Schizophrenia in older adults

Although the number of people older than 55 with schizophrenia is expected to double during the next 20 years, the research data on older adults with schizophrenia are limited. This appears to be because until the middle of the 20th century, it was assumed that mental illness in older adults was a part of the aging process and because older adults are often excluded from research investigations. Nursing research is needed to explore how people with schizophrenia learn to manage their problems as they age, as well as how those who are first diagnosed with schizophrenia in later life adapt to their illness. Mental health nurses need to be cautious in assigning premature labels to older adults with mental illness that may lead to unsubstantiated assumptions about levels of disability. Instead, nurses should realize individual potential regarding undiscovered strengths and should attempt to create interventions that recognize and foster personal development for older adults with schizophrenia.     

Revisiting the Association between Pornography Use and Risky Sexual Behaviors: The Role of Early Exposure to Pornography and Sexual Sensation Seeking

Among the suggested problems and harms associated with widespread pornography use among young people, risky sexual behaviors have been frequently mentioned. To further explore this public health concern, this article analyzed sexual sensation seeking (SSS) as a potential confounder of the association between pornography use and sexual risks using data collected in 2010 from a population-based sample of young Croatian adults aged 18 to 25 (n = 1,005). Significant, but small, correlations were found between the indicators of pornography use (age at first exposure, frequency of use in the past 12 months, and personal importance of pornography) and sexual risk taking. However, in a multivariate analysis, only age at first exposure to pornography remained a significant, albeit weak, predictor of sexual risk taking among both women and men. SSS, defined as the dispositional tendency toward the impulsive pursuit of sexual arousal and stimulation, neither confounded nor moderated this association. Overall, the findings do not support the notion that pornography use is substantially associated with sexual risk taking among young adults, but suggest that early exposure to sexually explicit material and high SSS are additive risk factors for sexual risk taking.     

Older adults' narratives about a flood disaster: Resilience, coherence, and personal identity

Older adults are a vulnerable group in a disaster and are more at risk of adverse effects as a result. This paper draws on the use of narrative theory in health and gerontology studies to examine how a disruptive disaster was storied. Narrative interviews were conducted with nine older adults aged over 65 years who had recently experienced a flood disaster. The participants' narratives about the disruptive event were integrated with past personal events that spanned more than seven decades. The disaster became a reference point for previous challenging experiences, which created biographical continuity, coherence and order over time. Furthermore, the disaster stories were about biography and identity, and showed how older adults made sense of the flood from a life-course perspective. The use of narrative approaches provides an insight into how the flood disaster was experienced, and reveals how four older adults storied their experiences of a significant life challenge.     

Berufliches Handeln in Dilemmasituationen — Führungskräfte zwischen Pflichterfüllung und Eigenverantwortung

Taking decisions and acting in non-standard situations — which are not described in company guidelines and procedures — is part of a manager′s role and responsibilities. As part of an empirical study 158 managers as well as potential management candidates have been put into dilemma situations in which they have to choose between strictly following company policies or alternatively taking own initiative and choosing a self-responsible action path with more risks and conflict potential. To explain the decisions taken different background information is used such as the organizational culture, the manager′s personal goals and a scale describing self-responsibility as a part of the individual′s self-concept. The preference of organizations is described in relation to the organization′s culture: Following guidelines and ′doing one′s duty′ was the most favored solution from the organization′s point of view. Managers and management candidates choose self-responsible acting with low conflict potential when they feel in harmony with their organization. Managers only choose self-responsible acting with high conflict potential if they have a strong tendency for taking own initiative and are ready to take responsibility for their actions. The results are discussed focusing on self-responsibility levels and on consequences for organizations.     

Social Relationships of African American and Hispanic Older Assisted Living Residents: Exploring the Role of Race and Ethnicity

African American and Hispanic older adults are underrepresented in assisted living communities, so little is known about how they experience social relationships in these settings. The purpose of the study was to explore resident-to-resident and resident-to-staff relationships experienced and perceived by African American and Hispanic older residents in assisted living settings. In-depth interviews with 15 African American and 15 Hispanic older adults were conducted in seven assisted living communities in Central Florida. Three salient themes emerged using a grounded theory approach: formation of relationships: emotional vs. instrumental support; language as a facilitator or barrier; and avoidance of inter-racial relationships. Implications for providing culturally competent services in assisted living communities with diverse populations are discussed.     

Network recall among older adults with cognitive impairments

Although it is widely accepted that personal networks influence health and illness, network recall remains a major concern. This concern is heightened when studying a population that is vulnerable to cognitive decline. Given these issues, we use data from the Social Network in Alzheimer Disease project to explore similarities and discrepancies between the network perceptions of focal participants and study partners. By leveraging data on a sample of older adults with normal cognition, mild cognitive impairment, and early stage dementia, we explore how cognitive impairment influences older adults’ perceptions of their personal networks. We find that the average individual is more likely to omit weaker, peripheral ties from their self-reported networks than stronger, central ties. Despite observing only moderate levels of focal-partner corroboration across our sample, we find minimal evidence of perceptual differences across diagnostic groups. We offer two broad conclusions. First, self-reported network data, though imperfect, offer a reasonable account of the core people in one’s life. Second, our findings assuage concerns that cognitively impaired older adults have skewed perceptions of their personal networks.     

Learning about Cognitive Dissonance and Race Relations: A Study of the Personal Narratives of Older White Southern Women Who Grew up with Maids

A critical analysis of the content of a recent collection of personal narratives of 23 older White women from the Deep South who grew up with domestic servants in their homes was conducted to study how these Whites who enjoyed the fruits of segregation look upon their White privilege from the perspective of today. The interviews revealed much about the close bonds that formed across racial lines. However, they also provide a wealth of information about how the White individuals handled the dissonance or discrepancy between their personal values of today and their behavior and attitudes back then.     

Gender,Preloss Marital Dependence,and Older Adults’ Adjustment to Widowhood

I examine how preloss emotional and instrumental dependence on one's spouse affects older adults’ psychological adjustment to widowhood. Analyses are based on 297 persons from the Changing Lives of Older Couples (CLOC) study, a prospective study of widowhood among adults aged 65 and older. Women who were most emotionally dependent on their spouses had the poorest self‐esteem while still married, yet evidence the highest levels of self‐esteem following loss. Men who were most dependent on their wives for home maintenance and financial management tasks experience the greatest personal growth following loss. These results suggest that widowed persons who were once highly dependent upon their spouses reap psychological rewards from the recognition that they are capable of managing on their own.     

Powerlessness and Abuse and Neglect of Older Adults

ABSTRACT

This article is a qualitative study which addresses the interacting relationship between the environmental context of care giving and abuse and neglect of older adults. These are examined through a thematic content analysis of risk factors identified in sixteen ‘in depth’ interviews of abused and neglected victims including two of their abusers. The interviews provide a portrait of their past and present situations, their roles and relationships and the process through which the interviewees move into their described process of powerlessness.

The interviewees are analysed through a critical, systemic, ecological analysis of the historical, gender and cultural perspectives of the interviewees. Through the relationships of the victims and their abusers in the macro, meso, exo and micro systems, questions are raised about the growing debate regarding changes in family patterns and demographics that affect how societies define the provision of care to their dependent adults. They demonstrate that violence is produced by complex interacting systems and significant events, that impact on the life courses of some older adults and some care givers leading them into powerless positions and resulting in abuse and neglect.     

Perceptions of Parental Intimate Relationships and Their Affects on the Experience of Romantic Relationship Development Among African American Emerging Adults

The quality of romantic relationships that parents maintain has an impact on their children. Emerging adult children base their relationships on similar values and/or opposing beliefs of their parental romantic relationships. This phenomenological study aimed to identify how African American emerging adults experience their parental romantic relationships and how they find meaning in the romantic relationships of their parents. Results suggest that African American emerging adults develop both positive and negative perceptions about romantic relationships from their parents’ relationships, which affect the way these adults perceive, develop, and maintain their own romantic unions. African American emerging adults also find meaning in their parental couple relationships as they share similar experiences in their relationship quality, mate choice, and/or personal or mate characteristics and personality traits as their parents.     

Responsibility Inferences and Intergenerational Obligations to Parents and Stepparents: Are Step/Children Less Obligated When Older Adults Are at Fault for Their Problems?

Beliefs about intergenerational obligations to assist older adults are known to be influenced by contextual variables such as the type of kin relationship (i.e., stepparent, parent) between older and younger adults. One contextual variable that has not been studied is the degree to which older individuals are seen as culpable for their problems. If older kin are perceived to be at fault for their problems, are they seen as less deserving of help than if they are not to blame? Do judgments about being at fault for problems affect beliefs about helping parents differently than beliefs about helping stepparents? A random national sample of 229 men and 274 women responded to vignettes about an older parent or stepparent who needed help managing diabetes, which was presented as either the consequence of the older adult's actions or as an inherited illness. Respondents were asked about younger family members' obligations to help older adults, how much help younger adults and public agencies should provide, and how much older adults were responsible for themselves. The effects of older adults' marital status and sex of both adults also were examined. Obligations to stepparents were less than obligations to parents. The amount of help respondents thought should be provided was moderated by older adults' marital status. Obligations and aid to parents and stepparents generally were not affected by the older adults' culpability for the problems.     

Exercise intervention designed to improve strength and dynamic balance among community-dwelling older adults

Loss of balance and falling are critical concerns for older adults. Physical activity can improve balance and decrease the risk of falling. The purpose of this study was to evaluate a simple, low-cost exercise program for community-dwelling older adults. Sixteen senior adults were evaluated using the Senior Fitness Test for measures of functional strength, aerobic endurance, dynamic balance and agility, and flexibility. In addition, measures of height, weight, resting blood pressure, blood lipids, and cognitive function were obtained. Participants then attended a 10-week exercise class including stretching, strengthening, and balance-training exercises. At the completion of the program, significant improvements were observed in tests measuring dynamic balance and agility, lower and upper extremity strength, and upper extremity flexibility. The results indicate that exercise programs such as this are an effective, low-cost solution to improving health and factors that affect falling risk among older adults.     

Judgments about Risk and Perceived Invulnerability in Adolescents and Young Adults

This study examined age differences in risk judgments and perceptions of invulnerability, by surveying 577 adolescents (grades 5, 7, and 9) and young adults (ages 20 to 30 years) for their judgments concerning natural hazards and behavior–linked risks. Adolescents were less likely than were young adults to see themselves as invulnerable, and only a small minority of adolescents evidenced such perceptions. Moreover, individuals’ perceptions about the magnitude of their personal risk for experiencing negative outcomes showed an inverse relation to age. Most participants were inaccurate and significantly overestimated risks; this was especially true of adolescents. These patterns of age differences were consistent across different types of risks and sociodemographic configurations. The results pose a challenge to conventional wisdom concerning adolescents’ perceptions of risk and have important implications for theory, programs, and policies related to adolescents.     

Deploying an Ecological Model to Stem the Rising Tide of Firearm Suicide in Older Age

A central objective of the Surgeon General’s National Strategy for Suicide Prevention is to focus on older adults. We review individual risk-factors for suicide in late life and then introduce an ecological model to expand conceptualization of elder suicide. We first look at the role of firearms, providing evidence that firearm availability increases the means of elder suicide and gun access policies can contribute to reducing risk. Next, we focus on primary care providers, documenting how older adults often come into contact with these professionals before ending their lives and how these providers could take a more active role in mediating individual-level risk factors. We then turn our attention to the intersection between gun access and primary care and consider how advancing standards of care concerning gun access and suicide risk might be an effective policy alternative for blocking the pathway to suicide among older adults.     

Marriage and family therapy faculty members' balance of work and personal life

A sense of imbalance is common among both professors and therapists, though few studies have been published examining the work and personal life balance of those who work in both professions simultaneously. Using in-depth telephone interviews, this study examined the work and personal life balance of 16 marriage and family therapy (MFT) faculty members. Results showed that six were satisfied with their balance, six were dissatisfied, and four were "middle of the road." Men, older participants, and those who were in their career longer were more likely to report feeling satisfied with their balance. Internal indicators of their balance included family and workplace messages, health indicators, feelings of contentment, and congruence with personal values. Child and relationship status, tenure status, and gender issues also impacted their sense of balance. Specific balance enhancers and reducers were highlighted, and participants discussed coping strategies and recommendations for other MFT faculty members. Clinical, training, and career implications are discussed.     

Ambivalence in Later‐Life Family Networks: Beyond Intergenerational Dyads

In later life, changing conditions related to health, partnership, and economic status may trigger not only support but also conflict and ambivalence, with the consequent renegotiation of family ties. The aim of this study is to investigate both conflict and emotional support in the family networks of older adults, taking the research beyond the level of intergenerational dyads. We used a subsample of 563 elders (aged 65 years and older) from the Swiss Vivre/Leben/Vivere survey. Multiple correspondence analysis and in‐depth case studies were used to identify the key social conditions that relate to the prevalence of conflicted and supportive dyads in family networks. Findings showed that the balance of conflict and emotional support in older adults' family networks varied according to the composition of their family network as well as their age, health, income, and gender.     

Adolescents’ Narratives of Schadenfreude

This study explored the experiential determinants of schadenfreude, how schadenfreude changes as a function of relationship, and how recollections of schadenfreude may vary by age. Using a narrative approach, 12‐ and 15‐year‐olds (N = 60) described times they felt schadenfreude toward various peers and adults. We coded their responses to extract information regarding preceding misfortunes and underlying reasons for schadenfreude. We found that adolescents' schadenfreude often involved another’s physical harm and failure, and was rooted in reasons of deservingness and personal gain. There were unique trends in the types of misfortunes and reasons mentioned toward each target of interest. Finally, deservingness reasoning was prominent within 15‐year‐olds’ schadenfreude experiences. The findings are discussed in relation to adolescents’ emotional experiences in conflict situations.     

Blessed assurance: The role of religion and spirituality in Alzheimer's disease caregiving and other significant life events

Increasing attention in the scientific literature is being given to the relationships among religion, spirituality, and overall well-being. Moreover, research has repeatedly identified religion and spirituality as significant coping resources throughout the life course. For this study, a group of 20 Catholic and Protestant older adults were interviewed; half were caregivers of a spouse with Alzheimer's disease and half were noncaregivers. The informants were asked about their views on religion, spirituality, and how they integrated their faith into their lives. Qualitative analysis identified several themes reinforcing previous work that has shown religion and spirituality are important dimensions to the human experience. All of the informants had integrated religious and spiritual beliefs and practices into their lives to help make sense out of stressful situations. The findings underscore the need for further scientific inquiry that examines how religion and spirituality promote healthy adaptation to significant life events.     

Positive dying and resiliency in later life: A qualitative study

This article examines resiliency factors and processes of older adults who experienced positive dying from their perspectives. A qualitative study was conducted based on interviews with 16 hospice patients and their primary caregivers. Core resiliency factors identified included empowering relationships with significant others, spiritual beliefs and practices, ability to skillfully confront mortality, and a stable caregiving environment. These older adults' psychological processes were characterized by a dialectical tension of surrender and resistance, and a creation of life-affirming narratives through which they derived meaning of death and dying. Aspects of personal growth and psychosocial and spiritual well-being were interrelated in these dying older adults' experience of life fulfillment. The examples of resilient older adults suggest that greater attention should be devoted to the interrelatedness of spiritual and psychosocial well-being and human development. Developing an understanding of the positive potential at the end of life is essential to form new ideas in end-of-life care.     

The Use of Body Movements and Gestures as Cues to Emotions in Younger and Older Adults

Eighty-two younger and older adults participated in a two-part study of the decoding of emotion through body movements and gestures. In the first part, younger and older adults identified emotions depicted in brief videotaped displays of young adult actors portraying emotional situations. In each display, the actors were silent and their faces were electronically blurred in order to isolate the body cues to emotion. Although both groups made accurate emotion identifications well above chance levels, older adults made more overall errors, and this was especially true for negative emotions. Moreover, their errors were more likely to reflect the misidentification of emotional displays as neutral in content. In the second part, younger and older adults rated the videotaped displays using scales reflecting several movement dimensions (e.g., form, tempo, force, and movement). The ratings of both age groups were in high agreement and provided reliable information about particular body cues to emotion. The errors made by older adults were linked to reactions to exaggerated or ambiguous body cues.