A multidimensional approach to the resilience in older adults despite COVID-19.

Researchers have mainly focused on aging risk factors and COVID-19 consequences. However, older adults have proved their ability to overcome adversities along their life. Resilience is a protective variable that dampens the impact of stress. Based on MacLeod's et al. (2016) approach, we aimed to analyze the relationship between older adults' resilience and COVID-19 related-stressors as well as their physical, mental, and social characteristics. Eight hundred eighty-nine people aged 60 and over participated in this study. Older participants, women, having better perceived health and not losing a loved one because of the virus were associated with more resilience. Moreover, higher levels of gratitude, personal growth, life purpose and lower levels of depression were associated with greater scores in resilience. This study offers a change of perspective in which aging is perceived from a positive viewpoint by focusing on easily accessible resources that may help older adults to cope with adverse situations.

Psychological well-being among older adults during the COVID-19 outbreak: a comparative study of the young-old and the old-old adults.

The COVID-19 outbreak could be considered as an uncontrollable stressful life event. Lockdown measures have provoked a disruption of daily life with a great impact over older adults' health and well-being. Nevertheless, eudaimonic well-being plays a protective role in confronting adverse circumstances, such as the COVID-19 situation. This study aims to assess the association between age and psychological well-being (personal growth and purpose in life). Young-old (60-70 years) and old-old (71-80 years) community-dwelling Spaniards (N = 878) completed a survey and reported on their sociodemographic characteristics and their levels of health, COVID-19 stress-related, appraisal, and personal resources. Old-old did not evidence poorer psychological well-being than young-old. Age has only a negative impact on personal growth. The results also suggest that the nature of the COVID-19 impact (except for the loss of a loved one) may not be as relevant for the older adults' well-being as their appraisals and personal resources for managing COVID-related problems. In addition, these results suggest that some sociodemographic and health-related variables have an impact on older adults' well-being. Thus, perceived-health, family functioning, resilience, gratitude, and acceptance had significant associations with both personal growth and purpose in life. Efforts to address older adults' psychological well-being focusing on older adults' personal resources should be considered.

Development and assessment of the content validity of the professional good practices scale in nursing homes.

Recent approaches in the care of older people have led to a greater emphasis on good practices to prevent elder abuse. The instruments assessing good practices are very limited, and those focused on elder abuse have rarely considered subtle forms, especially in institutional settings. The aim of this study was to develop and assess the content validity of a good practices scale for professionals working in nursing homes. An extensive literature review of the tools assessing professionals' good-bad practices towards older people was conducted. A preliminary scale based on Kayser-Jones' (1990) [Old, Alone and Neglected: Care of the Aged in Scotland and the United States. Berkeley, CA: University of California Press] types of abuse was developed, including four subscales: Personalization, Humanization, Absence of Infantilization, and Absence of Victimization. Content validity was analyzed through a panel of eight experts. Rovinelli and Hambleton's index of item-objective congruence was used to analyze the items' inclusiveness in the assigned subscale to establish their representativeness. Items' relevance and clarity were analyzed using the paired comparison method. The final version of the scale included 56 items, with appropriate levels of item objective-congruence, relevance, and clarity. This instrument will allow professionals to detect and develop awareness and intervention programs that aim to promote good practices in nursing homes.

Risk factors of elder abuse in a community dwelling Spanish sample.

We analyzed the discriminative capacity of several risk factors for elder abuse and neglect, in order to identify what characteristics distinguish between caregivers with a high or low risk of abuse and neglect. Forty-five caregivers of relatives with dementia participated. The combination of caregiving impact, frequency of aggressive behaviors by care-recipients, stress related to provocative and aggressive behaviors, the frequency of provocative behaviors, interpersonal burden, autoefficiency expectations, quantity of help received and depression classify correctly as risk factors in 90.9% of the cases. This study permits us to identify what characteristics distinguish between caregivers with a high or low risk of abuse and neglect and caregivers.

Modification of dysfunctional thoughts about caregiving in dementia family caregivers: description and outcomes of an intervention programme.

UNLABELLED: Among the diverse group of interventions developed to help dementia family caregivers cognitive-behavioural approaches show especially promising results. OBJECTIVES: This study describes a cognitive-behavioural group intervention aimed principally at the modification of dysfunctional thoughts associated with caregiving (MDTC). The efficacy of the MDTC intervention in reducing caregivers' depressive symptomatology, together with the frequency and appraisal of problem behaviours, is compared to that of a waiting-list control group (WL). Furthermore, the potential mediating role of the dysfunctional thoughts in the relationship between this intervention and caregivers' depressive symptomatology is analyzed. Of the 74 dementia caregivers who were randomized to one of two conditions (MDTC and WL), 39 completed the post-intervention assessment. Statistical analyses were performed on an intention-to-treat basis, using last observation carried forward. The results reveal that the MDTC intervention is successful in reducing caregivers' level of depressive symptomatology and dysfunctional thoughts about caregiving, as well as in modifying their appraisal of their relative's problem behaviours. Furthermore, a mediating role for dysfunctional thoughts was found in the relationship between the MDTC intervention and levels of depressive symptomatology. The relevance of addressing dysfunctional thoughts and cognitive distortions in group interventions with caregivers is highlighted.

Tratamiento psicológico del miedo a las caídas: un estudio de caso / Psycological treatment of the fear of falling: A case study

Objetivo: el miedo a las caídas es la complicación más común entre las personas mayores que han presentado una caída de la que no se ha derivado lesión física importante. Material y método: se presentan los resultados de una intervención conductual llevada a cabo con una mujer de 69 años que, durante un período de 1 año, había presentado diversas caídas sin causa física que, según informe médico, las justificara. Esta persona había reducido drásticamente su actividad, y se desplazaba tan sólo apoyada en muebles o en otra persona. La intervención consistió en una fase educativa acerca del problema y la explicación de éste en términos conductuales; el aprendizaje de estrategias para minimizar la ansiedad ante la realización de actividades y reanudar de forma gradual las actividades temidas (exposición en vivo, respiración profunda, autoinstrucciones, parada de pensamiento y aserción encubierta), así como correciones ambientales y eliminación de factores de riesgo. Resultados y discusión: los resultados del programa, tras 8 sesiones de intervención, evaluados con distintas técnicas de autoinforme y tests situacionales, indican que se ha reducido de una forma notable la ansiedad global para andar y mantenerse de pie, así como que ha aumentado significativamente el número de conductas de movilidad en solitario —especialmente, en el ámbito del hogar— y de actividades de la vida diaria realizadas de forma independiente, cuya realización se había suprimido desde la primera caída (AU)

Objective: fear of falling is the most common complication in elderly people who have suffered a fall without sustaining serious physical injury. Material and methods: we present the results of a behavioural intervention carried out in a 69-year-old woman who had had various falls over a period of 1 year, with no cause, according to her medical report, that would explain these falls. The patient had drastically reduced her activity and moved about only by supporting herself on items of furniture or on other people. The intervention consisted of an education phase about the problem and its explanation in behavioural terms. The patient learned behavioural strategies to minimise anxiety in the face of activities, and gradual recommencement of the feared activities (exposure in vivo, deep breathing, self-instructions, thought stopping and covert assertion), in addition to environmental changes and elimination of risk factors. Results and discussion: the results of the intervention programme after eight sessions, assessed with various self-report techniques and situational tests, indicate a notable reduction in the patient’s overall anxiety about walking and remaining on her feet, and a significant increase in the number of unaided mobility behaviours -especially in the home environment- and of independently carried out everyday activities, which had been ceased since the first fall (AU)

[Differential efficacy of two psychoeducational interventions for dementia family caregivers]. / Eficacia diferencial de dos intervenciones psicoeducativas para cuidadores de familiares con demencia.

INTRODUCTION AND OBJECTIVES: The aim of this work is to compare the effectiveness of two psychoeducational interventions for dementia caregivers: a cognitive behavioral one (PCC), aimed at the modification of dysfunctional thoughts about caregiving, and another one consisting in problem solving skills training (PSP) for caregivers, with the aim of modifying the behavioral problems of their relative. SUBJECTS AND METHODS: Seventy five caregivers were asked to participate in an intervention program, of whom 31 finally completed the study. Both group interventions are compared with a control group (CG). The caregiver groups were randomly assigned to each experimental condition. Pre, post intervention, and follow up assessments of the following variables have been made: depression, perceived stress, frequency of behavioral problems, perceived stress associated with the behavioral problems and dysfunctional thoughts about caregiving. RESULTS: Following the intervention, caregivers in the PCC program show significantly less perceived stress than the other two groups. In the same direction, a trend exists to a significant reduction of the stress associated with the behavioral problems. In the follow up assessment, caregivers of the PCC program significantly report less relative's behavioral problems than the other two groups. Caregivers of the PCC program have less dysfunctional thoughts than the other two groups, differences almost reaching significance. CONCLUSIONS: Benefits of a psychoeducational intervention vary as a function of the contents it includes. The importance of intervening on the caregiver dysfunctional thoughts for an adequate coping with caregiving is highlighted.

Eficacia diferencial de dos intervenciones psicoeducativas para cuidadores de familiares con demencia / Differential efficacy of two psychoeducational interventions for dementia family caregivers

Introducción y objetivo. A través de este trabajo se comparan dos intervenciones psicoeducativas con cuidadores de personas con demencia, un programa cognitivoconductual (PCC) dirigido a la modificación de pensamientos disfuncionales para el cuidado y otro programa de solución de problemas (PSP) dirigido a entrenar a los cuidadores en el manejo de los comportamientos problemáticos de su familiar. Sujetos y métodos. Se ofreció la posibilidad de participar en un programa de intervención a 75 cuidadores, de los cuales completaron el estudio 31. Las dos intervenciones grupales se comparan, a su vez, con un grupo control. Cada grupo de cuidadores se asignó aleatoriamente a cada una de las condiciones experimentales. Se realizaron evaluaciones antes y después de la intervención y otra de seguimiento de las siguientes variables: depresión, estrés percibido, frecuencia de comportamientos problemáticos, estrés asociado a los comportamientos y pensamientos disfun cionales sobre el cuidado. Resultados. Tras la intervención, los cuidadores que participaron en la intervención PCC tenían significativamente menos estrés percibido que los otros dos grupos, así como una tendencia a la significación en el mismo sentido cuando se analizaba el estrés asociado a los comportamientos problemáticos. En la fase de seguimiento, los cuidadores que participaron en la intervención PCC informaron de una frecuencia significativamente menor de comportamientos problemáticos que los otros dos grupos, y de menos pensamientos disfuncionales que los otros dos grupos, diferencias que rozan la significación estadística. Conclusiones. Los beneficios de una intervención psicoeducativa varían en función de los contenidos que incluya. Se destaca la importancia de intervenir sobre pensamientos poco adaptativos para un adecuado afrontamiento del cuidado (AU)

Introduction and objectives. The aim of this work is to compare the effectiveness of two psychoeducational interventions for dementia caregivers: a cognitive-behavioral one (PCC), aimed at the modification of dysfunctional thoughts about caregiving, and another one consisting in problem-solving skills training (PSP) for caregivers, with the aim of modifying the behavioral problems of their relative. Subjects and methods. Seventy-five caregivers were asked to participate in an intervention program, of whom 31 finally completed the study. Both group interventions are compared with a control group (CG). The caregiver groups were randomly assigned to each experimental condition. Pre, post-intervention, and follow-up assessments of the following variables have been made: depression, perceived stress, frequency of behavioral problems, perceived stress associated with the behavioral problems and dysfunctional thoughts about caregiving. Results. Following the intervention, caregivers in the PCC program show significantly less perceived stress than the other two groups. In the same direction, a trend exists to a significant reduction of the stress associated with the behavioral problems. In the follow-up assessment, caregivers of the PCC program significantly report less relative’s behavioral problems than the other two groups. Caregivers of the PCC program have less dysfunctional thoughts than the other two groups, differences almost reaching significance. Conclusions. Benefits of a psychoeducational intervention vary as a function of the contents it includes. The importance of intervening on the caregiver dysfunctional thoughts for an adequate coping with caregiving is highlighted (AU)