The church's response to the severely emotionally distressed

The clergy and church are deeply involved in aiding persons who have emotional problems. Many of those seeking help manifest psychotic symptoms. This paper addresses the issue of how organized religion can better understand and minister to the needs of those suffering severe emotional distress. Programs and models at national and local levels are discussed, with an emphasis upon the latter. Local level models include mental health promoting aspects of local church functions, pastoral counseling programs of the local church, the Wholistic Health Center (WHC), Community Organization for Personal Enrichment (COPE), Christian Action Ministry (CAM), and Mennonite Mental Health Services. Clinical vignettes illustrate the functioning of these models.This work was, in part, done at and supported by the Harvard University School of Public Health, Boston, Massachusetts.     

How Can Ethics Support Innovative Health Care for an Aging Population?

The rapidly expanding aging population presents an urgent global challenge cutting through just about every dimension of worldly life, including the social, political, cultural, and economic. Developing innovations in health and assistive technology (AT) are poised to support effective and sustainable health care in the face of this challenge, yet there is scant (but growing) discussion of the ethical issues surrounding AT for older persons with dementia. Demands for ethical frameworks that can respond to frontline dilemmas regarding AT development and provision, and how the needs of aging persons themselves are defined throughout this development process, are increasing. This article suggests that fulfilling the promises of AT to provide effective and ethically informed solutions may demand shifting away from standard bioethical analyses that centralize the principle of respect for autonomy. An autonomy-centric paradigm is dubiously equipped to theorize the foundational ethical issues in dementia care and to effectively guide AT development and implementation. An agency-centered approach to dementia care, which could engage more adaptively with the perspectives and choices of older persons themselves while offering strong support to AT research and stakeholders, may offer an attractive alternative.     

An Investigation of Quality of Life of the Elderly in South Africa, with Specific Reference to Mpumalanga Province

This paper is based on a research study that investigated the quality of life of elderly persons (aged 60 years and over) in South Africa in the wake of population aging, HIV/AIDS, the process of modernization which ushered in new challenges and the legacy of apartheid. A combination of all these factors among others has played a major role in lowering the quality of life of senior citizens in South Africa. For effective measurement purposes, a conceptual framework of broad categories of quality of life indicators for this proportion of the population are identified as: household structure, social inclusion, care of older persons and care burden on the elderly. Under these broad categories we investigate such specific indicators as: general health; satisfaction with basic needs of food, clothing and housing; emotional well-being; and their environmental harmony regarding access to amenities of transport, sanitation, safe water and security. The influence of socio-demographic factors on the above indicators is also examined. The long term goal of the study is to provide guidance for more creative policies including strategies of poverty reduction, housing older people in a dignified way and providing a wide range of options that facilitate healthy aging, in so doing, catering for the best interests and needs of senior citizens in South Africa. A representative sample of size 900 randomly selected elderly persons in Mpumalanga Province, South Africa is used. Structured interviews and direct observation are used to collect data, and bivariate statistical analyses performed.     

Chapter Six: Individual Responses to a Changing Chinese Society (Taiwan)

Buddhist teachings in general have been widely rnisunderstood as being pessimistic in nature. This paper examines the Buddhist teachings on aging by presenting representative depicfions of aging mainly from the Tibetan Buddhist literature. While on the surface they may present aging in a negative way, the context in which they are to be understood and practiced needs to be considered. Buddhist depictions of aging are meant to be powerful antidotes to the conceit of youth and act as spurs to spiritual growth and realization.     

Description of a Community Involvement Program for Persons with Special Needs

This article describes an extensive community involvement program which is intended to: (1) provide year-round social and recreational opportunities for persons with special needs; (2) support and empower families of these persons; and (3)facilitate community awareness and knowledge about persons with special needs in the Fort Knox (KY) community and region. Initially, the background and context of program development is presented, followed by analysis of need for the progrma, and then delineation of guiding principles which have provided programmatic focus. Next, central program elements are outlined to demonstrate its complexity, integrity, and replicability. Finally, a discussion of the program's implications for other communities is provided.     

Performance of normal elderly on the Boston Naming Test

The Boston Naming Test has enjoyed increasing use in many research studies since its introduction. However, there is little normative data on the age group above 60 years of age. This study presents data from a sample of 58 well-defined healthy elderly males and females between the ages of 60 and 85. In comparison with published normative data, our sample has higher means, smaller standard deviations, and narrower ranges. These results suggest that aging alone does not significantly alter recognition-cued word-finding ability as defined by the Boston Naming Test. Also there is remarkably consistent performance throughout our age range.     

The severely emotionally distressed: A conceptual framework and potential roles for clergy and church

The importance of the clergy in the treatment of emotional distress can not be overestimated. Yet throughout the literature, there is a curious absence of attention to the role of the clergy and church in aiding severely emotionally distressed persons, i.e., those manifesting psychotic symptoms. This study first presents a clinical conceptual framework within which the severely disturbed may be understood. Second, potential roles of the pastor in helping such persons are described, followed by an examination of several common clinical syndromes. Finally, models used by the church on national and local levels to aid the severely distressed are discussed.Dr. Holinger is on the staff of the Psychosomatic and Psychiatric Institute, Michael Reese Hospital, Chicago, Illinois 60616. The research which forms the basis for this paper was done when Dr. Holinger was at the Harvard University School of Public Health, Boston, Massachusetts.     

Crossed aphasia: analysis of four cases

Data from the Rehabilitation Institute of Chicago was used to contrast a sample of 358 aphasics with data from a Boston aphasia and aging study (L. Obler, M. Albert, H. Goodglass, and F. Benson, Brain and Language, 6, 318–322, 1978). Unlike the females, Chicago males showed remarkable similarity to the Boston male sample for the Broca, Wernicke, and Global groups with ratios of approximately four Broca's to every two Wernicke's and Global aphasics. Similar to the Boston Sample, Wernicke's aphasics were 11.6 years older (p < .001) than Broca's aphasics.     

Religion and aging

Life history data and cultural values are used to suggest ways in which personal and social beliefs influence the quality of experiences of aging. Central questions are the extent to which an individual can select beliefs that lead to a longer, more meaningful life and the special influence that religion may have in enhancing aging. Responsiveness to needs of the elderly is a necessary component of enlightened planning for the future. Secularization and industrialization have diminished roles and expectations for the elderly. Religion may be an effective means to identify these concerns and improve the quality of life of older people.     

Successful aging: criteria and predictors

In the Anglo-Saxon scientific literature, successful aging has been consolidated during the last four decades. Nevertheless, several terms have been used as synonymous: healthy, active, productive, optimal, positive aging. Although, all these terms have been described through a broad set of bio-psycho-social factors, usually, research in this field reduces successful aging to daily life functioning and physical health. Also, in spite of the fact that authors consider that determinants might be multi-domain, empirical research usually reduces them to life styles. Logically, the prevalence of this kind of ageing found empirically is not very consistent and research of its determinants or predictors refers to biomedical conditions. In this study, data from 458 participants (170 males and 288 females; mean age: 66.47, range: 55-75) from ELEA ("Longitudinal Study of Active Aging") were examined. The results show (depending on the simple or multidimensional definitions used) a very varied range of proportions of successfully aging older persons as well as a large number of multi-domain predictors of successful ageing, among which are intelligence, personality and motivational psychological characteristics.     

Quality Aging

Our culture has an ageist bias whereby the aged are discriminated against; they are treated stereotypically rather than as individuals. Emphasis on aging's positive aspects, or quality aging, can conteract discrimination at its beginnings. Individuals who are models of quality aging exhibit certain characteristics: they are needed, they belong to a community, and they have good health habits. There is a sense of investent in the future. Quality aging reflects a healthy spiritual life, and is posisble for all aged persons, even the infirm, if they receive the necessary support to remain in community life.     

Global Aging: Challenges for Community Psychology

Older persons are among the major marginalized, disenfranchised citizens worldwide, yet this group has generally been ignored in the community psychology literature. In this paper, we trace the demographic trends in aging worldwide, and draw the field’s attention to the United Nations Program on Aging, which structures its policy recommendations in terms of concepts that are familiar to community psychologists. A central theme of the paper is that community psychology can have a role in producing the conceptual shifts needed to change societal attitudes now dominated by negative age stereotypes.     

Authentic Humor as an Expression of Spiritual Maturity

SUMMARY

Erikson's understanding of ego integrity and Fowler's depiction of conjunctive faith provide theoretical insights into the holistic nature of spiritual maturity. In order to ground the theory in the actual experience of aging persons, this paper demonstrates, how authentic humor represents an expression of spiritual maturity. Authentic humor can articulate the trust, hope and the faith of elders who maintain a sense of meaning and wholeness despite the changes, losses and suffering which often accompany the aging process. Persons who possess the resource of authentic humor experience the paradoxicalities of aging without yielding to despair.     

Regulatory Focus Theory: Implications for the Study of Emotions at Work

Previous theory and research have shown that people have two distinct self-regulatory foci. When promotion focused, people are motivated by growth and development needs in which they attempt to bring their actual selves (their behaviors and self-conceptions) in alignment with their ideal selves (self-standards based on wishes and aspirations of how they would like to be). When prevention focused, people are responsive to security needs in which they try to match their actual selves with their ought selves (self-standards based on felt duties and responsibilities). Strategically, eagerness or ensuring gains predominate for promotion-focused persons, whereas vigilance or ensuring nonlosses predominate for prevention-focused persons. People's regulatory focus influences the nature and magnitude of their emotional experience. Promotion-focused people's emotions vary along a cheerful-dejected dimension, whereas prevention-focused people's emotions vary along a quiescent-agitated dimension. We consider the implications of the relationship between regulatory focus and emotions for such topics as person/organization fit, goal-setting theory, expectancy-valence theory, behavioral decision theory, and employee resistance to organizational change. Possible antecedents of employees' regulatory focus also are discussed.     

Serious mental illness and capitation financing

Traditional organization and financing of mental health care has not adequately served the needs of persons with serious mental illness. Capitation financing is being tested in several localities, but little experimental data has been yielded to date, and it is mixed. The results from the Rochester experiment were positive but limited, and some other pilots also reported positive experiences with capitation. Others have ended prematurely or confronted obstacles. Experimental findings are also anticipated from the Philadelphia and California pilots, and others are just beginning. Existing financing mechanisms, cost-shifting efforts, and professional cultures represent powerful obstacles to successfully implementing capitation financing for care of persons with long-term mental illnesses, and potential incentives to underserve enrollees require adequate accountability structures. In spite of obstacles, the goodness of fit between the needs of persons with serious mental illness and capitation flexibility warrant further exploration of this financing modality.     

Arthritic pain, aging, and psychomotor decline in people with HIV

Arthritic pain and subsequent immobility are common in people with Human Immunodeficiency Virus (HIV) and in persons of older ages. It is hypothesized that such pain may contribute to psychomotor impairment commonly observed with HIV and aging. Empirical evaluation of this hypothesis among older persons with HIV and consideration of treatment should be undertaken.     

Aging and depression

The assumption that aging is associated with an increased risk of depression is a recurring theme in the gerontological literature. Yet empirical studies that have investigated the relation between aging and depression do not show consistent support for this assumption or hypothesis. Indeed, some investigators contend that the thrust of empirical evidence favors a view of elderly persons as relatively immune from depression, at least in contrast to their younger adult counterparts. The present article examines the empirical basis for these disparate claims in the context of a careful review of the growing body of research on the relation between aging and depression. The central conclusion of the review is that diverse measurement approaches, coupled with flaws in design and analysis, make it difficult to draw any definitive conclusions regarding the age-depression relation at this time. The article concludes with a discussion of implications for future research.     

State orientation and memory load impair prospective memory performance in older compared to younger persons

A modified event-based paradigm of prospective memory was applied to investigate intention initiation in older and younger participants under high versus low memory load (subsequent episodic word recall vs. recognition). State versus action orientation, a personality dimension related to intention enactment, was also measured. State-oriented persons show a superiority effect for the storage of intentions in an explicit format but have a paradoxical deficit in their actual enactment. We predicted an interaction between aging, personality, and memory load, with longer intention-initiation latencies and higher omission rates for older state-oriented participants under high memory load. Results were consistent with predictions and are interpreted according to current personality and prospective memory models of aging.     

AN INVESTIGATION OF COMPLIANCE-GAINING AS POLITENESS

This study considers an alternative perspective on the compliance-gaining phenomenon, specifically the theory of politeness articulated by Brown and Levinson (1978). They posit that all interaction is characterized by concern over the other person's autonomy needs and his or her desire to be liked, manifested in message behavior that addresses these needs (i.e., politeness). Brown and Levinson's typology of politeness strategies was translated into 32 items to which 155 respondents indicated likelihood of use and perceived politeness. Respondents assessed the items while imagining themselves in one of eight hypothetical scenarios created to manipulate the three situational factors posited as significant by Brown and Levinson: relationship distance, relationship power, and the magnitude of the request. A factor analysis reduced the 32 tactics to four underlying factors, which in turn served as one variable set for a canonical correlation whose second variable set was the situational factors and the agent's gender. Results indicated that females and persons in close relationships use more polite tactics than males and persons in more distant relationships. Secondarily, results also indicated that persons with power use less politeness than less powerful persons.     

Narcissistic Crises of Aging and Suicidal Despair

After reviewing some of the dangers inherent in oversimplifying the nature of suicide for public education purposes, a model (the “wedding-cake model”) of elderly suicide is outlined. This model is derived from a community-based psychological autopsy study. It is hypothesized that elderly persons who die by suicide have a lifelong character fault that remains invisible until aging life-changes force the issue into the open.