The Therapeutic Use of Humor With Clients Who Have Schizophrenia

A positive worker/client relationship contributes greatly to a mental health client’s achievement of intervention goals. Practitioners who work with clients who have schizophrenia sometimes face challenges in developing positive relationships with them when the cognitive impairments characteristic of that disorder make verbal communication difficult. The purpose of this article is to review the indications for using humor with clients in general and then consider the potential for practitioners to use humor as one means of developing constructive working relationships with clients who have schizophrenia. This article does not address the use of specific humor techniques, but considers whether practitioners with a natural sense of humor can use it to their advantage in working with members of this population. Seven principles for the use of humor, and seven client examples, are included.     

Music listening: its effects in creating a healing environment

Older adults face challenges in function, cognition, and isolation as they age. Nurses are responsible for providing a healing environment to promote health and well-being. Music listening is an intervention that could be used to facilitate a healing environment. This article provides examples of evidence that music can improve the healing environment for older adults, both physiologically and psychologically. Music can connect individuals with their emotions and bring about a sense of self-awareness that improves the quality of life for older adults. Music is a safe, inexpensive, and easy-to-use intervention that nurses can implement independently to help older adults cope with pain, acute confusion, and functional deficits. Examples of ways nurses can use music to provide a healing environment are also included.     

The Greatest Veneration: Humor as a Coping Strategy for the Challenges of Aging

One hundred and thirty million Traditionalists and Baby Boomers are tackling the reality of aging. It may be captured by the lyrics to the Alan Menken–Tim Rice song “A Whole New World.” The salient characteristics and experiences of these two generations are examined along with a few of the mental and physical challenges they are encountering. Then the research on and applications of humor and laughter to these challenges are reviewed. Particular attention is given to the psychological, physiological, and medical studies that have specific implications for seniors. Coping strategies to deal with daily life challenges are described in terms of detachment from crises and problem situations and coping with interpersonal conflict. The Coping Humor Scale is provided for readers to assess their own coping skills. Then a list of techniques seniors can use to improve their own coping skills, including how to search for humor opportunities, is provided. Despite the potential research-based benefits of humor and laughter, their application to the lives of seniors are not well known. Those benefits should be part of the trend toward complementary or alternative medical treatments over the past two decades. It does not get any more “alternative” than “humor.”     

Challenges to Aging in Place: Understanding Home Maintenance Difficulties

Age-related declines in capabilities may compromise older adults’ ability to maintain their homes, threatening successful aging in place. Structured interviews were conducted with 44 independently living older adults (mean age = 76.1, standard deviation = 4.7) to discuss difficult home maintenance tasks and how they managed those tasks. Solutions to managing difficulties were categorized as person-related or environment-related. The majority (85%) of responses were person-related solutions. An understanding of the specific challenges that older adults face in maintaining their homes can guide redesign efforts and interventions to effectively support older adults’ desire to age in place.     

Translating collaborative models of mental health care for older adults: using Iowa's experience to inform national efforts

The Patient Protection and Affordable Care Act supports the translation of collaborative models of mental health care, but how the act will affect older adults remains unclear. The authors examined a sample of older Medicare beneficiaries and evaluated how individual characteristics, local service supplies, and other contextual features corresponded with the identification of older persons with psychiatric diagnoses and their access to specialty mental health care providers. Older adults presented a variety of psychiatric disorders, and their access and use of specialty mental health care related to age; sex; diagnosis; supply of mental health, health, and long-term care providers; and whether an older person lived in a rural area. Translation of collaborative models should consider a range of psychiatric conditions, adjust for varying local provider supplies, and consider the challenges in establishing collaborative care within rural areas.     

Conducting Research Among Older Lesbian,Gay, and Bisexual Adults

Gerontologists and developmental researchers have neglected the study of sexual orientation among older adults. The apparent assumptions are either that it does not exist or that it is not necessary to know; consequently, older lesbian, gay, and bisexual (LGB) adults remain invisible groups with the exception of a relatively small number of studies using convenience samples. This article examines some conceptual, practical and ethical challenges involved in designing and conducting research among older LGB adults. The limitations and emphases of extant research and the challenges in conducting such research are examined. The design of two studies that focused on mental and physical health and on care-giving among older LGB adults are discussed to suggest ways of meeting the challenges.     

Atheistic, agnostic, and religious older adults on well-being and coping behaviors

Previous research reports relationships between religion and both well-being and positive coping, especially among the older adult age group. However, researchers have failed to consider the non-religious when comparing groups categorized by religious belief, ignoring possible differences between those with a belief and the non-religious, atheists, and agnostics. To explore possible differences, we gathered data from a sample of 134 religious and non-religious older adults (55 years old plus) who completed an online questionnaire assessing relationships between religiosity and well-being, social support, locus of control, and meaning in life. Belief groups, including atheists, agnostics, and those high and low on religious beliefs, were compared on coping behaviors. The religious groups did not significantly differ from atheists and agnostics on well-being, satisfaction with social support, or locus of control; however, the high religiosity group did endorse higher levels of presence of meaning in life than the atheists and a greater number of social supports compared to the non-religious groups. The groups significantly differed on their use of religious coping (p < .05), and differences approached significance on the groups utilization of humor and substances as coping mechanisms (p = .07). The religious groups endorsed religious-oriented coping at significantly greater rates, whereas the atheists endorsed a greater use of substances to cope than the other three groups. Additionally, atheists endorsed humor for coping more so than their low religiosity counterparts.     

Challenges to Aging in Place: Understanding Home Maintenance Difficulties

Age-related declines in capabilities may compromise older adults' ability to maintain their homes thus threatening successful aging in place. Structured interviews were conducted with forty-four independently living older adults (M(age) = 76.1, SD = 4.7) to discuss difficult home maintenance tasks and how they managed those tasks. Solutions to managing difficulties were categorized as person-related or environment-related. The majority (85%) of responses were person-related solutions. An understanding of the specific challenges that older adults face in maintaining their homes can guide redesign efforts and interventions to effectively support older adults' desire to age in place.     

Preventing economic hardship among Chinese elderly in Hong Kong

Over the next 20 years, Hong Kong will face a rapidly aging population as the number of older adults aged 65 or above increases to approximately 1.4 million by 2021, that is, 17% of the total population. In 2001, there were 1.2 million adults aged 45-59. To assess the differences between these middle-aged adults and the current cohort of older adults, we identified the challenges that Hong Kong society will face in meeting the financial needs of older adults in the coming two decades. In this paper, we examine the retirement economic status of three groups of older adults: those who are financially independent, those who are financially supported by their adult children or children-in-law, and those who are receiving welfare assistance. We describe the current situations of these groups, prevailing social policy, future trends, and recommend policies for tackling problem areas.     

The Employers' View on Older Adults as Staff in Early Childhood Education Services

Abstract

Changing demographics report increases in the number of older women that will modify the structure of the workforce. The aim of this qualitative study is to examine the employer's views on employment for women, 50 years and above. It consists of interviews with 19 employers in New Zealand early childhood services. The findings show an acknowledgement of the strengths that the older women bring to their work. Further, a number of benefits of employing older adults are identified. The employers raised some issues and concerns, such as the older adult's hesitancy in accepting changes. The findings also identify work conditions that might be unsuitable for older adults. Despite the challenges, older women have the potential to make a valid contribution, in which their skills and strengths are utilized in ways that do not exploit them.     

The notion of precariousness among older adults living alone in the U.S.

This paper argues that older adults living alone in the U.S. face a set of unique challenges, as they are likely to experience a sense of precariousness. The term precariousness points to an intrinsic sense of instability and insecurity stemming from a lack of, or difficulty to, access essential resources. During a two-year ethnography of 47 older solo dwellers, this term captured one of the distinctive traits of the experience of living alone in older age in the U.S. The findings from semi-structured interviews and participant observation highlight the emergence of the notion of precariousness along three levels of analysis. First, on the micro and subjective level of analysis, older solo dwellers may struggle to perform the chores related to their household as they may deal with a failing body, faltering memory, and fixed if not shrinking income. Second, on the meso and institutional level of analysis, older adults living alone need to navigate the complex, scattered, and ever-changing landscape of services and understand their eligibility criteria, accessibility, fees, and conditions. At the same time they may have to deal with family issues. Finally, the macro level examines the pressure on older solo dwellers of a prevalent ideology that prizes independent behaviors and personal responsibility. In conclusion, the notion of precariousness illustrates the unique position of older adults living alone as they face different type of challenges on a micro, meso, and macro dimension. The paper ends with an invitation to create social policies that accommodate the needs of a growing number of older adults living alone.     

Coping strategies used by LGB older adults in facing and anticipating health challenges: A narrative analysis

ABSTRACT

Given that lesbian, gay, and bisexual (LGB) older adults face notable health disparities compared to their heterosexual counterparts, there is a need for understanding how LGB adults cope with health challenges in late life. The current study analyzes narratives from nine LGB adults age 65 and older living in an urban area in the Southeast United States. Participants spoke of coping strategies related to health promotion behaviors, shifting perspectives of health and body, trusting in spirituality for comfort, and accepting the end of life. We discuss implications for social services professionals who work with older LGB adults and for future research.     

Social Innovation in Rural Regions: Older Adults and Creative Community Development*

Many so-called structurally disadvantaged rural regions are characterized by an ongoing demographic change, low economic productivity, and an insufficient infrastructure. Paradoxically, citizens of such regions are often urged to address local challenges by developing innovative ideas, products, or services. Innovation is becoming a “message of salvation” and imperative to local action due to a rise of an innovation regime that conceptualizes innovation as reflexive and ubiquitous. Unlike cities, however, disadvantaged rural regions are often seen as not conducive to innovation. And older adults are rarely ever regarded as potential innovators. This article will examine how innovations emerge in disadvantaged rural regions and what role older adults play in this context. It focuses on social innovation which is important for processes of rural renewal. Drawing on insights gained through the “Innovation in Rural Municipalities” research project, the paper illustrates the resourcefulness of older adults in the context of socially innovative community development. Older adults can in fact act as drivers of innovative projects, actively participate in and make use of social innovations. Their specific role, however, depends on their personal motives, community-related interests, and available resources.     

Preventing Economic Hardship Among Chinese Elderly in Hong Kong

Abstract

Over the next 20 years, Hong Kong will face a rapidly aging population as the number of older adults aged 65 or above increases to approximately 1.4 million by 2021, that is, 17% of the total population. In 2001, there were 1.2 million adults aged 45-59. To assess the differences between these middle-aged adults and the current cohort of older adults, we identified the challenges that Hong Kong society will face in meeting the financial needs of older adults in the coming two decades. In this paper, we examine the retirement economic status of three groups of older adults: those who are financially independent, those who are financially supported by their adult children or children-in-law, and those who are receiving welfare assistance. We describe the current situations of these groups, prevailing social policy, future trends, and recommend policies for tackling problem areas.     

Interactive remembering: Insights into the communicative competence of older adults

This paper challenges some of the traditional views of older adults' speech by considering conversational narrative interaction among three elderly peers from a life-span developmental perspective of aging. A range of pragmatic models developed primarily for younger adults' talk are extended to facilitate an analysis of interaction among elderly peers, showing how the speakers in the data use sophisticated strategies to recall events and establish communicative bridges between conversation participants. The differing social and communicative goals of older adults are examined, contrasting their communicative, and particularly narrative, competency with negative perceptions of elderly discourse, thus demonstrating that to view aging as synonymous with linguistic decline is unfounded.     

Lessons from Erikson

Abstract

The purpose of this paper is to examine issues related to autonomy across the life span and to draw comparisons between a young child's search for autonomy and an older adult's efforts to maintain autonomy. The paper includes an introduction of the challenges for young children and older adults as related to autonomy. A definition of autonomy and an explanation of Erik Erikson's stages of psychosocial development are included. Each of Erikson's stages is reviewed with consideration given to traits, characteristics, and needs of the young child and older adult. Similarities and differences between young children and older adults in their search for autonomy are examined. The paper concludes with implications for caregivers regarding their practices with young children and older adults.     

Vulnerable African American Seniors: The Challenges of Aging in Place

American Community Survey data are used to develop typologies of the generational dynamics and living arrangements of the estimated 1.6 million African American older adult households who will likely encounter the most difficulty aging in place. Policy recommendations and strategies are offered to address the specific barriers and challenges that must be overcome in order for these older adults to successfully live out their lives in their homes and community.     

Willingness to Use Formal Long-Term Care Services by Korean Elders and Their Primary Caregivers

This study examined predictors of older adults' and primary caregivers' willingness to use formal long-term care (LTC) services to understand possible use patterns of mandatory public LTC insurance programs in Korea. It focused on views regarding who (adult children or the government) should bear the responsibility for older adults' care. Logistic regression models were estimated using data from 1,168 older Korean adults aged 65 or older and their primary caregivers from a national survey. The results showed that older adults' and their caregivers' views on care responsibility were a dominant predictor of their willingness to use both formal home care services and nursing home care services. Both older adults and their family caregivers' willingness to use LTC services should be considered when predicting demand for LTC services. Efforts should promote the perspective that formal LTC services are an acceptable social norm.     

A systematic review of education for the prevention of HIV/AIDS among older adults

Through a comprehensive literature search, the authors of this systematic review identified 21 articles focused on primary prevention of HIV/AIDS for adults aged 50 and over. Three major challenges to providing HIV/AIDS education for older adults include health professionals' ageism, older adults' reluctance to discuss sexuality, and their misconception of their HIV risk. Clinical guidelines for social workers, nurses, and physicians identified the importance of sharing information and assessing risk, considering cultural diversity, and devising creative delivery strategies. Three models of HIV/AIDS education include group education programs delivered by social workers or other health professionals, peer education models, and one-on-one early intervention models including HIV/AIDS testing. Additional outreach and research on HIV/AIDS prevention among older adults is needed.