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6. An Integrational Model of Quality of Life in Older Age. Results from the Esrc/mrc Hsrc Quality of Life Survey in Britain.(author Abstract)

Author

Bowling, Ann and Gabriel, Zahava

Abstract

This paper is based on the results of a national survey of the quality of life of 999 randomly sampled people aged 65 and over, living at home in Britain. The survey was semi-structured, and a sample of survey respondents was followed up and interviewed in-depth in order to explore their perceptions of quality of life in full. Comparisons are made here between the results of (i) a hierarchical multiple regression model based on theoretically derived indicators of survey respondents' ratings of their overall quality of life, with (ii) the same respondents' own definitions of quality of life, categorised from their responses to open ended survey questions, and (iii) the views of a sub-sample of these survey respondents who were subsequently interviewed in greater depth. Respondents were asked the open ended questions on quality of life at the outset of the survey interview in order to prevent any respondent bias from the structured measures used. The core components, and the central planks, of quality of life, which were consistently emphasised by the three approaches, were psychological characteristics and outlook, health and functional status, personal and neighbourhood social capital. The lay models also emphasised the importance of financial circumstances and independence, which need to be incorporated into a definition of broader quality of life.

Published
2004

19. A Good Death

Author

Grogono, James, Bowling, Ann, Thomas, Matthew, Day, Richard, Brown, Margaret, Fowell, Andrew, and Finlay, Ilora

Published
2000

29. Rationing Health Care

Author

Marshall, Tom, Leger, Moya Frenz St, Woodroffe, Caroline, and Bowling, Ann

Published
1997

44. Age- and sex-related bias in the management of heart disease in a district general hospital

Author

Dudley, Nigel J., Bowling, Ann, Bond, Matthew, McKee, Dorothy, Scott, Marie McClay, Banning, Adrian, Elder, Andrew T., Martin, A. Tony, and Blackman, Iva

Subjects
Cardiac patients -- Care and treatment, Discrimination in medical care -- Research, Heart diseases -- Care and treatment, Hospital patients -- Care and treatment, Health, Psychology and mental health, Seniors, Social sciences
Published
2002

50. Service provision for older homeless people with memory problems:a mixed methods study

Author

Manthorpe, Jill, Samsi, Kritika, Joly, Louise Marjorie Anne, Crane, Maureen Ann, Gage, Heather, Bowling, Ann, and Nilforooshan, Ramin

Abstract

Background: Early or timely recognition of dementia is a key policy goal of the National Dementia Strategy. However, older people who are homeless are not considered in this policy and practice imperative, despite their high risk factors of developing dementia. Objectives & study design: This 24-month study was designed to (1) determine prevalence of memory problems among hostel-dwelling homeless older people and the extent that staff are aware of this; (2) identify help and support received, current care and support pathways; (3) explore quality of life among older homeless people with memory problems; (4) investigate service costs for older homeless people with memory problems, compared to those without; and (5) identify unmet needs or gaps in services. Participants: Following two literature reviews to help study development, we recruited 8 hostels; 4 in London and 4 in North England. From these, we first interviewed 62 older homeless people, exploring current health, lifestyle and memory. Memory assessment was also conducted with these participants. Of these, 47 were included in the case study groups – 23 had “memory problems", 17 had “no memory problems” and 7 were “borderline”. We interviewed 43 hostel staff who were participants’ keyworkers. We went back 3 and 6 months later to ask further about residents’ support, service costs and any unmet need.Findings: Overall, the general system of memory assessment for this group was found to be difficult to access and not patient-centred. Older people living in hostels are likely to have several long-term conditions including mental health needs, which remain largely unacknowledged. Experiences of declining abilities were reported frequently by participants and hostel staff were often undertaking substantial care for residents. Limitations: Hostels accessed were mainly in urban areas and needs of rural homeless people were not specifically captured. For many residents, we were unable to access NHS data. Many hostel staff referred to this study as “dementia” focussed when introducing it to residents, which may have deterred recruitment. Conclusions: To the best of our knowledge, no other study and no policy acknowledges hostels as ‘dementia communities’ or questions the appropriateness of hostel accommodation for people with dementia. Given the declining number of hostels in England, the limits of NHS engagement with this sector, and growing homelessness, this group of people with dementia are under-recognised and excluded from other initiatives. . Future work: A longitudinal study could follow hostel dwellers and outcomes. Ways of improving clinical assessment, record keeping and treatment could be investigated. Dementia diagnosis could trigger sustained care co-ordination for this vulnerable group.

Published
2019

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