Caregivers' perceptions of case management and community-based services: barriers to service use.

This study explored the use of case-managed services for dementia patients and their families. Forty-six primary caregivers, recruited from five case-managed programs and from independent sources, participated in a structured interview. The findings suggest ways in which case-managed services might be structured more effectively for caregivers to dementia patients.

Changes in cognitive functioning of the oldest old.

Cognitive changes during a 2-year interval in a representative sample of the oldest old were investigated. Respondents were 324 people aged 84 to 90 at baseline who were selected from census records in the Jönköping region of Sweden. Following a 2-year interval, it was possible to reinterview 213 people, or 94% of individuals, still alive.

Empirical perspectives on services integration and aging: a review.

This article combines a review of social service literature with interviews of key informants on the issue of integrating services for the elderly into human services across the life span. Empirical findings concerning the relative benefits and drawbacks of age-integrated vs. specialized service organizational structures are emphasized.

Caregiver activity on respite and nonrespite days: a comparison of two service approaches.

Use of time was examined among female caregivers of dementia patients who used home care (n = 20) and day care (n = 20) respite services. Assessment of caregiver activity during respite and nonrespite days revealed significant program differences in the amount of caregiving time and overall differences in the amount of noncaregiving time. Use of respite time was also examined.

Informal support from black churches and the well-being of elderly blacks.

This paper explores the type of support black churches and families provide, and how that support relates to the well-being of elderly blacks. Findings indicate that the family network is perceived as more supportive than the church network, but that church support contributes to feelings of well-being. Perceptions of support from the churches and not the spiritual aspects of religion or involvement in organized religious activities were associated with well-being.

Efficacy of interventions with caregivers: a reanalysis.

This paper presents a reanalysis of data from a previously reported study with family caregivers of dementia patients using the method of prediction analysis. Compared with subjects on a waiting list or enrolled in support groups, caregivers in individual and family counseling were more likely to have successful outcomes on all dependent measures (Brief Symptom Inventory, personal strain, and role strain).

Current research issues in caregiving to the elderly.

Caregivers for dependent elders have been the subject of numerous studies in recent years. This first wave of research demonstrates that caregiving is demanding and may be expensive to the caregiver socially, psychologically, physically, and financially. This article reviews the caregiving literature and focuses on current limitations and future directions for study in two areas: sampling and research design.

Dementia and cognitive impairment in the oldest old: a comparison of two rating methods.

Rates of cognitive impairment in a representative population of the oldest old (aged 84 to 90) were examined using two indicators: The Global Deterioration Scale (GDS), and a Cognitive Rating (CR) derived from performance on five neuropsychological tests. Prevalence was estimated at 25.3%, using the GDS, and 30% with the CR.

Incontinence among elderly community-dwelling dementia patients. Characteristics, management, and impact on caregivers.

Incontinence was identified by 36% of 184 caregivers as a problem in their care of older community-dwelling patients with dementia. Incontinent dementia patients had greater impairment of cognitive function and more frequent behavioral problems than did patients without incontinence. Burden scores were higher among caregivers of incontinent patients, but multiple regression analyses indicated that factors other than incontinence contributed more to perceived burden.

Family caregiving to dependent older adults: stress, appraisal, and coping.

Articles presented in this 1987 APA symposium adopt a stress, appraisal, and coping framework for conceptualizing the experience of family caregiving. Each article emphasizes 2 themes: (a) caregivers' adaptation to the chronic demands of in-home caregiving and (b) factors that mediate the relationship between caregiving stress and caregiver's adaptation. The articles presented in this symposium illustrate both the utility of this theoretical approach to studying caregiving stress and the difficulty inherent in its use.

Current and future direction in family caregiving research.

The Symposium concludes with suggested ways to improve measurement of treatment effects in studies of group interventions for family caregivers: better specification of goals and outcomes, development of measures less likely to have floor and ceiling effects, and determination of whether specific treatment processes have been implemented and goals attained. Samples too heterogeneous on key variables also make identification of change more difficult.

Symptoms of psychological distress among caregivers of dementia patients.

Nine subscales of the Brief Symptom Inventory (BSI) were examined for caregivers of dementia patients. Caregivers (N = 184) were divided into groups on the basis of age (less than or equal to 59 and 60+ ) and gender. Their scores were compared with age-matched norms.

Interventions with care givers of dementia patients: comparison of two approaches.

We compared the effect of two approaches, family counseling and support groups, for relieving the stress and burden experienced by care givers of dementia patients. Both treatments are designed to implement features of a stress-management model that have been identified in prior research with this population: providing information about the patient's disease and its effects on behavior, teaching behavioral problem solving for managing difficult behavior, and identifying potential support for care givers. Subjects were primary care givers of dementia patients living in the community; they included husbands, wives, daughters, and other relatives.

Psychological deficits in depressed medical patients.

A frequent clinical problem observed in the medical setting is depression secondary to the impact of physical illness and hospitalization. Typically, approaches developed on physically healthy samples are applied to these patients without many specific data on this particular subtype of depression. Both cognitive abilities and behavioral functions were assessed in a sample of medically ill depressed patients, who were compared to medically ill nondepressed patients and community-dwelling healthy controls.

The structure of post-retirement adaptation for recent and longer-term women retirees.

A review of the literature on adjustment to retirement reveals that many investigators have studied retirees together as a group, regardless of the amount of time they have been retired. The present study questions the validity of that approach. The post-retirement adaptation of a group of 59 relatively recent (3-6 years) and 122 longer-term (7 + years) retirees was compared via canonical correlation analyses.

Helping an aging patient to cope with memory problems.

Memory loss is often a subjective symptom rather than an objective one. Complaints of poor memory appear to be related to stereotypes of aging and to the presence of depression, rather than to chronic brain disease. Reassuring an elderly person that occasional forgetfulness does not indicate senility, and improving morale in those who are depressed, effectively reduce exaggerated memory concerns.