Interventions for improving independence and mental wellbeing of older people

Protecting the wellbeing and improving independence of older people living in the community has been one of the main policy priorities in recent years. A research team from the Personal Social Services Research Unit (PSSRU) at the London School of Economics and Political Science (LSE) in collaboration with the Finnish National Institute for Health and Welfare (THL) led work on evidence reviews focusing on interventions for improving the independence and wellbeing of older people. The work was commissioned by the National Institute for Health and Care Excellence (NICE) and the findings were aimed at informing the development of a guideline on independence and wellbeing in older people residing in the community and at risk of decline (https://www.nice.org.uk/guidance/ng32).  A set of three reviews were carried out, each guided by specifically defined questions.

In the first review[1], the aim was to gather evidence on the most effective ways to improve and protect mental wellbeing and/or independence in later life. A total of 86 studies were included in this review grouped under six themes each representing a group of interventions referring to a set of broadly similar activities. Among the effective interventions were participation in social activities, intergenerational activities and volunteering, friendship programmes, continuing education, self-management activities, and the use of computers and other information and communication technologies.

To understand the factors that encourage or prevent participation in interventions, the second review[2] focused on the barriers and facilitators in using interventions and services to improve the mental wellbeing and independence of older people. 38 studies were selected for this review. The interventions ranged from the information and communications technology (ICT) based interventions, volunteering, and arts interventions to educational programmes, social activities, and more generally, the social perceptions of older people. Some of the principal barriers included a lack of time, access issues such as transport and timings, negative perceptions of older people and caring duties. The facilitators were high personal motivation, a sense of empowerment, social networks, health benefits, and being treated with fairness and respect.

Identifying examples of the existing services was the purpose of the third review[3]. Information was collected across six areas in England (Blackpool, Cotswold District Council, East Dorset/Bournemouth, Sandwell, Tower Hamlets and Wigan) on current practices in terms of developing and using interventions and services for protecting and improving the wellbeing of older population. The findings from this mapping review indicated that services were patchy in availability and support and mainly provided by third sector providers and community organisations. There was also inconsistent evidence about the use of services in place and whether they are utilised by the population for whom they were developed. Future work needs to focus on building the evidence base primarily by conducting evaluations of the interventions and developing innovative services for improving the wellbeing and independence in later life. 

More information on the evidence reviews can be found at https://www.nice.org.uk/guidance/ng32/evidence

Contact information:

David McDaid D.Mcdaid@lse.ac.uk

Tihana Matosevic T.Matosevic@lse.ac.uk

A-La Park A.Park@lse.ac.uk

Anna Forsman annakfor@abo.fi

Kristian Wahlbeck Kristian.Wahlbeck@mielenterveysseura.fi

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