Social capital and older people in farming communities

This study draws on data from interviews with older people aged 65 to 85 (n = 65) to assess the extent to which the concept of social capital can be used to inform our understanding of social networks in farming families. Findings indicate that key indicators of social capital such as trust, reciprocity and co-operation strongly influence and determine social relations. Interestingly, though contrary to much of the literature on social capital, a strong community spirit can exist where associational activities are extremely limited. Older people in this community have few opportunities for social interaction, yet this did not affect their perception of being part of a close knit community. Significantly this work challenges the assumption that older people are simply recipients of social capital and demonstrates that they are also important producers of social capital. The article contends that the relevance of this concept to older people in these rural communities has not been fully explored and is poorly understood.     

The salience of terminology: Housing research with older people from minority ethnic communities

In this article we focus on recent literature on the housing needs of older people from minority ethnic communities. Such research has undoubtedly benefited particular communities in demonstrating that their needs have been neglected to date. However, the terminology used to describe ethnicity often assumes an unproblematic black-white divide in that it defines communities as discrete and homogeneous groups. Moreover, whilst much research in this field is described as concerned with 'black and minority ethnic' communities, it is in effect about specifically defined 'black' communities with little or no room for other minority ethnic communities. We argue in this paper, using two examples, that this has consequences for resource distribution and for funding of initiatives to help minority ethnic communities.     

Outsourcing within the Nordic context: Care services for older people in Finland

The early 1990s economic setback brought significant reforms favoring the outsourcing of care in Finnish municipalities. Here, outsourcing refers to the practice of municipalities employing private organizations through different means (e.g., open tendering) to deliver public care services. In this context, this study examines the growth in the outsourcing of service housing and home-help services in 311 municipalities from 2001 to 2015 and investigates the municipal factors associated with outsourcing using four dimensions: care needs, population size, economic situation, and political ideology of the municipality. The findings reveal a steep increase in the outsourcing of home-help and service housing. Care needs of older people are the most influential factor for outsourcing, particularly for service housing. Overall, the findings show a growing trend in private care provision in Finnish municipalities.     

Community participation and inclusion: people with disabilities defining their place

Disability‐related public policy currently emphasises reducing the number of people experiencing exclusion from the spaces of the social and economic majority as being the pre‐eminent indicator of inclusion. Twenty‐eight adult, New Zealand vocational service users collaborated in a participatory action research project to develop shared understandings of community participation. Analysis of their narratives suggests that spatial indices of inclusion are quiet in potentially oppressive ways about the ways mainstream settings can be experienced by people with disabilities and quiet too about the alternative, less well sanctioned communities to which people with disabilities have always belonged. Participants identified five key attributes of place as important qualitative antecedents to a sense of community belonging. The potential of these attributes and other self‐authored approaches to inclusion are explored as ways that people with disabilities can support the policy objective of effecting a transformation from disabling to inclusive communities.     

Cultural diversity and the mistreatment of older people in black and minority ethnic communities: some implications for service provision

Previous research on mistreatment of older people in black and minority ethnic communities has identified limited service responses and the need to consider mistreatment as an issue not only for individuals but also for families, communities, and institutions. The impact of cultural factors on understandings, experiences, and remedies for mistreatment has been debated. Drawing on empirical research in the United Kingdom involving service providers and ethnically-diverse community members, the article explores implications of cultural variation for service provision. Clear gaps exist between service provision and people experiencing mistreatment due to structural and contextual factors; cultural factors have a relatively minor impact.     

Care of older people in migration contexts: local and transnational arrangements between Peru and Spain

Care arrangements for the elderly are becoming a main social process in contemporary societies due to socio-political and lifestyle changes over the last few decades. The family and the State play a basic role in the construction of care systems and in the establishment of strategies to access care resources. In the present context of migration, these resources interact at a transnational level, challenging family and State migratory regimes. These new realities need the recognition of basic international social rights, as the experiences of Peruvians living in a migration context in Spain show.     

The effectiveness of adult day services for disabled older people

Adult day care has attracted a considerable amount of attention among researchers, practitioners, and policymakers. However, there have been few efforts to synthesize empirical results. This paper reviews research that determines the effectiveness of adult day services in improving client functioning, alleviating caregiver stress, and delaying nursing home placement. In addition, the strengths and limitations of the research are considered. This paper concludes with a discussion of policy-relevant issues that must be addressed when determining the effectiveness of adult day services.     

Are clinician's ever biased in their judgments of the capacity of older adult's to make medical decisions?

Capacity assessment is a growing area of practice in geriatrics. In this pilot study we illustrate the potential relationship between clinician variables and capacity ratings. Twelve older adults with mild dementia or schizophrenia were rated by six clinicians from diverse disciplinary backgrounds. Capacity ratings were associated with clinician values regarding patient involvement in medical decisions, clinician-patient mismatches on such values, and emotional reactions to patients. Expanding our understanding of the impact of clinician variables on capacity ratings may enhance the reliability and validity of capacity assessments and help to promote autonomy when appropriate.     

The desire for control: Negotiating the arrangement of help for older people in Sweden

The interface between formal (public) and informal help for older people is unclear and subject to change in many welfare states. Our aim in this study was to contribute to increased understanding of the experiences of older people, their next of kin, and the care managers from the municipalities in the process of negotiating help in the everyday lives of older people who can no longer manage on their own. We took a qualitative approach, using qualitative interviews as the main data collection method. The results revealed that the different actors had contrary interests that made it difficult for all parties to be content with the outcome of the negotiations. The everyday lives of dependent older people and their next of kin are strongly affected by the conditions of formal eldercare.     

Resource effects on access to long-term care for frail older people

Access to long-term care depends primarily on personal resources, including family members and income, and on external resources, including Medicaid and Medicare. This study investigates how resources affect frail older individuals' access to long-term care, with a focus on Black and White widows. Data from the 1989 National Long-Term Care Survey is used, in conjunction with state-level Medicaid and Medicare reimbursement rates for nursing home and home health care, to estimate the likelihood of five types of care arrangements. Results show that children are a primary resource for unmarried individuals in maintaining access to informal care. Income effects are nonlinear in relation to nursing home care: increasing incomes below the mean income are associated with decreasing probabilities of nursing home care, while increasing incomes above the mean are associated with increasing probabilities of nursing home care. Income and Medicaid effects are interrelated, with nonlinearities associated with income having the potential to adversely affect some older persons' ability to access nursing home care.     

The life-course origins of mastery among older people

In this article, we aim to identify the sources of mastery--the understanding that individuals hold about their ability to control the circumstances of their lives. The sample for our inquiry was drawn from the Medicare beneficiary files of people 65 and older living in Washington, DC, and two adjoining Maryland counties. We find that past circumstances, particularly those reflecting status attainment and early exposure to intractable hardships, converge with stressors experienced in late life to influence elders' level of mastery. The impact of past conditions, however, does not necessarily directly affect the current mastery of older people. Instead, the effect of prior experiences on current mastery is mediated by what we refer to as life-course mastery: one's belief that one has directed and managed the trajectories that connect one's past to the present. Our analyses show that life-course mastery largely serves as the mediating channel through which individuals connect their past to their present.     

Innovative models of aging in place: Transforming our communities for an aging population

As the proportion of the global population over 60 continues to grow, the issue of where and how elders are going to live becomes increasingly pressing. The idea or “aging in place” – in which elders remain in their own homes and communities – is becoming an increasingly popular alternative to age-segregated retirement communities. This article documents three new models of aging in place – naturally occurring retirement communities (NORC-SSPs), villages and campus-affiliated communities – and explores how they seek to provide both services and meaningful connections among members. Data from interviews and site visits reveal both promising practices as well as challenges such as how to ensure access for low and moderate-income elders, integrating elders from diverse cultural and linguistic back grounds, and building the leadership and participation of elders. By looking critically at these models, the author argues that many previously held theories and assumptions about the aging process and social capital formation must be reexamined in light of the agency of elders and the new organizational models. Ultimately the design of our communities – both physically and socially – and our approach to retirement must be restructured to support the needs of an aging population.     

Rural communities and well‐being: a good place to grow up?

This study looks at young people's accounts of life in communities in rural northern Scotland, and considers in what ways affective and social aspects of community are bound up with well‐being, over and above young people's concerns for the future, rural youth transitions, and out‐migration. Interviews were held with 15–18 year‐olds in four study areas (16 groups, N=60+) and a parallel survey of 11–16 year‐olds was conducted in eight study areas (N=2400+). Themes to emerge from the interviews included: opportunities locally, the future and staying on, as well as local amenities and services; but older teenagers also spoke at length about their social lives, family and social networks, and their community, both as close‐knit and caring and as intrusive and controlling. Rural communities were seen as good places in childhood, but not necessarily for young people. In parallel with that, the survey data paints a picture where feelings of support, control, autonomy, and attachment were all associated with emotional well‐being. Importantly, links between emotional well‐being and practical, material concerns were outweighed by positive identifications of community as close‐knit and caring; and equally, by negative identifications as intrusive and constraining, where the latter was felt more strongly by young women. Certainly, beliefs about future employment and educational opportunities were also linked to well‐being, but that was over and above, and independently of, affective and social aspects of community life. Additionally, migration intentions were also bound up with sense of self and well‐being, and with feelings about community life; and links between thoughts about leaving and community life as controlling and constraining were, yet again, felt more strongly by young women. Thus, gender was a key dimension affecting young people's feelings about their communities with significant implications for well‐being, and out‐migration. The study illustrates the importance of understanding the experiences young people have of growing up in rural areas, and how they evaluate those experiences: particularly, how life in rural communities matters for young people's well‐being; and especially, for young women.     

The experience of quality of life among older people

Although quality of life has been in the focus of attention for over a decade there are few studies available investigating, how the old and the oldest old experience their quality of life or what quality of life actually means for them? To illuminate this, eleven in-depth interviews were conducted with six women and five men (80+) living in their home. An interpretative hermeneutic phenomenological analysis revealed that quality of life in old age meant a preserved self and meaning in existence. Maintained self-image meant that the older people experienced a coherent life with an intact meaning. How quality of life was valued depended on the meaning the old people attached to the areas of importance as well as how they were evaluated. Additionally, areas not generally included when measuring quality of life became discernible. The meaning of home, how life was viewed, thoughts about death and dying, and telling ones story proved to be areas of importance for their perception of quality of life. Thus, indicating that older people's view of quality of life is more complex than some of today's most commonly used quality of life instruments capture and that quality of life assessment tools needs to measure beyond pure health indices. For nursing care the use of life review in everyday care, and an open way towards existential topics as well as a family oriented care along with preventive work helping people to remain in their own homes may enhance their experience of quality of life.     

The role of communities in safeguarding children and young people

Historically, children's safeguarding policy and practice in the UK have focused on individual and family‐level explanations of abuse and neglect, with relatively little attention given to children's overall well‐being or the role played by neighbourhood conditions in shaping it. As a result, community‐oriented practice, designed to improve the neighbourhood conditions in which many of the families who come to the attention of child welfare agencies live, has largely remained on the margins of mainstream provision for safeguarding children and young people. However, more recent policy developments, including Every Child Matters and the Children's Plan, do highlight the influence of children's wider circumstances on their well‐being, providing the foundations for more holistic approaches to service provision. Nevertheless, it is argued that these policy developments are unlikely to be successful unless they are accompanied by fundamental changes within the culture of many agencies and professions. Using a combination of ecological theory and practice examples, some of the main strands of the changes required (developing a culture of listening to children and adults; recognising and supporting the safeguarding activities of local people; and promoting partnership approaches to extending local provision) are critically examined. Copyright © 2009 John Wiley & Sons, Ltd.     

Theorizing accommodation in supportive home care for older people

This paper examines the issue of what thinking is necessary in order to advance a notion of accommodation in the organization and provision of supportive home care for older people. Accommodation in this context is understood as responsiveness to the singularity of older adults, and we consider how this idea might be used to support opportunities for (independent) living for elders as they age and become frailer. To elaborate the question we draw on examples from our empirical work – ethnographic studies of home care practice undertaken in Canada and Iceland – and consider these examples in light of critical philosophical and social theory, particularly Agamben's (1993) work, The Coming Community. This is a relevant frame through which to consider the potential for the accommodation of the unique needs of older adults in home care because it helps us to problematize the systems through which care is accomplished and the current, dominant terms of relations between individuals and collectives. We argue that giving substance to a notion of accommodation contributes an important dimension to aligned ideas, such as patient-centeredness in care, by working to shift the intentionality of these practices. That is, accommodation, as an orientation to care practices, contests the organizational impulse to carry on in the usual way.     

What are friends for? Elective communities of single people

The paper presents the results of a qualitative research on friendship networks of single people. The research has been undertaken using social network analysis tools (egonetworks) and qualitative interviews, on a non-representative sample of 23 heterosexual singles of Milan, aged between 25 and 35 years, 12 male and 11 female.