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BACKGROUND: Based on self-determination theory and adaptation theories, the study aim was to investigate the relationship between need fulfillment (of autonomy, relatedness, and competence), need importance, and depressive symptoms during the first months of living in a nursing home. METHODS: Eight-month longitudinal questionnaire study in which 75 persons newly admitted to units for physically frail residents participated at baseline. Twenty-three longitudinal participants were remaining at the third and final measurement wave. RESULTS: The results show a main effect of need fulfillment and an interaction effect of need fulfillment and need importance on depressive symptoms over time. A prototypical plot shows that residents with low need fulfillment had higher initial levels of depressive symptoms that decreased modestly over time, regardless of their need importance. Residents with high need fulfillment had lower initial levels of depressive symptoms, but their trajectories differed for participants with low and high need importance. Residents with low need importance started with lower levels of depressive symptoms but remained stable over time, whereas residents with high need importance had more depressive symptoms at T1 that decreased slightly over time. CONCLUSIONS: In general, depressive symptoms do not change over time. However, individual trajectories of depressive symptoms seem to depend on individual need fulfillment and need importance. The residents that consider need fulfillment to be highly important but experience low need fulfillment had higher initial levels of depressive symptoms that decreased modestly over time, although the level of depressive symptoms remained higher as compared to the other residents.

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OBJECTIVES: Visual media influence the general public's perceptions and attitudes regarding people with mental conditions. This qualitative study investigates the depiction accuracy of dementia's clinical features in motion pictures. METHOD: Using the search terms 'dementia', 'Alzheimer's disease' and 'senility' movies with release dates between January 2000 and March 2012 were sought on the Internet Movie Database. Based on four selection criteria 23 movies were included. Independently, three researchers watched all movies, scored symptoms, capacities, and behaviors. Scores were discussed and refined during consensus meetings, resulting in a taxonomy of clinical features. RESULTS: Various features are found, most often cognitive symptoms. Behavioral features are also shown - retiring behavior more than agitation - and various emotions, but physical symptoms are rarely depicted. Capacities are infrequently presented and are unrealistic in several of the movies. CONCLUSION: The clinical picture of dementia portrayed in fictional movies is mild and may be misleading.

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Self-reports in nursing homes generally show highly satisfied residents, whereas observational studies provide more nuanced results. In this study, which is based on self-determination theory, the perspective of nursing home residents (self-reports) is compared to the perspective of trained "neutral" observers (video-observations). The experiences of physically frail older residents are measured with regard to the fulfillment of their needs for relatedness, autonomy, and competence. Self-reports of need fulfillment in general, in the caring relationship, and during a caregiving episode recorded on videotape of 36 residents (64 % female, mean age 80 years) were compared with observer ratings of resident need fulfillment during the latter caregiving episode. Furthermore, it was investigated which measure relates best to residents' self-reported well-being. The results show that residents rate their need fulfillment higher than observers. There is weak to moderate agreement between resident and observer ratings. Furthermore, only residents' self-reported need fulfillment in general is related with self-reported well-being. Different explanations are provided, including the "barrier of happiness," the use of cognitive strategies, a change in identity and existing power relations. There seems to be a paradox in caregiving: Residents and their needs should be central, but because residents might adapt their needs and wishes it is hard to assess these. Suggestions for practical applications are given.

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OBJECTIVES: Quality of life and well-being in nursing homes are becoming more important in research and practice. Based on self-determination theory, the objective of this study is to examine the contribution of need fulfillment in the caring relationship to residents' subjective well-being. It was expected that the relation of need fulfillment in the caring relationship with well-being is mediated by need fulfillment in general. METHOD: During interviews with 88 residents of somatic nursing homes (age 50-97, mean age 78.6), perceptions of need fulfillment in the caring relationship, need fulfillment in general, and two components of subjective well-being, i.e., depressive feelings and life satisfaction, were measured. The hypotheses were tested using hierarchical multiple regression analyses and mediational analysis. RESULTS: As expected, the results indicated that need fulfillment in the caring relationship was related to lower levels of depressive feelings and more life satisfaction. Need fulfillment in general mediated the relation of need fulfillment in the caring relationship with depressive feelings. CONCLUSION: As suggested by the results, it can be concluded that high-quality caring relationships contribute to the need fulfillment of residents and their well-being. The quality of caring relationships is thus an important topic for further research. The field may especially benefit from longitudinal studies and studies that use observations of the caring relationship in addition to self-reports.

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We investigated whether adults with a parent with dementia experience their personal aging differently than adults whose parents do not have dementia. Semi-structured interviews were conducted with 25 adults who had a parent with dementia and 25 controls. We found that, although in a general sense the two groups were quite similar in their personal experiences of aging, there were specific differences. The children of parents with dementia had a health-concept in which there was substantial emphasis on mental health. Moreover, they linked the dementia of their parent to their own aging and worried about developing a dementia syndrome themselves. They also held different attitudes with regard to end-of-life decisions. Finally, participants having a parent with dementia gave more extensive answers to simple questions. This overall response suggests more involvement with growing older and finitude in the children of parents with dementia.

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