Validation of interaction-based egocentric elicitation using ecological momentary assessment with young adults currently or formerly homeless

IntroductionSocial network changes are common as individuals transition from homeless to Supportive Housing. Egocentric approaches to elicit network members have been utilized with young adults experiencing homelessness to better understand such socio-environmental contexts; however, such approaches are subject to recall bias. Momentary measurements of one’s social network via Ecological Momentary Assessment (EMA) can support in understanding the accuracy of egocentric elicitation methods.ObjectiveTo examine who is elicited using an interaction-based approach in egocentric social network analysis among currently homeless and formerly homeless young adults residing in Supportive Housing and explore which alters are reported in interactions and how often are they reported when egocentric network analysis is embedded in EMA.MethodsThe present study utilizes interaction-based elicitation embedded within Ecological Momentary Assessment (EMA) in two sub-samples: currently homeless young adults (n = 72) and formerly homeless young adults residing in Supportive Housing (n = 118).ResultsMost egos interacted with three of their top five alters, while only 8.9% interacted with all five. Conversely, only 2% of egos reported that they did not interact with any of their top five. Several differences in alter characteristics were identified by housing status. Alters indicated as being more supportive are elicited first and alters elicited first are interacted with the most.ConclusionsEMA findings suggest that a cross-sectional social network survey of top five alters will results in an ordered list, with the most important/frequent alter being named first and trend downward. Results have implications for future study design involving egocentric network analyses. Present findings indicate qualities of alters present and thus, offer plausible “best practices” when utilizing network elicitation methods, particularly interaction-based methods.     

Older Adults and the Digital Divide: Assessing Results of a Web-Based Survey

SUMMARY

This study used an on-line, web-based survey to assess the significance of computer and Internet technology in the lives of adults over age 60. A convenience sample of 110 individuals from the United States, Canada and other countries responded to a 20-question survey regarding individual use, opportunities for learning, family and social connectivity and preferences for and barriers to effectual use. Particular focus was made on the self-described perceptions of personal control and life satisfaction within the responding population.     

Prevalence and correlates of diabetes mellitus among homeless veterans nationally in the Veterans Health Administration

Abstract

Background: Homeless people are at high risk for many chronic medical conditions although their risk of diabetes has not been well studied. Current epidemiological studies of diabetes prevalence among homeless adults have been based mostly on self-report data not supported by clinical assessments.

Objectives: To determine the prevalence and risk factors for diabetes mellitus (DM) among homeless veterans in the Veteran Health Administration (VHA).

Methods: The sample included 3?464?364 veterans with documented body mass indexes (BMI), 137?720 (4%) of whom had been homeless. Logistic regression models were used to determine the odds of having DM among homeless veterans compared to non-homeless veterans. Bivariate and multi-variate analyses were then used to identify potential risk factors for DM among homeless veterans.

Results: The prevalence of DM in homeless veterans was 19%. Homeless veterans with DM, compared to those without it were older, more likely to have a BMI?>?40 and more likely to have DM-related co-morbidities.

Conclusions: There is a high prevalence of DM among homeless veterans in the VHA compared to previous reports for homeless adults (8%). Tailored approaches to improve access to DM screening, prevention, and treatment could benefit homeless veterans.     

Memory for Goblins

Summary

This author distinguishes between short-term memory and working memory. The game, Memory For Goblins has been developed primarily for use in the assessment of working memory, In addition, this game can be used for the training of working memory. The game is described in this article with particular attention to its use with older populations.     

Chapter 16. Community Caregiving Partnerships in Aging

SUMMARY

Although greater numbers of families are providing support to older adults, a lack of comprehensive programming in resource allocation continues to exist at the social policy level. This chapter explores how community caregiving partnerships may contribute to a solution.     

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.     

Chapter 10. Care Needs of Older Adults Following a Traumatic or Disastrous Event

SUMMARY

This chapter addresses biopsychosocial and spiritual needs of older adults following a traumatic or disastrous event. It assumes that most older adults have established a pattern of positive adaptation over the life course as they encountered acute stress or chronic adversities. The importance of social supports and mutual aid is also described.     

Presence and Visibility of Outdoor and Indoor Physical Activity Features and Participation in Physical Activity Among Older Adults in Retirement Communities

Abstract

In this paper we examine how the presence and visibility of outdoor and indoor physical activity resources (e.g., walking path/ trail, outdoor tennis courts, gardens, etc.) influences participation in physical activity among elderly residents in non-profit continuing care retirement communities and other senior housing communities. This paper reports findings from a survey of 800 such communities. A social ecological model was used to study the relationships between the environment and physical activity behavior. A fifty-two percent response rate (n = 398) was obtained. Campuses with more attractive outdoor and indoor physical activity facilities had more residents participating in different types of physical activity.     

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.     

Voices of Homeless Parents

Abstract

Homeless families with children comprise approximately 40% of homeless people and the fastest-growing group among the homeless. However, the pain and suffering faced by homeless parents, especially single mothers, as providers for and protectors of their children has yet to be documented and understood. In this paper, we illustrate the frustrations, guilt, confusion, and hope of 50 homeless parents staying at three homeless shelters in two large northeastern cities. We hope that a clear understanding of these parents' subjective experiences of homelessness will contribute to the evaluation and improvement of the effectiveness of social work interventions for homeless families.     

Older lesbians' experiences with home care: Varying levels of disclosure and discrimination

ABSTRACT

There is considerable evidence that lesbian, gay, bisexual and transgender (LGBT) older adults have experienced barriers to health care access and have profound fears about how they will be treated in the long-term care system, but the specific experiences of older lesbians have received less attention. Most older adults needing long-term services and supports (LTSS) prefer to remain at home, and this is true for lesbians as well. This article reports on a national, qualitative study of the experiences of 20 older lesbians (age 65 and older) with home care workers. The experiences of six informal partner caregivers with home care services are also included. Emergent themes regarding level of disclosure, experiences with homophobia, evaluation of care received, and thoughts about ideal LTSS are described. Most study participants did not disclose their sexual orientation to their home care workers. A significant minority experienced homophobia, but nearly all ultimately found workers who provided good care with which they were comfortable. Their visions of ideal LTSS included greater affordability and particular qualities that were important for home care workers to possess, such as competence, caring and acceptance. Practice and policy implications are outlined including careful recruitment, training and supervision of home care workers to foster lesbian-sensitive care, but also improved wages and work conditions in order to maintain a quality home care workforce.     

Resource Accessibility and Walkability Among Older Adults in Extended-Stay Hotels

Older adults represent a large and growing population group in the United States. This population cohort is projected to grow to 72.1 million, or 19% of the total population, by 2030, up from 40 million in 2010 (Administration on Aging, 2011; Federal Interagency Forum on Aging-Related Statistics, 2012). Despite reported decreases in the proportion of older adults living in poverty in recent years, inequities prevail. Approximately 40% of older American households reported housing cost burdens¹Cost burdens are expenditures on housing and utilities that exceed 30% of household income. (Federal Interagency Forum on Aging-Related Statistics, 2012). Many of these low-income older adults live in socially and economically marginalized positions, and housing them remains a major challenge complicated by (a) limited affordable housing options and (b) chronic health conditions that seriously undermine long-term health and mobility. In a study on the impacts of public housing transformation in Atlanta, Oakley, Reid, & Ruel (2011) reported that 26% of seniors entered public housing because of a health condition or disability. According to Smith (2006), seniors in public housing are in worse health than other older Americans, even other poor older Americans suffering from such chronic health conditions as hypertension, diabetes, arthritis, and asthma. Despite these realities, Ball (2012) has noted that older adults receive little attention in comprehensive development planning beyond specialized age-segregated retirement and care communities. Salkin (2009) echoes similar concerns about the tendency toward housing initiatives and designs for more affluent older adults. She commented that most states have focused attention on programs that are best suited for seniors who do not have the same income limitations as those who are truly on fixed incomes and living close to the poverty level (Salkin, 2009). While public housing remains the predominant affordable housing option for low-income older adults, such housing is out of reach for many low-income older adults who find themselves displaced and homeless. As a result, some of these adults move into extended-stay hotels to remain sheltered.     

Young and Older Caregivers at Homeless Animal and Human Shelters: Selfish and Selfless Motives in Helping Others

In the present study, young (n = 34) and older(n = 70) adult volunteers at either animal (n= 48) or human (n = 56) homeless shelters were asked to complete measures of caregiver stress/satisfaction, volunteer motives, and social desirability. Young compared to older volunteers assisting animals, but not humans, reported a significantly higher caseload and spending significantly more time per visit with their clients. In addition, young volunteers reported significantly higher levels of caregiver stress with humans more than animals. Also, volunteers at human (but not animal) homeless shelters claimed the need for meeting social expectations as a motive for community service. Furthermore, younger compared to older volunteers reported gaining relevant career experience, obtaining a knowledge of the plight of others, relieving aversive emotions, and meeting normative expectations as significant motives for volunteering. These results may have important implications for recruitment and training of community volunteers at homeless shelters.     

Homelessness in the 21st Century: The Implications of Spirituality for Muslim Populations

Abstract

Relative to recent immigration trends, Muslim populations in America have emerged as significant among the homeless. Yet the social work manner of attending to homeless Muslim populations has not acknowledged the significance of spirituality proportionate to Muslims in need. Subsequently, homeless shelters must acknowledge the significance of Islamic spirituality vis-à-vis homeless Muslim populations to enable the delivery of services. That consideration should remain constant and viable as a modus operandi for homeless shelters which address homelessness in the 21st century.     

Genealogy and Ideology of Taiwan Homeless Delivery Services

Abstract

Since the mid-1990s, the number of homeless in Taiwan has been increasing. Politicians, policy makers, and service providers frequently debate whether the government should provide services for the homeless. Democracy and economic change have increased the number of homeless in Taiwan. However, the current homeless problem is also a product of a conservative welfare ideology based on family values and moral judgments. This study has implications for social workers and policy makers. (1) A universal principle for nationwide homeless delivery systems is required. (2) Restrictions that prohibit adults and youths with families providing little support from entering shelters should be eliminated. (3) Employment consultation and housing compensation should be provided to assist street people in re-entering mainstream society. (4) Supportive relationships with mainstream- based outreach services should be developed.     

Can we prevent deaths of homeless persons? Police led public health approach to prevent homeless deaths

Abstract

Research on homeless populations demonstrates that homelessness in itself is an independent risk factor for death. However, there is a dearth of detailed data on homeless decedents and the situations surrounding their deaths. This lack of knowledge, a desire to understand how and why homeless individuals were dying, and a sentinel event death led the Indianapolis Metropolitan Police Department Homelessness and Panhandling Unit to partner with a local researcher and begin conducting homeless death reviews. The approach is modeled after the evidence-based, public health approach of the Fetal and Infant Mortality Review process (FIMR). The FIMR model is a systematic approach to understanding system gaps and obtaining insights into the factors that resulted in homelessness and ultimately death. This article reports on the process to develop this unique multi-agency, police-led review of homeless deaths in Indianapolis, Indiana and resulting recommendations for action to decrease these deaths.     

Intergenerational Activities that Promote Engaging Conversations are Preferred among Young and Older Adults

ABSTRACT

Loneliness negatively affects young and older adults. Intergenerational activities foster social connectedness. Using quantitative and qualitative methods, this study explored which intergenerational activities are most enjoyable for college students and retirement community residents. Demographics, loneliness, enjoyment, conversation level, and type of activity were analyzed. The enjoyment and conversation variables were positively correlated (r = .59, p < .001) which was supported by participants’ narratives. Both populations most enjoyed the activities with higher conversation levels, with the first being committees, followed by meals, one on one activities, and transportation. Retirement communities and universities should promote intergenerational activities, which include meaningful conversations.     

Dance of the Dedicated Bottom

Abstract

LGBT caregiving for midlife and older adults facing chronic illness or disability as well as the development and evaluation of interventions targeting LGBT caregivers remains fundamentally unexplored. Caregivers regardless of their sexual orientation or gender identity often juggle multiple roles and responsibilities leading to increased stress and distress. However, largely due to discrimination and discriminatory policies, many LGBT caregivers face barriers at multiple levels of service provision that can exacerbate stress and negatively impact caregiver and care recipient quality of life. This article highlights many of these obstacles and provides examples of intervention strategies designed to assist LGBT caregivers ranging from interventions aimed at the individual and interpersonal levels of service provision to changes needed at the social policy level. As an example of an individual or interpersonal level of intervention designed to assist LGBT caregivers, the SURE 2 framework is presented and more thoroughly discussed. Given the diversity of the LGBT community, the article ends with ways to extend or adapt SURE 2 as well as suggesting that the time has come to develop and test a variety of interventions for LGBT caregivers.     

The Salvaging of Identities among Homeless Men: Reflections for Social Work

Abstract

This research reveals the social and individual processes that dominate the experiences of homeless men through an exploration of their struggle to achieve ontological worth. Drawing on eight in-depth interviews with homeless men who are experiencing homelessness, this research demonstrates this struggle is because of the situated nature of identities that homeless men continually reconstruct and renegotiate. It proposes that relations to this set of identities are relevant to homeless men, in particular the construction and reconstruction of their identities within homelessness. The central findings of this research reveal that homeless men actively manage their identities to cope with the instability inherent to the experience. The implications of this for social work practice are explored, focusing on the importance of self-conception and the restoration of positive identities.     

Experience of elder abuse among older Korean immigrants

ABSTRACT

Studies on the scope and nature of Asian American elder abuse conducted with older immigrants are extremely limited. The overall purpose of this study was to examine the extent and type of elder abuse among older Korean immigrants, and to investigate critical predictors of elder abuse in this population. The sample consisted of 200 older Korean immigrants aged 60 to 90 years who resided in Los Angeles County in 2008. One of the key findings indicated that 58.3% of respondents experienced one or more types of elder abuse. Logistic regression indicated that the victims’ health status and educational level were statistically significant predictors of the likelihood of experiencing abuse. The present study, although limited in sample size, measures, sampling methods, and population representation, has contributed to this important area of knowledge. It is recommended that future studies conduct research on elder abuse with more representative national samples that can measure the extent of abuse and neglect more accurately.