This study was conducted to explore how the identity processes of assimilation and accommodation work together to enable older adults to adjust to age-related physical and cognitive change. The study introduces of the concept of micro and macro levels of identity processes to Whitbourne's identity model as a means of further understanding the concept of a identity balance, an approach to identity that employs both assimilation and accommodation, and is theorized to be the optimal approach to maintaining well-being and positive self-esteem in later life. A sample of 50 community-dwelling adults between the age of 50 and 93 (M = 72.42) completed a structured interview that included measures of identity and self-esteem. It was hypothesized that participants would use identity assimilation in response to the impact of age on overall sense of self (macro identity), and identity accommodation in response to most salient physical or cognitive changes (micro identity). The results indicate that identity assimilation was used most at the macro level, but was not positively correlated with self-esteem. Identity assimilation was also used most at the micro level; however, it was not clear whether the structured interview accurately assessed assimilation and accommodation at the micro level due to a contradiction in reporting by a substantial percentage of the identity assimilators. The results suggest that a balanced approach to overall identity, as well as engaging in behavior to manage physical or cognitive change, are most effective in maintaining positive self-esteem in later life. The relationship of engaging in behavior to identity at both the micro and macro levels of identity was explored, and a model based on the findings was proposed for understanding how identity at both levels can be employed in order to maintain a high self-esteem and a balanced sense of self.

In this study, the author investigated the hypothesis that an animal visitation program could alleviate depressed behaviors among a group of elderly subjects residing in a nursing facility. The program consisted of twice weekly visits of volunteers accompanying their dogs. The effect of the visits upon the patients was evaluated regularly using two behavioral monitoring devices (the Geriatric Rating Scale, and the Social Interaction Rating Scale) and two self-report questionnaires (the Geriatric Depression Scale, and the Profile of Mood States). Twenty-five subjects participated in the treatment. The performance of this group was compared with that of a matched no-treatment group. At the conclusion of the twelve week treatment, experimental subjects reported less depression, anxiety, anger, fatigue, and confusion. There were significant reductions in apathetic, withdrawn behaviors and significant increases in prosocial behavior. Control subjects were unchanged. The Pet Attitude and Experience Questionnaire (PAEQ) provided a quantitative representation of the quality of the subject's past experiences with and current attitudes toward pet animals. Grouping subjects by PAEQ scores revealed that experimental subjects who reported strongly positive experiences and attitudes improved significantly over control subjects, while experiments subjects with less positive attitudes and experiences failed to show significant improvement on the dependent measures. The role of pet-facilitated therapy as a behavioral treatment for depression in institutionalized elderly is discussed.

Infantilizating speech, in which individuals speak to older adults as if they were children, is a communication style that affects the recipient's ability to form important relationships and elicit vital information. The purpose of the present study was to identify specific factors that may relate to the type of speech directed toward nursing home residents by staff members of those institutions, specifically infantilizing speech. The factors examined were knowledge about the aging process, attitudes toward the elderly, education and experience of nursing home staff, the extent to which infantilizing speech may be perceived as nurturing and respectful and the way it relates to ratings of satisfaction and competence of the patient. Fifty staff members of long term care facilities, including nurses and certified nursing assistants, participated in this study by filling out a questionnaire addressing the areas of interest. Regression analyses were carried out for each of the eight dependent variables in order to determine the effect of the designated independent variables. There were significant predictors for the dependent variables of respect and nurturance. Nurturance was rated as low by those with higher levels of knowledge (Beta = $-$.31, t = $-$2.21, p $<$.03, R$\sp2$ =.03). Fewer negative attitudes was also related to viewing infantilizing speech as more respectful (Beta = $-$.45, t = $-$3.18, p $<$.00, R$\sp2$ =.13) and nurturing (Beta = $-$.48, t = $-$3.47, p $<$.00, R$\sp2$ =.14) when compared to the neutral conditions. Recommendations are made for using these findings in the development of staff training programs.

Diagnostic classification systems are designed to identify clinical conditions that produce significant decrements in functional status. Historically, there has been a tendency to consider conditions that fall below threshold levels as temporary phenomena that do not interfere with daily functioning. However, dismissing subthreshold symptoms may be particularly problematic for older adults. The present study examined the relationship between depression, anxiety, and decrements in functional status among older adults using both continuous and categorical diagnostic approaches. One hundred veterans were recruited from the Veterans Health Study, a longitudinal investigation of male veterans' health. Participants completed screening measures of depression, anxiety, functional status, medical comorbidity, and the SCID anxiety and mood modules. One-quarter of the sample met DSM-IV criteria for one of the targeted mood or anxiety disorders. Continuous and categorical measures of depression were significantly related to decrements in functional status above and beyond comorbid medical conditions. A significant association was found between anxiety symptoms (per continuous measure) and decrements in functional status. This finding suggests that anxious symptoms are related to decrements in work, self-care, and leisure activities. Moreover, the results indicate that continuous measures of anxiety that focus on severity of symptoms rather than the presence or absence of a disorder, may be a more appropriate for assessing late-life anxiety. Health care professionals who treat older adults should not dismiss anxious or depressive symptoms among frail older adults as merely a natural outcome of aging or disease. Efforts to reduce decrements in functional status experienced by older adults with anxious and depressive symptoms should focus on educating health care providers to recognize and treat the full spectrum of anxiety and depressive syndromes.