Advance care planning ideally includes communication about values between patients, family members, and care providers. This study examined the utility of health care values assessment tools for older adults with and without dementia. Adults aged 60 and older, with and without dementia, completed three values assessment tools-open-ended, forced-choice, and rating scale questions-and named a preferred surrogate decision maker. Responses to forced-choice items were examined at 9-month retest. Adults with and without dementia appeared equally able to respond meaningfully to questions about values regarding quality of life and health care decisions. People with dementia were generally as able as controls to respond consistently after 9 months. Although values assessment methods show promise, further item and scale development work is needed. Older adults with dementia should be included in clarifying values for advance care planning to the extent that they desire and are able. Keywords advance care planning; values; dementiaOlder adults at risk for dementia or with early dementia may be particularly interested to engage in advance care planning. Broadly speaking, advance care planning entails communicating with loved ones, health care providers, or other relevant parties to prepare for decisions that may need to be made during a time of future decisional incapacity. For older adults at risk for dementia, such planning might entail preparing for financial, residential, and/or health care eventualities. Within the health care realm, advance care planning has primarily focused on the completion of advance directives that allow individuals to designate surrogate decision makers (i.e., durable power of attorney for health care) or to document particular health care instructions (i.e., living will). However, research and clinical evidence suggests that completing advance directives-in the absence of communication about an individual's and his or her family's values, fears, and preferences -may not ultimately help to facilitate good decisions on behalf of individuals with dementia or other incapacitating illnesses (Covinsky et al., 2000;Miles, Koepp, & Weber, 1996;Teno et al., 1997).Please address correspondence to Michele J. Karel, PhD, Psychology Service 3-5-C, Brockton VA Medical Center, 940 Belmont Street, Brockton, MA 02301; Michele.Karel@va.gov.. Authors' Note: Adam Bank is now in independent practice in Weston, Florida. Armin Azar is now at the Department of Psychological and Brain Sciences, University of Louisville, Kentucky. U.S. Department of Veterans AffairsPublic Access Author manuscript J Aging Health. Author manuscript; available in PMC 2016 May 06. VA Author Manuscript VA Author Manuscript VA Author ManuscriptA process of values clarification in advance care planning recognizes both that individuals differ in health-care related beliefs and preferences and that medical decisions are made within a social context. With regard to individual differences, cultural (Blackhall, Murphy, Frank, Michel, & Aze...
The findings demonstrate that telecommunications technology can overcome the often formidable logistical problems faced by both English- and Spanish-speaking caregivers, and it can provide benefits similar to those obtained in face-to-face support groups.
Normative data for the Mattis Dementia Rating Scale (MDRS), stratified by age and education, are provided for use with older adults (ages 61-94) in urban medical settings. Age and education accounted for the greatest amount of variance in MDRS performance. Gender and race were also associated with total MDRS scores, though to a lesser extent. The present normative data are more appropriate for use with older patients seen in urban medical settings than normative data obtained from samples of better-educated, relatively healthy, Caucasian adults. This study provides additional evidence of the significant influence of age and education on MDRS total score (MDRS-T) performance, and highlights the importance of matching an examinee's demographic background to the normative sample with which his or her test score is being compared. Careful consideration of this match is likely to lead to more accurate diagnostic conclusions and potentially improved patient care.
Buss, Larsen, Westen, and Semmelroth claimed that sex differences in the dislike of sexual or emotional infidelity supported the socio-biological hypothesis of men (i.e., most men) having evolved sexual jealousy, whereas women (i.e., most women) evolved emotional jealousy. In two studies with 745 undergraduates, our finding was that, similar to the Buss et al. finding, over 50% of the men and women reported greater upset over imagined emotional infidelity. Subjects responded to a self-rating of jealousy, the Bem Sex-Role Inventory, 39 items articulating gender norms, a request to explain their dislike of infidelity, and which of 8 excuses by the wayward partner was most upsetting. We proposed that the findings could be explained more parsimoniously by the concept of the social construc tion of gender and Eagly's social-role perspective.
The relationship of cognition to perceived social support (PSS) was examined in a sample of 188 older medical patients who lived alone before admission to the hospital. Most of the patients were African American, and a majority (54.3%) was classified as cognitively impaired based on their performance on the Mattis Dementia Rating Scale. Compared with cognitively intact elders, impaired participants reported lower overall PSS as well as lower PSS in their relationships with friends and significant others. These findings suggest that cognitive functioning is an important factor in influencing older, medically ill African Americans'perceived social support. Possible risk factors for low PSS and the role of cognition in friendship and maintenance of a social support network are discussed. Older adults who live alone typically have fewer medical conditions and fewer cognitive deficits than does the general population of older adults (Mui & Burnette, 1994), yet there remain substantial numbers of older adults who manage to live alone with mild, moderate, and even severe cognitive impairment. Research on a sample of 372 predominantly African American older adults who lived alone prior to admission to a medical rehabilitation hospital indicates that 38.9% scored in the impaired range on a measure of global cognitive functioning (MacNeill & Lichtenberg, 1997). Impaired cognition has also been associated with depression (Cervilla & Prince, 1997), lessened ability to perform self-care tasks (Heaton & Pendleton, 1981), greater 437
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.