COUPLES LIVING WITH ADVANCED CANCER: RAMIFICATIONS OF SOCIAL ISOLATION AND BENEFITS OF AN EMBEDDED SOCIAL NETWORK

Abstract Cancer remains a leading cause of death, especially among older adults. While spouses are commonly involved in the provision of emotional and practical assistance to their ill spouse, their caregiving is not without cost. Although knowledge of an impending death permits preparation for the loss, a long and protracted illness, or one marked by intense caregiving demands, can deplete the well spouse’s personal resources, increasing the risk of morbid bereavement outcomes. Well spouses (n=138), aged 50 and older (mean age 63.6), 41% male, providing 8+ hours of caregiving to a spouse with advanced cancer and a life expectancy of 6 months or less were followed over the terminal illness period. Caregiving spouses’ anticipatory grief, depression and anxiety were all significantly, inversely correlated with sufficiency of social support, specifically tangible, informational and emotional support (p<.05). At 2-3 months post-death (widowed subsample, n=82), the surviving spouses’ grief was inversely correlated with informational support (p<.01) and their social re-engagement post-death was directly correlated with sufficient tangible support (p<.05). Their narrative accounts about the illness and post-death period reveal various demands and negative social encounters they experienced with family members and others during this period, as well as, documenting support received. Spousal death presents a significant adaptive challenge, particularly to older adults who must adjust to the dissolution of longstanding bonds and altered life circumstances. Awareness of these complex relationship issues, i.e. problematic network relationships, will enable clinicians to attend to the needs and preferences of bereaved spouses during this period of heightened vulnerability.

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“We can’t carry the weight of the whole world”: illness experiences among Peruvian older adults with symptoms of depression and anxiety

International Journal of Mental Health Systems ◽

10.1186/s13033-020-00381-8 ◽

2020 ◽

Vol 14 (1) ◽

Cited By ~ 1

Author(s):

Oscar Flores-Flores ◽

Alejandro Zevallos-Morales ◽

Ivonne Carrión ◽

Dalia Pawer ◽

Lorena Rey ◽

...

Keyword(s):

Mental Health ◽

Older Adults ◽

Mental Health Professionals ◽

Emotional Support ◽

Anxiety Symptoms ◽

Health Interventions ◽

Depression And Anxiety ◽

Community Based ◽

Illness Experiences ◽

Mental Health Interventions

Abstract Background Despite the high levels of depression and anxiety symptoms in old age, the use of mental health services in this population is low. Help-seeking behaviors are shaped by how an individual perceives and experiences their illness. The objective of this study was to characterize the illness experiences of Peruvian older adults with depression and anxiety symptoms in order to lay the foundation for tailored community-based mental health interventions. Methods In this qualitative study, we conducted in-depth interviews with a purposively selected sample of older adults (≥ 60 years) from peri-urban areas of Lima, Peru. We included individuals with only depressive symptoms (Patient Health Questionnaire-9 ≥ 10), only anxiety symptoms (Beck Anxiety Inventory ≥ 16), with depressive and anxiety symptoms, and older adults who mentioned they had received mental health treatment/care. The interview guide included the following topics: perceptions and experiences about depression and anxiety; perceptions about the relationship between physical chronic diseases and mental health; experiences with mental health professionals and treatments, and coping mechanisms. Data collection was conducted between October 2018 and February 2019. Results We interviewed 38 participants (23 women, 15 men) with a mean age of 67.9 years. Participants’ ideas and perceptions of depression and anxiety showed considerable overlap. Participants attributed depression and anxiety mainly to familial and financial problems, loneliness, loss of independence and past traumatic experiences. Coping strategies used by older adults included ‘self-reflection and adaptation’ to circumstances, ‘do your part’, and seeking ‘emotional support’ mainly from non-professionals (relatives, friends, acquaintances, and religion). Conclusions Illness experiences of depression and anxiety set the pathway for tailored community-based mental health interventions for older adults. Overlapping narratives and perceptions of depression and anxiety suggest that these conditions should be addressed together. Mental health interventions should incorporate addressing areas related to depression and anxiety such as prevention of loss of independence, trauma, and loneliness. Good acceptability of receiving emotional support for non-professionals might offer an opportunity to incorporate them when delivering mental health care to older adults.

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"We can’t carry the weight of the whole world": illness experiences among Peruvian older adults with symptoms of depression and anxiety

10.21203/rs.3.rs-26185/v1 ◽

2020 ◽

Author(s):

Oscar Flores-Flores ◽

Alejandro Zevallos-Morales ◽

Ivonne Carrión ◽

Dalia Pawer ◽

Lorena Rey ◽

...

Keyword(s):

Mental Health ◽

Older Adults ◽

Mental Health Professionals ◽

Emotional Support ◽

Anxiety Symptoms ◽

Health Interventions ◽

Depression And Anxiety ◽

Community Based ◽

Illness Experiences ◽

Mental Health Interventions

Abstract Background: Despite the high levels of depression and anxiety symptoms in old age, the use mental health services in this population is low. Help-seeking behaviors are shaped by how an individual perceives and experiences their illness. The objective of this study was to characterize the illness experiences of Peruvian older adults with depression and anxiety symptoms in order to lay the foundation for tailored community-based mental health interventions.Methods: In this qualitative study, we conducted in-depth interviews with a purposively selected sample of older adults (≥ 60 years) from peri-urban areas of Lima, Peru. We included individuals with only depressive symptoms (Patient Health Questionnaire-9 ≥ 10), only anxiety symptoms (Beck Anxiety Inventory ≥ 16), with depressive and anxiety symptoms, and older adults who mentioned they had received mental health treatment/care. The interview guide included the following topics: perceptions and experiences about depression and anxiety; perceptions about the relationship between physical chronic diseases and mental health; experiences with mental health professionals and treatments, and coping mechanisms. Data collection was conducted between October 2018 and February 2019. Results: We interviewed 38 participants (23 women, 15 men) with a mean age of 67.9 years. Participants’ ideas and perceptions of depression and anxiety showed considerable overlap. Participants attributed depression and anxiety mainly to familial and financial problems, loneliness, loss of independence and past traumatic experiences. Coping strategies used by older adults included ‘self-reflection and adaptation’ to circumstances, ‘do your part’, and seeking ‘emotional support’ mainly from non-professionals (relatives, friends, acquaintances, and religion). Conclusions: Illness experiences of depression and anxiety set the pathway for tailored community-based mental health interventions for older adults. Overlapping narratives and perceptions of depression and anxiety suggest that these conditions should be addressed together. Mental health interventions should incorporate addressing areas related to depression and anxiety such as prevention of loss of independence, trauma, and loneliness. Good acceptability of receiving emotional support for non-professionals might offer an opportunity to incorporate them when delivering mental health care to older adults.

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"We can’t carry the weight of the whole world": Illness experiences among Peruvian older adults with symptoms of depression and anxiety

10.21203/rs.3.rs-26185/v2 ◽

2020 ◽

Author(s):

Oscar Flores-Flores ◽

Alejandro Zevallos-Morales ◽

Ivonne Carrión ◽

Dalia Pawer ◽

Lorena Rey ◽

...

Keyword(s):

Mental Health ◽

Older Adults ◽

Mental Health Professionals ◽

Emotional Support ◽

Anxiety Symptoms ◽

Health Interventions ◽

Depression And Anxiety ◽

Community Based ◽

Illness Experiences ◽

Mental Health Interventions

Abstract Background: Despite the high levels of depression and anxiety symptoms in old age, the use of mental health services in this population is low. Help-seeking behaviors are shaped by how an individual perceives and experiences their illness. The objective of this study was to characterize the illness experiences of Peruvian older adults with depression and anxiety symptoms in order to lay the foundation for tailored community-based mental health interventions.Methods: In this qualitative study, we conducted in-depth interviews with a purposively selected sample of older adults (≥ 60 years) from peri-urban areas of Lima, Peru. We included individuals with only depressive symptoms (Patient Health Questionnaire-9 ≥ 10), only anxiety symptoms (Beck Anxiety Inventory ≥ 16), with depressive and anxiety symptoms, and older adults who mentioned they had received mental health treatment/care. The interview guide included the following topics: perceptions and experiences about depression and anxiety; perceptions about the relationship between physical chronic diseases and mental health; experiences with mental health professionals and treatments, and coping mechanisms. Data collection was conducted between October 2018 and February 2019. Results: We interviewed 38 participants (23 women, 15 men) with a mean age of 67.9 years. Participants’ ideas and perceptions of depression and anxiety showed considerable overlap. Participants attributed depression and anxiety mainly to familial and financial problems, loneliness, loss of independence and past traumatic experiences. Coping strategies used by older adults included ‘self-reflection and adaptation’ to circumstances, ‘do your part’, and seeking ‘emotional support’ mainly from non-professionals (relatives, friends, acquaintances, and religion). Conclusions: Illness experiences of depression and anxiety set the pathway for tailored community-based mental health interventions for older adults. Overlapping narratives and perceptions of depression and anxiety suggest that these conditions should be addressed together. Mental health interventions should incorporate addressing areas related to depression and anxiety such as prevention of loss of independence, trauma, and loneliness. Good acceptability of receiving emotional support for non-professionals might offer an opportunity to incorporate them when delivering mental health care to older adults.

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PREDICTING LIFE EXPECTANCY IN OLDER ADULTS WITH ADVANCED CANCER: AN EVALUATION OF ONCOLOGISTS’ ESTIMATES AND A GERIATRIC ASSESSMENT-BASED PREDICTIVE MODEL

Journal of Geriatric Oncology ◽

10.1016/s1879-4068(19)31134-8 ◽

2019 ◽

Vol 10 (6) ◽

pp. S8-S9 ◽

Cited By ~ 1

Author(s):

J.L. Lund ◽

P.R. Duberstein ◽

K.P. Loh ◽

S. Plumb ◽

L. Lei ◽

...

Keyword(s):

Older Adults ◽

Life Expectancy ◽

Predictive Model ◽

Advanced Cancer ◽

Geriatric Assessment

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PATIENT-REPORTED NUMBNESS AND TINGLING AUGMENTS COMMON TERMINOLOGY CRITERIA FOR ADVERSE EVENTS (CTCAE) TO DETECT CHEMOTHERAPY-INDUCED PERIPHERAL NEUROPATHY (CIPN) IN OLDER ADULTS WITH ADVANCED CANCER UNDERGOING SYSTEMIC TREATMENT

Journal of Geriatric Oncology ◽

10.1016/s1879-4068(19)31231-7 ◽

2019 ◽

Vol 10 (6) ◽

pp. S67-S68

Author(s):

E. Culakova ◽

M. Mohamed ◽

M. Flannery ◽

A. Patil ◽

S. Obrecht ◽

...

Keyword(s):

Older Adults ◽

Peripheral Neuropathy ◽

Adverse Events ◽

Advanced Cancer ◽

Systemic Treatment ◽

Patient Reported

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Loving Others: The Impact of Compassionate Love on Later-Life Psychological Well-Being

Innovation in Aging ◽

10.1093/geroni/igaa057.1554 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 480-481

Author(s):

Eva Kahana ◽

Tirth Bhatta ◽

Boaz Kahana ◽

Nirmala Lekhak

Keyword(s):

Older Adults ◽

Depressive Symptoms ◽

Negative Affect ◽

Positive Affect ◽

Emotional Support ◽

Later Life ◽

Well Being ◽

Psychological Well Being ◽

Compassionate Love ◽

The Impact

Abstract Existing scholarship in social gerontology has surprisingly paid little attention to broader loving emotions, such as compassionate and altruistic love, as potentially meaningful mechanisms for improving later life psychological well-being. This study examined the influence of feeling love toward other persons and experiencing love from others on later life psychological well-being. We conducted a 3-wave longitudinal study of a representative sample of 340 ethnically heterogeneous community dwelling older residents of Miami, Florida. The increase in feeling of being loved (β=-1.53, p<0.001) and love for others (β=-1.43, p<0.001) led to decline in odds of reporting greater level of depressive symptoms over time. The odds of reporting higher level of positive affect were significantly greater for older adults who reported feeling loved by others (β=1.16, p<0.001) and expressed love for other people (β=1.18, p<0.01). Older adults who felt loved had 0.92-point lower ordered log odds of reporting higher negative affect than those who reported lower level of love. The impact of compassionate love on depressive symptoms and negative affect remained statistically significant even after adjustment for altruistic attitudes and emotional support. The influence of loving emotions on positive affect was, however, explained by altruistic attitudes and emotional support. Our findings underscore the powerful influence of both receiving and giving love for the maintenance of later life psychological well-being. We offer support for the expectation that love is a significant force in the lives of older adults that transcends intimate relationships.

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Telephone-Based Emotional Support for Older Adults during the COVID-19 Pandemic

Journal of Aging & Social Policy ◽

10.1080/08959420.2021.1924414 ◽

2021 ◽

pp. 1-17

Author(s):

Liora Bar-Tur ◽

Michal Inbal-Jacobson ◽

Sharon Brik-Deshen ◽

Yael Zilbershlag ◽

Sigal Pearl Naim ◽

...

Keyword(s):

Older Adults ◽

Emotional Support

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What You Say and Where You Say It Matter: Effects of Facebook Message Publicity and Support Type on Evaluation of Support Message Quality

Social Science Computer Review ◽

10.1177/08944393211007311 ◽

2021 ◽

pp. 089443932110073

Author(s):

Yining Malloch ◽

Bo Feng

Keyword(s):

Social Support ◽

Emotional Support ◽

Communication Channel ◽

Computer Mediated Communication ◽

Communication Model ◽

Mediated Communication ◽

Message Type ◽

Computer Mediated ◽

Tangible Support ◽

The Impact

Guided by the masspersonal communication model, this study examined the impact of the communication channel (masspersonal vs. interpersonal) and support message type on evaluation of social support message quality in Facebook settings. An online factorial experiment with 480 participants revealed that support messages sent through interpersonal channels (e.g., private messaging) were perceived as higher in quality than those sent through masspersonal channels (e.g., status update). Regardless of channels, participants considered tangible support messages as higher quality than informational and emotional support messages. Implications for computer-mediated communication and social support theories and practices were discussed.

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Palliative care referral practices and perceptions: The divide between metropolitan and non-metropolitan general practitioners

Palliative & Supportive Care ◽

10.1017/s1478951511000058 ◽

2011 ◽

Vol 9 (2) ◽

pp. 181-189 ◽

Cited By ~ 13

Author(s):

Claire E. Johnson ◽

Afaf Girgis ◽

Christine L. Paul ◽

David C. Currow

Keyword(s):

Palliative Care ◽

General Practitioners ◽

Advanced Cancer ◽

Terminal Illness ◽

Symptom Control ◽

Physical Symptoms ◽

Care Physician ◽

Self Report ◽

Psychosocial Needs ◽

Consultative Service

AbstractObjective:Late or non-referral of patients to specialist palliative care (SPC) services may affect patients' and their carers' quality of care. General practitioners (GPs) are key professionals in linking people with SPC. The aim of this article is to assess GPs' perceptions and SPC referrals for their patients with advanced cancer and differences between metropolitan (M GPs) and non-metropolitan GPs (NM GPs).Method:Self-report survey mailed to a stratified random sample of 1,680 Australian GPs was used.Results:Thirty-one percent (469) of eligible GPs returned surveys. More M GPs than NM GPs reported referring >60% of their patients for SPC (p = 0.014); and that a more comprehensive range of SPC services was available. The most frequently reported referral prompts were: presence of terminal illness (M GPs, 71%, NM GPs, 66%, ns (not significant)); future need for symptom control (69% vs. 59%, ns) and uncontrolled physical symptoms (63% vs. 54%, ns). Reasons for not referring were: doctor's ability to manage symptoms (62% vs. 68%, ns) and the absence of symptoms (29% vs. 18%, p = 0.025). Higher referral was associated with: having a palliative care physician or consultative service available; agreeing that all patients with advanced cancer should be referred, and agreeing that with SPC, the needs of the family are better met.Significance of results:Referrals for SPC were primarily disease-related rather than for psychological and emotional concerns. Measures are needed to encourage referrals based upon psychosocial needs as well as for physical concerns, and to support GPs caring for people with advanced cancer in areas with fewer comprehensive SPC services.

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