Older adults, perceived ageism, civic participation and mental health: a qualitative study.

OBJECTIVES: This study has three objectives: A) To investigate the relationship of ageism on older adults' civic activities; B) To analyze the influence of ageism on mental health; and C) To explore the impact of civic participation on older adults' mental health. METHOD: This qualitative study included 782 older people from three different nationalities (Portuguese, Brazilian, and English) ranging in age from 65 to 88. All the interviews went through the process of content analysis. RESULTS: For the first objective, the findings encompass one high-level theme (Social and individual incompetence), which included social rejection (86%), reduced competence (84%), expectations of failure (83%), and not being able to contribute (77%). For the second objective, findings indicated two overarching categories: Perceived inability, including frustration and impotence (89%), incompetence (77%) and irrelevance (71%); and Perceived distress, including anger (81%), feelings of anxiety (68%); and emotional bursts (63%). For the third objective, the following two high-level themes emerged: Ego-oriented resources, which comprised the development of a sense of purpose (81%), learning cognitive skills (71%), and (A3) practising sense of agency (67%); and Social-oriented resources, encompassing feeling socially integrated (80%); and expressing emotionally (54%). Findings indicated that the most verbalized themes for the three objectives were the same across the three nationalities. CONCLUSIONS: Ageism made it difficult for people to participate in civic life, which has been linked to better mental health. These findings emphasize the need to encourage inclusive civic involvement to improve older individuals' mental health.

Mentally healthy living after pandemic social distancing: a study of older Canadians reveals helpful anxiety reduction strategies.

BACKGROUND: Throughout the COVID-19 pandemic, older Canadians were the most at risk of severe physical harm, including death, and their return to post-COVID life was expected to be especially anxiety-provoking. A study was conducted to obtain nationally representative evidence of older Canadians' self-perceived anxiety levels and their strategies to manage or mitigate it as public health restrictions were lifting. MATERIALS AND METHODS: This study had a cross-sectional descriptive design. An e-survey was used to collect data from 1327 Canadians aged 60+ stratified by age, sex, and education to resemble the larger general population. Participants completed the Geriatric Anxiety Scale (GAS-10) and indicated which of the 16 Centre for Addictions and Mental Health's (2022) Coping with Stress and Anxiety strategies they were using to manage or mitigate their anxiety when social distancing was lifting. Descriptive statistics, Pearson correlation, and multiple regression analysis were used to explore the data. RESULTS: While, on average, older Canadians were mildly anxious, nearly one-quarter of responders rated their anxiety as severe. Age, sex, perceived health, were statistically significant correlates of anxiety. Six coping strategies were associated with significantly lower anxiety scores. Moreover, accepting some fear and anxiety as normal, challenging worries and anxious thoughts, and practising relaxation/meditation appeared to increase anxiety. CONCLUSION: Older Canadians used multiple strategies to manage or mitigate their anxiety, and seemingly, with more successful than detrimental tries. Practitioners have much to learn and understand about older people's mental health promotion efforts after social distancing, now and for future pandemics.

Wolf in Sheep's Clothing? Violent, Abusive, and Harmful Behavior by the Older Person Toward Their Family Caregivers: A Qualitative Study.

Violent, abusive, and harmful behavior enacted by older adults upon their caregivers represents a distressing and frequently disregarded facet within the domain of caregiving. This qualitative study aims to (a) explore family caregivers' experiences of violent, abusive, and harmful behavior by the older person and (b) explore how violent, abusive, and harmful behavior by the older person affects family caregivers' mental health. This qualitative study encompassed 393 participants, with a diverse age range spanning from 40 to 72 years. All the interviews went through the process of content analysis. For the first objective, findings indicated six emerging themes: Frequent and extreme verbal violence (77.3%); feeling manipulated and controlled by older adults (74.7%); experiencing unpredictable illegal circumstances provoked by older adults (62.1%); experiencing damaging financial issues provoked by older adults (43.1%); experiencing physical violence (34.2.%); and experiencing sexual violence (31.1%). The second objective highlighted four themes: depression and anxiety (89.9 %), anger (81.2%), feeling morally isolated (78.3%), and emotional outbursts (65.1%). Brazilian participants mainly experienced frequent and extreme verbal violence (62.4%). Moreover, depression and anxiety were mainly verbalized by English participants (84.3%). These findings underscore the significant toll that older individuals' violent, abusive, and harmful behavior can have on the mental well-being of family caregivers. This study sheds light on the complex experiences faced by family caregivers and emphasizes the urgent need for targeted interventions to foster healthier caregiving environments. Older individuals' violent, abusive, and harmful behavior toward their caregivers has received limited attention in research and public discourse. The findings of this study call attention to the pressing need of addressing this issue, given its detrimental impact on the mental health of family carers. Recognizing the significance of this topic demands a comprehensive and targeted approach to ensure the well-being and safety of caregivers and older adults.

Sexual Well-Being and Aging Patterns: Findings of a Cluster Analysis among Older Adults in Portugal and Spain.

OBJECTIVES: From a cross-cultural perspective, aging well may encompass pertinent challenges in terms of adjustment, sexual well-being, and satisfaction with life in the late years. Considering the paucity of empirical data concerning cultural diversity of experiencing aging, this study aims to help fill this gap by assessing the specific patterns of sexual satisfaction, adjustment to aging (AtA), and life satisfaction with life (SwL) of older adults in Portugal and Spain. METHODS: This cross-national study included 326 older adults, age 65 and older, from Portugal and Spain. Five instruments were applied: (a) Adjustment to Aging Scale (ATAS); (b) Satisfaction with Life Scale (SwLS); (c) New Sexual Satisfaction Scale-Short (NSSS-S); (d) Mini-Mental State Exam; and (e) Sociodemographic, Health and Lifestyle questionnaire. K-means cluster analysis was employed to identify and characterize the clusters considering adjustments to aging, sexual satisfaction, and life satisfaction. One-way ANOVAs were conducted to analyze differences in sexual well-being among clusters. RESULTS: Findings indicated three clusters, which explained 77.7% (R-sq = 0.777) of the total variance: Cluster 1: "Most skilled" (n = 26, 8.0%), Cluster 2: "Least adjusted" (n = 115, 35.3%), and Cluster 3: "Aging strivers" (n = 185, 56.7%). Participants in Cluster 1 were mostly Portuguese, with high levels of AtA, sexual satisfaction, and SWL. Conversely, Cluster 2 included mostly Portuguese participants with moderate sexual satisfaction and lower levels of AtA and SwL. Participants from Cluster 3 were mostly Spanish, with moderate levels of AtA and reduced sexual satisfaction and SwL. CONCLUSIONS: This study innovates by exploring the elaborate interplay among sexual satisfaction, AtA, and SwL in a cross-cultural perspective, with implications for tailoring interventions, service planning, development, and evaluation of culturally diverse older populations.

The promotion of older adults' sense of coherence through Person-Centered Therapy: A randomized controlled pilot study

El objetivo del estudio que se informa fue explorar si una intervención individual de terapia centrada en la persona (TCP) en personas adultas mayores puede promover su sentido de coherencia, en comparación con un grupo control (lista de espera). Se plantea que los participantes asignados al azar a TCP informarían mejoras en SDC de pre y post-intervención en comparación con el grupo control. Un grupo de 87 participantes de 65 a 86 años (M = 72.4; DE = 5.15) fue evaluado con la Escala de Sentido de Coherencia (ESDC) y el cuestionario sociodemográfico en tres momentos diferentes: al inicio del estudio (t1), post-tratamiento (t2) y a los 12 meses de seguimiento (t3). Los resultados indicaron que los participantes en TCP evidenciaron un aumento significativo en cuanto a su SDC (16.7%), mientras que en el grupo control se encontró una disminución significativa (-2.7%), entre el inicio del estudio y el momento de seguimiento. El tamaño del efecto en el grupo TCP fue alto (n²p= .776). En concreto, tanto en la post-intervención como en el momento del seguimiento, los participantes que se sometieron a TCP tenían un SDC significativamente mayor (M = 3.84, DE = .219). Se encontraron diferencias significativas entre el grupo de intervención y el grupo control en la post-intervención y en el seguimiento. Se concluye que los cambios en SDC fueron positivos y mantenidos, por lo tanto, los resultados sugieren que la TCP es favorable a la mejora de SDC. Por otra parte, ya que la SDC se asocia con el bienestar relacionado con la salud de las poblaciones de mayor edad, hay que enfatizar el desarrollo de SDC en la vejez.

Sense of Coherence (SOC) derived from the salutogenic approach and seems to be a health promoting resource, which strengthens resilience and develops a positive subjective state of health. Older adults' SOC is often challenged by specific issues in later adulthood such as grieving for losses, illness, feelings of worthless and solitude, retirement, disability and death, which require distinctive consideration. To our best knowledge, there are no previous studies that indicated the relation between a person-centered therapy (PCT) and older adults' SOC. Therefore, this study aims to explore if a brief eight-session individual PCT intervention on older adults can promote their SOC, as compared with a control group (waiting list). Specifically, this is a randomized controlled pilot study designed to explore the promotion of SOC through an individual-based PCT intervention. We posited that participants randomized to PCT would report improvements in SOC from the pre- to the post-intervention moments when compared to those on the waiting list. The Orientation to Life Questionnaire (OtLQ) and demographics were assessed at the baseline (t1), post-treatment (t2) and at the 12-month follow-up (t3), in a group of 87 participants between 65 - 86 years (M = 72.4; SD = 5.15), from community and health centers in the Great Lisbon area, in Portugal. Participants were mostly women (59.8%), married (65.5%) and professionally inactive (63.2%). The Cronbach's Alpha coefficients for SOCS were .878, .989, and .988, in the three moments, respectively. Inclusion criteria determined their eligibility to participate in the study. No participant with a compromised cognitive function integrated the sample. All potential participants were given a brief description of the study and gave their informed consent. After the baseline assessment, participants were randomly assigned to one of the two groups. The eight-session intervention was conducted in an adequate setting and with a weekly frequency. Comparisons between the three assessments (t1, t2 and t3) for the two groups were done using Repeated Measures ANOVA. Post-hoc Fisher's Least Significant Difference (LSD) test for mean differences was used to compare the three assessments for the SOC, in each group (PCT and waiting list). After the intervention, a significant increase of 17.3% (M = 3.86, SD = .218) was observed in the participants who did the PCT. The SOC evidence dat follow-up (t3) (M = 3.84, SD = .219) by these participants was significantly higher (16.7%) in comparison to the baseline score (M = 3.29, SD = .245). Conversely, participants in the control group experienced a minor decrease between baseline (M = 3.28, SD = .236) and follow-up (M = 3.19, SD = .244) (- 2.7%). The effect size in the PCT group was high (n²p = .776). Significant differences between the intervention group and the control group were found at the post-intervention and follow-up. Findings also showed that participants in PCT experienced an increment in the three dimensions of SOC. The highest increase was observed in the Comprehensibility dimension (71.2%). Manageability and Meaningfulness sub-scales showed an increase of 32.9% and 12.1%, respectively. Changes in SOC were positive and maintained, thus, findings suggest that PCT is favorable to enhancing SOC. In particular, for the participants who did PCT, the significant increase of their SOC was mainly due to the high increase of the comprehensibility of events. This study contributed to filling a gap in gerontological literature and this intervention has the potential to offer a reasonably low-cost self-regulatory approach to the SOC. In this context, PCT is also a personal resource to promote SOC, in late adulthood. Moreover, since SOC is associated with health-related well-being among older populations, SOC development in old age should be stressed.

The promotion of older adults sense of coherence through Person-Centered Therapy: A randomized controlled pilot study

El objetivo del estudio que se informa fue explorar si una intervención individual de terapia centrada en la persona (TCP) en personas adultas mayores puede promover su sentido de coherencia, en comparación con un grupo control (lista de espera). Se plantea que los participantes asignados al azar a TCP informarían mejoras en SDC de pre y post-intervención en comparación con el grupo control. Un grupo de 87 participantes de 65 a 86 años (M = 72.4; DE = 5.15) fue evaluado con la Escala de Sentido de Coherencia (ESDC) y el cuestionario sociodemográfico en tres momentos diferentes: al inicio del estudio (t1), post-tratamiento (t2) y a los 12 meses de seguimiento (t3). Los resultados indicaron que los participantes en TCP evidenciaron un aumento significativo en cuanto a su SDC (16.7%), mientras que en el grupo control se encontró una disminución significativa (-2.7%), entre el inicio del estudio y el momento de seguimiento. El tamaño del efecto en el grupo TCP fue alto (n²p= .776). En concreto, tanto en la post-intervención como en el momento del seguimiento, los participantes que se sometieron a TCP tenían un SDC significativamente mayor (M = 3.84, DE = .219). Se encontraron diferencias significativas entre el grupo de intervención y el grupo control en la post-intervención y en el seguimiento. Se concluye que los cambios en SDC fueron positivos y mantenidos, por lo tanto, los resultados sugieren que la TCP es favorable a la mejora de SDC. Por otra parte, ya que la SDC se asocia con el bienestar relacionado con la salud de las poblaciones de mayor edad, hay que enfatizar el desarrollo de SDC en la vejez.(AU)

Sense of Coherence (SOC) derived from the salutogenic approach and seems to be a health promoting resource, which strengthens resilience and develops a positive subjective state of health. Older adults SOC is often challenged by specific issues in later adulthood such as grieving for losses, illness, feelings of worthless and solitude, retirement, disability and death, which require distinctive consideration. To our best knowledge, there are no previous studies that indicated the relation between a person-centered therapy (PCT) and older adults SOC. Therefore, this study aims to explore if a brief eight-session individual PCT intervention on older adults can promote their SOC, as compared with a control group (waiting list). Specifically, this is a randomized controlled pilot study designed to explore the promotion of SOC through an individual-based PCT intervention. We posited that participants randomized to PCT would report improvements in SOC from the pre- to the post-intervention moments when compared to those on the waiting list. The Orientation to Life Questionnaire (OtLQ) and demographics were assessed at the baseline (t1), post-treatment (t2) and at the 12-month follow-up (t3), in a group of 87 participants between 65 - 86 years (M = 72.4; SD = 5.15), from community and health centers in the Great Lisbon area, in Portugal. Participants were mostly women (59.8%), married (65.5%) and professionally inactive (63.2%). The Cronbachs Alpha coefficients for SOCS were .878, .989, and .988, in the three moments, respectively. Inclusion criteria determined their eligibility to participate in the study. No participant with a compromised cognitive function integrated the sample. All potential participants were given a brief description of the study and gave their informed consent. After the baseline assessment, participants were randomly assigned to one of the two groups. The eight-session intervention was conducted in an adequate setting and with a weekly frequency. Comparisons between the three assessments (t1, t2 and t3) for the two groups were done using Repeated Measures ANOVA. Post-hoc Fishers Least Significant Difference (LSD) test for mean differences was used to compare the three assessments for the SOC, in each group (PCT and waiting list). After the intervention, a significant increase of 17.3% (M = 3.86, SD = .218) was observed in the participants who did the PCT. The SOC evidence dat follow-up (t3) (M = 3.84, SD = .219) by these participants was significantly higher (16.7%) in comparison to the baseline score (M = 3.29, SD = .245). Conversely, participants in the control group experienced a minor decrease between baseline (M = 3.28, SD = .236) and follow-up (M = 3.19, SD = .244) (- 2.7%). The effect size in the PCT group was high (n²p = .776). Significant differences between the intervention group and the control group were found at the post-intervention and follow-up. Findings also showed that participants in PCT experienced an increment in the three dimensions of SOC. The highest increase was observed in the Comprehensibility dimension (71.2%). Manageability and Meaningfulness sub-scales showed an increase of 32.9% and 12.1%, respectively. Changes in SOC were positive and maintained, thus, findings suggest that PCT is favorable to enhancing SOC. In particular, for the participants who did PCT, the significant increase of their SOC was mainly due to the high increase of the comprehensibility of events. This study contributed to filling a gap in gerontological literature and this intervention has the potential to offer a reasonably low-cost self-regulatory approach to the SOC. In this context, PCT is also a personal resource to promote SOC, in late adulthood. Moreover, since SOC is associated with health-related well-being among older populations, SOC development in old age should be stressed.(AU)