Alison
PhD at the Centre for Applied Dementia Studies
- Supervised by Dr Catherine Quinn, Professor Gail Mountain and Elizabeth Teale
- Project: 'The impact of psychological and social factors on the lived experience of ageing with physical frailty and cognitive impairment.'
- Start date: December 2019
My background
"I began working with older people as a care assistant in a residential care home around 13 years ago. I worked in this role for about eight years and during this time I also undertook my first degree in psychology at the University of Bradford.
"I found that I was interested in the lived experiences of other people and the use of qualitative approaches to explore this. To gain further experience of such research I worked with one of my former lecturers on her work on the experiences of ageing in motherhood. I moved into research with the NHS on a number of projects based in care home, hospital and community settings.
"The bulk of this work was trial based, although my preference was always direct contact with older people and those who provide care. I was also involved with development of a ‘living lab’ approach to research in care homes undertaken since 2018 by the University of Leeds, working with staff, families and residents on priority setting and enhancing care provision."
What was your motivation for pursuing a PhD and for researching your particular topic?
"My experience providing care and undertaking research with older people has been a major motivation for my PhD.
"Caring for those with advanced physical and cognitive decline made me question how ageing varies from person to person, how some people live well, and others have more difficulties in later life."
Aims of the study
"The overall aim of my PhD is to explore and understand the ways in which current and past psychological and social circumstances may impact upon current health and wellbeing for older people living with coexistent physical frailty and cognitive impairment. Further aims include identification of current and best working practice for frontline community care staff."
Methods for the study
"Both studies of the thesis will employ qualitative methods. The first study will use narrative inquiry to allow older people living with physical frailty and cognitive impairment to share their life stories. Data collection and analysis will focus on life course events of a social or psychological nature which may impact on co-existent decline in later life from the perspective of the older person.
"The second study will use findings of the first study to inform data collection regarding current and best practice related to the care of older people in the community."
Study 1: Exploring change in later life study
"The Exploring Change in Later Life study is aiming to investigate the experiences of older people living with both physical frailty and cognitive impairment. Those living with co-existent physical frailty and cognitive impairment often experience more adverse health outcomes, a poorer overall quality of life and have increased health and social care needs. There is little research which considers co-existent decline from a life-course perspective; or considers the views of older people themselves. Psychological and social factors may increase the risk of decline, but findings currently lack depth, quality and consistency.
"This study will use narrative methods, to collect the life stories of 16 to 20 older people, living with both physical frailty and cognitive impairment, through telephone or internet video call interviews. Participants will be identified through the existing Community Ageing Research (CARE) 75+ cohort study. This cohort was developed to promote the participation of older people in research projects.
"The use of remote data collection will enable the involvement of people across the UK. A framework will be used to ensure variation over education level and whether participants live alone or with others. Data will be analysed using a content analysis approach, focusing upon how older people describe and understand their own health and wellbeing and how they may relate this to their current and past psychological and social circumstances.
"The findings from this study will inform further work with health and social professionals to identify support needs for older people in a community setting."
Findings to date
"A review conducted to inform the project research questions has been undertaken during year one. The findings of this review indicate that there has been little high quality or in-depth examination of psychological and social factors and their relationship with coexistent physical and cognitive decline.
"Findings broadly show that higher levels of depressive symptomology, lower levels of education, lower wealth and living alone appear more common in those who experience physical and cognitive decline."
"I will be presenting findings of my review at the British Society or Gerontology in the summer, I also hope to publish a paper discussing these findings."
What impact do you hope your study will have?
"My aim is to ensure that findings of my studies are disseminated to academics, those in care service provision and older adults themselves through appropriate forums, to inform further research and practice. I am hoping that the two studies will inform a postdoctoral grant application to work on the development of training or support for those who work outside of the NHS in community services for older people."
Partners and funding
This PhD is being undertaken with support from:
- The Wolfson Centre for Applied Health Research and the Bradford Institute for Health Research, at Bradford Royal Infirmary
This PhD is funded by a University of Bradford studentship as part of the National Institute for Health Research, Yorkshire and Humber Applied Research Collaborations.