Older adults living with dementia experience progressive decline, prompting reliance on others for spiritual care and support. Despite a growing interest in studying persons living with dementia (PLwDs), empirical evidence on the spiritual needs of PLwDs has not been synthesized. Using the Whittemore and Knafl method, this integrative review examined the literature from 2000 to 2022 on the spiritual care needs of PLwDs. We sought to identify characteristics of the spiritual needs of PLwDs and ways to address them. The ATLA Religion, CINAHL, PsycINFO, PubMed, and Socindex databases were used to search the literature, and 12 peer-reviewed articles met the inclusion criteria. Spiritual care needs varied across studies. Overall, findings support the importance of identifying PLwDs’ religious and spiritual backgrounds to inform person-centered care. Spiritual needs were identified as verbal and non-verbal expressions related to past meaning and religious and spiritual background and were not consistently addressed in care. Providers reported observing spiritual distress in the mild stage prompting the need for spiritual care. There is a great need for dementia-specific spiritual assessment tools and spiritual care interventions to support spiritual well-being in dementia care. Spiritual care involves facilitating religious rituals and providing spiritual group therapy and religious and spiritual activities.
Objectives The association between religiosity and secular mental health utilization is unclear. Evidence suggests that religious and spiritual leaders (R/S leaders) may be more trusted than secular mental health therapists (SMHTs) and are often the first point of contact for individuals with mental health problems who identify as religious. Methods A generalized equation estimate (GEE) analysis was performed to examine the association between religiosity and mental health seeking behaviors in 2107 participants using the Midlife in the United States Study (MIDUS) data from 1995 to 2014. Results Results from the final model indicated that after adjusting for covariates, higher levels of baseline religious identification and baseline spirituality (assessed in 1995) predicted an increase in visits to R/S leaders from 1995-2014 by a factor of 1.08 [95% CI, 1.01, 1.16] and 1.89 [95% CI, 1.56, 2.28], respectively. Higher levels of baseline religious identification reduced SMHTs visits by a factor of .94 [.90, .98], whereas higher levels of baseline spirituality increased SMHTs visits by a factor of 1.13 [95% CI, 1.00, 1.27] during the same timeframe. Conclusion Higher levels of spirituality and religious identification increased the frequency over time of seeking mental health support from R/S leaders relative to SMHTs. Individuals with mental illness may seek support from religious resources, mental health professionals, or both, underscoring the importance of collaboration between R/S leaders and SMHTs. Mental health training for R/S leaders and collaboration with SMHTs may help alleviate mental health burden, especially among those who highly value their religious and spiritual beliefs.
Recruitment of diverse community-dwelling persons living with dementia (PLWD) and their caregivers (dyads) into randomized controlled trials (RCT) is challenging, time consuming and expensive. This presentation will describe community outreach efforts used over a one-year period to recruit dyads of PLWD and their caregivers in Healthy Patterns RCT. Community outreach yielded 296 inquiries, such that people expressed interest in joining the study. Of the 296 inquiries, almost all (95.6%) identified as African American, and 91(30.7%) consented to join the study. Presentations at senior centers yielded the highest number of inquiries (n=148), followed by staff presence at various community events such as health fairs and senior galas (n=145) and referrals (n=3). We found that community outreach was an effective recruitment strategy to generate inquiries among diverse PLWD and their caregivers to enroll in Healthy Patterns. We will discuss these strategies and provide suggestions for recruiting diverse dyads into clinical trials.
Anxiety symptoms are common among older adults and are often associated with adverse outcomes. Thus, it is important to examine modifiable factors and manage anxiety symptoms in this population. While many biological and psychological factors related to anxiety symptoms in older adults have been found, little is known about social factors which are essential in one’s mental health. The purpose of this study was to examine the prevalence of anxiety symptoms among older adults new to long-term services and supports (LTSS) and to investigate the relationship between social support and presence of anxiety. This was a secondary data analysis from a study funded to examine health related quality of life in older adults new to LTSS. Anxiety was assessed using a single item, “Recently, how often have you felt anxious?” and the answers were dichotomized into “anxiety” (ratings: ‘very often’, ‘often’, ‘sometimes’, and ‘seldom’) and “no anxiety” (rating: ‘never’). Social support was measured by Medical Outcomes Study Social Support Scale. Prevalence of anxiety symptoms in this sample was 82.7% (n=225). In multivariate logistic regression, adjusting for age, gender, LTSS type, cognitive status, physical and emotional health, and depressive symptoms, older adults with more tangible social supports had lower odds of having anxiety symptoms (Odds ratio=0.515; 95% CI: 0.289-0.919, p=0.025). Improving access to tangible social supports for older adults at the start of LTSS may impact anxiety in older adults. Implications for future research and intervention development to provide tangible social support to older adults in LTSS will be discussed.
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