Family caregivers at risk: who are they?

This study examined the characteristics, activities, challenges, and perceived burden of high-risk family caregivers of persons diagnosed with Alzheimer's disease. A descriptive design was used. A convenience sample of 121 family caregivers participated in the interview. High-risk family caregivers with poor health and one medical condition were compared with low-risk family caregivers. Caregivers with low income, depressive symptoms, and high care demands are more likely to be in the high-risk group. Health care providers need to screen family caregivers for depression and monitor those with high care demands.

Self-concept in older adults: an integrative review of empirical literature.

The aging process leads to normative age-related bodily and functional declines and numerous social changes and life events that potentially threaten the self-concept. Despite these changes, the majority of older adults are able to maintain a positive sense of self and remain resilient. This article presents an integrative review of the empirical literature addressing self-concept in older adults.

Self-disclosure of sexually transmitted diseases: an integrative review.

In the United States, there are currently more than 65 million individuals living with a sexually transmitted disease (STD), and approximately 19 million new infections will continue to occur each year. To decrease the transmission of potentially dangerous and life-altering STDs, self-disclosure of sexual and drug history and sexual orientation is paramount. This integrative review examines the concept of self-disclosure of STDs, suggests areas of additional research, and proposes a comprehensive public health campaign, with a specific focus on the recent human papillomavirus epidemic to improve the physical and psychological health of all individuals.

Influence of hope, social support, and self-esteem in early stage dementia.

Background People in the early stages of dementia adjust to the illness through stages of awareness, coping, and evaluation. Studies have found that hope, social support, and self-esteem facilitate coping, adjustment, and adaptation in chronic illness. Objective The purpose of this descriptive study was to examine the relationships between hope, social support, and self-esteem in individuals with early stage dementia. Methods Data were obtained from 53 individuals with early stage dementia. The scores on the Herth Hope Index, Social Support Questionnaire Short-Form, and the State Self-Esteem Scale were analyzed using linear regression. Results Hope was moderately associated with self-esteem ( r = .49, p < .001). Hope accounted for 25% of the variance in self-esteem and was a key component in predicting self-esteem. No significant relationship was found between social support and self-esteem. Conclusion Findings suggest that hope may be an important factor to help individuals manage potential threats to self-esteem in the experience of early stage dementia. Strategies to inspire hope and then enhance self-esteem are promising for individuals living with early stage dementia.

Recruitment and retention of older adults in influenza immunization study.

Minority older adults have been under-represented in previous research studies in which Caucasian populations have been recruited. This article describes a consumer-centered model that addresses strategies to enhance recruitment and retention of a racially diverse healthy elderly population in an influenza immunization study. A consumer-centered model was employed in a 3-year research study that examined age-related changes in the immune responses to influenza vaccination. Four factors seem to be critical for successful recruitment and retention of African American, Latino and Caucasian elders: (1) building trust between the research team, and the community at large; (2) convenience (or inconvenience) to the volunteer; (3) timing of recruitment and data collection; and (4) incentives.

Enhancing resourcefulness to improve outcomes in family caregivers and persons with Alzheimer's disease: a pilot randomized trial.

This pilot randomized trial tested an intervention aimed at enhancing resourcefulness in family caregivers of persons with dementia, postulating that caregivers' emotional outcomes (anxiety and depression) and role outcomes (reward, strain, mutuality, and preparedness) would be improved, and problem behaviors in the care recipients (persons with dementia) would be reduced as a result of the intervention. Subjects were stratified by race (white or African American) and by baseline resourcefulness (high or low). Family caregivers were randomly assigned to an intervention group in which subjects attended six resourcefulness training sessions, meeting for 2 hours weekly over 6 weeks, or to a control group that received no treatment. Small to medium effects were shown for the intervention program on resourcefulness, anxiety, and preparedness of the caregivers and on frequency of behavior problems in the care recipients. Caregivers in the intervention group reported significantly more resourcefulness skills, with a medium effect at week 6 and a small effect 12 weeks later, compared with the control group. Persons with dementia had fewer behavior problems in the intervention group compared with control, although the difference was not significant. Caregivers' anxiety was reduced in the intervention group at 12 weeks.

Needs assessments of memory disorder patients.

BACKGROUND: Previous research shows that informal caregivers of individuals with a memory disorder experience financial strain, declining physical health, and psychological distress. Various resources and services have been developed to address and/or prevent these potential outcomes, yet caregivers continue to be negatively affected by the demands of caregiving. We hypothesize that better identification and clarification of concrete patient and caregiver needs will aid in the modification and improvement of the available resources. The purpose of this study is to determine the psychosocial needs of the cognitively impaired population and their caregivers. METHODS: A one-page Needs Assessment was created to address areas of potential concern for the individual with a memory disorder and the caregiver. This assessment was administered during visits to an outpatient clinic in Philadelphia. RESULTS: A total of 204 Needs Assessments were collected. The significant needs found in our study cohort include sleep, exercise, clinical trials, education, and assistance with ADLs and IADLs. CONCLUSIONS: This study satisfied the initial identification of caregiver and patient needs; now each must be explored further to determine how to successfully meet such needs. If the primary needs of the patient can be met by a focused service, the caregiver will no longer be the sole provider of meeting the specific need. This will decrease the involved role of the caregiver, maximize patient homecare, minimize caregiver stress, and increase the quality of life for both the patient and caregiver.

Review of intervention studies on depression in persons with multiple sclerosis.

Depression is prevalent among persons with multiple sclerosis (MS), an acquired neurologic disability that affects predominantly women. The purpose of this article is to review intervention studies on depression in persons with MS. An integrative review of eight intervention studies published from 2000 to 2005 has revealed that various interventions could potentially alleviate depression. Although no definite conclusions can be made from this review, there is reasonable evidence that cognitive behavioral approaches are beneficial in the treatment of depression and in helping people adjust to, and cope with, having MS.

Age-related changes in the immune response to influenza vaccination in a racially diverse, healthy elderly population.

Proliferation to phytohemagglutinin (PHA) and cell-mediated responses to influenza vaccine (FLU) were assessed in healthy elderly Caucasians, African Americans, Latinos and young Caucasians before and after immunization. Both PHA- and FLU-induced proliferation were reduced in elderly subgroups. FLU-induced proliferation increased post-vaccination in all elderly, except African Americans, but responses were lower than young. IL-2 and IFN-gamma levels did not change after vaccination of elderly, regardless of race. The altered response to FLU in elderly African Americans, compared to elderly Caucasians and Latinos, indicates that racial background is important when drawing conclusions about immune responses to FLU in mixed elderly populations.