A Paradoxical Model Empowering Reminiscence Group Members to Transcend Physical Impediments to Participation

Abstract

This article presents a pilot project with physically impaired members of four reminiscence groups in an assisted living residence. The members had already attended literary discussion groups which primed them for the project. First, they selected authors or characters described as living “once removed from their body.” Then, participants filled this space with a homonym term associated with their physical condition. Finally, they reflected on their conditions from the perspective of the other homonym term. Bemused detachment replaced obsessiveness about their health and eased the interaction and candidness among group members.     

Older Adults and Creative Arts: Personal and Interpersonal Change

Creative aging programs are recognized as an effective way to enhance the lives of older adults. This study examines creative arts programs offered through public libraries. Focus groups captured participants’ experiences. Themes that emerged from analysis of the focus group data generally clustered into two areas: Personal Change and Interpersonal Change. Personal change captured five perspectives: Healing; Safe Place/Freedom; New/Renewed Self; Creative; Joy/Fun. Interpersonal change entailed two perspectives: Connections and how they are Seen Differently by Others. The positive experiences of older adults who have engaged in organized creative arts programs suggest the potential life-changing possibilities of these programs.     

Can Creative Writing,as an Add-on to Treatment for Alcohol Use Disorder,Support Rehabilitation?

ABSTRACT

Creative writing may help patients find new powers in the acts of making art and expanding horizons beyond illness, including addiction. The aim of the present pilot study was to introduce creative writing workshops to alcohol use disorder (AUD) patients and investigate self-perceived rehabilitating impact, improvement in quality of life, and executive functions. The study was conducted in a mixed methods design; primarily semi-structured group and individual interviews as well as participant observation, supplemented by a small evaluation questionnaire at baseline and follow-up at the end of exposure. The patients had experienced the workshop as having influenced their lives in a positive direction, impacted by doing creative writing, sharing and receiving feedback, and the community of the group. The patients perceived both advantages and disadvantages about discussing alcohol in the workshop. The patients experienced an increase in quality of life from the beginning to the end of the workshop. There could be a need for creative writing workshops as add-ons to ordinary AUD treatment. In such an offer, creative writing might function as a means to improve patient rehabilitation, quality of life, and executive functions.     

Using Reminiscence Group Members' Family Slogans and Epitaphs to Enhance Their Planning Abilities

Abstract

Introducing a focus on family slogans and epitaphs into reminiscence groups serves three functions. It facilitates the group process by engaging all members in selecting the slogans and epitaphs that they discern in the memories the reviewers share. It also shows how these family dynamics over the grandparents' and parents' generations condition, if not determine, the slogans and epitaphs of the reviewers themselves. Finally, it enhances reviewers' planning for themselves by alerting them both to the accommodations they may need to make to their programming and to the talents they can draw upon because of the family they were born into.     

The Center of Excellence on Brain Aging/NYU Langone Medical Center/Mather LifeWays Institute on Aging

Reminiscence programs are believed to be beneficial for older adults; however, benefits may not be exclusively related to reminiscing but to group process. A reminiscence program for older adults aimed at intergenerational connection through multimedia is reported. This evaluation utilized three sources of data: participant's stories, focus groups conducted with group members, and responses from social networking websites along with blog readers. Overall, results show that participants benefited from the program by having a vehicle to tell their story and an activity that fulfilled social needs. Additionally, community members benefited from and learned about participants in a way that utilized efficient modes of communication and media. Findings support the intergenerationality of this program in that it was able to connect older adults with younger generations both in person and virtually.     

Are Older People Dying of Depression? Findings from the Medical Research Council Trial of the Assessment and Management of Older People in the Community

OBJECTIVES: To examine the relationship between symptoms of depression and mortality in older people. DESIGN: Prospective longitudinal study. SETTING: Fifty-three general practices in the United Kingdom. PARTICIPANTS: Thirteen thousand ninety-seven people aged 75 and older participating in the Medical Research Council Trial of the Assessment and Management of Older People in the Community. MEASUREMENTS: Depression was measured using the 15-item Geriatric Depression Scale (GDS-15); the main outcome was all-cause mortality. RESULTS: Morbidity, disability, and lifestyle factors can explain most of the observed relationship between symptoms of depression and mortality (hazard ratio=1.75, 95% confidence interval (CI)=1.53-1.99), but after mutual adjustment for these factors, subjects who reported six or more symptoms of depression on the GDS-15 were still 27% more likely to have died by the end of the follow-up period than those below the threshold for depression (95% CI=1.11-1.45). CONCLUSION: The findings from this study suggest that depression confers a small risk for mortality in older people, not explained solely by poor health. The results support the encouragement of effective diagnosis, treatment, and support for individuals with depression as highlighted by the World Health Organization and the UK National Service Framework for older people.     

Interdisciplinary Methods of Treatment of Depression in Older Adults: A Primer for Practitioners

The effective treatment of depression in older adults requires a wide repertoire of interventions from the knowledge bases of several disciplines. The purpose of this article is to offer professionals an overview of the various treatments for depression, as well as their theoretical foundation, in order to design appropriate interventions and activities for older adults who are depressed. Implications for practice are also offered.     

Living Legends: Students' Responses to an Intergenerational Life Review Writing Program

The purpose of the study was to examine the effects of participation in the Living Legends program upon health science students' image of older adults and interest in working with older people. A multisite quasi‐experimental control group design with a connected qualitative component was used. Program sites included three Naturally Occurring Retirement Communities (NORCs) and one senior center. Health science students (n = 43) from two universities and two community colleges and community‐dwelling seniors (n = 39) participated in the program. A baseline questionnaire was used to ascertain demographic characteristics and prior type and amount of contact with older adults. The Image of Aging Scale and Likert‐style questions to measure interest in working with older adults were the primary outcome measures. Written responses to program experiences were also collected. Analysis of covariance was used to compare changes in Image of Aging subscale scores from pre‐ to posttest. Mean change in positive image of older adults subscale scores was 4.6 (SD = 4.4) for the intervention group and ?0.6 (SD = 4.8) for the control group. The difference between groups was significant (F = 22.0, P < .001), and the effect size was large (Cohen's d = 1.07). Nine of the 22 students in the intervention group had a greater interest in working with seniors after the program. Qualitative themes that emerged included a positive and beneficial experience, life lessons, seeing the person beyond the visible, power of the written word, and shared lives. Living Legends is an effective program to enhance positive images of older adults in future healthcare professionals and may have a positive impact on some students with regard to interest in working with older adults.     

CyberEx Internet-Based Group Exercise for Rural Older Adults: A Pilot Study

The purpose of this study was to examine satisfaction with and outcomes of a real-time Internet-based group exercise program for older adults. Men and women age 50 and older (mean = 66.5) were recruited to participate in a 10-week distance group exercise program. Paired sample t-tests revealed that Sit-To-Stand (STS) repetitions increased significantly (p = .009), while Timed Up-and-Go(TUG) time decreased significantly (p = .000). Connectivity, visibility, and communication emerged as themes related to the use of technology; but overall, real-time Internet-based technology was shown to be an effective way to present group exercise programs for older adults in this rural setting.     

Chapter 3: Getting Started: The Beginning Steps for Starting a Writing Class

No abstract available for this article.     

Does “No” Mean “Sometimes”? How Older Adults Respond to the Same Depression Symptoms with Different Response Formats

This report describes problems associated with the administration of binary choice response questionnaires, with particular attention to depression measures given to older adults. A convenience sample of 77 respondents aged 70+ completed two different versions of the 8-item Center for Epidemiologic Studies–Depression (CES-D) scale. Versions were identical except for having either two- or four-response option formats. Within-person responses were compared to determine equivalence across formats. We found that a binary-response option format overestimated or underestimated depressive symptomatology. Thus, a four-response option for the CES-D may be a more precise estimate of currently experienced symptoms.     

Quality of Life in Australian Adults Aged 50 Years and Over: Data Using the Schedule for the Evaluation of Individual Quality of Life (SEIQOL-DW)

Objectives: This study explored unique and personal domains associated with quality of life (QOL) in 153 mid-aged and older Australian adults over age 50, using an innovative measure of individualized QOL, the Schedule for the Evaluation of Individual Quality of Life (SEIQOL-DW).

Methods: Demographic measures as well as the SEIQOL-DW were administered. The qualitative responses on this scale were analyzed by Leximancer, a text analysis program that extracts semantic meaning and relational information automatically from text.

Results: For the sample as a whole, the most important QOL domain was found to be Relationships, followed by Family, Health, Activities, Community, Security, Beliefs, Independence and finally Wellbeing. When the sample was broken down into age bands for analysis, the most important domain theme was Family (50–59 year olds), Relationships (60–69 year olds), Relationships (70–79 year olds), and Health (80+ year olds).

Conclusions: The wide range of concepts elicited in each domain via Leximancer underscores the argument for analyzing QOL in an individualized way, as it was clear from these concepts that different domains had unique meanings to each person.

Clinical Implications: Understanding QOL at the level of which domains in an individual are important to QOL in later life is critical to providing services to both healthy aged as well as those with health and mental health needs. The SEIQOL-DW affords clinicians a unique tool with which to describe an individual’s unique and relevant quality of life areas, and affords a way to measure change in these areas as a result of interventions.     

The middle of the road: results from the aging semantic differential with four cohorts of medical students

OBJECTIVES: To explore the presence of negative stereotypical attitudes among medical students and the extent to which attitudes changed over time. DESIGN: Analysis of pre- and postexperience administration of attitude measures to four cohorts of medical students (two cohorts as quasi-controls and two cohorts as curriculum "treatment" groups). SETTING: The curriculum of a community-based medical school in the United States. PARTICIPANTS: Four sequential cohorts of medical students. INTERVENTION: Experience in a required comprehensive vertically integrated curriculum. MEASUREMENTS: The Aging Semantic Differential (ASD), using an 85-year-old woman as the cue image. RESULTS: The reliability scores for all administrations were acceptable. The two control cohorts demonstrated no change in attitude scores, whereas the treatment cohorts reflected a slight shift toward more-positive scores. However, all cohorts had scores for all sittings that were in the neutral range; on average students routinely scored 70% of the 32 items neither positively nor negatively. CONCLUSION: These students seemed not to hold negative stereotypes as measured using the ASD. Although two of the 32 items prompted negative stereotyping, and six items elicited positive stereotyping, attitudes were neutral about older adults. Characteristics of the ASD itself or of the response set used in this study may have affected the results.     

Pain Treatment of Underserved Older African Americans

Older African Americans who experience pain are especially at high risk of underassessment and undertreatment. This study examined patterns and correlates of pain medication use: severity of pain, medical conditions, and access to care. African Americans aged 65 and older were recruited from 16 churches located in south Los Angeles (N = 400). Structured face‐to‐face interviews and visual inspection of each participant's medications were conducted. More than 39% of participants were aged 75 and older, and 65% were female. Forty‐seven percent used at least one type of pain medication. The frequency of pain medication use according to pharmaceutical class was nonopioid, 33%; opioid, 12%; adjuvant, 9%; and other drug, 8%. Seventy‐seven percent of nonopioids were nonsteroidal anti‐inflammatory drugs (NSAIDs), which 25% of participants with hypertension, 28% with stroke, 26% with kidney disease, and 28% with gastrointestinal problems used. Ninety‐eight percent of participants who used NSAIDs, 98% experienced potentially inappropriate medication (PIM) use, 69% experienced drug duplication, and 65% experienced drug–drug interactions. This study suggests severe mismanagement of pain in underserved older African Americans, particularly those with comorbidity, multiple providers, and limited access to health care. The use of pain medication was associated with drug–drug interactions, drug duplication, and PIM use. The data show that many participants with severe pain are not taking pain medication or experience PIM use. One in four participants was taking NSAIDs, which can cause serious side effects in older African Americans with multiple chronic conditions.     

Group Therapy in Long Term Care Sites

ABSTRACT

Group therapy is an intervention that is particularly suited for residents in long term care settings, because it can reduce social isolation and efficiently address the common issue of adjustment to institutional living. This article first specifies the types of groups that should be offered in long term care settings as a function of therapeutic aims and resident composition. It then enumerates Yalom's common curative factors and how they are reflected in the group process with frail nursing home residents. The unique elements in doing group therapy within long term care sites are then discussed. Next, the meager research on group psychotherapy in long term care sites is summarized, and a plea is made for more empirical studies to be conducted in this exciting but neglected area. Finally, reimbursement issues for group therapy in nursing homes are briefly considered.