Dale Lund - Academia.edu (original) (raw)

Papers by Dale Lund

American Journal of Hospice and Palliative Medicine, Mar 1, 2006

Music thanatology represents an emerging area in which the raw materials of music, usually harp a... more Music thanatology represents an emerging area in which the raw materials of music, usually harp and/or voice, assist and comfort the dying patient. During prescriptive ”music vigils,“ the clinician-mnusician carefully observes physiological changes, cues, and breathing patterns, thereby synchronizing the music to reflect or support the patient physiology and overall condition. Using data collected from 65 patients, this study was designed to assess the effectiveness of prescriptive harp music on selected palliative care outcomes using a sample of de-identified data forms from past music vigils. Patients were administered a 25- to 95-minute intervention of prescriptive harp music. Data collected included vital signs and observational indicators before (Ti) and after (T2) the vigil. Patients were more likely to experience decreased levels of agitation and wakefulness while also breathing more slowly and deeply with less effort at the conclusion of the music vigil. Results from this study suggest that a prescriptive vigil conducted by a trained music thanatologist could provide an effective form ofpalliative care for dying patients.

Omega - Journal Of Death And Dying, 1997

The primary purpose of this article is to stimulate interest in conducting research related to ad... more The primary purpose of this article is to stimulate interest in conducting research related to adult bereavement and provide suggestions for improving the quality of these studies and the application of their findings. Future research needs to generate new knowledge about grief and bereavement but it also needs to examine issues and questions that will make us more confident about what we already believe. Three general suggestions deal with the importance of integrating both theory and practice into future studies, issues related to types and designs of studies, and measurement issues that should be considered. Bereavement is a long-term, multidimensional process of adjustment and future research needs to be consistent with these defining features. Our knowledge about adult bereavement and grief continues to increase as evidenced by the growing numbers of books in local bookstores and libraries, educational videotapes, magazines, professional and academic journals and articles, professional and lay organizations, and mass media reports. Some of this information comes from autobiographical accounts of personal experiences with grief, clinical reports from professionals who work directly with the bereaved, clergy and religious leaders providing spiritual guidance, media interviews with survivors of natural disasters and widely publicized accidents, and educators who synthesize this potpourri of knowledge and experience. Research on adult bereavement also has increased over the past fifteen years but not nearly at the pace of these other sources of knowledge. All of these sources have made 287

Death Studies, May 9, 2007

The Dual Process Model of Coping with Bereavement (Stroebe & Schut, 1999) suggests that the most ... more The Dual Process Model of Coping with Bereavement (Stroebe & Schut, 1999) suggests that the most effective adaptation involves oscillation between two coping processes: loss-orientation (LO) and restoration-orientation (RO). A 22-item Inventory of Daily Widowed Life (IDWL) was developed to measure these processes and the oscillation between them, and assessed by examining 163 bereaved widow(er)s, ages 45-94 years. The LO and RO subscales produced alpha coefficients of .90 & .79, respectively. The more recently widowed demonstrated a high degree of oscillation balance between the two processes, while there was a greater emphasis on restoration-orientation among those bereaved longer. Both subscales generated significant relationships with the bereavement outcome measures used in this study. Furthermore, restoration-orientation was directly related to the level of self-care and daily living skills as well as personal growth. We identify six dimensions of oscillation that warrant further consideration and encourage others to help develop and refine all features of the IDWL and make it adaptable to other loss relationships.

International Journal of Aging & Human Development, 1996

The purpose o f this study was to examine the multidimensional nature o f caregiver burden by spe... more The purpose o f this study was to examine the multidimensional nature o f caregiver burden by specifically analyzing the patterns of association between five dimensions o f burden as measured by the Caregiver Burden Inventory [1] and selected demographic, health, functioning, and well-being indicators. Subscales measuring each dimension were internally consistent and relatively independent in a sample o f 160 caregivers. Time dependence burden was most influenced by patient impairment and caregiving involvement, whereas emotional burden was largely a function o f caregiving satisfaction. Most o f the variance in developmental burden was explained by depression and caregiving satisfaction. Contrary to expectations, physical health measures explained little variance in physical burden, of which most was explained by depression. Less than 10 percent o f the variance in social burden was explained by depression and caregiver days sick. The findings lend sup port to a multidimensional view o f burden and with minor modifications, the CBI appears to be a promising instrument with which to measure the construct.

ABSTRACT Most husbands do not outlive their wives. The 1990 Census of the United States reveals t... more ABSTRACT Most husbands do not outlive their wives. The 1990 Census of the United States reveals that while nearly 49 percent of women are widowed after age sixty-five only 14 percent of the men are widowed. After age eighty-five the rates of widowhood increase for both men and women. About 80 percent of these women are widows compared with 43 percent of the men [1]. Men may not know these exact statistics but their life experiences remind them that it would be unusual or unexpected if their wives were to die before them. Statistical odds do not operate like rules in our lives. No one can be guaranteed that death will occur at a particular time or in a specific way. A seventy-nine-year-old man in one of our research studies on spousal bereavement described the surprise he felt when his wife died unexpectedly. "I just can't believe this happened. My wife was healthy. She was strong. She took me to the emergency room three times in six months last year. I almost died twice. All of a sudden she has a heart attack and she's dead. I'm here and she's gone. This is crazy. Nobody thought I'd be the one to live the longest." The focus of this chapter is on the ways in which men, particularly those in mid and later life, cope with the deaths of their spouses. We have learned a great deal from research on bereavement over the past twenty years but we know much less about older adults, especially men. Widows are more available and we have assumed that they are more willing to participate in research because we also believe that they are quite willing to discuss the personal and sensitive issues.

Journal of religion & aging, Nov 5, 2010

Bereaved persons (n = 190) between the ages of 50 and 93 completed mailed and interview questionn... more Bereaved persons (n = 190) between the ages of 50 and 93 completed mailed and interview questionnaires at three time periods (3 weeks, 1 year and 2 years) following their spouses&#x27; death. The Mormons (73%) in the sample were compared with the others (27%) in terms of their social support networks and health, psychosocial functioning and other global measures of

Activities, Adaptation & Aging, Jun 2, 2003

... Michael S. Caserta, PhD, is Associate Professor and Dale A. Lund, PhD, is Director and Profes... more ... Michael S. Caserta, PhD, is Associate Professor and Dale A. Lund, PhD, is Director and Professor, University of Utah Gerontology Center, 10 South ... Similarly, music is believed to be a particularly effec-tive way to stimulate old memories among those with AD (Prickett & Moore ...

American Journal of Orthopsychiatry, 1988

This study examined the experiences of 181 middle-aged women who, while raising a family, were al... more This study examined the experiences of 181 middle-aged women who, while raising a family, were also primary care providers for an older demented relative. Results indicated that the caregiver burden depended on the context of the caregiving experience, particularly the relative's place of residence. Employment did not alter responsibilities but did affect coping strategies and perceived health of the caregiver. ecent demographic trends of increased R life expectancy, particularly at advanced ages, together with overall decreases in fertility rates, higher ages at first marriage, rising divorce rates, and changes in the social and economic roles of women are having a profound impact on intergenerational patterns within American families. In 1985, for example, there were 9.1% more people from 65 to 75 years old than in 1980. In contrast, there were 14.2% more 75 to 84 year olds and 2 1 .O% more people over the age of 85 (U. S. Bureau of the Census, 1986). In fact, more of the elderly are now surviving with chronic illnesses that will require greater family commitment to expensive, long-term care (Burish & Bradley, 1983; Manton, 1986). While the U.S. population is growing older, the trend toward late marriage and small families is increasing. In 1982, the median age of women at first marriage was 22.3 years, an increase of nearly 10% since 1960, when it was 20.3 years. The average family size decreased from 3.7 members in 1960 to 3.2 in 1985. The divorce rate, on the other hand, increased by 125%, from 9.2 per 1,OOO married persons in 1960 to 21.7 per 1 ,OOO in 1982 (U.S. Bureau ofrhe Census, 1985). During this same period, the proportion of women participating in the labor force has remained substantial, particularly among women over the age of 45 who are traditionally the principal care providers for elderly parents and spouses

Cambridge University Press eBooks, Mar 26, 1993

The overall purpose of this chaptcr is to provide an overview of the major findings from our rese... more The overall purpose of this chaptcr is to provide an overview of the major findings from our research over the past 11 years on spousal bereavement among older adults in the United States. We began in 1980 with a longitudinal study funded by the National Institute on Aging (N IA) designed to describe, from a multidisciplinary perspective, the process of adjustment that follows the death of a spouse, examine factors that influence the observed outcomes, and identify potential focuses and strategies for intervention. A sample of 192 recently bereaved spouses and a control group of 104 currently married adults over the age of 50 participated in the study. Findings from this project were used to develop a second study, also funded by N IA , to examine the effectiveness of self help groups in facilitating the bereavement adjustment process. Another sample of 339 recently bereaved spouses participated in this intervention study, with 241 assigned to self-help groups and 98 assigned to a control condition. In the late 1970s, the National Institute on Aging recognized that little or no empirical research on bereavement had been completed that specifically focused on older adults. Although some studies had included older adults in their samples, there was no systematic attempt to learn more about their bereavement experiences until N IA established bereavement and aging as a priority for research funding. O ur first study was one of three that the institute initially supported. Each project had its own unique focus, ques tions, and measures, but they were similar in their purpose and prospective longitudinal designs. Larry Thompson, Dolores Gallagher, and their colleagues (1989) began their study in Los Angeles in 1979; we followed in Salt Lake City in 1980; and Martin Faletti, Jeanne Gibbs, and colleagues began in M iam i in 1981. Although the untimely deaths of Gibbs and Faletti limited the analysis and dissemination of their data, these three studies, and The studies described in this chapter were funded by the National Institute on Aging (R01 AG02193 and R01 AG06244). ' ' 240 brought to you by CORE View metadata, citation and similar papers at core.ac.uk provided by The University of Utah: J. Willard Marriott Digital...

Gerontologist, Oct 1, 1987

Gerontologist, Oct 1, 1995

ABSTRACT The development of a new and promising resource for family, professional caregivers, and... more ABSTRACT The development of a new and promising resource for family, professional caregivers, and persons with dementia is detailed in this article. The concept, Video Respite, refers to the initial goal of creating videotapes specifically for persons with dementia to capture and maintain their attention, enabling caregivers to have respite time. Ten 20-53-minute videotapes are described along with their potential benefits and limitations. Early research findings reveal that most persons with Alzheimer's disease (AD) watch and participate with the tapes, caregivers use the time for respite, and staff of SCU's report the tapes to be calming for the residents.

The Journals of Gerontology: Series B, Oct 29, 2013

Objectives. This study explored the relative contributions of friends and family to the social an... more Objectives. This study explored the relative contributions of friends and family to the social and emotional well-being of women and men in the first 2-6 months following the death of their spouse or partner. Methods. Three hundred and twenty-eight widowed men (39%) and women aged 50 and older completed self-administered questionnaires that included measures of contact and satisfaction with friends and family, as well as measures of affective (i.e., grief and depression) and self-evaluative (i.e., coping self-efficacy, mastery, self-esteem) responses to loss. Results. Regression analyses supported the positive features of social support and interaction but particularly highlight the role of friends: ease of contact and satisfaction with friendship support were associated with more positive selfevaluative aspects of loss; greater frequency of friendship help was associated with more negative affective reactions, whereas higher satisfaction with friendship support was associated with more positive affective reactions. Discussion. These analyses support the voluntary and socializing functions of friendship and social support, bolstering individuals during stressful life transitions, advancing our understanding of the underexamined and particularly distinct functions of friendship in the early phases of spousal loss.

Gerontologist, Dec 7, 2011

Widowhood is among the most distressing of all life events, resulting in both mental and physical... more Widowhood is among the most distressing of all life events, resulting in both mental and physical health declines. This paper explores the dynamic relationship between physical health and psychological well-being among recently bereaved spouses. Design and Methods: Using a sample of 328 bereaved persons who participated in the " Living After Loss " study, we modeled trends in physical health, somatic symptoms, and psychological well-being over the fi rst year and a half of widowhood. The primary focus is whether physical health at the time of widowhood modifi es psychological wellbeing over time. Results: There were considerable somatic symptoms during the earliest months of bereavement but no major health declines over the fi rst year and half of bereavement. Those in poor health had initially higher levels of grief and depressive symptoms, but the trajectories or changes over time were similar regardless of health status. Those with poor health at the time of widowhood had signifi cantly higher risks of complicated grief and major depression disorder. Implications: Bereavement requires physical and emotional adjustment, but the psychological trajectory of bereavement may be somewhat universal. Bereavement support ought to include a focus on self-care and health promotion in addition to emotional support, especially because those with poor health initially may be most susceptible to prolonged and intense clinical distress.

Journal of Community Psychology, Apr 1, 1987

Previous research has demonstrated that symptoms of depression and anxiety can impede the recover... more Previous research has demonstrated that symptoms of depression and anxiety can impede the recovery process of hospitalized medical patients. The purpose of this study was to identify those hospitalized patients who were more likely to be predisposed to these symptoms. Using a sample of 109 hospitalized women, the following hypothesis was tested: Depressive symptoms will be more prevalent among those who (a) had experienced the loss of their mother at 17 years of age or younger, (b) have been experiencing low marital companionship, or (c) have three or more children 17 years of age or younger at home. A contingency analysis revealed a significant relationship between early loss of mother and the development of depressive symptoms. Although marital companionship failed to differentiate between depressive symptom levels, a two-way analysis of variance yielded a significant inverse relationship between marital companionship and depression in general. The number of children at home was not a significant predictor, either as a main effect or interactively with marital companionship. Implications for interventions are discussed.

Journal of social work in end-of-life & palliative care, Apr 1, 2011

This study identified personal resources, features of the marital relationship, and death circums... more This study identified personal resources, features of the marital relationship, and death circumstances that affected perceived self-competency among recently bereaved older adults. Data come from 328 widowed persons who participated in the "Living After Loss" project. Results suggested that those who had more personal resources-namely, income and good health-were the most competent in daily life tasks. Surprisingly, neither death forewarning nor marital quality improved competency after widowhood. Higher competency was associated with more positive mental health outcomes, suggesting that grief is complicated by the need to enhance and/or restore daily life activities as well as the need to deal with the sadness associated with the loss.

Journal of Applied Gerontology, Feb 28, 2011

This study uses data from semistructured interviews and time-log diaries to explore both desired ... more This study uses data from semistructured interviews and time-log diaries to explore both desired and actual time-use among employed ( n = 26) and nonemployed caregivers ( n = 22). We found that employed caregivers were generally more satisfied with respite time-use than nonemployed caregivers. Employed caregivers were also more likely to do activities they had desired to do, suggesting they may have clearer expectations about what they could accomplish during respite. Although most employed caregivers considered employment to be a valuable and desired form of respite, lack of free time outside of work and caregiving was stressful. Similarly, nonemployed caregivers expressed a desire to do activities they wanted to do, rather than only those related to caregiving and household maintenance. These results suggest that both employed and nonemployed caregivers might benefit from better respite time-use. Practice and policy suggestions that might enhance caregivers’ use of respite time are provided.

Omega - Journal Of Death And Dying, Mar 1, 2009

The positive psychology movement has created more interest in examining the potential value of ex... more The positive psychology movement has created more interest in examining the potential value of experiencing positive emotions (e.g. humor, laughter and happiness) during the course of bereavement. This study of 292 recently widowed (5-24 weeks) men (39%) and women (61%) age 50 and over examined both the perceived importance of and actual experience of having positive emotions in their daily lives and how they might impact bereavement adjustments. We found that most of the bereaved spouses rated humor and happiness as being very important in their daily lives and that they were also experiencing these emotions at higher levels than expected. Experiencing humor, laughter and happiness was strongly associated with favorable bereavement adjustments (lower grief and depression) regardless of the extent to which the bereaved person valued having these positive emotions. The positive psychology movement has drawn more attention to not only examining positive outcomes associated with stressful life transitions and situations but has also brought greater awareness of the importance of positive coping processes (Fredrickson, 2003; Seligman & Csikszentmihalyi, 2000). For well over a decade, research has shown support for the potential role of positive emotions and humor in particular, in reducing stress (Folkman, 1997; Lefcourt, 2002; Martin, 2001). Having a sense of humor is recognized as a coping mechanism and has been found to be associated with overall quality of life, psychological well-being and physical health (Thorson & Powell, 1993; Thorson, Powell, Sarmany-Schuller & Hampes, 1997; Folkman & Moskowitz, 2000). In the well known study of young Catholic nuns' autobiographies dating back to the 1930's, those who experienced the most positive emotions over the course of their lives lived approximately 10 years longer than those whose accounts contained fewer positive emotions (Danner, Snowdon, & Friesen, 2001). Research on bereavement has clearly identified that most people experience both positive and negative emotions during the course of adjustment (Bisconti, Bergeman & Boker, 2004; Bonanno & Kaltman, 1999) and that it is not uncommon to experience a wide range of emotions nearly simultaneously (Lund, Caserta & Dimond, 1993; Byrne & Raphael, 1999). There is considerable intra-individual variation in grief (Ong, Bergeman & Bisconti, 2004). However, most attention has been directed toward an examination of the emotions that are problematic, or determined to interfere with daily life and threatening to well-being (e.g. anger, fear and sadness) (Fredrickson, 2003; Stroebe & Schut, 2001). While very little empirical research has examined positive aspects of the bereavement coping process and adjustment outcomes, there is some evidence that positive daily emotions among

Omega - Journal Of Death And Dying, Dec 1, 2003

The study examined the prevalence and pattern of reports of sleep disturbance over two years in a... more The study examined the prevalence and pattern of reports of sleep disturbance over two years in a group of 296 adults aged 50 years and over, and assessed the relationship between patterns of sleep disturbance and bereavement adjustment over time. A sample of 192 widows and widowers were compared to a matched sample of 104 non-bereaved persons. About half of the bereaved respondents experienced sleep disruption in the first month following their loss. Regardless of bereavement status, one-third of the sample experienced ongoing sleep disruption, and 10% consulted a physician for difficulty sleeping. Persons with a pattern of consistent sleep disturbance showed statistically significant differences in grief outcomes that persisted over time and tended to be female, older, with poor health, and taking more medications.

Symbolic Interaction, Nov 1, 1986

The purpose of this longitudinal study was to assess the extent to which the social anchorage dim... more The purpose of this longitudinal study was to assess the extent to which the social anchorage dimension of the self‐concept is impacted by the death of a spouse among a sample of older surviving spouses. Social anchorage was measured by the Twenty Statements Test (TST) in mailed questionnaires and consisted of self‐statements that signify important social relationships and group memberships. As hypothesized, the 42 bereaved persons had lower social anchorage scores than the 72 nonbereaved controls. This significant effect was evident as early as three to four weeks following the death, and it persisted through five more measurement periods that covered the first two years of bereavement.