients aged 65 years or older, non-institutionalised, consecutively selected in primary care (PC). The EASI questionnaires (Suspected Elderly Abuse Index), the EAI questionnaire (Suspected Abuse Index in patients with cognitive impairment), the Barthel index, and the EUROQOL-5D questionnaire were used with patients, and the CASE questionnaire and the Zarit test were used with caregivers. Socio-demographic, health, and quality of life variables were analysed in all patients. RESULTS Eight hundred four patients were included, mean age 78.9±7.9 years, 58.3% women. The prevalence of suspected abuse was 11.3% (95% CI: 9.1%-13.9%). Suspected abuse was more frequent in women than in men (14.4% vs. 7.1%; odds ratio (OR)=1.97; 95% CI=1.1-3.4; p=0.016) and in those who lived with two or more people compared to those who lived alone (18.4% vs. 7.3%; OR=2.42; 95% CI=1.1-5.0; p=0.017). Among older patients, the lower their dependency, the lower the prevalence of suspected abuse (30.0% in highly dependent vs. 8.7% in non-dependent: p-trend=0.006); and the better the perceived health status, the lower the prevalence of suspected abuse (29.6% in poor health status vs. 6.9% in optimal health status; p-trend=<0.001). Among caregivers, the prevalence of suspected abuse was 20.4% (95% CI=12.8%-28.0%). A trend of higher prevalence of suspected abuse could be observed with higher scores on the CASE questionnaire (56.3% at high risk and 9.6% with no risk of abuse; p-trend=0.007). In the case of the ZARIT questionnaire with scores below 47, the prevalence of suspected abuse was 9.1%, and for scores above 55, it was 52.6% (p-trend<0.001). CONCLUSIONS The results of the PRESENCIA study show that approximately 1 in 10 patients aged ≥65 meet the criteria for suspected abuse. The probability of abuse increases in women, in patients with greater dependency and in patients with poorer perceived health status. Caregivers with greater overload and greater risk presented a greater suspicion of elder abuse.
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Affiliation(s)
| | | | | | - A Segura-Fragoso
- Universidad de Castilla-La Mancha, Talavera de la Reina, Toledo, Spain
| | - V Martín-Sánchez
- Institute of Biomedicine, University of Leon, Center for Biomedical Research in Epidemiology and Public Health Network (CIBERESP), Spain
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Hernandez Chilatra JA, Patrician PA, Fazeli PL, Pickering CE. Neglect of older adults living with dementia in family caregiving: A dimensional concept analysis. Int J Psychiatry Med 2024:912174241272615. [PMID: 39129719 DOI: 10.1177/00912174241272615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/13/2024]
Abstract
OBJECTIVE To present a concept analysis of neglect, specifically examining its occurrence and implications in the context of family caregiving for older adults living with dementia. METHODS A literature search was conducted in Medline, CINAHL, Scopus, and Embase databases in February 2023. Inclusion criteria targeted articles focusing on neglect in dementia family caregiving, leading to the identification of 11 articles for thorough review. Employing Caron and Bowers' dimensional analysis approach, the concept analysis aimed to elucidate neglect as a social construct shaped by diverse contexts, perspectives, and underlying assumptions. RESULTS Neglect in this context emerged as a multidimensional phenomenon, influenced by contextual elements such as activities of daily living and behavioral symptoms of dementia. It encompasses dimensions including "expectations of unmet needs", "maladaptive behaviors", and "feelings of guilt", considering the perspectives of both caregivers and individuals living with dementia. Recognizing neglect as a dyadic phenomenon emphasizes the significance of interactions between caregivers and individuals living with dementia. CONCLUSION A comprehensive understanding of neglect in dementia family caregiving is crucial for effective interventions and support systems. The dyadic perspective is vital for accurate assessment. Primary care physicians, mental health, nurses, and other health professionals play a key role in prevention and supporting family caregivers. Further research is needed to explore the dynamics of dementia caregiving settings strengthening prevention strategies against elder neglect.
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Affiliation(s)
- Jessica A Hernandez Chilatra
- McWilliams School of Biomedical Informatics, The University of Texas Health Science, Houston, TX, USA
- Department of Research, Cizik School of Nursing, University of Texas Health Science Center at Houston, Houston, TX, USA
| | | | - Pariya L Fazeli
- School of Nursing, The University of Alabama at Birmingham, Birmingham, AL, USA
| | - Carolyn Ez Pickering
- Department of Research, Cizik School of Nursing, University of Texas Health Science Center at Houston, Houston, TX, USA
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Zhou W, Song X, Si H, Bian Y, Liu Q, Li Y, Yu J, Wang C. Effectiveness of interventions for informal caregivers of community-dwelling frail older adults: A systematic review and meta-analysis. J Adv Nurs 2024. [PMID: 38969397 DOI: 10.1111/jan.16314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 06/19/2024] [Accepted: 06/23/2024] [Indexed: 07/07/2024]
Abstract
AIM Systematic reviews on interventions for informal caregivers of community-dwelling frail older adults were published over a decade ago and they mistook frailty for other severe age-related conditions like disability and dementia. Therefore, this study aimed to systematically synthesize these interventions supporting these caregivers identified by an acknowledged frailty assessment instrument and to examine their effectiveness on caregiver-related outcomes. DESIGN Systematic review and meta-analysis. DATA SOURCES Fourteen electronic databases, grey literature and reference lists were systematically searched for randomized controlled trials (RCTs) and non-randomized controlled trials (NRCTs) from inception to November 3, 2023. METHODS Methodology quality and risk of bias were assessed. Data were meta-analysed using the Comprehensive Meta-Analysis, version 3.0. Studies and outcomes unsuitable for meta-analysis were summarized by narrative syntheses. RESULTS Four studies consisting of three RCTs and one NRCT were included involving 350 participants. Interventions for caregivers of frail older adults included multicomponent interventions (n = 3) and education intervention (n = 1). Interventions had a moderate effect on reducing depression and showed nonsignificant effects on caregiver burden, caregiving time or quality of life (QoL). The PEDro scores for RCTs ranged from 6 to 8, indicating good methodologic quality, but were all judged as high risk of bias. The NRCT reported all methodologic aspects and was at low risk of bias. CONCLUSIONS Few studies focus on interventions targeting caregivers of frail older adults, and their effectiveness may vary by outcomes. This review suggested the potential benefits of these interventions in reducing caregivers' depression. IMPACT The differential effectiveness by outcomes and high risk of bias of studies implicate that more rigorous studies are warranted.
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Affiliation(s)
- Wendie Zhou
- School of Nursing, Peking University, Beijing, China
| | - Xin Song
- School of Nursing, Peking University, Beijing, China
| | - Huaxin Si
- School of Nursing, Peking University, Beijing, China
| | - Yanhui Bian
- School of Nursing, Peking University, Beijing, China
| | - Qinqin Liu
- School of Nursing, Peking University, Beijing, China
| | - Yanyan Li
- School of Nursing, Peking University, Beijing, China
| | - Jiaqi Yu
- School of Nursing, Peking University, Beijing, China
| | - Cuili Wang
- School of Nursing, Peking University, Beijing, China
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Wang S, Huang Y, Fan AYN, Ho MH, Davidson PM. Factors influencing the psychosocial well-being of people with dementia and their informal caregivers: A systematic review of dyadic studies. Int J Ment Health Nurs 2024; 33:560-581. [PMID: 38131462 DOI: 10.1111/inm.13279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Revised: 11/20/2023] [Accepted: 12/05/2023] [Indexed: 12/23/2023]
Abstract
Individuals with dementia and their informal caregivers face significant challenges to their psychosocial well-being, necessitating immediate attention. In spite of the prevalence of this problem, there is limited data regarding the factors that influence the dyadic psychosocial well-being and potential actor-partner influencing mechanisms. Therefore, this review was conducted to synthesise the factors associated with the psychosocial well-being of people with dementia and their informal caregivers. MEDLINE via EBSCOhost, CINAHL, PsycINFO, Embase and Scopus were systematically searched to identify relevant studies. Quantitative, qualitative or mixed-method studies examining the factors influencing dyadic psychosocial well-being outcomes were included. The quality of included studies was assessed using Joanna Briggs Institute Critical Appraisal checklists. A narrative synthesis approach was employed for data analysis. A total of 3217 records were yield, out of which 26 studies were included in the analysis. Quality of life emerged as the most extensively investigated dyadic psychosocial well-being outcome, followed by depression. The interrelation between the quality of life for people with dementia and caregivers was observed, where individual members' quality of life was influenced by their own, partner and dyadic factors. However, there is a dearth of research exploring the mechanisms through which one member's factors exert influence on both their own and partner's quality of life within the dyad. This gap also exists for other psychosocial well-being outcomes, such as depression and anxiety. Further research is warranted to elucidate the underlying mechanisms through which dyadic members influence their own and their partner's psychosocial well-being.
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Affiliation(s)
- Shanshan Wang
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR, China
- School of Nursing and Health, Zhengzhou University, Zhengzhou, China
| | - Yaqi Huang
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Avis Yat Ngar Fan
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Mu-Hsing Ho
- School of Nursing, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong SAR, China
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Losada-Baltar A, Mausbach BT, Romero-Moreno R, Jiménez-Gonzalo L, Huertas-Domingo C, Fernandes-Pires JA, Barrera-Caballero S, Gallego-Alberto L, Martín-María N, Olazarán J, Márquez-González M. Longitudinal effects of ambivalent and guilt feelings on dementia family caregivers' depressive symptoms. J Am Geriatr Soc 2024; 72:1431-1441. [PMID: 38485230 PMCID: PMC11090735 DOI: 10.1111/jgs.18871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 12/22/2023] [Accepted: 02/18/2024] [Indexed: 05/14/2024]
Abstract
BACKGROUND The world prevalence of people with dementia is increasing. Most of the care received by people with dementia is provided by family caregivers, and this prolonged activity has a significant impact on caregivers' levels of depression. Stressors and frequency of leisure are known predictors of caregivers' depressive levels. The longitudinal impact of caregivers' ambivalent and guilt feelings is unknown. METHODS Participants were 177 family caregivers of relatives with dementia who were assessed three times during a 2-year period. In addition to demographic variables, psychological symptoms of the dementias, and frequency of leisure activities, caregivers' ambivalent feelings, guilt, and depressive symptoms were measured. The longitudinal association of changes in these variables with changes in caregivers' depressive symptoms over time was assessed using mixed linear models. RESULTS Changes over time in the assessed variables predicted 48.05% of variance of changes over time in depressive symptoms. Even when variables strongly associated with increased depressive symptoms were controlled (lower caregivers' age and educational level, higher reaction to BPSD, and lower leisure activities), increases in ambivalence and guilt contributed to an increase of 9.22% of the variance of changes depressive symptoms over a 2-year period. The effects of ambivalent feelings on depression are indirect, mediated by guilt feelings. Cessation of caregiving do not seem to alter these findings. CONCLUSIONS Caregivers' ambivalent and guilt feelings are significant predictors of caregivers' mental health. Caregivers may significantly benefit from early detection of ambivalent and guilt feelings and preventive strategies targeting triggers associated with ambivalent and guilt symptoms.
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Affiliation(s)
| | - Brent T Mausbach
- Department of Psychiatry, University of California San Diego, San Diego, California, USA
| | | | | | | | | | | | - Laura Gallego-Alberto
- Departamento de Psicología Biológica y de la Salud, Universidad Autónoma de Madrid, Madrid, Spain
| | - Natalia Martín-María
- Departamento de Psicología Biológica y de la Salud, Universidad Autónoma de Madrid, Madrid, Spain
| | - Javier Olazarán
- Departamento de Neurología, Hospital Universitario Gregorio Marañón, Madrid, Spain
| | - María Márquez-González
- Departamento de Psicología Biológica y de la Salud, Universidad Autónoma de Madrid, Madrid, Spain
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Coresidence of Older Parents and Adult Children Increases Older Adults' Self-Reported Psychological Well-Being. Int J Alzheimers Dis 2022; 2022:5406196. [PMID: 35127157 PMCID: PMC8813294 DOI: 10.1155/2022/5406196] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Accepted: 12/06/2021] [Indexed: 11/28/2022] Open
Abstract
A multigenerational household is no longer a rare phenomenon in contemporary society. However, relevant literature has focused on elderly parents receiving support from their adult child, thereby coresiding. This is potentially problematic, as both generations could benefit from living together, and little is known about the benefit of living with adult children from older adults' perspectives compared to the risk of this living situation. Previous research suggests a significant negative effect of living alone, e.g., low psychological well-being, and it becomes more salient among single parents, such as widowed or divorced. The current paper utilizes the National Health Measurement Study with a sample of age 55 and over. Their SF-36 Mental Health and Physical Health Component and self-acceptance scores were measured. Path analysis reveals that both physical and mental health and self-acceptance scores are lower among single older adults at the time of the survey (e.g., divorced and widowed) than among those who are nonsingle and living with their adult child. A complete mediation effect of living with an adult child on older adults' mental health and self-acceptance was observed in both White and non-White minority older adults. This suggests that living with an adult child possibly serves as a protective factor for the negative relationship between living alone and their well-being. The current study seeks to stimulate ideas that might generate the following answer to community-based care in our contemporary aging society.
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