Editorial

This initial report details the origin, development, and “charter residents” of the new ElderSpirit Community, a resident-managed elder-only cohousing community focusing on mutual support and affordable housing. The 33 resident sample was white, 79% female, averaged 70.4 years of age (range = 63 to 84 years), and was more likely to be childless and/or divorced/never married compared to the general older population. Mutual support was significant in choosing the ElderSpirit Community, and this case demonstrates that elders can proactively choose this new option: living intentionally with neighbors to provide an added layer of support. The ElderSpirit Community is important given the caregiver shortage and desire for nursing home alternatives.     

“I feel like her daughter not her mother”: Ethnographic trans-cultural perspective of the experiences of aging for a group of Southeast Asian refugees in the United States

ObjectiveThis study seeks to understand trans-cultural aging and stressors for aging refugees. It describes the experiences of Cambodian refugee women as they age in the United States.MethodExperiences of 16 Cambodian refugee women (ages 44–60), participants of a Cambodian community health center support group, were examined over a year.ResultsAnalysis revealed complex experiences of aging in the U.S. including these: (a) loss of role as respected elder, (b) fear of living separate from children, (c) feeling devalued by children, and (d) feeling self-blame for intergenerational cultural gap. The women described years of employment interrupted by the exacerbation of post-traumatic symptoms later in life preventing further employment.DiscussionAn ethnographic trans-cultural perspective of the experiences of aging for Southeast Asian refugees. Aging refugees face stressors even 20–30 years after resettlement. Findings show decrease in functioning as survivors of torture age. Recommendations for social service programs and providers are made.     

Support Network Connectedness in the Lives of Community-Dwelling Rural Elders and Their Families

Rural elders face challenges when accessing assistance from family, neighbors, and paid helpers. This support is essential to allow them to remain community dwelling as they develop physical challenges that limit their ability to care for themselves. This qualitative study followed a group of 16 rural elders with physical limitations for 1 year. In-depth interviews were conducted with them and eight members of their support networks, including five family members, to explore how rural older adults create and maintain support networks that allow them to remain community dwelling despite physical challenges that limit their self-care. The research question is, “How do members of the support network connect with each other to maximize the effectiveness of the network?” Family members coordinated assistance to maximize the abilities and availability of various network members. In addition, family members worked together with other family members, neighbors, and paid helpers to assist the elder. These strategies enhanced the ability of the network to assist the rural elder and also lessened the burden of care by dispersing it among network members.     

Recent developments in institutional elder care in China: changing concepts and attitudes

This study examines recent developments in institutional care for Chinese elders and attitudinal changes toward institutional care in Tianjin, China. Based on studies in 12 elder home sites and survey interviews with 265 older residents, this study compares institutional differences between government and non-government-owned elder homes, and examines elders' evaluations of elder homes' quality and their level of willingness to stay in elder homes. Findings suggest that government-owned elder homes still enjoy institutional and bureaucratic privileges in funding, staffing, and insurance. Elders' overall evaluation of elder home quality was high. Elders' former living arrangement and financial ability were related to their willingness to stay in the elder home. The unfair competition between governmental and non-governmental elder homes is likely to hinder the development of elder home industry in the free-market system and foster a growing gap between the rich and poor elders in their capability and decisions in elder home care. As adult children become increasingly unavailable due to the one-child policy and geographic mobility, institutional care for aging parents is likely to become one of the major options for parent care.     

Pioneering partnerships: Resident involvement from multiple perspectives

Resident involvement in residential care homes is a challenge due to shortcomings of consumerist and formal approaches such as resident councils. The PARTNER approach aims to involve residents through collective action to improve their community life and wellbeing. The purpose of this article is to provide insights into the process of resident involvement by the PARTNER approach from the perspectives of multiple stakeholders, including residents, volunteers and staff members. A responsive evaluation was conducted, using participant observations, semi-structured interviews with residents, volunteers and professionals (n = 16), and three focus groups. The findings show that critical elements in this process of resident involvement were the agenda-setting by residents, the formation of a cohesive resident group, the sharing of experiences and stories, the development of collective action, and the development of partnerships between residents and professionals and other stakeholder groups. Residents developed actions (gallery parties and a buddy project) to strengthen social interactions and realized these with the help of volunteers and professionals. We conclude that bringing residents together around a shared topic creates room for activism and leads to empowerment, feelings of social belonging and learning processes. We argue that it is a worthwhile enterprise to further develop structural partnership relations between residents, volunteers and staff in residential care homes.     

Differences between Cohousing and Gated Communities. A Literature Review

On the basis of the literature (produced mainly by sociologists, architects, and geographers) about gated and cohousing communities, this work analyzes how these communities differ from each other. The analysis suggests that cohousing and gated communities are different in the nature of relationships between residents and in the reasons why they arise, even if there are some points of similarity. The risk of a degeneration of cohousing in the gated type is linked in particular with a complete transformation of the grass‐roots model (typical of cohousing) to the top‐down speculative scheme (typical of gated communities).     

Elder Abuse in Costa Rica

ABSTRACT

This paper describes how the problem of domestic elder abuse in Costa Rica is being perceived and acted upon by direct service providers and other professionals in the field of aging. Costa Rica is a small Central American democracy in which the family is the central institution and the sense of filial obligation is strong. In this cultural context elder abuse often takes the form of overprotection by family members who deprive elders of their autonomy. Although they suffer from this loss, elders frequently do not define it as abuse, making it difficult for professionals to intervene. A more serious concern was abandonment of elders by families (with or without intent to harm) since there are few facilities or resources to accommodate such elders. Overall we found a mixture, sometimes in the same person, of resignation in the face of a phenomenon that may come inevitably with modernization and committed activism. We illustrate the latter by describing the efforts of two Costa Rican organizations to prevent elder abuse.     

Mistreatment of Vietnamese Elderly by Their Families in the United States

ABSTRACT

Generally, research on elder abuse has focused on the elders in mainstream America so that little is known about the nature and scope of elder abuse occurring in the Vietnamese community. This study presents the results of a research project on the relationship of Vietnamese elders residing in Santa Clara County, California and their families. It also explores cultural factors that may be associated with elder mistreatment such as issues of dependency and personal indebtedness. The implications for intervention and prevention are discussed, along with proposed changes in human service programs that could enhance the well-being of Vietnamese elders.     

Enhancing Gerontology Education

Abstract

Co-learning opportunities for elders and students may enhance the ability to make course information “real” for traditional students and provide elders with new relationships that can reduce stereotypical thinking about younger people. A Human Development and Aging course taught at Kansas State University in the Spring of 2003 brought eighteen young adult students and eighteen auditors from a retirement community together to explore their understanding of aging issues. Based on evaluations through focus groups and written surveys, older and younger participants alike experienced changes in their attitudes toward persons of age groups other than their own.     

Elder Abuse Telephone Screen Reliability and Validity

Purposes: (a) To identify reliable and valid questions that identify elder abuse, (b) to assess the reliability and validity of extant self-reported elder abuse screens in a high-risk elderly population, and (c) to describe difficulties of completing and interpreting screens in a high-need elderly population. Design and Methods: All elders referred to research-trained social workers in a community service agency were asked to participate. Of the 70 elders asked, 49 participated, 44 completed the first questionnaire, and 32 completed the duplicate second questionnaire. A research assistant administered the telephone questionnaires. Results: Twenty-nine (42%) persons were judged abused, 12 (17%) had abuse reported, and 4 (6%) had abuse substantiated. The elder abuse screen instruments were not found to be predictive of assessed abuse or as predictors of reported abuse; the measures tended toward being inversely predictive. Two questions regarding harm and taking of belongings were significantly different for the assessed abused group. Implications: In this small group of high-need community-dwelling elders, the screens were not effective in discriminating between abused and nonabused groups. Better instruments are needed to assess for elder abuse.     

“Those people” and troubles talk: Social typing and community construction in senior public housing

Community has developed as an increasingly important research topic in gerontology. As we search for the ever elusive sense of community and social integration among the aged, gerontologists have strangely left aside, for the most part, the interactional formation of community as a phenomenon. How do elders actually achieve this thing in their daily lives? By what interactional mechanisms is it constructed? Using data gathered from an ethnography of a senior public housing complex, I argue that in this particular neighborhood, community is accomplished by residents through “troubles talk.” An important component of this shared talk are social types indigenous to the complex. The act of social typing allows the residents to organize, categorize, and classify each other, providing recognizable and commonly held knowledge of each other, a vital component of community.     

The role of social isolation of elders in recidivism of self-neglect cases at San Francisco Adult Protective Services

This study examined the relationship between social isolation of elders and recidivism of self-neglect cases at San Francisco Adult Protective Services. Of secondary interest was an examination of other risk factors: mental health concerns, cognitive deficits, and substance/alcohol abuse. A secondary chart review was conducted on 704 elder clients with confirmed cases of self-neglect in 2004. Bivariate and multivariate analyses showed a positive relationship between substance/ alcohol abuse and recidivism, and a negative relationship between cognitive decline and recidivism. No significant relationships were found for social isolation or mental health concerns and recidivism. This study supports previous research suggesting significant relationships between substance abuse and self-neglect, further demonstrating a need for more substance/alcohol abuse programs for elders.     

The conceptualization of mistreatment by older American Indians

The problem of how to conceptualize elder mistreatment goes back several decades, and is especially important for ethnic minority populations, who may have perspectives that differ from the dominant society. This community-based participatory research study, which examined perceptions of mistreatment by family among 100 urban and rural older American Indians, permits a rare glimpse into how Native elders themselves understand this issue. Here, good treatment was conceptualized in terms of being taken care of, having one’s needs met, and being respected. We found relatively high standards for how elders should be treated—such as the belief that an elder’s needs should be anticipated and met without the elder needing to ask—in the face of widespread accounts of the mistreatment of elders within the community, largely through various acts of financial exploitation and neglect. Substance abuse and culture loss were blamed formuch of the elder mistreatment occurring in contemporary Native communities.     

The Meaning of a “Sense of Community” in a Finnish Senior Co-Housing Community

In the foreseeable future, alternative housing options will be needed to meet the needs of and answer to the wishes of older people. Co-housing schemes are developed to fulfill the need for a housing type that provides mutual support and social contacts while alleviating the isolation and loneliness often experienced in ordinary neighborhoods. This study on a senior co-housing community in Finland asked what a “sense of community” meant to the residents and how a sense of community becomes visible in daily life. For these residents, a sense of community meant not only living with like-minded people but also communal activities, doing things together, learning from each other, and having reciprocal support, all of which created a sense of togetherness, belonging, and trust. The findings of this study showed that moving in later life can offer a viable option of having a living environment that one likes, which calls for a broader interpretation of housing policy guided by “aging in place” thinking.     

WEB SITES

Abstract

It would be useful to better understand the personal determinants of successful interventions in the community, especially those interventions already recognized for their efficacy and efficiency, such as elder home care telesurveillance. This is a modality of health care services that transmits, via a call center on a 24/7 basis, the clinical information necessary to follow elders outside medical centers. Community health workers refer elders to this service. A qualitative research design was realized to understand why so much difference in the implementation of this service had arisen in two comparable sites previously judged receptive. The research objectives were as follows: (1) to document the personal determinants associated with telesurveillance adoption by community health workers, in two sites previously judged receptive; and (2) to point out the personal determinants that can explain successful adoption of telesurveillance. According to the Theory of Interpersonal Behavior, the results showed that habits (e.g., community health workers' knowledge of new information technologies) and perceived barriers in clinical practice were fundamental determinants in the adoption of telesurveillance.     

Elder self neglect: A geriatric syndrome or a life course story?

AimsTo explore the unique aspects of the elder self-neglect phenomenon and to achieve phenomenological understanding of self-neglect through the eyes of self-neglecting elders.MethodA qualitative study based on a sample of 16 self-neglecting elders. Data collection was performed through in-depth semi-structured interviews, followed by content analysis.FindingsFour major themes emerged from the older participants: “I was unlucky:” a life course of suffering; “That's the way it is:” self-neglect as a routine of life; “They tell me that I'm disabled:” old age as exposing situations of self-neglect; “My empire:” how do I perceive my old age.ConclusionsSelf-neglect is not necessarily an issue of old age, but is related to the person's life history. Self-neglect as a way of life accompanied the participants into old age, but it was not originated or created there. The overall message of the self-neglecting elders was to see them as human beings and not as old neglected people; not to label them as an “age syndrome” but to perceive them in a holistic and humanistic manner.     

Planning for Aging in Place: Incorporating the Voice of Elders to Promote Quality of Life

Abstract

Aging in place offers emotional and physical benefits; however, challenges associated with advanced age may make aging in place difficult. As communities across the country prepare for forecasted increases in the proportion of older residents, it is important to understand barriers that may prevent aging in place. Perceived barriers voiced by residents of a suburban county who completed an Aging in Place Needs Assessment Survey were categorized into four themes: need to downsize/home modification; need for assistance; family desire to reciprocate care; and isolation. A fifth group with no intent to relocate, but with concerns about having to, was also identified. Included among this group were persons with mental health or developmental disorders, such as anxiety and autism spectrum disorder. Results were examined through a person-centered lens to illustrate that aging in place may be the desired option even among residents who indicate that it is not. It is important that aging-in-place initiatives preserve identity by fostering a sense of autonomy, control, and well-being in older residents.     

Caregiving and long-term health care in the People's Republic of China

The growing proportion of frail elderly in the People's Republic of China has necessitated policy of the state toward their long-term care. In this decade, there has been an increase in the amount of data available on the care and needs of Chinese frail elders. This article synthesizes these data and traces the patterns of care of frail elders. It distinguishes between urban and rural patterns, and identifies the increasing role of the family and community in the caregiving of elders. State policy, evident from the data, suggests that the state's role in direct care of elders is minor but that it continues to influence and support eldercare as part of its policy of promoting the one-child per couple policy. This process can be seen in support programs for the childless elder, who symbolizes the expected condition of a large number of future elders under the one-child policy. The article identifies four factors that are influencing the changing patterns of long-term care of elders in China: (1) economic reform programs; (2) the political agenda of the Chinese Communist Party; (3) differences in urban and rural economic conditions; and (4) policy directed at long-term investment in health care technology.