Namkee G. Choi

Little research has been done on the use of antidepressants among homebound older adults, especially low‐income homebound older adults, and their perceptions of the effectiveness of their medication. The purposes of this study were to examine self‐reported use of antidepressants among depressed homebound older adults, class and type of antidepressants used, individual‐level correlates of antidepressant use, and users’ perceptions of the effectiveness of antidepressants. Data on self‐reported use of antidepressants were obtained as part of a feasibility study of short‐term telehealth problem‐solving therapy for depressed low‐income homebound adults (n= 162) aged 50 or older. The 24‐item Hamilton Rating Scale for Depression (HAMD) was used to assess depression severity. The findings show that about half of the study participants were taking antidepressants, with 26.6% of those on antidepressants rating their medications very effective and 21.5% rating them effective. Female gender was positively, but older age and being Black/African American were negatively associated with the likelihood of antidepressant use. Perceived effectiveness of antidepressants was negatively associated with older age and the HAMD score. The findings suggest that personalized approaches to depression management may be needed in subgroups of depressed older adults, including culturally tailored medication counseling in Black/African‐American older adults.

The purpose of this study was to explore Meals on Wheels' (MOW) organizational potential for integrating depression screening, referral, and treatment for homebound older adults. In a survey of 164 MOW administrators, MOW's current practice of depression services was examined, and the administrators' perception of MOW's organizational potential was measured focusing on external environment, financial resources, staffing/skills, and values and goals. Only 20 out of 164 MOWs provide depression screening, and 19 provide in-home counseling for their clients, while 86 provide referral services. About 64–72% of MOWs that are not current providers of screening and/or referrals want to provide the services, and 21% of those that are not current providers of in-home counseling want to provide it.

Previous wisdom research tended to focus on cognitive and intellectual aspects, highly educated professionals and/or prominent subjects, and wisdom as the outcome not process. In this study, based on in-depth interviews of 18 low- and moderate income older adults who were nominated as being wise by their aging-service providers, we explored the ways challenging life experiences and coping may have contributed to the development of their wisdom, their ideas/beliefs about the qualities of wisdom, and the ways they may be practicing wisdom in daily life. Their emphasis on interconnectedness and interdependence, forgiveness and patience, and gratitude appears to represent self-transcendental qualities of wisdom. Social work practice and research implications are discussed.

Previous studies provide conflicting information on the relationship between drinking and mental health problems in older men and women. This paper addresses the relationship of binge/heavy drinking to psychological distress in community-dwelling older men and women. The study sample consisted of subjects aged 50 and older (n = 2,462 men and 2,863 women) who participated in the 2008 National Survey on Drug Use and Health. Men and women who drank and drank heavily were compared, and ordinary least squares regression analysis was used to examine the association between drinking and psychological distress after demographic factors and health status were controlled for. Binge/heavy drinking was found to be related to psychological distress in older women, but not in older men. Though findings on the relationship between heavy drinking and psychological distress in men and women are not consistent across studies, older men and women should be assessed for both conditions in clinical settings. (Am J Addict 2011;00:1–9)

Objectives The purpose of this study was to examine the relationship between the severity of baseline depressive symptoms and the problems that low‐income homebound older adults (n = 66) identified in their problem‐solving therapy (PST) sessions. Methods Depressive symptoms were measured with the 24‐item Hamilton Rating Scale for Depression (HAMD). Participant‐identified problems recorded in the therapists' worksheets were coded into seven categories: living arrangement/housing issues, financial/health care expense issues, family or other relationship issues, hygiene/task issues, social isolation issues, physical/functional health issues, and mental/emotional health issues. T‐tests and ordinary least squares regression analyses were used to examine differences in HAMD scores between those who identified any problem in each category and those who did not. Results Participants who had living arrangement/housing and family or other relationship issues had higher baseline HAMD scores than the rest of the participants. At 2‐week posttest, those with living arrangement/housing issues continued to have higher HAMD scores than the others, whereas those with family or other relationship issues did not. Conclusion The study findings provide insights into the problems that low‐income, depressed homebound individuals bring to their PST sessions. It was not clear if family conflict or other relationship issues contributed to their depression or vice versa, but it appears that PST may have contributed to alleviating depressive symptoms associated with these issues. Precarious living/housing situations appeared to have had a serious depressogenic effect and could not be easily resolved within a short time frame of the PST process, as these issues required formal support. Copyright © 2011 John Wiley & Sons, Ltd.

A limited number of studies have examined the co-occurrence of alcohol use and smoking and their mental health effects in middle and late life. In this study, using the 2008 National Survey of Drug Use and Health, the characteristics of individuals aged 50 and older who abstained from both substances, who used both substances, and who used one or the other substance were examined. Then, the main and interaction effects of drinking and smoking on psychological distress were analyzed. Findings show that smoker-nondrinkers are the most disadvantaged group in terms of sociodemographic and health characteristics, while drinker-nonsmokers are the most advantaged group. When sociodemographic, health, and other factors were controlled, no direct effects of drinking or interaction effect of drinking and smoking were detected for either gender. However, heavy smoking (6+ cigarettes on a typical smoking day) was significantly associated with an elevated level of psychological distress among women. The findings highlight the vulnerability of heavy smoking middle-aged and older women. These women are the most psychologically distressed and may need interventions designed to help them quit smoking, reduce or quit drinking, and alleviate psychological distress.

Journal of Medical Internet Research - International Scientific Journal for Medical Research, Information and Communication on the Internet

Although accumulated research findings point to both short- and long-term salutary effects of time volunteering on older adults' physical and mental health, little research has been done on the effect of older adults' making charitable donations on their wellbeing. Guided by activity theory and the theory of volunteering and using data from the first and second waves of Midlife Development in the United States (MIDUS, 1995–1996 and MIDUS II, 2004–2006), this study examined the question of whether time volunteering and charitable donations nine years earlier had a positive direct effect on psychological wellbeing among individuals age 55 and above. Controlling for time 1 (T1) psychological wellbeing and T1 human, cultural, and social capital resources, a moderate amount (up to ten hours monthly) of T1 time volunteering and any amount of T1 charitable donations had a direct positive effect on time 2 (T2; nine years later) psychological wellbeing. The findings also show a greater effect on psychological wellbeing of any amount of charitable donations than of any amount of time volunteering, although the extent of the effect of both time volunteering and charitable donations was small. With regard to human, cultural, and social capital resources, T1 self-rated health and generative quality were significant predictors of T2 psychological wellbeing, but T1 social capital had no significant effect on T2 psychological wellbeing.