Clinical Gerontologist Research Articles

Clinical Gerontologist Special Issue: Lethal Means Safety in Older Adults

Clinical Gerontologist Special Issue: Lethal Means Safety in Older Adults

Clinical Gerontologist

Clinical Gerontologist

Grief and Healing in Young and Middle Age: A Widower's Journey.

The experience of grief is both uniquely personal and universal. Our personality, our relationship with the deceased, the manner in which the deceased died, our life stage, and many other contextual factors matter and impact grief, and yet there are many experiences, phases, stages of grief that are universal. Those who are grieving deeply or who are farther along in their healing are often trying to understand grief and its realities. It has been said that people die but relationships do not. As a widower twice, once at age 25 and then again nearly 30 years later, I agree with that sentiment, and it is the profound relationships with my wives Becky and Susan that propelled me to share my experiences and reflections on grief and healing. As a clinical psychologist and gerontologist I examined the grief and gerontology literature, learning new things that were useful and not as useful.

Sustaining and realizing the promise of telemedicine.

Sustaining and realizing the promise of telemedicine.

Telehealth and Older Adults with Chronic Illness

(2007). Telehealth and Older Adults with Chronic Illness. Clinical Gerontologist: Vol. 31, No. 1, pp. 1-4.

Is Length of Stay on Hospice a Critical Quality of Care Indicator?

Journal of Palliative MedicineVol. 10, No. 2 Guest EditorialsIs Length of Stay on Hospice a Critical Quality of Care Indicator?Timothy E. QuillTimothy E. QuillSearch for more papers by this authorPublished Online:13 Feb 2007https://doi.org/10.1089/jpm.2006.9984AboutSectionsPDF/EPUB ToolsPermissionsDownload CitationsTrack CitationsAdd to favorites Back To Publication ShareShare onFacebookTwitterLinked InRedditEmail FiguresReferencesRelatedDetailsCited ByThe pain in the Emergency Department: Choosing and treating wisely before and during the COVID-19 era20 December 2021 | Emergency Care Journal, Vol. 17, No. 4Hospice Care: Nurses’ Experience and Perception of Older Adult Patients’ Experience9 October 2017 | Clinical Gerontologist, Vol. 42, No. 3The Impact of Hospice Patient Disease Type and Length of Stay on Caregiver Utilization of Grief Counseling: A 10-Year Retrospective Study16 August 2016 | American Journal of Hospice and Palliative Medicine®, Vol. 34, No. 9Examining hospice enrollment through a novel lens: Decision time13 July 2016 | Palliative and Supportive Care, Vol. 15, No. 2Development of a set of process and structure indicators for palliative care: the Europall project2 November 2012 | BMC Health Services Research, Vol. 12, No. 1The Role of Race and Ethnicity in Predicting Length of Hospice Care among Older Adults Nan S. Park, Iraida V. Carrion, Beom S. Lee, Debra Dobbs, Hae Jung Shin, and Marion A. Becker17 February 2012 | Journal of Palliative Medicine, Vol. 15, No. 2Racial disparities in length of stay in hospice care by tumor stage in a large elderly cohort with non-small cell lung cancer23 May 2011 | Palliative Medicine, Vol. 26, No. 1Impact of Combined Hospice Care on Terminal Cancer Patients Song-Seng Loke, Kung-Ming Rau, and Chih-Fang Huang8 June 2011 | Journal of Palliative Medicine, Vol. 14, No. 6Hospice Care and the Emergency Department: Rules, Regulations, and ReferralsAnnals of Emergency Medicine, Vol. 57, No. 3Signs of Life Charles F. von Gunten13 February 2007 | Journal of Palliative Medicine, Vol. 10, No. 2 Volume 10Issue 2Apr 2007 InformationMary Ann Liebert, Inc.To cite this article:Timothy E. Quill.Is Length of Stay on Hospice a Critical Quality of Care Indicator?.Journal of Palliative Medicine.Apr 2007.290-292.http://doi.org/10.1089/jpm.2006.9984Published in Volume: 10 Issue 2: February 13, 2007PDF download

Introduction to Special Issue

This Special Issue provides a clinically focused look at newer psychosocial interventions for families impacted by Alzheimer’s disease and other dementing illnesses. Readers of Clinical Gerontologist are likely to be familiar with the prevalence, consequences, and care-related challenges of Alzheimer’s disease and other dementias. Although families encountering dementia may share a number of concerns, there is also significant intra-and interindividual variability in experiences and reactions. With progression of an illness such as Alzheimer’s disease, challenges and needs also change. Thus, investigators of psychosocial interventions are confronted with the reality that no single approach can adequately address the multiple and changing concerns faced by individuals with dementia and their families. Instead, psychosocial interventions are best considered as a range of strategies to be made available for families to use as appropriate. How do we know what is “appropriate” use of programs and services? The development of empirically supported and clinically significant interventions in this area has been somewhat elusive, but the research literature is continuing to grow and improve both conceptually and methodologically (Burgio et al., 2001; Gitlin et al., 2003; Schulz et al., 2002). The original focus of this issue was family-caregiver intervention research funded by either the Alzheimer’s Association or National Institutes of Health (NIH). Once I began to invite these contributors and

Treatments for Later-Life Depressive Conditions: A Meta-Analytic Comparison of Pharmacotherapy and Psychotherapy

To improve interventions for depressed older adults, data are needed on the comparative effects of pharmacotherapy versus psychotherapy. Given that most older adults with clinically significant depressive symptoms do not have major depression, data on treatments for minor depression and dysthymia are especially needed. Meta-analysis was used to integrate the results of 89 controlled studies of treatments focused on acute major depression (37 studies) and other depressive disorders (52 studies conducted with mixed diagnostic groups, including patients with major depression, minor depression, and dysthymia). A total of 5,328 older adults received pharmacotherapy or psychotherapy in these studies. Clinician-rated depression scores improved, on average, by 0.80 standard deviation (SD) units; self-rated depression scores improved by 0.76 SD units. Clinician-rated depression improved by 0.69 SD units in pharmacotherapeutic studies and by 1.09 SD units in psychotherapeutic studies. Self-rated depression improved by 0.62 SD units and 0.83 SD units, respectively. An interesting finding was the stronger improvements in clinician-rated depression among control subjects participating in medication studies, compared to those in psychotherapeutic studies. Available treatments for depression work, with effect sizes that are moderate to large. Comparisons of psychotherapy and pharmacotherapy must be interpreted with caution, in part because medication studies are more likely to use a credible active placebo, which may lead to smaller adjusted effect sizes in medication studies. Given that psychotherapy and pharmacotherapy did not show strong differences in effect sizes, treatment choice should be based on other criteria, such as contraindications, treatment access, or patient preferences.

Mental Health Services for Homebound Elders From Home Health Nursing Agencies and Home Care Agencies

Mental Health Services for Homebound Elders From Home Health Nursing Agencies and Home Care Agencies

Introduction to the Special Series on Long Term Care

"Introduction to the Special Series on Long Term Care." Clinical Gerontologist, 29(3), pp. 1–2

Early Stage Dementia Client as Group Leader

(2005). Early Stage Dementia Client as Group Leader. Clinical Gerontologist: Vol. 28, No. 4, pp. 81-85.

Long-Term Effectiveness of Spaced-Retrieval Memory Training for Older Adults with Probable Alzheimer's Disease

ABSTRACT Ten older adults with probable Alzheimer's disease (AD) were trained to recall everyday objects using the spaced-retrieval technique. Five persons had participated in a prior spaced-retrieval program (Cherry & Simmons-D'Gerolamo, 1999, Clinical Gerontologist, 20, 39–63). The authors retested these original participants to measure the long-term effectiveness of spaced-retrieval training. Five new participants were included for comparison purposes. During training, participants selected a target object from an array of items at increasingly longer retention intervals. To enhance the effectiveness of spaced-retrieval training, two original and two new participants were given a target object orientation task prior to training. Positive effects of prior experience occurred for most of the original participants. The orientation task enhanced memory for the target objects. Implications for memory remediation in late adulthood are considered.

Vision Statement for the Next 3 Years of the Clinical Gerontologist

(2005). Vision Statement for the Next 3 Years of the Clinical Gerontologist. Clinical Gerontologist: Vol. 28, No. 3, pp. 1-2.

Treatment of Depressive Symptoms in a Chinese Female Dementia Caregiver

(2005). Treatment of Depressive Symptoms in a Chinese Female Dementia Caregiver. Clinical Gerontologist: Vol. 28, No. 3, pp. 81-85.

Margaret P. Norris, Victor Molinari and Suzann Ogland-Hand (eds), Emerging Trends in Psychological Practice in Long-Term Care, Haworth, New York, 2003, 303 pp., hbk $69.95, ISBN 0 7890 2004 1, pbk $39.95, ISBN 0 7890 2005 X. Co-published simultaneously as Clinical Gerontologist, 25, 1/2 and 3/4, 2003.

Margaret P. Norris, Victor Molinari and Suzann Ogland-Hand (eds), Emerging Trends in Psychological Practice in Long-Term Care, Haworth, New York, 2003, 303 pp., hbk 39.95, ISBN 0 7890 2005 X. Co-published simultaneously as Clinical Gerontologist, 25, 1/2 and 3/4, 2003. - Volume 24 Issue 5

Emerging trends in psychological practice in long-term care.

Review of: Norris MP, Molinari V, Ogland‐Hand S, eds. Trends in Psychological Practice in Long‐Term Care, Copublished Clinical Gerontologist (Vol. 25, nos. 1/2/3/4, 2002), Binghamton, NY: The Haworth Press, 2002, pp 303.Purpose: To bring geropsychologists up to date on the ever‐evolving field of geriatric mental health in long‐term care settings.Background: Over the last 25 years, the number of older adults with mental disorders in nursing homes has surpassed the number in state mental health facilities as these facilities have closed down. This has made skilled nursing homes often times de facto inpatient psychiatric care units for older adults using a large amount of psychotropic and neuroleptic medications. In addition, many older adults with no premorbid history of mental illness develop a range of psychiatric, psychological, and behavioral disorders in response to the losses experienced through aging, illness, and subsequent placement in long‐term care (LTC) settings. The balance between appropriate therapeutic usage of psychoactive medications and overmedication resulting in usage as chemical restraint has always been a difficult one. With the institution of the Omnibus Budget Reconciliation Act of 1987, which restricted use of physical and chemical restraints in nursing homes, opting instead for psychological and behavioral interventions, the role of the psychologist has become more important in the LTC setting. Not only are there far fewer iatrogenic effects, but also nursing home residents' quality of life has improved, enabling each of them to achieve the highest practical, physical, mental, and psychosocial well‐being. Emerging Trends in Psychological Practice in Long‐Term Care has been copublished as Clinical Gerontologist, Volume 25, Numbers 1/2/3/4, 2002. Margaret P. Norris, PhD, president, Psychologists in Long‐Term Care, Victor Molinari, PhD, president‐elect, American Psychological Association section on clinical geropsychology, and Suzann Ogland‐Hand, PhD, geropsychologist and former secretary for Psychologists in Long‐Term Care, edited it. Each editor is also a contributor of a chapter in the book.Contents: The book is divided into three sections.

Tying it together.

Rudi Westendorp, a Dutch physician-scientist known for his love of bow ties, seeks elegant solutions in his work as a clinical epidemiologist, geriatrician, and gerontologist at Leiden University Medical Center in the Netherlands. After completing his residency training and earning a Ph.D., in 1993 he made a detour into clinical epidemiology, studying patient populations to identify underlying risk factors for disease. He now supervises the long-running Leiden 85-plus study, which tracks cognitive decline, heart disease, and other illnesses in very old people. To round out his knowledge, Westendorp spent 1998 studying the biology of aging at the University of Manchester, U.K. His quest to test the evolutionary theory of the tradeoff between fertility and longevity has led him into the genealogical archives of British aristocrats and, more recently, to Ghana.

Alzheimer memory training: Positive results replicated

In December, 1992, Clinical Gerontologist published the results of my dissertation research single subject experiments in which two early Alzheimer patients (Folstein MMSE scores of 23) were assisted to relearn two sets of forgotten biographical information by means of informational narratives and interactive quizzes presented via audio cassette recorder1I Subsequent articles in this journal have discussed my memory training work in the context of a multi-modal treatment program,2 and presented findings from a research study that compared quizzing to repetition as a means of reteaching forgotten information.3 Since none of the previously published articles referred to memory training in their titles, it is conceivable that researchers and practitioners might not find these articles in routine literature searches. This article brings together in one place a summary of my memory training work with the 14 Alzheimer's patients and one undiagnosed amnestic patient with whom I have used the tape-recorded intervention. During the next five years, the technique will be tested, among other interventions, with 18 of 28 early stage Alzheimer patients with whom I'll be working under a grant from the National Institute on Aging. So far, the technique has resulted in substantial learning in 13 of the 15 subjects with whom it was tried. MMSE scores of successful learners ranged from 10 to 27. The two who failed to learn had the highest and lowest mental status scores of the Alzheimer subjects: eight and 26, respectively. One or two week follow-up was done in 12 studies. In 11 of the 12 studies, 78 to 100 percent of questions answered correctly at post-test were answered correctly at follow-up.

Bonding and Separateness, Two Major Factors in the Relations Between Holocaust Survivors and Their Children

The relationship of the mental health of the aging and intergenerational relations has been a major topic in Clinical Gerontologist over the years. Wardi uses a psychoanalytic perspective to examine the impact of the Holocaust on intergenerational relations. The ideal situation is a balance between closeness and separation. The boundaries of the parent-child relationship (and what I would call "appropriate role expectations") are challenged by the Holocaust experience, as well as by the process of aging. Wardi then presents examples of therapy for the next generation.

APPENDIXES

Yiddish, Hebrew, Rumanian and Russian versions of the brief (15-item) version of the Geriatric Depression Scale were published in Clinical Gerontologist, 8(2), pages 72-83. Several of the authors whose chapters appear in this volume were asked to do complete translations of the full Geriatric Depression Scale, as well as the Hypochondriasis Scale and International Version of the Mental Status questionnaire. The Hebrew versions of the IVMSQ, GDS, and Hypochondriasis scale published here were developed by Eli Somer, and the Yiddish versions are by Esther-Lee Marcus and Pesach Lichtenberg and Yehoshua Rochman. The editor will welcome future articles and clinical comments about the validity, reliability, and use of these translations.