Personal Narratives of Ageing: This paper presents personal narratives reflecting on the ageing process, and growing older in the UK.

This presentation reflects on self-written narratives from 170 respondents to a mass observation directive, focusing on the experiences of growing older. Narrative methods are theoretically and methodologically diverse, and are helpful in social research to understand events or happenings in human lives. This data presents accounts from a heterogeneous sample in the form of self-penned responses. These experience-centred narratives bring stories of personal understanding into being by means of the first-person description of past, present, future or imaginary experiences of later life. This presentation will focus on the findings with reference to mental and physical and impacts, both real and anticipated to the ageing experience. We will also explore themes arising from the data including gender differences, age-cohort effects and stigma.

The data should be utilised to inform Health and Social Care education and practice, particularly in co-producing appropriate person-centred services with older people.

The Health Impact of financial fraud: This presentation will offer new and alternative insights into fraud and the health effects on older people, using data from the mass observation directive. The term utilised for such crimes in the UK is ‘Scam’.

The paper reports data captured from a Mass Observation Project “Directive” focusing on ‘scams’ (see the UK definition of ‘scam’ below) and the impact on individuals. One hundred and forty-four ‘Observers’ responded to the ‘Directive’. Narratives indicate that victimisation to a scam may have negative impacts on individuals’ mental wellbeing, self-esteem, and relationships with others. Furthermore, data analysis identified that fear of victimisation can also affect individuals, resulting in worry, anxiety, and maladaptive coping strategies.

Offering further understanding of the health impacts of ‘scams’ highlights the necessity to legitimise the issue as a public health concern.

A scam is interpreted to be: a misleading or deceptive business practice where you receive an unsolicited or uninvited contact (for example by email, letter, phone or ad) and false promises are made to con you out of money (Office of Fair Trading 2006).

Perceptions of Dementia: This paper (Exploring public perceptions and understanding of dementia: Analysing narratives from the Mass Observation Project, (Olsen et al 2019) presents a perspective on the public knowledge and understanding about dementia not previously considered, where respondents have written openly about their own experiences, and reflected on their perception of the wider public’s knowledge and understanding about dementia.

This paper considers narratives of 143 respondents (“Observers”) to a Mass Observation Project Directive exploring individuals’ perceptions of dementia. Perceptions of dementia held by “Observers” with experience of dementia and those without differed sharply. “Observers” with experience of dementia offered insight into living with, and caring for, a person with dementia; including the impact this had on their lives and personal relationships. Whereas, “Observers” with no direct experience of dementia focused more on common disease symptoms, such as memory loss and reflected idealised views of care. “Observers” often feared being diagnosed with dementia themselves. This suggests education to facilitate care planning and ameliorate fears held by the public is required.

Previously, perceptions of dementia have been captured utilising traditional research methods and samples drawn mainly from professionals. This new approach identifies public understanding of dementia, highlighting areas concern, and supplements the existing UK

Olsen, V., Taylor, L., Whitely, K., Ellerton, A., Kingston, P. & Bailey, J. Exploring public perceptions and understanding of dementia: Analysing narratives from the Mass Observation Project. Dementia: The International Journal of Social Research and Practice.https://doi.org/10.1177/1471301219861468.

This paper considers narratives from two Mass Observation Directives exploring individuals’ perceptions of dementia (n=143) and personal narratives of ageing (n=170). ‘End of Life Care’ has, in a UK context, focused on care and support for individuals in the last months or years of their life. Care planning and management of this stage in the life course usually incorporates symptom management and emotional support for the individual, the family and carers. Whilst patient choice, involvement and co-production of the care plan is widely advocated to promote a dignified death, responses to the mass observation directives also reflect the need to revisit the options for individuals with a diagnosis of dementia and other life limiting illness. There was, in particular, a renewed call to return to the ‘euthanasia’ debate and to encourage discussion and end of life decisions to be undertaken earlier in the life course, prior to any diagnosis of a life limiting illness. As people’s attitudes and behaviours towards end of life care planning change, it is imperative to ascertain current perspectives to inform and guide future direction of social policy and services.

To examine the role of subjective cognitive difficulties (SCD), posttraumatic stress disorder (PTSD), and their interaction in predicting suicidal ideation and current suicidal intent in middle-aged and older United States (US) military veterans.

Population-based cross-sectional study.

Data were analyzed from the 2019 to 2020 National Health and Resilience in Veterans Study, which surveyed a nationally representative sample of 3602 US veterans aged 50 years and older (mean age = 69.0).

Questionnaires including the Medical Outcomes Study Cognitive Functioning Scale (SCD), PTSD Checklist for DSM-5 (PTSD), Patient Health Questionnaire-9 (suicidal ideation in the previous two weeks), and the Suicide Behaviors Questionnaire-Revised (current suicidal intent).

A total of 154 (4.4%) veterans screened positive for current PTSD, 239 (6.7%) reported past two-week suicidal ideation, and 37 (1.0%) reported current suicidal intent. The probability of suicidal ideation among veterans with both SCD and PTSD was more than six times higher than that observed in the full sample (44.5% vs. 6.7%) and more than 2.5 times higher than that observed in veterans with SCD and no PTSD (44.5% vs. 17.5%). Veterans with both subjective memory and concentration difficulties were more likely to report suicidal intent, though the interaction between SCD and PTSD was not significantly associated with suicidal intent.

Middle-aged and older U.S. veterans with subjective cognitive impairment and PTSD report higher rates of suicidal ideation than those with SCD alone. Interventions targeting SCD and PTSD may mitigate suicide risk among middle-aged and older veterans.

Mary Michael, Vice President, Patient Advocacy and Stakeholder Management, Otsuka America Pharmaceutical, Inc.

To evaluate the extent to which the cost of both treated and untreated agitation in Alzheimer’s disease has been studied in order to inform future research and development of predictive models of the cost of untreated agitation in Alzheimer’s disease.

There is inadequate understanding of the costs of agitation in Alzheimer’s disease in the scientific and academic literature. Agitation in Alzheimer’s disease contributes to negative social and financial outcomes for people with the condition, their care partners, and health systems. When left untreated, the impact of these outcomes is exacerbated, yet the scale of this impact is unknown. This gap in the literature both reflects and perpetuates the broader under-recognition of agitation as a serious unmet need in the Alzheimer’s community. Conversely, a better understanding of the costs can help elevate agitation within the global Alzheimer’s dialogue.

We used MEDLINE, PubMed, PsychINFO the Cochrane Library and Google Scholar databases to identify relevant articles published between 2000 until May 2020. We also reviewed reliable literature published outside of these databases. Keywords utilized in the search include agitation in Alzheimer’s, neuropsychiatric symptoms of Alzheimer’s, cost of informal and formal care, Medicare and Medicaid costs, economic costs associated to delirium, among others. Only articles in English were included. Inclusion and exclusion criteria were determined by study design, data source and population studied, number of cases included in analysis, source of health service use or cost data, statistical methods and agitation in Alzheimer’s attributable and/or incremental costs.

Results will describe the breadth and depth to which costs of treated and untreated agitation in Alzheimer’s have been examined, indicating data and statistical methodology used.

This literature review serves as the basis for understanding global costs of agitation in Alzheimer’s disease. From our analysis, we recommend that further cost modeling activities be conducted. We also urge the greater community to use these findings to elevate agitation to the top of the Alzheimer’s agenda.

The primary objective of this study was to determine whether a brief education session about Alzheimer's disease (AD) stages and associated behavioral and psychological symptoms of dementia (BPSD) changes healthy seniors’ treatment choices. A secondary objective was to determine whether pharmacotherapy to reduce BPSD would be preferred over other potentially more restrictive interventions.

Participants (n = 32; 8 men; aged > 64years; no self-reported dementia diagnosis) were assigned to one of ten group sessions during which they received information about AD and BPSD. Our a-priori hypotheses were: (1) education about AD stages significantly changes care preferences in moderate and severe stages, i.e. less active treatment options (no CPR/hospitalization) are chosen as the disease progresses; and (2) most participants prefer pharmacotherapy over restraints and seclusion to manage BPSD. The main outcome measure was a change in the interventions chosen including CPR and hospitalization. Participants completed three questionnaires and two decisional grids before and after the information session. Qualitative data were derived from discussions during the session.

Participants expressed a wide range of attitudes about AD, BPSD, and their management. Those who are born in Canada, had a proxy, and a university education, each have around half of the odds of receiving treatment compared to those in the complementary group. (OR 0.47, 0.40, 0.43) Finally, not knowing someone with AD increases the odds of wanting a treatment by around six times (OR 6.4). Pharmacological measures were preferred over restraints.

Education about dementia and advance directives should consider the person's educational background and experience with dementia. Discussing BPSD may impact a person's advance directives and preferences.