The picture of happiness in Alzheimer's disease: Living a life congruent with personal values

Pet ownership issues encountered by geriatric professionals: Preliminary findings from an interdisciplinary sample

Pets often factor in older adults' health behaviors and decisions. However, the degree to which issues related to pet ownership are encountered or addressed by professionals working with this population remains unknown. The aim of this study was to identify specific issues stemming from pet ownership professionals had encountered in their work with older adults, people living with dementia, and care partners. An interdisciplinary (e.g., social services and healthcare) sample (N = 462, 89.13% female, M age = 53.02, SD age = 12.18) completed an online survey addressing pet ownership issues encountered in their work. Descriptive statistics, t-tests, and repeated measures ANOVAs were used to analyze quantitative data. A conventional content analysis was used to analyze open-ended responses to an item asking about "other" issues encountered in their work with these populations. The professionals estimated 46.29% of clients had been pet owners, 41.23% regularly asked about pets, and 79.22% had encountered issues related to pet ownership. Specific issues raised to the professionals varied by type of client. The professionals reported older adults most often raised getting pet items into the home and concerns about their pets' health. The issues most often raised by people living with dementia to the professionals were planning for the pet due to a housing transition and basic pet care. Care partners focused on basic pet care and planning for the pet due to a housing transition. The professionals themselves most often raised the issues of basic pet care, concerns about falling, and the pets' behavior. Professionals who entered clients' homes were more likely to raise issues stemming from pet ownership compared to those who reported they did not enter clients' homes in their current job, t(429.40) = 5.59, p < 0.00001. The eleven new issues identified by the content analysis (e.g., pets impeding care, people refusing care due to the pet) underscored how the health and wellbeing of people and their pets are linked. The results of this study provide strong evidence that professionals do encounter issues related to pet ownership. Including issues stemming from pet ownership into procedures, policies, and programs is likely to have positive impacts on those served by and working in the geriatric workforce.

The use of visual methods to support communication with older adults with cognitive impairment: A scoping review

Older adults with cognitive impairment often face difficulties with comprehension and communication, which can impact other cognitive processes such as decision-making. This scoping review investigates how visual methods can support older adults with cognitive impairment. The review involved querying four databases. From these databases, eleven articles fit inclusion criteria. This paper examines the purposes, use contexts, types, and effectiveness of the visual methods described in each study. The two major use contexts were elicitation of thoughts, feelings, and preferences in everyday life and health/healthcare related uses. Studies that used visual methods for eliciting preferences generally employed static visualizations. Health-related contexts employed more complex and interactive visualizations. Three studies used visual tools to support older adults in understanding; six, communication; and three, decision-making. None addressed all three outcomes of interest. This study provides recommendations and future directions for visual communication research with older adults with cognitive impairment.

Racial Differences in Associations of Cognitive Health Status With Happiness, Helplessness, and Hopelessness Among Older Adults: An Exploratory Study

Background

The relationship between healthy and positive aging and dementia and cognitive impairment has received limited attention in the field of aging. Affect impacts cognitive changes and processes, and cognitive impairment is associated with affective comorbidities. The purpose of the study was to examine (a) whether happiness, helplessness, and hopelessness are linked to cognitive health status, and (b) whether these associations differ by race.

Methods

Participants were enrollees in the Wisconsin Alzheimer's Disease Research Center's Clinical Core (ADRC). Average age at baseline was 60.85 (SD = 8.65), 73.70 (SD = 8.02), and 73.80 (SD = 9.59) years for cognitively normal individuals, individuals with MCI, and individuals with dementia, respectively.

Results

In the full sample, chi-square test results revealed associations between Cognitive Health Status (CHS) and (a) happiness, χ2(2) = 6.06, p < 0.05, (b) helplessness, χ2(2) = 6.44, p < 0.05, and (c) hopelessness, χ2(2) = 14.11, p < 0.01.

Conclusion

This study provides support for the association of both positive and negative affect with cognitive health status in middle- to older-aged adults.

A Typical Week With Mild Cognitive Impairment

BACKGROUND AND OBJECTIVES

Identifying the experience of people with mild cognitive impairment (MCI) may help develop research agendas, interventions, and other supports to better match individuals' needs. The purpose of this study was to explore the subjective experience of a "typical week" living with MCI to document (a) important activities, (b) barriers to usual activities, and (c) facilitators and supports.

RESEARCH DESIGN AND METHODS

We conducted remote individual photo-elicitation interviews with 11 community-dwelling adults aged 55 years or older with MCI. Participants each provided 5-10 photographs of daily life taken over 1 week to facilitate a semistructured qualitative interview. Interview transcriptions were coded in Dedoose software and analyzed using thematic analysis.

RESULTS

Participants shared photos and narratives highlighting the important activities in a typical week, in which physical activity, social engagement, spiritual and religious practice, hobbies, and cognitive stimulation were central. Many also shared disruptions to former routines and reduction of activities alongside increased use of new strategies and environmental supports (e.g., calendars, smartphones). Finally, emergent themes centered on disclosure of their diagnosis and reflections about the future.

DISCUSSION AND IMPLICATIONS

Participant-generated images aided data collection and facilitated discussion of sensitive topics with individuals with MCI. Such narratives may illustrate the needs and opportunities to promote well-being in individuals with MCI, including engagement in meaningful and health-promoting activities, assessing barriers to important daily activities, and considering supports that match the experience and needs of those with MCI.

Dementia and advance directives: some empirical and normative concerns

The authors of the paper 'Advance euthanasia directives: a controversial case and its ethical implications' articulate concerns and reasons with regard to the conduct of euthanasia in persons with dementia based on advance directives. While we agree on the conclusion that there needs to be more attention for such directives in the preparation phase, we disagree with the reasons provided by the authors to support their conclusions. We will outline two concerns with their reasoning by drawing on empirical research and by providing reasons that contradict their assumptions about competence of people with dementia and the (un)importance of happiness in reasoning about advance directives of people with dementia. We will draw attention to the important normative questions that have been overstepped in their paper, and we will outline why further research is required.

The Impact of a Care Recipient's Pet on the Instrumental Caregiving Experience

Older adults report strong emotional bonds with their pets which often become increasingly important as health declines and dependence upon others increases. Individuals requiring assistance meeting their own needs are likely to need assistance in meeting the needs of their pet. The care recipient's pet may be an important, though presently overlooked, factor in the caregiving experience. This study measured the amount of care tasks/ activities informal caregivers of older adults devoted to their care recipients' pet. Caregivers for an individual aged 50 and older who did not consider the care recipient's pet to be his/her own animal completed an online questionnaire. Descriptive statistics and Pearson correlations were used in analyses. Caregivers (N = 34) performed an average of 14.9 (SD = 5.4) different pet care tasks/activities and an average of 11.21 (SD = 1.33) hours per week in pet care. The total number of tasks/activities performed was significantly and positively correlated with the care recipients' degree of functional limitation (r = 0.49, p = 0.004). Care recipients' pets may be a significant factor in shaping the instrumental caregiving experience.