Religiosity and perceived rewards of black and white caregivers.

Using data from a larger study of caregivers of the elderly, this study explores the extent to which religiosity variables function as mediators of the effects of situational/demographic factors on perceived caregiver rewards. In the parent project, random digit dialing was used to select 136 Black and 255 White caregivers of community-dwelling elders for face-to-face interviews. Regression analyses revealed that Black caregivers perceived higher levels of rewards than Whites and the relationship between race and perceived rewards was mediated by comfort from religion and prayer. Blacks and Whites with more education reported fewer perceived rewards than caregivers with less education.

Issues related to behavior and the physical environment: bathing cognitively impaired patients.

Twenty-two patients in moderate and late stages of dementia were observed for 8 weeks by caregiving staff of a special care unit. Results indicated that bathing in a typical institutional tub is both a source of apprehension and obstreperous behavior and a considerable departure from prior lifelong bathing experiences. Given information about the habits and idiosyncrasies of patients, staff can play an important role in minimizing obstreperous behaviors. Staff training and awareness of the physical environment, which included attention to the interrelationship between environment and behavior, were found to be instrumental in successful bathing.

Impact of adult age and Alzheimer's disease on levels of neural noise for letter matching.

We tested healthy young and older adults as well as higher-scoring (Mini-Mental State Exam, MMSE, scores between 14-20) and lower-scoring patients diagnosed with probable Alzheimer's disease (AD) on a letter-matching task. Subjects were instructed to respond "same" if two simultaneously presented letters were identical, or "different" if the letters did not match. Healthy older adults showed a larger "fast-same" effect than healthy young adults. Also, higher-scoring AD patients showed a large "false-different" effect for errors, but lower-scoring AD patients showed a large "false-same" effect. These data indicate that older adults exhibit higher neural noise levels than younger adults. The cross-over error pattern for AD suggests that moderately demented AD patients show evidence of forming degraded visual percepts whereas more severely demented AD patients show evidence of forming incomplete percepts.

Visual barriers to prevent ambulatory Alzheimer's patients from exiting through an emergency door.

Mobility combined with impaired mental functioning presents safety risks for Alzheimer's patients and poses an ethical dilemma for staff. This study, conducted on an Alzheimer's unit, tested seven different visual barrier conditions for reducing patient exists. Findings indicate that exiting was eliminated under two conditions. The results suggest visual agnosia, the inability to interpret what the eye sees, may be utilized as a tool in managing wandering behavior of Alzheimer's patients.

Psychological well-being of elderly board and care home residents.

This paper examines the effect of several social and physical environmental features of small unregulated board and care homes on the psychological well-being of elderly residents. Data were collected from operators (N = 177) and residents (N = 285) of board and care homes in five counties in Ohio. The social aspects of the environment such as peer relationships had a more significant impact on resident's psychological well-being than aspects of the physical environment.

Self-care among older adults.

Defining self-care as treatment for a perceived symptom, this paper posits that explanations for such illness behavior will differ depending on whether symptoms experienced are perceived as not serious and most amenable to self-treatment or more serious and less likely to respond to self-care. Borrowing from the Health Belief Model, two major concepts, a health set (consisting of five measures of perceived physical and mental health) and an attitude set (comprising four indicators of belief in physician efficacy) are included to explain rates of self-care across all reported symptoms. Self-care rate, calculated as the percentage of experienced symptoms self-treated without professional advice, was slightly higher for persons whose symptoms were seen as less serious. Measures of self-assessed health were related to self-care for those less severe symptoms, while lower faith in doctors as well as health were more closely related to the ailments perceived as more serious. Implications of the results for further studies are discussed.

Physician use among the old-old. Factors affecting variability.

A random sample of 189 noninstitutionalized adults aged 75 and older was used to examine the influence of personal and social characteristics of the old-old on physician use. A path analysis traced direct and indirect effects of predisposing, enabling, and need variables within Andersen's health-behavior model. Income and perceived severity of symptoms were the only two variables with direct causal effects, whereas education, gender, race, living arrangements, and number of symptoms influenced physician use indirectly. Implications of the heterogeneity of the old-old for future research in health behavior are discussed.

Unlicensed board and care homes: An extra-familial living arrangement for the elderly.

This article examines the emergence of unlicensed board and care homes as alternative forms of housing arrangements for the elderly in the United States. The care of vulnerable and dependent adults in the private homes of unrelated individuals has a long historical tradition in Europe and the United States. However, unlicensed homes offering board and care have remained largely unnoticed and unexamined. Unlicensed board and care homes are pseudo familial types of residences providing food, shelter, and protective supervision to unrelated adults who are physically or emotionally impaired. Cross-sectional, face-to-face interviews were conducted with 177 caregivers in six counties in a mid-western state. The caregivers were found to provide good care in a social environment with few totalistic features, at a cost significantly below that charged by nursing homes. Moreover, caregivers were genuinely concerned about their residents' physical as well as emotional well-being.