scholarly journals Re-thinking reablement strategies for older adults in residential aged care: a scoping review

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Lucy K. Lewis ◽  
Tim Henwood ◽  
Jo Boylan ◽  
Sarah Hunter ◽  
Belinda Lange ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Mental Health ◽  
Older Adults ◽  
Cost Effectiveness ◽  
Adverse Events ◽  
Physical Function ◽  
Aged Care ◽  
Residential Aged Care ◽  
Controlled Trials

Abstract Background The number of older adults in residential aged care is increasing. Aged care residents have been shown to spend most of the day sedentary and have many co-morbidities. This review aimed to systematically explore the effectiveness of reablement strategies in residential aged care for older adults’ physical function, quality of life and mental health, the features of effective interventions and feasibility (compliance, acceptability, adverse events and cost effectiveness). Method This scoping review was undertaken according to PRISMA guidelines (extension for scoping reviews). Five e-databases (Medline, Embase, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews and CINAHL) were searched from 2010 onwards. Randomised controlled trials investigating reablement strategies addressing physical deconditioning for older adults (mean age ≥ 65 yrs) in residential aged care on physical function, quality of life or mental health were included. Feasibility of the interventions (compliance, acceptability, satisfaction, adverse events and cost effectiveness) was explored. Results Five thousand six hundred thirty-one citations were retrieved, and 63 studies included. Sample sizes ranged from 15 to 322 and intervention duration from one to 12 months. Exercise sessions were most often conducted two to three times per week (44 studies) and physiotherapist-led (27 studies). Interventions were predominately multi-component (28 studies, combinations of strength, balance, aerobic, functional exercises). Five interventions used technology. 60% of studies measuring physical function reported significant improvement in the intervention versus control, 40% of studies measuring quality of life reported significant improvements in favour of the intervention, and 26% of studies measuring mental health reported significant intervention benefits. Over half of the studies measured compliance and adverse events, four measured acceptability and none reported cost effectiveness. Conclusions There has been a research surge investigating reablement strategies in residential aged care with wide variability in the types and features of strategies and outcome measures. Few studies have measured acceptability, or cost effectiveness. Exploration of core outcomes, mapping stakeholders and co-designing a scalable intervention is warranted. Trial registration Prospectively registered review protocol (Open Science Framework: DOI 10.17605/OSF.IO/7NX9M).

scholarly journals Exercise Is Medicine: Restoring Function in Older Adults with Hematologic Malignancy

Blood ◽  
2018 ◽  
Vol 132 (Supplement 1) ◽  
pp. 4870-4870 ◽  
Author(s):  
Ashley E. Rosko ◽  
Sarah A Wall ◽  
Carolyn Presley ◽  
ReNea Owens ◽  
Desiree Jones ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Older Adults ◽  
Adverse Events ◽  
Physical Health ◽  
Physical Function ◽  
Hematologic Malignancy ◽  
Functional Decline ◽  
Exercise Program ◽  
Exercise Programs

Abstract Background: Exercise programs are proven to positively impact physical fitness, quality of life, and late toxicities in cancer patients, and many recent reports document the benefit of exercise in patients with diverse cancers.1-3 However, such programs are underutilized in patients with hematologic malignancy.2,3 As anemia and thrombocytopenia associated with hematologic diseases are risk factors for falls and bleeding complications, exercise has not been routinely recommended. Thus, exercise programs have yet to gain traction in patients with hematologic malignancy and are rarely seen as a preventative measure for functional decline. Of critical importance, functional decline is not an inevitable part of illness or aging and is potentially modifiable.4,5 Here, we identified older adults with functional decline and incorporated a preventative exercise program to attenuate complications associated with disease- and therapy-related de-conditioning. Methods: This is a single center, pilot prospective study of older adults (≥60 years) with hematologic malignancy actively receiving chemotherapy. Patients enrolled had mild or moderate impairments in physical function, as defined by a score ≤9 on the Short Physical Performance Battery (SPPB). The SPPB is an objective, validated tool used to capture at risk patients and has been shown to be prognostic in predicting decline in function, re-hospitalization, and mortality.6 The primary objective was to assess the feasibility of implementing a structured exercise program; including recruitment and retention, adherence, sustainability, adverse events and implementation challenges. Reasons why patients decline exercise participation were also tracked. The Otago Exercise Program (OEP) has been found to be an effective exercise regimen to improve functional balance, muscle strength, and prevent fall-related injury and mortality.8 The OEP is a structured combination of physical therapist prescribed individualized exercise plans with home-based exercise, demonstrated to improve balance and functional decline.9 The OEP focuses on strengthening, balance retraining, and walking. Results: Older adults actively receiving chemotherapy with a median age of 75.5 (62-83) with hematologic malignancy (myeloma=18, NHL=6, leukemia=5) were enrolled. Chemotherapy regimens were variable (e.g. R-EPOCH, venetoclax, IMiDS, proteasome inhibitors, bone marrow transplant). Patients were approached (n=63) for participation of a structured exercise program and a target accrual of n=30 was achieved over 17 months. Reasons for declining participation included travel (n=13), inconvenience (n=12), not appropriate (n=5) or concern for side effects/cost/uninformed (n=3). There was no relationship with distanced traveled and exercise completion, R=-0.01 (p=0.94). Adherence was excellent with all 8 sessions complete (n=18) or 7 sessions complete (n=4), at time of analysis. Geriatric assessment factors were analyzed at baseline (Visit 1) and following 4 months of exercise (Visit 2). Physical health scores as measured by the MOS-PFS increased significantly [MOS-PFS: V1=55 (0-100), V2=67.5 (30-100), p=0.005], where patient reported KPS were similar [KPS V1=80 (40-100), V2=85 (60-100), p=0.065]. Importantly, objective measures of physical function improved to normal scores by visit 2 [SPPB V1=7(0-11), V2=11(2-12), p<0.001]. Moreover, quality of life scores by PROMIS demonstrated improvement in physical health symptoms. No adverse events were attributable to exercise. Conclusions: In this pilot study evaluating a structured exercise program for older adults undergoing chemotherapy, physical deficits normalized for patients, resulting in improved subjective and objective measurements of functional capacity. The program was feasible, sustainable and adherence was optimal. Here we demonstrate that exercise programs can attenuate complications associated with disease- and therapy-related de-conditioning and are feasible in older adults. Disclosures No relevant conflicts of interest to declare.

scholarly journals Biography work in in long-term residential aged care with tablet support to improve the quality of life and communication – study protocol for app development and evaluation / Biografiearbeit in Senioreneinrichtungen mit Tablet-Unterstützung zur Verbesserung der Lebensqualität und Kommunikation (BaSeTaLK) – Studienprotokoll zur App-Entwicklung und Evaluation

2020 ◽  
Vol 7 (1) ◽  
pp. 13-23
Author(s):  
Sabine Corsten ◽  
Norina Lauer
Keyword(s):  
Quality Of Life ◽  
Older Adults ◽  
Aged Care ◽  
Life Assessment ◽  
World Health ◽  
Residential Aged Care ◽  
Care Facilities ◽  
Senior Volunteers

AbstractBackgroundOlder adults in care facilities face a high risk of experiencing depression. The impact that early interventions like biographical work have on the quality of life for older adults in such facilities is unknown.AimTo develop and evaluate a tablet-supported intervention for biographical work in long-term residential aged care to increase the quality of life for older adults.DesignThe study will be conducted in a randomized pretest–posttest control group design with follow-up testing in group and single settings. Participants will be randomized to the experimental intervention (tablet-supported biographic work) or the control intervention (planned tablet-supported game playing), each guided by senior volunteers. A total of 80 residents and 16 volunteers will be recruited. The primary outcome for the residents and volunteers will be quality of life as measured with the World Health Organization Quality of Life Assessment-for older adults. Secondary measures will be self-esteem and life satisfaction. In addition, we will examine residents’ ability to communicate and their functional independence.MethodThe first stage of the project involves developing an app. The app is developed in a user-centered, agile development process. It will use multimedia to prepare life history topics and links them to key questions. Next, a workshop is developed for the volunteers who accompany the use of the app in the institutions. During the second phase, biographic work stimulated by the app will be conducted in groups or individually with residents.DiscussionThis is the first known program tailored to older adults in care facilities and senior volunteers that aims to prevent depression by providing digitally supported biographic work.

scholarly journals Effectiveness and cost effectiveness of interpersonal community psychiatric treatment (ICPT) for people with long-term severe non-psychotic mental disorders: a multi-Centre randomized controlled trial

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Mark van Veen ◽  
Bauke Koekkoek ◽  
Steven Teerenstra ◽  
Eddy Adang ◽  
Cornelis L. Mulder
Keyword(s):  
Quality Of Life ◽  
Mental Health ◽  
Cost Effectiveness ◽  
Community Mental Health ◽  
Mental Health Treatment ◽  
Psychiatric Treatment ◽  
Illness Management ◽  
Illness Management And Recovery ◽  
Perceived Difficulty

Abstract Background Long-term community mental health treatment for non-psychotic disorder patients with severe mental illness (SMI) who are perceived as difficult by clinicians, is poorly developed and lacks a structured, goal-centred approach. This study compares (cost-)effectiveness of Interpersonal Community Psychiatric Treatment (ICPT) with Care As Usual (CAU) on quality of life and clinician perceived difficulty in the care for non-psychotic disorder SMI-patients. A multi-centre cluster-randomized clinical tria was conducted in which Community Mental Health Nurses (Clinicians) in three large community mental health services in the Netherlands were randomly allocated to providing either ICPT or CAU to included patients. A total of 56 clinicians were randomized, who treated a total of 93 patients (59 in ICPT-group and 34 in CAU-group). Methods Primary outcome measure is patient-perceived quality of life as measured by the Manchester Short Assessment of Quality of Life (MANSA). Secondary outcome measures include clinician-perceived difficulty, general mental health, treatment outcomes, illness management and recovery, therapeutic relationship, care needs and social network. Patients were assessed at baseline, during treatment (6 months), after treatment (12 months) and at 6 months follow-up (18 months). Linear mixed-effects models for repeated measurements were used to compare mean changes in primary and secondary outcomes between intervention and control group of patients over time on an intention to treat basis. Potential efficiency was investigated from a societal perspective. Economic evaluation was based on general principles of a cost-effectiveness analysis. Outcome measures for health economic evaluation, were costs, and Quality Adjusted Life Years (QALYs). Results Half of the intended number of patients were recruited. There was no statistically significant treatment effect found in the MANSA (0.17, 95%-CI [− 0.058,0.431], p = 0.191). Treatment effects showed significant improvement in the Different Doctor-Patient Relationship Questionnaire-scores and a significant increase in the Illness Management and Recovery–scale Client-version scores). No effects of ICPT on societal and medical costs nor QALYs were found. Conclusions This is the first RCT to investigate the (cost)-effectiveness of ICPT. Compared with CAU, ICPT did not improve quality of life, but significantly reduced clinician-perceived difficulty, and increased subjective illness management and recovery. No effects on costs or QALY’s were found. Trial registration NTR 3988, registered 13 May 2013.

scholarly journals Clustered domestic residential aged care in Australia: fewer hospitalisations and better quality of life

2018 ◽  
Vol 208 (10) ◽  
pp. 433-438 ◽  
Author(s):  
Suzanne M Dyer ◽  
Enwu Liu ◽  
Emmanuel S Gnanamanickam ◽  
Rachel Milte ◽  
Tiffany Easton ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Aged Care ◽  
Residential Aged Care

Effect of complementary therapies on functional capacity and quality of life among prefrail and frail older adults: A systematic review of randomized controlled trials

2020 ◽  
Vol 91 ◽  
pp. 104236
Author(s):  
Marcele Stephanie de Souza Buto ◽  
Marcos Paulo Braz de Oliveira ◽  
Cristiano Carvalho ◽  
Verena Vassimon-Barroso ◽  
Anielle Cristhine de Medeiros Takahashi
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Older Adults ◽  
Randomized Controlled Trials ◽  
Functional Capacity ◽  
Complementary Therapies ◽  
Controlled Trials ◽  
Frail Older Adults ◽  
Randomized Controlled

scholarly journals Disparities in Mental Health Quality of Life Between Hispanic and Non-Hispanic White LGB Midlife and Older Adults and the Influence of Lifetime Discrimination, Social Connectedness, Socioeconomic Status, and Perceived Stress

2016 ◽  
Vol 39 (9) ◽  
pp. 991-1012 ◽  
Author(s):  
Hyun-Jun Kim ◽  
Karen I. Fredriksen-Goldsen
Keyword(s):  
Quality Of Life ◽  
Mental Health ◽  
Older Adults ◽  
Socioeconomic Status ◽  
Perceived Stress ◽  
Social Connectedness ◽  
Health Quality ◽  
Health Quality Of Life ◽  
Hispanic White

We assessed factors contributing to ethnic and racial disparities in mental health quality of life (MHQOL) among lesbian, gay, and bisexual (LGB) midlife and older adults. We utilized cross-sectional survey data from a sample of non-Hispanic White and Hispanic LGB adults aged 50 and older. Structural equation modeling was used to test the indirect effect of ethnicity/race on MHQOL via explanatory factors including social connectedness, lifetime discrimination, socioeconomic status (SES), and perceived stress. Hispanics reported significantly lower levels of MHQOL, compared to non-Hispanic Whites. In the final model, the association between ethnicity/race and MHQOL was explained by higher levels of perceived stress related to lower SES, higher frequency of lifetime discrimination, and lack of social connectedness among Hispanic LGB adults. This study suggests that perceived stress related to social disadvantage and marginalization plays an important role in MHQOL disparities among Hispanic LGB midlife and older adults.

scholarly journals HEALTH-RELATED QUALITY OF LIFE AND CARDIOVASCULAR DISEASE IN ASIAN AMERICAN AND PACIFIC ISLANDER OLDER ADULTS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S515-S516
Author(s):  
Lan Doan ◽  
Yumie Takata ◽  
Karen Hooker ◽  
Carolyn Mendez-Luck ◽  
and Veronica L Irvin
Keyword(s):  
Quality Of Life ◽  
Mental Health ◽  
Risk Factors ◽  
Older Adults ◽  
Asian American ◽  
Medicare Advantage ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related

Abstract Cardiovascular disease (CVD) is the leading cause of death for Asian American (AA), Native Hawaiian, and Pacific Islander (NHPI) older adults, and AAs/NHPIs have not enjoyed decreases in CVD mortality rates, as have non-Hispanic whites (NHWs). Heterogeneity exists in the prevalence of traditional CVD risk factors for AAs/NHPIs. Health-related quality of life (HRQOL) reflect physical and mental burdens beyond clinical burdens, which may help explain discrepant CVD rates and risk factors in AAs/NHPIs. We examined HRQOL among NHW and AA/NHPI Medicare Advantage enrollees with and without a CVD (i.e., coronary artery disease, congestive heart failure, myocardial infarction, and stroke) using the Medicare Health Outcomes Survey. The sample included 655,914 older adults who were 65 years or older, self-reported as AA/NHPI or NHW, and were enrolled in Medicare Advantage plans in 2011-2015. HRQOL was measured using the Veterans RAND 12-item survey and is composed of a physical component score (PCS) and mental component score (MCS), where higher scores reflect better physical and mental health, respectively. Multivariable linear regression was used to explore HRQOL and CVD prevalence. Asian Indian, Filipino, Vietnamese, Other Asian, and NHPI subgroups had lower overall PCS, and all AA/NHPI subgroups had lower overall MCS, compared to NHWs. Among those reporting having any CVD, PCS varied by CVD outcomes and subgroups, whereas MCS was lower for all CVD outcomes and for all but one AA/NHPI subgroups (Japanese), compared to NHWs. Attention to mental health for AA/NHPI older adults could be important for the equitable realization of healthy aging.

Sign in / Sign up

Export Citation Format

Share Document