Senior Centers and Services for the Frail Elderly

This article reviews and synthesizes the research on senior center programming and utilization relating to one important group of elders-the physically and mentally frail. It examines the thesis that senior centers do play an important role in providing programs for this population, especially given the resources available to them, and can be considered as part of the long-term care continuum. The article also identifies a number of barriers that limit how much most centers do in serving significant numbers of frail older persons.     

Setting priorities in aging populations: formal service use among Mexican American female elders

This study establishes empirical patterns of formal service use by a sample of 483 elderly Mexican American women, and identifies the predictors of formal service utilization. Results indicated two patterns of service use-in the home and at senior centers. Regression analysis demonstrated that the best predictors of who used formal in-home services were those with functional impairment in Instrumental Activities of Daily Living (IADLs) and those with the least amount of assistance with IADLs provided by family members. Living alone and attending group social events were the best predictors of the use of senior center services. Anticipated changes in the Mexican American population portend a growing need for both in-home and senior center services. These findings can be used to establish policy and programming priorities for this neglected population. If resources are to be effectively targeted to frail elders, in-home services should receive priority, and the provision of in-home services should be modified to include additional programs that facilitate care of the elderly by the family.     

A comprehensive policy analysis of and recommendations for senior center gambling trips

Gambling is one of the fastest growing industries in America. Public support is high for legalized gambling among all age groups. Because gambling is growing in popularity as an activity among those 65 and over, many senior centers are beginning to offer group trips to casinos and other gambling attractions such as dog tracks. This paper analyzes senior center casino gambling trips, with particular attention to the number of trips offered, how trips are funded, the policy implications of offering trips, and policy alternatives for state and local policymakers. Data for the study come from personal interviews with activity directors of 16 senior centers across Massachusetts and a formal survey of 30 additional senior centers in Central Massachusetts. Benefits of a new policy option, a public education strategy, are also reviewed.     

Housing Policy and the Elderly

Subsidized senior high-rise apartments have tended to neglect the needs of an increasingly aged and frail resident population. Research demonstrates that this population has greater unmet needs than elderly who reside in traditional community housing. This paper makes the case for enriched senior high-rise apartments as a viable alternative for elders who need assistance in order to maintain an independent lifestyle.     

A Comprehensive Policy Analysis of and Recommendations for Senior Center Gambling Trips

Abstract

Gambling is one of the fastest growing industries in America. Public support is high for legalized gambling among all age groups. Because gambling is growing in popularity as an activity among those 65 and over, many senior centers are beginning to offer group trips to casinos and other gambling attractions such as dog tracks. This paper analyzes senior center casino gambling trips, with particular attention to the number of trips offered, how trips are funded, the policy implications of offering trips, and policy alternatives for state and local policymakers. Data for the study come from personal interviews with activity directors of 16 senior centers across Massachusetts and a formal survey of 30 additional senior centers in Central Massachusetts. Benefits of a new policy option, a public education strategy, are also reviewed.     

Being disabled,being a manager: ‘glass partitions’ and conditional identities in the contemporary workplace

This article critically explores the working lives and views of disabled senior staff working in UK organisations. The qualitative research at the core of the article establishes that some disabled people are confounding established notions of disabled people only working in peripheral employment roles by exploring the working lives and perceptions of disabled managers. The findings do, however, point to continued barriers to what disabled staff in senior positions can be seen to do and be organisationally. Here both practical and ontological risk inheres in organisationally induced change, openness about impairment and risky identities. Such ideas, it is argued, present limits to further promotion and workplace inclusion for some disabled managers.     

Shanghai: Front-Runner of Community-Based Eldercare in China

Facing dramatic growth in its elderly population, Shanghai, China’s economic center, has strategically exercised decentralized policy-making power to develop community-based service centers for the elderly. A growing number of elders have been using such services, particular dining services, since 2007. We discuss the evolution in community-based eldercare services in Shanghai, using dining services as an example. We also compare these service centers in Shanghai to multipurpose senior centers in the United States to offer policy recommendations for Shanghai and China’s growing eldercare industry. Tailored policy recommendations are discussed.     

Exploring the politics and policy surrounding senior center gambling activities

Gambling is a controversial activity that is supported by some but opposed by others for a variety of reasons that are largely ethical, moral, and religious. These issues have been in place a long time and will continue. But gambling has become even more controversial because of the ever-expanding dependence of local and state governments on gambling and gambling-related tax revenue as a source of support for their programs, including senior centers. This dissertation research addresses the politics and policy surrounding the relationship between gambling and senior centers. The results indicate that senior center gambling is on the local agenda of nearly all of the case study communities. A variety of issues relating to senior center gambling was found, including evidence of the negative impact of dependence on gambling-generated revenues for centers and their clientele. These findings have implications for future research and for practice and policy relating to senior center gambling activities. In particular, these findings suggest the need for further investigation of the independent roles of historical, political, and cultural factors in the development of gambling regulations and their respective impacts on the agenda-setting process.     

An Overview and Critique of the Experience Corps for Independent Living Initiative

Abstract

This article presents findings of the evaluation of the Experience Corps for Independent Living (ECIL) initiative. The ECIL initiative was a two-year demonstration program designed to test innovative ways to use the experience, time, and resources of volunteers over 55 to expand significantly the size and scope of volunteer efforts on behalf of independent living services for frail older people and their caregivers in specific communities. Six demonstration projects were selected to participate in this initiative. The intensive volunteers, the critical component of the program, were more highly skilled than typical volunteers from existing senior volunteer programs. ECIL volunteers collaborated with agency partners to develop new programs, supervise direct service activities, and enhance the performance of the agencies being served. Although the projects addressed many of the goals of the initiative, they did not fully accomplish all of their objectives. The ECIL initiative was particularly successful in providing independent living services to frail elders and their families in the communities served. It was less successful in developing and maintaining the team and corps concept, in attracting and retaining the anticipated numbers of volunteers during the study period, and in becoming self-sufficient by the end of Year Three.     

An overview and critique of the experience corps for independent living initiative

This article presents findings of the evaluation of the Experience Corps for Independent Living (ECIL) initiative. The ECIL initiative was a two-year demonstration program designed to test innovative ways to use the experience, time, and resources of volunteers over 55 to expand significantly the size and scope of volunteer efforts on behalf of independent living services for frail older people and their caregivers in specific communities. Six demonstration projects were selected to participate in this initiative. The intensive volunteers, the critical component of the program, were more highly skilled than typical volunteers from existing senior volunteer programs. ECIL volunteers collaborated with agency partners to develop new programs, supervise direct service activities, and enhance the performance of the agencies being served. Although the projects addressed many of the goals of the initiative, they did not fully accomplish all of their objectives. The ECIL initiative was particularly successful in providing independent living services to frail elders and their families in the communities served. It was less successful in developing and maintaining the team and corps concept, in attracting and retaining the anticipated numbers of volunteers during the study period, and in becoming self-sufficient by the end of Year Three.     

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.     

Searching for Innovative Design: Architectural Competitions in the Silvering Swedish Welfare State

The new millennium has seen an increased interest in appropriate housing for the senior part of the Swedish population, defined as those aged 65 years and older. In 2010, the Swedish government launched a 2-year program called “Growing Old, Living Well” that targeted the living conditions of not only older people with few or some needs for homecare services, but also the smaller group of dependent and frail older persons whose everyday living depends upon regular caregiving. The program promoted architectural competitions as a tool for innovation. This article assesses the outcome of 3 architectural competitions that were carried out by 3 municipalities in accordance with the program. It concludes that existing notions about appropriate space for aging populations prevailed, since the competition briefs evolved from existing data and consequently allowed for only a low degree of innovative thinking. Hence, the relationship between architectural design and older people's age-related needs was only addressed indirectly. Further work needs to be done in the area of housing for the Swedish silvering welfare state in order for this factor to become an essential criterion for creating innovative architecture and urban design.     

Public Relations Practitioner Role Enactment at the Senior Management Level Within U.K. Companies

This article presents the findings of an initial investigation into the role that the public relations function plays in some of the leading companies in the United Kingdom. The study sought to uncover the pattern of practitioner role enactment within these companies and, in particular, the extent to which practitioners are involved directly in the formulation and implementation of corporate and business strategies. The study revealed considerable differences in the level of practitioner involvement in strategic decision making, with some practitioners fulfilling primarily technical roles and others enacting a more significant managerial role, advising senior executives on policy issues and assisting in the implementation of strategies. Factors such as the industry and organizational context, management expectations of public relations, and the perceived professional competence of practitioners emerged as important determinants of the level of practitioner involvement in strategic decision making. Drawing on the study's findings, a number of propositions have been advanced that may help to guide future inquiries into practitioner role enactment, particularly at the senior management level within organizations.     

FEMALE CAREGIVERS’ REFLECTIONS ON ETHICAL DECISION-MAKING: THE INTERSECTION OF DOMESTIC VIOLENCE AND ELDER CARE

As our population ages, increasing numbers of social workers and other therapists will provide counseling to women who are caregivers of frail elders. These female caregivers often face complex ethical dilemmas in caring for a frail elder. Furthermore, these dilemmas are compounded by domestic violence in the caregiver/frail elder relationship initiated before the onset of caregiving. Illustrated with case examples, this article presents an ethical decision-making model based on an empowerment framework for helping practitioners work with caregivers who face difficult dilemmas impacted by domestic violence. Implications for strengthening clinical practice with these caregivers are discussed.     

Conflicts,friendship cliques and territorial displays in senior center environments

Humans are territorial, laying claim to places and objects as a way of regulating social interaction and fulfilling a variety of social motives. We observed territoriality to facilitate both inclusionary and exclusionary group behaviors within senior center spaces. We observed approximately 300 participants over 120 h and interviewed 30 participants in three multipurpose senior centers. Territories supported group identity and interaction for friends who shared dining tables in two centers. However, those two centers also had frequent dining area territorial conflicts and few other spaces or opportunities for meaningful center participation. The conflicts entailed the reinforcement of social cliques at the cost of exclusion of others. A third center exhibited fewer territorial conflicts and a wider variety of shared and attractive settings, such as a living room and hobby rooms. In addition, strong self-governance of this center allowed participants to lay claim to the entire center, rather than relying on ownership of specific dining seats.     

At risk of exclusion? Degrees of ICT access and literacy among senior citizens

Drawing on data derived from a nationwide postal survey (n?=?1264) with a simple random sample of Swedes between ages 65 and 85 (response rate: 63%), the article analyses the general patterns of: (a) degrees of information and communication (ICT) access and (b) ICT-literacy among Swedish senior citizens. The overall patterns of access and literacy are analysed in light of senior citizens’ assets – conceptualized as material, discursive and social resources – and their age and gender. The analysis reveals a positive correlation between levels of material (e.g., income), discursive (e.g., English skills) and social (e.g., social networks) resources and access to ICT. With greater resources, the average number of devices increases. The analysis also reveals a positive correlation between discursive and social resources and ICT-literacy. Gender has no bearing on access to devices, but might have some effect on ICT-literacy. The correlation between age, access and literacy is negative. With increasing age, both access and literacy decreases. In this respect, the study reveals a generational effect. However, since all three resources tend to decrease over the life cycle, the results are also discussed in terms of an age effect. These data and our analyses are contextualized by a critical discussion that reflects on the implications of these general patterns: What do they mean for senior citizens’ abilities to be included and participate in a continuously digitalizing society?     

Aging in (Privatized) Places: Subsidized Housing Policy and Seniors

The market-based approach of delivering affordable housing has led to a net loss of traditional public housing and an increase in alternative subsidized housing options. For poor, physically frail older adult residents, subsidized housing and its associated services and support provide an important safety net. This article explores the implications and consequences of this movement for low-income seniors. Specifically, we look at the past and current housing policies, the focus on public-private partnerships, and the transition toward mixed-income communities. The article ends with suggestions for protecting vulnerable older adult populations in a market-driven arena.     

Caring for day care: a pilot project

Day care in Israel is not always of high quality, and the current forecast for upgrading the standards of the existing centers is bleak, due to economic and social factors that do not place high priority on quality infant care in group settings. The agency attempted, therefore, to develop a low-cost, efficient method of early intervention, wherein skilled social workers were hired, given special training, and worked alongside the caregivers of day care centers to help children and parents defined as at risk. This article describes the observations that were made and the interventions that were chosen.     

The Program of All-Inclusive Care for the Elderly (PACE): an innovative long-term care model in the United States

This article examines the long-term care service system in the United States, its problems, and an improved long-term care model. Problematic quality of care in institutional settings and fragmentation of service coordination in community-based settings are two major issues in the traditional long-term care system. The Program of All-Inclusive Care for the Elderly (PACE) has been emerging since the 1970s to address these issues, particularly because most frail elders prefer community-based to institutional care. The Balanced Budget Act of 1997 made PACE a permanent provider type under Medicare and granted states the option of paying a capitation rate for PACE services under Medicaid. The PACE model is a managed long-term care system that provides frail elders alternatives to nursing home life. The PACE program's primary goals are to maximize each frail elderly participant's autonomy and continued community residence, and to provide quality care at a lower cost than Medicare, Medicaid, and private-pay participants, who pay in the traditional fee-for-service system. In exchange for Medicare and Medicaid fixed monthly payments for each participating frail elder, PACE service systems provide a continuum of long-term care services, including hospital and nursing home care, and bear full financial risk. Integration of acute and long-term care services in the PACE model allows care of frail elders with multiple problems by a single service organization that can provide a full range of services. PACE's range of services and organizational features are discussed.     

The home care industry: strategies for survival in an era of dwindling resources

The home care component of our long-term care system is increasingly being recognized as the preferred alternative to institutional care for the frail elderly and disabled. Dwindling resources, both human and financial, are likely to have a deleterious effect on home care. Findings from a 1987-88 survey of paraprofessional home care workers of the frail elderly in New York City are used to draw implications for the home care industry. The scope of problems inherent in the industry imply that changes are necessary on both the micro and macro levels; the article concludes with recommendations for both levels.