Margaret Dimond

Identifying Elderly with Coping Difficulties after Two Years of Bereavement

This study answers three research questions. First, what proportion of the elderly are experiencing major coping difficulties after two years of bereavement? Second, what factors in early bereavement distinguish between those with difficulties and the others? Third, what set of factors are the best predictors of coping difficulties at two years? Of the 138 persons who completed a two-year longitudinal study of bereavement, twenty-five (18%) were found to be having difficulties after two years according to a scale which combined perceived stress, coping, and depression. The poor copers did not differ from the others with respect to any of the sociodemographic, health, or social support variables. However, those who were poor copers had lower self-esteem, experienced several feelings/behaviors with greater intensity/frequency in early bereavement. Low self-esteem, even prior to bereavement, is likely to be predictive of coping difficulties two years following the death of a spouse. Three weeks after the spouses death, the poor copers expressed confusion and a desire to die with greater intensity. They also were less likely to be proud of how they were managing the death, they cried more frequently, and did not try to keep as busy in this early bereavement period.

Stress, self-esteem and coping during bereavement among the elderly

The purpose of the study was to assess the stability of self-esteem as a coping resource during bereavement and to develop a dynamic model of the efficacy of coping ability in relation to the perceived stressfulness of the spouses death. Data were obtained from a longitudinal study of bereavement. Interviews and mailed questionnaires were completed by 192 persons at three time periods which covered the first year of bereavement. Results indicate that initially effective copers remain effective throughout the first year, those with initially high levels of self-esteem maintain their positive assessments, and those who initially experience high stress levels also continue to report high levels one year later. Early bereavement stress was reduced by positive self-evaluations. Persistent stress is associated negatively with coping at one year. The mediating influence of stress at six months also contributes most significantly to the negative effects on self-esteem. Perceived coping ability significantly reduces stress only at six months. Implications for ongoing interventions are discussed.

Reliability, construct validity, and subscale norms of the Brief Symptom Inventory when administered to bereaved parents

The Brief Symptom Inventory (BSI) was administered to parents (N = 260; 171 mothers and 89 fathers) whose adolescent and young adult children died unexpectedly and violently by accident, homicide, or suicide. Summary statistics and reliability coefficients (Cronbach’ s a) for the nine subscales and the Global Severity Index were calculated. A comparison of means and standard deviations confirmed the expectation that this sample is dramatically different from the normative American community standard. Raw scores for the subscales were transformed into standardized T scores and critical values for a screening heuristic presented. An attempt to obtain construct validity using factor analysis suggested that a five-factor solution provided a description of this population of bereaved parents that is more insightful than the nine standard subscales of the BSI. Implications for both clinicians and future research are discussed.

Falls: are rural elders at greater risk?

1. Advocating that elderly clients engage exclusively in behaviors that are free of risks may not always advance the goals of independence, autonomy, and a maximal level of functioning. 2. Falls in the elderly may not be primary events, but indicators of an as yet undetected decline in health, suggesting that the health care provider tailor fall prevention information to the specific lifestyle of the older adult. 3. There may be a range of safe and acceptable risk depending on the lifestyles and the demands of daily living.

Bereavement support groups for the elderly: Characteristics of potential participants

Abstract At the conclusion of a two-year longitudinal study of bereavement, 138 elderly persons were asked about their willingness to participate in support groups. Forty-four percent (N = 61) reported that they would have liked to participate. These persons were compared with those who did not want to participate with respect to sociodemographic, health, social support and psychosocial characteristics measured at six time periods. Nonstatistical patterns of the bereavement process indicate that those who are most likely to participate are more likely than the others to have a confidant but with less availability, have higher depression, and have lower perceived coping abilities and life satisfaction. Those wanting an intervention were also slightly more likely to be younger (ages 50–69), higher educated, and currently employed. Gender, perceived stress, health and self-esteem, and several social support variables did not differ substantially between the two groups. Implications for planning bereavement s...

Understanding Depression in Bereaved Older Adults

Depression is a common outcome of spousal bereavement Concurrent life events may contribute to the intensity of depression following spousal bereavement in older adults and, if not identified, may interfere with therapeutic plans for the management of depression. Taped interviews, conducted six times over two years, were analyzed for ten subjects, five whose depression scores were low, and fie whose scores were high. In addition, a detailed case comparison analysis of two subjects was done. Four recurring types of life events, reported by the bereaved spouses, were illness (of self or others), deaths of family or friends, residential relocation, and changes in interpersonal relationships. Significantly depressed spouses were more likely to report these events. Implications for nursing practice and for integrating qualitative and quantitative research methods are addressed.

Understanding the context of perceived health ratings: The case of spousal bereavement in later life

Abstract Using a sample of 339 older adults at 2 to 3 months of bereavement the following research questions are addressed: What objective physical and psycho-emotional factors influence the perceived health ratings of older adults following the death of their spouses and how much of the variance in their ratings can be explained by the specific set of characteristics? This investigation helps to identify the major factors that older adults take into account in rating their perceived health. Perceived health status was most strongly related to the number of symptoms reported. The objective physical health indicators as well as grief and depression were significantly correlated with perceived health ratings. Nearly 41% of the variance in perceived health was explained by six factors of which 25.9% was due to the number of reported symptoms. Depression and medical conditions made a moderate contribution while the role of unresolved grief was minimal. Physician visits and days sick also made minor contributions. The general conclusion is that the bereavement context influences the factors that older adults take into account in their perceived health ratings and that it is important to recognize that perceived health ratings occur within and are influenced by personal and situational factors of the context.

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