B. Jan McCulloch

Amyotrophic lateral sclerosis and hopelessness: psychosocial factors

The purpose of this study was to investigate the relationship of psychosocial factors to the presence of hopelessness among patients with amyotrophic lateral sclerosis (ALS). Secondary cross-sectional analyses were conducted with data collected from 136 ALS patients. Primary research questions were examined using hierarchical multiple regression procedures. Results showed that health locus of control and purpose in life were significant predictors of hopelessness among ALS patients. Other factors, including socioeconomic and demographic variables, variables measuring length and severity of illness, and additional psychosocial variables (social support satisfaction and degree to which spiritual beliefs help to cope with ALS) were not significant predictors of hopelessness. Results are discussed in light of the benefit to ALS patients of psychosocial interventions in disease management.

Barriers to Solutions: Service Delivery and Public Policy in Rural Areas:

Improvements in individual and community resources are complicated by inadequate rural public policy and increasing difficulties in the delivery of services, including health care. This article examines rural service delivery, particularly the delivery of health care, and public policy issues in the context of persistent rural poverty. Barriers, including those at both individual and community levels, are discussed as well as artificial barriers that professionals may impose as they work to improve the life status of older rural adults. Initiatives currently underway for the improvement of rural service delivery and issues regarding the development and implementation ofpublic policy responsive to rural areas also are discussed. Recommendations forfuture service delivery in and public policy for rural areas are noted. Central to this discussion is the recognition that any attempt to improve the quality of life for older adults m rural areas, particularly when applied to the reduction of current financial distress, will be developed and implemented during times of increased program and employee accountability at all levels.

Rural Mental Health and Elders: Historical Inequities

Although there have been unexpected and unintended consequences—and what many might consider inadequate care—America has consistently attempted to care for its mentally ill. This article provides a historical review of the pathways this care has taken, with particular focus on the persistent inequities older and rural adults experience with regard to mental health care. The care of people with mental illness has taken different forms as social, political, and economic environments have changed. The persistent social construction of myths about aging in rural areas and ageist biases necessitate greater advocacy if more equitable care is to be provided. This will unquestionably involve addressing the myths surrounding rural life, removing the stigma attached to mental illness, becoming aware of the biases inherent in current service delivery systems, and developing new and different models for the delivery of care that is appropriate to diverse, rural settings.

Call for Nominations and Applications for Editor

The Southern Gerontological Society Publications Committee is accepting nominations and applications for the position of editor for the Journal of Applied Gerontology. The JAG is published quarterly and devoted to the publication of contributions that focus explicitly on the application of knowledge to the improvement of the quality of life of older persons. Manuscripts are solicited from all fields and disciplines with interests in gerontology and, although the journal is sponsored by a regional association, contributions are sought from national and international sources. The major goal is to publish findings, recommendations, and promising ideas that have general applicability to and significance for older persons everywhere.

Book Reviews : Susan Garrett, Miles to Go: Aging in Rural Virginia. Charlottesville, VA: University Press of Virginia, 1998. Cloth,

This specifically focused volume is the fifth in the Aging Studies series, edited by Anne M. Wyatt. Susan Garrett, in her role as observer and volunteer, has provided the reader with a detailed account of the Rural Elder Outreach Project (REOP), a collaborative demonstration project funded by the W. K. Kellogg Foundation. The Schools of Nursing and Medicine at the University of Virginia partnered with two local agencies to model effective ways of providing health care to frail elders living in five rural Virginia counties. The volume is unique among those who have previously examined aging in rural areas because Garrett weaves together research, her own observations while serving as a volunteer for the project, conversations among project staff, diary entries regarding specific case studies, and details regarding the day-to-day operation of this collaboration. The volume contains eight chapters that chronicle the REOP project. A brief

22.95, 188 pp

This edited volume provides a collection of papers that focuses on two primary goals regarding the health and delivery of services to elders residing in rural areas: (a) review and critique of what we currently know about health and service delivery, and (b) identification of action agendas that could be used to improve rural health and service delivery to elders. Individual contributors were charged with identifying actions across research and scholarly pursuits, health policy and legislation, and program and service development. The majority of chapters presented in the volume were commissioned as background papers for a 1992 national invitational conference on Health and Aging in Rural America. The volume begins with an overview of rural health and aging. Coward, McLaughlin, Duncan, and Bull clarify rural, with an emphasis on the importance of moving beyond the rural-urban residential dichotomy when health and service issues are examined in rural areas. They also provide a general description of the rural elderly population

Book Reviews : Coward, Raymond T., C. Neil Bull, Gary Kukulka, & James M. Galliher (Eds.). Health Services for Rural Elders. New York: Springer, 1994.

admission to the nursing home. There are the &dquo;Sisters&dquo; and the &dquo;Spouses&dquo; who share rooms and whose lives in the facility are in many respects simply an extension of lifelong relationships. There are those for whom &dquo;Disability&dquo; provides a dominant and pervasive horizon of meaning. And there are the &dquo;Knowledgeable,&dquo; people whose lives in the facility are framed against a backdrop of a career in health care that has made them privy to a more informed perspective on their circumstances.