'We all have a stake in this': a phenomenological inquiry into integrating suicide intervention in home-delivered meal service contexts.

OBJECTIVES: Late-life suicide is a public health concern, yet many older adults do not have access to traditional mental health services. The present study sought to explore how suicide intervention is integrated into home-delivered meal (HDM) contexts following volunteer training in an evidence-based suicide first responder program. METHODS: Using phenomenological inquiry, we examined the experiences of 20 HDM volunteers trained in ASIST. RESULTS: Three primary themes emerged: (a) Logistics influencing integration of Suicide Intervention into HDM Systems, describing HDM program logistics; (b) Intrapersonal Context, describing HDM volunteer characteristics influencing intervention utilization and HDM client concerns; and (c) Interpersonal Context, describing HDM relationship characteristics that influenced intervention utilization. CONCLUSION: HDM and other nutrition services have potential for addressing late life suicide, particularly when volunteers best equipped to address risk receive training and HDM policies reflect the needs of their clients. Implications for HDM services, as well as the Aging Services Network, are discussed.

Racial Differences in the Relationship Between Pain and Suicide Desire in Older Adults.

Older adults are reported to die by suicide at higher rates than the general population. Suicide desire among older adults is associated with pain, and pain experiences have been found to differ based on race. To investigate the relationship between pain and suicidal desire, 437 racially diverse older adults who receive home-based services (home-delivered meals) in the Southeastern region of the United States completed standardized measures of psychological pain, chronic physical pain, and suicidal desire. Results identified race moderated the relationship between pain and suicidal desire, indicating a stronger relationship between pain and suicidal desire among Black older adults than White older adults. Chronic physical pain (i.e., emotional burden) interacted with race to predict Perceived Burdensomeness (p = .011) and Thwarted Belongingness (p = .032). Greater attention to pain experiences among Black older adults is warranted, considering the impact of COVID-19 on racial/ethnic minorities' mental health.

Holistic Wellness Coaching for Older Adults: Preliminary Evidence for a Novel Wellness Intervention in Senior Living Communities.

Although resident wellness is increasingly a priority in senior living communities, there are few programs that promote holistic wellness in later life. A total of 79 residents (ages 71 to 97; M = 84.27, SD = 6.46) from eight senior living communities completed a pilot study of a novel, staff-led wellness coaching program consisting of resident-driven goals and individual and group coaching sessions. Participants completed surveys at three time points (pre-program, post-program, and 1-month follow-up). Repeated measures ANOVAs revealed positive changes in resident health satisfaction, physical quality of life (QOL), psychological QOL, loneliness, relatedness, competence, and sense of purpose. Some of these results (i.e., psychological QOL, loneliness) persisted at follow-up. Residents reported high satisfaction with the program. These findings have implications for the application of holistic wellness frameworks in later life, as well as the development and implementation of wellness coaching programs with older adults.

Resource loss and mental health during COVID-19: Psychosocial protective factors among U.S. older adults and those with chronic disease.

Across the globe, COVID-19 has disproportionately affected the physical and mental health of several vulnerable groups. In a series of two cross-sectional studies conducted April to July 2020, we examined its acute mental health effects on two vulnerable U.S. community samples-home-bound older adults who were at or below the poverty line (Study 1, N = 293, Mage  = 76.94, SD = 8.64; 75.1% female, 67.9% Black) and adults with chronic disease (Study 2, N = 322, Mage  = 62.20, SD = 12.22; 46.3% female, 28.3% racial/ethnic minorities). Based on the conservation of resources theory, we hypothesised that pandemic-related resource loss would be associated with greater mental distress, but perceived social support and positive psychological characteristics (trait resilience and optimism) would buffer against this adverse effect. Across both samples of vulnerable adults, pandemic-related resource loss was related to mental distress. Perceived social support was related to lower mental distress but did not consistently buffer the effect of resource loss on mental health. However, in Study 2, both trait resilience and optimism buffered this relationship. Findings are discussed in terms of their implications for the conservation of resources theory.

Multidimensional wellness for people aging with mental health conditions: A proposed framework.

OBJECTIVE: This project aimed to develop a synthesized framework of multidimensional wellness for people aging with serious mental health conditions (SMHC) using existing frameworks to serve as a guide for policy and interventions to address the unique needs, experiences, and strengths of the population. METHOD: A concept analysis compared a widely used wellness approach (Swarbrick, 1997) for people with SMHC and one for older adults (Fullen, 2019) to synthesize into a practical framework for people aging with SMHC. RESULTS: Nine dimensions were proposed for conceptualizing the wellness of this population including: (a) Developmental, (b) Intellectual/Cognitive, (c) Physical, (d) Emotional, (e) Social, (f) Occupational, (g) Spiritual, (h) Environmental, and (i) Financial. Practical suggestions for implementation are identified. CONCLUSIONS AND IMPLICATION FOR PRACTICE: People aging with SMHC require rehabilitation services that address their unique perspectives, strengths, and challenges. The proposed adapted wellness framework offers a guide to comprehensively address well-being in people aging with SMHC. Placing the model in the context of external factors of resources and supports available, and the impact of societal perspectives about each dimension, further delineates a holistic model of wellness that considers well-being and successful living. This model can offer structure and practical application for services, and consideration of future needs of people aging with SMHC to support psychiatric rehabilitation services, as well as offer strategies to encourage positive aging and recovery. Future work should explore the impact of multidecade experiences of mental health conditions and the mental health system to better support individual recovery. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Mental health distress in homebound older adults: Importance of the aging network.

Homebound older adults may be at risk of suicide due to elevated loneliness, social isolation, and depression. The Interpersonal Theory of Suicide posits that thwarted belongingness, perceived burdensomeness, and reduced fear of death are key components of suicide risk. To better understand suicide risk among culturally diverse, homebound older adults, we collected baseline data on the prevalence of psychological distress, thwarted belongingness, perceived burdensomeness, and past/present suicidality. Standardized measures were completed by 493 adults (ages 60-103) during in-home interviews, and results were compared to existing cutoffs to assess current risk. In total, 15.62% scored above the suicide risk cutoff, 23.73% of homebound older adults reported a history of suicidal ideation or behavior, 65 adults in this sample (13.18%) indicated the possibility of attempting suicide in the future, and 2.43% described a future attempt as "likely" or "very likely." There were no differences in suicide risk, thwarted belongingness, or perceived burdensomeness based on sex and race. However, there was a significant difference in psychological distress (F(3,428) = 2.624, p = .05), with White females (M = 7.90, SD = 5.63; N = 78) scoring higher than Black males (M = 5.43, SD = 5.04; N = 81). Using Aging Network services such as nutrition services (e.g.home-delivered meal programs) to intervene with at-risk older adults represents a strategy to prevent suicide. Implications for suicide intervention, including the potential to deliver services by linking them to nutrition services programs, are discussed.

Holistic Wellness in Older Adulthood: Group Differences Based on Age and Mental Health.

PURPOSE: To understand how demographic variables and depression symptoms relate to the prevalence of wellness, resilience, and age perception within a sample of community-dwelling older adults. DESIGN: In all, 200 residents across 12 senior housing sites were surveyed. Research questions included the following: (1) Do group differences exist in wellness, resilience, and age perception based on age, sex, race, education, and depression symptoms? (2) Which profile of variables is most strongly associated with self-rated depression among older adults? METHOD: Multivariate analyses of variance were used to examine group differences. A discriminant analysis demonstrated which variables comprised the profile of individuals who ascribed to depression symptoms. FINDINGS: Younger respondents (i.e., age 55-70) had significantly lower levels of wellness (η2 = .034) and resilience (η2 = .052). Respondents suffering from depression symptoms had lower levels of wellness (η2 = .155), resilience (η2 = .163), and positive age perception (η2 = .067) and higher rates of negative age perception (η2 = .052). The discriminant analysis correctly categorized 75.3% of the cases related to depression symptoms, and resilience and certain forms of wellness were most relevant. CONCLUSIONS: The current study sheds light into within-group differences in wellness, resilience, and age perception that depend on variables such as age and depression.