Conquering Depression and Anxiety Through Exercise,by Keith Johnsgard

No abstract available for this article.     

Considerations in Care for Individuals with Intellectual Disability with Advanced Dementia

Abstract

A number of physical, psychosocial, or ethical issues related to the care of the individual with advanced dementia are reviewed and related to individuals with intellectual disabilities. The sources used include the published literature and illustrations drawn from personal observations. The author notes that through anticipation and early planning, advanced directives and service planning (which looks to adaptation of services and other care management interventions), can effectively impact care at the end. Areas that need to be addressed include technical information, including a review of and, as appropriate, adaptation of general advanced dementia resources, relief, rest, support, reassurance, receipt of on-going information, participation in planning, a sense of humor, and appreciation. Also noted, are the differences experienced because of the presence of paid staff as carers and residence outside of the family home. It is concluded that, although the goals of quality care is the same for all people with advanced dementia, the process by which to reach these goals often needs further consideration and adaptation for people with intellectual disabilities.     

Use of Group Counseling to Support Aging-Related Losses in Older Adults with Intellectual Disabilities

Abstract

With the noted increase in life expectancy of persons with intellectual disabilities (ID), there is a need to provide more physical and psychological preparation for aging and support for these individuals in their middle-age and aging periods of life. It is known that age-related losses result in major stressors and that these can produce changes in the way that older adults think, feel or act. Therefore, having methods and tools to help individuals with ID prepare for and adjust to their losses is important. To address this, the Neve Natoa Residential Center in Israel initiated a group intervention program to test whether a group counseling method could be used to help prepare adults for changes associated with aging. Nine adults (5 males and 4 females) between the ages of 39 and 56 (mean = 49) participated in the program pilot. After ten sessions, an evaluation indicated a positive change of attitudes, improvement of self-esteem, and less extreme behavioral reactions in the period after the intervention. Given the positive results, it is recommended that further studies involving group in tervention techniques with adults with ID be undertaken.     

Perspectives on family caregiving of people aging with intellectual disability affected by dementia: Commentary from the International Summit on Intellectual Disability and Dementia

ABSTRACT

This article, an output of the 2016 International Summit on Intellectual Disability and Dementia, examines familial caregiving situations within the context of a support-staging model for adults with intellectual disability (ID) affected by dementia. Seven narratives offer context to this support-staging model to interpret situations experienced by caregivers. The multidimensional model has two fundamental aspects: identifying the role and nature of caregiving as either primary (direct) or secondary (supportive); and defining how caregiving is influenced by stage of dementia. We propose staging can affect caregiving via different expressions: (1) the “diagnostic phase,” (2) the “explorative phase,” (3) the “adaptive phase,” and (4) the “closure phase.” The international narratives illustrate direct and indirect caregiving with commonality being extent of caregiver involvement and attention to the needs of an adult with ID. We conclude that the model is the first to empirically formalize the variability of caregiving within families of people with ID that is distinct from other caregiving groups, and that many of these caregivers have idiosyncratic needs. A support-staging model that recognizes the changing roles and demands of carers of people with ID and dementia can be useful in constructing research, defining family-based support services, and setting public policy.     

Beyond Income: A Social Justice Approach to Assessing Poverty among Older Adults with Chronic Kidney Disease

ABSTRACT

How social workers define and assess poverty is a matter of economic and social justice. Recent conceptual and measurement advances point to a multidimensional definition of poverty which captures material, social, and political deprivations. Using data from a survey, this article describes how nephrology social workers assess poverty among older adults living with a chronic kidney disease (N = 52). Results suggest respondents already conceive of poverty as a multidimensional experience, support awareness-raising about poverty, and primarily assess poverty by employment status, income, access to transportation, and education. Opportunities to expand poverty assessment in future work are promising.     

African-American Grandmother Carers of Children with Disabilities

Abstract

Estimates are that one in ten grandparents will take on the role of primary carer to a grandchild for at least six months before the child is age 18, including a child with a developmental delay or disability. This article reviews the current literature on grandparent caregiving with particular attention to African-American grandmother carers and discusses stressors and reports of elevated symptoms of depression among them. The demographics of a sample of 145 African-American grandmothers of children with a developmental disability are reported here as well as the result of a logistic regression analysis of a model of predictors of elevated (above a score of 16 on the CES-D) symptoms of depression. Being younger than age 60, not working outside of the home, not being married, and having no further than secondary school education, were all found to be significant predictors of elevated symptoms of depression in this sample of African-American grandmothers. Interventions for this group of carers must take into account their potential for depression and health problems, economic circumstances, and lack of knowledge of financial and other assistive resources.     

Grief and Intellectual Disability

Abstract

People with intellectual disabilities are living longer, which in turn leads to a higher probability that they will experience significant loss due to the death of someone they know. This paper describes a systemic therapeutic model, ROC, which combines bereavement therapy with training and support for staff. On reporting the effects of the ROC model, it is noted that changes over time in the type and nature of referrals has shown the ther apeutic value of the program. The author makes a case that the best way to detect and possibly prevent serious emotional problems in this population is to provide training and support in dealing with death and related issues for the service network surrounding these individuals.     

Remembering with and Without Awareness Through Poetry to Better Understand Aging and Disability

SUMMARY

Poetry has been described as a universal translator. I offer three poems that are evocative of my experience as a child with my grandfathers and their disabilities; and as an adult attempting to deal with the impending death of my father. My wish is that the first poem will reinforce the idea that connecting with one's own memories of aged and disabled family members might support our interactions with people who are aged and disabled in the here and now. I present the final two poems to encourage those working with family members of seriously ill aged people in a hospital setting to better understand the stress of decision-making and to consider devising short-term mutual aid groups to support them during a time for which no preparation exists.     

The Reaction of the Family to the Institutionalization of an Elderly Member: Factors Influencing Adjustment and Suggestions for Easing the Transition to a New Life Phase

The institutionalization of an elderly person is a crisis for the family. Using case illustrations, this article presents three major factors affecting family reactions and adjustment (the expectations of society, family roles and expectations, and the impact of the move upon daily family life), suggests that nursing home placement be viewed as a step in the normal family life cycle, and discusses ways in which rituals could be used to ease the tradition to the post-placement phase of the family.     

The Influence of Media and Respondent Characteristics on the Outcome of a Campaign to Recruit Host Families for Adults with Learning Disability

Family-based short break schemes depend on accessing suitablehosts. Recruitment is seen as a major challenge yet there areno published studies that examine this for adult services. Thispaper aims to redress that by describing what type of personresponded to a campaign to recruit hosts for adults with learningdisabilities, and to explore if there is a relationship between(i) the outcome of each enquiry and the respondents and (ii)outcome and how the respondents found out about the service.The study involved a retrospective examination of documentedinformation about each of forty-nine respondents, supplementedwith telephone contact. The respondents were mainly marriedwomen aged thirty to fifty, with two or more children, fromurban settings and who were employed outside the home. Mosthad heard about the service through newspapers and posters.Thirty-nine per cent applied to host. Age, family size, ageof children and location were associated with outcome. Experiencewas an important predictor of outcome. Word of mouth was themost successful means of recruiting. While broad-based advertisingis shown to attract hosts, the results can be maximized by follow-upof those who do not apply immediately. Implications for servicedelivery and research are discussed.     

Unmet Home Care Service Needs of Rural Older Adults With Alzheimer's Disease: A Perspective of Informal Caregivers

This study assessed unmet service needs of rural older adults with Alzheimer's disease (AD) and identified factors that were related to these needs. Data were collected from 109 informal caregivers of AD patients. Over half of the patients experienced unmet service needs in 1 or more areas of activities of daily functioning. Informal caregiver burden and patient's gender and functional status were significantly related to patients' unmet service needs. Patients' use of formal services was marginally related to their unmet service needs. To better address patients' service needs, a comprehensive needs assessment should be conducted with both patients and their caregivers.     

Efficacy of an Educational Program for Relatives of Persons in the Early Stages of Alzheimer's Disease

Abstract

This article describes the results of an educational intervention for family caregivers of persons in the early stages of Alzheimer's disease. A total of 45 family caregivers participated in this intervention that consisted of five weekly educational sessions about the disease and aspects of caring for someone in the early stages. Measures of knowledge about Alzheimer's disease, self-efficacy, reactions to patients' memory impairment, and level of depression at pretest and posttest were analyzed. Participants' knowledge about the disease improved substantially, self-efficacy and reactions to patients' impairments improved moderately, and level of depression showed no significant improvement. Results suggest that this intervention has merit for family caregivers coping with the early stages of Alzheimer's disease. Implications for implementation and evaluation are discussed.     

Assessing the Barriers to Achieving Genuine Housing Choice for Adults with a Learning Disability: The Views of Family Carers and Professionals

It has been reported that the capability of adults with a learningdisability to choose their housing is too often impeded by theviews and actions of their family carers and involved professionals(McGlaughlin and Gorfin, with Saul, in press). This study furtherexplores these apparent barriers to providing genuine housingchoice for adults with learning disabilities. It discusses findingsfrom a series of focus groups which explored family and professionalviews about housing and choice. The views expressed indicatethat risk is a fundamental concern for both professionals andfamilies when considering more independent housing for thisgroup. Although opportunities for choice were generally supported,many argued for the need to assess the ability to make informeddecisions. There were also examples of problematic relationshipsbetween professionals and carers, creating a barrier to choice.Carers need involvement, information and support during thedevelopment of housing plans if the needs of the primary serviceusersare to be met. The barriers identified have to be removed ifservice-users are to truly become the focus of decisions andbe enabled to make genuine informed choices.     

Older Carers of Adults with a Learning Disability Confront the Future: Issues and Preferences in Planning

The Valuing People White Paper (Department of Health, 2001)requires services to secure a plan for all service-users withlearning disabilities living with older carers and promisesthem and their families more choice and control over how andwhere they live. This paper examines the views of the oldercarers (aged over seventy) of sixty-two adults with a learningdisability about planning for the future. Fifty-six took partin interviews in their own homes and six completed a questionnaire.All carers were white and recruited from one local authorityin response to the requirements of the White Paper. Findingsindicate that a significant proportion (thirty-four—55per cent) is either not ready or is unwilling to make futureplans. Barriers to planning include a perceived lack of needdue to the existence of two carers, a lack of awareness of timescalesinvolved in securing housing, difficulties in letting go, alack of confidence in available housing options, and the existenceof mutually supportive relationships. The findings show a needfor a proactive approach to information and support provisionto enable these families to work through a process of makingplans for the future. This is essential to prevent the needfor emergency placements in response to crisis and in turn toensure that adults with learning disabilities have genuine choiceand involvement in how and where they live.     

Impact of Mid-Life Symptoms of Alcoholism on the Health and Wellbeing of Aging Parents of Adults with Disabilities

The study examined the effect of adult children’s disability on parents’ physical health in later life and the extent to which parents’ symptoms of alcoholism in mid-life moderates the link between children’s disability and later life parental health. Analyses are based on data from the Wisconsin Longitudinal Study. The analytic sample included parents of children with developmental disabilities (n = 145) or mental health problems (n = 200) and 2,432 parents of unaffected children. The results showed that the negative health consequences in later life of having a child with a developmental disability were greater for those who showed more symptoms of alcoholism in mid-life. However, symptoms of alcoholism in mid-life did not significantly moderate the impact of an adult child’s mental health problems on parents’ later life physical health. The findings suggest a potential area where gerontological social workers could intervene, given the negative impact of symptoms of alcoholism on the health of aging parents of children with a disability who may be significantly more susceptible to the negative health impacts of alcohol compared to their younger counterparts.     

Moving Toward Medicare Home Health Coverage for Persons with Alzheimer's Disease

ABSTRACT

Medicare home health care policy does not incorporate research evidence of effective palliative home care interventions for Alzheimer's disease and dementia patients and caregivers. This article examines the dissonance between the needs and burdens of Alzheimer's disease patients and caregivers, research results on medical and palliative care interventions, and medicalized public policy in the Medicare home health benefit. The article asserts existing research establishes a prima facie case exists for the federal government to fund a Medicare Palliative Home Care for Alzheimer's disease demonstration project. The article cites the success of the Medicare Hospice Demonstration project and Hospice Medicare Benefit in reducing costs and improving client quality of life as precedent and a model for Alzheimer's disease. Other research implications are identified.     

Economic and social inclusion of person with disability and transgender through skills development program of BRAC: A qualitative study

This article is based on the Skills Training for Advancing Resources (STAR) project for the youth initiative of the Bangladesh Rural Advancement Committee (BRAC) in Bangladesh. The objective was to explore the consequences of social and economic inclusion of this project for the persons with disability (PWDs) and transgender (TG) youth people. The research focused on how inclusive programmatic interventions created multidimensional impacts among the “marginalized” and “excluded” PWD and TG youths at the grassroots level. This study adopted a qualitative approach where in-depth case interviews and observation were applied for data collection. PWD and TG graduates, master craft persons (MCPs), employers, and program staff members were the participants in this study. Results found that PWD and TG youths faced vulnerabilities and social stigma in their lives and livelihood trajectories due to their physical inability and low level of social dignity. The STAR project has a certain level of contribution to the livelihoods of PWD and TG people, where these helped them to gain their social, cultural, and economic capital. Findings would be an important guideline for policymakers, NGO managers, and human rights workers.     

Facilitating Future Planning for Ageing Adults with Intellectual Disabilities Using a Planning Tool that Incorporates Quality of Life Domains

Abstract

When ageing families of an adult with a lifelong disability embark on a process of planning for the future, they generally think in terms of making hard and fast decisions about: (1) where the person with the disability is going to live when “the time comes”; and (2) who will take on their direct care. However, there is common trepidation among many families when it comes to launching their son or daughter with a lifelong disability. Generally, many families ignore, neglect, or simply do not engage in making any formal plans at all. When ageing families do make plans, they often focus only a place to live. This can mean that other significant aspects of a person's life (i.e., quality of life factors) are negated or neglected. Reviewing population demographics for both the Republic of Ireland and Northern Ireland, it was ascertained that a sizable number of parents will be aging in the near future and that some formalized assistance for future planning was needed. To this end, a planning instrument, What the Future Holds, was developed in order to help families and other carers with planning for the future and involving a variety of quality of life domains, including health, financial, vocational, social, civil, and residential well-being.