Browsing by Author "Harris, Grant M."

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    Aging Prisoners' Treatment Selection: Does Prospect Theory Enhance Understanding of End-of-Life Medical Decisions?
    (Oxford University Press, 2011) Phillips, Laura L.; Allen, Rebecca S.; Harris, Grant M.; Presnell, Andrew H.; DeCoster, Jamie; Cavanaugh, Ronald; University of Alabama Tuscaloosa
    Purpose: With the rapid growth in the older inmate population and the economic impact of end-of-life treatments within the cash-strapped prison system, consideration should be given to inmate treatment preferences. We examined end-of-life treatment preferences and days of desired life for several health scenarios among male inmates incarcerated primarily for murder. Design and Methods: Inmates over the age of 45 who passed a cognitive screening completed face-to-face interviews (N = 94; mean age = 57.7; SD = 10.68). Results: We found a 3-way interaction indicating that the effect of parole expectation on desire for life-sustaining treatment varied by race/ethnicity and treatment. Minority inmates desired cardiopulmonary resuscitation or feeding tubes only if they believed that they would be paroled. The model predicting desire for palliative care was not significant. Future days of desired life were related to prospective health condition, fear of death, negative affect, and trust in prison health care. Caucasian inmates expressed a desire for more days of life out of prison, whereas minority inmates did not differ in days of desired life either in or out of prison. Minorities wanted more days of life than Caucasians but only if they believed that they would be paroled. Implications: End-of-life care for the burgeoning inmate population is costly, and active life-sustaining treatments may not be desired under certain conditions. Specifically, expectation of parole but not current functional ability interacts with future illness condition in explaining inmates' desire for active treatment or days of desired life in the future.
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    Can Senior Volunteers Deliver Reminiscence and Creative Activity Interventions? Results of the Legacy Intervention Family Enactment Randomized Controlled Trial
    (Elsevier, 2014) Allen, Rebecca S.; Harris, Grant M.; Burgio, Louis D.; Azuero, Casey B.; Miller, Leslie A.; Shin, Hae Jung; Eichorst, Morgan K.; Csikai, Ellen L.; DeCoster, Jamie; Dunn, Linda L.; Kvale, Elizabeth; Parmelee, Patricia; University of Alabama Tuscaloosa; University of Virginia; US Department of Veterans Affairs; Veterans Health Administration (VHA); Geriatric Research Education & Clinical Center
    Context. Palliative care patients and their family caregivers may have a foreshortened perspective of the time left to live, or the expectation of the patient's death in the near future. Patients and caregivers may report distress in physical, psychological, or existential/spiritual realms. Objectives. To conduct a randomized controlled trial examining the effectiveness of retired senior volunteers (RSVs) in delivering a reminiscence and creative activity intervention aimed at alleviating palliative care patient and caregiver distress. Methods. Of the 45 dyads that completed baseline assessments, 28 completed postintervention and 24 completed follow-up assessments. The intervention group received three home visits by RSVs; control group families received three supportive telephone calls by the research staff. Measures included symptom assessment and associated burden, depression, religiousness/spirituality, and meaning in life. Results. Patients in the intervention group reported a significantly greater reduction in frequency of emotional symptoms (P = 0.02) and emotional symptom bother (P = 0.04) than the control group, as well as improved spiritual functioning. Family caregivers in the intervention group were more likely than control caregivers to endorse items on the Meaning of Life Scale (P = 0.02). Only improvement in intervention patients' emotional symptom bother maintained at follow-up after discontinuing RSV contact (P = 0.024). Conclusion. Delivery of the intervention by RSVs had a positive impact on palliative care patients' emotional symptoms and burden and caregivers' meaning in life. Meaningful prolonged engagement with palliative care patients and caregivers, possibly through alternative modes of treatment delivery such as continued RSV contact, may be necessary for maintenance of therapeutic effects. (C) 2014 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.
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    Treatment of depressive symptoms in diverse, rural, and vulnerable older adults
    (Wiley, 2014) Scogin, Forrest R.; Moss, Kathryn; Harris, Grant M.; Presnell, Andrew H.; University of Alabama Tuscaloosa
    BackgroundWe examined the effects of home-delivered cognitive-behavior therapy (CBT) on depressive symptoms among rural, diverse, and vulnerable older adults. Furthermore, we differentiated depression into its two salient aspects: psychological and somatic. MethodData came from a randomized controlled experiment of CBT on 134 individuals residing in rural Alabama. ResultsCognitive-behavior therapy resulted in significantly lower depressive symptom severity scores. When depressive symptoms were categorized as psychological or somatic, CBT was found to significantly improve the former but not the latter. Notably, there was a trend toward somatic symptom improvement. ConclusionCognitive-behavior therapy can be an effective treatment for depression in a hard-to-reach group of older adults. Home delivery affords advantages but is also an expensive delivery modality. Diverse older adults responded to the CBT intervention. Copyright (c) 2013 John Wiley & Sons, Ltd.