Unprepared for the depth of my feelings' - capturing grief in older people through research poetry
- Gerber, Katrin, Brijnath, Bianca, Lock, Kayla, Bryant, Christina, Hills, Danny, Hjorth, Larissa
- Authors: Gerber, Katrin , Brijnath, Bianca , Lock, Kayla , Bryant, Christina , Hills, Danny , Hjorth, Larissa
- Date: 2022
- Type: Text , Journal article
- Relation: Age and Ageing Vol. 51, no. 3 (2022), p.
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- Description: Background: Older people are more likely to experience bereavements than any other age group. However, in healthcare and society, their grief experiences and support needs receive limited attention. Through innovative, arts-based research poetry, this study aimed to capture older people's bereavement stories and the effects of grief on their physical and mental health. Method: Semi-structured in-depth interviews with 18 bereaved older adults were analysed using thematic and poetic narrative analysis, following a five-step approach of immersion, creation, critical reflection, ethics and engagement. Results: Research poems were used to illustrate three themes of bereavement experiences among older adults: feeling unprepared, accumulation of losses and ripple effects of grief. While half of participants reported that the death of their family member was expected, many felt unprepared despite having experienced multiple bereavements throughout their life. Instead, the accumulation of losses had a compounding effect on their health and well-being. While these ripple effects of grief focussed on emotional and mental health consequences, many also reported physical health effects like the onset of a new condition or the worsening of an existing one. In its most extreme form, grief was connected with a perceived increased mortality risk. Conclusions: By using poetry to draw attention to the intense and often long-lasting effects of grief on older people's health and well-being, this article offers emotional, engaging and immersive insights into their unique bereavement experiences and thereby challenges the notion that grief has an expiry date. © 2022 The Author(s) 2022. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For permissions, please email: journals.permissions@oup.com.
- Authors: Gerber, Katrin , Brijnath, Bianca , Lock, Kayla , Bryant, Christina , Hills, Danny , Hjorth, Larissa
- Date: 2022
- Type: Text , Journal article
- Relation: Age and Ageing Vol. 51, no. 3 (2022), p.
- Full Text:
- Reviewed:
- Description: Background: Older people are more likely to experience bereavements than any other age group. However, in healthcare and society, their grief experiences and support needs receive limited attention. Through innovative, arts-based research poetry, this study aimed to capture older people's bereavement stories and the effects of grief on their physical and mental health. Method: Semi-structured in-depth interviews with 18 bereaved older adults were analysed using thematic and poetic narrative analysis, following a five-step approach of immersion, creation, critical reflection, ethics and engagement. Results: Research poems were used to illustrate three themes of bereavement experiences among older adults: feeling unprepared, accumulation of losses and ripple effects of grief. While half of participants reported that the death of their family member was expected, many felt unprepared despite having experienced multiple bereavements throughout their life. Instead, the accumulation of losses had a compounding effect on their health and well-being. While these ripple effects of grief focussed on emotional and mental health consequences, many also reported physical health effects like the onset of a new condition or the worsening of an existing one. In its most extreme form, grief was connected with a perceived increased mortality risk. Conclusions: By using poetry to draw attention to the intense and often long-lasting effects of grief on older people's health and well-being, this article offers emotional, engaging and immersive insights into their unique bereavement experiences and thereby challenges the notion that grief has an expiry date. © 2022 The Author(s) 2022. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For permissions, please email: journals.permissions@oup.com.
Factors contributing to the mental health outcomes of carers during the transition of their family member to residential aged care : a systematic search and narrative review
- Camões-Costa, Vera, Loganathan, Jayasree, Barton, Chris, Chakraborty, Samantha, Hewitt, Alana, Lin, Xiaping, Brijnath, Bianca
- Authors: Camões-Costa, Vera , Loganathan, Jayasree , Barton, Chris , Chakraborty, Samantha , Hewitt, Alana , Lin, Xiaping , Brijnath, Bianca
- Date: 2022
- Type: Text , Journal article
- Relation: BMC Geriatrics Vol. 22, no. 1 (2022), p.
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- Description: Objectives: The transition of an older family member into a residential aged care facility (RACF) is often challenging for both the person being admitted and their family carer. This review aimed to identify the protective and contributing factors to adverse mental health outcomes among family carers following the decision to move a family member to a RACF. Method: A search of CINAHL, PubMed and PsycINFO was conducted for empirical papers published in English between 2004 and 2019, exploring the mental health or quality of life (QoL) of family carers of those recently admitted, or considering admission, to a RACF. Articles were reviewed by two authors for inclusion. Results: Twenty-three studies met the inclusion criteria. Pre-existing depressive symptoms and poor subjective health were related to adverse mental health outcomes following admission. Information from the facility, support to change roles, and factors related to carer’s health and demographics, were associated with changes in the mental health outcomes of carers during the transition of their relative to a RACF. Key protective factors of carer’s mental health outcomes following the transition of their relative to a RACF are flow and transparency of information between carer and the facility staff, and staff efforts to involve carers in providing emotional support to their relative, in monitoring care, and advocating for their quality of life. Conclusion: There is evidence to suggest factors such lack of flow and transparency of information between carer and the facility staff may predispose carers to poor mental health and QoL following the transition of a relative to a RACF. Key protective factors of carer’s mental health following admission are staff efforts to involve carers in providing emotional support to their relative, in monitoring care, and advocating for their quality of life. This review also indicates that the combination of factors that puts family carers more at risk of poor mental health and lower quality of life throughout the transition period. Policy and practice should follow recommendations that consider a combination of the above factors when addressing the needs of family carers before and after admission of an older person to RACF. © 2022, The Author(s).
- Authors: Camões-Costa, Vera , Loganathan, Jayasree , Barton, Chris , Chakraborty, Samantha , Hewitt, Alana , Lin, Xiaping , Brijnath, Bianca
- Date: 2022
- Type: Text , Journal article
- Relation: BMC Geriatrics Vol. 22, no. 1 (2022), p.
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- Description: Objectives: The transition of an older family member into a residential aged care facility (RACF) is often challenging for both the person being admitted and their family carer. This review aimed to identify the protective and contributing factors to adverse mental health outcomes among family carers following the decision to move a family member to a RACF. Method: A search of CINAHL, PubMed and PsycINFO was conducted for empirical papers published in English between 2004 and 2019, exploring the mental health or quality of life (QoL) of family carers of those recently admitted, or considering admission, to a RACF. Articles were reviewed by two authors for inclusion. Results: Twenty-three studies met the inclusion criteria. Pre-existing depressive symptoms and poor subjective health were related to adverse mental health outcomes following admission. Information from the facility, support to change roles, and factors related to carer’s health and demographics, were associated with changes in the mental health outcomes of carers during the transition of their relative to a RACF. Key protective factors of carer’s mental health outcomes following the transition of their relative to a RACF are flow and transparency of information between carer and the facility staff, and staff efforts to involve carers in providing emotional support to their relative, in monitoring care, and advocating for their quality of life. Conclusion: There is evidence to suggest factors such lack of flow and transparency of information between carer and the facility staff may predispose carers to poor mental health and QoL following the transition of a relative to a RACF. Key protective factors of carer’s mental health following admission are staff efforts to involve carers in providing emotional support to their relative, in monitoring care, and advocating for their quality of life. This review also indicates that the combination of factors that puts family carers more at risk of poor mental health and lower quality of life throughout the transition period. Policy and practice should follow recommendations that consider a combination of the above factors when addressing the needs of family carers before and after admission of an older person to RACF. © 2022, The Author(s).
The experience of structural burden for culturally and linguistically diverse family carers of people living with dementia in Australia
- Gilbert, Andrew, Antoniades, Josefine, Croy, Samantha, Thodis, Antonia, Adams, Jon, Goeman, Dianne, Browning, Colette, Kent, Mike, Ellis, Katie, Brijnath, Bianca
- Authors: Gilbert, Andrew , Antoniades, Josefine , Croy, Samantha , Thodis, Antonia , Adams, Jon , Goeman, Dianne , Browning, Colette , Kent, Mike , Ellis, Katie , Brijnath, Bianca
- Date: 2022
- Type: Text , Journal article
- Relation: Health and Social Care in the community Vol. 30, no. 6 (2022), p. e4492-e4503
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- Description: Evidence suggests that family carers of culturally and linguistically diverse (CALD) people living with dementia experience higher stress and unmet need than the general Australian population. These disparities are often framed as the result of CALD communities failing to seek formal support. Challenging this, we draw on the concept of ‘structural burden’ to explore how the complexity of health and aged systems contribute to the burden that CALD carers experience. We conducted semi‐structured interviews with 104 family carers for CALD people with dementia in Australia, followed by thematic analysis of transcripts. Additional to structural burdens encountered by the general older population, CALD carers faced challenges understanding Australia's Anglo‐centric aged care system, locating culturally appropriate care and were required to translate the languages and operations of health and aged care systems into terms their family members understood. This burden was mitigated by the presence of ethno‐specific organisations and other navigation support. Australia's aged care system has moved towards centralised governance and consumer‐directed care provision. This system involves a confusing array of different programmes and levels, bureaucratic applications and long waiting times. Carers' encounters with these systems demonstrates how some CALD people are being left behind by the current aged care system. While ethno‐specific services can reduce this burden, not all CALD groups are represented. Consequently, improving access to dementia care among CALD populations requires entry point and navigation support that is culturally appropriate and linguistically accessible.
- Authors: Gilbert, Andrew , Antoniades, Josefine , Croy, Samantha , Thodis, Antonia , Adams, Jon , Goeman, Dianne , Browning, Colette , Kent, Mike , Ellis, Katie , Brijnath, Bianca
- Date: 2022
- Type: Text , Journal article
- Relation: Health and Social Care in the community Vol. 30, no. 6 (2022), p. e4492-e4503
- Full Text:
- Reviewed:
- Description: Evidence suggests that family carers of culturally and linguistically diverse (CALD) people living with dementia experience higher stress and unmet need than the general Australian population. These disparities are often framed as the result of CALD communities failing to seek formal support. Challenging this, we draw on the concept of ‘structural burden’ to explore how the complexity of health and aged systems contribute to the burden that CALD carers experience. We conducted semi‐structured interviews with 104 family carers for CALD people with dementia in Australia, followed by thematic analysis of transcripts. Additional to structural burdens encountered by the general older population, CALD carers faced challenges understanding Australia's Anglo‐centric aged care system, locating culturally appropriate care and were required to translate the languages and operations of health and aged care systems into terms their family members understood. This burden was mitigated by the presence of ethno‐specific organisations and other navigation support. Australia's aged care system has moved towards centralised governance and consumer‐directed care provision. This system involves a confusing array of different programmes and levels, bureaucratic applications and long waiting times. Carers' encounters with these systems demonstrates how some CALD people are being left behind by the current aged care system. While ethno‐specific services can reduce this burden, not all CALD groups are represented. Consequently, improving access to dementia care among CALD populations requires entry point and navigation support that is culturally appropriate and linguistically accessible.
The impact of elder abuse training on subacute health providers and older adults : study protocol for a randomized control trial
- Cavuoto, Marina, Markusevska, Simona, Stevens, Catriona, Reyes, Patricia, Renshaw, Gianna, Peters, Micah, Dow, Briony, Feldman, Peter, Gilbert, Andrew, Manias, Elizabeth, Mortimer, Duncan, Enticott, Joanne, Cooper, Claudia, Antoniades, Josefine, Appleton, Brenda, Nakrem, Sigrid, O’Brien, Meghan, Ostaszkiewicz, Joan, Eckert, Marion, Durston, Cheryl, Brijnath, Bianca
- Authors: Cavuoto, Marina , Markusevska, Simona , Stevens, Catriona , Reyes, Patricia , Renshaw, Gianna , Peters, Micah , Dow, Briony , Feldman, Peter , Gilbert, Andrew , Manias, Elizabeth , Mortimer, Duncan , Enticott, Joanne , Cooper, Claudia , Antoniades, Josefine , Appleton, Brenda , Nakrem, Sigrid , O’Brien, Meghan , Ostaszkiewicz, Joan , Eckert, Marion , Durston, Cheryl , Brijnath, Bianca
- Date: 2024
- Type: Text , Journal article
- Relation: Trials Vol. 25, no. 1 (2024), p.
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- Description: Background: Elder abuse often goes unreported and undetected. Older people may be ashamed, fearful, or otherwise reticent to disclose abuse, and many health providers are not confident in asking about it. In the No More Shame study, we will evaluate a co-designed, multi-component intervention that aims to improve health providers’ recognition, response, and referral of elder abuse. Methods: This is a single-blinded, pragmatic, cluster randomised controlled trial. Ten subacute hospital sites (i.e. clusters) across Australia will be allocated 1:1, stratified by state to a multi-component intervention comprising a training programme for health providers, implementation of a screening tool and use of site champions, or no additional training or support. Outcomes will be collected at baseline, 4 and 9 months. Our co-primary outcomes are change in health providers’ knowledge of responding to elder abuse and older people’s sense of safety and quality of life. We will include all inpatients at participating sites, aged 65 + (or aged 50 + if Aboriginal or Torres Strait Islander), who are able to provide informed consent and all unit staff who provide direct care to older people; a sample size of at least 92 health providers and 612 older people will provide sufficient power for primary analyses. Discussion: This will be one of the first trials in the world to evaluate a multi-component elder abuse intervention. If successful, it will provide the most robust evidence base to date for health providers to draw on to create a safe environment for reporting, response, and referral. Trial registration: ANZCTR, ACTRN12623000676617p. Registered 22 June 2023. © The Author(s) 2024.
- Authors: Cavuoto, Marina , Markusevska, Simona , Stevens, Catriona , Reyes, Patricia , Renshaw, Gianna , Peters, Micah , Dow, Briony , Feldman, Peter , Gilbert, Andrew , Manias, Elizabeth , Mortimer, Duncan , Enticott, Joanne , Cooper, Claudia , Antoniades, Josefine , Appleton, Brenda , Nakrem, Sigrid , O’Brien, Meghan , Ostaszkiewicz, Joan , Eckert, Marion , Durston, Cheryl , Brijnath, Bianca
- Date: 2024
- Type: Text , Journal article
- Relation: Trials Vol. 25, no. 1 (2024), p.
- Full Text:
- Reviewed:
- Description: Background: Elder abuse often goes unreported and undetected. Older people may be ashamed, fearful, or otherwise reticent to disclose abuse, and many health providers are not confident in asking about it. In the No More Shame study, we will evaluate a co-designed, multi-component intervention that aims to improve health providers’ recognition, response, and referral of elder abuse. Methods: This is a single-blinded, pragmatic, cluster randomised controlled trial. Ten subacute hospital sites (i.e. clusters) across Australia will be allocated 1:1, stratified by state to a multi-component intervention comprising a training programme for health providers, implementation of a screening tool and use of site champions, or no additional training or support. Outcomes will be collected at baseline, 4 and 9 months. Our co-primary outcomes are change in health providers’ knowledge of responding to elder abuse and older people’s sense of safety and quality of life. We will include all inpatients at participating sites, aged 65 + (or aged 50 + if Aboriginal or Torres Strait Islander), who are able to provide informed consent and all unit staff who provide direct care to older people; a sample size of at least 92 health providers and 612 older people will provide sufficient power for primary analyses. Discussion: This will be one of the first trials in the world to evaluate a multi-component elder abuse intervention. If successful, it will provide the most robust evidence base to date for health providers to draw on to create a safe environment for reporting, response, and referral. Trial registration: ANZCTR, ACTRN12623000676617p. Registered 22 June 2023. © The Author(s) 2024.
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