Forced relocation between nursing homes: residents' health outcomes and potential moderators

2012 ◽  
Vol 22 (4) ◽  
pp. 301-319 ◽  
Author(s):  
Jacquetta M Holder ◽  
David Jolley
Keyword(s):  
Nursing Homes ◽  
Older People ◽  
Health Outcomes ◽  
Psychological Health ◽  
Care Home ◽  
Well Being ◽  
Adverse Outcomes ◽  
Legal Challenges ◽  
Forced Relocation ◽  
Poor Outcomes

SummaryThat transfer of older people from one institution to another is detrimental to well-being, health and survival has been reported for 50 years. This has led to fear, anger and legal challenges when closures occur. Previous reviews identified accounts of relocation followed by adverse outcomes and others where problems were avoided or benefits claimed. This paper reviews the last twelve years of literature on health outcomes following involuntary relocation between nursing homes. Reports of post-move mortality, physical or psychological health suggest and confirm that relocation without preparation carries higher risk of poor outcomes than moves that are orderly and include preparation. The literature on the care home closure process, admissions and individual transfers offers insights into practices that might help minimize adverse outcomes. A number of agencies have produced helpful guidelines. How these are implemented needs to be monitored and linked to in-depth studies of sample closures.

scholarly journals Social Well-Being and Its Related Areas in Older People Living in Nursing Homes

2019 ◽  
Vol 29 (1) ◽  
pp. 294-300
Author(s):  
Arezoo Mirzazadeh ◽  
Abdolhosein Emami Sigaroudi ◽  
Mohammad Taghi Moghaddamnia ◽  
Ehsan Kazemnezhad Leyli ◽  
Ali Noori Saeed ◽  
...  
Keyword(s):  
Nursing Homes ◽  
Older People ◽  
Well Being

scholarly journals The Development of a Digital Dysphagia Guide with Care Homes: Co-Production and Evaluation of a Nutrition Support Tool

Geriatrics ◽  
2019 ◽  
Vol 4 (3) ◽  
pp. 48
Author(s):  
Susan Pownall ◽  
Elizabeth Barnett ◽  
Julie Skilbeck ◽  
Angel Jimenez-Aranda ◽  
Sally Fowler-Davis
Keyword(s):  
Care Home ◽  
Well Being ◽  
Care Homes ◽  
Nutrition Support ◽  
Consensus Method ◽  
Support Tool ◽  
Care Workers ◽  
Good Nutrition ◽  
Poor Outcomes ◽  
Home Workers

Good nutrition is a recognised outcome in the health and well-being of older care home residents and dysphagia is a known risk factor associated with under nutrition and poor outcomes. The study co-produced a digital Dysphagia Guide with Care Homes using a consensus method with interviews and focus groups to prioritise the need for information and explore acceptability of an educational tool for care home workers. Evaluation of use, acceptability of design, and content of the guide were completed via remote monitoring. The workforce prioritised the need for training as well as the knowledge and skills in relation to planning resident-centred care and advice on textured diets. The technology was a means of offering ‘bite-size’ learning to enhance planning for nutrition across the whole organisation including managers, kitchen staff, and care workers. The Guide to Dysphagia was produced on a tablet and piloted in four care homes over 12 weeks, by 57 staff. Integrated analytics allowed user activity to be monitored. Findings showed that 73% of respondents reported the guide helped them in their job. Additionally, 88% of respondents stated they would recommend the guide to other staff, with 90% reporting it was easy to use. Engagement with staff and managers in four homes resulted in a co-designed, dysphagia guide.

scholarly journals Social Interventions Targeting Social Relations Among Older People at Nursing Homes: A Qualitative Synthesized Systematic Review

2019 ◽  
Vol 56 ◽  
pp. 004695801882392 ◽  
Author(s):  
Anne Sophie Bech Mikkelsen ◽  
Signe Petersen ◽  
Anne Cathrine Dragsted ◽  
Maria Kristiansen
Keyword(s):  
Systematic Review ◽  
Nursing Home ◽  
Nursing Homes ◽  
Older People ◽  
Social Relations ◽  
Well Being ◽  
Video Conference ◽  
Social Interventions ◽  
The Social ◽  
Health Related

Social relations are part of the complex set of factors affecting health and well-being in old age. This systematic review seeks to uncover whether social interventions have an effect on social and health-related measures among nursing home residents. The authors screened PubMed, Scopus, and PsycINFO for relevant peer-reviewed literature. Interventions were included if (1) they focused primarily on social relations or related terms such as loneliness, social support, social isolation, social network, or being involuntarily alone either as the base theory of the intervention or as an outcome measure of the intervention; (2) they were implemented at nursing homes (or similar setting); (3) they had a narrative activity as its core (as opposed to dancing, gardening or other physical activity); (4) their participants met either physically or nonphysically, ie, via video-conference or the like; and if (5) they targeted residents at a nursing home. The authors systematically appraised the quality of the final selection of studies using the Mixed Methods Assessments Tool (MMAT) version 2011 and did a qualitative synthesis of the final study selection. A total of 10 studies were included. Reminiscence therapy was the most common intervention. Studies also included video-conference, cognitive, and support group interventions. All studies found the social interventions brought about positive trends on either/or the social and health-related measures included. Despite limited and very diverse evidence, our systematic review indicated a positive social and health-related potential of social interventions for older people living in nursing homes or similar institutions.

scholarly journals Identity Denied: Comparing American or White Identity Denial and Psychological Health Outcomes Among Bicultural and Biracial People

2018 ◽  
Vol 45 (3) ◽  
pp. 416-430 ◽  
Author(s):  
Analia F. Albuja ◽  
Diana T. Sanchez ◽  
Sarah E. Gaither
Keyword(s):  
Depressive Symptoms ◽  
Health Outcomes ◽  
Psychological Health ◽  
Well Being ◽  
White Identity ◽  
Significant Variance ◽  
Dual Identity ◽  
Stress Study ◽  
Social Belonging ◽  
The Relationship

Because bicultural and biracial people have two identities within one social domain (culture or race), their identification is often challenged by others. Although it is established that identity denial is associated with poor psychological health, the processes through which this occurs are less understood. Across two high-powered studies, we tested identity autonomy, the perceived compatibility of identities, and social belonging as mediators of the relationship between identity denial and well-being among bicultural and biracial individuals. Bicultural and biracial participants who experienced challenges to their American or White identities felt less freedom in choosing an identity and perceived their identities as less compatible, which was ultimately associated with greater reports of depressive symptoms and stress. Study 2 replicated these results and measured social belonging, which also accounted for significant variance in well-being. The results suggest the processes were similar across populations, highlighting important implications for the generalizability to other dual-identity populations.

scholarly journals Changing prevalence and treatment of depression among older people over two decades

2019 ◽  
Vol 216 (1) ◽  
pp. 49-54 ◽  
Author(s):  
Antony Arthur ◽  
George M. Savva ◽  
Linda E. Barnes ◽  
Ayda Borjian-Boroojeny ◽  
Tom Dening ◽  
...  
Keyword(s):  
Older People ◽  
Risk Ratio ◽  
Care Home ◽  
Antidepressant Medication ◽  
Population Based ◽  
Computer Assisted ◽  
Depression Prevalence ◽  
Prevalence Of Depression ◽  
Antidepressant Use ◽  
Poor Outcomes

BackgroundDepression is a leading cause of disability, with older people particularly susceptible to poor outcomes.AimsTo investigate whether the prevalence of depression and antidepressant use have changed across two decades in older people.MethodThe Cognitive Function and Ageing Studies (CFAS I and CFAS II) are two English population-based cohort studies of older people aged ≥65 years, with baseline measurements for each cohort conducted two decades apart (between 1990 and 1993 and between 2008 and 2011). Depression was assessed by the Geriatric Mental State examination and diagnosed with the Automated Geriatric Examination for Computer-Assisted Taxonomy algorithm.ResultsIn CFAS I, 7635 people aged ≥65 years were interviewed, of whom 1457 were diagnostically assessed. In CFAS II, 7762 people were interviewed and diagnostically assessed. Age-standardised depression prevalence in CFAS II was 6.8% (95% CI 6.3–7.5%), representing a non-significant decline from CFAS I (risk ratio 0.82, 95% CI 0.64–1.07, P = 0.14). At the time of CFAS II, 10.7% of the population (95% CI 10.0–11.5%) were taking antidepressant medication, more than twice that of CFAS I (risk ratio 2.79, 95% CI 1.96–3.97, P < 0.0001). Among care home residents, depression prevalence was unchanged, but the use of antidepressants increased from 7.4% (95% CI 3.8–13.8%) to 29.2% (95% CI 22.6–36.7%).ConclusionsA substantial increase in the proportion of the population reporting taking antidepressant medication is seen across two decades for people aged ≥65 years. However there was no evidence for a change in age-specific prevalence of depression.

Pain and symptoms of depression in older adults living in community and in nursing homes: the role of activity restriction as a potential mediator and moderator

2014 ◽  
Vol 26 (10) ◽  
pp. 1679-1691 ◽  
Author(s):  
Almudena López-Lopez ◽  
José L. González ◽  
Miriam Alonso-Fernández ◽  
Noelia Cuidad ◽  
Borja Matías
Keyword(s):  
Older Adults ◽  
Depressive Symptoms ◽  
Nursing Homes ◽  
Older People ◽  
Pain Intensity ◽  
Nursing Home Residents ◽  
Well Being ◽  
Community Dwelling ◽  
Activity Restriction

ABSTRACTBackground:Chronic pain is likely to lead to depressive symptoms, but the nature of this relationship is not completely clear. The aim of the present study is to analyze the role of activity restriction in the pain-depression relationship in older people, and to test the hypothesis that this role is more relevant in community-dwelling older people than in nursing home residents.Method:Depressive symptoms, pain intensity, and activity restriction were measured in a sample of 208 older adults with osteoarthritis, 102 living in nursing homes (NH), and 106 in the community. Analyses were carried out using moderation and moderated mediation analyses approach, treating activity restriction as a confounder.Results:Results showed a significant confounding effect of activity restriction, interaction effect between pain intensity and activity restriction on depression, and modifying effect of pain intensity on depression by adding activity restriction into the model. These results suggest a potential mediating and moderating effects of activity restriction. Moreover, analyses suggest that, surprisingly, the strength of the mediation could be higher in nursing homes.Conclusions:Overall, it may be that what is really important to emotional well-being is not so much pain itself, but rather the way in which the pain alters older people's lives. The greater strength of the mediation in NH might be understood within the scope of self-determination theory. Generally speaking, the NH context has been considered as a coercive setting, promoting non-autonomous orientation. In this context, when events are objectively coercive, people may lack perceived autonomy and hence be at greater risk of depression.

Perception of risk of adverse outcomes of older people: comparison between nursing homes, day centers and home care services

2017 ◽  
Vol 18 (3) ◽  
pp. 212-220 ◽  
Author(s):  
Laetitia Teixeira ◽  
Maria João Azevedo ◽  
Sara Alves ◽  
Cátia L. Pires ◽  
Constança Paúl
Keyword(s):  
At Risk ◽  
Nursing Homes ◽  
Home Care ◽  
Older People ◽  
Perceived Risk ◽  
Home Care Services ◽  
Adverse Outcomes ◽  
Content Type ◽  
Care Services ◽  
Screen Instrument

Purpose In Portugal, the three main kinds of care services available for older people are nursing homes, day centers and home care services. The use of these care services is mostly based on complex socioeconomic and functional criteria; however it is not clear if this placement corresponds to a higher/lower risk of adverse outcomes. The purposes of this paper are: to characterize clients of each type of service; to estimate the proportion of individuals at perceived risk of each adverse outcome according to type of service; to assess the ability of the Risk Instrument for Screening in the Community (RISC) to identify the risk profiles according to type of service. Design/methodology/approach The sample comprised individuals aged 65+ (n=224), receiving care at home, in day centers or in nursing homes. The identification of individuals at risk for three adverse outcomes (institutionalization, hospitalization and death) was performed using a short pre-screen instrument (RISC). Findings The RISC identified mental state issues as the unique factor that differentiated clients according the type of care services (χ2 (6, N=224)=20.96, p=0.002), with day center presenting the lowest percentage of mental health concerns and nursing home presenting the highest percentage (44.44 and 71.91 percent, respectively). Additionally, a gradient was found between perceived risk of adverse outcomes (institutionalization and hospitalization) and care of levels required. Originality/value The RISC can be used to discriminate people in different settings of care and can be helpful in the selection of groups at risk that will benefit more from available services.

scholarly journals Measuring Self-Perceptions of Aging: Differences Between Measures When Predicting Health Outcomes

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 481-481
Author(s):  
Jordan Boeder ◽  
Dwight Tse
Keyword(s):  
Health Outcomes ◽  
Psychological Health ◽  
Well Being ◽  
Population Based ◽  
Physiological Indicators ◽  
Self Perceptions ◽  
Age Related ◽  
Ongoing Development ◽  
Perceptions Of Aging ◽  
The Relationship

Abstract The majority of self-perceptions of aging (SPA) research uses either a combination of the Age-related Cognition (AgeCog) scales of Ongoing Development and Physical Loss, or the Attitudes Towards Own Aging (ATOA) subscale to assess views on aging. Although these scales are used interchangeably, the valence (positive/negative) and the specificity of the view on aging (domain-based/general) being assessed are not consistent. This study investigates how different measures of SPA relate to one another and whether they differentially predict various types of health outcomes (psychological/physiological; well-being/ill-being). Data from the 2008 and 2014 waves of the German Aging Survey (DEAS; n=3,745), a population-based representative survey of adults aged 40 to 95, was used to examine the relationship between the AgeCog scales and the ATOA subscale, as well as the differences in the types of health outcomes each predicts. The correlations between the AgeCog scales and the ATOA were higher than the correlation between the AgeCog scales (p &lt; .001). The AgeCog scale of Ongoing Development significantly predicted psychological health outcomes across a six-year period, while the AgeCog scale of Physical Loss and the ATOA subscale predicted both physiological and psychological health outcomes. Evidence supports using the AgeCog scale of Ongoing Development to predict domain-relevant, psychological health outcomes. However, the multidimensionality of SPA is best measured by the ATOA subscale or a combination of the two AgeCog scales. Both forms of measurement were found to maximize the amount of explained variance for psychological and physiological indicators of well-being and ill-being.

Effects of Probiotics and Prebiotics on Frailty and Ageing: A Narrative Review

2020 ◽  
Vol 15 (3) ◽  
pp. 183-192 ◽  
Author(s):  
Kulapong Jayanama ◽  
Olga Theou
Keyword(s):  
Older People ◽  
Health Outcomes ◽  
Cost Effective ◽  
Adverse Outcomes ◽  
Narrative Review ◽  
Deficit Accumulation ◽  
Adverse Health Outcomes ◽  
Age Related ◽  
The Relationship ◽  
Health Deficit

Globally, the population over the age of 60 is growing fast, but people age in different ways. Frailty, shown by the accumulation of age-related deficits, is a state of increased vulnerability to adverse outcomes among people of the same chronological age. Ageing results in a decline in diversity and homeostasis of microbiomes, and gut flora changes are related to health deficit accumulation and adverse health outcomes. In older people, health deficits including inappropriate intake, sarcopenia, physical inactivity, polypharmacy, and social vulnerability are factors associated with gut dysbiosis. The use of probiotics and prebiotics is a cost-effective and widely available intervention. Intake of probiotics and prebiotics may improve the homeostasis of gut microflora and prevent frailty and unhealthy aging. However, health effects vary among probiotics and prebiotics and among individual populations. This narrative review summarizes recent evidence about the relationship between prebiotic and probiotic consumption with health outcomes in older people.

scholarly journals Social and Health Disparities Among Relocated Public Housing Residents by Age: Implications for Aging in Place

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 484-484
Author(s):  
Nia Reed ◽  
Tiffany Young
Keyword(s):  
Built Environment ◽  
Health Outcomes ◽  
Public Housing ◽  
Low Income ◽  
Oldest Old ◽  
Aging In Place ◽  
Group Analysis ◽  
Well Being ◽  
Neighborhood Context ◽  
Forced Relocation

Abstract Research illustrates that neighborhood outcomes (including the built environment) influence the mental and physical health of vulnerable older adults (OA). Many OA aim to age-in-place but aging-in-place is less realistic for low-income OA because of gentrification and forced relocation. Examining neighborhood context is vital to understanding how the places we live contribute to well-being, yet, there is insufficient research on the biopsychosocial effects of forced relocation on low-income OA. To address this gap, our study uses aging-in-place theory to understand the association of neighborhood and health outcomes of relocated and nonrelocated low-income OA in public housing. This study includes three waves of data from Georgia State University’s Urban Health Initiative Study. Participants (n=225) were categorized by age (young-old = 50-64; old-old = 65-74; and oldest-old = 75+). We conducted multivariate regression analyses to highlight relationships between neighborhood and health outcomes, and relocation. We used geocoding to provide within-group analysis of relocated residents to determine if geographic proximity to former public housing communities affected neighborhood and health outcomes. Results show that relocated OA have worse informal social control and neighborhood satisfaction outcomes, but better built environment conditions than those who aged-in-place. Mental health and physical functioning worsened for relocated OA. Relocation was associated with reduced social cohesion and worse built environment conditions for the oldest-old. Moderation analysis illustrated that OA who relocated farther away had worse neighborhood outcomes. Considering the importance of aging-in-place to OA well-being, policymakers may reconsider forced relocation and allocating funds to enhance neighborhoods.

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