ABSTRACT
The use of technological means in the process of neuropsychological assessment has been proposed as a technique with promising results in the field of detection of neurocognitive disorders for community-dwelling older adults. Especially during the pandemic period due to COVID-19, telemedicine assumed to be vital in the field of early diagnosis of cognitive disorders and highlighted the clinical utility of remote methods of neuropsychological assessmentby video-conference. This descriptive study presents the development of a remote neuropsychological assessment protocol by selecting appropriate validated tests as part of a more comprehensive evaluation for older adults dwelling in the community. We recruited participants from the Athens Alzheimer's Association center in collaboration with the Hellenic Neuropsychological Society, in Athens, Greece, regarding the period between April 2020 and October 2021. 90 individuals, tested for the first time, were categorized into three groups according to their diagnosis which included: (a) Mild Cognitive Impairment (MCI), (b) Alzheimer's disease, (c) cognitively healthy older adults. The presented protocol outlines the main considerations of a framework about remote neuropsychological assessment, which can maximize the effectiveness of interventions and continuity regarding the care of older adults. The recommendations outlined in the presented protocol highlight strengths and limitations that should be taken into account in remote control procedures. Although the protocol was created in response to pandemic restrictions, tele-neuropsychology shows promise as a way to improve access opportunity to neurodiagnostic services for rural aging and underserved populations, which lack specialized healthcare services. Further application to different populations will add validity to the presented descriptive protocol.
ABSTRACT
Τhe empty-nest syndrome is a transitional stage, when middle-aged parents are in the process of encouraging their children to take up their obligations as adults. The empty-nest syndrome is a psychological condition that affects both parents, who experience feelings of grief, loss, fear, inability, difficulty in adjusting roles, and change of parental relationships, when children leave the parental home. Τhis syndrome has gained special interest in a world where the current economic crisis has not only deepened global poverty but also a crisis of values reflected in the dynamic model of the family. The purpose of this review was to appraise the impact of psychosocial stress of the empty- nest syndrome on the parents' well-being through the years, during the current socio-economic crisis, taking into account gender, national and cultural background, socio-demographic and other context factors. We addressed the phenomenon of the "Boomerang Kids" and crowded nests as a result of current financial instability. Finally, we focused on the strategies which the family can employ to retain their resilience, according to the Transactional Model of Stress and Coping Family resilience framework and self-efficacy models. A literature review was conducted using web-based search engines provided by Medline, Scopus, Embase, Cochrane and PsychINFO. The term "empty nest syndrome'' was combined with women, men, economic crisis, parenthood, stress, menopause, midlife crisis, Boomerang kids, crowded nets, resilience, self-efficacy, wellbeing, and cultural differences. Women and men from diverse cultural groups have a different experience of the empty nest, as well as ways of coping. Distress caused by empty nest results in the incidence of symptoms of depression, behavioral symptoms and cognitive impairment. In most of studies, low marital quality and lack of social support affected negatively on a parent's well-being particularly for those experiencing the return of their "Boomerang kids". However, the financial crisis can transform an empty-nest into a "dynamic nest" by community health promotion services. Social support programs should be designed to strengthen family resource and improve family well-being.
