Joann Reinhardt - Academia.edu (original) (raw)
Papers by Joann Reinhardt
Women & Health
The qualities of daughter versus same-sex friend relationships were described by 151 married and ... more The qualities of daughter versus same-sex friend relationships were described by 151 married and widowed elderly women. The relation of these qualities to life satisfaction was assessed. Relationship qualities predicted life satisfaction in widowed women but not in married women. Significant predictors of life satisfaction for widows included the emotional support of daughters, the instrumental support of friends and friendship strength. In a comparison of the relationship qualities, both married and widowed respondents described daughters as providing more stimulation, ego support and utility than friends. Respondents also reported that relationships with daughters were stronger than those with friends. Married women described relationships with both daughters and friends as more stimulating than widowed women. The value of assessing qualitative indices compared to quantitative indices of later life relationships is discussed.
Journal of Social Work in End-Of-Life & Palliative Care, 2014
Family members of persons with advanced dementia may be asked to make complex treatment decisions... more Family members of persons with advanced dementia may be asked to make complex treatment decisions without having adequate knowledge regarding the risks and benefits. This 6-month, prospective, randomized trial tested the effect of an intervention consisting of a face-to-face, structured conversation about end-of-life care options with family members of nursing home residents with advanced dementia. A comparison group received only social contact via telephone. Structured conversations between a palliative care team and intervention group family members included goals of care and how best to achieve those goals, and provision of psychosocial support. Psychosocial support was also provided via telephone at three 2-month intervals. Family members participated in three telephone interviews: baseline, 3, and 6 months. Specific advance directives for persons with dementia were extracted from medical records. Results showed that intervention families had higher satisfaction with care than comparison families at the 6-month time point, and they were more likely to have decided on medical options listed in residents' advance directives (Do Not Resuscitate, Intubate, Hospitalize) over time. Study findings reinforce the need for increased education and support for families around issues of end-of-life care decisions for advanced dementia.
Journal of visual impairment & blindness
Поиск в библиотеке, Расширенный поиск. ...
Journal of visual impairment & blindness
The opinions, results, findings, and/or interpretations of data presented in this article are the... more The opinions, results, findings, and/or interpretations of data presented in this article are the responsibility of Lighthouse International and do not necessarily represent those of the Office of Children and Family Services, New York State Commission for the Blind and Visually Handicapped, or ...
Gerontechnology, 2002
Psychosocial aspects of driving transitions in elders with low vision, Gerontechnology, 2002; 1(4... more Psychosocial aspects of driving transitions in elders with low vision, Gerontechnology, 2002; 1(4): 262 -273. Although it has been suggested that the decision to stop driving is complex, there has been little research addressing the psychosocial influences on this decision. Two exploratory studies were conducted focusing on the psychosocial aspects of driving among older adults who are visually impaired. Results from multivariate analyses in Study 1 (n = 453) indicated that being older, female, more severely visually and functionally impaired, and urban residence were independently related to driving cessation. Qualitative findings from Study 2 (n = 47) suggested that the meaning ascribed to driving may influence the decisionmaking process. Further, family members may play a more influential role over time. A conceptual framework, based on models of health behavior change, is proposed that could guide future research on driving. Such work would facilitate a better understanding of the transition from driver to ex-driver, which could then inform interventions for older adults and their families faced with this critical decision.
Background and Purpose: For older adults, driving is more than simply an activity to accomplish d... more Background and Purpose: For older adults, driving is more than simply an activity to accomplish daily tasks. Rather, driving is a means to maintain one's socialization, and is imbued with a host of psychological meanings, including a sense of autonomy, independence, and self-worth. As a result, older adults with health problems typically resist giving up driving as long as possible, although many self-regulate their driving (e.g., avoid night driving) in what has been called a driving cessation continuum. Evidence is also emerging which suggests that driving cessation is associated with the onset of significant depressive symptomatology as well as persistence in depression over time. However, little is known about why some older adults are better able than others to make driving transitions with relatively less psychological distress. There has been surprisingly little research addressing the psychosocial influences on this decision. Decisions about driving are especially salien...
European journal of ageing, 2009
This study draws on an evolutionary model of exchange in relationships to examine the nature of p... more This study draws on an evolutionary model of exchange in relationships to examine the nature of perceived reciprocity in the context of kin and non-kin relationships among a sample of visually impaired older adults (age 63-99). Further, we examined the direct and moderating impact of functional impairment and adaptation to visual impairment on the nature of perceived reciprocity. Results showed that the greater the degree of genetic relatedness the more imbalanced the exchange. It was also found that degree of adaptation to visual impairment moderated the association between genetic relatedness and perceived exchange, such that the greater the degree of genetic relatedness the more people reported they gave rather than received except at very low levels of adaptation, when people received more than they gave the greater the degree of genetic relatedness. Thus, an evolutionary model was supported such that imbalanced exchange was found more with greater degrees of genetic relatedness...
The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry, 2005
Authors examined the potential risk factors of major and subthreshold depression among elderly pe... more Authors examined the potential risk factors of major and subthreshold depression among elderly persons seeking rehabilitation for age-related vision impairment. Participants (N=584), age 65 and older, with a recent vision loss, were new applicants for rehabilitation services. Subthreshold depression was defined as a depressive syndrome not meeting criteria for a current major depression (i.e., minor depression, major depression in partial remission, dysthymia) or significant depressive symptomatology. Seven percent of respondents had a current major depression, and 26.9% met the criteria for a subthreshold depression. Poorer self-rated health, lower perceived adequacy of social support, decreased feelings of self-efficacy, and a past history of depression increased the odds of both a subthreshold and major depression, versus no depression, but greater functional disability and experiencing a negative life event were significant only for a subthreshold depression. Only a history of p...
European Journal of Ageing, 2013
To successfully address the challenges of age-related visual impairment in rehabilitation and hea... more To successfully address the challenges of age-related visual impairment in rehabilitation and health care settings, it is crucial to gain a better understanding of the psychological and behavioral adaptations that occur in these populations. The purpose of this study was to modify the Optimization in Primary Secondary Control Scale (OPS) (Heckhausen Schulz and Wrosch 1999) to assess the utilization of lifespan control strategies among older adults with visual impairment. The Optimization in Primary and Secondary Control Scale (OPS) (Heckhausen et al. 1999) was used to develop a vision-specific version of this measure (i.e., VIS-OPS). The VIS-OPS was administered to older adults with recent vision loss (N = 364; Mean age = 82.9 years). Theory-driven confirmatory factor analysis was used to help refine the instrument and confirm the scale's four-factor structure. Items were removed from three of the four VIS-OPS subscales due to low squared-multiple correlations and poor model fit. Inter-item reliabilities for the resultant subscales ranged from 0.61 to 0.72. The final four-factor model fit the data well (RMSEA = .06, 90% CI .05--.06), with all items loading significantly on their associated factors (i.e. subscales). Correlational analyses provided criterion-related validity for the VIS-OPS with disability and psychosocial functioning measures in the expected directions. The VIS-OPS will allow researchers to more systematically and precisely measure control strategy use in reference to specific challenges associated with visual impairment, and may serve as a model for examining control strategy use in the context of other disabilities.
Clinical therapeutics, 2014
This was a Phase II pilot study of a problem-solving treatment (PST) to address subsyndromal depr... more This was a Phase II pilot study of a problem-solving treatment (PST) to address subsyndromal depression in residents of long-term care facilities. Our goal was to demonstrate PST implementation feasibility and to identify PST's potential for reducing depressive symptoms in this geriatric health care setting. Eligible participants were randomized to receive a PST treatment (six 1-hour sessions) or a social contact comparison (6 "friendly" visits) after an initial baseline assessment. Follow-up assessments occurred 7 weeks later (after treatment) and 2 months posttreatment. The basic analytic approach was based on an intention-to-treat analysis. We enrolled 21 elderly subjects in the PST group and 16 elderly subjects in the social contact comparison group. The PST group experienced a decline in depression scores compared with the social contact group. Although not statistically significant (likely due to the small sample size), PST was associated with decreased depressiv...
Structural Equation Modeling: A Multidisciplinary Journal, 2008
A correlation structure modeling method for comparison of mediated effects is outlined. The proce... more A correlation structure modeling method for comparison of mediated effects is outlined. The procedure permits point and interval estimation of differences in mediator effects, and is useful with models postulating 1 or more predictor, intervening, or response variables that ...
Psychology & Health, 2013
This study's purpose was to investigate changes i... more This study's purpose was to investigate changes in perceived overprotection - a problematic aspect of close relationships - over time in relationship to instrumental support receipt and vision rehabilitation service use in a sample of older adults with vision impairment. Participants were 584 older adults with chronic vision impairment who were interviewed three times over a 12-month period. Longitudinal data were analysed using a latent growth curve methodology to examine change over time in perceived overprotection and instrumental support in relation to vision rehabilitation service use. Self-reported levels of overprotection and receipt of instrumental support. Results. Over time perceived overprotection increased but not instrumental support. While perceived overprotection was positively associated with instrumental support initially, over time this relationship did not emerge. Perceived overprotection and instrumental support functioned as predictors of vision rehabilitation hours. However, over time vision rehabilitation service use did not influence these social supports. Perceived overprotection increases over time, yet this change is unaffected by rehabilitation service use and instrumental support. Both family members and elders need to be involved in the vision rehabilitation process and educated about how some level of independence can be regained.
Psychology and Aging, 2011
This study used vision loss due to age-related macular degeneration to learn about adaptation pro... more This study used vision loss due to age-related macular degeneration to learn about adaptation processes related to chronic functional impairment, focusing on Horowitz and concept of Adaptation to Age-related Vision Loss (AVL) as the outcome.
Journal of the American Medical Directors Association, 2012
Objective: A growing number of nursing homes across the country are embarking on culture change t... more Objective: A growing number of nursing homes across the country are embarking on culture change transformations that focus on maximizing elder residents' quality of life (QOL). Challenges to culture change implementation include the wide range of possible interventions as well as a lack of researchbased evidence to guide these choices. The purpose of this study was to determine those components of nursing home QOL that are associated with elder satisfaction so as to provide direction in the culture change journey. Design: A cross-sectional study using a survey administered face-to-face. Setting: Three large urban nursing homes within a long term care system in New York State. Participants: Sixty-two elder nursing home residents participated in face-to-face interviews. All elders had resided in their nursing communities for at least 3 months before participation. Measurements: The survey included the Quality of Life Scales for Nursing Home Residents, which examines elder QOL in 11 domains: autonomy, dignity, food enjoyment, functional competence, individuality, meaningful activity, physical comfort, privacy, relationships, security, and spiritual well-being. Elder satisfaction with the nursing home and nursing home staff were also examined. Results: After accounting for cognitive and physical functioning, among the QOL domains, dignity, spiritual well-being, and food enjoyment remained predictors of overall nursing home satisfaction. Additionally, dignity remained a significant predictor of elder satisfaction with staff. Conclusion: These results provide one possible path in the culture change journey based on empirical findings.
Journal of the American Medical Directors Association, 2012
Distressing behavioral symptoms often associated with dementia are not uncommon in the long term ... more Distressing behavioral symptoms often associated with dementia are not uncommon in the long term care setting. Culture change with its "person-centered approach to care" provides a potential nonpharmacological intervention to reduce these symptoms. The purpose of this study was to examine the relationship between a culture change initiative and nursing home elders' behavioral symptoms. Seven long term care communities (nursing units in 3 skilled nursing facilities) participated in a culture change intervention designed to transform the nursing home experience from a traditional hospital-model of care to one that is person-centered. Six comparison communities were matched to the intervention communities and continued to function along the typical nursing home organizational structure. Data were collected at baseline and 2 years later. Subjects were 101 elders (intervention group n = 50, comparison group n = 51). Each elder's primary day certified nursing assistant completed the Cohen-Mansfield Agitation Inventory, examining frequency of behavioral symptoms, including verbal and physical agitation as well as more forceful behaviors (eg, hitting, kicking) at both data collection periods. After controlling for functional status and race, a significant condition by time interaction was found for physical agitation and forceful behaviors with the person-centered group maintaining levels of behavioral symptoms as compared with a significant increase over time among the comparison group. A trend with the same pattern was found for verbal agitation. Person-centered care demonstrated potential as a nonpharmacological intervention for distressing behavioral symptoms. The positive impact of culture change appears to extend to elders with cognitive impairment who are less obvious beneficiaries of this model, featuring the central principals of autonomy and person-centered care.
Journal of Social Work in Disability & Rehabilitation, 2004
ABSTRACT The purpose of the present study was to identify factors associated with attitudes, know... more ABSTRACT The purpose of the present study was to identify factors associated with attitudes, knowledge, and fear of age-related vision impairment in a representative sample of US adults age 55 and older. Data were obtained from a national telephone survey. ...
The Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 2010
This study used the life-span theory of control (Heckhausen, J., &amp... more This study used the life-span theory of control (Heckhausen, J., & Schulz, R.) to examine adaptation to disability in old age. A narrative approach to data collection was used to assess the strategies employed by 364 older adults with macular degeneration to deal with daily challenges. Findings revealed a rich array of strategies. Compensatory Primary Control was reported by nearly all respondents, Compensatory Secondary Control by a majority, and Selective Primary Control by half of the participants. Selective Secondary Control was the least reported. Differences in strategy use depending on level of vision impairment were the most pronounced within the category of Compensatory Primary Control for strategies that involved using help from others and alternative means. Within the category of Selective Secondary Control, effort to maintain a positive outlook was associated with higher impairment levels, whereas within the category of Compensatory Secondary Control, attempts not to dwell on problems related to vision were associated with lower impairment levels. Implications for conceptual development and future research are discussed.
The Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 2006
Objectives. This article focuses on the effects of perceived overprotection, a potentially proble... more Objectives. This article focuses on the effects of perceived overprotection, a potentially problematic aspect of receiving support, on the ability to adjust to a chronic impairment, specifically, age-related vision loss. Perceived overprotection is an especially critical issue in this population of chronically ill older adults because of the safety issues associated with vision impairment and because perceptions on the part of the older adult that the support providers are overprotective may lead to excess disability.
Women & Health
The qualities of daughter versus same-sex friend relationships were described by 151 married and ... more The qualities of daughter versus same-sex friend relationships were described by 151 married and widowed elderly women. The relation of these qualities to life satisfaction was assessed. Relationship qualities predicted life satisfaction in widowed women but not in married women. Significant predictors of life satisfaction for widows included the emotional support of daughters, the instrumental support of friends and friendship strength. In a comparison of the relationship qualities, both married and widowed respondents described daughters as providing more stimulation, ego support and utility than friends. Respondents also reported that relationships with daughters were stronger than those with friends. Married women described relationships with both daughters and friends as more stimulating than widowed women. The value of assessing qualitative indices compared to quantitative indices of later life relationships is discussed.
Journal of Social Work in End-Of-Life & Palliative Care, 2014
Family members of persons with advanced dementia may be asked to make complex treatment decisions... more Family members of persons with advanced dementia may be asked to make complex treatment decisions without having adequate knowledge regarding the risks and benefits. This 6-month, prospective, randomized trial tested the effect of an intervention consisting of a face-to-face, structured conversation about end-of-life care options with family members of nursing home residents with advanced dementia. A comparison group received only social contact via telephone. Structured conversations between a palliative care team and intervention group family members included goals of care and how best to achieve those goals, and provision of psychosocial support. Psychosocial support was also provided via telephone at three 2-month intervals. Family members participated in three telephone interviews: baseline, 3, and 6 months. Specific advance directives for persons with dementia were extracted from medical records. Results showed that intervention families had higher satisfaction with care than comparison families at the 6-month time point, and they were more likely to have decided on medical options listed in residents' advance directives (Do Not Resuscitate, Intubate, Hospitalize) over time. Study findings reinforce the need for increased education and support for families around issues of end-of-life care decisions for advanced dementia.
Journal of visual impairment & blindness
Поиск в библиотеке, Расширенный поиск. ...
Journal of visual impairment & blindness
The opinions, results, findings, and/or interpretations of data presented in this article are the... more The opinions, results, findings, and/or interpretations of data presented in this article are the responsibility of Lighthouse International and do not necessarily represent those of the Office of Children and Family Services, New York State Commission for the Blind and Visually Handicapped, or ...
Gerontechnology, 2002
Psychosocial aspects of driving transitions in elders with low vision, Gerontechnology, 2002; 1(4... more Psychosocial aspects of driving transitions in elders with low vision, Gerontechnology, 2002; 1(4): 262 -273. Although it has been suggested that the decision to stop driving is complex, there has been little research addressing the psychosocial influences on this decision. Two exploratory studies were conducted focusing on the psychosocial aspects of driving among older adults who are visually impaired. Results from multivariate analyses in Study 1 (n = 453) indicated that being older, female, more severely visually and functionally impaired, and urban residence were independently related to driving cessation. Qualitative findings from Study 2 (n = 47) suggested that the meaning ascribed to driving may influence the decisionmaking process. Further, family members may play a more influential role over time. A conceptual framework, based on models of health behavior change, is proposed that could guide future research on driving. Such work would facilitate a better understanding of the transition from driver to ex-driver, which could then inform interventions for older adults and their families faced with this critical decision.
Background and Purpose: For older adults, driving is more than simply an activity to accomplish d... more Background and Purpose: For older adults, driving is more than simply an activity to accomplish daily tasks. Rather, driving is a means to maintain one's socialization, and is imbued with a host of psychological meanings, including a sense of autonomy, independence, and self-worth. As a result, older adults with health problems typically resist giving up driving as long as possible, although many self-regulate their driving (e.g., avoid night driving) in what has been called a driving cessation continuum. Evidence is also emerging which suggests that driving cessation is associated with the onset of significant depressive symptomatology as well as persistence in depression over time. However, little is known about why some older adults are better able than others to make driving transitions with relatively less psychological distress. There has been surprisingly little research addressing the psychosocial influences on this decision. Decisions about driving are especially salien...
European journal of ageing, 2009
This study draws on an evolutionary model of exchange in relationships to examine the nature of p... more This study draws on an evolutionary model of exchange in relationships to examine the nature of perceived reciprocity in the context of kin and non-kin relationships among a sample of visually impaired older adults (age 63-99). Further, we examined the direct and moderating impact of functional impairment and adaptation to visual impairment on the nature of perceived reciprocity. Results showed that the greater the degree of genetic relatedness the more imbalanced the exchange. It was also found that degree of adaptation to visual impairment moderated the association between genetic relatedness and perceived exchange, such that the greater the degree of genetic relatedness the more people reported they gave rather than received except at very low levels of adaptation, when people received more than they gave the greater the degree of genetic relatedness. Thus, an evolutionary model was supported such that imbalanced exchange was found more with greater degrees of genetic relatedness...
The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry, 2005
Authors examined the potential risk factors of major and subthreshold depression among elderly pe... more Authors examined the potential risk factors of major and subthreshold depression among elderly persons seeking rehabilitation for age-related vision impairment. Participants (N=584), age 65 and older, with a recent vision loss, were new applicants for rehabilitation services. Subthreshold depression was defined as a depressive syndrome not meeting criteria for a current major depression (i.e., minor depression, major depression in partial remission, dysthymia) or significant depressive symptomatology. Seven percent of respondents had a current major depression, and 26.9% met the criteria for a subthreshold depression. Poorer self-rated health, lower perceived adequacy of social support, decreased feelings of self-efficacy, and a past history of depression increased the odds of both a subthreshold and major depression, versus no depression, but greater functional disability and experiencing a negative life event were significant only for a subthreshold depression. Only a history of p...
European Journal of Ageing, 2013
To successfully address the challenges of age-related visual impairment in rehabilitation and hea... more To successfully address the challenges of age-related visual impairment in rehabilitation and health care settings, it is crucial to gain a better understanding of the psychological and behavioral adaptations that occur in these populations. The purpose of this study was to modify the Optimization in Primary Secondary Control Scale (OPS) (Heckhausen Schulz and Wrosch 1999) to assess the utilization of lifespan control strategies among older adults with visual impairment. The Optimization in Primary and Secondary Control Scale (OPS) (Heckhausen et al. 1999) was used to develop a vision-specific version of this measure (i.e., VIS-OPS). The VIS-OPS was administered to older adults with recent vision loss (N = 364; Mean age = 82.9 years). Theory-driven confirmatory factor analysis was used to help refine the instrument and confirm the scale's four-factor structure. Items were removed from three of the four VIS-OPS subscales due to low squared-multiple correlations and poor model fit. Inter-item reliabilities for the resultant subscales ranged from 0.61 to 0.72. The final four-factor model fit the data well (RMSEA = .06, 90% CI .05--.06), with all items loading significantly on their associated factors (i.e. subscales). Correlational analyses provided criterion-related validity for the VIS-OPS with disability and psychosocial functioning measures in the expected directions. The VIS-OPS will allow researchers to more systematically and precisely measure control strategy use in reference to specific challenges associated with visual impairment, and may serve as a model for examining control strategy use in the context of other disabilities.
Clinical therapeutics, 2014
This was a Phase II pilot study of a problem-solving treatment (PST) to address subsyndromal depr... more This was a Phase II pilot study of a problem-solving treatment (PST) to address subsyndromal depression in residents of long-term care facilities. Our goal was to demonstrate PST implementation feasibility and to identify PST's potential for reducing depressive symptoms in this geriatric health care setting. Eligible participants were randomized to receive a PST treatment (six 1-hour sessions) or a social contact comparison (6 "friendly" visits) after an initial baseline assessment. Follow-up assessments occurred 7 weeks later (after treatment) and 2 months posttreatment. The basic analytic approach was based on an intention-to-treat analysis. We enrolled 21 elderly subjects in the PST group and 16 elderly subjects in the social contact comparison group. The PST group experienced a decline in depression scores compared with the social contact group. Although not statistically significant (likely due to the small sample size), PST was associated with decreased depressiv...
Structural Equation Modeling: A Multidisciplinary Journal, 2008
A correlation structure modeling method for comparison of mediated effects is outlined. The proce... more A correlation structure modeling method for comparison of mediated effects is outlined. The procedure permits point and interval estimation of differences in mediator effects, and is useful with models postulating 1 or more predictor, intervening, or response variables that ...
Psychology & Health, 2013
This study's purpose was to investigate changes i... more This study's purpose was to investigate changes in perceived overprotection - a problematic aspect of close relationships - over time in relationship to instrumental support receipt and vision rehabilitation service use in a sample of older adults with vision impairment. Participants were 584 older adults with chronic vision impairment who were interviewed three times over a 12-month period. Longitudinal data were analysed using a latent growth curve methodology to examine change over time in perceived overprotection and instrumental support in relation to vision rehabilitation service use. Self-reported levels of overprotection and receipt of instrumental support. Results. Over time perceived overprotection increased but not instrumental support. While perceived overprotection was positively associated with instrumental support initially, over time this relationship did not emerge. Perceived overprotection and instrumental support functioned as predictors of vision rehabilitation hours. However, over time vision rehabilitation service use did not influence these social supports. Perceived overprotection increases over time, yet this change is unaffected by rehabilitation service use and instrumental support. Both family members and elders need to be involved in the vision rehabilitation process and educated about how some level of independence can be regained.
Psychology and Aging, 2011
This study used vision loss due to age-related macular degeneration to learn about adaptation pro... more This study used vision loss due to age-related macular degeneration to learn about adaptation processes related to chronic functional impairment, focusing on Horowitz and concept of Adaptation to Age-related Vision Loss (AVL) as the outcome.
Journal of the American Medical Directors Association, 2012
Objective: A growing number of nursing homes across the country are embarking on culture change t... more Objective: A growing number of nursing homes across the country are embarking on culture change transformations that focus on maximizing elder residents' quality of life (QOL). Challenges to culture change implementation include the wide range of possible interventions as well as a lack of researchbased evidence to guide these choices. The purpose of this study was to determine those components of nursing home QOL that are associated with elder satisfaction so as to provide direction in the culture change journey. Design: A cross-sectional study using a survey administered face-to-face. Setting: Three large urban nursing homes within a long term care system in New York State. Participants: Sixty-two elder nursing home residents participated in face-to-face interviews. All elders had resided in their nursing communities for at least 3 months before participation. Measurements: The survey included the Quality of Life Scales for Nursing Home Residents, which examines elder QOL in 11 domains: autonomy, dignity, food enjoyment, functional competence, individuality, meaningful activity, physical comfort, privacy, relationships, security, and spiritual well-being. Elder satisfaction with the nursing home and nursing home staff were also examined. Results: After accounting for cognitive and physical functioning, among the QOL domains, dignity, spiritual well-being, and food enjoyment remained predictors of overall nursing home satisfaction. Additionally, dignity remained a significant predictor of elder satisfaction with staff. Conclusion: These results provide one possible path in the culture change journey based on empirical findings.
Journal of the American Medical Directors Association, 2012
Distressing behavioral symptoms often associated with dementia are not uncommon in the long term ... more Distressing behavioral symptoms often associated with dementia are not uncommon in the long term care setting. Culture change with its "person-centered approach to care" provides a potential nonpharmacological intervention to reduce these symptoms. The purpose of this study was to examine the relationship between a culture change initiative and nursing home elders' behavioral symptoms. Seven long term care communities (nursing units in 3 skilled nursing facilities) participated in a culture change intervention designed to transform the nursing home experience from a traditional hospital-model of care to one that is person-centered. Six comparison communities were matched to the intervention communities and continued to function along the typical nursing home organizational structure. Data were collected at baseline and 2 years later. Subjects were 101 elders (intervention group n = 50, comparison group n = 51). Each elder's primary day certified nursing assistant completed the Cohen-Mansfield Agitation Inventory, examining frequency of behavioral symptoms, including verbal and physical agitation as well as more forceful behaviors (eg, hitting, kicking) at both data collection periods. After controlling for functional status and race, a significant condition by time interaction was found for physical agitation and forceful behaviors with the person-centered group maintaining levels of behavioral symptoms as compared with a significant increase over time among the comparison group. A trend with the same pattern was found for verbal agitation. Person-centered care demonstrated potential as a nonpharmacological intervention for distressing behavioral symptoms. The positive impact of culture change appears to extend to elders with cognitive impairment who are less obvious beneficiaries of this model, featuring the central principals of autonomy and person-centered care.
Journal of Social Work in Disability & Rehabilitation, 2004
ABSTRACT The purpose of the present study was to identify factors associated with attitudes, know... more ABSTRACT The purpose of the present study was to identify factors associated with attitudes, knowledge, and fear of age-related vision impairment in a representative sample of US adults age 55 and older. Data were obtained from a national telephone survey. ...
The Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 2010
This study used the life-span theory of control (Heckhausen, J., &amp... more This study used the life-span theory of control (Heckhausen, J., & Schulz, R.) to examine adaptation to disability in old age. A narrative approach to data collection was used to assess the strategies employed by 364 older adults with macular degeneration to deal with daily challenges. Findings revealed a rich array of strategies. Compensatory Primary Control was reported by nearly all respondents, Compensatory Secondary Control by a majority, and Selective Primary Control by half of the participants. Selective Secondary Control was the least reported. Differences in strategy use depending on level of vision impairment were the most pronounced within the category of Compensatory Primary Control for strategies that involved using help from others and alternative means. Within the category of Selective Secondary Control, effort to maintain a positive outlook was associated with higher impairment levels, whereas within the category of Compensatory Secondary Control, attempts not to dwell on problems related to vision were associated with lower impairment levels. Implications for conceptual development and future research are discussed.
The Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 2006
Objectives. This article focuses on the effects of perceived overprotection, a potentially proble... more Objectives. This article focuses on the effects of perceived overprotection, a potentially problematic aspect of receiving support, on the ability to adjust to a chronic impairment, specifically, age-related vision loss. Perceived overprotection is an especially critical issue in this population of chronically ill older adults because of the safety issues associated with vision impairment and because perceptions on the part of the older adult that the support providers are overprotective may lead to excess disability.