Handbook of Assessment in Clinical Gerontology

Front Cover

Handbook of Assessmentin Clinical Gerontology

Copyright

Contents

List of Contributors

Introduction

PART 1 -Psychopathologylater in life

CHAPTER 1Assessment of Depression andBereavement in Older Adults

EPIDEMIOLOGY OF LATE-LIFE DEPRESSION

CONCEPTUAL APPROACHES TO ASSESSMENT

DEFINITION AND DIAGNOSTIC ISSUES

DEPRESSION ASSESSMENT INSTRUMENTS

EPIDEMIOLOGY OF BEREAVEMENT

DEFINITION AND DIAGNOSTIC ISSUES

BEREAVEMENT ASSESSMENT INSTRUMENTS

CONCLUSION

References

CHAPTER 2Assessment of Anxiety in Older Adults

EPIDEMIOLOGICAL CONSIDERATIONS

SPECIAL CONSIDERATIONS

FACTORS INFLUENCING ANXIETY ASSESSMENT IN THE ELDERLY

CLINICAL UTILITY OF INSTRUMENTS TO ASSESS ANXIETY IN OLDERADULTS

MULTICULTURAL ISSUES IN ANXIETY ASSESSMENT IN THE ELDERLY

CLINICAL ILLUSTRATIONS

References

CHAPTER 3Psychotherapy with Older Adults: The Importance of Assessment

RESEARCH AND PSYCHOTHERAPY

WHY ASSESS BASELINE FUNCTIONING AND OUTCOMES?

PSYCHOTHERAPY MEASURES

A MODEL OF OLDER ADULTS IN PSYCHOTHERAPY

CAREGIVERS

TESTING IN DIFFERENT SETTINGS

CULTURAL DIVERSITY AND ASSESSMENT

CONCLUSION

SHORT FORM HEALTH SURVEY (SF-36)

UNIVERSITY OF RHODE ISLAND CHANGE ASSESSMENT

CLINICAL INSIGHT RATING SCALE

BASIS-32 (BEHAVIOR AND SYMPTOM IDENTIFICATION SCALE)

WORKING ALLIANCE INVENTORY

References

CHAPTER 4Assessment of Personality Disorders in Older Adults

OVERVIEW

DEFINITIONAL ISSUES

EPIDEMIOLOGY OF PERSONALITY DISORDERS

STABILITY AND CHANGE

PSYCHOMETRIC CONCERNS IN LATER LIFE

APPROACHES TO ASSESSMENT OF PERSONALITY DISORDERS

SUMMARY AND CONCLUSIONS

APPENDIX A: MULTI-SOURCE ASSESSMENT OF PERSONALITYPATHOLOGY (MAPP)

APPENDIX B: GERONTOLOGICAL PERSONALITY DISORDERS SCALE (GPS)

References

CHAPTER 5Assessing Psychosis in Acute and Chronic Mentally Ill Older Adults

INTRODUCTION

GENERAL ASSESSMENT CONSIDERATIONS

SCHIZOPHRENIA AND DELUSIONAL DISORDERS

BIPOLAR DISORDER AND PSYCHOTIC DEPRESSION

ASSESSMENT OF PSYCHOSIS IN DEMENTIA

CONCLUSION

POSITIVE AND NEGATIVE SYNDROME SCALE (PANSS)

ACKNOWLEDGEMENTS

References

CHAPTER 6Dementia Syndromes in the Older Adult

DEMENTIA

DESCRIPTION OF COGNITIVE DOMAINS

TYPES OF DEMENTING DISORDERS

STANDARD USES AND GOALS OF ASSESSMENT

TREATMENT

ROLE OF FOLLOW-UP ASSESSMENT

CONCLUSION

References

CHAPTER 7Delirium Assessment in Older Adults

HISTORY OF DELIRIUM AS A CLINICAL CONCEPT

EPIDEMIOLOGY

ETIOLOGY/RISK FACTORS

CLINICAL FEATURES

THE IMPORTANCE OF ASSESSING DELIRIUM

DIAGNOSTIC CRITERIA

REVIEW OF DELIRIUM ASSESSMENT MEASURES

CASE STUDIES

PSYCHOSOCIAL INTERVENTIONS

CONCLUSION

APPENDIX A: MEMORIAL DELIRIUM ASSESSMENT SCALE (MDAS)

REFERENCES

CHAPTER 8Assessment of Cognitive Training

INTRODUCTION

TOOLS AND TECHNIQUES FOR INITIAL ASSESSMENT OF MEMORY ANDCOGNITION IN LATE ADULTHOOD

DIAGNOSTIC ISSUES

COGNITIVE TRAINING PROGRAMS AND INTERVENTIONS

MEMORY TRAINING TECHNIQUES

MEMORY AND COGNITIVE ASSESSMENT AND INTERVENTIONS IN DIVERSEPOPULATIONS

USE OF REASSESSMENT IN CLINICAL WORK

CLINICAL CASE STUDY

CONCLUSION

References

CHAPTER 9The Assessment of Elder Abuse

INTRODUCTION AND HISTORY

DEFINITIONS AND SCOPE OF THE PROBLEM

EPIDEMIOLOGY OF THE PROBLEM—WHAT WE KNOW AND WHAT WE DON’TKNOW

CLINICAL SEQUELAE OF ELDER ABUSE AND NEGLECT

SCREENING FOR ELDER ABUSE

SPECIAL ISSUES

CONCLUSION AND FUTURE DIRECTIONS

APPENDIX A

APPENDIX B

APPENDIX C

APPENDIX D

ELDER ABUSE SCREENING TEST

References

CHAPTER 10Assessment of Dementia Family Caregivers

BACKGROUND ON ASSESSMENT

ASSESSMENT STRATEGY AND PROPOSED MEASURES

ASSESSING CONTEXTUAL VARIABLES: THE FAMILY UNIT AND SOCIALSUPPORT

THE PRACTICE OF ASSESSMENT

CONCLUSION

CASE STUDIES

APPENDIX A: ZARIT BURDEN INTERVIEW-12

APPENDIX B: CAREGIVER ASSESSMENT OF FUNCTION AND UPSET (CAFU)

APPENDIX C: POSITIVE ASPECTS OF CAREGIVING

References

CHAPTER 11Assessment with Late-Life Families: Issues and Instruments

INTRODUCTION

RATIONALE FOR A CHAPTER ON FAMILY ASSESSMENT

DIVERSITY IN LATE-LIFE FAMILIES

OTHER RELEVANT DEMOGRAPHIC AND SOCIAL TRENDS

KEY ASSESSMENT ISSUES

ASPECTS OF FAMILY FUNCTIONING

ASSESSMENT INSTRUMENTS

CONCLUSION

APPENDIX A:FAMILY ASSESSMENT DEVICE

INSTRUCTIONS:

APPENDIX B:

CHECKLIST OF FAMILY RELATIONAL ABILITIES

REFERENCES

PART 2 - Behavioral Disorders

CHAPTER 12Screening, Assessing and Intervening for Alcohol and Medication Misuse in Older Adults

INTRODUCTION

PREVALENCE OF ALCOHOL AND DRUG USE/MISUSE/ABUSE

MENTAL AND PHYSICAL HEALTH RISKS ASSOCIATEDWITH USE/MISUSE/ABUSE

DEFINITIONS OF SUBSTANCE USE RISK IN OLDER ADULTHOOD

SCREENING: ASKING THE FIRST QUESTIONS

BROAD-BASED ASSESSMENT OF ALCOHOL PROBLEMSIN OLDER ADULTS

SCREENING AND ASSESSMENT FOR PHYSICAL, MENTAL,AND FUNCTIONAL HEALTH

CULTURAL ISSUES IN SCREENING AND ASSESSMENT

SUMMARY

REFERENCES

CHAPTER 13Assessment and Conceptualization of SexualitynbspAmong Older Adults

INTRODUCTION

OLDER ADULT SEXUALITY AND CURRENT TIMES

WOMEN, AGING, AND FACTORS AFFECTING SEXUAL FUNCTIONING

MEN, AGING, AND FACTORS AFFECTING SEXUAL FUNCTIONING

RECENT ADVANCES IN PHARMACOTHERAPY FOR SEXUAL DISORDERS

DIVERSITY AND MULTICULTURAL CONSIDERATIONS IN OLDER ADULTS

INITIAL STAGES OF ASSESSMENT

DEATH, DYING, AND SEXUALITY IN OLDER ADULTS

ASSESSMENT TOOLS AND GUIDELINES

References

CHAPTER 14Nutrition in the Elderly

INTRODUCTION

PHYSIOLOGICAL CHANGES ASSOCIATED WITH AGING

NUTRITION RECOMMENDATIONS FOR OLDER AMERICANS

NUTRITIONAL ASSESSMENT FOR THE ELDERLY

AGING AND CHRONIC DISEASE STATES

MEDICATIONS THAT AFFECT APPETITE AND FOOD INTAKE

DIVERSITY ISSUES THAT IMPACT THE NUTRITION STATUS

CONCLUSION

REFERENCES

CHAPTER 15Assessment of Agitation innbspOlder Adults

INTRODUCTION

WHY ASSESS AGITATION?

AVAILABLE METHODOLOGIES FOR THE ASSESSMENT OF AGITATION

UTILIZING ASSESSMENTS IN CLINICAL SITUATIONS

INFLUENCE OF SETTING ON AGITATION AND ITS ASSESSMENT

MULTICULTURAL ISSUES

SUMMARY

REFERENCES

CHAPTER 16Assessing Sleep Problems of Older Adults

INTRODUCTION

THE STRUCTURE OF SLEEP FOR OLDER ADULTS

CAUSES OF SLEEP DISTURBANCE

SLEEP ASSESSMENT: MEASURES, METHODS, AND STRATEGY

APPENDIX A

APPENDIX B

APPENDIX C

References

CHAPTER 17Treatment Adherence in Late-Life

INTRODUCTION

RATES OF TREATMENT ADHERENCE

FACTORS INFLUENCING ADHERENCE

MEASURING MEDICATION ADHERENCE

INTERVENTIONS

CONCLUSIONS

References

PART 3 -Cognition

CHAPTER 18Geriatric Neuropsychological Assessment

INTRODUCTION

CONTEXTS AND PURPOSES OF GERIATRIC NEUROPSYCHOLOGICALASSESSMENT

PRACTICAL CONSIDERATIONS IN THE ASSESSMENT OF OLDER ADULTS

AVAILABILITY OF NORMATIVE DATA FOR OLDER ADULTS

CLINICAL CONSIDERATIONS IN ASSESSING THE OLDER ADULT

MEASURES FOR ASSESSING NEUROPSYCHOLOGICAL FUNCTIONING INOLDER ADULTS

CONTEMPORARY ISSUES IN GERIATRIC NEUROPSYCHOLOGY

SUMMARY

References

CHAPTER 19Screening Instruments and Brief Batteries for Dementia

INTRODUCTION

SCREENING FOR DEMENTIAdTHE LEGACY OF THE MMSE

BRIEF BATTERIES

CHALLENGES TO THE STANDARD APPROACH

APPENDIX

REFERENCES

CHAPTER 20Cognitive Assessment in Late Stage Dementia

INTRODUCTION

PROBLEMS IN ASSESSING COGNITION IN LATE STAGE DEMENTIA

MEETING THE CHALLENGE: INTERVENTION MODELS

SUMMARY AND CONCLUSIONS

ACKNOWLEDGMENTS

REFERENCES

CHAPTER 21Assessing the Personal Preferences of Persons with Dementia

INTRODUCTION

INCIDENCE OF DEMENTIA AND OTHER COGNITIVE IMPAIRING CONDITIONS

EARLY DIAGNOSIS OF DEMENTIA: CHALLENGES AND OPPORTUNITIES

UNDERSTANDING PREFERENCES AND DECISION MAKINGFOR EARLY-STAGE FAMILIES

INSTRUMENTS THAT ASSESS PERSONAL PREFERENCESAND DESIRES

DO PREFERENCES FOR CARE VARY ACROSS DIFFERENT POPULATIONS?

ENHANCING DECISION-MAKING AND UNDERSTANDING OF PERSONALPREFERENCES IN DEMENTIA

REASSESSMENT OF CARE VALUES AND PREFERENCES AND A LOOK TO THE FUTURE

WHERE DO WE GO FROM HERE?

ACKNOWLEDGMENTS

APPENDIX A: VALUES AND PREFERENCES SCALE (VPS)

APPENDIX B: PREFERENCES FOR CARE TASKS (PCT) WORKSHEET &MAGNET BOARD LAYOUT

References

PART 4 -Everyday Functioning

CHAPTER 22Assessment of Capacity

INTRODUCTION

WHAT IS CAPACITY?

CLINICAL EVALUATIONS OF CAPACITY

ADVANCES IN CAPACITY ASSESSMENT

A PROCESS FOR CAPACITY ASSESSMENT

SPECIAL ISSUES IN CAPACITY ASSESSMENT

FUTURE DIRECTIONS

APPENDIX A: QUESTIONS TO ADD TO A CLINICAL INTERVIEW

APPENDIX B: INTERVENTIONS TO ADDRESS DIMINISHED CAPACITY

APPENDIX C: CAPACITY ASSESSMENT TOOLS

APPENDIX D: CAPACITY WORKSHEET FOR PSYCHOLOGISTS

ACKNOWLEDGMENTS

REFERENCES

CHAPTER 23Household and Neighborhood Safety, Mobility

INTRODUCTION

FALLS AND BALANCE ASSESSMENTS

HOME SAFETY ASSESSMENTS

NEIGHBORHOOD SAFETY AND MOBILITY ASSESSMENTS

CONCLUSION

REFERENCES

CHAPTER 24Pain Assessment and Management in Older Adults

INTRODUCTION

NEUROCOGNITION AND NOCICEPTION

THE PAIN EXPERIENCE

CLINICAL PRACTICE GUIDELINES

CONCLUDING REMARKS

APPENDIX A: PAIN SELF-EFFICACY QUESTIONNAIRE (PSEQ)*

APPENDIX B: PAIN CATASTROPHIZING SCALE*

APPENDIX C: PAIN DISABILITY INDEX*

REFERENCES

CHAPTER 25Assessments in Driver Rehabilitation

INTRODUCTION

OLDER DRIVERS AS A GROUP

DRIVER REHABILITATION TEAM AND KEY SERVICES

SELF-ASSESSMENTS THAT CAN HELP TO SCREEN DRIVER READINESS

HOME-BASED DRIVING SELF-ASSESSMENT TOOLS

CLINICAL-BASED SCREENING TOOLS FOR DRIVING FITNESS

THE DRIVER REHABILITATION CLINICAL EVALUATION

PHYSICAL ASSESSMENT

THE ROLE OF VISION IN THE OPERATION OF A MOTOR VEHICLE

COGNITIVE SKILLS

DRIVING KNOWLEDGE

APPENDIX A: ASSESSMENTS THAT COMPRISE THE DRIVERREHABILITATION CLINICAL ASSESSMENT

APPENDIX B: INSTRUCTIONS FOR THE TRAIL MAKING TEST PARTS A AND B

APPENDIX C: GUIDELINES FOR MOTOR VEHICLE ADMINISTRATORS:LICENSE RENEWAL REQUIREMENTS

APPENDIX D: STATE OF MICHIGAN’S DRIVER LICENSING REQUIREMENTSAND REPORTING LAWS

APPENDIX E: LICENSING REQUIREMENTS

REFERENCES

Index