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Informal carers play an essential role in the care of individuals with Parkinson’s disease (PD). This role, however, is often fraught with difficulties, including emotional, physical, and financial. Coping styles and relationship quality have been hypothesized to influence the impact of stressors. The aim of this study is to examine the relationship between carers’ coping style, relationship quality, and carer burden.
Thirty-nine PD patient carer dyads were included in the study.
Participants completed self-rated questionnaires including the Dyadic Adjustment Scale, Zarit Burden Interview, and Brief Coping Orientation to Problems Experienced Inventory.
Correlational analyses found significant and positive correlation between carer burden and all three coping styles (problem-focused, emotion-focused, and dysfunctional). There was also a moderate association between carers’ perceived relationship quality and satisfaction and carer burden. Regression analyses found that carer’s gender, severity of PD, relationship quality, emotion-focused, and dysfunctional coping styles did not predict carer burden. Conversely, problem-focused coping style predicted carer burden.
The results highlight that there is no perfect way to react and care for a loved one and serves as important information for practitioners who design and implement interventions.
The literature on late-life anxiety has grown exponentially in the last two decades, and a wide array of research questions are being explored by an ever-growing cadre of clinicians and scientists internationally. In fact, in the last decade, there have been several special journal issues devoted to aspects of anxiety in later life – for example, American Journal of Geriatric Psychiatry (2011, vol. 19, issue 4), Journal of Anxiety Disorders (2013, vol. 27, issue 6), International Psychogeriatrics (2015, vol. 27, issue 7), and Clinical Gerontologist (2017, vol. 40, issue 3). All have made the point that while our understanding of the etiology, diagnosis, assessment, and treatment of such disorders has grown and continues to increase, there are still many areas requiring further research attention. In addition, experimental techniques to study the biological mechanisms underpinning anxiety continue to grow in sophistication and access.
Historically, clinicians and researchers interested in the mental health of older people have focused on depression and dementia and have given little attention to anxiety except as a complication of depression or dementia. Over recent years, however, research into anxiety in older people has increased substantially, leading to both a burgeoning scientific literature and increasing clinical interest in the field.
Anxiety disorders in later life have historically been overshadowed by strong clinical and epidemiological interest in mood disorders and cognitive disorders. This chapter reviews the key scientific literature on the epidemiology of anxiety disorders in older people and putative risk and protective factors.
Historically, clinicians and researchers have focused on depression and dementia in older people, paying little attention to anxiety except as a complication of these disorders. However, increased research into late-life anxiety has seen a growth in scientific literature and clinical interest. This important book brings together international experts to provide a comprehensive overview of current knowledge in relation to anxiety in older people, highlighting gaps in both theory and practice, and pointing towards the future. Early chapters cover the broader aspects of anxiety disorders, including epidemiology, risk factors, diagnostic issues, association with insomnia, impaired daily functioning, suicidality, and increased use of healthcare services. The book then explores cross-cultural issues, clinical assessment, and pharmacological and psychological interventions across a variety of settings. An invaluable resource for mental health professionals caring for older people including researchers, psychiatrists, psychologists, specialist geriatric nurses and social workers.
Driving and stopping driving present challenging issues for older people living with memory problems and the family members supporting them. Changes to driving status impact the individual stopping driving and their family members. CarFreeMe is an existing, effective driving cessation program for older people that may be applicable to older people living with dementia. The purpose of this study was to adapt the program and explore feasibility and key stakeholder perspectives.
The Medical Research Council guidelines for conducting research into complex interventions guided the development, acceptability and feasibility piloting. A multidisciplinary approach was taken, and key stakeholders were involved throughout the process. This included an adaptation process, followed by expert reference group feedback and case series pilot study.
The background research indicated that some key changes were required to meet the needs of people living with dementia. Aspects of the content, language, format and activities were adapted and an additional module was created for family members – whose involvement was identified as important. A more personalized, flexible approach was recommended. The expert reference group [psychologists (n = 2), occupational therapists (n = 3) and dementia behavior consultants (n = 2)] indicated the program was appropriate and needed, and made recommendations for feasibility. Pilot testing with three families indicated acceptability.
A driving cessation program adapted for use with people living with dementia and their families required some changes to meet the needs and situations based on feedback from key stakeholders. Future studies will evaluate implementation outcomes across a range of settings.
Sleep disturbances negatively impact the quality of life of patients with Parkinson’s disease (PD). While persons living in regional areas are at higher risk of PD, PD is poorly managed in regional communities. This study examined factors associated with sleep problems in PD in a regional context.
A mixed-methods cross-sectional design was used.
Patients with PD were recruited from the Queensland Parkinson’s Project database.
Those who agreed to participate were sent a questionnaire assessing aspects of sleep, depression, anxiety, quality of life, and PD severity. Qualitative information was also gathered. Correlations between variables were examined; thematic analyses were performed for qualitative data.
All participants (n = 49) reported sleep disturbances, with 73% (n = 36) reporting sleep disturbance to be problematic. Global sleep dysfunction positively correlated with daytime napping (r = .34, p = .01), watching the clock when unable to sleep (r = .38, p = <.01), staying in bed when unable to sleep (r = .43, p = <.01), and going to bed hungry (r = .31, p = .03) and negatively correlated with daytime exercise (r = -.32, p = .02). Positive correlations were observed between global sleep dysfunction and depression (r = .55, p = <.01), anxiety (r = .31, p = .04), and dysfunctional sleep beliefs (r = .39, p = <.01).
There is a clear need for identifying factors related to sleep disturbances in PD for effective management.