Drug use by demented and non-demented elderly people

Three functional assessments were conducted with a client with self-injurious behavior (SIB), which indicated that SIB appeared to be sensitive to attention as reinforcement. In addition, levels of SIB were much higher when the client was seated in his wheelchair. An additional analysis was conducted in which client location (in and out of wheelchair) was altered while reinforcement contingencies (attention) for SIB were held constant. Levels of SIB again were higher when the client was positioned in his wheelchair, even though the consequences for SIB were identical. The results of this final analysis suggested that the wheelchair functioned as an establishing stimulus altering the efficacy of social positive reinforcement.     

The psychosocial impact of caregiving on young people who have a parent with an illness or disability: Comparisons between young caregivers and noncaregivers.

Objective: To investigate the psychosocial impact of young caregiving by empirically validating prominent qualitative themes. This was achieved through developing an inventory called the Young Caregiver of Parents Inventory (YCOPI) designed to assess these themes and by comparing young caregivers and noncaregivers. Method: Two hundred forty-five participants between 10 and 25 years completed questionnaires: 100 young caregivers and 145 noncaregivers. In addition to the YCOPI, the following variables were measured: demographics, caregiving context, social support, appraisal, coping strategies, and adjustment (health, life satisfaction, distress, positive affect). Results: Eight reliable factors emerged from the YCOPI that described the diverse impacts of caregiving and reflected the key themes reported in prior research. The factors were related to most caregiving context variables and theoretically relevant stress and coping variables. Compared with noncaregivers, young caregivers reported higher levels of young caregiving impact, less reliance on problem-solving coping, and higher somatization and lower life satisfaction. Conclusions: Findings delineate key impacts of young caregiving and highlight the importance of ensuring that measures used in research on young caregivers are sensitive to issues pertinent to this population. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Differences in familism values and caregiving outcomes among Korean, Korean American, and White American dementia caregivers.

Recent theories have suggested that burden and distress among dementia caregivers may be higher in American culture, which emphasizes individualism, and lower in cultures with higher levels of familism. However, immigrants may experience higher levels of burden because of acculturation with attendant values, conflicts and stresses. Forty-four Korean caregivers and 32 Korean American caregivers were compared with 54 White American caregivers on sociodemographic variables, familism, burden, anxiety, and depression. Familism was highest in Korean caregivers and lowest in Whites, with Korean Americans in the middle. Koreans and Korean Americans reported higher levels of burden. Koreans showed higher levels of depression and of anxiety than White American caregivers, with Koreans and Korean Americans higher than Whites on anxiety. These results suggest a need for greater specificity in theories about familism values, with attention to the specific meaning of familism in different cultures. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Differences between caregivers and noncaregivers in psychological health and physical health: A meta-analysis.

Providing care for a frail older adult has been described as a stressful experience that may erode psychological well-being and physical health of caregivers. In this meta-analysis, the authors integrated findings from 84 articles on differences between caregivers and noncaregivers in perceived stress, depression, general subjective well-being, physical health, and self-efficacy. The largest differences were found with regard to depression (g = .58), stress (g = .55), self-efficacy (g = .54), and general subjective well-being (g = -.40). Differences in the levels of physical health in favor of noncaregivers were statistically significant, but small (g = .18). However, larger differences were found between dementia caregivers and noncaregivers than between heterogeneous samples of caregivers, and noncaregivers. Differences were also influenced by the quality of the study, relationship of caregiver to the care recipient, gender, and mean age of caregivers. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Latent growth models of the longitudinal effects of dementia caregiving: A comparison of African American and White family caregivers.

Self-report measures of depression, physical health symptoms, and life satisfaction were collected over a 2-yr period from 197 family caregivers of dementia patients and 218 noncaregivers (controls). Latent growth models were used to compare changes across time for African American and White caregivers, with gender, age, and socioeconomic status serving as covariates. Results indicated that White caregivers sustained higher levels of elevated depression and decreasing life satisfaction over time compared with African American caregivers. Both groups of caregivers reported increases in physical symptoms over time. These results indicate worsening difficulties over time for many White caregivers. African American caregivers show more resilience on measures of depression and life satisfaction but are still vulnerable to increases in physical symptoms over time. Implications for additional research and clinical intervention are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychological, social, and health impact of caregiving: A comparison of Black and White dementia family caregivers and noncaregivers.

Psychological, social, and health variables were compared in 175 Black and White family caregivers of patients with dementia and 175 Black and White noncaregivers. Caregivers and noncaregivers did not differ within race on demographic variables. Caregiving was associated with increased depression and decreased life satisfaction only in White families. However, caregiving appears to have similar social consequences for Black and White families, including restriction of social activity and increased visits and support by family from outside of the home. Race, but not caregiving, was associated with physical health variables. Methodological issues in comparing well-being in Black and White caregivers, in particular the importance of including noncaregiving comparison subjects, are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Memory training in normal and demented elderly populations: the E-I-E-I-O model

An heuristic classification scheme for memory interventions is described as a 2 x 2 matrix. One dimension of the matrix addresses the use of internal versus external mnemonics, and the other dimension addresses the use of explicit (effortful/conscious) versus implicit (automatic/unconscious) learning. Most attempts at memory interventions in normal older populations, such as the use of mental imagery, fall within the explicit-internal cell of the matrix and require expenditure of large amounts of cognitive effort. As a result, memory interventions in normal older populations, even when "successful," usually produce results that are limited in their generalization and are usually not maintained over time. Such interventions are rarely attempted in demented populations. Interventions are described that require less effort and are representative of other cells in the classification matrix. These may be more effective for demented and normal elders. Information acquired through these alternative means may eventually be stored internally and become consciously available, often producing an "O!" or "aha" experience when the individual realizes a shift to internal, consciously available storage has taken place.     

A comparison of primary stressors, secondary stressors, and depressive symptoms between elderly caregiving husbands and wives: The caregiver health effects study.

The present study examined gender differences in the experience of primary and secondary caregiving stressors, depressive symptoms, and their interrelationships using a sample of 283 elderly spouse caregivers (145 women, 138 men). Two primary stressors, two secondary stressors, and depressive symptoms were assessed. In general, t-tests indicated that caregiving husbands experience fewer stressors and depressive symptoms than their female counterparts. Multiple group analysis revealed that the primary stressors were more useful in explaining variance associated with the secondary stressors for women than men and that the path coefficients linking amount of caregiving assistance to caregivers' activity restriction was significantly different across men and women. Other paths linking primary stressors, secondary stressors, and depressive symptoms, however, were statistically equivalent across men and women. Hence, although caregiving women and men may vary in their reports of caregiving stressors, the complexity of the caregiving experience appears to be quite uniform for both groups. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Relationship between physical exercise and health of the elderly people in a rural community

The significance of life style and regular physical exercise for health of elderly people in a rural community was evaluated by questionnaires. The subjects studied were a group who had been playing gate ball (such as croquet) for more than three years (N = 86) and a group who had not (N = 255). Significantly more males in the group playing gate ball (GB group) than in the group not playing gate ball (n-GB group) reported feeling healthier than three years before. The average overall score for life style which indicates a healthier life style was analyzed. The score for life style of males was significantly lower in the GB group than in the n-GB group. Significantly more males in the GB group did not take snacks or smoke than those in the n-GB group. Regarding regular physical exercise, significantly fewer females in the GB group went for a daily walk than those in the n-GB group. The average score for integrated regular physical exercise was significantly higher in the GB group than in the n-GB group. The scores for regular physical exercise of females in the GB group, even in spite of disability or hypertension, were significantly higher than those in the n-GB group. From this survey it appears that regular physical exercise including gate ball may be beneficial for health of elderly people in a rural community.     

Relationship between blood pressure and subcortical lesions in healthy elderly people

The germinal center (GC) is an anatomic compartment found in peripheral lymphoid organs, wherein B cells undergo clonal expansion, somatic mutation, switch recombination, and reactivate immunoglobulin gene V(D)J recombination. As a result of somatic mutation, some GC B cells develop higher affinity antibodies, whereas others suffer mutations that decrease affinity, and still others may become self-reactive. It has been proposed that secondary V(D)J rearrangements in GCs might rescue B cells whose receptors are damaged by somatic mutations. Here we present evidence that mature human tonsil B cells coexpress conventional light chains and recombination associated genes, and that they extinguish recombination activating gene and terminal deoxynucleotidyl transferase expression when their receptors are cross-linked. Thus, the response of the recombinase to receptor engagement in peripheral B cells is the opposite of the response in developing B cells to the same stimulus. These observations suggest that receptor revision is a mechanism for receptor diversification that is turned off when antigen receptors are cross-linked by the cognate antigen.     

Self-care ability in a group of elderly Swedish people: a phenomenological study

The aims of this study were to describe self-care ability in a group of Swedish elderly and to elucidate the meaning of actualizing this self-care ability into self-care activity. Two different phenomenological methods were applied in the analyses of 11 self-reports written by home dwelling elderly in the community. The eidetic structure of self-care ability was twofold; it entailed, first, being present to the opportunity to act on certain perceived influences on the body and, second, alone or with support from somebody else to be able to bring about a change in attitude towards one's personal lifestyle or life situation. The meaning of actualizing this ability was interpreted as self-realization or self-transcendence.     

Psychotherapy and aging: Results of two empirical studies between psychotherapists and elderly people.

Reports results from 2 studies that investigated predictors of psychotherapists' interest in clients over age 65 and addressed elderly people's opinions and fears concerning psychotherapy. In Study 1, 82 (38%) practicing behavioral and psychodynamic or psychoanalytic therapists (mean age 50.6 yrs) returned questionnaires concerning their education and experiences with elderly clients and completed a test of gerontological knowledge. Contrary to common belief, neither gerontological knowledge nor therapist's age predicted interest in elderly clients. The only significant predictor was previous experience with elderly clients. Study 2 investigated the opinions and fears of 84 elderly persons (mean age 74.3 yrs) concerning psychotherapy, using a questionnaire that consisted of 3 scales: prejudices against psychotherapy, sharing problems with others, and fears of psychotherapy. Results show that prejudices and fears were higher in older elderly as compared to younger elderly but they were not as predominant as expected. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Prolonging life in elderly people: a worthwhile goal of medical care

The very elderly (over 80 years) have a relatively high level of disability and dependency, and this has been reported to be a greater problem in women. It has, therefore, been proposed that there may be little to gain from prolonging life of the very elderly, especially very elderly women. However, there is very little evidence to suggest that increasing survival leads to a higher prevalence of disability at a given age. Preventive measures that prolong life appear to postpone both morbidity and mortality. Moreover, there is little reliable evidence that an elderly woman is more dependent than a man of the same age. It is also suggested that there is a 'cap' on survival and, therefore, we should concentrate on preventing morbidity and compress it into the last few years of life. We consider whether or not the elderly are approaching a 'cap' on survival and think that they are not. We conclude that preventive medicine in the elderly should aim to prolong survival and prevent morbidity. It is uncertain whether morbidity can be prevented more than mortality or vice versa. The concept of compressing morbidity at the end of life is an attractive concept, but data are lacking to support this idea.     

Stressful situations in caregiving: Relations between caregiver coping and well-being.

We examined ways in which caregivers cope with stressful caregiving situations and the relations between coping strategies and caregivers' psychosocial well-being. Respondents were 58 family caregivers to patients discharged from a rehabilitation hospital. Caregivers identified a recent stressful event in caregiving and indicated strategies used to cope with this event. After controlling for patients' impairment level, analyses indicated that caregivers engaging in more escape–avoidance coping reported greater depression and more conflict in their personal relationships. Those using more positive reappraisal demonstrated greater positive affect. Younger caregivers, many of whom were women, used more avoidance strategies. Results have implications for therapeutic interventions with family caregivers. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Depression among caregivers of the elderly in need of care and their service utilization: a pilot study

This is the first reported case of a spontaneous migration of an embolized catheter fragment from the left side of the pulmonary arterial system to the right side.     

The self-concept of the elderly: a cross-cultural comparison

This study examines the self-concept of the elderly in a cross-cultural perspective. An open-ended sentence completion methodology was employed. A sample of elderly Spanish and elderly Dutch were compared to gain an idea of the cross-cultural generality of the content of the self-concept. Analysis focuses on responses to sentences which probed the respondents' motivations and future plans and goals. Differences could be interpreted as reflecting an individualistic (Dutch) vs. collectivistic (Spanish) distinction between the two cultures. Furthermore, the findings had implications for how to interpret dimensions of meaningful aging. For example, a dimension such as "purpose in life" was more generalizable across the two samples than a dimension such as "autonomy."