Life-sustaining treatment: a comparison of the preferences of Taiwanese older adults and their family caregiver.

BACKGROUND: Written advance directives are not common practice in Taiwan; thus, when older adults are critically ill, family members are usually the ones to make decisions regarding life-sustaining treatment. PURPOSE: This study determined how well the preferences of the family members for the older adults match the preferences of the older adults themselves with regard to life-sustaining treatment. METHODS: A cross-sectional comparative descriptive research design was used in this study. Ninety-five pairs of older adults and their families were included in the final analysis. The Life Support Preferences Questionnaire was used to measure life-sustaining preferences. Paired- sample t tests were performed to compare the mean differences between the older adults' preferences and the family members' preferences for these older adults. FINDING: Family members scored higher on life-sustaining treatment preferences than the older adults for all 32 examined items, with 23 (72%) of these items showing statistical significance. CONCLUSION/IMPLICATIONS FOR PRACTICE: Communication between older adults and their family members regarding life-sustaining treatment may help prevent older adults from receiving unwanted treatments.

Depression and gender differences: focus on Taiwanese American older adults.

Secondary analysis of cross-sectional data was used to examine gender differences and depression in elderly Taiwanese Americans. There is a paucity of health-related research focused on Asian Americans. This is especially true in the area of mental health. Depression, the most common psychiatric illness in older adults, is under-diagnosed in Asian Americans. A convenience sample of 100 elderly Taiwanese Americans, 47 women and 53 men, was used. Women were older, had higher depressions cores, more physical illness, poorer sleep scores, and less physical activity. Regression analysis indicated that 25% of the variance in depression scores was explained by sleep quality and physical activity.

Is somatization a significant depressive symptom in older Taiwanese Americans?

Adapting to psychosocial and physical changes can trigger nonspecific somatic complaints and depression. Somatization has been noted in all societies and cultures; however, it is more frequently observed in Asian populations. This study used the Geriatric Depression Scale (GDS) to screen 100 Taiwanese American older adults for depressive symptoms and found that seven participants (7%) experienced depressive symptoms (GDS >/= 14). Although the mean number of illnesses reported was significantly higher (t = -16.8, P <.001) in the depressive group, the seven individuals did not focus on physical symptoms during interview. They reported guilt, sadness, anger, resentment, loneliness, helplessness, hopelessness, inability to enjoy activities, and anhedonia. If older adults are given the time to express themselves, they are able to reveal their emotional pain and distress rather than remain preoccupied with somatic complaints. A simple depression screening tool, such as the GDS, can help detect depression.

Memory functions of Taiwanese American older adults.

Memory complaints are common among older adults, of which ethnic minorities are the fastest growing group. Little is known about the memory function of Taiwanese American older adults. This article utilizes a cross-sectional, correlational design to examine the relationship between sleep, physical activity, depression, and memory self-efficacy and memory function and to determine the variance in memory function explained by the four independent variables and six control variables in Taiwanese American older adults. Memory self-efficacy correlated significantly with memory performance. Among the independent variables and control variables, age was the strongest predictor of memory function. A simultaneous multiple regression analysis showed that the four independent and six control variables together accounted for 41.8% of the variance in memory function. Results of this study are consistent with that of many other studies conducted in the United States: Memory declined with age.