Prospective end-of-life decision-making: A study of Asian Indian Hindu younger and older adults

The process of end-of-life decision-making involves the choice of treatment preference and decision-maker. This study examined Asian Indian Hindus' decisions to determine age and cultural effects within the context of socioemotional selectivity theory. Younger (N=100) and older (N=100) Asian Indian Hindus completed a questionnaire on end-of-life scenarios, Western and Indian acculturation and Hindu end-of-life values. Twenty participants were interviewed. Results of sequential logistic regression provide support for the emphases on positive emotional experiences as predicted by socioemotional selectivity theory, but did not indicate age effects. This was substantiated in the qualitative interview data as well as supplemental analyses with a sample of younger (N=64) and older (N=59) non-Hispanic Whites. Asian Indians were less likely to choose life-sustaining treatments than non-Hispanic Whites. Autonomy in decision-making was important to both ethnic groups. The discussion focuses on implications of these findings for socioemotional selectivity and the role of culture in end-of-life decision-making

Age-Based Differences in Care Setting Transitions over the Last Year of Life

Context. Little is known about the number and types of moves made in the last year of life to obtain healthcare and end-of-life support, with older adults more vulnerable to care setting transition issues. Research Objective. Compare care setting transitions across older (65+ years) and younger individuals. Design. Secondary analyses of provincial hospital and ambulatory database data. Every individual who lived in the province for one year prior to death from April 1, 2005 through March 31, 2007 was retained (N = 19, 397). Results. Transitions averaged 3.5, with 3.9 and 3.4 for younger and older persons, respectively. Older persons also had fewer ER and ambulatory visits, fewer procedures performed in the last year of life, but longer inpatient stays (42.7 days versus 36.2 for younger persons). Conclusion. Younger and older persons differ somewhat in the number and type of end-of-life care setting transitions, a matter for continuing research and healthcare policy

A Hope Intervention Compared to Friendly Visitors as a Technique to Reduce Depression among Older Nursing Home Residents

Depression is common among older persons. An experimental study was undertaken to test the impact of a four-week hope program on depressed nursing home residents. Residents aged 65 or older, who met the criteria for this pilot study and agreed to participate, were randomly assigned to (a) an intervention group, and provided with weekday hope interventions mainly involving positive messages and pictures or (b) a modified control group, and provided with a friendly weekday greeting. The structured hope intervention was not proven effective for reducing depression or raising hope. Instead, a significant reduction in depression among the control subjects was found, as well as a nonsignificant increase in their level of hope. Although these findings suggest friendly visitors may be a more efficacious nonpharmacological approach for reducing depression, further investigations are needed to confirm this and to explore the impact of other hope interventions

The effects of aging and dual task performance on language production

This is an electronic version of an article published in Kemper, S., Schmalzried, R., Herman, R., Leedahl, S., & Mohankumar, D. (2009). The effects of aging and dual task performance on language production. Aging, Neuropsychology, and Cognition, 16, 241-259. PM#2674132. Aging, Neuropsychology, and Cognition is available online at www.taylorandfrancis.comA digital pursuit rotor task was used to measure dual task costs of language production by young and older adults. After training on the pursuit rotor, participants were asked to track the moving target while providing a language sample. When simultaneously engaged, young adults experienced greater dual task costs to tracking, fluency, and grammatical complexity than older adults. Older adults were able to preserve their tracking performance by speaking more slowly. Individual differences in working memory, processing speed, and Stroop interference affected vulnerability to dual task costs. These results demonstrate the utility of using a digital pursuit rotor to study the effects of aging and dual task demands on language production and confirm prior findings that young and older adults use different strategies to accommodate to dual task demands

Age-Based Differences in Care Setting Transitions over the Last Year of Life

Context. Little is known about the number and types of moves made in the last year of life to obtain healthcare and end-of-life support, with older adults more vulnerable to care setting transition issues. Research Objective. Compare care setting transitions across older (65+ years) and younger individuals. Design. Secondary analyses of provincial hospital and ambulatory database data. Every individual who lived in the province for one year prior to death from April 1, 2005 through March 31, 2007 was retained (N=19,397). Results. Transitions averaged 3.5, with 3.9 and 3.4 for younger and older persons, respectively. Older persons also had fewer ER and ambulatory visits, fewer procedures performed in the last year of life, but longer inpatient stays (42.7 days versus 36.2 for younger persons). Conclusion. Younger and older persons differ somewhat in the number and type of end-of-life care setting transitions, a matter for continuing research and healthcare policy.Peer Reviewe