Results for 'risk'
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An executive summary of a report commissioned by Nottinghamshire County Council to explore recent evidence and identify a set of risk factors to older people’s independence. It explores risk factors in three areas: Social and Psychosocial Domain; Long term or Personal Conditions Domain; and Life Events Domain. Risk factors are then further grouped into: modifiable risk factors such as depression or loneliness, where specific support or services can be offered to minimise their impact; and non-modifiable risk factors such as age or history of falls; which can help identify older people at greater risk and who may potentially benefit from some preventative services and support. The report identifies the following factors as being the most significant, primary risk factors to older people’s independence and institutionalisation: Dementia with co-morbidity; Co-morbidity; carer burden; falls; social isolation and loneliness; poor confidence and self-esteem; and poor perception of own health status. The report also highlights examples of preventative tools and interventions that could stop, delay or defer the need for long-term institutional care for older people. The findings will be used to inform Nottinghamshire County Council’s ongoing local development of an “early warning system”.
FANCOURT Daisy, TYMOSZUK Urszula
Background: There is a recognised need for the identification of factors that might be protective against the development of depression in older adults. Over the past decade, there has been growing research demonstrating the effects of cultural engagement (which combines a number of protective factors including social interaction, cognitive stimulation and gentle physical activity) on the treatment of depression, but as yet not on its prevention. Aims: To explore whether cultural engagement in older adults is associated with a reduced risk of developing depression over the following decade. Method: Working with data from 2148 adults in the English Longitudinal Study of Ageing who were free from depression at baseline, the study used logistic regression models to explore associations between frequency of cultural engagement (including going to museums, theatre and cinema) and the risk of developing depression over the following 10 years using a combined index of the Centre for Epidemiological Studies Depression Scale (CES-D) and physician-diagnosed depression. Results: There was a dose–response relationship between frequency of cultural engagement and the risk of developing depression independent of sociodemographic, health-related and social confounders. This equated to a 32% lower risk of developing depression for people who attended every few months (odds ratio (OR) = 0.68, 95% CI 0.47–0.99, P = 0.046) and a 48% lower risk for people who attended once a month or more (OR = 0.52, 95% CI 0.34–0.80, P = 0.003). Results were robust to sensitivity analyses exploring reverse causality, subclinical depressive symptoms and alternative CES-D thresholds. Conclusions: Cultural engagement appears to be an independent risk-reducing factor for the development of depression in older age.
LEWIS Camilla, COTTERELL Natalie
This report summarises the existing literature on social isolation among older black, Asian and minority ethnic (BAME) communities in the UK, including the risk and protective factors of social isolation. It argues that individuals from minority ethnic backgrounds are more likely to experience health, social, and economic inequalities, thereby increasing the risk of social isolation. BAME individuals are more likely to experience discrimination and racism over the course of their lives, which can also increase the risk of social isolation by limiting opportunities for social and economic participation. It also highlights the role cultural and community organisations can play in facilitating access to services and raising awareness about ways of preventing social isolation. It discusses the findings in relation to Greater Manchester's Ambition for Ageing programme and suggests how older BAME communities could be engaged across Greater Manchester, using co-research methodologies. It concludes that future research must acknowledge variations across and within BAME groups, as well as exploring other factors, including existing gender and class differences.
WARD Gillian, WALKER-CLARKE Aimee, HOLLIDAY Nikki
Introduction: Given the impact falls can have on older people and their families, many health and social care services are focused on preventing falls and implementing interventions to reduce future falls. FallCheck is a web app that supports identification of home-hazards and directs users towards self-management strategies to reduce risk of falling. Method: A survey by clinical experts of a beta version of FallCheck was conducted, producing quantitative and qualitative data including issues and attributes identified by respondents. Thirty-six individuals signed up to take part in the study, and 27 respondents took part in the final evaluation survey. Findings: Testing by health and social care professionals found there is scope for using the app as a digital self-assessment tool by people at risk of falls. It has further potential as an effective tool to support environmental/behavioural change to reduce risk of falls. Conclusion: FallCheck was developed from a sound evidence-base to support home-hazard modification as an effective intervention component within a multifactorial intervention to prevent falls. Health and social care professionals found it had good acceptability for use in practice, justifying further testing of the usability and effectiveness of the app in supporting behavioural changes and environmental modifications with people at risk of falling and carers.
This report provides an overview of social isolation and loneliness in the UK and highlights innovative uses of technology in addressing the issue. It considers the factors that contribute to the development of social isolation and loneliness, the people most at risk, the impact on an individual's health and wellbeing, and the impact on public services. It outlines three main approaches and interventions used to address social isolation and loneliness: enabling people to maintain existing relationships, facilitating the creation of new connections, and psychological approaches to change the perceptions of individuals that are suffering from loneliness. In particular, it highlights innovative uses of technology to show their potential to increase access to initiatives and deliver interventions in new ways. Local and international best practice case-studies are included. The final section looks at the challenges that exist when trying to finance interventions aiming to combat social isolation and loneliness, and introduces an outcome-based financing model, Social Impact Bonds, which has the potential to allow commissioners and delivery partners to deliver more innovative solutions.
CO-OPERATIVES UK, BRITISH RED CROSS
This research investigates potential triggers for loneliness across life stages, focusing on the causes, experiences and impacts of loneliness for six selected groups. It also looks at the support available for people experiencing loneliness, the services people would like, and how they would like that support to be delivered. The research focuses on: young new mums; individuals with mobility limitations; individuals with health issues; individuals who are recently divorced or separated; individuals living without children at home ('empty-nesters') and retirees; and the recently bereaved. It also draws on the views of experts and public opinion on loneliness gathered through a survey. The research found that the causes of loneliness of often complex, stemming from a combination of personal, community, and UK-wide factors. It also confirmed that people experiencing life events which can disrupt existing connections or change their role in society are at risk of loneliness. Other factors contributing to loneliness included: difficulty in accessing statutory services and support, the rapid disappearance of social spaces, and inadequate transport infrastructure. Loneliness can have physical, psychological and social impacts which can negatively impact on communities and people’s ability to connect. Experts recommend a combination of the following three models of support to tackle loneliness, depending on individual circumstances: preventative; responsive, which is shaped by the needs of those already experiencing loneliness and restorative, helping people to rebuild connections and prevent people slipping into chronic loneliness. Participants experiencing loneliness had a preference for face-to-face services, with digital services seen as important but supplementary. All those involved in the research supported the need for small, personal steps to help build community connectedness.
FACULTY OF PUBLIC HEALTH, MENTAL HEALTH FOUNDATION
This report looks at what can be done individually and collectively to improve the mental health of individuals, families and communities and prevent mental health problems using a public health approach. The report aims to encourage proportionate use of universal services with a focus on the promotion of mental wellbeing and on high level support for those at risk of poor mental health and mental health problems, complementing recovery and prevention approaches. Section one maps out why mental health is an important, highlights its economic and social costs and examines why it is often overlooked. Section two outlines the risk and protective factors through the life course from the early years, to adulthood and later-life. It also looks at the risk and protective factors across communities, for example in the home, education and work settings, and the effects of the built environment and neighbourhoods. Section three addresses approaches and interventions to improve mental health at different stages of the life course and in different settings. Section four offers a practical guide to enable practitioners to support their own mental wellbeing. Case studies of innovative public mental health programmes and projects being run across the UK are included throughout. Annex A includes a list of initiatives received as entries for the Faculty of Public Health public mental health award, 10 of which are included in the report as case examples.
CAMPAIGN TO END LONELINESS
A guide to help commissioners and service providers to develop ways of identifying older people experiencing loneliness or who are at risk of being lonely. Section one identifies methods of identifying older people who may be at risk of loneliness. These include top down approaches which use available data and data mapping to identifying geographical areas likely to contain more people at risk; and bottom up approaches, which draw on the local knowledge and capacity of communities to identify and engage with older people experiencing loneliness in their area. Section two illustrates how these different methods can be used and provides case studies to show how they have been used successfully by other organisations. Section three provides advice to help staff and volunteers to speak to people at risk of loneliness in a way that can bring about positive change. It shows the importance of using empathy, openness and respect when holding conversations and also taking a problem-solving approach to help people identify and plan their own solutions. Each section includes summary learning points and provides advice to help providers and commissioners to help change their ways of working. The report makes 10 key recommendations for service providers and commissioners.
DOUGHTY Kevin, ORTON Mike
Purpose: The purpose of this paper is to identify opportunities where technology interventions could help manage the risks associated with fire and explosions in homes of people who are older or who are vulnerable through other causes such as mental health problems or a history of substance abuse.
Design/methodology/approach: The approach focused on reviewing the latest available statistics in order to identify the major causes and rooms in which fire accidents occurred.
Findings: The authors found that the number of incidents and fatalities continues to decrease as a result of preventive measures such as a greater use of smoke detectors, but that there remained issues with cooking safety. New products for limiting damage and managing risks are available which could have a positive impact.
Research limitations/implications: The paper concludes that the challenges are making both professionals and the public aware of the available technologies and of introducing them following appropriate assessment of needs and risks.
Practical implications: Greater resources need to be offered for training of the public and of health and safety professionals. Further funding may be needed to implement the introduction of new technology.
Originality/value: This is the most up-to-date review of fire control measures employing assistive technology and telecare for domestic properties and will be of value to community health teams, adults care organisations, housing associations and other public bodies.
DARBYSHIRE Laura Valerie, KROESE Biza Stenfert
The pressure of becoming a parent for a person with intellectual disabilities (ID) may magnify the risks of social isolation and poor psychological well-being. This review examined the psychological well-being and social support among parents with ID, addressing three aims that explore the importance of these two factors in their lives. A search of electronic databases uncovered eight studies which met the inclusion criteria. Findings revealed that parents with ID experience poorer psychological well-being than the general parenting population and a relationship was found between psychological well-being and social support. Two of the intervention studies found evidence that by improving social support, psychological well-being was improved. The relationship between social support and parenting ability was supported by findings of a positive relationship between satisfaction with social support and positive maternal reactions. A number of recommendations for further research are suggested to more fully explore the relationship between psychological well-being and social support.
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