The Stigma Experienced by Terminally Ill Patients: Evidence From a Portuguese Ethnographic Study

The aim of this study was to offer an understanding of the ways in which terminally ill patients may face discrimination due to their visibly altered body. An ethnographic approach was adopted and fieldwork was conducted over 10 months in 2 inpatient hospice units in Portugal. Participant observation was complemented by 50 in-depth interviews with terminally ill patients, family members, and hospice staff. The stigma experienced by terminally ill patients derived mostly from the behavior of peers, extended family members, and friends toward their visibly altered body. There was no evidence that these patients were discredited by their immediate family when they became visibly unwell; unlike what has been reported in previous studies. This finding could be related to the strong familial culture of Portuguese society.     

The Grief Experience of Prison Inmate Hospice Volunteer Caregivers

Correctional institutions are obligated to provide end-of-life care to a population with complex medical needs. Prison hospices are increasingly being formed to address this demand. Few empirical studies have examined the impact of caring for dying inmates on the hospice inmate volunteers, who, in several prison health care systems, provide direct care. In this study, experiences of the inmate hospice volunteers with death were investigated to illuminate their grief processes. Understanding the bereavement needs of hospice volunteers and how prison hospice volunteers navigate grief and remain committed to providing excellent hospice care can inform the grief processes and practices of hospice care professionals.     

Recommendations for Hospice Care to Terminally Ill Cancer Patients: A Phenomenological Study of Oncologists' Experiences

The aim of this exploratory study was to better understand oncologists' experiences and their perceptions of hospice care as an end-of-life treatment choice for terminally ill cancer patients. To describe this experience, semi-structured qualitative interviews were conducted using phenomenological methods with nine oncologists. Four themes emerged from the data analysis: (a) feelings of discomfort and relief, (b) being different from others, (c) experience with nonhospice patients, and (d) factors influencing the decision to recommend hospice. Future research and a flexible interdisciplinary practice model are suggested to better assist with end-of-life care decision making and recommendations for hospice care with oncologists and their terminally ill cancer patients are presented.     

A Study of Battered Women’s Purpose of Life and Resilience in South Korea

The principal objective of this study is to determine whether battered women’s purpose of life (meaning/value) affects resilience (self‐efficacy/communication efficiency/optimism). This purpose is meaningful in that it may help provide battered women with a new perspective of a changeable life, away from the negative perspectives frequently associated with domestic violence sufferers. The subjects of this study were 110 battered women staying at shelters located in Seoul and Gyeonggi Province, Korea. The survey was conducted between August 15 and September 20, 2010. The data were collected using questionnaires measuring sociodemographic variables, a purpose‐of‐life scale, and a resilience scale. The collected data were evaluated with frequency, correlation, and multiple regression analysis. The results of this study can be summarized as follows. First, the meaning and value of life positively influenced self‐efficacy. Second, only the meaning had a beneficial effect on communication efficiency. Third, only the value variable positively affected optimism. Therefore, this study implied that resilience is an important area in the context of spousal abuse. Based on these results, a program for enhancing the meaning of life is suggested to help domestic violence survivors to build up resilience.     

Resilience of Young People in Residential Care

Children and young people in residential care may have experienced or may experience various difficult, life-threatening events, such as neglect, abuse, or violence and maltreatment known as adversities. Despite this, some of them are able to function and even prosper and this has been attributed to the development of resilience. In this qualitative empirical study, we focus on the under-researched area of how young people in care reflect on and cope with such adversities. The exploratory research comprised of semi-structured interviews with young people in two different care settings – re-education centres and children’s homes. The results showed that the sample of 34 young people had experienced 73 adversities prior to leaving residential care and that half of them were not able to resolve some of these adversities. It was found that methods for dealing with adversity change during time spent in care and that a combination of various individual strategies, adaptation and accepting support are effective. The findings also indicate that the development of resilience may vary according to type of residential care setting specifically, whether these facilities allow the development of multiple individual strategies for dealing with adversities, or whether they provide social support. The article discusses implications for future research and practice in residential care.     

Hearing the Voices of Abused Older Women

Summary

This paper focuses on a qualitative research process that gathered responses from 64 older women aged fifty and older on their experience of violence and abuse. What older women said about abuse in their lives supports the use of a feminist framework as well as the age based analysis of the elder abuse field. Some respondents spoke of abuse from childhood into their later years. Some spoke of partners witnessing or experiencing abuse as children. Some women express concern about possible abuse by their adult children of their own children.

Abused older women like younger women need a safe environment, emotional support, advocacy, information, and peer support. While it is important to consider the perspectives and knowledge of service providers when developing policy and practice on abuse of older women, it is critical to ask the women survivors of abuse or neglect what they believe would benefit them, and others in similar situations.     

Discharge procedures for mentally ill people The perspectives of professionals and former psychiatric patients on their quality of life

This article draws on literature about the quality of life and social relations to integrate a number of key concepts. Fifty-three former patients were interviewed to give their opinion on their quality of life. Almost as many professionals gave their opinion on the same issue. According to the former patients, the quality of life was influenced by duration of and stigma attached to mental illness, being without work, financial difficulties, inability to exert influence over their own situation and negative expectations of the future. Illness patterns seemed to be the all-pervading issue concerning the professionals' views on the former patients' quality of life. A social psychological analysis of these disparate views made it clear that they bring about contrasting claims; the professionals demanded continuation of a patient role whereas the former patients mostly wanted to find some means of embarking on ordinary useful lives.     

Family Caregiving and the Site of Care: Four Narratives About End-of-Life Care for Individuals with Dementia

Little is known about end-of-life care for individuals with Alzheimer’s disease and other dementias. Four case studies are presented, using data collected by qualitative interviews conducted with family caregivers who were closely involved with end-of-life care for relatives with dementia. The case studies are formatted in two pairs, with one reflecting two deaths occurring at home and the other pair representing two deaths in the nursing home. The cases reveal a range of end-of-life experiences, suggesting that there is not just one “good” path. The extent of care needed, the responsiveness of the individual, the health of the caregiver(s), and the residence and support situations, can all intersect in a variety of ways that make no one scenario the answer for all. Although most people say they would prefer to die at home, in some situations the nursing home can be a satisfactory choice, particularly if hospice is involved. These narrative case studies give the reader insight into the variety of the end-of-life experiences and suggest the environment should be considered as part of the care provision.     

THE SOCIAL WORK FUNCTION IN NURSING HOMES AND HOME CARE

No abstract available for this article.     

Formal Alternative Transportation Options for Older Adults: An Assessment of Need

ABSTRACT

This study measured the need for formal alternative modes of transportation among older adults by applying traditional factors of the Behavioral Model. Survey participants who regularly drove were compared to those who could no longer drive. Race/ethnicity and self-reported health were significant predictors of perceived need for transportation services for both groups. However, income and service awareness were significant predictors only for drivers, while family proximity was a significant predictor only for non-drivers. Results suggest the importance of gaining a better understanding of the factors associated with need for senior-focused transportation services to more effectively plan such programs.     

Assessment of Resilience to Drought of Rural Communities in Iran

In recent years, drought has inflicted significant damage on agriculture and rural communities in Iran. Resilience is the capability of communities to handle and tolerate exterior pressures such as drought. The purpose of this study was to identify the indicators affecting social resilience against drought, determining the cause of reduction or increase of resilience in different regions. It also focuses on strategies for increasing resilience of rural communities through the provision of social services in Iran. The required information was collected using a questionnaire from five villages, including 237 villagers who were selected through snowball method. Shannon’s entropy and COPRAS methods were employed to determine and classify the drought resilience. The results show that some indicators like modified irrigation methods and new methods of coping with drought have devoted the highest weight. Also, there is a significant relationship between resilience rating of villages with average age of the households and number of households in nonfarm job. Finally, absolute drought resilience of rural communities remained in moderate situation. Doing study in wider areas to coordinate the effective indicators in the matter and studying how empowerment of local communities by providing a variety of social services can be considered as a further research in the future.     

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.     

Use of Group Counseling to Support Aging-Related Losses in Older Adults with Intellectual Disabilities

Abstract

With the noted increase in life expectancy of persons with intellectual disabilities (ID), there is a need to provide more physical and psychological preparation for aging and support for these individuals in their middle-age and aging periods of life. It is known that age-related losses result in major stressors and that these can produce changes in the way that older adults think, feel or act. Therefore, having methods and tools to help individuals with ID prepare for and adjust to their losses is important. To address this, the Neve Natoa Residential Center in Israel initiated a group intervention program to test whether a group counseling method could be used to help prepare adults for changes associated with aging. Nine adults (5 males and 4 females) between the ages of 39 and 56 (mean = 49) participated in the program pilot. After ten sessions, an evaluation indicated a positive change of attitudes, improvement of self-esteem, and less extreme behavioral reactions in the period after the intervention. Given the positive results, it is recommended that further studies involving group in tervention techniques with adults with ID be undertaken.     

Discharge procedures for mentally ill people: The perspective of former psychiatric patients on their primary social network, quality of life and future life expectations

This article on literature about social networks and social support in order to integrate a number of key concepts and findings that must be considered in research about the social conditions of mentally ill people. Interviews with 53 former psychiatric patients were carried out to get their perspective on their social network, quality of life and future life expectations. The duration of and stigma attached to mental illness, being without work and gender seemed to have the most influence on the primary network. The same issues, except for gender, together with place of residence, financial difficulties and inability to exert influence over one's own situation influenced the respondents' quality of life and their expectations of the future. These findings are analysed and discussed from a social psychological perspective.     

Empathic Action and Family Resilience: A Narrative Examination of the Benefits of Helping Others

ABSTRACT

Empathy is identified as a protective factor that has been helpful for children considered at high risk for poor mental health and social functioning due to experiencing stressful circumstances such as family violence, substance abuse of a parent, or poverty. Yet, little is known about its relevance to a family's ability to overcome adversity. This study examined the narratives of 20 resilient families who maintained family functioning despite experiencing a multitude of risk factors including poverty, death of a child, significant health problems, or substance abuse problems. Narrative analysis was used to identify the ways families situated empathic actions within their stories of resilience. Findings suggest families developed increased compassion for others as a result of their own experiences with loss, trauma, or stress and discussed how helping others increased their ability to cope with the challenges they faced. Future research and practice implications are outlined and support the usefulness of strengths-based concepts and interventions.     

Economic Status,Family Dependence,and Health Outcomes of Older People in Western Rural China

There is a deficiency in empirical knowledge on the physical and mental health of lower-income older people with weak family support in western rural China. To address this research gap, this article uses the data from the 2014 China Longitudinal Aging Social Survey to analyze the disadvantaged situation of older people in western rural China through a regional comparative analysis. Our sample consisted of 7,138 older adults aged 60 or older in eastern and western, rural and urban China. We find that lower personal income is significantly associated with poor physical and mental health. Economic support from families means more for older people when they have a disability related to activities of daily living in western rural China. Fostering stronger family support networks might improve the mental health status of older people in western rural China. Our study suggests a broader scope for the state to play a greater role in economic empowerment and in the development of policies to effectively meet the present and future needs of older people in western rural China or other countries with an imbalance in the distribution of the aging population and welfare resources.     

Outcomes of the ON FIRE peer support programme for children and adolescents in families with mental health problems

Children in families with mental health problems may encounter multiple risks to their well‐being. General aims of peer support programmes for these children include fostering resilience and effective coping strategies, and enhancing self‐esteem and social skills. This study aimed to evaluate outcomes from a pilot multi‐site implementation of the ON FIRE peer support programme. The purpose of ON FIRE is to cultivate hope, resilience and well‐being in children and adolescents aged 8–17 years living in families affected by sibling or parental mental health problems. We employed a pre‐post test (baseline and 4 months) evaluation using a suite of outcome measures. The Strengths and Difficulties Questionnaire (SDQ), Children's Hope Scale, Kids Connections Scale and Positive and Negative Affect Scale for Children (PANAS‐C) were completed for 64 child/adolescent participants. At baseline, participants had significantly greater difficulties compared with Australian norms. At 4 months, there were significant differences in children's hope and in connections outside the family. There were no significant differences in the SDQ or the PANAS‐C.     

Unexpected Caregiving in Later Life: Illuminating the Narratives of Resilience of Grandmothers and Relative Caregivers through Photovoice Methodology

ABSTRACT

This research study implements photovoice methodology with unexpected caregivers to illuminate the lived experiences of female grandparents and relative caregivers who are raising young children in the later stages of their life. As they enter older adulthood, grandmothers are increasingly finding themselves taking care of their children’s children for various reasons, including, but not limited to, their adult child’s incarceration, mental health issues, drug and alcohol addiction, or child abuse or neglect. Informed by various feminist theoretical lenses, we use photovoice methodology to highlight the narratives of resilience and explore the ways in which grandmothers re-conceptualize their roles and identity as an unexpected caregiver and the sources of strength and resilience that inform the ways in which they navigate the various circumstances in their lives.