Geriatric Mental Health Disaster and Emergency Preparedness

Chapter 8 Self-Help Tools for Older Persons and Their Caregivers 145
decreased feelings of isolation and depression, decreased pain, and decreased
physician visits.
The value of self-help groups for eating disorders is not as clear, and
the level of perceived success may depend upon the goal of the group. A
self-help program with face-to-face counseling sessions has been shown
to be less effective than a structured commercial program for weight loss
in overweight and obese people (Heshka, et al., 2003). However, active
participation in an online program for the prevention of eating disorders
shows promise in predicting reduced levels of eating disorder attitudes
and behaviors (Manwaring, et al., 2008). A study of group-based lifestyle
programs on obesity management (Pettman, et al., 2008) showed improvements
in body composition and cardio-metabolic and physical fitness
that were similar to one-on-one interventions, which are more resourceintensive
to deliver. The study concluded that programs were more
successful if they included social support and self-management techniques.
SELF-CARE PROGRAMS
Many self-care programs do not rely upon group participation but involve
a person acting alone or in conjunction with a caregiver. A comprehensive
Tool Chest of assistive tools for diabetics with hearing, manual, and visual
disabilities (Bartos, et al., 2008) can be accessed privately by diabetic patients
to make them self-sufficient in their disease management. The tool
chest includes such information as where to locate blood glucose monitors,
magnifiers for syringes and pumps, injection devices, and talking label
prescriptions, as well as lists of relevant phone numbers and Web sites.
Another promising new assessment tool is the Therapy-Related Symptom
Checklist , an innovative checklist for cancer patients. A study by Williams
and colleagues (2006) suggests this checklist gives patients the opportunity
to play an important role in their own comfort care and pain management.
Users of the checklist reported it gave them a sense of structure
that helped them cope with their illnesses and treatments.
Self-rated instruments for patients suffering from mental trauma have
also been shown to be useful in disease management. Several self-report
instruments that can be used on patients with depression — for example,
the Zung Self-Rating Depression Scale (Zung, Richards, & Short, 1965)
or, with suicide ideation, the Hopelessness Scale (Beck, Weissman, Lester,
& Trexler, 1974)—are described by Valente and Saunders (2005).
Because these tools rely upon self-report, informal caregivers can easily