Hostname: page-component-cd9895bd7-p9bg8 Total loading time: 0 Render date: 2024-12-21T17:13:12.244Z Has data issue: false hasContentIssue false
  • English
  • Français

Predicting social isolation among geriatric psychiatry patients

Published online by Cambridge University Press:  30 October 2008

Trevor Frise Smith  and
John P. Hirdes
Trevor Frise Smith*
Affiliation:
Department of Sociology, Nipissing University, North Bay, Ontario, Canada
John P. Hirdes
Affiliation:
Department of Health Studies and Gerontology, University of Waterloo, Ontario, Canada and Homewood Research Institute, Guelph, Ontario, Canada
*
Correspondence should be addressed to: Dr. Trevor Frise Smith, Department of Sociology, Nipissing University, North Bay, Ontario, Canada, P1B 8L7. Phone: +1 705 474 3461; Fax: +1 705 474 1947. Email: trevors@nipissingu.ca.
Get access

Abstract

Background: This exploratory study examines factors associated with isolation from informal social ties among geriatric psychiatry inpatients. Specifically, it examines the associations of diagnoses, psychiatric history, and measures of current functioning with social isolation.

Methods: Analyses rely upon data derived from the Resident Assessment Instrument – Mental Health (RAI-MH), which is a patient focused, multidimensional, comprehensive assessment instrument designed to be a component of a larger, integrated health information system linking mental health with home care, long-term care, acute care, rehabilitation, and palliative care.

Results: Controlling for age, multivariate results show that being married or widowed was associated with a lower odds of being isolated. Mood disorders were also associated with a lower odds of isolation, while a history of a personality disorder and a personal biography of institutionalization were both clearly associated with an increased odds for isolation. Although significant bivariate predictors in the multivariate model, both schizophrenic and organic diagnoses failed to reach statistical significance. In addition, patients hospitalized at an earlier age and/or predicted to have a longer stay on the current admission were much less likely to have contact with informal supports. Of the study variables indexing functional status, only activities of daily living (ADLs) remained a significant predictor for isolation in the final multivariate model.

Conclusions: The analyses demonstrate the detrimental effects of an earlier life experience with mental illness. Having an earlier age of illness onset may lead to a potentially greater impairment in establishing and maintaining informal social ties throughout the life course into older age. These analyses reinforce the need for comprehensive assessment of patients on admission and over time.

Keywords

psychogeriatricRAI-MHinterRAIsocial isolation
Type
Research Article
Information
International Psychogeriatrics , Volume 21 , Issue 1 , February 2009 , pp. 50 - 59
Copyright
Copyright © International Psychogeriatric Association 2008

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Blazer, D. G. (2000). Psychiatry and the oldest old. American Journal of Psychiatry, 157, 1915–1924.Google Scholar
Burrows, A. B., Morris, J. N., Simon, S. E., Hirdes, J. P. and Phillips, C. (2000). Development of an MDS based depression rating scale for use in nursing homes. Age and Ageing, 29, 165–172.Google Scholar
Cattan, M., White, M., Bond, J. and Learmouth, A. (2005). Preventing social isolation and loneliness among older people: a systematic review of health promotion interventions. Ageing and Society, 25, 41–67.CrossRefGoogle Scholar
Cohen, C. I. et al. (2000). Schizophrenia and older adults. An overview: directions for research and policy. American Journal of Geriatric Psychiatry, 8, 19–28.Google Scholar
Ell, K. (1996). Social networks, social support and coping with serious illness: the family connection. Social Science and Medicine, 42, 173–183.CrossRefGoogle ScholarPubMed
Findlay, R. A. (2003). Interventions to reduce social isolation amongst older people: where is the evidence? Ageing and Society, 23, 647–658.CrossRefGoogle Scholar
Hall, M. and Havens, B. (2002). Social isolation and social loneliness. Writings in Gerontology: Mental Health and Aging, 18 (pp. 33–44). Ottawa: National Advisory Council on Aging.Google Scholar
Hirdes, J. P. et al. (1999). Integrated health information systems based upon the RAI/MDS series of instruments. Healthcare Management Forum, 12, 30–40.CrossRefGoogle ScholarPubMed
Hirdes, J. P. et al. (2001). Development of the Resident Assessment Instrument – Mental Health (RAI-MH). Hospital Quarterly, 4, 44–51.Google Scholar
Hirdes, J. P. et al. (2002). The resident assessment instrument-mental health (RAI-MH): Inter-rater reliability and convergent validity. Journal of Behavorial Health Services Research, 29, 419–432.Google Scholar
House, J. S., Landis, K.R. and Umberson, D. (1988). Social relationships and health. Science, 241, 540–545.Google Scholar
Lee, J. (1994). Odds ratio or relative risk for cross-sectional data? International Journal of Epidemiology, 23, 201–203.CrossRefGoogle ScholarPubMed
Morgan, C., Burns, T., Ffitzpatrick, R., Pinfold, V. and Priebe, S. (2007). Social exclusion and mental health: conceptual and methodological review. British Journal of Psychiatry, 191, 471–483.CrossRefGoogle ScholarPubMed
Morris, J. N. et al. (1994). MDS Cognitive Performance Scale. Journal of Gerontology: Medical Sciences, 49, M174–M182.CrossRefGoogle ScholarPubMed
Morris, J. N., Fries, B.E. and Morris, S.A. (1999). Scaling ADLs within the MDS. Journal of Gerontology: Medical Sciences, 54A, M546–M553.Google Scholar
Nelson, G., Hall, G. B., Squire, D. and Walsh-Bowers, R. T. (1992). Social network transactions of psychiatric patients. Social Science and Medicine, 34, 433–445.CrossRefGoogle ScholarPubMed
Perlman, C. and Hirdes, J. P. (in press). The Aggressive Behavior Scale (ABS): a new scale to measure aggression based on the Minimum Data Set (MDS), Journal of the American Geriatrics Society.Google Scholar
Robins, S. (2006). From “rights” to “ritual”: aids activism in South Africa. American Anthropologist, 108, 312–323.Google Scholar
Sarason, I. G., Pierce, G. R. and Sarason, B. R. (1994). General and specific perceptions of social support. In Avison, W. R. and Gotlib, I. H. (eds.), Stress and Mental Health: Contemporary Issues and Prospects for the Future (pp. 151–177). New York: Plenum Press.CrossRefGoogle Scholar
Scharf, T., Phillipson, C. and Smith, A. E. (2005). Social exclusion of older people in deprived urban communities of England. European Journal of Ageing, 2, 76–87.Google Scholar
Smith, T. F. (1996). The psychosocial determinants of perceived social support among former psychiatric patients. Unpublished doctoral dissertation, University of Toronto, Canada.Google Scholar
Sorgaard, K. W. et al. (2001). Predictors of social relations in persons with schizophrenia living in the community: a Nordic multicentre study. Social Psychiatry and Psychiatric Epidemiology, 36, 13–19.Google ScholarPubMed
Sweeting, H. and Gilhooly, M. (1997). Dementia and the phenomenon of social death. Sociology of Health and Illness, 19, 93–117.CrossRefGoogle Scholar
Tomaka, J., Thompson, S. and Palacios, R. (2006). The relation of social isolation, loneliness, and social support to disease outcomes among the elderly. Journal of Aging and Health, 18, 359–384.Google Scholar
Turner, R. J. and Marino, F. (1994). Social support and social structure: a descriptive epidemiology. Journal of Health and Social Behavior, 35, 2–15.CrossRefGoogle ScholarPubMed
Vaux, A. and Harrison, D. (1985). Support network characteristics associated with support satisfaction and perceived support. American Journal of Community Psychology, 13, 245–268.Google Scholar
Whitehead, E. (2001). Teenage pregnancy: on the road to social death. International Journal of Nursing Studies, 38, 437–446.CrossRefGoogle ScholarPubMed