Resilience In Older People Research Articles

The Association between Frailty, Quality of Life and Resilience in Community-dwelling Retirement Village Residents

ObjectivesHousing quality has significant impact on the wider determinants of health and quality of life (QoL). Retirement villages are considered age-friendly accommodation for community-dwelling older people, offering a variable range of services and supports. We wished to explore the relationship among frailty, QoL, and resilience in older people residing in retirement villages. DesignCross-sectional analysis within a longitudinal study. Setting and participantsResidents from 33 retirement villages in Auckland, Aotearoa, New Zealand. MethodsFrailty [using an interRAI-Community Health Assessment-based frailty index FI)], QoL [World Health Organization Quality of Life–Brief Version (WHOQOL-BREF) and WHOQOL–Older Adults Module (WHOQOL-OLD)], and resilience [Brief Resilience Scale (BRS)]. Associations among frailty, QoL, and resilience were examined using regression analysis adjusting for confounders. ResultsMean (SD): FI 0.2 (0.1) in 479 residents, BRS 3.7 (0.8) in 395 residents, WHOQOL-OLD total score 69.9 (12.2). FI was inversely related to BRS [adjusted mean difference (MD) −0.35; 95% CI −0.43 to −0.26; P < .001] and WHOQOL-OLD (MD, −5.45; 95% CI −6.89 to 4.01; P < .001). FI inverse relationship was seen across all facets of WHOQOL-OLD and all WHOQOL-BREF facets except psychological. Conclusions and ImplicationsFrailty was inversely related to resilience and multiple domains of QoL in those living in presumed age-friendly and relatively resource-rich environments. Studies exploring causal relationships between these facets could inform interventions necessary to improve QoL and resilience in those living with frailty. Specific multidimensional needs, wishes, and concerns of older people living with frailty needs to be explored in order to potentially intervene on frailty, QoL, and resilience.

Resilience improvement through a multicomponent physical and cognitive intervention for older people: the DanzArTe emotional well-being technology project

BackgroundResilience is a crucial component of successful aging. However, which interventions might increase resilience in older adults is yet unclear.AimsThis study aims to assess the feasibility and the physical and psychological effects of a technology-based multicomponent dance movement intervention that includes physical, cognitive, and sensory activation in older people living in community-dwelling and nursing home.MethodsDanzArTe program consists of four sessions on a weekly basis, using a technological platform that integrates visual and auditory contents in real time. 122 participants (mean age = 76.3 ± 8.8 years, 91 females = 74.6%) from seven nursing homes and community-dwelling subjects were assessed, before and after the intervention, with the Resilience Scale-14 items (RES-14), the Multidimensional Prognostic Index (MPI), the Psychological General Well-Being Index (PGWBI-S), and the Client Satisfaction Questionnaire-8 (CSQ-8). Mann–Whitney and Wilcoxon signed-ranks tests were used for statistical analyses.ResultsAt baseline significant differences in MPI and RES-14 between community-dwelling and nursing home residents were observed (p < 0.001 for both analyses). After the intervention, resilience significantly increased in total sample (RES-14 mean T1 = 74.6 Vs. T2 = 75.7) and in the nursing home residents (RES-14 mean T1 = 68.1 Vs. T2 = 71.8). All participants showed high overall satisfaction for DanzArTe program (CSQ-8 mean = 23.9 ± 4.4). No differences in MPI and PGWBI-S were observed.DiscussionDanzArTe was a feasible intervention and high appreciated by all older adults. Nursing home residents revealed improvements in resilience after DanzArTe program.ConclusionThe DanzArTe technology-based multi-component intervention may improve resilience in older people living in nursing homes.

Resilience in Older People: A Concept Analysis.

(1) Background: Resilience has been presented as a potential protective factor to be promoted in difficult experiences in older people. However, further clarification of the concept of resilience for this population is required, as this is of critical interest for nursing care. (2) Aim: To develop the concept of resilience in older people to establish the elements that refer to the nursing outcome. Personal resilience (1309) from the Nursing Outcomes Classification (NOC), specifically in older people. (3) Methods: Concept analysis using Beth Rodgers' evolutionary model. The attributes, antecedents, consequents, and empirical elements were described in the integrative review, with searches in PubMed, CINAHL, PsycINFO, LILACS, and Embase databases. A total of 2431 citations have been identified, and 110 studies were included. (4) Results: The concept of "resilience in older people" is composed of two attributes, available resources and positive behaviors, and is defined as positive attitudes of older people with the assistance of resources available from experiences of adversity. Conclusion: This analysis and concept development of resilience in older people provided sensitive indicators for nursing care in the context of adversity, considering available resources and with positive attitudes during this phase of life span.

Resilience in later life: the impact of social exclusion on access to networks of support

PurposeThe aim of this paper is to respond to a gap in the literature around resilience in later life for older people from minority groups of identity or experience. Specifically, it argues that we need to pay greater attention to how access to different types of social capital may leave some older people more or less able to cope with adverse events and how experiences of social exclusion can limit access to important networks of support during times of crisis.Design/methodology/approachThis paper draws on research conducted to inform the resilience strategy of Greater Manchester in 2019, and specifically looked at how this strategy could better address the needs of the regions’ diverse ageing population. It used a qualitative design including focus groups with older women of Punjabi heritage living in Greater Manchester, interviews with staff from a community and voluntary organisation working with these women, and interviews with staff at an organisation supporting refugees and asylum seekers in Greater Manchester who specifically worked with older adults.FindingsThe research found that belonging to a minority group and experiences of social exclusion gave participants in this study both resources and vulnerabilities when it came to dealing with external shocks in later life. Whilst participants in this study had access to strong networks of bonding capital based on shared identity and experience, social exclusion often meant they faced barriers to accessing network of support outside of these communities.Research limitations/implicationsFindings from this study have implications for both future research and policy. In the case of the latter there are implications for those working in resilience planning in terms of how to address the needs of diverse older populations. For researchers, this paper has implications for how we understand the impacts on inequality in later life particularly in the context of the COVID-19 pandemic.Originality/valueThe originality of this paper lies in its consideration of the impact of inequalities and social exclusion on the resilience of older people in times of crisis. It included older people from minority groups of identity and experience addressing an important gap in the literature.

Shielding without a Shield—Older People under COVID-19: A Comparison of Four Cities

Older people were globally the most vulnerable during the pandemic. This paper examines the mortality and psychological crisis of older people during the pandemic in four cities, namely Wuhan, Milan, London, and Hong Kong, in order to explain their high death rates. The sample cities were purposefully selected to cover different degrees of social connectedness and outbreak periods. Quantitative data were employed to account for death and suicide data. Qualitative data analyses in government reports, public press releases, NGO announcements, and journal articles were used to study government responses and disruptions of essential healthcare services. Published scientific studies provided important information on the psychological stress and resilience of older people. Findings based on a welfare regime perspective showed that society and governments have not learned from the experiences of other countries, which resulted in high numbers of preventable deaths. Older people have successfully coped with living difficulties while serious psychological disturbances and suicidal ideations were absent at least for the period up to 2022. Older care home residents, unfortunately, were not protected with proper shielding and available vaccinations. Public inefficiency and negligence contributed to a disproportionately high rate of mortality in nursing homes.

Resiliencia en las personas mayores durante la primera ola pandémica de la COVID-19 en Chile: una perspectiva desde los determinantes sociales de la salud

ObjectiveTo assess the association between social determinants of health (SDH) and resilience in older people during the first period of confinement in the COVID-19 pandemic in Chile. Materials and methodsAn observational study with a cross-sectional design was conducted using a nationally representative survey data-set. In this survey, using a systematic randomization process, a subsample of people aged ≥60 years from the community were interviewed by telephone during the first wave of the COVID-19 pandemic in Chile. Resilience was assessed using the Brief Resilient Coping Scale (BRCS) and depressive symptoms using the Patient Health Questionnaire (PHQ-9) scale. The SDH considered were: age, sex, educational level, employment status, social isolation, loneliness, discontent with housing and health care needs. ResultsA total sample of 582 persons was obtained. The mean age was 71 years (SD: 7.64; 69% women). A significant association was obtained between low resilience and the following conditions: loneliness (OR: 1.776 [95% CI: 1.146–2.751]), high risk of social isolation (OR: 1.667 [95% CI: 1.149-2.419]), and depressive symptoms (OR: 2.602 [95% CI: 1.795-3.774]). Female gender was a protective factor (OR: 0.589 [95% CI: 0.406-0.855]). ConclusionThe SDH, such as loneliness and social isolation, are factors associated with low resilience in older people during the COVID-19 pandemic and may be taken into account in planning public health intervention strategies.

Pandemic Disruptions of Older Adults’ Meaningful Connections: Linking Spirituality and Religion to Suffering and Resilience

The COVID-19 pandemic has upended the lives of persons of all ages throughout the world. Older adults have been particularly susceptible to the virus and have died at higher rates than any other age group. Starting from the early days of the pandemic, gerontologists rallied to address a wide variety of issues affecting older people’s lives. This paper reviews gerontological research that began shortly after the pandemic was declared and examines how a model of meaningful connectedness undergirding spiritual and religious experiences sheds light on the suffering and the resilience of older people during the pandemic. It notes that despite over four decades of research on the role of religion and spirituality in older people’s lives, there has been little mention in major gerontology journals of the role of elders’ religiousness and spirituality in their responses to the pandemic. The paper concludes with a call for gerontologists to pay closer attention to elder religiousness and spirituality and the many questions that need to be addressed regarding older people’s experiences during the pandemic.

Resilience: Key Factors Associated With Resilience of Older People in Botswana

This study aims to determine key factors that predict resilience in older people. A cross-sectional design and quantitative methods were used for this study. Four districts were selected in Botswana using cluster random sampling. Data on resilience from 378 older adults aged 60 years+ [Mean Age ( SD) = 71.1(9.0)] was collected using snowballing technique. Data on socio-demographics, protective and risk factors were also collected from urban and rural areas. CHAID (Chi-squared Automatic Interaction Detection) analysis was used to predict the strengths of the relationships among resilience and all predictor variables because the data were skewed. Five major predictor variables reached significance to be included in the model: depression, QOL, social impairment, education, and whether participants paid for services or accessed free services, along with high self-esteem ( p &lt; .001), security, and self-efficacy ( p &lt; .05). The presence of depression symptoms (χ2 = 23.7, p = .001, df = 1) and self-esteem (χ2 = 39.6, p &lt; .001) had the greatest influence on resilience. Older people with no depression symptoms but had low QOL still had social impairment (χ2 = 3.9, p &lt; .05). Older people with no depression symptoms had moderate to high QOL but had low resilience as a result of paying for services (χ2 = 7.4, p &lt; .02). Both protective and risk factors had a significant influence on resilience. Knowledge about the predictors of resilience in older people may assist stakeholders devise effective intervention, especially now with COVID-19 ravaging the country. Additionally, policies and programs inclined to assist older people may be established and implemented.

Supporting resilience in older people: implications for nursing practice.

Resilience refers to an individual's ability to adapt and bounce back following adversity. As a concept it may help to explain how some people cope with stressors using internal and social support, leading to personal growth. The concept of resilience is frequently mentioned in the literature but often poorly understood. Older people are vulnerable to multiple adversities such as loss and chronic illness and therefore it is important to introduce strategies that promote resilience. The aim of this article is to explore the concept of resilience in older people by using the social ecological model to examine factors that influence resilience within this context. It further discusses the role of the nurse and uses a case study to highlight how nurses can facilitate the use of individual, contextual and sociocultural resources to foster resilience with older people in practice.

Neuropathology of Dementia Disorders.

This article provides an overview of the neuropathology of common age-related dementing disorders, focusing on the pathologies that underlie Alzheimer disease (AD) and related dementias, including Lewy body dementias, frontotemporal dementia, vascular dementia, limbic-predominant age-related transactive response DNA-binding protein 43 (TDP-43) encephalopathy (LATE), and mixed-etiology dementias. This article also discusses the underlying proteinopathies of neurodegenerative diseases (eg, amyloid-β, paired helical filament tau, α-synuclein, and TDP-43 pathology) and vascular pathologies, including tissue injury (eg, infarcts, hemorrhages) with or without vessel disease. New criteria for AD pathologic diagnosis highlight amyloid-β as the sine qua non of AD; they require molecular markers of amyloid and establish a minimum threshold of Braak neurofibrillary tangle stage 3. Pathologic diagnosis is separated from clinical disease (ie, pathologic diagnosis no longer requires dementia). TDP-43 pathology, a major pathology in a frontotemporal dementia subtype, was found as a central pathology in LATE, a newly named amnestic disorder. Multiple pathologies (often co-occurring with AD) contribute to dementia and add complexity to the clinical picture. Conversely, Lewy body, LATE, and vascular dementias often have accompanying AD pathology. Pathology and biomarker studies highlight subclinical pathologies in older people without cognitive impairment. This resilience to brain pathology is common and is known as cognitive reserve. The pathologies of dementia in aging are most commonly amyloid, tangles, Lewy bodies, TDP-43, hippocampal sclerosis, and vascular pathologies. These pathologies often co-occur (mixed pathologies), which may make specific clinical diagnoses difficult. In addition, dementia-related pathologies are often subclinical, suggesting varying levels of resilience in older people.

260 EXPLORING OLDER PEOPLE’S EXPERIENCES OF SHIELDING DURING THE COVID-19 PANDEMIC

Abstract Background COVID-19 has resulted in large scale infection rates, significant death rates and an economic crisis for many countries. Older people were identified as being in a high-risk group in terms of morbidity severity and mortality rates. This led to many governments recommending older people shield as a protective, public health measure. This study considers how older people experienced shielding in an urban area of Ireland. Methods Twenty participants were recruited through nursing services in one Community Healthcare Organisation. Semi-structured interviews were conducted between 14/1/21 to 8/3/21 and analysed using thematic analysis (Braun &amp; Clarke, 2006). Results Two overarching themes were identified: 1) Shielding experienced as a social disruption: Compliance resulted in transformed lives with marked impacts on social roles, identities, ways of living as well as the personal consequences of adhering to restrictions. Older participants spoke of careful strategies of self-protection and acute awareness of the personal and societal effects of the ongoing pandemic. 2) Coping with and countering social disruption: Participants described strategies they engaged in to adapt to, resist, address or avoid the impacts of shielding that challenged pre-COVID-19 social roles, identities, or ways of living. Conclusion As global societies slowly emerge from the pandemic, particularly in the context of vaccination roll out, older people’s experiences are important to acknowledge. In this study, there was evidence of both the resilience of older people but also the multi-faceted negative impact on their health and welfare. In addition, the experience of the pandemic has highlighted pre-existing service issues (home care service provision fragmentation), digital divides and the lack of older people’s voices in political decision making. This points to the need to have robust, and accessible rehabilitation services incorporating comprehensive geriatric assessment and to reform health care delivery to enhance capacity to sustain services in pandemic times.

Low Psychological Resilience in Older Individuals: An Association with Increased Inflammation, Oxidative Stress and the Presence of Chronic Medical Conditions.

The term resilience, which has been present in science for almost half a century, stands for the capacity of some system needed to overcome an amount of disturbance from the environment in order to avoid a change to another stable state. In medicine, the concept of resilience means the ability to deal with daily stress and disturbance to our homeostasis with the intention of protecting it from disturbance. With aging, the organism becomes more sensitive to environmental impacts and more susceptible to changes. Mental disturbances and a decline in psychological resilience in older people are potentiated with many social and environmental factors along with a subjective perception of decreasing health. Distinct from findings in younger age groups, mental and physical medical conditions in older people are closely associated with each other, sharing common mechanisms and potentiating each other’s development. Increased inflammation and oxidative stress have been recognized as the main driving mechanisms in the development of aging diseases. This paper aims to reveal, through a translational approach, physiological and molecular mechanisms of emotional distress and low psychological resilience in older individuals as driving mechanisms for the accelerated development of chronic aging diseases, and to systematize the available information sources on strategies for mitigation of low resilience in order to prevent chronic diseases.

The Influence of Life Experiences on the Development of Resilience in Older People With Co-morbid Health Problems.

Background: Co-morbidity is a major late-life challenge with poor outcomes, yet many older people are resilient. We consider an ecopsychosocial framework of resilience to investigate this disparity. This theorises that sources of resilience may be personal, social and structural. We explored older people's responses and reactions to significant life experiences, to understand resilience development for managing later life health challenges.Methods: We applied a two-stage, cross-sectional mixed-methods design to the Cognitive Function and Ageing Studies Wales (CFAS Wales). Participants' defined quantitatively as resilient (high level of well-being despite co-morbidity) were identified in the wave 1 dataset. A sub-sample of the resilient participants aged 65+ were randomly selected for semi-structured interviews (N = 20). Qualitative thematic analyses were both inductive and deductive.Results: The analyses revealed four primary life experiences reflecting different developmental trajectories. “Early years as formative” and “work and employment as formative” occurred at normative developmental stages in the life-course. In contrast non-normative life events such as loss, bereavement, illness of self, and others underpinned the themes of “adverse events and experiences” and “caring experiences.” Four potential mechanisms for resilience were central to these life experiences, reflecting reactions, actions, and development: “character and self-identity;” “approach to life and insight;” “meaningful relationships and belonging.”Conclusions: This work contributes further theoretical insights into the ecopsychosocial resilience framework. It highlights the process of interdependence between the individual and the wider environment, suggesting how the availability and accessibility of resources and human agency (protective factors), can influence, and be influenced by, the timing of significant events and experiences. In doing so, it corroborates international healthy ageing policy which recognises resilience as important for a public health response to support older people to adjust to changes and losses experienced in later life. It highlights the importance of current and future policies and services for supporting the management of adverse events earlier in the life-course, and recommends that policies and services take a “long view” on population health and well-being and consider the whole life-course, in addition to specific points in the ageing process.

Religious/Spiritual Struggles and Spiritual Resilience in Marginalised Older Adults

Spiritual and religious struggles emerge in times where life meaning is unclear, has changed or is challenged. Resilience has been addressed in terms of psychological, social, emotional and physical capacity or competence related to struggle. However, there is a relatively sparse literature defining and addressing spiritual resilience, both what it is and how it is demonstrated. This is especially true of the oppressive and marginalised experiences of diverse older persons. This paper asks how older persons have responded to life challenge and spiritual struggle through spiritually resilient responses. It provides a foundation for the discussion of spiritual resilience in older people through examples from two different community studies: 55 LGBQ older dyads across several nations, and 75 older Black and Jewish persons residing in Chicago, IL. The first study highlights same-sex couples, discussing the complex relationship of sexuality and religion and how resilience is achieved. The second study addresses religious/spiritual struggle using a life course perspective to note where spiritual resilience has been an outcome. Spiritual resilience is at the heart of posttraumatic and stress-related growth and often emerges through a process of lived transformation leading to greater self-awareness and self-understanding in a revised construction of identity.

Defining Resilience in Older People: Does a Subjective Definition of Stressor Work?

The operational definition of resilience is elusive and resilient people are difficult to identify. We used self-reported "major health event" (srMHE) to identify resilience and evaluate the functional and mortality trajectories associated with this condition. We selected from the InCHIANTI study persons aged 65 or older who could perform the Short Physical Performance Battery at baseline and attended the 3 years follow-up visit. We identified 4 groups: Controls: no srMHE and no decline in physical function; Decliners: no srMHE and decline in physical function; Resilient: srMHE and no decline in physical function; and Non-resilient: srMHE and decline in physical function. Linear mixed models and Cox regression were used to analyze changes in activities of daily living (ADL) score over 9- and 10-year mortality across groups, respectively. The 313 participants that reported a srMHE had worse perceived health status and higher number of GP visits and prescribed drugs at baseline. Of these, 78 were Resilient and 235 Non-resilient; of the remaining, 136 were Controls and 277 Decliners. Compared to the Controls, Resilient had similar change of ADL score over time (β: -.03, p = .92) and mortality (hazard ratio: 1.31, 95% confidence interval: 0.76-2.23), while Decliners and Non-resilient showed significantly higher mortality and, the latter, worsening of ADL score. Additional srMHE during follow-up affected the rate of change of ADL score and mortality more in the Controls group than in the Resilient group. A srMHE along with repeated evaluation of physical function may be used to identify resilience in older people, and may complement the standard functional evaluation of geriatric patients.

Effect of Capacity to Undertake Instrumental Activities of Daily Living on Entry to Aged Residential Care in Older People With Heart Failure.

Background: Heart failure is a common condition in older people with complex medical needs. A key factor in resilience after heart failure is the capacity to perform the instrumental activities of daily living (IADLs). Knowing the association between capacity to perform IADLs and entry into aged residential care will help health professionals plan interventions that will allow older people to remain independent longer.Methods: We analyzed the association between the capacity to perform eight IADLs and entry into ARC. Participants included New Zealanders aged ≥65 years with a diagnosis of heart failure, and who had an InterRAI 9.1 Home Care assessment between July 2012 and June 2018. A multivariable competing risks regression model for entry to ARC with death as the competing risks was used to establish sub-hazard ratios (SHR) for IADL capacity. Co-variates included demographic variables, co-morbidities, living arrangements, cognitive performance, depression, timed walk, alcohol use, smoking, activities of daily living, recent hospitalization and history of falls.Results: There were 13,220 participants with heart failure who were followed for a median 1.69 (0.70–3.17) years. There were 3,177 (24.0%) participants who entered aged residential care and 5,714 (43.2%) who died without having first entered residential care. Overall capacity to perform specific IADLs was “very poor” for housework (85.5%), shopping (68.0%), stairs (61.7%), meal preparation (53.0%), and transportation (52.2%). In the multivariable model, compared to adequate capacity (the reference) poorer capacity for managing finance, managing medications, meal preparation and transport were all associated with increased risk of entering aged residential care, with SHR from 1.05 to 1.18. Overall, the IADL capacity explained ~10% of the risk of entering aged residential care.Conclusion: Capacity to perform IADL is a key factor in maintaining resilience in older people with heart failure. Capacity to manage finances, transport and medications, prepare meals, and transport oneself with minimal supervision could reduce the risk of entry into aged residential care. Developing early interventions and support for people with poor capacity to perform their IADL may help reduce admission into aged residential care.

Rejuvenation of three germ layers tissues by exchanging old blood plasma with saline-albumin.

Heterochronic blood sharing rejuvenates old tissues, and most of the studies on how this works focus on young plasma, its fractions, and a few youthful systemic candidates. However, it was not formally established that young blood is necessary for this multi-tissue rejuvenation. Here, using our recently developed small animal blood exchange process, we replaced half of the plasma in mice with saline containing 5% albumin (terming it a “neutral” age blood exchange, NBE) thus diluting the plasma factors and replenishing the albumin that would be diminished if only saline was used. Our data demonstrate that a single NBE suffices to meet or exceed the rejuvenative effects of enhancing muscle repair, reducing liver adiposity and fibrosis, and increasing hippocampal neurogenesis in old mice, all the key outcomes seen after blood heterochronicity. Comparative proteomic analysis on serum from NBE, and from a similar human clinical procedure of therapeutic plasma exchange (TPE), revealed a molecular re-setting of the systemic signaling milieu, interestingly, elevating the levels of some proteins, which broadly coordinate tissue maintenance and repair and promote immune responses. Moreover, a single TPE yielded functional blood rejuvenation, abrogating the typical old serum inhibition of progenitor cell proliferation. Ectopically added albumin does not seem to be the sole determinant of such rejuvenation, and levels of albumin do not decrease with age nor are increased by NBE/TPE. A model of action (supported by a large body of published data) is that significant dilution of autoregulatory proteins that crosstalk to multiple signaling pathways (with their own feedback loops) would, through changes in gene expression, have long-lasting molecular and functional effects that are consistent with our observations. This work improves our understanding of the systemic paradigms of multi-tissue rejuvenation and suggest a novel and immediate use of the FDA approved TPE for improving the health and resilience of older people.

Resilience in older people living with dementia - A narrative analysis.

Dominant discourses surrounding dementia tend to focus on narratives of loss and decline. Simultaneously, individuals living with dementia are vulnerable to being dispossessed of personal narratives supportive of identity and well-being. How older people with dementia story their experiences of resilience in this context has not previously been investigated. In response, this qualitative study utilised a narrative approach to understand lived experiences of resilience shared by eight older people living with dementia. Structural analyses indicated that participants' personal narratives regarding resilience in living with dementia contained distinct and common phases (The Diagnosis, Initial Tasks, 'The High Point', Reflecting on Limitations and Focusing on Today) as well as a variety of dynamic characters. Overarching themes within participants' narratives included sense of self/identity, being connected to others, sense of agency and having positive attitudes. Participants narrated richer, more active personal stories than those typically represented in dominant social discourses surrounding dementia. As such, their narratives depict lived experiences of resilience that unfolded over time in response to adversity and uncertainty and involved a dialectical process in relation to adjustment and well-being. The findings have important implications for the way resilience in living with dementia is framed and supported.

Understanding the psychological drivers of loneliness: the first step towards developing more effective psychosocial interventions

Purpose The purpose of this paper is to outline the need to develop a more balanced approach to addressing the loneliness experience by older people by recognising the psychological and emotional dynamics which cause it. It proposes a more holistic psychosocial approach to loneliness. Design/methodology/approach This paper draws on and reviews the published literature on the psychological aspects of loneliness. Findings Although not extensive, there is sufficient evidence to begin to develop and test more psychosocial approaches to addressing loneliness. Research limitations/implications The evidence base is not extensive and a fair degree of it has not been fully trialled with older people. Practical implications There is an a priori case for using the evidence that exists to develop and test out new psychosocial interventions for addressing loneliness. Social implications It is possible that a more psychosocial approach to loneliness will enable more to be done to address the significant distress of older people experience severe and chronic loneliness. It may also be possible to develop more effective preventative strategies which build resilience in older people. Originality/value The field of loneliness practice and research is overwhelmingly based on sociological analysis and social interventions. This paper is one of the first to explicitly highlight the value in drawing from psychological data in order to develop psychosocial approaches.

Extending the Comfort Zone: Building Resilience in Older People With Long-Term Conditions.

This article examines how a 6-week mental health resilience course for people with long-term conditions (LTCs; diabetes, heart disease, and arthritis) increased perceived resilience of older participants. This article examines how peer support assisted participants to develop resilience, considers gender issues, examines the importance of course activities, and explores how resilience enhances quality of life. A mixed methods approach was used. A before-and-after questionnaire was administered 3 times, including 3-month follow-up. Interviews were held with 24 program participants, aged 45 to 80 years. Diaries were kept by participants over 3 months. Survey findings showed significant gains in perceived resilience, at the end of the course, with no significant drop-off after 3 months. Interview and diary narratives highlighted positive experiences around well-being, condition management, and social engagement. Peer support was key to effective processes. Challenges concern ongoing support in communities, and considering age and gender variables when researching what improved resilience means to older people with LTCs.