Functional declines, social support, and mental health in the elderly: Does living in a state supportive of home and community-based services make a difference?

Abstract

This study examines how acute and chronic stresses associated with functional declines in seniors and their spouses are moderated by their informal and formal support contexts. In the United States, states vary greatly in their support for home and community-based services (HCBS) for seniors with disabilities. This state-to-state variation allowed us to examine mental health effects of living in a society supportive of HCBS for the oldest old, who are at high risk for low or declining functions in daily activities and cognitive abilities. Using a ten-year panel study of a nationally representative sample of the oldest old (>=70 years old) covering the period 1993 to 2002, we conducted mixed-effects logistic regression analysis to incorporate time-varying characteristics of persons and states. As expected, low and declining functions in daily living and cognition constituted significant stressors among seniors and their spouse. Results demonstrated the important role of informal support available from non-spouse family/friends in lowering depression. Living in a state supportive of HCBS was associated with lower depression among seniors experiencing consistently low levels of function or recent functional declines, especially among those without informal support. Our findings were consistent with moderating or buffering models of formal support, suggesting that state HCBS support is effective mainly under conditions of high levels of stressors. Political will is needed to prepare US society to collectively support community-based long-term needs, given the difficulty of preparing ourselves fully for common, but often unexpected, functional declines in later life.

The effect of supportive-expressive therapy on hope and quality of life in patients with multiple sclerosis (MS)

“…This finding was in line with the results of Foote et al's research [38] which indicates that there is a significant relationship between hope, self-esteem, and social support in MS patients. Furthermore, the results of the current research are consistent with Muramatsu et al [39] and Zielinski et al [40] which illustrated that there is a positive relationship between social support and hope. In line with the results of the current research, Gibbons et al [24] showed that the dynamic supportive-expressive therapy is effective in the community mental health system and depression.…”

Leveraging the Health and Retirement Study To Advance Palliative Care Research

“…For example, past studies have linked to the US Census, Dartmouth Atlas of Health Care, American Hospital Association, Centers for Disease Control, RAND Center for Population Health and Health Disparities and others. 27,[39][40][41][42][43] …”

Psychosocial Predictors Of Depression In Elderly Patients Of A Brazilian Health Unit

“…Olagunju et al (2015) came to the same conclusions in a Nigerian elderly community; and Muramatsu,Yin and Hedeker (2010) in North-American elderly. Loneliness -a psychosocial dimension highly interconnected with social support -has been associated to severe depressive symptoms and to elevated depression levels in the follow-up on Dutch elderly (Holvastet al, 2015).…”

“…The study by Olagunju, Olutoki, Ogunnubi and Adeyemi (2015) showed that the severity of depression in elderly people is significantly correlated with social support availability from significant people and family. Muramatsu, Yin and Hedeker (2010) also determined that there is a predominant role of informal support from the family (other than from the spouse) and from friends in the elderly's low levels of depression. In conclusion, we consider that these results make sense because it is natural that those elderly who perceive themselves as having social support in a stage of life in which they frequently experience adverse events (e.g.…”

“…Also, the study by Olangunju et al (2015) verified a strong association between the depression's severity and the informal social support perceived by the elderly. The importance of social support in depression prevention and decrease in elder people was found as well in Muramatsu, Yin and Hedeker's (2010) research. In the third age, social support and depression may also interact and, together, they may predict the chance of survival to a heart attack (Frasure-Smith et al, 2000).…”