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P74: Psychological interventions for young carers: A systematic review
- Ilaria Chirico, Valentina degli Esposti, Giovanni Ottoboni, Ylenia Druda, Rita Casapulla, Rabih Chattat
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- Journal:
- International Psychogeriatrics / Volume 35 / Issue S1 / December 2023
- Published online by Cambridge University Press:
- 02 February 2024, pp. 162-163
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Objective:
In the last decades, the issue of caring for a sick parent at young age has received increased attention due to recent changes in society. The term “carer” (also known as caregiver) refers to anyone who carries out, on a regular and unpaid basis, significant caring tasks for a friend or family member who cannot cope alone because of an illness or other condition. Existing evidence suggests that young carers tend to have more mental health problems and more difficulties in behavioral, psychosocial, and academic adjustment than their peers without an ill parent. Since caring can be viewed as a natural extension of family relationships, young people often do not receive support from social policy, health and social services. Therefore, the aim of this review was to systematically ascertain the literature on psychological interventions for young carers (aged 11-30 years), aimed to promote their mental health and well-being, thus mitigating the psychosocial impact of caring on their development.
Methods:A systematic literature search was performed in CINAHL, PsycINFO, PubMed and Scopus; in addition, reference lists from reviewed papers were used to identify additional relevant studies. A rigorous screening process was followed, and a checklist for qualitative and observational studies was used to assess the methodological quality of the studies. Narrative synthesis of the selected articles was carried out.
Results:Only 9 studies were included. Interventions had a different nature and mixed evidence on their efficacy emerged. Moreover, several methodological concerns limited study replicability.
Conclusions:Given the clinical relevance of this topic, it is important that these interventions and the new ones will undergo rigorous evaluation. Effective interventions for young carers may also lead to considerable savings in healthcare and societal costs.
P73: Clinical Psychology of Ageing: The Italian Manifesto
- Chirico Ilaria, Ottoboni Giovanni, Cammisuli Davide, Casagrande Maria, Castelnuovo Gianluca, Della Vedova Anna Maria, Di Rosa Elisa, Franzoi Isabella, Granieri Antonella, Peirone Luciano, Petretto Donatella, Quattropani Maria Catena Ausilia, Sardella Alberto, Chattat Rabih
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- Journal:
- International Psychogeriatrics / Volume 35 / Issue S1 / December 2023
- Published online by Cambridge University Press:
- 02 February 2024, pp. 161-162
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Objective:
By 2030, 1 in 6 people in the world will be aged 60 years or over (World Health Organization, 2022). This Manifesto is the result of the work undertaken by the Task Force of the Italian Association of Psychology working in the field of Clinical Psychology of Ageing. There is a general belief that older people do not benefit from psychological interventions, due to the prejudice that they may be less psychologically flexible or unable to change and/or improve their functioning. However, current evidence suggests that psychological interventions, including both more and less structured ones, are equally effective for older and working-age adults. Therefore, the aim of this Manifesto was to highlight the specific role of the Clinical Psychology in enabling older adults to overcome the multiple challenges associated with the ageing process and disease-related issues.
Methods:We reviewed existing empirical and conceptual literature on main issues in clinical work with older adults.
Results:We identified and thoroughly described areas of major interest, such as theoretical models on how we think, feel and act towards age and ageism; prevention of emotional distress and cognitive decline and promotion of older adults’ psychological health in community; multidimensional assessment and evidence-based psychological interventions, also mediated by technology, for healthy older adults and those living with chronic disease such as dementia. Attention to psychological issues related to informal and formal caregiving, as well as the need for education, training and public engagement will be highlighted.
Conclusion:With a population living longer worldwide, it is essential to introduce and formalize initiatives to reduce health inequities and improve the lives of older people and their families. This should take place in communities able to foster the abilities of older people, while providing them with access to quality long-term care, if needed.
Social health of people with dementia during the SARS-CoV-2 pandemic
- Marta Lenart, Maria Mackowiak, Adrianna Senczyszyn, Dorota Szczesniak, Clarissa Giebel, Rabih Chattat, Mark Gabbay, Katarzyna Lion, Wendy Moyle, Giovanni Ottoboni, Joanna Rymaszewska, Hilary Tetlow, Elzbieta Trypka, Marco Valente, Ilaria Chirico, Monica Cations
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- International Psychogeriatrics / Volume 33 / Issue S1 / October 2021
- Published online by Cambridge University Press:
- 01 November 2021, pp. 24-25
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Background:
Limited access to medical and social services during the coronavirus outbreak has contributed to the exclusion of vulnerable populations, such as people with dementia and older adults. These limitations and the resulting social isolation have highlighted the importance of social relationships and their relationship to the mental health of these people. In the context of dementia, ‘social health’ (SH) can be defined as the role of social abilities for achieving a dynamic balance between opportunities and limitations. The concept encompasses the capacity and independency of an individual to participate in social activities alongside the influences of the surrounding social network.
Methods:Using a qualitative and quantitative approach, we will present social health and its determinants of people with dementia related to social care service closures and self-isolation during the SARS-CoV-2 pandemic. We present an analysis of the survey data from the cross-country population- based study and the semi-structured telephone interviews with people with and without dementia from Poland, UK, Australia and Italy aged 65 and over.
Results:Measuring the Social Health Index in relation to experiencing self-isolation and changes in the use of services before and during the pandemic among the people with dementia, allow us to identify the level of SH and its determinants. Also, the qualitative results revealed the indirect consequences of the pandemic-related restrictions in the access to social care service and social isolation. Reduction of social support was significantly related to deficits in social health and well-being.
Conclusions:Our results highlight the emerging impact of health the current global epidemiological situation upon social health, with a particular focus on those affected by social disadvantage and isolation.
A cross-country comparison of family carers experiences with residential aged care facilities during the COVID-19 pandemic
- Katarzyna M Lion, Clarissa Giebel, Ilaria Chirico, Monica Cations, Rabih Chattat, Mark Gabbay, Wendy Moyle, Giovanni Ottoboni, Marco Valente
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- International Psychogeriatrics / Volume 33 / Issue S1 / October 2021
- Published online by Cambridge University Press:
- 01 November 2021, p. 26
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Background:
The number of research projects into residential aged care (RAC) during the COVID-19 pandemic is increasing, however there are limited data on the cross-country comparison of experiences residents living with dementia and their families. Our study aimed to 1) give an overview of the RAC restrictions and changes (visiting policy, governmental & health authorities’ advice, service delivery) implemented during the pandemic in Australia, Italy and the UK and 2) and their impact on people with dementia in RAC facilities and their families.
Methods:A total of 56 informal family carers of people with dementia residing in RAC took part in semi- structured interviews over the telephone or via Skype in Australia (n=6), Italy (n=25) and the UK (n=26) between July 2020 and March 2021. The interviews were recorded and translated verbatim. Transcripts were analysed by researchers in each country using thematic analysis, then combined across sites.
Results:Inductive thematic analysis identified four overarching themes: 1) Adaptations implemented in RAC facilities due to the COVID-19 pandemic in Australia, Italy and the UK; 2) means of communication between RAC facility personnel, people with dementia living in RAC and family members; 3) impact of the implemented restrictions and changes in care provision due to the COVID-19 pandemic on people with dementia in RAC facilities and 4) impact of the implemented restrictions and changes in care provision due to the COVID-19 pandemic on families of people with dementia in RAC facilities. While differences between countries and facilities were identified, the restrictions and changes within the residential care system impacted families’ well-being, increased their worries about care quality and safety of people with dementia. The consequences of a lack or modified services for people with dementia included noticeable physical and mental health changes. Although the majority of the facilities implemented some form of video-communication between families and residents, those solutions were unable to replace face-to-face contact.
Conclusions:These findings demonstrate the need for implementing safe solutions which might facilitate more frequent in-person contact between families and residents with dementia preventing consequences in mental and physical health in both groups.
The use of technology by people with dementia and informal carers during COVID-19: a cross-country comparison
- Ilaria Chirico, Clarissa Giebel, Katarzyna Lion, Maria Mackowiak, Monica Cations, Rabih Chattat, Mark Gabbay, Wendy Moyle, Alessandro Pappadà, Joanna Rymaszewska, Adrianna Senczyszyn, Dorota Szczesniak, Hilary Tetlow, Elzbieta Trypka, Marco Valente, Giovanni Ottoboni
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- Journal:
- International Psychogeriatrics / Volume 33 / Issue S1 / October 2021
- Published online by Cambridge University Press:
- 01 November 2021, pp. 25-26
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Background:
Social distancing rules and the closure of services associated with the COVID-19 pandemic have strongly impacted the physical and mental health of people with dementia. Digital technologies can represent an effective means to compensate for the distress associated with social distancing rules and the decreased use of in-person services. More specifically, technologies such as smartphones, tablets, and smart home systems can minimize the negative effects of social distancing and isolation, and the pressure on health and care systems. Indeed, they can provide a continuity of care and social connectedness, while decreasing exposure to risk. However, barriers such as digital literacy and lower income households can impede the access and use of digital technologies. The aim of this international study was to compare the use of technology by people with dementia from different care settings, and their informal carers across four countries (Italy, UK, Australia, and Poland).
Methods:People with dementia and informal carers were invited to participate in semi-structured interviews. Verbatim transcripts were analysed by researchers in each country using inductive thematic analysis.
Results:A total of 141 people with dementia and carers (47 in Italy; 50 in the UK; 18 in Australia; 26 in Poland) were interviewed. The analysis identified three overarching themes: 1) different uses of technology (three subthemes); 2) benefits of technology (three subthemes); 3) limitations of technology (three subthemes). Results show that calls, video calls, and group-chats were effectively used across countries to guarantee the continuity of relationships with professionals, families, and small groups of peers. Telemedicine was used with varying levels of satisfaction. Furthermore, the benefits experienced by carers exceeded those for people with dementia. Similar barriers were reported across countries, and were strictly associated with dementia deficits, low level digital literacy, and the need for carer’s supervision.
Conclusions:These international findings highlight the importance to maximise the benefits related to the use of technology according to people with dementia’s impairment and care context. Moreover, it should be complementary to in-person care which should be provided, at least to some extent, even during pandemic times.
Amplifying dementia as a global public health problem: A cross-country comparison of the impact of COVID-19 pandemic
- Clarissa Giebel, Katarzyna Lion, Maria Mackowiak, Rabih Chattat, PN Suresh Kumar, Monica Cations, Mark Gabbay, Wendy Moyle, Giovanni Ottoboni, Joanna Rymaszewska, Adrianna Senczyszyn, Dorota Szczesniak, Hilary Tetlow, Elzbieta Trypka, Marco Valente, Ilaria Chirico
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- Journal:
- International Psychogeriatrics / Volume 33 / Issue S1 / October 2021
- Published online by Cambridge University Press:
- 01 November 2021, pp. 23-24
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Background:
Emerging evidence describes impacts of the COVID-19 pandemic upon people living with dementia and their informal carers, however without evidence-based global comparisons to date. The aim of this international study was to explore and compare the impact of COVID-19 and associated public health restrictions on the lives of people living with dementia and informal carers and access to dementia care across five countries.
Methods:People with dementia and informal carers from the UK, Australia, Italy, India, and Poland participated in remote semi-structured interviews. Participants were asked about their experiences of the pandemic and how restrictions have impacted on their lives and care. Transcripts were analysed by researchers in each country using thematic analysis, then combined across sites.
Results:Fifteen people living with dementia and 111 informal carers participated across the five countries. Four themes emerged: (1) Limited access and support; (2) Technology and issues accessing remote support; (3) Emotional impact; and (4) Decline of cognitive and physical health reported by carers. Whilst variations were noted, the pandemic has indirectly affected people with dementia and carers across all five countries. The pandemic removed access to social support services and thus increased carer burden. Remote services were not always provided and were limited in benefit and usability for those with dementia. Carers frequently described noticeably deteriorating cognitive and physical health in people with dementia.
Conclusions:The pandemic has amplified dementia as a global public health problem, and both people affected by the condition ad their carers need support to better access vital support services to live well. This is even more important with emerging new waves and new variants of the virus affecting different countries, in our globally connected world.
Discussing advance care planning: insights from older people living in nursing homes and from family members
- Francesca Ingravallo, Veronica Mignani, Elena Mariani, Giovanni Ottoboni, Marie Christine Melon, Rabih Chattat
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- International Psychogeriatrics / Volume 30 / Issue 4 / April 2018
- Published online by Cambridge University Press:
- 09 October 2017, pp. 569-579
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Background:
Evidence concerning when and in which manner older people living in nursing homes (NHs) would prefer to discuss advance care planning (ACP) is still scarce. This study explored the attitudes of NH residents and family members toward ACP and their opinions as to the right time to broach the subject, the manner in which it should be approached, and the content of ACP.
Methods:This was a qualitative study using face-to-face interviews with 30 residents (age range 66–94), and 10 family members from 4 Italian NHs. The interviews were analyzed using content analysis.
Results:Three main themes were identified: (1) life in the NH, including thoughts about life in a nursing home, residents’ concerns, wishes and fears, and communication barriers; (2) future plans and attitudes toward ACP, including attitudes toward planning for the future and plans already made, and attitudes toward and barriers against ACP; (3) contents and manner of ACP, including contents of ACP discussions, the right moment to introduce ACP, with whom it is better to discuss ACP, and attitudes toward advance directives.
Conclusions:ACP was a welcome intervention for the majority of participants, but an individualized assessment of the person's readiness to be involved in ACP is needed. For people with dementia, it is essential to identify the right time to introduce ACP before NH admission. Participants in our study suggested that ACP should include palliative care and practical issues, and that in the NH setting all staff and family members may have a valuable role in ACP.