Older Adults

  • Roger L. Patterson
  • Larry W. Dupree

Abstract

Interviewing older adults is often associated with some type of assessment of the individuals or their situations or both. Frequently encountered objectives usually include the determination of one or more of the following: (1) cognitive functioning, (2) emotional status, (3) need for resources, and (4) ability to utilize objects, materials, and resources in order to function successfully in required activities of daily living (ADLs). This chapter will present a type of interview involving an assessment that both simplifies and improves on this process. The method to be explained and illustrated uses the Behavioral Interview (BI) techniques developed by Pascal and Jenkins (1961) combined with a focus on problems that are widely recognized to be prevalent in elderly populations. Their interview method achieves its usefulness by seeking to determine the way an older adult interacts with his or her personal social and material environment so as to maintain (or fail to maintain) a desirable level of functioning. In contrast, most other approaches have sought to measure resource availability and abilities of the individual as separate entities. The authors seek to make the case that discovering the unique way the particular person interacts with his or her own environment can provide much more direct information regarding strengths and deficits in the person—environment system.

Keywords

Mental Health Leisure Activity Cognitive Distortion Daily Living Skill Mental Health Counseling 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. American Psychiatric Association (1980). Diagnostic and statistical manual of mental disorders, 3rd ed. Washington, DC: Author.Google Scholar
  2. American Psychiatric Association (1987). Diagnostic and statistical manual of mental disorders, 3rd ed., revised. Washington, DC: Author.Google Scholar
  3. American Psychiatric Association (1993). Diagnostic and statistical manual of mental disorders, 4th ed., draft criteria. Washington, DC: Author.Google Scholar
  4. Baltes, M. M., & Barton, E. M. (1977). New approaches toward aging: A case for the operating model. Educational Gerontology, 2, 383–405.CrossRefGoogle Scholar
  5. Benedict, K. B., & Nacoste, D. B. (1990). Dementia and depression in the elderly: A framework for addressing difficulties in the differential diagnosis. Clinical Psychology Review, 10, 513–537.CrossRefGoogle Scholar
  6. Berkman, L. E, Berkman, C. S., Kasl, S., Freeman, D. H., Leo, L., Ostfeld, A. M., Cornoni-Huntley, J., & Brody, J. A. (1986). Depressive symptoms in relation to physical health and functioning in the elderly. American Journal of Epidemiology, 124, 372–387.PubMedGoogle Scholar
  7. Bernstein, L. O. (1990). A special service: Counseling the individual elderly client. Generations, 14, 35–38.Google Scholar
  8. Blazer, D. (1978). Techniques for communicating with your elderly patient. Geriatrics, 33, 79–84.PubMedGoogle Scholar
  9. Blazer, D. G., Hughes, D. C., & George, L. K. (1987). The epidemiology of depression in an elderly community population. Gerontologist, 27, 281–287.PubMedCrossRefGoogle Scholar
  10. Butler, R. N. (1969). Age-ism: Another form of bigotry. The Gerontologist, 9, 243–246.PubMedCrossRefGoogle Scholar
  11. Butler, R. N. (1980). Ageism: A foreword. Journal of Social Issues, 36, 8–11.CrossRefGoogle Scholar
  12. Butler, R. N., & Lewis, M. I. (1977). Aging and mental health, 2d ed. St. Louis: C. V. Mosby.Google Scholar
  13. Chacko, R. C. (1982). Diagnostic dilemmas in geriatric psychiatry. The Gerontologist, 22(5), 240.Google Scholar
  14. Chandler, M. H. H. (1989). Teaching interview techniques utilizing an instructional videotape. Educational Gerontology, 15, 377–383.CrossRefGoogle Scholar
  15. Czirr, R., & Gallagher, D. (1984). Assessing depression in older adults. In P. A. Keller & L. G. Ritt (Eds.), Innovations in clinical practice: A source book, Vol. III. Sarasota, FL: Professional Resource Exchange.Google Scholar
  16. DeNelsky, G., & Boat, B. (1986). A coping skills model of psychological diagnosis and treatment. Professional Psychology: Research and Practice, 17, 322–330.CrossRefGoogle Scholar
  17. Dupree, L. W, O’Sullivan, M. J., & Patterson, R. L. (1982). Problems relating to aging: Rationale for a behavioral approach. In R. L. Patterson, L. W. Dupree, D. A. Eberly, G. M. Jackson, M. J. O’Sullivan, L. A. Penner, & C. D. Kelly (Eds.), Overcoming deficits of aging (pp. 7–21). New York: Plenum Press.CrossRefGoogle Scholar
  18. Exum, H. A. (1980). Cultural diverse elderly: An overview of the issues. In C. J. Pulvino & N. Colangelo (Eds.), Counseling for the growing years: 65 and over (pp. 197–217). Minneapolis: Educational Media Corporation.Google Scholar
  19. Fillenbaum, G. G. (1988). Multidimensional functional assessment of older adults: The Duke older Americans resources and services procedures. Hillsdale, NJ: Lawrence Erlbaum Associates.Google Scholar
  20. Finney, J., Moos, R., & Brennan, P. (1991). The drinking problems index: A measure to assess alcoholrelated problems among older adults. Journal of Substance Abuse, 3, 395–404.PubMedCrossRefGoogle Scholar
  21. Fleiss, J., Gurland, B., & Des Roche, P. (1976). Distinctions between organic brain syndrome and functional disorders: Based on the Geriatric Mental State Interview International Journal of Aging and Human Development, 7, 323–330.PubMedCrossRefGoogle Scholar
  22. Folstein, M. F, Folstein, S. E., & McHugh, P. R. (1975). Mini-mental State: A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 189–198.PubMedCrossRefGoogle Scholar
  23. Friday, J. C. (Ed.) (1986). Geriatric mental health: Assessing and improving the performance of personnel. Available from Southern Regional Education Board, 592 Tenth Street N.W., Atlanta, GA 30318–5790.Google Scholar
  24. Gaitz, C. M. (1969). Functional assessment of the suspected mentally ill aged. Journal of the American Geriatrics Society, 17, 541–548.PubMedGoogle Scholar
  25. Gaitz, C. M., & Baer, P. E. (1970). Diagnostic assessment of the elderly: A multifunctional model. The Gerontologist, 10, 47–52.PubMedCrossRefGoogle Scholar
  26. Gallagher, D., Thompson, L. W, & Levy, S. M. (1980). Clinical psychological assessment of older adults. In L. W. Poon (Ed.), Aging in the 1980’s (pp. 19–40). Washington, DC: American Psychological Association.Google Scholar
  27. Ganote, S. (1990). A look at counseling in long-term-care settings. Generations, 14, 31–34.Google Scholar
  28. Gatz, M., & Hurwicz, M. L. (1990). Are old people more depressed? Cross section data on Center for Epidemiological Studies depression scale factor. Psychology of Aging, 5, 284–290.CrossRefGoogle Scholar
  29. Gatz, M., & Pearson, C. (1988). Ageism revised and the provision of psychological services. American Psychologist, 43, 184–188.PubMedCrossRefGoogle Scholar
  30. Goodstein, R. K. (1980). The diagnosis and treatment of elderly patients: Some practical guidelines. Hospital and Community Psychiatry, 31, 19–24.PubMedGoogle Scholar
  31. Graham, K. (1986). Identifying and measuring alcohol abuse among the elderly: Serious problems with existing instrumentation. Journal of Studies on Alcohol, 47, 322–326.PubMedGoogle Scholar
  32. Gurland, B. J. (1973). A broad clinical assessment of psychopathology in the aged. In C. Eisdorfer & M. P. Lawton (Eds.), The psychology of adult development and aging (pp. 343–377). Washington, DC: American Psychological Association.Google Scholar
  33. Gurland, B. J., Fleiss, J. L., Cooper, J. E., Sharpe, L., Kendell, R. E., & Roberts, P. (1970). Cross-national study of diagnosis of mental disorders: Hospital diagnosis and hospital patients in New York and London. Comprehensive Psychiatry, 11, 18–25.PubMedCrossRefGoogle Scholar
  34. Gurland, B. J., Fleiss, J. L., Goldberg, K., Sharpe, L., Copeland, J. R. M., Kelleher, M. J., & Kellett, J. M. (1976). A semi-structured clinical interview for the assessment of diagnosis and mental state in the elderly: The Geriatric Mental State Schedule. II. A factor analysis. Psychological Medicine, 6, 451–459.PubMedCrossRefGoogle Scholar
  35. Gurland, B., Kuriansky, J., Sharpe, L., Simon, R., Stiller, P., & Birkett, P. (1977/1978). The comprehensive assessment and referral evaluation (CARE)-rationale, development and reliability. International Journal of Aging and Human Development, 8, 9–42.Google Scholar
  36. Hittner, A., & Bornstein, H. (1990). Group counseling with older adults: Coping with late-onset hearing impairment. Journal of Mental Health Counseling, 12, 332–341.Google Scholar
  37. Hoyer, W. J. (1973). Application of operant techniques to the modification of elderly behavior. The Gerontologist, 22, 240.Google Scholar
  38. Kahn, R. L., & Miller, N. E. (1978). Assessment of altered brain function in the aged. In M. Storandt, I. Siegler, & M. Elias (Eds.), Clinical psychology of aging. New York: Plenum Press.Google Scholar
  39. Kane, R. L., Ouslander, J. G., & Abrass, I. B. (1989). Essentials of Clinical Geriatrics. New York: McGraw Hill.Google Scholar
  40. Kaszniak, A. W. (1990). Psychological assessment of the aging individual. In J. E. Birren & K. W. Schaie (Eds.), Handbook of the psychology of aging (pp. 427–445). San Diego: Academic Press.Google Scholar
  41. Kimmel, D. (1988). Ageism, psychology, and public policy. American Psychologist, 45, 175–178.CrossRefGoogle Scholar
  42. Kinsey, A. C., Pomeroy, W, & Martin, C. (1948). Sexual behavior in the human male. Philadelphia: W. B. Saunders.Google Scholar
  43. Knight, B. (1986). Psychotherapy with older adults. Newbury Park, CA: Sage Publications.Google Scholar
  44. Lankford, D. A., & Herman, S. H. (1978). Behavioral geriatrics: A critical review. Summary of paper presented at the Nova Behavioral Conference on Aging, Port St. Lucie, Florida.Google Scholar
  45. Lawton, M. P. (1970). Assessment, integration, and environments for the older people. The Gerontologist, 10, 38–46.PubMedCrossRefGoogle Scholar
  46. Lawton, M. P. (1972). Assessing the competence of older people. In D. P. Kent, R. Kastenbaum, & S. Sherwood (Eds.), Research planning and action for the elderly. New York: Behavioral Publications.Google Scholar
  47. Lawton, M. P. (1978, October). What is the good life for aging? Kesten Lecture, University of Southern California, Ethel Percy Andrus Gerontology Center.Google Scholar
  48. Lawton, M. P. (1986). Functional assessment. In L. Teri & P. M. Lewinsohn (Eds.), Geropsychological Assessment and Treatment (pp. 39–84). New York: Springer.Google Scholar
  49. Lawton, M. P., Moss, M. S., Fulcomer, M., & Kleban, M. H. (1982). A research and service oriented multi-level assessment instrument. Journal of Gerontology, 37, 91–99.PubMedCrossRefGoogle Scholar
  50. Lawton, M. P., Whelihan, W. M., & Belsky, J. K. (1980). Personality tests and their uses with older adults. In J. Birren & R. B. Sloane (Eds.), Handbook of mental health and aging (pp. 537–553). Englewood Cliffs, NJ: Prentice-Hall.Google Scholar
  51. London, J., & Behncke, C. M. (1987). Intergenerational communication skills. In H. S. Briggs (Ed.), Teaching aging: A series of training modules on aging for educators (pp. III-1–III-28). Tampa: Human Resource Institute, Center for Applied Gerontology, University of South Florida.Google Scholar
  52. Mahoney, M. J. (1975). The sensitive scientists in empirical humanism. American Psychologist, 30, 864–867.CrossRefGoogle Scholar
  53. McEvoy, C., & Patterson, R. (1986). Behavioral treatment of deficit skills in dementia patients. Gerontologist, 26, 475–478.PubMedCrossRefGoogle Scholar
  54. Meeks, S. (1990). Age bias in the diagnostic decision-making behavior of clinicians. Professional Psychology: Research and Practice, 21, 279–284.CrossRefGoogle Scholar
  55. Miller, L. (1979). Toward a classification of aging behaviors. The Gerontologist, 19(3), 282–289.CrossRefGoogle Scholar
  56. Myers, J. E. (1990). Aging: An overview for mental health counselors. Journal of Mental Health Counseling, 12, 245–259.Google Scholar
  57. Palmore, E. (1990). Ageism: Negative and positive. New York: Springer.Google Scholar
  58. Pascal, G. R., & Jenkins, W. O. (1961). Systematic observation of gross human behavior. New York: Grune & Stratton.Google Scholar
  59. Patterson, R. L. (1985). Senile dementias. In R. J. Daitzmann (Ed.), Diagnosis and intervention in behavior therapy and behavioral medicine. New York: Springer.Google Scholar
  60. Patterson, R. L. (1992). Psychogeriatric rehabilitation. In R. P. Liberman (Ed.), Handbook of psychiatric rehabilitation. New York: Macmillan.Google Scholar
  61. Patterson, R. L., & Eberly, D. A. (1983). Social and daily living skills. In P. M. Lewinsohn and L. Teri (Eds.), Clinical geropsychology (pp. 116–138). New York: Pergamon Press.Google Scholar
  62. Patterson, R. L., & Jackson, G. M. (1980a). Behavior modification with the elderly. In M. M. Hersen, R. M. Eisler, and P. Miller (Eds.), Progress in behavior modification, Vol. 9 (pp. 205–239). New York: Academic Press.Google Scholar
  63. Patterson, R. L., & Jackson, G. M. (1980b). Behavioral approaches to gerontology. In M. L. Michelson, M. Hersen, and S. M. Turner (Eds.), Future perspectives in behavior therapy (pp. 295–315). New York: Plenum Press.Google Scholar
  64. Patterson, R. L., Dupree, L. W, Eberly, D. A., Jackson, G. M., O’Sullivan, M. J., Penner, L. A., & DeeKelly, C. (1982). Overcoming deficits of aging: A behavioral approach. New York: Plenum Press.CrossRefGoogle Scholar
  65. Pfeiffer, E. (1975). Functional assessment: The OARS Multidimensional Functional Assessment Questionnaire. Durham, NC: Duke University Center for the Study of Aging and Human Development.Google Scholar
  66. Pfeiffer, E. (1980). The psychosocial evaluation of the elderly patient. In E. W. Busse and D. G. Blazer (Eds.), Handbook of geriatric psychiatry (pp. 275–284). New York: Van Nostrand Reinhold.Google Scholar
  67. Pfeiffer, E., Johnson, T., & Chiofolo, R. (1981). Functional assessment of elderly subjects in four service settings. Journal of the American Geriatrics Society, 29, 433.PubMedGoogle Scholar
  68. Pinkston, E. M., & Linsk, N. L. (1984). Care of the elderly: A family approach. Elmsford, NY: Pergamon Press.Google Scholar
  69. Portnoi, V. A. (1982). Underrepresentation of geriatric mental health disorders in DSM-III: Need for revision. The Gerontologist, 22(5), 239.Google Scholar
  70. Rebok, G. W, & Hoyer, W. J. (1977). The functional context of elderly behavior. The Gerontologist, 17, 27–34.PubMedCrossRefGoogle Scholar
  71. Robison, F. F, Smaby, M. H., & Donovan, G. L. (1989). Influencing reluctant elderly clients to participate in mental health counseling. Journal of Mental Health Counseling, 11, 259–272.Google Scholar
  72. Salmon, H. E. (1987). Counseling older people. In G. Lesnoff-Caravaglia (Ed.), Handbook of applied gerontology (pp. 231–248). New York: Human Sciences Press.Google Scholar
  73. Schaie, K. W. (1988). Ageism in psychological research. American Psychologist, 43, 179–183.PubMedCrossRefGoogle Scholar
  74. Sundberg, N. D., Snowden, L. R., & Reynolds, W. M. (1978).Toward assessment of personal competence and incompetence in life situations. Annual Review of Psychology, 29, 179–221.PubMedCrossRefGoogle Scholar
  75. Supiano, K. P. (1980). The counseling needs of elderly nursing home residents. In C. J. Pulvino and N. Colangelo (Eds.), Counseling for the growing years: 65 and over (pp. 233–246). Minneapolis: Educational Media Corporation.Google Scholar
  76. Tobin, S. S., & Gustafson, J. D. (1987). What do we do differently with elderly clients? Journal of Gerontological Social Work, 10, 107–121.CrossRefGoogle Scholar
  77. Waters, E. B. (1984). Building on what you know: Techniques for individual and group counseling with older people. The Counseling Psychologist, 12, 63–74.CrossRefGoogle Scholar
  78. Waters, E., McCarroll, J., & Penman, N. (1987). Training mental health workers for the elderly: An instructor’s guide. Rochester, MI: Continuum Center, Oakland University.Google Scholar
  79. Whelihan, W. (1979). Dynamics of the team interaction in geriatric assessment. Paper presented at the Conference on Geriatric Assessment, VA Medical Center, St. Louis.Google Scholar
  80. Wilber, K. H., & Zarit, S. H. (1987). Practicum training in gerontological counseling. Educational Gerontology, 13, 15–32.CrossRefGoogle Scholar
  81. Witherspoon, A., deValera, E., Jenkins, W, & Sanford, W. (1973). Behavioral interview guide. Montgomery, AL: Rehabilitation Research Foundation.Google Scholar
  82. Zarit, S. H., & Zarit, J. M. (1983). Cognitive impairment of older persons: Etiology, evaluation, and intervention. In P. M. Lewinsohn & L. Teri (Eds.), Coping and adaptation in the elderly. New York: Pergamon Press.Google Scholar

Copyright information

© Springer Science+Business Media New York 1994

Authors and Affiliations

  • Roger L. Patterson
    • 1
  • Larry W. Dupree
    • 2
  1. 1.Department of Veterans AffairsWilliam V. Chappell Jr. Outpatient ClinicDaytona BeachUSA
  2. 2.Florida Mental Health InstituteUniversity of South FloridaTampaUSA

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