scholarly journals Managing older people’s perceptions of alcohol-related risk: a qualitative exploration in Northern English primary care

2020 ◽  
Vol 70 (701) ◽  
pp. e916-e926
Author(s):  
Bethany Kate Bareham ◽  
Eileen Kaner ◽  
Barbara Hanratty

BackgroundRisk of harm from drinking increases with age as alcohol affects health conditions and medications that are common in later life. Different types of information and experiences affect older people’s perceptions of alcohol’s effects, which must be navigated when supporting healthier decisions on alcohol consumption.AimTo explore how older people understand the effects of alcohol on their health; and how these perspectives are navigated in supportive discussions in primary care to promote healthier alcohol use.Design and settingA qualitative study consisting of semi-structured interviews and focus groups with older, non-dependent drinkers and primary care practitioners in Northern England.MethodA total of 24 older adults aged ≥65 years and 35 primary care practitioners participated in interviews and focus groups. Data were analysed thematically, applying principles of constant comparison.ResultsOlder adults were motivated to make changes to their alcohol use when they experienced symptoms, and if they felt that limiting consumption would enable them to maintain their quality of life. The results of alcohol-related screening were useful in providing insights into potential effects for individuals. Primary care practitioners motivated older people to make healthier decisions by highlighting individual risks of drinking, and potential gains of limiting intake.ConclusionLater life is a time when older people may be open to making changes to their alcohol use, particularly when suggested by practitioners. Older people can struggle to recognise potential risks or perceive little gain in acting on perceived risks. Such perceptions may be challenging to navigate in supportive discussions.

2021 ◽  
pp. BJGP.2020.1118
Author(s):  
Bethany Kate Bareham ◽  
Jemma Stewart ◽  
Eileen Kaner ◽  
Barbara Hanratty

Background: Risk of harm from drinking is heightened in later life, due to age-related sensitivities to alcohol. Primary care services have a key role in supporting older people to make healthier decisions about alcohol. Aim: To examine primary care practitioners’ perceptions of factors that promote and challenge their work to support older people in alcohol risk-reduction. Design and Setting: Qualitative study consisting of semi-structured interviews and focus groups with primary care practitioners in Northern England. Method: Thirty-five practitioners (general practitioners, practice/district nurses, pharmacists, dentists, social care practitioners, domiciliary carers) participated in eight interviews and five focus groups. Data were analysed thematically, applying principles of constant comparison. Results: Practitioners highlighted particular sensitivities amongst older people to discussing alcohol, and reservations about older people’s resistance to making changes in old age; given drinking practices could be established, and promote socialisation and emotional wellbeing in later life. Age-related health issues increased older people’s contact with practitioners; but management of older people’s long-term conditions was prioritised over discussion of alcohol. Dedicated time to address alcohol in routine consultations with older people, and training in alcohol intervention facilitated practitioners; particularly pharmacists and practice nurses. Conclusion: There are clear opportunities to support older people in primary care to make healthier decisions about alcohol. Dedicated time to address alcohol, training in identification of alcohol-related risks, particularly those associated with old age; and tailored interventions for older people, feasible to implement in practice settings, would support primary care practitioners to address older people’s alcohol use.


BMJ Open ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. e049829
Author(s):  
Elizabeth Tyler ◽  
Fiona Lobban ◽  
Rita Long ◽  
Steven H Jones

ObjectivesAs awareness of bipolar disorder (BD) increases and the world experiences a rapid ageing of the population, the number of people living with BD in later life is expected to rise substantially. There is no current evidence base for the effectiveness of psychological interventions for older adults with BD. This focus group study explored a number of topics to inform the development and delivery of a recovery-focused therapy (RfT) for older adults with BD.DesignA qualitative focus group study.SettingThree focus groups were conducted at a university in the North West of England.ParticipantsEight people took part in the focus groups; six older adults with BD, one carer and one friend.ResultsParticipant’s responses clustered into six themes: (1) health-related and age-related changes in later life, (2) the experience of BD in later life, (3) managing and coping with BD in later life, (4) recovery in later life, (5) seeking helping in the future and (6) adapting RfT for older people.ConclusionsParticipants reported a range of health-related and age-related changes and strategies to manage their BD. Participants held mixed views about using the term ‘recovery’ in later life. Participants were in agreement that certain adaptations were needed for delivering RfT for older adults, based on their experience of living with BD in later life. The data collected as part of the focus groups have led to a number of recommendations for delivering RfT for older adults with BD in a randomised controlled trial (Clinical Trial Registration: ISRCTN13875321).


2015 ◽  
Vol 19 (1) ◽  
pp. 25-32 ◽  
Author(s):  
Sheila J. Gewolb

Purpose – The purpose of this paper is to demonstrate how older workers and people who have already retired speak about ageing and change and their experience of retirement. Design/methodology/approach – A qualitative study is described in which focus groups with older workers and semi-structured interviews with retired people were carried out. The recorded data were analysed using a linguistic approach (Discourse Analysis), which investigates in detail how people express their views and opinions and how their discourse might relate to societal attitudes towards ageing and retirement. Findings – Many older people who were still at work were concerned that they would decline and become senile once they retired unless they could remain active in some way. This was confirmed by people who had already retired and who spoke about how keeping busy and active had resulted in successful retirement and ageing. Research limitations/implications – Participants from four focus groups and five interview respondents represent only a small sample of older people who are still working or who are retired. This means that the results of this study cannot be extended to include all older workers and retired people. Social implications – This study will help to raise awareness of the concerns of older workers who may be nearing retirement, and how keeping busy and active after leaving work is considered by retirees to be part of successful retirement and helping to combat decline. Originality/value – A study of this nature which examines how older workers express their views about retirement using Discourse Analysis is original and may be used as a method for future research into other aspects of being older at work.


2019 ◽  
Author(s):  
Alice Moult ◽  
Tom Kingstone ◽  
Carolyn Chew-Graham

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.


Author(s):  
Deepti Adlakha ◽  
Mina Chandra ◽  
Murali Krishna ◽  
Lee Smith ◽  
Mark A. Tully

The World Health Organization and the United Nations have increasingly acknowledged the importance of urban green space (UGS) for healthy ageing. However, low- and middle-income countries (LMICs) like India with exponential ageing populations have inadequate UGS. This qualitative study examined the relationships between UGS and healthy ageing in two megacities in India. Participants were recruited using snowball sampling in New Delhi and Chennai and semi-structured interviews were conducted with consenting participants (N = 60, female = 51%; age > 60 years; fluent in English, Hindi, or Tamil). Interviews were recorded, transcribed, translated, and analysed using inductive and thematic analysis. Benefits of UGS included community building and social capital, improved health and social resilience, physical activity promotion, reduced exposure to noise, air pollution, and heat. Poorly maintained UGS and lack of safe, age-friendly pedestrian infrastructure were identified as barriers to health promotion in later life. Neighbourhood disorder and crime constrained older adults’ use of UGS in low-income neighbourhoods. This study underscores the role of UGS in the design of age-friendly communities in India. The findings highlight the benefits of UGS for older adults, particularly those living in socially disadvantaged or underserved communities, which often have least access to high-quality parks and green areas.


2020 ◽  
pp. 073346482098241
Author(s):  
Ruheena Sangrar ◽  
Kyung Joon Mun ◽  
Lauren E. Griffith ◽  
Lori Letts ◽  
Brenda Vrkljan

Driver training has the potential to keep older adults safe behind-the-wheel for longer, yet there is limited evidence describing factors that influence their willingness to participate in training. Focus groups with community-dwelling older drivers ( n = 23; 70–90 years) and semi-structured interviews with driving instructors ( n = 6) and occupational therapists ( n = 5) were conducted to identify these factors. Qualitative descriptive analyses highlighted how self-awareness of behind-the-wheel abilities in later life can influence an older adult’s motivation to participate in driver training, as well as their willingness to discuss their behaviors. Collision-involvement and near-misses prompted participants to reflect on their driving abilities and their openness to feedback. Participants’ preferences for learning contexts that use a strengths-based approach and validate the driving experience of older drivers, while providing feedback on behind-the-wheel performance, were raised. Older driver training initiatives that consider the needs of the aging population in their design can promote road safety and community mobility.


Author(s):  
Mary Jo Dorsey ◽  
Ellen Detlefsen

Objective – To describe preliminary findings from a study of information-seeking behaviors of primary care physicians who care for elderly and depressed patients, and the correlation between what is sought versus what is provided to the patient and (or) caregiver. Setting – Physicians in two large ambulatory primary care practices throughout urban Pittsburgh, Pennsylvania, who take care of geriatric patients. Methods – Structured interviews, with common questions, will be conducted with 12 primary care physicians to determine patterns of information-seeking behaviors. Environmental scans of physicians' offices for evidence of their existing information behaviors will complement the information obtained from the interviews. Results – This pilot study provides an analysis of the resources primary care physicians use to seek information to provide to patients and caregivers. Analyses show types of information sought, time spent seeking information, and methods used to find information given to patients. Conclusions – With mounting evidence of the Internet being used for patient self care, it is essential to understand if primary care physicians understand the scope and breadth of information readily available to their patients. The primary care physician needs to be aware of the types of information made available to their patients and the caregivers who are inclined to obtain information for the patient.


2021 ◽  
pp. 238008442110419
Author(s):  
M. Hijryana ◽  
M. MacDougall ◽  
N. Ariani ◽  
L.S. Kusdhany ◽  
A.W.G. Walls

Introduction: The impact of periodontal disease on oral health–related quality of life (OHRQoL) has often been investigated from a quantitative research perspective, which is based on clinical findings and an OHRQoL questionnaire. Very few studies have examined the issue from the view of qualitative research. To our knowledge, there have been no previous qualitative studies focusing the effect of periodontal disease on OHRQoL in Indonesian older people. Objectives: To explore and understand the impact of periodontal disease on the OHRQoL of older people as a subjective reflection in relation to periodontal disease experiences. Methods: Semi-structured interviews were conducted in a sample of 31 older people with generalized chronic periodontitis. Thematic analysis was used to identify the key issues in participants’ accounts. The analysis was undertaken by 2 independent coders to ensure reliability. To achieve thematic saturation, successive interviews were undertaken until 5 sequential interviews did not bring new themes. Results: Participants reported the negative effects likely related to periodontal disease. The impacts of periodontal disease were described by these older people as affecting more than pain, physical discomfort, and physical function restrictions. Periodontal disease also affected their psychological and social aspects of daily living. In addition, this study identified themes related to individual and environmental factors that may modify and personalize periodontal disease experiences. Furthermore, this study identified a misleading belief that problems related to periodontal disease were a normal part of aging, which might influence individuals’ expectations toward oral health. Relatedly, participants frequently reported that the progression of tooth mobility to tooth loss was an inevitable part of the aging process. Conclusions: Periodontal disease negatively affected participants’ OHRQoL. It is fundamental to understand older people’s perceptions toward their periodontal disease as well as individual and environmental factors that may have an influence on their periodontal disease experiences. Knowledge Transfer Statement: This study is a reflection of Indonesian older people’s subjective periodontal disease experiences. Therefore, the present study can be used to understand older people’s perceptions, attitudes, behaviors, and experiences toward periodontal disease and how this disease may affect their quality of life. This study also highlights a widespread and misleading belief that oral problems related to periodontal disease are an inevitable part of aging in this study population.


2020 ◽  
Author(s):  
◽  
Amy Murray ◽  

The following thesis is based upon an exploration into the process of driving cessation in later life, with a specific focus upon informal support. Although informal support has been highlighted as a highly important factor across the process of driving cessation (Johnson, 2008; Hanson & Hilldebrand, 2011; Ichikawa et al, 2016; Schryer et al, 2017), there is limited research which has explored this in depth. There is even less literature available which has incorporated the views of informal support network members, to understand their lived experiences of the driving cessation process. Studies which have addressed this gap, have tended to focus upon the views of adult children only (Rosenbloom, 2010; O’Connell et al, 2013). Using a phenomenological line of qualitative inquiry, individual semi-structured interviews with current and retired older drivers (n=15), and their family, friends, and wider community members (n=15) were completed. This was to provide a holistic approach to understand the driving cessation process, for the receivers and providers of informal support. Following a detailed thematic analysis, findings revealed both the process of driving cessation and informal support, to be profoundly complex, multi-faceted phenomena’s, holding multiple meanings for participants. This included a range of practical and psychosocial outcomes, which were both positive and negative. Often, findings were inter-linked, demonstrating the complexity of experiences amongst this far from homogeneous sample. The implications of the study have important messages for a number of individuals and groups, including older adults, their informal networks, policy and practice, and third sector organisations.


Gerontology ◽  
2018 ◽  
Vol 64 (6) ◽  
pp. 576-588
Author(s):  
Deirdre A. Robertson ◽  
David Weiss

Background: Social status is the standing of a person or group in the social hierarchy, and is perceived to change across the life span from low social status in early life, to peak in midlife, and to a decline thereafter. As threats to subjective social status are known to be detrimental to individuals’ health, it is important to better understand how older adults perceive themselves and others in terms of age-related social status. Objective: We examined status ambivalence – the potential discrepancy between how older adults’ perceive social status for themselves compared to older adults in general. Method: Study 1 used qualitative data from 37 semi-structured interviews with older adults to assess perceptions of social status. Study 2 used quantitative survey data from 114 older adults who completed explicit and implicit measures of social status. Results: Study 1 (n = 37, meanage = 71.72, SDage = 5.69; 81.1% women) provided preliminary evidence for status ambivalence such that older adults reported unequivocal low social status for other older adults but a more ambivalent perception of their own social status. Study 2 (n = 114, meanage = 64.32, SDage = 8.98, 57.9% women) compared implicit and explicit measures of social status revealing that older adults consistently perceive older adults to have low social status but again show a more ambivalent perception of their own social status. Conclusion: We discuss status ambivalence as a potential protective mechanism in the context of negative societal perceptions of age-related social status that may be important for well-being in later life.


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