Older adults self-managing distress: could the Internet help? A qualitative study

Problem

Anxiety and depression are common in older adults but are under-diagnosed and under-treated. Rather than seeing themselves as suffering from anxiety or depression, older adults may be more likely to self-identify as being ‘distressed.’ There is a lack of previous research reporting the self-management strategies that older adults with distress employ. The Internet could potentially offer self-management support for mental health problems as it could increase access to health information and social support, but this has not been explored in older adults. A Patient and Public Involvement and Engagement (PPIE) group informed the research.

Approach

Qualitative study, university ethics approval obtained. Participants over age 65 were recruited from community-based social and activity groups around North Staffordshire. Semi-structured interviews incorporating innovative ‘think-aloud’ methods (including ‘storyboards’ and extracts from online forums) were used to generate data. The PPIE group contributed to creating the pictures and text used within the ‘storyboards.’

Findings

Initial analysis suggests a range of self-management strategies are employed, including engaging in positive health behaviours such as exercising and staying active, trying to stay independent, attending community groups and creating a sense of purpose by helping others. Some participants did report consulting their GP when distressed and sometimes being offered medication, however, there was an overall negative attitude towards long term medication. Attitudes towards the Internet were nuanced – the Internet was seen as a source of health information once a diagnosis (or a physical problem) had been given by the GP, but was rarely seen as a source of information for distress or as a means of accessing social support. There was also a general lack of confidence in engaging with the Internet, although many participants were supported in accessing the Internet by family members and computer classes offered by third sector services.

Consequences

GPs need to be aware of the self-management strategies older adults with distress already employ, and those which they might potentially find acceptable. This could be useful to the GP when signposting distressed older adults to sources of information and support.