Health Burden, Support Adequacy, and Depressive Symptoms in Older Men With HIV.

Background And Objectives: Older adults with HIV face greater health burden than HIV-uninfected counterparts. Little is known about resources that might mediate the influence of physiological health burden on psychological well-being. Informed by the stress process model, we assessed the influence of multifaceted health burden indicators on depressive symptoms and evaluated the mediating effects of social support adequacy.

Palliative care for case managers: Building capacity to extend community-based palliative care to underserved older adults.

Palliative care has demonstrated effectiveness in alleviating the biological, emotional, social, and spiritual symptoms that accompany serious illness, and improving quality of life for seriously ill individuals and their family members. Despite increasing availability, there are significant disparities in access to and utilization of palliative care, particularly among diverse, low-income, and community-dwelling older adults with chronic illness. Training frontline service providers is a novel approach to expanding access to palliative care among underserved elders.

Hospice Bereavement Service Delivery to Family Members and Friends With Bereavement-Related Mental Health Symptoms.

Objectives:: A sizable minority of those who lose a loved one in hospice will experience symptoms of bereavement-related mental health disorders. Though hospices offer services to bereaved informal caregivers (family members or friends) of patients, little is known about services offered or interest in them. Therefore, we sought to assess services offered by hospice staff and interest expressed by bereaved informal caregivers with symptoms of depression, anxiety, or complicated grief (CG).

Correlates of Subjective Cognitive Decline in Lesbian, Gay, Bisexual, and Transgender Older Adults.

Background: Little is known about subjective cognitive decline (SCD) in lesbian, gay, bisexual, and transgender (LGBT) older adults.

Objectives: To examine SCD and its association with dementia risk factors, other physical and psychosocial health factors in LGBT older adults.

Methods: A cross-sectional study of SCD was conducted with LGBT older adults, aged 50 and older (n = 210).

Identifying Palliative Care Needs Among Older Adults in Nonclinical Settings.

Though palliative care is appropriate for patients with serious illness at any stage of the illness and treatment process, the vast majority of palliative care is currently delivered in inpatient medical settings in the past month of life during an acute hospitalization. Palliative care can have maximal benefit to patients when it is integrated earlier in the illness trajectory. One possible way to increase earlier palliative care use is to screen for unmet palliative care needs in community settings.

The Intersectionality of Stigmas among Key Populations of Older Adults Affected by HIV: a Thematic Analysis.

Objectives: The present study examined the intersectionality of stigma across varying groups of older persons living with HIV (PWH).

Methods: Four focus groups of older PWH (gay/bisexual men, heterosexual men, heterosexual and bisexualwomen, and Spanish-speaking) were audio-recorded and transcribed. Inductive thematic text analysis was used to identify qualitative themes.

"We Take Care of People; What Happens to Us Afterwards?": Home Health Aides and Bereavement Care in Hospice.

After a hospice patient dies, hospice providers can experience a variety of emotional responses. While work has been done on social workers' and nurses' reactions to patient death, home health aides (HHAs) have been overlooked. To address this gap, we conducted focus groups and individual qualitative interviews with 14 hospice HHAs.

Development of a Community-Based Palliative Care Screening Tool for Underserved Older Adults With Chronic Illnesses.

Although they experience high rates of chronic illness, low-income minority communities have traditionally underutilized palliative care services compared to whites and those with higher incomes. One reason for this trend is lack of screening by community providers. We utilized a community-based participatory research approach to develop and implement an innovative multidomain palliative care screening tool in aging service agencies.

Factors associated with depression detection in a New Hampshire mental health outreach program.

Objectives: For mental health outreach programs for older adults, accurately detecting depression is key to quality service provision. Multiple factors, including gender, cognitive impairment, or recent bereavement may affect depression detection, but this is under-studied. Therefore, we sought to both establish rates of depressive symptom detection and to examine factors associated with inaccuracies of detecting depression among participants in a mental health outreach program serving older adults.

Professional quality of life of adult protective service workers.

Adult Protective Services (APS) workers are exposed to substantial occupational hazards and job stress, but these stressors are underdocumented. Therefore, we sought to describe APS workers' work environments and responses to occupational hazards and stressors, including compassion fatigue, burnout, and secondary traumatic stress. Survey data were gathered with closed-ended questionnaires administered to APS workers in an urban setting.

Expanding palliative care's reach in the community via the elder service agency network.

Over the past two decades, palliative care has established itself as a promising approach to address the complex needs of individuals with advanced illness. Palliative care is well-established in US hospitals and has recently begun to expand outside of the hospital setting to meet the needs of non-hospitalized individuals. Experts have called for the development of innovative community-based models that facilitate delivery of palliative care to this target population.

Measures of Financial Capacity: A Review.

Purpose Of The Study: Capacity to manage finances and make financial decisions can affect risk for financial exploitation and is often the basis for legal determinations of conservatorship/guardianship. Several structured assessments of financial capacity have been developed, but have not been compared regarding their focus, validity, or reliability. Therefore, we conducted a review of financial capacity measures to examine these factors.

Performance and psychometric properties of the Interpersonal Support Evaluation List (ISEL) in older adults with Complicated Grief.

Background: Complicated Grief (CG) is a recently recognized bereavement-related mental health disorder. Social support is commonly measured with the Interpersonal Support Evaluation List (ISEL), a 40-item, 4-factor, self-report measure. Though the ISEL has been well-studied, no identified research has examined its psychometric properties or performance in older adults with CG.

Training residents in depression and grief.

Background: About 20 per cent of Americans will experience depression in their lifetimes, and almost all will experience the death of a loved one. Both depression and grief have been associated with adverse health outcomes, including a decline in quality of life and excess mortality. Primary care physicians (PCPs) are the initial health care contact for most patients with depression and grief, yet often perceive that they lack the skills to adequately address these issues.

Performance characteristics and clinical utility of diagnostic criteria proposals in bereaved treatment-seeking patients.

Background: Persistent complex bereavement disorder (PCBD) is a protracted form of grief included in DSM Section 3 indicating a need for more research. Two other criteria sets [prolonged grief disorder (PGD) and complicated grief (CG) disorder] are also currently in use by researchers. This study evaluates rates of diagnosis of each proposed criteria set in a clinical sample of bereaved individuals participating in clinical research.

Factors Associated with Providers' Perceptions of Mental Health Care in Santa Luzia's Family Health Strategy, Brazil.

Brazil has a unique mental health care system, characterized by universal coverage delivered by interdisciplinary teams both in the community and in specialized centros de atenção psicossocial (CAPS-psychosocial care centers). Provision of patient-centered mental health care is an important principle of Brazilian mental health care, but this topic has not been well-studied. We analyzed data from a cross-sectional survey of 151 community health workers (CHWs), nurses, and physicians in Santa Luzia, Minas Gerais State, Brazil.

Utilization of Hospice Bereavement Support by At-Risk Family Members.

Approximately 10% of the bereaved are at risk of bereavement-related mental health disorders. Hospices' bereavement services could potentially address needs of many at risk, but little is known about their service use. We analyzed data from 6160 bereaved family members of hospice patients.

Treatment of complicated grief in elderly persons: a randomized clinical trial.

Importance: Complicated grief (CG) is a debilitating condition, most prevalent in elderly persons. However, to our knowledge, no full-scale randomized clinical trial has studied CG in this population.

Objective: To determine whether complicated grief treatment (CGT) produces greater improvement in CG and depressive symptoms than grief-focused interpersonal psychotherapy (IPT).

Mind-body techniques, race-ethnicity, and depression among urban senior center participants.

As the older adult population grows and becomes more diverse, more of its members are turning to complementary and alternative medicine (CAM). There are mixed findings regarding racial and ethnic differences in the use of CAM. This article explores racial and ethnic differences in use of a category of CAM known as mind-body techniques (MBT) among senior center participants with symptoms of depression.

The value of daily money management: an analysis of outcomes and costs.

For vulnerable and frail older adults, management of daily financial obligations can become an overwhelming burden spiraling into at-risk situations. Social service agencies have developed community-based Daily Money Management programs to assist these adults in protecting their financial security. Through this study the authors present the first economic estimates of the costs of Daily Money Management programs which, along with case management programs, save $60,000 per individual when compared with the cost of nursing home placement, making them highly cost effective.

The influence of neighborhood factors on the quality of life of older adults attending New York City senior centers: results from the Health Indicators Project.

Purpose: To examine the association between self-assessed quality of life (QOL) and perceived neighborhood safety, social cohesion, and walkability among older adults in New York City (NYC).

Methods: We used data from the 2008 Health Indicators Project, a cross-sectional survey of 1,870 older adults attending 56 NYC senior centers. QOL, a binary measure, was created by dichotomizing a 5-point Likert-scaled global assessment.

Senior gambling: risk or reward?

For a growing number of older adults, a day outing to a local casino has become one of the more enjoyable and accessible opportunities for socialization and entertainment. Unfortunately, for some older adults this growing pastime increases their risk for developing a gambling problem or, worse yet, a gambling addiction. The consequences of problematic gambling behaviors for individuals living on a fixed income require greater attention by social work researchers, practitioners, and providers of senior services.

Factor analysis of financial and operational performance measures of non-profit hospitals.

Objective: To understand the important dimensions of the financial and operational performance of non-profit hospitals.

Data Source: Secondary data for non-profit US hospitals between 1996 and 2004.

Study Design: I use iterative principal factor analysis of hospitals' financial and operational ratios for each year of the study.

Health behaviors of older Chinese adults living in New York City.

The dramatic increase in the number of older immigrants living in the U.S. presents new challenges to policy makers concerned with promoting healthy aging.