Impact of Family Involvement on Impact of Family Involvement on Geriatric Depression in Residents Geriatric Depression in Residents

Living in Long –Term Care Living in Long –Term Care FacilitiesFacilities

As the Baby-Boomer generation (those born As the Baby-Boomer generation (those born between 1946 and 1964) reaches retirement age, between 1946 and 1964) reaches retirement age,

the population of senior adults is expected to the population of senior adults is expected to increase in all fifty states. The Census Bureau increase in all fifty states. The Census Bureau

projects that America’s aging population will projects that America’s aging population will double between 1995 and 2025. Literature double between 1995 and 2025. Literature

suggests a direct correlation between family suggests a direct correlation between family involvement and the life satisfaction and geriatric involvement and the life satisfaction and geriatric depression levels of residents in long-term care depression levels of residents in long-term care

facilities. (Gaugler, 2003, p. 3)facilities. (Gaugler, 2003, p. 3)

Family InvolvementFamily Involvement

“ “While much of the gerontological literature While much of the gerontological literature emphasizes the institutionalization of an older emphasizes the institutionalization of an older adult as an endpoint of family care, research has adult as an endpoint of family care, research has emerged illustrating the continued involvement of emerged illustrating the continued involvement of family members in the lives of residents.” family members in the lives of residents.” (Gaugler, 2003, p. 3) As literature suggests a (Gaugler, 2003, p. 3) As literature suggests a direct correlation between family involvement and direct correlation between family involvement and the life satisfaction and geriatric depression level the life satisfaction and geriatric depression level of residents in long-term care facilities, it is of residents in long-term care facilities, it is important to further understand this relationship.important to further understand this relationship.

Family InvolvementFamily Involvement

In order to review the life satisfaction of the elder In order to review the life satisfaction of the elder population, it must first be understood what factors population, it must first be understood what factors impact life satisfaction. This proves to be a impact life satisfaction. This proves to be a challenge in itself due to the fact that “as people challenge in itself due to the fact that “as people age they become more differentiated, rather than age they become more differentiated, rather than alike.” (Kelley-Gillespie, 2007, p.208) This makes alike.” (Kelley-Gillespie, 2007, p.208) This makes it difficult to identify common elements that it difficult to identify common elements that contribute to the overall life satisfaction of the contribute to the overall life satisfaction of the elderly population and thus affecting their levels of elderly population and thus affecting their levels of geriatric depression.geriatric depression.

Affecting FactorsAffecting Factors

An article penned by Kelley-Gillespie (2007) An article penned by Kelley-Gillespie (2007) outlines the factors that influence life satisfaction outlines the factors that influence life satisfaction as defined by three different researchers. The first as defined by three different researchers. The first identified such attributes as “physical functioning identified such attributes as “physical functioning and symptoms; emotional functioning and and symptoms; emotional functioning and behavioral dysfunction; intellectual and cognitive behavioral dysfunction; intellectual and cognitive functioning; social functioning and the existence of functioning; social functioning and the existence of a supportive network…” (p. 208) a supportive network…” (p. 208)

Affecting FactorsAffecting Factors

The second found that life satisfaction can The second found that life satisfaction can be measured by the following eleven be measured by the following eleven domains: “sense of safety, security and domains: “sense of safety, security and order, physical comfort, enjoyment, order, physical comfort, enjoyment, meaningful activity, relationships, function meaningful activity, relationships, function competence, dignity, privacy, individuality, competence, dignity, privacy, individuality, autonomy/choice and spiritual well-being.” autonomy/choice and spiritual well-being.” (p.208)(p.208)

Affecting Factors Cont.Affecting Factors Cont.

Finally, the third researcher identified the following Finally, the third researcher identified the following characteristics: “freedom of choice, maximum characteristics: “freedom of choice, maximum control over one’s life, and involvement in decision control over one’s life, and involvement in decision making; recognition of individuality; right to privacy making; recognition of individuality; right to privacy and fostering of human dignity; continuity with the and fostering of human dignity; continuity with the past and continuation of normal social roles; past and continuation of normal social roles; stimulating environment; age-appropriate stimulating environment; age-appropriate opportunities and activities; sense of opportunities and activities; sense of connectedness between home, neighborhood, and connectedness between home, neighborhood, and community; and opportunities for enjoyment, fun, community; and opportunities for enjoyment, fun, humor, and creativity.” (p. 209)humor, and creativity.” (p. 209)

Continuum of Four Different Types of Family Continuum of Four Different Types of Family

Roles” Seen in Long-Term Care FacilitiesRoles” Seen in Long-Term Care Facilities

1) the disengaged family, 2) the consultant,3) the 1) the disengaged family, 2) the consultant,3) the competitive family member, and the 4) competitive family member, and the 4) collaborating family member. (2004) The collaborating family member. (2004) The disengaged family disappears after placement. disengaged family disappears after placement. The consultant communicates with the staff and is The consultant communicates with the staff and is involved in care plans but does not “include the involved in care plans but does not “include the elder in the family system” any longer. The elder in the family system” any longer. The competitive family member competes with the competitive family member competes with the facility to control how and when the care is given. facility to control how and when the care is given. Finally, the collaborating family member interacts Finally, the collaborating family member interacts and supports the staff, while being involved in and supports the staff, while being involved in developing care plans. developing care plans.

Clinical Depression among older adults is Clinical Depression among older adults is estimated to be between 18% to 40%.estimated to be between 18% to 40%.

Statistics are as follows:Statistics are as follows:

Two to eight percent of olderTwo to eight percent of olderpeople with clinical depression live people with clinical depression live in the community.in the community.

Ten percent live in primary healthcare Ten percent live in primary healthcare settings. settings.

Fifteen percent live in acute care or nursingFifteen percent live in acute care or nursinghome settings (Bishop & Sweet, 2003).home settings (Bishop & Sweet, 2003).

Implications For Practice

SW should remember the importance of family involvement.

SW should remember that the older population will double between 1995 and 2025 and research possible ways to better support.

SW should encourage family visitation through structured activities.

SW should work in conjunction with other support systems.

SW should encourage residents to make their own decisions about the care they receive

Sources CitedSources CitedBishop, M. & Swett, E.A. (2003). Mental health and the aging population: Implications for Bishop, M. & Swett, E.A. (2003). Mental health and the aging population: Implications for

rehabilitation counselors. rehabilitation counselors. Journal of Rehabilitation, Journal of Rehabilitation, 69(2), 13-18.69(2), 13-18.Chou, S. C., Duncan, P.B., & Lee, A. L. (2003). Factors influencing residents’ satisfaction in residential Chou, S. C., Duncan, P.B., & Lee, A. L. (2003). Factors influencing residents’ satisfaction in residential

aged care. aged care. The Gerontological Society of America, 43The Gerontological Society of America, 43(2), 459-472.(2), 459-472.Gaugler, J. E., Anderson, K. A., & Leach, C. R. (2003). Predictors of family involvement in residential Gaugler, J. E., Anderson, K. A., & Leach, C. R. (2003). Predictors of family involvement in residential

long-term care. long-term care. Journal of Gerontological Social Work, 42Journal of Gerontological Social Work, 42(1), 3-26.(1), 3-26.Gaugler, J. E., Anderson, K. A., Zarit, S. H., & Pearlin, L. I. (2004). Family involvementin nursing homes: Gaugler, J. E., Anderson, K. A., Zarit, S. H., & Pearlin, L. I. (2004). Family involvementin nursing homes:

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Hansen, S. S., Patterson, M. A., & Wilson, R. W. (1988). Family involvement on a dementia unit: The Hansen, S. S., Patterson, M. A., & Wilson, R. W. (1988). Family involvement on a dementia unit: The resident enrichment and activity program. resident enrichment and activity program. The Gerontologist, 28The Gerontologist, 28(4), 508-510.(4), 508-510.

Jervis, L. J. (2005). The missing family: Staff perspectives on and responses to familial noninvolvement Jervis, L. J. (2005). The missing family: Staff perspectives on and responses to familial noninvolvement in two diverse nursing homes. in two diverse nursing homes. Journal of Aging Studies, 20Journal of Aging Studies, 20(1), 55-66.(1), 55-66.

Kelley-Gillespie, N., & Farley, O. W. (2007). The effect of housing on perceptions of quality of life of older Kelley-Gillespie, N., & Farley, O. W. (2007). The effect of housing on perceptions of quality of life of older adults participating in a Medicaid long-term care demonstration project. adults participating in a Medicaid long-term care demonstration project. Journal of Gerontological Journal of Gerontological Social Work, 49Social Work, 49(3)(3), , 205-228.205-228.

Malench, S. S. (2004). Family and social work roles in the long-term care facility. JMalench, S. S. (2004). Family and social work roles in the long-term care facility. Journal of ournal of Gerontological Social Work, 43Gerontological Social Work, 43(1), 49-61.(1), 49-61.