Promotion

OLDER PEOPLE: THE RETIREMENT YEARS 195
Wider environmental and political interventions intended to improve the quality of
life among older people
There is little ‘non-health specific’ evidence of interventions that impact on older
people’s mental well-being. The main exceptions are housing and transport. The
majority of studies on housing have not considered the health impact on older people
specifically, but have included them in broader studies on re-housing and housing
adaptations (see Chapter 6). A study on Teesside of medical priority re-housing found a
reduction in the prevalence of mental health problems and less frequent use of health
services (Blackman et al. 2003). Again the study did not focus specifically on older
people but included them in the general study population. Consequently, we know
very little about the specific mental health benefits of housing for older people.
The effectiveness of transport interventions in improving population health has
been evaluated extensively (Morrison et al. 2003). However, most of this research has
focused on injury prevention and on children and young people. We mentioned earlier
that driving cessation increases depressive symptoms in older drivers. These consequences
should obviously be taken into account when older drivers are advised about
a possible transition to not driving and alternative driving strategies developed sensitively.
The introduction of local traffic calming schemes has been found to be associated
with increased pedestrian activity but not with improved mental health (Morrison
et al. 2004). Here again the study did not distinguish between age groups, which could
have highlighted possible differences in need and response between older people and
younger adults.
Box 7.7 Summary of evidence of effective mental health promotion interventions for
older people
• There is good evidence that group-based social support activities are effective in
reducing social distress, social isolation and loneliness.
• There is increasing evidence that exercise promotes self-esteem, happiness and wellbeing,
and reduces depression.
• There is conflicting evidence regarding the effectiveness of befriending and home
visiting schemes for older people. Qualitative research suggests that they are acceptable
and helpful.
• Despite a significant body of research there is little evidence that respite care, psychosocial
interventions, group education and support impact significantly on depression,
stress or coping skills in older carers.
• There is some evidence (based on mainly American research) to suggest that volunteering
has a positive effect on older people’s mental health.
• To date there is little research and consequently evidence to demonstrate the
effectiveness of reminiscence, computer technology and lifelong learning in improving
or maintaining mental health in later life.