Promoting Wellness in Older Adults with Mental Illnesses and Substance Use Disorders: Call to Action to All Stakeholders

Jeste, Dilip V.; Peschin, Susan; Buckwalter, Kathleen C.; Blazer, Dan G.; McGuire, Michael T.; Moutier, Christine; Doederlein, Allen; Niederehe, George; Altman, Brian A.; Borenstein, Jeff; Saks, Elyn R.; Norquist, Grayson S.; Koob, George F.; Compton, Wilson M.; Sperling, Andrew; Bain, Lisa J.; Glorioso, Danielle; Paul, Ilisa Halpern; Reynolds, Charles F.

doi:10.1016/j.jagp.2018.03.011

Cited by 6 publications

(8 citation statements)

References 35 publications

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“…The question of how OAL-HIV who use drugs manage these comorbidities and, relatedly, polypharmacy, and how different substances might have unique interactions with specific comorbidities in this population remains largely unanswered in the literature. Furthermore, while many studies have reported adverse impacts of substance use on non-adherence to medications, including ART, among PLHIV, knowledge remains limited on the mechanisms linking substance use with medication and treatment regimens among OALHIV [7,24,25]. Research that explores how older adults manage HIV alongside other co-occurring health conditions in the context of substance use is warranted.…”

Section: Discussionmentioning

confidence: 99%

“…OALHIV face myriad challenges that compromise their health and wellbeing, and these may be further magnified for those who use drugs [6]. At the same time, recent research on ageing has shown that, while ageing is associated with mortality, morbidity and decreased autonomy and functional independence, it is also associated with increased wellbeing and psychosocial functioning [7]. Support in the home and community are needed to achieve the positive outcomes associated with ageing [7].…”

Section: Introductionmentioning

confidence: 99%

“…At the same time, recent research on ageing has shown that, while ageing is associated with mortality, morbidity and decreased autonomy and functional independence, it is also associated with increased wellbeing and psychosocial functioning [7]. Support in the home and community are needed to achieve the positive outcomes associated with ageing [7]. This not only adds a layer of complexity but also informs research about optimal delivery of care and services for a population whose experiences are constituted at the intersection of HIV, substance use and ageing.…”

Section: Introductionmentioning

confidence: 99%

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Addressing treatment and care needs of older adults living with HIV who use drugs

Chayama

McNeil

2020

J Intern AIDS Soc

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Introduction Older adults living with HIV (OALHIV; ≥50 years) who use drugs face unique needs and challenges that compromise their health and wellbeing due to the structural and environmental barriers they experience, in addition to being disproportionately affected by comorbidities. Nevertheless, research on this population is limited and work is needed to tailor and optimize their care and services. The purpose of this commentary is to address the key research gaps pertaining to OALHIV who use drugs. Discussion We identified four key research gaps specific to OALHIV who use drugs. Gap 1: Increased understanding of how older adults manage HIV alongside comorbidities in the context of substance use is critical to optimize their care management. Gap 2: More information on the geriatric characteristics of OALHIV who use drugs and the need and role of harm reduction in geriatric care is necessary for the provision of appropriate and effective care. Gap 3: Greater knowledge around the adoption of harm reduction and case manager approaches in various care facilities is essential to ensure equitable access to care for OALHIV who use drugs. Gap 4: Improved understanding of barriers to high‐quality palliative care among OALHIV who use drugs is important to enhance quality of life across their life course. Conclusions Addressing the identified gaps in literature will lead to a more fulsome understanding of the issues encountered by OALHIV who use drugs and inform the development and implementation of strategies that address disparities at the intersection of HIV, substance use and ageing.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Addressing treatment and care needs of older adults living with HIV who use drugs

Chayama

McNeil

2020

J Intern AIDS Soc

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“…This population is also at high risk for early mortality, with a reduced life expectancy of between 10 and 25 years, due to numerous health disparities, including higher rates of cardiovascular disease, obesity, diabetes, and chronic obstructive pulmonary disease (World Health Organization, 2014). An additional unique challenge facing people with SMHC is the risk for rapid aging; a physiological functioning level lower than predicted by their chronological age (Jeste et al, 2018; Zechner et al, 2021). A result is a population coping with multiple health conditions, reduced mobility, and physical functioning at a younger age, which could suggest the need to address the aging process earlier in the lifespan (Jeste et al, 2018; Zechner et al, 2018).…”

Section: Unique Needs Of People Who Are Aging With Smhcmentioning

confidence: 99%

“…This is problematic because, although there is literature on wellness models and people living with SMHC broadly, existing models for people with SMHC may not be appropriate during later life, or may need to incorporate additional factors to improve services for people who are aging. For example, people who are aging with SMHC are “further burdened by social factors, including loss of independence and autonomy” (Jeste et al, 2018, p. 623) that can occur at younger ages, lead to premature institutionalization and loss of decision-making rights (Bartels et al, 2018; O’Neal et al, 2008). Other populations may not face these challenges or may face them less intensely.…”

Section: Unique Needs Of People Who Are Aging With Smhcmentioning

confidence: 99%

Multidimensional wellness for people aging with mental health conditions: A proposed framework.

Zechner¹,

Swarbrick²,

Fullen

et al. 2022

Psychiatric Rehabilitation Journal

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Objective: This project aimed to develop a synthesized framework of multidimensional wellness for people aging with serious mental health conditions (SMHC) using existing frameworks to serve as a guide for policy and interventions to address the unique needs, experiences, and strengths of the population. Method: A concept analysis compared a widely used wellness approach (Swarbrick, 1997) for people with SMHC and one for older adults (Fullen, 2019) to synthesize into a practical framework for people aging with SMHC. Results: Nine dimensions were proposed for conceptualizing the wellness of this population including: (a) Developmental, (b) Intellectual/Cognitive, (c) Physical, (d) Emotional, (e) Social, (f) Occupational, (g) Spiritual, (h) Environmental, and (i) Financial. Practical suggestions for implementation are identified. Conclusions and Implication for Practice: People aging with SMHC require rehabilitation services that address their unique perspectives, strengths, and challenges. The proposed adapted wellness framework offers a guide to comprehensively address well-being in people aging with SMHC. Placing the model in the context of external factors of resources and supports available, and the impact of societal perspectives about each dimension, further delineates a holistic model of wellness that considers well-being and successful living. This model can offer structure and practical application for services, and consideration of future needs of people aging with SMHC to support psychiatric rehabilitation services, as well as offer strategies to encourage positive aging and recovery. Future work should explore the impact of multidecade experiences of mental health conditions and the mental health system to better support individual recovery. Impact and ImplicationsPeople aging with significant mental health conditions can benefit from a tailored integrated multidimensional wellness framework informed by existing models to improve well-being, guide interventions, and frame policies. Developmental wellness is a critical addition to a multidimensional wellness framework to promote positive aging. Mental health providers should be aware of, and address challenges to, positive aging and recovery that can be described as developmental.

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Basic Considerations for Understanding and Treating Delirium Psychosis in Older Adults

Nwogu¹,

Keilman

Peraza-Smith

et al. 2022

Advances in Family Practice Nursing

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Promoting Wellness in Older Adults with Mental Illnesses and Substance Use Disorders: Call to Action to All Stakeholders

Cited by 6 publications

References 35 publications

Addressing treatment and care needs of older adults living with HIV who use drugs

Addressing treatment and care needs of older adults living with HIV who use drugs

Multidimensional wellness for people aging with mental health conditions: A proposed framework.

Basic Considerations for Understanding and Treating Delirium Psychosis in Older Adults

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