Congregations and Older Adult Resources

This article defines ways in which a community can honor older adults as an invaluable resource to community life. A biographical study of a particular community is undertaken in order to extricate its theological convictions and ethical values. This study underscores the pivotal role of older adults in community function. Moreover, this article challenges scholars, caregivers, congregations to develop theories and strategies of care efficacious for healing.     

Treatment of Depression and Suicide in Older Adults

This article describes a cognitive behavior therapy (CBT) intervention for suicide prevention in older adults. Although many studies have found that CBT interventions are efficacious for reducing depressive symptoms in the elderly, researchers have yet to evaluate the efficacy of such interventions for preventing suicide or reducing suicide risk in older adults. In this article we describe a 12-session CBT protocol for reducing depression, suicide ideation, and other risk factors of late-life suicide. The following aspects of the treatment are described: assessing suicide risk, conceptualizing the problem through a cognitive behavioral framework, developing a safety plan, increasing hope and reasons for living, improving social resources, improving problem-solving skills and efficacy, improving adherence to medical regimen, and relapse prevention. In addition, we review other behavioral and cognitive strategies such as activity scheduling and cognitive restructuring that are commonly associated with CBT interventions for depression. We illustrate the application of these strategies through the use of case examples.     

Building Blocks for Older Adult Ministry

SUMMARY

The final building block is deciding what program fits ministry goals, congregational resources and skills, and the needs of the older adults who will benefit from this ministry. A final form is used to choose, from the many options gathered in the previous steps, which ministries to begin, at this time, for this group of people, with these specific resources, be they congregational resources or those from community collaboration. Choosing target dates for specific tasks and assigning those tasks to specific committee member is crucial for success. The place of attendance in declaring success or failure is discussed. Using the OAM mission statement as a basis for continuing evaluation is suggested.     

Spiritual Need Two: Continued Learning for Older Adults and Older Adult Organizations

SUMMARY

Age provides opportunity not only for a person to grow spiritually, but also for people to enlarge their understandings of the world about them, including God, and connect them to previous learnings and life-experiences. In older age, learning is not merely an affirmation of what has been, but a re-creation of the self in relation to everything that surrounds the person. The theories of James Fowler, Malcom Knowles, Peter Senge, and Erik Erikson provide insight as to the purpose of older adult education. The goal is for churchs to encourage and assist in each person's re-construction of their lives as they view life from the perspective of length of years. Concrete examples of re-constructive learning are provided.     

Acceptance of Conditional Suicide and Euthanasia among Adult Americans

ABSTRACT: Analysis of the attitudes of a 1977 cross-sectional sample of 1,530 American adults concerning euthanasia and suicide indicates that sex, age, and education are significant variables. Males, those who are younger and those who are better educated, are more likely to approve of euthanasia and suicide when a person has an incurable disease. Religious affiliation was not an important variable, although those who were frequent church-service attenders or who were high on religiosity were highly likely to reject euthanasia and suicide.     

Applying Continuity Theory to Older Adult Friendships

Continuity theory provides a rationalization for understanding older adult friendships. Older adults do not have to anticipate disengagement but can exercise their choice to actively participate in establishing and maintaining friendship structures. The role of friend is one a person can choose to maintain. Friendships are dynamic and progress on a continuum with beginnings, periods of endurance and change, and endings. Continuity theory provides ways to understand why particular people have developed and adapted distinct friendship and social support networks. This insight provides social service professionals, gerontologists, and family members ways to enable older adults to remain in their communities longer and maintain support stability.     

3 Culture and Ego-Ideal in Suicide: An Adult Case

A case is presented in which the patient's self-expectations, arising from his ego ideal, were violated by a conflict with his wife, who came from a different culture and did not share his marital and family values. When she left him he was devastated, not only by the loss of his family, but by the destruction of his ideal vision of himself as a husband and father. A dangerous suicide attempt followed. The psychodynamic formulation of the case and the treatment that followed from it are discussed.     

2 Rick: A Suicide of a Young Adult

A small but concerning percentage of completed suicides are seen as having left no clues. The classical case, albeit a literary one, is Robinson's Richard Cory. These people often dissemble, even about their suicide risk. An even smaller group of these individuals present themselves in therapy without communicating a sign of suicide risk. Utilizing an idiographic approach, the case of a young adult male (Rick) is presented. The narrative reconstruction gives voice behind the man's mask. The autopsy reveals a young man who was in deep pain and unable to adjust to life's demands. Rick lacked ego strength, being overly narcissistic and having deeply troubled, symbiotic attachments to his family in a world of interpersonal isolation. In the end, even the help of his therapist, who tried to reach through the mask, was not enough and Rick killed himself. The pain had become unbearable. A few guiding remarks for such cases are offered, noting that therapists must constantly address the dissembling in some suicidal patients.     

Subjective Reports and Postural Performance Among Older Adult Passengers on a Sea Voyage

We sought to evaluate changes in subjective experience and postural performance among older adult passengers during the first 2 days of a sea voyage. On a vacation cruise, volunteer passengers gave verbal ratings of subjective bodily stability and awareness of ship motion followed by performance on the tandem Romberg test while facing fore-aft and athwartship. Data were collected when the ship was at the dock and on each of the first 2 full days at sea. Ship motion reduced subjective bodily stability and performance on the Romberg test and increased awareness of ship motion. On the first day at sea, Romberg performance was more strongly impacted by motion of the ship in roll (i.e., when facing fore-aft) than in pitch (i.e., when facing athwartship). Also on the first day at sea, subjective bodily stability was correlated with Romberg performance when facing fore-aft but not when facing athwart. In summary, at the beginning of the voyage older adult passengers on a sea voyage exhibited consistent changes in subjective awareness and postural performance. Subjective reports were correlated with postural performance in ways that appeared to be functional. We suggest that this finding may help to illuminate the role of conscious awareness within ecological analyses of perception and action.     

Adult ADHD: Associations with Personality and Other Psychopathology

The goals of this study were to explicate adult ADHD’s relations with personality at both the domain and facet levels and to examine its associations with other psychological symptoms. Community members (N?=?294) completed measures assessing ADHD inattentive and hyperactive/impulsive symptoms, five-factor model personality domains and facets, and other internalizing and externalizing symptoms. Inattentiveness showed strong negative relations with conscientiousness and extraversion and strong positive relations with neuroticism; in contrast, hyperactivity/impulsivity related negatively to agreeableness, positively to extraversion, and weakly to neuroticism. Whereas inattentiveness emerged as a positive predictor of internalizing psychopathology—and depression in particular—hyperactivity/impulsivity related weakly to internalizing but more strongly to externalizing psychopathology. Thus, inattentive and hyperactive/impulsive symptoms showed differential relations with personality—at both the domain and facet levels—and with other psychological symptoms. These results demonstrate the value in examining ADHD’s relations with personality facets and with a wide range of psychopathology within the same study.     

Suicide Potential and Behavior in Children Ages 4 to 12

ABSTRACT: From a population of 662 children 12 years of age and under, seen at the UCLA Neuropsychiatric Institute, during the years 1970 to 1974, 34 severely depressed children were identified who were also self-abusive and/or suicidal. Case study revealed fragmented, pathological homes, where the children's affect disorders and behaviors were symptomatic of acute family breakdown, marital disharmony, and observed and experienced violence, both verbal and physical. Follow-up on all available children, at least three years posttreatment, revealed that no child had committed suicide. Treatment evaluation by the parents was highly positive, with the great majority of children showing fair to good recovery and adjustment.     

The Phenomenology of Posttraumatic Distress in Older Adult Holocaust Survivors

This paper focuses on the effects of the Holocaust on its survivors more than 55 years after the end of World War II. The emphasis is on survivors who were either adults during the Holocaust and who are now over the age of 70, or survivors who were children during the Holocaust and whose age is now between 56 and 70. The central question was: What kinds of posttraumatic phenomena are seen in older adult survivors? After an overview of the field, the situation of survivors in Israel is presented in 2 ways. Results of a survey of survivors who were referred to Amcha, the National Israeli Center for Psychosocial Support of Survivors of the Holocaust, is provided to give some insight in a clinical population. In addition, 2 case histories of survivors are presented to give a more in-depth perspective. The gap between the data from the questionnaires and the clinical material has relevance for the way in which we conceptualize the late consequences of massive trauma.