WHO’S SINGING THE BLUES? DEPRESSIVE SYMPTOMS AMONG OLDER ADULTS ACROSS THE CONTINUUM OF CARE

Abstract In 2016, the CDC estimated that 2.1 million Americans had Opioid Use Disorder (OUD); about 1.8 million related to prescribed painkillers. Older adults are especially susceptible; SAMHSA estimates that 2.7 million older adults will misuse prescription drugs by 2020. The Massachusetts Department of Public Health (MDPH) issued a 2016 Circular Letter advising long-term care facility (LTCF) administrators that, if otherwise eligible for admission, facilities are expected to admit individuals diagnosed with OUD, and provide medication for OUD (MOUD) as prescribed. Yet, many facilities express concern for admitting residents with OUD. The MDPH and their partners are conducting a multi-faceted training/technical support (TS) program to foster best practices across the continuum of care, targeting LTCF. The 15-month program consists of in-person learning sessions, a comprehensive toolkit, on-site TS, weekly contact, and a peer-to-peer webinar. Pre-training data indicated that 24 of 42 recruited LTCFs had not admitted residents with OUD. Although licensed LTCF practitioners can obtain a waiver to prescribe certain MOUD, only 4 of the 28 LTCF medical directors interviewed had done so. Subject matter experts led topic-specific discussions in the first learning session to educate on OUD/MOUD, dispel myths, make community connections, and provide resources. Almost all participants agreed that the session met the objectives of understanding OUD as a chronic disease, recognizing the stigma of OUD, gaining knowledge of MOUD treatments, and obtaining strategies to enhance best practices across the continuum of care. All items on the pre/post-session assessments indicated a significant increase in understanding (37% versus 60%, respectively).

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Continuum of Care for Older Adults With Concurrent Hearing and Vision Impairment: A Systematic Review Protocol

10.21203/rs.3.rs-61670/v1 ◽

2020 ◽

Author(s):

Atul Jaiswal ◽

Shikha Gupta ◽

Patrice Dupont ◽

Walter Wittich

Keyword(s):

Systematic Review ◽

Older Adults ◽

Care Home ◽

Continuum Of Care ◽

Cochrane Library ◽

Future Research ◽

World Population ◽

Care Providers ◽

Term Care ◽

The Continuum

Abstract Background: A recent global report estimates around 2% of the world population (~150 million people) to have concurrent hearing and vision difficulties (referred to as dual sensory impairment/DSI). Older adults with DSI often experience poorer levels of health and barriers to accessing health services in long-term care, home care and hospitals. Yet, the evidence is limited to inform the healthcare planning for this vulnerable population. Understanding the current state of the continuum of care for older adults with DSI is paramount to determine ways to promote healthy ageing. Hence, the objective of this systematic review is to summarize the information available on the continuum of care and synthesize evidence on existing and emergent strategies of screening, assessment and interventions to optimize care for older adults with DSI.Methods: The review will be conducted in accordance with the Preferred Reporting Items for Systematic Reviews (PRISMA). Electronic research databases (CINAHL, Embase, MEDLINE, PsycINFO, Cochrane Library, Global Health and Web of Science), clinical trial registries (ISRCTN Registry, WHO ICTRP, and ClinicalTrials.gov) will be searched. Editorials, conference publications, thesis/dissertations, books or letters will be excluded. There is no date and language restriction applied, and databases are searched since inception.Discussion: Healthcare professionals have little guidance on how to screen, assess, and provide best possible care to older adults with DSI while accommodating for their hearing and vision challenges; thus, the results of this review will be a relevant resource for policymakers, decision-makers, healthcare organizations, clinicians/professionals, and informal care providers of older adults with DSI. This review will document current practices, determine the evidence gaps, synthesize research findings, and make recommendations for future research priorities.Systematic Review Registration: PROSPERO registration # CRD42020180545

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Disability in older adults across the continuum of cognitive decline: unique contributions of depression, sleep disturbance, cognitive deficits and medical burden

International Psychogeriatrics ◽

10.1017/s1041610218002144 ◽

2019 ◽

Vol 31 (11) ◽

pp. 1611-1625 ◽

Cited By ~ 4

Author(s):

Haley M. LaMonica ◽

Ian B. Hickie ◽

Jerome Ip ◽

Catriona Ireland ◽

Loren Mowszowski ◽

...

Keyword(s):

Older Adults ◽

Depressive Symptoms ◽

Sleep Quality ◽

Cognitive Decline ◽

Clinical Sample ◽

Self Report ◽

World Health ◽

Early Dementia ◽

Medical Burden ◽

The Continuum

ABSTRACTObjectives:Disability in older adults is associated with a need for support in work, education, and community activities, reduced independence, and poorer quality of life. This study examines potential determinants of disability in a clinical sample of older adults across the continuum of cognitive decline, including sociodemographic, medical, psychiatric, and cognitive factors.Design:This is a cross-sectional study.Setting:Participants were recruited from a specialty clinic for adults “at risk” of or with early dementia (including subjective cognitive complaints, mild cognitive impairment, and early dementia).Participants:Four hundred forty-two older adults (mean age = 67.11, SD = 9.33) underwent comprehensive medical, neuropsychological, and mood assessments.Measurements:Disability was assessed via the self-report World Health Organization Disability Assessment Schedule 2.0. A stepwise (forward) linear regression model was computed to determine factors that contribute to disability within this group.Results:Depressive symptoms were the largest predictor, uniquely explaining 31.8% of the variance. Other contributing factors in the model included younger age, medical burden, and sleep quality, with all factors together accounting for a total of 50.4% of the variance in disability. Cognitive variables did not contribute to the model.Conclusions:Depressive symptoms account for a significant portion of the variance in disability, but other factors such as age, medical burden and sleep quality are also important contributors in older adults across the continuum of cognitive decline. The relative association of these variables with disability appears to differ for older (≥65 years) relative to younger (<65 years) participants. Given the relationship between disability and these risk factors, an integrative and multidisciplinary approach to risk reduction will likely be most effective, with potential carry over effects for physical and mental health.

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Undernutrition in Older Adults Across the Continuum of Care: Nutritional Assessment, Barriers, and Interventions

Journal of Gerontological Nursing ◽

10.3928/0098-9134-20060101-11 ◽

2006 ◽

Vol 32 (1) ◽

pp. 22-27 ◽

Cited By ~ 47

Author(s):

Ellen F Furman

Keyword(s):

Older Adults ◽

Nutritional Assessment ◽

Continuum Of Care ◽

The Continuum

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Contemporary considerations relating to health promotion and older people

British Journal of Nursing ◽

10.12968/bjon.2019.28.21.1414 ◽

2019 ◽

Vol 28 (21) ◽

pp. 1414-1419

Author(s):

Louise Daly ◽

Gobnait Byrne ◽

Brian Keogh

Keyword(s):

Older Adults ◽

Health Promotion ◽

Older People ◽

Later Life ◽

Continuum Of Care ◽

Healthy Ageing ◽

Positive Health ◽

Health And Wellbeing ◽

The Continuum

Health promotion in later life can support healthy ageing and wellbeing. Nurses across the continuum of care have an important role in promoting positive health and wellbeing messages, but they must be cognisant of the need to engage in, modify and tailor health promotion for and with older adults. This article provides an overview of contemporary issues relevant to health promotion and older people, and the role and contribution of nurses.

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Depressive Symptoms, omega-6:omega-3 Fatty Acids, and Inflammation in Older Adults

Yearbook of Anesthesiology and Pain Management ◽

10.1016/s1073-5437(08)71001-5 ◽

2008 ◽

Vol 2008 ◽

pp. 273-274

Author(s):

M.F. Roizen

Keyword(s):

Older Adults ◽

Fatty Acids ◽

Depressive Symptoms ◽

Omega 3 Fatty Acids ◽

Omega 3 ◽

Omega 6

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Poor Acceptance of the Past is Related to Depressive Symptoms in Older Adults

GeroPsych ◽

10.1024/1662-9647/a000227 ◽

2020 ◽

Vol 33 (4) ◽

pp. 246-251

Author(s):

Gozde Cetinkol ◽

Gulbahar Bastug ◽

E. Tugba Ozel Kizil

Keyword(s):

Older Adults ◽

Regression Analysis ◽

Depressive Symptoms ◽

Death Anxiety ◽

Geriatric Depression ◽

Ego Integrity ◽

The Past ◽

Depressed Group ◽

Total Death ◽

The Relationship

Abstract. Depression in older adults can be explained by Erikson’s theory on the conflict of ego integrity versus hopelessness. The study investigated the relationship between past acceptance, hopelessness, death anxiety, and depressive symptoms in 100 older (≥50 years) adults. The total Beck Hopelessness (BHS), Geriatric Depression (GDS), and Accepting the Past (ACPAST) subscale scores of the depressed group were higher, while the total Death Anxiety (DAS) and Reminiscing the Past (REM) subscale scores of both groups were similar. A regression analysis revealed that the BHS, DAS, and ACPAST predicted the GDS. Past acceptance seems to be important for ego integrity in older adults.

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Analysis of Self-Concept in Older Adults in Different Contexts

European Journal of Psychological Assessment ◽

10.1027/1015-5759.20.4.262 ◽

2004 ◽

Vol 20 (4) ◽

pp. 262-274 ◽

Cited By ~ 13

Author(s):

Manuel de Gracia Blanco ◽

Josep Garre Olmo ◽

María Marcó Arbonès ◽

Pilar Monreal Bosch

Keyword(s):

Older Adults ◽

Nursing Home ◽

Depressive Symptoms ◽

External Validity ◽

Aging Process ◽

Well Being ◽

Self Esteem ◽

Self Concept ◽

Self Perceptions ◽

Discriminatory Capacity

Summary: Self-concept is a construct consisting of a group of specific self-perceptions that are hierarchically organized. Age-associated changes of self-concept are related to the individual's perception of the changes occurring throughout the aging process. The authors examined external validity and internal consistency of an instrument that has been developed to assess self-concept in older adults and examined self-concept's characteristics in two different contexts. Results confirm the multidimensionality of the scale and show a satisfactory external validity, indicating good discriminatory capacity. Findings support the hypothesis that older people who live in a nursing home have a poor self-esteem, self-concept, and psychological well-being and have a greater presence of depressive symptoms than people who live in their own home.

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