Papers by Georgina Charlesworth
PLOS ONE, Feb 23, 2015
Introduction Loneliness among older adults is a major public health problem that may be associate... more Introduction Loneliness among older adults is a major public health problem that may be associated with processes of social participation and identity. This study therefore sought to examine the relationship between social participation and identity in a sample of lonely older adults living independently in London, England. Method An inductive qualitative approach, based on semi-structured interviews and thematic analysis, was employed. Results Participants commonly spoke of barriers to social participation that have been reported elsewhere, including illness/disability, loss of contact with friends/relatives, lack of a supportive community, and lack of acceptable social opportunities. However, novel findings were also derived. In particular, participants commonly minimised the difficulties they faced alone, and described attempts to avoid social opportunities. These behaviours were linked to fears about engaging in social participation opportunities, including fears of social rejection and/or exploitation, and fears of losing valued aspects of identity. Discussion It is concluded that social participation amongst lonely older people will not improve through the removal of previously reported barriers alone; instead, older peoples' beliefs, fears and identities must be addressed. Suggestions for implementing these findings within community organisations are provided.
Behavioural and Cognitive Psychotherapy, Oct 1, 2004
This is the third in a series of three papers on cognitive therapy formulation with older people.... more This is the third in a series of three papers on cognitive therapy formulation with older people. The aims of this paper are to identify barriers to collaborative conceptualization, and to summarize useful strategies for overcoming these barriers. Obstacles to collaborative conceptualization with older clients have previously been thought of as a consequence of age-related skills deficits. In this paper we focus instead on the barriers created by therapistand client-held prejudicial beliefs. A social cognitive perspective is used to conceptualize stereotypical prejudices. Strategies are described for challenging or reframing prejudicial beliefs, and addressing the mechanisms that perpetuate these beliefs.
International Psychogeriatrics, Jun 27, 2016
Background: Behavioral and psychological symptoms in dementia (BPSD) are important predictors of ... more Background: Behavioral and psychological symptoms in dementia (BPSD) are important predictors of institutionalization as well as caregiver burden and depression. Previous reviews have tended to group BPSD as one category with little focus on the role of the individual symptoms. This review investigates the role of the individual symptoms of BPSD in relation to the impact on different measures of family caregiver well-being. Methods: Systematic review and meta-analysis of papers published in English between 1980 and December 2015 reporting which BPSD affect caregiver well-being. Paper quality was appraised using the Downs and Black Checklist (1998). Results: Forty medium and high quality quantitative papers met the inclusion criteria, 16 were suitable to be included in a meta-analysis of mean distress scores. Depressive behaviors were the most distressing for caregivers followed by agitation/aggression and apathy. Euphoria was the least distressing. Correlation coefficients between mean total behavior scores and mean distress scores were pooled for four studies. Irritability, aberrant motor behavior and delusions were the most strongly correlated to distress, disinhibition was the least correlated. Conclusions: The evidence is not conclusive as to whether some BPSD impact caregiver well-being more than others. Studies which validly examined BPSD individually were limited, and the included studies used numerous measures of BPSD and numerous measures of caregiver well-being. Future research may benefit from a consistent measure of BPSD, examining BPSD individually, and by examining the causal mechanisms by which BPSD impact well-being by including caregiver variables so that interventions can be designed to target BPSD more effectively.
Social Semiotics, May 20, 2020
Six advertisements were explored that sell surveillance technologies for people living with demen... more Six advertisements were explored that sell surveillance technologies for people living with dementia through qualitative content analysis. Advertisements from the United Kingdom, Sweden and the Netherlands were analysed to explore semiotic textual meaning and people with dementia (N=5) and carers (N=4) responded to these advertisements. The semiotic themes report a "wanderer" discourse which signals to track people living with dementia, children pets and possessions. Mainly negative representations communicate the dangers of wandering towards younger-female carers, few positive representations show a smiling person with dementia and only one person was represented as interacting with technology. Participants did not understand the advertisements and people living with dementia felt stigmatised. There is a lack of reflexivity when people living with dementia are seen as objects. The reliance on stereotypes targeted at carers with misunderstood conceivable trackers hinders resilience for people living with dementia and implies the continuous stigmatisation that occurs when they are disregarded as human technology-users.
Journal of the American Medical Directors Association, Aug 1, 2020
Main text word count: 3044 References: 30 Tables/figures: tables =1, figures=4 Brief summary: Dep... more Main text word count: 3044 References: 30 Tables/figures: tables =1, figures=4 Brief summary: Depressive symptoms may be either a risk factor or prodrome for cognitive decline. Decline in attention predicts depressive symptoms. Future studies should consider dynamic relationships between affective symptoms and cognition.
Gerontologist, Mar 4, 2023
Background and Objectives: A dementia diagnosis can impact on social interactions. This study aim... more Background and Objectives: A dementia diagnosis can impact on social interactions. This study aims to understand how people living with dementia act as social beings within everyday interactions in their local communities. Research Design and Methods: Focused ethnography informed by Spradley"s approach to data collection and analysis. Observations in community spaces. Results: Twenty-nine observations were undertaken in everyday social settings with 11 people with dementia who were part of a longitudinal interview study. Data consisted of 40 hours of observation, and researcher fieldnotes. The overarching theme "The dynamic nature of being a person" encapsulates participants" exhibited experiences in negotiating to attain and sustain an acknowledged place in their communities. Two sub-themes characterized contexts and actions: 1 "Being me-not dementia": participants constructed narratives to assert their ontological presence in social settings. They and others used strategies to mediate cognitive changes evidencing dementia. 2 "Resisting or acquiescing to "being absent in place"": Participants were often able to resist being absent to the gaze of others, but some social structures and behaviors led to a person being "in place", yet not having their presence confirmed. Discussion and Implications: People living with dementia can actively draw on personal attributes, familiar rituals, objects, and social roles to continue to present themselves as social beings. Identifying how post-diagnosis people may self-manage cognitive changes to retain their presence as a person can help health and social care practitioners and families collaborate with the person living with dementia enabling them to have a continued social presence.
FPOP Bulletin: Psychology of Older People
Mild Cognitive Impairment is a diagnosis of uncertainty. Although some people with MCI may go on ... more Mild Cognitive Impairment is a diagnosis of uncertainty. Although some people with MCI may go on to receive a dementia diagnosis, others do not. In the absence of national guidelines for MCI assessment and support, there is considerable variation in practice. In this paper we provide a description of the approach taken by one Memory Service to recalling people given an MCI diagnosis, including consumer feedback.
FPOP Bulletin: Psychology of Older People
It is estimated that just under a third of people with mild cognitive impairment (MCI) also have ... more It is estimated that just under a third of people with mild cognitive impairment (MCI) also have obstructive sleep apnoea (OSA; a form of sleep disordered breathing distinguished by repeated upper airway collapse during sleep), and disordered sleep is a potential risk factor for dementia. In this paper, we consider the potential role for the old age psychologist in (1) identifying OSA for onward referral and treatment, (2) assessing neurocognitive profiles in people with comorbid OSA and cognitive decline, (3) providing behavioural interventions to improve OSA treatment adherence, and (4) providing health psychology (lifestyle change) interventions relevant to both MCI and OSA.
FPOP Bulletin: Psychology of Older People
Journal of Occupational Science, 2020
Background: Everyday life outside home and accessing a variety of places are central to occupatio... more Background: Everyday life outside home and accessing a variety of places are central to occupation. Technology is ever more taken for granted, even outside home, and for some may culminate in occupational injustice. This study aims to explore the association between everyday technologies (ET), particularly out of home, and the number of places older adults with and without dementia go to, in rural and urban environments. Method: The Everyday Technology Use Questionnaire, and Participation in Activities and Places Outside Home Questionnaire, were administered with 128 people in England. Six logistic regression models explored the association between ET and the number of places people went to, with other demographic factors (i.e., rurality, diagnosis, deprivation). Results: The amount of out of home technologies a person perceived relevant and relative levels of neighbourhood deprivation were most persistently associated with the number of places people went to. Associations with ability to use technology, diagnosis, and education were more tentative. In no model was rurality significant. All models explained a low proportion of variance and lacked sensitivity to predict the outcome. Conclusion: For a minority of people, perceptions of the technological environment are associated with other personal and environmental dimensions. Viewed kaleidoscopically, these associations assemble to generate an impermanent, fragmented view of occupational injustice that may jeopardise opportunities outside home. However, there will be other influential factors not identified in this study. Greater attention to the intersections between specific environmental dimensions may deepen understanding of how modifications can be made to deliver occupational justice.
Journal of the American Medical Directors Association, 2020
The version presented here may differ from the published version. If citing, you are advised to c... more The version presented here may differ from the published version. If citing, you are advised to consult the published version for pagination, volume/issue and date of publication Internet therapy for dementia caregiver mood 1 Running header (40/45 characters) Internet therapy for dementia caregiver mood Title: (98/100 characters) On-line Education and Cognitive Behavior Therapy improve dementia caregivers' mental health: A randomized trial
Scandinavian Journal of Occupational Therapy, 2020
Background: The changing technological environment is reflected in regular updates made to the ev... more Background: The changing technological environment is reflected in regular updates made to the everyday technology (ET) use questionnaire (ETUQ). Newly added ETs may not present comparable challenges across countries and diagnoses. Aims: To identify whether country context, or dementia diagnosis, impact ETs' challenge level. Material and methods: 315 older adults from three countries were included; Sweden (n ¼ 73), United States (n ¼ 114), England (n ¼ 128), and had a confirmed diagnosis of mild dementia (n ¼ 99) or no known cognitive impairment (n ¼ 216). Differential Items Functioning (DIF) analysis was performed on 88 ETs included in the ETUQ by country and diagnosis. The impact of DIF was evaluated in a Differential Test Functioning (DTF) analysis. Results: Nine items (10.2%) in the ETUQ showed statistically significant DIF between countries; five of which were public space ETs and none of which were information and communication technologies (ICTs). Three ICT items, and no others, showed significant DIF by diagnosis. The items' DIF was shown to have no impact upon person measures of ability to use ET in the DTF. Conclusions and significance: The utility of the ETUQ in occupational therapy practice and research internationally is highlighted through the stability of the challenge hierarchy and lack of impact on person measures.
Behavioural and Cognitive Psychotherapy, 1999
Memory aid groups have often been used as a method for teaching mnemonic strategies to older adul... more Memory aid groups have often been used as a method for teaching mnemonic strategies to older adults in early stages of dementia. This study describes the use of CBT to address unhelpful memory-related beliefs in three older men with mild/moderate dementia and associated low mood or anxiety. The members were able to participate and engage in the sessions, and changes in behaviour, cognition and affect were monitored over the course of a 7 week group intervention. Recommendations are made for further research.
International Psychogeriatrics, 2019
ABSTRACTObjective:There is emerging evidence that cognitive behavioral therapy (CBT) can be effec... more ABSTRACTObjective:There is emerging evidence that cognitive behavioral therapy (CBT) can be effective for treating anxiety and depression in people living with dementia (PLWD). Discriminating between thoughts and feelings is a critical element of CBT and also of relevance to emotional understanding more generally. The aim of the present study was the structured adaptation and preliminary validation of an existing measure of thought–feeling discrimination for use in PLWD.Methods/Design:The Behavior Thought Feeling Questionnaire (BTFQ) was adapted via expert and service-user consultation for use in PLWD. One hundred two PLWD and 77 people aged over 65 years who did not have measurable cognitive impairments completed the adapted measure along with two measures of emotional recognition and reasoning. The factor structure of this measure was examined and the measure reduced.Results:Factor analysis suggested a two-factor solution with thought and feeling items loading on separate factors....
Behavior Modification, Dec 16, 2014
This article describes a 10-session cognitive-behavioral therapy (CBT) used in a randomized contr... more This article describes a 10-session cognitive-behavioral therapy (CBT) used in a randomized controlled trial with people with anxiety and mildto-moderate dementia. The aim of the therapy is to reduce symptoms of anxiety by increasing a sense of safety and self-efficacy. The therapy is characterized by a person-centered approach to CBT, using individual tailoring to accommodate for cognitive deficits and other challenges. Three phases of therapy are described: (a) socialization to model (including overcoming barriers to participation), goal setting, and formulation; (b) application of cognitive and behavioral change techniques to address unhelpful autonomic reactions, "strategic" reactions, "rules for living," and interpersonal aspects; and (c) consolidation and ending in the context of chronic, deteriorating illness. The approach prioritizes direct work with the person with dementia, with the involvement of a "supportive other" where
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Papers by Georgina Charlesworth