Health and Well–Being in the Young Old and Oldest Old

Most individuals experience a decline in health status during old age. Paradoxically, there are proposals that older adults nevertheless maintain a positive sense of well–being, an indicator of successful aging. Data from the Berlin Aging Study (BASE: Baltes & Mayer, 1999), a locally representative sample of men and women aged 70 to 100+ ( N = 516, M = 85 years), suggest that cumulative health–related chronic life strains set a constraint on the potential of oldest old individuals to experience the positive side of life. The young old in BASE reported significantly higher positive SWB than did the oldest old. Chronic illness and functional impairments (e.g., vision, hearing, mobility, strength) limit well–being especially in very old age.     

Well–Being: Concepts and Measures

Well–being, or quality of life, is a continuing goal for individuals and a major criterion for the evaluation of governments and societies. As a research concept, however, it has been marked by persisting problems of definition and measurement and by uncertainties about its changing pattern over the life course. In this article, these issues are discussed; the concept of well–being is "unpacked" and a model of stocks and flows is described as applicable to the analysis of well–being. Finally, the concept of resilience is proposed as important for research on well–being in relation to age.     

Functional Capacity and Self–Evaluation of Health and Life of Oldest Old in China

This study is based on survey data from a sample of 8,805 elders aged 80–105 in 22 provinces of China. Rural oldest old are significantly more active in daily living than urban oldest old; adaptation is perhaps the major explanation of this difference. Female oldest old are seriously disadvantaged in functional capacities and self–reported health as compared with their male counterparts. Percentages of being active in daily living, having good physical performance, normal cognitive function and well–being drop dramatically from age 80–84 to 100–105. Proportion reporting satisfaction in current life, however, remains almost constant from age 80–84 to 90–94 and declines slightly afterwards. This may suggest that being more positive in self–feeling of life is one of the secrets of longevity.     

Researching Quality of Life in Early Old Age: The Importance of the Sociological Dimension

Measurement of quality of life has become a major feature of much social and epidemiological research in health and social care settings. It is seen as an important alternative to more process‐based outcome measures but remains poorly defined. A major weakness is the absence of any coherent theoretical underpinning whether sociological, psychological or philosophical. Into this conceptual vacuum proxies for quality of life have been introduced. Quality of life [QoL] research into older populations has focused on measures of health and illness as equivalents of QoL. This paper argues that this response is inadequate as it reduces old age to a dimension of health, disability and disease. Instead, we argue that it is necessary to create a theoretically based measure of QoL in early old age which relates to those aspects of later life that are not defined by health. We present a model of QoL that is derived from aspects of contemporary social theory as they relate to the ontology of late modernity. In particular, we utilize a model based upon needs satisfaction. The model contains four domains: Control, Autonomy, Pleasure and Self‐realization. The measure consists of a 19‐item scale. The four domains load on to a single latent QoL factor. We argue that the CASP 19 scale offers an approach to QoL that integrates a sociologically based model of quality of life with a meaningful and valid research instrument.     

In Their Own Words: Elders' Reactions to Vision Loss

Understanding how persons over 70 years of age cope with the stresses of living is of central interest to gerontologists, service providers and policy makers. Their family life has been studied as an indicator of quality of life. Frequently there has been an implicit assumption that the family is, or should be, a sufficient informal resource system. In 1987-88, 520 elderly persons living in Vancouver were interviewed in their homes regarding their general and dental health and support systems. Information was obtained on interaction with family, friends, neighbors and formal caregivers. To determine respondents' appraisal of her/his social resources, they were asked to whom respondents' would turn if she had problems. To establish reciprocity, they were asked who would turn to them for help with the same problems. Significant differences by gender and marital status are found as to whom one perceives to be available to meet personal care, instrumental and emotional needs. Expected reciprocity is low except for instrumental needs with neighbors and emotional needs with friends.     

Food Banks and Food Security: Welfare Reform,Human Rights and Social Policy. Lessons from Canada?

In the past twenty years food banks have established themselves as one of the fastest–growing charitable industries in first world societies. As institutionalized centres or clearing houses for the redistribution of donated and surplus food they have emerged as a key frontline response to the growing problem of food poverty and inequality. As welfare states have been restructured and cut back and basic entitlements have been denied, food banks have become secondary extensions of weakened social safety nets. This paper explores the growth of food banking in Canada and analyses its role in terms of advancing the human right to food, its effectiveness in achieving food security and the extent to which it contributes to, and/or counters the increasing emphasis by governments on welfare reform policies informed by neo–conservative ideology. Food banks are examined from the perspective of their origins and purposes, institutionalization, usage, food distributed and effectiveness. The rise of food banks in Canada is concrete evidence both of the breakdown of the social safety net and the commodification of social assistance. As such, they undermine the state's obligation, as ratified in international conventions, to respect, protect and fulfil the human right to food. They enable governments to look the other way and neglect food poverty and nutritional health and well–being. A possible future role for food banks in countries where they are already established lies in public education and advocacy, but their institutionalization makes this seem an unlikely course. In countries where they are in their infancy, the question of whether to support their development should be a matter of urgent public debate.     

More than therapy: The link between adverse childhood experiences,social support,and therapeutic services

Adverse childhood experiences (ACEs) have a cumulative effect on physical, emotional, and social well‐being throughout the life course. ACEs also impact parenting practices, which may contribute to intergenerational cycles of trauma. Access to child mental health services and caregiver social support are two protective factors that may reduce the burden of ACEs. To advance understanding of the relationships between caregiver social support and child mental health services among caregivers with ACEs, we interviewed 13 caregivers of young children receiving outpatient mental health services. Thematic analysis revealed the integral role of therapeutic providers in the social support circles of caregivers with high ACE scores. Caregivers frequently named therapeutic providers as the first point of contact in a problem situation. Implications for social work research, clinical practice, and advocacy are discussed.     

Sources of social support,job satisfaction,and quality of life among childcare teachers

Although literature has suggested a link between social support and well-being, relatively little research has examined the association of social support with job satisfaction and quality of life for employees. This study aimed to investigate whether and how different sources of social support influenced quality of life in conjunction with job satisfaction among teachers. Two-hundred and eighty-one childcare teachers in Korea completed measures of social support, job satisfaction, and quality of life. The results revealed that while director and colleague support predicted job satisfaction, director and family support predicted quality of life after controlling for age and marital status. Furthermore, results showed that job satisfaction mediated the relationship between director support and quality of life. The findings suggest the protecting role of different sources of social support in teachers’ job experience and evaluation of life domains. Suggestions for future research and implications for improving childcare teachers’ quality of life are discussed.     

Calling the Question of “Possible Dying” Among Nursing Home Residents

Abstract

Glaser and Strauss reported decades ago that in order for a person to be treated as dying, he/she must be defined as dying. Defining nursing home residents as “dying” can be complicated because most residents are in advanced old age with multiple chronic conditions. Using a social construction theoretical framework, this study looks at the step before the declaration of dying, that is, the consideration of the possibility of dying. This qualitative study is a secondary analysis of prospective data collected during 16 months of fieldwork on behalf of 45 nursing home residents whose health was considered declining. The purpose of this paper is to build understanding about the social construction of “possible dying” by reporting triggers that can call the question of possible dying and stimulate a discussion about the nursing home resident's status, prognosis, care options, and preferences. These triggers include: Health status decline; noncompliance with diet or medications; available medical interventions not being well suited for the residents; and family consideration of an out-of-town trip. The paper also reports barriers (family, staff, and disease process) and facilitators to calling the question of possible dying, including families having a sense of treatments they would like to avoid and having the opportunity to talk through options. Findings are discussed in light of basic assumptions of social construction. Implications for social workers include helping residents, families, and staff anticipate and address the possibility of dying, and to reflect these discussion in care plans, as well as the need to be available to help residents and family members with psychosocial issues related to living and dying in the nursing home setting, including the profound issues that can be provoked or exacerbated by resident health status decline and possible dying.     

Intergenerational pathways leading to foster care placement of foster care alumni's children

This study examined a path model that postulated intergenerational relationships between biological parent psychosocial functioning and foster care alumni mental health, economic status and social support; and from these to the likelihood of children of foster care alumni being placed in foster care. The sample included 742 adults who spent time in foster care as children with a private foster care agency and who reported having at least one biological child. A full pathway was found between poorer father's functioning to greater alumni depression, which was in turn associated with negative social support, and then a greater likelihood of child out‐of‐home placement. Other parent to alumni paths were that poorer father functioning was associated with alumni anxiety and post‐traumatic stress disorder (PTSD), and poorer mother's mental health was associated with PTSD; however, anxiety and PTSD were not implicated as precursors of foster care placement of the child. Findings support the need for increased practice and policy support to address the mental health needs of parents of children in or at risk of foster care, as well as the children themselves, as family history may have a lasting influence on quality of life, even when children are raised apart from biological parents.     

Adult Children's Supportive Behaviors and Older Parents' Subjective Well–Being—A Developmental Perspective on Intergenerational Relationships

Adult children's supportive behaviors were examined with respect to children's autonomy and social motivation towards parents, and with respect to longitudinal changes of parents' subjective well–being. In total, 115 adult children from 83 German families completed a questionnaire on supportive behaviors and social motivation. The children also reported what pleased or irritated their parents most. Findings suggest that filial autonomy was associated with resistance to strain. Older parents' satisfaction improved when children expressed affection or gave emotional support. However, informational support from children was associated with decreased satisfaction among parents. Findings suggest that filial autonomy may facilitate supportive behaviors that correspond to older parents' socioemotional needs.     

The relationship between perceived parental physical availability and child sexual,physical and emotional abuse among high school students in the Northern Province,South Africa

This is an investigation into the relationship between perceived parental physical availability and child sexual, physical and emotional abuse among high school students in the Northern Province (South Africa). All the secondary school students in standards 9 and 10 in three secondary schools filled in a retrospective self-rating questionnaire in a classroom setting. The questionnaire asked questions about perceived parental physical availability during childhood, and childhood sexual, physical and emotional abuse. Logistic Regression Analysis shows that among all the participants, “haven ever had a stepfather or adoptive father until he or she was at least 16 years old” and again, “haven ever had a stepfather or adoptive father until he or she was at least 16 years old” and “haven lived in a ‘group home’ until he or she was at least 16 years”; and “haven been raised by any other adult” predict child sexual, physical and emotional abuse, respectively. Mental health and social workers, educators and law enforcement agencies dealing with prevention and protection against child abuse in the Province should take note of the above identified predictors while designing programmes for the eradication of child sexual, physical and emotional abuse.     

Calling the question of "possible dying" among nursing home residents: triggers, barriers, and facilitators

Glaser and Strauss reported decades ago that in order for a person to be treated as dying, he/she must be defined as dying. Defining nursing home residents as "dying" can be complicated because most residents are in advanced old age with multiple chronic conditions. Using a social construction theoretical framework, this study looks at the step before the declaration of dying, that is, the consideration of the possibility of dying. This qualitative study is a secondary analysis of prospective data collected during 16 months of fieldwork on behalf of 45 nursing home residents whose health was considered declining. The purpose of this paper is to build understanding about the social construction of "possible dying" by reporting triggers that can call the question of possible dying and stimulate a discussion about the nursing home resident's status, prognosis, care options, and preferences. These triggers include: Health status decline; noncompliance with diet or medications; available medical interventions not being well suited for the residents; and family consideration of an out-of-town trip. The paper also reports barriers (family, staff, and disease process) and facilitators to calling the question of possible dying, including families having a sense of treatments they would like to avoid and having the opportunity to talk through options. Findings are discussed in light of basic assumptions of social construction. Implications for social workers include helping residents, families, and staff anticipate and address the possibility of dying, and to reflect these discussion in care plans, as well as the need to be available to help residents and family members with psychosocial issues related to living and dying in the nursing home setting, including the profound issues that can be provoked or exacerbated by resident health status decline and possible dying.     

The Role of Mastery and Social Support in the Association Between Life Stressors and Psychological Distress in Older Canadians

Gerontological social workers and other health professionals are often dealing with older adults in psychological distress. Greater clarity on the relationship between stress and psychological distress will enhance the efficacy of outreach and treatment initiatives for older adults. This study explored the underlying causal structure of the relationships of common life stressors and psychosocial resources for Canadians 65 years and older (542 men and 835 women). Using structural equation modeling of data collected in the National Population Health Survey in 2004–2005 and 2002–2003, the roles played by socioeconomic conditions, physical health, chronic stress, sense of mastery, and perceived social support in the stress–psychological distress relationship were estimated and compared. Findings revealed that chronic stress was the strongest determinant of the level of psychological distress for both genders; however its effect was higher for men compared to women. Poor physical health played a more important role in determining women's psychological distress compared to men. Higher levels of mastery and perceived social support were associated with lower levels of psychological distress for both men and women. These associations were somewhat stronger for men compared with women. Socio-economic conditions played a minor role in the stress–mental health relationship for both genders.     

Life Satisfaction of Rural Migrant Workers in Urban China: The Roles of Community Service Participation and Identity Integration

Abstract

China is home to approximately 245 million rural-to-urban migrant workers. The influx of migrants into urban areas has posed various challenges for local social service systems. Recently, increasing number of community services have been developed to meet the growing service demands from the migrant population. However, whether increase in community service use results in improved wellbeing among migrant workers remains critically unexplored. As such, this study examines the role of community service use in migrant workers’ life satisfaction and the potential mediating effect of identity integration in Shenzhen, China. Bootstrapped models were adopted to examine relationship among variables. Drawing from a sample of 1,087 rural-to-urban migrant workers, we found that community service use is positively correlated with both identity integration and migrant workers’ life satisfaction. Moreover, identity integration served as a partial mediator between community service use and life satisfaction. The mediating effect of identity integration was found to increase with age. This study highlights that diverse services should be implemented to address divergent needs of migrants in different age groups. Community service can also serve as a vehicle to foster integration among migrant workers in host communities, especially for older age groups. Future studies may further investigate the relationships between community social capital, community social support, quality of community-based organization and frequency of service use so as to optimize the life satisfaction of migrant workers.     

中国社会养老的文化分析

本文关注福利文化对社会养老制度和实践的影响,从文化视角审视中国现代社会养老项目的发展,揭示了老年社会福利模式与特定社会政策制定者对社会福利概念的理解和传统福利文化之间的关系。限定主义的价值观和公民权利意识的缺失阻碍着中国老年社会福利模式从剩余性到制度性的转变,抑制了社会福利在缩小老年群体内阶层差异方面的作用,促使了福利资源分配的不公。尽管人口老龄化和福利国家的文化扩散正在促使中国老年社会福利呈多元化发展趋势,多元福利体系的最终建立还有赖于社会公众和政策制定者对个人和国家关系的重新解读。     

应对人口老龄化挑战的中国道路

老年人口的养老负担问题、代际关系问题以及价值实现问题是影响中国未来可持续发展的三个关键性问题。从经济学视角看,就是生之者寡和食之者众的关系问题;从社会学角度看,有一个资源和权力分配的代际冲突和老年价值实现问题;从人口学视角看,计划生育弱势老人的比例在上升,今后中国会出现大量的“计划生育老人”,提出“计生老人”概念的意义在于,国家各级政府和部门要凸显人口计生公共服务的公益性和福利性。中国作为一个先老后富的国家,人口老龄化带来的挑战是长期的、多样的。本文提出了成功老龄化的战略构想,包括健康老龄化、积极老龄化、和谐老龄化和幸福老龄化。在应对人口老龄化和老龄问题挑战的过程中,中国社会逐渐走出了一条传统与现代相结合的中国道路,概括说：就是以家庭养老、单位（集体）养老和自我养老为基础,以社区助老、福利助老、慈善助老为补充的中国道路。最后,本文作者对本专题几位学者的观点在“中国问题和中国选择”的框架内进行了综合性的介绍和评论。     

Migration, ageing and mental health: an ethnographic study on perceptions of life satisfaction, anxiety and depression in older Somali men in east London

This ethnographic study was carried out in the aftermath of an epidemiological investigation, the first of its kind, on the health and social status of Somalis aged 60 years and over living in Tower Hamlets, east London. The main aims of the study are to explore views on mental health and well-being and identify sources of stress and support so as to gain greater understanding of background factors of life satisfaction and depression in 'first-generation' older Somali migrants in Tower Hamlets (males). Face-to-face interviews were conducted among 28 males in Somali with the help of a bilingual interpreter from the same age, sex and cultural background of participants. Several factors were perceived to decrease life satisfaction and increase vulnerability to depression in male Somalis, in particular low family support in the face of increasing physical disability, loneliness, inadequate access to community services and inability to return home. Social isolation, low level of control over one's life, helplessness and social degradation – ageism, perceived racial/religious discrimination and, to a lesser extent, racial harassment – were common themes identified in people who said to be depressed. Family support was the main buffer against depression; other coping resources were represented by religious practices and reliance on Somali peers. Avoidance coping seemed to encompass denial of depression in participants who had low mood. The study revealed multiple reasons for ill-being, in particular in people who had high expectations about medical and social care. Low levels of distress were found in Somalis who felt supported by their families. There is a need for social workers and other health professionals to advance discussions of mental-health issues in the community and for service providers to promote greater access to culturally relevant medical and social services for Somali elders in Tower Hamlets and strengthen their informal support networks.     

Social Relationships and Internet Use among Adolescents in Israel

Objective . This study examined the relationship between youth leisure activities, peer relations, and prosocial attitudes and the frequency of Internet use among adolescents in Israel. Methods . Hypotheses were tested using data from a face-to-face survey of a representative sample of the Israeli youth population ( n = 927) conducted in February 1998. Results . It was found that the lower an individual's level of attachment to close friends and the less prosocial attitudes he/she expressed, the higher was the likelihood of his/her being a frequent Internet user. However, Internet users were more likely than nonusers to participate in social activities such as parties, singers' performances, and sports activities. Conclusions . Contrary to public perceptions it appears that among the adolescent population of Israel, Internet use is not displacing other social activities. However, adolescents who are more socially isolated are more likely to be frequent Internet users. Future research should explore whether for this group, the Internet is being used to overcome individuals' barriers to the formation of social relationships.