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The purpose of this study was to describe the caregiving demands and difficulties for older adult spousal caregivers of coronary artery bypass (CAB) surgery patients. Caregiving demands and difficulties were measured by the Caregiving Burden Scale. The sample size was 35 caregivers of CAB surgery patients who were, on average, 60 years old and 19 days since hospital discharge. Descriptive analysis revealed that the top four most demanding caregiving activities perceived by spousal caregivers were providing transportation, additional household tasks, providing emotional support, and two tied for fourth: monitoring symptoms and additional tasks outside the home. The top four most difficult caregiving tasks were additional household tasks, providing transportation, and two tied for third: additional tasks outside home and managing behavior problems. Also, caregivers reported experiencing more demands than difficulties. Examining the demanding and difficult caregiving tasks provides information from which to develop and test tailored interventions for caregivers of this population.

Objective To compare the relative ability of patient self-assessments and clinician assessments of functional limitations for predicting hospitalizations for older adults with left ventricular dysfunction. Study Design Latent growth model analyses used secondary data from a clinical drug study, the Studies of Left Ventricular Dysfunction. Self-report and clinician-report data of patients' functional limitations were collected at baseline, and 6 weeks, 12 months, and 24 months postbaseline to assess the effects of an angiotensin-converting enzyme inhibitor versus placebo. Latent growth model analyses were used to assess the relative effect of baseline ratings and changes in these 2 ratings of patient functional limitations over the initial 2 years of the study (ie, the drug study component) as potential predictors of the number of hospitalizations occurring over 3 subsequent years. Results Data from 1099 patients aged 65+ years were analyzed. Both baseline patient assessments and changes in patient assessments of functional limitations were significant predictors of the number of subsequent hospitalizations (β = 0.119 and 0.273, respectively). This was not the case for clinician assessments. Moreover, baseline patient and clinician assessments of the patient's functional limitations were correlated at 0.42, indicating only a modest relationship between the 2 assessments. Conclusions These results demonstrate the greater utility of patient self-report measures for predicting hospitalizations. Incorporating patient-reported outcomes into clinical practice will expand understanding of the effect of diseases. Assessing changes in patient reports yields important insights into those patients more likely to have multiple admissions for heart failure.

Little is known about the specific sources and types of support that assist patients in alleviating stress and achieving positive recovery outcomes after a cardiac event. The purpose of this study is to examine the effects of illness-related stress, emotional and tangible support from a significant other, and informational support from a health care provider on physical and psychological recovery outcomes in cardiac patients 8 weeks after their cardiac event. The sample consists of 220 cardiac patients. Data analysis uses structural equation modeling. Final fit indices were as follows: χ2( df = 110) = 156.169, comparative fit index = .963, Tucker—Lewis index = .949, and root mean square error of approximation = .044 suggesting an acceptable model. Illness-related stress has direct effects on depression, physical recovery, and activity levels. Partner emotional support has a direct effect on depression. The findings provide direction for developing social support interventions aimed at improving recovery outcomes.

The purpose of this study was to gauge the impact of social embarrassment on caregivers of Alzheimer's patients. Two hypotheses were tested: First, social embarrassment adds a unique component of distress to caregivers of Alzheimer's patients, controlling for other factors known to cause depression; second, the negativity of the embarrassment varies according to the caregiver's race/ethnicity. Using data from the Alzheimer's Disease Demonstration Grants to States program ( N = 1,183), the caregiver's perceived depression was regressed on culturally situated variables and a set of covariates that included characteristics of both caregiver and care receiver. Results indicate that social embarrassment exerts a substantial effect on caregiver depression, but the effect does not vary meaningfully across cultural groups. In addition to social embarrassment, the health of the caregiver, the certainty of the Alzheimer's diagnosis, and the caregiver's perceived duty to care all uniquely contribute to the caregiver's level of depression.

This study examined whether a reciprocal relationship exists between measures of self-assessed global health and depressive symptoms, net of covariates that included chronic illness, functional disability, education, income, gender, race, and age. Analyses of five waves of data from the Rand version of the Health and Retirement Survey (N=7,475), using an autoregressive, cross-lagged panel design, indicated that self-assessed overall health had a modest but statistically significant and consistent effect on depressive symptoms. In contrast, the level of depressive symptoms had a statistically nonsignificant effect on self-assessed health. There has been growing interest in identifying the factors that inform self-assessments of overall health. The present findings indicate that self-assessed global health is not simply a manifestation of depressed affect.

Persons with midstage dementia and in special care (N = 45) were assessed in groups by a music therapy practitioner to determine the level of engagement in a 15-minute protocol that included a five-minute segment for each of three music activity types—rhythm playing, exercising with music, and singing. Activity staff with little to no formal music training who were employed by the facility were taught to use the protocol to conduct eight subsequent activity sessions for small groups from which activity engagement data were collected for each subject. Results indicated the protocol was accessible and successful for indigenous activity staff, initial assessments were strong predictors of subsequent engagement, and participation levels were stable over time and across each of the three activities.

Purpose The goal of this study was to evaluate the practice-oriented model of service use (Yeatts, Crow, & Folts, 1992) relative to the more widely used behavioral model ( Andersen, 1968) in its ability to explain the use of respite services by caregivers of Alzheimer's patients. Unlike the behavioral model, which focuses primarily on characteristics of the service user, the practice-oriented model focuses primarily on characteristics of the service. Design and methods Interview data from 1,158 caregivers participating in the Alzheimer's Disease Demonstration Grants to States program ( Montgomery, Kosloski, Karner, & Schaefer, 2002) were analyzed. Separate regression models were estimated for adult day care and in-home respite, using the full information maximum likelihood procedure described by Arbuckle (1996), and ordinary least squares regression with listwise deletion of missing data. Results The findings indicate that the factors related to respite use tapped by the practice-oriented model add significantly to explanatory models of service use over models that use only the factors typically represented by the behavioral model. Additional analyses, including a set of interactions with ethnicity, indicated that this improvement occurs primarily for White and Hispanic caregivers, and less so for African Americans. Implications The findings are discussed in terms of their implications for enhancing the timely use of respite services and directions for future research.

Family members who wish to have their older relatives live with them often encounter obstacles that make such an arrangement unworkable. Proponents of the Elder Cottage, and its variant, the Homecare Suite, suggest that many of these obstacles can be avoided with Elder Cottage use. The purpose of this study was to evaluate the impact of Elder Cottages on a variety of resident and host outcomes. A nonequivalent comparison group design was used. Thirty-one treatment group residents and their hosts received Elder Cottages whereas 24 comparison group residents and their hosts remained on a waiting list. Results showed that residents using Elder Cottages reported significantly greater satisfaction with their housing, increased independence, more telephone contacts with friends and family, improved relationships with hosts, more accessible housing, and less formal service use than those in the comparison group. Similarly, hosts in the treatment group reported significantly greater satisfaction with the residents' housing and less stress in their caregiving roles than those in the comparison group. In addition, fewer Elder Cottage hosts than comparison group hosts engaged in caregiver-related driving. Answers to short-answer questions mirrored the quantitative findings. These results provide substantial optimism with respect to the Elder Cottage as a housing option for older adults, although interviews with housing specialists suggested that families will need financial and caregiving assistance for this option to be viable.

Involving people with dementia in group exercise activities often presents a challenge. The effects of a recorded instrumental musical accompaniment was evaluated on participation in a series of 14 exercise activities with a group of nursing home residents with dementia. All exercise sessions, specifically designed by physical therapists for older adults, were lead by an activity aide and consisted of a series of seated exercises. Direct observations of resident behavior were conducted over a 25-week period in a reversal experimental design. Results showed increased levels of participation during the experimental condition observations where rhythmic music accompanied the exercise activities. The music intervention was most successful on those generally most willing to participate in social activities.

Four hundred fifty-eight family caregivers of Alzheimer's patients in Michigan were interviewed to identify factors associated with respite use. Of these caregivers, 176 were using respite (users), 128 had inquired about the service but had not yet used it (seekers), and 154 had neither used nor inquired about respite services (nonseekers). Separate logistic regression models were evaluated to identify users versus nonusers ( n = 458) and seekers versus nonseekers ( n = 282). Need for assistance with activities of daily living, availability of other caregivers, concern with cost, and adherence by the respite programto an established service schedule contributed significantly to the model distinguishing service users from nonusers. Caregiver burden, the presence of other caregivers, and the availability of transportation services made significant, unique contributions to the model distinguishing seekers from nonseekers.

The scope of explanation for retirement behavior could be greatly enlarged by acknowledging workers’ extended engagement with the question before the event—its “givenness” in their future, and their course of action toward it. This study provides evidence for such extended involvement among workers aged 51 to 61 in the 1992 Health and Retirement Study (HRS) who saw themselves being within 15 years of retiring. To the extent that workers foresaw less time left at work, they reported more frequent thinking and talking about retirement. This pattern was quite general. The consideration given to retirement was, as expected, more frequent in circumstances that might orient workers toward the future. However, even absent these circumstances, subjective proximity still predicted the topicality of retirement. Widely held, albeit individual, timetables for retirement demonstrate its embeddedness in the subjective life course of older workers.

Various explanations have been advanced to explain why older members of ethnic minority groups in the United States tend to use proportionally fewer assistive social and medical services than nonminorities. One possibility is that culturally based differences in attitudes toward need for particular services affect the likelihood of use. Data were analyzed from 2,947 Black, His panic, and White caregiving dyads participating in the Demonstration Grants to States program. Hierarchical logistic regression models were estimated separately for three discretionary ser vices (adult day care, in-home respite, and meal services) and one nondiscretionary service (home health care). Hypothesized outcomes were observed in all of the service models tested

The goal of this study was to examine the relationship between acculturation and familism in a samnple of 182 Hispanics of Puerto Rican descent. Exploratory factor analysis was used to establish the multidimensionality of each construct. Consistent with earlier studies, three dimensions of acculturation and familism were identified. Each dimension offamilism was then regressed on a set of explanatory variables that included three dimensions of acculturation. For two dimensions offamilism (familial obligations and support from relatives), acculturation was positively related to familism; for the other dimension (family as referents), the relationship was nonsignificant. In explaining variance in attitudinal familism, the results suggest that acculturation may be better represented as a single, second-orderfactor In interpreting the findings in the context of previous research, however; it is useful to treat acculturation as a multidimensional construct.

The results of experimental studies of the effects of respite care have been difficult to interpret because researchers have lacked experimental control over who actually received the treatment. Data from one such study are reanalyzed, focusing on the linear relationship between amount of respite use and probability of nursing home placement at the end of the treatment period. The results indicate a significant negative relationship between amount of respite use and nursing home placement.

Caregiving at the end of the life cycle is now widely recognized as a normal role in later life for most women and many men. The caregiving role, however, is not uniformly embraced by all potential caregivers, nor is it experienced in the same manner by those who assume the role. Indeed, a large number of studies conducted over the two past decades have documented differential impacts of caregiving on caregivers’ lives (Anhensel, Pearlin, Mulan, Zarit, & Whitlach, 1995; Farran, Miller, Kaufman, & Davis, 1997). Despite early questions about the utility of research on caregiving and its corresponding costs (Zarit, 1989), the experience of caregiving has been designated by The National Institute on Aging as one of the top priorities for social and behavioral research. Caregiving has also moved on to center stage in the policy arena. Where in the past, the presence of a family caregiver was often the basis for denial of public services, the introduction of the National Family Caregiver Support Program (NFCSP) as Title III-E of the Older American’s Act in 2000 legitimized family caregivers as a group with needs deserving of assistance. Since the initial implementation of the NFCSP in 2000, there has been an explosion of newly developed family support programs at both the state and local levels.

The purpose of the present study was to evaluate the quality of retrospective assessments of a number of commonly used measures in gerontological and caregiving research. Data were taken from interviews with 242 caregivers participating in a longitudinal study of caregiving. Results indicate moderate to high 1-year retrospective reliability for measures of ADL, obligation to the elder, affection for the elder, and global assessments of the caregiver's health. In contrast, retrospective assessments of objective and subjective burden were found to be of relatively low quality.

Five-wave panel data from 531 informal caregivers and frail elders were analyzed using an event history framework to identify how changes in the caregiving situation are related to nursing home placement. The results indicate that the predictors of placement differ substantially for elders cared for by spouses vs those cared for by adult children. In addition, the findings suggest dramatically different descriptions of the caregiving role over time for the two groups of caregivers. There were differences not only in the conditions under which caregiving ends, but also apparent differences in when caregiving begins and how it is perceived by the caregiver. Differences in the probability of placement of elders cared for by spouses vs adult children are interpreted within the framework of these contextual differences in the caregiving role.

The behavioral model developed by Andersen in 1968 was used to investigate patterns of support service use by families caring for dependent elders. It was hypothesized that differences in background or predisposing factors that serve to define caregivers (e.g., spouse vs. adult-child) would interact with need factors to influence the use of "discretionary" support services (e.g., adult day care), but not influence the use of nondiscretionaryy" services (e.g., hospitalization). Information was obtained on the use of eight different support services from a sample of 503 caregiving dyads. Caregivers were either spouses or adult children of the dependent elder. The results supported the hypotheses derived from the behavioral model and indicate that, among caregiving families, it is important to consider not only the type of service, but who is assessing the need for that service.

Caregiver burden is one of the most commonly used variables in caregiving research, both as a predictor and as an outcome. It has been suggested that caregiver burden can be measured in terms of discrete dimensions of well-being and that burden and well-being represent opposite sides of the same coin. The goal of this study was to explore this issue further by comparing commonly used dimensions of burden with parallel dimensions of well-being, both as outcome variables and as predictors of other outcomes, in a sample of caregivers. The findings suggest that burden may tap a unique domain of caregiving outcomes that is not represented by more objective indicators of these effects. Dismissing burden as an unnecessary or redundant construct seems premature.

Objectives We examined the effects of a manualized care management protocol specifically designed for care managers working with caregivers, the Tailored Caregiver Assessment and Referral® (TCARE®) protocol, on caregiver identity discrepancy, burden, and depressive symptoms. Methods Preliminary data from a longitudinal, randomized, controlled intervention study with 266 family caregivers served by 52 care managers in 4 states were analyzed using repeated measures random effects regression procedures. Caregivers in the intervention and control groups were repeatedly assessed for up to 9 months on caregiver identity discrepancy, 3 areas of caregiving burden-objective, relationship, and stress burdens; depression; and intention for nursing home placement. Results We found significant group by time interaction effects for caregiver identity discrepancy, relationship burden, stress burden, depression, and intention for nursing home placement. Caregivers in the intervention group experienced significant improvement on these measures, whereas caregivers in the control group worsened on these measures over time. Discussion The preliminary findings provide strong support for effectiveness of the TCARE® protocol on improving caregiver well-being and mental health outcomes.

Growing recognition of the significant contributions of family caregivers to the long-term care system and the negative consequences that may accrue from caregiving have led to the development of an array of caregiver support services including in-home services, respite programs, assistance with information, counseling, support groups, caregiver education, and supplemental services (Family Caregiver Alliance, 2006; Feinberg, 2002). Although numerous studies of caregiver interventions have been conducted and reviewed over the past decade (e.g., Goy, Freeman, & Kansagara, 2010;Montgomery & Kwak, 2008; Schulz et al., 2002, only a small number of intervention studies (Bass, Clark, Looman, McCarthy, & Eckert, 2003; Gitlin, Reever, Dennis, Mathieu, & Hauck, 2006; Guberman et al., 2003) have examined the effect on caregiver outcomes of a standardized assessment or care planning process designed specifically for caregivers. Consequently, minimal information has been made available to help care managers or other family specialists systematically assess the needs and strengths of caregivers or strategically link caregivers with services. As a result, practitioners tend to offer caregivers the services that are available from the agency for which the practitioner works or the services available in the community about which the practitioner has the most knowledge. Unfortunately, this practice creates the circumstance that many caregiver services go unused or do not fully benefit the caregiver or the care receiver (Montgomery, 2002).

Purpose of the study: Caregiver b urden i s a multidimensional construct, addressing tension and anxiety (stress burden), changes in dyadic relationships (relationship burden), and time infringements (objective b urden) r esulting f rom c aregiving. T he study aims were to assess (a) whether the dimensions of burden were the same for caregiving spouses and adult children, (b) the role of assisting with problem behaviors (PBs) and activities of daily living (ADLs) on e ach d imension o f b urden, a nd ( c) t he r ole o f each dimension of burden on self-rated health and intention t o i nstitutionalize t he c are r eceiver. Design and Methods: This study included 280 spouse/ partner and 243 adult child caregivers of persons with c hronic i llnesses. Results: Analysis u sing 2-group structural equation modeling showed that the factor structure of burden was equivalent for spouses a nd a dult children. F or b oth g roups, a ssisting w ith A DLs w as d irectly r elated w ith o bjective burden, w hereas PBs w ere d irectly r elated t o a ll dimensions o f b urden. F or b oth g roups, s tress b urden w as t he o nly p redictor o f s elf-rated h ealth, whereas PBs were significantly linked with intention to i nstitutionalize. H owever, s tress b urden a mong spouses a nd r elationship b urden a mong a dult children w ere s ignificantly l inked w ith i ntention t o institutionalize. Implications: We d iscuss t he research and practice implications of the differing needs of spouses and adult children.

Purpose The purpose of this study was to investigate the extent to which a psychoeducational intervention called “Powerful Tools for Caregivers” (PTC) influences burden of spouse caregivers. Specifically, this study examined whether spouse caregivers who attended PTC exhibited reductions in stress burden, relationship burden, and objective burden compared to a comparison group. Design and Methods The 6 week intervention used a self-efficacy framework to train caregivers to focus on self-care, communicate effectively, and manage emotions. This quasi-experimental study included 115 participants from the PTC group and 95 participants from a comparison group. Assessments were completed before and after the intervention for the PTC group and within a 6 week time period for the comparison group. Results Analyses using structural equation modeling showed that participants in the PTC group reported significantly lower levels of stress and objective burden than the comparison group. There were no group differences in relationship burden. Implications The findings indicate that PTC can be an effective resource for reducing psychological distress and objective burden among spouses caring for disabled partners. Copyright © 2010 John Wiley & Sons, Ltd.

The purpose of this study was to investigate the factors that influence the extent to which family caregivers of Alzheimer's patients use publicly subsidized respite programs. A model linking caregivers' attitudes concerning the convenience, quality of care, and perceived usefulness of a particular respite program to levels of respite use is hypothesized and tested. One hundred fourteen caregivers throughout Michigan who were eligible for respite services under the auspices of the Michigan Model Respite Program and caring for a noninstitutionalized elder with Alzheimer's disease participated in the study. Controlling for functional limitations of the elder, health of the caregiver, use of other support services, perceptions concerning the usefulness of respite, and the convenience of respite use were found to have significant direct effects on the level of actual respite use. Perceptions of program convenience affected service use indirectly by influencing caregivers' perceptions of program usefulness.

The impact of respite care on informal caregiversforparticipants in the Michigan Model Respite Programs was evaluated Using a nonequivalent control group design, 72 caregivers were assessed prior to program participation and again 6 months later on three dimensions: subjective, or felt, burden; objective burden; and morale. Caregivers who had used respite had a significantly lower level of subjective burden and significantly higher morale compared to controls. No differences between groups of caregivers were observed for objective burden. The findings are discussed within the context of recent research that has generally failed to document the effectiveness of respite programs for family caregivers.

"Adult foster care" is a label that has been applied to very diverse programs. Although adult foster care appears to be a potentially important element in the continuum of care for older adults, its assumptions and characteristic features have not been clearly explicated. In this paper, common assumptions underlying adult foster care are suggested, representative adult foster care programs are examined, and persisting issues discussed. The results suggest that, as yet, there is no consensus among practitioners as to what are reasonable goals for adult foster care, who should participate in such programs, and what constitutes evidence of program success. Until these issues are resolved, adult foster care is likely to remain an underutilized form of long term care for older adults.

Completion of first-line treatment is an important milestone for adults newly diagnosed with cancer. However, for many adults, the cancer experience of the 21st century does not end with the completion of initial treatment. Decreased functional status, distressing symptoms, and residual effects of treatment impact the daily lives of cancer survivors. Cancer has evolved into a chronic illness, in which a disease-free period may be followed by recurrent cancer. Researchers face challenges in the design and analysis of symptom management studies in recurrent disease. Residual effects can preclude a true "baseline" measurement of the symptom(s) of interest to the researcher. In addition, as cancer survivors age, they are more likely to have comorbid conditions that increase the likelihood of developing toxicities and residual symptoms that are specific to cancer treatments. Research studies of cancer-related symptoms in adults with recurrent disease pose many methodological challenges. Selection of appropriate study design, sample inclusion and exclusion criteria, measures of comorbidity and symptoms, and advanced analysis techniques are among the strategies proposed to address these methodological challenges.

Purpose: The goal of our study was to identify a representative sample of direct care aides to generate an accurate profile of the long-term-care workforce, with a special focus on home care workers. Design and Methods: Data were taken from the 5% Public Use Microdata Sample (PUMS) of the 2000 Census. Results: Variable coding in the 2000 Census data allowed for a more detailed identification of long-term-care workers than was available in previous studies. On the basis of this new sample, the estimated size of the home care workforce is much larger than that in previous estimates, and it is more heterogeneous. In addition, our analyses revealed more self-employed workers, higher salaries than previously reported, and greater ethnic diversity, with Hispanics or Latinos comprising a significant proportion of the home care workforce. Implications: Numerous state and federal programs are currently underway to increase the capacity of the long-term-care workforce. A more comprehensive understanding of the characteristics of the long-term-care workforce will facilitate more effective development of programs designed to enhance recruitment and retention of these workers to meet the increasing demands of future years.

The goal of this study was to identify factors related to client satisfaction with respite services. Data were analyzed from interviews with 1183 family caregivers participating in the AoA Demonstration Grants to States program. Two groups of potential explanatory variables were examined: (1) characteristics of client families, and (2) caregivers' perceptions of service delivery. Separate regression models were estimated for users of in-home respite and adult day care. Factors related to satisfaction with in-home respite included elder's ADL, ethnicity, caregivers' expectations for what the respite worker would and would not do, access to services, and the amount of red tape. Factors related to satisfaction with adult day care included the caregiver's age and health, ethnicity, caregivers' expectations for what the respite worker would and would not do, access to services, and the amount of red tape. Differences be- tween the models are discussed in the context of how providers can improve client satisfaction with respite services.

This article describes the initial development and implementation of the Alzheimer's Disease Demonstration Grants to States (ADDGS) program in 15 states. In addition to describing the services delivered and the client populations served, key elements of program development are discussed. Development strategies common to the programs that most successfully used the demonstration as a catalyst for developing services that are likely to continue are identified. Successful community programs were characterized by community commitment fostered by forging new partnerships and expanding public awareness. Success was also linked to the creation of new resources an d flexibility in implementation of the federal program.

SUMMARY Profiles of long-term respite use are reported for a diverse sample of 4, 369 families from seven states who participated in the Alzheimer's Disease Demonstration Grant to States program. Data from service records spanning a period of seven years were analyzed using hierarchical linear modeling techniques. Respite use was examined in both day care and in-home settings using three different measures of use. Client characteristics related to use include the caregiver's gender and relationship to the elder, and the ethnicity, income, functional level, and problem behaviors of the elder. Provider characteristics linked with different patterns of use include level of service, fee structure, and level of capitation. Implications for service delivery are discussed.

KOLOTKIN, RONETTE L., ROSS D. CROSBY, KARL D. KOSLOSKI, AND G. RHYS WILLIAMS. Development of a brief measure to assess quality of life in obesity. Obes Res. 2001;9:102‐111. Objective: Obesity researchers have a growing interest in measuring the impact of weight and weight reduction on quality of life. The Impact of Weight on Quality of Life questionnaire (IWQOL) was the first self-report instrument specifically developed to assess the effect of obesity on quality of life. Although the IWQOL has demonstrated excellent psychometric properties, its length (74 items) makes it somewhat cumbersome as an outcome measure in clinical research. This report describes the development of a 31-item version of the IWQOL (IWQOL-Lite). Research Methods and Procedures: IWQOLs from 996 obese patients and controls were used to develop the IWQOL-Lite. Psychometric properties of the IWQOL-Lite were examined in a separate cross-validation sample of 991 patients and controls. Results: Confirmatory factor analysis provided strong support for the adequacy of the scale structure. The five identified scales of the IWQOL-Lite (Physical Function, SelfEsteem, Sexual Life, Public Distress, and Work) and the total IWQOL-Lite score demonstrated excellent psychometric properties. The reliability of the IWQOL-Lite scales ranged from 0.90 to 0.94 and was 0.96 for the total score. Correlations between the IWQOL-Lite and collateral measures supported the construct validity of the IWQOL-Lite. Changes in IWQOL-Lite scales over time correlated significantly with changes in weight, supporting its sensitivity to change. Significant differences in IWQOL-Lite scale and total scores were found among groups differing in body mass index, supporting the utility of the IWQOL-Lite across the body mass index spectrum. Discussion: The IWQOL-Lite appears to be a psychometrically sound and clinically sensitive brief measure of quality of life in obese persons.

Actual decision making for retirement is largely inaccessible to investigation, yet research can focus on plans as a window into the preretirement process. This article proposes a construct that profiles five generic types of retirement plans, including plans to retire completely, change jobs, never retire, and uncertainty about retirement. The heuristic value of the construct lies in its recognition of the heterogeneity of retirement intentions. The five plan types were operationalized among workers aged 51-61 in the 1992 Health and Retirement Study. Convergent validity was demonstrated by comparisons to analogous survey questions. Construct validity was shown by predictable relationships between intentions and elements of workers' opportunity structure. The retirement-plans construct can serve as the foundation for a taxonomy of specific retirement plans (e.g., about timing, employment), to organize research on stability and change in retirement intentions, and characterize the path dependence of eventual retirement behavior.

OBJECTIVE This study examined an assumption of retirement theory that typifies older workers as preretirees who are planfully engaged in paths toward retirement. METHODS Using survey responses among workers in the 1992 and 1994 waves of the Health and Retirement Study, we described the prevalence of nonsubstantive answers to questions about the expected form and timing of retirement (e.g., "don't know," "haven't thought about it"). We tested explanations for this uncertainty as an artifact of the survey process, but also as an outcome of the opportunity structure for retirement planning. RESULTS Survey procedure did generate some of these noncommittal responses. Depending on question type, approximately 10% to 40% of workers did not state when or how they would retire, and such responses were less prevalent across age and time. In addition, categorical uncertainty about form and timing was theoretically predictable in a framework that supposed that workers less subject to a socially attended life--at work or away--would be more undecided about the future. DISCUSSION Uncertainty is an authentic, meaningful stance toward retirement that theory and research design should not ignore. Just as actual transitions to retirement can be ambiguous or blurred, the expectation of retirement, as well, can be untidy.

Data from 573 caregivers of Alzheimer's patients were used to examine the impact of caregivers' expectations to provide care on depression. The Center for Epidemiologic Studies Depression Scale (Radloff 1977) was regressed on a set of covariates, using George 's (1996) multistage conceptual model of the social precursors of mood impairment. Results showed that in addition to standard covariates of depression, caregivers' expectation to provide care was significantly related to the caregiver ' level of depression.

This study was an archival study attempting to determine whether certain descriptive client characteristics are related to high levels of client absenteeism or client attrition. Subjects were 354 former outpatient clients from a community mental health center. Descriptive characteristics such as age income, and treatment latency were taken from information routinely collected for all clients. Correlations revealed no significant relationships between the descriptive client characteristics and either absenteeism or attrition.

Separating age, period, and cohort effects in developmental research is complicated by their linear dependence. Differing approaches have been advanced to address this problem. These approaches generally presume that age, period, and cohort are conceptually discrete entities; that is, they are confounded statistically, but not logically. This article outlines the dilemma, reviews solutions that have been advanced, and critically examines the assumptions on which these solutions are based.

Occupational retirement looms as a social fact for many workers in industrialized countries. And with the continuing development of public and private pension programs and increased longevity and health, the number of retired workers is constantly growing. As an aggregate, the occupationally retired will be an important political and economic force, and they also will represent a pool of considerable talent and expertise. But retirement is not only a societal phenomenon; it also is a significant personal event in the lives of workers. Up to the time of retirement, the work role is a central role in the lives of many people. Not only is it a means for obtaining a variety of rewards and gratifications, but it also structures day-to-day behavior, provides status and social interaction, and generally shapes the nature of the worker’s life style as a whole. Given these considerations, the transition from the work role to the retirement role—whether in fact or in anticipation—is likely to instigate a period of adaptation on the part of the retiree. But exactly how people make the transition from work to retirement is, as yet, a poorly understood process.