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The purpose of this study was to evaluate the effectiveness of the Quality of Life~Contribution Model (QOLC) developed by Murrell and Norris (19S3) as a mental health needs assessment technique for the rural elderly. In this field survey method, measures of mental health areas and program targets within each mental health area are compared and prioritized according to their relative contributions to a subjective index of quality-of-life (QOL). An in-home survey of 60 older adults was conducted. Needs were defined in terms of problems, services, and community support and were measured across the following mental health areas: 1) Depression; 2) Organic Brain Syndrome; 3) Alcohol and Drug Abuse; 4) Anxiety; 5) Caregiver Problems; 6) Schizophrenia; and 7) Health Habits. The utility of the QOLC model was evaluated via the descriptive conclusions generated by multiple regression analysis of the sample survey data, with QOL as the dependent variable and the different need measures and mental health areas as the independent variables. A cost analysis was also completed comparing the net total cost of the QOLC with the hypothesized net total cost of a more traditional mental health needs assessment (consisting of a key informant plus a service use statistics component). The results suggest that although the QOLC mental health needs assessment costs more than simpler needs assessment techniques, it can yield important information that can prevent wasteful spending on increased direct mental health services and can also be used to determine the criteria that should be used to segment the target population. / Master of Science

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published_or_final_version / abstract / toc / Social Work and Social Administration / Master / Master of Philosophy

The purpose of this study was to test one theoretical explanation for elders' perceived current adequacy of everyday remembering, and the antecedent perceptions, values and beliefs, and consequent feelings related to this perception. Fourteen hypotheses, deduced from the theory of subjective forgetfulness in elders (Cromwell, 1991), tested one theoretical explanation for the relationships among: Personal Importance of Remembering, Perceived Seriousness of Forgetting, Perceived Frequency of Forgetting, Belief in a Relationship between Aging and Memory Decline, Belief in a Personal Health Risk for Memory Decline, Perceived Current Adequacy of Everyday Remembering, Distress about Current Forgetting, Concern about Future Forgetting and Self Esteem in elders. Multiple regression analysis of the data obtained from 202 community based elders, age 65 to 97, supported the assertions that perceiving self to forget frequently negatively influenced elders' judgments of their current memory adequacy and increased their distress about current forgetting. Believing that one had risk factors for memory decline influenced the current distress experienced about forgetting, and the level of concern about future memory. Present concerns about forgetting, in response to perceived frequency of forgetting and perceived risks, influenced in part the degree to which the present situation was viewed as a warning sign of potential progressive future decline. Concerns about memory and forgetting influenced elders' level of self esteem. Intriguing differences in the relationships among antecedent perceptions, values and beliefs, and consequent feelings about self were discovered between older and younger elders, and between elders who highly valued remembering and those for whom remembering was of lesser importance. Future research to expand our understanding of the subjective experience of forgetfulness in elders and potential future intervention research to increase perceived memory adequacy and decrease present and future concerns were proposed.

A descriptive study was conducted to examine the relationship between family support and elder well-being of a group of ambulatory elders living in the community. Information regarding the elder parent's reporting of the overall support received by adult children and its affect on well-being was sought. Forty five female subjects, aged 65 to 91 years, participated in this study. The subjects completed a questionnaire which included the Demographic Questionnaire, Family Support Exchange Questionnaire, Family APGAR, and Philadelphia Geriatric Center Morale Scale. The sample population was homogeneous and no significant correlations were demonstrated between quantity or quality measures of family support and elder well-being. The study findings were consistent with previous studies in that elder parents generally live in close proximity to at least one adult child and have frequent contact with them. Elderly parents were satisfied with the support they received from children and would confide in their children.

Older adults' attitudes toward mental health services have received little research attention. Overall, older adults are thought to hold relatively negative attitudes. In this study, Analysis 1 investigated historical shifts in attitudes toward mental health services among three independent samples of older adults, separated by 14-year and 9-year intervals (1977 sample, N = 90; 1991 sample, N = 101; 2000 sample, N = 99). Analysis 2 compared two samples of older and younger adults, each separated by a 9-year interval (Older Adults: 1991 sample, N = 93; 2000 sample, N = 91 and Younger Adults: 1991 sample, N = 131; 2000 sample, N = 147). Participants completed a questionnaire containing five, internally consistent scales assessing multiple dimensions of mental health attitudes (Openness, Biases, Range of Knowledge, Breadth, Help Seeking Attitudes). Analyses suggested that the 1991 and 2000 samples of older adults had more positive attitudes than did the 1977 sample. However, a sustained trend for more positive attitudes beyond 1991 was not seen. In fact, no differences existed between 1991 and 2000 samples with exception of two. Older and younger adults together had lower Biases and Breadth scores in 2000 than in 1991. Age effects, gender effects, and interactions were also examined. Possible historical influences were discussed along with implications for the delivery of mental health care to future cohorts of older adults.

The Aronson Shopping List is a short-term memory test which integrates current knowledge of brain-behavior relationships in assessment. The test was designed to detect deficiency in fluid intelligence. The goal of this study was to standardize the test on an elderly population. The sample was composed of 67 males and females whose ages ranged from 62 to 89 years. It was found that recent stressful events did not account for variation of performance on the ASL. The reliability of the test, established by means of a test and alternate form retest procedure, was found to be .70 after an average of eleven months. Percentiles are presented indicating performance comparisons. Further experimentation would be needed to establish whether the test would be useful to designate organic brain pathology.

Data was provided by researchers of the Einstein Aging Study (EAS) of the Albert Einstein College of Medicine, Yeshiva University whom statistically analyzed data from the Bronx Aging Study cohort, concluding that participation in cognitive leisure activities and one physical activity, dancing, were associated with a reduced risk of dementia [1]. We explore data from a second (the EAS) cohort, utilizing Cox Proportional-Hazards and extended Cox regression [13]. Cognitive leisure activities in general, and particularly doing crossword puzzles, reading books, watching television, and emailing are associated with a reduced risk of dementia. Doing aerobics, learning computer programming, babysitting, dancing, jogging singing, and weight training are associated with an increased risk of dementia. Participation in cognitive leisure activities in general, and reading books in particular, remains highly significant even after adjustment for well-known risk factors [14] such as: age, cognitive status, depression, medical illnesses, gender, ethnicity, education and economic status. / by Carrie Stevens. / Thesis (M.S.)--Florida Atlantic University, 2011. / Includes bibliography. / Electronic reproduction. Boca Raton, Fla., 2011. Mode of access: World Wide Web.