Gambling Among Older Adults in Singapore Some Preliminary Empirical Findings

The purpose of this study is to shed light on gambling among older adults (age 60 and above) in Singapore. A sample of 74 older adults who were participants of a community-based elderly outreach program was surveyed. The results indicate that 27% of the respondents had gambled in the past one month and their favorite gambling game was 4D. Those who gambled were found to have more free time than those who did not (64 hours per week vs. 38 hours per week). Almost all the respondents (97%) did not know where to get help for problem gambling.     

Poverty Among Korean Immigrant Older Adults: Examining the Effects of Social Exclusion

ABSTRACT

Previous studies have shown that elderly Asian immigrants face greater risks for living in poverty compared with their native contemporaries. Particularly, Korean immigrant older adults are reported to be most likely to experience poverty among many Asian immigrant groups. The purpose of this study is to examine the extent to which demographic, human capital, and social exclusion factors contribute to such economic vulnerability among Korean immigrant older adults. Adding to previous research, this study broadly conceptualizes social exclusion and tests for its additive effects on poverty using nationally representative public data of Korean immigrant older adults. From the 2008–2010 Public Use Microdata Sample of the American Community Survey, this study extracts a sample that consists of individuals aged 65 years and older whose national origin is Korean, who were not born in the United States, and thereafter immigrated to the United States (N = 3,820). The findings indicate that 3 dimensions of social exclusion—exclusion from social and civic life, exclusion from asset building, and exclusion from the labor market—contribute significantly to Korean immigrant older adults’ odds of living in poverty. The study concludes with practice implications for socially inclusive workforce development as a way to ameliorate economic afflictions among Korean immigrant older adults.     

Preferences and Expectations for Delivering Bad News Among Korean Older Adults

ABSTRACT

 The purpose of this study was to explore Korean older adults’ perspectives toward physicians’ disclosure of serious illness to patients. Seventy Korean older adults residing in the community were interviewed in person using a semistructured interview guide. Major themes included conflicting desires among participants to: 1) inform the patient directly, 2) inform the patient indirectly, and 3) inform only the family. Subthemes under the first theme included: a) decision making about treatment, b) planning and preparation for the future, c) need for use of an ethical standard, d) consideration of patient coping responses, and e) disclosure of serious illness as a relational process. Disclosure of bad news is more than revealing or concealing information. Needs and preferences regarding to what extent and how information is delivered differ by culture. Thus, understanding preferred communication pathways for advanced care planning in specific cultural frameworks is important. Future studies using clear concepts and measures about serious illness disclosure can better prepare health care professionals in interacting with those from minority cultures. In addition, studies of those with poor health status from diverse cultural groups may further assist social workers to tailor interventions to accommodate cultural needs and expectations in end-of-life settings.     

Correlates of,and Barriers to,Internet Use Among Older Adults

Older adults constitute the group with the greatest increase in Internet usage in the past decade; however, usage varies greatly within this population. Services to older adults require a current understanding of Internet-use trends. This study utilized a quantitative survey method to examine correlates of, and barriers to, current Internet use in a demographically diverse county in Southern California. Findings indicate that the presence of a computer at home, a job requiring computer use, age, education, and ethnicity are important factors in predicting Internet use in older adults. Implications for social work practice with older adults is discussed.     

The Validation of the Texas Revised Inventory of Grief on an Older Latino Sample

Abstract

Purpose: Bereavement is considered to be one of the most profound experiences in older adulthood. However, assessments of emotional reactions to grief and loss have often been based on measures tested on primarily Anglo samples. This study examined the validity and factor structure of a commonly used bereavement measure on an older Latino sample.

Design and Methods: Using convergent and discriminant validation procedures, this instrument was tested using a purposive sample of 134 older, recently bereaved Latinos.

Results: While the instrument was originally designed to measure two domains of grief: Past Behaviors and Present Feelings, confirmatory and exploratory factor analysis revealed a three-factor solution for this sample which included also Disbelief of the loss. Items within this domain included anger, rejection, and a sense of injustice.

Implications: This study underscores the need for improved measures in research on grief and bereavement to capture the intensity and severity of grief in a cross-cultural context.     

Adverse Childhood Experiences and Substance Use History among Vulnerable Older Adults Living in Public Housing

ABSTRACT

Previous research shows strong correlations between adverse childhood experiences (ACE) and later life health. The current study examines the relationship between ACEs and substance use among older adults living in public housing. Results show that about one-third of participants had four or more ACEs, and ACE score predicted likelihood of substance use history. Over half of older adults with four or more ACEs experienced substance abuse in their lifetime compared to one out of ten older adults with less than four ACEs. Findings shed light on a vulnerable group and point to next steps in research and practice.     

Mindfulness-Based Cognitive Therapy With Older Adults: An Exploratory Study

An 8-week mindfulness-based cognitive therapy (MBCT) group for older adults with depression and/or anxiety is described. This article is based on an exploratory study of this therapeutic approach and changes in participants’ symptoms associated with participation. Pre-post data from 5 MBCT groups showed significant improvements in reported anxiety, ruminative thoughts, and sleep problems and a reduction in depressive symptoms. Case examples are presented to illustrate these symptom changes. Findings showed that this nonpharmacological intervention is acceptable to older adults and is associated with positive changes. Suggestions are provided for both practitioners and researchers interested in using MBCT with older adults.     

An Evidence Base for Group Work with Older Adults Living in the Community

There is a small but illuminating body of research related to group work with older adults living in the community. A broad range of interventions with diverse elderly participants have been studied internationally using qualitative and quantitative methodologies. Although scanty, the published literature informs group work practitioners on the strengths and limitations of different interventions. This article presents a critical review of 13 studies published between 1990 and 2007 to guide group work practitioners in organizing and facilitating groups for older adults in the community. Each review notes the characteristics of the participants, type of group intervention, methodology, and findings of the study. It examines the rigor, impact, and applicability of the findings to practice with this population. Much needs to be done to develop an evidence base for group work with older adults living in the community. Recommendations for practice and future research are offered.     

The Influence of Rural and Urban Substance Abuse Treatment Counselor Characteristics on Client Outcomes

ABSTRACT

Focus group data were collected from 28 substance abuse treatment counselors employed in rural and urban areas to examine their perceptions of factors influencing treatment outcomes. The influence of the counselor characteristics (i.e., education, experience, and recovery status) on client outcomes and geographic differences is explored. Focus group data were analyzed by three raters using line-by-line coding, focused coding, and memoing. This analytic approach revealed geographic differences in the counselors’ perceptions of the effect of counselor education, experience, and recovery status on client outcomes. Recommendations for treatment planning and future research are provided.     

Chapter 7 Sexual Abuse of Older Women Living in Nursing Homes

Abstract

Aggregated data from APS case files of sexually abused older women between the agesof70 and 89living in nursing homes were collected over a five-year period, yielding a total of 50 substantiated cases. The most common types of sexual abuse involved instances of sexualized kissing and fondling and unwelcome sexual interest in the women's body. All alleged perpetrators were male; they typically were 70 years of age and older and residents in the nursing home. In only three cases was the alleged offender prosecuted in court and only one of these cases was the offender convicted. Implications of these data for future practice and research are discussed.     

Social Work Knowledge of Community-Based Services for Older Adults: An Educational Model for Social Work Students

Social workers are often the key link between older adults, their families and community-based services. Thus, knowledge about older adults and community-based care is imperative for social work practice. Evaluation data are provided on a national multisite effort (N = 353) from 35 schools to assure graduate social work student's competency related to community services for older adults. Results suggest that the educational model as described in this article sets forth positive outcomes in the education of aging savvy social workers. Ongoing social work education is needed to meet the burgeoning needs of the geriatric population.     

The Effects of Marketization of Long-term Care Services for Older Adults in Korea

To cope with the rapid increase in aging population, the South Korean government introduced new long-term care insurance in 2008 by using the market forces and mechanisms of competition and choice. The study explored the effect of the marketization of long-term care (LTC) services on the provision of services under the Korean long-term care insurance (LTCI) system. By adopting qualitative semi-structured in-depth interview methods, the experiences of 17 home visiting service provider managers were examined. The study results suggest that the marketization of LTC services faces several challenges. Some of the stakeholders in the field, such as home visiting service providers, care workers, and older clients, appear to employ unlawful activities or unprincipled behaviors to maximize their individual interests. The results also suggest that the unprincipled behavior, unlawful activities, and financial problems that service providers face contribute to low quality care services. Future studies should explore these issues using larger samples of service users and providers.     

Risk and Protective Factors for Depressive Symptoms Among Indigenous Older Adults: Intimate Partner Violence (IPV) and Social Support

Research on depression and intimate partner violence (IPV) experienced by Indigenous older adults is virtually nonexistent. Given the associations between IPV and depression and their disproportionately high rates among Indigenous peoples in a context of historical oppression, the purpose of this inquiry is to examine how IPV and social support are associated with depressive symptoms for Indigenous older adults. We expand the knowledge base on IPV in later life, which primarily focuses on female samples, by including older men. We predicted: (a) IPV will be positively associated with depressive symptoms and (b) levels of social support will be negatively associated with depressive symptoms. Hierarchical regression analyses of data from a sample of Indigenous older adults (N = 233) in the Upper Midwest indicated that physical aggression (but not psychological aggression, sexual coercion, injury, or negotiation) was positively associated with depressive symptoms, whereas social support was negatively associated with depressive symptoms.     

Long-Term Outcome Effectiveness of a Health Promotion Program for the Elderly

A sample of long-term care facilities utilizing ombudsman services was compared to facilities not in receipt of such mediation services. Independent assessment measures were derived from State Department of Health ratings and complaint statistics for long-term care facilities. Findings revealed that ombudsman-served facilities were not appreciably different from facilities not served by ombudsmen. Facilities served by ombudsmen, however, received a relatively higher amount of complaints than did the facility group not served by ombudsmen, particularly in areas not covered by statutory abuse reporting requirements. It is suggested that nursing home patient ombudsmen call attention to aspects of quality care not currently assured by other protective mechanisms.     

Integration of Supportive Psychotherapy with Case Management for Older Adults with Borderline Personality Disorder

This article attempts to demonstrate how supportive psychotherapy may serve as a companion therapeutic modality for case management activities with older adult clients suffering with borderline personality disorder (BPD). Justification for this approach is provided and techniques and interventions are identified. Three case examples demonstrating the modalities integration are provided.     

Use of Nondeliberative Practice in Groups for Older Adults with Substance Use and Mental Health Disorder: Group in an Art Gallery

ABSTRACT

This article presents an application of Norma Lang’s nondeliberative theory in groupwork with clients of Community Outreach Programs in Addictions (COPA), a Toronto community-based organization that assists adults age 55 and older who struggle with addictions and mental health. The article illustrates how we challenged concepts of group work which are predominantly discussion-based problem solving or premeditated by hosting a group in a major art gallery with clients considered difficult to serve. What was done is juxtaposed with what might have been done with greater knowledge of nondeliberative theory.     

The Heterogeneity of Socially Isolated Older Adults: A Social Isolation Typology

Recent statistics show a growing number of older adults who are living alone and are socially isolated. It is against this background that, in recent years, many interventions have been developed to address social isolation among the elderly. Evaluative studies show that most interventions are hardly effective, though. An important reason for this is the heterogeneity of the socially isolated. This article offers insight into this heterogeneity by presenting a typology with different profiles of socially isolated older adults and the intervention implications of this typology. The typology is derived from an extensive qualitative study on socially isolated elderly individuals in the Netherlands. The typology imposes some degree of order to a diversity of circumstances, ambitions, and possibilities of the socially isolated elderly, thereby deepening the understanding of the heterogeneity of this population. The definition of social isolation used in this study starts from a societal angle of incidence, namely the current policy context of Western European welfare states, in which governments emphasize the importance of independence and self-reliance of their citizens. Developed from that perspective, the typology provides a theoretical basis for applying interventions aimed at increasing self-reliance of social isolated elderly. This perspective on social isolation also has consequences for the way in which the effectiveness of interventions to alleviate social isolation is assessed.     

Supporting the Labor Force Participation of Older Adults: An International Survey of Policy Options

The unprecedented aging of the world's population challenges many institutions, including labor markets and public pension programs. This study was conducted to survey expert opinions regarding conditions and policies that affect employment of older adults. Eighty-nine respondents from 26 nations responded to an Internet survey regarding their own experiences with the aging labor force; factors that encouraged or discouraged labor force participation of older adults; and government responses to these issues. Respondents identified barriers to employment of older adults and described their governments' responses. Findings illuminate a range of current policy options and suggest possible opportunities for innovation.     

Structuring Mental Health Within Senior Services: A Case Study of an Outpatient Mental Health Clinic Serving Latinos

The article presents a case study of an outpatient mental health clinic serving Latino older adults. The study explored staff perceptions on the clinic development and the context within an immigrant multicultural community. The study used in-depth, semistructured interviews with support staff, clinical social workers, and administrators. Interviews were analyzed using a thematic content analysis. The mental health clinic formation was perceived by staff as an ecological process stemming from the needs of the Latino immigrant senior clients. A close knit and interdependent culture allowed the clinic to adjust to diversity and changing cultural contexts.