Hostname: page-component-8448b6f56d-jr42d Total loading time: 0 Render date: 2024-04-23T09:52:40.931Z Has data issue: false hasContentIssue false
  • English
  • Français

Interventions that support major life transitions in older adulthood: a systematic review

Published online by Cambridge University Press:  11 July 2018

Brenda Vrkljan ,
Ariane Montpetit ,
Gary Naglie ,
Mark Rapoport  and
Barbara Mazer
Brenda Vrkljan*
Affiliation:
School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
Ariane Montpetit
Affiliation:
Intergo, Laval, Quebec, Canada
Gary Naglie
Affiliation:
Department of Medicine, University of Toronto, Toronto, Ontario, Canada
Mark Rapoport
Affiliation:
Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
Barbara Mazer
Affiliation:
School of Physical and Occupational Therapy, McGill University, Montreal, Quebec, Canada Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Jewish Rehabilitation Hospital, Laval, Quebec, Canada
*
Correspondence should be addressed to: Brenda Vrkljan, Ph.D., O.T. Reg. (Ont.), Associate Professor, Occupational Therapy, School of Rehabilitation Science, McMaster University, IAHS Bldg, Rm. 450, 1400 Main St. W. Hamilton, Ontario L8S 1C7, Canada. Phone: +1-905-525-9140 ext. 27817. Email: vrkljan@mcmaster.ca.
Get access Rights & Permissions [Opens in a new window]

Abstract

Background:

Major life transitions can negatively impact the emotional well-being of older people. This study examined the effectiveness of interventions that target the three most common transitions in later life, namely bereavement, retirement, and relocation.

Methods:

A systematic search was performed via MEDLINE, EMBASE, CINAHL, Cochrane Library, PsycINFO, and reference lists of retrieved non-randomized and randomized controlled trials (RCTs) in English that studied the effectiveness of interventions addressing the three transitions in those >50 years of age. Two researchers independently selected the publications, piloted the data extraction form, and critically appraised studies specific to transition type and study design.

Results:

A total of 11 studies (bereavement: 7; retirement: 2; relocation: 2) of 8 unique interventions met the inclusion criteria of which nine were RCTs and two were of quasi-experimental designs were reviewed. Six studies were group-based interventions, three studies used individualized sessions, and one intervention used a combination of group and individualized programming. Group size varied (20–32 participants), as did qualifications of those administering the interventions. The methodological quality of included studies was weak. Findings suggest that group-based approaches provided by trained personnel can mitigate the negative health-related consequences associated with major transitions in later life.

Conclusion:

Evidence concerning interventions that address mental health challenges associated with these major transitions is limited. Future research should better characterize participants at study outset and use validated measures to capture effectiveness. Use of peer mentorship to navigate such transitions is promising, but given the small number of studies and their methodological weaknesses, further research on effectiveness is warranted.

Keywords

BereavementLong-Term CareNursing homesAgingtransition
Type
Original Research Article
Information
International Psychogeriatrics , Volume 31 , Issue 3: Issue Theme: Caregiving for People with Dementia , March 2019 , pp. 393 - 415
Copyright
Copyright © International Psychogeriatric Association 2018 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Barbosa, V., Sa, M. and Rocha, J. C. (2014). Randomised controlled trial of a cognitive narrative intervention for complicated grief in widowhood. Aging & Mental Health, 18, 354–362. doi:10.1080/13607863.2013.833164.Google Scholar
Caserta, M., Utz, R., Lund, D., Swenson, K. L. and de Vries, B. (2014). Coping processes among bereaved spouses. Death Studies, 38, 145–155. doi:10.1080/07481187.2012.738767.Google Scholar
Dale, M. C., Burns, A., Panter, L. and Morris, J. (2001). Factors affecting survival of elderly nursing home residents. International Journal of Geriatric Psychiatry, 16, 70–76.Google Scholar
Gaugler, J. E., Roth, D. L., Haley, W. E. and Mittelman, M. S. (2008). Can counseling and support reduce burden and depressive symptoms in caregivers of people with Alzheimer's disease during the transition to institutionalization? Results from the New York University caregiver intervention study. Journal of the American Geriatrics Society, 56, 421–428. doi:10.1111/j.1532-5415.2007.01593.x.Google Scholar
Gaugler, J. E., Roth, D. L., Haley, W. E. and Mittelman, M. S. (2011). Modeling trajectories and transitions: results from the New York University caregiver intervention. Nursing Research, 60, S28–S37. doi:10.1097/NNR.0b013e318216007d.Google Scholar
Higgins, J. P. T. and Green, S. (Eds.) (2011). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 [updated March 2011]. The Cochrane Collaboration. Available at: http://handbook.cochrane.orgGoogle Scholar
Joo, J. H., Hwang, S., Abu, H. and Gallo, J. J. (2016). An innovative model of depression care delivery: peer mentors in collaboration with a mental health professional to relieve depression in older adults. American Journal of Geriatric Psychiatry, 24, 407–416. doi:10.1016/j.jagp.2016.02.002.Google Scholar
Kaplan, D. V. and Berkman, B. J. (2016). Effects of Life Transitions on the Elderly. New Jersey: Merck. Available at: https://www.merckmanuals.com/en-ca/professional/geriatrics/social-issues-in-the-elderly/effects-of-life-transitions-on-the-elderly; updated Aug 2016; cited June 5, 2017.Google Scholar
Kim, J. E. and Moen, P. (2002). Retirement transitions, gender, and psychological well-being: a life-course, ecological model. The Journals of Gerontology, Series B, Psychological Sciences and Social Sciences, 57, P212–P222.Google Scholar
Kim, J. Y., Kim, D. G. and Nam, S. I. (2012). TSL family therapy followed by improved marital quality and reduced oxidative stress. Research on Social Work Practice, 22, 389–399. doi:10.1177/1049731512442104.Google Scholar
Lane, A. M. and Reed, M. B. (2015). Older Adults: Understanding and Facilitating Transitions, 2nd edn. Dubuque: Kendall Hunt.Google Scholar
Lipsey, M. W. and Wilson, D. B. (1993). The efficacy of psychological, educational, and behavioral treatment: confirmation from meta-analysis. American Psychologist, 48, 1181–1209.Google Scholar
Lund, D., Caserta, M., Utz, R. and De Vries, B. (2010). Experiences and early coping of bereaved spouses/partners in an intervention based on the dual process model (DPM). Omega (Westport), 61, 291–313. doi:10.2190/OM.61.4.c.Google Scholar
Moher, D., Liberati, A., Tetzlaff, J., Altman, D. G. and the PRISMA Group (2009). Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Public Library of Science Medicine, 6, e1000097. doi:10.1371/journal.pmed.1000097.Google Scholar
Ong, A. D., Uchino, B. N. and Wethington, E. (2016). Loneliness and health in older adults: a mini-review and synthesis. Gerontology, 62, 443–449. doi:10.1159/000441651.Google Scholar
Onrust, S., Smit, F., Willemse, G., van den Bout, J. and Cuijpers, P. (2008). Cost-utility of a visiting service for older widowed individuals: randomised trial. BioMed Central Health Services Research, 8, 128. doi:10.1186/1472-6963-8-128.Google Scholar
Onrust, S., Willemse, G., Bout, J. and Cuijpers, P. (2010). Effects of a visiting service for older widowed individuals: a randomized clinical trial. Death Studies, 34, 777–803.Google Scholar
Peila-Shuster, J. J. (2012). Retirement self-efficacy: the effects of a pre-retirement strengths-based intervention on retirement self-efficacy and an exploration of relationships between positive affect and retirement self-efficacy. Dissertation Abstracts International. B, The Sciences and Engineering, 72, 7086.Google Scholar
Pishvaei, M., Moghanloo, R. A. and Moghanloo, V. A. (2015). The efficacy of treatment reminders of life with emphasis on integrative reminiscence on self-esteem and anxiety in widowed old men. Iranian Journal of Psychiatry, 10, 19–24.Google Scholar
Schumacher, K. L., Jones, P.S. and Meleis, A.I. (1999). Helping elderly persons in transition: a framework for research and practice. In Swanson, E. A. and Tripp-Reimer, T. (eds.), Life Transitions in the Older Adult: Issues for Nurses and Other Health Professionals. New York: Springer.Google Scholar
Schut, H. A., Stroebe, M. S., Bout, J. and Keijser, J. (1997). Intervention for the bereaved: gender differences in the efficacy of two counselling programmes. British Journal of Clinical Psychology, 36, 63–72.Google Scholar
Shor, E., Roelfs, D. J., Curreli, M., Clemow, L., Burg, M. M. and Schwartz, J. E. (2012). Widowhood and mortality: a meta-analysis and meta-regression. Demography, 49, 575–606. doi:10.1007/s13524-012-0096-x.Google Scholar
Smith, M. L., Ory, M. G., Jiang, L., Lorig, K., Kulinski, K. P. and Ahn, S. (2015). Workshop characteristics related to chronic disease self-management education program attendance. Frontiers in Public Health, 3, 19. doi:10.3389/fpubh.2015.00019.Google Scholar
Stroebe, M., Schut, H. and Stroebe, W. (2007). Health outcomes of bereavement. The Lancet, 370, 1960–1973. doi:10.1016/S0140-6736(07)61816-9.Google Scholar
Sullivan, G. J. and Williams, C. (2017). Older adult transitions into long-term care: a meta-synthesis. Journal of Gerontological Nursing, 43, 41–49. doi:10.3928/00989134-20161109-07.Google Scholar