Physical and mental health symptoms of older people: who do they tell?

A research study was designed to develop information about the day-to-day symptoms of older persons that often are not reported to professionals. As one aspect of the research, the subjects (N = 132) were asked: 1) if they had had any of a predetermined list of 20 symptoms during the previous month; 2) to whom did they report these symptoms; and 3) if no one had been told, what was the reason for not reporting. About half of the subjects had experienced difficulty in sleeping, tiredness, nervousness, feeling blue, unsteadiness on feet, and forgetfulness. A slight majority told someone (a professional, family member, or friend) about their symptoms, but a large proportion did not tell anyone. Most symptoms (56 percent) were not reported to health professionals. When another person was told, usually the recipient of the information was as likely to be a family member or friend as a professional. Reasons for not telling anyone included: the symptom ws "no big deal"; "nobody cares"; "nothing can be done about it"; and "don't want to bother people." The data are discussed in terms of the implications for health education of older people and family members, and for the attitudes and behaviors of health professionals.

What older people do about their day-to-day mental and physical health symptoms.

In four detailed "yesterday" interviews, old people (n = 132) were studied to identify their day-to-day mental and physical symptoms. Previous reports have described the nature, frequency, and severity of the symptoms reported. This paper describes the actions taken by old people to alleviate discomfort from their symptoms. Some action was taken to treat four fifths of the complaints but virtually none of the symptoms were reported to health care professionals. Among the authors' findings are that about 20 per cent of the drug doses taken by the interviewees could not be identified and the remaining 80 per cent were divided equally between prescription drugs and over-the-counter medications. It is evident that there is a world of day-to-day health experiences and practices of which health care professionals are unaware. Sensitive questioning is needed to elicit information about that world from elderly patients, who in turn are often in considerable need of health education from professional sources.

Predictors of falls among institutionalized women with Alzheimer's disease.

Falls among elderly residents are a major concern of facilities caring for the aged. A group of institutionalized women with senile dementia of the Alzheimer type (N = 60; mean age 83) were studied longitudinally and evaluated annually on 21 variables of physical, social, emotional, self-care, and cognitive functioning. A substudy of falls they experienced used data from two such annual evaluations. Clinical ratings by the interdisciplinary team estimated 1) the women's changes in function during the preceding year and 2) the current levels of the women's functioning. Separate regressions for each of the two years returned identical significant patterns indicating that ratings of physical vigor were significantly related to number of falls. Those women who had been among the most vigorous in the group but who had shown significant declines in the preceding year were the most vulnerable to falls; women who had been rated as the least vigorous but whose levels of vigor had been stable during the year tended to have fewer falls. Falling therefore appears to be related to the process of decline in vigor among those in the group whose levels of vigor were higher initially. There were corresponding significant declines in emotional and cognitive scales.

Marital status of caregiving daughters and co-residence with dependent parents.

The role of caregiving daughters' marital status is examined as it relates to their sharing households with disabled elderly parents. Married daughters fared best in well-being, income, and social support. Never-married women were the most likely to have never moved out of the parental home. Separated/divorced caregivers, more than the married and widowed, had moved into the parent's home rather than the reverse and widowed daughters had lived in re-formed joint households longest. The main reason for re-forming shared households was disability of the parent. Among other reasons were death or withdrawal of previous caregiver and financial problems, with separated/divorced daughters the most likely to mention finances.

Caregiving daughters and their local siblings: perceptions, strains, and interactions.

Daughters who are principal caregivers to disabled elderly mothers are compared with their geographically proximate sisters and brothers as to the amount of help each group provides, the effects of care they experience, and the problems and benefits of the siblings' interactions about the caregiving situations. Caregivers reported the most and brothers the least service provision and strain; sisters fell in between, and also equaled caregivers in strain from intersibling problems. Negative intersibling interactions are associated with less emotional closeness in the families and the mothers' greater care needs.

Mental health of sons and daughters of the institutionalized aged.

Predictors of depression in a study of 331 adult children whose parents resided in nursing homes were respondent's poor health, time pressures, viewing the parent as demanding, and lack of involvement with IADL tasks. Emotional effects specific to parent's situation were predicted by poor health, negative perceptions of nursing home staff, upsetting visits, time pressures, and being female and young. Predictors of depression and emotional effects between sons and daughters are compared.

A controlled study of respite service for caregivers of Alzheimer's patients.

After a baseline interview of 642 caregivers of aged Alzheimer's disease victims, half were offered formal respite care. Over 12 months, families with respite care maintained their impaired relative significantly longer in the community (22 days). Although respite was ineffective for caregiver burden and mental health, satisfaction was very high. Although not a strong intervention, respite care can increase caregivers' quality of life.

Differential effects of daughters' marital status on their parent care experiences.

This study compared the parent care experiences of five groups of daughters (N = 492) (married, remarried, separated/divorced, widowed, and never married). Data include demographic characteristics and measures of depression, positive affect, personality strength, health, social support, relationship quality, caregiving burden, caregiving mastery, and caregiving satisfaction. Women with husbands had more socio-emotional and instrumental support, much higher incomes, less financial strain from caregiving, and less depression. They felt their own particular marital status made caregiving easier than did the three groups of not-married women.

Caregiving daughters' perceptions of their own and their mothers' personalities.

This research explores differences between caregiving daughters' perceptions of their own and their mothers' personalities. A sample of caregiving daughters (N = 150) rated themselves and their mothers on the same 17 personality attributes. Daughters generally rated their mothers more negatively than themselves. Within this pattern of generally negative evaluations, varying types of impairment function differently. Functional impairment is not related to assessments of mothers' personalities, whereas psychological and cognitive impairments are.