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.     

Formal Social Participation and Utilization of Community-based Services among Urban Elderly Chinese Living Alone in Shanghai,China

This research examined formal social participation among elderly Chinese adults living alone and the association between utilization of community-based services and formal social participation, which refers to participation in employment, volunteer jobs, and social groups. Using a secondary analysis on a survey data from a simple random sample of 228 adults aged 60 and older living alone in a Shanghai neighborhood, it was found that only small percentage of older adults living alone were involved in formal social participation. Hierarchical multiple regression analysis showed that use of community-based services is significantly associated with formal social participation among elderly Chinese living alone. Thus, future policies and programs should focus on strengthening community-based services for elderly Chinese, to more effectively promote and facilitate their social participation.     

THE USE OF SOCIAL SERVICES BY BLACK AND WHITE ELDERLY

Little is known about the roles of the family, kin, and non-kin support networks in determining the use of social services by the elderly. The purpose of this study was to examine the role of the formal and informal support systems in explaining social service utilization by Black and White elderly. Path analytic procedures are used to test an explanatory model of utilization by a national area probability sample of 3.996 non-institutionalized elderly. The findings indicate that informal family support was more important for Black elderly than White elderly. In addition, family aid was found to be supplementary rather than an alternative support system. In the planning, designing, and delivery of social services to the elderly, it is imperative that racial and cultural differences become explicit input factors. Additionally, future researchers have a responsibility to employ research procedures capable of simultaneously dealing with a comprehensive range of variables in investigating this rather complex phenomenon.     

Post Acute Care of the Elderly in Singapore What Factors Influence Use of Services?

This research focused on understanding the factors associated with utilization of post-acute care services in Singapore and how these are woven into family care as well as the lived experience of elderly persons and their families. The multi-method study applied Andersen's model and the quantitative results of the 299 elderly Singaporeans surveyed showed medical and physical conditions, perceived health and utility, knowledge and previous use of service, ethnicity, family size, paid help, housing type, and living arrangement as significant factors. Qualitative results from interviews of a subsample of 13 elderly and their family members and focus group discussions of providers consistently pointed affordability of services as an important factor. Findings surfaced the question of service accessibility and its implications on practice, policy, and research.     

Services Provided by Elderly Volunteers

As the number of elderly persons increases, the social service needs of older Americans will grow too. To provide a variety of services, many social service agencies across the nation are helping the elderly organize to help themselves. This paper represents the second of a series of research reports derived from a federally funded research project to investigate the types of services that trained elderly volunteers provide to other elderly persons in the community. This paper presents a multivariate analysis of elderly volunteers who go beyond providing socializing and reassuring services and provide instrumental services. The independant variables are developed to capture the level of the physical and mental strengths of elderly volunteers. Theses strengths are psychological functioning, perceived health, psychological adjustment, and social resources. In addition, program-participation factors, such as the duration of participation in the volunteer project and the number of persons served, as well as variables related to demographic and educational backgrounds, are included in the analysis as controls. The major findings from this study are the following: (1) Among the independant variables, perceived health is a statistically significant predictor of a volunteer's becoming a provider of instrumental services; (2) The volunteer's level of education and the number of elderly persons served are also statistically significant predictors. One the whole, however, elderly volunteers perfer socialization and reasurance over instrumental services when they try to help other elderly persons.     

图形的逻辑力量：因果图的概念及其应用

本文旨在系统性地引介因果图方法,一种社会科学领域新近发展起来的探究因果推断的非参数估计工具。首先对因果图的基本概念和构型进行介绍,讨论变量之间不同“通路”对应的开启和阻断规则及因果推断中的三种偏差来源,即混淆偏差、过度控制偏差、内生性选择偏差。在此基础上,本文将因果图框架与现有定量社会科学研究中基于回归模型的因果推断方法思路进行融合,结合实际案例使用因果图阐释包括遗漏变量、样本选择、自选择及联立性在内的四种内生性问题,并对多元回归与匹配、代理变量、实验、工具变量、面板模型等因果推断方法的运行机制进行了图形化。最后,本文使用因果图厘清一些关于因果推断的不准确理解。     

Befriending Services for Culturally Diverse Older People

Befriending services may address loneliness and social isolation amongst older people. However social diversity is rarely reported in investigations of befriending services. The views of non-users are also rarely explored. In this research, we explored older adults’ experiences of, and attitudes towards, a befriending service, among service users and non-service users, drawing on interviews and focus groups with 76 older adults, 10 volunteer visitors, and 20 service providers. Participants agreed that the befriending service helped alleviate social isolation and loneliness and that supportive services to foster connection are needed. Barriers to engagement included lack of knowledge, appropriateness of services and feeling undeserving. The befriending service was most successful when a match went beyond a transactional ‘professional-client’ relationship to resemble genuine friendship, underpinned by mutual interests and norms of reciprocity and reliability. We also identified five clear ideas about what characterizes an ideal supportive service; supported opportunities for getting out, genuine and reciprocal relationships, reliability, visitor characteristics, and connecting people to their culture. Befriending adds to social networks, and enhances connectedness to the community. Loneliness is alleviated when mutually beneficial and genuinely reciprocal relationships develop. However, group interventions or connections to community groups may be more appropriate for some.     

The Elderly Blind:

This paper discusses some of the problems faced by the elderly blind in society. It is pointed out that the definition of blindness as well as the development of blind services mainly for the young and employable adults have contributed to public misunderstanding of blindness and the magnitude of visual problems among the elderly. It is also noted that with coordinated efforts between blind service agencies and social service agencies future problems among this group could be minimized.     

Assessment of a Brief CES-D Measure for Depression in Homebound Medically Ill Older Adults

Black elderly individuals represent one of the most disadvantaged groups in the United States in terms of income levels, health problems, and access to supportive services. This paper describes four major factors to be considered by social service providers to focus their programs toward needs of the black elderly population in their local communities. A research project designed to examine the social service needs and service utilization of the black elderly in a Midwestern community indicated that the following factons hould be considered if effective service programs are to be implemented: (1) Negotiation Initiative, (2) Responsible Research, (3) Symbolism, (4) Modeling.     

FAMILY CARERS: SOME IMPEDIMENTS TO EFFECTIVE POLICY AND SERVICE DEVELOPMENT

The shift to community care for people with disabilities in Australia has given rise to some recognition and acknowledgment, in both academic research and policy development, of the importance of their carers. However, information about government policy and services for carers is fragmented and limited. Our knowledge about the prevalence of caregiving and the socio-demographic characteristics of carers and their service needs, is inadequate. Studies in relation to carer use of and satisfaction with services tend to be small scale and focussed on a specific service or carer group. Carer views on broader mainstream service provision have received little attention. This paper identifies gaps in our knowledge as well as the practical and conceptual difficulties in documenting the range of services available and the relevant social policy. These difficulties are likely to reflect barriers to broad and effective policy and service development.     

Family support services delivered using a restorative approach: A framework for relationship and strengths‐based whole‐family practice

Family support services, an integral part of many welfare systems across the developed world, have witnessed a growing demand for the use of relationship and strengths‐based whole‐family approaches in the belief that this increases service engagement and effect. Despite this, knowledge that delivering services using such approaches can be challenging and calls for the identification and exploration of methods likely to promote and sustain their use. Restorative approach is an ethos and method centred on building and sustaining positive relationships, which is increasingly being adopted in family and children's services in the United Kingdom. Despite this, the scarcity of research conducted in this area as yet, means little is known of its use and effect in this context. This article draws on empirical data collected in a wider study exploring the efficacy of different family service delivery models to describe the use of restorative approach in family service provision and determine whether its adoption promotes sustained use of strengths and relationship‐based whole‐family approaches when working with families. Furthermore, it explores whether the process incorporates wider evidence‐based methods of change.     

Primary Caregivers and Chinese Elders’ Demand on Community Services

Abstract

The most influential model explaining the elderly’s service use is Andersen and Newman's model. But the applicability of the model on elders’ demand on community services has not been tested, especially in developing countries such as China. This research tested the applicability of the model by studying how primary caregiver relations to the elderly influence Chinese community-dwelling elders’ demand on community services. With a total of 2,124 respondents aged 65 and older who reported primary caregivers, six primary caregiver relations were examined: son, spouse, daughter, daughter-in-law, unmarried son and daughter, and other. Data came from the 2014 wave of the Chinese Longitudinal Healthy Longevity Survey (CLHLS). Results indicated that: (1) Elders cared for by daughters-in-law showed a significantly stronger tendency of expecting community services than elders cared for by other caregivers among both rural and urban areas. (2) Elders were least likely to expect community services in two cases: urban elders taken care of by daughters and rural elders whose primary caregivers were unmarried sons and daughters. Since Chinese elders cared for by different caregivers tended to seek community care in different manners, future research may study how suitable community service programs can be developed to well meet the needs of various elderly groups.     

Elderly Consumers and Social Care Policy

The development of social care policy for elderly Australians is proceeding with little regard for the preferences and perspectives as expressed by the elderly themselves. The likely consequence is a continuation of policies based largely on other people's assumptions about what elderly people actually need and the extension of service categories into which many elderly people do not easily fit. Discussions with 71 elderly consumers during 1983 in Queensland established that they have input to make into policy and service delivery issues such as the provision of information on services, the determination of needs, the extension of choices between alternative services and choice of appropriate service providers. Social care policy should not continue to develop around singular and untested assumptions concerning what elderly people need and prefer.     

Social Work as a Social Institution

This paper discusses trends in social work in the last twenty-fiveyears. Within the broad theme of social work as a social institution,more detailed attention is focused on: services for childrenand elderly people; manageralism; and social work research andevaluation. Processes of secularization, professionalism andmanageralism have weakened the impetus for social reform. Thishas sharpened dilemmas for social work in balancing benefitsfor service users and public involvement with tight state controland regulation.     

The Elder Latino Population in Holyoke,MA

Abstract

Holyoke's elderly Latino population's needs, as well as their patterns of service utilization, were explored through detailed interviews of 13 individual elders and a focus group of an additional 10 participants. The research uncovered a gap in the web of resources available, with some services, such as medical care, functioning well. However, there continue to be unmet needs, particularly in the areas of transportation, social and recreational activities, and sense of safety. Negative perceptions of aging and complaints of anxiety, depression, and boredom are also an area of concern.

The barriers to use of services were also explored. Recommendations for the enhanced provision and utilization of services, many suggested by the elders themselves, are offered. Implications for social work research and policy on, and practice with, Latino elders are discussed.     

Sociocultural Perceptions and Patterns of Cigarette and Alcohol Use among College Students in Vietnam

This empirical study was conducted in the Socialist Republic of Vietnam to investigate cross‐sectionally the influences of sociocultural contexts on the patterns of addictive substance use cigarette, alcohol, and illicit drugs. A sample of 202 monolingual adults who were enrolled in college courses at the University of Hanoi in Vietnam responded to a self‐reported questionnaire in their native language on the frequency, quantity, and occasions of addictive behavior. The project staff were fluent in English and Vietnamese. The questionnaire was critically reviewed for its face validity and cultural appropriateness before being translated into Vietnamese. In addition to patterns of use, this research explored the central role of drinking alcohol and smoking cigarettes in peer socialization among college adults. Vietnam, like other Asian cultures, emphasizes initiation and conformity to social traditions and norms. The empirical findings provide invaluable knowledge of the complex roles of cigarette and alcohol in the social processes and relationship‐building among college adults in Vietnam. Further knowledge will assist in identifying intervention approaches and health prevention that is more focused and congruent with cultural and social beliefs about this behavior and these substances. Its implications for research into culturally appropriate intervention and prevention are also discussed.     

Public Willingness to Utilize Psychiatric Social Work Services

This paper reports the results of a survey of New Orleans residents concerning knowledge about and willingness to utilize the services of psychiatric social workers. The research was inspired by the complaints of some psychiatric social workers that the public neither understands nor utilizes their services. Analysis of the survey findings indicates that this assessment is only partially correct. The public does possess a general knowledge of psychiatric social work and does grant the occupation relatively high prestige. Twenty-five percent of the sample could imagine themselves ulilizing the clinician's services. However, only one variable explored in this research is directly linked to use propensity: family contact with psychiatric social workers. The implications of this finding for increasing public use of clinical services are discussed.     

Services for the Rural Elderly

This paper examines the interaction between social policy and community characteristics as they relate to the development of formal long-term care services for the rural elderly. A model for the conversion of policy opportunity into actual services for the rural elderly is presented. This model suggests that while social policy in rural areas is a constant, selected community level characteristics contribute to or impede service development.     

Research Review: Child and family support services with minority ethnic families: what can we learn from research?

This paper considers some of the available published research on family support services for minority ethnic families. In addressing this aspect of social work with minority ethnic families, we seek to make a contribution to the knowledge base of practitioners. The paper begins with an overview of what is known about family support services for particular minority ethnic groups, before exploring three specific areas: family centres, a home visiting service, and family group conferences. The paper finally examines what research says about the qualities sought in social workers by minority ethnic parents.