Theresa Scott

The effectiveness of group reminiscence therapy for loneliness, anxiety and depression in older adults in long-term care: A systematic review

Loneliness, anxiety and depression are common problems for older adults in long-term care. Reminiscence therapy is a non-pharmacological intervention that may be of some benefit. In comparison to individual reminiscence therapy, group reminiscence therapy is a preferred option when dealing with the resource constraints of long-term care. The aim of this paper was to systematically review the literature in order to explore the effectiveness of group reminiscence therapy for older adults with loneliness, anxiety and depression in long-term care. Results indicated that group reminiscence therapy is an effective treatment for depression in older adults, however to date, there is limited research support for its effectiveness to treat loneliness and anxiety. Further research and an improvement in methodological quality, such as using qualitative and mixed methods approaches, is recommended to help establish an evidence base and provide better understanding of the effectiveness of group reminiscence therapy.

Multisensory installations in residential aged-care facilities: increasing novelty and encouraging social engagement through modest environmental changes.

The current study examined the effect of an indoor simulated garden installation that included visual, auditory, and olfactory stimuli on resident well-being, compared to the effect elicited by a reminiscence installation and a control no-installation condition. A quasi-experimental ABA design was used (i.e., two intervention conditions plus a wait-list control condition). A survey instrument was administered to nursing home residents (N = 33) at three time points (pre-, during, and post intervention) over an 8-week period, which measured mood, behavior, health, and social interaction. Additionally, staff reports (N = 24) were collected. Both the nature-based and non-nature-based installations led to enhanced well-being and significantly more social benefits for residents because of their novel and aesthetic appeal, compared with the control condition. Residents in the nature-based installation condition reported more satisfaction with their living environment during the intervention phase than those in the comparison conditions. The results show that an indoor garden simulation is a relatively inexpensive way to transform a disused indoor area of an aged-care facility for the benefit of residents and staff.

Translating Training in the NYU Caregiver Intervention in Australia: Maintaining Fidelity and Meeting Graduate Standards in an Online Continuing Professional Education Setting

The aim of this study was to develop an Internet-based self-directed training program for Australian healthcare workers to facilitate learning and competence in delivery of a proven intervention for caregivers of people with dementia: The New York University Caregiver Intervention (NYUCI). The NYUCI is a nonpharmacological, multicomponent intervention for spousal caregivers. It is aimed at maintaining well-being by increasing social support and decreasing family discord, thereby delaying or avoiding nursing home placement of the person with dementia. Training in the NYUCI in the United States has, until now, been conducted in person to trainee practitioners. The Internet-based intervention was developed simultaneously for trainees in the U.S. and Australia. In Australia, due to population geography, community healthcare workers, who provide support to older adult caregivers of people with dementia, live and work in many regional and rural areas. Therefore, it was especially important to have online training available to make it possible to realize the health and economic benefits of using an existing evidence-based intervention. This study aimed to transfer knowledge of training in, and delivery of, the NYUCI for an Australian context and consumers. This article details the considerations given to contextual differences and to learners’ skillset differences in translating the NYUCI for Australia.

Clinical and Counseling Psychology Graduate Students’ Expectations for Future Work With Older Adults

In a study that sampled clinical and counseling graduate students in four countries, we examined ways in which students who do not plan to specialize in work with older adults anticipate future work with this population. Participants (n = 431) completed an online survey of geropsychology training opportunities and the Pikes Peak Geropsychology Knowledge and Skill Assessment Tool. Counseling psychology students and those pursuing a PsyD or Master’s degree were more likely to anticipate future work with older adults than clinical psychology students and those pursuing a PhD, though clinical psychology students tended to have more training opportunities in geropsychology. Content analysis was used to examine open-ended responses about expectations for future work with older adults. Themes varied by country, degree, and specialty.

Supporting carers of people with dementia: An innovative learning platform for health workers

The objective of the EVIDEM-EXERCISE study was to evaluatethe effectiveness of an exercise regime as a therapy for the behaviouraland psychological symptoms of dementia (BPSD). A pragmatic, ran-domized, controlled, single-blind, parallel-group trial of a dyadic exer-cise regime (tailored walking) for community-dwelling individuals withBPSD and their carers was undertaken. The primary outcome wasBehavioural and Psychological Symptoms as measured by the Neuro-Psychiatric Inventory at week 12. Results show no significant differ-ence of NPI score at week 12 between the group receiving the dyadicexercise regime and those that did not. Secondary outcome measure ofcaregiver’s burden was significantly improved; caregiver burden dou-bled by week 12 for the control group participants, but decreased forthose receiving the exercise intervention. In conclusion, this study foundthat regular simple exercise does not improve BPSD but did seem toattenuate changes of caregiver burden.Studies about intimacy in old age have mostly focused on institutionalized life-long marriages. Little research has focused on re-partnering in later life and the impact these relationships have on life satisfaction. Framed by Giddens’ Transformation of intimacy and Laslett’s Third age, as well as changing social and demographical conditions, this paper focuses on how different forms of new intimate relationships impact on life satisfaction in later life. Qualitative interviews were conducted with a strategic sample of 28 Swedes, 63–91 years, who were married, cohabiting and living apart together in new intimate heterosexual relationships initiated after the age of 60 or who were currently dating. The results showed the significance of new intimate relations the experience of life satisfaction in later life: The importance of being needed and confirmed by one’s partner, for intimacy and sexuality, for unloading children’s care responsibility, for sharing experiences in everyday life and for safety. The results also showed the importance of the partner as a resource for new experiences and a healthier life style. In conclusion, the results will be theorized in a time frame: First, in the light of new post (re)productive free time in the third age. Second, in the light of the finite remaining life-time. The results from the qualitative study will be contextualized by results from a representative survey on intimate relations among 3 000 60-90 year old Swedes (data collection has just finished).It is often argued that in late modernity sex has escaped its reproductive cage and people form pure relationships, based on mutual satisfaction. Ironically, although older people are per definitio ...

Embedding clinical competency evaluations into clinical postgraduate training

Debates over models of professional training have occurred in several clinical disciplines, including psychology. Currently, clinical competencies often form the backbone for the accreditation of such training programmes, with sample domains including ethical and legal issues, assessment, intervention, and experience with a diversity of clients across cultures and the lifespan. This paper presents data from a large Australian research project on clinical psychology training. We review key models for clinical competencies in the international literature and report on results of a survey of students undertaking clinical training as to the methods of assessment used in their training programmes. Results showed that direct competency assessment was less commonly used than expected from the stated accreditation standards. One factor behind the results may be that ways to assess such competencies remain elusive. In this paper, models of clinical competency assessment are offered, with practical considerations for embedding this and data on student outcomes when such a programme is firmly in place.Assessment of Fitness to Practise (FTP) guidelines within clinical psychology training programmes requires balancing the individual student’s right to pursue their vocation of interest and the rights of others with whom that person comes in contact, most especially clients. The past decade has seen an international growth in policies related to formal FTP assessment built into clinical training programmes leading to professional qualifications. We draw on data from a large Australian research project on clinical psychology training in Australia. This national survey of 35 clinical psychology programmes explored views from both clinical directors and clinical students. Recommendations on realistic ways to move forward in this area are offered.

Facilitators and barriers to achieving an ageing literate clinical psychology workforce

This series of papers presents reflections on the diagnostic complexities of late-life anxiety. Nancy Pachana and Richard Oude Voshaar are discussants.[Extract] Discussions of clinical psychology training can be placed more broadly within wider discussions of the best ways to train health professionals[1]. At issue is how to improve the ability of newly trained mental health professionals to respond to the changes in a dynamic health care environment [2]. This paper uses quantitative and qualitative data gathered in Australia to highlight difficulties in delivering a coherent curriculum in old age psychology. Australia as a country has some distinct advantages with respect to geropsychology training (e.g., much national awareness of clinical ageing issues) as well as important disadvantages (most prominently, a dearth of trained clinical psychology specialists in ageing) [3]. Data from a recent survey of Australian clinical directors highlights the increased need and demand for clinical psychology training to embrace specific training to meet the needs of older adults. Open-ended queries about the growth of ageing as an area of clinical psychology provoked a range of telling responses. This data, analysed via Leximancer version 3.5, led to 10 primary themes being identified. These included the fact that geropsychology was a subspecialty of increasing interest and importance; that current accreditation requirements posed a barrier to extending coursework and placement opportunities focussing on older adult, and that student interest in this area was growing (although the latter point was controversial). In another survey of student views of strengths and weaknesses in clinical psychology training in Australia, assessment of clinical competencies was highly desired yet often not adequate.

“One who plants a garden, plants happiness”: the therapeutic benefit of gardening activities for older community dwelling adults

IntroductionThis paper uses data from My Health @ Age (2008-2010), an EU, Northern Periphery funded project. Its aim is to offer the rapidly ageing population in the northern periphery regions of E ...Age and ageing related humour expressed in birthday cards has been suggested to support negative attitudes towards aged people. Little attention has been paid to how retired people themselves exper ...It is well known that reduced ability to perform activities of daily living (ADL) and declining mobility are both related to advanced age. This relation is also valid for low quality-of-life. It is ...The HPA-1 polymorphism of alphaIIbbeta3 arises from a Leu to Pro exchange at residue 33 of the beta3 subunit resulting in HPA-1a (Leu33) or HPA-1b (Pro33). We have documented that patients with coronary artery disease who are carriers of HPA-1b experience their myocardial infarction 5.2 years earlier than HPA-1a/1a patients (JTH 2005; 3: 1522). Based on these observations, it has been postulated that HPA-1b is a prothrombotic variant of alphaIIbbeta3. To explore the molecular nature of this phenotype, we have now generated a model overexpressing fluorescent proteins fused with alphaIIbbeta3 in transfected HEK293 cells. The yellow (YFP) and the cyan fluorescent protein (CFP) were cloned to the C-termini of the beta3 and alphaIIb subunits prior to transfection of HEK293 cells, subsequently expressing the fusion proteins of both HPA-1 isoforms. Using flow cytometry, Western blotting and specific antibodies directed against alphaIIb or beta3, we identified 12 HPA-1a and 11 HPA-1b positive clones expressing equal amounts of fluorescent fusion proteins, i.e. a 140 kD alphaIIb-CFP and a 113 kD beta3-YFP. Functional integrity of both integrin variants and proper membrane insertion were documented by intact activation through G protein-coupled receptors with organic acid, PMA-induced activation of protein kinase C and by specific binding of Alexa647 fibrinogen to alphaIIbbeta3. In the presencence of pertussis toxin or abciximab, activation or ligand binding of alphaIIbbeta3 were completely (> 98%) inhibited in both isoforms. Analysis of Src, a tyrosine kinase associated with alphaIIbbeta3, revealed that activation of the phosphotyrosine motif at residue 418 was higher in adherent HPA-1b than HPA-1a cells (P < 0.01). Upon activation of alphaIIbbeta3, analysis by FRET showed equal kinetics with signal disappearance of 40 5% in both HPA-1 variants. We therefore conclude that the postulated prothrombotic phenotype of HPA-1b (Pro33) is related to increased outside-in signaling rather than to allosteric changes of the C-terminal cytoplasmic tails of alphaIIbbeta3. Disclosure of interest: none declared.