Key Determinants to using Telehealth Technology to Serve Medically Ill and Depressed Homebound Older Adults

Despite the increasing evidence for the effectiveness of telehealth technology in screening and treating chronic diseases, and comorbid depression among older adults, they have been slowly adopted by home health care (HHC) agencies. Therefore, this study aimed to identify factors that determine telehealth technology adoption. Twenty directors from the National Association for Homecare & Hospice member agencies completed a 45-min telephone interview. Questions were asked regarding their perceptions of telehealth, the key determinants of telehealth adoption and use, and recommendations they would give on telehealth adoption. The majority of the participants perceived telehealth as effective for managing symptoms and reducing cost. Meanwhile, some participants had a mixed feeling toward telehealth for depression care as they did not recognize their agency as equipped with the necessary resources and trained staff. Moreover, significant determinants of telehealth adoption included the agency-related characteristics, the patient-home environment, reimbursement and cost-related factors, and staff telehealth perception. Findings imply that there is a need for financial support both at the state and the federal levels to encourage telehealth adoption among HHC agencies. Future studies should consider exploring strategies used by successful programs to overcome barriers.     

Anxiety and Related Symptoms in Older Persons With Dementia: Directions for Practice

Anxiety disorders and related symptoms commonly occur in older people with cognitive impairment or dementia, significantly worsening functioning and reducing quality of life. This review of the literature outlines the extent of the problem, and focuses on current best practices in psychosocial interventions anxiety in persons with dementia. Discussion follows on promising nonpharmacological interventions that are recommended for further consideration and future research.     

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.     

Anxiety and related symptoms in older persons with dementia: directions for practice

Anxiety disorders and related symptoms commonly occur in older people with cognitive impairment or dementia, significantly worsening functioning and reducing quality of life. This review of the literature outlines the extent of the problem, and focuses on current best practices in psychosocial interventions anxiety in persons with dementia. Discussion follows on promising nonpharmacological interventions that are recommended for further consideration and future research.     

Social Work Practitioner Knowledge and Assessment of Late-Life Depression

Late-life depression has attracted considerable attention in the social work literature. This study examined levels of knowledge and self-efficacy (confidence) in evaluation of depression in late life among a random sample of social workers (N = 168) from the National Association of Social Workers. Relationships among knowledge on aging, job-related variables, and predictors of knowledge of geriatric depression were examined. Participants ranked depression as one of the most frequent clinical problems seen in practice, scored at the lower end on knowledge about aging, and experienced great difficulty on the items pertaining to suicide in the older adults.     

Assessment of a Brief CES-D Measure for Depression in Homebound Medically Ill Older Adults

Black elderly individuals represent one of the most disadvantaged groups in the United States in terms of income levels, health problems, and access to supportive services. This paper describes four major factors to be considered by social service providers to focus their programs toward needs of the black elderly population in their local communities. A research project designed to examine the social service needs and service utilization of the black elderly in a Midwestern community indicated that the following factons hould be considered if effective service programs are to be implemented: (1) Negotiation Initiative, (2) Responsible Research, (3) Symbolism, (4) Modeling.     

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.     

Short-Term Prospective Effects of Impulsivity on Binge Drinking: Mediation by Positive and Negative Drinking Consequences

Abstract. Objective: Although the association of impulsivity with diverse alcohol outcomes has been documented, the mechanisms by which impulsivity predicts drinking over time remain to be fully characterized. The authors examined whether positive drinking consequences, but not negative drinking consequences, mediated the association between impulsivity and subsequent binge drinking, over and above prior binge drinking. Participants: Participants were 171 college students. Methods: Participants completed 2 online surveys with an average interval of 68 days between assessments at Time 1 (September to October 2012) and Time 2 (November to December 2012). Results: Path analysis showed that, among 5 facets of impulsivity, the effect of sensation seeking on subsequent binge drinking was completely mediated by prior positive consequences. No mediating effects of negative consequences were found. Conclusions: Prior experience of positive drinking consequences may serve as one of the risk pathways by which sensation seeking shapes binge drinking over time. Personalized intervention strategies may utilize information about students’ impulsivity facets to address their binge drinking and alcohol-related consequences.     

Psychological Distress and Help-Seeking by Residents of a Neighborhood Naturally Occurring Retirement Community (NNORC)

This article presents findings from an annual program survey of residents of a horizontal neighborhood naturally occurring retirement community (NNORC). The study explored the relationship between several factors (age, co-residents, number of chronic illnesses, self-reported health, loneliness, sense of mastery, locus of control, pain, and psychological distress) and their ability to predict general health, level of psychological distress, and the quantity and type of help-seeking behaviors. Although residents generally reported moderate to high levels of chronic disease, pain, loneliness, and concerns about life issues, 25% of them sought no help from any of the listed resources, and 65% sought help from only one of seven resources. The most common source of help for most (70%) was a primary care physician (PCP), and comparatively few respondents sought help from other sources. Older adults, especially those with chronic illness, generally consider their PCP to be the first, and perhaps only, source to consult. However, research indicates that the most effective health promotional programs for older adults are social and educational group activities, rather than individual health-focused interventions. Possible means of redirecting residents toward NNORC services include more vigorous outreach and creating collaborative partnerships between local PCPs serving older populations and the NNORC.