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Results 1 - 10 of 421

Loneliness: how do you know your council is actively tacking loneliness?


Sets out a framework of interventions for tackling loneliness, which could be used to shape local areas delivery plans. There is a growing body of research showing that loneliness is a serious condition which can have a harmful effect on individuals’ physical and mental health, as well as bringing costs to public finance, particularly health and social care, and to the economy. The report argues that it is important that local areas define the nature of loneliness in their area, and who is at risk, through their JSNA, using local intelligence and national information such as that provided by the ONS and Age UK’s Loneliness heat map. The document identifies a number of services and approaches that provide the first steps in finding individuals who are experiencing loneliness and enabling them to gain support that meets their specific needs. These include: first contact schemes; door-knocking schemes, targeting people at risk; formal social care assessments; social prescribing in primary care; home from hospital or admissions avoidance schemes; information about activity to tackle loneliness available through settings such as supermarkets, one-stop-shops, pharmacies and GP surgeries. The report also considers direct interventions, which can help people maintain existing relationships and develop new ones, including: group activities such as men’s groups, lunch clubs, walking groups, book groups for people with mental health problems, choirs, and cooking groups for young parents; one-to-one approaches such as befriending schemes; psychological support, such as counselling or cognitive-behavioural therapy. Specific community approaches provide an enabling environment and include: establishing age-friendly, dementia-friendly and mental health-friendly communities; developing volunteering, including people who might not ordinarily volunteer; mobilising peer support, and intergenerational support in neighbourhoods. In addition, gateway services such as transport, technology, spatial planning and housing make it easier for communities to come together and help people build and maintain social connections.

Using dolls for therapeutic purposes: A study on nursing home residents with severe dementia


Objectives: Among the psychosocial interventions intended to reduce the behavioural and psychological symptoms of dementia (BPSD), doll therapy (DT) is increasingly used in clinical practice. Few studies on DT have been based on empirical data obtained with an adequate procedure; however, none have assessed its efficacy using an active control group, and the scales used to assess changes in BPSD are usually unreliable. The aim of the present study was to measure the impact of DT on people with severe dementia with a reliable, commonly used scale for assessing their BPSD, and the related distress in formal caregivers. Effects of DT on the former's everyday abilities (i.e., eating behaviour) were also examined. Method: Twenty‐nine nursing home residents aged from 76 to 96 years old, with severe dementia (Alzheimer's or vascular dementia), took part in the experiment. They were randomly assigned to an experimental group that used dolls or an active control group that used hand warmers with sensory characteristics equivalent to the dolls. Benefits of DT on BPSD and related formal caregiver distress were examined with the Neuropsychiatric Inventory. The effects of DT on eating behaviour were examined with the Eating Behavior Scale. Results: Only the DT group showed a reduction in BPSD scores and related caregiver distress. DT did not benefit eating behaviour, however. Conclusions: This study suggests that DT is a promising approach for reducing BPSD in people with dementia, supporting evidence emerging from previous anecdotal studies.

Place, belonging and the determinants of volunteering

DALLIMORE David J., et al

The article discusses findings from an ethnography investigating how volunteering in local associational life is changing, asking whether structural factors fixed in localities remain important or whether, as others have suggested, volunteering is becoming disembedded from place. Across two locations, how situational variables, including belonging, identification and interaction, remain important determinants of volunteering, and how the relationship between people and their localities has distinct meanings were observed. In one locality, people participated as volunteers because they had a strong sense of belonging; in the other, they often volunteered because they wanted to belong. Findings: local voluntary association is important in forming bridges between people in 'places' and wider society, but that differing notions of belonging mean that localities are not equally situated to operate as effective conduits. Conclusion: understanding these dynamics is important for outside agencies in delivering support and public services.

LAUGH: playful objects in advanced dementia care


The article reports on an international research project led by the Cardiff School of Art and Design at Cardiff Metropolitan University to develop highly personalised, playful objects for people with advanced dementia. The aim of the project was to understand the best ways to design objects that can give pleasure and comfort to people in the advanced stages of dementia and to provide guidance for designers working in the sector. The article discusses the participatory approach to the research, testing and feedback and provides an example of one of the LAUGH objects that was found to have a significant impact on wellbeing - a comforting "Hug". The article also covers how the objects stimulate memories and some of the outcomes from the project and future direction.

Imagine Arts: how the arts can transform care homes


Imagine Arts was a three year programme funded by Arts Council England and the Baring Foundation involving a collaboration between the national home care provider Abbeyfield, Nottingham council, local arts organisations and Nottingham University. The aim was to enrich the lives of older people in care homes. Residents in 17 care homes took part in the programme, many of whom had dementia. This article discusses the outcomes of an independent evaluation that looked at the impact of Arts on care homes. Findings suggest that the delivery of high quality arts activities in care homes is feasible. Overall, residents had positive reflections and socialisation seemed to improve as the series of arts sessions progressed. The article also discusses the culture shift that is needed to embed the arts fully in residential care. The article also comments on the project legacy and provides some recommendations for care homes looking to introduce arts programmes.

Improving social support for older adults through technology: findings from the prism randomized controlled trial

CZAJA Sara J., et al

Objectives: Information and communication technology holds promise in terms of providing support and reducing isolation among older adults. The impact of a specially designed computer system for older adults, the Personal Reminder Information and Social Management (PRISM) system is evaluated in this study. Design, Setting, and Participants: The trial was a multisite randomized field trial conducted at 3 sites. PRISM was compared to a Binder condition wherein participants received a notebook that contained paper content similar to that contained in PRISM. The sample included 300 older adults at risk for social isolation who lived independently in the community (Mage = 76.15 years). Primary outcome measures included indices of social isolation, social support, loneliness, and well-being. Secondary outcome measures included indices of computer proficiency and attitudes toward technology. Data were collected at baseline and at 6 and 12 months post-randomization. Results: The PRISM group reported significantly less loneliness and increased perceived social support and well-being at 6 months. There was a trend indicating a decline in social isolation. Group differences were not maintained at 12 months, but those in the PRISM condition still showed improvements from baseline. There was also an increase in computer self-efficacy, proficiency, and comfort with computers for PRISM participants at 6 and 12 months. Discussion: The findings suggest that access to technology applications such as PRISM may enhance social connectivity and reduce loneliness among older adults and has the potential to change attitudes toward technology and increase technology self-efficacy.

Efficacy of nature-based therapy for individuals with stress-related illnesses: randomised controlled trial

STIGSDOTTER Ulrika Karlsson, et al

Background: Stress-related illnesses are a major threat to public health, and there is increasing demand for validated treatments. Aims: To test the efficacy of nature-based therapy (NBT) for patients with stress-related illnesses. Method: Randomised controlled trial (ClinicalTrials.gov ID NCT01849718) comparing Nacadia® NBT (NNBT) with the cognitive–behavioural therapy known as Specialised Treatment for Severe Bodily Distress Syndromes (STreSS). In total, 84 participants were randomly allocated to one of the two treatments. The primary outcome measure was the mean aggregate score on the Psychological General Well-Being Index (PGWBI). Results: Both treatments resulted in a significant increase in the PGWBI (primary outcome) and a decrease in burnout (the Shirom–Melamed Burnout Questionnaire, secondary outcome), which were both sustained 12 months later. No significant difference in efficacy was found between NNBT and STreSS for primary outcome and secondary outcomes. Conclusions: The study showed no statistical evidence of a difference between NNBT and STreSS for treating patients with stress-related illnesses.

Yoga-based exercise improves health-related quality of life and mental well-being in older people: a systematic review of randomised controlled trials

TULLOCH Alice, et al

Objective: health-related quality of life (HRQOL) and mental well-being are associated with healthy ageing. Physical activity positively impacts both HRQOL and mental well-being. Yoga is a physical activity that can be modified to suits the needs of older people and is growing in popularity. A systematic review was conducted with meta-analysis to determine the impact of yoga-based exercise on HRQOL and mental well-being in people aged 60+. Methods: searches were conducted for relevant trials in the following electronic databases; MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, CINAHL, Allied and Complementary Medicine Database, PsycINFO and the Physiotherapy Evidence Database (PEDro) from inception to January 2017. Trials that evaluated the effect of physical yoga on HRQOL and/or on mental well-being in people aged 60+ years were included. Data on HRQOL and mental well-being were extracted. Standardised mean differences and 95% confidence intervals (CI) were calculated using random effects models. Methodological quality of trials was assessed using the PEDro scale. Results: twelve trials of high methodological quality (mean PEDro score 6.1), totalling 752 participants, were identified and provided data for the meta-analysis. Yoga produced a medium effect on HRQOL (Hedges’ g = 0.51, 95% CI 0.25–0.76, 12 trials) and a small effect on mental well-being (Hedges’ g = 0.38, 95% CI 0.15–0.62, 12 trials). Conclusion: yoga interventions resulted in small to moderate improvements in both HRQOL and mental well-being in people aged 60+ years. Further, research is needed to determine the optimal dose of yoga to maximise health impact.

Cognitive behavioural therapy for fear of falling and balance among older people: a systematic review and meta-analysis

LIU Tai-Wa, et al

Background: fear of falling is prevalent among older people and associated with various health outcomes. A growing number of studies have examined the effects of interventions designed to reduce the fear of falling and improve balance among older people, yet our current understanding is restricted to physiological interventions. Psychological interventions such as cognitive behavioural therapy (CBT) have not been reviewed and meta-analysed. Objective: to perform a systematic review and meta-analysis evaluating the effects of CBT on reducing fear of falling and enhancing balance in community-dwelling older people. Method: randomised controlled trials (RCTs) addressing fear of falling and balance were identified through searches of six electronic databases, concurrent registered clinical trials, forward citation and reference lists of three previous systematic reviews. Results: a total of six trials involving 1,626 participants were identified. Four studies used group-based interventions and two adopted individual intervention. Intervention period ranged from 4 to 20 weeks, and the number and duration of face-to-face contact varied. Core components of the CBT intervention included cognitive restructuring, personal goal setting and promotion of physical activities. The risk of bias was low across the included studies. Our analysis suggests that CBT interventions have significant immediate and retention effects up to 12 months on reducing fear of falling, and 6 months post-intervention effect on enhancing balance. Conclusions: CBT appears to be effective in reducing fear of falling and improving balance among older people. Future researches to investigate the use of CBT on reducing fear of falling and improving balance are warranted.

Reducing falls in older adults recently discharged from hospital: a systematic review and meta-analysis

NASERI Chiara, et al

Background: older adults are known to have increased falls rates and functional decline following hospital discharge, with substantial economic healthcare costs. This systematic review aimed to synthesise the evidence for effective falls prevention interventions in older adults recently discharged from hospital. Methods: literature searches of six databases of quantitative studies conducted from 1990 to June 2017, reporting falls outcomes of falls prevention interventions for community-dwelling older adults discharged from hospital were included. Study quality was assessed using a standardised JBI critical appraisal tool (MAStARI) and data pooled using Rev-Man Review Manager® Results: sixteen studies (total sample size N = 3,290, from eight countries, mean age 77) comprising 12 interventions met inclusion criteria. Findings: home hazard modification interventions delivered to those with a previous falls history (1 study), was effective in reducing the number of falls (RR 0.63, 95%CI 0.43, 0.93, Low GRADE evidence). Home exercise interventions (3 studies) significantly increased the proportion of fallers (OR 1.74, 95%CI 1.17, 2.60, Moderate GRADE evidence), and did not significantly reduce falls rate (RR 1.27, 95%CI 0.99, 1.62, Very Low GRADE evidence) or falls injury rate (RR 1.16, 95%CI, 0.83,1.63, Low GRADE evidence). Nutritional supplementation for malnourished older adults (1 study) significantly reduced the proportion of fallers (HR 0.41, 95% CI 0.19, 0.86, Low GRADE evidence). Conclusion: the recommended falls prevention interventions for older adults recently discharged from hospital are to provide home hazard minimisation particularly if they have a recent previous falls history and consider nutritional supplementation if they are malnourished.

Results 1 - 10 of 421


My Guide: new case example

My Guide: new case example My Guide is a sighted guiding service, started by The Guide Dogs for the Blind Association (Guide Dogs), in which trained volunteers assist blind and partially sighted adults to get out and about, thus helping to prevent social isolation.
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