Behaviour Of Older People Research Articles

Older people: how do they find out about their health? A pilot study

Information about health is gained from various sources but little is known about the health information-seeking behaviours of older people and what factors affect this. This pilot study aimed to explore older people's experiences and views on their health information-seeking behaviours and to gain a better understanding of these. A qualitative study with nine older people was undertaken, using diaries and semi-structured interviews to gather data. Three key themes emerged relating to why they sought information, what shaped this and where health information was accessed. This study is generating new knowledge of older people's experiences and views on their health information-seeking behaviour. By understanding these, community nurses will be better placed to promote strategies that improve older people's access to appropriate health information and support its effective use.

The effect of massage on agitated behaviours in older people with dementia: a literature review

To review the literature on massage used to manage agitated behaviours in older people with dementia, assess its efficacy as a non-pharmacological approach and provide recommendations for future research. Agitation has traditionally been managed with chemical or physical restraint. There has been a growing interest in complementary therapies such as massage. A literature review. Cooper's five-stage model of synthesising research guided the review process. The search terms 'massage', 'agitation' and 'dementia' were defined, and 10 databases were searched in October 2011. No date limitations were applied, although searches were limited to articles written in English. For relevant records, full-text copies were obtained and assessed in terms of inclusion criteria and methodological quality using the Validity Rating Tool (VRT). Data were extracted using a form constructed with reference to the checklist of items to consider in data extraction, produced by the Cochrane Handbook for Systematic Reviews of Interventions. Thirteen studies met the inclusion criteria and were assessed on the VRT. One study was considered of adequate methodological quality to be included in the review. This prospective study found that massage significantly reduced levels of agitation in 52 cognitively impaired residents in two long-term care facilities. There is a severe paucity of research that considers the effects of massage on managing agitated behaviours in older people with dementia. Whilst conclusions cannot be drawn from the one study included in this review, it did provide evidence to support the use of massage as a non-pharmacological approach to managing agitation in older people with dementia. More research, of better methodological quality, is needed. There is a need for health practitioners to be aware of the limited evidence for massage as an intervention for agitation and to provide opportunities to validate massage practice.

Prevalence of physical activity behaviour in older people: Findings from the Dynamic Analyses to Optimise Ageing (DYNOPTA) project and Australian national survey data

Many older people lead sedentary lives. National Health Survey physical activity prevalence data provide limited coverage of the 'old old' (≥75 years). The Dynamic Analyses to Optimise Ageing (DYNOPTA) project's dataset provided physical activity data for 13,420 participants. Physical activity (walking, moderate- and vigorous-intensity activities in the previous week) was measured. Data were weighted and prevalence was calculated. The frequency of walking in DYNOPTA was similar to that in the national sample. Walking remained relatively stable until a decline among persons aged 80 years and over; moderate and vigorous activity declined in all but a minority of persons aged 70 years and over. Although DYNOPTA participants reported more physical activity than those in the contemporary national survey, the rates of sedentary behaviour were high. We require more information about the 'oldest old' (85+ years). There is great scope for increasing physical activity, even walking, among older people.

Managing agitated behaviour in older people

Older people diagnosed with dementia can have complex needs, especially when they exhibit agitated behaviour. Patients with agitated behaviour challenge the delivery of health care. Often the behaviour is a symptom of unmet needs in this population (Dewing 2010). It is important for nurses to understand the underlying causes and apply evidence-based interventions in their nursing practice to promote health, safety and the highest quality of life possible. This article defines and classifies agitated behaviours, discusses implications for their management and then presents evidence-based interventions nurses can use. The interventions are categorised according to each of the five senses.

A Novel Human Autonomy Assessment System

This article presents a novel human autonomy assessment system for generating context and discovering the behaviors of older people who use ambulant services. Our goal is to assist caregivers in assessing possibly abnormal health conditions in their clients concerning their level of autonomy, thus enabling caregivers to take countermeasures as soon as possible.

Spotlight on the February 14 Issue

A nationwide analysis of claims data for Medicare beneficiaries 65 years old and older revealed that epilepsy was very common among older Americans. Certain populations, especially African Americans, were more at risk. A strong suspicion of seizures should be entertained as a cause of altered behavior in older people. See p. 448; Editorial, p. 444 The authors present a diagnostic approach to “on” freezing of gait (FOG) during the “on state.” Four patients with Parkinson disease (PD) with suspected “on” FOG were examined in the “off state,” “on state,” and “supra-on state.” True “on” FOG exists as a rare phenotype in PD, unassociated …

The association between suicidality and treatment with Selective Serotonin Reuptake Inhibitors in older people with major depression: a systematic review

The association between suicidality and treatment with Selective Serotonin Reuptake Inhibitors in older people with major depression: a systematic review

Clustering of multiple healthy lifestyles among older Korean adults living in the community

Despite the predictive value of combined healthy lifestyles in maintaining physical and cognitive functioning in late life, little is known about the clustering patterns of healthy lifestyle behaviors in older people. The aim of the present study was to examine the prevalence, clustering and population characteristics of adherence to multiple health behaviors in community-dwelling older Korean adults. The study population consisted of a nationally representative sample of 4165 Korean adults aged 65 years and older in 2006. Healthy lifestyles, defined as adherence to recommended guidelines, included non-smoking, no heavy drinking, physical activity and healthy weight. Combinations of behavioral patterns and prevalence odds ratios for pairwise clusters were analyzed. Multinomial logistic regression was used to identify demographic and health-related characteristics associated with the number of adherence to guideline recommendations. Those who adhered to all four guideline recommendations constituted the minority (11.7%). More women than men engaged in a higher number of healthy lifestyles. Clustering was more pronounced in men for whom no heavy alcohol drinking and physical activity centered around non-smoking. In women, clustering patterns were less obvious. Men, those with low levels of education, income and wealth, and the functionally impaired were less likely to adhere to multiple healthy lifestyles. Clustering of healthy lifestyles, especially among older men, supports the potential benefit of a multiple behavior change approach. Health promotion efforts should target the socially disadvantaged and functionally compromised segment of the older population presenting low adherence to recommended behaviors.

Can vouchers make a difference to the use of private primary care services by older people? Experience from the healthcare reform programme in Hong Kong

Background As part of its ongoing healthcare reform, the Hong Kong Government introduced a voucher scheme, intended for encouraging older patients to use primary healthcare services in the private sector, thereby, reducing burden on the overwhelmed public sector. The voucher program is also considered one of the strategies to further develop the public private partnership in healthcare, a policy direction of high political priority as indicated in the Chief Executive Policy Address in 2008-09. This study assessed whether the voucher scheme, as implemented so far, has reached its intended goals, and how it might be further improved in the context of public-private partnership. Methods This was a cross-sectional study using structured questionnaires by face-to-face interviews with older people aged 70 or above in Hong Kong, the target group of the demand-side voucher program. Results 71.2% of 1,026 older people were aware of the new voucher scheme but only 35.0% had ever used it. The majority of the older people used the vouchers for acute curative services in the private sector (82.4%) and spent less on preventive services. Despite the provision of vouchers valued US$30 per year as an incentive to encourage the use of private primary care services, after 12-months of implementation, 66.2% of all respondents agreed with the statement that "the voucher scheme does not change their health seeking behaviours on seeing public or private healthcare professionals". The most common reasons for no change in their behaviours included "I am used to seeing doctors in the public system" and "The amount of the subsidy is too low". Those who usually used a mix of public and private doctors and those with better self-reported health condition compared to last year were more likely to perceive a change in their own health seeking behaviours. Conclusions Our study showed that despite a reasonably high awareness of the voucher scheme, its usage was low. The voucher alone was not enough to realize the government's policy of greater use of the private primary care services. Greater publicity and more variety of media promotion would increase awareness but the effectiveness of vouchers in changing older people's behaviour needs to be revisited. Designating vouchers for use of preventive services with evidence-based practice could be considered. In addition to the demand-side subsidies, improving transparency and comparability of private services against the public sector might be necessary.

GPCR, a rider of Alzheimer’s disease

Alzheimer’s disease (AD) is the most common type of dementia that affects thinking, learning, memory and behavior of older people. Based on the previous studies, three pathogenic pathways are now commonly accepted as the culprits of this disease namely, amyloid-β pathway, tauopathology and cholinergic dysfunction. This review focuses on the current findings on the regulatory roles of G protein-coupled receptors (GPCRs) in the pathological progression of AD and discusses the potential of the GPCRs as novel therapeutic targets for AD.

Improving dementia care in hospitals

AbstractIn their article on managing challenging behaviour in older people with dementia (page 20), Dr Krishnamoorthy and Dr Anderson highlight the importance of a person‐centred approach to dementia care. However, several recent reports indicate that elderly patients may not always receive the care they deserve in UK hospitals. Copyright © 2011 Wiley Interface Ltd

Exploring the effect of foot massage on agitated behaviours in older people with dementia: A pilot study

To explore the effects of foot massage on agitated behaviours in older people with dementia living in long-term care. Seventeen men and 5 women (mean age 84.7 years), with a diagnosis of dementia and a history of clinically significant agitation, received a 10-minute foot massage each day for 14 days. The short form of the Cohen-Mansfield Agitation Inventory (CMAI-SF) and the Revised Memory and Behavior Problems Checklist (RMBPC) were completed at baseline, post-test and 2-weeks follow up. CMAI-SF and RMBPC scores were significantly reduced at post-test and remained significantly lower than baseline at follow up. This study provides preliminary evidence suggesting that limited short-duration foot massage reduces agitation and related behavioural problems in people with dementia, and that these behaviour changes are maintained after the massage ceases. A randomised controlled trial is required to confirm these findings.

Constructing ageing and age identities: a case study of newspaper discourses

ABSTRACTPublic discourses concerning older people are available in a variety of texts, including popular media, and these discourses position older people with particular age identities. This study examined discursive formations of ageing and age identities in print media in Ireland. Constituting a single media event, newspaper texts concerned with revised welfare provision for older people were subjected to critical discourse analysis and revealed particular ways of naming and referencing older people and distinct constructions of ageing and age identities. The use of nouns and phrases to name and reference older people positioned them as a distinct demographic group and a latent ageism was discernible in texts that deployed collective names like ‘grannies and grandads’ and ‘little old ladies’. Five distinct identity types were available in the texts, variously constructing older people as ‘victims’; ‘frail, infirm and vulnerable’; ‘radicalised citizens’; ‘deserving old’ and ‘undeserving old’. The discourses made available subject positions that collectively produced identities of implied dependency and otherness, thereby placing older people outside mainstream Irish society. The proposition that older people might be healthy, self-reliant and capable of autonomous living was largely absent in the discourses. Newspaper discourses betray taken-for-granted assumptions and reveal dominant social constructions of ageing and age identity that have consequences for older people's behaviour and for the way that society behaves towards them.

S42-04 - Decision making and vulnerability to suicidal behaviour in elderly

Suicide is a major public health concern, especially for older adults, who have higher rates of completed suicide than any other age group in most countries of the world. However, understanding suicidal behaviour remains a challenging task particularly among the elders who have been poorly studied. Decision making has been recently found to be altered in suicide attempters under 65.To test wether decision making would be a neuropsychological trait of vulnerability to suicidal behaviours, the authors used the Iowa Gambling Task to investigate normothymic non demented elders with a history of suicidal behaviour (N = 35) and compared it to decision making in non suicide attempters with a past history of depression (N = 52) and comparison subjects (N = 43). The data also were compared to those of similar groups of younger normothymic subjects. Moreover, the old suicidal patients were assessed according to the age at the onset of suicidal behaviour (before or after 60).Old suicide attempters did not significantly differ from the other aged groups and according to the age of first suicidal behaviour. Old suicide attempters presented better performances than that of younger suicidal patients.Vulnerability to suicidal behaviour in older people may proceed from cognitive processes which are different from the ones involved in suicidal vulnerability of younger subjects. These results are preliminary and further studies are needed to explore vulnerability cognitive patterns to suicide among elders.

Conducting randomized controlled trials with older people with dementia in long‐term care: Challenges and lessons learnt

The characteristics of older people with dementia and the long-term care environment can make conducting research a challenge and, as such, this population and setting are often understudied, particularly in terms of clinical or randomized controlled trials. This paper provides a critical discussion of some of the difficulties faced whilst implementing a randomized controlled trial exploring the effect of a live music programme on the behaviour of older people with dementia in long-term care. A discussion of how these challenges were addressed is presented to aid investigators planning the design of similar research and help encourage a proactive approach in dealing with research-related challenges right from project conception. The article is structured according to the three principles of a randomized controlled trial in order to keep experimental rigour at the forefront of this research area.

Prescription medication hoarding and borrowing or sharing behaviours in older residents in the Illawarra, New South Wales, Australia

To examine prescription medication hoarding and borrowing or sharing (PMHBS) behaviours in older people, particularly which medications are subject to these behaviours and the circumstances that enable these behaviours. A mixed methods triangulation design, using consecutive qualitative (focus groups) and quantitative (survey) methodologies in a convenience sample of people older than 65 years, living independently in the Illawarra region (New South Wales). Focus group participants (n = 28) acknowledged PMHBS behaviours were widespread; however, very few survey respondents (n = 226) admitted to engaging in these behaviours. Main findings in the study were enablers for these behaviours: the prescription medication is considered the same as that prescribed previously; and self-medicating for pain relief. The prevalence of PMHBS behaviours in this study was low, although it was acknowledged such behaviours occurred in the wider community. Sharing strong pain medication and the same prescription medication appeared to be acceptable in this population.

Job satisfaction research

I am a psychology student investigating how nurses and care assistants are affected by the challenging behaviour of older people in non-NHS nursing homes and daycare facilities in the UK. This research is for my final-year dissertation.

Health-Related Behaviors in Older Adults: Relationships with Socioeconomic Status

There is limited information about the clustering of health behaviors in older people. This study aims to examine clustering of smoking, low levels of physical activity, and risky drinking in older adults and the relationship of these behaviors with measures of SES. Data on health behaviors were analyzed from 11,214 individuals aged > or =50 years (mean age=65.2 years) who participated in the 2002 wave of the English Longitudinal Study of Ageing. Clustering was examined by studying the ratio of observed to expected prevalence of each combination of health behavior. Logistic regressions tested the relationship between socioeconomic measures (education, wealth, and subjective social status) and health behaviors. Data were collected between March 2002 and March 2003, and analyses were conducted in 2008. Only a small proportion of participants reported all three health-risk behaviors, although this was higher than that expected on the basis of prevalence of individual behaviors. Combinations of two health-risk behaviors were common. Multiple health-risk behaviors were less common among individuals of a higher SES. Total accumulated wealth and subjective social status were more consistently related to health-risk behaviors than education in this population. This study provides evidence of clustering of health-risk behaviors in older adults and suggests that interventions aimed at multiple risk factors could usefully target less affluent groups.

The persistence of stuttering behaviours in older people

Objective. To measure and describe the speech characteristics of a group of 16 people over the age of 55 years who self-reported stuttering into adulthood.Design. A cross-sectional, descriptive design was used.Subjects. Sixteen participants were divided into two groups: a group of 12, (mean age 68.8) who self-reported that they continued to stutter in older age, and a group of four who self-reported recovery from stuttering in adulthood (mean age 75.5).Methods. Speech samples during face-to-face and telephone conversations were analysed for stuttering frequency (%SS) and stuttering behaviours using the Lidcombe Behavioural Data Language.Results. Descriptive statistics showed that all participants in the persistent stuttering group evidenced stuttering with varying severity. In the group of four who reported recovery, one participant presented with measurable stuttering behaviours in the conversational and telephone sample. Participants, in the group who reported persistence of stuttering evidenced the full range of stuttering behaviours seen in younger adults.Conclusion. Stuttering is a disorder that may persist for some beyond 55 years of age. This result compels investigation to explore how stuttering impacts on activity and participation for this older group.

Developing a new service provision for challenging behaviour in older people’s care settings

At the Nottingham 2007 conference, members of the Newcastle and Northumberland County Challenging Behaviour Services presented a number of papers which described various aspects of the teams’ research including a debate around the telling of lies to people with dementia, the impact of care staff’s emotional reactions to episodes of challenging behaviour on their care giving behaviour, the use of psychotropic medication in dementia care and an overview of the development of the three challenging behaviour teams using the ‘Colombo’ approach. There was clear interest from the attendees regarding the process by which the teams were developed. As a result of this interest, a full-day workshop was held at the York 2008 PSIGE conference. This paper is a brief description of the development of the Northumberland County Challenging Behaviour Service. The service uses psychological models and is embedded in an Older People’s Psychology Service.