Development of a framework for recovery in older people with mental disorder

TY - JOUR

T1 - Development of a framework for recovery in older people with mental disorder

AU - Daley, Stephanie

AU - Newton, David

AU - Slade, Mike

AU - Murray, Joanna

AU - Banerjee, Sube

PY - 2013/5

Y1 - 2013/5

N2 - Objective  To evaluate whether a conceptual framework of recovery developed for working age adults holds value for users of older people's mental health services, including those with dementia.  Method  Thirty-eight qualitative interviews were undertaken with service users and carers from an older people's mental health service in South London and were analysed using grounded theory methods.  Results  Components of recovery, which appear to be meaningful to older people with mental disorder include the following: (i) the impact of illness, (ii) the significance of personal responsibility, and (iii) specific coping strategies. Unlike their younger peers, older people did not aspire to a new and revised sense of identity, nor did they seek peer support from others with lived experience of mental illness. Three components of recovery were identified as being distinct to older people: the significance of an established and enduring sense of identity; coping strategies, which provide continuity and reinforce identity; and the associated impact of physical illness. Finally, two additional components of recovery were identified for people with dementia: (i) the changing experience over time and (ii) support from others.  Conclusion  Mental health policy is increasingly framed in terms of recovery'. This paper provides empirical evidence of how it applies to users of older people's mental health services. Practice implications include the need to focus on the maintenance of identity, and embed the values of empowerment, agency and self-management within service delivery.

AB - Objective  To evaluate whether a conceptual framework of recovery developed for working age adults holds value for users of older people's mental health services, including those with dementia.  Method  Thirty-eight qualitative interviews were undertaken with service users and carers from an older people's mental health service in South London and were analysed using grounded theory methods.  Results  Components of recovery, which appear to be meaningful to older people with mental disorder include the following: (i) the impact of illness, (ii) the significance of personal responsibility, and (iii) specific coping strategies. Unlike their younger peers, older people did not aspire to a new and revised sense of identity, nor did they seek peer support from others with lived experience of mental illness. Three components of recovery were identified as being distinct to older people: the significance of an established and enduring sense of identity; coping strategies, which provide continuity and reinforce identity; and the associated impact of physical illness. Finally, two additional components of recovery were identified for people with dementia: (i) the changing experience over time and (ii) support from others.  Conclusion  Mental health policy is increasingly framed in terms of recovery'. This paper provides empirical evidence of how it applies to users of older people's mental health services. Practice implications include the need to focus on the maintenance of identity, and embed the values of empowerment, agency and self-management within service delivery.

KW - identity

KW - continuity

KW - DEMENTIA

KW - dementia

KW - older people

KW - SCHIZOPHRENIA

KW - ALZHEIMERS-DISEASE

KW - mental disorder

KW - recovery

U2 - 10.1002/gps.3855

DO - 10.1002/gps.3855

M3 - Article

SN - 0885-6230

VL - 28

SP - 522

EP - 529

JO - International Journal of Geriatric Psychiatry

JF - International Journal of Geriatric Psychiatry

IS - 5

ER -