Older Adults’ Expectations about Mortality,Driving Life and Years Left without Driving

ABSTRACT

People are living and driving longer than ever before, with little preparation for transitioning to being non-drivers. We investigated driving expectations among drivers age 65 and older, including sociodemographic and driving context predictors. Cross-sectional data from 349 older drivers were explored to determine variation in how many years they expected to continue driving. General linear models examined predictors of both expectations. In this predominantly Black/African American sample, 76% of older drivers (mean age = 73 ± 5.7 years) expected a non-driving future, forecasting living an average of 5.75 ± 7.29 years after driving cessation. Regression models on years left of driving life and years left to live post-driving cessation predicted nearly half of the variance in older drivers’ expectations with five significant predictors: income, current age, age expected to live to, self-limiting driving to nearby places and difficulty, visualizing being a non-driver. Many older drivers expect to stop driving before end of life.     

Involvement in Voluntary Organizations: How Older Adults Access Volunteer Roles?

ABSTRACT

This study examines how older adults access organizational volunteer roles and what socio-structural factors are associated with the access. Using the data from the Current Population Survey (U.S. Department of Commerce, Bureau of the Census, 2002 U.S. Department of Commerce, Bureau of the Census. 2002. Current population survey, September 2002: Volunteer supplement, Washington, DC: Author. [Computer file] [Google Scholar]), bivariate analyses show that there are variations in access to volunteer roles across types of organizations. Results from multinomial logistic regressions indicate that education, income, age, and race are associated with the ways that older adults access volunteer roles. Voluntary organizations are advised to approach older adults directly, use current volunteers to recruit potential ones, publicize their organizational goals, and disseminate relevant information in efforts to improve access of older adults to volunteer roles.     

Inclusion or Exclusion? Exploring Barriers to Employment for Low-Income Older Adults

Faced with economic uncertainty and declining retirement security, older adults have increasingly tried to remain in, or return to, the workforce in recent years. Unfortunately, a host of factors, such as ageism and changing skill requirements, present challenges for older adults seeking employment. Low-income older adults, in particular, may lack necessary education and skills and have limited access to job opportunities and training. In this review, we examine factors that inhibit and support employment for low-income older adults and explore the role of social work in facilitating their inclusion in the workforce.     

How relevant are ‘Irrelevant’ Alternatives?

Arrow's Independence of Irrelevant Alternatives Condition is examined. It is shown why the standard rationale for (or against) the condition tends to be inconclusive as it fails to consider the basic game issue in social choice. Specifically it is explained how some recent results (Gibbard-Satterthwaite) on the general non-existence of strategy-proof voting procedures provide the strongest rationale for the independence condition. Also, it is shown that this rationale was exactly the one used by Condorcet in his work on decision rules for juries and elections.     

How conservative are British attitudes to reproduction?

Current British attitudes concerning fertility are examined, and the probabilities that these will lead either to a further decline to below replacement-level fertility or to a level that will sustain population replacement are assessed. The author concludes that the optimistic, or replacement-level, alternative is the more likely. The evidence for this conclusion is examined, including evidence of conservative attitudes toward fertility and childbearing, and the relative stability of the family structure; comparisons are made with the situation elsewhere in Europe.     

A Pilot Randomized Trial of an Intervention to Enhance the Health-Promoting Effects of Older Adults’ Activity Portfolios: The Engaged4Life Program

The purpose of this study was to evaluate the feasibility and outcomes of the Engaged4Life program, an intervention to encourage inactive community-dwelling older adults to embed physical activity, cognitive activity, and social interaction into their everyday lives in contexts that are personally meaningful and natural for them. Fifteen participants were randomized to the intervention group (technology-assisted self-monitoring of daily activity via pedometers and daily tablet-based surveys; psychoeducation + goal-setting via a 3-hour workshop; and peer mentoring via phone 2×/week for 2.5 weeks) and 15 to the control (technology-assisted self-monitoring only). Recruitment was shown to be feasible and efficient, but not able to reach the target for men. Retention rate was 83% and participants manifested high adherence and engagement with the intervention. Though this pilot trial was not powered to demonstrate significant differences between groups, daily steps increased by 431 (11% increase) from baseline to Week 4 for the intervention (p < .05), but decreased by 458 for the control, for a net difference of 889 steps (p < .05). Findings were sustained at Week 8 (p < .01). In a future trial, difficulties in recruiting men, barriers due to the technology-intensive design, and the optimization of secondary outcome measures should be addressed.     

Geriatric Case Managers’ Perspectives on Suicide Among Community-Dwelling Older Adults

It has been suggested that clinical screening for suicide, along with firearm assessment and safety counseling, are important in service provision to older adults. It is unclear, however, how geriatric case managers respond to these issues. This study surveyed geriatric case managers (n=161) from Area Agencies on Aging in Ohio on their knowledge, attitudes, and behaviors related to suicide, firearm assessment, and safety counseling. Results indicated that the majority of respondents (70%) agree their clients are at risk for suicide. However, few (30%) in this study reported that they assess for firearms and less than half (48%) discuss firearms with their clients/family members when specifically assessing for suicide. Analyses identified barriers that contribute to the decreased likelihood that routine firearm assessment and safety counseling would occur, such as lack of training and time. Implications include the need for training with geriatric case managers that addresses barriers to suicide, firearm assessment and safety counseling as a means to decrease these population risks.     

Solutions to the Challenge of Meeting Rural Transportation Needs: Middle-Aged and Older Adults’ Perspectives

This study aimed to explore how the aging population in Appalachia manages its transportation and plans for the transition to non-driving and to seek possible solutions to the challenge of meeting rural transportation needs. Four focus groups (N = 38) were conducted, supplemented by a questionnaire, in Appalachian Kentucky. The results showed that few alternative transportation existed except a local paratransit service and informal transportation support. Compared to older adults, middle-aged adults reported a greater willingness to use mobile phones and the Internet to arrange transportation if they were available. Participants also recommended expanding the use of existing transportation in the community – such as church vans – to better meet the aging population’s needs. The findings suggest that partnership between government, non-profit, and private sectors is needed, not solely focusing on a tax-dependent solution. Additionally, information and communication technology-based transportation management system would help maximize the use of scare but existing resources in rural areas.     

How vicious are cycles of intransitive choice?

Transitivity is a compelling requirement of rational choice, and a transitivity axiom is included in all classical theories of both individual and group choice. Nonetheless, choice contexts exist in which choice might well be systematically intransitive. Moreover, this can occur even when the context is transparent, and the decision maker is reflective. The present paper catalogues such choice contexts, dividing them roughly into the following classes:

Resident-Managed Elder Intentional Neighborhoods: Do They Promote Social Resources for Older Adults?

Social isolation has serious negative public health impacts for older adults. Survey data were collected at three resident-managed elder intentional neighborhoods in the United States (n = 59), to determine if these neighborhoods, each based on the cohousing model, promote development of social resources for their residents. Social resources were measured on three dimensions: social networks, neighborly support, and satisfaction with the neighborhood community. Respondents were White, mean age of 73.3 (range = 63–91), primarily female (76.3%), and generally had high levels of education and self-reported health. Almost half (47%) were never married/divorced and 37% were childless. Inclusion of neighborhood ties ameliorated risk of social isolation. Satisfaction with support and a variety of neighboring behaviors were reported. These neighborhoods are meeting the needs of a potentially at-risk population as an avenue to promote social resources and reduce social isolation. The implications for gerontological social workers include a role in helping to mobilize and support these types of neighborhoods as a way to encourage mutual support among older adults. With the increase in the aging population, such models of proactive interdependence and communal coping have the potential to lessen or delay the demands that socially isolated elders place on social workers.     

How to Measure Social Progress?

A good society is the goal for social policy. Recent years have seen a growing awareness that gross domestic product (GDP) alone does not measure this. Happiness and well‐being have increasingly been seen as elements that should influence welfare policies. This review article provides an overview of many of the ways to measure well‐being and happiness. It attempts to cover three distinct, but interrelated subjects. First, why and what can be used to complement GDP as measures for societal development. Second, is there a relation between well‐being, happiness and central social policy areas? Third, whether knowledge on what makes people happy could inform policymakers in their decisions. The article discusses the many new attempts to measure societal development, and the fact that there are so many that decision makers and citizens are drowning by numbers and thereby not able to grasp whether or not there is social progress. Lastly, by using the classical depiction of welfare states, the article analyses whether the indexes are in line herewith, and that, therefore, they might be used as an instrument for steering societies in the direction of a good society.     

Indifference to the difference? Older lesbian and gay men’s perceptions of aging services

ABSTRACT

This qualitative study examined: 1) What older lesbians and gay men know about OAA-funded services; 2) attitudes towards the services; 3) experiences utilizing the services; 4) how current needs are met; and 5) plans for care as they age. Focus groups were conducted from June-August 2016. Purposive and snowball sampling yielded a sample size of 31. Five focus groups were conducted, and analysis used Grounded Theory. Four themes emerged: 1) low expectations of a welcoming environment, 2) the importance of being out, 3) need for LGBT-specific services, and 4) how to create inclusive services.     

Mechanisms of the Effect of Involuntary Retirement on Older Adults’ Self-Rated Health and Mental Health

This study examined mechanisms of the effect of involuntary retirement on self-rated health and mental health among adults aged 50 or older. Using two waves of the Health and Retirement Study (2006 and 2010), we selected a sample of 1,195 individuals working for pay at baseline who responded to a lifestyle questionnaire in both waves. Regression-based path analyses were conducted to test the mediating effects of financial control, positive and negative family relationships, and social integration on the relationship between involuntary retirement and self-rated health and mental health. Results of mediation analyses indicated that transition to involuntary retirement was directly negatively associated with subsequent self-rated health and indirectly negatively associated with mental health via perception of less financial control. Voluntary retirement was indirectly positively associated with both self-rated and mental health via perception of more financial control. No significant direct or indirect effects of retirement were found when retirement was measured with an aggregate measure without specifying its voluntariness. Findings emphasize the importance of specifying the voluntariness of retirement and recognizing the heterogeneity in the mechanisms of involuntary and voluntary retirement.     

Are Methadone Counselors Properly Equipped to Meet the Palliative Care Needs of Older Adults in Methadone Maintenance Treatment? Implications for Training

Today's methadone patients differ greatly from those of the past. Because of the rise of polydrug use and the HIV and hepatitis epidemics, treatment has become much more complex, which multiply the concerns and complexities of treatment. Patients entering methadone programs are also more commonly presenting at ages well into their 50s, 60s, and 70s; and this phenomenon of high rates continues to grow. The majority of these individuals in treatment have presented with a number of significant comorbid medical conditions that will progress and eventually lead to death. This aging cohort must be approached with a modified treatment plan that focuses on management and promoting healthy aging, while attending to their maximum delay of illness, disease, and disability. This article argues that it is necessary for counselors working with this group to adopt a palliative care philosophy. This article also makes recommendations in areas that counselors need to be knowledgeable and skilled in to provide appropriate palliative services specific to this aging population with multiple needs as they near end of life.     

“You Never Get Used to Loneliness” – Older Adults’ Experiences of Loneliness When Applying for Going on a Senior Summer Camp

ABSTRACT

The aim of the present study was explore why the informants were feeling lonely and considered themselves to be in need of attending a senior summer camp, and how the informants were experiencing loneliness before they went to the senior summer camp. Interviews was made with nineteen older adult people (15 women and 4 men). A phenomenological inspired approach was used for the analysis of the interviews. Eight themes resulted: Hard to make new friends, Other circumstances making it hard to be social, Feel very lonely even if they lead rich social lives, Loss of loved ones, Do not want to do things alone, Friends make a difference, Do not feel lonely but need a change and Loneliness occurs at certain times. Through this analysis, we have gain insights to better understand loneliness as a multifaceted phenomenon that is associated with both personal circumstances and social situations. Many of the informants experienced being very lonely, even if they lead rich social lives. The experience of loneliness was connected to not having anyone they can turn to in confidence or to share experiences with and the need to belong to something or the need of a change in everyday life.     

‘Making It’ Versus Satisfaction: How Women Raising Young Children in Poverty Assess How Well They Are Doing

ABSTRACT

Using in-depth interviews with 17 women raising young children in urban poverty, two separate standards were examined—“making it” and satisfaction. “Making it” referred to one's perceived ability to meet the basic physical needs of her children. In contrast, satisfaction referred to how closely one's current life circumstances align with her personal notions of success. Results indicated that self-expectations greatly influenced which standard individuals prioritized, such that those with higher expectations valued satisfaction while those with lower expectations prioritized “making it.” Self-expectations aligned largely with one's poverty status, and women with the fewest economic resources typically expected the least for their lives. Findings from this study suggest that efforts to support women raising young children in poverty must address both standards if they are to be relevant, effective, and sustainable. Similarly, if individuals are to succeed in such interventions, they must be supported in developing higher expectations for their lives, given the role that expectations play in catalyzing one's sense of a life beyond survival. Future research and implications for theory and practice are outlined.     

How to deal with partially analyzable acts?

In some situations, a decision is best represented by an incompletely analyzed act: conditionally on a given event A, the consequences of the decision on sub-events are perfectly known and uncertainty becomes probabilizable, whereas the plausibility of this event itself remains vague and the decision outcome on the complementary event [`(A)]{\bar{A}} is imprecisely known. In this framework, we study an axiomatic decision model and prove a representation theorem. Resulting decision criteria aggregate partial evaluations consisting of (i) the conditional expected utility associated with the analyzed part of the decision, and (ii) the best and worst consequences of its non-analyzed part. The representation theorem is consistent with a wide variety of decision criteria, which allows for expressing various degrees of knowledge on (A, [`(A)]{A, \bar{A}}) and various types of attitude toward ambiguity and uncertainty. This diversity is taken into account by specific models already existing in the literature. We exploit this fact and propose some particular forms of our model incorporating these models as sub-models and moreover expressing various types of beliefs concerning the relative plausibility of the analyzed and the non-analyzed events ranging from probabilities to complete ignorance that include capacities.     

How fair are unemployment benefits? The experience of East Asia

Despite an increasing emphasis on active labour market measures, unemployment benefits still remain a focal point of employment protection. This article takes the cases of four East Asian economies – China, Japan, Republic of Korea, Taiwan (China) –, which are often characterized as having welfare states with a strong developmental and productivist orientation, to investigate whether, as is sometimes argued, unemployment benefits are restrictive and exclusionary. In doing so, it examines the logic behind the design of unemployment benefits and argues that they are in fact progressive in design and fair when they pay out. Nonetheless, low effective coverage and low benefit rates weaken their redistribution and compensation objectives.     

Which Welfare States are Most Likely to Survive?

This paper considers the major shocks to which modern welfare systems are having to adapt. These include the growing inequalities of rewards for those in work, the growing scale of unemployment, global economic pressures, the ageing of populations and the combination of fiscal constraint with rising consumer expectations. It discusses how different kinds of welfare state are responding to these pressures and looks especially at the policies of the new Blair government. The paper concludes by suggesting that these issues are taking the UK to a distinctive welfare regime position.