Spiritual Care: Recognizing Spiritual Needs of Older Adults

SUMMARY

This paper explores aspects of spiritual needs and assessment, while emphasizing the importance of aged care providers being spiritually self-aware. The context of this exploration is meaning in life, spirituality and quality of life as experienced by older adults. Depression and dementia are frequently seen among older adults in residential aged care with resultant lowered quality of life. Pastoral and spiritual care may be used effectively to help alleviate depression and support older people who have dementia. However, to be able to provide appropriate spiritual care, spiritual needs should be assessed. Ways of assessing spiritual needs are suggested.     

A Spiritual Screening Tool for Older Adults

Objective The purpose of this non-experimental study was to investigate the reliability and validity of a self-administered screening tool for spiritual distress in older adults. The tool was unique in that items were consistent with a conceptual definition of spirituality presented in the professional literature and supported by theories of behavioral development for older adults. Methods Questionnaires were distributed to residents of a continuing care retirement community participating in a class on spirituality. Results The split-half reliability coefficient was found to be 0.776. Construct validity was established and a cutoff value for spiritual distress was determined. Discussion Tests for reliability and validity demonstrated confidence in use of the tool to screen for spiritual distress in older adults.     

Counselling Older Adults Living in Residential Aged Care Settings: Four Illustrative Case Studies

The role of psychologists and other mental health professionals in long‐term care settings is undefined in Australia. Graduate psychology students receive little training in clinical geropsychology, and residential aged care providers do not routinely employ psychologists within such settings. Further, despite high rates of depression, neurocognitive problems, and other mental health problems, residents are rarely referred for evidence‐based psychological treatment. This article presents four case studies showing how psychology services may be employed in such settings within the context of a postgraduate psychology placement programme. These case studies emphasise the importance of engagement, the use of flexible and individualised treatment approaches, and the involvement of family and professional carers in the provision of psychological services. Psychology services in residential settings can have a positive impact on the care of older adults and their families.     

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.     

Mental Health Concerns of Older Adults Living in Long-Term Care Facilities: An Area of Expansion for MFTs

As baby boomers reach retirement age, the number of older adults living in long-term care will inevitably increase. Living in long-term care often brings psychological, relational, and emotional challenges for older adults, their families, and professional care-providers. Despite these trends and associated challenges, there appears to be an underrepresentation of attention addressing the mental health care of older adults and their families in marriage and family therapy (MFT) literature. Emphasis needs to be turned to assessing the quality and effectiveness of mental health resources for older adults in residential facilities, and to filling the gap where needed services are unavailable. The current review summarizes research addressing residential care for older adults, detailing a) mental health challenges faced by residents, families, and professional care-providers, b) effective mental health treatment options, and c) how MFTs are uniquely suited to working in long-term care settings.     

Personality and Everyday Functioning in Older Adults With and Without HIV

Journal of Clinical Psychology in Medical Settings - In a cross-sectional multi-method study of older adults living with and without HIV (n?=?202; 69.8% HIV seropositive), we tested...     

A Conceptual and Empirical Basis for Including Medical Family Therapy Services in Cancer Care Settings

Psychosocial interventions in oncology settings have largely been individually and group-based despite evidence that a family-based approach fills a treatment gap in the cancer care experience. Medical Family Therapists are trained to address the family as the unit of treatment and provide services that consider family dynamics, reorganization of couple and family roles, and broader systemic issues. This article describes the conceptual bases for Medical Family Therapy services provided in cancer care settings, and reviews research on their implementation and effectiveness. Following a review of the literature, recommendations for studying the effectiveness and efficacy of MedFT in cancer care treatment are detailed.     

Daily Functioning, Health Status, and Happiness in Older Adults

The hypothesis that the degree to which disease disrupts daily functioning is inversely associated with happiness is widely accepted, yet existing literature offers little direct evidence in its support. This paper explores the hypothesized association in a community-based sample of 383 older adults. To assess the degree to which disease disrupts daily functioning we developed a measure—called the freedom-from-debility score—based on four Short Form-12 (SF-12) Health Survey questions explicitly designed to represent “limitations in physical activities because of health problems” and “limitations in usual role activities because of physical health problems.” The results were consistent with the hypothesis. When participants were divided into categories based on their freedom-from-debility score, median happiness scores were monotonically increasing across categories. Controlling for demographic and socio-economic factors as well as health status (measured both subjectively and objectively), a one-point increase in freedom-from-debility score (on a scale from 0 to 100) was associated with a three-percent reduction in the odds of lower-quartile happiness. The results support the contention that health status is one of the most influential predictors of happiness, that the association between health status and happiness depends greatly on the manner in which health status is measured, and that the degree to which disease disrupts daily functioning is inversely associated with happiness.     

Relationship Between Private Religious Activity and Physical Functioning in Older Adults

This study sought to further understand the relationship between physical functioning and use of private religious activity in older adults. Subjects were age 65 or older from urban and rural counties in North Carolina who participated in the Duke University Established Populations for Epidemiologic Studies of the Elderly (Duke/EPESE). A total of 3,851 subjects responded to a question that inquired about their use of prayer, meditation, or Bible reading in 1986. Their response was correlated to number of impairments in activities of daily living (ADLs) (n = 3,791). Subjects who indicated use of private religious activity either dailyor neverhad the greatest number of impairments. Those who prayed or meditated one time per weekhad the least number of impairments. This cross-sectional finding is explained in terms of both changes in private religious activity in response to increasing physical disability and changes in physical disability in response to private religious activity. Previous research has found that prayer is often used as an effective coping mechanism with various sicknesses and chronic conditions. Further studies are needed to examine older individuals' health over time and evaluate their use of private religious activity to see its impact over time on physical disability.     

A Behavioral Health Screening Measure for Use with Young Adults in Primary Care Settings

Many healthcare professionals argue that mental health assessment should be routinely incorporated into young adults' medical health care. This project is an evaluation of the Behavioral Health Screening Measure (BHSM) that could be integrated into a primary healthcare setting to aid in the identification of mental illness in young adults. First, Receiver Operating Characteristics analysis was used to calculate a cutoff score that distinguishes a sample of 134 young adult outpatients and 233 young adult nonpatients. Second, a sample of 120 young adults that completed BHSM was divided into two groups by using the cutoff score. Analyses suggested that the two groups had significantly different scores on various measures of depression, anxiety, and general well-being. Results suggest that BHSM would be a valid screening instrument for detecting emotional problems in young adults.     

Environmental Choice and Control In Community Care Settings for Older People1

This study focuses on the long-term stable levels of environmental choice and control available in community care settings, and explores how variations in these factors affect elderly residents of such settings. New methods to evaluate naturally-existing levels of policy choice and resident control are developed and applied to a representative sample of residential care facilities. The findings showed that residents with more functional resources, and women residents, were inore likely to live in facilities high in choice and control, and that these personal and environmental factors were associated with better resident functioning and more cohesive, independence-oriented social environments with relatively little conflict. Functionallyable residents reacted more positively to high control and women residents reacted more positively to high choice. Investigators who attempt to manipulate perceived control in institutional settings need to consider the existing opportunities residents have to exercise control, as well as the levels of other relevant personal and environmental resources.     

Bartlett Revisited: Reconfiguration of Long-Term Memory in Young and Older Adults

This study was performed after the tradition of F. C. Bartlett (1932), who demonstrated that memory reconfigures over time. The authors investigated the memory of young and older adults to examine the degree to which the aging process influences reconfigurative tendencies. From an initial sample of 53 participants, 20 young and 19 older adults completed 6 tests of recall for Bartlett's original text materials over an 84-day period. Consistent with the broad conclusions of Bartlett's study, reconfiguration was observed: Both young and older adults introduced errors into memory. Older adult recall was lower overall than that of young adults, and recall performance diminished over time. However, there was no difference between the performances of young and older adults with respect to incorrectly recalled intrusive elements.     

Age-neutrality of the NEO-PI-R: Potential Differential Item Functioning in Older Versus Younger Adults

Geriatric researchers and clinicians often have to deal with a lack of valid personality measures for older age groups (e.g., Mroczek, Hurt, & Berman, 1999; Zweig 2008), which hampers a reliable assessment of personality in later life. An age-neutral measurement system is one of the basic conditions for an accurate personality assessment across the lifespan, both longitudinally and cross-sectionally. In the present study, we empirically investigate the age-neutrality of one of the most widely used personality measures (i.e., the NEO PI-R (Costa & McCrae, 1992)), by examining potential Differential Item Functioning (DIF). Overall, results indicate that the vast majority (92.9?% at domain-level and 95?% at facet-level) of the NEO PI-R items was similarly endorsed by younger and older age groups with the same position on the personality trait of interest, corroborating the NEO PI-R??s age neutrality. However, Differential Test Functioning (DTF) analyses revealed large DTF for Extraversion, and facet A6 (Tender-Mindedness). Results are discussed in terms of their implications for using the current format of the NEO PI-R in older aged samples.     

Transcendence,the Most Important Spiritual Need of Muslim Older Adults: A Content Analysis Study

Journal of Religion and Health - Healthcare providers agree that promoting spirituality among older adults while caring for them increases their quality of life. However, there is little knowledge...     

Models for Ministry: The Spiritual Needs of the Frail Elderly Living in Long-Term Care Facilities

ABSTRACT

Litte information has been available pertaining to the spirituality of the institutionalized elderly. This paper presents the self-perceived spiritual needs of the elderly living in long-term-care facilities. Additional information is presented indicating the clergy's perceptions of these needs.

Semi-structured interviews were conducted with resident council members from three nursing homes in western North Carolina. The following three domains of spirituality were covered: (1) relationship to God; (2) relationship to church; and (3) relationship to community. Semi-structured interviews were also conducted with these residents' pastors and other clergy members who minister in these three facilities. Data collected from these interviews indicates a variation between the residents' self-perceived spiritual needs and the clergy's perceptions of these needs.

Data analyses suggested a three-step process of the resident's spiritual journey in the nursing home. This process provided a model describing the spiritual journey of the nursing home resident.     

Improving Memory Knowledge,Satisfaction, and Functioning Via an Education and Intervention Program for Older Adults

Many healthy older adults are concerned about memory change and are interested in learning techniques for enhancing memory function in their everyday lives A memory education and intervention program was developed and administered to 36 community-dwelling older adults Pretest-posttest change scores showed significant improvement on measures of knowledge (ie, general facts about memory, memory strategies), metamemory (ie, satisfaction with memory, self-rated memory ability), and objective memory performance (ie, everyday prospective memory) in comparison to 24 demographically matched control participants Findings support the effectiveness of memory education and training in improving everyday functioning, particularly for older adults whose memory concerns result from inadequate knowledge about memory and aging