Unmet Needs and Depressive Symptoms Among Low-Income Older Adults

Previous studies have found that declining health, decreased social interaction, and inadequate financial resources were significant risk factors for late-life depression, and social support from families and friends and religiosity were significant protective factors. In this study, we examined if low-income older adults' perceived unmet need for home- and community-based services for many aging-associated problems would be independently associated with their depressive symptoms, controlling for these known risk and protective factors. We interviewed a total of 213 community-residing older adults to assess their depressive symptoms, using the Geriatric Depression Scale (GDS), and unmet needs in the areas of personal assistance, instrumental and environmental support, emotional support, and other facilitative/enabling services. We found that the number of unmet needs was significantly positively associated with these older adults' depressive symptoms, although it explained only a small proportion of the variance of the GDS scores. Future research and practice implications are discussed.     

COVID-19 pandemic and the determinants of depressive symptoms among senior citizens of India: An empirical investigation

The COVID-19 pandemic inflicted multiple threats to individuals' physical, mental, and financial health conditions. The pandemic-related restrictive behaviors pose serious consequences for public health and increase the risk of mental illness among individuals, particularly among older citizens. The combination of their pre-existing illnesses, social isolation, COVID fear, and financial adversity frequently aggravates their condition and leads to depression and mental illness. Thus, the present study investigates the mental health status and the determinants of depressive symptoms among older adults of Bhubaneswar during the COVID pandemic context. The study used the Geriatric Depression Scale (GDS-15) to measure their depressive symptoms. The social isolation parameter is measured with the De Jong Gierveld Loneliness Scale. Financial self-efficacy, COVID-19-related psychological fear, and comorbidity health status are other determinants considered. A chi-square test and multinomial logistic regression (MLR) models are adopted to find the probable risk factors that may influence depressive symptoms among older people. The results indicate that comorbidity health conditions, a social isolation mindset, and financial efficacy issues are the significant determinants that drive an older person towards different depression categories. The improvement of these influential factors can lead senior citizens to avoid any health emergency like COVID pandemic. In the event of a public health emergency, such as COVID pandemic, the government could use the study's findings to devise methods for assisting the elderly. Society as a whole should be aware of these findings, which can lead to depressive symptoms, and offer support to the elderly. Future research may concentrate on identifying the causes of depressive symptoms in different age groups or in the presence of specific comorbidity health conditions. Future research may also investigate the factors influencing depressive symptoms in a specific occupation.     

Integrating mental health parity for homebound older adults under the medicare home health care benefit

Despite high rates of mental illness, very few homebound older adults receive treatment. Comorbid mental illness exacerbates physical health conditions, reduces treatment adherence, and increases dependency and medical costs. Although effective treatments exist, many home health agencies lack capacity to effectively detect and treat mental illness. This article critically analyzes barriers within the Medicare home health benefit that impede access to mental health treatment. Policy, practice, and research recommendations are made to integrate mental health parity in home health care. In particular, creative use of medical social work can improve detection and treatment of mental illness for homebound older adults.     

Integrating Mental Health Parity for Homebound Older Adults Under the Medicare Home Health Care Benefit

Despite high rates of mental illness, very few homebound older adults receive treatment. Comorbid mental illness exacerbates physical health conditions, reduces treatment adherence, and increases dependency and medical costs. Although effective treatments exist, many home health agencies lack capacity to effectively detect and treat mental illness. This article critically analyzes barriers within the Medicare home health benefit that impede access to mental health treatment. Policy, practice, and research recommendations are made to integrate mental health parity in home health care. In particular, creative use of medical social work can improve detection and treatment of mental illness for homebound older adults.     

Home and Community-based Services and Life Satisfaction among Homebound and Poor Older Adults

ABSTRACT

Little evidence exists regarding the role of Home and Community-Based Services (HCBS) utilization on life satisfaction among older people who are both homebound and low-income. Guided by the personal-environment (P-E) fit perspective, this study aims to: (1) describe characteristics of older people with homebound and low-income status; (2) investigate how the combination of homebound and low-income status is associated with life satisfaction; and (3) examine whether HCBS utilization moderates the association between homebound and low-income status and life satisfaction. Data were drawn from the 2012 Health and Retirement Study, and the sample included respondents who were 51+ years who completed a questionnaire for HCBS utilization (n= 1,662). Results describe sociodemographic, health-related, and environmental characteristics of older adults. Combined homebound and low-income status was a significant predictor of lower life satisfaction (β = ?0.15, p< .05), but better life satisfaction when they used HCBS (β = 0.33, p <.10). These findings suggest that promoting HCBS utilization is a promising strategy to enhance well-being among those homebound and poor. Further studies are needed to test the effectiveness of HCBS with longitudinal data and to investigate the details of effective HCBS utilization such as frequency of use and types of services.     

Social participation,health‐related behavior,and depression of older adults living alone in Korea

This study aims to identify the effects of social participation on depression among adults over 60 years old living alone in Korea, focusing on the mediating effect of health‐related behavior on the social participation–depression relationship. The study relies on secondary data analysis using the 6th wave of the Korea Longitudinal Study of Ageing, and structural equation modeling method was employed for analyses. The findings indicate that older adults' participation in religious and social gatherings decreases depressive symptoms. The study also finds that regular eating behavior, drinking, and exercise also act as significant mediators, as older adults' participation in social gatherings is associated with those health‐related behaviors and that they also reduce depression. The results suggest that social participation by older adults who live alone is crucial not only for providing them with support but also for encouraging health‐related activities that can have direct effects on their mental health. Implications for social work practice are also discussed.     

Treating Older Persons with Severe Mental Illness in the Community: Impact of an Interdisciplinary Geriatric Mental Health Team

Little information is available concerning community-based interventions to treat the growing number older persons with severe mental illness. This study examined treatment efficacy of a specialized interdisciplinary geriatric mental health team (mental health geriatric interdisciplinary teams or MHGITs) for 69 older clients with severe mental disorders. Depression, life satisfaction, health, and psychiatric and medical hospitalization data were gathered. A decrease in depressive symptoms and in psychiatric hospitalizations, and an increase in life satisfaction at 6 months were found. No change in health nor medical hospitalizations were reported. This study provides preliminary support for the feasibility and efficacy of a MGHIT approach in treating older community-dwelling adults with severe mental illnesses. Implications for social workers are discussed.     

A Comparison of Rural and Urban Older Adults in Iowa on Specific Markers of Successful Aging

This study examines the differences between rural and urban older adults on level of life satisfaction and depressive symptoms, focusing on the effect of social support. Data were collected through structured interviews at senior centers and senior meal sites in eastern and southeastern Iowa. The Duke Social Support Index (DSSI), the Life Satisfaction Index-Z (LSI-Z), and the Geriatric Depression Scale 15 (GDS15) were used. Correlations (Pearson's r), independent sample t-tests, and multiple regression were computed. Findings indicated that urban residents reported more depressive symptoms, as compared to rural residents. Subjective level of social support was a stronger predictor of life satisfaction and was more negatively related to depressive symptoms among rural than among urban older adults. Results suggest that social workers who work with aging people need to be aware of rural–urban differences in mental health. Furthermore, social workers need to have knowledge of older adults' social networks and work to ensure greater opportunity for social interaction.     

Self-Esteem Mediates the Relationship Between Volunteering and Depression for African American Caregivers

Research on the influence of volunteering on mental health outcomes has not placed enough focus on African American female caregivers who are at risk for adverse outcomes such as depression. This study addresses this gap by examining the mechanism through which volunteering might influence depressive symptoms using data collected from 521 African American female caregivers of older adults. Regression results indicate that although volunteering is inversely associated with depressive symptoms, self-esteem mediates this relationship. Findings suggest inclusion in volunteering for African American female caregivers may be relevant to promotion of their mental well-being.     

Functional Independence of Community-Dwelling Older Adults in China and South Korea

ABSTRACT

Population aging is occurring at an unprecedented pace in China and South Korea. This study intended to identify and compare factors associated with older adults’ functional status in China and South Korea using data from 2 national surveys. The study sample consisted of adults aged 65 to 79 years old drawn from the Chinese Longitudinal Healthy Longevity Survey (2005; n = 4,898) and the Korean Longitudinal Study on Aging (2006; n = 4,152). The outcome variable, functional status, was defined as dependence in self-care tasks. Stepwise multiple regression analysis was used to assess the explanatory contributions of sociodemographics, health conditions, and health behaviors and activities to functional status. These Asian older adults shared certain commonalities in maintaining functional independence in their communities, and absence of diseases and higher cognition were associated with functional independence in both countries. Rural residence and outdoor activity were significant for Chinese older adults; for their South Korean peers, gender, employment status, drinking, and exercise were important. This study adds to a slowly growing body of knowledge of ways to improve the functional independence of community-dwelling older persons in these 2 Asian countries and beyond. More research is needed to identify cross-cultural and/or cross-country differences.     

社区特征与中国农村老人的抑郁症状

农村老年人的抑郁水平显著高于城市老人,在极端情况下,甚至表现为自杀行为.通过中国健康与养老追踪调查 (CHARLS) 2011年基线数据,运用分层线性模型 (HLM) 分析村级社区水平的经济、人口、管理、设施、生态环境五个维度的特征对农村老人抑郁症状的影响,发现中国农村老人的抑郁水平具有显著的村间差异.加入村级水平的解释变量后发现,村子的平均收入水平高,村里具有高中学历的人口比例高,村主任的任职年限长以及村里的基础设施水平高,村里老人抑郁水平显著更低;而在工业污染排放中度和严重的村子里,老人抑郁显著更高.进一步的跨水平交互作用分析则探索了村级变量对具有不同个体特征的老人群体的作用差异.研究结果对于农村社区建设的政策发展以及农村老人的抑郁干预提供了实证依据.     

Trajectories of Community-Based Service Use: The Importance of Poverty and Living Arrangements

ABSTRACT

This study examined how older adults’ living arrangements and poverty status affected their use of in-home health, functional, and out-of-home services over time. Using eight waves of data from the Korea Welfare Panel Study, we employed a logistic mixed-effect model to analyze how poverty and living arrangements affect community-based service use. Living-alone older adults and elder-only couples were more likely than co-residing households to use services. Elder-only couples, when poor, were more likely to use in-home and out-of-home services over time. Understanding predictors of community-based service use over time enables researchers and policymakers to better understand the process of aging-in-place.     

Intergenerational Conflict,Attitudinal Familism,and Depressive Symptoms Among Asian and Hispanic Adolescents in Immigrant Families: A Latent Variable Interaction Analysis

ABSTRACT

Research has shown an association between intergenerational conflict (IC) due to acculturation and negative mental health outcomes, including depressive symptoms, among Asian and Hispanic adolescents from immigrant families. Using the data from the first survey of the Children of Immigrants Longitudinal Study, which included a culturally diverse sample of second-generation immigrant children, this study examines whether attitudinal familism (AF) moderates the effect of IC on depressive symptoms among Asian and Hispanic adolescents. Latent variable interaction models involving multiple-group comparisons were established. Results show that there is a significant buffering effect (b = –.05, p < .001). Specifically, a high level of AF is generally associated with fewer depressive symptoms compared with a low level of AF. These findings may inform the development of social service programs that aim to reduce IC by exposing immigrant adolescents to more traditional cultural values. Future research implications are discussed.     

Adolescents at risk of mental health problems in the COVID-19 pandemic: A prospective population-based study of the effects of government mandates and school closures

There is increasing evidence that the COVID-19 pandemic has had substantial mental health impacts for adolescents. Yet, few definitive studies have investigated which adolescents were at higher risk of poor mental health and well-being during the pandemic. Data were drawn from the Childhood to Adolescence Transition Study, a prospective cohort study of students in Australia (N = 1211). Prevalence of mental health outcomes (depressive symptoms, anxiety symptoms, self-harm and good subjective well-being) was estimated in school Years 5–12, where Years 11 (2020) and 12 (2021) coincided with the pandemic. The age- and sex-adjusted relative risk of each mental health outcome for each priority group during the pandemic were estimated. During the pandemic, over 50% of study participants reported depressive symptoms, and one quarter reported anxiety symptoms. There was a decrease in good subjective well-being compared with pre-pandemic years, while self-harm prevalence remained similar. History of mental health problems, school disengagement and frequent peer victimisation increased the risk of experiencing mental health problems during the pandemic. Schools play a central role in maintaining the mental health and good subjective well-being of students, and this is particularly important during periods of social disruption, such as the COVID-19 pandemic.     

HIV/AIDS fifty and older: a hidden and growing population

Contrary to common belief, HIV and AIDS are prevalent in the older adult population. Currently, between ten to fifteen percent of HIV/AIDS new cases occur in individuals fifty and older (Chiao, Ries, & Sande, 1999). With the aging of the baby boomer generation, and the introduction of erectile dysfunction medications, such statistics are guaranteed to increase at alarming rates. This population also faces hazardous risk factors that increase its possibility of contracting the disease. Stereotypes and lack of information continue to limit older adults from receiving the medical, educational, and psychological attention they need to avoid and to combat the virus. This article discusses the rising trends in the fifty and older population as well as some of the factors that increase the prevalence of HIV/AIDS among this population. Prevention, assessment, and treatment practices are also outlined; if instituted, these interventions may help promote a significant reduction in the rate of HIV/AIDS infection in the older adult population.     

Using Community-Based Participatory Research Strategies in Age-Friendly Communities to Solve Mobility Challenges

ABSTRACT

The number of older adults is steadily increasing in the United States and across the globe. Aging is linked to an increased risk of disability. Disabilities that limit one or more major life activities such as seeing, hearing, walking, and motor skills impact a person’s ability to drive a car. Low utilization of alternative transportation by older adults and people with disabilities may put them at risk for social isolation. Social isolation is associated with a variety of negative health outcomes. While communities are challenged to create available, acceptable, accessible, adaptable and affordable mobility options, there are widely held, inaccurate biases around older adults’ abilities to contribute to the development and improvement of alternative transportation options. Gerontological social workers are well-positioned to address this bias. This paper presents a case study of a large metropolitan county in the Midwest where community-based participatory research (CBPR) strategies were used to engage older residents to support the development of alternative transportation options supporting the tenets of environmental justice.     

Psychological Vulnerability and Gambling in Later Life

ABSTRACT

Objectives: Because behavioral problems often emerge from maladaptive coping methods, we investigated whether unmet basic psychological needs evolve toward a level of psychological vulnerability that puts older adults who gamble at risk for becoming problem gamblers. Methods: Data from a community sample of 379 adults ages 60 and above were analyzed using structural equation modeling. Participants responded to items regarding their demographics, gambling frequency, engagement in at-risk gambling behaviors, and the extent to which their basic psychological needs were met. Results: Satisfaction of basic psychological needs among older adults who gamble was negatively associated with their being at risk for developing a gambling problem. Satisfaction of basic psychological needs also mediated the negative effect of socioeconomic status on at-risk gambling behavior. Conclusion: Social workers should become mindful of how older adults, who are confronting psychological vulnerabilities in later life, might well turn to gambling as a maladaptive coping mechanism.As per journal style, abstract must not exceed100 words. Please amend accordingly.