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Results for 'older people'

Results 11 - 20 of 182

Interventions to reduce social isolation and loneliness among older people: an integrative review


Loneliness and social isolation are major problems for older adults. Interventions and activities aimed at reducing social isolation and loneliness are widely advocated as a solution to this growing problem. The aim of this study was to conduct an integrative review to identify the range and scope of interventions that target social isolation and loneliness among older people, to gain insight into why interventions are successful and to determine the effectiveness of those interventions. Six electronic databases were searched from 2003 until January 2016 for literature relating to interventions with a primary or secondary outcome of reducing or preventing social isolation and/or loneliness among older people. Data evaluation followed Evidence for Policy and Practice Information and Co‐ordinating Centre guidelines and data analysis was conducted using a descriptive thematic method for synthesising data. The review identified 38 studies. A range of interventions were described which relied on differing mechanisms for reducing social isolation and loneliness. The majority of interventions reported some success in reducing social isolation and loneliness, but the quality of evidence was generally weak. Factors which were associated with the most effective interventions included adaptability, a community development approach, and productive engagement. A wide range of interventions have been developed to tackle social isolation and loneliness among older people. However, the quality of the evidence base is weak and further research is required to provide more robust data on the effectiveness of interventions. Furthermore, there is an urgent need to further develop theoretical understandings of how successful interventions mediate social isolation and loneliness.

Effectiveness and cost-effectiveness of community singing on mental health-related quality of life of older people: randomised controlled trial

COULTON Simon, et al

Aims: This study aimed to evaluate the effectiveness and cost-effectiveness of community group singing for a population of older people in England. Method: A pilot pragmatic individual randomised controlled trial comparing group singing with usual activities in those aged 60 years or more. Results: A total of 258 participants were recruited across five centres in East Kent. At 6 months post-randomisation, significant differences were observed in terms of mental health-related quality of life measured using the SF12 in favour of group singing. In addition, the intervention was found to be marginally more cost-effective than usual activities. At 3 months, significant differences were observed for the mental health components of quality of life, anxiety and depression. Conclusions: Community group singing appears to have a significant effect on mental health-related quality of life, anxiety and depression, and it may be a useful intervention to maintain and enhance the mental health of older people.

A review of the basic principles of sustainable community-based volunteering approaches to tackling loneliness and social isolation among older people


This study examines the social, economic and environmental conditions that enable community-based volunteering projects to reduce loneliness and isolation in older people to become successful. It also identifies barriers to volunteering approaches, and how they can be tackled. The study involved a literature review, consultation with stakeholders, and an analysis of eight case studies in Wales. Drawing on the findings, it also sets out a Theory of Change to show how programmes have the potential to reduce loneliness and social isolation and provides a framework for the future self-evaluation of programmes. The study found that schemes employ a range of approaches in order to engage and support their clients, including in-home visits, telephone befriending, and group activities. This can be influenced by funding or its ability to support the project’s aims and outcomes. Other key findings highlight the need for schemes to be able to accurately assess the social and emotional status of older people so as to deliver appropriate interventions; for schemes to target effectively to reach those most at risk. It also found that schemes adopting a participatory approach which places local people at the heart and schemes which focused on smaller geographical areas tended to be more effective. The report makes eight recommendations, which include the development of a standard method or tools for monitoring and evaluating volunteer-led schemes.

Effectiveness of complex falls prevention interventions in residential aged care settings: a systematic review

FRANCIS-COAD Jacqueline, et al

Objective: The objective of this review was to synthesize the best available evidence for the effectiveness of complex falls prevention interventions delivered at two or more of the following levels: resident, facility or organization, on fall rates in the residential aged care (RAC) population. Introduction: Preventing falls in the high risk RAC population is a common global goal with acknowledged complexity. Previous meta-analyses have not specifically addressed complexity, described as falls prevention intervention delivery at multiple levels of a RAC organization, to determine its effect on fall outcomes. Inclusion criteria: The current review considered studies that included participants who were aged 65 years and over residing in long-term care settings providing 24-hour supervision and/or care assistance. Studies that evaluated complex falls prevention interventions delivered by single discipline or multidisciplinary teams across at least two or all of the following levels: residents, RAC facility and RAC organization were eligible. Experimental study designs including randomized controlled trials, controlled clinical trials and quasi-experimental trials that reported on measures related to fall incidence were considered, namely, rate of falls (expressed as the number of falls per 1000 occupied bed days), the number of participants who became fallers (expressed as the number of participants who fell once or more) and the rate of injurious falls (expressed as the number of falls with injury per 1000 occupied bed days). Methods: A three-step search strategy was undertaken, commencing with an initial scoping search of MEDLINE and CINAHL databases prior to an extensive search of all relevant published literature, clinical trial registries and gray literature. Two independent reviewers assessed selected studies for methodological validity using the standardized critical appraisal instrument from the Joanna Briggs Institute System for the Unified Management, Assessment and Review of Information (JBI SUMARI). Data were extracted from the selected studies using the standardized data extraction tool from JBI SUMARI. Quantitative data were pooled in statistical meta-analysis for rate of falls, the number of participants who became fallers and the rate of injurious falls. Meta-analysis was conducted using a random-effect model with heterogeneity assessed using the standard Chi-squared and I2 index. Where statistical pooling was not possible, study findings were presented in narrative form. Results: Twelve studies were included in this review with seven being eligible for meta-analysis. Complex falls prevention interventions delivered at multiple levels in RAC populations did not show a significant effect in reducing fall rates (MD = −1.29; 95% CI [−3.01, 0.43]), or the proportion of residents who fell (OR = 0.76; 95% CI [0.42, 1.38]). However, a sensitivity analysis suggested complex falls prevention interventions delivered with additional resources at multiple levels had a significant positive effect in reducing fall rates (MD = −2.26; 95% CI [−3.72, −0.80]). Conclusions: Complex falls prevention interventions delivered at multiple levels in the RAC population may reduce fall rates when additional staffing, expertise or resources are provided. Organizations may need to determine how resources can be allocated to best address falls prevention management. Future research should continue to investigate which combinations of multifactorial interventions are effective.

Interventions to prevent and reduce excessive alcohol consumption in older people: a systematic review and meta-analysis

KELLY Sarah, et al

Background: harmful alcohol consumption is reported to be increasing in older people. To intervene and reduce associated risks, evidence currently available needs to be identified. Methods: two systematic reviews in older populations (55+ years): (1) Interventions to prevent or reduce excessive alcohol consumption; (2) Interventions as (1) also reporting cognitive and dementia outcomes. Comprehensive database searches from 2000 to November 2016 for studies in English, from OECD countries. Alcohol dependence treatment excluded. Data were synthesised narratively and using meta-analysis. Risk of bias was assessed using NICE methodology. Reviews are reported according to PRISMA. Results: thirteen studies were identified, but none with cognition or dementia outcomes. Three related to primary prevention; 10 targeted harmful or hazardous older drinkers. A complex range of interventions, intensity and delivery was found. There was an overall intervention effect for 3- and 6-month outcomes combined (8 studies; 3,591 participants; pooled standard mean difference (SMD) −0.18 (95% CI −0.28, −0.07) and 12 months (6 studies; 2,788 participants SMD −0.16 (95% CI −0.32, −0.01) but risk of bias for most studies was unclear with significant heterogeneity. Limited evidence (three studies) suggested more intensive interventions with personalised feedback, physician advice, educational materials, follow-up could be most effective. However, simple interventions including brief interventions, leaflets, alcohol assessments with advice to reduce drinking could also have a positive effect. Conclusions: alcohol interventions in older people may be effective but studies were at unclear or high risk of bias. Evidence gaps include primary prevention, cost-effectiveness, impact on cognitive and dementia outcomes.

The association between physical activity and social isolation in community-dwelling older adults

ROBINS Lauren M., et al

Objectives: Social isolation is an increasing concern in older community-dwelling adults. There is growing need to determine effective interventions addressing social isolation. This study aimed to determine whether a relationship exists between physical activity (recreational and/or household-based) and social isolation. An examination was conducted for whether group- or home-based falls prevention exercise was associated with social isolation. Methods: Cross-sectional analysis of telephone survey data was used to investigate relationships between physical activity, health, age, gender, living arrangements, ethnicity and participation in group- or home-based falls prevention exercise on social isolation. Univariable and multivariable ordered logistic regression analyses were conducted. Results: Factors found to be significantly associated with reduced social isolation in multivariable analysis included living with a partner/spouse, reporting better general health, higher levels of household-based physical activity (OR = 1.03, CI = 1.01–1.05) and feeling less downhearted/depressed. Being more socially isolated was associated with symptoms of depression and a diagnosis of congestive heart failure (pseudo R2 = 0.104). Discussion: Findings suggest that household-based physical activity is related to social isolation in community-dwelling older adults. Further research is required to determine the nature of this relationship and to investigate the impact of group physical activity interventions on social isolation.

A return on investment tool for the assessment of falls prevention programmes for older people living in the community


This report presents results of a tool developed by York Health Economics Consortium to assess the potential return on investment (ROI) of falls prevention programmes targeted at older people living in the community. The tool pulls together evidence on the effectiveness and associated costs for four programmes where there was evidence of cost-effectiveness: Otago home exercise, Falls Management Exercise group programme, Tai Chi group exercise, and home assessment and modification. Based on an example analysis, all four interventions were found to be cost-effective, thus producing a positive societal ROI. One out of four interventions was also found to have a positive financial ROI (ie cost savings outweigh the cost of implementation). An accompanying Excel sheet allows for results to be tailored to the local situation based on the knowledge of the user.

What do older people experiencing loneliness think about primary care or community based interventions to reduce loneliness? A qualitative study in England

KHARICHA Kalpa, et al

Twenty-eight community dwelling people, aged 65 and over who reported being ‘lonely much of the time’ or identified as lonely from the de Jong Gierveld six-item loneliness scale in a larger study, participated in in-depth interviews, between June 2013 and May 2014. Views and experiences on seeking support from primary care and community based one-to-one and group based activities, including social and shared interest groups, were explored. Interviews were recorded and transcribed. Thematic analysis was conducted by a multidisciplinary team, including older people. Using two different measures of loneliness enabled a spectrum of loneliness experience to be explored. Two-thirds of the participants were the ‘younger old’ and all were able to leave their homes independently. Older people with characteristics of loneliness were generally knowledgeable about local social and community resources but, for the majority, community and primary care based services for their loneliness were not considered desirable or helpful at this point in their lives. However, group based activities with a shared interest were thought preferable to one-to-one support (befriending) or groups with a social focus. Descriptions of support as being for loneliness and specific to older people discouraged engagement. Older people experiencing or at risk of loneliness did not consider that primary care has a role in alleviating loneliness because it is not an illness. They thought primary care practitioners lack understanding of non-physical problems and that a good relationship was necessary to discuss sensitive issues like loneliness. For many, loneliness was a complex and private matter that they wished to manage without external support.

Pulling together


This practice handbook draws on the work of the Mental Health Foundation's Standing Together project, which facilitated 19 peer-support groups for older people living in extra care housing. The aim of the groups was to improve the emotional and social wellbeing of participants, and reduce loneliness and social isolation. The handbook pulls together learning from the project and provides inspiration to anyone wanting to set up a peer-support group with older people – whether they are tenants in housing schemes, staff or volunteers. It includes information on group activities used by the facilitators, including digital photography activities, memory boxes, collages and art sessions, and flower arranging workshops. It also provides advice on managing conflict between group members, information on how to support a community when a member dies, information for facilitators, and highlights the importance of listening to group members.

An evaluation of the Standing Together project


An evaluation of the Standing Together project, which examines the impact of peer-support groups on the emotional and social wellbeing of people living in extra care housing. Specifically, it looks at whether participation in the Standing Together programme had an effect on the outcomes of loneliness and social isolation; emotional wellbeing; and meaningful activity and community engagement. The groups ran once a week for six months in 19 extra care housing schemes within Housing & Care 21 and Notting Hill Housing Trust. Each group was led by two trained facilitators. Facilitators sought to include all residents from the extra care housing group including individuals with mental health difficulties, dementia, learning disability and/or significant loneliness. Focus group findings, which consisted of 45 residents at baseline and 57 at follow-up, demonstrated that most residents felt that participating in the groups led to positive impacts in all the outcome areas. Residents also expressed a desire for the groups to continue. Staff involved in the programme also felt that the groups led to reduced feelings of isolation and loneliness, increased companionship, mental stimulation and social inclusion. The process evaluation also emphasised the value in having two skilled tactful facilitators in each group who are able to effectively manage a group of residents, some of whom may have dementia or cognitive impairments. The report includes recommendations for conducting evaluations of group work in later life.

Results 11 - 20 of 182

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