Continuing to Participate in the Dance of Life as Oneself: The Lived Experience of Meaning in Life for Older Adults With Alzheimer's Disease

Developing and Validating the Senior Meaning in Life Evaluation (SMiLE) Scale

The Senior Meaning in Life Evaluation scale encompasses not only older adults' personal motivation and growth but also the meaning for them in society and in their relationships: With this scale, we aimed to present their voices. A three-phase process was followed: The scale's items were developed empirically from interviews of older adults; exploratory factor analysis (EFA) was conducted to test convergent and concurrent validity; and finally, confirmatory factor analysis (CFA) was performed. EFA resulted in 18 items grouped into 4 factors (i.e., proactive on life, overcoming emptiness, acceptance in life, and social contribution), which was supported by the CFA.

The relationship between alexithymia, depression, anxiety, and stress in elderly with multiple chronic conditions in China: a network analysis

Objective

This study aimed to construct a network structure to investigate the connections between alexithymia, depression, anxiety, and stress in Chinese older adults with multiple chronic conditions (MCC), identifying core and bridge symptoms, and comparing the network structure across different levels of alexithymia.

Methods

This study used a cross-sectional survey design and convenience sampling to recruit participants from six cities in Jiangsu Province. The study assessed the levels of alexithymia, depression, anxiety, and stress in older adults with MCC using the Toronto Alexithymia Scale (TAS-20) and the Depression Anxiety and Stress Scale-21 (DASS-21). Network analysis was performed using R language to identify core and bridge symptoms in the network and compare the network structure across different levels of alexithymia.

Results

A total of 662 participants were included in the analysis, including 395 men and 267 women. The mean age was 70.37 ± 6.92 years. The finding revealed that the "Difficulty Identifying Feelings" (DIF) node had the highest strength centrality (strength = 2.49) and predictability (rp = 0.76) in the network. The next highest strength centrality was observed for "Meaningless" (strength = 1.50), "Agitated" (strength = 1.47), "Scared" (strength = 1.42), and "No look forward" (strength = 0.75). They were identified as core symptoms. The bridge strength analysis identified "Panic," "Scared," "No wind down," "No initiative," and "No positive" as the bridge symptoms. There were notable differences in the overall network structure and specific connections between the groups with and without alexithymia (p < 0.05).

Conclusion

"DIF" is a core node in the network of older adults with MCC, indicating its significance as a potential target for psychological interventions in clinical practice. Preventing and mitigating bridge symptoms such as "panic," "Scared," "No wind down," "No initiative," and "No positive" can effectively impede the spread of symptom activation, thereby interrupting or severing the connections among comorbidities in older adults. Additionally, compared to non-alexithymia individuals, the psychological issues of older adults with alexithymia require prioritized intervention from healthcare professionals.

Living with a diagnosis of frontotemporal dementia: An interpretative phenomenological analysis

Frontotemporal dementia describes a spectrum of disorders which include behavioural changes, changes to affect, speech difficulties and physical issues. Although literature exists which identifies the need for the voices of people with dementia to be heard, there is a paucity of research which includes hearing the experiences of people diagnosed with FTD. The purpose of this research was to explore the lived experience of frontotemporal dementia from the persons' perspective using interpretative phenomenological analysis. The themes that emerged in the analysis were: the rocky road through assessment; the changing self; in touch with reality; and keeping going. Two overarching themes emerged which were: the need to hear the voice of people with frontotemporal dementia; and for people with frontotemporal dementia to exercise some control over the decision making process throughout their journey. Recommendations are presented for future practice and research.

Die Angst vor dem Sinnverlust nach der Diagnose Demenz. Eine Rekonstruktion unter Bezug auf Susan Wolf

Verbunden mit dem drohenden Verlust von kognitiven Kapazitäten und der Veränderung der eigenen Persönlichkeit, ist zu vermuten, dass bei Demenzerkrankungen ein Sinnverlust vom Erkrankten befürchtet wird. Es ist Aufgabe dieses Papers aufzuklären, was es mit einer solch meist diffus empfundenen Angst auf sich hat. Dazu wird ein Deutungsangebot gemacht, das auf die Sinnkonzeption Susan Wolfs zurückgreift. Es wird gezeigt, dass es möglich ist, bis zu einem gewissen Grad der Demenz ein sinnvolles Leben zu führen – ein Leben, bei dem subjektiv Anziehendes und rational (bzw. objektiv) Wertvolles zusammengreifen müssen. Dies ist möglich, weil ein Mensch mit Demenz noch über entsprechende Fähigkeiten der Wertschätzung verfügt und eine Hilfsbedürftigkeit der Befähigung zu einem sinnvollen Leben nicht widerspricht. Bei einer sehr schweren Beeinträchtigung der kognitiven Kapazitäten wird es hingegen nicht mehr möglich sein, ein solches Leben zu leben; die solcherart erkrankte Person wird dies aber auch nicht mehr vermissen. Wenn das, was man mit der Demenzerkrankung zu verlieren befürchtet, durch das Sinnverständnis Wolfs getroffen ist, dann sollte man diese Überlegungen bei der Beurteilung einer empfundenen Angst berücksichtigen.

Care, dementia, and the fourth age in Erica Jong's later work

Background and Objectives

This article addresses the representations of dementia and caregiving in the fourth age as depicted in Erica Jong’s later-life work. It shows how the experience of parental care leads to the discovery of new ways of human interaction and expressions of personhood.

Research Design and Methods

Framed within literary-cultural age studies, the article shows how humanities-based inquiry can illuminate important aspects of aging and care of the oldest old, which are significant and revealing, but often hidden under the dark shadow of dementia.

Results

Newly discovered ways of communication challenge the notion of the loss of agency as they demonstrate that the body itself has the power of creative and intentional capacities and self-expression.

Discussion and Implications

Care-related narratives offer new insights into aging, dementia and subjectivity that can help pursue a better analysis of the ‘deep’ old age, strengthen collective solidary and manage increasing ageism, especially pronounced during the Covid-19 pandemic.