Towards Zero Suicide: need and opportunities to improve implementation of clinical elements for older adults

2021 ◽  
pp. 103985622110540
Author(s):  
Anne Wand ◽  
Roderick McKay ◽  
Dimity Pond
Keyword(s):  
Risk Factors ◽  
Older Adults ◽  
Decision Making ◽  
Older People ◽  
Cultural Change ◽  
Help Seeking ◽  
Service Use ◽  
Evidence Based ◽  
Evidence Based Practices ◽  
Self Harm

Objective: The Zero Suicide (ZS) framework is increasingly used in Australia, but without published adaptations for older people, and limited access by older people when implemented. The aim of this paper is to inform Towards Zero Suicide (TZS) implementations to benefit older adults by considering the key differences in older adults at risk of suicide according to each clinical component of the ZS framework. Conclusion: TZS aspires to reduce deaths by suicide for people within healthcare by refocusing interventions on suicidality rather than diagnosis alone, emphasising evidence-based practices and cultural change. For TZS to be effective for older people, it is essential to ensure practices are based upon evidence relevant to older people and to ensure ageism is effectively counteracted. Older adults have distinct patterns of help seeking and service use, accompanied by differences in risk factors, presentations, and outcomes of suicidal behaviours. Ageism affects assessment, decision-making and actions to address self-harm and suicide for older people. Immediate and longer-term actions are essential to effectively implement TZS in this population.

scholarly journals Self-harm in older people: a clear need for specialist assessment and care

2012 ◽  
Vol 200 (5) ◽  
pp. 356-358 ◽  
Author(s):  
Michael S. Dennis ◽  
David W. Owens
Keyword(s):  
Older Adults ◽  
Older People ◽  
Evidence Based ◽  
Short Term ◽  
Younger Adults ◽  
Suicide Rates ◽  
Self Harm ◽  
Evidence Based Care

SummarySuicide rates are generally elevated after episodes of non-fatal self-harm, especially among older adults. Evidence suggests that non-fatal and fatal self-harm are more closely related in older than in younger adults. Older people who have self-harmed need specialist assessment followed by good short-term and long-term evidence-based care.

scholarly journals Using Evidence-Based Practice and Data-Based Decision Making in Inclusive Education

2021 ◽  
Vol 11 (3) ◽  
pp. 129
Author(s):  
Gabrielle Wilcox ◽  
Cristina Fernandez Conde ◽  
Amy Kowbel
Keyword(s):  
Decision Making ◽  
Inclusive Education ◽  
Evidence Based ◽  
Teacher Capacity ◽  
Evidence Based Practices ◽  
Full Inclusion ◽  
Current State ◽  
Inclusive Settings ◽  
Using Data ◽  
Data Based Decision Making

There are longstanding calls for inclusive education for all regardless of student need or teacher capacity to meet those needs. Unfortunately, there are little empirical data to support full inclusion for all students and even less information on the role of data-based decision making in inclusive education specifically, even though there is extensive research on the effectiveness of data-based decision making. In this article, we reviewed what data-based decision making is and its role in education, the current state of evidence related to inclusive education, and how data-based decision making can be used to support decisions for students with reading disabilities and those with intellectual disabilities transitioning to adulthood. What is known about evidence-based practices in supporting reading and transition are reviewed in relationship to the realities of implementing these practices in inclusive education settings. Finally, implications for using data-based decisions in inclusive settings are discussed.

scholarly journals Prevalence and Risk Factors of Postprandial Hypotension Among Japanese Older Adults in a Facility

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 222-222
Author(s):  
Noriko Suzuki ◽  
Masahiko Hashizume ◽  
Hideyuki Shiotani
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Older Adults ◽  
Older People ◽  
Future Research ◽  
Baseline Body Mass Index ◽  
Term Care ◽  
Postprandial Hypotension ◽  
Before And After ◽  
Japanese Older Adults

Abstract Postprandial hypotension (PPH) is an unrecognized sudden drop of blood pressure (BP) after meals and a hidden problem among older people including those living in long-term care facilities (LTCFs). Though PPH causes dizziness, falls, and syncope, it has received little attention from¬¬¬ healthcare workers (HCW) including caregivers, nurses and physicians, and risk factors of PPH should be carefully assessed to improve quality of life. Therefore, we aimed to examine the prevalence and risk factors of PPH in a LTCF in Japan. Participants were 114 older adults living in a LTCF in Japan (mean age 85.9 years old; 85 female (74%)). To examine PPH, blood pressure (BP) was measured before and after lunch. BP after meal was measured four times every 30 minutes. PPH is defined as a BP drop of 20 mmHg or more and we also defined a BP drop within a range of 19 to 15 mmHg as potential-PPH. As risk factors, we compared systolic and diastolic BP at baseline, body mass index, pulse rate, disease and complications between groups with/without PPH. The prevalence of PPH was 41% (47/114) and 52% with potential-PPH; 11% (13/114) added. Among risk factors, systolic BP was significantly higher in those with PPH (142.6 vs 123.5 mmHg, p <0.001). This study revealed that PPH & potential-PPH occurred in half of the subjects in a LTCF in Japan. HCW need to focus on high systolic BP to predict PPH and future research is necessary to prevent and cope with PPH for older people.

scholarly journals Editorial: Evidence-Based Practices to Reduce Falls and Fall-Related Injuries Among Older Adults

2018 ◽  
Vol 6 ◽  
Author(s):  
Cassandra W. Frieson ◽  
Maw P. Tan ◽  
Marcia G. Ory ◽  
Matthew Lee Smith
Keyword(s):  
Older Adults ◽  
Evidence Based ◽  
Evidence Based Practices

scholarly journals Multifunctionality of agriculture, public policies and scientific evidences: Some critical issues of contemporary controversies

2010 ◽  
Vol 4 (1-2) ◽  
pp. 53-58 ◽  
Author(s):  
Catherine Laurent ◽  
Marielle Berriet-Solliec ◽  
Marc Kirsch ◽  
Pierre Labarthe ◽  
AurélieT AurélieTrouvé
Keyword(s):  
Decision Making ◽  
Theoretical Models ◽  
Evidence Based ◽  
Evidence Based Practices ◽  
Policy Makers ◽  
Science And Policy ◽  
Public Policy Analysis ◽  
Critical Issues ◽  
The Status ◽  
New Situation

Various theoretical models of public policy analysis are used to treat situations of decision-making in which public deciders have to take into account the multifunctionality of agriculture. For some, science-society relations are not really problematical. Others acknowledge the current attempts of these policy-makers to find adequate scientific knowledge, and the difficulties they encounter. These difficulties stem partly from the very content of knowledge produced by research. Could other modes of production be more efficient? The status of the knowledge produced by these approaches is a subject of debate. Bridging the divide between science and policy more effectively is not only a question of knowledge brokerage.Accessibility and reliability of the existing evidences are also problems to be addressed. The debates around evidence-based practices may provide some landmarks in this new situation although they also emphasize the limits of the tools that can be built for this purpose.  

Substance misuse and older people: a question of values

2015 ◽  
Author(s):  
Ilana Crome
Keyword(s):  
Risk Factors ◽  
Older People ◽  
Prescription Drugs ◽  
Substance Misuse ◽  
Evidence Based ◽  
Younger Adults ◽  
Evidence Based Treatment ◽  
Treatment Regimes ◽  
Key Points ◽  
Physical Disorders

Key points• Substances are drugs that alter mental state and are potentially addictive.• Substance abuse is not confined to the younger population; it is also prevalent in older people—alcohol and prescription drugs are the most commonly misused in this population.• The possibility of substance misuse should not be dismissed because of the patient’s age.• Recommended alcohol limits are likely to be lower than for younger adults.• Risk factors differ for older people, e.g. bereavement, retirement, loneliness, boredom.• Substance misuse is often accompanied by other mental and physical disorders.• Older people can improve with treatment so should be comprehensively assessed and offered evidence-based treatment regimes that are adjusted to take their special needs into account.

scholarly journals Sense-making strategies and help-seeking behaviours associated with urgent care services: a mixed-methods study

2019 ◽  
Vol 7 (26) ◽  
pp. 1-122 ◽  
Author(s):  
Joanne Turnbull ◽  
Gemma McKenna ◽  
Jane Prichard ◽  
Anne Rogers ◽  
Robert Crouch ◽  
...  
Keyword(s):  
Decision Making ◽  
Literature Review ◽  
Help Seeking ◽  
Service Use ◽  
Urgent Care ◽  
Sense Making ◽  
Service Users ◽  
The Public ◽  
Care Services ◽  
Future Work

BackgroundPolicy has been focused on reducing unnecessary emergency department attendances by providing more responsive urgent care services and guiding patients to ‘the right place’. The variety of services has created a complex urgent care landscape for people to access and navigate.ObjectivesTo describe how the public, providers and policy-makers define and make sense of urgent care; to explain how sense-making influences patients’ strategies and choices; to analyse patient ‘work’ in understanding, navigating and choosing urgent care; to explain urgent care utilisation; and to identify potentially modifiable factors in decision-making.DesignMixed-methods sequential design.SettingFour counties in southern England coterminous with a NHS 111 provider area.MethodsA literature review of policy and research combined with citizens’ panels and serial qualitative interviews. Four citizens’ panels were conducted with the public, health-care professionals, commissioners and managers (n = 41). Three populations were sampled for interview: people aged ≥ 75 years, people aged 18–26 years and East European people. In total, 134 interviews were conducted. Analyses were integrated to develop a conceptual model of urgent care help-seeking.FindingsThe literature review identified some consensus between policy and provider perspectives regarding the physiological factors that feature in conceptualisations of urgent care. However, the terms ‘urgent’ and ‘emergency’ lack specificity or consistency in meaning. Boundaries between urgent and emergency care are ill-defined. We constructed a typology that distinguishes three types of work that take place at both the individual and social network levels in relation to urgent care sense-making and help-seeking.Illness workinvolves interpretation and decision-making about the meaning, severity and management of physical symptoms and psychological states, and the assessment and management of possible risks. Help-seeking was guided bymoral work: the legitimation and sanctioning done by service users.Navigation workconcerned choosing and accessing services and relied on prior knowledge of what was available, accessible and acceptable. From these empirical data, we developed a model of urgent care sense-making and help-seeking behaviour that emphasises that work informs the interaction between what we think and feel about illness and the need to seek care (sense-making) and action – the decisions we take and how we use urgent care (help-seeking).LimitationsThe sample population of our three groups may not have adequately reflected a diverse range of views and experiences. The study enabled us to capture people’s views and self-reported service use rather than their actual behaviour.ConclusionsMuch of the policy surrounding urgent and emergency care is predicated on the notion that ‘urgent’ sits neatly between emergency and routine; however, service users in particular struggle to distinguish urgent from emergency or routine care. Rather than focusing on individual sense-making, future work should attend to social and temporal contexts that have an impact on help-seeking (e.g. why people find it more difficult to manage pain at night), and how different social networks shape service use.Future workA whole-systems approach considering integration across a wider network of partners is key to understanding the complex relationships between demand for and access to urgent care.Study registrationThis study is registered as UKCRN 32207.FundingThe National Institute for Health Research Health Services and Delivery Research programme.

scholarly journals How do older adults understand and manage distress? A qualitative study

2019 ◽  
Author(s):  
Alice Moult ◽  
Tom Kingstone ◽  
Carolyn Chew-Graham
Keyword(s):  
Older Adults ◽  
Primary Care ◽  
Older People ◽  
Help Seeking ◽  
Management Strategies ◽  
Healthcare Services ◽  
Ethical Review ◽  
Structured Interviews ◽  
Management Options ◽  
Community Groups

Abstract Background Anxiety and depression are prevalent in older adults, however, older people may be reluctant to seek medical help and may manage their own mood problems. Due to stigma, older adults are more likely to perceive and/ or recognise their mood problems as distress. Whilst previous literature has focused on how younger adults self-manage mood problems, little research has explored how older people self-manage distress. The study reported here seeks to address this gap through qualitative methods. Methods This study was approved by Keele University’s ethical review panel. Older adults who self-identified as distressed, depressed or anxious within the previous 12 months were recruited from community groups in North Staffordshire, England. Data were generated through semi-structured interviews and analysed thematically using constant comparison methods. A public and patient involvement and engagement group contributed to development of the research questions and methods, and offered their perspectives on the findings. Results Data saturation was achieved after 18 interviews. Key themes were: experiences of distress, actions taken, help-seeking from healthcare services and perceptions of treatments offered in primary care. Various forms of loss contributed to participants’ distress. Participants initiated their own self-management strategies which included: pursuing independent activities, seeking social support and attending community groups and church. Five participants reported having consulted a GP when distressed but described a lack of acceptable treatments offered. Conclusions To support older adults who are distressed, primary care healthcare professionals need to explore patients’ existing ways of managing mood problems, provide information about a range of management options and consider the use of sign-posting older adults to community resources.

scholarly journals Program Practices Predict Intergenerational Interaction among Youth and Older Adults

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 794-794
Author(s):  
Shannon Jarrott ◽  
Shelbie Turner ◽  
Jill Juris Naar ◽  
Rachel Scrivano ◽  
Raven Weaver
Keyword(s):  
Older Adults ◽  
Best Practices ◽  
Older Adult ◽  
Program Implementation ◽  
Evidence Based ◽  
Evidence Based Practices ◽  
Adult Participants ◽  
Potential Benefits ◽  
Participant Response ◽  
Intergenerational Interaction

Abstract Non-familial intergenerational programs engage younger and older people in shared programming for mutual benefit, frequently involving senior centers or adult day programs and preschools. With growing interest in the potential benefits of intergenerational strategies, it is imperative to know their effects on participant interaction during intergenerational programming. To address this knowledge gap, activity leaders at five sites serving older adults and/or preschoolers received training to implement 14 evidence-based practices during intergenerational activities involving 109 older adult and 105 preschool participants over four years. We utilized multi-level modeling to test whether variations in implementation of practices were associated with variations in participants’ responses to programming on a session-by-session basis. For both preschool and older adult participants, analyses revealed that the implementation of certain practices was associated with significantly more intergenerational interaction. Specifically, when person-centered best practices (e.g., leading activities that are age- and role-appropriate for older adults) were implemented, preschoolers (estimate=5.83, SD=2.11, p=0.01 and older adults (estimate=5.11, SD=.10, p=0.02) had more intergenerational interaction. Likewise, when environmental-centered best practices were implemented, such as pairing materials between intergenerational partners, preschoolers (estimate=6.05, SD=1.57, p=0.002) and older adults (estimate=6.50, SD=1.85, p=0.001) had more intergenerational interaction. Our findings reveal session-by-session variation in intergenerational interaction that can be impacted by implementation practices, which highlights the importance of training activity leaders to implement evidence-based practices. Researchers and practitioners should consider how session-by-session variation in program implementation affects participant response.

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