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Journal article

Evidence-based interventions with older adults: concluding thoughts

Authors:
KROPF Nancy P., CUMMINGS Sherry M.
Journal article citation:
Journal of Gerontological Social Work, 50(S1), 2008, pp.345-355.
Publisher:
Taylor and Francis
Place of publication:
Philadelphia, USA

This paper summarises the findings of the systematic reviews of psychosocial interventions reported in this issue of the journal, identifying effective intervention approaches for physical health problems, mental health problems and particular social roles (end of life care, family carers, grandparent carers, people with developmental disabilities and their carers). Problems with psychosocial intervention research are noted, including the small size and methodological weakness of many studies, a failure to report the details of an intervention and its implementation, and lack of consensus over which outcomes should be measured. Future research studies need to be larger, more robustly designed and with long term follow-up. They also need to cover more diverse populations (e.g. ethnic minority groups) and more diverse topics in addition to the problems of functional decline. (Copies of this article are available from: Haworth Document Delivery Centre, Haworth Press Inc., 10 Alice Street,  Binghamton, NY 13904-1580).

Journal article

Perceptions of biopsychosocial services needs among older adults with severe mental illness: met and unmet needs

Authors:
CUMMINGS Sherry M., CASSIE Kimberly McClure
Journal article citation:
Health and Social Work, 33(2), May 2008, pp.133-143.
Publisher:
Oxford University Press

This study sought to identify the psychiatric, physical, and social services needs experienced by older adults with severe mental illness (SMI) and to examine factors influencing their experience of need and service provision adequacy. Seventy-five older adults with SMI were recruited from a community mental health centre in a large southern American city to participate in the study. The typical client experienced a need for care in 10 areas, with the greatest needs occurring in the areas of psychological pain, physical illness, social contacts, looking after the home, and daily activities. The total number of unmet needs ranged from zero to 10, with the typical client having an average of 2.3 unmet needs (SD = 2.4). The highest proportions of unmet needs were in the areas of social contact, benefits, sight or hearing difficulties, and intimate relationships. Linear hierarchical regression analyses revealed that clients with lower income, greater impairments in independent daily living skills, and higher levels of depression experienced increased needs for care. Older clients who lived in private homes or apartments had higher levels of depression, and those who required assistance in the areas of intimate relationships and benefits experienced higher levels of unmet needs. Research and practice implications are discussed.

Journal article

Caregivers of older clients with severe mental illness: perceptions of burdens and rewards

Authors:
CUMMINGS Sherry M., MacNEIL Gordon
Journal article citation:
Families in Society, 89(1), January 2008, pp.51-60.
Publisher:
The Alliance for Children and Families

Approximately 1 million older persons have a severe mental illness (SMI) and this number is expected to double in the coming decades. While research studies have examined the experiences of family members of younger persons with SMI, very little is known about caregivers of older SMI clients. This study examined the characteristics, burdens, and rewards of 60 caregivers of older SMI clients in the US using a modified version of family caregiver scales of Tessler, Fisher, & Gamache (1992). Hierarchical linear regression analyses indicated that increased client symptoms, higher levels of help provided, increased caregiver income, and knowledge about the care recipient’s diagnosis were predicative of caregiver burden. Decreased number of client symptoms, care recipient being female, and greater experience of the presence of God predicted caregiver rewards. Implications of these findings are discussed.

Journal article

Predictors of depression among caregivers of older adults with severe mental illness

Authors:
CUMMINGS Sherry M., KROPF Nancy P.
Journal article citation:
Journal of Gerontological Social Work, 58(3), 2015, pp.253-271.
Publisher:
Taylor and Francis
Place of publication:
Philadelphia, USA

Caregivers of older persons with severe mental illness (SMI) contend with the double challenge of providing assistance related to both the psychiatric condition and older age of their family member. Study explored factors influencing negative psychological outcomes experienced by caregivers (n = 96) of older adults with severe mental health problems (defined as schizophrenia, schizoaffective disorder, bipolar disorder, or major recurrent depression). The Stress-Process Model was used as a framework for conceptualizing constructs to be explored in the study. One-quarter of caregivers scored at or above the clinical point for depression. Low income, care recipient gender, poor health, problems dealing with care recipient’s symptoms and the interaction of health and problems dealing with symptoms were associated with higher rates of depression. Implications for service provision and future research are discussed. (Edited publisher abstract)

Journal article

Formal and informal support for older adults with severe mental illness

Authors:
CUMMINGS Sherry M., KROPF Nancy P.
Journal article citation:
Aging and Mental Health, 13(4), July 2009, pp.619-627.
Publisher:
Taylor and Francis

This study sought to examine the combination of formal and informal services supplied to older adults with severe mental illness, to assess the adequacy of services received, and to determine factors predictive of formal and informal service provision. A cross-sectional research design was employed. Seventy-five older adults diagnosed with a SMI were recruited through local community mental health centre. Data was collected through face-to-face interviews using the Camberwell Assessment of Needs for the Elderly. Clients most frequently received services from formal sources for psychiatric distress, physical health, information, and dangerous behaviour needs while informal sources provided the greatest amount of assistance for self-care, psychiatric distress, and money management needs. Appropriate assistance was most often not provided for benefits, sight/hearing, and incontinence. Formal services were predicted by group residence and dangerous behaviour, physical illness, medication, and daily activity needs. Assistance from informal sources was predicted by private residence, self-care, mobility, and money management needs. While formal and informal sources provided adequate services for certain client needs, over 70% of the clients did not receive the correct type of help for some of their needs. Greater communication between mental health care staff and informal caregivers, and the integration of aging network services, is essential for the adequate provision of care to older severely mentally ill (SMI) adults. Education and greater linkages among care providers are necessary so that all service providers are aware of and are able to appropriately respond to the complex multi-level needs experienced by older SMI adults.

Journal article

Treating older persons with severe mental illness in the community: impact of an interdisciplinary geriatric mental health team

Author:
CUMMINGS Sherry M.
Journal article citation:
Journal of Gerontological Social Work, 52(1), January 2009, pp.17-31.
Publisher:
Taylor and Francis
Place of publication:
Philadelphia, USA

This study examines the treatment efficacy of a mental health geriatric interdisciplinary team in Tennessee, which includes social workers, a psychologist, a clinical nurse specialist, a psychiatrist, case managers and a programme manager, all with geriatric training. The sample consisted of 69 community dwelling clients aged 55 or older with severe mental health problems defined as schizophrenia, schizoaffective disorder, bipolar disorder or major recurrent depression. The majority had major recurrent depression. The results show a reduction in depressive symptoms and psychiatric hospital admissions, and an increase in life satisfaction, at six-month follow-up. No changes were found in health status or in medical hospital admissions.

Journal article

Substance abuse

Authors:
CUMMINGS Sherry M., et al
Journal article citation:
Journal of Gerontological Social Work, 50(S1), 2008, pp.215-241.
Publisher:
Taylor and Francis
Place of publication:
Philadelphia, USA

Although the prevalence of alcohol abuse is generally less among older than younger people in the USA, it poses particular risks for increased morbidity and mortality among older people. It is also expected to increase as the population ages. However, little attention has been paid to the development and evaluation of interventions for this population. This systematically conducted review identifies nine outcome studies, finding that promising interventions include those that are age-specific, less confrontational and cognitive-behavioural in approach. The paper concludes with a ‘treatment resource appendix’ directed at American social workers. (Copies of this article are available from: Haworth Document Delivery Centre, Haworth Press Inc., 10 Alice Street,  Binghamton, NY 13904-1580).

Journal article

Impact of an infusion model on social work students' aging knowledge, attitudes, and interests

Authors:
CUMMINGS Sherry M., et al
Journal article citation:
Journal of Gerontological Social Work, 47(3/4), 2006, pp.173-186.
Publisher:
Taylor and Francis
Place of publication:
Philadelphia, USA

This American study sought to provide data regarding the use of infusion of gerontological materials throughout curriculums to enhance students' attitudes toward older adults, their knowledge of aging-related issues, and their perceptions of gerontological social work. A quasi-experimental design was used to compare outcomes for graduate social work students who were and those who were not exposed to gerontological infusion. Results indicated that exposed students experienced a greater improvement in their view of aging-related career opportunities and in their belief in the importance of gerontological social work. Treatment group students also showed greater gains in self-rated aging knowledge. Both treatment and control group students had significant gains in a test of aging-related knowledge. Pedagogical implications are discussed. (Copies of this article are available from: Haworth Document Delivery Centre, Haworth Press Inc., 10 Alice Street,  Binghamton, NY 13904-1580).

Journal article

Alcohol abuse treatment for older adults: a review of recent empirical research

Authors:
CUMMINGS Sherry M., BRIDE Brian, RAWLINS-SHAW Ann M.
Journal article citation:
Journal of Evidence-Based Social Work, 3(1), 2006, pp.79-99.
Publisher:
Taylor and Francis
Place of publication:
Philadelphia, USA

The purpose of this article is to enhance social work practitioners and researchers' understanding of the nature of elder alcohol abuse, the needs of elders with alcohol abuse disorders, and the availability of effective treatment strategies by reviewing the epidemiological and outcomes research literatures related to alcohol abuse and the elderly. The few empirical studies that examine outcomes associated with the treatment of elderly substance abusers reveal positive outcomes, especially when “age-specific,” cognitive-behavioural, and less confrontational treatment approaches are employed. The authors highlight the need for further research  concerning the nature of alcohol abuse among the elderly and the impact of specific alcohol treatment strategies on older adults. Such research should consider the needs and experiences of specific sub-populations of elders such as women, minorities, and those with late onset disorders. (Copies of this article are available from: Haworth Document Delivery Centre, Haworth Press Inc., 10 Alice Street,  Binghamton, NY 13904-1580).

Journal article

Spousal caregivers of early stage Alzheimer's patients: a psychoeducational support group model

Author:
CUMMINGS Sherry M.
Journal article citation:
Journal of Gerontological Social Work, 26(3/4), 1996, pp.83-98.
Publisher:
Taylor and Francis
Place of publication:
Philadelphia, USA

The needs and experiences of caregivers of persons with early Alzheimer's Disease are often complex and intense. These challenges are heightened for spousal caregivers who must contend with the dissolution of their primary relationship and expectations of the future based upon that relationship. The article describes a psychoeducational support model for caregiving spouses of early Alzheimer's patients which has been used in the United States. Outlines the format of the groups, discusses the major themes that have emerged for the caregiving spouses and provides some case examples. Goes on to discuss recommendations for those working with caregiving spouses.

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