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Occupational therapy with older people
- Author:
- MOUNTAIN Gail
- Publisher:
- Whurr
- Publication year:
- 2004
- Pagination:
- 330p.
- Place of publication:
- London
This book is about older people, and the contribution occupational therapy can make towards the maintenance of their health and the appropriate provision of rehabilitation and care. The aim is to help occupational therapists and those involved in the commissioning of occupational therapy services for older people to target their efforts both sensitively and effectively, and to anticipate the demands which will shape service provision in the future. The entire work is underpinned by current evidence regarding best practice and opinions voiced by older people during several research projects undertaken by the author. The first chapters examine the experience of growing older, from both societal and individual perspectives, the factors contributing towards vulnerability in older age and the provision of services to meet needs. The second part of the book concentrates upon the occupational therapy assessment and treatment processes. The final chapter considers the challenges for occupational therapy.
Factors associated with illegal drug use among older methadone clients
- Author:
- ROSEN Daniel
- Journal article citation:
- Gerontologist, 44(4), August 2004, pp.543-547.
- Publisher:
- Oxford University Press
The overall aims of this study are to describe the life stressors of, exposure to illegal drug use of, and illegal drug use by older methadone clients. The current study focuses on a subsample of the larger administrative data of a methadone clinic that is limited to African American and White clients over the age of 50 (N = 143). A logistic regression model tested the relationship between life stressors, exposure to illegal drug use, and a respondent's ability to remain abstinent from illegal drug use in the previous month. Older methadone clients exposed to illegal drug use in their social networks and neighborhoods were significantly more likely to use illegal drugs in the last month. Although demographic trends in the methadone population indicate that this cohort is aging and that their numbers are growing, little research exists on their well-being and service needs.
Developing and implementing an HIV/AIDS educational curriculum for older adults
- Authors:
- ALTSCHULER Joanne, KATZ Anne D., TYNAN Magaret
- Journal article citation:
- Gerontologist, 44(1), February 2004, pp.121-126.
- Publisher:
- Oxford University Press
Recent data (2002) from the Centers for Disease Control and Prevention indicate that almost 11% of all cases of AIDS were diagnosed in people 50 and older. Despite the steady rise and future projections of increase, there is still a paucity of education and prevention programmes targeting this population. This article reports on the development and piloting of an HIV/AIDS education prevention programme. It describes an educational curriculum that provides older adults with accurate information about the relevance of HIV/AIDS to their lives. A purposive sample (n = 249) of ethnically and economically diverse adults 50 years and older was selected from 14 organizations in rural and urban settings in California. They were surveyed to determine their interest in participating in HIV/AIDS education prevention programmes. A majority of participants reported interest in an HIV/AIDS prevention program for older people, with female respondents more likely to attend than male respondents. Participants who were moderately or very religious were also more likely to attend. Participants expressed preference for prevention education through presentations at centers serving older adults, and from physicians and other health care providers. On the basis of these findings, a specialized curriculum targeting older adults was developed, presented, and disseminated. People 50 years and older are sexually active, lack accurate information about HIV/AIDS, and are in need of HIV/AIDS education.
The Dysfunctional Attitudes Scale: factor structure, reliability, and validity with older adults
- Authors:
- FLOYD M., SCOGIN F., CHAPLIN W. F.
- Journal article citation:
- Aging and Mental Health, 8(2), March 2004, pp.153-160.
- Publisher:
- Taylor and Francis
The Dysfunctional Attitudes Scale Form A (DAS-A), a self-report measure of depression-related attitudes, has been used in numerous depression studies. The DAS-A has a two-factor structure that has been found consistently with college student samples and clinically depressed samples of middle-aged adults, but it has not been validated with older adults. The present study examined the factor structure with a sample of 100 depressed older adults (average age = 68.19; average initial Hamilton Rating Scale for Depression [HRSD] score = 16.72) who participated in a depression treatment study. Results indicated the factor structure established with younger adults was not replicated with older adults. Furthermore, the factor structure with older adults was uncertain: a single factor structure, two-factor structure, and three-factor structure were essentially of equal validity. The uncertainty of the latent structure of the DAS-A suggests that it should be interpreted with caution whenever used with older adults.
Residential substance abuse treatment for older adults: an enhanced therapeutic community model
- Author:
- GUIDA Frank
- Journal article citation:
- Journal of Gerontological Social Work, 44(1/2), 2004, pp.95-109.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
Areview of the epidemiology of substance abuse and corollary treatment capabilities for older adults is summarized. This review demonstrates that there is a growing number of older adults with substance abuse problems, and that a majority of such adults are under-diagnosed and have little access to treatment. Research at Odyssey House, a non-profit, substance abuse and mental health treatment agency based in New York City, where older adults have been treated since 1997 within a discrete residential unit, is reviewed. Findings identify two distinct subgroups among the older adults being treated at Odyssey House: lifelong users (become dependent on drugs during adolescence) and late-in-life users (become dependent on drugs after age 45). Treatment implications are discussed in terms of the provision of special groups, such as trauma and bereavement groups for late-in-life users; and poly-substance abuse and relapse prevention groups for the lifelong users. The Enhanced Therapeutic Community is presented as the primary social group and treatment modality for the effective care of older adults with chemical dependence problems. Two case study vignettes, which mirror the research and group process, are presented.
Evidenced-based treatment for older adults
- Authors:
- CUMMINGS Sherry M., et al
- Journal article citation:
- Journal of Evidence-Based Social Work, 1(4), 2004, pp.53-81.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
This article reviews the outcomes research literature related to individual and group treatments for older adults and their familial caregivers. Empirically based research studies published between 1985 and the present were examined for this review. Results indicate an emerging evidence base of efficacious psychosocial interventions for older individuals and their families. Most consistent support was found for treatments employing cognitive-behavioral, problem-solving, and reminiscence therapies. Many gaps do exist in the literature, however, and replication studies are needed. Implications are discussed.
A comparison of the effects of Snoezelen and reminiscence therapy on the agitated behaviour of patients with dementia
- Authors:
- BAILLON Sarah, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 19(11), November 2004, pp.1047-1052.
- Publisher:
- Wiley
Behavioural disturbance, such as agitation, is a common feature of dementia, and causes significant problems and distress for carers. Snoezelen is increasingly used with people who have dementia, but there is limited evidence of its efficacy. This crossover randomised controlled study aimed to evaluate the effect of Snoezelen on the mood and behaviour of patients with dementia, in comparison to the effect of an established and accepted intervention, reminiscence therapy. Twenty patients with dementia and significant agitated behaviour, received three sessions each of Snoezelen and reminiscence. The effects were assessed using measures of observed agitated behaviour and heart rate over the course of the sessions, and mood and behaviour during the sessions. Both interventions had a positive effect. Snoezelen was no more beneficial than reminiscence in terms of effecting a significant reduction in agitated behaviour or heart rate. There was considerable variation in the way individuals responded to each intervention. Snoezelen may have a more positive effect than reminiscence, but due to the observed differences between the interventions being small, and the small number of subjects, this advantage was not demonstrated statistically. Further research, with larger numbers of subjects, and an appropriate control is required to establish the benefits of Snoezelen for people at different stages of dementia, and to identify any benefits additional to those derived from increased staff attention.
Rural practitioners' experiences in dementia diagnosis and treatment
- Author:
- TEEL C. S.
- Journal article citation:
- Aging and Mental Health, 8(5), September 2004, pp.422-429.
- Publisher:
- Taylor and Francis
When diagnosis of dementia occurs earlier in the disease process, more time is available for treatment aimed at maintaining patient function and delaying decline, and for family education about the disease and its management. Primary care providers often, however, face challenges in making timely diagnoses. Nineteen practitioners in mostly rural areas of a mid-western state were interviewed about their experiences in diagnosis and treatment, to develop a more comprehensive understanding of barriers encountered by providers in non-metropolitan areas. Participants estimated that the time from symptom onset to diagnosis ranged from several months to one year, largely dependant upon family recognition. Limitations in access to consultants and limited or non-existent community support and education resources were major impediments to diagnosis and treatment, respectively. Like their colleagues in more urban communities, denial among family members, or families who were absent or uncooperative, created additional challenges for providers in making and communicating diagnoses and in supporting home-based or institutional care. Conversely, supportive and motivated families played a central role in positive patient care experiences. Participants agreed that support and education services were important for family caregivers, but generally had few resources to offer families, which constrained their ability to provide optimal care. Identifying challenges faced by rural practitioners is essential to planning appropriate interventions for consultative support and educational outreach.
Development and implementation of nonpharmacologic protocols for the management of patients with Alzheimer's disease and their families in a multiracial primary care setting.
- Authors:
- AUSTROM Mary Guerriero, et al
- Journal article citation:
- Gerontologist, 44(4), August 2004, pp.548-553.
- Publisher:
- Oxford University Press
Most patients and families with dementia are cared for in primary care clinics. These clinics are seldom designed to provide the necessary comprehensive care. The purpose of this article is to describe nonpharmacologic protocols for the management of patients with Alzheimer's disease and their families that are administered as part of a multifaceted care-management intervention program in a multiracial primary care clinic. The nonpharmacologic component for the integrated program of collaborative care was developed based on a literature review and previous clinical experience. The care is coordinated by a geriatric nurse practitioner who meets with patients, families, and the primary care physicians. The nonpharmacologic protocols included general educational guidelines about Alzheimer's disease. Specific protocols to treat the common behavioral disturbances associated with Alzheimer's disease also were developed. A major component of the intervention is a monthly psychoeducational support group for caregivers. The intervention has been well accepted by patients, families, and physicians. Approximately one-half of the treatment group has participated in the support group regularly. The integration of behavioural interventions and team care within the primary care environment has been successful.
Presentations and management of Post Traumatic Stress Disorder and the elderly: a need for investigation
- Author:
- BUSUTTIL Walter
- Journal article citation:
- International Journal of Geriatric Psychiatry, 19(5), May 2004, pp.429-439.
- Publisher:
- Wiley
With an aging population increasing presentations of cases of Post Traumatic Stress Disorder (PTSD) can be expected to old age services. While progress has been made in recent years in relation to the understanding and development of aetiological theories, classification, assessment and management strategies and protocols in the adult population, similar advances have lagged behind for the elderly. The aim was to review the adult literature regarding PTSD and discuss how this might apply to an elderly population. An attempt is made to highlight a better awareness of the field of psychological trauma in the elderly in the hope of stimulating debate and research. A review of the adult literature is conducted relating to classification, aetiology, demographic features, vulnerability, assessment, clinical management including psychotherapy and medications and how these may apply to the elderly. Little has been published in this field that directly relates to the elderly. The adult literature allows insight into understanding how PTSD may present in the elderly, and how they may be managed. Further specific research is needed in the elderly in order to facilitate a better understanding of PTSD that present in this unique population. This will lead to better clinical assessment, management and treatment provision.