Suffering and mental health among older people living in nursing homes-a mixed-methods study

Spiritual Care Perspectives of Elderly Individuals with Parkinson's Disease and Formal Caregivers: A Qualitative Study in Turkish Nursing Homes

This study aimed to determine the perceptions and experiences of elderly individuals with Parkinson's disease and formal caregivers regarding spiritual care. A qualitative study was conducted using a descriptive phenomenological design. Fifteen formal caregivers and eight elderly individuals with Parkinson's disease from two nursing homes in Türkiye participated in the study. Data were collected through face-to-face individual interviews, and thematic analysis was employed to examine the data. Two themes were obtained from the data analysis: (I) spiritual care in nursing homes and (II) living with Parkinson's disease in nursing homes. Findings showed that living in a nursing home with Parkinson's disease affects the spiritual dimensions of elderly individuals and increases their spiritual needs. Additionally, it was found that although formal caregivers implemented a diverse range of practices to address the spiritual care needs of individuals residing in a nursing home, they did not offer any specific spiritual care practices for individuals with Parkinson's disease. Based on our findings, it is considered necessary to have spiritual counselors and formal caregivers with expertise in Parkinson's disease in nursing homes.

The effect of intergenerational support from children on loneliness among older adults-the moderating effect of internet usage and intergenerational distance

Objective

Loneliness is a key social and public health issue, mainly affecting the mental health of older adults. The article aimed to explore the influence of intergenerational support from children on loneliness among older adults. Meanwhile, the article also analyzed the moderating effects of internet usage and intergenerational distance in this process.

Methods

Based on the data received from 2018 China Longitudinal Aging Social Survey (CLASS), the ordinary least square (OLS) regression model was used to analyze the influence of intergenerational support from children on loneliness among older adults. Furthermore, the Bootstrap method was used to test the moderating effect of internet usage and intergenerational distance on the relationship between intergenerational support from children on loneliness among older adults.

Results

Baseline regression showed that economic support (β = -0.059, p < 0.001), caregiving support (β = -0.070, p < 0.001), and emotional support (β = -0.108, p < 0.001) from children can positively influence loneliness among older adults. Meanwhile, the results of the moderated effects analysis showed that internet usage and intergenerational distance moderates the relationship between caregiving support, emotional support from children and loneliness among older adults.

Conclusion

The article demonstrates that family support, particularly intergenerational support from children plays a pivotal role in alleviating loneliness among older adults, so the government should further regulate the behavior of children's alimony support, improve the digital infrastructure, these measures help to reduce loneliness among older adults and expand the depth and breadth of family care of older adults.

The effects of resourcefulness-based instrumental reminiscence therapy on psychological adjustment in nursing home residents: a randomised controlled trial

BACKGROUND

Older adults do not always adapt successfully to nursing homes. Learning resourcefulness and instrumental reminiscence may contribute to the psychological adjustment made by nursing home residents. How both attributes can be combined to enhance residents' adjustment remains unclear.

OBJECTIVES

This study examined the effects of resourcefulness-based instrumental reminiscence therapy (RBIRT) on psychological adjustment, learned resourcefulness, self-efficacy, social support and quality of life (QoL) of nursing home residents.

METHODS

A randomised, controlled, assessor-blinded, parallel-arm trial was conducted between January 2022 and February 2023 in Fujian, China, with 120 participants (intervention = 60, comparison = 60) from two separate nursing homes. The intervention group participants received a 6-week RBIRT, involving Reminiscence Interview, Emotional Venting, Reconstruction Strategies, Planning for the Future and Strengthening Support. The control group participants received routine institutional care. Participants were assessed using the Nursing Home Adjustment Scale, Resourcefulness Scale, General Self-efficacy Scale, Perceived Social Support Scale and the 12-item Short-Form Health Survey. Outcomes were evaluated at baseline (T0), immediately post intervention (T1) and at 1-month (T2) and 3-months (T3) post-intervention.

RESULTS

Participants in the intervention group showed significant improvement in 'psychological adjustment,' 'learned resourcefulness,' 'self-efficacy,' 'social support' and 'QoL-mental health dimension' compared to the control group (P < 0.001). These effects were sustained at the 1- and 3-month follow-ups.

CONCLUSIONS

Innovative RBIRT improved psychological adjustment, learned resourcefulness, self-efficacy, social support and mental health-related QoL among nursing home residents.

Integrating social support into interventions among the elderly in nursing homes: a scoping review

OBJECTIVES

This study aimed to understand the evidence related to integration of social support into interventions, to identify literature gaps related to social support interventions, and to clarify dimensions of supportive functions, outcomes, and providers among the elderly in nursing homes.

DESIGN

This scoping review followed the approach by Arksey and O'Malley. The Mixed Methods Appraisal Tool V.2018 was used for quality assessment of the studies.

DATA SOURCES

Searches were conducted of the PubMed, ScienceDirect, Public Library of Science, SocioHub, Wiley Online Library and PsycINFO databases for publications from 2010 to 2021.

ELIGIBILITY CRITERIA FOR SELECTING STUDIES

We searched for primary studies and heterogeneous study designs published in English. Eligible studies took place in nursing and care homes and had study populations of elderly adults (older adults, geriatrics, ageing, seniors, older people and those aged 60 years and older).

DATA EXTRACTION AND SYNTHESIS

A data extraction form based on Joanna Briggs Institute's recommendations for scoping reviews was used. Two reviewers independently extracted data and performed quality assessment of the studies. Then, extracted data and quality assessment reports were discussed by all authors.

RESULTS

Thirty-one eligible studies were included in this review. 54.8% of the studies provided interventions for cognitively impaired residents. The top-three outcomes were neuropsychiatric symptoms, physical function and quality of life, respectively. The interventions were performed by nursing home staff (83.9%), other persons with specific qualifications (58.1%) and health volunteers (6.5%). Most studies (90.3%) depicted the integration of emotional and instrumental supportive functions into interventions.

CONCLUSION

The appropriate dimensions of supportive function, mainly emotional and instrumental support, are important to integrate into the social care of elderly people living in nursing homes.

Investigating the relationship between satisfaction of basic psychological needs, general health, and some background variables in the Iranian older adults: a cross-sectional study

BACKGROUND

Promoting the health and mental health (MH) of the older adults making up a large part of the world's population in the coming years can provide the necessary conditions for their health and well-being of them. This study aimed to investigate the relationship between the satisfaction of basic psychological needs (BPNs), general health (GH), and some variables in Iranian older adults.

METHODS

The present descriptive-correlational study was conducted on 780 older adults from Sarpol-e Zahab (Kermanshah) in 2019 including the study by multi-stage cluster random sampling. The data collection tool was BPNs satisfaction and GH questionnaire and a researcher-made questionnaire of individual and background information. Was used for data analysis using the SPSS version 16 program and descriptive statistics and tests Pearson correlation coefficient, chi-square test, independent-sample T-test, and multivariate linear regression.

RESULTS

In the present study, participating a total of 780 older adult men aged 73.0 ± 29.32 years. There was a significant relationship between the satisfaction of BPNs and GH (p <  0.001). Also, 41% of the older adults were in poor GH and 30% were high in BPNs. Multiple logistic regression showed that the BPNs, age, income satisfaction, weather, and war zone were strong predictors of GH. the adjusted R2 value of 0.55 shows that the model described 55% of changes in the GH score.

CONCLUSION

According to the findings of the study on the relationship between the satisfaction of BPNs and GH, providing insurance, social and economic support by developing health policies, creating supportive health environments, strengthening community action, and developing individual skills in the older adults can help improve their MH and that of the community.

The use of digital touch screen technology to deliver reminiscence therapy among people with dementia in Jordanian care homes: a mixed-method feasibility study

BACKGROUND

Using technology to deliver psychosocial interventions such as reminiscence therapy (RT) to people with dementia may improve their mental health. Yet, establishing the feasibility of digital interventions in low- to middle-income countries is still in the early stages. This study aimed to: (i) determine the feasibility of using digital touch screen technology to deliver RT among people with dementia living in Jordanian care homes; and (ii) compare study outcomes pre- and post-reminiscence sessions to investigate whether specific outcomes are sensitive to change and explore the acceptability and experiences of the intervention.

METHODS

A pragmatic mixed-method study design was implemented. Sixty residents with dementia were recruited from two Jordanian care homes (Site 1: n = 35; Site 2: n = 10). A process evaluation was conducted alongside a single-group pre-post-intervention study. The intervention involved 10 supported RT sessions of up to 1 h each, delivered over 5 weeks. Feasibility was determined by assessing the rate of recruitment, adherence, retention, data completion, implementation fidelity, and adverse events. Qualitative semi-structured interview questions were used to explore experience and acceptability, and data were thematically analysed.

RESULTS

Response rate was 100%; loss to follow up at post-intervention was 25%. Median session attendance for those who received the intervention was 80%. No serious adverse events were reported. A positive, statistically significant and clinically relevant difference was found in all outcome measures before and after reminiscence sessions. Qualitative findings suggest that digital RT intervention is generally well accepted by people with dementia who reported positive changes, including enhanced communication and cognitive abilities.

CONCLUSION

Using digital touch screen technology to deliver RT is feasible and acceptable among people with dementia in Jordanian care homes. Digital RT intervention is a promising approach to improving mental health and communication for people living with dementia.

Integrating social support into interventions among the elderly in nursing homes: a scoping review protocol

INTRODUCTION

The instituted elderly in nursing home need professional support targeting to maintain their daily activities and quality of life. Social support affects the health of elderly through its influence as a stress buffering or main effects on emotions, cognitions and behaviour that improve health outcomes. Understanding and identifying available interventions for the elderly in the literature related to integrating social support into interventions will be benefits to guide future practice, research and policy.

METHODS AND ANALYSIS

A scoping review designed by Arksey and O'Malley has been used in this study. Key words, inclusion and exclusion criteria were elaborated to search the primary articles that published in English from 2010 to 2021 mainly from PubMed, Science Direct, Public Library of Science, SocioHub, Wiley Online Library and PsycINFO databases targeting to reach the selected articles and combined the results with reference lists and hand searches. The Mixed Methods Appraisal Tool version 2018 will be used to identify the quality of the studies. Authors developed the Data Extraction Form for data extraction and analysis. The Preferred Reporting Items for Systematic Reviews and Meta-analyses extension for Scoping Reviews tool will be employed for reporting guideline.

ETHICS AND DISSEMINATION

Authors forecast to obtain relevant studies reporting integrating specific dimensions of supportive functions into interventions for the elderly in nursing home. This finding will benefit in quality improvement of supportive interventions in nursing home and to continue the further experimental study. The findings will be disseminated via electronic and hard copy through peer-reviewed publications, conference presentations and internal organisation meeting.

A systematic review of language and communication intervention research delivered in groups to older adults living in care homes

BACKGROUND

The communication skills of older adults living in care homes is an underexplored topic. Ageing can lead to reduced communication ability and activity; and in the care home environment there may also be fewer communication opportunities. This situation is likely to negatively impact well-being. Previous reviews have found evidence of the effectiveness of behavioural interventions in increasing well-being, but no systematic review to date has focused specifically on the evidence base for group language and communication interventions in this population.

AIMS

To identify and evaluate the evidence for behavioural interventions with older adults, delivered in groups in care homes, that specifically included a language or communication activity. To explore the impact of such intervention on the specific domains of language, communication and social interaction. To determine whether behavioural mechanisms of action can be identified.

METHODS & PROCEDURES

Embase, Medline, Ovid Nursing database, Psych info and CINAHL complete were searched and produced 158 records for screening, of which 22 remained for review. In order to identify and evaluate the quality of the evidence base presented the following research questions were posed: What research has been conducted in this area? What is the methodological quality of the studies identified? How complete is the intervention reporting? How was change measured in the domains of language, communication and social interaction? Is there evidence of efficacy, indicated by statistically significant improvement, in these domains? How did the interventions work? Synthesis tools employed included the PEDro-P Scale, the TIDieR checklist and the ITAX.

MAIN CONTRIBUTION

A total of 22 studies met the criteria for review. One study used solely language or communication interventions, but the remaining 21 studies used behavioural interventions which incorporated language and communication activities to varying degrees. Studies fell into four broad intervention types: reminiscence or life review; cognitive stimulation; narrative or storytelling; and multi-modality group communication. The majority of studies were of fair methodological quality, with a moderate level of detail provided in treatment reporting. Statistically significant improvement was reported by authors in all four intervention types and across language, communication and social domains. Social interaction, social support and behavioural skills were the most consistent mechanisms of action in the reviewed behavioural interventions.

CONCLUSIONS & IMPLICATIONS

Despite limitations in the evidence base, there are important positive signs for the beneficial effects of supporting language and communication in care homes. Blinding of assessors, and the accuracy and accessibility of statistical reporting are important areas to address in order to improve the quality of the evidence base.

WHAT THIS PAPER ADDS

Ageing can lead to reduced communication ability and activity, and in the care home setting there may also be fewer communication opportunities. This situation is likely to negatively impact well-being. Previous reviews have found evidence of the effectiveness of behavioural interventions in increasing well-being. The communication skills of older adults living in care homes is an underexplored topic. No systematic review to date has focused specifically on the evidence base for group language and communication interventions in this population. This review reveals important positive signs for the beneficial effects of supporting language and communication in care homes. Social interaction, social support, and behavioural skills were the most consistent mechanisms of action in the reviewed behavioural interventions.

Can theory of mind of healthy older adults living in a nursing home be improved? A randomized controlled trial

BACKGROUND

Research in nursing homes mainly focused on interventions for residents affected by cognitive decline. Few studies have considered healthy older adults living in nursing homes, and this research targeted cognitive functioning.

AIMS

To evaluate whether socio-cognitive abilities can be improved by means of a theory of mind (ToM) training conducted by nursing home's operators.

METHODS

RESULTS: Results revealed that older adults benefitted from the ToM intervention in both practiced and non-practiced tasks, while the control group showed no change from pre- to post-test evaluation. Analyses on errors scores indicated that the ToM intervention led to a reduction of both excessive mentalizing and absence of mental states inference.

DISCUSSION

The conversation-based ToM intervention proved to be effective in improving socio-cognitive skills in cognitively healthy nursing home residents. Notably, older adults were able to transfer the skills acquired during the training to new material.

CONCLUSIONS

Promoting healthy resident's ToM ability could positively impact on their social cognition, consequently increasing their quality of life. Our findings showed that the intervention can be feasibly managed by health care assistants within the residential context.

Changes in depressive symptoms and cognitive impairment in older long-stay nursing home residents in the USA: a latent transition analysis

OBJECTIVES

To longitudinally examine the latent statuses of depressive symptoms and their association with cognitive impairment in older U.S. nursing home (NH) residents.

METHOD

Using Minimum Data Set 3.0, newly-admitted, long-stay, older NH residents with depression in 2014 were identified (n = 88,532). Depressive symptoms (Patient Health Questionnaire-9) and cognitive impairment (Brief Interview of Mental Status) were measured at admission and 90 days. Latent transition analysis was used to examine the prevalence of and the transition between latent statuses of depressive symptoms from admission to 90 days, and the association of cognitive impairment with the statuses at admission.

RESULTS

Four latent statuses of depressive symptoms were identified: 'Multiple Symptoms' (prevalence at admission: 17.3%; 90 days: 13.6%), 'Depressed mood' (20.0%; 19.5%), 'Fatigue' (27.4%; 25.7%), and 'Minimal Symptoms' (35.3%; 41.2%). Most residents remained in the same status from admission to 90 days. Compared to residents who were cognitively intact, those with moderate impairment were more likely to be in 'Multiple Symptoms' and 'Fatigue' statuses; those with severe impairment had lower odds of belonging to 'Multiple Symptoms', 'Depressed Mood', and 'Fatigue' statuses.

CONCLUSION

By addressing the longitudinal changes in the heterogeneous depressive symptoms and the role of cognitive impairment, findings have implications for depression management in older NH residents.

About a Third of Nursing Home Social Services Directors Have Earned a Social Work Degree and License

Nursing home (NH) residents have high psychosocial needs related to illness, disability, and changing life circumstances. The staff member with the most expertise in addressing psychosocial needs is the social worker. However, federal regulations indicate that only NHs with 120+ beds need hire a social services staff member and that a "qualified social worker" need not have a social work degree. Therefore, two-thirds of NHs are not required to employ a social services staff member and none are required to hire a degreed social worker. This is in stark contrast to NASW professional standards. Reporting findings from this nationally representative sample of 924 social services directors, we describe the NH social services workforce and document that most NHs do hire social services staff, although 42% of social services directors are not social work educated. 37% of NHs have a degreed and licensed social worker at the helm of social services. The odds of hiring a degreed and licensed social workers are higher for larger NHs, especially if not-for-profit and not part of a chain. NH residents deserve psychosocial care planned by staff with such expertise. Quality of psychosocial care impacts quality of life.

Factors associated with nursing home adjustment in older adults: A systematic review

BACKGROUND

An ageing population has resulted in increased numbers of older adults moving to a nursing home, and the challenges triggered by relocation are highlighted. Various factors are identified to be associated with relocation and psychological adjustment to living in a nursing home. However, no systematic review has synthesised the evidence, and its associated factors remain unclear.

OBJECTIVE

To examine and synthesise the best available evidence on the factors associated with adjustment to living in a care facility.

DESIGN

Systematic review.

DATA SOURCES

Nine electronic databases were searched from database inception to March 2020: Pubmed, Embase, CINAHL, PsycINFO, Cochrane library, China National Knowledge Infrastructure, China Wanfang Database, Chinese Biomedical Literature Database, Chinese Periodical Full-text Database.

REVIEW METHODS

The references listed in the included studies were manually checked. The quality of the eligible studies was assessed using the 11-item checklist of the Agency for Healthcare Research and Quality.

RESULTS

A total of 20 studies were included in this review, with 17 cross-sectional studies, and three longitudinal study. 19 studies were rated as moderate quality and the other one was high quality. 17 measures were used to assess nursing home adjustment. Six distinct categories of the associated factors for nursing home adjustment were identified: demographic characteristics (n = 11), physiological factors (n = 3), psychological factors (n = 9), social factors (n = 9), relocation factors (n = 6), and facility factors (n = 5).

CONCLUSIONS

Decision-making control, self-efficacy, social support, activities of daily living, and length of stay should all be taken into account when assisting resident scoping with a relocation to a nursing home. Infuture research, multiple areas can be considered when improving the level of nursing home adjustment, as well as interventions and health policies.

REGISTRATION NUMBER

PROSPERO CRD 42018115935.

TWEETABLE ABSTRACT

A systematic review of the factors associated with adjustment to living in a care facility.

Is the Physical Environment Associated with Spiritual and Religious Coping in Older Age? Evidence from Brazil

In this cross-sectional Brazilian survey, we examined associations between aspects of physical environment (PE) and spiritual/religious coping (SRC) behaviors. Our studied sample was 77 nursing homes (NH) and 326 community-dwelling residents (CDRs). Aspects of the PE were measured using the environmental domain of the WHOQOL-BREF. SRC was assessed using the BRIEF SRC scale. The PE was significantly associated with positive SRC alone and differed between the two studied samples. "Feeling safe in daily life" and "having access to health services" were positively associated with positive SRC behaviors in NH residents. "Having access to information" and "adequate transport" were significant among CDRs. Positive SRC behaviors are influenced by PE and should be considered in geriatric and gerontology care.

The assessment of anxiety in aged care residents: a systematic review of the psychometric properties of commonly used measures

ABSTRACTBackground:Assessing anxiety among residential aged care facility (RACF) residents is challenging, and it cannot be assumed that valid and reliable measures used within the community are also appropriate for this setting. This review systematically examined the literature to identify which anxiety measures were most commonly used with older adults in RACFs, and determine whether psychometric data support their use within this population.

METHODS

Using the PRISMA guidelines, five electronic databases were searched using key terms and subject headings. The search was limited to literature published in English. Eligible studies utilized an anxiety measure to assess anxiety symptoms among RACF residents. Based on the findings of this search, a critical review of the research into the reliability, validity, and administrative and respondent burden of the most commonly used measures (i.e. used in four or more studies) was conducted.

RESULTS

In total, 1,771 articles were identified, with 50 studies included in this review. Overall, 22 measures were used, with the majority of studies utilizing a clinician-administered or self-report measure. The RAID, HADS, STAI, and GAI were the most commonly used measures. While overall there is a lack of research and consensus into the psychometric properties of these measures within RACFs, strongest evidence of reliability and validity was found for the GAI.

CONCLUSION

Commonly used measures of anxiety within aged care populations are not well validated for this complex subsample of older adults. Strengths and weaknesses of each measure with regards to their usefulness in aged care settings are discussed, with future research areas highlighted.