Productive engagement among older Americans: prevalence, patterns, and implications for public policy

This study estimates the prevalence of productive engagement among adults aged 60 and over residing in the United States over a nine-year period. We analyze three waves of data from the Americans' Changing Lives Study, which allows the findings to describe the non-institutionalized older American population. Focusing upon five activities--formal paid employment, irregular paid work, unpaid volunteerism, caregiving, and informal assistance to others--we identify changes in the engagement rates, examine the extent to which engagement occurs through single or multiple concurrent activities, and document intra-individual patterns of engagement within and across forms of productive activity, including the continuity, initiation, and cessation of involvement. The findings reveal that late-life productive engagement is widespread, with the majority of older individuals involved in multiple forms of activity concurrently. Non-market-based activities such as caregiving, informal assistance, and volunteering are most prevalent. Initiation and cessation of activities are common and yield more complex patterns and lower rates of non-participation than are revealed in cross-sectional analyses. Time spent in productive engagement is highly variable and exhibits an overall decline across time. We conclude by highlighting policy strategies to increase the availability and quality of opportunities for productive engagement and promote planning for engagement in late life.     

Links between informal caregiving and volunteering in Sweden: a 17-year perspective

This article analyses informal caregiving and volunteering in organizations over 17 years in Sweden, with a focus on links between these two forms of unpaid activities. The discussion is based on results from a national survey that was repeated four times in the period 1992–2009. Links were found between the different types of activities. In all four studies a substantial group of the population was involved both in informal caregiving and volunteering. This group of ‘active citizens’ are commonly also engaged in informal social networks. This ‘double active’ group had increased over time and they provide a substantial amount of hours of involvement. Patterns outlined in this article demonstrate that unpaid activities represent a multifaceted phenomenon, and that the boundaries between informal caregiving and volunteering as forms of engagement may be more fluid than has previously been acknowledged. The results challenge the literature in which informal caregiving is viewed as a major obstacle to volunteering. At the same time, however, informal caregiving in general was found to be increasing. There might be reasons to be cautious about the possible risk that too much pressure on citizens for informal caregiving might jeopardize the type of double involvement that is outlined in this article.     

Long-term care preferences among older adults: a moving target?

This study investigates long-term care preferences across three hypothetical scenarios and over one year of time among a sample of disabled older women receiving informal care (n = 420). Unpaid or paid help in one's home was preferred, given scenarios of instrumental activities of daily living (IADL) and activities of daily living (ADL) needs; nursing home care was most preferred for dementia care. While aggregate preferences for long-term care were relatively stable, there was considerable fluctuation in individuals' preferences over time, with just 52.5%, 44.4%, and 44.6% of participants retaining their initial first choice across IADL, ADL, and dementia scenarios, respectively. Implications of study findings are discussed.     

Gay Bars and Serendipity

Abstract

HIV/AIDS continues to be a serious public health issue. As HIV changes from an acute disease to a more chronic illness, it places increased responsibility on family caregivers to provide on-going assistance. Based on a conceptual model of caregiving resilience, this study found high variation in caregiving outcomes with many caregivers demonstrating high levels of well-being despite adverse life circumstances. Factors that contributed significantly to caregiver well-being included income, caregiver health, discrimination, multiple loss, dispositional optimism and self-empowerment. These findings suggest that HIV/AIDS and caregiving entail more than stress and distress and that future research needs to consider caregiving within the context of a historically disadvantaged community, resilience of informal caregivers, and risk and protective factors at the personal, cultural and community levels. Such information is necessary to design community-based interventions to support informal caregivers and persons living with HIV/AIDS.     

Long-Term Care Preferences Among Older Adults: A Moving Target?

ABSTRACT

This study investigates long-term care preferences across three hypothetical scenarios and over one year of time among a sample of disabled older women receiving informal care (n?=?420). Unpaid or paid help in one's home was preferred, given scenarios of instrumental activities of daily living (IADL) and activities of daily living (ADL) needs; nursing home care was most preferred for dementia care. While aggregate preferences for long-term care were relatively stable, there was considerable fluctuation in individuals' preferences over time, with just 52.5%, 44.4%, and 44.6% of participants retaining their initial first choice across IADL, ADL, and dementia scenarios, respectively. Implications of study findings are discussed.     

The Role of Environmental Features in Social Engagement Among Residents Living in Assisted Living Facilities

The objective of this study was to describe how physical and social environmental features of assisted living facilities influence social engagement behaviors of older residents. A secondary objective was to identify the environmental features that were important to residents’ social engagement based on their perspectives. Using a qualitative approach, the authors depicted the environmental features and the social engagement patterns of older residents in two assisted living facilities in urban Saint Louis, Missouri. A stratified sample of 10 participants participated in in-depth interviews and 16 participant observations were conducted. Five physical and social features were identified as factors that influenced residents’ social engagement patterns. Environmental features that supported social engagement appeared to differ according to participant activity level. Findings from this study have the potential to inform design guidelines that will enhance social engagement in future assisted living facilities.     

Being a pretty good citizen: an analysis and monetary valuation of formal and informal voluntary work by gender and educational attainment

This paper is set in the context of macrosocial/macroeconomic theories of the organization of both paid and unpaid work. The specific topic investigated is engagement in unpaid voluntary work, an activity which is thought to be important for social cohesion, civil society and citizenship. Research on the sources of social cohesion has focused on organizational membership and voluntary organization activity. There has been little investigation of informal helping of non-resident kin, friends or acquaintances, an activity which is not measured in most social surveys but is measured in time use surveys. Previous research shows that the highly educated are more likely to engage in formal voluntary organizations and data from the UK 2000 HETUS survey confirm that the highly educated spend more time on formally organised voluntary work. However, the less qualified, particularly women, spend more time on extra-household unpaid helping activities. Since both types of voluntary work are partly dependent on available time, these findings are modelled adjusting for time allocated to paid work, study, family and personal care. The findings remain statistically significant. Drawing on work carried out by the Office for National Statistics, a monetary value is placed on both formally organized and informal voluntary work. Although the median wage rates for formal voluntary work are greater than those for informal helping, the latter is greater in frequency and duration and therefore more economically valuable from a population perspective. This finding is discussed in the light of recent debates on citizenship and gender.     

Tagging Walls and Planting Seeds: Creating Spaces for Youth Civic Action

Youth civic spaces are environments in which youth participation in civic action is fostered—the pathways, structures, and vehicles that provide opportunities for young people to engage in critical discussion, dialogue, and action. The concept of youth civic space includes the formal and informal places in which youth civic engagement can occur and how the lived experience of those places contributes to young people's development as civic actors. It extends discussions regarding the physical locations of youth civic engagement to include the activities, perceptions, and interactions within them. Drawing on archival materials from 2 multiyear projects, this article explores the role of community-based organizations in mediating youth civic action and understanding the characteristics and qualities of the organizations that facilitate youth engagement in community action and social change. We use this analysis of empirical examples to develop a conceptual framework for strengthening practice.     

Family support in late life: A review of the literature on aging,disability, and family caregiving

ABSTRACT

For older adults and people with disabilities in the United States, family caregiving is an important part of remaining at home and in the community. As care recipients and caregivers age, family dynamics change, and the health, social, and financial impacts of this (largely unremunerated) work have implications for individuals, families, and social policy. In this review, the authors map the literature across multiple fields related to disability and aging to understand caregiving in late life, what it means to be an older caregiver and/or to care for older people. The authors summarize the findings of 97 articles to address the care, services, and supports family caregivers provide for older adults; negative and positive impacts for caregivers serving in this role; supports that family members use or need; and societal impact of family caregiving. Much of the literature describes the work family caregivers provide and negative impacts of caregiving. Less attention is devoted to caregiving benefits, supports used by family caregivers, and societal impacts. The authors conclude with an agenda for future research that attends to the need for research that includes: more diverse samples, new types of caregivers, longitudinal data, qualitative data and analysis, and comparative research.     

Dementia Problem Behavior and the Production of Informal Caregiving Services

Informal caregivers of individuals with Alzheimer's disease spend a considerable amount of time providing care. In this paper, we use Grossman's health production and Becker's time allocation models to develop a model of informal care provision to elderly dementia patients. In our model, time inputs produce caregiving services, which provides utility to the caregiver, but reduces leisure. We assume that time is less productive of services on the margin as the disease progresses. In this framework, an increase in patients' disease severity does not necessarily increase informal caregiver time input. The cost of formal care establishes a reservation price for informal caregiving. When the costs of informal caregiving rise above this reservation level, the patient is institutionalized. We test empirically the effect of deterioration in the patients' condition, proxied by both disease severity and dementia problem behavior, on informal caregiving time. We find that dementia-related problem behaviors and functional limitations significantly increase inputs of informal caregiving time. Patients' problem behavior exerts a modifying effect on functional limitations, and patients' comorbidities have no effect on informal caregiving time.     

Community Connections: Social Capital and Community Success1

This article examines the impact of two types of community social capital—ties between civic organizations formed through shared members and ties between residents formed through socializing in local gathering places—on residents’ subjective appraisals of community success. Community social capital studies tend to focus on the first of these types of ties, networks of civic engagement, while the second, gathering place networks, has received relatively little scholarly attention. Studying both allows me to assess the formal and informal arenas of community sociability, providing a more thorough understanding of social capital and community life. I assess the effects of community‐level social capital networks on the individual‐level experience of residing in the community using survey data on 9,962 residents from 99 small towns in Iowa. This rich data set allows me to avoid two shortcomings common in social capital research: I construct genuine network measures of social capital (rather than infer network structure from community attributes) and conduct multi‐level analyses (rather than rely on disaggregation). My findings indicate both types of social capital are positively and significantly associated with resident ratings of community success, suggesting community networks—in both the formal and informal sectors—have important consequences for small towns and their residents.     

Trade-Offs Between Formal Home Health Care and Informal Family CareGiving

Using 1994 National Long Term Care Survey data, we estimated logistic regressions of formal and informal home health care use and hours. Home health care use and intensity were differentially impacted by chronic conditions, are higher for Medicaid enrollees and rural or small town residents, but lower for HMO enrollees. Decreases in the probability of home health care use increased informal instrumental activities of daily living (IADL) support four hours and decreased informal activities of daily living (ADL) support eight hours weekly. IADL caregiving substituted for formal care, but ADL caregiving declined with reductions in formal care. Public policy reducing formal home health care access may reduce informal ADL caregiving and increase informal IADL caregiving, producing net declines in support.     

The Community Development for Healthy Children Initiative

Abstract

An increasing interest in positive youth development has led to the creation and expansion of programs and initiatives related to youth involvement and engagement. This article focuses on the Community Development for Healthy Children initiative, which envisions making Kansas the best state in the nation in which to raise a child. The initiative includes three primary strategies: A multi-media campaign; technical assistance and support to local communities; and mini-grant opportunities. The paper provides examples of activities from across the state that promote youth involvement. Outcomes across four areas are examined, and the benefits and challenges of this initiative are also discussed.     

Is caring for older parents detrimental to women’s mental health? The role of the European North–South gradient

In the last decades, both the lengthening of life expectancy and an accentuated decline in birth rates have reduced the consistency of the younger generational cohorts. Due to an ageing population, the burden of caregiving is expected to intensify in the next quarter of the century in Europe, especially for mature women. This paper investigates the impact of the provision of constant care for older parents on the mental health of adult daughters, between the ages of 50 and 75, living in different European countries. Data is drawn from the Survey of Health, Ageing and Retirement in Europe. Information on mental health status is provided by Euro-D depression scale, a measure of depression standardized across European countries. We focus on differences in the effects according to the North–South gradient: we test whether the relationship between informal caregiving and mental health differs across European macro-regions. Our results, robust under different specifications of the propensity score model, reveal a clear North–South gradient: the provision of informal care has a negative and significant impact on daughters’ mental health in the Mediterranean countries only, where the amount of resources allocated to the Long Term Care is minimal and the local system of health and social services for the elderly lacks the necessary structures to meet the increasing demand for eldercare.     

Practitioners’ Perspectives on Choice for Older Spousal Caregivers in Rural Areas

Recent shifts toward individual choice and consumer-directed practices largely conflict with traditional expectations of familial obligation and informal caregiving. The research reported on in this paper aimed to understand how practitioners’ perspectives of spousal caregiving obligations impact on choice in rural communities. Seven focus groups were conducted in rural and outer regional areas of North East Victoria, comprising 42 practitioners who work with older couples who reside in the community. Thematic analysis revealed practitioners’ personal values and constraints of the direct practice environment impact on the experience of choice for older Australians. This discussion considers the problematic nature of choice in policy and practice for older people and their caregivers in light of these findings.     

Private lives and public programs: an Australian longitudinal study of the elderly

Major late life events, reported in the Dubbo longitudinal study of older Australians, are used to examine the interaction of private lives with public programs. First, the data indicate strong supportive effects of publicly funded income, health, and aged care programs in reducing family burdens from major life changes. In particular, financial crises were rarely mentioned, directly or indirectly, as major threats. Next, the central role of informal social support in these events is demonstrated, first, as in previous studies, family support was responsive to risky events and to aging itself. Also, in new findings, one-third of surviving elderly respondents coped with the burdens of family crises as a substantial proportion of the "major" life changes that occurred over 13 years of the study. Within the security and support provided by the Australian welfare system, and with strong social networks, families with older persons in the Dubbo study manage multiple, major life changes. With rapid population aging, the development of more, and more easily accessible, services for a growing population of older people is a priority. The critical challenge will be to harmoniously grow public financing, private funding, and informal caregiving to deal with the growing burden arising from an aging society.     

Crafting Communities: Promoting Inclusion,Empowerment, and Learning between Older Women

Abstract

While social policy and planning documents are replete with ominous warnings about the cost of an ageing population, this article tells a different story about the productive and self-sustaining networks that exist among older women in the community who do craftwork. From our research conducted in Victoria, Australia during 2007–2008 we discovered a resilient and committed group of older women quietly and steadily contributing to community fundraising, building social networks, and providing learning opportunities to each other in diverse ways. Through our conversations with nine craftswomen we have been able to articulate clear links between the theory and models commonly espoused in the community development literature and the life-enriching practices used in organising informal community craft group activities. From our interviews with the older women we provide evidence of sustained participation, the generation of social capital, and the fostering of life-long learning. While none of the women we spoke to were trained in community development and did not use language commonly associated with feminist ideology, the relationship between the informal group work with principles of empowerment and self-efficacy were unmistakeable. We conclude with a discussion of the implications of our findings for critical social work practice.     

The family caregiving career: implications for community-based long-term care practice and policy

Informal (i.e., unpaid) long-term care for disabled older adults is often chronic, but it is only recently that research has considered the longitudinal implications of family caregiving. In particular, investigators have conceptualized caregiving as a "career," and within the caregiving career, a number of diverse trajectories and transitions can occur. Following a summary of these findings, this paper considers how longitudinal caregiving research can influence and potentially address key policy and practice concerns, especially in the delivery and support of community-based long-term care (CBLTC) services. It is suggested that with the refinement of the informal long-term care literature, existing policy and practice to support caregiving families can be similarly advanced.     

Continuity and Change in Mothers' Favoritism Toward Offspring in Adulthood

The importance of parental favoritism in childhood and adulthood has been well documented; little is known, however, about changes over time in such within‐family differentiation. Drawing on theories of life course processes and developmental psychology, the authors used 7‐year panel data collected from 406 older mothers about their relationships with 1,514 adult children to explore patterns of favoritism regarding caregiving and emotional closeness. The findings demonstrated continuity in patterns of mothers' favoritism. Mothers tended to prefer the same children across time, particularly regarding preferred caregivers. It was anticipated that children's social‐structural characteristics, similarity to their mothers, structural position in the family, and support provision to mothers would predict favored child status across time; however, only similarity and support processes were strong and consistent predictors of change and continuity in patterns of mothers' favoritism.