Research Abstracts: Social workers’ assessments

TITLE: Mental disorders in older adults: fundamentals of assessment and treatment
AUTHOR: Steven H Zarit, Judy M Zarit
PUBLISHER: London: Guilford, 2007, 468p

ABSTRACT: This book provides foundational knowledge and skills for mental health practice with older adults and their caregivers. The authors draw on research and clinical expertise to comprehensively address normal ageing processes, frequently encountered clinical problems, and effective approaches to evaluation, psychotherapy, family support, and consultation in institutional settings. Updated throughout, the second edition features many new case examples, a new chapter on treating anxiety, and innovative assessment strategies. Increased attention is given to different forms of dementia and how to distinguish among them. Coverage of psychopharmacology and combined treatments also has been expanded.

TITLE: Depression among older people with cognitive impairment: prevalence and detection
AUTHOR: Marita P McCABE et al
REFERENCE: International Journal of Geriatric Psychiatry, 21(7), July 2006, pp633-644

ABSTRACT: Past research has demonstrated that there is a high level of depression among older people, particularly for those with cognitive impairment and those in residential care. The current study was designed to determine the prevalence of depression among older people in hostels with cognitive impairment using a structured diagnostic interview. A further aim was to determine an appropriate screening instrument to detect depression within this population. It was also designed to evaluate the extent to which depression among these older people had previously been detected. Five commonly used depression scales were administered and compared to the results of the diagnostic interview. The results demonstrated that 38.9% of older people were diagnosed with depression, but that only 50% of these people had been previously diagnosed with this disorder. All scales showed some level of validity to detect depression. The implications of these findings for our understanding of depression among older people with cognitive impairment are discussed.

TITLE: Disclosing a diagnosis of dementia: a systematic review
REFERENCE: International Journal of Geriatric Psychiatry, 19(2), February 2004, pp151-169

ABSTRACT: The issue of diagnostic disclosure in dementia has been debated extensively in professional journals, but empirical data concerning disclosure in dementia has not previously been systematically reviewed. Five electronic databases were searched up to September 2003 (Medline, Embase, Cinahl, Sociological Abstracts, Web of Science). Additional references were identified through hand searches of selected journals and bibliographies of relevant articles and books. The title and abstract of each identified paper were reviewed independently by two reviewers against pre-determined inclusion criteria: original data about disclosure were presented and the paper was in English. Any disagreements were resolved by discussion until consensus was reached. Data were extracted independently by two reviewers using a structured abstraction form. Data quality was not formally assessed although each study was critically reviewed in terms of methodology, sampling criteria, response rates and appropriateness of analysis. Fifty-nine papers met the inclusion criteria for detailed review. Many of the studies had methodological shortcomings. The studies reported wide variability in all areas of beliefs and attitudes to diagnostic disclosure and reported practice. Studies of the impact of disclosure indicate both negative and positive consequences of diagnostic disclosure for people with dementia and their carers. Existing evidence regarding diagnostic disclosure in dementia is both inconsistent and limited with the perspectives of people with dementia being largely neglected. This state of knowledge seems at variance with current guidance about disclosure.

TITLE: Making the journey brighter: early diagnosis and support services for people with dementia and their carers
AUTHOR: Kate Fearnley
PUBLISHER: Edinburgh: Alzheimer Scotland Action on Dementia, 2003. 68p, bibliog

ABSTRACT: This report is intended to encourage the rapid development of early intervention services for people with dementia. Early interventions needed include:

● Accurate and timely diagnosis and assessment.
● Appropriate medical interventions, both for cognitive symptoms and for other conditions.
● Accurate information in a helpful form, including the name and nature of the illness, its possible symptoms and other effects.

Also including details of how to cope, treatment options, legal and financial issues and making arrangements for the future.

● Counselling and other forms of emotional support for the person with dementia and carers.
● Support groups for people with dementia.
● Carer support groups and carer education.
● Rehabilitative approaches such as memory training and compensatory memory and aids.
● Advocacy to assist people with early dementia speaking up for themselves and support them in decision-making one-to-one support by paid staff or befrienders and aids and adaptations to help maintain independence.


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