COVID Pandemic Impact on Nevada Adult Protective Services

Empirical data regarding Covid pandemic impact on the Nevada Adult Protective Services (APS) Program clients, casework, and staff was gathered and analyzed as part of a multi-faceted program evaluation. Key findings include: 66% of the staff agreed or strongly agreed that the pandemic made their jobs more challenging. Respondents reported Covid-related challenges faced by clients, the program, and themselves as social workers serving older and vulnerable adults. Adverse client impacts observed included increased social and emotional isolation, loss of housing, exacerbation of symptoms of mental illness, necessary services being cut from clients subsequent to testing Covid positive, and fear and reluctance to allow needed visiting service providers, such as home health aides, into their homes. We will discuss the implications of the findings on APS services and clients, and on related health and human services designed to promote the wellness and independence of older and vulnerable adults.

Effects of restriction of activities and social isolation on risk of dementia in the community

ABSTRACT Objective: Social isolation and emotional isolation, i.e. loneliness, have been associated with dementia or cognitive decline. In contrast, the relationship of restriction of physical and instrumental activities of daily living to cognitive decline and dementia has been less studied. Design: We examined multiple quality of life (QoL) indicators, including isolation and restriction of activities, utilizing two validated scales in elders without dementia to determine their associations with cognitive decline and incident dementia that were followed longitudinally over 6 years. We comprehensively controlled for other symptom constellations, including depression and anergia. Setting: A large multi-ethnic prospective study was conducted in northern Manhattan, NYC. Participants: An ethnically diverse sample of 855 non-demented individuals at baseline participated. Measures: The following QoL scales were utilized: Restriction, Anergia, Isolation, Loneliness, and Affective Suffering. Results: Both Restriction (HR = 2.22, 95% CI [1.42, 3.47], P < .001) and Isolation (HR = 1.78, 95% CI [1.17, 2.70], P = 0.007) were associated with episodic memory and incident dementia, controlling for age, sex, and education. Loneliness and Affective Suffering (depression) were not associated with these outcomes (P’s > .1) with both Restriction and Isolation in the same model for the prediction of dementia, only Restriction remained significant (HR = 1.97, 95% CI [1.24, 3.14], P = 0.004). In cross-lagged panel analyses, Restriction and Isolation had reciprocal influences (P’s < .001), indicating that Restriction at the previous time point influenced current Isolation. Importantly, Restriction (but not Isolation) and Selective Reminding total recall memory demonstrated highly significant direct and reciprocal influences over time (P’s < .001). Conclusions: Restriction and Isolation were associated with incident dementia. Restriction played a more prominent role in its impact on memory decline. The development of these impairments in QoL, particularly Restriction, may provide warning signs of future cognitive decline and dementia and provide multiple and novel avenues for therapeutic interventions with the goal of delaying the development of cognitive decline and dementia.

The link between social and emotional isolation and dementia in older black and white Brazilians

ABSTRACT Objective: To examine the link between social and emotional isolation and likelihood of dementia among older black and white Brazilians. Design: Cross-sectional clinical–pathological cohort study. Setting: Medical center in Sao Paulo, Brazil. Participants: As part of the Pathology, Alzheimer’s and Related Dementias Study, we conducted uniform structured interviews with knowledgeable informants (72% children) of 1,493 older (age > 65) Brazilian decedents. Measurements: The interview included measures of social isolation (number of family and friends in at least monthly contact with decedent), emotional isolation (short form of UCLA Loneliness Scale), and major depression plus the informant portion of the Clinical Dementia Rating Scale to diagnose dementia and its precursor, mild cognitive impairment (MCI). Results: Decedents had a median social network size of 8.0 (interquartile range = 9.0) and a median loneliness score of 0.0 (interquartile range = 1.0). On the Clinical Dementia Rating Scale, 947 persons had no cognitive impairment, 122 had MCI, and 424 had dementia. In a logistic regression model adjusted for age, education, sex, and race, both smaller network size (odds ratio [OR] = 0.975; 95% confidence interval [CI]: 0.962, 0.989) and higher loneliness (OR = 1.145; 95% CI: 1.060, 1.237) were associated with higher likelihood of dementia. These associations persisted after controlling for depression (present in 10.4%) and did not vary by race. After controlling for depression, neither network size nor loneliness was related to MCI. Conclusion: Social and emotional isolation are associated with higher likelihood of dementia in older black and white Brazilians.

Psychological Health Status of Psychiatric Patients Living in Treatment Communities before and during the COVID-19 Lockdown: A Brief Report

Many studies investigated the psychological impact of lockdown measures on the general population, while few studies focused on the psychiatric population. This study aimed to investigate the role of therapeutic communities in the management and containment of symptoms of patients with psychosis living in psychiatric residential facilities. Data were collected at two different points: November 2019 (Coronavirus disease 19 had not yet spread) and April 2020 (during the lockdown in Italy). Twenty-two study participants were recruited from three residential accredited psychiatric facilities. During lockdown, the patients showed a small increase in symptomatology in terms of emotional isolation. In addition, it was been observed significant differences in certain functional areas of the behavior, measured as lower inclination towards violent behaviors during lockdown, and higher scores in substance abuse and medical impairment. The lockdown condition could represent a form of containment; daily routines, along with adequate social support, are important aspects of the stability and the level of behavioral functioning of psychiatric patients. Social support and continuity of care offered by psychiatric communities can be an effective safeguard against the psychological impact of the COVID-19 epidemic.

Perceived Elderly Stigma and Emotional Well-Being Among Korean Older Adults: The Mediating Role of Self-Esteem

This study examined whether self-esteem mediates the association between perceived elderly stigma and emotional well-being (loneliness and emotional isolation) among Korean older adults, and how these processes differ by marital status. Using the 2018 Age Integration Survey, a cross-sectional national survey of adults in Korea, we analyzed data from 266 older adults aged 60 and older. Older adults who perceived greater elderly stigma reported higher levels of loneliness and emotional isolation. Self-esteem played a significant indirect role in the association between perceived elderly stigma and the two emotional well-being outcomes. Moderated mediation analyses further revealed significant differences by marital status; self-esteem was a more powerful mechanism among unmarried older adults relative to their married counterparts. The findings suggest that efforts to minimize public and internalized stigmatization of older adults and to improve their own self-esteem may be critical for their emotional well-being.

Effects of a Court-Ordered Service Dog Training Program with U.S. Veterans: A Qualitative Study

This qualitative study investigated the impacts of a court-ordered service dog training program on justice-involved U.S. veterans. An experienced qualitative research team conducted three focus groups with nine veterans to explore how training service dogs influenced their daily lives. Focus groups were audio recorded, transcribed, and manually coded. Two graduate research assistants developed preliminary themes; the full team generated final themes. Themes illustrated how participation in the program: 1) decreased physical and emotional isolation; 2) assisted veterans with reintegrating into civilian life; 3) improved emotional self-regulation; and 4) helped veterans discover potential; 5) find camaraderie; 6) reconnect with community; and 7) create a sanctuary. In a follow-up session, several participants confirmed that the results accurately captured their experiences. The overall finding suggests the service dog training program served as a rehabilitative process for justice-involved veterans to rediscover their abilities and talents that existed before their experiences in the justice system.

Effects of Physical Self-Concept, Emotional Isolation, and Family Functioning on Attitudes towards Physical Education in Adolescents: Structural Equation Analysis

(1) Background: The present research seeks to define and contrast an explanatory model of physical self-concept, emotional isolation, attitude towards physical education, and family functioning, and analyse the existing associations between these variables. (2) Methods: The sample was made up of 2388 adolescents (43.39% male and 56.61% female), with ages of 11–17 years (M = 13.85; SD = 1.26) from Spain. Self-concept (AF-5), Isolation (UCLA), Attitude towards Physical Education (CAEF), and Family Functioning (APGAR) were analyzed. (3) Results: Good fit was obtained for all evaluation indices included in the structural equation model, which was significantly adjusted (χ2 = 233,023; DF = 14; p < 0.001; comparative fit index (CFI) = 0.913; normalized fit index (NFI) = 0.917; incremental fit index (IFI) = 0.906; root mean square error of approximation (RMSEA) = 0.072). (4) Conclusions: Attitudes towards physical activity were found to be positive when isolation levels were low and where adequate self-concept existed, specifically in students reporting high family functioning.

Shakespeare's Contagious Sympathies

ULYSSES … No man is the lord of any thing,Though in and of him there be much consisting,Till he communicate his parts to others.Troilus and Cressida Understanding the early-modern subject to be constituted, as Shakespeare’s Ulysses explains, by its communications with others—by its open involvement with interlocutors, its participation in interaction—this study considers what happens when these conceptions of compassionate communication and sympathetic exchange are comprehensively undermined by period anxieties concerning contagion and the transmission of disease. Allowing that ‘no man is … any thing’ till he has ‘communicate[d] his parts to others’, can these formative communications still be risked in a world preoccupied by communicable sickness, where every contact risks contraction, where every touch could be the touch of plague, where kind interaction could facilitate cruel infection, and where to commiserate is to risk ‘miserable dependence’ (Tro.)? Counting the cost of compassion, this study offers analysis of how medical explanations of disease impact upon philosophical conceptions and literary depictions of individuals who find themselves precariously implicated within a world of ill communications. It examines the influence of scientific thought upon the history of the subject, and explores how Shakespeare—alive to both the importance and dangers of sympathetic communication—articulates an increasing sense of both the pragmatic benefits of monadic thought, emotional isolation, and subjective quarantine, while offering his account of the considerable loss involved when we lose faith in vulnerable and tender, extensive existence.