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Roncal-Belzunce V, Atares L, Escalada G, Minobes-Molina E, Pamies-Tejedor S, Carcavilla-González N, García-Navarro JA. First steps towards the deinstitutionalization of older adults: A protocol for the implementation of a complex intervention. Rev Esp Geriatr Gerontol 2024; 59:101453. [PMID: 38103438 DOI: 10.1016/j.regg.2023.101453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 11/15/2023] [Accepted: 11/17/2023] [Indexed: 12/19/2023]
Abstract
BACKGROUND Nursing homes are becoming increasingly important as end-of-life care facilities. However, many older adults want to stay in their homes as they age. OBJECTIVE To assess the feasibility of a deinstitutionalization process on selected institutionalized older adults who are willing to initiate the process. METHODS This study, divided into two phases, will be carried out over 15 months on 241 residents living in two nursing homes in Navarra (Spain). The first phase has a cross-sectional design. We will identify the factors and covariates associated with feasibility and willingness to participate in a deinstitutionalization process by bivariate analysis, essential resources for the process and residents to participate in the process. The second phase has a complex interventional design to implement a deinstitutionalization process. An exploratory descriptive and comparative analysis will be carried out to characterize the participants, prescribed services and the impact deinstitutionalization intervention will have over time (quality of life will be the main outcome; secondary variables will be health, psychosocial, and resource use variables). This study will be accompanied by a pseudo-qualitative and emergent sub-study to identify barriers and facilitators concerning the implementation of this process and understand how intervention components and context influence the outcomes of the main study. Intervention components and the way the intervention is implemented will be of great relevance in the analysis. DISCUSSION Alternatives to institutionalization with adapted accommodation and community support can allow people who wish to return to the community. TRIAL REGISTRATION NCT05605392.
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Affiliation(s)
- Victoria Roncal-Belzunce
- Spanish Society of Geriatrics and Gerontology, C. Príncipe de Vergara, 57-59, 28006 Madrid, Spain; Department of Health Sciences, Public University of Navarra, 31006 Pamplona, Spain
| | - Laura Atares
- Spanish Society of Geriatrics and Gerontology, C. Príncipe de Vergara, 57-59, 28006 Madrid, Spain.
| | - Gema Escalada
- Spanish Society of Geriatrics and Gerontology, C. Príncipe de Vergara, 57-59, 28006 Madrid, Spain
| | - Eduard Minobes-Molina
- Spanish Society of Geriatrics and Gerontology, C. Príncipe de Vergara, 57-59, 28006 Madrid, Spain; Research Group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Faculty of Health Sciences and Welfare, Center for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVIC-UCC), C. Sagrada Família, 7, 08500 Vic, Spain
| | - Sandra Pamies-Tejedor
- Spanish Society of Geriatrics and Gerontology, C. Príncipe de Vergara, 57-59, 28006 Madrid, Spain
| | - Nuria Carcavilla-González
- Spanish Society of Geriatrics and Gerontology, C. Príncipe de Vergara, 57-59, 28006 Madrid, Spain; Department of Health Sciences, Public University of Navarra, 31006 Pamplona, Spain
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Carcavilla-González N, Escalada San Adrián G, Minobes-Molina E, Pàmies-Tejedor S, Roncal-Belzunce V, Atarés-Rodríguez L, García-Navarro JA. A Paradigm Shift on Deinstitutionalization and Dementia Care: A Narrative Review. J Alzheimers Dis 2024; 99:829-841. [PMID: 38759003 DOI: 10.3233/jad-231180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/19/2024]
Abstract
This narrative explores the impact of deinstitutionalization policies on the quality of life and care outcomes for individuals with Alzheimer's disease and related dementias. We offer a historical perspective on these policies, their implications on dementia care, and the barriers to deinstitutionalization. The potential benefits of deinstitutionalization, such as improved quality of life and access to community-based support and services, are highlighted. Challenges and controversies surrounding safety, caregiver burden, and resource allocation are also examined. Ethical considerations related to the autonomy and decision-making capacity of people living with dementia are discussed. We present best practices and innovative models in dementia care that balance deinstitutionalization with appropriate care. We further put forth recommendations for future research and policy development in dementia care and deinstitutionalization, emphasizing the need for a balanced approach that respects the autonomy and preferences of people living with dementia while ensuring their safety and well-being.
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Affiliation(s)
- Nuria Carcavilla-González
- Department of Health Sciences, Public University of Navarra, Campus de Arrosadia, Pamplona, Spain
- Spanish Society of Geriatrics and Gerontology, Madrid, Spain
| | | | - Eduard Minobes-Molina
- Spanish Society of Geriatrics and Gerontology, Madrid, Spain
- Research group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Faculty of Health Sciences and Welfare. Center for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVIC-UCC), Victoria, Spain
- Institute for Research and Innovation in Life Sciences and Health in Central Catalonia (IRIS-CC), Victoria, Spain
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Kamalzadeh L, de Filippis R, El Hayek S, Heidari Mokarar M, Jatchavala C, Koh EBY, Larnaout A, Noor IM, Ojeahere MI, Orsolini L, Pinto da Costa M, Ransing R, Sattari MA, Shalbafan M. Impact of stigma on the placement of mental health facilities: insights from early career psychiatrists worldwide. Front Psychiatry 2023; 14:1307277. [PMID: 38193134 PMCID: PMC10773878 DOI: 10.3389/fpsyt.2023.1307277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 11/08/2023] [Indexed: 01/10/2024] Open
Affiliation(s)
- Leila Kamalzadeh
- Geriatric Mental Health Research Center, Department of Psychiatry, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Renato de Filippis
- Psychiatry Unit, Department of Health Sciences, University Magna Graecia of Catanzaro, Catanzaro, Italy
| | - Samer El Hayek
- Medical Department, Erada Center for Treatment and Rehabilitation in Dubai, Dubai, United Arab Emirates
| | - Mohsen Heidari Mokarar
- Department of Psychiatry, Imam Hossein Hospital, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran
| | - Chonnakarn Jatchavala
- Department of Psychiatry, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
| | - Eugene Boon Yau Koh
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Amine Larnaout
- Faculty of Medicine, University of Tunis El Manar, Tunis, Tunisia
- Department of Psychiatry D, Razi Hospital, Tunis, Tunisia
| | - Isa Multazam Noor
- Department of Psychiatry, Faculty of Medicine, YARSI University, Jakarta, Indonesia
- Child and Adolescent Mental Health Unit, Dr Soeharto Heerdjan Teaching Mental Hospital, Jakarta, Indonesia
| | | | - Laura Orsolini
- Unit of Clinical Psychiatry, Department of Neurosciences/Department of Experimental and Clinical Neurosciences (DIMSC), Polytechnic University of Marche, Ancona, Italy
| | - Mariana Pinto da Costa
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
- Institute of Biomedical Sciences Abel Salazar, University of Porto, Porto, Portugal
| | - Ramdas Ransing
- Department of Psychiatry, Addiction Medicine, and Clinical Neurosciences, All India Institute of Medical Sciences, Guwahati, Assam, India
| | - Mohammad Amin Sattari
- Department of Psychiatry, Imam Hossein Hospital, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran
| | - Mohammadreza Shalbafan
- Mental Health Research Center, Psychosocial Health Research Institute (PHRI), Department of Psychiatry, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
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Tan RXR, Goh YS. Community mental health interventions for people with major depressive disorder: A scoping review. Int J Ment Health Nurs 2022; 31:1315-1359. [PMID: 35695678 DOI: 10.1111/inm.13029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/23/2022] [Indexed: 12/30/2022]
Abstract
People with major depressive disorder continue to be marred by chronically pernicious yet preventable outcomes in the biopsychosocial aspects. With the reallocation of healthcare resources towards the fight against the coronavirus 2019 pandemic, much emphasis has been placed on existing community mental health interventions to ameliorate the disruption of mental health services. Moreover, the recent propulsion of community mental health services by the World Health Organization Mental Health Action Plan 2013-2030 ignited the need to bolster existing community interventions by providing comprehensive, responsive and integrated mental healthcare. The enhanced emphasis on mental healthcare in the community and the heightened demands of people with major depressive disorder underscores the need to explore the current state of community mental health interventions. This scoping review examined 51 primary studies published from year 2010 to 2020 using Arskey & O'Malley's five-stage framework and provided an overview of the impact of existing community mental health interventions for people with major depressive disorder. Findings using thematic analysis have recommended the adoption of person-centred community mental healthcare via the biopsychosocial approach for people with major depressive disorder. Enablers of community mental health interventions were driven by culturally appropriate care and augmented by technology-driven modalities. Challenges and gaps of community mental health interventions include the perpetuation of stigma and misconception, complex demands of persons with major depressive disorder and lack of holistic and long-term outcomes. Given the impact of major depressive disorder on the various biopsychosocial aspects, it is envisioned that our insights into the enablers and barriers of community mental health interventions will guide prospective interdisciplinary and nurse-led interventions in holistically improving the care of persons with major depressive disorder in the community settings.
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Affiliation(s)
- Ronel Xian Rong Tan
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Yong Shian Goh
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
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Factors of Parental Preparation of Children with Mental Illnesses for Their Independent Living after Their Own Death. Healthcare (Basel) 2022; 10:healthcare10122360. [PMID: 36553884 PMCID: PMC9777822 DOI: 10.3390/healthcare10122360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 11/16/2022] [Accepted: 11/23/2022] [Indexed: 11/27/2022] Open
Abstract
Families of children with mental illnesses are often concerned about living in the community after their parents' death. The cross-sectional study aimed to examine the association between how parents prepare adult children with mental illnesses to live independently after the death of the parent(s). The participants were 1112 members of 46 family support groups for mental illnesses in Tokyo, Japan. The age of the people with mental illness was 40s, and that of their parents was 70s. Logistic regression analysis showed that mothers' support in daily living, no income or pension for disabled people, staying at home during free time, and parental livelihood being the same as the person with mental illness were factors that were negatively associated with the independent living of people with mental illness. In contrast, parental participation in the family group and creating a system for securing regular living expenses of the person with mental illness were positively associated with independent living. The results suggest that parents need to promote their children's recovery and prepare them financially by forecasting their independent living after their own death.
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Barberato-Filho S, Bergamaschi CDC, Godman B, Silva MT, Del Fiol FDS, Baldoni AO, Barreto JOM, Lopes LC. Editorial: New Horizons in Health-Promoting: From Methods to Implementation Science. Front Pharmacol 2022; 12:830957. [PMID: 35095538 PMCID: PMC8795761 DOI: 10.3389/fphar.2021.830957] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Accepted: 12/20/2021] [Indexed: 11/13/2022] Open
Affiliation(s)
- Silvio Barberato-Filho
- Pharmaceutical Science Graduate Course, University of Sorocaba (Uniso), Sorocaba, Brazil
| | | | - Brian Godman
- Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow, United Kingdom.,Centre of Medical and Bio-allied Health Sciences Research, Ajman University, AlAin, United Arab Emirates.,School of Pharmacy, Sefako Makgatho Health Sciences University, Garankuwa, South Africa
| | - Marcus Tolentino Silva
- Pharmaceutical Science Graduate Course, University of Sorocaba (Uniso), Sorocaba, Brazil
| | | | | | | | - Luciane Cruz Lopes
- Pharmaceutical Science Graduate Course, University of Sorocaba (Uniso), Sorocaba, Brazil
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