scholarly journals What is the prevalence of loneliness amongst older people living in residential and nursing care homes? A systematic review and meta-analysis

2020 ◽  
Vol 49 (5) ◽  
pp. 748-757 ◽  
Author(s):  
Clare Gardiner ◽  
Pete Laud ◽  
Tim Heaton ◽  
Merryn Gott
Keyword(s):  
Systematic Review ◽  
Older People ◽  
Nursing Care ◽  
Social Engagement ◽  
Significant Variation ◽  
Meta Analysis ◽  
Care Home ◽  
Care Homes ◽  
Prevalence Estimates ◽  
Age Range

Abstract Background the number of older people living in residential and nursing care homes is rising. Loneliness is a major problem for older people, but little is known about the prevalence of loneliness amongst older people living in care homes. Aim to undertake a systematic review of literature on the prevalence of moderate and severe loneliness amongst older people living in residential and nursing care homes. Design we systematically reviewed the databases Cumulative Index to Nursing and Allied Health Literature (CINAHL), MEDLINE, PsycINFO, Embase, Scopus, Cochrane and Allied and Complementary Medicine Database (AMED) from inception to January 2019. We included all studies reporting data on the prevalence of loneliness amongst older people living in care homes. A random-effects meta-analysis was conducted on all eligible data. Results a total of 13 articles were included, representing 5,115 participants (age range of 55–102 years, mean age 83.5 years, 68% female). There was a significant variation between studies in estimates of prevalence. The prevalence of moderate loneliness ranged from 31 to 100%, and the prevalence of severe loneliness ranged from 9 to 81%. The estimated mean prevalence of ‘moderate loneliness’ was 61% (95% confidence interval (CI): 0.41, 0.80). The estimated mean prevalence of ‘severe loneliness’ was 35% (95% CI: 0.14, 0.60). Conclusion the prevalence of both moderate loneliness and severe loneliness amongst care home residents is high enough to warrant concern. However, the significant variation in prevalence estimates warrants further research. Future studies should identify which interventions can address loneliness and promote meaningful social engagement to enhance quality of life in care homes.

scholarly journals Ownership and COVID-19 in care homes for older people: A living systematic review of outbreaks, infections, and mortalities

2021 ◽  
Author(s):  
Anders Malthe Bach-Mortensen ◽  
Ben Verboom ◽  
Ani Movsisyan ◽  
Michelle Degli Esposti
Keyword(s):  
Systematic Review ◽  
Older People ◽  
Care Home ◽  
Academic Research ◽  
Developed Countries ◽  
Care Homes ◽  
For Profit ◽  
News Reports ◽  
Increased Risk ◽  
New Research

AbstractBackgroundThe adult social care sector is increasingly outsourced to for-profit providers, who constitute the largest provider of care homes in many developed countries. During the COVID-19 pandemic, for-profit providers have been accused of failing their residents by prioritising profits over care, prevention, and caution, which has been reported to result in a higher prevalence of COVID-19 infections and deaths in for-profit care homes. Although many of these reports are anecdotal or based on news reports, there is a growing body of academic research investigating ownership variation across COVID-19 outcomes, which has not been systematically appraised and synthesised.ObjectivesTo identify, appraise, and synthesise the available research on ownership variation in COVID-19 outcomes (outbreaks, infections, deaths, shortage of personal protective equipment (PPE) and staff) across for-profit, public, and non-profit care homes for older people, and to update our findings as new research becomes available.DesignLiving systematic review.MethodsThis review was prospectively registered with Prospero (CRD42020218673). We searched 17 databases and performed forward and backward citation tracking of all included studies. Search results were screened and reviewed in duplicate. Risk of bias (RoB) was assessed in duplicate according to the COSMOS-E guidance. Data was extracted by ABM and independently validated. The results were synthesised by country, RoB, and model adjustments, and visualised using harvest plots.ResultsTwenty-nine studies across five countries were included, with 75% of included studies conducted in the Unites States. For-profit ownership was not consistently associated with a higher probability of a COVID-19 outbreak. However, there was compelling evidence of worse COVID-19 outcomes following an outbreak, with for-profit care homes having higher rates of accumulative infections and deaths. For-profit providers were also associated with shortages in PPE, which may have contributed to the higher incidence of infections and deaths in the early stages of the pandemic. Chain affiliation was often correlated with an increased risk of outbreak but was usually not reported to be associated with higher rates of deaths and infections.ConclusionFor-profit ownership was a consistent risk factor for higher cumulative COVID-19 infections and deaths in the first wave of the pandemic. Thus, ownership and the characteristics associated with FP care home providers may present key regulatable factors that can be addressed to improve health outcomes in vulnerable populations and reduce health disparities. This review will be updated as new research becomes published, which may change the conclusion of our synthesis.

scholarly journals Measuring the prevalence of sleep disturbances in people with dementia living in care homes: a systematic review and meta-analysis

SLEEP ◽  
2019 ◽  
Vol 43 (4) ◽  
Author(s):  
Lucy Webster ◽  
Sergi Costafreda Gonzalez ◽  
Aisling Stringer ◽  
Amy Lineham ◽  
Jessica Budgett ◽  
...  
Keyword(s):  
Systematic Review ◽  
Sleep Disturbance ◽  
Associated Factors ◽  
Sleep Disturbances ◽  
Meta Analysis ◽  
Care Home ◽  
Care Homes ◽  
People With Dementia ◽  
Falling Asleep ◽  
Clinically Significant

Abstract Study Objectives Sleep disturbances are a feature in people living with dementia, including getting up during the night, difficulty falling asleep, and excessive daytime sleepiness and may precipitate a person with dementia moving into residential care. There are varying estimates of the frequency of sleep disturbances, and it is unknown whether they are a problem for the individual. We conducted the first systematic review and meta-analysis on the prevalence and associated factors of sleep disturbances in the care home population with dementia. Methods We searched Embase, MEDLINE, and PsycINFO (29/04/2019) for studies of the prevalence or associated factors of sleep disturbances in people with dementia living in care homes. We computed meta-analytical estimates of the prevalence of sleep disturbances and used meta-regression to investigate the effects of measurement methods, demographics, and study characteristics. Results We included 55 studies of 22,780 participants. The pooled prevalence on validated questionnaires of clinically significant sleep disturbances was 20% (95% confidence interval, CI 16% to 24%) and of any symptom of sleep disturbance was 38% (95% CI 33% to 44%). On actigraphy using a cutoff sleep efficiency of <85% prevalence was 70% (95% CI 55% to 85%). Staff distress, resident agitation, and prescription of psychotropic medications were associated with sleep disturbances. Studies with a higher percentage of males had a higher prevalence of sleep disturbance. Conclusions Clinically significant sleep disturbances are less common than those measured on actigraphy and are associated with residents and staff distress and the increased prescription of psychotropics. Actigraphy appears to offer no benefit over proxy reports in this population.

scholarly journals Community-based complex interventions to sustain independence in older people, stratified by frailty: a protocol for a systematic review and network meta-analysis

BMJ Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. e045637
Author(s):  
Thomas F Crocker ◽  
Andrew Clegg ◽  
Richard D. Riley ◽  
Natalie Lam ◽  
Ram Bajpai ◽  
...  
Keyword(s):  
Systematic Review ◽  
Older People ◽  
Meta Analysis ◽  
Care Home ◽  
Complex Interventions ◽  
Interaction Model ◽  
Published Data ◽  
Community Based ◽  
Care Services ◽  
At Home

IntroductionMaintaining independence is a primary goal of community health and care services for older people, but there is currently insufficient guidance about which services to implement. Therefore, we aim to synthesise evidence on the effectiveness of community-based complex interventions to sustain independence for older people, including the effect of frailty, and group interventions to identify the best configurations.Methods and analysisSystematic review and network meta-analysis (NMA). We will include randomised controlled trials (RCTs) and cluster RCTs of community-based complex interventions to sustain independence for older people living at home (mean age ≥65 years), compared with usual care or another complex intervention. We will search MEDLINE (1946 to September 2020), Embase (1947 to September 2020), CINAHL (1981 to September 2020), PsycINFO (1806 to September 2020), CENTRAL and clinical trial registries from inception to September 2020, without date/language restrictions, and scan included papers’ reference lists. Main outcomes were: living at home, activities of daily living (basic/instrumental), home-care services usage, hospitalisation, care home admission, costs and cost effectiveness. Additional outcomes were: health status, depression, loneliness, falls and mortality. Interventions will be coded, summarised and grouped. An NMA using a multivariate random-effects model for each outcome separately will determine the relative effects of different complex interventions. For each outcome, we will produce summary effect estimates for each pair of treatments in the network, with 95% CI, ranking plots and measures, and the borrowing of strength statistic. Inconsistency will be examined using a ‘design-by-treatment interaction’ model. We will assess risk of bias (Cochrane tool V.2) and certainty of evidence using the Grading of Recommendations Assessment, Development and Evaluation for NMA approach.Ethics and disseminationThis research will use aggregated, anonymised, published data. Findings will be reported according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidance. They will be disseminated to policy-makers, commissioners and providers, and via conferences and scientific journals.PROSPERO registration numberCRD42019162195.

scholarly journals Hydration Interventions for older people living in residential and nursing care homes: overview of the literature

2019 ◽  
Vol 131 (1) ◽  
pp. 71-79 ◽  
Author(s):  
Glenda Cook ◽  
Philip Hodgson ◽  
Juliana Thompson ◽  
Lesley Bainbridge ◽  
Amy Johnson ◽  
...  
Keyword(s):  
Social Sciences ◽  
Older People ◽  
Nursing Care ◽  
Fluid Intake ◽  
Care Home ◽  
Care Homes ◽  
Cochrane Library ◽  
Older Person ◽  
Cognitive Problems ◽  
Applied Social Sciences

Abstract Introduction Care home populations experiencing high levels of multi-morbidity and dementia require support from caregivers to meet their hydration requirements. This article provides an overview of literature related to hydration interventions and highlights gaps in knowledge. Sources of data This paper draws on UK-focused literature from Applied Social Sciences Index and Abstracts (ASSIA), CINAHL, Medline, Proquest Hospital Premium Collection, Cochrane Library and RCN databases on hydration interventions for older people living with multi-morbidity and dementia in care homes. Areas of agreement Fluid intake is too low in care home residents, and no single hydration intervention is effective in addressing the complex problems that older residents present. Areas of controversy There is a lack of consensus about how much fluid an older person should consume daily for optimum health. There is also lack of agreement about what interventions are effective in supporting individuals with complex physical and cognitive problems to achieve daily fluid intake targets. Growing points To improve hydration care for residents, care home teams should be competent in the delivery of hydration care, and work closely with integrated multi-professional healthcare specialists to provide proactive case management. Areas timely for developing research There is a need for understanding of what hydration practices and processes are effective for care home residents and including these in multi-component interventions.

scholarly journals Prevalence of loneliness amongst older people in high-income countries: A systematic review and meta-analysis

PLoS ONE ◽  
2021 ◽  
Vol 16 (7) ◽  
pp. e0255088
Author(s):  
Kavita Chawla ◽  
Tafadzwa Patience Kunonga ◽  
Daniel Stow ◽  
Robert Barker ◽  
Dawn Craig ◽  
...  
Keyword(s):  
Public Health ◽  
Systematic Review ◽  
Older People ◽  
Meta Analysis ◽  
Later Life ◽  
High Income ◽  
Health Concern ◽  
Pooled Prevalence ◽  
Prevalence Estimates ◽  
Reported Data

Background and objective Loneliness is associated with increased rates of morbidity and mortality, and is a growing public health concern in later life. This study aimed to produce an evidence-based estimate of the prevalence of loneliness amongst older people (aged 60 years and above). Study design and setting Systematic review and random-effects meta-analysis of observational studies from high income countries 2008 to 2020, identified from searches of five electronic databases (Medline, EMBASE, PsychINFO, CINAHL, Proquest Social Sciences Premium Collection). Studies were included if they measured loneliness in an unselected population. Results Thirty-nine studies reported data on 120,000 older people from 29 countries. Thirty-one studies were suitable for meta-analysis. The pooled prevalence estimate of loneliness was 28.5% (95%CI: 23.9% - 33.2%). In twenty-nine studies reporting loneliness severity, the pooled prevalence was 25.9% (95%CI: 21.6% - 30.3%) for moderate loneliness and 7.9% (95%CI: 4.8% - 11.6%) for severe loneliness (z = -6.1, p < 0.001). Similar pooled prevalence estimates were observed for people aged 65–75 years (27.6%, 95%CI: 22.6% - 33.0%) and over 75 years (31.3%, 95%CI: 21.0% - 42.7%, z = 0.64, p = 0.52). Lower levels of loneliness were reported in studies from Northern Europe compared to South and Eastern Europe. Conclusions Loneliness is common amongst older adults affecting approximately one in four in high income countries. There is no evidence of an increase in the prevalence of loneliness with age in the older population. The burden of loneliness is an important public health and social problem, despite severe loneliness being uncommon. PROSPERO registration CRD42017060472.

Efficacy of conservative therapy in older people with nonspecific low back pain: A systematic review with meta-analysis and GRADE recommendations

2020 ◽  
Vol 90 ◽  
pp. 104177 ◽  
Author(s):  
Lorena K.B. Amaral ◽  
Mateus B. Souza ◽  
Mariana G.M. Campos ◽  
Vanessa A. Mendonça ◽  
Alessandra Bastone ◽  
...  
Keyword(s):  
Systematic Review ◽  
Low Back Pain ◽  
Back Pain ◽  
Older People ◽  
Conservative Therapy ◽  
Meta Analysis ◽  
Low Back

scholarly journals Study protocol of a systematic review and qualitative evidence synthesis using two different approaches: Healthcare related needs and desires of older people with post-stroke aphasia

BMJ Open ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. e039348
Author(s):  
Nadine Janis Pohontsch ◽  
Thorsten Meyer ◽  
Yvonne Eisenmann ◽  
Maria-Inti Metzendorf ◽  
Verena Leve ◽  
...  
Keyword(s):  
Systematic Review ◽  
Older People ◽  
Evidence Synthesis ◽  
Meta Analysis ◽  
Research Question ◽  
Treatment Success ◽  
Qualitative Studies ◽  
Qualitative Evidence Synthesis ◽  
Healthcare Needs ◽  
Qualitative Evidence

IntroductionStroke is a frequent disease in the older population of Western Europe with aphasia as a common consequence. Aphasia is known to impede targeting treatment to individual patients’ needs and therefore may reduce treatment success. In Germany, the postacute care of patients who had stroke is provided by different healthcare institutions of different sectors (rehabilitation, nursing and primary care) with substantial difficulties to coordinate services. We will conduct two qualitative evidence syntheses (QESs) aiming at exploring distinct healthcare needs and desires of older people living with poststroke aphasia. We thereby hope to support the development of integrated care models based on needs of patients who are very restricted to communicate them. Since various methods of QESs exist, the aim of the study embedding the two QESs was to determine if findings differ according to the approach used.Methods and analysisWe will conduct two QESs by using metaethnography (ME) and thematic synthesis (ThS) independently to synthesise the findings of primary qualitative studies. The main differences between these two methods are the underlying epistemologies (idealism (ME) vs realism (ThS)) and the type of research question (emerging (ME) vs fixed (ThS)).We will search seven bibliographical databases. Inclusion criteria comprise: patients with poststroke aphasia, aged 65 years and older, studies in German/English, all types of qualitative studies concerning needs and desires related to healthcare or the healthcare system. The protocol was registered in the International Prospective Register of Systematic Reviews, follows Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols guidelines and includes three items from the Enhancing Transparency in Reporting the synthesis of Qualitative Research checklist.Ethics and disseminationEthical approval is not required. Findings will be published in a peer-reviewed journal and presented on national conferences.

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