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Objectives: The study examined major diatheses and stressors directly related to suicidal ideation among elderly Korean immigrants. The study also explored the significant interactions among these factors.Method: Data were collected from a cross-sectional survey of 220 elderly Korean immigrants (age ≥ 65) in Los Angeles County.Results: Using a robust hierarchical regression, the study found that neuroticism and hopelessness were significantly associated with suicidal ideation. In addition, two interaction terms – neuroticism by hopelessness and neuroticism by acculturation – were both significant predictor variables with strong explanatory power.Conclusion: The theoretical implications as well as the practical implications for developing and implementing late-life suicide prevention strategies are discussed. [ABSTRACT FROM AUTHOR]

Objectives:The purposes of this study were to explore elderly outpatients’ perceived reasons for, opinions of, and suggestions for elderly people considering suicide in Taiwan.Method:Elderly outpatients (N= 83) were recruited in 2011–2012 by convenience sampling from three randomly selected medical centers in Taiwan. Data were collected in individual interviews using a semi-structured guide and analyzed by content analysis.Results:Findings revealed that most participants had heard of elderly suicide, with television news as the main source for their information. Their opinions about elderly suicide reflected judgmental attitudes, negative emotional reactions, expectations of social welfare, and could happen after losing one's meaning in life. Their suggestions for elderly people considering suicide fell into four major themes: give up suicidal ideas, seek help, enhance social welfare, and attend religious activities.Conclusion:Since television news was the main source for participants’ information about elderly suicide, this mass medium should be used in suicide prevention to disseminate suicide knowledge, increase access to help, and strengthen suicide-protective factors among the elderly. Furthermore, no participants mentioned depression as a reason for attempted or completed suicide among older people despite depression being a well-known suicide-risk factor. Future suicide-prevention programs should emphasize the role of depression in suicide among older people. Participants also did not suggest that older people considering suicide seek help from the health system. Thus, older people should be educated about the role of the health system in suicide prevention and trained as gatekeepers to recognize signs of suicide ideation and respond appropriately. [ABSTRACT FROM PUBLISHER]

Objectives: This is the first known study that sought to understand the experience of an eight-week art-gallery-based interventionoffered at two distinctly different galleries for people with mild to moderate dementia and their carers. The study examined impact on social inclusion, carer burden, and quality of life and daily living activities for a person with dementia. Method: A mixed-methods pre-post design using standardised questionnaires and interviews involved 24 participants (12with dementia) and compared similar interventions at a traditional and a contemporary art gallery. Qualitative data was analysed using thematic analysis. Results: No significant pre-post difference was found between the traditional or contemporary gallery groups on quantitative measures. There was, however, a non-significant trend towards a reduction in carer burden over the course of the interventionfor both gallery groups. Thematic analysis revealed well-being benefits from both traditional and contemporary art gallery sites that included positive social impact resulting from feeling more socially included, self-reports ofenhanced cognitive capacities for people with dementia, and an improved quality of life. Conclusion: Participants were unanimous in their enjoyment and satisfaction with the programme, despite the lack of significancefrom standardised measures. Further consideration of art galleries and museums, as non-clinical community resources for dementia care, is warranted. The interventions at both galleries helped to foster social inclusion and social engagement, enhance the caring relationship between the carers and PWD, support the personhood of PWD, and stimulate cognitive processes of attention and concentration. [ABSTRACT FROM AUTHOR]

Objectives:The primary purposes of the present study were (1) to assess the living arrangements among urban Chinese elders, (2) to examine the relationship between household living arrangement and elders’ mental health, and (3) to investigate how individuals’ neighborhood identity affects their mental health. Method:The random sample was collected in 2011, including 939 respondents aged 60 and above who lived in the Jing’an district of Shanghai, China. The study examined well-being and depression of elders. The domestic living arrangements were assessed by a single item with five options: ‘With whom are you living together?’ The neighborhood identity was measured by four items: the sense of belonging, the sense of pride, volunteer work, and monetary donation for the neighborhood. Results:Urban Chinese elders’ living arrangement had transited from a traditional intergenerational co-residence pattern to a more self-independent style. However, living with children was positively associated with elders’ mental health after controlling for demographic variables. Although the neighborhood identity had no interaction with living arrangement, it also contributed to elders’ mental health. Conclusion:The study highlighted the importance of living with children and spouse, the sense of belonging, volunteer work, and the feelings of pride on elders’ mental health. Results of the current study suggested implications for both government and non-governmental organizations to design family-based support for eldercare and improve neighborhood identity for elders. [ABSTRACT FROM PUBLISHER]

Background:Researchers have demonstrated that adult day services (ADS) benefit elders with dementia and their caregivers, but they have also observed infantilization that diminishes personhood. Many ADS are socially constructed as places for incompetent elders, where clients are labeled as child-like dependents. Most ADS research has been performed in Western society; little is known about ADS in Asian countries. The Taiwanese Government seeks to expand ADS availability to meet the needs of an aging population; researchers must examine their ADS environments and practices to inform program development and expansion that supports respectful elder care. Objectives:Elders’ experiences of daily life were examined within the physical and social environments of one social and one medical model ADS in Taiwan. The ecological model and place rules informed our research framework. Methods:Ethnographic data were analyzed for themes reflecting our framework with attention to physical and social environment and staff–client interactions. Results:The social model center included unique environmental features, such as a temple, indicating the purpose of different areas. Staff treated clients like family, sometimes to clients’ detriment, providing limited privacy and demanding compulsory activity participation. The medical model center with nurse's station and institutional furniture reflected a hospital-like environment and fostered a patient–nurse relationship. Staff inattention actually created opportunities for autonomy among some clients. Conclusion and discussion:Physical features and social interactions within Taiwanese ADS reflected infantilization similar to that seen in the US and uniquely embedded within a traditional cultural background. Our findings reveal a tension between physical and social care features reflecting Eastern traditions of respect for elders and western traditions of institutional care. [ABSTRACT FROM PUBLISHER]

Objectives:Silicosis is a fibrosing and irreversible lung disease. In China, 9870 new silicosis cases were reported in 2010. The physical and mental status of patients with silicosis should be paid attention to. The aims of this study were to evaluate the influence of the patients’ functional capacity on subjective well-being (SWB) and quality of life (QOL), provide the scientific basis for further intervention measures, and improve their health status. Methods:We investigated 324 inpatients with silicosis during April 2011 to September 2011. The 6-minute walk test (6MWT) was the major methodology used to evaluate the functional capacity, the SF-12 (Short Form-12) to evaluate the QOL, and the MUNSH (Memorial University of Newfoundland Scale of Happiness) scale to evaluate the SWB. Results:The distance of 6MWT suggested a significant and positive correlation with SWB and QOL of patients with silicosis (P< 0.01). In China, patients with silicosis had low SWB and QOL. Conclusions:The SWB and QOL of patients with silicosis are still relatively low and their health status needs improvement. At the same time, longer distances walked by patients suggest more positive influences on their SWB and QOL. It indicates that when the 6MWT cooperates with SWB and QOL, it may be able to get more accurate evaluation results of patients’ survival status. [ABSTRACT FROM PUBLISHER]

Objectives:To investigate the prevalence of insomnia (DIS: difficulty initiating sleep; DMS: difficulty maintaining sleep; and EMA: early morning awakening), its socio-demographic and clinical correlates, and the treatment patterns in older adults in rural China. Method:A sample of 263 subjects was recruited in Mianyang and interviewed using standardized instruments. Basic socio-demographic and clinical data were collected. Results:The expected mean total sleep time (TST) of the whole sample was 6.8 ± 2.2 hours, and the actual mean TST was 6.3 ± 2.1 hours. The 1-year prevalence of at least one type of insomnia was 7.6%; the rates of DIS, DMS, and EMA were 5.7%, 7.2%, and 6.8%, respectively. On multivariate analyses, female sex and psychiatric disorders were independently associated with more frequent insomnia. Conclusion:Insomnia is not uncommon in older adults in rural China, and the low percentage of subjects treated suggests that improved access to treatment might be indicated. [ABSTRACT FROM PUBLISHER]

Objectives: Researcher, clinical professional and lay understandings of the meaning of trauma may differ. An awareness of older people's perspectives on trauma may be important, given the potential for historical and cultural features to shape how the term is conceptualised among this group, thereby influencing related help-seeking behaviour. Method: Older people living in Essex, Cambridgeshire and Suffolk were interviewed about their perceptions of the term, as was a group of mental health professionals who work with the elderly. Results: Many older people regarded significant adversity as just part of life, with collectively understood methods of avoidance or limited support-seeking pointing to emotional management through non-disclosure. This position seemed further informed by views that disclosure may be self-indulgent, which is in stark contrast to the historical and cultural background in which many older people were raised. The professionals also suggested that some older people may be unused to expressing their emotions. The concept of trauma seems to be relative, with stigma and shame appearing to influence the way that responses to adversity are managed by this age group. Conculsion: We conclude that focused history taking by clinicians may be needed to help elicit symptoms of trauma among elderly patients, while at the same time services might engage in a compassionate dialogue to encourage those suffering in silence to seek help. [ABSTRACT FROM AUTHOR]

Objective:The aim of the analysis is to assess the impact of privately employed migrant care workers (MCWs) on the burden of Italian family members who care for a disabled older person. Methods:EUROFAMCARE is a one-year prospective survey carried out to provide evidence on the availability and use of support services by family carers of older people in Europe. In Italy, 990 family caregivers were enrolled and successful follow-ups were completed for 863 subjects. The survey also assessed the level of caregiver burden using the COPE index, which has three sub-sections: ‘Positive Value’ (PV), ‘Quality of Support’ (QS) and ‘Negative Impact’ (NI). We used the one-year change of the COPE-NI as dependent variable and we realised multilevel regression models to estimate the longitudinal predictors of caregivers’ burden increase. Results:At a cross-sectional level, most burdened caregivers are those caring for a demented relative (COPE-NI = 13.6), with no educational title (14.5) and looking after their own spouses (15.1). Longitudinally those employing an MCW are significantly protected against burden increase (regression coefficient: −1.52;p< 0.01) while those who cannot rely on the support of other family members are exposed to the risk of burden increase (0.991;p< 0.05). Other formal services do not have any protective effect. Conclusion:Our study suggests that employing an MCW, rather than using formal services, is associated with a reduction of caregiving burden. Further research should assess whether the shift in care responsibilities to the MCWs also implies a transfer of care burden, and understand how these workers can be better supported by existing formal services. [ABSTRACT FROM PUBLISHER]

Objectives:This Australian study examined individual experiences of the implementation of the Capabilities Model of Dementia Care (CMDC) and subsequent outcomes for the care of residents with dementia living in long-term care. Furthermore, this study aimed to explore those factors that facilitated and inhibited the implementation of the new model of care. Methods:The CMDC was developed and then tested in a non-randomised clinical trial. Staff, residents and family experiences of their involvement and perceptions of the model were captured at the end of 12 months. Semi-structured interviews and focus groups were conducted with the 25 participants (12 nursing staff, 6 residents with dementia, 7 family members). Questions varied depending on the participant group but were designed to assess experiences of and changes to care during the intervention. Inductive thematic analysis was used to identify the experiences of the implementation of the CMDC. Results:Five themes included: general reflections on nursing care, implementation of the CMDC intervention, positive outcomes of the CMDC intervention, challenges in the implementation of the CMDC, difficulty sustaining care and tensions between participants’ perspectives of care. Conclusion:Positive change resulted from implementation of the CMDC, however, staff mentorship was identified as a key to sustaining changes in practice. [ABSTRACT FROM PUBLISHER]

Objectives:Psychological consultation is becoming increasingly common within older adult mental health and dementia services. However, there is very little research that examines the impact or effectiveness of this method of working. This study explored how psychological consultation impacted on the daily practice of staff working on mental health and dementia inpatient units. It also examined the mechanisms that enabled this process. Method:Given the lack of current literature in this area, an exploratory qualitative design was employed. Ten staff who had received psychological consultation were individually interviewed. Staff comprised qualified and unqualified staff from a range of professions, and worked on older adult mental health or dementia units. Interviews were subject to thematic analysis. Results:Five themes were identified from the analysis: (1) ‘It makes you understand the reasons why people are like they are’; (2) ‘It depends on the patient or service user’; (3) the importance of visibility and accessibility; (4) impact of psychology consultation on the effectiveness of the team; and (5) impact of psychology consultation on feelings invoked in the workplace. Conclusions:The findings suggest that psychological consultation impacted on staffs’ daily practice in a variety of ways. Psychological consultation also appeared to increase team efficiency. Less positive findings were identified within the dementia setting. Specific recommendations are drawn from the conclusions to further guide clinical psychologists working within teams. Direction for future research in the area of psychological consultation is also suggested. [ABSTRACT FROM PUBLISHER]

Personality traits have been shown to influence suicidal behaviour but the literature on ‘older’ elderly is sparse. The aim was to compare neuroticism and extroversion in hospitalized suicide attempters aged 75 and above and a general population comparison group. Seventy-two hospitalized suicide attempters (mean age 81 years) were interviewed. Comparison subjects were drawn from participants in population studies on health and ageing. Participants completed the Eysenck Personality Inventory (EPI) and symptoms of depression were rated with the Montgomery–Asberg Depression Rating Scale (MADRS). Depression diagnoses were made in accordance with Diagnostic and Statistical Manual of Mental Disorders, fourth edition. Attempters scored higher on the neuroticism scale than comparison subjects (mean = 9.9 vs. 7.6,t = 3.74,df = 358,p < 0.001) and lower on the extroversion scale (mean = 10.8 vs. 12.0;t = −2.76,df = 358,p = 0.006). While these differences did not remain after adjustment for major depression, attempters with minor depression were less neurotic than comparison subjects with this diagnosis (mean = 6.6 vs. 11.1,t = −3.35,df = 63,p = 0.001) and a negative association with neuroticism remained in a multivariate model. In conclusion cases scored higher on neuroticism and lower on extroversion compared to comparison subjects. The finding that attempters with minor depression werelessneurotic than comparison subjects with this diagnosis was unexpected and needs to be examined in larger samples. [ABSTRACT FROM PUBLISHER]

International policy initiatives have highlighted the need to include older lesbian, gay, bisexual and transgender (LGBT) issues in the provision of appropriate health and social care. However, empirical studies in the area remain sparse. The aim of this study was to investigate the experiences and needs of LGBT people over the age of 55 years living in Ireland and this article reports on specific mental health issues. Mixed methods were used involving 144 surveys and 36 semi-structured in-depth interviews. The findings revealed that a significant number of the survey respondents had experienced a mental health problem at some point in their lives with interview participants providing further details of their concerns. It is recommended that policy makers address the mental health needs of older LGBT people in future strategic directives and develop standards of care that support the principles of equality, inclusion and respect for diversity. [ABSTRACT FROM AUTHOR]

Objectives: Higher-level competence is crucial for healthy and socially independent living, and general intelligence may underlie heath status. The aim of this study was to elucidate associations between general intelligence and higher-level competence in elderly individuals without dementia. Methods: A total of 207 community-dwelling elderly persons, aged 70–74 years, were enrolled. A personal interview was performed to obtain data on socio-demographic and medical factors; higher-level competence was evaluated using the Tokyo Metropolitan Institute of Gerontology index of competence (TMIG index). Raven's Coloured Progressive Matrices (RCPM) test was used to assess general intelligence. Correlations between the TMIG index, its subscale scores and the RCPM score were evaluated by Spearman's rank correlation coefficients. Ordinal regression models were conducted with the TMIG index and its subscales as the dependent variables, RCPM as the principal independent variable, and age, sex, type of household, employment status, educational background, chronic medical conditions and number of natural teeth as the potential independent variables. Results: There were significant but weak positive correlations between total score on the TMIG index, scores on the intellectual activity and social role subscales and RCPM score. In ordinal regression models, RCPM and educational background were significantly associated with total score on the TMIG index and the intellectual activity subscale, and only RCPM was associated with the social role subscale score, after adjusting for other potential variables. Conclusion: General intelligence may be significantly associated with higher-level competence, especially with intellectual activity and social role subscales, in community-dwelling older adults. [ABSTRACT FROM AUTHOR]

Satisfaction with life is of particular interest in the study of old age well-being because it has arisen as an important component of old age. A considerable amount of research has been done to explain life satisfaction in the elderly, and there is growing empirical evidence on best predictors of life satisfaction. This research evaluates the predictive power of some aging process variables, on Angolan elderly people's life satisfaction, while including perceived health into the model. Data for this research come from a cross-sectional survey of elderly people living in the capital of Angola, Luanda. A total of 1003 Angolan elderly were surveyed on socio-demographic information, perceived health, active engagement, generativity, and life satisfaction. A Multiple Indicators Multiple Causes model was built to test variables’ predictive power on life satisfaction. The estimated theoretical model fitted the data well. The main predictors were those related to active engagement with others. Perceived health also had a significant and positive effect on life satisfaction. Several processes together may predict life satisfaction in the elderly population of Angola, and the variance accounted for it is large enough to be considered relevant. The key factor associated to life satisfaction seems to be active engagement with others. [ABSTRACT FROM PUBLISHER]

Objectives: The purpose of this article was to describe socio-emotional themes in the stories of 16 Centenarians living in the United Kingdom. Methodology: Sixteen Centenarians were recruited and interviewed face-to-face by members of the research team. Participants were invited to tell the story of their lives in line with the principles of participatory action research (Koch and Kralik, 2006). The resultant story was returned to the Centenarian and their significant others for their validation and ownership. Stories were further analysed alongside verbatim interview transcripts. The first author wrote her psycho-social interpretation of the socio-emotional content in each person s life. These psycho-social interpretations were combined to provide commonalities in experience. Findings: These six common experiences or themes were: Engagement in the world, Happiness and describing a good life, Stoicism, Sources of support, Sources of frustration and Talking about death. All participants had strong interests. They reported their lives as having been ‘good’ or ‘happy’. They were resilient in the face of stress. Their frustrations pertained to visual or mobility impairments. While they were accepting the death of spouses, siblings and significant others, they were silent about the proximity of their own. In this article, we consider these themes in the light of previous empirical findings and theories. Conclusion: Centenarians indicated that life had been worth living and that it felt good to be 100 years of age. We explore the limitations of this study and discuss implications of the findings for those involved with the oldest old. [ABSTRACT FROM PUBLISHER]

Objectives: First, to use participative research methods to obtain views from people with dementia and carers about their experiences and the interventions that they consider can assist in facilitating independence and quality of life post diagnosis. Second, to use these views to identify priority topics for a potential self-management programme. Third, to explore the relevance of the identified topics with a consultation group of people with dementia and their carers, thus informing the creation of a draft self-management programme. Method: A series of individual and dyad interviews were conducted with people with dementia and family carers to explore their experiences post diagnosis and obtain views of how quality life can be maintained while living with dementia. A further group of people with dementia and carers then met over six successive weeks to explore and provide feedback on the topic areas generated out of the initial interviews and add to the content. Results: Data generated from the individual interviews identified a number of themes for a potential self-management group which were then validated through consultation. Optimum modes of delivery of a self-management programme were also indicated. Conclusions: A draft programme has been constructed building upon the framework of identified priorities. The process and outputs from the consultation also indicated the significant ramifications of such a programme for services. [ABSTRACT FROM AUTHOR]

Objectives: To examine the association of cognitive function with use of non-prescribed therapies for managing acute and chronic conditions, and to determine whether use of non-prescribed therapies changes over time in relation to baseline cognitive function. Methods: 200 community-dwelling adults aged 65 and older were recruited from three counties in south central North Carolina. Repeated measures of daily symptoms and treatment were collected on three consecutive days at intervals of at least one month. The Mini-Mental State Examination, the primary cognitive measure, was collected as part of the baseline survey. Data were collected on the daily use of common non-prescribed therapies (use of prayer, ignore symptoms, over-the-counter remedies, food and beverage therapies, home remedies, and vitamin, herb, or supplements) on each of the three days of the follow-up interviews for up to six consecutive months. Results: Older adults with poorer cognitive function were more likely to pray and ignore symptoms on days that they experienced acute symptoms. Poorer cognitive function was associated with increased use of home remedies for treating symptoms related to existing chronic conditions. Conclusions: Cognitive function may play a role in why older patients use some non-prescribed therapies in response to acute and chronic conditions. [ABSTRACT FROM AUTHOR]