Search results for ‘Subject term:"older people"’ Sort:
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How to stay afloat
- Author:
- NICHOLAS Elinor
- Journal article citation:
- Community Care, 6.3.03, 2003, pp.40-41.
- Publisher:
- Reed Business Information
Reports in research from the Social Policy Research Unit at York University which describes how support for carers could be improved even when resources are limited.
Social networks and use of social supports of minority elders in East Harlem
- Authors:
- CLEAK Helen, HOWE Judith L.
- Journal article citation:
- Social Work in Health Care, 38(1), 2003, pp.19-37.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
Considerable empirical research substantiates the importance of social networks on health and well-being in later life. A study of ethnic minority elders living in two low income public housing buildings in East Harlem was undertaken to gain an understanding of the relationship between their health status and social networks. Findings demonstrate that elders with supportive housing had better psychological outcomes and used significantly more informal supports when in need. However, elders with serious health problems had poorer outcomes regardless of their level of social support. This study highlights the potential of supportive living environments to foster social integration and to optimise formal and informal networks. (Copies of this article are available from: Haworth Document Delivery Centre Haworth Press Inc., 10 Alice Street Binghamton, NY 13904-1580)
Case management: effects of improved risk and value information
- Authors:
- WEISSER William G., et al
- Journal article citation:
- Gerontologist, 43(6), December 2003, pp.797-803.
- Publisher:
- Oxford University Press
The purpose of this study was to determine the impact on resource use of providing case managers with information on the potential for patients to benefit from home care services. Twenty-four case managers working in the Arizona Long Term Care System (ALTCS) were randomized into treatment and control groups. Members of the treatment group were given patient assessments for 25 ALTCS clients, estimates of the patients' risks for various adverse outcomes, and estimates of the aggregate potential benefit for each patient. Members of the control group were given only patient assessments (as is usual practice) for the same sample of 25 clients. Both groups were asked to independently write nonbinding care plans for each patient. The cost of each case manager's care plans was computed by multiplying standard costs per service times the mix and volume of services prescribed for each patient. Treatment group care plan costs were, on average, lower than control group costs and closely tracked variation in estimated patient risks. Comparison group care plan costs were unrelated to risks. Information about risk and potential benefit can improve targeting of services to long-term-care clients. A prospective study using such an approach is warranted to see if provision of risk and potential benefit information would produce better clinical and economic outcomes.
Caregiver stress and noncaregiver stress: exploring the pathways of psychiatric morbidity
- Authors:
- AMIRKANYAN Anna A., WOLF Douglas A.
- Journal article citation:
- Gerontologist, 43(6), December 2003, pp.817-827.
- Publisher:
- Oxford University Press
This study examines depressive symptoms among adult children of elderly parents; it views the parents' care needs and child's care activities as two separate stressors, different combinations of which may affect both caregiving and noncaregiving family members. A sample of 4,380 women and 3,965 men from the first wave of the Health and Retirement Study was analyzed by use of four alternative forms of multiple regression analysis. Using the Center for Epidemiological Studies Depression scale, respondents reported on their depressive symptoms, as well as on parental disability and care provided by themselves, their spouses, and siblings. Noncaregivers reporting severe parental disability were significantly more likely to experience depression symptoms. Evidence of increased manifestations of depression was not found among those caring for severely disabled relatives; nor was it found among those providing care in the absence of severe parental care needs. Having a caregiving sibling was associated with increased CES-D scores among noncaregivers. this approach to members of a family network regardless of caregiver status, this study allows us to distinguish the magnitude of negative outcomes of serious parental care needs while clarifying the impact uniquely attributable to caregiving activities.
Case management: effects of improved risk and value information
- Authors:
- WEISSER William G., et al
- Journal article citation:
- Gerontologist, 43(6), December 2003, pp.797-805.
- Publisher:
- Oxford University Press
The purpose of this study was to determine the impact on resource use of providing case managers with information on the potential for patients to benefit from home care services. Twenty-four case managers working in the Arizona Long Term Care System (ALTCS) were randomized into treatment and control groups. Members of the treatment group were given patient assessments for 25 ALTCS clients, estimates of the patients' risks for various adverse outcomes, and estimates of the aggregate potential benefit for each patient. Members of the control group were given only patient assessments (as is usual practice) for the same sample of 25 clients. Both groups were asked to independently write nonbinding care plans for each patient. The cost of each case manager's care plans was computed by multiplying standard costs per service times the mix and volume of services prescribed for each patient. Treatment group care plan costs were, on average, lower than control group costs and closely tracked variation in estimated patient risks. Comparison group care plan costs were unrelated to risks. Information about risk and potential benefit can improve targeting of services to long-term-care clients. A prospective study using such an approach is warranted to see if provision of risk and potential benefit information would produce better clinical and economic outcomes.
Intermediate care: it's place in a whole-systems approach
- Authors:
- ASTHANA Sheena, HALLIDAY Joyce
- Journal article citation:
- Journal of Integrated Care, 11(6), December 2003, pp.15-24.
- Publisher:
- Emerald
Considers intermediate care as part of a whole-systems approach to care. It argues that this perspective allows a wider appreciation of the potential benefits of intermediate care, and that this would also be a welcome feature in future research studies. Draws on an evaluation of intermediate care in Cornwall and outlines the central role of intermediate care co-ordination in the whole system. The example of residential rehabilitation is then used to examine how an individual service relates to the system as a whole. Finally, factors that may also influence local systems such as partnership working and rurality are considered; these are seen as important considerations for any other authorities which might seek to replicate the Cornwall approach to intermediate care.
Programme evaluation of 'Young at Heart': examining elderly volunteers' generativity
- Authors:
- SCOTT Jean Pearson, et al
- Journal article citation:
- Journal of Intergenerational Relationships, 1(3), 2003, pp.25-34.
- Publisher:
- Routledge
- Place of publication:
- Philadelphia
The authors conducted a programme evaluation study of “Young at Heart,” a Texas (United States) programme. that places elderly volunteers in childcare settings. The main constructs evaluated in this research-based article are Erikson's generativity (a motivation to guide younger generations) and life satisfaction. The authors compared four groups of elderly persons on these constructs: Young at Heart volunteers, Meals on Wheels volunteers (who deliver food to other elderly persons and thus gain volunteer experience, but not with children), non-volunteers drawn from the general population of one Texas community, and individuals in the same community who volunteered in a variety of activities (“miscellaneous volunteers”). The guiding assumption was that volunteering with children would appear to be a clear expression of generativity; we thus hypothesized that YAH volunteers would score highest in it. Contrary to prediction, the miscellaneous volunteers averaged the highest generativity, followed by YAH volunteers. Philosophical and conceptual issues are identified with regard to research on generativity and intergenerational programming. (Copies of this article are available from: Haworth Document Delivery Centre, Haworth Press Inc., 10 Alice Street, Binghamton, NY 13904-1580).
The state of our art: intergenerational program research and evaluation: part two
- Author:
- KUEHNE Valerie
- Journal article citation:
- Journal of Intergenerational Relationships, 1(2), 2003, pp.79-94.
- Publisher:
- Routledge
- Place of publication:
- Philadelphia
In the second part of this two-part paper, the author examines intergenerational programme research and evaluation based on a framework derived from a collaborative UNESCO (2000)-sponsored review of the intergenerational programme field. In Part One, which appeared in the previous issue, conceptual foundations for intergenerational programming were considered, taking into account theories that focus on individuals and groups within interactive contexts, those that focus primarily on individual development, and conceptually based program evaluations. In Part Two, effects of intergenerational programme participation are described, with emphasis on programme activities and various program contexts. Challenges and questions emerging from the literature are presented, identifying the need for a greater use of theory in research, more cross-cultural research, expanded outcomes, and solutions to some of the methodological challenges in intergenerational programme research and evaluation. (Copies of this article are available from: Haworth Document Delivery Centre, Haworth Press Inc., 10 Alice Street, Binghamton, NY 13904-1580).
Comparison of methods for analyzing longitudinal binary outcomes: cognitive status as an example
- Authors:
- KUCHIBHATLA M., FILLENBAUM G. G.
- Journal article citation:
- Aging and Mental Health, 7(6), November 2003, pp.403-408.
- Publisher:
- Taylor and Francis
Longitudinal data generate correlated observations. Ignoring correlation can lead to incorrect estimation of standard errors, resulting in incorrect inferences of parameters. In the example used here, standard logistic regression, a population-averaged (PA) model fit using generalized estimating equations (GEE), and random-intercept models are used to model binary outcomes at baseline, three and six years later. The outcomes indicate cognitive impairment versus no cognitive impairment in a sample of community dwelling elders. The models include both time-invariant (age, gender) and time-varying (time, interactions with time) covariates. The absolute estimates from random-intercept models are larger than those of both standard logistic and GEE models. Compared to the model fit using GEE that accounts for time dependency, standard logistic regression models overestimate standard errors of time-varying covariates (such as time, and time by problems with activities of daily living), and underestimate the standard errors of time-invariant covariates (such as age and gender). The standard errors from the random-intercept model are larger than those from logistic regression and GEE models. The choice of models, GEE or random-intercept, depends on the research question and the nature of the covariates. Population-averaged methods are appropriate when between-subjects effects are of interest, and random-effects are useful when subject-specific effects are important.
The impact of religious practice and religious coping on geriatric depression
- Authors:
- BOSWORTH Hayden B., et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 18(10), October 2003, pp.905-914.
- Publisher:
- Wiley
Both religiousness and social support have been shown to influence depression outcome, yet some researchers have theorized that religiousness largely reflects social support. We set out to determine the relationship of religiousness with depression outcome after considering clinical factors. Elderly patients (n = 114) in the MHCRC for the Study of Depression in Late Life while undergoing treatment using a standardized algorithm were examined. Patients completed measures of public and religious practice, a modified version of Pargament's RCOPE to measure religious coping, and subjective and instrument social support measures. A geriatric psychiatrist completed the Montgomery-Asberg Depression Rating Scale (MADRS) at baseline and six months. Both positive and negative religious coping were related to MADRS scores in treated individuals, and positive coping was related to MADRS six months later, independent of social support measures, demographic, and clinical measures (e.g. use of electro-convulsive therapy, number of depressed episodes). Public religious practice, but not private religious practice was independently related to MADRS scores at the time of completion of the religiousness measures. Religious coping was related to social support, but was independently related to depression outcome. Clinicians caring for older depressives should consider inquiring about spirituality and religious coping as a way of improving depressive outcomes.