Systematic Monitoring of the Implementation of a Case Management Model

A systematic approach for monitoring case management service provision and the results obtained when this approach was applied to a program for community-dwelling elders with severe mental illness are presented. A detailed, closed-ended, daily service log was used to collect data on 713 client-contact days. Participants (N = 24) were predominantly female (71%), were White (63%) or African American (37%), and tended to have diagnoses of either schizophrenia (42%) or major depression (21%). Services were delivered most frequently in the client's home (47%), the program office (35%), or by phone (27%); most frequent activities were monitoring psychiatric symptoms/medications (62 %), and monitoring physical symptoms or medications or both (54%). Service characteristics did not differ with regard to demographics but did vary with living situation and psychiatric diagnosis. The findings point to the need for flexible programs capable of meeting diverse service needs as well as the utility of a daily service log in studying case management.     

When Psychologists Work with Older Adults: A Survey of Ethical Beliefs and Practices

Despite the number of publications concerning legal and ethical issues faced by psychologists, and despite the increased interest in addressing specific concerns related to aging, little is known about the actual beliefs and practices of psychologists when they work with older adults. Given the changing demographics in the United States, many mental health professionals will have contact with older adult clients, and the focus of the present study was to examine the extent to which psychologists are prepared to work competently with older adult clients. Survey data were collected from 156 APA Division 12 (Clinical Psychology) and 17 (Counseling Psychology) members regarding the degree to which they engaged in each of 50 behaviors and the degree to which they considered each behavior ethical. Findings are presented in terms of percentages of responses to items on the questionnaire, and ANOVAs were performed on important demographic items to identify statistically significant differences among variables. Coursework in geropsychology or aging, specialization with older adults, and working with a high percentage of older adults were related to higher scores on the Overall Ethical Behavior scale. Females scored higher than males on the Overall Ethical Belief scale.     

Counseling Older Adults with Dementia: A Survey of Therapists in Massachusetts

Although much has been written about therapeutic interventions with caregivers, little is known about the counseling services that are available for victims of dementia. The present study was designed to explore community mental health center (CMHC) services and therapists' experiences in providing psychotherapy to this population in Massachusetts. Only 27 of the 36 CMHCs in the state reported providing mental health services to older adults with a dementing illness. A survey of therapists who specialized in working with older adults found that the percentage of older adult clients estimated to have dementia averaged about half of their caseload. Older persons in the early phase of a dementing illness were most frequently referred for depression and anxiety, whereas those with moderate decline were most frequently referred for management of disruptive behavior. The most common services provided to clients with dementia consisted of assessment and individual counseling. The latter finding indicates a discrepancy between what is practiced and the professional literature. Most of the psychotherapy described in the literature concerns group interventions, which were rarely provided by the mental health centers in Massachusetts. The centers tended to offer individual counseling; however, little information on how to provide this form of treatment can be found.     

Androgyny and Adjustment in Later Life: Living in a Veterans' Home

This study builds on literature that suggests that interaction with friends in later life is important to the well-being of older adults and other research that argues that androgynous individuals may have a greater range of social skills with which to further their adjustment. We apply these arguments to later life through interviews from a pilot sample of 27 residents in a state-operated veterans' home. Findings suggest that women, who often hold high expectations for the interpersonal domain, are more likely to experience adjustment problems than are men. Men, who may have lower expectations for friendship and intimacy, seem less likely to report dissatisfaction, regardless of gender characteristics. A typology of adjustment and androgyny in later life is developed.     

How Effective is the Enhanced Cognitive Interview when Aiding Recall Retrieval of Older Adults including Memory for Conversation?

The percentage of older adults in the general population is growing. As a result, older adults are coming more frequently into contact with the Criminal Justice System as witnesses to and victims of crime. Older adults are also over‐represented in crimes where conversation detail is of particular importance to an investigation (e.g. distraction burglary). The present study therefore examined the efficacy of cognitive interview (CI) compared with structured interview in improving the recall of an event by older witnesses, specifically conversational detail. Young adults (19–54 years old), young‐old adults (60–74 years old), and old‐old adults (75+ years old) were asked to watch a short film of a laptop theft and were then, after a 1.5 hour delay, randomly allocated to one of two interview conditions. It was found that the CI significantly increased recall of all age groups, without increasing the amount of incorrect or confabulated information reported. The individuals in the young adult and the young‐old adult conditions were found to remember significantly more than the individuals from the old‐old adult condition, without decreasing the accuracy of the information. The CI enhanced memory for conversation gist, person and action detail. Results will be discussed in relation to interviewing and investigating practices. Copyright © 2011 John Wiley & Sons, Ltd.     

Does Social Drinking Affect Memory in Older Adults?

The present study examines the possible impact of drinking status on objective memory performance in older adults. Subjects were 214 seniors who were participating in a memory research project and had been screened for cognitive impairment. Cognitive measures included the California Verbal Learning Test (CVLT) and the visual reproduction subtest of the Wechsler Memory Scale–Revised. Drinking status classification (i.e., abstinent, past drinker, light drinker, moderate drinker, and problem drinker) was based on the Alcohol Use Disorder Identification Test scores for the past year and report of past drinking history. Very few subjects were classified in the problem group, with the majority abstaining in the past year. Findings indicated that problem drinkers differed from moderate social drinkers on immediate visual memory, and also had a trend for more retroactive interference on the CVLT. There was no evidence that moderate social drinking (average 13.6 standard drinks) had an adverse impact on memory in this population.     

The Life Reflection and Consequences of Older Adults' Relationships: An Empirical Study

Fifty‐eight Austrian adults, ages 65 to 99 years, participated in semistructured life reflections regarding their relationships with life partners, children, relatives, and friends. This study identified the consequences of the reflections, the implementation of the consequences, and the degree to which participants were satisfied with the life changes they made.     

老年人社会支持与期望的调查研究

运用问卷调查法,通过对272名城市老年人的调查,考察了老年人的社会支持与期望的现状及其特点。结果发现:老年人的社会支持系统很不平衡,性别、年龄、受教育年限和职业对老年人的婚姻和家庭生活,人际关系和互助行为,住房情况和经济状况,以及心理需要和社会期望等具有不同的影响;相当比例的老年人在不同侧面尚需要家人和社会的关注、理解和支持。     

My Grandmother's Personality: A Posthumous Evaluation

The author's grandmother's personality is investigated posthumously through the use of a significant-other form of the Coolidge Axis II Inventory (CATI) designed for the assessment of personality disorders. The CATI was given to the three surviving children (ages 80, 78, and 76). The oldest child had the highest mean correlation across 13 personality disorders with both of her sisters (r = .67) and the youngest child had the lowest (r = .47). The three highest mean T scores across all three raters were Sadistic (71), Self-defeating (68), and Borderline (67). The parameters of accuracy for significant-other ratings are discussed.     

Alcohol Use Among Older Adults

Alcohol use problems among older adults have been called the "invisible epidemic." As the population of older adults continues to grow, there is an increased need to reexamine alcohol use in this population. The authors provide an overview on alcohol use in the over-60 age group. The main areas of focus included research on the prevalence of drinking in that population, as well as comments on the best practices in assessment and psychological treatment. Several screening assessments have been recommended for use with older adults, such as the CAGE questionnaire, Michigan Alcohol Screening Test-Geriatric version, Alcohol-Related Problems Survey, and the Alcohol Use Disorders Identification Test. The authors note age-appropriate psychological treatment interventions that include brief interventions, family interventions, motivational counseling, and cognitive behavioral therapies. Barriers to assessment and treatment are also discussed.     

老年抑郁症的症状、诊断及测量

对老年抑郁症的症状、诊断和测量的探讨有利于寻找更有效的治疗方法。文章在简要讨论老年抑郁症主要症状以及诊断特点的基础上,重点介绍老年抑郁症的测量工具。文章指出,开展老年抑郁症研究的多学科研究,运用认知神经科学方法深入研究老年抑郁症,制订相对独立的老年抑郁症的分类标准,结合老年抑郁症患者身心特点开发更简便可靠的老年抑郁症量表,将有利于老年抑郁症的进一步研究。     

Views of Aging African American Women: Memories Within the Historical Context

This article examines the generational experiences of older African American women using case studies of two women born in 1911. Through the telling of their life stories, these women recount their memories of their own lives. By viewing their life histories within the larger historical context, we gain a clearer understanding of their life experiences and their perspectives as older African American women. These women lived through the Jim Crow era of blatant racial discrimination and segregation in the South and raised their children in this environment. The segregation statutes, or Jim Crow laws, were the public symbols and constant reminders of the subordinate position assigned to African Americans, and the code lent the sanction of law to a racial separation that extended to churches, schools, housing, jobs, eating and drinking. Using a lifecourse perspective, the past is viewed within the context of the present, considering historical and cohort factors that have affected the life situation of individuals. Through the women's telling of their life stories, they outline the chapters of their lives and describe how their experiences have made them the strong older women they are today and helped shape their values.