Elliott M. Stein

Geriatric sweet tooth. A problem with tricyclics.

Ninety‐three consecutive outpatients receiving tricyclic antidepressants for at least one month were asked about medication side effects, including excessive appetite and craving for sweets. Prevalence of these side effects and their relationship (Pearson r) to type of medication, dosage, patient characteristics, diagnoses, weight gain, and clinical improvement were examined. More than one‐third (38%) reported excessive appetite, 34% had a craving for sweets, and about one‐half (48%) had either one or the other of these reactions. These adverse side effects were related significantly to weight gain (P < .001) and a higher dose of medication, but not to clinical improvement. Clinical improvement was in the moderate‐to‐good range but was not related to medication dose. Because increasing degrees of overweight can pose serious health risks, especially for the elderly, it is critical for future research to examine ways of maintaining therapeutic benefit while minimizing food craving side effects. Methods of dealing with these issues clinically are suggested.

Effect of Nursing Home Staff Training on Quality of Patient Survival

This study tests the effects of nursing home staff training in care for the dying on the quality of life of terminally ill patients. Ten matched community nursing homes were assigned randomly to experimental (training) or control (no training) conditions. Patients (N = 306) admitted to the homes were assessed at admission, one month, and three months concerning quality of life as measured by depression, alienation, self-esteem, and locus of control. Satisfaction with care was also measured at one and three months. Patients in trained homes had less depression and greater satisfaction with care than patients in control homes at one and three months. Training effects were similar in all of the five homes. The study shows that a favorable impact on patient care can be achieved when staff in nursing homes are trained to work with dying patients.

The Relationship of Self-help Networks to Physical and Psychosocial Functioning

One hundred fifty‐eight elderly persons living in retirement hotels and apartments were classified by being receivers or givers of help to their neighbors into four groups: givers, getters, both (GG), or neither (NGG). The aim was to determine whether the groups differed in personal characteristics, physical functioning, or psychologic adjustment at baseline and six months later. The groups did not differ in personal characteristics. The NGG group (N = 55) functioned significantly less well, both physically and psychosocially. At six months, with baseline scores adjusted, the givers had fewer illnesses and the GG group had better self‐esteem. Thus, subjects did not change significantly in other variables. Efforts to enhance the ability of the NGG group to form social networks, if applied cautiously, may help to improve their overall adjustment.

Future Concerns and Recent Life Events of Elderly Community Residents

Fifty‐eight elderly community residents completed a 37–item inventory that measured their level of concern about potentially stressful events or emotions. Afterwards, they indicated whether selected life events had actually occurred in the last six months. All data were intercorrelated to determine if there were relationships between total scores, personal characteristics, and recent life events. Results showed elderly persons in this sample to be most worried about immediate economic survival and disability. Those in poorer health who had less education, were living with their children, and had less tenure in the neighborhood evidenced greater total concern.

Geriatric in the Office and Clinic1

The aged are high risk for mental health problems, and their treatment will become an increasing focus for psychiatrists. Many elderly are responsive to psychother apeutic interventions, even though they are less often referred and treated than are younger persons with similar problems. In addition to the traditional modalities, such as psychotherapy and chemotherapy, this article reviews some of the specialized techniques that can be helpful to older people and provides examples illustrating their use.