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Fealy S, McLaren S, Nott M, Seaman CE, Cash B, Rose L. Psychological interventions designed to reduce relocation stress for older people transitioning into permanent residential aged care: a systematic scoping review. Aging Ment Health 2024:1-12. [PMID: 38634443 DOI: 10.1080/13607863.2024.2340731] [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] [Received: 10/06/2023] [Accepted: 04/02/2024] [Indexed: 04/19/2024]
Abstract
OBJECTIVES This study aimed to identify and evaluate psychological interventions or strategies designed to reduce relocation stress in older people making the permanent transition into residential aged care. METHOD A scoping review following the Joanna Briggs Institute methodology for scoping reviews and the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) was conducted. An electronic search of nine databases and the search engine google scholar was completed in December 2022. Article screening and quality appraisal was undertaken independently by at least two reviewers. RESULTS Eight full-text articles were included for review, from which four psychological interventions were identified: 1) Resident peer support; 2) Life review; 3) Mental Health Service for Older Adults; 4) The Program to Enhance Adjustment to Residential Living. No interventions were implemented before transitioning into care; all were implemented within three months of resident relocation into an aged care facility. CONCLUSION The transition to residential aged care is an inherently distressing experience. The absence of interventions implemented during the pre- and mid-transition phases presents a gap in the literature and suggests an opportunity for early intervention. As population ageing continues to increase, there is a pressing need for the development and implementation of interventions aimed at reducing symptoms of depression and anxiety for older people undertaking this major life transition.
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Affiliation(s)
- Shanna Fealy
- Ageing Well in Rural and Regional Australia Research Group, Charles Sturt University, Port Macquarie, NSW, Australia
- College of Health, Medicine and Wellbeing, The University of Newcastle, Callaghan, Australia
| | - Suzanne McLaren
- Ageing Well in Rural and Regional Australia Research Group, Charles Sturt University, Port Macquarie, NSW, Australia
- School of Psychology, Charles Sturt University, Port Macquarie, NSW, Australia
| | - Melissa Nott
- Ageing Well in Rural and Regional Australia Research Group, Charles Sturt University, Port Macquarie, NSW, Australia
- Three Rivers Department of Rural Health, Charles Sturt University, Port Macquarie, NSW, Australia
| | - Claire Ellen Seaman
- Ageing Well in Rural and Regional Australia Research Group, Charles Sturt University, Port Macquarie, NSW, Australia
- Three Rivers Department of Rural Health, Charles Sturt University, Port Macquarie, NSW, Australia
| | - Belinda Cash
- Ageing Well in Rural and Regional Australia Research Group, Charles Sturt University, Port Macquarie, NSW, Australia
- School of Social Work and Arts, Charles Sturt University, Port Macquarie, NSW, Australia
| | - Lorraine Rose
- Division of Library Services, Charles Sturt University, Port Macquarie, NSW, Australia
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Zhu R, Hou W, Wang L, Zhang C, Guo X, Luo D, Wang F. Willingness to purchase institutionalised elderly services and influencing factors among Chinese older adults: a nationwide cross-sectional study. BMJ Open 2024; 14:e082548. [PMID: 38471688 DOI: 10.1136/bmjopen-2023-082548] [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: 03/14/2024] Open
Abstract
OBJECTIVES In view of the serious ageing of China's population and the low desire of elderly people to purchase institutionalised elderly care services, we explored the willingness of Chinese elderly people to purchase institutionalised elderly care services and its influencing factors. DESIGN This was a cross-sectional study. Three multivariate logistic regression analysis models of the willingness of elderly people to purchase institutionalised elderly care services were established (model 1: 'reluctance - willingness'; model 2: 'reluctance - hesitation'; and model 3: 'hesitation - willingness') to explore the factors that influence elderly people's willingness to purchase institutionalised elderly care services. SETTING This study was based on the 2022 Psychology and Behaviour Investigation of Chinese Residents database. PARTICIPANTS Research data from 4123 older adults who met the requirements of this study were screened from the database. RESULTS Of the 4123 respondents, roughly equal numbers had negative and positive attitudes towards purchasing institutionalised senior care services (1125, 27.3% vs 1079, 26.2%, respectively), and 1919 (46.5%) had hesitant attitudes. The analysis of model 1 showed that medical insurance participation, the number of children and siblings, chronic diseases and per capita monthly household income had an influential effect on the willingness of elderly people to purchase institutional care. In model 2, we found that factors such as per capita monthly household income and anxiety led to hesitancy among older adults to purchase institutionalised senior care services. In model 3, we further found that social support and health literacy led to a shift from hesitation to willingness to purchase institutionalised elderly care services. CONCLUSION The number of children, number of siblings, per capita monthly income of the family, medical insurance participation, health status, health literacy and social support were found to be the main factors influencing the purchase of institutionalised care by elderly individuals.
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Affiliation(s)
- Rui Zhu
- School of Nursing, Bengbu Medical College, Bengbu, Anhui, China
| | - Wenjie Hou
- School of Nursing, Bengbu Medical College, Bengbu, Anhui, China
| | - Lingmeng Wang
- School of Nursing, Bengbu Medical College, Bengbu, Anhui, China
| | - Chenchen Zhang
- School of Nursing, Bengbu Medical College, Bengbu, Anhui, China
| | - Xing Guo
- School of Nursing, Bengbu Medical College, Bengbu, Anhui, China
| | - Dan Luo
- School of Nursing, Bengbu Medical College, Bengbu, Anhui, China
| | - Fuzhi Wang
- School of Nursing, Bengbu Medical College, Bengbu, Anhui, China
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Larkey FA, Hughes M, Nancarrow S. The experience of entering residential aged care: The views of residents, family members and staff-an Appreciative Inquiry. Australas J Ageing 2024; 43:52-60. [PMID: 37828653 DOI: 10.1111/ajag.13236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 08/05/2023] [Accepted: 08/10/2023] [Indexed: 10/14/2023]
Abstract
OBJECTIVES To understand resident, family and staff perspectives of older people's transition to residential aged care and initiatives that support this transition. METHODS A qualitative Appreciative Inquiry was undertaken with residents, family members and staff in residential aged care. It included semistructured interviews (n = 40), three focus groups (n = 17) and an organisational summit (n = 72). Each stage sought to build on the previous one, deepening understanding of the issues experienced and identifying positive strategies for change. Data were analysed thematically using framework analysis. RESULTS The transition experience was characterised by grief and guilt felt by family members and the challenges they faced in participating in a decision to admit a relative to residential aged care. Residents found the transition challenging but stressed the need to adjust to the situation. Family members struggled with trusting others to provide appropriate care and both residents and relatives reported challenges in communicating with staff. Initiatives were recommended by the organisational summit to assist in the transition to residential aged care. These included developing a service navigator role, co-designing new systems and resources with residents and relatives, and ensuring more consistent staffing. CONCLUSIONS Improved communication strategies and resources are needed to support the resident's identity, build trust in the organisation and support transition to residential aged care. Staff should continue to value the contribution family members play in the life of the resident and the culture of the aged care community.
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Affiliation(s)
- Frances Anne Larkey
- Research and Innovation: Wesley Mission Queensland, Southern Cross University, Bilinga, Queensland, Australia
| | - Mark Hughes
- Faculty of Health, Southern Cross University, Bilinga, Queensland, Australia
| | - Susan Nancarrow
- Faculty of Health, Southern Cross University, Bilinga, Queensland, Australia
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Marsh P, Courtney Pratt H, Kelly L, White L. Film as cooperative endeavour: The promises for people living with dementia, their relatives, caregivers and aged care staff. DEMENTIA 2023; 22:1440-1460. [PMID: 37295968 PMCID: PMC10521151 DOI: 10.1177/14713012231183394] [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] [Indexed: 06/12/2023]
Abstract
Creative expression by people living with dementia and their families and carers can improve communication and relationships and strengthen relational personhood. The transition to residential aged care from living at home with dementia is a time of 'relocation stress", and a time when additional psychosocial supports like these might be particularly beneficial. This article reports on a qualitative study that explored how a co-operative filmmaking project functioned as a multifaceted psychosocial intervention, and explored its potential impacts on relocation stressors. Methods included interviews with people living with dementia who were involved in the filmmaking, and their families and close others. Staff from a local day centre and residential aged care home also took part in interviews, as did the filmmakers. The researchers also observed some of the filmmaking process. Reflexive thematic analysis techniques were used to generate three key themes in the data: Relationship building; Communicating agency, memento and heart; Being visible and inclusive. The findings reveal challenges regarding privacy and the ethics of public screenings, as well as the pragmatics of using short films as a communication tool in aged care settings. We conclude that filmmaking as a cooperative endeavour holds promise to mitigate relocation stressors by: improving family and other relationships during challenging times for family and for people living with dementia; providing opportunities for new self-narratives derived from relational subjectivities; supporting visibility and personhood; and improving communication once in residential aged care. This research has relevance for communities who are looking to support dynamic personhood and improve the care of people living with dementia.
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Affiliation(s)
| | | | - Lisa Kelly
- University of Tasmania, Hobart, AU-TAS, Australia
| | - Lynsey White
- University of Tasmania, Hobart, AU-TAS, Australia
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Guo Y, Liu S, Zhou F, Hu Z, Li S, Xu H. Psychometric properties of the Chinese version of the Nursing Home Adjustment Scale (C-NHAS) in Central China: Classical test theory and item response theory. Geriatr Nurs 2023; 51:102-111. [PMID: 36921393 DOI: 10.1016/j.gerinurse.2023.02.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 02/21/2023] [Accepted: 02/21/2023] [Indexed: 03/14/2023]
Abstract
Evidence for the nursing home adjustment scale (NHAS)' s applicability in less developed regions of China is still absent. Besides, there is a need to provide further validity evidence for the NHAS using modern test theory. This study aims to investigate the psychometric properties of the Chinese version of the NHAS (C-NHAS) in a sample of nursing home residents in central China. A total of 761 older adults who lived in 21 nursing homes in Hunan Province, China, were investigated from July 2021 to December 2021. The C-NHAS yielded a four-factor structure and showed good reliability and validity. The difficulty of items matched most individuals' ability, while a small number of individuals with low ability had no items for matching. The results indicated the C-NHAS is a reliable and valid instrument while the high difficulty may restrict the performance of the C-NHAS among the less educated older adults.
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Affiliation(s)
- Yicong Guo
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, Hunan, China
| | - Siyue Liu
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, Hunan, China
| | - Feixiang Zhou
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, Hunan, China
| | - Zhao Hu
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, Hunan, China
| | - Shaojie Li
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, Hunan, China
| | - Huilan Xu
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, Hunan, China.
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Plys E, Levy C. Depression within the First Year of Relocation to Residential Care/Assisted Living: Where You Come From Matters. J Appl Gerontol 2022; 41:2532-2541. [PMID: 35930794 DOI: 10.1177/07334648221117524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Depression is common within the first year of relocation to residential care/assisted living (RC/AL). Yet, few studies investigate the relationship between depression and relocation factors that might help identify at-risk residents, such as previous location. This study analyzed cross-sectional resident data (n = 2651) from the National Survey of Residential Care Facilities to test: (1) group differences between residents relocating from acute/post-acute facilities (e.g., hospital, rehabilitation facility) and community-based residences, and (2) the relationship between previous location and depression within the first year of relocation. The 921 (35%) residents relocating directly from acute/post-acute facilities were more likely to have depression (p < .001) and poorer outcomes on select health and psychosocial variables. After controlling for covariates, relocating directly from an acute/post-acute facility significantly related to depression (OR = 1.22). Findings highlight opportunities to improve routine screening and transitional care for this subpopulation of RC/AL residents at heightened risk for depression.
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Affiliation(s)
- Evan Plys
- Department of Psychiatry, 129263University of Colorado School of Medicine, Aurora, CO, USA
| | - Cari Levy
- Department of Medicine, 19982Rocky Mountain Regional VA Medical Center, Aurora, CO, USA.,Division of Health Care Policy and Research, Department of Medicine, University of Colorado School of Medicine - Anschutz Medical Campus, Aurora, CO, USA
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