Functional Independence of Community-Dwelling Older Adults in China and South Korea

ABSTRACT

Population aging is occurring at an unprecedented pace in China and South Korea. This study intended to identify and compare factors associated with older adults’ functional status in China and South Korea using data from 2 national surveys. The study sample consisted of adults aged 65 to 79 years old drawn from the Chinese Longitudinal Healthy Longevity Survey (2005; n = 4,898) and the Korean Longitudinal Study on Aging (2006; n = 4,152). The outcome variable, functional status, was defined as dependence in self-care tasks. Stepwise multiple regression analysis was used to assess the explanatory contributions of sociodemographics, health conditions, and health behaviors and activities to functional status. These Asian older adults shared certain commonalities in maintaining functional independence in their communities, and absence of diseases and higher cognition were associated with functional independence in both countries. Rural residence and outdoor activity were significant for Chinese older adults; for their South Korean peers, gender, employment status, drinking, and exercise were important. This study adds to a slowly growing body of knowledge of ways to improve the functional independence of community-dwelling older persons in these 2 Asian countries and beyond. More research is needed to identify cross-cultural and/or cross-country differences.     

Impact of older adults' mobility and social participation on life satisfaction in South Korea

South Korea has been experiencing rapid population aging. In an aging society, the need for healthy lives is greater. Two of the fundamental factors to enable independent and active life for the elderly are mobility and social participation. The purpose of this study was to examine the relationship between older adults’ mobility, social participation, and quality of life in South Korea. We used data from the 2017 National Survey of Older Koreans conducted by the Ministry of Health and Welfare and the Korea Institute for Health and Social Affairs and applied hierarchical regression. The major finding was that older adults’ mobility had a positive impact on their life satisfaction. After controlling for older adults’ mobility, social participation was positively associated with life satisfaction regardless of the place of residence. The findings of this study not only make a valuable contribution to further research on mobility and social participation but also provide new insight into improving older adults’ quality of life.     

Loneliness in senior housing communities

There are many studies on loneliness among community-dwelling older adults; however, there is limited research examining the extent and correlates of loneliness among older adults who reside in senior housing communities. This study examines the extent and correlates of loneliness in three public senior housing communities in the St. Louis area. Data for this project was collected with survey questionnaires with a total sample size of 148 respondents. Loneliness was measured using the Hughes 3-item loneliness scale. Additionally, the questionnaire contained measures on socio-demographics, health/mental health, social engagement, and social support. Missing data for the hierarchical multivariate regression models were imputed using multiple imputation methods. Results showed approximately 30.8% of the sample was not lonely, 42.7% was moderately lonely, and 26.6% was severely lonely. In the multivariate analyses, loneliness was primarily associated with depressive symptoms. Contrary to popular opinion, our study found the prevalence of loneliness was high in senior housing communities. Nevertheless, senior housing communities could be ideal locations for reducing loneliness among older adults. Interventions should focus on concomitantly addressing both an individual’s loneliness and mental health.     

Pathways to Problem Gambling in Seniors

Little is known about problem gambling in older adults, particularly when gambling problems only commence late in life. Knowledge of pathways to later life problem gambling can assist prompt and effective interventions for vulnerable older adults. This study builds on a generic Pathways Model. It proposes routes to problem gambling for individuals aged 55 years and above, with a particular focus on late-life, rather than lifetime problem gambling. Gambling-related risk and protective factors/correlates were extracted from the literature based on the extent to which the studies were senior-specific. Common themes were then identified and classified into 3 main clusters: 1 concerning individual vulnerability factors, a 2nd concerning social and environmental factors, and a 3rd concerning factors affecting behavioural regulation.     

Nonpharmacological Pain Management by Ethnically Diverse Older Adults With Chronic Pain: Barriers and Facilitators

As key players in multidisciplinary health care systems, geriatric social workers must understand the dynamics of pain management among older adults with chronic pain. This study identified perceived barriers to, and facilitators for, utilizing nonpharmacological pain management through face-to-face interviews with 44 ethnically diverse community-dwelling older adults. Constant comparative analysis identified barriers not recognized in prior studies: (a) embarrassment/self-consciousness, (b) unavailability of certain treatments, and (c) lack of faith in effectiveness of nonpharmacological treatments. Most frequently reported facilitators were (a) social support, (b) positive attitude, and (c) available resources. Social workers can provide counseling to motivate older adults to exercise to manage chronic pain and refer them to exercise programs tailored for older adults. To resolve the most frequently reported barrier—transportation—social workers can link older adults with transportation services offered by senior centers or other nonprofit agencies.     

Community Service Use by Older Adults: The Roles of Sociocultural Factors in Rural–Urban Differences

ABSTRACT

This study examined the influence of sociocultural factors in explaining the rural–urban differences in home and community-based service (HCBS) use among older adults. Survey data of 228 older adults living in Alabama were analyzed. Sociocultural factors included participants’ perceptions of service availability, attitudes toward seeking formal help, informal support, and religious behaviors. Rural older adults were less likely to use HCBS than their urban counterparts (p < .05). An interaction effect between perceived service availability and church attendance was found. These findings suggest a need for collaborations between community aging services with religious organizations to ensure existing programs are accessible to older adults living in rural areas. Future research based upon large probability samples is needed to shed more light on the relation between church attendance and service use.     

The Relationship between Public Long-Term Care Insurance Awareness and Preparation for Later Life in South Korea

An increased focus on individual preparation for later life paired with a shift in family support within South Korea makes it necessary to study factors that influence preparation for later life among South Korean adults. This study examined whether the awareness of public long-term care insurance (LTCI) was related to South Koreans' financial, psychosocial, and physical preparations for later life. Data from the third wave (2009) and third supplement wave (2010) of the Korean Retirement and Income Study (KReIS) yielded a sample of 2,487 middle-aged adults. Multiple regression analyses were used to compare the influence of the awareness of public LTCI on financial, psychosocial, and physical preparation by dividing the sample into negative status and positive status groups based on subjective perceptions of current economic, relationship, and health conditions. The results showed that being aware of public LTCI increased preparation for later life in financial, psychosocial, and physical domains. In addition, participants in the negative status group had higher scores for psychosocial and physical preparation than individuals who perceived themselves as being in relatively better situations. These findings suggest that the policy makers and practitioners should include education on LTCI and the risks it targets across various preparation domains as well as account for differences in perception and preparation among sub-populations of middle-aged adults in order to ensure effective social policies for the elderly population.     

Home modification among families with older adults with disability in Korea

Abstract

This study explores psychosocial factors related to the use of home modification among older adults with disabilities and their caregivers in Korea. Using in-depth interviews, this study elaborates specific socio-cognitive factors leading to home modification from the multiple perspectives of care recipients, family caregivers and home care helpers. The study findings are theoretically organised into four domains: structural factors, care recipients’ service needs, socio-cognitive factors, and enabling resources. Practice and policy implications are discussed in the context of underdeveloped housing policies for ageing-in-place in Korea.     

An Evidence Base for Group Work with Older Adults Living in the Community

There is a small but illuminating body of research related to group work with older adults living in the community. A broad range of interventions with diverse elderly participants have been studied internationally using qualitative and quantitative methodologies. Although scanty, the published literature informs group work practitioners on the strengths and limitations of different interventions. This article presents a critical review of 13 studies published between 1990 and 2007 to guide group work practitioners in organizing and facilitating groups for older adults in the community. Each review notes the characteristics of the participants, type of group intervention, methodology, and findings of the study. It examines the rigor, impact, and applicability of the findings to practice with this population. Much needs to be done to develop an evidence base for group work with older adults living in the community. Recommendations for practice and future research are offered.     

Learning Experiences of Older Volunteers in a Community-based Social Program for People with Dementia

Abstract

This qualitative study aimed to explore older adults’ perspectives on volunteering in an activity-based social program for community-dwelling people with dementia called Stepping Stones. Semi-structured interviews were individually conducted with eight older adults who had volunteered in Stepping Stones. Interpretative phenomenological analysis was used to analyze interview data. Four themes related to learning experiences of older volunteers in Stepping Stones emerged. These themes include (a) self-growth and confidence in working with people with dementia; (b) understanding dementia, people with dementia, and needed support for people with dementia and their families; (c) desire not to develop dementia, while recognizing that anything can happen in old age; and (d) exercising person-centered approaches and taking on advocacy roles. Findings suggest that older volunteers gain feelings of personal growth and confidence in working with people with dementia, better understanding, and enhanced attitudes toward people with dementia through volunteering in an activity-based social program for people with dementia. Older adults will be able to fill the needs of community programs for people with dementia, while experiencing benefits from volunteering and learning in later life. Further research is needed to examine to what extent having previous dementia experiences make their experiences and learning different.     

Perceptions of inequality and attitudes towards redistribution in four East Asian welfare states

This study examined the effects of perceived economic inequality and inequality of opportunity on individual preferences for redistributive policies among people in mainland China, Japan, South Korea and Taiwan. Using data from the 2009 International Social Survey Program, a series of regression analyses were performed. Results of the analyses indicate that perceived economic inequality is the most significant predictive factor of attitudes towards redistribution in all four states. Perceived inequality of opportunity was positively associated with favourable attitudes towards redistribution in mainland China and South Korea. Perceived socioeconomic status was not found to have a significant effect on attitudes towards redistribution in South Korea.     

An exploratory study of substance abuse among Latino older adults

Substance abuse among older adults is on the rise. Of particular concern is the increase in alcohol and drug use predicted among Latino elders, expected to result from an upsurge in the Latino population and concurrent growth in the number of older adults. Providing effective treatment for this group will require age-specific, culturally competent interventions. However, few studies have focused on geriatric substance abuse among Latinos. This study aims to lay the groundwork for further research by examining perceptions of the problem among treatment providers and researchers in aging and substance abuse. Implications for social work research and practice are addressed.     

"Religion is the finding thing": an evolving spirituality in late life

This paper discusses some important dimensions of faith and of the social contexts surrounding faith that are illustrative of continuity and growth in spirituality in the lives of older adults. Examples of an evolving spirituality emerge in the analysis of a recent qualitative research study that probed the nature of religious experience among thirty-one community-dwelling elders and fifteen elders residing in long-term care facilities. Face-to-face interviews with these forty-six older adults and with seven people who directed or assisted with formal and informal programs of faith comprise the empirical base for this paper. The seven people, I refer to them mnemonically as faithreps, worked in various ways in the long-term care settings to provide programs involving faith to older adults. The faithreps came from a range of educational and religious backgrounds and are not accurately or handily categorized. An evolving spirituality is shaped by the older person's links to the structural and the socio-relational contexts that have been created through interaction in the past as well as through interaction in the present. Moreover, the interaction of older adults and faithreps encourages spiritual growth because as social actors engaged with one another over a sustained period of time in an institutional setting, questions and dialogue about life and its meaning are regularly evoked. The social interactions that foster spiritual evolution may be an admixture of the secular and the sacred. Such socio-relational contexts were once part of the naturalistic settings of daily life among the old, but now must emerge through the efforts and planning of others. The salience of faith among present cohorts of older adults sensitizes us to the necessity of devoting more consideration to optimal ways of strengthening and building contexts that are conducive to the evolution of spirituality.     

Disaster Preparedness among Older Adults: Social Support,Community Participation,and Demographic Characteristics

This study examined factors associated with disaster preparedness among older adults, with special attention paid to demographic characteristics, social support, and community participation. From a larger study about disaster preparedness of persons with disabilities, a total of 719 adults aged 55 years and older were used for this study. The results of the logistic regressions indicate that individuals who have higher levels of social support and more connections to community organizations are more likely to be prepared for disaster-related emergency situations. In another model, using resource preparedness as the dependent variable, an interaction effect between social support and income was found. Overall, higher income and higher informal support are related to a higher level of resources for disaster preparedness. However, the relationship between income and disaster preparedness is much stronger for those sub-groups receiving more informal support. The findings of this study expand knowledge regarding issues of disaster preparedness among older adults and demonstrates the importance of social resources and networks. This study suggests an intervention model for decision-makers and community leaders in terms of providing information and advice to members of their communities about how to adequately prepare for natural disasters.     

Job satisfaction of social workers in senior welfare centres in South Korea: the effects of individual,client and organisational factors

This study investigates the individual, client and organisational factors that affect the job satisfaction of social workers employed by senior welfare centres in Korea. The data were collected from 130 social workers in senior welfare centres and subjected to hierarchical multiple regression analysis. The job satisfaction of social workers in senior welfare centres was influenced by their self-efficacy, positive attitude to older adults, their relationships with colleagues, and supervision. Ways to improve the job satisfaction of social workers are discussed.     

Factors Associated With Productive Engagement Among Older South Koreans

ABSTRACT

 Although positive relationships among health, types of activities, and productive aging have been documented in Western industrial nations, little attention has been paid to rapidly developing countries. This study examined unique factors using national South Korean data. Community-dwelling adults aged 55 years and older (n = 6,688) were drawn from Wave II of the Korean Longitudinal Study on Aging. Binary logistic regression analysis was conducted to identify the main and interaction effects related to labor force participation (LFP) and lifelong-learning participation (LLP). Whereas one third (34.4%) of the respondents were involved in LFP, LLP was extremely low (6.8%). Health and socioeconomic status were significant in conducting LFP and LLP. Depression and cognition contributed to LFP but not LLP. Older men who reported higher levels of depression were less likely to engage in LLP than were their female peers. For female respondents, the social activities of exercise and alumni meetings contributed to the likelihood of LLP. Given the lower socioeconomic characteristics and low participation in lifelong learning, it is essential to establish financial incentives to encourage activity participation and develop programs to promote productive aging in South Korea. Future studies should consider the impact of environments and social policy on productive engagement.     

An Exploratory Study of Substance Abuse Among Latino Older Adults

ABSTRACT

Substance abuse among older adults is on the rise. Of particular concern is the increase in alcohol and drug use predicted among Latino elders, expected to result from an upsurge in the Latino population and concurrent growth in the number of older adults. Providing effective treatment for this group will require age-specific, culturally competent interventions. However, few studies have focused on geriatric substance abuse among Latinos. This study aims to lay the groundwork for further research by examining perceptions of the problem among treatment providers and researchers in aging and substance abuse. Implications for social work research and practice are addressed.     

Impact of Geriatric Assessment and Self-Management Support on Community-Dwelling Older Adults with Chronic Illnesses

Purpose: The purpose of this study was to assess the effectiveness of interdisciplinary geriatric home-based assessment and self-management support services to community-dwelling older adults. Design: A quasi-experimental, pre-post test design tested two types of service delivery models. The first protocol included geriatric assessment services, with a brief self-management care plan intervention. The second protocol added a telephone support intervention. Results: All participants showed significant progress in improved self–efficacy, self-rated health, functional status and physical mobility (specifically lower extremity muscle strength), mental health (specifically reduced depression) and in reduced fall hazards in their physical home environment. The telephone support intervention protocol did not provide additional value to the first protocol. Implications: This study demonstrates the value of non-medical intervention strategies for community dwelling older adults with chronic illnesses.     

Unmet Needs and Depressive Symptoms Among Low-Income Older Adults

Previous studies have found that declining health, decreased social interaction, and inadequate financial resources were significant risk factors for late-life depression, and social support from families and friends and religiosity were significant protective factors. In this study, we examined if low-income older adults' perceived unmet need for home- and community-based services for many aging-associated problems would be independently associated with their depressive symptoms, controlling for these known risk and protective factors. We interviewed a total of 213 community-residing older adults to assess their depressive symptoms, using the Geriatric Depression Scale (GDS), and unmet needs in the areas of personal assistance, instrumental and environmental support, emotional support, and other facilitative/enabling services. We found that the number of unmet needs was significantly positively associated with these older adults' depressive symptoms, although it explained only a small proportion of the variance of the GDS scores. Future research and practice implications are discussed.     

Individual- and Contextual-Level Factors Affecting the Use of Social Support Services among Older Adults

ABSTRACT

By 2060, the number of Americans aged 65 and older is expected to more than double, while the number of Americans aged 85 and older is expected to nearly triple. As the nation's aging population grows, older adults will need to rely on social support services, such as transportation and housing services, in order to remain active and lead independent lives. In this study we use data collected from the elderly supplement of the Southeastern Pennsylvania Household Health Survey (SPHHS) (n = 3,042) to explore the relationship between the availability of elderly specific social service providers and utilization of social support services among older adults. We find that while the number of elderly specific social service providers can increase use of social support services among older adults, its impact is relatively minimal. We find that individual factors, instead, are stronger predictors of service use. This is a finding that should be particularly encouraging for elder care providers who may not have the resources needed to undertake large structural changes (like building new facilities). Still, future research should explore how the availability of a broader range of elderly specific social services (than explored in this study) impacts use.