The Loss of Aging Identity: Social Theory, Old Age, and the Power of Special Hospitals

Medical and health languages have emerged as master narratives used to police the identities that older offenders adopt in contemporary special hospitals such as Broadmoor, Rampton, and Ashworth, in the United Kingdom. Both contain continually changing technologies that function to mediate relations between older offenders and special hospitals. Medical and institutional discourses have been presented as reducing limitations associated with psychiatric disorders. This represents an increase in professional control that can be exerted on inmates' lifestyles in special hospitals which extends to the surveillance and governance of older persons in such secure settings. It is evident that the use of the indeterminate sentence, compulsory treatment prevents older offenders from rehabilitation. The process of treatment is to transform, discipline and normalize their behavior. In order to achieve normalization, coercive forms of treatment are invoked from informal social rules to the use and overuse of psychothropic drugs. Mentally disordered older offenders are placed under the gaze of perpetual surveillance but find ways of negotiating, resisting, and subverting that gaze. Furthermore, this article illuminates how the aging body and the use of time become other sources of punishment, which are pivotal to the structural organization of secure settings in the United Kingdom.     

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.     

Age Differences in Risk: Perceptions,Intentions and Domains

Although it is commonly assumed that older people are more cautious and risk averse than their younger counterparts, the research on age differences in risk taking is mixed. While some research has found that older adults are less risk seeking, other research has found the opposite or no differences. One explanation is that age differences vary across risk domains. In two studies, we surveyed three adult age groups ranging in age from 18 to 83 on their risk perceptions and intentions of risky behaviors across several domains. Our studies showed that compared with young adults, older adults tend to see more risk in behaviors in health and ethical domains but less risk in behaviors from the social domain. A similar pattern occurred for participants' intentions of engaging in the risky behaviors. Older adults rated risky behaviors from health and ethical domains as less enjoyable and less likely to produce gains than young adults, whereas they rated risky behaviors from the social domain as more enjoyable, less unpleasant, and less likely to produce losses than young adults. These results suggest that age differences in risk preferences may vary across domains and may result from differing motivations. Copyright © 2015 John Wiley & Sons, Ltd.     

The Impact of Spirituality on Wellness for Appalachian Older Adults

The authors examined the role spirituality can play as a protective factor in the wellness of older adults residing in the Appalachian region of the United States. Analysis of participants' interviews identified 4 themes. These themes and implications for counselors working with Appalachian older adults are discussed.     

认知训练对健康老年人认知能力的影响

近年来,认知训练被广泛应用于防治和延缓老年人的认知功能衰退。通过总结近7年(2008~2014年)关于老年人认知功能训练的研究,比较训练的有效性、训练效果的迁移和保持,结果表明,大部分实验都发现了积极的即时训练效果,训练效果得到保持的研究以认知控制和综合认知能力训练为主;大部分的迁移都集中在与流体智力联系较密切的认知功能如工作记忆和注意力等上;部分研究探索了认知功能提升的大脑神经可塑性基础。未来研究应进一步将行为训练与神经测量手段相结合考察训练效果的迁移与保持,更加注重个体差异的影响,并深入考察认知训练对日常生活能力的迁移。     

Increasing walking among older people: A test of behaviour change techniques using factorial randomised N-of-1 trials

Objective: Evaluations of techniques to promote physical activity usually adopt a randomised controlled trial (RCT). Such designs inform how a technique performs on average but cannot be used for treatment of individuals. Our objective was to conduct the first N-of-1 RCTs of behaviour change techniques with older people and test the effectiveness of the techniques for increasing walking within individuals.

Design: Eight adults aged 60–87 were randomised to a 2 (goal-setting vs. active control) × 2 (self-monitoring vs. active control) factorial RCT over 62 days. The time series data were analysed for each single case using linear regressions.

Main outcome measures: Walking was objectively measured using pedometers.

Results: Compared to control days, goal-setting increased walking in 4 out of 8 individuals and self-monitoring increased walking in 7 out of 8 individuals. While the probability for self-monitoring to be effective in 7 out of 8 participants was beyond chance (p = .03), no intervention effect was significant for individual participants. Two participants had a significant but small linear decrease in walking over time.

Conclusion: We demonstrate the utility of N-of-1 trials for advancing scientific enquiry of behaviour change and in practice for increasing older people’s physical activity.     

Social cognition is not associated with cognitive reserve in older adults

Social and general cognitive abilities decline in late life. Those with high cognitive reserve display better general cognitive performance in old age; however, it is unknown whether this is also the case for social cognition. A total of 115 healthy older adults, aged 60–85 years (m = 44, f = 71) were assessed using The Awareness of Social Inference Test (TASIT-R; social cognition), the Lifetime of Experiences Questionnaire (LEQ; cognitive reserve), and the Wechsler Abbreviated Scale of Intelligence (WASI-II; general cognitive ability). The LEQ did not predict performance on any TASIT-R subtest: Emotion Evaluation Test (β = -.097, p = .325), Social Inference – Minimal (β = -.004, p = .972), or Social Inference – Enriched (β = -.016, p = .878). Sensitivity analyses using two alternative cognitive reserve measures, years of education and the National Adult Reading Test, supported these effects. Cognitive reserve was strongly related to WASI-II performance. Unlike general cognitive ability, social cognition appears unaffected by cognitive reserve. Findings contribute to the emerging understanding that cognitive reserve differentially affects individual cognitive domains, which has implications for the theoretical understanding of cognitive reserve and its brain correlates. Cognitive measures unbiased by cognitive reserve may serve as best indicators of brain health, free of compensatory mechanisms.     

Religious and spiritual struggle: prevalence and correlates among older adults with depression in the BRIGHTEN Program

Older adults (OA) are more religious and/or spiritual (R/S) than younger adults, but some experience R/S struggle which is associated with poorer quality of life. Little is known about R/S struggle in community dwelling OA. This study examines prevalence, correlates, the association with depression for R/S struggle, and a desire for spiritual care in community dwelling OA with depression. In a programme for integrating care for these OA, 188 participants provided demographic information along with the Geriatric Depression Scale and a tool screening for potential R/S struggle. Prevalence of potential R/S struggle was 50%. The younger OA and Caucasian individuals vs. Hispanic individuals were more likely to experience potential R/S struggle. A relationship of potential R/S struggle with depression persisted with the inclusion of controls. Of those with potential struggle, 52% wanted to see a chaplain. Screening for potential R/S struggle can play an important role in choosing specific interventions for OA with depression.