Depression,Hopelessness, and Suicidal Ideation Among the Elderly

Abstract

This study attempts to compare levels of depression, hopelessness, and suicidal ideation among elderly males and females, in reference to their living arrangement, i.e., community vs. nursing homes. For many elderly people, old age is characterized by various losses: physiological, functional, social, cognitive, financial, etc. The outcomes of such losses often include, more often than not, environmental isolation, a subjective feeling of loneliness, anxiety, depression, and frequently, loss of motivation to continue living. In light of the rise in life expectancy and the multitude of losses which can be associated with the aging process, it is probable that one out of five elderly persons will spend part of his/her life in a long term care institute. Such living arrangements may have negative effects on the mental health of its residents, because placement is often accompanied by feelings of lack of control over one's own life, and inability to make decisions regarding daily issues. Elderly persons living in the community (227: 78 men, 149 women) and 91 living in nursing homes (33 men, 58 women), in both independent and frail functional status (ADL), participated in the study. Findings show significantly more hopelessness, helplessness, and depression among residents of nursing homes compared to those living in the community, differences between men and women living in both environments, and a correlation between other demographic variables and the three dependent variables of the study. The conclusions of the study indicate a need to pay interdisciplinary attention to the mental health of elderly residents of nursing homes, particularly in the preliminary stages of placement and adjustment.     

The Impact of Religiousness,Spirituality, and Social Support on Psychological Well-Being Among Older Adults in Rural Areas

Summary

This paper presents the results of a study on the impact of spirituality, religiousness, and social support on the psychological well-being among rural elderly. With a rural community sample of 215 older adults, hierarchical regression analyses found significant associations between dimensions of spirituality/religiousness, social support, and psychological well-being, with spirituality/religiousness inversely related to depression and social support, positively related to life satisfaction. Findings of this study suggest that practitioners need to develop programs or services that are congruent with religious/spiritual beliefs and practices in order to better enhance the psychosocial well-being and improve the quality of life among older persons in rural areas.     

The Experiences of Reciprocity among Filipino Older Adults in Canada: Intergenerational,Transnational, and Community Considerations

ABSTRACT

This article illustrates the concept of reciprocity in the context of immigrant families. It recommends that definition of reciprocity account for exchanges beyond the immediate family, and render visible the simultaneous location of older people as care recipients and providers, and care arrangements across generations, borders, community, and time. Adopting a critical ethnographic study on the aging and care experiences of older Filipinos in Canada, this article analyzes data from extended observations and in-depth semi-structured interviews with 18 older people, 6 adult children, and 13 community stakeholders. Findings highlight the unique configurations of care among the Filipino community whereby older people engage in care exchange as active participants across intergenerational, transnational, and fictive kin networks.     

Living Arrangements,Depression, and Health Status Among Elderly Russian-Speaking Immigrants

Abstract

This study examines the relationship between living arrangements, depression, and health status in a community-based sample of 300 elderly Russian-speaking immigrants. Data were collected via a self-administered questionnaire survey method. The questionnaire was designed to investigate various aspects of health, mental health, health services utilization, and health behaviors. A team of bilingual professionals was involved in the construction and translation of the survey instrument. The sample consists of 150 females and 150 males. The respondents' average age was 73.2 years. The regression analysis reveals that elderly Russian-speaking immigrants who live alone are more likely to experience a higher level of depression than those living with others. This relationship remains statistically significant after controlling for age, education, income, ability to speak English, years residing in the United States, gender, and health status. Since health status appears to influence depression, we performed further regression analyses and found that living arrangements had no statistically significant relationship with health status. Health status serves as an intermediate variable between the block of demographic variables and depression. Implications for future research are discussed.     

Discrimination by whom? : Unraveling the effect of experiences of discrimination on depression of multi-ethnic children and adolescents in Korea

ABSTRACT

Using the National Survey of Multicultural Families 2015, we examine the mediation effect of self-esteem and the effects of discrimination from different sources on young people’s depression, and we account for the importance of geographic area. The results indicate that peer discrimination has an adverse effect on depression among multi-ethnic children and adolescents in both urban and rural areas. Further, discrimination from neighbours affects self-esteem and depression among those in rural areas, and discrimination by strangers is strongly associated with depression among urban-residing children and adolescents. Based on such findings, implications for social work practice are provided.     

Transcending Differences: Using Concrete Subject-Matter in Heterogeneous Groups

ABSTRACT

The need to conduct social group work with heterogeneous members is a reality. Yet the social work literature does not offer much guidance in how to work with diverse groups of people. This paper illustrates a method of social group work that utilizes tangible and palpable subject matter as a therapeutic vehicle to create strong group cohesion with heterogeneous group members. It aims to explain how and why using non-personal subjects as the heart of the group helps people connect to themselves, to the world and to each other in a personal way. The examples given are from two groups that are very different in their compositions and very different from each other. One is a psycho-educational group at a Continuing Day Treatment Program for severely and persistently mentally ill elderly and the other is a group with adolescent and pre-adolescent females in a community center. Four benefits of using this method of social group work are outlined.     

Functional Status of the Non-Institutionalized Elderly in Sweden

Abstract

Functional ability was assessed in a randomly recruited population of elderly persons, totalling 553 individuals, living in their homes in four municipalities in central Sweden. These subjects were interviewed at home, using the Sickness Impact Profile. The response rate was 75%. No significant differences in functional ability were found among the municipalities. For those subjects 85 years old or more, average physical and overall functional ability was significantly worse than among the 81-84 year olds. Women had a significantly lower functional ability than men. Less well educated elderly persons had lower psychosocial and overall functional abilities than had the better educated. Physical dysfunctionbut not psychosocial dysfunctionwas significantly associated with formal and informal home help.     

Transformation of Social Care Services for the Elderly in Slovakia

ABSTRACT

The main objective of this article is to present a theoretical framework for the relevant historical, economic, demographic, and political factors influencing the transformation of social care services for the elderly in Slovakia. A major restructuring of the social care services for the elderly is necessitated by the aging of the Slovak population (demographic reason), the path dependency of the current Slovak elderly care system (historical reason), the growing purchasing power of older people and the general population (economic reason), and new requirements formulated by the European Union and the general public (political reason). Historical documents, legislative acts, strategic documents, international project documents, and statistics were reviewed, and 34 open-ended interviews within the framework of two case studies were carried out in order to obtain qualitative and quantitative data. The theoretical framework and the results based on those interviews indicate that the Slovak social care service for the elderly may turn out to become more similar to the advanced Central European systems, but also that prompt legislative and financial changes are required. Nevertheless, the future direction can only be more precisely identified when more case studies can be compared with one another.     

Impact of Support Groups on Well-Being of Older Women

ABSTRACT

The goal of this study was to determine whether differences in incidence of depression and level of well-being are manifested between older women, aged 60 and older, who attend either (a) a peer-run support group, (b) a staff-run support group, or (c) a comparison group (i.e., who do not attend a support group).

Thirty-six women participating in peer-run and staff-run support groups and 9 women receiving nongroup support were administered the Geriatric Depression Scale and the Philadelphia Geriatric Center Morale Scale. Separate analyses of variance were employed on each scale to determine the significance of differences in scores according to facilitator type (i.e., peer-run vs. staff-run vs. comparison group).

Analysis of scores on the Geriatric Depression Scale indicated significant differences between women in the peer-run groups and women in the comparison group, but no significant differences between women in the peer-run groups and women in the staff-run groups or between women in the staff-run groups and women in the comparison group. Analysis of scores on the Philadelphia Geriatric Center Morale Scale did not indicate any significant differences between women based on facilitator type.

Results of this study have implications for those who run face-to-face support groups for older adults, for those who train peer group facilitators, and for community agencies that desire to initiate a support group system for their clientele.     

The Perceptions and Needs of Farm Dwellers Regarding Aging,Advanced Age,and Future Perspectives

Abstract

This article reports on a multidisciplinary study that was undertaken by the Faculty of Health Sciences of the Potchefstroom University for Christian Higher Education. This study was done on certain farms in the North West Province of South Africa and called the FLAGH study, meaning the Farm Labour, Agriculture and General Health study. This article reports on a need assessment of farm dwellers done during the second half of 2002 and focuses specifically on perceptions and needs regarding aging, advanced age and future perspectives of aged farm dwellers.

The objective of this study was to ascertain the psychosocial needs and problems of farm dwellers in order to eventually design, implement and evaluate a programme aimed at the improvement of the quality of life of farm dwellers. An exploratory study was done, utilising in-depth interviewing according to a schedule of both quantitative and qualitative nature. Certain aspects, like the attitude of the community towards the elderly, relationships of the elderly with peers, children, grandchildren and spouses were dealt with in this study. Topics like the needs or problems of the elderly, nearing death, old age homes and retirement were also covered in this project.     

Suicide risk assessment in the depressed elderly patient with cancer

Although several studies have identified different factors that increase the risk for suicide in the elderly, depression, especially in cancer patients, puts people at even greater risk. In geriatric patients with co-morbid illnesses, depression is often diagnosed or overlooked because of the assumption that it is to be expected. When patients with cancer are diagnosed with depression, it is imperative that clinicians have a clear-cut tool for assessing and identifying signs of suicidality in order to develop a treatment plan to manage the patient. This article delineates the steps involved in conducting a thorough and systematic suicide risk assessment in depressed elderly patients with cancer.     

Integrated Group Program for Improving Sleep Quality of Elderly People

ABSTRACT

This article reports an exploratory study on the effects of an integrated group program for improving the sleep quality of elderly people in Hong Kong. Elderly people aged over 55 who had obtained a Pittsburgh Sleep Quality Index (PSQI) score >5 were recruited as subjects of the study. While 19 subjects of the treatment group were taking part in an integrated group program involving social group work intervention as well as Chinese medicine therapeutics, 9 subjects of comparison group received no intervention. Using a pretest and posttest design, the study revealed positive effects of the integrated group program. It has added knowledge serving the development of interventions that can help to improve the sleep quality of elderly people.     

“Working with COW”: Social Work Supporting Older Women Living in the Community

ABSTRACT

Australia, like all developed Western countries, is experiencing a demographic shift resulting in an increasing proportion of the population being over the age of 65 years. Contrary to stereotypes, the vast majority of older people live independently in communities. This article explores the potential of social work practice informed by community development principles to enable socially disadvantaged older women to live in vibrant and supportive communities, in which they feel safe and are able to access the support services they need. It argues that participation in social action not only builds older women’s well-being but also enables them to become (or continue to be) agents for social change in local communities. Adopting a community-based research methodology, this article draws on a decade of community development practice with the Concerned Older Women’s (COW) Group. This data suggests that community development practice based on participation, empowerment, and social action founded on respectful relationships may accrue significant benefits to individuals and the broader community. This social work practice creates the social conditions to facilitate older women’s capacity to work collectively to achieve social change, challenging ageist stereotypes.     

Primary Caregivers and Chinese Elders’ Demand on Community Services

Abstract

The most influential model explaining the elderly’s service use is Andersen and Newman's model. But the applicability of the model on elders’ demand on community services has not been tested, especially in developing countries such as China. This research tested the applicability of the model by studying how primary caregiver relations to the elderly influence Chinese community-dwelling elders’ demand on community services. With a total of 2,124 respondents aged 65 and older who reported primary caregivers, six primary caregiver relations were examined: son, spouse, daughter, daughter-in-law, unmarried son and daughter, and other. Data came from the 2014 wave of the Chinese Longitudinal Healthy Longevity Survey (CLHLS). Results indicated that: (1) Elders cared for by daughters-in-law showed a significantly stronger tendency of expecting community services than elders cared for by other caregivers among both rural and urban areas. (2) Elders were least likely to expect community services in two cases: urban elders taken care of by daughters and rural elders whose primary caregivers were unmarried sons and daughters. Since Chinese elders cared for by different caregivers tended to seek community care in different manners, future research may study how suitable community service programs can be developed to well meet the needs of various elderly groups.     

昆明市空巢老人健康与照顾需求的评估

“空巢”是中国科技与社会发展、独生子女政策落实的必然。日益增长的“空巢老人”为国家福利、代际和谐和社区照顾带来了严峻挑战。本文从社会保障的视角,采用健康自测量表（SRHMS）,从生理、心理和社会健康的维度,对昆明市10所养老机构和18个社区的289位空巢老人和212名非空巢老人进行了比较分析,发现空巢老人社会健康与心理支持令人担忧。文章就构建“空巢老人”长期照顾网络作了讨论和建议。     

Community-Based Services and Depression from Person-Environment Fit Perspective: Focusing on Functional Impairments and Living Alone

ABSTRACT

Guided by the Person-Environment Fit perspective, we investigated the extent to which personal and environmental factors influence depression among community-dwelling adults. The data came from the special section about community-based service utilization in the 2012 Health and Retirement Study (N=1,710). Although community-based service was not significantly associated with depression after controlling for covariates, respondents with functional limitations and living alone were less likely to be depressed when using community-based services. This study demonstrates the different associations between community-based services and depression depending on personal needs. It discusses the importance of community-based services for aging-in-place policy, particularly among vulnerable populations.     

The Survival Experiences of People with Depression in Taiwan

ABSTRACT

Depression is one of the most common mental health problems, yet it is a challenge for service practitioners to establish a relationship with those that suffer in silence. Relatively few qualitative studies have been conducted in East Asia to understand the illness experience of people with depression and their interaction with service practitioners. This study delineates the struggling and surviving experiences of 4 qualitative interviews with people with depression in Taiwan and their comments on service provision. It is found that all participants lived with depression by developing their own coping strategies. Moreover, the participants preferred a friend-like relationship with service provider and some service practitioners' attributes can enhance the interaction and relationship with depression sufferers. Future research is needed to investigate depression sufferers' preferences on professional relationship in different societies and search for effective ways to work with seemingly “apathetic” sufferers.     

The impact of acculturation on depression among older Muslim immigrants in the United States

Using a cross-sectional design, this study utilized a self-administered survey to examine the relationship between acculturation, physical and emotional health, health locus of control (LOC), life events and depression among a convenient sample of 70 immigrant Muslim elderly in United States of America. In addition to demographic variables, 5 standardized measures including the Vancouver Index of Acculturation, Center for Epidemiologic Studies Depression Scale (CESD), Iowa Self-Assessment Inventory, Multidimensional Health Locus of Control Scale, and the Geriatric Scale of Recent Life Events were utilized in this study. The results showed that about 50% of participants reported a score of 16 and above on the CESD scale, indicating a presence of depressive symptoms. In addition, most participants identified with their heritage culture compared to the American culture. The results of multiple regression analysis revealed 4 significant predictors of depression: cognitive status (β = -.34, p < .01), heritage culture (β = .35, p < .01), physical health (β = -.27, p < .05), and internal health locus of control (β = -.25, p < .05). These factors explain about 37% of the total variance in levels depression (R = .61).     

The Development of a “Neighborhood in Solidarity” in Switzerland

ABSTRACT

This article presents a case study based on the “Neighborhood in Solidarity” (NS) methodology to illustrate its application in a locality of 8,000 inhabitants in Switzerland. This specific project is proposed to exemplify the global aim of the NS methodology. That aim is to increase the integration of elderly persons in societies in order to improve their quality of life. The case study demonstrates the enhancement of the capacity of the older people to remain actively engaged in their neighborhood. The article focuses on the creation of an autonomous community of empowered older people who can resolve their own problems after a 5-year project. The construction of the local community is presented throughout the six steps of the methodology: (1) preliminary analysis, (2) diagnostic, (3) construction, (4) project design, (5) project implementation, and (6) empowerment and with three degrees of involvement (community, participative, and integrative involvement). Performance and output indicators, quality indicators, and social determinants of health assess the development of the local project. The impacts of the projects which are illustrated in this specific example motivated this publication to inspire practitioners from other countries.