Aging With a Severe Mental Illness: Challenges and Treatments

Cummings, Sherry M.; Kropf, Nancy P.

doi:10.1080/01634372.2010.538815

Cited by 31 publications

(42 citation statements)

References 37 publications

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“…One group of patients who might benefit from ACT are elderly patients with SMI who are difficult to engage, have heterogeneous care needs, such as psychiatric as well as somatic problems, and have problems with activities of daily living, housing and social support [16,17]. Only one study has focused on ACT for the elderly (ACTE).…”

Section: Introductionmentioning

confidence: 99%

The effectiveness of assertive community treatment for elderly patients with severe mental illness: a randomized controlled trial

et al. 2014

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BackgroundDue to fragmented mental, somatic, and social healthcare services, it can be hard to engage into care older patients with severe mental illness (SMI). In adult mental health care, assertive community treatment (ACT) is an organizational model of care for treating patients with SMI who are difficult to engage. So far all outcome studies of assertive community treatment have been conducted in adults.MethodsIn a randomized controlled trial design we compared the effectiveness of ACT for elderly patients with that of treatment as usual (TAU). Sixty-two outpatients (60 years and older) with SMI who were difficult to engage in psychiatric treatment were randomly assigned to the intervention or control group (32 to ACT for elderly patients and 30 to TAU). Primary outcomes included number of patients who had a first treatment contact within 3 months, the number of dropouts (i.e. those discharged from care due to refusing care or those who unintentionally lost contact with the service over a period of at least 3 months); and patients’ psychosocial functioning (HoNOS65+ scores) during 18 months follow-up. Secondary outcomes included the number of unmet needs and mental health care use. Analyses were based on intention-to-treat.ResultsOf the 62 patients who were randomized, 26 were lost to follow-up (10 patients in ACT for elderly patients and 16 in TAU). Relative to patients with TAU, more patients allocated to ACT had a first contact within three months (96.9 versus 66.7%; X2 (df = 1) = 9.68, p = 0.002). ACT for elderly patients also had fewer dropouts from treatment (18.8% of assertive community treatment for elderly patients versus 50% of TAU patients; X2 (df = 1) = 6.75, p = 0.009). There were no differences in the other primary and secondary outcome variables.ConclusionsThese findings suggest that ACT for elderly patients with SMI engaged patients in treatment more successfully.Trial registrationNTR1620

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Section: Introductionmentioning

confidence: 99%

The effectiveness of assertive community treatment for elderly patients with severe mental illness: a randomized controlled trial

et al. 2014

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“…Challenges facing mental health patients as they age than their healthier peers (Covan, 2005;Uotinen, Suutama, & Ruoppila, 2003), and experience greater difficulties with social interactions, relationships, and participation, with older age intensifying social challenges (Clifton, Marples, & Clarke, 2013;Mueser et al, 2010;Ramaprasad et al, 2015). Mental illness can strain family relationships and patients with mental illness may be less likely to marry and raise children, limiting family support as they age, and family caregivers may face challenges in addressing needs associated with both mental illness and aging-related changes (Cummings & Kropf, 2011). Aging-related challenges also include the death or loss of loved ones.…”

Section: Introductionmentioning

confidence: 99%

The experience of growing old in chronic mental health patients

Lai

Chan

Xie

et al. 2019

Aging & Mental Health

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Objectives: Research evidence has demonstrated disparities and barriers associated with mental illness, which creates challenges for individuals with mental illness to maintain physical, mental, and social health as they age. The aim of this study was to examine the meaning of aging from the perspective of individuals with mental illness and explore their motivations and challenges to adopting healthy aging lifestyles and practices. Method: Using a qualitative narrative inquiry approach, interviews were conducted with 61 aging patients with mental illness aged 40 and older in community and institutional settings in Hong Kong. Results: Participants discussed the meaning of healthy aging in terms of meaningful occupation and use of time, and independence and autonomy. Motivating factors included a desire to avoid 'burdening' other people, to 'give back' to society, and gain back 'lost time'. These were connected to strategies for healthy aging, including social relationships and activities, spirituality, and healthy lifestyles. Challenges to adopting healthy aging practices included physical health difficulties and medication side effects, lack of purpose and boredom associated with daily routines and use of time, and conflicts and loss affecting family and peer relationships. Conclusion: Social and health services should be tailored to support aging individuals with mental illness and their families, addressing motivations and barriers to adopting healthy lifestyles. Promoting healthy aging practices to enable individuals with mental illness to achieve healthy aging is important for preparing for the aging of this population.

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“…These difficulties are exacerbated by what Hirschfeld discusses as a diagnostic lag wherein although the symptoms of bipolar manifest relatively early in life, obtaining an accurate diagnosis often takes several years [2,7,8]. Strained family relationships frequently surround people with bipolar disorder as family members struggle for understandings [9,10] and individuals with bipolar experience stigma and rejection within a broader social world that continues to desire social distance from people with mental illness [3,[11][12][13].…”

Section: Introductionmentioning

confidence: 99%

Poetry as a Framework for Understanding Embodied Experiences of Bipolar Disorder

Lashewicz¹

2013

J Psychol Psychother

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This paper is about making sense of bipolar disorder. We open with lines from a poem titled "Oasis of Life" by the poet /coauthor of this article which are part of his endeavor to know and tell some of his embodied experience living with bipolar disorder. We then use this poetry as a framework for interpreting stories of others living with/ supporting someone living with bipolar disorder as described by three members-two sisters and their mother-from a family where both sisters and their father have bipolar disorder. These family members stories are treated here as an instrumental casestudy and were collected through in-depth private interviews as part of a qualitative study conducted by the first author to better understand needs of adults who have disability and/or mental health issues and who support close family members with disability and/or mental health issues. Our purpose is to bring together poetry and research data in an exploratory way with the poet, or to use Hornstein's term, "expert by experience", sharing in data analysis with the researcher or "expert by training". From our analysis, we provide an early stage illustration of how poetry may be an effective and unifying mechanism for interpretation and communication of complex embodied experience of bipolar disorder.

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Aging With a Severe Mental Illness: Challenges and Treatments

Cited by 31 publications

References 37 publications

The effectiveness of assertive community treatment for elderly patients with severe mental illness: a randomized controlled trial

The effectiveness of assertive community treatment for elderly patients with severe mental illness: a randomized controlled trial

The experience of growing old in chronic mental health patients

Poetry as a Framework for Understanding Embodied Experiences of Bipolar Disorder

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