Caring for the caregiver: a systematic review characterising the experience of caregivers of older adults with advanced cancers

The steady advances in oncology bring a host of therapeutic options for older adults (≤65 years old) with cancer. As these patients experience this proliferation of anticancer therapies, their caregivers too have witnessed their role rapidly expanding and evolving as they care for these individuals. To better understand the caregiver experience, a review of the current literature on informal caregiving and cancer caregiving was conducted. These informal caregivers are often individuals with a strong personal connection to the person with advanced cancer, such as a close relative, spouse/partner or friend. Caregivers provide a broad range of assistance with most aspects of day-to-day life. However, we have limited knowledge of the impact of this role on the caregivers themselves, particularly in the context of an older adult patient and their unique needs. Here, we explore the data on caregiver experience when caring for a person with advanced cancers—specifically, we characterise the symptom burden and effects on the caregiver well-being with emphasis on the care of older adults with cancer.

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Self-compassionate Aging: A Systematic Review

The Gerontologist ◽

10.1093/geront/gny108 ◽

2018 ◽

Vol 59 (4) ◽

pp. e311-e324 ◽

Cited By ~ 5

Author(s):

Lydia Brown ◽

Jeff C Huffman ◽

Christina Bryant

Keyword(s):

Systematic Review ◽

Older Adults ◽

Psychological Symptoms ◽

Meta Analysis ◽

Later Life ◽

Well Being ◽

Physical Symptoms ◽

Search Term ◽

Self Compassion ◽

The Impact

Abstract Abstract Background and Objectives There is considerable heterogeneity in experiences of aging, with some experiencing greater well-being and adapting more successfully to the challenges of aging than others. Self-compassion is a modifiable psychological skill that might help explain individual differences in well-being and adjustment in later life. The aim of this study was to systematically review the literature on self-compassion and well-being outcomes in studies of older adults aged 65 and older. Research Design and Methods This systematic review was conducted according to PRISMA guidelines, using databases PsycINFO, Medline, and Embase. The search term self-compassion was paired with terms relating to well-being, psychological symptoms, and adjustment. Meta-analysis was used to synthesize results on the relationship between self-compassion and four outcomes including depression, anxiety, hedonic well-being, and eudaimonic well-being. Results Eleven studies met inclusion criteria for this review. Meta-analysis revealed that self-compassion was associated with lower levels of depression (r = −.58, 95% CI [−.66, −.48]) and anxiety (r = −.36, 95% CI [−.60, −.07]), and higher levels of hedonic (r = .41, 95% CI [.15, .62]) and eudaimonic (r = .49, 95% CI [.41, .57]) well-being. Further, three studies found self-compassion weakened the impact of physical symptoms on well-being outcomes. Discussion and Implications We found preliminary evidence that self-compassion is associated with well-being outcomes in older adults, and that self-compassion may buffer the psychological sequelae of health symptoms in later life. Higher quality studies with uniform outcome measures are needed to replicate and extend these results.

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The Impact of Natural Hazards on Older Adult Health: Lessons Learned From Hurricane Maria in Puerto Rico

Disaster Medicine and Public Health Preparedness ◽

10.1017/dmp.2021.305 ◽

2021 ◽

pp. 1-8

Author(s):

Elizabeth L. Andrade ◽

Megan Jula ◽

Carlos E. Rodriguez-Diaz ◽

Lauren Lapointe ◽

Mark C. Edberg ◽

...

Keyword(s):

Older Adults ◽

Puerto Rico ◽

Natural Hazards ◽

Older Adult ◽

Natural Hazard ◽

Emotional Health ◽

Well Being ◽

Adult Health ◽

Preparedness Planning ◽

The Impact

Abstract Objective: With natural hazards increasing in frequency and severity and global population aging, preparedness efforts must evolve to address older adults’ risks in disasters. This study elucidates potential contributors to the elevated older adult mortality risk following Hurricane Maria in Puerto Rico through an examination of community stakeholder preparedness, response, and recovery experiences. Methods: In April 2018, qualitative interviews (n = 22) were conducted with stakeholders in 7 Puerto Rican municipalities. Interview transcripts were deductively and inductively coded and analyzed to identify salient topics and themes representing participant response patterns. Results: The hurricane’s detrimental impact on older adult health emerged as a prominent finding. Through 6 months post-hurricane, many older adults experienced unmet needs that contributed to declining physical and emotional health, inadequate non-communicable disease management, social isolation, financial strain, and excess morbidity and mortality. These needs were predominantly consequences of lengthy public service gaps, unsafe living conditions, interrupted health care, and the incongruence between preparedness and event severity. Conclusions: In a landscape of increasing natural hazard frequency and magnitude, a pattern of older adult risk has become increasingly clear. Study findings compel practitioners to engage in natural hazard preparedness planning, research, and policy-making that considers the multiple facets of older adult well-being.

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Driving, transportation, and mobility in the older adult

Oxford Textbook of Geriatric Medicine ◽

10.1093/med/9780198701590.003.0169 ◽

2017 ◽

pp. 1303-1310

Author(s):

Benjamin M. Shapiro ◽

L. Jaime Fitten

Keyword(s):

Older Adults ◽

Older Adult ◽

Well Being ◽

Driving Safety ◽

Crash Risk ◽

Accident Risk ◽

Healthy Older Adults ◽

Crash Rates ◽

Normal Ageing ◽

The Impact

Older adults drive more miles than prior generations and have mobility and transportation needs that are central to independence and well-being. While older adult crash rates have decreased due to safety improvements, those aged 80 years and older have higher morbidity and mortality from crashes due to physical vulnerabilities. Normal ageing is associated with cognitive, motor, and sensory changes that prompt healthy older adults to modify their driving. Older adults use a wide range of potentially driver-impairing medications that increase accident risk. Glaucoma, visual field changes from strokes, and other impairments assessed in the Useful Field of View test can significantly increase crash risk. Moderate and advanced dementia results in unsafe driving due to the impact on ‘process skills’, resulting in the prevailing opinion that they should not drive. However, there is no appropriate screening instrument to assess driving safety among older adults.

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Health assets in older age: a systematic review

BMJ Open ◽

10.1136/bmjopen-2016-013226 ◽

2017 ◽

Vol 7 (5) ◽

pp. e013226 ◽

Cited By ~ 22

Author(s):

Yvonne Claire Hornby-Turner ◽

Nancye May Peel ◽

Ruth Eleanor Hubbard

Keyword(s):

Systematic Review ◽

Older Adults ◽

Health Status ◽

Well Being ◽

Community Dwelling ◽

Older Age ◽

Health And Social Care ◽

Mental Wellness ◽

Health Assets ◽

The Impact

BackgroundFinding ways to optimise health in older age is key to reducing the impact of population ageing on health and social care systems. A salutogenic approach takes into account an individual’s health assets—internal or external strengths or accessible resources which improve and preserve physical, social and mental wellness, independence and quality of life. The aim of this narrative systematic review was to provide a summary and appraisal of the evidence for factors that act as health assets within personal, social, economic and environmental domains.MethodsSystematic searches of databases were conducted for literature published in peer-reviewed journals between January 2000 and November 2016. Selection criteria included community dwelling populations aged 65 years and over and publications written in English. Data on study population, design, measures of health status, factors within the four previously stated domains and results were extracted. Study quality was independently assessed using an appraisal instrument.ResultsTwenty-three publications, including 78 422 participants, from more than 13 different countries were identified for inclusion in this review. There was strong evidence that higher scores of self-rated health, psychological well-being and life satisfaction were associated with better health in older age. Social network and contact with family and friends, and engagement in leisure and social activities were important support mechanisms. Education and financial resources consistently proved to be key economic health assets for older adults.ConclusionsImplementing an asset-based approach to health promotion uncovers the skills, knowledge, connections and potential of the individual and the community. This approach is an ideal opportunity for government health bodies and their partners to respond to the challenges faced by global ageing.Factors are often interdependent and cumulative, suggesting the potential for an instrument to measure the accumulated effect of health assets on health status in older adults.

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The Impact of Epidemic Outbreak

Crisis ◽

10.1027/0227-5910/a000015 ◽

2010 ◽

Vol 31 (2) ◽

pp. 86-92 ◽

Cited By ~ 80

Author(s):

Paul S.F. Yip ◽

Y.T. Cheung ◽

P.H. Chau ◽

Y.W. Law

Keyword(s):

Older Adults ◽

Older Adult ◽

Negative Impact ◽

Well Being ◽

The Elderly ◽

Control Measures ◽

High Rate ◽

Completed Suicide ◽

The Impact ◽

The Relationship

Background: Previous studies revealed that there was a significant increase in suicide deaths among those aged 65 and over in 2003. The peak coincided with the majority of SARS cases being reported in April 2003. Aims: In this paper we examine the mechanism of how the SARS outbreak resulted in a higher completed suicide rate especially among older adults in Hong Kong. Methods: We used Qualitative data analysis to uncover the association between the occurrence of SARS and older adult suicide. Furthermore, we used a qualitative study based on the Coroner Court reports to provide empirical evidence about the relationship between SARS and the excessive number of suicide deaths among the elderly. Results: SARS-related older adult suicide victims were more likely to be afraid of contracting the disease and had fears of disconnection. The suicide motives among SARS-related suicide deaths were more closely associated with stress over fears of being a burden to their families during the negative impact of the epidemic. Social disengagement, mental stress, and anxiety at the time of the SARS epidemic among a certain group of older adults resulted in an exceptionally high rate of suicide deaths. Conclusions: We recommend that the mental and psychological well-being of the community, in particular older adults, be taken into careful account when developing epidemic control measures to combat the future outbreak of diseases in the community. In addition, it is important to alert family members to vulnerable individuals who are at potential risk because of their illnesses or anxieties.

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Older adult maintaining and improving health self-management through peer supported SMART goal setting

Innovation in Aging ◽

10.1093/geroni/igab046.2326 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. 611-611

Author(s):

Mary Hynes ◽

Nicole Anderson ◽

Monika Kastner ◽

Arlene Astell

Keyword(s):

Older Adults ◽

Older Adult ◽

Goal Setting ◽

Health Management ◽

Well Being ◽

Self Management ◽

Medical Interventions ◽

Adult Participants ◽

Smart Goals ◽

The Impact

Abstract Non-medical interventions to address risk factors (such as reducing smoking, increasing physical activity, and tackling limited social interaction) are needed to help tackle escalating social and financial health costs. Peer supported interventions have been used successfully to support persons’ health self-management; however, there is limited evidence for group interventions facilitated by older adults. A proof-of-concept study by the first author demonstrated the potential of older adults meeting in groups to each create and follow through with a single SMART goal for any area of health over one-month. This study extends SMART goal setting to enhancing health management over six months. Older adult participants from across Ontario will attend virtual SMART goal setting group sessions followed by six monthly support group meetings where they are free to choose any goal, whether a mitigation or a new behavior. Each month the facilitator will assist participants to continue, modify, or set a new goal. At the end participants will complete surveys about their satisfaction with the method, their results and their desire to continue with SMART goals. They will also be asked if they would like to facilitate new groups to continue the spread of peer-supported SMART goal groups. This study is designed to empower older adults to maintain or improve management of their physical, psychological, and/or social health. It will reveal the impact of an older adult created and guided group health intervention on feelings of self-efficacy and well-being.

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Older Adult Technology Use During a Global Pandemic: A Study of Mental Health, Social Supports, and Resiliency

Innovation in Aging ◽

10.1093/geroni/igab046.841 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. 219-220

Author(s):

Geunhye Park ◽

Erin Robinson ◽

Gashaye M Tefera

Keyword(s):

Mental Health ◽

Older Adults ◽

Older Adult ◽

Technology Use ◽

Social Connectedness ◽

New Technology ◽

Smart Phone ◽

Well Being ◽

Video Interface ◽

The Impact

Abstract Older adults have been disproportionately impacted by the COVID-19 pandemic, which has led many to isolate during this time. Technology enables people to remain connected, however little is known about how older adults have used technology and the impact it has had on their mental health and connectedness. This study was to explore how the COVID-19 pandemic has influenced older adult mental health and social connectedness, with a particular emphasis on how technology has played a role. One-on-one interviews (N=29) were conducted with adults aged 65+ (Mean age=71.5; 86% female) via phone/Zoom. Participants were asked open-ended questions about the impact social distancing has had on their quality of life, health, and social connectedness as well as their technology use to remain connected. Findings highlight the mental health stressors experienced by older adults during the pandemic, as well as much resiliency and innovation. In speaking of the isolation and its effect on her mental health, one participant said, “I thought fighting cancer was bad, but this is worse.” Nearly all of the participants had used technology in some form to remain connected to others, which the most common being a smart phone to call, text, and video-interface. One participant commented, “You can’t beat an iPhone. How in the world could we ever live without an iPhone?” Many participants had learned a new technology during the pandemic, such as Zoom. Our findings raise the possibility that technology may be a good strategy for enhancing well-being of aging population amid the pandemic.

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Co-Designing Technology for Aging in Place: A Systematic Review

The Gerontologist ◽

10.1093/geront/gnaa064 ◽

2020 ◽

Cited By ~ 3

Author(s):

Jennifer Sumner ◽

Lin Siew Chong ◽

Anjali Bundele ◽

Yee Wei Lim

Keyword(s):

Systematic Review ◽

Older Adults ◽

Well Being ◽

Beneficial Effects ◽

Age In Place ◽

Problems And Solutions ◽

Definition Of ◽

Adult Involvement ◽

The Impact ◽

Health And Well Being

Abstract Background and Objectives There is a growing interest to involve older adults in the co-design of technology to maintain their well-being and independence. What remains unknown is whether the beneficial effects of co-designed solutions are greater than those reported for non co-designed solutions. The aim of this study was to evaluate the effects and experiences of co-designed technology that support older adults to age in place. Research Design and Methods We conducted a systematic review to (a) investigate the health and well-being outcomes of co-designed technology for older adults (≥60 years), (b) identify co-design approaches and contexts where they are applied, and (c) identify barriers and facilitators of the co-design process with older adults. Searches were conducted in MEDLINE, EMBASE, CINAHL, Science Citation Index (Web of Science), Scopus, OpenGrey, and Business Source Premiere. Results We identified 14,649 articles and included 34 projects. Four projects reported health and well-being outcomes; the effects were inconsistent. Co-design processes varied greatly and in their intensity of older adult involvement. Common facilitators of and barriers to co-design included the building of relationships between stakeholders, stakeholder knowledge of problems and solutions, and expertise in the co-design methodology. Discussion and Implications The effect of co-designed technology on health and well-being was rarely studied and it was difficult to ascertain its impact. Future co-design efforts need to address barriers unique to older adults. Evaluation of the impact of co-designed technologies is needed and standardization of the definition of co-design would be helpful to researchers and designers.

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405 - Emotional Resilience of Older Adults During COVID-19: A Systematic Review of Studies of Stress and Well-Being

International Psychogeriatrics ◽

10.1017/s1041610221001642 ◽

2021 ◽

Vol 33 (S1) ◽

pp. 31-32

Author(s):

Evelina Sterina ◽

Adriana P. Hermida ◽

Danielle J. Gerberi ◽

Maria I. Lapid

Keyword(s):

Mental Health ◽

Systematic Review ◽

Older Adults ◽

Well Being ◽

Post Traumatic Stress ◽

Younger Adults ◽

Emotional Resilience ◽

Ovid Medline ◽

Distress Scale ◽

The Impact

Objectives:To examine post-traumatic stress, depression, anxiety, and well-being in older adults under quarantine in the context of epidemics.Methods:A systematic review of CINAHL, Ovid EBM Reviews, Ovid Embase, Ovid Medline, Ovid PsycINFO, Scopus, and Web of Science databases from 2000-2020 was conducted. Keywords included coronavirus, epidemic, quarantine, stress, mental health, and similar terms. Included studies enrolled participants under quarantine, quantitatively measured of mental health or psychological well-being, and characterized outcomes by age.Results:Of 894 initial results, 20 studies met criteria and were included in the analysis. Studies comprise a total of 106,553 participants from eight countries, age range 6-100, involved two epidemics (COVID- 19, SARS), and used 27 tools used to assess psychological responses to quarantine. The majority (70%) of the studies utilized recruited participants through online surveys, utilizing open web and snowball recruitment. Of the 20 studies, one found greater distress in older adults relative to younger adults on a COVID-19 distress scale, one study found no significant differences, and 18 studies found lower negative outcomes in older participants in at least one metric.Conclusions:Older adults in this review generally have lower stress and less negative emotions under quarantine than younger adults. It is unknown how this compares to the pre-pandemic state. More representative and longitudinal studies are needed to better measure the impact of quarantine on the mental health of older adults.Clinical Implications:As existing scales may not capture the full extent of pandemic’s psychological effects on older adults, clinicians must be vigilant in monitoring older adults’ mental health in quarantine.

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Talk or Walk? Gait Speed over Self-Report in Association with Cognitive Speed in Healthy Older Adults

GeroPsych ◽

10.1024/1662-9647/a000202 ◽

2019 ◽

Vol 32 (1) ◽

pp. 41-52

Author(s):

Matthew C. Costello ◽

Shane J. Sizemore ◽

Kimberly E. O’Brien ◽

Lydia K. Manning

Keyword(s):

Older Adults ◽

Older Adult ◽

Gait Speed ◽

Well Being ◽

Self Report ◽

Subjective Report ◽

Healthy Older Adults ◽

Relative Value ◽

Cognitive Speed ◽

Age Range

Abstract. This study explores the relative value of both subjectively reported cognitive speed and gait speed in association with objectively derived cognitive speed. It also explores how these factors are affected by psychological and physical well-being. A group of 90 cognitively healthy older adults ( M = 73.38, SD = 8.06 years, range = 60–89 years) were tested in a three-task cognitive battery to determine objective cognitive speed as well as measures of gait speed, well-being, and subjective cognitive speed. Analyses indicated that gait speed was associated with objective cognitive speed to a greater degree than was subjective report, the latter being more closely related to well-being than to objective cognitive speed. These results were largely invariant across the 30-year age range of our older adult sample.

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