Factors associated with depression and low life satisfaction in the low-income, frail elderl

This study examined psychosocial constructs in the lives of frail, low-income elders and assessed the level of influence these constructs had on the development of depression and life satisfaction. The sample consisted of 79 elderly (60+ years old) clients of The Alternatives Program (TAP), which provides outreach services to adults at risk for nursing home placement. Interviews were conducted in participants' homes to collect demographic data, as well as to assess cognitive status, social support, self-esteem, perceived physical health, economic resources, health locus of control, depression level, and life satisfaction. Data also were collected from participants' TAP records to validate information collected in the study interview.;Participants, on average, showed little cognitive impairment and reported good social supports and self-esteem. Elders in this sample perceived their physical health as good (22.8%) to fair (32.9%) and showed a tendency toward externally controlled beliefs about physical health. Participants also reported insufficient financial resources. Depressive symptomatology was present among 29% of the sample; however, life satisfaction was comparatively high.;Hierarchical multiple regression analyses were conducted to determine the extent to which environmental and individual constructs explained depression and life satisfaction among elders in this sample. Two identical models were developed, which indicated that social support, perceived physical health, and self-esteem accounted for a significant amount of variance in depression and life satisfaction scores. Record review data indicated that fewer than half (31%) of the elders in the sample who showed depressive symptomatology during the study interview were receiving mental health counseling. Further, among elders presenting with depressive symptomatology in the study interview, 42% reported feeling depressed to their case managers, and case managers identified 37% of these elders as depressed.;Descriptive and multivariate analyses indicated that several environmental and individual constructs were significantly associated with depression and life satisfaction among elders in this sample. The findings of this study have implications for social work policy, practice, education, and research. Among these implications is the need to develop more appropriate, community-based mental health policies and services for frail, low-income elders.