Pathfinders: a self-care and health education program for older widows and widowers.

Recent studies suggest that the loss of a spouse can be disruptive to the survivor's self-care and health promotion practices, especially for those who lack the knowledge and skills to successfully engage in these behaviors. Pathfinders is a theoretically and research-based self-care and health education program for recently widowed persons aged 50 and older. This article describes the program's structure, content, and recruitment methods. Preliminary evaluation data suggest that the program is achieving many of the intended outcomes. Issues pertaining to replication as well as limitations are discussed.

Older women's feelings about exercise and their adherence to an aerobic regimen over time.

Sedentary, overweight women aged 60-70 years were assigned either to a 16-week health education group (n = 70) in which they were instructed to exercise aerobically on their own three times per week or to a 16-week exercise group (n = 76) that consisted of three supervised aerobic sessions per week. Regression analyses performed at post-test and at 3-, 6-, and 18-months follow-up revealed that exercise frequency was not explained by group membership, but often was negatively associated with placing a greater value on exercising with peers. Those who were exercising more often at 6- and 18-months follow-up, however, valued the perceived benefits of exercise more highly. The findings of this study suggest the importance of emphasizing strategies that stress the intrinsically motivating benefits of exercise, as well as building into programs those aspects of exercise valued by the participants.

Beyond bereavement support group meetings: exploring outside social contacts among the members.

This article examines the extent to which bereavement support group participants engage in social interaction with fellow group members outside of the meetings, demographic influences on outside contact, and the relationship between this social interaction and bereavement outcomes. Data are presented from a longitudinal study that included 144 recently bereaved spouses between the ages of 51 and 89 who participated in a support group intervention. During the course of the study the majority of the participants had contact with other group members in addition to the scheduled meetings even though the group leaders did not encourage outside contact. Although the frequency of the interaction was only moderate, the support group participants reported feeling relatively close to their fellow group members. Men were as likely as women to have outside contact but they delayed in doing so. Those who engaged in outside contact were slightly more depressed, experienced more stress, and were more lonely at the time of the contact relative to others. Those who maintained some kind of interaction by Time 3 (1 year bereaved), however, reported less loneliness by the end of the study (Time 4). Findings are discussed in terms of the frequency and duration of support group interventions, the gender composition of the groups, and the need to incorporate into future studies a more systematic examination of outside interaction among support group participants.

Exploring the Caregiver Burden Inventory (CBI): further evidence for a multidimensional view of burden.

The purpose of this study was to examine the multidimensional nature of caregiver burden by specifically analyzing the patterns of association between five dimensions of burden as measured by the Caregiver Burden Inventory [1] and selected demographic, health, functioning, and well-being indicators. Subscales measuring each dimension were internally consistent and relatively independent in a sample of 160 caregivers. Time dependence burden was most influenced by patient impairment and caregiving involvement, whereas emotional burden was largely a function of caregiving satisfaction. Most of the variance in developmental burden was explained by depression and caregiving satisfaction. Contrary to expectations, physical health measures explained little variance in physical burden, of which most was explained by depression. Less than 10 percent of the variance in social burden was explained by depression and caregiver days sick. The findings lend support to a multidimensional view of burden and with minor modifications, the CBI appears to be a promising instrument with which to measure the construct.

Video Respite: an innovative resource for family, professional caregivers, and persons with dementia.

The development of a new and promising resource for family, professional caregivers, and persons with dementia is detailed in this article. The concept, Video Respite, refers to the initial goal of creating videotapes specifically for persons with dementia to capture and maintain their attention, enabling caregivers to have respite time. Ten 20-53-minute videotapes are described along with their potential benefits and limitations. Early research findings reveal that most persons with Alzheimer's disease (AD) watch and participate with the tapes, caregivers use the time for respite, and staff of SCU's report the tapes to be calming for the residents.

Health promotion and the older population: expanding our theoretical horizons.

As the year 2000 approaches (and beyond) more health educators will be involved in the implementation of health promotion programs and related activities specifically designed for the older population. Most health educators draw upon a variety of theoretical frameworks as they design programs. Traditionally, health education has been grounded in behavior change theories such as the Health Belief Model, the Theory of Reasoned Action, and Bandura's Social Learning/Cognitive Theories. When the focus is gerontological, however, an opportunity exits to expand health education's theoretical horizons by incorporating features drawn from gerontology itself. Principles of adult cognitive development, social gerontology and person-environment fit can potentially complement and supplement those models already in use as more programs are targeted for a growing older population.

Intrapersonal resources and the effectiveness of self-help groups for bereaved older adults.

The relative impact of three intrapersonal resources (self-esteem, competencies and life satisfaction) and the duration of a self-help group intervention on levels of depression and grief were examined over time among a sample of 295 recently bereaved older adults. In general, the resources examined had a greater direct influence on outcomes than the intervention. Also, those with lower competencies reported reduced depression and grief with greater meeting attendance, whereas the opposite was at first true for those with high competencies. Depression eventually decreased, however, among those with high competencies who continued to attend self-help group meetings for more than 8 weeks. Although bereavement self-help groups can aid those who may be deficient in selected skills, it is equally important to emphasize ways the bereaved can more effectively use those strengths that they may already possess in order to facilitate adaptation.

Bereaved older adults who seek early professional help.

The purpose of this exploratory study was to determine the characteristics of older bereaved spouses who sought early professional help related to their grief. Among a sample of 339 bereaved older adults, aged 50 years or older, 39 (11.5%) reported that they had obtained some form of professional help. The most commonly reported source of help sought was from clergy followed by that provided by the health-care system and community groups. Those who sought help reported higher depression, lower coping ability, and poorer perceived health as well as slightly lower self-esteem and instrumental and resource-identification skills. With a few exceptions, the particular source of help sought was not statistically related to many of the indicators examined.

Intergenerational conflict: middle-aged women caring for demented older relatives.

This study examined the experiences of 181 middle-aged women who, while raising a family, were also primary care providers for an older demented relative. Results indicated that the caregiver burden depended on the context of the caregiving experience, particularly the relative's place of residence. Employment did not alter responsibilities but did affect coping strategies and perceived health of the caregiver.

Assessing interviewer effects in a longitudinal study of bereaved elderly adults.

In a 2-year study, bereaved elders who were personally interviewed were compared with those who completed a mailed questionnaire on measures of depression, life satisfaction, and five global measures constructed from a series of bereavement-related feelings and behaviors. Data were gathered at six separate measurement periods. Multiple analyses of variance with repeated measures revealed no effect due to group assignment. Although significant changes over time were observed on most measures, these changes were statistically independent of whether the respondents were interviewed or not. The presence of interviewers was, however, associated with higher and more consistent completion rates at each measurement period.